Multiple persistent organic pollutants in mothers' breastmilk: Implications for infant dietary exposure and maternal thyroid hormone homeostasis in Uganda, East Africa

Levels and carcinogenic risk assessment of polycyclic aromatic hydrocarbons in the breast milk of selected lactating mothers in Abeokuta, Nigeria

This study evaluated the levels and carcinogenic risks of polycyclic aromatic hydrocarbons (PAHs) in the breast milk of lactating mothers. Breast milk biomonitoring provides insights into human exposure levels of PAHs from increasing environmental sources, which is scantily reported in Nigeria. Twenty-eight breast milk samples were obtained from lactating mothers with written informed consent, and lifestyle data was elicited with a structured questionnaire. Eight PAH compounds were analyzed using Gas Chromatography with Flame Ionization Detector. Detected PAH levels significantly exceed the European Union maximum permissible limits for human exposure (0.001 mg/kg) in all samples. Benzo[a]pyrene (BaP) (1.07 mg/kg) was the highest, and lowest was benzo[b]naphtho[2,1-d]thiophene (BNT) (0.07 mg/kg), which was higher than the average concentrations reported in most studies globally. This may suggest substantial risks of acute and chronic health effects to vulnerable groups (lactating mothers and newborns). The carcinogenic risk assessment indicates that 60% of infants may develop carcinogenic health risks due to the ingestion of PAH-contaminated breast milk. Low birth weight, preterm birth, and fetal loss were experienced by the participating mothers. Findings highlight the potential health risk posed by the elevated levels of PAHs, thus necessitating timely interventions that would mitigate the risks of PAHs.

Polybrominated diphenyl ethers in paired dust-breast milk samples: Levels, predictors of contamination, and health risk assessment for infants and mothers

An integrated study on the levels of 7 polybrominated diphenyl ethers (PBDEs) in house dust and breast milk samples from women (N = 30) living in these households was conducted. ∑PBDEs ranged from Collapse

Key Words

• Biomonitoring
• Flame retardants
• House dust
• PBDEs
• Risk assessment

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MESH Headings

• Humans
• Halogenated Diphenyl Ethers/analysis
• Milk, Human/chemistry
• Dust/analysis
• Female
• Adult
• Risk Assessment
• Infant
• Environmental Pollutants/analysis
• Young Adult
• Maternal Exposure
• Mothers

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Affiliation(s)

Karla Jagić Division of Environmental Hygiene, Institute for Medical Research and Occupational Health, Ksaverska cesta 2, Zagreb 10001, Croatia
Marija Dvoršćak Division of Environmental Hygiene, Institute for Medical Research and Occupational Health, Ksaverska cesta 2, Zagreb 10001, Croatia
Blanka Tariba Lovaković Division of Toxicology, Institute for Medical Research and Occupational Health, Ksaverska cesta 2, Zagreb 10001, Croatia
Darija Klinčić Division of Environmental Hygiene, Institute for Medical Research and Occupational Health, Ksaverska cesta 2, Zagreb 10001, Croatia.

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Occurrence and ecotoxicological impacts of polybrominated diphenyl ethers (PBDEs) in electronic waste (e-waste) in Africa: Options for sustainable and eco-friendly management strategies

Polybrominated diphenyl ethers (PBDEs) are persistent contaminants used as flame retardants in electronic products. PBDEs are contaminants of concern due to leaching and recalcitrance conferred by the stable and hydrophobic bromide residues. The near absence of legislatures and conscious initiatives to tackle the challenges of PBDEs in Africa has allowed for the indiscriminate use and consequent environmental degradation. Presently, the incidence, ecotoxicity, and remediation of PBDEs in Africa are poorly elucidated. Here, we present a position on the level of contamination, ecotoxicity, and management strategies for PBDEs with regard to Africa. Our review shows that Africa is inundated with PBDEs from the proliferation of e-waste due to factors like the increasing growth in the IT sector worsened by the procurement of second-hand gadgets. An evaluation of the fate of PBDEs in the African environment reveals that the environment is adequately contaminated, although reported in only a few countries like Nigeria and Ghana. Ultrasound-assisted extraction, microwave-assisted extraction, and Soxhlet extraction coupled with specific chromatographic techniques are used in the detection and quantification of PBDEs. Enormous exposure pathways in humans were highlighted with health implications. In terms of the removal of PBDEs, we found a gap in efforts in this direction, as not much success has been reported in Africa. However, we outline eco-friendly methods used elsewhere, including microbial degradation, zerovalent iron, supercritical fluid, and reduce, reuse, recycle, and recovery methods. The need for Africa to make and implement legislatures against PBDEs holds the key to reduced effect on the continent.

