Associations of accumulated persistent organic pollutants in breast adipose tissue with the evolution of breast cancer after surgery

Chronic exposure to persistent organic pollutants (POPs) is suspected to contribute to the onset of breast cancer, but the impact on the evolution of patients after diagnosis is unclear. We aimed to analyze the contribution of long-term exposure to five POPs to overall mortality, cancer recurrence, metastasis, and development of second primary tumors over a global follow-up of 10 years after surgery in breast cancer patients in a cohort study. Between 2012 and 2014, a total of 112 newly diagnosed breast cancer patients were recruited from a public hospital in Granada, Southern Spain. Historical exposure to POPs was estimated by analyzing their concentrations in breast adipose tissue samples. Sociodemographic data were collected through face-to-face interviews, while data on evolution tumor were retrieved from clinical records. Statistical analyses were performed using Cox regression (overall survival, breast cancer recurrence or metastasis) and binary logistic regression models (joint outcome variable). We also tested for statistical interactions of POPs with age, residence, and prognostic markers. The third vs first tertile of hexachlorobenzene concentrations was associated with a lower risk of all-cause mortality (Hazard Ratio, HR = 0.26; 95 % Confidence Interval, CI = 0.07-0.92) and of the appearance of any of the four events (Odds Ratio = 0.37; 95 % CI = 0.14-1.03). Polychlorinated biphenyl 138 concentrations were significantly and inversely associated with risk of metastasis (HR = 0.65; 95 % CI = 0.44-0.97) and tumor recurrence (HR = 0.69; 95 % CI = 0.49-0.98). Additionally, p,p'-dichlorodiphenyldichloroethylene showed inverse associations with risk of metastasis in women with ER-positive tumors (HR = 0.49; 95 % CI = 0.25-0.93) and in those with a tumor size <2.0 cm (HR = 0.39; 95 % CI = 0.18-0.87). The observed paradoxical inverse associations of POP exposure with breast cancer evolution might be related to either a better prognosis of hormone-dependent tumors, which have an approachable pharmacological target, or an effect of sequestration of circulating POPs by adipose tissue.

Serum levels of non-persistent environmental pollutants and risk of incident hypertension in a sub-cohort from the EPIC study

BACKGROUND

The prevalence of arterial hypertension (AHT), a well-known risk factor for cardiovascular disease, has considerably increased over last decades. Non-persistent environmental pollutants (npEPs) are a group of ubiquitous chemicals, widely used in consumer products such as food packaging and cosmetics, which have been identified as endocrine disrupting chemicals and obesogens. The aim of this study was to assess the potential associations of serum levels of three groups of npEPs with the risk of incident AHT.

METHODS

Cohort study within a sub-cohort of Granada EPIC-Spain center (n = 670). We quantified serum concentrations of three groups of npEPs, i.e., bisphenol A (BPA), four parabens: methylparaben (MP), ethylparaben (EP), propylparaben (PP) and butylparaben (BP), and two benzophenones: benzophenone 1 (BP1), benzophenone 3 (BP3), in samples collected at recruitment. Statistical analyses were performed by means of Cox Proportional Hazard Models.

RESULTS

Median follow-up time was 23 years. BPA and MP were found in >80% of the study population. Individuals within the 4th PP quartile (0.53-9.24 ng/ml) showed a statistically significant increased risk of AHT (HR = 1.40, p = 0.015). No associations were found for the rest of pollutants.

CONCLUSIONS

Overall, we evidenced no associations of most npEPs with AHT risk, with the exception of an increased risk in the highest PP percentiles. Considering the limitations of using one spot serum sample for exposure characterization, further research on the potential contribution of npEPs on the development of AHT risk is warranted.

Perception of the risk of contamination through feeding in pregnant and breastfeeding women

Introduction

Persistent Toxic Substances (PTS) are substances that are characterized by the cumulative effect at low doses inside the body. Exposure to PTS in pregnant and breastfeeding women, through food consumption, shows various harmful effects on the health of the mother, the fetus and the baby. The objective of this article is to analyze how pregnant and breastfeeding women perceive the presence of chemical substances in food and reflect on the accumulation, transmission and elimination of these substances.

Methodology

Descriptive and interpretive study under the qualitative research paradigm following a phenomenological and ethnographic perspective. As instruments to obtain the primary data we rely on 111 semi-structured interviews with pregnant and breastfeeding women, 4 focused ethnographies, 8 focus groups (63 women), 71 feeding diaries, 71 free listings. To encode the content of the speeches of pregnant and nursing women we rely on the N-Vivo 12 software.

Results

Pregnant and breastfeeding women are concerned about food quality controls. Women trust on local and seasonal foods such as fresh fruits and vegetables from non-extensive crops and close to their home. Foods that produce distrust in women are processed, packaged foods, red meat and large fish. The latter foods promote in women a perception of risk of contamination by chemical substances, manifesting a defenseless situation to maintain a diet without contaminants.

