Organochlorine compounds, nitro musks and perfluorinated substances in breast milk - results from Bavarian Monitoring of Breast Milk 2007/8

PFC/PFAS concentrations in human milk and infant exposure through lactation: a comprehensive review of the scientific literature

Per- and polyfluoroalkyl substances (PFAS), previously known as perfluorinated compounds (PFC), are a group of synthetic chemicals widely used over the past decades. Their extensive application, combined with their environmental persistence, has contributed to their ubiquitous presence in the environment and the associated toxicological risks. Regarding humans, blood serum testing remains the primary method for biomonitoring PFAS exposure, while breast milk has also been used due to the transfer of these substances from mothers to infants during lactation. This paper aims to review the scientific literature (using PubMed and Scopus databases) on PFAS concentrations in the breast milk of non-occupationally exposed women. Where available, the estimated daily intake of these compounds by breastfeeding infants is also examined. The reviewed studies are categorized by continent and country/region, revealing a significant lack of data for many countries, including both developed and developing nations. The findings indicate substantial variability in PFAS concentrations, influenced by factors such as geographic location, sampling year, and the specific PFAS analyzed. Among the identified compounds, perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) are most commonly detected, along with perfluorohexanesulfonic acid (PFHxS) and perfluorononanoic acid (PFNA), being the only PFAS with regulated maximum levels in certain foodstuffs. Most studies were conducted before the implementation of the current (updated) tolerable weekly intake (TWI) values for these substances. Consequently, the majority reported a low health risk for breastfeeding infants, even in high-intake scenarios. Nevertheless, biomonitoring studies are urgently needed in countries with limited or no data, and new investigations should assess whether current estimated intakes exceed the updated TWI. Special focus should be given to rural and industrial areas where exposure levels remain poorly understood.

Association Between Prenatal Exposure to Per- and Poly-Fluoroalkyl Substances From Electronic Waste Disassembly Areas and Steroid Hormones in Human Milk Samples

Per- and poly-fluoroalkyl substances (PFAS), which are long-lasting environmental contaminants that are released into the environment during the e-waste disassembly process, pose a threat to human health. Human milk is a complex and dynamic mixture of endogenous and exogenous substances, including steroid hormones and PFAS. Therefore, in this study, we aimed to investigate the association between PFAS and steroid hormones in human milk from women living close to an e-waste disassembly area. In 2021, we collected milk samples from 150 mothers within 4 weeks of delivery and analyzed them via liquid chromatography-tandem mass spectrometry to determine the levels of 21 perfluorinated compounds and five steroid hormones (estrone, estriol, testosterone, progesterone, and androstenedione [A-dione]). We also performed multiple linear regression analysis to clarify the association between maternal PFAS exposure and steroid hormone concentrations. Our results indicated that PFOA and PFOS were positively associated with estrone (β, 0.23; 95% CI, 0.08-0.39) and A-dione (β, 0.186; 95% CI, 0.016-0.357) concentrations in human milk, respectively. Further, the average estimated daily intake of PFOA and PFOS were 36.5 ng/kg bw/day (range, 0.52-291.7 ng/kg bw/day) and 5.21 ng/kg bw/day (range, 0.26-32.3 ng/kg bw/day), respectively. Of concern, the PFAS intake of breastfeeding infants in the study area was higher than the recommended threshold. These findings suggested that prenatal exposure to PFAS from the e-waste disassembly process can influence steroid hormones levels in human milk. Increased efforts to mitigate mother and infant exposure to environmental pollutants are also required.

Short- and medium-chain chlorinated paraffins in breast milk in Shanghai, China: Occurrence, characteristics, and risk assessment