Polychlorinated biphenyls and risk of metabolic syndrome and comparison with the risk of diabetes: A systematic review and meta-analysis

With the increasing incidence of metabolic syndrome (MetS) worldwide and no consistent results on PCBs and MetS. A meta-analysis to explore their relationship was conducted. Given the high correlation and overlap of MetS with diabetes, analysis of diabetes risk, was used as a supplement to compare with MetS. Seven studies included MetS, 15 studies for diabetes, and one study included both outcomes. It was found that PCBs may not be a risk factor for MetS, but their high heterogeneity indicates that they are under-represented. In addition, our results showed that total PCBs might be a protective factor against diabetes. In the whole blood subgroup, which can reflect the accumulation of more than one body load, heterogeneity was reduced, and its OR value suggested that PCBs increased the risk of MetS in the whole blood biomaterial. DL-PCBs were positively associated with MetS and diabetes, while NDL-PCBs were negatively associated with diabetes. In the subgroup analysis of PCBs homologs, DL-PCB-126 and DL-PCB-118 were risk factors for MetS and diabetes, respectively. In addition, PCB-153 and 180 showed a dose-response relationship between them and diabetes mellitus, respectively. The results of total analysis of MetS and diabetes mellitus and subgroup analysis of PCBs were mixed, and this reason might be attributed to the different mechanisms of action and effect sizes of different PCBs, so based on subgroup results and in vivo and in vitro experiments, we considered PCBs to be a risk factor for MetS and diabetes. Due to various reasons, there are still many shortcomings in the evaluation of PCBs impact on human health, and more high-quality research are needed to further explore the role of PCBs of different species and congeners in MetS and diabetes.

Perchlorate and chlorate assessment in drinking water in northern Chilean cities

Perchlorate and chlorate are endocrine disruptors considered emerging contaminants (ECs). Both oxyanions are commonly associated with anthropogenic contamination from fertilizers, pesticides, explosives, and disinfection byproducts. However, the soils of the Atacama Desert are the most extensive natural reservoirs of perchlorate in the world, compromising drinking water sources in northern Chile. Field campaigns were carried (2014-2018) to assess the presence of these ECs in the water supply networks of twelve Chilean cities. Additionally, the occurrence of perchlorate, chlorate and other anions typically observed in drinking water matrices of the Atacama Desert (i.e., nitrate, chloride, sulfate) was evaluated using a Spearman correlation analysis to determine predictors for perchlorate and chlorate. High concentrations of perchlorate (up to 114.48 μg L-1) and chlorate (up to 9650 μg L-1) were found in three northern cities. Spatial heterogeneities were observed in the physicochemical properties and anion concentrations of the water supply network. Spearman correlation analysis indicated that nitrate, chloride, and sulfate were not useful predictors for the presence of perchlorate and chlorate in drinking water in Chile. Hence, this study highlights the need to establish systematic monitoring, regulation, and treatment for these EC of drinking water sources in northern Chilean cities for public health protection.

Polychlorinated dibenzo-p-dioxins and dibenzofurans and dioxin-like polychlorinated biphenyls in human milk from national human breast milk monitoring in 2016-2019 in China

Human breast milk monitoring programs were recommended to be carried out to assess human body burden to persistent organic pollutants and their temporal trends. Thus, we conducted a national survey during the period of 2016-2019 to determine PCDD/Fs and dl-PCBs in human breast milk from China. The total TEQ amounts in the upper bound (UB) was in the range of 1.97 to 15.1 pg TEQ g^-1 fat with a geometric mean (GM) of 4.50 pg TEQ g^-1 fat. 2,3,4,7,8-PeCDF, 1,2,3,7,8-PeCDD, and PCB-126 were more predominant contributors with the percentage contribution of 34.2 %, 17.9 %, and 17.4 %, respectively. By comparison with our previous monitoring results, the total TEQ in breast milk sample of the present study is statistically lower than that in 2011 with a reduction of 16.9 % in the average (p < 0.05), and comparable to that in 2007. The estimated GM of dietary intake of total TEQ for the breastfed was 25.4 pg TEQ kg^-1 body weight day^-1 that was higher than that of the adult. It is therefore worthy to make more efforts to reduce amounts of PCDD/Fs and dl-PCBs in breast milk and to continue monitoring to further observe if the amount of these chemicals continue to decrease.

