Review article
Monitoring concentrations of persistent organic pollutants in the general population: The international experience

https://doi.org/10.1016/j.envint.2007.10.004Get rights and content

Abstract

Assessing the adverse effects on human health of persistent organic pollutants (POPs) and the impact of policies aiming to reduce human exposure to POPs warrants monitoring body concentrations of POPs in representative samples of subjects. While numerous ad hoc studies are being conducted to understand POPs effects, only a few countries are conducting nationwide surveillance programs of human concentrations of POPs, and even less countries do so in representative samples of the general population. We tried to identify all studies worldwide that analyzed the distribution of concentrations of POPs in a representative sample of the general population, and we synthesized the studies' main characteristics, as design, population, and chemicals analyzed. The most comprehensive studies are the National Reports on Human Exposure to Environmental Chemicals (USA), the German Environmental Survey, and the Arctic Monitoring and Assessment Programme. Population-wide studies exist as well in New Zealand, Australia, Japan, Flanders (Belgium) and the Canary Islands (Spain). Most such studies are linked with health surveys, which is a highly-relevant additional strength. Only the German and Flemish studies analyzed POPs by educational level, while studies in the USA offer results by ethnic group. The full distribution of POPs concentrations is unknown in many countries. Knowledge gaps include also the interplay of age, gender, period and cohort effects on the prevalence of exposures observed by cross-sectional surveys. Local and global efforts to minimize POPs contamination, like the Stockholm convention, warrant nationwide monitoring of concentrations of POPs in representative samples of the general population. Results of this review show how such studies may be developed and used.

Introduction

Persistent organic pollutants (POPs) are synthetic chemicals highly resistant to degradation that bioaccumulate in the environment, and are suspicious of or known to harm human health (Department of Health and Human Services, 2005, Hansen, 1998, Institute of Medicine, 2003, United Nations Environment Programme, 2003, United Nations Environment Programme, 2007). Virtually all humans are thought to store POPs in fat tissues, in particular dichlorodiphenyldichloroethane (DDE, the main degradation product of the pesticide dichlorodiphenyltrichloroethane, DDT), trans-nonachlor, hexachlorobenzene, the hexachlorociclohexanes (including lindane), dioxins, and polychlorinated biphenyls (PCBs) (DeVoto et al., 1998, Liem et al., 2000, Porta and Zumeta, 2002, Porta et al., 2003, Sanz-Gallardo et al., 1999). Nowadays literally throughout life, human exposure to POPs occurs mostly from the fatty components of animal foods (Kalantzi et al., 2001, Schafer and Kegley, 2002, Schepens et al., 2001, van Larebeke et al., 2001). Although some POPs have been banned or restricted others remain deeply rooted in our societies, and human exposure continues even to compounds long banned like DDT, mostly through food chains. Implementing effective measures to decrease POPs contamination of animal feed and human foods is recognized as a major challenge to our societies (Porta, 2002). Monitoring the impact of such policies on human contamination requires surveillance of POP levels in representative samples of subjects. The Stockholm Treaty on POPs and other laws thus encourage health authorities to monitor concentrations of POPs in the general population (Porta and Zumeta, 2002, United Nations Environment Programme, 2007).

Furthermore, a lively debate exists on POP ‘doses’; for instance, on the clinical, epidemiological and social relevance of some physiopathologic effects, which long periods of exposure to low doses of some POPs may contribute to cause (Kaiser, 2000, Myers, 2002, Stokstad, 2004, Weinhold, 2003, Lee et al., 2007). Theoretically, such controversies and uncertainties about the effects of POPs on human health should strengthen the value of knowing as accurately as possible the distribution of concentrations of POPs in human populations. However, as we shall show, comprehensive surveillance and monitoring systems on human exposure to POPs are more scarce than would be thought.

Our primary aim was to identify all studies worldwide that analyzed the distribution of concentrations of POPs in a representative sample of the general population, and to synthesize the main characteristics of the studies. We also summarized some other population-wide studies that were particularly comprehensive and relevant.

Section snippets

Methods

The aim of our literature search was to identify all studies that analyzed the distribution of concentrations of persistent organic pollutants in a representative sample of the general population. All countries and regions worldwide were eligible for inclusion. Articles published in the academic literature were as eligible as reports from governmental and nongovernmental organizations. We were able to use articles and reports in English, German, French, Italian, Portuguese and Spanish. We

Results

Two broad types of literature products were identified in the review: government reports on POP concentrations in a general population, and ad hoc studies published in the academic literature, usually lead by a research group. Reports tend to analyze wider populations; often, a representative sample of a country or region. They also tend to analyze a larger number of compounds. Nearly all reports are linked to a national or regional health survey (Table 1).

Discussion and conclusions

Our review excluded polybrominated biphenyls, polybrominated biphenyl ethers, phthalates and other compounds of more recent appearance, even though their levels in biological media have increased in recent years to varying degrees in different population groups (Bernes, 1998, Department of Health and Human Services, 2005, Hauser et al., 2005, Stokstad, 2004, Swedish Environmental Protection Agency, 2007, United Nations Environment Programme, 2007). We focused the review on compounds that are

Acknowledgments

We thank José Pumarega, Marta Crous, Magda Gasull, Eva Morales, Magda Bosch de Basea, Isabel Egea and Sílvia Geeraerd. Party funded by grants from the Ministry of the Environment of Spain; Oficina de Ciència i Tecnologia, Generalitat Valenciana (03/136); Departament de Salut, Generalitat de Catalunya; Agència de Salut Pública de Barcelona; CIBER de Epidemiología y Salud Pública; the INMA Network (G03/176, and FIS-FEDER 031615, 041509); the U.S. National Cancer Institute project “Use of the

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