Persistent organochlorine and organobromine compounds in mother's milk from Sweden 1996-2006: compound-specific temporal trends

Do dietary exposures to multi-class endocrine disrupting chemicals translate into health risks for Gangetic dolphins? An assessment and way forward

Dietary exposure risks of 39 multi-class Endocrine Disrupting Chemicals (EDCs) to the threatened Gangetic dolphins (Platanista gangetica) were investigated in a conservation-priority segment of the Ganga River. Elevated EDCs bioaccumulation was observed across prey fish species, with di(2-ethylhexyl) phthalate (DEHP) and di-n-butyl phthalate (DnBP) significantly contributing to the EDC burden. The concentrations of persistent organochlorines in prey revealed a shift from dioxin-like polychlorinated biphenyls (PCBs) to non-dioxin-like PCBs. The prevalence of regulated p,p' DDT (Dichlorodiphenyltrichloroethane) and γ-HCH (Lindane) residues suggests regional non-compliance with regulatory standards. The concentration of some EDCs is dependent on the habitat, foraging behavior, trophic level and fish growth. The potential drivers of EDCs contamination in catchment includes agriculture, vehicular emissions, poor solid waste management, textile industry, and high tourist influx. Risk quotients (RQs) based on toxicity reference value were generally below 1, while the RQ derived from the reference dose highlighted a high risk to Gangetic dolphins from DEHP, DDT, DnBP, arsenic, PCBs, mercury, and cadmium, emphasizing the need for their prioritization within monitoring programs. The study also proposes a monitoring framework to provide guidance on monitoring and assessment of chemical contamination in Gangetic dolphin and habitats.

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.

Update of the risk assessment of polybrominated diphenyl ethers (PBDEs) in food

The European Commission asked EFSA to update its 2011 risk assessment on polybrominated diphenyl ethers (PBDEs) in food, focusing on 10 congeners: BDE-28, -47, -49, -99, -100, -138, -153, -154, -183 and ‑209. The CONTAM Panel concluded that the neurodevelopmental effects on behaviour and reproductive/developmental effects are the critical effects in rodent studies. For four congeners (BDE-47, -99, -153, -209) the Panel derived Reference Points, i.e. benchmark doses and corresponding lower 95% confidence limits (BMDLs), for endpoint-specific benchmark responses. Since repeated exposure to PBDEs results in accumulation of these chemicals in the body, the Panel estimated the body burden at the BMDL in rodents, and the chronic intake that would lead to the same body burden in humans. For the remaining six congeners no studies were available to identify Reference Points. The Panel concluded that there is scientific basis for inclusion of all 10 congeners in a common assessment group and performed a combined risk assessment. The Panel concluded that the combined margin of exposure (MOET) approach was the most appropriate risk metric and applied a tiered approach to the risk characterisation. Over 84,000 analytical results for the 10 congeners in food were used to estimate the exposure across dietary surveys and age groups of the European population. The most important contributors to the chronic dietary Lower Bound exposure to PBDEs were meat and meat products and fish and seafood. Taking into account the uncertainties affecting the assessment, the Panel concluded that it is likely that current dietary exposure to PBDEs in the European population raises a health concern.

Polychlorinated alkanes in paired blood serum and breast milk in a Swedish cohort study: Matrix dependent partitioning differences compared to legacy POPs

BACKGROUND

Polychlorinated alkanes (PCAs) constitute a large group of individual congeners originating from commercial chlorinated paraffin (CP) products with carbon chain lengths of PCAs-C10-13, PCAs-C14-17, and PCAs-C18-32, occasionally containing PCAs-C6-9 impurities. The extensive use of CPs has led to global environmental pollution of PCAs. This study aimed to quantify PCAs in paired serum and breast milk of lactating Swedish mothers, exploring their concentration relationship.

METHODS

Twenty-five paired samples of mothers' blood serum and breast milk were analysed and concentrations were determined for PCAs C6-32 and compared to 4,4'-DDE, the PCB congener 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153), and hexachlorobenzene (HCB).

RESULTS

The median concentrations of PCAs-C6-9, PCAs-C10-13, PCAs-C14-17, PCAs-C18-32 and ΣPCAs in serum were 14, 790, 520, 16 and 1350 ng/g lipid weight (lw), respectively, and in breast milk 0.84, 36, 63, 6.0 and 107 ng/g lw. Levels of 4,4'-DDE, CB-153 and HCB were comparable in the two matrices, serum and breast milk at 17, 12 and 4.9 ng/g lw. The results show significant differences of PCAs-C10-13 and PCAs-C14-17 in breast milk with 22- and 6.2-times lower lw-based concentrations than those measured in serum. On wet weight the differences serum/breast milk ratios of PCAs-C6-9, PCAs-C10-13, PCAs-C14-17, PCAs-C18-32 and ΣPCAs were 1.7, 3.2, 1.0, 0.4 and 1.6, respectively, while the ratio for 4,4'-DDE, CB-153 and HCB were each close to 0.1.

CONCLUSION

Swedish lactating mothers had high serum concentrations of PCAs-C10-13 and PCAs-C14-17, with the ΣPCAs median serum concentration of 1350 ng/g lw. The breast milk concentration, although considerably lower at 107 ng/g lw, still surpassed those of 4,4'-DDE, CB-153 and HCB, suggesting an exposure risk of infants to PCAs. The variation in blood and breast milk accumulation between PCAs and studied legacy POPs, is rarely discussed but warrants further studies on partitioning properties as well as associated toxicological implications.

Has Regulatory Action Reduced Human Exposure to Flame Retardants?

Flame retardant (FR) exposure has been linked to several environmental and human health effects. Because of this, the production and use of several FRs are regulated globally. We reviewed the available records of polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDDs) in human breast milk from literature to evaluate the efficacy of regulation to reduce the exposure of FRs to humans. Two-hundred and seven studies were used for analyses to determine the spatial and temporal trends of FR exposure. North America consistently had the highest concentrations of PBDEs, while Asia and Oceania dominated HBCDD exposure. BDE-49 and -99 indicated decreasing temporal trends in most regions. BDE-153, with a longer half-life than the aforementioned isomers, typically exhibited a plateau in breast milk levels. No conclusive trend could be established for HBCDD, and insufficient information was available to determine a temporal trend for BDE-209. Breakpoint analyses indicated a significant decrease in BDE-47 and -99 in Europe around the time that regulation has been implemented, suggesting a positive effect of regulation on FR exposure. However, very few studies have been conducted globally (specifically in North America) after 2013, during the time when the most recent regulations have been implemented. This meta-analysis provides insight into global trends in human exposure to PBDEs and HBCDD, but the remaining uncertainty highlights the need for ongoing evaluation and monitoring, even after a compound group is regulated.

Time trends of PCDDs, PCDFs, DL-PCBs, and NDL-PCBs in Italian women from biomonitoring studies

A number of biomonitoring investigations were carried out in Italy between 2000 and 2018 by the Unit of Human Exposure to Environmental Chemicals of the Italian National Institute of Health (Rome). The investigations were characterized by different features (case-control or cross-sectional studies, participants from impacted or no impacted areas, etc), but despite the differences, it was possible to study the time trends of Σ₇(PCDDs), Σ₁₀(PCDFs), Σ₁₂(DL-PCBs), and Σ₆(NDL-PCBs) (analytical and TEQ cumulative concentrations, as appropriate). All the chemicals considered showed clear rates of a time-dependent concentration decrease, data having previously been adjusted for the sampled Region and subject age. Σ₇(PCDDs) exhibited the fastest decrease with an average rate of -4.44 pg/g-fat year^-1 (2009-2018), whereas Σ₆(NDL-PCBs) was characterized by the slowest decrease with a rate of -0.771 ng/g-fat year^-1 (2000-2018). A clear distinction between the decreasing rates of Σ₇(PCDDs) and Σ₁₀(PCDFs) was observed, as the latter decreased at half the rate of the Σ7(PCDDs). The slower rate of the Σ₁₀(PCDFs) decline may be due to an ongoing source of PCDFs in the environment beyond those traditionally considered for this group of contaminants such as the production of PCDFs due to PCBs thermal conversion from matrices contaminated with PCBs. Production of PCDFs due to thermal conversion of matrices contaminated with PCBs could be an ongoing source which may be of concern because recent data have highlighted the diffusion of PCBs in the European environment. The decreasing rates of PCDDs + PCDFs, DL-PCBs, and PCDDs + PCDFs + DL-PCBs - original analytical data converted to "dioxin equivalents" - were respectively estimated as (pgTEQ/g-fat year^-1) -2.08, -2.06, and -2.10, values exhibiting good compatibility between one another.

