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Exposure and body burden of environmental pollution and risk of cancer in a historically contaminated areas
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

There are many villages where environmental contamination is substantial due to historical industrial activities. According to the European Environment Agency, there are about 2.5 million potentially contaminated sites in the European member states. In Sweden, there are about 80 000 more or less contaminated areas. About 1000 of them are classified into the highest risk category, Hazard Class 1, and should be remediated. Population exposure due to these industrially contaminated sites may contribute to adverse health effects and is a global environmental problem.

The general aim of this thesis was to evaluate the occurrence of cancer in populations residing in contaminated areas in relation to indirect exposure via the long-term consumption of locally produced food, taking into account residential, occupational and lifestyle factors. Associations between reported local food consumption frequencies, biomarker concentrations and environmental and lifestyle factors were explored. The Swedish national cancer registers and questionnaire information was used to identify cancer risk groups in the study population. The questionnaire was evaluated regarding how well it reflected measured levels of biomarkers in human biological samples, and how the consumption of local food from contaminated areas contributed to the total body burden of contaminants.

Despite historically high environmental levels of contaminants in the soil and sediments, current contaminant exposure in the studied population living in the contaminated areas was similar to or only moderately higher than that of the general population.

No significant associations with increased cancer risk were detected in the highest tertile of metals concentrations in blood or PAH in urine.

Reported long-term high consumption of certain local foods was associated with higher cadmium (vegetarian food) and lead (fish, meat) concentrations in blood and urine. Long-term high consumption of non-local food from places outside the study areas was not associated with increased concentrations of metals compared with consumers of local food. It was concluded that the questionnaire information on consumption of locally produced food describes differences in food consumption in the study population reasonably well.

An increased risk of cancer was associated with smoking, family history of cancer and obesity. Residing in a contaminated area during the first five years of life was associated with an increased risk of cancer, which may indicate exposure to contaminants in early life. Also, long-term high consumption of particular local foods (fish, chicken, lamb, game meat) was associated with an increased risk of various forms of cancer, while reported high consumption of these foods from non-local sources was not associated with increased risk of cancer. The associations between habitual consumption of local food and different types of cancer may reflect a higher exposure in the past, and thus, if consumption of local food contributes to the risk of acquiring cancer, that contribution is probably lower today than previously. Furthermore, it cannot be ruled out that other contaminants in the food contribute to the increased cancer risks observed.

In conclusion, the questionnaire that was developed for the present thesis can identify risk groups within populations and can be used as a tool in a health-risk assessment.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2019. , p. 69
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1699
Keywords [en]
Contaminated area, cancer, exposure, metals, POPs, Consumption of local food
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-160957DOI: 10.3384/diss.diva-160957ISBN: 9789176850060 (print)OAI: oai:DiVA.org:liu-160957DiVA, id: diva2:1361603
Public defence
2019-11-22, Birgittasalen, Universitetssjukhuset, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2019-10-17 Created: 2019-10-16 Last updated: 2019-10-31Bibliographically approved
List of papers
1. Health effects and exposure to polychlorinated biphenyls (PCBs) and metals in a contaminated community
Open this publication in new window or tab >>Health effects and exposure to polychlorinated biphenyls (PCBs) and metals in a contaminated community
2012 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 44, p. 53-58Article in journal (Refereed) Published
Abstract [en]

Environmental measurements carried out by local authorities during the 1970s, 80s and 90s in an area contaminated by hundreds of years of industrial activities have revealed high levels of zinc (Zn), copper (Cu), lead (Pb) and cadmium (Cd) in soil, vegetables, root crops, berries and mushrooms. In 1972, a large quantity of oil contaminated with polychlorinated biphenyls (PCBs) was accidentally spilled into the river running through the village. To investigate the possible health effects of exposure from local sources, all cancer diagnoses, registered in 1960-2003 for individuals living in the study area, were collected from the regional cancer register of southeast Sweden. The total cancer incidence was non-significantly decreased both among males and females as compared to national rates (SIR = 0.91) for each gender. Among males, increased risks, of border-line significance, were seen for testicular cancer and lymphomas as well as significantly decreased risks for cancer in the rectum, respiratory system and brain. Information on lifetime residence, occupation, smoking habits, diseases, childbirth and food consumption, was collected via questionnaires from cancer cases and randomly selected controls. In both genders combined, significant associations were found for total cancer and high consumption of local perch, and for lymphomas and high consumption of both perch and pikeperch. Female breast cancer was significantly associated with high consumption of local perch and pike as well as with work in metal production. Mothers residing in the parish before the age of five reported significantly more preterm child deliveries. In spite of study limitations, the results indicate that residing in a rural contaminated area may contribute to the development of certain cancers and reproductive effects. In females, high consumption of local fish was shown to be the strongest determinant for total cancer, while in males, the strongest determinant was residing in the study area the first five years of life. Further research including validation of exposure using biomarkers is required to verify the findings as well as future studies in other polluted areas in Sweden with larger population bases.

