Mortality in a cohort with high fish consumption

Metabolic Syndrome and Cardiovascular Risk Factors in a Fishing Community in Southern Italy

Background

Work organization and psychosocial factors influencing sleep patterns may be significant risk factors for developing obesity and metabolic syndrome (MetS). However, the impact on the health of working patterns in the fishing sector is not well characterized. The aim of the study is to determine the prevalence of MetS and its components in fishermen and to analyze occupational-specific risk factors contributing to metabolic alterations.

Methods

One hundred forty-three male fishermen from Apulia (Southern Italy) and 93 male university workers age-matched and from the same geographical area were included in this cross-sectional study. A questionnaire was administered to investigate socio-demographic variables, work activity, health status, and dietary habits. All subjects underwent clinical evaluation and blood sampling to depict their metabolic profile.

Results

A higher body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (p < 0.001) were observed in fishermen than in university workers. No significant difference between the two groups was observed in the prevalence of MetS (15.4% fishermen vs 16.1% university workers) and its relevant diagnostic criteria, except abdominal obesity (42.7% fishermen vs 29.0% university workers, p = 0.021). The Castelli risk index, the monocyte/c-HDL ratio, and the Sokolow index were significantly greater in fishermen (p < 0.001). In the fishermen group, the total number of sleeping hours on working days was negatively correlated with WC (r = -0.17; p = 0.04), low-density lipoprotein cholesterol (c-LDL) (r = -0.21; p = 0.02), and the homeostasis model assessment (HOMA) index (r = -0.19; p = 0.02).

Conclusion

The higher prevalence of obesity and the imbalance of the metabolic profile observed in fishermen could be related to occupational factors, including the specific working pattern that influences their sleeping hours and sleeping-waking rhythms.

Multi-level assessment of the origin, feeding area and organohalogen contamination on salmon from the Baltic Sea

The Atlantic salmon (Salmo salar) population in the Baltic Sea consists of wild and hatchery-reared fish that have been released into the sea to support salmon stocks. During feeding migration, salmon migrate to different parts of the Baltic Sea and are exposed to various biotic and abiotic stressors, such as organohalogen compounds (OHCs). The effects of salmon origin (wild or hatchery-reared), feeding area (Baltic Main Basin, Bothnian Sea, and Gulf of Finland), and OHC concentration on the differences in hepatic proteome of salmon were investigated. Multi-level analysis of the OHC concentration, transcriptome, proteome, and oxidative stress biomarkers measured from the same salmon individuals were performed to find the key variables (origin, feeding area, OHC concentrations, and oxidative stress) that best account for the differences in the transcriptome and proteome between the salmon groups. When comparing wild and hatchery-reared salmon, differences were found in xenobiotic and amino acid metabolism-related pathways. When comparing salmon from different feeding areas, the amino acid and carbohydrate metabolic pathways were notably different. Several proteins found in these pathways are correlated with the concentrations of polychlorinated biphenyls (PCBs). The multi-level analysis also revealed amino acid metabolic pathways in connection with PCBs and oxidative stress variables related to glutathione metabolism. Other pathways found in the multi-level analysis included genetic information processes related to ribosomes, signaling and cellular processes related to the cytoskeleton, and the immune system, which were connected mainly to the concentrations of Polychlorinated biphenyls and Dichlorodiphenyltrichloroethane and their metabolites. These results suggest that the hepatic proteome of salmon in the Baltic Sea, together with the transcriptome, is more affected by the OHC concentrations and oxidative stress of the feeding area than the origin of the salmon.

PCDD/Fs and PCBs in Baltic fish - Recent data, risk for consumers

This study determines the levels of PCDD/Fs and PCBs in Baltic fish caught in ICES areas 24, 25, and 26, and the related risk for fish consumers in relation to the newly established Tolerable Weekly Intake dose (TWI) (2 pg WHO-TEQ kg -^-1 body weight). The total PCDD/F/DL-PCBs toxic equivalents in the fish muscle ranged from 0.12 to 10.34 pg WHO-TEQ g - ^-1 wet weight. Salmon muscles contained the highest average concentration and cod the lowest, below 0.5 pg WHO-TEQ g - ^-1 wet weight of total TEQ. The average intake of PCDD/F/DL-PCBs (portion of fish 200 g) was 91-2420% of the TWI for children, and 30-799% of the TWI for adults. It appears that despite the decreased levels of PCDD/F and PCBs in Baltic fish, in relation to the newly established TWI dose, this decrease is not enough to make the Baltic fish safe for frequent consumers.

