Differential contribution of animal and vegetable food items on persistent organic pollutant serum concentrations in Spanish adults. Data from BIOAMBIENT.ES project

Systematic evidence mapping of potential correlates of exposure for per- and poly-fluoroalkyl substances (PFAS) based on measured occurrence in biomatrices and surveys of dietary consumption and product use

Per- and poly-fluoroalkyl substances (PFAS) are widely observed in environmental media and often are found in indoor environments as well as personal-care and consumer products. Humans may be exposed through water, food, indoor dust, air, and the use of PFAS-containing products. Information about relationships between PFAS exposure sources and pathways and the amounts found in human biomatrices can inform source-contribution assessments and provide targets for exposure reduction. This work collected and collated evidence for correlates of PFAS human exposure as measured through sampling of biomatrices and surveys of dietary consumption and use of consumer products and articles. A systematic evidence mapping approach was applied to perform a literature search, conduct title-abstract and full-text screening, and to extract primary data into a comprehensive database for 16 PFAS. Parameters of interest included: sampling dates and locations, cohort descriptors, PFAS measured in a human biomatrix, information about food consumption in 11 categories, use of products/articles in 11 categories, and reported correlation values (and their statistical strength). The literature search and screening process yielded 103 studies with information for correlates of PFAS exposures. Detailed data were extracted and compiled on measures of PFAS correlations between biomatrix concentrations and dietary consumption and other product/article use. A majority of studies (61/103; 59%) were published after 2015 with few (8/103; 8%) prior to 2010. Studies were most abundant for dietary correlates (n = 94) with fewer publications reporting correlate assessments for product use (n = 56), while some examined both. PFOA and PFOS were assessed in almost all studies, followed by PFHxS, PFNA, and PFDA which were included in >50% of the studies. No relevant studies included PFNS or PFPeS. Among the 94 studies of dietary correlates, significant correlations were reported in 83% of the studies for one or more PFAS. The significant dietary correlations most commonly were for seafood, meats/eggs, and cereals/grains/pulses. Among the 56 studies of product/article correlates, significant correlations were reported in 70% of the studies. The significant product/article correlations most commonly were for smoking/tobacco, cosmetics/toiletries, non-stick cookware, and carpet/flooring/furniture and housing. Six of 11 product/article categories included five or fewer studies, including food containers and stain- and water-resistant products. Significant dietary and product/article correlations most commonly were positive. Some studies found a mix of positive and negative correlations depending on the PFAS, specific correlate, and specific response level, particularly for fats/oils, dairy consumption, food containers, and cosmetics/toiletries. Most of the significant findings for cereals/grains/pulses were negative correlations. Substantial evidence was found for correlations between dietary intake and biomatrix levels for several PFAS in multiple food groups. Studies examining product/article use relationships were relatively sparse, except for smoking/tobacco, and would benefit from additional research. The resulting database can inform further assessments of dietary and product use exposure relationships and can inform new research to better understand PFAS source-to-exposure relationships. The search strategy should be extended and implemented to support living evidence review in this rapidly advancing area.

PFAS: exploration of neurotoxicity and environmental impact

Per- and polyfluoroalkyl substances (PFAS) are widespread contaminants stemming from various industrial and consumer products, posing a grave threat to both human health and ecosystems. PFAS contamination arises from multiple sources, including industrial effluents, packaging, and product manufacturing, accumulating in plants and impacting the food chain. Elevated PFAS levels in water bodies pose significant risks to human consumption. This review focuses on PFAS-induced neurological effects, highlighting disrupted dopamine signalling and structural neuron changes in humans. Animal studies reveal apoptosis and hippocampus dysfunction, resulting in memory loss and spatial learning issues. The review introduces the BKMR model, a machine learning technique, to decipher intricate PFAS-neurotoxicity relationships. Epidemiological data underscores the vulnerability of young brains to PFAS exposure, necessitating further research. Stricter regulations, industry monitoring, and responsible waste management are crucial steps to reduce PFAS exposure.

Blood Levels of Organochlorine Contaminants Mixtures and Cardiovascular Disease

Importance

Cardiovascular toxic effects derived from high exposures to individual organochlorine compounds are well documented. However, there is no evidence on low but continuous exposure to combined organochlorine compounds in the general population.

Objective

To evaluate the association of combined exposure to several organochlorine compounds, including organochlorine pesticides and polychlorinated biphenyls, with incident cardiovascular disease (CVD) in the general population.

Design, Setting, and Participants

This prospective nested case-control study included data from 2 cohorts: the Swedish Mammography Cohort-Clinical (SMC-C) and the Cohort of 60-Year-Olds (60YO), with matched case-control pairs based on age, sex, and sample date. Baseline blood sampling occurred from November 2003 to September 2009 (SMC-C) and from August 1997 to March 1999 (60YO), with follow-up through December 2017 (SMC-C) and December 2014 (60YO). Participants with myocardial infarction or ischemic stroke were matched with controls for composite CVD evaluation. Data were analyzed from September 2020 to May 2023.

Exposures

A total of 25 organochlorine compounds were measured in blood at baseline by gas chromatography-triple quadrupole mass spectrometry. For 7 compounds, more than 75% of the samples were lower than the limit of detection and not included.

Main Outcomes and Measures

Incident cases of primary myocardial infarction and ischemic stroke were ascertained via linkage to the National Patient Register (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes I21 and I63). The quantile-based g-computation method was used to estimate the association between the combined exposure to several organochlorine compounds and composite CVD.

Results

Of 1528 included participants, 1024 (67.0%) were female, and the mean (SD) age was 72 (7.0) years in the SMC-C and 61 (0.1) years in the 60YO. The odds ratio of composite CVD was 1.71 (95% CI, 1.11-2.64) per 1-quartile increment of total organochlorine compounds mixture. Organochlorinated pesticides were the largest contributors, and β-hexachlorocyclohexane and transnonachlor had the highest impact. Most of the outcome was not explained by disturbances in the main cardiometabolic risk factors, ie, high body mass index, hypertension, lipid alteration, or diabetes.

Conclusions and Relevance

In this prospective nested case-control study, participants with higher exposures to organochlorines had an increased probability of experiencing a cardiovascular event, the major cause of death worldwide. Measures may be required to reduce these exposures.

Exposure of the general French population to herbicides, pyrethroids, organophosphates, organochlorines, and carbamate pesticides in 2014-2016: Results from the Esteban study

Esteban is a nationwide cross-sectional study conducted in France in 2014-2016, including 2503 adults aged 18-74 years old and 1104 children aged 6-17 years old, as part of the French Human Biomonitoring programme. The present paper describes the biological levels of five families of pesticides analysed on random sub-samples of 900 adults and 500 children for urine concentrations, and 759 adults and 255 children for serum concentrations, and the determinants of exposure. Organophosphates, carbamates and herbicides were measured in urine by UPLC-MS/MS; chlorophenols and pyrethroids were measured in urine by GC-MS/MS; specific organochlorines were measured in serum by GC-HRMS. Multivariate analyses were performed to identify the determinants of exposure using a generalized linear model. Pyrethroid metabolites were quantified in 99% of adults and children, with the exeption of F-PBA, which was quantified in 31% of adults and 27% of children, respectively. Carbamates and some specific organophosphates were barely or not quantified. DMTP was quantified in 82% of adults and 93% of children, and γ-HCH (lindane) was quantified in almost 50% of adults and children. Concentration levels of pesticide biomarkers were consistent with comparable international studies, except for β-HCH, DMTP, and the deltamethrin metabolite Br2CA, whose levels were sometimes higher in France. Household insecticide use and smoking were also associated with higher levels of pyrethroids. All pyrethroids concentration levels were below existing health-based HBM guidance values, HBM-GVsGenPop, except for 3-PBA, for which approximately 1% and 10% of children were above the lower and upper urine threshold values of 22 μg/L and 6.4 μg/L, respectively. Esteban provides a French nationwide description of 70 pesticide biomarkers for the first time in children. It also describes some pesticide biomarkers for the first time in adults, including glyphosate and AMPA. For the latter, urine concentration levels were overall higher in children than in adults. Our results highlight a possible beneficial impact of existing regulations on adult exposure to organochlorine and organophosphate pesticides between 2006 and 2016, as concentration levels decreased over this period.