Changes in Polychlorinated Biphenyl Residues in Milk during Lactation: Levels of Contamination, Influencing Factors, and Infant Risk Assessment

Given the importance of breastfeeding infants, the contamination of human milk is a significant public concern. The aim of this study was to assess the contamination of human milk with dioxin-like PCBs (dl-PCBs) and non-dioxin-like PCBs (ndl-PCBs) in relation to the duration of lactation and other influencing factors, especially the frequency of the consumption of selected foods during pregnancy. Based on this, the health risk to infants was assessed and compared to the tolerable daily intake (TDI). PCB determinations were performed using gas chromatography/mass spectrometry. The ∑ndl-PCB content ranged from 0.008 to 0.897 ng/g w.w., at an average of 0.552 ng/g wet weight, which was 55% of the maximum level according to the EU guidelines for foods for infants and young children. The toxic equivalent (TEQ) was in the range of 0.033-5.67 pg-TEQ/g w.w. The content of non-ortho, mono-ortho, and ndl-PCBs in human milk decreased the longer lactation continued. Moreover, when pregnant women smoked tobacco, this correlated significantly with increases in the concentrations of PCB congeners 156, 118, and 189 in human milk. The human milk contents of PCB congeners 77, 81, 186, 118, and 189 were strongly positively correlated with the amount of fish consumed. The content of stable congeners PCB 135 and PCB 153 increased with age.

Human Biomonitoring of Polychlorinated Biphenyls (PCBs) in the Breast Milk of Colombian Mothers

Polychlorinated biphenyls (PCBs) are persistent in the environment, bioaccumulate and biomagnify throughout the food chain, and may have adverse effects on human health and wildlife. PCB indicator (PCB 28, PCB 52, PCB 101, PCB 118, PCB 138, PCB 153, and PCB 180) were monitored in human milk using 68 samples from healthy and primiparous mothers from seven cities in Colombia, and the estimated daily intake (EDI) of infants was calculated. The PCB indicator with the highest concentration was PCB 153 with a value of 7.30 ng g^-1 lipids. The maximum EDI was calculated as 0.257 μg kg^-1 bw^-1 day^-1. In general, the PCB levels found in the 68 samples were low and did not represent a risk to breastfed infants. Additionally, these results could strengthen Colombia's efforts to increase the practice of breastfeeding. Finally, the results establish a general overview of population exposure and can be a scientific tool to improve environmental health policies in the country.

Organohalogens: A persisting burden in Slovenia?

Persistent organic pollutants (POPs) represent a concern for the environment and human health due to their persistence and toxicity. Exposure in Slovenia is geographically differentiated because the country, as part of former Yugoslavia, has a history of industry and regional contamination and is - at the same time - known for its clean nature. The PCB pollution of the Krupa River drew the public's attention to the chemical burden of Slovenians, and the demand for studies has been rising since. We assessed the exposure of men (n = 548) and primiparous women (n = 536) to POPs in 12 regions of Slovenia as well as exposure pathways via questionnaires. Most PCDD/Fs, PCBs, and PBDEs could be determined in pooled samples of maternal milk at low concentrations (1.57 pg/gTEQ, 1.47 pg/gTEQ, and 1076 pg/g fat, respectively), but a much lower number of compounds could be measured above the LOQ in pooled men's plasma samples (PCDD/Fs 0.08 pg/gTEQ, PCBs 0.007 pg/gTEQ, ΣPBDE 920 pg/g), and only HCB, p,p'-DDE, ΣDDT, and the non-dioxin-like PCB congeners 138, 153, and 180 could be determined in individual samples of milk (concentration range 5-60 ng/g fat). In individual samples of men's serum, only p,p'-DDE and ΣPCB were detected at concentrations of 0.25 ng/g and 0.3 ng/g, respectively. Nonetheless, we were able to differentiate between polluted and unpolluted areas on a national level, with higher exposure levels in the PCB polluted region of Bela Krajina, the industrial region Zasavje, and the capital, Ljubljana. Despite low concentrations, determinants of exposure, such as age, proximity to roads, old building materials, private water supplies, and consumption of alcohol, fish, meat, and eggs that have previously been observed only at higher levels could still be identified. Furthermore, levels of PCBs and PBDEs were highly correlated suggesting common exposure sources and pathways, whereas PCDD/Fs were correlated to a lesser extent. The calculated ratio between DDT and DDE in maternal milk samples was decreasing with the year of sampling, suggesting no ongoing exposure to DDT. The study findings suggest low exposure of men and lactating women to legacy pollutants in Slovenia, which gave rise to the hypothesis that Slovenia's geographical location might provide shelter from the long-range transport of POPs via Westerly winds. This hypothesis remains to be confirmed within future studies.

Are temporal trends of some persistent organochlorine and organobromine compounds in Swedish breast milk slowing down?

We investigated body burdens of persistent organic pollutants (POPs) in Swedish first-time mothers by measurements in breast milk, and followed up the temporal trends between 1996 and 2017. POPs were analysed in individual samples (n = 539) from participants from Uppsala county, Sweden. This made it possible to adjust temporal trends for age of the mother, pre-pregnancy BMI, weight gain during pregnancy, weight loss after delivery, and education, the main determinants for POP body burdens, apart from sampling year. We also compared observed body burdens with the body burdens determined to be safe from a health perspective in the risk assessment of dioxin-like polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs), published by the European Food Safety Authority (EFSA). Declining temporal trends in breast milk of on average -4 to 14% per year were observed 1996-2017 for PCBs, PCDD/Fs, chlorinated pesticides, and brominated flame retardants, except for the polybrominated diphenyl ethers (PBDEs) BDE-153 and BDE-209. The toxic equivalents (TEQs) for PCDD declined faster than PCDF TEQs, -6.6% compared to -3.5% per year. For CB-169, CB-180, PCDDs, PCDFs, Total TEQ, and hexachlorobenzene (HCB), a change point year (CP) was observed around 2008-2009 and after that, the decline in levels has slowed down. If breast milk levels follows the exponential declining trend of total TEQ estimated for the entire period (-5.7% per year), 97.5% of first time mothers from the Uppsala area will have body burdens below the estimated safe level in year 2022. If instead it follows the estimated % decline after the CP in 2008 (-1.6% per year), it will take until 2045 before 97.5% is below the estimated safe level. It is important to proceed with the monitoring of POPs in breast milk from Swedish mothers in order to further observe if the levels are stabilizing or continue to decline.

Total mercury in hair as biomarker for methylmercury exposure among women in central Sweden- a 23 year long temporal trend study

Exposure to methylmercury (MeHg) through fish is a global public health problem. Exposure monitoring is essential for health risk assessment, especially in pregnant women and children due to the documented neurotoxicity. Herein, we evaluate a time series of MeHg exposure via fish in primiparous Swedish women, covering a time period of 23 years (1996-2019). The 655 included mothers were part of the POPUP study (Persistent Organic Pollutants in Uppsala Primiparas) conducted by the Swedish Food Agency (SFA). MeHg exposure was assessed via measurements of total mercury (Hg) in hair using either cold vapor atomic fluorescence spectrophotometry or inductively coupled plasma mass spectrometry, showing very good linear agreement (R² = 0.97). Maternal characteristics and fish consumption were obtained via questionnaires. The median concentration of total Hg in hair was 0.38 mg/kg (range 0.17-1.5) in 1996 and 0.25 mg/kg (range 0.03-1.1) in 2019. On average the women consumed 11 ± 8.2 meals of fish per month, and fish consumption was positively correlated with total Hg in hair (Spearman correlation: 0.39; p < 0.001). In multiple regression analyses, the geometric mean annual decrease of total Hg in hair was -2.5% (95% CI: -3.2, -1.8%). Total fish consumption increased up to 2011 (B: 0.32 times/month per year; 95% CI 0.17, 0.46) after which it started to decline (B: -0.66 times/month per year; 95% CI -0.92, -0.40). Moreover, both total Hg in hair and fish consumption was positively associated with maternal age and education, and inversely associated with pre-pregnancy BMI. In conclusion, the exposure to MeHg via fish appears to be slowly declining among Swedish pregnant women.