Estimated PCDD/F TEQ and total TEQ concentrations in the serum of 7-10 year old Finnish children

Polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs) and polychlorinated biphenyls (PCBs) are persistent organic pollutants that have detrimental health effects. As people are exposed to them mainly through the diet, EU has set maximum food dioxin and PCBs levels. EFSA CONTAM Panel made new risk assessment in 2018 that lowered the tolerable weekly intake (TWI) from 14 pg-TEQ/kg bw/week to 2 pg-TEQ/kg bw/week. Critical effect was decreased semen count at the age of 18-19 years if serum total TEQ at the age of 9 years exceeded the No Observed Adverse Effect Level (NOAEL) of 7 pg/g lipid. However, it is largely unknown to what extent NOAEL is exceed in European boys currently. We thus measured PCBs from small volume of serum in 184 Finnish children 7-10 years of age. To estimate the TEQ levels of children from measured PCB levels, we used our existing human milk PCDD/F and PCB concentrations to create a hierarchical Bayesian regression model that was used to estimate TEQs from measured PCBs. For quality control (QC), three pooled blood samples from 18 to 20 year old males were measured for PCDD/Fs and PCBs, and estimated for TEQs. In QC samples measured and estimated TEQs agreed within 84%-106%. In our estimate for 7-10 year old children, PCDD/F TEQ exceeded NOAEL only in 0.5% and total TEQ in 2.7% of subjects. Risk management following the decreased TWI proposed by the CONTAM Panel should be carefully considered if total TEQ in children is already largely below the NOAEL.

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) role in hematopoiesis and in hematologic diseases: A critical review

Dioxin exposure and its effect on hematopoiesis and cancer have been largely investigated in both human and non-human settings. Here we systematically reviewed literature to address the question of what we know about TCDD biology and exposure. Most effects are due to TCDD interaction with a receptor of xenobiotics called AHR, which is ubiquitously represented and also works on hematopoietic myeloid and lymphoid stem cells, inducing proliferation and stem cell release from bone marrow to peripheral circulation. Epidemiologic studies on TCDD exposure demonstrated an association with onco-hematologic diseases, particularly with non Hodgkin lymphomas and multiple myeloma, and non hematologic cancers, such as sarcomas, although these relationships are affected by multiple confounding factors.

Fish consumption and mortality in the European Prospective Investigation into Cancer and Nutrition cohort

Fish is a source of important nutrients and may play a role in preventing heart diseases and other health outcomes. However, studies of overall mortality and cause-specific mortality related to fish consumption are inconclusive. We examined the rate of overall mortality, as well as mortality from ischaemic heart disease and cancer in relation to the intake of total fish, lean fish, and fatty fish in a large prospective cohort including ten European countries. More than 500,000 men and women completed a dietary questionnaire in 1992-1999 and were followed up for mortality until the end of 2010. 32,587 persons were reported dead since enrolment. Hazard ratios and their 99% confidence interval were estimated using Cox proportional hazard regression models. Fish consumption was examined using quintiles based on reported consumption, using moderate fish consumption (third quintile) as reference, and as continuous variables, using increments of 10 g/day. All analyses were adjusted for possible confounders. No association was seen for fish consumption and overall or cause-specific mortality for both the categorical and the continuous analyses, but there seemed to be a U-shaped trend (p < 0.000) with fatty fish consumption and total mortality and with total fish consumption and cancer mortality (p = 0.046).

Cancer incidence in a cohort with high fish consumption

PURPOSE

Evidence suggests that fish-derived omega-3 polyunsaturated fatty acids inhibit cancer promotion and progression. On the other hand, fish may contain endocrine-disrupting and potentially carcinogenic environmental contaminants. Our objective was to describe cancer incidence among the Finnish professional fishermen and their wives who are presumed to eat a lot of fish, partly from the contaminated Baltic Sea. Additionally, we wanted to see whether occupational characteristics are reflected in the fishermen's cancer pattern.

METHODS

All Finnish fishermen during 1980-2002 were identified from the Professional Fishermen Register (n = 6,410) and their wives from the National Population Information System (n = 4,260). The cohort was linked with the Finnish Cancer Registry data until 2011, and the standardized incidence ratios (SIR) were calculated based on national incidence rates.

RESULTS

The total cancer incidence among the fishermen and their wives was the same as in the Finnish general population. Among the fishermen, the incidence was increased for lip (SIR 2.17, 95 % confidence interval 1.26-3.47) and testis (2.51, 1.15-4.75) and decreased for colon (0.72, 0.52-0.98) cancers.

CONCLUSIONS

We cannot exclude the possibility that the observed excess in testis cancer among the fishermen could reflect life-long high exposure to environmental contaminants. An excess in lip cancer has been repeatedly observed among outdoor workers due to high exposure to ultraviolet radiation, whereas high physical activity during fishing is the most likely explanation for the deficit in colon cancer.