Endocrine disrupting compounds in the baby's world - A harmful environment to the health of babies

Globally, there has been a significant increase in awareness of the adverse effects of chemicals with known or suspected endocrine-acting properties on human health. Human exposure to endocrine disrupting compounds (EDCs) mainly occurs by ingestion and to some extent by inhalation and dermal uptake. Although it is difficult to assess the full impact of human exposure to EDCs, it is well known that timing of exposure is of importance and therefore infants are more vulnerable to EDCs and are at greater risk compared to adults. In this regard, infant safety and assessment of associations between prenatal exposure to EDCs and growth during infancy and childhood has been received considerable attention in the last years. Hence, the purpose of this review is to provide a current update on the evidence from biomonitoring studies on the exposure of infants to EDCs and a comprehensive view of the uptake, the mechanisms of action and biotransformation in baby/human body. Analytical methods used and concentration levels of EDCs in different biological matrices (e.g., placenta, cord plasma, amniotic fluid, breast milk, urine, and blood of pregnant women) are also discussed. Finally, key issues and recommendations were provided to avoid hazardous exposure to these chemicals, taking into account family and lifestyle factors related to this exposure.

PFAS levels and exposure determinants in sensitive population groups

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) are persistent organic pollutants. The first exposure to PFAS occurs in utero, after birth it continues via breast milk, food intake, environment, and consumer products that contain these chemicals. Our aim was to identify determinants of PFAS concentrations in sensitive population subgroups- pregnant women and newborns.

METHODS

Nine European birth cohorts provided exposure data on PFAS in pregnant women (INMA-Gipuzkoa, Sabadell, Valencia, ELFE and MoBa; total N = 5897) or newborns (3xG study, FLEHS 2, FLEHS 3 and PRENATAL; total N = 940). PFOS, PFOA, PFHxS and PFNA concentrations were measured in maternal or cord blood, depending on the cohort (FLEHS 2 measured only PFOS and PFOA). PFAS concentrations were analysed according to maternal characteristics (age, BMI, parity, previous breastfeeding, smoking, and food consumption during pregnancy) and parental educational level. The association between potential determinants and PFAS concentrations was evaluated using multiple linear regression models.

RESULTS

We observed significant variations in PFAS concentrations among cohorts. Higher PFAS concentrations were associated with higher maternal age, primipara birth, and educational level, both for maternal blood and cord blood. Higher PFAS concentrations in maternal blood were associated with higher consumption of fish and seafood, meat, offal and eggs. In cord blood, higher PFHxS concentrations were associated with daily meat consumption and higher PFNA with offal consumption. Daily milk and dairy consumption were associated with lower concentrations of PFAS in both, pregnant women and newborns.

CONCLUSION

High detection rates of the four most abundant PFAS demonstrate ubiquitous exposure of sensitive populations, which is of concern. This study identified several determinants of PFAS exposure in pregnant women and newborns, including dietary factors, and these findings can be used for proposing measures to reduce PFAS exposure, particularly from dietary sources.

Healthy eating index and diet diversity score as determinants of serum perfluoroalkyl acid (PFAA) concentrations in a national survey of Swedish adolescents

Food is an important source of perfluoroalkyl acid (PFAA) exposure for the general adult population, but few data exist for adolescents. Healthy food habits established during adolescence may positively influence health later in life. Associations between serum PFAA concentrations and a healthy eating index (SHEIA15), as well as a diet diversity score (RADDS), were determined in a nationally representative adolescent population from Sweden (Riksmaten Adolescents 2016-2017, RMA). Using consumption data from food registrations and frequency questionnaires, we additionally analyzed associations with commonly consumed food groups. Associations were analyzed by fitting a cumulative probability model using ordinal regression. Among the seven PFAAs detected in ≥70% of the 1098 participants (age 10-21 years), median concentrations ranged from <1 ng/g serum of perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perflurorundecanoic acid (PFUnDA), linear (lin-) perfluorohexanesulfonic acid (PFHxS) and branched (br-) perfluorooctanesulfonic acid (PFOS) to 1-2 ng/g serum of lin-perfluorooctanoic acid (PFOA) and lin-PFOS. PFNA, PFDA, PFUnDA and lin-PFOS concentrations were positively associated with both SHEIA15 and RADDS, a finding most likely driven by higher consumption of seafood. PFDA, PFUnDA and lin-PFOS concentrations were positively related to commonly consumed fish/shellfish groups, such as lean marine fish and shellfish. Inverse associations between PFAA concentrations and dairy consumption suggest an underlying factor behind dairy consumption that similarly affects adolescent exposure to the different PFAAs. Isomeric differences in dietary exposure between lin-PFOS and br-PFOS were suggested, as br-PFOS concentrations, in contrast to lin-PFOS, were not associated with SHEIA15, RADDS and consumption of different food groups. We conclude that Swedish adolescents, adhering to a diverse and healthy diet, appears to be more highly exposed to legacy PFAAs than those eating less healthy. Additional research is necessary for a better understanding of the health implications of healthy eating from a PFAA exposure perspective.

Chemical Mixtures in the EU Population: Composition and Potential Risks

Regulating chemical mixtures is a complex scientific and policy task. The aim of this study was to investigate typical mixtures and their potential risks based on internal exposure levels in the European population. Based on human biomonitoring (HBM) data made available via the HBM4EU project, we derived generic mixtures representative of a median (P50) and a worst-case scenario (P95) for adults and children. We performed a mixture risk assessment based on HBM concentrations, health-based guidance values (HBGVs) as internal thresholds of concern, and the conservative assumption of concentration addition applied across different toxicological endpoints. Maximum cumulative ratios (MCRs) were calculated to characterize the mixture risk. The mixtures comprise 136 biomarkers for adults and 84 for children, although concentration levels could be quantified only for a fraction of these. Due to limited availability of HBGVs, the mixture risk was assessed for a subset of 20 substance-biomarker pairs for adults and 17 for children. The mixture hazard index ranged from 2.8 (P50, children) to 9.2 (P95, adults). Six to seven substances contributed to over 95% of the total risk. MCR values ranged between 2.6 and 5.5, which is in a similar range as in previous studies based on human external exposures assessments. The limited coverage of substances included in the calculations and the application of a hazard index across toxicological endpoints argue for caution in the interpretation of the results. Nonetheless the analyses of MCR and MAF_ceiling can help inform a possible mixture assessment factor (MAF) applicable to single substance risk assessment to account for exposure to unintentional mixtures.