Biomonitoring of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and dioxin-like polychlorinated biphenyls (dl-PCBs) in human milk: Exposure and risk assessment for lactating mothers and breastfed children from Spain

The main objective of the present research was to evaluate the levels of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and dioxin-like polychlorinated biphenyls (dl-PCBs) in the human milk of Spanish lactating women who participated in the BETTERMILK project so that exposure and risk could be assessed for these mothers and their breastfed children. The total ∑PCDD/Fs + dl-PCBs TEQ₂₀₀₅ concentrations in the upper-bound (UB) ranged from 1.29 to 13.48 pgTEQ₂₀₀₅ g^-1 lipid. The estimated geometric mean level for the sum of PCDD/F and dl-PCBs was 4.10 and 4.42 pgTEQ₂₀₀₅ g^-1 lipid, lower-bound (LB) and UB respectively and were below the reference level reported by EFSA, which is associated with adverse effects in boys of 9 years and related to lactating mothers' exposure values of the tolerable weekly intake (TWI) of around 2 pgTEQ₂₀₀₅ kg^-1 bw per week. Nevertheless, it was exceeded when the 95th percentile (8.31 pgTEQ₂₀₀₅ g^-1 lipid, as UB) was considered. Results from a multiple regression analysis showed that age has a significant impact on milk ∑PCDD/Fs + dl-PCBs levels, with higher concentrations observed in the milk from older mothers.

Temporal trends of suspect- and target-per/polyfluoroalkyl substances (PFAS), extractable organic fluorine (EOF) and total fluorine (TF) in pooled serum from first-time mothers in Uppsala, Sweden, 1996-2017

A combined method for quantitative analysis, along with suspect and non-target screening of per- and polyfluoroalkyl substances (PFAS) was developed using ultra-high pressure liquid chromatography-ultra-high resolution (Orbitrap) mass spectrometry. The method was applied together with measurements of total- and extractable organofluorine (TF and EOF, respectively), to pooled serum samples from 1996-2017 from first-time mothers living in the county of Uppsala, Sweden, some of which (i.e. 148 of 472 women sampled 1996-2012) were exposed to drinking water contaminated with perfluorohexane sulfonate (PFHxS) and other PFAS until mid-2012. Declining trends were observed for all target PFAS as well as TF, with homologue-dependent differences in year of onset of decline. Only 33% of samples displayed detectable EOF, and amongst these samples the percentage of EOF explained by target PFAS declined significantly (-3.5% per year) over the entire study period. This finding corroborates prior observations in Germany after the year 2000, and may reflect increasing exposure to novel PFAS which have not yet been identified. Suspect screening revealed the presence of perfluoro-4-ethylcyclohexanesulfonate (PFECHS), which displayed declining trends since the year 2000. Non-target time trend screening revealed 3 unidentified features with time trends matching PFHxS. These features require further investigation, but may represent contaminants which co-occurred with PFHxS in the contaminated drinking water.

Dynamics of PCB exposure in the past 50 years and recent high concentrations in human breast milk: Analysis of influencing factors using a physiologically based pharmacokinetic model

In this study we reconstruct the long-term exposure of Czech mothers to polychlorinated biphenyls (PCBs) and determine the causes of high contamination of breast milk by indicator PCBs (iPCBs). A data set containing information from more than 1000 primiparous women from the Czech Republic was used, including iPCB concentrations in breast milk, individual physiology and living characteristics. The time series of PCB intakes for the whole period from the beginning of PCB production in 1958 until 2011 were reconstructed. We estimated the individual lifetime exposure of mothers for all iPCBs, i.e. congeners 28, 52, 101, 118, 138, 153 and 180, using a physiologically based pharmacokinetic (PBPK) model. Various model scenarios were investigated to determine the influence of physiology, age at delivery, past dietary exposure, and food composition on concentrations in breast milk for all iPCBs. The highest contributions to the presence of iPCBs in breast milk were observed for food composition. The main factor determining the concentration of higher-chlorinated PCBs (138, 153 and 180) was past exposure. The most important parameter for identification of children's postnatal exposure through breast milk was the time-span from the maximum of the exposure peak to the birth of the child. The current concentrations of iPCBs in breast milk in the Czech population are still high because the maximum of the exposure peak occurred more than 10 years later than in other European countries and was very broad, e.g. covered more than 10 years.

Perfluoroalkyl Acids (PFAAs) in Children's Serum and Contribution from PFAA-Contaminated Drinking Water

We investigated associations between serum perfluoroalkyl acid (PFAA) concentrations in children aged 4, 8, and 12 years (sampled in 2008-2015; n = 57, 55, and 119, respectively) and exposure via placental transfer, breastfeeding, and ingestion of PFAA-contaminated drinking water. Sampling took place in Uppsala County, Sweden, where the drinking water has been historically contaminated with perfluorobutanesulfonate (PFBS), perfluorohexanesulfonate (PFHxS), perfluorooctanesulfonate (PFOS), perfluoroheptanoate (PFHpA), and perfluorooctanoate (PFOA). PFOS showed the highest median concentrations in serum (3.8-5.3 ng g^-1 serum), followed by PFHxS (1.6-5.0 ng g^-1 serum), PFOA (2.0-2.5 ng g^-1 serum), and perfluorononanoate (PFNA) (0.59-0.69 ng g^-1 serum) in children. Including all children, serum PFOA, PFHxS, and PFOS concentrations in children increased 10, 10, and 1.3% (adjusted mean), respectively, per unit (ng g^-1 serum) of increase in the maternal serum level (at delivery), the associations being strongest for 4 year-old children. PFHxS and PFOS significantly increased 3.9 and 3.8%, respectively, per month of nursing, with the highest increase for 4 year-olds. PFOA, PFBS, PFHxS, and PFOS increased 1.2, 207, 7.4, and 0.93%, respectively, per month of cumulative drinking water exposure. Early life exposure to PFOA, PFHxS, and PFOS is an important determinant of serum concentrations in children, with the strongest influence on younger ages. Drinking water with low to moderate PFBS, PFHxS, PFOS, and PFOA contamination is an important source of exposure for children with background exposure from other sources.

Determinants of persistent organic pollutant (POP) concentrations in human breast milk of a cross-sectional sample of primiparous mothers in Belgium

BACKGROUND

Bio-accumulation of persistent organic pollutants (POPs) in the environment and in the food chain can lead to high pollutant concentrations in human fat-containing tissues and breast milk.

OBJECTIVES

We aimed to identify the maternal characteristics that determined POP concentrations in breast milk of primiparous mothers in Belgium.

METHODS

Breast milk samples were obtained from a cross-sectional sample of 206 primiparous mothers in 2014. POP concentrations in breast milk samples were determined by GC-ECNI-MS and GC-EI-MS/MS depending on the analytes' sensitivity. Associations between POP concentrations in breast milk and potential determinants were investigated using two-way contingency tables and multivariable generalized linear models.

RESULTS

Fifteen of the 23 screened POPs were detected in the breast milk samples. Four organochlorine compounds (p,p'-DDT, p,p'-DDE, HCB and β-HCH) and two brominated flame retardant congeners (BDE-47, BDE-153) were detected at concentrations above the limit of quantification in >50% of the breast milk samples. Maternal age and BMI were usually associated with higher POP concentrations. Rural residency and consumption of home-produced eggs, fatty fish and fish oil supplements were associated with higher concentrations of DDT and DDE. Consumption of fatty fish and being breastfed during childhood were associated with higher concentrations of HCB and β-HCH. Fish oil supplements and home-produced eggs were associated with higher concentrations of BDEs, but for BDE congeners exposure routes other than diet require further investigation.

CONCLUSIONS

Dietary and non-dietary determinants predict individual POP concentrations in breast milk.