Omega-3 fatty acids protect the brain against ischemic injury by activating Nrf2 and upregulating heme oxygenase 1

Ischemic stroke is a debilitating clinical disorder that affects millions of people, yet lacks effective neuroprotective treatments. Fish oil is known to exert beneficial effects against cerebral ischemia. However, the underlying protective mechanisms are not fully understood. The present study tests the hypothesis that omega-3 polyunsaturated fatty acids (n-3 PUFAs) attenuate ischemic neuronal injury by activating nuclear factor E2-related factor 2 (Nrf2) and upregulating heme oxygenase-1 (HO-1) in both in vitro and in vivo models. We observed that pretreatment of rat primary neurons with docosahexaenoic acid (DHA) significantly reduced neuronal death following oxygen-glucose deprivation. This protection was associated with increased Nrf2 activation and HO-1 upregulation. Inhibition of HO-1 activity with tin protoporphyrin IX attenuated the protective effects of DHA. Further studies showed that 4-hydroxy-2E-hexenal (4-HHE), an end-product of peroxidation of n-3 PUFAs, was a more potent Nrf2 inducer than 4-hydroxy-2E-nonenal derived from n-6 PUFAs. In an in vivo setting, transgenic mice overexpressing fatty acid metabolism-1, an enzyme that converts n-6 PUFAs to n-3 PUFAs, were remarkably resistant to focal cerebral ischemia compared with their wild-type littermates. Regular mice fed with a fish oil-enhanced diet also demonstrated significant resistance to ischemia compared with mice fed with a regular diet. As expected, the protection was associated with HO-1 upregulation, Nrf2 activation, and 4-HHE generation. Together, our data demonstrate that n-3 PUFAs are highly effective in protecting the brain, and that the protective mechanisms involve Nrf2 activation and HO-1 upregulation by 4-HHE. Further investigation of n-3 PUFA neuroprotective mechanisms may accelerate the development of stroke therapies.

Organohalogen concentrations and feeding status in Atlantic salmon (Salmo salar L.) of the Baltic Sea during the spawning run

Changes in the concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), dibenzofurans (PCDFs), and biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) in Baltic salmon muscle were studied during the spawning migration from the southern Baltic Sea to rivers flowing into the northern Gulf of Bothnia and during the spawning period. The aim was to obtain information to facilitate the arrangement of salmon fisheries such that the human dioxin intake is taken into account. The EC maximum allowable total toxic equivalent concentration (WHO-TEQPCDD/F+PCB) was exceeded in the muscle of the majority of the migrating salmon, except in the Baltic Proper. The fresh-weight-based concentrations of all toxicant groups in salmon tended to be the lowest in the Baltic Proper and the Northern Quark, and all toxicant concentrations, except PCDDs and PCDFs, were significantly higher in the spawning salmon than in the salmon caught during the spawning run. The fat content of the salmon muscle decreased by 60% during the spawning run, and the lipid-based total toxicant concentrations were consequently 4.2-6.2 times higher during the spawning period than during the spawning migration. However, the toxicants were concentrated just before spawning, and thus there is no essential difference related to whether the salmon are caught in the sea or the recreational river fishery.

Diabetes, metabolic syndrome, and obesity in relation to serum dioxin concentrations: the Seveso women's health study

BACKGROUND

In animal studies, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) alters glucose transport and increases serum lipid levels and blood pressure. Epidemiologic evidence suggests an association between TCDD and metabolic disease.

OBJECTIVES

On 10 July 1976, a chemical explosion in Seveso, Italy, resulted in the highest known residential exposure to TCDD. Using data from the Seveso Women's Health Study (SWHS), a cohort study of the health of the women, we examined the relation of serum TCDD to diabetes, metabolic syndrome, and obesity > 30 years later.

METHODS

In 1996, we enrolled 981 women who were newborn to 40 years of age in 1976 and resided in the most contaminated areas. Individual TCDD concentration was measured in archived serum that had been collected soon after the explosion. In 2008, 833 women participated in a follow-up study. Diabetes was classified based on self-report or fasting serum glucose and glycated hemoglobin levels. Metabolic syndrome was defined by International Diabetes Federation criteria. Obesity was defined as body mass index ≥ 30 kg/m2.

RESULTS

A 10-fold increase in serum TCDD (log10TCDD) was not associated with diabetes (adjusted hazard ratio = 0.76; 95% CI: 0.45, 1.28) or obesity [adjusted odds ratio (OR) = 0.80; 95% CI: 0.58, 1.10]. Log10TCDD was associated with metabolic syndrome, but only among women who were ≤ 12 years of age at the time of the explosion (adjusted OR = 2.03; 95% CI: 1.25, 3.29; pinteraction = 0.01).

CONCLUSIONS

We found an increased prevalence of metabolic syndrome associated with TCDD, but only among women who were the youngest at the time of the explosion. Continued follow-up of the SWHS cohort will be informative.

Fish consumption, omega-3 fatty acids, and environmental contaminants in relation to low-grade inflammation and early atherosclerosis

BACKGROUND

Fish consumption and omega-3 polyunsaturated fatty acid (PUFA) intake are shown to protect from cardiovascular diseases (CVD). However, most fish contain environmental contaminants such as dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), polychlorinated biphenyls (PCBs), and methylmercury (MeHg) that may have adverse effects on cardiovascular health.

OBJECTIVE

Our aim was to elucidate the associations of fish consumption, omega-3 PUFAs, environmental contaminants with low-grade inflammation, early atherosclerosis, and traditional CVD risk factors.

METHODS

The Health 2000 survey participants (n=1173) represented the general Finnish population and the Fishermen study participants (n=255) represented a population with high fish consumption and high exposure to environmental contaminants. Model-adjusted geometric means and tests for linear trend were calculated for CVD risk factors by tertiles of fish consumption and serum omega-3 PUFAs, and additionally in the Fishermen study only, by tertiles of serum PCDD/F+PCB, and blood MeHg.

