title: Dietary exposure to brominated flame retardants and abnormal Pap test results.
abstract: OBJECTIVE
  This study examined a possible association of dietary exposure to polybrominated biphenyls (PBBs), a brominated flame retardant, and self-reported abnormal Pap test results and cervical dysplasia as a precursor to cervical cancer.
  
  
  METHODS
  Women in Michigan who ingested contaminated poultry, beef, and dairy products in the early 1970s were enrolled in a population-based cohort study in Michigan. Serum PBB and serum polychlorinated biphenyl (PCB) concentrations were measured. Reproductive history and health information, including Pap test results, were self-reported by participants.
  
  
  RESULTS
  Of the women, 23% (223 of 956) reported an abnormal Pap test. In unadjusted analyses, self-reporting an abnormal Pap test was associated with younger age, current smoking (hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.19-2.17), and longer duration of lifetime use of oral contraceptives (≥10 years; HR 1.92, 95% CI 1.21-3.06). When adjusting for PCB exposure, age at the interview, and smoking history, there was a slightly elevated risk of self-reporting an abnormal Pap test among the highly exposed women compared to women with nondetectable PBB concentrations (PBB≥13 μg/L, HR 1.23, 95% CI 0.74-2.06); however, the CI was imprecise. When breastfeeding duration after the initial PBB measurement was taken into account, there was a reduced risk of self-reporting an abnormal Pap test among the highly exposed women who breastfed for ≥12 months (HR 0.41, 95% CI 0.06-3.03; referent group: women with nondetectable PBB concentrations who did not breastfeed).
  
  
  CONCLUSIONS
  It remains important to evaluate the potential reproductive health consequences of this class of chemicals as well as other potential predictors of abnormal Pap tests.
authors.affiliation: Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
authors.forename: Metrecia L
authors.initials: ML
authors.lastname: Terrell
authors.forename: Nnenna N
authors.initials: NN
authors.lastname: Aguocha
authors.forename: Chanley M
authors.initials: CM
authors.lastname: Small
authors.forename: Lorraine L
authors.initials: LL
authors.lastname: Cameron
authors.forename: Michele
authors.initials: M
authors.lastname: Marcus
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000818:Animals; D001942:Breast Feeding; D015331:Cohort Studies; D003276:Contraceptives, Oral; D003611:Dairy Products / Q000009:adverse effects; D004032:Diet; D005260:Female; D005411:Flame Retardants / Q000633:toxicity*; D005506:Food Contamination; D006801:Humans; D008461:Meat Products / Q000009:adverse effects; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D011075:Polybrominated Biphenyls / Q000097:blood / Q000633:toxicity*; D012907:Smoking / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000139:chemically induced / Q000453:epidemiology*; D014626:Vaginal Smears; D055815:Young Adult
chemical_list: D003276:Contraceptives, Oral; D005411:Flame Retardants; D011075:Polybrominated Biphenyls