The human body burden of polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs) in residents' human milk from Guangdong Province, China

Human milk samples were collected from 179 mothers in 2017 and 2018 in six counties of Guangdong province, China. Concentrations of polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs) were determined to evaluate the human body burden of dioxin-like compounds on the general population of South China. Samples were analyzed using high-resolution gas chromatography/high-resolution mass spectrometry in six pools, according to the subjects' resident county. The mean ∑PCDD/Fs and ∑DL-PCBs concentrations in human milk samples were 323.10 pg g-1 lipid and 2166.58 pg g-1 lipid, respectively, and the corresponding WHO toxicity equivalent (TEQ) values calculated with Toxic Equivalent Factors (TEFs) established by the WHO in 2005 (TEFWHO 2005) were 6.96 and 2.13 pg g-1 lipid. The concentrations of samples collected in Guangzhou, the capital city of Guangdong Province, were higher than those taken in the other five investigation regions. The levels of PCDD/Fs and DL-PCBs in human milk and the estimated daily intake doses of breast-fed infants were still high when compared with some non-exposure areas in mainland China. TEQ levels of PCDD/Fs and DL-PCBs in the present study have been compared to data obtained from a reported national study conducted in 2011. The mean TEQ (calculated with TEFWHO 2005) of ∑(DL-PCBs + PCDD/Fs) (8.4-9.0 pg g-1 lipid in 2011 vs. 9.09 pg g-1 lipid in 2018) seemed to be relatively stable during the period 2011-2018. These findings and continuing the surveillance of PCDD/Fs and DL-PCBs in human milk will be helpful in furthering our understanding of human exposure to dioxin-like compounds in the general population.

Linking organochlorine contaminants with demographic parameters in free-ranging common bottlenose dolphins from the northern Adriatic Sea

Marine top predators, including marine mammals, are known to bio-accumulate persistent pollutants such as polychlorinated biphenyls (PCBs), a serious conservation concern for these species. Although PCBs declined in European seas since the 1970s-1980s ban, considerable levels still persist in European and Mediterranean waters. In cetaceans, stranded animals are a valuable source of samples for pollutant studies, but may introduce both known and unknown biases. Biopsy samples from live, free-ranging cetaceans offer a better alternative for evaluating toxicological burdens of populations, especially when linked to known histories of identified individuals. We evaluated PCB and other organochlorine contaminants in free-ranging common bottlenose dolphins (Tursiops truncatus) from the Gulf of Trieste (northern Adriatic Sea), one of the most human-impacted areas in the Mediterranean Sea. Biopsies were collected from 32 male and female dolphins during 2011-2017. All animals were photo-identified and are part of a well-known population of about 150 individuals monitored since 2002. We tested for the effects of sex, parity and social group membership on contaminant concentrations. Males had significantly higher organochlorine concentrations than females, suggesting offloading from reproducing females to their offspring via gestation and/or lactation. Furthermore, nulliparous females had substantially higher concentrations than parous ones, providing further support for maternal offloading of contaminants. Overall, 87.5% of dolphins had PCB concentrations above the toxicity threshold for physiological effects in experimental marine mammal studies (9 mg/kg lw), while 65.6% had concentrations above the highest threshold published for marine mammals based on reproductive impairment in ringed seals (41 mg/kg lw). The potential population-level effects of such high contaminant levels are of concern particularly in combination with other known or suspected threats to this population. We demonstrate the utility of combining contaminant data with demographic parameters such as sex, reproductive output, etc., resulting from long-term studies.

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.

Site-specific bioaccumulation of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/PCDFs) in mothers and their infants living in vicinity of Bien Hoa airbase, Southern Vietnam

Bien Hoa airbase is located in Dong Nai Province (Southern Vietnam). Several sites within the airbase are highly contaminated by Agent Orange/Dioxin, and thus, they are also commonly named as an Agent Orange/Dioxin hotpot. In the present study, 36 maternal milk samples were collected from primiparas who have lived at least 5 years in four wards, Buu Long, Quang Vinh, Trung Dung and Tan Phong, which are closed to Bien Hoa airbase in order to investigate the level and distribution of Agent Orange/Dioxin exposure in different local communities. The mean concentrations of PCDD/PCDFs in four investigated wards range from 6.4 to 13.6 pgTEQ/g lipid. The highest mean TEQ of PCDD/PCDFs was observed in Buu Long ward (13.6 pgTEQ/g lipid), followed by Tan Phong ward (12.3 pgTEQ/g lipid), and the lowest value was observed in Trung Dung ward (6.4 pgTEQ/g lipid). The mean concentration of 2,3,7,8-TCDD in Buu Long (7.6 pg/g lipid) was approximately 2-6 times higher than those in Tan Phong (3.9 pg/g lipid), Quang Vinh (2.3 pg/g lipid), or Trung Dung (1.2 pg/g lipid). These results imply site-specific exposure to PCDD/PCDFs in different local communities living around Bien Hoa airbase. The mean values of daily intake of dioxin estimated for the breast fed infants living in Buu Long, Quang Vinh, Trung Dung and Tan Phong were about 80, 37.5, 31.7 and 58 pg TEQ/kg bw/day, respectively.

Risk for animal and human health related to the presence of dioxins and dioxin-like PCBs in feed and food

The European Commission asked EFSA for a scientific opinion on the risks for animal and human health related to the presence of dioxins (PCDD/Fs) and DL-PCBs in feed and food. The data from experimental animal and epidemiological studies were reviewed and it was decided to base the human risk assessment on effects observed in humans and to use animal data as supportive evidence. The critical effect was on semen quality, following pre- and postnatal exposure. The critical study showed a NOAEL of 7.0 pg WHO2005-TEQ/g fat in blood sampled at age 9 years based on PCDD/F-TEQs. No association was observed when including DL-PCB-TEQs. Using toxicokinetic modelling and taking into account the exposure from breastfeeding and a twofold higher intake during childhood, it was estimated that daily exposure in adolescents and adults should be below 0.25 pg TEQ/kg bw/day. The CONTAM Panel established a TWI of 2 pg TEQ/kg bw/week. With occurrence and consumption data from European countries, the mean and P95 intake of total TEQ by Adolescents, Adults, Elderly and Very Elderly varied between, respectively, 2.1 to 10.5, and 5.3 to 30.4 pg TEQ/kg bw/week, implying a considerable exceedance of the TWI. Toddlers and Other Children showed a higher exposure than older age groups, but this was accounted for when deriving the TWI. Exposure to PCDD/F-TEQ only was on average 2.4- and 2.7-fold lower for mean and P95 exposure than for total TEQ. PCDD/Fs and DL-PCBs are transferred to milk and eggs, and accumulate in fatty tissues and liver. Transfer rates and bioconcentration factors were identified for various species. The CONTAM Panel was not able to identify reference values in most farm and companion animals with the exception of NOAELs for mink, chicken and some fish species. The estimated exposure from feed for these species does not imply a risk.

Health-Relevant Phenotypes in the Offspring of Mice Given CAR Activators Prior to Pregnancy

Hepatic induction in response to drugs and environmental chemicals affects drug therapies and energy metabolism. We investigated whether the induction is transmitted to the offspring. We injected 3-day- and 6-week-old F0 female mice with TCPOBOP, an activator of the nuclear receptor constitutive androstane receptor (CAR, NR1I3), and mated them 1-6 weeks afterward. We detected in the offspring long-lasting alterations of CAR-mediated drug disposition, energy metabolism, and lipid profile. The transmission to the first filial generation (F1) was mediated by TCPOBOP transfer from the F0 adipose tissue via milk, as revealed by embryo transfer, crossfostering experiments, and liquid chromatography-mass spectrometry analyses. The important environmental pollutant PCB153 activated CAR in the F1 generation in a manner similar to TCPOBOP. Our findings indicate that chemicals accumulating and persisting in adipose tissue may exert liver-mediated, health-relevant effects on F1 offspring simply via physical transmission in milk. Such effects may occur even if treatment has been terminated far ahead of conception. This should be considered in assessing developmental toxicity and in the long-term follow-up of offspring of mothers exposed to both approved and investigational drugs, and to chemicals with known or suspected accumulation in adipose tissue.

Chemical indicators of exposure to polychlorodibenzo-p-dioxins, polychlorodibenzofurans and polychlorobiphenyls in breast milk samples from mothers residing in Trento, Italy, and neighboring country municipalities

A human biomonitoring study was carried out in the province of Trento, northern Italy, on two groups of women residing in areas with presumably different levels of exposure to polychlorodibenzo-p-dioxins (PCDDs), polychlorodibenzofurans (PCDFs) and polychlorobiphenyls (PCBs). The aim was characterization of the possible impact of a steel plant and an urban environment on the internal doses of these contaminants. The areas investigated were the following: (i) the municipality of Borgo Valsugana, where a steel plant has been operating for the last 30 years, and (ii) the city of Trento. Ten women were enrolled from each area, and breast milk samples were collected from each woman. The amounts of PCDDs, PCDFs and PCBs were analyzed in all samples, and the data obtained were evaluated by descriptive and multivariate statistical approaches. For all samples, the concentrations observed were in the current acceptable concentration range observed in Europe. The descriptive statistics, however, clearly showed that some differences existed between the two groups: the PCDD, PCDF and DL-PCB concentrations were consistently higher in the Trento group of women living in the area surrounding the steel plant. Congener-profile analysis was carried out on both groups, and an appropriate multivariate approach, such as classical factor analysis (CFA), was used to investigate possible differential exposure sources. The application of this approach made it possible to show the quantitative and qualitative differences that characterized the two areas.