Conclusions

Pregnant and breastfeeding women in Spain have no information on the risk and danger of synthetic chemicals or PTS, with the exception of certain toxic substances such as mercury present in large fish. Women maintain a duality in their own care and that of the fetus or child. This circumstance implies that the women interviewed believe that PTS and synthetic chemicals may have different harmful effects on the mother and the degree of growth of the fetus and, subsequently, of the baby.

Key messages

Future mothers are worried about the type of product they eat, knowing that food influences healthy growth and development of the fetus. Pregnant and breastfeeding women often distrust “processed” or “industrial” foods, which they tend to associate with low quality and large amounts of additives and chemical substances.

Influence of polychlorinated biphenyls and organochlorine pesticides on the inflammatory milieu. A systematic review of in vitro, in vivo and epidemiological studies

BACKGROUND

Organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) are relevant families of persistent organic pollutants, which have been linked to several long-term adverse health effects. The mechanisms of action of these pollutants are still poorly understood. However, there are some evidences suggesting that inflammation might play a key role on their effects.

AIM

To systematically synthesize the published in vitro, in vivo and epidemiological data assessing the potential influence of exposure to OCPs and PCBs on the development of an inflammatory milieu.

METHODS

A systematic review of peer-reviewed original research papers published until 1st May 2019 was conducted, by using Medline, Web of Science and Scopus databases. A total of 39 articles met the inclusion criteria and were evaluated in this review.

RESULTS

The majority of the studies showed significant associations of PCB and OCP exposure with all inflammatory markers measured (n = 30). Some studies showed positive and negative associations (n = 7) and only two studies evidenced negative associations (n = 2). Most of the available evidences came from in vitro and in vivo studies (n = 31), with few epidemiological studies (n = 8).

CONCLUSIONS

We found consistent positive associations between exposure to PCBs and OCPs and the development of a pro-inflammatory milieu, with only few discrepancies. However, given the limited epidemiological evidence found, our results warrant further research in order to elucidate the real contribution of these pollutants on the inflammatory processes and subsequent diseases.

Historical exposure to non-persistent environmental pollutants and risk of type 2 diabetes in a Spanish sub-cohort from the European Prospective Investigation into Cancer and Nutrition study

BACKGROUND

Environmental factors are believed to account for a substantial burden of type 2 diabetes mellitus (T2DM). Non-persistent environmental pollutants (npEPs) are a group of widely-used chemicals identified as endocrine/metabolic disrupting chemicals and obesogens. The aim of this study was to analyse the potential associations of serum levels of three groups of npEPs with the risk of incident T2DM.

METHODS

This is a longitudinal study within a sub-sample of Granada EPIC-Spain cohort (n = 670). We quantified serum concentrations of 7 npEPs: four parabens (Methylparaben (MP) ethylparaben (EP), propylparaben (PP) and butilparaben (BP); two benzophenones: Benzophenone 1 (BP1), Benzophenone 3 (BP3); and Bisphenol A (BPA). Exposure was assessed by means of chemical analyses of serum samples collected at recruitment, and information on potential confounders was gathered by using validated questionnaires at baseline. Follow-up was performed by review of patients' clinical records. Cox Proportional Hazards Models were used for the statistical analyses.

RESULTS

Median follow-up time was 23 years. There were 182 (27%) incident T2DM diagnoses in our sub-cohort. MP was the most frequently detected npEP, 88.42% samples above the limit of detection, and BP showed the lowest percentage of detection (19.21%). Those individuals within the fourth PP quartile (0.53-9.24 ng/ml) showed a statistically significant increased risk of T2DM (HR = 1.668 p = 0.012), while BP1 concentrations showed an inverse non-significant trend with the risk.

CONCLUSIONS

We evidenced a potential contribution of npEP exposure on T2DM, but no clear trend was observed. However, limitations in relation to exposure estimation might influence our findings and further research is warranted to confirm our results.

Adipose tissue concentrations of non-persistent environmental phenols and local redox balance in adults from Southern Spain

The aim was to evaluate the associations of environmental phenol and paraben concentrations with the oxidative microenvironment in adipose tissue. This study was conducted in a subsample (n = 144) of the GraMo cohort (Southern Spain). Concentrations of 9 phenols and 7 parabens, and levels of oxidative stress biomarkers were quantified in adipose tissue. Associations were estimated using multivariable linear regression analyses adjusted for potential confounders. Benzophenone-3 (BP-3) concentration was borderline associated with enhanced glutathione peroxidase (GPx) activity [exp(β) = 1.20, p = 0.060] and decreased levels of reduced glutathione (GSH) [exp(β) = 0.55, p = 0.070]. Concentrations of bisphenol A (BPA) and methylparaben (MeP) were associated to lower glutathione reductase (GRd) activity [exp(β) = 0.83, exp(β) = 0.72, respectively], and BPA was borderline associated to increased levels of oxidized glutathione (GSSG) [exp(β) = 1.73, p-value = 0.062]. MeP was inversely associated to both hemeoxygenase-1 (HO-1) and superoxide dismustase (SOD) activity, as well as to the levels of thiobarbituric acid reactive substances (TBARS) [0.75 < exp(β) < 0.79]. Our results suggest that some specific non-persistent pollutants may be associated with a disruption of the activity of relevant antioxidant enzymes, in addition to the depletion of the glutathione stock. They might act as a tissue-specific source of free radicals, contributing to the oxidative microenvironment in the adipose tissue.