Internal exposure of Flemish teenagers to environmental pollutants: Results of the Flemish Environment and Health Study 2016-2020 (FLEHS IV)

The Flemish Environment and Health Study (FLEHS) collects information on internal exposure to a broad range of environmental chemicals in the general population in Flanders, the Northern region of Belgium. The aim is to establish biomonitoring exposure distributions for the general population in support of public health and environmental policy, environmental risk assessment and risk management decisions. In 2017-2018, urine and blood samples were collected from 428 teenagers by a stratified clustered two stage randomized design. Samples were analyzed for a broad range of biomarkers related to exposure to chlorinated and newer pesticides, brominated and organophosphate flame retardants (BFR/OPFR), polychlorinated biphenyls (PCBs), bisphenols, phthalates and alternative plasticizers, per-and polyfluoroalkyl substances (PFAS), polycyclic aromatic hydrocarbons (PAHs), benzene, metals and trace elements. The geometric mean levels and percentiles of the distribution were estimated for each biomarker, for the whole study population and following stratification for sex, the household educational attainment and the residence area's urbanicity. Geometric means of biomarkers of lead, dichlorodiphenyltrichloroethane (DDT), PCBs, PAHs, regulated phthalates and bisphenol A (BPA) were lower than in the previous FLEHS cycles. Most biomarker levels were below health-based guidance values (HB-GVs). However, HB-GVs of urinary arsenic, blood lead, blood cadmium, sum of serum perfluorooctane sulfonate (PFOS) and perfluoro-1-hexanesulfonate (PFHxS) and the urinary pyrethroid metabolite (3-PBA) were exceeded in respectively 25%, 12%, 39.5%, 10% and 22% of the teenagers. These results suggest that the levels of exposure in the Flemish population to some environmental chemicals might be of concern. At the same time, we noticed that biomarkers for BPA substitutes, metabolites of OPFRs, an expanded list of PFAS, glyphosate and its metabolite could be measured in substantial proportions of participants. Interpretation of these levels in a health-risk context remains uncertain as HB-GVs are lacking. Household educational attainment and residential urbanicity were significant exposure determinants for many biomarkers and could influence specific biomarker levels up to 70% as shown by multiple regression analysis. The research consortium also took care of the broader external communication of results with participants, policy makers, professional groups and civil society organizations. Our study demonstrated that teenagers are exposed to a wide range of chemicals, it demonstrates the success of public policies to reduce exposure but also points to concern and further priorities and needs for follow up.

Association between dietary quality indices and serum polychlorinated biphenyls and organochlorine pesticides levels among Lebanese adults

Polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) remain a global concern in both developed and developing countries. Given that diet constitutes the major route of exposure to these pollutants, the objective of the current study is to investigate PCBs and OCPs serum levels in relation to dietary quality indices in a sample of Lebanese adults. Sociodemographic, nutritional, and anthropometric data were obtained from 302 participants in face-to-face interviews. Nutritional intakes from a previously validated quantitative 164-item food frequency questionnaire were used to calculate six a priori dietary indices: Healthy Eating Index (HEI-2015), alternate Healthy Eating Index (aHEI), Diet Quality Index-International (DQI-I), Mediterranean Diet Quality Index (Med-DQI), Med-DQIf, Mediterranean Diet Scale (MDS), and Mediterranean Diet Score (MedDietScore). Serum levels of six indicator PCBs (PCBs 28, 52, 101, 138, 153, 180) and four OCPs (HCB, β-HCH, DDT, and DDE) were investigated in relation to diet quality indices. Individuals with a higher adherence to the HEI-2015 and to the Mediterranean diet assessed by the Med-DQI/Med-DQIf displayed increased levels of OCPs (HCB, βHCH, DDT, and DDE). An inverted U-shaped association was observed between DQI-I and PCBs serum levels (PCBs 138, 153, 180, and ƩPCBs). This is the first study in the Middle East and North Africa region to investigate the association between POPs serum levels and a substantial number of a priori dietary indices. The impact of different food combinations and nutrient interactions on pollutants body burden and toxicity remains to be established in future studies.

The questionnaire design process in the European Human Biomonitoring Initiative (HBM4EU)

BACKGROUND

Designing questionnaires is a key point of epidemiological studies assessing human exposure to chemicals. The lack of validated questionnaires can lead to the use of previously developed and sub-optimally adapted questionnaires, which may result in information biases that affect the study's validity. On this ground, a multidisciplinary group of researchers developed a series of tools to support data collection within the HBM4EU initiative. The objective of this paper is to share the process of developing HBM4EU questionnaires, as well as to provide researchers with harmonized procedures that could help them to design future questionnaires to assess environmental exposures.

METHODS

In the frame of the work package on survey design and fieldwork of the HBM4EU, researchers carried out procedures necessary for the development of quality questionnaires and related data collection tools. These procedures consisted of a systematic search to identify questionnaires used in previous human biomonitoring (HBM) studies, as well as the development of a checklist and evaluation sheet to assess the questionnaires identified. The results of these evaluations were taken into consideration for the development of the final questionnaires.

RESULTS

The main points covered by each of the sections included in HBM4EU questionnaires are described and discussed in detail. Additional tools developed for data collection in the HBM4EU (e.g. non-responder questionnaire, satisfaction questionnaire, matrix-specific questionnaire) are also addressed. Special attention is paid to the limitations faced and hurdles overcome during the process of questionnaire development.

CONCLUSIONS

Designing questionnaires for use in HBM studies requires substantial effort by a multidisciplinary team to guarantee that the quality of the information collected meets the study's objectives. The process of questionnaire development described herein will contribute to improve the harmonization of HBM studies within the social and environmental context of the EU countries.

Maternal dietary patterns during pregnancy and exposure to persistent endocrine disrupting chemicals in two European birth cohorts

Food consumption, particularly of animal-based products, is considered the most important contributor to persistent endocrine disrupting chemical (EDC) exposure. This study aims to describe the association between maternal diet during pregnancy and exposure to persistent EDCs using dietary pattern analysis. This study is based on subsamples of the Avon Longitudinal Study of Parents and Children (ALSPAC) (N=422) and the Norwegian Mother, Father, and Child Cohort Study (MoBa) (N=276) which uses data from the Medical Birth Registry of Norway (MBRN). Women in both studies completed food frequency questionnaires (FFQs) during pregnancy, from which consumption data were categorized into 38 aggregated food groups. Maternal blood samples were collected during pregnancy and concentrations of perfluoroalkyl substances (PFAS), polychlorinated biphenyls (PCBs), and organochlorine pesticides (OCPs) in serum/plasma were measured. Dietary patterns were identified using reduced rank regression, with blood EDC concentrations as response variables. Within ALSPAC, all patterns (PFAS, PCB, and OCP) were characterized by high consumption of meat, poultry, white fish, and biscuits. In MoBa, high consumption of sausages and burgers (representing processed meats), pasta, and chocolate bars characterized PCB and OCP dietary patterns, while high consumption of cheese characterized the PFAS pattern. Across both cohorts, PFAS patterns were characterized by high consumption of cheese, PCB patterns by high consumption of rice, and OCP patterns by poultry. Dietary patterns explained between 8 and 20% of the variation in serum EDC concentrations, with explained variance being the highest for PCBs in both cohorts. In conclusion, dietary patterns high in animal-based products appear to be associated with persistent EDC concentrations among pregnant women. Diet explains more variation in PCB concentrations than for other persistent EDC classes.