Longitudinal changes in persistent organic pollutants (POPs) from 2001 to 2009 in a sample of elderly Swedish men and women

BACKGROUND

Prospective cohort studies evaluating the temporal trends of background-level persistent organic pollutants (POPs) and their potential negative health effects in humans are needed.

OBJECTIVE

The objectives of this study are to examine the five year longitudinal trend in chlorinated and brominated (Cl/Br) POP concentrations in a sample of elderly individuals and to investigate the relationship between gender, changes in body weight, plasma lipid levels and POP concentrations.

METHODS

In the population-based Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study, plasma samples were collected from the same individuals over a 5 year period. Originally 992 subjects (all aged 70) were sampled between 2001 and 2004 and 814 returning subjects (all aged 75) were sampled again from 2006 to 2009. Plasma concentrations of 16 polychlorinated biphenyls (PCBs), 5 organochlorine pesticides (OCPs), octachlorinated dibenzo-p-dioxin (OCDD), and one polybrominated diphenylether (BDE 47) were determined using high-throughput 96-well plate solid phase extraction and gas chromatography-high resolution mass spectrometry (GC-HRMS).

RESULTS

During the 5-year follow-up, plasma concentrations of all POPs significantly decreased (p < 0.00001). Median reductions ranged from 4% (PCB105) to 45% (PCB 99), with most reductions being in the 30-40% range. For most POPs, a larger decline was seen in men than in women. The relationship between the weight change and change in POP concentrations was generally negative, but a positive relationship between lipid levels and POP concentrations when expressed as wet-weight was observed. In general, similar changes in POP concentrations and their relationships to body weight were observed regardless of using either wet-weight (pg/mL) or lipid-normalized (ng/g lipid) concentrations.

CONCLUSION

In this longitudinal cohort study, gender and minor, but varying changes in body weight and lipid levels greatly influenced the individual-based changes in POP concentrations. In general, our findings suggest that men and women with larger decreases in body weight and greater increases in lipid levels have the slowest decline in body burden of POPs. Based on the results from this study, either wet-weight or lipid normalized concentrations can be used to determine the percent change in POP concentrations and their relationships to physiological changes and differences.

Chlorinated persistent organic pollutants in serum of New Zealand adults, 2011-2013

A national survey was conducted in 2011-2013 to assess serum concentrations of persistent organic pollutants (POPs) in adult New Zealanders. Participants were randomly selected from the 2010 Electoral Roll within 64 demographic strata according to 4 age groups, 4 regions, 2 ethnic groups (Māori/non-Māori) and gender. Eligible subjects (n=734) donated up to 30ml of blood, after which serum was pooled (n=49) according to demographic strata prior to analysis by GC-HRMS. Associations between demographic variables (age, region, ethnicity, gender) and serum POPs were assessed using linear regression. The weighted geometric mean (GM) of PCDD/Fs was 5.3pg/g lipid toxic equivalents using the WHO 2005 toxic equivalence factors (TEQ₀₅), which increased by age (3.2, 4.4, 4.8, and 8.1pg/g lipid for the 19-24, 25-34, 35-49, and 50-64year age groups, respectively). The weighted GM of dioxin-like PCBs was 1.4pg TEQ₀₅/g lipid which also increased by age (0.82, 0.86, 1.4, and 2.3pg/g lipid for the same age groups, respectively). Of the detected OCPs, the highest concentration was observed for p,p'-DDE (weighted GM, 220ng/g lipid) followed by hexachlorobenzene (HCB; 7.3ng/g lipid), beta-HCH (7.0ng/g lipid), and dieldrin (4.7ng/g lipid). For most Cl-POPs, concentrations were lowest in the youngest age group, and were similar for men and women and Māori and non-Māori. Serum Cl-POPs were, on average, 50% lower than those measured 15years earlier in 1997. This survey provides evidence of declining serum concentrations of chlorinated POPs in the New Zealand adult population. Age was the most important determinant of POPs concentrations. Body burdens of PCDD/Fs and PCBs in New Zealand are relatively low by international comparison, while for OCPs they are similar or lower compared to those reported for other developed countries.

Perfluoroalkyl acid levels in first-time mothers in relation to offspring weight gain and growth

We investigated if maternal body burdens of perfluoroalkyl acids (PFAAs) at the time of delivery are associated with birth outcome and if early life exposure (in utero/nursing) is associated with early childhood growth and weight gain. Maternal PFAA body burdens were estimated by analysis of serum samples from mothers living in Uppsala County, Sweden (POPUP), sampled three weeks after delivery between 1996 and 2011. Data on child length and weight were collected from medical records and converted into standard deviation scores (SDS). Multiple linear regression models with appropriate covariates were used to analyze associations between maternal PFAA levels and birth outcomes (n=381). After birth Generalized Least Squares models were used to analyze associations between maternal PFAA and child growth (n=200). Inverse associations were found between maternal levels of perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluoroundecanoic acid (PFUnDA), and birth weight SDS with a change of -0.10 to -0.18 weight SDS for an inter-quartile range (IQR) increase in ng/g PFAA. After birth, weight and length SDS were not significantly associated with maternal PFAA. However, BMI SDS was significantly associated with PFOA, PFNA, and PFHxS at 3 and 4years of age, and with PFOS at 4 and 5years of age. If causal, these associations suggest that PFAA affects fetal and childhood body development in different directions.

An 18-Year Follow-up Survey of Dioxin Levels in Human Milk in Japan

Background

Globally, few published studies have tracked the temporal trend of dioxin levels in the human body since 2000. This study describes the annual trend of dioxin levels in human breast milk in Japanese mothers from 1998 through 2015.

Methods

An observational study was conducted from 1998 through 2015. Participants were 1,194 healthy mothers following their first delivery who were recruited annually in Japan. Breast milk samples obtained from participants were analyzed using gas chromatography and mass spectrometry for dioxins, including polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and coplanar polychlorinated biphenyls (PCBs).

Results

Mean age was 29.5 years, and 53% of participants were 20–25 years old. A declining trend in total dioxin levels was found, from a peak of 20.8 pg toxic equivalence (TEQ)/g fat in 1998 to 7.2 pg TEQ/g fat in 2014. Data from the last 5 years of the study indicated a plateau at minimal levels. In contrast, an increasing trend was found in the mean age of participants during the last 5 years. Although significantly higher dioxin levels were observed in samples from older participants, an upward trend in dioxin levels was not observed, indicating that dietary and environmental exposure to dioxins had greatly diminished in recent years.

Conclusions

Dioxin levels in human breast milk may be approaching a minimum in recent years in Japan. The findings may contribute to global reference levels for environmental pollution of dioxins, which remains a problem for many developing countries.

Polybrominated diphenyl ethers and indicator polychlorinated biphenyls in human milk from China under the Stockholm Convention

Seven congeners of polybrominated diphenyl ethers (PBDEs) (BDE-28, BDE-47, BDE-99, BDE-100, BDE-153,BDE-154 and BDE-183) and six indicator polychlorinated biphenyls (PCBs) (PCB-28, PCB-52, PCB-101, PCB-138, PCB-153 and PCB-180) were measured in 32 regional pooled human milk samples originating from 1760 volunteering primiparous mothers to evaluate the current human body burden of general population and the temporal trend in China. Individual human milk samples were collected following a WHO-designed procedure. This work is one of parts of the evaluation of effectiveness of Stockholm Convention performance. The concentration of ∑₇PBDEs ranged from 0.3 ng g^-1 lipid to 4.0 ng g^-1 lipid with a mean of 1.5 ng g^-1 lipid. The concentration of ∑₆PCBs ranged from 2.3 ng g^-1 lipid to 19.0 ng g^-1 lipid with a mean of 6.6 ng g^-1 lipid. By comparing with background determination in 2007, there was no significance for ∑₇PBDEs. However, BDE-47, BDE-99, and BDE-100 significantly decreased with an average of 45%, 48%, and 46%, respectively, from 2007 to 2011, and an increase of BDE-183 was founded in most regions. For ∑₆PCBs, there was a significant decline with an average reduction of 41% from 2007 to 2011. These results indicate the effectiveness of reduction and elimination of POPs in China. Future national human milk biomonitoring is worthy to be done to further evaluate the time trend and effectiveness of the Convention performance.