Environmental phenols and parabens in adipose tissue from hospitalized adults in Southern Spain

Urinary concentrations of non-persistent environmental pollutants (npEPs) are widely assessed in biomonitoring studies under the assumption that they are metabolised and eliminated in urine. However, some of these chemicals are moderately lipophilic, and their presence in other biological matrices should also be evaluated to estimate mid/long-term exposure to npEPs and its impact on human health. The present study aims to explore concentrations and potential determinants of npEPs in adipose tissue from a hospital-based adult cohort (GraMo cohort, Southern Spain). Concentrations of bisphenol-A (BPA), benzophenone-3 (BP-3), triclosan (TCS), three chlorophenols (2,4-DCP, 2,5-DCP and 2,4,5-TCP) and two phenylphenols (2-PP and 4-PP), triclocarban (TCCB) and parabens [methyl- (MeP), ethyl- (EtP), propyl- (n-PrP and i-PrP), butyl- (n-BuP and i-BuP) and benzyl-paraben (BzP)] were analysed in adipose tissue samples from a subcohort of 144 participants. Spearman correlation tests were performed, followed by stepwise multivariable linear regression analyses to assess determinants of the exposure. Detection frequencies and median concentrations were: BPA (86.8%, 0.54 ng/g tissue), BP-3 (79.2%, 0.60 ng/g tissue), TCS (45.8%, <LOD), 2-PP (18.8%, <LOD), MeP (100.0%, 0.40 ng/g tissue), EtP (20.1%, <LOD) and n-PrP (54.2%, 0.06 ng/g tissue). The remaining npEPs were detected in <10% of the samples. BPA, MeP, EtP and n-PrP levels were significantly and positively correlated, while BP-3 showed a positive correlation with TCS and 2-PP. Older participants showed higher concentrations of TCS and MeP, while BMI was inversely associated with most of the analysed compounds and perceived recent weight loss was inversely associated with 2-PP. Female participants and residents of rural areas had increased BP-3 concentrations. npEP concentrations were positively associated with the consumption of fatty food but negatively associated with the consumption of vegetables and fruit. This study reveals the widespread presence of numerous npEPs in adipose tissue from adults in southern Spain, suggesting a generalized distribution of these environmental compounds in fatty tissues. In these adults, many of the determinants of npEP concentrations in adipose tissue were similar to those of more lipophilic and persistent compounds.

Serum concentrations of organochlorine compounds and predictors of exposure in children living in agricultural communities from South-Eastern Spain

BACKGROUND

Information on exposure levels to organochlorine compounds (OCs) in child population is limited, despite their greater vulnerability to the adverse health effects of these chemicals.

OBJECTIVE

To determine serum concentrations of 10 OCs (including organochlorine pesticides and polychlorinated biphenyls -PCBs-) in children living in agricultural communities from Almería (South-Eastern Spain), and to identify the main predictors of exposure related to socio-economic characteristics, diet and lifestyle.

METHODS

A cross-sectional study was conducted on 133 children aged 6-11 years selected from public schools of the study area. OCs compounds were determined in serum samples by GC/ECD. Anthropometric measures were obtained during sample collection. Information on sociodemographic characteristics, parental occupation, residential history, lifestyle and frequency of food consumption, among other relevant factors, was obtained by questionnaires administered to the mothers.

RESULTS

Geometric means of serum concentrations (ng/ml) were 0.11 for β-hexachloro-cyclohexane (β-HCH), 0.09 for endosulfan, 0.20 for endosulfan-ether, 0.51 for hexachorobenzene (HCB), 0.08 for mirex, 0.06 for oxychlordane, 0.36 for p,p'-DDE, 0.20 for PCB 138, 0.36 for PCB 153, and 0.45 for PCB 180. Percentage of samples above the limit of detection (0.05 ppb) ranged from 32 (β-HCH) to 100 (HCB). A high variability in OC levels depending on the compound was observed between our results and others found in similar studies carried out in children. Variables related to fish consumption were found to be the major dietary determinant of PCB 138, p,p´-DDE, endosulfan-α, β-HCH, mirex and oxychlordane levels.

CONCLUSIONS

Children participating in this study showed detectable levels of many OC, despite these compounds are no longer used. Their presence in children serum can be explained by their high lipophilicity and environmental persistence, leading to contamination of fatty food. In this line, fish consumption seemed to be the most relevant determinant of OC levels found in our study.