Endocrine-Disrupting Chemicals and Persistent Organic Pollutants in Infant Formulas and Baby Food: Legislation and Risk Assessments

Human milk is the healthiest option for newborns, although, under specific circumstances, infant formula is a precious alternative for feeding the baby. Except for the nutritional content, infant formulas and baby food must be pollutant-free. Thus, their composition is controlled by continuous monitoring and regulated by establishing upper limits and guideline values for safe exposure. Legislation differs worldwide, although there are standard policies and strategies for protecting vulnerable infants. This work presents current regulations and directives for restricting endocrine-disrupting chemicals and persistent organic pollutants in infant formulas. Risk assessment studies, which are limited, are necessary to depict exposure variations and assess the health risks for infants from dietary exposure to pollutants.

Ecologies, synergies, and biological systems shaping human milk composition-a report from "Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)" Working Group 2

Human milk is universally recognized as the preferred food for infants during the first 6 mo of life because it provides not only essential and conditionally essential nutrients in necessary amounts but also other biologically active components that are instrumental in protecting, communicating important information to support, and promoting optimal development and growth in infants. Despite decades of research, however, the multifaceted impacts of human milk consumption on infant health are far from understood on a biological or physiological basis. Reasons for this lack of comprehensive knowledge of human milk functions are numerous, including the fact that milk components tend to be studied in isolation, although there is reason to believe that they interact. In addition, milk composition can vary greatly within an individual as well as within and among populations. The objective of this working group within the Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN) Project was to provide an overview of human milk composition, factors impacting its variation, and how its components may function to coordinately nourish, protect, and communicate complex information to the recipient infant. Moreover, we discuss the ways whereby milk components might interact such that the benefits of an intact milk matrix are greater than the sum of its parts. We then apply several examples to illustrate how milk is better thought of as a biological system rather than a more simplistic "mixture" of independent components to synergistically support optimal infant health.

Postnatal exposure to organic pollutants in maternal milk in north-western Spain

Evaluation of postnatal exposure to organic pollutants is especially important for suckling infants during breastfeeding, a crucial perinatal growth period when organs and hormonal systems develop. We determined levels of 60 pollutants, including organochlorine pesticides (OCPs), organophosphorus pesticides (OPPs), pyrethroids (PYRs), polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), and polybrominated diphenyl ethers (PBDEs), in 81 breast milk samples from breastfeeding mothers from Santiago de Compostela (north-western Spain). For most detected organic pollutants, levels were correlated with the season of milk sampling, maternal age at delivery, and place of residence. Dietary consumption habits (eggs, molluscs, and vegetable oils) were also correlated with OCP, OPP, PCB, PBDE and PYR levels. We also assessed the risk to infant health of exposure to organic pollutants in breast milk. PAHs, OCPs, OPPs, and PYRs accounted for almost 95% of the targeted organic pollutants in the samples analysed.

A bibliometric analysis of pre- and post-Stockholm Convention research publications on the Dirty Dozen Chemicals (DDCs) in the African environment

Persistent organic pollutants (POPs) are toxic chemicals that stay in the environment for a long time. To address the toxicity issues, global nations, including 53 African countries, ratified the Stockholm Convention to minimize or eliminate the production of 12 POPs known as the "Dirty Dozen". However, these Dirty Dozen Chemicals (DDCs) still exist in significant concentration in the African environment, prompting numerous research to investigate the level of their occurrences. Here, we conducted a bibliometric analysis to examine the publication trends in DDCs-related research in Africa using articles published between 1949 and 2021 from the Web of Science and Scopus databases. A total of 884 articles were published within the survey period, with a publication/author and author/publication ratio of 0.36 and 2.76, respectively. South Africa ranked first in terms of number of publications (n = 133, 15.05%), and total citations (n = 3115), followed by Egypt (n = 117), Nigeria (n = 77), USA (n = 40), and Ghana (n = 38). Research collaboration was relatively high (collaboration index = 2.88). The insignificant difference between the theoretical and observed Lotka's distribution indicates Lotka's law does not fit the DDC literature. An annual growth rate of 0.57% implies that a substantial increase of articles in years to come is not expected. More research programs should be established in other African countries to measure up to South Africa's supremacy. This is critical in order to provide a basis for effective compliance to the Stockholm Convention on POPs in Africa.

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

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

A Review of Polychlorinated Biphenyls (PCBs) Pollution in the Air: Where and How Much Are We Exposed to?

