Problemi correnti
Latte materno, diossine e PCB
BREASTMILK, DIOXINS AND PCBs
Patrizia Gentilini1, Annamaria Moschetti2, Ernesto Burgio3, Michelangiolo Bolognini4, Stefano Raccanelli5, Adriano Cattaneo6
1Oncoematologo, Associazione Medici per l’Ambiente ISDE Italia; 2Pediatra di famiglia, ACP Puglia e Basilicata; 3Coordinatore Comitato Scientifico ISDE Italia; 4Medico igienista, ISDE Pistoia; 5Chimico ambientale, Consorzio INCA, Venezia; 6Epidemiologo, IRCCS Pediatrico “Burlo Garofolo”, Trieste
Ottobre 2011 - pagg. 510 -517
Abstract
The presence of dioxin and polychlorinated biphenyls (PCBs) in breastmilk and their transfer
to the infant represent the tip of the iceberg of a serious situation: the exposure in utero
and the subsequent damage to the foetus. Several populations, especially those living
in densely industrialised areas, are subject to increasing exposure to these and other pollutants.
Monitoring the contamination of breastmilk allows the present and past exposure
in a population to be estimated. Thanks to the control measures implemented after the
Stockholm Convention on persistent organic pollutants in 2004, the levels of contamination
are decreasing in Europe. Alarming situations persist, however, in some places: in Italy
these concentrate around densely industrialised areas and close to incinerators. In Taranto
and Montale (Pistoia), upon citizens’ initiatives, samples of breastmilk were analysed and
levels of dioxins far higher than those recommended as safe were found. In Montale, the
profile of PCBs found in breastmilk was exactly the same as the one of those released by
the incinerator. These results should not be used to discourage breastfeeding, which may
in fact represent an advantage, compared to non breastfeeding, for those infants already
exposed to the same substances in utero. They should be used instead, with the setting up
of a regular biomonitoring system by the competent authorities, to advocate for public policies
aiming at a different model of development that will safeguard the health of future generations.
Parole chiave
Classificazione MeSH
Bibliografia
1. Tomatis L. Prenatal exposure to chemical
carcinogens and its effect on subsequent generations.
Natl Cancer Inst Monogr 1979;51:
159-84.
2. Barr DB, Bishop A, Needham LL. Concentrations
of xenobiotic chemicals in the maternal-
fetal unit. Reprod Toxicol 2007;23:260-6.
3. Gluckman PD, Hanson MA, Cooper C, et
al. Effect of in utero and early-life conditions
on adult health and disease. N Engl J Med
2008;359:61-73.
4. Massart F, Gherarducci G, Marchi B, et al.
Chemical Biomarkers of Human Breast Milk
Pollution. Biomark Insights 2008;3:159-69.
5. http://www.euro.who.int/_data/assets/
pdf_file/0003/97032/enhis_factsheet09_4_3.
pdf.
6. Boersma ER, Lanting CI. Environmental
exposure to polychlorinated biphenyls
(PCBs) and dioxins. Consequences for longterm
neurological and cognitive development
of the child lactation. Adv Exp Med Biol
2000;478:271-87.
7. Ribas-Fito N, Cardo E, Sala M, et al. Breastfeeding,
exposure to organochlorine compounds,
and neurodevelopment in infants.
Pediatrics 2003;111:e580-5.
8. Ribas-Fito N, Julvez J, Torrent M, et al. Beneficial
effects of breastfeeding on cognition
regardless of DDT concentrations at birth.
Am J Epidemiol 2007;166:1198-202.
9. Mead MN. Contaminants in human milk:
weighing the risks against the benefits of
breastfeeding. Environ Health Perspect 2008;
116:A427-34.
10. Lakind JS, Berlin CM, Mattison DR. The
heart of the matter on breastmilk and environmental
chemicals: essential points for
healthcare providers and new parents. Breastfeed
Med 2008;3:251-9.
11. http://www.eper.sinanet.apat.it/site/_contentfiles/
00000000/56_50_dati_Registro
_INES_2006_al25nov2008.xls.
12. http://ec.europa.eu/environment/dioxin/
pdf/stage2/volume_3.pdf.
13. Schecter A, di Domenico A, Turrio-Baldassarri
L, et al. Dioxin and dibenzofurans levels
in the milk of women from four geographical
regions in Italy as compared to levels
in other countries. Organohalogen Compounds
1992;9:227-30.
14. Abballe A, Ballard TJ, Dellatte E, et al.
Persistent environmental contaminants in
human milk: concentrations and time trends
in Italy. Chemosphere 2008;73:S220-7.
15. Pirkle JL, Wolfe WH, Patterson DG, et al.
Estimates of the half-life of 2,3,7,8-tetrachlorodibenzo-
p-dioxin in Vietnam Veterans of
Operation Ranch Hand. J Toxicol Environ
Health 1989;27:165-71.
16. Wang LC, Hsi HC, Chang JE, et al. Influence
of start-up on PCDD/F emission of
incinerators. Chemosphere 2007;67:1346-53.
17. http://chm.pops.int/Portals/0/download.
aspx?d=UNEP-POPS-TREATY-NOTIFCN524-
2009.En.pdf.
18. Nguyen LP, Bradfield CA. The search for
endogenous activators of the aryl hydrocarbon
receptor. Chem Res Toxicol 2008;21:102-16.
19. Schecter A, Birnbaum L, Ryan JJ, et al.
Dioxins: an overview. Environ Res 2006;101:
419-28.
20. Sauer PJ, Huisman M, Koopman-Esseboom
C, et al. Ef fects of polychlorinated
biphenyls (PCBs) and dioxins on growth and
development. Hum Exp Toxicol 1994;13:900-6.