Risk of dietary intake of organochlorine pesticides among the childbearing-age women: A multiple follow-up study in North China

Exposure to organochlorine pesticides (OCPs) can cause adverse health effects in the female population. We investigated the dietary OCP intake of childbearing-age women living in large agricultural areas of Northern China, as well as their associated health risks. Ten childbearing-age women were recruited during 2015-2016. Their weekly dietary intake diaries and food samples were collected over the course of five visits. The OCP residues of 322 food samples from seven categories (i.e., cereal, vegetable, fruit, fish, meat, egg, and milk) were analyzed by gas chromatography-mass spectrometry. The average concentrations of the total hexachlorocyclohexanes (ΣHCH), dichlorodiphenyltrichloroethanes and their metabolites (ΣDDX), endosulfans (ΣES), and dieldrin and endrin (ΣDrin) in all food categories were, overall, much lower than the maximum residue limits. Relative high mean residues of ΣDrin and ΣES were found in fruits (ΣDrin: 0.687 ng g-1 wet weight (w.w.), ΣES: 2.24 ng g-1 w.w.) and vegetables (ΣDrin: 0.690 ng g-1 w.w., ΣES: 2.11 ng g-1 w.w.). The estimated daily dietary intake (EDI) of these compounds was calculated, with mean levels of 10.6 (ΣES) > 4.37 (ΣDrin) > 1.51 (ΣHCH) > 0.850 (ΣDDX) ng kg-1 day-1. Women during the heating period (from January to March) tended to ingest more ΣHCH, ΣDDX, ΣDrin, and ΣES. Overall, women had no obvious non-carcinogenic and carcinogenic risks due to intake of OCPs, but 83.9% of them has potential carcinogenic risk, with estimated life carcinogenic risk (LCR) exceeding 10-6. Furthermore, women had a higher potential carcinogenic risk during the heating period (mean LCR: 1.33 × 10-5) than during the non-heating period (mean LCR: 8.50 × 10-6). ΣDrin was the dominant OCP responsible for health risks, followed by ΣHCH. We concluded that women in North China still have some dietary OCP intake, especially during the heating period.

Adipose Tissue Redox Microenvironment as a Potential Link between Persistent Organic Pollutants and the 16-Year Incidence of Non-hormone-Dependent Cancer

We aimed to assess the relationships among the adipose tissue's (AT) oxidative microenvironment, in situ accumulated persistent organic pollutant (POP) concentrations, and cancer development. POP and oxidative stress levels were quantified in AT samples from 382 adults recruited within the GraMo cohort (2003-2004) in Granada (Spain). The 16-year cancer incidence was ascertained by reviewing health/administrative databases. Cox-regression models and mediation analyses were performed. The enzymes superoxide dismutase (SOD) and glutathione reductase (GRd) were positively associated with the risk of non-hormone-dependent (NHD) cancer [adjusted hazard ratio (HR) 1.76; 95% confidence interval (CI): 1.17, 2.64 and HR 2.35; 95% CI: 1.41, 3.94, respectively]. After adjustment for covariates, polychlorinated biphenyl-138 (PCB-138) (HR 1.78; 95% CI: 1.03, 3.09), β-hexachlorocyclohexane (β-HCH) (HR 1.70; 95% CI: 1.09, 2.64), and hexachlorobenzene (HR 1.54; 95% CI: 1.02, 2.33) were also positively associated with the risk of NHD cancer. Although confidence intervals included the null value, probably because of the modest number of cancer cases, we observed a potential mediation effect of SOD and GRd on the associations between β-HCH and the risk of NHD tumors (percent mediated = 33 and 47%, respectively). Our results highlight the relevance of human AT's oxidative microenvironment as a predictor of future cancer risk as well as its potential mediating role on POP-related carcinogenesis. Given their novelty, these findings should be interpreted with caution and confirmed in future studies.

Bioaccessibility dependence of dietary exposure to dichlorodiphenyltrichloroethane and its metabolites and hexachlorocyclohexane isomers and their induced health risk: A case study in Beijing City, China

Bioaccessibility is essential for evaluating dietary intake of contaminants. However, there is insufficient information on the dependence of dietary intake and risk assessment of dichlorodiphenyltrichloroethane and its metabolites (DDXs) and hexachlorocyclohexane isomers (HCHs) on bioaccessibility. Here, we investigated the bioaccessibilities of DDXs and HCHs in various foods and their influences on assessing exposure in the residents of Beijing City, China. Forty-three major foods in five types (fruit, vegetables, cereals, aquatic food, and meat) were sampled, and the bioaccessibility of DDXs and HCHs was evaluated using a static in vitro gastrointestinal digestion model. The bioaccessibility of DDXs in different food types ranked in the order of meat > vegetables > fruit > cereals > aquatic food, with mean ± standard deviation values of 62.2 ± 22.1%, 20.5 ± 10.6%, 12.4 ± 3.66%, 11.2 ± 9.69%, and 10.7 ± 4.97%, respectively. The highest average bioaccessibility of HCHs was found in meat (83.4 ± 14.2%), followed by fruit (41.0 ± 12.5%), vegetables (37.6 ± 18.1%), aquatic foods (24.2 ± 9.22%), and cereals (8.73 ± 4.07%). The estimated daily intakes (EDI) of the sum of DDXs and the sum of HCHs based on the bioaccessible concentration were only about 17% and 55% of the total EDI based on the residual concentration, respectively. Meat was found to play a more important role in EDI after bioaccessibility correction. The proportion of the population with potential non-carcinogenic and carcinogenic risks markedly decreased when considering bioaccessibility. It was concluded that bioaccessibility should be integrated into dietary exposure evaluation.

Identification of common genetic variants associated with serum concentrations of p, p'-DDE in non-occupational populations in eastern China

Dichlorodiphenyldichloroethylene (DDE) is the major and most stable toxic metabolite of dichlorodiphenyltrichloroethane (DDT), a well-known organochlorine pesticide banned worldwide in the 1980s. However, it remains easy to detect in humans, and internal levels vary widely among individuals. In the present study, a genome-wide association study (GWAS) (511 subjects) and two replications (812 and 1030 subjects) were performed in non-occupational populations in eastern China. An estimated dietary intake (EDI) of p, p'-DDT and p, p'-DDE was calculated by a food frequency questionnaire (FFQ) and the determination of 195 food and 85 drinking water samples. In addition, functional verifications of susceptible loci were performed by dual-luciferase reporter, immunoblotting and metabolic activity assays in vitro. p, p'-DDT and p, p'-DDE were measured using gas chromatography-tandem mass spectrometry (GC-MS/MS). A common loci rs3181842 (high linkage equilibrium with rs2279345) in CYP2B6 at 19p13.2 were found to be strongly associated with low serum levels of p, p'-DDE in this population in GWAS and were verified by two replications and combined analysis of 2353 subjects (P = 1.00 × 10^-22). In addition, p, p'-DDE levels were significantly lower in subjects with the rs3181842 C allele than in those carrying the normal genotype, even in individuals with similar EDIs of p, p'-DDT. Furthermore, the rs3181842 C allele functionally led to low CYP2B6 expression and activity, resulting in a low metabolic capacity for the formation of p, p'-DDE from p, p'-DDT. The study highlighted that CYP2B6 variants were more relevant than environmental exposure to internal p, p'-DDE exposure, which is important information for DDT risk assessments.

A state-of-the-science review of polychlorinated biphenyl exposures at background levels: relative contributions of exposure routes

Exposure to polychlorinated biphenyls (PCBs) can occur through multiple routes and sources, including dietary intake, inhalation, dermal contact, and ingestion of dust and soils. Dietary exposure to PCBs is often considered the primary exposure route for the general population; however, recent studies suggest an increasing contribution from indoor inhalation exposure. Here, we aim to estimate the relative contribution of different PCB exposure pathways for the general population, as well as for select age groups. We conducted a targeted literature review of PCB concentrations in environmental media, including indoor and outdoor air, indoor dust, and soils, as well as of total dietary intake. Using the average concentrations from the studies identified, we estimated PCB exposure through different routes for the general population. In addition, we assessed exposure via environmental media for select age groups. We identified a total of 70 studies, 64 that provided background PCB concentrations for one or more of the environmental media of interest and 6 studies that provided estimates of dietary intake. Using estimates from studies conducted worldwide, for the general population, dietary intake of PCBs was the major exposure pathway. In general, our review identifies important limitations in the data available to assess population exposures, highlighting the need for more current and population-based estimates of PCB exposure, particularly for indoor air and dietary intake.

