Human breast milk and xenoestrogen exposure: a possible impact on human health

Micro problems with macro consequences: accumulation of persistent organic pollutants and microplastics in human breast milk and in human milk substitutes

Industrial activities provide a modern human lifestyle with advances and comforts in every field. However, such scenario has brought several negative issues. Persistent organic pollutants (POPs) and a growing plastic usage together with the degradation byproducts, namely microplastics (MPs), are current environmental problems present in every ecosystem, disturbing all forms of life. POPs and MPs are also found in human consumption products including animal and vegetal derivatives, human milk substitutes, and in human breast milk. To date, it is currently unknown what are the effects of MPs and POPs when ingested during the first and most important stage for health programming of the offspring, the first 1000 days of life. Here, we add epidemiological and clinical evidence supporting major sources of POPs and MPs in the ecosystem; and we will precisely describe the effect of POP and MP accumulation in animal- or plant-based infant formulas and human breast milk, modulating health outcomes in the newborn. This review provides a rational to incentive the POP and MP identification in human breast milk and human milk substitutes for avoiding susceptibility to negative health outcomes for the newborn.

Oestrogens and progesterone in human milk and their effects on infant health outcomes: A narrative review

Human milk (HM) is a complex biological system that contains a wide range of bioactive components including oestrogens and progesterone. Whilst maternal oestrogens and progesterone concentrations drop rapidly after birth, they remain detectable in HM across lactation. Phytoestrogens and mycoestrogens, which are produced by plants and fungi, are also present in HM and can interact with oestrogen receptors to interfere with normal hormone functions. Despite the potential impact of HM oestrogens and progesterone on the infant, limited research has addressed their impact on the growth and health of breastfed infants. Furthermore, it is important to comprehensively understand the factors that contribute to these hormone levels in HM, in order to establish effective intervention strategies. In this review, we have summarized the concentrations of naturally occurring oestrogens and progesterone in HM from both endogenous and exogenous sources and discussed both maternal factors impacting HM levels and relationships with infant growth.

Evaluation of (Anti)androgenic Activities of Environmental Xenobiotics in Milk Using a Human Liver Cell Line and Androgen Receptor-Based Promoter-Reporter Assay

The recent reports on milk consumption and its associated risk with hormone related disorders necessitates the evaluation of dairy products for the presence of endocrine disrupting chemicals (EDCs) and ensure the safety of consumers. In view of this, we investigated the possible presence of (anti)androgenic contaminants in raw and commercialized milk samples. For this purpose, a novel HepARE-Luc cell line that stably expresses human androgen receptor (AR) and the androgen responsive luciferase reporter gene was generated and used in the present study. Treatment of this cell line with androgens and corresponding antiandrogen (flutamide) stimulated or inhibited expression of reporter luciferase, respectively. Real time polymerase chain reaction and immunostaining results exhibited transcription response and translocation of AR from the cytoplasm to the nucleus in response to androgen. Observations implied that a cell-based xenobiotic screening assay via AR response can be conducted for assessing the (anti)androgenic ligands present in food chain including milk. Therefore, the cell line was further used to screen the (anti)androgenic activity of a total of 40 milk fat samples procured as raw or commercial milk. Some of the raw and commercial milk fat samples distinctly showed antiandrogenic activities. Subsequently, some commonly used environmental chemicals were also evaluated for their (anti)androgenic activities. Initial observations with molecular docking studies of experimental compounds were performed to assess their interaction with AR ligand binding domain. Furthermore, (anti)androgenic activities of these compounds were confirmed by performing luciferase assay using the HepARE-Luc cell line. None of the test compounds showed androgenic activities rather some of them like Bisphenol A (BPA) and rifamycin showed antiandrogenic activities. In conclusion, our results provide a valuable information about the assessment of (anti)androgenic activities present in milk samples. Overall, it is proposed that a robust cell-based CALUX assay can be used to assess the (anti)androgenic activities present in milk which can be attributed to different environmental chemicals present therein.