Assumed non-persistent environmental chemicals in human adipose tissue; matrix stability and correlation with levels measured in urine and serum

The aim of this study was to (1) optimize a method for the measurement of parabens and phenols in adipose tissue, (2) evaluate the stability of chemical residues in adipose tissue samples, and (3) study correlations of these compounds in urine, serum, and adipose tissue. Samples were obtained from adults undergoing trauma surgery. Nine phenols and seven parabens were determined by isotope diluted TurboFlow-LC-MS/MS. The analytical method showed good accuracy and precision. Limits of detection (LOD) for parabens and phenols ranged from 0.05 to 1.83ng/g tissue. Good recovery rates were found, even when biological samples remained defrosted up to 24h. Benzophenone-3 (BP-3; range of values: <LOD-1.48ng/g tissue) and methylparaben (MeP; <LOD-1.78ng/g tissue) were detected in >70% of adipose tissue samples, while bisphenol-A (BPA; <LOD-3.28ng/g tissue) and 2-phenylphenol (2-PP; <LOD-0.78ng/g tissue) were detected in >40% of adipose tissue samples. In general, levels were similar between adipose tissue and serum, while a correlation between adipose tissue and urine was only found for BP-3. In conclusion, adipose tissue samples in this study were found to contain environmental chemicals considered to be non-persistent, whose levels were weakly or not at all correlated with the urine burden. Therefore, adipose tissue may potentially provide additional information to that obtained from other biological matrices. Further investigations are warranted to explore whether adipose tissue might be a suitable matrix for assessment of the consequences for human health of mid/long-term exposure to these chemicals.

Incidence and risk factors for post-traumatic stress disorder in a population affected by a severe flood

OBJECTIVES

We aimed to study the risk of developing post-traumatic stress disorder (PTSD) symptoms in people who resided in an affected area by an extremely severe flood, and sociodemographic risk factors associated with this condition.

STUDY DESIGN

A geographic information system (GIS) was used to distribute the rainfall data. A case-control study was developed to study the relationship between PTSD and sociodemographic risk factors.

METHODS

To delineate the areas affected by the flood and the intensity of this rainfall in comparison with historical hydrological data, we employed geographical information systems (GIS). Then, we recruited a representative sample of the affected population and another population sample that lived at the time of this disaster in adjacent geographical areas that were not affected. Both groups were randomly selected in primary care practices, from December 1st 2012 to January 31st 2013. All participants, 70 from the affected areas and 91 from the non-affected, filled a sociodemographic questionnaire and the trauma questionnaire (TQ) to identify and rate PTSD symptoms.

RESULTS

Our GIS analysis confirmed that the amount of precipitation in 2012 in the areas affected by the flood was exceptionally high compared with historical average rainfall data (461l per square metre vs 265). Individuals who resided in the affected areas at the time of the flood were at much higher risk of developing PTSD symptoms (OR: 8.18; 95% CI: 3.99-17.59) than those living in adjacent, non-affected localities. Among the sociodemographic variables included in this study, only material and financial losses were strongly associated with the onset of PTSD (P < 0.001). Physical risk during this life-threatening catastrophe also indicated a positive correlation with later development of PTSD symptoms; however, it did not reach statistical significance (P = 0.06).

CONCLUSIONS

Populations affected by severe floods may suffer an increase of PTSD symptoms in the following months. This finding, along with the importance of material losses as a predictor for such disorder, may help develop effective plans to minimize the negative impact of these natural disasters on public health.

Associations of persistent organic pollutants in serum and adipose tissue with breast cancer prognostic markers

This study aimed to evaluate associations between exposure to a group of persistent organic pollutants, measured in both adipose tissue and serum samples from breast cancer patients, and a set of tumor prognostic markers. The study population comprised 103 breast cancer patients recruited in Granada, Southern Spain. Data for tumor prognostic markers were retrieved from hospital clinical records and socio-demographic information was gathered by questionnaire. Persistent organic pollutants were quantified by gas chromatography with electron capture detection. Exposure levels were categorized in quartiles, and associations were evaluated using unconditional logistic regression. Adipose tissue HCB concentrations were associated positively with ER and PR expression (p-trends=0.044 and 0.005, respectively) and negatively with E-Cadherin and p53 expression (p-trends=0.012 and 0.027, respectively). PCB-180 adipose tissue concentrations were positively associated with HER2 expression (p-trend=0.036). Serum PCB-138 concentrations were positively associated with ER and PR expression (p-trends=0.052 and 0.042, respectively). The risk of p53 expression was higher among women in the lowest quartile of serum PCB-138 concentrations, but no significant trend was observed (p-trend=0.161). These findings indicate that human exposure to certain persistent organic pollutants might be related to breast cancer aggressiveness. We also highlight the influence on exposure assessment of the biological matrix selected, given that both serum and adipose tissue might yield relevant information on breast cancer prognosis.