First nationwide exposure profile of major persistent organic pollutants among Korean adults and their determinants: Korean National Environmental Health Survey Cycle 3 (2015-2017)

Since 2009, Korea has measured the exposure levels of major environmental chemicals and heavy metals among representative adult populations through the Korean National Environmental Health Survey (KoNEHS). However, exposure to persistent organic pollutants (POPs) has never been assessed. This study reports the serum concentrations of twenty-four POPs and their influencing factors for Korean adults (n = 1295) who participated in the KoNEHS Cycle 3 (2015-2017). The POPs included seven organochlorine pesticides (OCPs), eleven polychlorinated biphenyls (PCBs), and six polybrominated diphenyl ethers (PBDEs). Among them, three OCPs (i.e., hexachlorobenzene (HCB), p,p'-dichlorodiphenyltrichloroethane (p,p'-DDT), and p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE)) and five PCBs (i.e., PCB52, PCB118, PCB138, PCB153, and PCB180) were detected in over 60% of the samples. PBDEs were not detected at a detection frequency of 60% or above. The most frequently detected POPs were p,p'-DDE (99.8%, geometric mean of 128.47 ng/g lipid), followed by PCB180 (98.8%, 8.49 ng/g lipid), PCB153 (98.8%, 13.14 ng/g lipid), HCB (96.2%, 67.08 ng/g lipid), PCB138 (95.2%, 8.84 ng/g lipid), PCB118 (89.6%, 2.66 ng/g lipid), p,p'-DDT (80.5%, 6.68 ng/g lipid), and PCB52 (71.2%, 1.57 ng/g lipid). The concentrations of most POPs were lower than or similar to concentrations reported in national-scale biomonitoring surveys. The only exception was HCB, whose concentration was up to seven-fold higher than the concentration reported by the Canadian Health Measures Survey. Excluding HCB and PCB52, most POPs showed increasing serum levels among older adults, adults with higher body mass index, adults living in coastal areas, and more frequent fish consumption. Relatively higher POP concentrations were observed in menopausal women. This study provides the first data on POP exposure levels among the representative adult population in Korea, and the results highlight the need to integrate POPs in the national biomonitoring program.

Dietary exposure to polychlorinated biphenyls (PCB) and risk of Non-Hodgkin's lymphoma: Evidence from the French E3N prospective cohort

INTRODUCTION

Polychlorinated biphenyls (PCB) are persistent and bioaccumulative lipophilic substances, mostly used in the past by industry. Known to be cancerogenic, PCB are suspected to increase Non-Hodgkin's Lymphoma (NHL) risk in the general population mainly due to evidence from cases-controls studies. Since their interdiction in 1987, diet represents the main route of exposure for the general population, nevertheless no study has assessed the relationship between PCB dietary exposure and NHL risk. The aim of this study was to analyze the association between dietary exposures to dioxin like PCB (DL PCB) and non-dioxin like PCB (NDL PCB) and NHL risk in the E3N prospective cohort of French women.

MATERIALS AND METHODS

Among 67,879 women included in this study, 457 cases of NHL were confirmed during 21 years of follow-up. Dietary exposure to PCB was estimated combining food consumption data collected in E3N and food contamination data provided by French Agency for Food, Environmental and Occupational Health & Safety (ANSES) in the second French total diet study. Cox regression models, adjusted for potential confounders, were used to estimate hazard ratio (HR) and 95% confidence intervals (CI).

RESULTS

Average age at diagnosis was 67 years. The median dietary exposure to DL PCB and NDL PCB was, 18.5 pg TEQ/d and 138,843.2 pg/d, respectively. While no association was found between dietary exposure to DL PCB or NDL PCB and overall NHL risk, analyses by NHL histological subgroups showed a positive association between dietary exposures to DL PCB and Diffuse Large B Cell Lymphoma (OR3vs1 1.90, 95%CI [1.03-3.51], p_trend 0.02). Nevertheless these findings were no longer statistically significant when the models were adjusted for fish and dairy products consumption. In addition, an inverse association was found between dietary exposure to NDL PCB and the risk of follicular lymphoma (OR3vs1 0.46, 95%CI [0.24-0.87], p_trend 0.01).

CONCLUSION

This is the first study to evaluate the association between dietary exposure to DL and NDL PCB and the risk of NHL in a prospective cohort study. Overall, the findings suggest a lack of association between dietary exposure to DL or NDL PCB and NHL risk. Additional studies are needed to reproduce these findings.

Dietary Energy Density and Fertility: Results from the Lifestyle and Fertility Study

BACKGROUND

Diet is a modifiable lifestyle factor linked with fertility in a growing number of studies.

OBJECTIVE

The objective of this study was to evaluate the association between dietary energy density (ED), a summary measure of diet quality that estimates the amount of energy per unit food (kcal/g) consumed, and conception and pregnancy outcomes.

METHODS

A prospective cohort study of couples planning their first pregnancy was conducted in the Northeast region of the USA. Dietary data were collected prior to conception via 3 unannounced interviewer-administered 24-h dietary recalls. Multivariable-adjusted logistic regression (ORs and Cox proportional hazards models [RR] and 95% CIs) were estimated for continuous and categorical (tertile [T]) variables of dietary ED.

RESULTS

The majority of women (n = 80; 61%) achieved clinical pregnancy. Median time to conception of a clincal pregnancy(TTC) for those who conceived was 4.64 mo with an IQR of 4.37 mo. ED modeled as a continuous variable was not associated with clinical pregnancy, live birth, or TTC after controlling for race, physical activity, and male partner's ED. When ED was categorized to consider nonlinear associations, 60%, 73%, and 50% of the participants in the tertiles (from lowest ED to highest) achieved clinical pregnancy. In multivariable logistic analyses with the middle group as the referent (ED = 1.37-1.60), membership in the highest ED group (ED >1.60) was associated with lower odds of clinical pregnancy (OR = 0.30; 95% CI: 0.11, 0.81, P = 0.02). In Cox proportional hazards analyses, membership in the highest ED group was associated with significantly longer TTC compared with the middle category (HR = 0.41; 95% CI: 0.21,0.82, P = 0.01).

CONCLUSIONS

These results suggest that high dietary ED is associated with reduced fertility.This study evaluated associations between dietary energy density and the probability of conceiving clinical pregnancy, having a live birth, and the time to conception among couples planning pregnancy.