RESULTS

Serum triglyceride decreased across omega-3 PUFA tertiles in both sexes and studies. Insulin resistance, C-reactive protein, tumour necrosis factor α, and interleukin 6 decreased across omega-3 PUFA tertiles among the Health 2000 survey participants. Among the Fishermen study men, insulin resistance and arterial stiffness indicated by β-stiffness index tended to increase and the RR estimate for carotid artery plaque tended to decrease across tertiles of PCDD/F+PCB and MeHg.

CONCLUSION

Previously established hypotriglyceridemic and anti-inflammatory effects of omega-3 PUFAs were seen also in this study. The hypothesised favourable effect on insulin sensitivity and arterial elasticity was suggested to be counteracted by high exposure to environmental contaminants but the effect on plaque prevalence appeared not to be harmful.

Polychlorinated biphenyls and cancer: an epidemiological assessment

Polychlorinated biphenyls (PCBs) are toxic and persistent chemicals produced between 1930s and 1980s primarily for insulating fluids in heavy-duty electrical equipment in power plants, industries, and large buildings. They persist in the environment and accumulate in plants and animals, and have been classified as probable carcinogens to humans. We performed a systematic review and meta-analysis of scientific literature on the relationship between PCB exposure and human cancer. Two cohorts of people highly exposed to PCBs through ingestion of contaminated rice oil and some cohorts of occupationally exposed workers failed to show a definite increase in total cancer mortality and provided inconsistent results regarding single cancers. Several cohort and case-control studies investigated the association between PCBs and specific cancers, showing an association between PCB serum levels and non-Hodgkin lymphomas (NHL), with a summary odds ratio of 1.5 (95% confidence interval: 1.1-1.7), but no consistent results for the other cancer sites and types. In conclusion, this review provides some evidence for the role of PCBs in the development of NHL, although the inconsistent results of studies performed on highly polluted people and occupationally exposed workers do not allow a firm conclusion to be drawn.

Is the fear of dioxin cancer more harmful than dioxin?

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a proven animal carcinogen. Occupational cohorts with the highest exposures imply that there is a small risk of all cancers combined, but it is difficult to pinpoint the confounding effect of the main chemicals. Studies after major accidents do not unequivocally confirm this risk. The risks to populations at the current dioxin levels seem trivial if present at all. There is increasing evidence that the aryl hydrocarbon receptor (AhR), i.e. the so called "dioxin receptor", is a physiological transcription factor exerting important functions in the body. Consequently a certain level of AhR activation may be beneficial rather than harmful. This challenges the wisdom of excessive regulation of dioxin levels in certain foods and nutrients. This could pose indirect nutritional risks, in fact being more harmful than even the worst case predictions of the putative cancer risks attributable to dioxins.

Risk-benefit evaluation of fish from Chinese markets: nutrients and contaminants in 24 fish species from five big cities and related assessment for human health

The risks and benefits of fish from markets in Chinese cities have not previously been fully evaluated. In the present study, 24 common fish species with more than 400 individual samples were collected from markets from five big Chinese cities in 2007. The main nutrients and contaminants were measured and the risk-benefit was evaluated based on recommended nutrient intakes and risk level criteria set by relevant authorities. The comprehensive effects of nutrients and contaminants in marine oily fish were also evaluated using the data of two related human dietary intervention trials performed in dyslipidemic Chinese men and women in 2008 and 2010, respectively. The results showed that concentrations of contaminants analyzed including DDT, PCB(7), arsenic and cadmium were much lower than their corresponding maximum limits with the exception of the mercury concentration in common carp. Concentrations of POPs and n-3 LCPUFA, mainly EPA and DHA, were positively associated with the lipid content of the fish. With a daily intake of 80-100g marine oily fish, the persistent organic pollutants in fish would not counteract the beneficial effects of n-3 LCPUFA in reducing cardiovascular disease (CVD) risk markers. Marine oily fish provided more effective protection against CVD than lean fish, particularly for the dyslipidemic populations. The risk-benefit assessment based on the present daily aquatic product intake in Chinese urban residents (44.9 and 62.3g for the average values for all cities and big cities, respectively) indicated that fish, particularly marine oily fish, can be regularly consumed to achieve optimal nutritional benefits from n-3 LCPUFA, without causing significant contaminant-related health risks. However, the potential health threat from contaminants in fish should still be emphasized for the populations consuming large quantities of fish, particularly wild fish.