Urinary levels of bisphenol A, benzophenones and parabens in Tunisian women: A pilot study

Bisphenol A (BPA), benzophenones and parabens are commonly used in the production of polycarbonate plastics, as UV-filters and as antimicrobial preservatives, respectively, and they are thought to exhibit endocrine disrupting properties. Exposure to these compounds remains poorly characterized in developing countries, despite the fact that certain behaviors related to westernization have the potential to influence exposure. The aim of this pilot study was to measure urinary concentrations of BPA, six different benzophenones and four parabens in 34 Tunisian women. In addition, we identified some socio-demographic and dietary predictors of exposure to these compounds. Chemical analyses were carried out by dispersive liquid-liquid microextraction (DLLME) and ultra-high performance liquid chromatography with tandem mass spectrometry detection (UHPLC-MS/MS). Detection frequencies of methylparaben (MP), ethylparaben (EP) and propylparaben (PP) ranged between 67.6 and 94.1%. Butylparaben (BP) was found in 38.2% of the analyzed samples; BPA in 64.7%; and benzophenone-1 (BP-1) and benzophenone-3 (BP-3) were detected in 91.2 and 64.7% of the analyzed samples, respectively. Urinary geometric mean concentrations of MP, EP, PP, and BP were 30.1, 1.4, 2.0 and 0.5ngmL(-1), respectively. Geometric mean concentrations of BPA, BP-1, and BP-3 were 0.4, 1.3 and 1.1ngmL(-1), respectively. Our results suggest that Tunisian women are widely exposed to BPA, parabens and some benzophenones. Further studies on the general Tunisian population are needed in order to assess the levels of exposure to these compounds and to identify sources of exposure and population groups at higher risk.

Levels and predictors of persistent organic pollutants in an adult population from four Spanish regions

This research aimed to assess serum concentrations of a group of persistent organic pollutants (POPs) in a sample of adults recruited in four different regions from Spain and to assess socio-demographic, dietary, and lifestyle predictors of the exposure. The study population comprised 312 healthy adults selected from among controls recruited in the MCC-Spain multicase-control study. Study variables were collected using standardized questionnaires, and pollutants were analyzed by means of gas chromatography with electron capture detection. Multivariable analyses were performed to identify predictors of log-transformed pollutant concentrations, using combined backward and forward stepwise multiple linear regression models. Detection rates ranged from 89.1% (hexachlorobenzene, HCB) to 93.6% (Polychlorinated biphenyl-153 [PCB-153]); p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) showed the highest median concentrations (1.04ng/ml), while HCB showed the lowest (0.24ng/ml). In the multivariable models, age was positively associated with HCB, p,p'-DDE, and PCB-180. BMI was associated positively with p,p'-DDE but negatively with PCB-138. Total accumulated time residing in an urban area was positively associated with PCB-153 concentrations. The women showed higher HCB and lower p,p'-DDE concentrations versus the men. Notably, POP exposure in our study population was inversely associated with the breastfeeding received by participants and with the number of pregnancies of their mothers but was not related to the participants' history of breastfeeding their children or parity. Smoking was negatively associated with HCB and PCB-153 concentrations. Consumption of fatty foods, including blue fish, was in general positively associated with POP levels. Although POP environmental levels are declining worldwide, there is a need for the continuous monitoring of human exposure in the general population. The results of the present study confirm previous findings and point to novel predictors of long-term exposure to persistent organic pollutants.

Serum and adipose tissue as matrices for assessment of exposure to persistent organic pollutants in breast cancer patients

The aim of this study was to assess differences between two biological matrices (serum and breast adipose tissue) in the evaluation of persistent organic pollutant (POP) exposure in breast cancer patients. The study population consisted of 103 women undergoing surgery for newly diagnosed breast carcinoma in a public hospital in Granada, Southern Spain. Independent variables were gathered from questionnaires and clinical records. POP concentrations were quantified in breast adipose tissue and serum samples. Spearman correlation tests were performed between pairs of POP concentrations and stepwise multivariable linear regression analyses were conducted to assess predictors of concentrations in the two matrices. p,p'- Dichlorodiphenyldichloroethylene (p,p'-DDE) showed the the highest median concentration in both matrices (194.34 and 173.84 ng/g lipid in adipose tissue and serum, respectively). Median wet-basis adipose tissue:serum ratios ranged from 109.34 to 651.62, while lipid-basis ratios ranged from 0.88 to 4.34. In general, we found significant positive correlation coefficients between pairs of POPs in adipose tissue and in serum, which were always higher in adipose tissue. We found positive and statistically significant correlations between serum and adipose tissue concentrations of p,p'-DDE and hexachlorobenzene (HCB) but not of polychlorinated biphenyls (PCBs). Age was positively associated with most POPs in adipose tissue and serum, while the body mass index was positively associated with adipose tissue HCB concentrations and negatively associated with serum PCB-153 and PCB-138 concentrations. Recent weight loss was inversely associated with POP residues in adipose tissue and positively associated with POP residues in serum. Serum HCB and PCB-180 concentrations were lower in patients who had received preoperative chemotherapy. According to our results, serum and adipose tissue POP concentrations in breast cancer patients may be differentially affected by external predictors. Taken together, these findings indicate the need to take account of the individual POP(s) under study and the biological matrix used when relating internal POP exposure to breast cancer disease and to make a careful selection of covariates for adjusting the model.