Effects of Organochlorine Pesticide Residues in Maternal Body on Infants

There are many organochlorine pollutants in the environment, which can be directly or indirectly exposed to by mothers, and as estrogen endocrine disruptors can cause damage to the lactation capacity of the mammary gland. In addition, because breast milk contains a lot of nutrients, it is the most important food source for new-born babies. If mothers are exposed to organochlorine pesticides (OCPs), the lipophilic organochlorine contaminants can accumulate in breast milk fat and be passed to the infant through breast milk. Therefore, it is necessary to investigate organochlorine contaminants in human milk to estimate the health risks of these contaminants to breastfed infants. In addition, toxic substances in the mother can also be passed to the fetus through the placenta, which is also something we need to pay attention to. This article introduces several types of OCPs, such as dichlorodiphenyltrichloroethane (DDT), methoxychlor (MXC), hexachlorocyclohexane (HCH), endosulfan, chlordane, heptachlorand and hexachlorobenzene (HCB), mainly expounds their effects on women's lactation ability and infant health, and provides reference for maternal and infant health. In addition, some measures and methods for the control of organochlorine pollutants are also described here.

Antagonistic activity towards the androgen receptor independent from natural sex hormones in human milk samples from the Norwegian HUMIS cohort

In this paper, we investigated the possible presence of endocrine disrupting chemicals (EDCs) based on measuring the total estrogenic and androgenic activity in human milk samples. We used specific bioassays for analysis of the endocrine activity of estrogens and estrogen-like EDCs and androgens and androgen-like EDCs and developed a separation method to evaluate the contribution from natural hormones in comparison to that of EDCs to total endocrine activities. We extracted ten random samples originating from the Norwegian HUMIS biobank of human milk and analyzed their agonistic or antagonistic activity using the ERα- and AR CALUX® bioassays. The study showed antagonistic activity towards the androgen receptor in 8 out of 10 of the assessed human milk samples, while 2 out of 10 samples showed agonistic activity for the ERα. Further investigations demonstrated anti-androgenic activity in the polar fraction of 9 out of 10 samples while no apolar extracts scored positive. The culprit chemicals causing the measured antagonistic activity in AR CALUX was investigated through liquid chromatography fractionation coupled to bioanalysis and non-target screening involving UHPLC-Q-TOF-MS/MS, using a pooled polar extract. The analysis revealed that the measured anti-androgenic biological activity could not be explained by the presence of endogenous hormones nor their metabolites. We have demonstrated that human milk of Norwegian mothers contained anti-androgenic activity which is most likely associated with the presence of anthropogenic polar EDCs without direct interferences from natural sex hormones. These findings warrant a larger scale investigation into endocrine biological activity in human milk, as well as exploring the chemical sources of the activity and their potential effects on health of the developing infant.

Hormones and Hormonal Anabolics: Residues in Animal Source Food, Potential Public Health Impacts, and Methods of Analysis

The demand for nutritious food, especially food of animal origin, is globally increasing due to escalating population growth and a dietary shift to animal source food. In order to fulfill the requirements, producers are using veterinary drugs such as hormones and hormone-like anabolic agents. Hormones such as steroidal (estrogens, gestagens, and androgens), nonsteroidal, semisynthetic, and synthetic or designer drugs are all growth-promoting and body-partitioning agents. Hence, in food animal production practice, farm owners use these chemicals to improve body weight gain, increase feed conversion efficiency, and productivity. However, the use of these hormones and hormonal growth-promoting agents eventually ends up with the occurrence of residues in the animal-originated food. The incidence of hormone residues in such types of food and food products beyond the tolerance acts as a risk factor for the occurrence of potential public health problems. Currently, different international and national regulatory bodies have placed requirements and legislative frameworks, which enable them to implement residue monitoring test endeavors that safeguard the public and facilitate the trading activity. To make the tests on the animal-origin food matrix, there are different sample extraction techniques such as accelerated solvent extraction, supercritical fluid extraction, solid phase extraction, solid-phase microextraction, and hollow-fiber liquid-phase microextraction. After sample preparation steps, the analytes of interest can be assayed by screening and confirmatory methods of analysis. For screening, immunological tests such as ELISA and radioimmunoassay are used. Detection and determination of the specific residues will be done by chromatographic or instrumental analysis. Mainly, among high-performance liquid chromatography, liquid chromatography with mass spectrometry (LC-MS, LC-MS/MS), and gas chromatography with mass spectrometry (GC-MS and GC-MS/MS) methods, LC-MS/MS is being preferred because of easier sample preparation without a derivatization step and high detection and quantification capacity.