Associations of persistent organic pollutants in human adipose tissue with retinoid levels and their relevance to the redox microenvironment

Humans are exposed to a myriad of chemical substances in both occupational and environmental settings. Persistent organic pollutants (POPs) have drawn attention for their adverse effects including cancer and endocrine disruption. Herein, the objectives were 1) to describe serum and adipose tissue retinol levels, along with serum retinol binding protein 4 (RBP4) concentrations, and 2) to assess the associations of adipose tissue POP levels with these retinoid parameters, as well as their potential interaction with the previously-observed POP-related disruption of redox microenvironment. Retinol was measured in both serum and adipose tissue along with RBP4 levels in serum samples of 236 participants of the GraMo adult cohort. Associations were explored by multivariable linear regression analyses and Weighted Quantile Sum regression. Polychlorinated biphenyls (PCBs) 180, 153 and 138 were related to decreased adipose tissue retinol levels and increased serum RBP4/retinol ratio. Dicofol concentrations > limit of detection were associated with decreased retinol levels in serum and adipose tissue. Additionally, increased adipose tissue retinol levels were linked to an attenuation in previously-reported associations of adipose tissue PCB-153 with in situ superoxide dismutase activity. Our results revealed a suggestive link between retinoids, PCBs and redox microenvironment, potentially relevant for both mechanistic and public health purposes.

Dietary Intake of Endocrine Disrupting Substances Presents in Environment and Their Impact on Thyroid Function

According to the available data, environmental pollution is a serious problem all over the world. Between 2015 and 2016, pollution was responsible for approximately nine million deaths worldwide. They also include endocrine disrupting chemicals (EDCs) that can interfere with the functioning of the thyroid gland. They are characterized by high persistence in the environment. These substances can enter the body through the gastrointestinal tract, respiratory system, as well as contact with the skin and overcome the placental barrier. EDC can be found in food, water, and personal care products. They can get into food from the environment and as a result of their migration to food products and cosmetics from packaging. EDCs can disrupt the functioning of the thyroid gland through a number of mechanisms, including disrupting the activation of thyroid receptors and the expression of genes that are related to the metabolism, synthesis, and transport of thyroid hormones (HT). There is a need to strengthen the food safety policy that aimed at the use of appropriate materials in direct contact with food. At the same time, an important action is to reduce the production of all waste and, when possible, use biodegradable packaging, which may contribute to the improvement of the quality of the entire ecosystem and the health of food, thus reducing the risk of developing thyroid diseases.

A review of chemical and microbial contamination in food: What are the threats to a circular food system?

A circular food system is one in which food waste is processed to recover plant nutrients and returned to the soil to enable the production of more food, rather than being diverted to landfill or incineration. The approach may be used to reduce energy and water use in food production and contribute to the sustainability of the system. Anaerobic digestion and composting are common food waste treatment technologies used to stabilize waste and produce residual materials that can replenish the soil, thus contributing to a circular food system. This approach can only be deemed safe and feasible, however, if food waste is uncontaminated or any contaminants are destroyed during treatment. This review brings together information on several contaminant classes at different stages of the food supply chain, their possible sources, and their fates during composting and digestion. The main aim is to identify factors that could impede the transition towards a safe, reliable and efficient circular food system. We investigated heavy metals, halogenated organic compounds, foodborne pathogens and antibiotic resistance genes (ARGs) in the food system and their fates during digestion and composting. Production and processing stages were identified as major entry points for these classes of contaminants. Heavy metals and foodborne pathogens pose less risk in a circular system than halogenated organics or antibiotic resistance. Given the diversity of properties among halogenated organic compounds, there is conflicting evidence about their fate during treatment. There are relatively few studies on the fate of ARGs during treatment, and these have produced variable results, indicating a need for more research to clarify their fate in the final products. Repeated land application of contaminated food waste residuals can increase the risk of accumulation and jeopardize the safety of a circular food system. Thus, careful management of the system and research into the fate of the contaminants during treatment is needed.

Maternal and cord serum levels of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) among Lebanese pregnant women and predictors of exposure

In this study, the six indicator non-dioxin-like polychlorinated biphenyls NDL-PCBs (PCB28, PCB52, PCB101, PCB138, PCB153, PCB180), as well as four organochlorine pesticides (OCPs), hexachlorobenzene (HCB), β-hexachlorocyclohexane (β-HCH), dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichlorethylene (DDE) were measured in 98 maternal and 49 cord sera samples of a group of Lebanese women who gave birth in three hospitals in Greater Beirut, between March and July 2018. Results showed that the levels of these persistent organic pollutants (POPs) in maternal serum were below critical limits as well as those in other countries (Tunisia, France, Portugal, Spain, Poland, Greenland, Canada, Brazil, and China). The ratios of cord serum concentrations to maternal serum concentrations of analyzed POPs were higher than 1. PCB maternal serum concentrations were found to be linked to illegal incineration (OR = 5.78; p = 0.004) as well as eggs (OR = 4.68; p = 0.027) and fruits and vegetables consumption (OR = 3.92; p = 0.016). OCP concentrations were linked to red meat and cold cuts intake (OR = 3.67-4.59; p = 0.001-0.004). While PCB levels were not correlated to newborns anthropometric measurements, OCP levels in cord serum were found to be positively linked to the birth length of newborns (p = 0.014-0.027).

Endocrine Disruptor Potential of Short- and Long-Chain Perfluoroalkyl Substances (PFASs)-A Synthesis of Current Knowledge with Proposal of Molecular Mechanism

Endocrine disruptors are a group of chemical compounds that, even in low concentrations, cause a hormonal imbalance in the body, contributing to the development of various harmful health disorders. Many industry compounds, due to their important commercial value and numerous applications, are produced on a global scale, while the mechanism of their endocrine action has not been fully understood. In recent years, per- and polyfluoroalkyl substances (PFASs) have gained the interest of major international health organizations, and thus more and more studies have been aimed to explain the toxicity of these compounds. PFASs were firstly synthesized in the 1950s and broadly used in the industry in the production of firefighting agents, cosmetics and herbicides. The numerous industrial applications of PFASs, combined with the exceptionally long half-life of these substances in the human body and extreme environmental persistence, result in a common and chronic exposure of the general population to their action. Available data have suggested that human exposure to PFASs can occur during different stages of development and may cause short- or/and long-term health effects. This paper synthetizes the current literature reports on the presence, bioaccumulation and, particularly, endocrine toxicity of selected long- and short-chain PFASs, with a special emphasis on the mechanisms underlying their endocrine actions.

The concentration of several perfluoroalkyl acids in serum appears to be reduced by dietary fiber

Fiber-rich food intake has been associated with lower serum concentrations of perfluoroalkyl substances (PFAS) in some studies and dietary fiber was related to lower serum PFAS in a recent study. Given the previous epidemiologic data suggesting that fiber might decrease serum PFAS concentrations, we examined the relation of serum PFAS concentrations to intake of dietary fiber in National Health and Nutrition Examination Survey (NHANES) data. We examined the PFAS-fiber association among 6482 adults who participated in the NHANES, 2005-2016. Fiber intake was estimated based on two 24-hour diet recalls. We adjusted the models for determinants of PFAS and potentially confounding factors such as intake of foods reported to increase PFAS exposure. Results were expressed as the percent difference in PFAS concentration per interquartile range (IQR) increase in fiber (and 95 percent confidence interval), and the NHANES sampling parameters were used to make the results generalizable to the U.S. The adjusted percent difference in perfluorooctanoic acid (PFOA) per IQR increase in fiber was -3.64 (-6.15, -1.07); for perfluorooctane sulfonic acid (PFOS) was -6.69 (-9.57, -3.73), and for perfluorononanoic acid (PFNA) was -8.36 (-11.33, -5.29). These results suggest that dietary fiber increases the gastrointestinal excretion of PFOA, PFOS, and PFNA. Because fiber also lowers serum cholesterol, in some studies of the serum cholesterol-PFAS relationship confounding by fiber may be worth evaluating.