Long-term time trends in human intake of POPs in the Czech Republic indicate a need for continuous monitoring

Polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) from the group of persistent organic pollutants are detected in human tissues years or even decades after their ban. Exposure to PCBs and OCPs can pose risks to human health. In the present study, we calculated the daily intakes of PCBs and OCPs in the Czech population and investigated the long-term trends of human exposure to POPs. Data on POP concentrations from a 16-year period of breast-milk monitoring were used. A toxicokinetic model with consideration of compound-specific elimination half-lives was used to calculate the mothers' daily intake of PCBs and OCPs representing the intake of POPs by all exposure routes. The calculated intakes were compared with dietary intakes calculated by the Czech National Institute of Public Health. The comparison shows good agreement of both intake estimates with decreasing intake trends of POPs in the Czech population in the time period studied. However, several fluctuations with peaks of higher levels were observed in both datasets which are not typical for the period after the ban of use and production of POPs. The available evidence suggests that the increases in chemical concentrations might be caused by food contamination. The calculated intakes of compounds with longer elimination half-lives, such as higher-chlorinated PCBs, were higher in older mothers. This "memory effect" was already observed in other studies and indicates higher exposure in earlier life periods of the mother. Our results suggest that exposure to POPs is still relevant for the Czech population in the period after the ban of the use and production of POPs (post-ban period), especially via food ingestion, though the intake trends are decreasing. Possible food contamination by POPs in the post-ban period requires further assessment.

Distribution of polybrominated diphenyl ethers in breast milk, cord blood and placentas: a systematic review

Polybrominated diphenyl ethers (PBDEs) have been extensively used as flame retardants in consumer products. PBDEs rapidly bioaccumulate in the environment, food, wild animals and humans. In this review, we investigated the harmful effects of PBDEs on humans, especially in early life, and summarised the levels of PBDEs in human biological samples (breast milk, cord blood and placentas). In addition, we described the spatiotemporal distribution of PBDEs in this review. PBDE levels in breast milk, cord blood and placentas were generally higher in North America than in other regions, such as Asia, Europe, Oceania and Africa. However, high levels of PBDEs in human biological samples were detected at e-waste recycling sites in South China, East China and South Korea. This finding suggests that newborns living in e-waste regions are exposed to high levels of PBDEs during prenatal and postnatal periods. The time trends of PBDE concentration differed according to the region. Few studies have investigated PBDE levels in humans from 1967 to 2000, but they increased rapidly after 2000. PBDE concentration peaked at approximately 2006 globally. Compared with other PBDE congeners, BDE-47, BDE-153 and BDE-209 were the major components, but the detection rate of BDE-209 was lower than those of others. Future studies should focus on determining the BDE-209 concentration, which requires the implementation of different analytical approaches. Additionally, the levels of PBDEs in human samples and the environment should be monitored, especially in e-waste recycling regions. Graphical abstract The figures described the spatial distribution of the lowest (Fig. a1) and highest concentration of ∑PBDE (Fig. a2) in different countries by 2006 and described the spatial distribution of the lowest (Fig. b1) and highest concentration of ∑PBDE (Fig. b2) in different countries from 2007 to 2015. All the figures indicated that the levels of PBDEs in North America were substantially higher than those in many regions of Europe, Asia, Oceania, or Africa. Comparing Fig. a1-b1 or Fig. a2-b2, increasing trends were observed in some countries, especially in some regions in China, Korea and Canada.

Organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) in human breast milk and associated health risks to nursing infants in Northern Tanzania

This is the first study to report organochlorines (OCs), including chlorinated pesticides (OCPs) and polychlorinated biphenyls (PCBs) in human milk from Tanzania. The main aims of this study were to assess the level of contamination and the possible health risks related to OC exposure in nursing infants from the Northern parts of Tanzania. Ninety-five healthy mother-infant couples attending Mount Meru Regional Referral Hospital (MMRRH), Arusha, Tanzania, were assessed for associations between maternal/infant characteristics, i.e. mother's age, BMI, gestational weight gain, occupation, residence and fetal growth parameters and breast milk levels of OCPs, such as dichlorodiphenyltrichloroethane (DDT) and its metabolites, dieldrin and PCBs. p,p'-DDE and p,p'-DDT were detected in 100% and 75% of the breast milk samples, respectively, and ranged between 24 and 2400ng/g lipid weight (lw) and <LOD and 133ng/g lw, respectively. Dieldrin was detected in 66% of the samples in levels up to 937ng/g lw. ∑7PCBs ranged between <LOD and 157ng/g lw. Other OCPs were detected in low levels. For assessment of health risks, the Hazard Quotient (HQ) was calculated by comparing estimated daily intakes of OCPs and PCBs with health based guidance values. The estimated daily intake (ng/kg body weight/day) of ∑DDTs, dieldrin and nondioxin-like PCBs (∑6PCBs) exceeded the provisional tolerable daily intake (PTDI) in two, six and forty-eight of the nursing infants, respectively, suggesting potential health risks. In addition, head circumference were negatively associated with p,p´-DDE in female infants, suggesting that OC exposure during pregnancy may influence fetal growth.

Diverging temporal trends of human exposure to bisphenols and plastizisers, such as phthalates, caused by substitution of legacy EDCs?

Phthalates and phenolic substances were investigated in urine samples from first-time mothers in Uppsala, Sweden, collected between 2009 and 2014. These substances have a comparably fast metabolism and urinary metabolites are predominantly analysed. The main aim was to investigate if measures to decrease production and use of certain phthalates and bisphenol A (BPA) have resulted in decreased human exposure, and to determine if exposures to replacement chemicals have increased. Temporal trends were evaluated for metabolites (n=13) of seven phthalates, a phthalate replacer, four different bisphenols, triclosan, one organophosphate-based flame retardant, and for two pesticides. The results showed downward trends of several phthalates which are in the process of being regulated and phased out. Concomitantly, an increasing trend was seen for a metabolite of the phthalate replacer Di-iso-nonylcyclohexane 1,2-dicarboxylate (DiNCH). Bisphenol A (BPA) showed a downward trend, whereas bisphenol F, identified as one of the substitutes for BPA, showed an increasing trend. The decreasing trend of triclosan is likely due to declining use within the EU. Temporal trend studies of urine samples make it possible to investigate human exposure to rapidly metabolised substances and study how measures taken to regulate and replace problematic chemicals affect human exposure.

Temporal trends of chlorinated paraffins and polychlorinated biphenyls in Swiss soils

Persistent organic pollutants (POPs), such as polychlorinated biphenyls (PCBs), are ubiquitous environmental contaminants that have been targeted by national regulations since the 1970-1980s, followed in 2004 by the worldwide regulation under the Stockholm Convention on POPs. However, concerns are growing regarding the emergence of additional POP-like substances, such as chlorinated paraffins (CPs), which have particularly large production volumes. Whereas short-chain CPs (SCCPs) have recently been restricted in Europe and are currently under evaluation for inclusion into the Stockholm Convention, medium-chain CPs (MCCPs) have received little attention. On the one hand, temporal trends of CPs in the environment have hardly been investigated. On the other hand, the effectiveness of the Stockholm Convention on environmental levels of PCBs is still a matter of debate. Here, we reconstructed temporal trends of SCCPs, MCCPs, and PCBs in archived soil samples from six sampling sites in Switzerland, covering the period 1989-2014 (respectively 1988-2013 for one site). Concentrations of SCCPs have decreased in soil since 1994, which indicates positive effects of the reduction of production of SCCPs in Europe and the increasingly stringent regulation. However, the decline in soil is slow with a halving time of 18 years. Concentrations of MCCPs have continuously increased in soil over the entire period 1989-2014, with a doubling between 2009 and 2014. The concentrations of MCCPs have surpassed those of SCCPs, showing their relevance today, partly as replacements for SCCPs. Soil concentrations of PCBs peaked in 1999, i.e. three decades later than worldwide production and use of PCBs, but earlier than the entry into force of the Stockholm Convention. PCBs follow a decline in soil with a halving time of approx. 8 years. This study shows the usefulness of sample archives for the reconstruction and interpretation of time trends of persistent environmental contaminants.