Fish consumption in relation to other foods in the diet

Our aim was to investigate whether fish consumption is associated with the consumption of other healthy foods. The study population consisted of 2605 men and 3199 women from the nationally representative Health 2000 survey and 114 professional fishermen and 114 fishermen's wives (the Fishermen substudy) in Finland. Dietary data were collected using a calibrated (i.e. determined to have relative validity) FFQ. Model-adjusted means for food consumption and P values for linear trend were calculated across fish consumption tertiles. Those with the highest fish consumption had the highest consumption of vegetables, fruit and berries, potatoes, oil and wine even after adjusting for other food groups. The consumption of red meat and sausages had a tendency to decrease across fish consumption tertiles but the associations were inconsistent in the study populations. In conclusion, fish consumption had a positive linear association with the consumption of some other healthy foods such as vegetables, fruit, berries, and oil both in the general population of Finland and in a population with high fish consumption. Additional adjustment for other food groups had a clear effect on some of the studied associations. Therefore, when evaluating the health effects of fish consumption, confounding by other foods characterising a healthy diet needs to be considered.

Environmental exposure, obesity, and Parkinson's disease: lessons from fat and old worms

BACKGROUND

A common link has been exposed, namely, that metal exposure plays a role in obesity and in Parkinson's disease (PD). This link may help to elucidate mechanisms of neurotoxicity.

OBJECTIVE

We reviewed the utility of the nematode, Caenorhabditis elegans, as a model organism to study neurodegeneration in obesity and Parkinson's disease (PD), with an emphasis on the neurotransmitter, dopamine (DA).

DATA SOURCES

A PubMed literature search was performed using the terms "obesity" and any of the following: "C. elegans," "central nervous system," "neurodegeneration," "heavy metals," "dopamine" or "Parkinson's disease." We reviewed the identified studies, including others cited therein, to summarize the current evidence of neurodegeneration in obesity and PD, with an emphasis on studies carried out in C. elegans and environmental toxins in the etiology of both diseases.

DATA EXTRACTION AND DATA SYNTHESIS

Heavy metals and DA have both been linked to diet-induced obesity, which has led to the notion that the mechanism of environmentally induced neurodegeneration in PD may also apply to obesity. C. elegans has been instrumental in expanding our mechanism-based knowledge of PD, and this species is emerging as a good model of obesity. With well-established toxicity and neurogenetic assays, it is now feasible to explore the putative link between metal- and chemical-induced neurodegeneration.

CONCLUSIONS

One side effect of an aging population is an increase in the prevalence of obesity, metabolic disorders, and neurodegenerative orders, diseases that are likely to co-occur. Environmental toxins, especially heavy metals, may prove to be a previously neglected part of the puzzle.

Dioxins, the aryl hydrocarbon receptor and the central regulation of energy balance

Dioxins are ubiquitous environmental contaminants that have attracted toxicological interest not only for the potential risk they pose to human health but also because of their unique mechanism of action. This mechanism involves a specific, phylogenetically old intracellular receptor (the aryl hydrocarbon receptor, AHR) which has recently proven to have an integral regulatory role in a number of physiological processes, but whose endogenous ligand is still elusive. A major acute impact of dioxins in laboratory animals is the wasting syndrome, which represents a puzzling and dramatic perturbation of the regulatory systems for energy balance. A single dose of the most potent dioxin, TCDD, can permanently readjust the defended body weight set-point level thus providing a potentially useful tool and model for physiological research. Recent evidence of response-selective modulation of AHR action by alternative ligands suggests further that even therapeutic implications might be possible in the future.

Organotin intake through fish consumption in Finland

BACKGROUND

Organotin compounds (OTCs) are a large class of synthetic chemicals with widely varying properties. Due to their potential adverse health effects, their use has been restricted in many countries. Humans are exposed to OTCs mostly through fish consumption.

OBJECTIVES

The aim of this study was to describe OTC exposure through fish consumption and to assess the associated potential health risks in a Finnish population.

METHODS

An extensive sampling of Finnish domestic fish was carried out in the Baltic Sea and freshwater areas in 2005-2007. In addition, samples of imported seafood were collected in 2008. The chemical analysis was performed in an accredited testing laboratory during 2005-2008. Average daily intake of the sum of dibutyltin (DBT), tributyltin (TBT), triphenyltin (TPhT) and dioctyltin (DOT) (SigmaOTCs) for the Finnish population was calculated on the basis of the measured concentrations and fish consumption rates.

RESULTS

The average daily intake of SigmaOTCs through fish consumption was 3.2ng/kgbwday(-1), which is 1.3% from the Tolerable Daily Intake (TDI) of 250ng/kgbwday(-1) set by the European Food Safety Authority. In total, domestic wild fish accounted for 61% of the SigmaOTC intake, while the intake through domestic farmed fish was 4.0% and the intake through imported fish was 35%. The most important species were domestic perch and imported salmon and rainbow trout.

CONCLUSIONS

The Finnish consumers are not likely to exceed the threshold level for adverse health effects due to OTC intake through fish consumption.