Body Representations of Internal Pollution: The Risk Perception of the Circulation of Environmental Contaminants in Pregnant and Breastfeeding Women in Spain

In this article, we analyze how pregnant and breastfeeding women perceive the inside of their bodies as well as their thoughts regarding the accumulation and elimination of chemical compounds present in food, and how these are then transmitted to the fetus. We explore different social perceptions of risk regarding the circulation of chemical compounds inside the body using qualitative research based on the technique of body mapping, comprised of women’s figures of their bodies in combination with comments on the figures, food diaries and narratives from in-depth interviews. We examine how these 41 women (21 pregnant and 20 breastfeeding) perceive the body’s internal mechanisms during the stages of pregnancy and breastfeeding, as well as the circulation of chemical contaminants within it. The body mapping technique allowed us to analyze participants’ knowledge of internal pollution, a little-understood process in society. Thanks to these pregnant and breastfeeding women, who made an effort to represent and reflect on these new risks, this study shows that scientists and obstetricians need to collaborate with women in order to better understand and publicize the risks of internal pollution.

Risk to human health related to the presence of perfluoroalkyl substances in food

The European Commission asked EFSA for a scientific evaluation on the risks to human health related to the presence of perfluoroalkyl substances (PFASs) in food. Based on several similar effects in animals, toxicokinetics and observed concentrations in human blood, the CONTAM Panel decided to perform the assessment for the sum of four PFASs: PFOA, PFNA, PFHxS and PFOS. These made up half of the lower bound (LB) exposure to those PFASs with available occurrence data, the remaining contribution being primarily from PFASs with short half-lives. Equal potencies were assumed for the four PFASs included in the assessment. The mean LB exposure in adolescents and adult age groups ranged from 3 to 22, the 95th percentile from 9 to 70 ng/kg body weight (bw) per week. Toddlers and 'other children' showed a twofold higher exposure. Upper bound exposure was 4- to 49-fold higher than LB levels, but the latter were considered more reliable. 'Fish meat', 'Fruit and fruit products' and 'Eggs and egg products' contributed most to the exposure. Based on available studies in animals and humans, effects on the immune system were considered the most critical for the risk assessment. From a human study, a lowest BMDL 10 of 17.5 ng/mL for the sum of the four PFASs in serum was identified for 1-year-old children. Using PBPK modelling, this serum level of 17.5 ng/mL in children was estimated to correspond to long-term maternal exposure of 0.63 ng/kg bw per day. Since accumulation over time is important, a tolerable weekly intake (TWI) of 4.4 ng/kg bw per week was established. This TWI also protects against other potential adverse effects observed in humans. Based on the estimated LB exposure, but also reported serum levels, the CONTAM Panel concluded that parts of the European population exceed this TWI, which is of concern.

Determination of perfluoroalkyl substances (PFASs) in fats and oils by QuEChERS/micro-HPLC-MS/MS

Per- and polyfluoroalkyl substances (PFASs) are man-made chemicals that have been identified as global pollutants. Their widespread occurrence, including in food, is a potential concern for consumers. This work focuses on the application of a simple and reliable analytical method for the simultaneous determination of ten perfluoroalkyl acids in highly complex fatty matrices (fats and oils). The perfluoroalkyl substances were extracted by the QuEChERS method, based on the dispersive-Solid Phase Extraction using styrene-divinylbenzene bulk sorbent, and quantitatively analysed by micro-high performance liquid chromatography tandem mass spectrometry. Recoveries ranged from 72 to 104% with an acceptable relative standard deviation below 10%. Limits of quantification were within the range 0.002-0.075 ng/g depending on the perfluoroalkyl compound. The most predominant compound in fat and oil food samples was perfluorooctanoic acid (PFOA) with a detection frequency of 100%, and the highest levels were found for perfluorobutanoic acid (PFBA). The estimated exposure to PFOA, which was 46% and 19% of the existing TWI for the EU and Polish population, respectively, is relatively high and indicates a potential risk to human health.

Potential therapeutic applications of the gut microbiome in obesity: from brain function to body detoxification

The prevalence of obesity is rising every year and associated comorbidities such as cardiovascular diseases are among the leading causes of death worldwide. The gut microbiota has recently emerged as a potential target for therapeutic applications to prevent and treat those comorbidities. In this review, we focus on three conditions related to obesity in which the use of gut microbiota modulators could have benefits; mood disorders, eating behaviors, and body detoxification of persistent organic pollutants (POPs). On one hand, modulation of gut-derived signals to the brain in a context of obesity is involved in the development of neuroinflammation and can subsequently alter behaviors. An altered gut microbiome could change these signals and alleviate their consequences. On the other hand, obesity is associated with an increased accumulation of lipophilic contaminants, such as POPs. Targeting the microbiota could help body detoxication by reducing bioavailability, enhancing degradation by bioremediation or their excretion through the enterohepatic circulation. Thus, a supplementation of prebiotics, probiotics, or synbiotics could represent a complementary strategy to current ones, such as medication and lifestyle modifications, to decrease depression, alter eating behaviors, and lower body burden of pollutants considering the actual obesity epidemic our society is facing.

Perceptions and Attitudes of Gynecologic and Pediatric Professionals Regarding Dietary Exposure to Chemical Pollutants

There is increasing concern regarding the potential implications of continuous dietary exposure to low doses of artificial chemical pollutants, particularly in critical life stages such as pregnancy and lactation. Within a wider social research, we analyzed the risk perception, discourses, and attitudes of health professionals regarding dietary exposure to artificial chemical contaminants. Data was collected by personal interviews on 35 health professionals from two Spanish regions. Although the participants' discourses were strongly dominated by the nutritional composition and microbiological contamination, 34 expressed some concern regarding metals, and 23 regarding pesticides. Although only one participant mentioned a plasticizer (i.e., bisphenol A), we noted an underlying concern, since six professionals admitted to recommending pregnant women to somewhat avoid plastic food containers, and were aware of mother-to-child transmission and accumulation of artificial chemicals. The ubiquity of the exposure, the inability to locate the threat, and contradictory messages can all create a sense of helplessness and subsequent cognitive adjustments. Our participants also reported a lack of information, particularly on emerging pollutants. In conclusion, we found a range of valuable discourses that can aid in orienting public health strategies aimed at health professionals who have a substantial influence on their patients.

An acute exposure to perfluorooctanoic acid causes non-reversible plasma membrane injury in HeLa cells

Health and environmental risks regarding perfluorooctanoic acid, a well-known perfluorinated compound, are still a subject of great concern. Ubiquitous exposure and disparity of results make it difficult to determine the underlying mechanism of action, especially at the cellular level. This study proposes an experimental design to assess the reversibility of adverse effects after a one-time exposure to the compound, in comparison with other more conventional timings. Complementary endpoints including total protein content, neutral red uptake and MTT reduction tests along with division rates and microscopic observations were evaluated in HeLa cells. In addition, PFOA quantification inside the cells was performed. The cellular effects exerted after 24 h exposure to perfluorooctanoic acid are non-reversible after a 48 h recovery period. In addition, we describe for the first time the induction of plasma membrane blebbing and the activation of membrane repair mechanisms after recovery from non-cytotoxic treatments with the compound. This experimental design has provided relevant information regarding the toxicity of this perfluorinated compound, relating all the adverse effects detected to its interaction with the plasma membrane.

Exposure to dietary polychlorinated biphenyls and dioxins, and its relationship with subclinical coronary atherosclerosis: The Aragon Workers' Health Study

BACKGROUND

Experimental evidence has revealed that exposure to polychlorinated biphenyls (PCBs) and dioxins directly impairs endothelial function and induces atherosclerosis progression. In the general population, despite a small number of recent studies finding a link between PCBs, and stroke and myocardial infraction, the association with early coronary atherosclerosis has not been examined yet.