Polycyclic aromatic hydrocarbons in breast milk of obese vs normal women: Infant exposure and risk assessment

Biomonitoring of human breast milk is one of the best ways to identify body burdens of contaminants and associated risk estimation. The objectives of the current study were to evaluate milk concentrations of persistent organic pollutants (POPs), mainly polycyclic aromatic hydrocarbons (PAHs), associated exposure estimation, and the role of body mass index (BMI) in their bioaccumulation. A total of 45 breast milk samples were collected from 24 women with BMI > 30 (obese) and 21 women with BMI < 25 (18.5-24.9, normal) from 14 different counties surrounding Lubbock in west Texas/New Mexico (age range: 18-34 years). Samples were analyzed using high resolution gas chromatography coupled with mass spectrometry. A total of 31/45 (69%) of samples tested positive for PAHs. Phenanthrene was the most frequently detected PAH followed by pyrene and fluoranthene. The mean of individual PAH concentration for all samples ranged from 0 to 25.1 ng/g milk fat; the sum of all means of individual PAHs was 146.9 ng/g milk fat. The mean concentration of total PAHs in the BMI > 30 group was 224.8 ng/g milk fat, which was approximately 4 times the mean concentration of total PAHs in the BMI 18.5-24.9 group (57.9 ng/g milk fat). None of the samples from the BMI 18.5-24.9 group contained higher molecular weight (5-6 rings) PAHs, while in the BMI >30 group, a total of 11 PAHs including listed EPA priority pollutants were observed. In this study, benzo(b)fluoranthene was found to contribute the highest percentage of carcinogenic PAHs (32.08%), yet it was not detected in any samples from the BMI 18.5-24.9 group. The estimated total PAHs intakes by infants via obese and normal mothers' milk were 1.26 and 0.32 (μg/kg/day), which are 0.049 and 0.003 (μg/kg/day) B[a]P equivalent, respectively. These findings suggest that breastfed babies from obese mothers are potentially at higher risk of exposure to carcinogenic PAHs.

Infant Dietary Exposures to Environmental Chemicals and Infant/Child Health: A Critical Assessment of the Literature

BACKGROUND

The benefits of breastfeeding to the infant and mother have been well documented. It is also well known that breast milk contains environmental chemicals, and numerous epidemiological studies have explored relationships between background levels of chemicals in breast milk and health outcomes in infants and children.

OBJECTIVES

In this paper, we examine epidemiological literature to address the following question: Are infant exposures to background levels of environmental chemicals in breast milk and formula associated with adverse health effects? We critically review this literature a) to explore whether exposure-outcome associations are observed across studies, and b) to assess the literature quality.

METHODS

We reviewed literature identified from electronic literature searches. We explored whether exposure-outcome associations are observed across studies by assessing the quality (using a modified version of a previously published quality assessment tool), consistency, and strengths and weaknesses in the literature. The epidemiological literature included cohorts from several countries and examined infants/children either once or multiple times over weeks to years. Health outcomes included four broad categories: growth and maturation, morbidity, biomarkers, and neurodevelopment.

RESULTS

The available literature does not provide conclusive evidence of consistent or clinically relevant health consequences to infants exposed to environmental chemicals in breast milk at background levels.

CONCLUSIONS

It is clear that more research would better inform our understanding of the potential for health impacts from infant dietary exposures to environmental chemicals. A critical data gap is a lack of research on environmental chemicals in formula and infant/child health outcomes. https://doi.org/10.1289/EHP1954.

State of the evidence 2017: an update on the connection between breast cancer and the environment

BACKGROUND

In this review, we examine the continually expanding and increasingly compelling data linking radiation and various chemicals in our environment to the current high incidence of breast cancer. Singly and in combination, these toxicants may have contributed significantly to the increasing rates of breast cancer observed over the past several decades. Exposures early in development from gestation through adolescence and early adulthood are particularly of concern as they re-shape the program of genetic, epigenetic and physiological processes in the developing mammary system, leading to an increased risk for developing breast cancer. In the 8 years since we last published a comprehensive review of the relevant literature, hundreds of new papers have appeared supporting this link, and in this update, the evidence on this topic is more extensive and of better quality than that previously available.

CONCLUSION

Increasing evidence from epidemiological studies, as well as a better understanding of mechanisms linking toxicants with development of breast cancer, all reinforce the conclusion that exposures to these substances - many of which are found in common, everyday products and byproducts - may lead to increased risk of developing breast cancer. Moving forward, attention to methodological limitations, especially in relevant epidemiological and animal models, will need to be addressed to allow clearer and more direct connections to be evaluated.

Lactation history, serum concentrations of persistent organic pollutants, and maternal risk of diabetes

OBJECTIVE

Lactation may help curb diabetes risk and is also known as an excretion route for some environmental pollutants. We evaluated associations of lifetime lactation history with serum concentrations of persistent organic pollutants (POPs) in the National Health and Nutrition Examination Survey 1999-2006, and examined whether potentially diabetogenic POPs account for associations between lactation and diabetes.

