Organochlorine residues in human breast milk: analysis through a sentinel practice network

Exposure and risk assessment of the Czech population to chlorinated pesticides and polychlorinated biphenyls using archived serum samples from the period 1970 to 1990

The serum samples from the years 1970-1990 archived at the temperature of -20°C in the biobank primarily intended for serological survey performed in the CR since 1960 were pooled and analyzed for DDT, its metabolites, HCB, HCHs, and indicator PCB congeners using up-to-date GC/MS/MS methods to retrospectively assess health risks according to current health guidelines. Samples were pooled based on the decade of sampling, age, gender, and three geographical areas; in adults, one pooled samples consisted of ten and in children of twenty individual samples. Altogether 233 pooled samples were analyzed. For all organochlorine pesticides (OCPs), significant downward trends were observed in the period 1970-1990 (p<0.001). The levels of HCB exceeded the Biomonitoring Equivalent (BE) value. The hazard quotient (HQ) in Prague and Ostrava during the 1970s and 1980s was about 40 and in the 1990s it had dropped to about five. In Uherské Hradiště, the HQ in 1975 was one order of magnitude higher (about 170), and had decreased to approximately 12 by 1987. For both HCB and the DDT sum, the BE-related carcinogenic risk of actual concentrations in the past exceeded significantly the individually accepted cancer risk level of 10(-4). The levels of the main PCB congeners in the 1970s through 1990s revealed an upward time trend in all analyzed strata. The highest concentrations were found in the serum of residents from the hot-spot area Uherské Hradiště. Critical PCB sum concentration levels (700ng/g lipid for vulnerable population groups and 1800ng/g lipid for other population groups) were substantially exceeded with an increasing time trend. PCB sum had exceeded HBM II values of 7μg/L of serum since 1980 in all age strata. In conclusion, the body burden of the Czech general population relative to persistent organic pollutants (POPs) in the period 1970 through 1990 significantly exceeded currently existing health based limit values. The past exposure might adversely affect the health status of the Czech population.

Spatial and temporal trends of the Stockholm Convention POPs in mothers' milk -- a global review

Persistent organic pollutants (POPs) have been of environmental and health concern for more than half a century and have their own intergovernmental regulation through the Stockholm Convention, from 2001. One major concern is the nursing child's exposure to POPs, a concern that has led to a very large number of scientific studies on POPs in mothers' milk. The present review is a report on the assessment on worldwide spatial distributions of POPs and of their temporal trends. The data presented herein is a compilation based on scientific publications between 1995 and 2011. It is evident that the concentrations in mothers' milk depend on the use of pesticides and industrial chemicals defined as POPs. Polychlorinated biphenyls (PCBs) and "dioxins" are higher in the more industrialized areas, Europe and Northern America, whereas pesticides are higher in Africa and Asia and polybrominated diphenyl ethers (PBDEs) are reported in higher concentrations in the USA. POPs are consequently distributed to women in all parts of the world and are thus delivered to the nursing child. The review points out several major problems in the reporting of data, which are crucial to enable high quality comparisons. Even though the data set is large, the comparability is hampered by differences in reporting. In conclusion, much more detailed instructions are needed for reporting POPs in mothers' milk. Temporal trend data for POPs in mothers' milk is scarce and is of interest when studying longer time series. The only two countries with long temporal trend studies are Japan and Sweden. In most cases, the trends show decreasing concentrations of POPs in mothers' milk. However, hexabromocyclododecane is showing increasing temporal concentration trends in both Japan and Sweden.

Body burden of POPs of Hong Kong residents, based on human milk, maternal and cord serum