As novel contaminants, short-chain chlorinated paraffins (SCCPs) and medium-chain chlorinated paraffins (MCCPs) have been of great concern in the past several years. Shanghai was one of the provinces with the largest chlorinated paraffins (CPs) emission in China; nevertheless, there is currently little information on the human exposure to SCCPs and MCCPs, particularly MCCPs. In this study, 25 breast milk samples were collected in Shanghai from 2016 to 2017. The concentrations of SCCPs and MCCPs were determined using two-dimensional gas chromatography coupled with orbitrap high-resolution mass spectrometry (GC × GC-orbitrap-HRMS) to investigate their characteristics and assess the associated health risks for breast-fed infants. Compared with the previous studies in other areas, the current study presented the higher CPs concentrations, with median concentrations of SCCPs and MCCPs up to 771 and 125 ng/g lipid weight (lw), respectively. The exposure profiles of the CPs were characterized by C10 and Cl6-7 as the predominant congeners of SCCPs, while C14 and Cl7-9 were identified as the dominant groups of MCCPs. CP-42 and CP-52 were identified as potential sources of CPs found in breast milk samples collected in Shanghai. The concentrations of MCCPs exhibited a positive correlation (p value < 0.05) with the dietary consumption of meat and poultry. No significant positive correlations were observed for SCCPs and MCCPs with polychlorinated dibenzodioxins/furans (PCDD/Fs) congeners. A preliminary exposure assessment showed that SCCPs in breast milk potentially posed high risks to the breast-fed infants in Shanghai.

Persistent Organic Pollutants in Austrian Human Breast Milk Collected between 2013 and 2016

Breast milk holds an immense nutritional value as it contains health-promoting substances in a unique, optimal form. Additionally, breast milk's significance extends to health and environmental protection, as it serves as an indicator of both maternal and infant exposure. In this study, breast milk samples collected in 2013 and in 2014-2016 from mothers in Vienna (Austria) were analysed for polybrominated diphenyl ethers (PBDE) and per- and polyfluoroalkyl substances (PFAS), as well as further substances which have been listed under the Stockholm Convention on Persistent Organic Pollutants (POPs) due to their persistent, bioaccumulative and toxic properties. The total concentration of the PBDE congeners in the samples (n = 18, sampled 2013) ranged from 0.055 to 52 ng/g lipid, and from 0.002 to 2.5 ng/g breast milk. In the pooled sample, the sum of PBDEs was detected at a level of 4.4 ng/g lipid. Based on the 2014-2016 study population, certain PFAS were detected in all samples (n = 40). Exposure to the sum of four specific PFAS including perfluorooctanesulphonate (PFOS), perfluorooctanoic acid (PFOA), perfluoro-n-nonanoic acid (PFNA) and perfluoro-1-hexanesulfonate (PFHxS) ranged between 0.014 and 0.12 ng/L breast milk. In the pooled sample, PFOS and PFOA were found in concentrations of 0.025 ng/g and of 0.045 ng/g, respectively. In addition, the first generation of POPs, mainly organochlorine compounds, was measured in a pooled sample of breast milk from participants sampled in 2014-2016 as part of the WHO/UNEP breast milk monitoring program and compared to the POPs measured in pooled samples collected in 1987/1988 and 1992/1993, respectively. Therefore, this paper demonstrates the effectiveness of the Stockholm Convention on POPs by comparing the Austrian results from the WHO/UNEP global breast milk study from 1987 to 2016. However, the data also show that, despite these reductions, health-relevant levels are still being reached, particularly in terms of children's health when the presence of the new generation of POPs, such as PBDEs and PFAS, in human breast milk is taken into account.

First WHO/UNEP survey of the current concentrations of persistent organic pollutants in human milk in Morocco

The presence of persistent organic pollutants (POPs) in human milk is an indicator of the level of these substances in the environment and enables evaluation of the potential exposure of breastfed children. POPs concentrations in a Moroccan human milk pooled sample (59 donors) were determined for the first time by the WHO reference laboratory to provide a baseline and allow monitoring of the future trends for those persistent organohalogen compounds. Eighty-one different POPs, including organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), and dioxins and furans (PCDD/Fs) were identified and quantified by using gas chromatography (GC) with an electron capture detector (ECD) and confirmed by gas chromatography-mass spectrometry (GC/LRMS). The obtained results showed that the sum of DDT (sum of o,p'-DDD, p,p'-DDD, o,p'-DDE, p,p'-DDE, o,p'-DDT, and p,p'-DDT) was 237.9 ng/g, representing 94.0% of all detected OCPs levels, with a dominance of p,p'-DDE, and p,p'-DDT. Cis-heptachlor epoxide, HCB, and HCH were found at much lower levels. PCB indicator level was 60.7 ng/g of lipid, with the dominance of PCB 138, PCB 153, and PCB 180, presenting 98.3% of the total. Among the 25 PBDE congeners quantified, BDE-47, BDE-153, BDE-197, and BDE-207 were the dominant congeners account for 15.4% of the total concentration of PBDE (1.3 pg/g lipid). The lipid-adjusted level of PCDD/Fs and dl-PCBs expressed in Toxic Equivalents (TEQs: 6.65 pg/g) were lower in comparison to those found in the other countries. In summary, detected POPs levels in Moroccan human milk were much lower compared to the other countries, reflecting the effectiveness of the compliance with Stockholm Convention requirements on eliminating or reducing emissions of selected POPs. Continued monitoring is needed for these compounds, for which this is the first data available, provided by the WHO/UNEP survey in Morocco.