RESEARCH DESIGN AND METHODS

Among 4479 parous women, breastfeeding history was defined as the number of children breastfed ≥1 month. Diabetes was identified by self-report or hemoglobin A1c >6.5%. Twenty-four POPs were measured in serum among subsamples of 668 to 1073 participants.

RESULTS

Compared with women without lactation history, odds ratios (95% confidence intervals) of having diabetes among those with 1-2 and ≥3 lactation periods were 0.83(0.61, 1.13) and 0.63(0.44, 0.91; P trend=0.03). Lifetime lactation history was inversely associated with serum concentrations of 17 out of the 24 organochlorine pesticides, polychlorinated biphenyl congeners (PCBs), and perfluoroalkyl substances (Ptrend<0.05). Comparing the ≥3 lactations group with women without a lactation history, the relative reduction of POPs ranged from 12% (PCB-196) to 30% (oxychlordane). The inverse association between lactation and diabetes was slightly attenuated after adjustment for POPs. Age-stratified analyses showed that the inverse association between lactation periods and serum POP concentrations was observed primarily among participants <60 years, whereas age did not significantly modify the association between lactation history and diabetes prevalence.

CONCLUSION

Crudely-classified lifetime lactation history was inversely associated with concurrent serum POP concentrations and diabetes prevalence. Prospective studies are needed to clarify how lactation could complement diabetes prevention through decreasing the POP body burdens.

Risk assessment of environmental mixture effects

Determining interactions of multi-component environmental mixtures towards accurate risk assessment.

Comparison of DDT and its metabolites concentrations in cow milk from agricultural and industrial areas

The risk of pesticidal intoxication in humans is severe, especially because of the strongly negative impact on human health. The consequences of the exposure to these substances may include cancerogenesis or endocrine abnormalities resulting for example in decreased fertility. Therefore, the aim of our study was to evaluate the content of dichlorodiphenyltrichloroethane (DDT) and its metabolites in cow milk from two regions of Poland, varying by level of industrialization. Samples were collected from agricultural (n = 25) and industrial (n = 25) areas, and the concentrations of DDT and its metabolites were evaluated by gas chromatography. Residues of DDT were detected in all the milk samples tested, mostly in the samples from the agricultural area, where a total DDT median concentration reached 0.336 μg L(-1). In the milk samples from the industrial area, the median concentration was lower, at 0.131 μg L(-1). 4,4'-DDT was the main metabolite, constituting 83% of total DDT metabolites. Although none of the samples exceeded the level above which they should be considered dangerous, the results showed that the problem of DDT had not diminished and so should be constantly monitored.

Exogenous hormonal regulation in breast cancer cells by phytoestrogens and endocrine disruptors

Observations on the role of ovarian hormones in breast cancer growth, as well as interest in contraception, stimulated research into the biology of estrogens. The identification of the classical receptors ERα and ERβ and the transmembrane receptor GPER and the resolution of the structure of the ligand bound to its receptor established the principal molecular mechanisms of estrogen action. The presence of estrogen-like compounds in many plants used in traditional medicine or ingested as food ingredients, phytoestrogens, as well as the estrogenic activities of many industrial pollutants and pesticides, xenoestrogens, have prompted investigations into their role in human health. Phyto- and xenoestrogens bind to the estrogen receptors with a lower affinity than the endogenous estrogens and can compete or substitute the hormone. Xenoestrogens, which accumulate in the body throughout life, are believed to increase breast cancer risk, especially in cases of prenatal and prepuberal exposure whereas the role of phytoestrogens is still a matter of debate. At present, the application of phytoestrogens appears to be limited to the treatment of post-menopausal symptoms in women where the production of endogenous estrogens has ceased. In this review we discuss chemistry, structure and classification, estrogen signaling and the consequences of the interactions of estrogens, phytoestrogens and xenoestrogens with their receptors, the complex interactions of endogenous and exogenous ligands, the evaluation of the health risks related to xenoestrogens, and the perspectives toward the synthesis of potent third generation selective estrogen receptor modulators (SERMs).