This study is one of the very few investigating the body burdens of persistent organic pollutants in residents of Hong Kong. Twenty-nine human milk samples and 21 human blood (and cord blood) samples collected from 2005 were analyzed for PAHs, OCPs and PCBs levels. Higher levels of PAHs, DDTs and PCBs were detected in human milk samples when compared to maternal serum and cord serum (PAHs: milk: 1981 ng g⁻¹ fat, maternal serum: 1461, cord serum: 1158; DDTs: 3099, 1934, 1556; PCBs: 49, 41, 40). Among the 16 PAHs, naphthalene (human milk: 786 ng g⁻¹ fat, maternal serum: 331, cord serum: 348), phenanthrene (361, 144, 193), pyrene (187, 154, 98) and fluoranthene (158, 128, 89) were the major PAHs detected in three human tissues. p,p'-DDE and p,p'-DDT were the only metabolites of DDT detected in the three types of human tissues. High detection rate of the p,p'-DDE and p,p'-DDT (> 90%) were noted in the three types of human samples. On the contrary, low detection frequency of PCBs in human milk (10.7%), maternal serum (1.7%) and cord serum (0.8%) were observed. The correlation coefficients of the PAHs, DDTs and PCBs levels in the three types of human tissues together with fish consumption, maternal age and tissue fat were analyzed. The following significant correlations were observed: Σ DDTs and p,p'-DDE in human milk with consumption of freshwater and marine fish, and maternal age; Σ PCBs in human milk with marine fish consumption, and maternal age; Σ PAHs in human milk with maternal age, respectively. The estimated daily intakes of DDTs by infants indicated that 7 out of 29 of the human milk samples exceeded 20 ng g⁻¹ day⁻¹, the tolerable daily intake (TDI) proposed by the Health Canada Guideline in terms of DDTs levels. The high intake of DDTs by infants may be of concern as infants are more susceptible to the adverse effects imposed by various environmental contaminants. Human milk is a reliable and comparatively non-invasive tool for monitoring body loading of POPs, which also allows health risk assessment of residual chemicals on our next generation.

Long-term biomonitoring of polychlorinated biphenyls and organochlorine pesticides in human milk from mothers living in northern Germany

Polychlorinated biphenyls (PCBs) and organochlorine pesticides are persistent organic pollutants that have a widespread distribution in the environment. Human biomonitoring is a suitable tool to assess the burden of humans with these substances. Over a time span of 8 years, a free analysis of their milk was offered to lactating mothers residing in the state of Lower Saxony, Germany. The human milk was analyzed for a number of organic chemicals including polychlorinated biphenyls (PCBs), 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT), hexachlorobenzene (HCB) and beta-hexachlorocyclohexane (beta-HCH). Factors that may influence these levels were investigated using a questionnaire. In total, 4314 samples were collected in the years 1999-2006 and analyzed for their content of these persistent organic pollutants (POPs). A clear downward trend of median total PCB, DDT, beta-HCH and HCB values in all participants and also in different selected subgroups could be observed. The median values of calculated total PCB in the year 2006 including all participants was 0.1825mg/kg lipid, that of DDT 0.0815mg/kg lipid, beta-HCH 0.0116mg/kg lipid and of HCB 0.0229mg/kg lipid. There were reductions between 40.9% and 47.1% compared to the year 1999. Among other influencing factors, median concentrations of total PCB, DDT, beta-HCH and HCB showed a clear rise with increasing age of mothers whereas an increasing number of breastfed infants per mother led to a decrease. The proportions of other measured substances exceeding limits of quantification were as follows: dieldrin 68.6%, alpha-HCH 1.3%, gamma-HCH 60.1%, heptachlor epoxide 41.5%, musk xylene 15.6%, musk ambrette 0.4%. We conclude that the known declining trend of important xenobiotic substances in human milk of German mothers has continued.

Incidence, prevalence and coronary heart disease risk level in known Type 2 diabetes: a sentinel practice network study in the Basque Country, Spain

AIMS/HYPOTHESIS

The aim of this study was to determine the incidence, prevalence and coronary heart disease risk in patients with known Type 2 (non-insulin-dependent) diabetes mellitus in a Basque Country sentinel practice network study.

METHODS

During the year 2000 we did a survey among sentinel practitioners who registered information about previously and newly diagnosed Type 2 diabetic patients older than 24 years of age. We studied 65,651 people attending a primary care service in the Basque Country Health Service-Osakidetza. We collected information about diabetic complications and cardiovascular risk factors and measured the coronary heart disease risk in these patients.

RESULTS

In the year 2000, the standardized cumulative incidence and prevalence of known Type 2 diabetes were 5.0 per 1000 (CI 95%: 4.9-5.1) and 4.6% (CI 95%: 4.5-4.7) respectively. Macroangiopathy was the most frequent complication both in the newly diagnosed (21.6%) and previously known Type 2 diabetic patients (33%). Total cholesterol > or =5.17 mmol/l and LDL cholesterol > or =2.58 mmol/l were found in 75% and 90% of newly diagnosed and 65% and 85% of previously diagnosed Type 2 diabetic patients respectively. Of the Type 2 diabetic patients 42% were obese and 80% had high blood pressure. More than 55% of the men compared with 44% of the women with Type 2 diabetes had high or very high risk of coronary heart disease (p<0.05).