OBJECTIVE

To examine whether dietary exposure to PCBs and dioxins is associated with subclinical coronary atherosclerosis in a middle-aged men.

DESIGN

Cross-sectional analysis comprising 1844 men in their 50 s and free of cardiovascular disease, who participated in the Aragon Workers' Health Study (AWHS). Individual dietary exposures to PCBs and dioxins were estimated by the contaminant's concentration in food coupled with the corresponding consumption and then participants were classified into quartiles of consumption. Coronary artery calcium score (CACS) was assessed by computerized tomography. We conducted ordered logistic regressions to estimate the odds ratio (OR) and 95% confidence intervals (CIs) for progression to the categories of more coronary artery calcium, adjusting for potential confounders.

RESULTS

Among the participants, coronary calcium was not shown in 60.1% (n = 1108), 29.8% had a CACS > 0 and <100 (n = 550), and the remaining 10.1% (n = 186) had a CACS ≥ 100. Compared with those in the first quartile of PCBs exposure, those in the fourth one had an increased odds for having coronary calcium (OR 2.02, 95% CI [1.18, 3.47], p trend 0.019) and for having progressed to categories of more intense calcification (OR 2.03, 95% CI [1.21, 3.40], p trend 0.012). However, no association was found between dietary dioxins exposure and prevalent coronary artery calcium.

CONCLUSIONS

In this general male population, dietary exposure to PCBs, but not to dioxins, was associated with a higher prevalence of coronary calcium and to more intense subclinical coronary atherosclerosis. PCBs exposure seems to increase the risk of coronary disease in men from the very early stages.

Patterns of PCBs and OCPs exposure in a sample of Lebanese adults: The role of diet and physical activity

BACKGROUND

Exposure to persistent organic pollutants (POPs) in the general population is 90% from food intake. Dietary patterns provide a global estimation of exposure to POPs, taking into account multiple food sources of environmental contaminants.

OBJECTIVES

To evaluate the association of dietary, socio-demographic, anthropometric, and lifestyle-related variables with clusters of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs), in a sample of students and employees of Saint Joseph University of Beirut.

METHODS

A total of 302 participants were randomly recruited. Questionnaires covering dietary, socio-demographic, and lifestyle-related characteristics were administered. Anthropometric measurements were obtained. Serum concentrations of six indicator PCBs (PCB 28, 52, 101, 138, 153 and 180) and four OCPs, hexachlorobenzene (HCB), β-hexachlorocyclohexanes (β-HCH), p,p'-dichlorodiphenyltrichloroethane (DDT) and its metabolite p,p'-dichlorodiphenyldichloroethylene (DDE) were measured, and cluster analysis was applied. We evaluated the association of dietary intake with PCBs/OCPs exposure using two different approaches: food consumption categories and dietary patterns retrieved from principal component analysis (PCA).

RESULTS

Three clusters of PCBs/OCPs were obtained: middle-level, high-level, and low-level. Practicing physical activity was associated with a three times higher risk of having high-level PCBs/OCPs, after adjustment for confounding variables (ORa = 2.97; CI = 1.23-7.19; p < 0.05). The highest tertile of fish and shellfish consumption increased by three-folds the odds of having high-level PCBs/OCPs (ORa = 3.41; CI = 1.07-10.84; p < 0.05). PCA revealed six dietary patterns. A "cereals, fats and oils, and eggs" dietary pattern was associated with 50% increase in the risk of having high-level PCBs/OCPs (ORa = 1.48; CI = 1.03-2.13; p < 0.05).

CONCLUSION

The present results offer a valuable contribution to the understanding of the factors increasing exposure to POPs, namely fish consumption and the "cereals, fats and oils, and eggs" dietary pattern. We also demonstrated that physical activity was positively associated with a higher risk of exposure to PCBs and OCPs, knowing that data on this matter are scarce.

Prenatal exposure to PFOS and PFOA in a pregnant women cohort of Catalonia, Spain

This study was aimed at assessing the prenatal exposure to perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) in a cohort of pregnant women living in Reus (Tarragona County, Catalonia, Spain). These chemicals were biomonitored in maternal plasma during the first trimester of pregnancy, at delivery, and in cord blood. The dietary exposure of PFOS and PFOA was estimated by using questionnaires of food frequency and water intake, as well as data on food levels previously reported in the same area. In addition, the exposure through air inhalation and indoor dust ingestion was also calculated. Finally, a physiologically-based pharmacokinetic (PBPK) model was applied in order to establish the prenatal exposure of the fetus/child and to adjust exposure assessment vs. biomonitoring results. Probabilistic calculations of fetal exposure were performed by forward internal dosimetry and Monte-Carlo simulation. Mean plasma levels of PFOA were 0.45, 0.13 and 0.12 ng/mL at the first trimester, at delivery and in cord plasma, while those of PFOS were 2.93, 2.21, and 1.17 ng/mL, respectively. Traces of PFOS were found in all samples in the trimester and at delivery, and almost in all cord blood samples. Transplacental transfers of PFOS and PFOA were estimated to be around 70% and 60%, respectively. A temporal decrease trend in plasma levels of PFOS and PFOA was noticed, when comparing current values with data obtained 10 years ago in the same area. In agreement with many other studies, dietary intake was the main route of exposure to PFOS and PFOA in our cohort of pregnant women. It is an important issue to establish the exposure in critical windows periods such as fetal development to perfluoroalkylated substances, but also to other endocrine disrupting chemicals.

Associations of multiple exposures to persistent toxic substances with the risk of hyperuricemia and subclinical uric acid levels in BIOAMBIENT.ES study

Hyperuricemia is becoming a serious public health issue, which is highly influenced by environmental factors, although there is still controversial information on the potential influence of the exposure to Persistent Toxic Substances (PTSs) in the general population. In this study we aimed to assess the association. PTS exposure with uric acid homeostasis in a sample of the Spanish population. Participants were recruited during 2009-2010 in all the main geographical areas of Spain. Exposure to 34 PTSs was estimated by chemical analyses of serum levels of 6 Polychlorinated Biphenyls (PCBs, n = 950), 13 Organochlorine Pesticides (OCPs, n = 453), 6 Perfluoroalkyl Substances (PFAs, n = 755), 7 Polybrominated Diphenyl Ethers (PBDEs, n = 365), urinary Cadmium (n = 926), and Lead in whole blood (n = 882). The two study outcomes were defined as the prevalence of hyperuricemia in the study population and uric acid levels, the latter only in individuals with no previous diagnosis of hyperuricemia. Statistical analyses were performed by means of binomial logistic regression and linear regression, and mixture effects were screened using Weighted Quantile Sum Regression (WQS). Serum concentrations of γ-HCH, o,p´-DDE, PCB-138, PCB-153, PFOA, and urinary Cadmium were associated with an increased risk of hyperuricemia, while PBDE-153 showed an inverse association with the effect. Furthermore, exposure to Cadmium, PCB-138, and to PCB-153 was positively associated with uric acid levels. Results were consistent after lipid adjustment or standardization. WQS analyses revealed a major contribution of PCB-153 within the PCB mixture on both the risk of hyperuricemia and uric acid levels. Sensitivity analyses were performed by adjusting for dietary habits, fasting glucose and estimated glomerular filtration rate. Overall, we found novel associations between human exposure to mixtures of PTSs and disturbances in uric acid homeostasis. However, we cannot completely rule out potential residual confounding effect or reversed-causality related to the cross-sectional design.