Environment and human exposure to persistent organic pollutants (POPs) in India: a systematic review of recent and historical data

Persistent organic pollutants (POPs) have been used in a wide range of agricultural and industrial commodities, resulting in vigorous deterioration of environment and human health. A number of studies on the occurrence of POPs confirm their presence in various environmental compartments and human body. In order to deal with this global concern, India has recently prepared the National Implementation Plan (NIP) of the Stockholm Convention. Common beliefs point at India as a hot spot of POP contamination and human exposure; however no systematic analysis was ever performed so far considering all available past data on POP occurrence. This review aims to examine the distribution pattern of POPs in multicompartment environment and human samples, meta-analysis of time trends in exposure levels to environment and humans, and cross country comparison of POP contamination with China. Based on this review, it can be concluded that the Indian environment and human population are highly contaminated by DDTs and HCHs; however scarcity of data on other POPs makes it challenging to assess their nationwide human and environmental exposure. No evidence of a general decline in DDT and HCH residues in the environment and human body come out from the meta-analysis of time trend. While comparing contamination levels between India and China, tendency towards decline in POP contamination is visible in China, unlike India.

Organochlorine pesticide residues in biological compartments of healthy mothers

The present study was conducted to detect placental and breast milk (BM) transfer of organochlorine pesticides (OCPs) between biological compartments in healthy lactating mothers. The study explores the effect of parity, breast-feeding and urban/rural residence on body burden of OCP residues. The study included 38 healthy participants submitted to cesarean delivery. Sociodemographic data and specimens of maternal and umbilical sera, adipose tissue (Adp T) and BM were collected. Specimens were analyzed to detect OCP residues. The lindane in BM, o,p'-dichlorodiphenyldichloroethane (DDD) in maternal serum (MS) and total dichlorodiphenyltrichloroethane (DDT) and o,p'-dichlorodiphenyldichloroethylene in umbilical serum were the only detected residues in significantly higher frequencies and/or means in the primigravidae than multigravidae. There was a high risk of detecting o,p'-DDD (odds ratio = 8.3) in umbilical serum of the mothers with o,p'-DDD detected in the MS. Total DDT was detected in about 65% of specimens of BM, MS and Adp T and in about 40% of the umbilical serum specimens. There was only a significant positive correlation between total DDT residues in the BM and Adp T. Total DDT residues in umbilical serum and Adp T were significantly higher in the urban than in the rural mothers. The detection of some OCPs in maternal biological compartments suggests their potential placental and BM transfer to her child during pregnancy and lactation, respectively. Furthermore, it might reflect the persistence or recent use of these pesticides in the environment.

Brominated flame retardants and polychlorinated biphenyls in human breast milk from several locations in India: potential contaminant sources in a municipal dumping site

This study investigated the status of contamination of organohalogen compounds (OCs) such as polychlorinated biphenyls (PCBs) and brominated flame retardant (BFRs), including polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDs) in human milk samples from several locations in India. The levels of OCs were significantly higher in the milk of mothers living in and near municipal dumping site than other locations indicating that the open dumping sites for municipal wastes act as potential sources of these contaminants in India. The PCB concentrations observed in this study tended to decrease compared to those in the matched locations reported previously, probably due to the restriction of technical PCB usage in India. PBDE levels in human milk were two to three folds lower than those of PCBs in all the sampling locations investigated. Congener profiles of PCBs and PBDEs were different between samples from the dumping site mothers and general populations in other areas suggesting the presence of region-specific sources and pathways. HBCDs were detected in human milk from only two sites, with much lower concentrations and detection frequencies compared to PCBs and PBDEs. When hazard quotients (HQs) of PCBs and PBDEs were estimated for infant health risk, the HQs in some milk samples from the dumping site exceeded the threshold value (HQ>1) of PCBs, indicating the potential risk for infants in the specific site.

Measurement of paraben concentrations in human breast tissue at serial locations across the breast from axilla to sternum