CONCLUSION/INTERPRETATION

We report new epidemiological data on known Type 2 diabetes in the Basque Country. These patients have a high frequency of cardiovascular risk factors causing a high coronary heart disease risk.

Parents worried about breast milk contamination. What is best for baby?

Breast milk contamination may concern parents who are worried about their infant's exposure to environmental or occupational chemicals. This article examines the risks posed by chemicals in breast milk compared to the risks of formula feeding. In addition, this article provides guidance to health care professionals about how to evaluate maternal exposures that may influence breast milk quality. A guide to assessing potential exposures at home and in the workplace is provided.

Early childhood determinants of organochlorine concentrations in school-aged children

We investigated whether early childhood factors such as breast-feeding, parity, and smoking contribute to the variation of organochlorine compounds (OC: dichlorodiphenyldichloroethene, hexachlorobenzene, beta-hexachlorocyclohexane, and the sum of polychlorinated biphenyls including the congeners 101, 118, 138, 153, 170, 180, 183, and 187) at approximately 7 y of age. OC were measured in whole blood of 350 children. Pregnancy characteristics and the child's living conditions were gathered by questionnaires administered to the parents and interviews with the mother. Height and weight were determined during the medical examination. Exclusion of incomplete data and nonbiologic children of the mothers yielded a sample of 337 children. We applied regression analysis with indicator variables, controlling for confounders. No systematic association was detected for birth order or maternal smoking during pregnancy. The OC concentrations are diluted in children with a higher body mass index (>18 kg/m(2)). We found a strong, dose-dependent relationship between the duration of breast-feeding (none, 1-4 wk, 5-8 wk, 9-12 wk, >12 wk) and the concentration of all five OCs. Of the potential determinants analyzed, more of the variance of the OC concentration is accounted for by breast-feeding than by any other variable. Exclusive breast-feeding beyond 12 wk was associated with a doubling of OC whole blood concentration compared with bottle-fed children (dichlorodiphenyldichloroethene, 0.28 microg/L versus 0.55 microg/L; beta-hexachlorocyclohexane, 0.05 microg/L versus 0.14 microg/L; hexachlorobenzene, 0.14 microg/L versus 0.25 microg/L; sum of polychlorinated biphenyls, 0.25 microg/L versus 0.55 microg/L). These findings indicate that breast-feeding can lead to an extended duration of increased OC exposure in childhood.

Perinatal metabolism of dichlorodiphenyldichloroethylene in Nicaraguan mothers

Umbilical cord and venous blood samples were collected at the time of delivery from 52 mothers living in urban and rural areas of the Atoya River basin, Nicaragua. In a subsample of 24 mothers that delivered by Cesarean section, abdominal adipose tissue samples were also collected, as was breast milk later in lactation. Cord and venous blood sera were analyzed for 13 organochlorine pesticides: 1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane (pp'-DDT); 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (pp'-DDE); pp'-dichlorophenyldichlorodiene (pp'-DDD); alpha-hexachlorocyclohexane (alpha-HCH); beta-hexachlorocyclohexane (beta-HCH); gamma-hexachlorocyclohexane (gamma-HCH); delta-hexachlorocyclohexane (delta-HCH); toxaphene; dieldrin; endrin; aldrin; heptachlor; and heptachlor epoxide. In venous blood only pp'-DDE (100% of samples), pp'-DDT (1.92%), dieldrin (15.38%), heptachlor (15.38%), gamma-HCH (7.69%), beta-HCH (11.53%), and delta-HCH (1.92%) were found, whereas in cord blood only pp'-DDE (100%), pp'-DDT (3.84%), dieldrin (19.23%), and heptachlor (9.16%), were found. The persistent DDT metabolite pp'-DDE, present in all samples of blood serum, adipose tissue, and breast milk, was studied in relation to maternal characteristics such as body mass index (BMI), age, lactation experience, and fetal pesticide acquisition. Mean venous (7.12 microg/g) and cord (6.39 microg/g) pp'-DDE concentrations were not significantly different but were significantly correlated. pp'-DDE in maternal adipose tissue was positively correlated with pp'-DDE in cord blood (P=0.0001) and breast milk (P<0.0001) and marginally correlated with changes in BMI (r=-0.03088; P=0.06). There was a higher proportion of samples (58%) with a greater concentration of DDE in venous than in cord blood. Although DDE accumulation may be less during fetal development than during breast feeding, exposure during embryogenesis may be more important than during the postnatal period.