21. Yonemoto J. The effects of dioxin on reproduction
and development. Ind Health
2000;38:259-68.
22. Brouwer A, Morse DC, Lans MC, et al.
Interactions of persistent environmental organohalogens
with the thyroid hormone system:
mechanisms and possible consequences
for animal and human health. Toxicol Ind
Health 1998;14:59-84.
23. Toft G, Hagmar L, Giwercman A, et al.
Epidemiological evidence on reproductive effects
of persistent organochlorines in humans.
Reprod Toxicol 2004;19:5-26.
24. Toft G, Axmon A, Giwercman A, et al.
Fertility in four regions spanning large contrasts
in serum levels of widespread persistent
organochlorines: a cross-sectional
study. Environ Health 2005;4:26.
25. Vreugdenhil HJ, Lanting CI, Mulder PG,
et al. Ef fects of prenatal PCB and dioxin
background exposure on cognitive and motor
abilities in Dutch children at school age. J
Pediatr 2002;140:48-56.
26. Schantz SL, Widholm JJ, Rice DC. Effects
of PCB exposure on neuropsychological function
in children. Environ Health Perspect 2003;
111:357-76.
27. Todaka T, Hirakawa H, Kajiwara J, et al.
Relationship between the concentrations of
polychlorinated dibenzo-p-dioxins, polychlorinated
dibenzofurans, and polychlorinated
biphenyls in maternal blood and those in
breast milk. Chemosphere 2010;78:185-92.
28. Suzuki G, Nakano M, Nakano S. Distribution
of PCDDs/PCDFs and Co-PCBs in human
maternal blood, cord blood, placenta,
milk, and adipose tissue: dioxins showing high
toxic equivalency factor accumulate in the
placenta. Biosci Biotechnol Biochem 2005;
69:1836-47.
29. Somogyi A, Beck H. Nurturing and breast-
feeding: exposure to chemicals in breast
milk. Environ Health Perspect 1993;101(Suppl.
2):45-52.
30. Hirakawa H, Ilda T, Matsueda T, et al.
Comparison of Concentrations of PCDDs,
PCDFs, PCBs and other Organohalogen
Compounds in Human Milk of Primiparas
and Multiparas. Organohalogen Compounds
1995;26:197-200.
31. http://www.euro.who.int/__data/assets/
pdf_file/0003/97032/enhis_factsheet09
_4_3.pdf.
32. Noren K, Meironyte D. Certain organochlorine
and organobromine contaminants in
Swedish human milk in perspective of past
20-30 years. Chemosphere 2000;40:1111-23.
33. Fürst P, Päpke O. PCDDs, PCDFs and
dioxin-like PCBs in human milk and blood
from Germany. Organohalogen Compounds
2002;55:251-4.
34. Wang SL, Lin CY, Guo YL, et al. Infant exposure
to polychlorinated dibenzo-p-dioxins,
dibenzofurans and biphenyls (PCDD/Fs,
PCBs)-correlation between prenatal and postnatal
exposure. Chemosphere 2004;54:
1459-73.
35. Kunisue T, Someya M, Kayama F, et al.
Persistent organochlorines in human breast
milk collected from primiparae in Dalian and
Shenyang, China. Environ Pollut 2004;131:
381-92.
36. Li J, Zhang L, Wu Y, et al. A national survey
of polychlorinated dioxins, furans
(PCDD/Fs) and dioxin-like polychlorinated
biphenyls (dl-PCBs) in human milk in China.
Chemosphere 2009;75:1236-42.
37. Cok I, Donmez MK, Uner M, et al. Polychlorinated
dibenzo-p-dioxins, dibenzofurans
and polychlorinated biphenyls levels in human
breast milk from different regions of
Turkey. Chemosphere 2009;76:1563-71.
38. Wilhelm M, Wittsiepe J, Lemm F, et al.
The Duisburg birth cohort study: influence
of the prenatal exposure to PCDD/Fs and
dioxin-like PCBs on thyroid hormone status
in newborns and neurodevelopment of infants
until the age of 24 months. Mutat Res
2008;659:83-92.
39. Wittsiepe J, Furst P, Schrey P, et al.
PCDD/F and dioxin-like PCB in human
blood and milk from German mothers. Chemosphere
2007;67:S286-94.
40. Tajimi M, Watanabe M, Oki I, et al.
PCDDs, PCdfs and Co-PCBs in human breast
milk samples collected in Tokyo, Japan.
Acta Paediatr 2004;93:1098-102.
41. Turrio-Baldassarri L, Abate V, Battistelli
CL, et al. PCDD/F and PCB in human serum
of differently exposed population groups of an
Italian city. Chemosphere 2008;73:S228-34.
42. Chellini E, Cherubini M, Chetoni L, et al.
Risk of respiratory cancer around a sewage
plant in Prato, Italy. Arch Environ Health 2002;
57:548-53.
43. http://www.arpa.emr.it/pubblicazioni/
moniter/generale_654.asp.
44. Progetto Enhance Health. Valutazione
dello stato di salute della popolazione residente
nell’area di Coriano, Forlì, 2007.
http://www.arpa. emr.it/cms3/documenti/_
cerca_doc/rifiuti/inceneritori/enh_relazi
one_finale.pdf.
45. Lettera aperta ai Colleghi dell’AIE. Epidemiologia
e prevenzione 2008;32:188.
46. http://por tale.fnomceo.it/Jcmsfnomceo/
cmsfile/attach_6121.pdf.
47. Kriebel D. Incinerators, birth defects and
the legacy of Thomas Bayes. Occup Environ
Med 2010;67:433-4.
Corrispondenza: patrizia.gentilini@villapacinotti.it