Breastfed infants' exposure to polychlorinated biphenyls, polychlorinated dibenzo-p-dioxins and dibenzofurans, and per- and polyfluoroalkyl substances: A cross-sectional study of a municipal waste incinerator in China

A municipal waste incinerator (MWI) in Zhejiang, China, operating since 2008 was completely reconstructed from 2016 to 2019. In 2013, we conducted a cross-sectional study of breastfeeding mothers living near the MWI. We evaluated the concentrations of polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in the mothers' breast milk and their infants' estimated daily intake (EDI). To investigate the temporal variations of these pollutants, we conducted a cross-sectional study of 29 mothers in 2019. We assessed the levels of 18 PCB congeners, 17 PCDD/F congeners, and 21 per- and polyfluoroalkyl substance (PFAS) congeners in breast milk and estimated the EDI. The mean total concentrations of PCDD/Fs (ΣPCDD/Fs) and PCBs (ΣPCBs) were 81.2 and 4.90 ng/g lipid, respectively, while the toxic equivalent quantity (TEQ) levels of ΣPCDD/Fs and dioxin-like PCBs (ΣDL-PCBs) were 2.7 and 1.4 pg WHO-TEQ/g lipid, respectively. Compared to our 2013 measurements, the mass concentrations of ΣPCDD/Fs and ΣPCBs decreased by 13% and 35%, respectively (3.361 vs. 2.915 pg/g wet weight [ww] and 269.1 vs. 175.0 pg/g ww, respectively). The TEQ-ΣPCDD/F levels decreased by 67% (0.241 vs. 0.080 pg/g ww), but the TEQ-ΣDL-PCB levels increased by 11% (0.046 vs. 0.051 pg WHO-TEQ/g ww). The median concentration of PFASs was 0.250 ng/mL, ranging from 0.151 to 0.833 ng/mL. The infants' mean EDI of total PCDD/Fs and DL-PCBs was 17.7 pg TEQ/kg body weight [bw], representing a 20% decline compared to 2013. The average EDI levels of PFOS, PFOA, and PFNA were 5.8, 17.9, and 1.7 ng/kg bw, respectively. A comprehensive comparison of the results with studies from around the world showed that the potential health risks posed by legacy PCDD/F and PCB pollutants were not as grave for mothers and infants living near this MWI, but the emerging PFAS pollutants represented a new cause for concern. MAIN FINDINGS: The potential health risks posed by legacy PCDD/F and PCB pollutants were not particularly serious for mothers and infants living near the MWI, but the emerging PFAS pollutants raised new concerns.

Polychlorinated dioxins and dibenzofurans (PCDD/F), polybrominated dioxins and dibenzofurans (PBDD/F), polychlorinated biphenyls (PCB), polybrominated diphenyl ethers (PBDE), and per- and polyfluoroalkyl substances (PFAS) in German breast milk samples (LUPE 8)