Factors affecting the transfer of organochlorine pesticide residues to breastmilk

Existing studies monitoring organochlorine pesticide residues in breastmilk were examined to identify whether common factors determine the extent of transfer of these residues. A structured review of the English language literature was conducted. Papers were reviewed and assessed using a structured protocol. A total of 77 papers were initially identified, 46 of which contained conclusions relating to the factors which may affect the transfer of residues into breastmilk. Owing to the diversity of findings, papers were screened further to include only those in which a minimum of background information relating to selection of mothers and to milk sampling procedures were reported. Only eight papers were deemed to contain adequate information. Age, parity/length of previous lactation, fat mobilisation and the time of sampling were identified as the most likely factors to be considered when assessing transfer of organochlorine pesticide residues into breastmilk. This review highlights the difficulties of assessing trends in breastmilk contaminants where comparable sampling procedures are not used.

Aldrin and dieldrin: a review of research on their production, environmental deposition and fate, bioaccumulation, toxicology, and epidemiology in the United States

In the last decade four international agreements have focused on a group of chemical substances known as persistent organic pollutants (POPs). Global agreement on the reduction and eventual elimination of these substances by banning their production and trade is a long-term goal. Negotiations for these agreements have focused on the need to correlate data from scientists working on soil and water sampling and air pollution monitoring. Toxicologists and epidemiologists have focused on wildlife and human health effects and understanding patterns of disease requires better access to these data. In the last 20 years, substantial databases have been created and now are becoming available on the Internet. This review is a detailed examination of 2 of the 12 POPs, aldrin and dieldrin, and how scientific groups identify and measure their effects. It draws on research findings from a variety of environmental monitoring networks in the United States. An overview of the ecologic and health effects of aldrin and dieldrin provides examples of how to streamline some of the programs and improve access to mutually useful scientific data. The research groups are located in many government departments, universities, and private organizations. Identifying databases can provide an "information accelerator" useful to a larger audience and can help build better plant and animal research models across scientific fields.

Toxaphenes and chlorinated naphthalenes in adipose tissue of children

BACKGROUND

Chlorinated hydrocarbons are ingested by humans in food and accumulate in adipose tissue. At the University Kinderklinik, Mannheim, previously unknown substances have been found in children (e.g., the pesticide toxaphene and chlorinated naphthalenes). These substances have been widely used for industrial purposes in the past. Samples from West and East Germany; Saratov, Russia; and Almaty, Kazakhstan were examined to determine whether these substances are ubiquitous.

METHODS

After Soxhlet extraction, the extracts were cleaned up using a liquid chromatographic technique. Measurement was performed by gas chromatography-mass spectrometry using negative chemical ionization in the single-ion-monitoring mode.

RESULT

In specimens from all cities, toxaphene congeners Parlar 26 and Parlar 50 and six chlorinated naphthalenes were traced. Highest median load of toxaphene was 1.97 microg/kg for Parlar 26 and 2.36 microg/kg for Parlar 50 in Stralsund, East Germany. For chlorinated naphthalenes, the median was highest in Mannheim, West Germany, with 12.0 microg/kg.

CONCLUSION

These findings show that monitoring these toxic substances remains necessary. Even though the use and as a consequence the amount of chlorinated hydrocarbons were reduced, these substances have by no means disappeared from the environment.