The concentrations of five esters of p-hydroxybenzoic acid (parabens) were measured using HPLC-MS/MS at four serial locations across the human breast from axilla to sternum using human breast tissue collected from 40 mastectomies for primary breast cancer in England between 2005 and 2008. One or more paraben esters were quantifiable in 158/160 (99%) of the tissue samples and in 96/160 (60%) all five esters were measured. Variation was notable with respect to individual paraben esters, location within one breast and similar locations in different breasts. Overall median values in nanograms per gram tissue for the 160 tissue samples were highest for n-propylparaben [16.8 (range 0-2052.7)] and methylparaben [16.6 (range 0-5102.9)]; levels were lower for n-butylparaben [5.8 (range 0-95.4)], ethylparaben [3.4 (range 0-499.7)] and isobutylparaben 2.1 (range 0-802.9). The overall median value for total paraben was 85.5 ng g(-1) tissue (range 0-5134.5). The source of the paraben cannot be identified, but paraben was measured in the 7/40 patients who reported never having used underarm cosmetics in their lifetime. No correlations were found between paraben concentrations and age of patient (37-91 years), length of breast feeding (0-23 months), tumour location or tumour oestrogen receptor content. In view of the disproportionate incidence of breast cancer in the upper outer quadrant, paraben concentrations were compared across the four regions of the breast: n-propylparaben was found at significantly higher levels in the axilla than mid (P = 0.004 Wilcoxon matched pairs) or medial (P = 0.021 Wilcoxon matched pairs) regions (P = 0.010 Friedman ANOVA).

Being breastfed in infancy and adult breast cancer risk among Japanese women

OBJECTIVE

Being breastfed in infancy has been hypothesized to influence subsequent breast cancer risk. In a hospital-based case-control study, we investigated the relationship between having been breastfed and breast cancer risk, both overall and separately among female subjects with different birth years.

METHODS

The study subjects included 571 cases and 2,155 controls admitted to a single hospital in Miyagi Prefecture, Japan, between 1997 and 2005. History of having been breastfed was assessed with a self-administered questionnaire. Odds ratios (ORs) and 95% confidence interval (CI) were estimated using logistic regression.

RESULTS

After adjustment for known risk factors, no association for having been breastfed was observed overall (OR = 1.20; 95% CI: 0.82-1.76). Analysis stratified according to birth year (<1950, ≥1950) demonstrated heterogeneity in the association for having been breastfed between the two birth-year groups (p for interaction = 0.0006); having been breastfed was significantly associated with a decreased risk among subjects who were born before 1950 (OR = 0.59; 95% CI: 0.35-0.99), whereas no such risk reduction was observed for subjects born after 1950 (OR = 1.60; 95% CI: 0.88-2.90).

CONCLUSION

Although having been breastfed is not related to overall risk, birth year may modify the association between having been breastfed in infancy and breast cancer risk. In Japan, sociodemographic changes have occurred since the end of World War II. The use of standard formula supplement began to spread around 1950. The difference of breast cancer risk between birth-year groups may be attributable to these environmental changes.

Estrogens in the daily diet: in vitro analysis indicates that estrogenic activity is omnipresent in foodstuff and infant formula

Food is a main source of exposure to endocrine active compounds, many of which have been linked to adverse health effects. Phytoestrogens, especially from soy, are the major dietary source of estrogenicity. However, foodstuff contains a variety of estrogen-like compounds that might not be detected analytically. To assess the total estrogenic activity of foodstuff, we employed the Yeast Estrogen Screen (YES). We analyzed 18 food samples and five milk-based infant formulas. Soy-based products contained potent estrogenicity of 100-1500ng estradiol equivalents per kilogram (EEQ/kg). The estrogenicity in soy-free products was far lower (10-40ng EEQ/kg). We also detected significant estrogenic activity in three infant formulas (14-22ng EEQ/kg). Furthermore, we found soy lecithin to be strongly estrogenic. It might, therefore, be a major contributor to total estrogenicity. We conclude that dietary estrogens are omnipresent and not limited to soy-based food. In an exposure assessment we calculated a total dietary intake of 27.5 and 34.0ng EEQ/d for adults and 1.46ng EEQ/d for infants. While the dietary exposure to estrogenic activity is lower than previously estimated, our results demonstrate that many food types are a source of unidentified estrogen-like compounds still awaiting toxicological evaluation.

Regional differences in levels of chlorinated and brominated pollutants in mother's milk from primiparous women in Sweden

