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      Perfluorinated compounds are related to breast cancer risk in greenlandic inuit: A case control study

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          Abstract

          Background

          Breast cancer (BC) is the most common cancer for women in the western world. From very few cases an extraordinary increase in BC was observed in the Inuit population of Greenland and Canada although still lower than in western populations. Previous data suggest that exposure to persistent organic pollutants (POPs) might contribute to the risk of BC. Rat studies showed that perfluorinated compounds (PFCs) cause significantly increase in mammary fibroadenomas. This study aimed at evaluating the association between serum levels of POPs/PFCs in Greenlandic Inuit BC cases and their controls, and whether the combined POP related effect on nuclear hormone receptors affect BC risk.

          Methods

          Thirty-one BC cases and 115 controls were sampled during 2000-2003 from various Greenlandic districts. The serum levels of POPs, PFCs, some metals and the combined serum POP related effect on estrogen- (ER), androgen- (AR) and Ah-receptor (AhR) transactivity were determined. Independent student t-test was used to compare the differences and the odds ratios were estimated by unconditional logistic regression models.

          Results

          We observed for the very first time a significant association between serum PFC levels and the risk of BC. The BC cases also showed a significantly higher concentration of polychlorinated biphenyls at the highest quartile. Also for the combined serum POP induced agonistic AR transactivity significant association to BC risk was found, and cases elicited a higher frequency of samples with significant POP related hormone-like agonistic ER transactivity. The AhR toxic equivalent was lowest in cases.

          Conclusions

          The level of serum POPs, particularly PFCs, might be risk factors in the development of BC in Inuit. Hormone disruption by the combined serum POP related xenoestrogenic and xenoandrogenic activities may contribute to the risk of developing breast cancer in Inuit. Further investigations are needed to document these study conclusions.

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          Most cited references68

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          Biological monitoring of polyfluoroalkyl substances: A review.

          Polyfluoroalkyl substances (PFSs) are used in industrial and commercial products and can degrade to persistent perfluorocarboxylates (PFCAs) and perfluoroalkyl sulfonates (PFSAs). Temporal trend studies using human, fish, bird, and marine mammal samples indicate that exposure to PFSs has increased significantly over the past 15-25 years. This review summarizes the biological monitoring of PFCAs, PFSAs, and related PFSs in wildlife and humans, compares concentrations and contamination profiles among species and locations, evaluatesthe bioaccumulation/biomagnification in the environment, discusses possible sources, and identifies knowledge gaps. PFSs can reach elevated concentrations in humans and wildlife inhabiting industrialized areas of North America, Europe, and Asia (2-30,000 ng/ mL or ng/g of wet weight (ww)). PFSs have also been detected in organisms from the Arctic and mid-ocean islands (< or = 3000 ng/g ww). In humans, PFSAs and PFCAs have been shown to vary among ethnic groups and PFCA/PFSA profiles differ from those in wildlife with high proportions of perfluorooctanoic acid and perfluorooctane sulfonate. The pattern of contamination in wildlife varied among species and locations suggesting multiple emission sources. Food web analyses have shown that PFCAs and PFSAs can bioaccumulate and biomagnify in marine and freshwater ecosystems. Knowledge gaps with respect to the transport, accumulation, biodegradation, temporal/spatial trends and PFS precursors have been identified. Continuous monitoring with key sentinel species and standardization of analytical methods are recommended.
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            Perfluorinated compounds--exposure assessment for the general population in Western countries.

            Perfluorinated compounds (PFCs) can currently be detected in many environmental media and biota, as well as in humans. Because of their persistence and their potential to accumulate they are of toxicological concern. The present review presents the current knowledge of PFC monitoring data in environmental media relevant for human exposure. In this context, PFC concentrations in indoor and ambient air, house dust, drinking water and food are outlined. Furthermore, we summarize human biomonitoring data of PFC levels in blood, breast milk, and human tissues. An estimate of the overall exposure of the general adult population is provided and compared with tolerable intake values. Using a simplified model, the average (and upper) level of daily exposure including all potential routes amounts to 1.6 ng/kg(body weight) (8.8 ng/kg(body weight)) for PFOS and 2.9 ng/kg(body weight) (12.6 ng/kg(body weight)) for PFOA in adults in the general population. The majority of exposure can be attributed to the oral route, mainly to diet. Overall, the contribution of PFOS and PFOA precursors to total exposure seems to be limited. Besides this background exposure of the general population, a specific additional exposure may occur which causes an increased PFC body burden. This has been observed in populations living near PFC production facilities or in areas with environmental contamination of PFCs. The consumption of highly contaminated fish products may also cause an increase in PFC body burdens.
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              Chlorinated hydrocarbon levels in human serum: effects of fasting and feeding.

              Twenty healthy adult humans had serum samples drawn on four occasions within a 24-hr period: after a 12 hr overnight fast, 4-5 hr after a high fat breakfast, at midafternoon, and the next morning after another 12 hr fast. Nonfasting samples had 22% to 29% higher mean concentrations (p less than 0.05) than did fasting samples for polychlorinated biphenyls (PCBs, 4.81 vs 3.74 ng/g serum wt), hexachlorobenzene (HCB, 0.163 vs 0.134 ng/g serum wt), and p,p'-dichlorodiphenyl-dichloroethylene (p,p'-DDE, 6.74 vs 5.37 ng/g serum wt) measured by electron capture gas liquid chromatography. Total serum lipids were estimated from measurements of total cholesterol, free cholesterol, triglycerides, and phospholipids and were 20% higher in nonfasting samples than in fasting samples (7.05 g/L vs 5.86 g/L). When PCBs, HCB, and p,p'-DDE concentrations were corrected by total serum lipids, results from fasting and non-fasting samples were not statistically different. Because of the differences in these chlorinated hydrocarbon concentrations observed with different sample collection regimens, meaningful comparison of analytical results requires standardizing collection procedures or correcting by total serum lipid levels.
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                Author and article information

                Journal
                Environ Health
                Environmental Health
                BioMed Central
                1476-069X
                2011
                6 October 2011
                : 10
                : 88
                Affiliations
                [1 ]Centre for Arctic Environmental Medicine, Department of Public Health, Aarhus University, Denmark
                [2 ]National Environmental Research Institute, Aarhus University, Denmark
                [3 ]Institut National de Santé Publique du Québec, Québec, QC, Canada
                [4 ]Dronning Ingrids Hospital, Nuuk Greenland
                Article
                1476-069X-10-88
                10.1186/1476-069X-10-88
                3203030
                21978366
                03251f9d-1458-4f94-9670-947749757f92
                Copyright ©2011 Bonefeld-Jorgensen et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 May 2011
                : 6 October 2011
                Categories
                Research

                Public health
                pops,pfcs,combined serum xenohormone and dioxin-like activities,n-3 fatty acids
                Public health
                pops, pfcs, combined serum xenohormone and dioxin-like activities, n-3 fatty acids

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