Benefits versus risks associated with consumption of fish and other seafood

Fish provide nutrition for much of the world's population, and when not contaminated with chemicals, fish is a very good food. A major benefit of fish is that they are high in polyunsaturated fatty acids (PUFAs), low in saturated fat, and they contain other critical nutrients. Much of the benefit of fish consumption derives from their high levels of long chain omega-3 PUFAs, which are produced by aquatic microorganisms and bioconcentrate in the aquatic food supply. The PUFAs are essential, in that humans and other vertebrates are not able to synthesize them and therefore must obtain them from the diet. The PUFAs particularly concentrate in the nervous system, alter immune system function reduce serum triglyceride levels and have been reported to reduce the risk of sudden death after a myocardial infarction. But the problem is that most fish have at least some degree of chemical contamination with methylmercury, (which binds to muscle) and/or with persistent organic pollutants such as dioxins, polychlorinated biphenyls, polybrominated diphenyl ethers, chlorinated pesticides (which concentrate in fish fat). These chemicals have adverse effects on nervous system function, modulate the immune system, and are associated with elevations in risk of cardiovascular disease. Thus the question of benefits and risk from fish consumption is complex but very important.

Blood concentration of methylmercury in relation to food consumption

OBJECTIVE

Dietary fish is the main source of methylmercury (MeHg) for man, and fish consumption has been used as a measure of MeHg exposure. However, other dietary sources of exposure exist and MeHg metabolism may also be modified by nutritional factors. The aim of the present study was to examine the association between blood MeHg concentration and consumption of different foods in a Finnish population with high fish consumption.

DESIGN

Blood samples, a detailed FFQ and additional frequency data on fish consumption were collected. MeHg was analysed from whole blood by the isotope dilution method with high-resolution MS. The consumption of different foods was calculated by MeHg quartiles and tested for linear trend.

SETTING

Finnish southern and south-western coast of the Baltic Sea.

SUBJECTS

Two hundred and ninety-nine professional fishermen, their spouses and other family members.

RESULTS

Mean (range) blood MeHg concentration was 4·6 (0·21-22) μg/l among men and 2·8 (<0·15-20) μg/l among women. Fish had the strongest positive association with MeHg (P for linear trend <0·001 among both men and women). Among men, positive associations were also observed for fruit vegetables, wheat and wine. Among women, positive associations were observed for root vegetables, legumes, potato and game, but adjustment for fish consumption attenuated these trends.

CONCLUSIONS

The study shows that, besides fish, MeHg may have other dietary sources that should be taken into account in risk assessment studies. Due to the observed high blood MeHg concentration, a thorough exposure assessment among the general Finnish population is recommended.

Fish consumption and omega-3 polyunsaturated fatty acids in relation to depressive episodes: a cross-sectional analysis

High fish consumption and omega-3 polyunsaturated fatty acid (PUFA) intake are suggested to benefit mental well-being but the current evidence is conflicting. Our aim was to evaluate whether a higher level of fish consumption, a higher intake of omega-3 PUFAs, and a higher serum concentration of omega-3 PUFAs link to a lower 12-month prevalence of depressive episodes.We used data from the nationwide Health 2000 Survey (n = 5492) and the Fishermen Study on Finnish professional fishermen and their family members (n = 1265). Data were based on questionnaires, interviews, health examinations, and blood samples. Depressive episodes were assessed with the M-CIDI (the Munich version of the Composite International Diagnostic Interview) and a self-report of two CIDI probe questions, respectively. Fish consumption was measured by a food frequency questionnaire (g/day) and independent frequency questions (times/month). Dietary intake (g/day) and serum concentrations (% from fatty acids) of PUFAs were determined. Fish consumption was associated with prevalence of depressive episodes in men but not in women. The prevalence of depressive episodes decreased from 9% to 5% across the quartiles of fish consumption (g/day) in men of the Health 2000 Survey (p for linear trend = 0.01), and from17% to 3% across the quartiles of fish consumption (times/month) in men of the Fishermen Study (p for linear trend = 0.05). This association was modified by lifestyle; in the Health 2000 Survey a higher level of fish consumption was related to a lower prevalence of depressive episodes in men who consumed the most alcohol, were occasional or former smokers, or had intermediate physical activity. The associations between depressive episodes and the intake or serum concentrations of omega-3 PUFAs were not consistent.In men, fish consumption appears as a surrogate for underlying but unidentified lifestyle factors that protect against depression.

Fish consumption and polyunsaturated fatty acids in relation to psychological distress

BACKGROUND

It has been suggested that high fish consumption improves mental well-being. The aim of this study was to assess whether high fish consumption or omega-3 polyunsaturated fatty acid (PUFA) intake was associated with reduced self-reported psychological distress.

METHODS

We used three cross-sectional data sets, the nationwide Health 2000 Survey (n = 5840), the Fishermen Study on Finnish fishermen and their family members (n = 1282) and the Finntwin16 Study on young adults (n = 4986). Data were based on self-administered questionnaires, interviews, health examinations and blood samples. Psychological distress was measured using the 12-item and 21-item General Health Questionnaires (GHQs). Fish consumption was measured by a food frequency questionnaire (FFQ, g/day) and independent frequency questions (times/month). Dietary intake (g/day) and serum concentrations (% from fatty acids) of PUFAs were determined. Relationships were analysed using regression analysis.

RESULTS

Regardless of the measure, fish consumption and omega-3 PUFA dietary intake were not associated with distress in any of the data sets. In contrast to the hypothesis, high serum docosahexaenoic acid was associated with high distress in the Fisherman Study men. Some non-linear associations were detected between serum omega-3 PUFAs or fish consumption (times/month) and distress. In the Fishermen Study, the associations were modified by alcohol consumption, smoking and physical activity.