Serum levels of brominated flame retardants (BFRs: PBDE, HBCD) and influence of dietary factors in a population-based study on Swedish adults

The aim of this study was to investigate associations between serum concentrations of brominated flame retardants and personal characteristics, including diet, in adults participating in a population-based study in Sweden 2010-11. Moreover, observed concentrations were used in a health risk assessment, using published health-based reference values. Serum samples of 170 adult individuals of both sexes were analyzed for 10 PBDE congeners and HBCD by GC-MS. When including concentrations between LOD and LOQ, highest median serum concentration was observed for BDE-153 (1.2 ng/g serum lipid), followed by BDE-209 (0.95 ng/g lipid), BDE-47 (0.49 ng/g lipid) and BDE-100 (0.21 ng/g lipid). Median concentration of HBCD was 0.10 ng/g lipid. A few markedly elevated concentrations of BDE-209, HBCD (77-78 ng/g lipid) and BDE-47 (44 ng/g lipid) were observed. The only statistical significant findings were higher BDE-153 concentrations in men than in women, and positive associations between serum BDE-153 concentrations and consumption of fish (total), beef, mutton and poultry. PBDE concentrations were in accordance with concentrations reported in other European countries but generally lower than those found in North America. Median PBDE serum concentrations observed in adults from Sweden suggest sufficient health protection, when compared with published health-based reference values, although some outliers with high serum concentrations had lower safety margins.

Fish pollutants MeHg and Aroclor cause permanent structural damage in male gonads and kidneys after prepubertal exposure

This study investigated whether or not prepubertal exposure to the fish contaminants methylmercury (MeHg) and the polychlorinated bisphenol Aroclor in low doses interferes with the histomorphometry of the testes, epididymis, liver and kidneys in rats. Wistar male rats, 21 days old, were allocated into the following: control (n = 17, received corn oil), MeHg (n = 17, received MeHg at 0.5 mg/kg/day), Aroclor (n = 17, received Aroclor at 1.0 mg/kg/day), low mix (n = 18, received MeHg at 0.05 mg/kg/day and Aroclor at 0.1 mg/kg/day), high mix (n = 18, received MeHg at 0.5 mg/kg/day and Aroclor at 1.0 mg/kg/day). Dosing continued from post natal day (PND) 23 to 53, by gavage. Euthanasia was performed on PND 53; or, after an interval of 62 days without exposure to chemicals, on PND 115. The degree of maturation of the seminiferous epithelium was delayed in chemical-exposed groups and testicular interstitial oedema was observed at adulthood. The pattern of male gonad organization was changed in the Aroclor group on PND 53 and in all treated groups at adulthood. The animals from Aroclor, low mix and high mix groups showed a reduction in the number of Sertoli cells. Histological evidence of renal injury was observed in all chemical-exposed groups in both ages. A probable target for MeHg and Aroclor in the reproductive system was Sertoli cells, in which possible dysfunctions could be linked to the other testicular alterations. Curiously, the main deleterious effects were late outcomes, along with the absence of synergistic interaction of MeHg and Aroclor in the parameters investigated. In conclusion, fish pollutants MeHg and Aroclor caused permanent structural damage in male gonads and kidneys after prepubertal exposure, without showing clear chemical interactions.

Environmental organic pollutants in human milk before and after weight loss

Many persistent organic pollutants (POPs) are banned because they accumulate in organisms and are toxic. Lipophilic POPs are stored in maternal adipose tissue and concentrations in human milk (HM) may increase during weight loss. Our aim was to examine associations between weight loss and concentrations of chlorinated POPs in HM in lactating women participating in a weight loss study. We analysed POPs (PCB 28, PCB 153, HCB, DDE) in HM at 12 and 24 weeks postpartum from 32 women who participated in a randomized, 2 × 2 factorial trial of diet and exercise for postpartum weight loss. Participants donated milk before and after the intervention period. We examined associations between weight loss and change in POP concentrations and estimated the intake of POPs by their breastfed infants. Most (n = 27) women lost weight during intervention, 0.45 ± 0.30 kg/week (mean ± SD). Among these women, the concentration of PCB 153 in HM was significantly (p = 0.04) higher at follow-up than at baseline. Weight loss was significantly positively associated with changes in concentrations of all studied POPs (2.0-2.4% increase per percent weight loss). Estimated mean intakes of POPs (ng/day) remained stable because infant milk consumption decreased during the study period. As infants gained weight, estimated mean intakes per kg body weight decreased 17-22%. Changes in concentrations of POPs in HM correlated positively with maternal weight loss, but it is unlikely that the balance between the benefits and risks of breastfeeding will change if the weight loss is restricted to 0.5 kg per week.

A pharmacokinetic analysis and dietary information are necessary to confirm or reject the hypothesis on persistent organic pollutants causing type 2 diabetes

A number of studies have found an association between the concentrations of persistent organic pollutants (POP) and type 2 diabetes. Causality has remained uncertain. This study describes the pharmacokinetic behavior of PCDD/Fs (polychlorinated dibenzo-p-dioxins and dibenzofurans) both in a theoretical model based on elimination rate constants, and in a group of 409 adult surgical patients with known PCDD/F concentrations and dietary information. A model assuming 10% annual decrease in past PCDD/F intake, predicted the measured profile of TEQ (toxic equivalents) in the patient population fairly well. The dominant determinant of PCDD/F level was age, and the level in patients was also associated with consumption of animal source products. Predicted daily intakes correlated with diet, but also with body mass index (BMI), indicating that high BMI was preceded by high consumption of foods containing PCDD/Fs. The results suggest that a third factor, e.g. high intake of animal source foods, could explain both higher levels of POPs in the body and higher incidence of type 2 diabetes, and BMI is not sufficient in describing the confounding caused by diet. Thus, to fully address the causality between POPs and type 2 diabetes, careful studies considering the pharmacokinetics of the studied compounds, and including the analysis of food consumption, are needed.

Increase of polychlorinated dibenzo-p-dioxins and dibenzofurans and dioxin-like polychlorinated biphenyls in human milk from China in 2007-2011

A national survey was conducted to determine polychlorinated dibenzo-p-dioxins and dibenofurans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (dl-PCBs) in human milk samples collected from 16 provinces in China to assess current exposure and temporal trends in China. The arithmetic mean concentration of total TEQ (PCDD/Fs and dl-PCBs) in 2011 is 6.7pgTEQg^-1 lipid with a range of 2.9-15.4pgTEQg^-1 lipid in 2011. Levels have been compared to data obtained during a previous national study conducted in 2007. The mean of PCDD/Fs has increased about 32.6% and 99.9% for total TEQ concentration (3.7pgTEQg^-1 lipid in 2007 vs 4.9pgTEQg^-1 lipid in 2011) and mass concentration (66.7pgg^-1 lipid in 2007 vs 133.3pgg^-1 lipid in 2011) during the period of 2007-2011, respectively. Continuous surveillance on PCDD/Fs and dl-PCBs in human milk is critical to evaluate the human health effect and environment impact in China.

Environment and Health: Not Only Cancer

The Hippocratic tradition emphasized environmental causes of diseases and the need for harmony between the individual and the natural environment as the right philosophy to maintain a good health status. Public awareness and scientific attention concerning environmental pollution is usually focused on the consequent increased risk of developing cancer. Air pollution has been recognized by the World Health Organization (WHO) to cause cardiovascular and respiratroy diseases, as well as lung cancer, after acute/chronic exposure to fine particulates (PM2.5 and PM10) even at concentrations which are 50% lower than those accepted as legal limits in many developed countries. An increase of 10 µg/m³ of PM2.5 produces a +4%-6% of overall mortality, a +10% of cardiovascular disease prevalence (arithmyas, acute myocardial infarctions, and heart failure) and a +22% of lung cancer prevalence. In addition to these chronic effects, acute hospitalizations are also affected, especially among susceptible populations such as children and diabetic patients. Water and soil contamination also have an additional detrimental effect on people's health. Other issues concerning environment contamination and human health include male/female fertility, metabolic and thyroid conditions, but also professional exposures resulting in occupational diseases. Moreover, in the perspective of "gender medicine", different acute or chronic effects of environmental pollution should be specifically assessed both in men and in women. This special issue on "Environmental Diseases" is aimed at providing a global overview about different threats to human health possibily originating from environmental contamination.

