title: WHO/UNEP global surveys of PCDDs, PCDFs, PCBs and DDTs in human milk and benefit-risk evaluation of breastfeeding.
abstract: Since 1987, the World Health Organization (WHO) carried out global surveys on polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and polychlorinated biphenyls (PCBs) in human milk. This study presents a review of the three most recent surveys from 2000 to 2010, including DDT. The objective was to identify global quantitative differences and provide baseline information for 52 countries or provide time-trends for countries with previous data. Individual human milk samples were collected following a WHO-designed procedure and combined to form a national pooled sample. Here, we report global levels for PCDDs, PCDFs, PCBs and the sum of o,p'-DDT, p,p'-DDT, o,p'-DDE, p,p'-DDE, o,p'-DDD and p,p'-DDD (ΣDDTs). A concise risk-benefit evaluation related to human milk contamination with these persistent organic pollutants (POPs) was also done. Large global and regional differences were observed. Levels of PCDDs and PCDFs were highest in India and some European and African countries. PCB levels were highest in East and West Europe. The highest levels of ΣDDTs were found in less industrialized countries. A temporal downward trend for PCDDs, PCDFs and PCBs is indicated. A risk-benefit assessment indicates that human milk levels of PCDDs, PCDFs and PCBs are still significantly above those considered toxicologically safe, while ΣDDTs are below or around those considered safe. With respect to potential adverse health effects, a more dominant role of in utero exposure versus lactational exposure is indicated. If potential adverse effects are balanced against positive health aspects for (breastfed) infants, the advantages of breastfeeding far outweigh the possible disadvantages. Our observations provide a strong argument to plea for further global source-directed measures to reduce human exposure further to dioxin-like compounds.
authors.affiliation: Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80177, 3508 TD, Utrecht, The Netherlands. m.vandenberg@uu.nl.
authors.forename: Martin
authors.identifier: http://orcid.org/0000-0001-6239-6301
authors.initials: M
authors.lastname: van den Berg
authors.affiliation: WHO/UNEP Reference Laboratory, State Institute for Chemical and Veterinary Analysis of Food (CVUA), Bissierstrasse 5, 79114, Freiburg, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Kypke
authors.affiliation: WHO/UNEP Reference Laboratory, State Institute for Chemical and Veterinary Analysis of Food (CVUA), Bissierstrasse 5, 79114, Freiburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kotz
authors.affiliation: Department of Food Safety and Zoonoses, World Health Organization, Ave Appia 20, 1211, Geneva 27, Switzerland.
authors.forename: Angelika
authors.initials: A
authors.lastname: Tritscher
authors.affiliation: Department of Food Safety and Zoonoses, World Health Organization, Ave Appia 20, 1211, Geneva 27, Switzerland.
authors.forename: Seoung Yong
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Stockholm Convention Secretariat, United Nations Environment Programme (UNEP), International Environment House, 1219, Châtelaine, Geneva, Switzerland.
authors.forename: Katarina
authors.initials: K
authors.lastname: Magulova
authors.affiliation: Division of Technology, Industry and Economics/Chemical Branch, United Nations Environment Programme (UNEP), Chemin des Anémones 11-13, 1219, Châtelaine, Geneva, Switzerland.
authors.forename: Heidelore
authors.initials: H
authors.lastname: Fiedler
authors.affiliation: WHO/UNEP Reference Laboratory, State Institute for Chemical and Veterinary Analysis of Food (CVUA), Bissierstrasse 5, 79114, Freiburg, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Malisch
mesh_terms: D001711:Biotransformation; D001942:Breast Feeding / Q000009:adverse effects*; D003634:DDT / Q000032:analysis / Q000378:metabolism / Q000633:toxicity; D000072338:Dibenzofurans, Polychlorinated / Q000032:analysis / Q000378:metabolism / Q000633:toxicity; D004147:Dioxins / Q000032:analysis* / Q000378:metabolism / Q000633:toxicity; D004782:Environmental Health / Q000379:methods* / Q000639:trends; D005506:Food Contamination; D014943:Global Health; D006306:Health Surveys; D006801:Humans; D008895:Milk, Human / Q000737:chemistry*; D010573:Pesticide Residues / Q000032:analysis* / Q000378:metabolism / Q000633:toxicity; D011078:Polychlorinated Biphenyls / Q000032:analysis / Q000378:metabolism / Q000633:toxicity; D000072317:Polychlorinated Dibenzodioxins / Q000032:analysis / Q000378:metabolism / Q000633:toxicity; D018570:Risk Assessment; D014480:United Nations; D014944:World Health Organization
chemical_list: D000072338:Dibenzofurans, Polychlorinated; D004147:Dioxins; D010573:Pesticide Residues; D000072317:Polychlorinated Dibenzodioxins; D003634:DDT; D011078:Polychlorinated Biphenyls
keywords: Benefit–risk; Breastfeeding; DDT; Dioxins; Human milk; PCBs