Most organic pollutants (POP) are persistent in the environment, accumulate in fatty tissues, and so a transfer through the food chain is probably, thereby causing various health effects. We quantified PCDD/F, PBDD/F, PCB, PBDE, perfluorinated substances, and ADONA in breast milk samples collected in two German federal states and breast milk and blood samples from subjects additionally exposed to PFOA. The median (95th percentile) concentrations were 2.43 (6.58) pgWHO₂₀₀₅TEQ/g l.w. for PCDD/F, 2.45 (4.82) pgWHO₂₀₀₅TEQ/g l.w. for dioxin-like PCB (dl-PCB), and 0.62 (2.69) pgWHO₂₀₀₅TEQ/g l.w. for PBDD/F. The relative contributions of the median values of PCDD/F, dl-PCB, and PBDD/F to the total-TEQ were approximately 41%, 42%, and 11%, respectively. Nondioxin-like PCB (ndl-PCB) concentrations were clearly dominated by the higher chlorinated PCB congeners, with medians of 23.2 ng/g l.w. for PCB 153, 13.9 ng/g l.w. for PCB 138, and 13.0 ng/g l.w. for PCB 180. The sum of the 3 congeners (PCB 138, 153, and 180) were multiplied with 1.64 (total PCB) and showed a median of 82.16 ng/g l.w. and a 95th percentile of 173.3 ng/g l.w. Only PFOA and PFOS could be quantified in 29% and 17% of in total 180 samples with 95th percentiles of 53 ng/l and 33 ng/l, respectively. Milk samples (n = 13) from subjects living on PFOA contaminated sites showed higher levels between 33 and 854 ng/l PFOA (mean: 199 ng/l), whilst PFOS could be quantified only in three samples. The sum of 17 PBDE congeners showed medians (95th percentile) of 1737 pg/g l.w. (22,806 pg/g l.w.), with the highest medians of 422 pg/g l.w. for BDE 209 and 378 pg/g l.w. for BDE 153. Overall, our study confirms the declining contamination level in breast milk during the last decade, but points out the need to further reduce the environmental contamination with persistent substances and subsequently the exposure in childhood.

Highly elevated levels, infant dietary exposure and health risks of medium-chain chlorinated paraffins in breast milk from China: Comparison with short-chain chlorinated paraffins

Short-chain chlorinated paraffins (SCCPs) are persistent organic pollutants which are toxic to human. Median-chain chlorinated paraffins (MCCPs) have similar toxicity to SCCPs. The productions of chlorinated paraffins (CPs) in China were 1 million tons in 2013 and remained high after that, which may lead to high risks for human exposure to CPs. To investigate temporal trends and health risks of SCCPs and MCCPs in breast milk in China, samples (n = 2020) were collected from urban and rural areas of 11 Chinese provinces in 2017 and mixed into 42 pooled samples. SCCPs and MCCPs were analyzed by two-dimensional gas chromatography with electron-capture negative-ionization mass spectrometry (GC × GC-ECNI-MS). The MCCP concentrations (median (range)) were 472 (94-1714) and 567 (211-1089) ng g^-1 lipid in urban and rural areas, respectively, which showed continuously rapidly increasing during 2007-2017. The SCCP concentrations (median (range)) were 393 (131-808) and 525 (139-1543) ng g^-1 lipid in urban and rural areas, respectively. The results showed SCCP levels decreased in urban areas between 2007 and 2017. Significant increases in MCCP/SCCP ratios might arise from extensive manufacturing and use of MCCPs. The median estimated dietary intake via breast milk in urban and rural samples were 1230 and 2510 ng kg^-1 d^-1, respectively, for SCCPs and 2150 and 1890 ng kg^-1 d^-1, respectively, for MCCPs. Preliminarily risk assessment showed that SCCPs posed a significant health risk to infants via breastfeeding. The high MCCP levels should also be of concern because of continuous growth and negative effect on infants. Correspondence analysis indicated congeners with higher carbon and chlorine numbers in dietary tend to accumulate in breast milk.

Synthetic Musk Compounds in Human Biological Matrices: Analytical Methods and Occurrence-A Review

Extensive use of synthetic musk compounds (SMs) in numerous consumer and personal care products has resulted in direct human exposures via dermal absorption, inhalation of contaminated dust and volatilized fragrances, and oral ingestion of contaminated foods and liquids. SMs and their metabolites are lipophilic, hence commonly detected in various biological matrices such as blood, breast milk, and adipose tissue. Appropriate analytical techniques are needed to detect and quantify SMs in biological matrices to assess their potential effects on human health. Different methods to process and analyze SMs in biological matrices, including sample-pretreatment, solvent extraction, cleanup, and instrumental analysis, are presented in this review. The concentration levels of selected musk compounds in biological samples from different countries/regions are summarized. Finally, research gaps and questions pertaining to the analysis of SMs are identified and suggestions made for future research studies.