Organochlorine pesticides and PCBs (including dl-PCBs) in human milk samples collected from multiparae from Croatia and comparison with primiparae

This study investigated the levels of 20 congeners of polychlorinated biphenyls (PCBs), including toxic dioxin-like PCBs and 7 organochlorine pesticides (OCPs) in 33 human milk samples collected in 2011 from multiparae living in Zadar, Croatia. Concentrations of ∑PCBs, ∑DDTs, ∑HCHs and HCB in samples ranged from 11.7 to 146.3, 8.7 to 89.2, 0.9 to 28.4, and <LOD to 8.0ngg(-1) milk fat, respectively. PCB congeners -153, -138, -180 and -170 dominated in the PCB profiles, while p,ṕ-DDE was the most abundant OCP. PCB-126 was the most abundant non-ortho PCB, while among mono-ortho PCBs, the congeners -118, -105 and -156 equally contributed to the mono-ortho PCB fraction. TEQs for dl-PCBs ranged between 0 and 13.3pgg(-1) milk fat. The calculated estimated daily intakes for all compound groups were below the tolerable daily intake indicating no risk for breastfed infants. A comparison of our results with our previous study on primiparae revealed that the concentrations of the main contaminant groups are lower in the milk of multiparae, with the exception of toxic mono-ortho PCBs whose concentrations and TEQ remained similar among the groups, and HCB whose concentrations were found to be higher in multiparae. Concentrations of PCBs and OCPs found in the samples from this study did not exceed those from other parts of the world. This study revealed that there are differences in contaminant concentrations depending on the mothers' parity and that this fact should be taken into account when risk assessment studies are conducted.

Recommendations for Evaluating Temporal Trends of Persistent Organic Pollutants in Breast Milk

BACKGROUND

Biomonitoring data of persistent organic pollutants (POPs) in breast milk are increasingly collected and available for quantitative analysis of levels and time trends. A common approach is to apply log-linear regression to calculate doubling and halving times of the POP concentrations based on the temporal trend observed in breast milk. However, there are different, sometimes conflicting interpretations of these doubling and halving times.

OBJECTIVES

We provide a mechanistic understanding of doubling and halving times where possible. Five recommendations are proposed for dealing with POP concentration trends in breast milk during three distinct periods (pre-ban, transition, post-ban period).

DISCUSSION

Using temporal trends of BDE-47 and PCB-153 in breast milk data, we show which information can be gained from the time-trend data. To this end, we analyzed time trends of hypothetical POPs for different periods with time-variant exposure and different intrinsic elimination half-lives, using a dynamic population-based pharmacokinetic model. Different pieces of information can be extracted from time-trend data from different periods. The analysis of trends of short-lived POPs is rather straightforward and facilitates extraction of the intrinsic elimination half-lives from the breast milk data. However, trends of slowly eliminated POPs only provide indications for the exposure time trend.

CONCLUSIONS

Time-trend data of rapidly eliminated POPs provide information on exposure time trends and elimination half-lives. Temporal trends of slowly eliminated POPs are more complicated to interpret, and the extraction of exposure time trends and elimination half-lives require data sets covering several decades.

CITATION

Gyalpo T, Scheringer M, Hungerbühler K. 2016. Recommendations for evaluating temporal trends of persistent organic pollutants in breast milk. Environ Health Perspect 124:881-885; http://dx.doi.org/10.1289/ehp.1510219.

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.

Maternal body burdens of PCDD/Fs and PBDEs are associated with maternal serum levels of thyroid hormones in early pregnancy: a cross-sectional study

BACKGROUND

Thyroid hormones (THs) regulate many biological functions in the human body and are essential for normal brain development. Epidemiological studies have observed diverging associations between halogenated persistent organic pollutant (POP) exposure and concentrations of THs in pregnant women and their infants. We investigated whether background exposure to polybrominated diphenyl ethers (PBDEs) is related to TH status in a Swedish population of pregnant women and their infants. Furthermore, we examined associations between polychlorinated dibenzo-p-dioxins/dibenzofurans (PCDD/Fs) and polychlorinated biphenyls (PCBs) and TH status in early pregnancy as an extension of an earlier study focusing on late pregnancy TH status.

METHODS

Free thyroxine (T4), total triiodo-thyronine (T3) and thyroid stimulating hormone (TSH) were analysed in serum from first-time mothers (N = 220-281) in the first and third trimester, and in infants (N = 115-150) 3 weeks and 3 months after delivery. Antibodies to thyroid peroxidase (anti-TPO) (N = 260) were measured in maternal third trimester serum. Maternal body burdens of PCBs (N = 281) were estimated from serum lipid PCB concentrations in late pregnancy, and PCDD/F (N = 97) and PBDE (N = 186) body burdens were estimated from concentrations in mother's milk lipids 3 weeks after delivery. Linear regression models allowed for covariate adjustment of the associations between ln-transformed POP body burdens and concentrations of TH and anti-TPO.

RESULTS

Maternal body burden of BDE-153 was inversely associated with first trimester total T3, otherwise no associations between PBDEs and first and second trimester THs were observed. No associations were found between maternal PBDE body burdens and infant THs. Maternal body burden of PCDD/Fs were inversely associated with first trimester total T3. No associations were observed between PCBs and first trimester THs. Third trimester anti-TPO was not associated with maternal PCBs, PCDD/Fs and PBDEs.

CONCLUSIONS

Our results suggest that maternal PCDD/F and BDE-153 body burdens influence maternal TH status in early pregnancy, which is a critical period when maternal TH status influences fetal development.

Dietary exposure to polychlorinated biphenyls and risk of myocardial infarction in men - A population-based prospective cohort study

BACKGROUND

Major food contaminants such as polychlorinated biphenyls (PCBs) are proposed to play a role in the etiology of cardiovascular disease (CVD), but to date the impact of PCBs on cardiovascular health need to be explored.

METHODS AND RESULTS

We assessed the association between validated food frequency questionnaire-based estimates of dietary PCB exposure and risk of myocardial infarction, ascertained through register-linkage, among 36,759 men from the population-based Swedish Cohort of Men, free of cardiovascular disease, diabetes and cancer at baseline (1997). Relative risks were adjusted for known cardiovascular risk factors, long-chain omega-3 fatty acids (eicosapentaenoic and docosahexaenoic acids) and methyl mercury exposure. During 12years of follow-up (433,243 person-years), we ascertained 3005 incident cases of myocardial infarction (654 fatal). Compared with the lowest quintile of dietary PCB exposure (median 113ng/day), men in the highest quintile (median 436ng/day) had multivariable-adjusted relative risks of 1.74 (95% confidence interval [CI], 1.30-2.33; p-trend<0.001) for total and 1.97 (95% CI 1.42-2.75; p-trend<0.001) for non-fatal myocardial infarction. In mutually adjusted models, dietary PCB exposure was associated with an increased risk of myocardial infarction, while the intake of long-chain omega-3 fish fatty acids was associated with a decreased risk. We also observed an effect modification by adiposity on the association between of dietary PCB exposure and myocardial infarction, with higher risk among lean men (p value for interaction =0.03).

CONCLUSIONS

Exposure to PCBs via diet was associated with increased risk of myocardial infarction in men.

Persistent Organic Pollutants and Concern Over the Link with Insulin Resistance Related Metabolic Diseases

Persistent organic pollutants (POPs) are mostly halogenated compounds tending to persist in the environment, enter into the food chain, and accumulate in fat mass of mammals due to their high lipophilicity. They include some organochlorine pesticides, polychlorinated biphenyls, brominated flame retardants and polycyclic aromatic hydrocarbons. Some of these chemicals were widely used in the past so that their residues can be detected in the human body, though their usage has been banned for years. POPs have been shown to perturb the health of biological systems in different ways evidenced by carcinogenicity and disrupting effects on endocrine, immune, and reproductive systems. There are many epidemiologic and experimental studies on the association of exposure to POPs with insulin resistance and related metabolic disorders like obesity, diabetes, and metabolic syndrome. Inflammation as a known mechanism accompanying insulin resistance has also been shown to arise in insulin target tissues exposed to POPs. This review addresses the breast milk concentration of POPs in different regions of the world, synthesizes the current information on the association of POPs with insulin resistance related metabolic disorders, and discusses the inflammation as an involved mechanism. Considering high prevalence of insulin resistance related metabolic diseases and their relation with POPs, much need is felt regarding international and regional programs to not only limit their production and usage but eliminate these persistent pollutants from the environment.