Zearalenone and its metabolites in urine and breast cancer risk: a case-control study in Tunisia

Zearalenone (ZON) is a non-steroidal estrogenic mycotoxin produced by Fusarium species. The exposure risk to humans and animals is the consumption of contaminated food and animal feeds. It has been reported that ZON and some of its metabolites promote the development of hormone-dependent tumors. The aim of this case-control study was to estimate exposure to ZON and its five metabolites (α-zearalenol [α-ZOL], β-zearalenol [β-ZOL], α-zearalanol [zeranol, α-ZAL], β-zearalanol [teranol, β-ZAL] and zearalanone [ZAN]) by measuring urinary concentrations of these compounds, and to evaluate the risk of breast cancer related to this exposure. Chemical analyses were carried out by liquid-liquid extraction (LLE) and ultra-high performance liquid chromatography with tandem mass spectrometry detection (UHPLC-MS/MS). Statistical analyses were performed in order to determine the association between exposure to these compounds and the development of breast cancer. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated by unconditional logistic regression to estimate the magnitude of the associations. The obtained results (adjusted OR=1.54, 95% CI=1.10-2.77) suggest a potential role of α-ZAL in the risk of developing breast cancer.

Serum levels of persistent organic pollutants and predictors of exposure in Tunisian women

INTRODUCTION

In spite of the international consensus on the human health risks associated with exposure to persistent organic pollutants (POPs), the Tunisian population is suspected to have been inadvertently exposed to POPs over the last decades.

OBJECTIVES

The aim of this study was to evaluate POP concentrations in the serum of a subset of 54 Tunisian women and to identify some socio-demographic and dietary predictors of exposure to POPs.

RESULTS

Of the ten POPs analyzed, three polychlorinated biphenyl (PCB) congeners (-138, -153 and -180), and two organochlorine pesticides (OCPs), HCB and p,p'-DDE, showed frequencies ranging from 98 to 100%. Serum median concentrations of PCB congeners (-138, -153 PCB-180) were 26.08, 119.1 and 29.84 ng/g lipid, respectively, and median concentrations of HCB and p,p'-DDE were 19.98 and 127.59 ng/g lipid, respectively. Age was positively correlated with serum levels of selected POPs. Women living in northern Tunisia showed higher serum levels of all PCBs. Working outside home and cereal consumption were positively associated to serum levels of p,p'-DDE. The duration of the lactation was also related to lower serum levels of p,p'-DDE and HCB.

CONCLUSION

The levels of exposure to POPs found warrant a biomonitoring program in order to identify routes of exposure and population groups at higher risk. This program will help to establish prevention policies and to determine the association between exposure to POPs and chronic diseases.

Thyroid status and its association with cognitive functioning in healthy boys at 10 years of age

OBJECTIVE

Thyroid hormones (THs) are crucial for the correct maturation of the CNS and the neurodevelopment of the child. We aimed to investigate the association of TSH and free thyroxine (FT4) levels with cognitive functioning in children from the INMA-Granada cohort studied during their follow-up at the age of 9-11 years.

DESIGN

We evaluated 300 children from the original cohort, which comprised 668 eligible mother-son pairs recruited at birth from 2000 to 2002 in Granada (Spain).

METHODS

FT4 and TSH concentrations were measured, and cognitive development was assessed using neuropsychological tests (n=187). Children with chronic disease related to thyroid function and/or cognitive development were excluded.

RESULTS

Median TSH and FT4 levels were 3.1 μIU/ml and 1.2 ng/dl respectively. In multivariable regression analyses adjusted for maternal and child characteristics, children with TSH levels in the top tertile had worse verbal comprehension and immediate and long-term recall. Children with FT4 levels in the top tertile had better attention and lower impulsivity and were at a lower risk of scoring below the 20th percentile in intelligence quotient (OR=0.24; 95% CI=0.08-0.74; P=0.013) and in abstract reasoning ability (OR=0.28; 95% CI=0.09-0.88; P=0.029).

CONCLUSION

Our findings indicate that circulating THs and TSH may in the top tertile have an impact on cognitive functions; thus, higher TSH slightly but significantly increased the risk of a lower score in certain neuropsychological tests.

Polychlorinated biphenyls (PCBs) and p,p'-dichlorodiphenyldichloroethylene (DDE) concentrations in maternal and umbilical cord serum in a human cohort from South Portugal

Organochlorine compounds as polychlorinated biphenyls (PCBs) and pp'-dichlorodiphenyldichloroethylene (pp'DDE) are ubiquitous, resistant to degradation and lipophilic compounds, commonly found in the general population. Prenatal exposure to these compounds has been associated to adverse developmental effects. Levels of PCBs and pp'DDE were investigated in maternal and umbilical cord serum of 68 women/newborns pairs from Algarve, South Portugal. Mean sum PCBs congeners and pp'DDE concentrations were 1.62 ± 0.39 ng mL(-1)and 1.11 ± 0.69 ng mL(-1)-for maternal and 1.45 ± 0.25 ng mL(-1) and 0.85 ± 0.50 ng mL(-1)for cord serum, respectively. Congeners distribution pattern followed the order PCB 153>180>130, both for maternal and cord serum). Significant correlations (p<0.05) were found between maternal and cord serum concentrations. The umbilical cord/maternal serum ratio were 0.90 and 0.76, respectively for ΣPCB and pp'DDE Multivariate analyses relate women in urban centers with higher PCB levels, while higher pp'DDE relates to older primiparous women that live at rural areas. PCBs were also correlated to more portions of fat rich foods, while pp'DDE is associated to higher ingestion of vegetables and fruits. Smoking habits only correlated to maternal PCB. The present work provides, to our knowledge and for the first time, baseline human-biomonitoring data and establishes background ranges of PCB and pp'DDE levels in the maternal and umbilical cord serum in the Algarve region. These compounds exhibited the capacity to pass the placenta barrier and target the fetus. Even in non-industrialized areas, and in non-intensive agriculture areas, like the Southern Portugal, there is a need to take measures to eliminate or minimize the risk of organochlorine exposure during pregnancy.