Biomonitoring of PFOA, PFOS and PFNA in human milk from Czech Republic, time trends and estimation of infant's daily intake

BACKGROUND

Perfluoralkylated substances (PFASs) are persistent and bioaccumulative environmental contaminants. They are included on the list of emergent compounds monitored in the frame of HBM4EU project.

OBJECTIVES

To analyze PFASs levels in human milk samples collected in the period 2006 through 2017, to follow their time trends, to assess the PFASs exposure in breastfed infants, to calculate the daily intake of PFASs and to compare it with the tolerable daily/weekly) intakes and to quantify risk from exposure using the hazard quotient and hazard index approach.

MATERIAL AND METHODS

A broad spectrum of PFASs were analyzed by means of UHPLC-MS/MS in primipara human milk samples collected in four consecutive time periods 2006, 2010/11, 2014, and 2017; N = 46, 183, 164 and 232, respectively. Mothers living in urban and suburban residences were recruited after their delivery at maternity hospitals, and milk samples were taken within 2 and 8 weeks after delivery. The questionnaire was focused on possible sources of exposure, dietary habits and lifestyle.

RESULTS

Only perfluorooctane sulfonate (PFOS) and perfluorooctanoid acid PFOA (in 2017, also perfluorononanoic acid (PFNA)) were quantified in more than 90% of analyzed human milk samples. In all sampling periods, the levels of PFOA were higher than those of PFOS (p < 0.05). A significant downward temporal trend (p < 0.001) was observed for both PFOA and PFOS levels. The median concentrations in sampling years 2006, 2010/11, 2014, and 2017 were 0.075, 0.059, 0.035, and 0.023 ng/mL for PFOA and 0.045, 0.031, 0.029, and 0.020 ng/mL for PFOS, respectively. In 2017, PFNA was also quantified in 99% of samples with the median concentration of 0.007 ng/mL. The levels of PFASs correlated with maternal sea fish consumption. No maternal age-related relationship was observed. Using the tolerably daily intake (TDI) values for PFOS and PFOA set by the European Food Safety Authority (EFSA) in 2008, the calculated daily intakes from breastfeeding were clearly below these limits. Using the new, more conservative EFSA Provisional Tolerably Weekly Intake (PTWI) values set in 2018, we demonstrated a considerable exceedance of PTWI, with a hazard index above 1.

CONCLUSION

Significant time-related decreasing trends in the PFOS and PFOA levels in human milk were observed. Nevertheless, the body burden of infants from breastfeeding might pose an enhanced health risk to infants when the current PTWI values are applied. These findings strongly support the present EU efforts to phase out PFOA, its salts and PFOA related compounds. Since PFOS exposure there has still been widely detected despite PFOS usage reduction measures, the major exposure routes should be further monitored and, if possible, eliminated.

Persistent Organic Pollutants in Human Breast Milk and Associations with Maternal Thyroid Hormone Homeostasis

Epidemiological studies have indicated the thyroid-disrupting effects of persistent organic pollutants (POPs). However, the association of low-exposure POPs with thyroid hormones (THs) remains unclear. Here, we aim to assess the association of low exposure of POPs, including polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs), and polybrominated dibenzo-p-dioxins and furans, with THs [total _L-thyroxine (TT₄), total 3,3',5-triiodo-_L-thyronine (TT₃), and total 3,3',5'-triiodo-_L-thyronine (TrT₃)] measured in human breast milk. Ninety-nine breast milk samples were collected from the LUPE cohort (2015-2016, Bavaria, Germany). Fourteen PBDEs, 17 PCBs, and 5 PCDD/Fs had quantification rates of >80%. Nonmonotonic associations were observed. In adjusted single-pollutant models, (1) TT₄ was inversely associated with BDE-99, -154, and -196; (2) TT₃ was inversely associated with BDE-47, -99, -100, -197, -203, -207, and OCDD; and (3) TrT₃ was inversely associated with BDE-47, -99, -183, and -203. Multipollutant analysis using principal component analysis and hierarchical clustering revealed inverse associations of PBDEs (BDE-28, -47, -99, -100, -154, -183, and -197) with TT₄ and TrT₃. These results indicate that POPs at low levels might be related to reduced THs. This study shows that human breast milk might be an appropriate specimen to evaluate the thyroid disruption of POPs.