Polychlorinated biphenyls (PCBs) were widely used in industrial and commercial applications, until they were banned in the late 1970s as a result of their significant environmental pollution. PCBs in the environment gained scientific interest because of their persistence and the potential threats they pose to humans. Traditionally, human exposure to PCBs was linked to dietary ingestion. Inhalational exposure to these contaminants is often overlooked. This review discusses the occurrence and distribution of PCBs in environmental matrices and their associated health impacts. Severe PCB contamination levels have been reported in e-waste recycling areas. The occurrence of high PCB levels, notably in urban and industrial areas, might result from extensive PCB use and intensive human activity. Furthermore, PCB contamination in the indoor environment is ten-fold higher than outdoors, which may present expose risk for humans through the inhalation of contaminated air or through the ingestion of dust. In such settings, the inhalation route may contribute significantly to PCB exposure. The data on human health effects due to PCB inhalation are scarce. More epidemiological studies should be performed to investigate the inhalation dose and response mechanism and to evaluate the health risks. Further studies should also evaluate the health impact of prolonged low-concentration PCB exposure.

Polycyclic aromatic hydrocarbons in breast milk of nursing mothers: Correlates with household fuel and cooking methods used in Uganda, East Africa

Maternal breast milk, which is a complete food for the infant's growth, development, and health, contains fats and lipids making it susceptible to accumulation of lipophilic compounds like polycyclic aromatic hydrocarbons (PAHs). This study aimed at analyzing correlates of measured levels of PAHs in breast milk of nursing mothers to frequently used household fuels and cooking methods in Uganda, and estimate the potential health risks of PAHs to infants through breastfeeding. Sixty breast milk samples were collected from healthy and non-smoking mothers who had lived in Kampala capital city (urban area) and Nakaseke district (rural area) for at least five years. Sample extracts were analyzed for PAHs using a gas chromatograph coupled with a triple quadrupole mass spectrometer. ∑₁₃PAHs in samples from Kampala ranged from 3.44 to 696 ng/g lw while those from Nakaseke ranged from 0.84 to 87.9 ng/g lw. PAHs with 2-3 rings were more abundant in the samples than PAHs with 4-6 rings. At least 33 % of the variance in the levels of ∑₁₃PAHs in the breast milk samples was attributable to the fuel type and cooking methods used. Nursing mothers who used charcoal for cooking accumulated higher levels of ∑₁₃PAHs in their breast milk samples compared to those who used firewood. Levels of ∑₁₃PAHs in breast milk of mothers increased depending on the cooking methods used in the order; boiling< grilling< deep-frying. In all samples, hazard quotients for PAHs were <1 and estimated incremental cancer risks were all between 10^-6 and 10^-4, indicating that the health risks to infants due to the ingestion of PAHs in breast milk was tolerable. Further studies with large datasets on PAHs and their derivatives and, larger samples sizes are needed to confirm these findings.

Accumulation characteristics of polychlorinated dibenzo-p-dioxins and dibenzofurans and polychlorinated biphenyls in human breast milk from a seaside city of North China

Breast milk samples were collected from 51 mothers in a seaside city Dalian, where the residents usually have higher dietary exposure to polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and polychlorinated biphenyls (PCBs) due to the larger consumption of seafood. The lipid-basis concentrations of ∑Cl_2-8DD/Fs, ∑Cl_2-10Bs, and total toxicity equivalent (WHO-TEQ) were measured to be in the ranges of 35.7-2727.8 pg/g, 4.91-52.64 ng/g, and 2.27-36.30 pg/g, respectively. The average proportion of ∑Cl_2-3DD/Fs was higher than that of ∑Cl_4-7DD/Fs in the collected human breast milk samples, suggesting that the health risk of Cl_2-3DD/Fs should be especially concerned. The concentration data of PCDD/Fs and PCBs in human breast milk essentially followed a positive skew probability distribution. Women in high-level exposure scenarios exhibited a higher potential to accumulate homologues Cl₄DFs, Cl₇DFs, Cl₈DF, and Cl₆Bs in breast milk. Three PCDD/F congeners (1,2,3,6,7,8-Cl₆DF, 1,2,3,4,7,8-Cl₆DF, and 1,2,3,4,6,7,8-Cl₇DD) and three PCB congeners (PCB 126, PCB 138, and PCB 169) were identified as good indicators for the accumulation of PCDD/Fs and PCBs in human breast milk, respectively. The food-to-milk accumulation factors (FMAF) were calculated to evaluate the accumulation potentials of different PCDD/F and PCB congeners in human breast milk via dietary exposure. The calculated FMAF value presented a non-monotonic variation with the logarithm of n-octanol-water partition coefficient (log K_OW) with a peak at a log K_OW value of about 7.3 and a valley at a log K_OW value of about 8. The mean value of the estimated daily intake (EDI) of total WHO-TEQ for breast-fed infants in Dalian, predicted by Monte Carlo simulation, was 10 folds higher than the upper range of the tolerable daily intake (TDI) value (4 pg WHO-TEQ/kg bw/d), suggesting continued and enhanced efforts should be made to reduce the exposure risk of infants to PCDD/Fs and PCBs.