Body mass index and myocardium at risk in patients with acute coronary syndrome

BACKGROUND AND OBJECTIVES

Whilst traditional studies have shown that obese individuals are at a higher risk of cardiovascular events compared to lean subjects, recent studies in patients with acute myocardial infarction (AMI) have suggested that obesity may exert protective effects (the "obesity paradox"). We sought to assess the relationship between body mass index (BMI) and the BARI score (BARIsc), a validated tool used to assess myocardium at risk, in patients with acute coronary syndrome.

PATIENTS AND METHODS

Participants were 116 consecutive patients (mean age, 60.6 years; 97 men) with AMI (68 ST elevated myocardial infarction, STEMI; 48 non-ST elevated myocardial infarction, NSTEMI). Demographics, BMI, risk factors, biochemistry data, left ventricular function, angiographic data and the BARIsc were assessed in every patient.

RESULTS

Multiple linear regression analyses showed that BMI significantly correlated with BARIsc; β=.23, p<0.02. This was found only in the overweight/obese patients, β=.27, p<0.01, but not in patients with normal BMIs, β=0.08, p=0.71.

CONCLUSIONS

An increased body weight is associated with an increased area of myocardium at risk in patients with ACS.

Factors influencing combined exposure to three indicator polychlorinated biphenyls in an adult cohort from Bolivia

Polychlorinated biphenyls are persistent organic pollutants that have been used for decades in several industrial applications. Although production of polychlorinated biphenyls was restricted from the 1970s in most countries, substantial amounts remain in old equipment and buildings and they have been detected in various environmental and biological matrices. The main objective of this study was to analyze predictors of the combined exposure to three non-dioxin-like polychlorinated biphenyls (congeners 138, 153 and 180) in serum and adipose tissue from an adult cohort (n=112) living in the city of Santa Cruz de la Sierra (Bolivia) and surrounding towns/villages. A second aim was to identify modifiers that might influence the statistical associations found, using crude, partially-adjusted, and global multiple linear regression models. Main predictors of serum concentrations were occupation and fatty food consumption, while those for adipose tissue concentrations included age, smoking habit, fatty food consumption, and residence. The differences between the two matrices might be derived from their biological meaning, given that adipose tissue concentrations are an indicator of chronic exposure to polychlorinated biphenyls while serum levels are a good predictor of ongoing exposure and the mobilization of polychlorinated biphenyls stored in fatty tissues. Body mass index was found to be an important modifier of these associations.

Concentrations of organochlorine pesticides and polychlorinated biphenyls in human serum and adipose tissue from Bolivia

Organochlorine pesticides and polychlorinated biphenyls (PCBs) are synthetic chemicals that are highly resistant to biodegradation and have proven adverse health effects. The objectives of this study were to determine concentrations of three selected organochlorine pesticides (p,p'-DDT, p,p'-DDE, HCB) and three specific PCB congeners (PCB 138, 153, 180) in adipose tissue and serum samples from an urban adult population (n=112) in the city of Santa Cruz de la Sierra, Bolivia, and to investigate their relationships within and between the two matrices and with selected socio-demographic characteristics. The percentages of samples positive for these compounds ranged from 40% for PCB 180 to 100% for p,p'-DDE in adipose tissue, and from 21% for HCB to 93% for p,p'-DDE in serum. Median number of residues per sample was five for adipose tissue and three for serum. Geometric mean concentrations indicate a considerable historical and recent exposure to organochlorine pesticides and PCBs in this population. Adipose tissue:serum ratios ranged from 149.3 to 590.3 (wet basis) and from 0.9 to 3.5 (lipid basis). We found positive and statistically significant correlations between adipose tissue and serum concentrations only in p,p'-DDE and HCB. This novel study in Bolivia underlines the need for human biomonitoring to assess exposure to environmental pollutants in South America.