Concentrations of dioxins and furans in breast milk of women living near a hazardous waste incinerator in Catalonia, Spain

Since 1999, a hazardous waste incinerator (HWI) is operating in Constantí (Tarragona County, Catalonia, Spain). In 1996-1998, when the facility was being built, we started a monitoring program aimed at evaluating the impact of the emissions of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) by the HWI on the environment and the human health. This study aimed at determining the current concentrations of PCDD/Fs in breast milk samples of women living nearby the HWI and at comparing these levels and profiles with those obtained in the baseline (1996-1998) and previous surveys (2002, 2007 and 2012). Furthermore, the association between the dietary intake of PCDD/Fs and the congener profiles in breast milk was also explored. Twenty milk samples were collected from women living in Tarragona downtown and near the industrial area where the HWI is placed. The content of PCDD/Fs was analyzed by following a procedure derived from the US EPA methods 1613 and 8290A. The mean concentration of PCDD/Fs was 2.26 pg WHO-TEQ/g fat. No significant differences were found between women living in industrial and urban areas (1.67 pg vs. 2.48 pg WHO-TEQ/g fat). Interestingly, a notable significant reduction (81%) was observed with respect to the concentrations found in the baseline study. The profiles of PCDD/Fs in breast milk were similar independently on the area and period of collection, being mainly influenced by the intake of fish, meat, oils and fats. The decreasing trend of PCDD/Fs in human milk agrees with the reduction observed in the dietary intake of these pollutants. It was also concluded that the current levels of PCDD/Fs in human milk levels are not influenced by the HWI stack emissions.

Levels of polychlorinated biphenyls in human milk samples in European countries

Polychlorinated biphenyls (PCBs) are persistent pollutants, harmful to human health, which enter the human body mainly through food and bind to body fat. For these reasons their use in most countries is prohibited. Human milk has an advantage over other types of human samples in measuring human exposure to PCBs, as it is obtained with non-invasive sampling methods. In Europe, including Croatia, PCB levels have been monitored for many years. This review summarises PCB trends in human milk across Europe. The trend is generally downward, with higher levels prevailing in urban areas near industrial plants. The highest PCB levels were reported in the Czech Republic and Slovakia.

Perfluoroalkyl substances (PFASs) in breast milk from Korea: Time-course trends, influencing factors, and infant exposure

Breastfeeding is an important exposure pathway to perfluoroalkyl substances (PFASs) for newborn infants. Nevertheless, reports are limited on the occurrence and time-course of PFASs in breast milk, and most studies have focused on the analysis of perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). In this study, 16 PFASs were analyzed in breast milk samples (n=293) collected from 128 mothers in Korea during various lactation periods to assess maternal exposure levels, contamination profiles, time-course variations, and infant health risks. The total concentrations of PFASs (ΣPFAS) ranged from 31.7 to 1004 (median: 188) ng/L, which was within the ranges recently reported for Asian and European populations. After a month of nursing, the concentrations of PFOS, PFOA, perfluorononanoic acid (PFNA), and ΣPFAS significantly increased. This could be due to changes in the dietary and behavior patterns of the mothers after the first month of lactation. The concentrations of PFOS and PFOA were significantly correlated with maternal age, body mass index, and parity. Certain types of diet (e.g. consuming snacks and milk) and eating-out frequency were significantly associated with increasing levels of PFAS. Significant correlations and similar time-course trends were found between PFASs and PCBs/DDTs, implying similar exposure sources and biokinetics for these contaminants. The estimated daily intakes of PFOS and PFOA via the consumption of breast milk were below the tolerable daily intakes for infants suggested by the European Food Safety Authority (EFSA).

Pesticides in human milk of Western Australian women and their influence on infant growth outcomes: A cross-sectional study

Persistent organic pollutants in human milk (HM) at high levels are considered to be detrimental to the breastfed infant. To determine the pesticide concentration in HM, a pilot cross-sectional study of 40 Western Australian (WA) women was carried out. Gas chromatography-tandem mass spectrometry (GC-MS/MS) with a validated QuEChERS was used for the analysis of 88 pesticides in HM. p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) with a mean concentration of 62.8 ± 54.5 ng/g fat was found, whereas other organochlorines, organophosphates, carbamates and pyrethroids were not detected in HM. Overall, no association was observed between HM p,p'-DDE concentrations and maternal age, parity, body mass index and percentage fat mass. Furthermore, for the first time no significant association was found between p,p'-DDE concentrations in HM and infant growth outcomes such as weight, length, head circumference and percentage fat mass. The calculated daily intake was significantly different to the estimated daily intake of total DDTs and was well below the guideline proposed by WHO. The DDTs levels in WA have also significantly decreased by 42 - fold since the 1970s and are currently the lowest in Australia.