Early life exposure to halogenated persistent organic pollutants, such as polychlorinated biphenyls (PCBs), the DDT metabolite p,p'-dichlorodiphenyldichloroethane (p,p'-DDE), polybrominated diphenylethers (PBDEs), and hexabromocyclododecane (HBCD), may affect human health. We determined if there are regional differences in mother's milk levels of these compounds in Sweden. In year 2000-2004, milk was sampled from 204 randomly recruited primiparas from four regions of Sweden. Levels of the compounds were measured by gas chromatography with dual electron-capture detectors. Women were recruited at delivery in three hospitals located in urban areas in southern and central Sweden (Lund, Gothenburg and Uppsala), and in one hospital located in a more rural area in northern Sweden (Lycksele). Information about dietary habits and medical/life-style factors were collected by questionnaires. Among PCB congeners, CB 153, CB 138 and CB 180 showed the highest median concentrations (18-48 ng/g mother's milk lipid), whereas more than 50% of the women had CB 52, CB 101, CB 114, and CB 157 levels below the LOQ (0.3-1.5 ng/g lipid). Median p,p'-DDE levels were in the range of 46-78 ng/g lipid. BDE 47 showed the highest median concentrations (1-2 ng/g lipid) among the brominated compounds, whereas more than 50% of the women had levels of BDE 28, BDE 66, BDE 138, BDE 154, and HBCD below the LOQ (0.05-0.10 ng/g lipid). Regional differences in median organohalogen compound concentrations were small, less than 2-fold. Lycksele women generally had the lowest levels of Σmono-and Σdi-ortho PCBs, mainly due to a lower average age. In contrast, these women had higher tetra- to penta-brominated PBDE levels, but no diet or life-style factor could explain this finding. Wide ranges of PBDEs and HBCD levels (up to 200-fold) were found, especially in the Lycksele area. The highest levels of PBDE were in the range of average levels found in mother's milk from North America, suggesting that food may not be the only source of exposure to PBDEs among some individuals.

Assessment of estrogenic activity and total lipids in maternal biological samples (serum and breast milk)

The present study investigated estrogenic activity and total lipid levels in maternal serum and breast milk. The study was performed with 50 mothers from Fang district of northern Thailand. Maternal serum was collected 5 times, including the second trimester, pre-delivery period, delivery period, and lactating period at day 30 and day 60. Breast milk was collected 7 times, including day 1, 7, 14, 21, 30, 45, and 60 of lactation. There were the same patterns of variation between estrogenicity and total lipid levels both in serum and breast milk. The correlation between serum estrogenicity and serum total lipids was found with a correlation coefficient (r) ranging from 0.403 to 0.661. However, no correlation was found between milk estrogenicity and milk total lipids. The results therefore suggest that lipid contents might be the major factors affecting the variation of estrogenicity levels, and xenoestrogens, which the mother subjects exposed, were lipophilic pollutants. The remarkable findings were that the mean levels of estrogenicity in breast milk were approximately 8-13.5 times higher than those in maternal serum compared at the same period. However, no correlation was found between estrogenicity levels in serum and breast milk, leading to decreased accuracy in predicted infant exposure by maternal serum.

Lymphoma and lung cancer in offspring born to pregnant mice dosed with dibenzo[a,l]pyrene: the importance of in utero vs. lactational exposure

The fetus and neonate cannot be viewed as "little adults"; they are highly sensitive to toxicity from environmental chemicals. This phenomenon contributes to the fetal basis of adult disease. One example is transplacental carcinogenesis. Animal models demonstrate that environmental chemicals, to which pregnant women are daily exposed, can increase susceptibility of the offspring to cancer. It is uncertain to what degree in utero vs. lactational exposure contributes to cancer, especially for hydrophobic chemicals such as polyhalogenated biphenyls, ethers, dioxins, furans, etc., which can partition into breast milk. We developed a pregnant mouse model in which exposure to the polycyclic aromatic hydrocarbon (PAH), dibenzo[a,l]pyrene (DBP), during late gestation, produces an aggressive T-cell lymphoma in offspring between 3 and 6 months of age. Survivors exhibit multiple lung and liver (males) tumors. Here, we adopt a cross-foster design with litters born to dams treated with DBP exchanged with those born to dams treated with vehicle. Exposure to DBP in utero (about 2 days) produced significantly greater mortality than residual DBP exposure only through breast milk (3 weeks of lactation). As previously observed pups in all groups with an ahr(b-1/d) ("responsive") genotype were more susceptible to lymphoma mortality than ahr(d/d) ("non-responsive") siblings. At termination of the study at 10 months, mice exposed in utero also had greater lung tumor multiplicity than mice exposed only during lactation. Our results demonstrate that short exposure to DBP during late gestation presents a greater risk to offspring than exposure to this very hydrophobic PAH following 3 weeks of nursing.

Effects of birth order and maternal age on breast cancer risk: modification by whether women had been breast-fed

BACKGROUND

Early life risk factors for breast cancer have been investigated in relation to hormonal, nutritional, infectious, and genetic hypotheses. Recent studies have also considered potential health effects associated with exposure to environmental contaminants in breastmilk.