Weight change during lactation does not alter the concentrations of chlorinated organic contaminants in breast milk of women with low exposure

The purpose of this longitudinal study was to evaluate whether a loss of body fat during lactation between 4 and 20 wk postpartum increases the concentration of environmental contaminants in breast milk. We examined this relationship in two different cohorts of exclusively breastfeeding women: (1) California women with low exposure to contaminants (n = 10 whose weight was stable [mean change, 0.0 +/- 0.2 kg] and n = 11 who lost weight [mean loss, -4.1 +/- 0.4 kg]) and (2) Hispanic women (n = 30) who had recently immigrated to North Carolina, primarily from Mexico, and were presumed to have a higher prior exposure to contaminants. Breast milk samples were analyzed for hexachlorobenzene (HCB) and DDT and its related products. There was no significant relationship between change in body composition and change in milk contaminant concentrations in either California or North Carolina women. Concentrations of HCB were similar between the California and North Carolina women, but those of DDT and related products were higher in the North Carolina subjects. Results suggest that moderate weight loss in lactating women with low exposure to environmental contaminants does not increase contaminant concentration in breast milk.

Organochlorine pesticide residues in human milk in the United Kingdom 1997 - 8

1 The concentrations of a range of organochlorine pesticide residues have been determined in 168 samples of human milk collected between January 1997 and May 1998 in the UK. 2 Of the 18 residues sought, only p,p'-DTT, p,p'-DDE, dieldrin, HCB, beta-HCH and gamma-HCH were detected. 3 The continuing trend of a reduction in the concentrations of these pesticide residues in human milk samples and in the percentage of human milk samples containing residues was seen. 4 Correlations between the concentrations of p,p'-DDE, dieldrin, HCB, beta-HCH and gamma-HCH and age were seen. 5 When compared to studies carried out in Europe over a similar time period, residues in this present study were shown to occur at similar or lower concentrations.

Organochlorine pesticides and polychlorinated biphenyls in human milk of mothers living in northern Germany: current extent of contamination, time trend from 1986 to 1997 and factors that influence the levels of contamination

This study reports the concentration levels of PCB, DDT, HCB and beta-HCH in the human milk of women living in northern Germany over a period of 12 years and determines factors that may influence these levels. From 1986 to 1997 more than 3500 milk samples were analyzed for organochlorine compounds. A questionnaire was used to obtain information regarding personal characteristics, life style factors and eating habits. Descriptive statistics of concentration levels were computed to characterize the current extent of contamination. To follow time trends across the years homogeneous subgroups were compared and multiple regression analyses were used to investigate associations between determining factors and specific contaminants. Between summer 1995 and summer 1997 the median PCB concentration level was 0.502 mg/kg, the median DDT level 0.202 mg/kg, the median HCB level 0.065 mg/kg and the median beta-HCH level 0.036 mg/kg, all values expressed on a fat basis. The median concentration levels decreased by 80-90% during the past 12 years and the median PCB levels by 60%. The concentration levels of all substances were positively correlated with maternal age and negatively associated to parity, to the total period of breast-feeding and to a weight increase of mothers before and after delivery. Post-pregnancy BMI was a significant predictor of the likelihood of having higher concentrations for DDT, HCB and beta-HCH and of having lower concentrations for PCB levels. A balanced diet for at least 3 years was related to lower HCB and beta-HCH levels. Women who ate more than 100 g of fish or more than 700 g of meat per week were more likely to have higher PCB and beta-HCH levels or higher HCB levels, respectively. Higher HCB and beta-HCH concentration levels were associated with lower birth weights of female infants.

Accounting for susceptibility in risk assessment: current practice and new directions

Differences in susceptibility between individuals can lead to variability in response to chemical exposures which in turn modify the risk of illness. As a means of exploring the basis for such differences in susceptibility, a project was undertaken to determine what data were available on the range of response variability for several health effects: neurotoxicity, reproductive/developmental toxicity, pulmonary toxicity, and cancer. In addition, modeling approaches for characterizing response variability were examined and evaluated. The main goal of this effort was to determine whether human response variability was adequately accounted for in the current risk assessment procedures for human health effects. The conclusions of the project were that few data are available, both because variability has rarely been the primary focus of study, and because data are not usually reported in such a way that response variability can be determined. Several recommendations were made to facilitate better characterization of interindividual variability, including the study of variability in available human data (e.g. the NHANES database) and allowing greater access to raw data from epidemiologic studies. In addition, the identification of relevant biomarkers, improved understanding of sources of variability, interaction of chemical effects with other exposures or pre-existing disease, and retrospective evaluations of risk assessments were recommended. It is hoped that these recommendations will stimulate research on susceptibility and response variability and encourage the reporting of data in a way that facilitates analysis of interindividual variability in response.