Elevated levels of short carbon-chain PFCAs in breast milk among Korean women: Current status and potential challenges

Breast milks can be contaminated with perfluoroalkyl substances (PFASs). Exposure to PFASs during early stages of life may lead to adverse health effects among breastfed infants. To date, perfluorootanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) have been most frequently measured PFASs in breast milks worldwide. Information on shorter carbon-chain PFASs in breast milk is scarce. In this study, breast milks were sampled from 264 Korean lactating women, and measured for seventeen PFASs, including ten perfluoroalkyl carboxylates (PFCAs), four perfluoroalkyl sulfonates, and three perfluoroalkyl sulfonamides. PFOA and PFOS were detected in 98.5% of the breast milk samples, with median concentrations of 0.072 and 0.050ng/mL, respectively. Perfluoropentanoic acid (PFPeA), perfluorohexanoic acid (PFHxA), and perfluoroheptanoic acid (PFHpA) were detected in higher frequencies, ranging between 67.4% and 81.8%. The concentrations of short carbon-chain PFCAs in breast milk such as PFPeA and PFHxA were the highest ever reported to date, and were comparable to that of PFOS. Concentrations of shorter chain PFCA in breast milk tended to be higher among the women with longer lactation period, while those of PFOA showed the opposite trend, suggesting a possibility that breastfeeding might be an important route of excretion for PFOA among lactating women. Fish consumption and the use of consumer products, e.g., skin care products, cosmetics and non-stick coated cooking utensils, were identified as significant predictors of PFAS concentrations in breast milk. Health risks associated with PFOA and PFOS exposure through breastfeeding were estimated negligible, however, risks of the short carbon-chain PFCAs could not be assessed because of lack of relevant toxicological information. Further efforts for source identification and exposure management measures for shorter chain PFCAs are necessary.

Cumulative Chemical Exposures During Pregnancy and Early Development

Industrial and consumer product chemicals are widely used, leading to ubiquitous human exposure to the most common classes. Because these chemicals may affect developmental milestones, exposures in pregnant women and developing fetuses are of particular interest. In this review, we discuss the prevalence of chemical exposures in pregnant women, the chemical class-specific relationships between maternal and fetal exposures, and the major sources of exposures for six chemical classes of concern: phthalates, phenols, perfluorinated compounds (PFCs), flame retardants, polychlorinated biphenyls (PCBs), and organochlorine pesticides (OCs). Additionally, we describe the current efforts to characterize cumulative exposures to synthetic chemicals during pregnancy. We conclude by highlighting gaps in the literature and discussing possible applications of the findings to reduce the prevalence of cumulative exposures during pregnancy.

A Simple Pharmacokinetic Model of Prenatal and Postnatal Exposure to Perfluoroalkyl Substances (PFASs)

Most children are exposed to perfluoroalkyl substances (PFASs) through placental transfer, breastfeeding, and other environmental sources. To date, there are no validated tools to estimate exposure and body burden during infancy and childhood. In this study, we aimed to (i) develop a two-generation pharmacokinetic model of prenatal and postnatal exposure to perfluorooctanoic acid (PFOA), perfluorooctanesulfonate (PFOS), and perfluorohexanesulfonate (PFHxS); and to (ii) evaluate it against measured children's levels in two studies. We developed a pharmacokinetic model consisting of a maternal and a child compartment to simulate lifetime exposure in women and transfer to the child across the placenta and through breastfeeding. To evaluate the model, we performed simulations for each mother-child dyad from two studies in which maternal PFAS levels at delivery and children's PFAS levels were available. Model predictions based on maternal PFAS levels, sex of child, body weight, and duration of breastfeeding explained between 52% and 60% of the variability in measured children's levels at 6 months of age and between 52% and 62% at 36 months. Monte Carlo simulations showed that the daily intake through breastfeeding and resulting internal PFAS levels can be much higher in nursing infants than in mothers. This pharmacokinetic model shows potential for postnatal exposure assessment in the context of epidemiological studies and risk assessment.