Contribution of sociodemographic characteristics, occupation, diet and lifestyle to DDT and DDE concentrations in serum and adipose tissue from a Bolivian cohort

The organochlorine pesticide p,p'-Dichlorodiphenyltrichloroethane (DDT) was widely used in the early 1960s-70s for vector control in tropical and subtropical areas of South America. Due to its persistence, DDT has a high potential to bioaccumulate in the food chain and living organisms and is a major public health concern, especially in South America. The main purpose of the present study was to investigate predictors of serum and adipose tissue concentrations of p,p'-DDT and its main metabolite, p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), in an adult cohort (n=112) from Santa Cruz de la Sierra, Bolivia, using multiple linear regression models. These models explained 29.3-47.8% of the variability in adipose tissue concentrations of p,p'-DDT and p,p'-DDE, respectively, and 32.9-47.0% of that in serum. Main exposure predictors included age, occupational class, residence, diet, smoking habit, and accumulated breastfeeding time. This is one of the few studies to explore predictors of human exposure to these chemicals using a multivariate approach in a South American population. Results show that predictors of human exposure to p,p'-DDT and p,p'-DDE in Santa Cruz de la Sierra may diverge from those found in other populations of the world, due to particular sociodemographic and lifestyle characteristics of this region.

Nonylphenol and octylphenol in adipose tissue of women in Southern Spain

Alkylphenols (APs) and AP ethoxylates are environmental contaminants with endocrine disrupting activities in wildlife and humans. They have been largely used in industrial, agricultural, and domestic applications. Despite strong concerns about the consequences of human exposure to endocrine disrupters, little information is available on the presence in humans of compounds such as APs. The aim of the present study was to determine 4-nonylphenol (NP) and 4-octylphenol (OP) residues in adipose tissue of non-occupationally exposed women living in Southern Spain. NP was detected in 100% (n=20/20) and OP in 23.5% (n=4/20) of samples, with median levels of 57 and 4.5 ng g(-1) adipose tissue, respectively. Body mass index emerged as a determinant of exposure since it was associated with NP levels (p=0.041). Adipose tissue NP and OP levels are similar to the few data previously published in other countries. This is the first report on NP and OP levels in a population in Southern Spain. Further research is needed to determine trends in human exposure to these compounds and to investigate their consequences.

Predictors of concentrations of hexachlorobenzene in human adipose tissue: a multivariate analysis by gender in Southern Spain

Hexachlorobenzene (HCB) was measured in adipose tissue intraoperatively collected from 387 subjects over 16 years old undergoing surgery in two hospitals in Granada (Southern Spain). HCB was quantified in 90.7% of subjects. The concentrations and frequencies of HCB were similar to those reported in adipose tissue samples in other recent European studies. Exposure patterns differed between females and males: higher HCB concentrations were found in females than in males (geometric mean 18.3 vs. 6.8 ng/g, p<0.001). The relationship between HCB concentrations and exposure risk factors was assessed by multivariate analysis stratifying by gender. In men, HCB concentrations were predicted (r(2)=0.45) by age, body mass index (BMI), place of residence, smoking, consumption of fish, chicken and cheese, occupation related to agriculture, and family involvement in construction activities. In women, HCB concentrations were predicted (r(2)=0.50) by age, BMI, consumption of milk and cheese, and occupation related to industry. The finding that women had three-fold higher levels of HCB than the men deserves further investigation.

The total effective xenoestrogen burden, a biomarker of exposure to xenoestrogen mixtures, is predicted by the (anti)estrogenicity of its components

Appropriate biomarkers of human exposure are required for epidemiological studies of endocrine disruption. We addressed this issue by improving a standardized method to assess the total effective xenoestrogen burden (TEXB), a biomarker of xenoestrogen exposure. Extensive separation of xenoestrogens from endogenous hormones was made in 20 adipose tissue samples by HPLC, and two eluates were separated and tested in the E-Screen bioassay. An extensive fractionation protocol was also developed. The objective of this study was to investigate predictors of TEXB by using a multiple regression model after adjusting by confounding factors. The final model included the estrogenicity of 8 out of 11 individual 1-min fractions into which the xenoestrogen eluate was split and the marital status of patients, and it explained 97% of TEXB variability, and variables. Our results indicate that TEXB of complex mixtures can be accurately predicted from the estrogenicity of a small number of components.

Bisphenol-A and chlorinated derivatives in adipose tissue of women

Bisphenol-A (BPA) and chlorinated derivatives (Cl(x)BPA) were investigated in adipose tissue of women in Southeast Spain. BPA was above limit of detection (LOD) in 11 out of 20 samples (55%). Among Cl(x)BPA, Cl(2)BPA was the most frequent (80%) and abundant, constituting 94.6% of total chlorinated BPA in adipose tissue. Mean +/- S.D. of BPA, monochloro-BPA (ClBPA), dichloro-BPA (Cl(2)BPA), and trichloro-BPA (Cl(3)BPA) were 5.83 +/- 3.48, 3.05 +/- 0.28, 9.21 +/- 9.26, and 0.74 +/- 0.15 ng/g of adipose tissue, respectively. No tetrachloro-BPA (Cl(4)BPA) was found above LOD. There are no published data on BPA in human adipose tissue or on Cl(x)BPA in adipose tissue or blood, limiting comparisons. BPA levels were similar (w/w) to findings in blood (w/v) in other populations and below levels reported in placenta tissue (w/w). Because of the estrogen mimicking effects of BPA and its Cl(x)BPA, further research is needed to explore their combined effects on human health and trends in human exposure.