CONCLUSIONS

Our results do not support the hypothesis that fish consumption or omega-3 PUFA intake are associated with reduced psychological distress in the general population or in a population with high fish consumption.

Early developmental effects of separate or combined perinatal exposure to methylmercury (MeHg) and 2,2',4,4',5,5'-hexachlorobiphenyl (PCB 153) in the rat

OBJECTIVES

Methylmercury (MeHg) and polychlorinated biphenyls (PCBs) are ubiquitous and persistent environmental pollutants and food contaminants. Both are neurotoxic, especially for the developing nervous system.

MATERIAL AND METHODS

Female rats were exposed from day 7 of pregnancy up to day 21 after the delivery to MeHg in drinking water, PCB 153 per os or MeHg+PCB 153. Assessment of the exposure effects in mothers included food and water intake, body weight and reproduction success. Assessment of the progeny comprised determination of body weight, time of pinna detachment, eye opening, incisor eruption, and the negative geotaxis, grip strength and righting reflex.

RESULTS

The following effects of the exposures were observed: A) MeHg: 0.5 mg/kg/day - no effect on maternal health status and reproduction. In the progeny: faster incisor eruption and hastened negative geotaxis development. MeHg 2.0 mg/kg/day: In mothers: signs of MeHg toxicity (reduced food intake and body weight, ataxia) during lactation. In the progeny: reduced rate of body weight increase, accelerated incisor eruption but delayed development of the righting reflex. B) PCB 153 exposure: 1.0 mg/kg/day: no effect on maternal health status, reproduction success or morphological and physical development of the progeny; 5.0 mg/kg/day: no effect on maternal health status and reproduction. In the progeny: accelerated growth in females, faster pinna detachment and incisor eruption but delayed development of the grip strength. C) MeHg+PCB153 exposure: none overt effect was noted in mothers or in their progeny.

CONCLUSION

The results confirm the ability of a low level perinatal exposure to MeHg or PCB 153 to affect the early development in the rat. They have not provided, however, an evidence of a synergistic interaction of these contaminants. To the contrary, the results suggest that, at least under the conditions prevailing in the present study, MeHg and PCB 153 interact antagonistically.

Cancer incidence in the population exposed to dioxin after the "Seveso accident": twenty years of follow-up

BACKGROUND

The Seveso, Italy accident in 1976 caused the contamination of a large population by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Possible long-term effects have been examined through mortality and cancer incidence studies. We have updated the cancer incidence study which now covers the period 1977-96.

METHODS

The study population includes subjects resident at the time of the accident in three contaminated zones with decreasing TCDD soil levels (zone A, very high; zone B, high; zone R, low) and in a surrounding non-contaminated reference territory. Gender-, age-, and period-adjusted rate ratios (RR) and 95% confidence intervals (95% CI) were calculated by using Poisson regression for subjects aged 0-74 years.

RESULTS

All cancer incidence did not differ from expectations in any of the contaminated zones. An excess of lymphatic and hematopoietic tissue neoplasms was observed in zones A (four cases; RR, 1.39; 95% CI, 0.52-3.71) and B (29 cases; RR, 1.56; 95% CI, 1.07-2.27) consistent with the findings of the concurrent mortality study. An increased risk of breast cancer was detected in zone A females after 15 years since the accident (five cases, RR, 2.57; 95% CI, 1.07-6.20). No cases of soft tissue sarcomas occurred in the most exposed zones (A and B, 1.17 expected). No cancer cases were observed among subjects diagnosed with chloracne early after the accident.

CONCLUSION

The extension of the Seveso cancer incidence study confirmed an excess risk of lymphatic and hematopoietic tissue neoplasms in the most exposed zones. No clear pattern by time since the accident and zones was evident partly because of the low number of cases. The elevated risk of breast cancer in zone A females after 15 years since the accident deserves further and thorough investigation. The follow-up is continuing in order to cover the long time period (even decades) usually elapsing from exposure to carcinogenic chemicals and disease occurrence.

Considerations regarding neuropsychiatric nutritional requirements for intakes of omega-3 highly unsaturated fatty acids

BACKGROUND

Adverse neurodevelopmental and neuropsychiatric outcomes have been established as signs of nutrient deficiencies and may be applicable to insufficient dietary intakes of omega-3 highly unsaturated fatty acids (n-3 HUFAs).

OBJECTIVE

Consider if statistical definitions for Daily Reference Intakes can be applied to n-3 HUFAs intakes during pregnancy for maternal and neurodevelopmental deficiencies.

DESIGN

Data were prospectively collected from women during pregnancy and children up to age 8 years participating in the Avon Longitudinal Study of Parents and Children (ALSPAC). Statistical analyses took social and lifestyle factors into account.