Occurrence of biomarkers of pesticide exposure in non-invasive human specimens

Biomonitoring has been used in many types of investigations, including national programmes and epidemiological studies, to explore the occurrence of biomarkers of pesticide exposure in the general population or relevant groups. This review discusses recent studies that measure levels of biomarkers of pesticide exposure in non-invasive human specimens such as urine, breast milk, meconium and hair. Specific and non-specific metabolites of organophosphate and pyrethroid insecticides have been widely investigated in urine, where some of the suitable biomarkers present rates of detection higher than 80%, which stand for an ongoing chronic exposure to traces of these chemicals. Hair is a promising emerging matrix, but some issues on its suitability and the biological relevance needs further research. Breast milk was used in research investigations focused mainly on legacy pesticides, which provide useful information about time trends.

Recent applications of CE- and HPLC-MS in the analysis of human fluids

The present review intends to cover the literature on the use of CE-/LC-MS for the analysis of human fluids, from 2010 until present. It has been planned to provide an overview of the most recent practical applications of these techniques to less extensively used human body fluids, including, bronchoalveolar lavage fluid, synovial fluid, nipple aspirate, tear fluid, breast fluid, amniotic fluid, and cerumen. Potential pitfalls related to fluid collection and sample preparation, with particular attention to sample clean-up procedures, and methods of analysis, from the research laboratory to a clinical setting will also be addressed. While being apparent that proteomics/metabolomics represent the most prominent approaches for global identification/quantification of putative biomarkers for a variety of human diseases, evidence is also provided of the suitability of these sophisticated techniques for the detection of heterogeneous components carried by these fluids.

Biological monitoring of Persistent Organic Pollutants in human milk in Israel

BACKGROUND

The Stockholm Convention on Persistent Organic Pollutants (POPs) aims to eliminate or restrict the production and use of POPs around the globe. The Ministry of Health, collaborating with the Ministry of Environmental Protection, measured the exposure of the population to POPs as part of the WHO-coordinated exposure study. Human milk, with a relatively high fat content is a preferred matrix for the monitoring of exposure.

METHODS

Donors of breast milk were recruited from three hospitals after signing informed consent forms. Breast milk was collected from 52 primipara women, aged 23-35, living in Israel for the last 10 years who gave birth to singleton full term healthy infants. Samples, collected at 3-17 weeks postpartum, were stored at -20 °C until sent to the WHO Reference Laboratory, State Laboratory for Chemical and Veterinary Analysis of Food (CVUA), in Frieburg, Germany for a single pooled analysis. Mothers were provided with the pooled analysis results.

RESULTS

Out of over 50 Persistent Organic Pollutants listed in the analysis, 16, including aldrin, endrin, parlar and mirex were not found at detectable levels in the Israeli pooled sample. For the indicator compounds found at detectable levels, most were lower than those reported in European countries.

DISCUSSION

Since 1982, levels of POPs contamination as measured in breast milk have declined significantly. This is likely due to restrictions on agricultural, industrial, and other uses of many POPs in Israel. Ongoing biomonitoring in Israel and inter-ministerial collaboration supports the elimination of POPs in the environment and human milk.

Breastfeeding as an Exposure Pathway for Perfluorinated Alkylates

Perfluorinated alkylate substances (PFASs) are widely used and have resulted in human exposures worldwide. PFASs occur in breast milk, and the duration of breastfeeding is associated with serum-PFAS concentrations in children. To determine the time-dependent impact of this exposure pathway, we examined the serum concentrations of five major PFASs in a Faroese birth cohort at birth, and at ages 11, 18, and 60 months. Information about the children's breastfeeding history was obtained from the mothers. The trajectory of serum-PFAS concentrations during months with and without breastfeeding was examined by linear mixed models that accounted for the correlations of the PFAS measurements for each child. The models were adjusted for confounders such as body size. The duration of exclusive breastfeeding was associated with increases of most PFAS concentrations by up to 30% per month, with lower increases during partial breast-feeding. In contrast to this main pattern, perfluorohexanesulfonate was not affected by breast-feeding. After cessation of breastfeeding, all serum concentrations decreased. This finding supports the evidence of breastfeeding being an important exposure pathway to some PFASs in infants.