Perinatal effects of persistent organic pollutants on thyroid hormone concentration in placenta and breastmilk

Thyroid hormones (TH) are known to play a critical role in regulating many biological processes including growth and development, energy homeostasis, thermogenesis, lipolysis and metabolism of cholesterol. Severe TH deficiency especially during fetal development results in cretinism, but can also lead to an imbalance in metabolism with, among others, an alteration in body weight composition. Over the past two decades, increasing evidence has shown that certain persistent organic pollutants (POP) can interfere with the endocrine system. These POP referred to as "endocrine disrupting chemicals" are widely present in the environment and populations are exposed globally. Moreover, epidemiological studies have shown that a particularly sensitive period is the pre- and postnatal time. Indeed, perinatal exposure to such chemicals could lead to the onset diseases in later life. It is known, that, maternal thyroid hormones are transported by the placenta to the fetus from 6 weeks of gestation and it seems that during the first trimester, and part of the second, the fetus is entirely dependent on maternal TH supply for its development. Interferences in the TH-network as a consequence of the exposure to such pollutants could cause variations in TH concentration. Only small changes in maternal thyroid hormone levels in early stages of pregnancy can influence fetal neurological and cardiovascular development, as well as according to recent studies, have effect on childhood body composition. With this review, we will report the most recent and important studies concerning the association between thyroid hormone concentration and POP levels measured during the perinatal period. We will mostly focus on the data recently reported on placenta and breastmilk as main sources for understanding the potential consequences of exposure. The possible link between exposure to pollutants, TH dysregulation and possible adverse outcome will also be briefly discussed. From our literature search, several studies support the hypothesis that pre- and postnatal exposure to different pollutants might play a role in causing variation in thyroid hormone concentration. However, few research papers have so far studied the relationship linking exposure to pollutants, TH concentration and possible health consequences. Therefore, this review highlights the need for further research in this direction.

Levels of Polychlorinated Dibenzo-p-Dioxins/Furans (PCDD/Fs) and Dioxin-Like Polychlorinated Biphenyls (DL-PCBs) in Human Breast Milk in Chile: A Pilot Study

Persistent organic pollutants (POPs) are organic compounds that resist biochemical degradation, moving long distances across the atmosphere before deposition occurs. Our goal was to provide up-to-date data on the levels of polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs) in breast milk from Chilean women and to estimate the exposure of infants due to breast milk consumption. In Chile, we conducted a cross-sectional study based on methodologies proposed by the WHO, with a sample of 30 women recruited from three defined areas: 10 from the Arica Region (urban; Arica and Parinacota Region), 10 from Coltauco (rural; O'Higgins Region), and 10 from Molina (40% rural; Maule Region). High-resolution gas chromatography coupled with high-resolution mass spectrometry (HRGC/HRMS) was performed on pooled samples from each area. We calculated equivalent toxic concentrations (WHO-TEQ) based on the current WHO Toxic Equivalency Factors (TEF). The minimum and maximum values of ∑ PCDDs/Fs + DL-PCBs-TEQ were 4.317 pg TEQ/g fat in Coltauco and 6.31 pg TEQ/g fat in Arica. Molina had a total TEQ of 5.50 pg TEQ/g fat. The contribution of PCDD/Fs was approximately five-fold higher than that of DL-PCBs. The Estimated Daily Intake (EDI) of ∑ PCDDs/Fs + DL-PCBs based on the three pooled samples ranged between 6.71 and 26.28 pg TEQ/kg body weight (bw)/day, with a mean intake of 16.11 (±6.71) pg TEQ/kg bw/day in breastfed children from 0 to 24 months old. These levels were lower than those reported in international studies. Despite the fact that the observed levels were low compared to those in most industrialized countries, the detection of a variety of POPs in breast milk from Chilean women indicates the need for follow-up studies to determine whether such exposures during childhood could represent a health risk in adulthood.