RESULTS

During pregnancy, n-3 HUFA intakes from seafood that putatively meet statistical definitions of an estimated average requirement ranged from 0.05 to 0.06 en% (111-139 mg/d/2000 Cal) for suboptimal fine motor control at 42 m and 0.065-0.08 en% (114-181 mg/d/2000 Cal) for suboptimal verbal IQ at age 8 years and 0.18-0.22 en% (389-486 mg/d/2000 Cal) for maternal depression at 32 weeks. Intakes of n-3 ranging from 0.2 to 0.41 en% (445-917 mg/d/2000 Cal) prevented both increased risk of maternal depression and adverse neurodevelopmental outcomes for children among 97.5% of the population. No upper limit for safety was found.

CONCLUSION

During pregnancy, a n-3 HUFA intake of 0.40 en% (900 mg/d/2000 Cal) from seafood is likely to meet the nutritional requirements for 97.5% of the mothers and children of this population. These considerations do not constitute DRI's for docosahexaenoic acid and n-3 HUFAs, but may contribute to their formulation.

A decision framework for possible remediation of contaminated sediments in the River Kymijoki, Finland

BACKGROUND, AIM, AND SCOPE

The paper describes the spatial contamination of the River Kymijoki, South-Eastern Finland, and the coastal region of the Gulf of Finland with PCDD/Fs and mercury. The findings of ecotoxicologial and human health studies are also reported, including environmental and human risk assessments. Sediments from the River Kymijoki, draining into the Gulf of Finland, have been heavily polluted by the pulp and paper industry and by chemical industries. A wood preservative, known as Ky-5, was manufactured in the upper reaches of the river between 1940 and 1984 causing severe pollution of river sediments with polychlorinated dibenzo-p-dioxins (PCDD) and dibenzofurans (PCDF). Moreover, the sediments have been polluted with mercury (Hg) from chlor-alkali production and the use of Hg as a slimicide in pulp and paper manufacturing.

MATERIALS AND METHODS

An extensive sediment survey was conducted as well as sediment transport modeling, toxicity screening of sediment invertebrates, and a survey of contaminant bioaccumulation in invertebrates and fish. Studies on human exposure to PCDD/Fs and the possible effects on hypermineralization of teeth as well as an epidemiological study to reveal increased cancer risk were also conducted. An assessment of the ecological and human health risks with a null hypothesis (no remediation) was undertaken.

RESULTS

The sediment survey revealed severe contamination of river and coastal sediments with PCDD/Fs and Hg. The total volume of contaminated sediments was estimated to reach 5x10(6) m3 and hot spots with extremely high concentrations (max 292,000 ng g(-1) or 1,060 ng I-TEQ g(-1) d.w.) were located immediately downstream from the pollution source (approximately 90,000 m3). Sediment contamination was accompanied by changes in benthic assemblages, but direct effects were masked by many factors. The fish showed only slightly elevated PCDD/F levels in muscle, but orders of magnitude higher in the liver compared with reference freshwater sites and the Baltic Sea. The concentrations in human fat did not reveal high human exposure in the Kymijoki area in general and was lower than in sea fishermen. The relative risk for total cancer among farmers was marginally higher (RR=1.13) among those living close to the river, compared with farmers living further away, and the possibility of increased cancer risk cannot be ruled out. A conservative risk assessment revealed that the present probability of exceeding the WHO upper exposure limit of 4 pg WHO-TEQ kg(-1) d(-1) for PCDD/Fs and DL-PCBs was 6%. The probability of exceeding the WHO limit value of 0.23 mug kg(-1) d(-1) for methyl mercury was estimated to be notably higher at 62%. Based on these studies and the estimated risks connected with different remediation techniques a general remediation plan with cost benefit analysis was generated for several sub-regions in the river. Dredging, on-site treatment, and a close disposal of the most contaminated sediments (90,000 m3) was suggested as the first phase of the remediation. The decision regarding the start of remediation will be made during autumn 2008.

CONCLUSIONS

The sediments in the River Kymijoki are heavily polluted with PCDD/Fs and mercury from earlier chlorophenol, chlor-alkali, and pulp and paper manufacturing. A continuous transport of contaminants is taking place to the Gulf of Finland in the Baltic Sea. The highly increased PCDD/F and Hg levels in river sediments pose an ecotoxicological risk to benthic fauna, to fish-eating predators and probably to human health. The risks posed by mercury exceed those from PCDD/Fs and need to be evaluated for (former) chlor-alkali sites and other mercury releasing industries as one basis for remediation decision making.

RECOMMENDATIONS AND PERSPECTIVES

The studies form the basis of a risk management strategy and a plan for possible remediation of contaminated sediments currently under consideration in the Southeast Finland Regional Environment Centre. It is recommended that a detailed restoration plan for the most seriously contaminated areas should be undertaken. Based on current knowledge, the restoration of the whole river is not feasible, considering the current risk caused by the contaminated sediment in the river and the costs of an extensive restoration project. The experiences gained in the present case should be utilized in the evaluation of PCDD/F- and mercury-contaminated sites in other countries. The case demonstrates that the historic reservoirs are of contemporary relevance and should be addressed, e.g., in the national implementation plans of the Stockholm Convention.