Place, publisher, year, edition, pages
Elsevier, 2012
Keywords
Contaminated area, Polychlorinated biphenyls, Heavy metals, Cancer, Reproduction
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-79086 (URN)10.1016/j.envint.2012.01.009 (DOI)000304745900007 ()
Note

Funding Agencies|Cancer and Allergy Fund, Sweden||

Available from: 2012-06-29 Created: 2012-06-29 Last updated: 2019-10-31
2. Exposure and body burden of polychlorinated biphenyls (PCB) and metals in a historically contaminated community.
Open this publication in new window or tab >>Exposure and body burden of polychlorinated biphenyls (PCB) and metals in a historically contaminated community.
Show others...
2015 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 76, p. 41-8Article in journal (Refereed) Published
Abstract [en]

There are many small villages where environmental contamination is substantial due to historical industrial activities. The aim of the present study was to investigate if long-term or current consumption of local foods, as reported in food frequency questionnaires, co-vary with measured concentrations of polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), lead (Pb), cadmium (Cd) and mercury (Hg) in blood, urine and hair from a population living in a historically contaminated village. Blood, urine and hair were provided by men (n=38) and women (n=57), who had participated in a previous case-control study in the contaminated area, and were analyzed for PCB, OCPs, Pb, Cd and Hg. A detailed food frequency questionnaire, used in the previous epidemiological study, was repeated, and up-dated information of life-style, exposure factors and other covariates was collected. Associations between reported consumption of local foods and exposure biomarkers were explored in relation to age, gender, life-style factors and other covariates. A large part of the population in the area reported consumption of local food, and thus, was potentially exposed to the contaminants. Despite the limited number of participants and other weaknesses described, it was possible to link reported consumption of different foods to biomarker concentrations. Reported consumption of local vegetables, forest berries and mushrooms co-varied with urinary Cd, indicating an influence from the contaminated area on the Cd exposure. We found no associations between PCB plasma concentrations with reported consumption of local fish, but with consumption of herring (non-local sea fish) which is typically high in PCB. Pesticide (HCB, p,p'-DDE, trans-nonachlor) exposure was mainly associated with agricultural work and having a private well the first five years of life, but we found no associations between pesticide concentrations in plasma and consumption of local vegetables or fish. Exposure to Hg was associated with consumption of fish, both local and non-local, and Pb exposure was associated with the consumption of game. Overall, the contaminant concentrations measured in blood, urine and hair varied substantially among study participants, but on average, the concentrations were similar to concentrations measured in other groups of the general Swedish population in the same age range. Larger studies are needed to evaluate health risks (and causality) associated with historical environmental contamination.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:liu:diva-113646 (URN)10.1016/j.envint.2014.12.004 (DOI)000349585600004 ()25529270 (PubMedID)
Note

We express our gratitude to the participating population. We thank the research nurse Louice Eskilsson for an excellent assistance in sample collection and for the dispatch of questionnaires together with Anna-Lena Hallsten. The study was partially financed by the Swedish Environmental Protection Agency, grant no. 502-4531-09.

Available from: 2015-01-27 Created: 2015-01-27 Last updated: 2019-10-16
3. Exposure of metals and PAH through local foods and risk of cancer in a historically contaminated glasswork area
Open this publication in new window or tab >>Exposure of metals and PAH through local foods and risk of cancer in a historically contaminated glasswork area
Show others...
2019 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 131, article id UNSP 104985Article in journal (Refereed) Published
Abstract [en]

Background

Production of crystal glass and colored art glassware have been going on in the south-eastern part of Sweden since the 1700s, at over 100 glassworks and smaller glass blowing facilities, resulting in environmental contamination with mainly arsenic (As), cadmium (Cd), lead (Pb) and polycyclic hydrocarbons (PAH). High levels of metals have been found in soil, and moderately elevated levels in vegetables, mushrooms and berries collected around the glassworks sites compared with reference areas. Food in general, is the major exposure source to metals, such as Cd and Pb, and PAHs. Exposure to these toxic metals and PAH has been associated with a variety of adverse health effects in humans including cancer.

Objective

The aim of the present study was to evaluate the occurrence of cancer in a cohort from the contaminated glasswork area in relation to long-term dietary intake of locally produced foods, while taking into account residential, occupational and life styles factors.

Methods

The study population was extracted from a population cohort of 34,266 individuals who, at some time between the years 1979–2004, lived within a 2 km radius of a glassworks or glass landfill. Register information on cancer incidence and questionnaire information on consumption of local foods (reflecting 30 years general eating habits), life-time residence in the area, life style factors and occupational exposure was collected. Furthermore, blood (n = 660) and urine (n = 400) samples were collected in a subsample of the population to explore associations between local food consumption frequencies, biomarker concentrations in blood (Cd, Pb, As) and urine (PAH metabolite 1-OHPy) as well as environmental and lifestyle factors. The concurrent exposure to persistent organic pollutants (POPs) from food was also considered. A case-control study was performed for evaluation of associations between intakes of local food and risk of cancer.

Results

Despite high environmental levels of Cd, Pb and As at glasswork sites and landfills, current metal exposure in the population living in the surrounding areas was similar or only moderately higher in our study population compared to the general population. Reported high consumption of certain local foods was associated with higher Cd and Pb, but not As, concentrations in blood, and 1-OHPy in urine. An increased risk of cancer was associated with smoking, family history of cancer, obesity, and residence in glasswork area before age 5 years. Also, a long-term high consumption of local foods (reflecting 30 years general eating habits), i.e. fish and meat (game, chicken, lamb), was associated with increased risk of various cancer forms.

Conclusions

The associations between consumption of local food and different types of cancer may reflect a higher contaminant exposure in the past, and thus, if consumption of local food contributes to the risk of acquiring cancer, that contribution is probably lower today than before. Furthermore, it cannot be ruled out that other contaminants in the food contribute to the increased cancer risks observed.

Place, publisher, year, edition, pages
Elsevier, 2019
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:liu:diva-160953 (URN)10.1016/j.envint.2019.104985 (DOI)000493550200042 ()31319292 (PubMedID)2-s2.0-85068874468 (Scopus ID)
Note

Funding agencies: Swedish Environmental Protection Agency; Medical Research Council of Southeast Sweden; Kamprad Family Foundation, Sweden; Occupational and Environmental Medicine, Linkoping University Hospital, Sweden

Available from: 2019-10-16 Created: 2019-10-16 Last updated: 2019-12-04Bibliographically approved

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