METHODS

We analyzed data from a population-based case-control study of women living in Wisconsin. Cases (n = 2016) had an incident diagnosis of invasive breast cancer in 2002-2006 reported to the statewide tumor registry. Controls (n = 1960) of similar ages were randomly selected from driver's license lists. Risk-factor information was collected during structured telephone interviews. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from multivariable logistic regression.

RESULTS

In multivariable models, maternal age and birth order were not associated with breast cancer risk in the full study population. The odds ratio for breast cancer risk associated with having been breast-fed in infancy was 0.83 (95% CI = 0.72-0.96). In analyses restricted to breast-fed women, maternal age associations with breast cancer were null (P = 0.2). Increasing maternal age was negatively associated with breast cancer risk among women who were not breast-fed; the odds ratio for breast cancer associated with each 5-year increase in maternal age was 0.90 (0.82-1.00). Higher birth order was inversely associated with breast cancer risk among breast-fed women (for women with 3 or more older siblings compared with first-born women, OR = 0.58 [CI = 0.39-0.86]) but not among nonbreast-fed women (1.13 [0.81-1.57]).

CONCLUSION

These findings suggest that early life risk factor associations for breast cancer may differ according to breast-feeding status in infancy.

Chemical Biomarkers of Human Breast Milk Pollution

Human milk is, without question, the best source of nutrition for infants containing the optimal balance of fats, carbohydrates and proteins for developing babies. Breastfeeding provides a range of benefits for growth, immunity and development building a powerful bond between mother and her child. Recognition of the manifold benefits of breast milk has led to the adoption of breast-feeding policies by numerous health and professional organizations such as the World Health Organization and American Academy of Pediatrics.In industrially developed as well as in developing nations, human milk contamination by toxic chemicals such as heavy metals, dioxins and organohalogen compounds, however, is widespread and is the consequence of decades of inadequately controlled pollution. Through breastfeeding, the mother may transfer to the suckling infant potentially toxic chemicals to which the mother has previously been exposed.In the present review, environmental exposure, acquisition and current levels of old and emerging classes of breast milk pollutants are systematically presented. Although scientific evidences indicated that the advantages of breast-feeding outweigh any risks from contaminants, it is important to identify contaminant trends, to locate disproportionately exposed populations, and to take public health measures to improve chemical BM pollution as possible.

Fish meal in animal feed and human exposure to persistent bioaccumulative and toxic substances

Persistent and bioaccumulative toxic substances (PBTSs) that end up in fish are health hazards and the object of fish-consumption advisories. Some of these substances are present as extraneous contaminants, e.g., man-made lipophilic pollutants such as organohalogen pollutants, and others such as monomethyl mercury can be considered naturally occurring. Omnivores (e.g., poultry and swine) and especially ruminants that are fed contaminated fish meal can pass monomethyl mercury and organohalogen pollutants to eggs, meat, and dairy products. Differences in fish meal PBTS profiles and farm animal (e.g., poultry, swine, cattle, and farmed fish) physiology modulate PBTSs in animal products. Fish-consumption advisories issued to protect human health do not extend to fish by-products fed to farmed animals. Animals (especially farmed fish) that are fed fish meal can bioconcentrate monomethyl mercury in protein matrices, and organohalogen pollutants can be passed on in the fat components of derived foods. Policies to decrease exposure to monomethyl mercury and organohalogen pollutants must consider farming practices that use fish by-products. A risk assessment of toxic contaminants in fish meal may indicate that food safety objectives must consider the human health impact of foods derived from animals fed contaminated meal.

Environmental oestrogens, cosmetics and breast cancer

The established role of oestrogen in the development and progression of breast cancer raises questions concerning a potential contribution from the many chemicals in the environment which can enter the human breast and which have oestrogenic activity. A range of organochlorine pesticides and polychlorinated biphenyls possess oestrogen-mimicking properties and have been measured in human breast adipose tissue and in human milk. These enter the breast from varied environmental contamination of food, water and air, and due to their lipophilic properties can accumulate in breast fat. However, it is emerging that the breast is also exposed to a range of oestrogenic chemicals applied as cosmetics to the underarm and breast area. These cosmetics are left on the skin in the appropriate area, allowing a more direct dermal absorption route for breast exposure to oestrogenic chemicals and allowing absorbed chemicals to escape systemic metabolism. This review considers evidence in support of a functional role for the combined interactions of cosmetic chemicals with environmental oestrogens, pharmacological oestrogens, phyto-oestrogens and physiological oestrogens in the rising incidence of breast cancer.