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A General Model of Dioxin Contamination in Breast Milk: Results from a Study on 94 Women from the Caserta and Naples Areas in Italy
St. Anna and St. Sebastiano Hospital, Via F. Palasciano, 81100 Caserta, Italy
ISDE Campania, International Society Doctors for the Environment, 80100 Naples, Italy
ISBEM, Euro Mediterranean Bio-Medical Scientific Institute, 72023 Brindisi, Italy
IZSAM, National Reference Laboratory for Dioxins and PCBs in Food and Feed, 64100 Teramo, Italy
Department of Epidemiology and Biostatistics, University of California, 185 Berry Street, San Francisco, CA 94107, USA
Department of Public Health, University Federico II, Via Pansini 5, 80131 Naples, Italy
On behalf of International Society Doctors for the Environment (ISDE Campania).
* Author to whom correspondence should be addressed.
Received: 26 July 2013; in revised form: 24 October 2013 / Accepted: 25 October 2013 / Published: 8 November 2013
Abstract: Background: The Caserta and Naples areas in Campania Region experience heavy environmental contamination due to illegal waste disposal and burns, thus representing a valuable setting to develop a general model of human contamination with dioxins (PCDDs-PCDFs) and dioxin-like-PCBs (dl-PCBs). Methods: 94 breastfeeding women (aged 19–32 years; mean age 27.9 ± 3.0) were recruited to determine concentrations of PCDDs-PCDFs and dl-PCBs in their milk. Individual milk samples were collected and analyzed according to standard international procedures. A generalized linear model was used to test potential predictors of pollutant concentration in breast milk: age, exposure to waste fires, cigarette smoking, diet, and residence in high/low risk area (defined at high/low environmental pressure by a specific 2007 WHO report). A Structural Equation Model (SEM) analysis was carried out by taking into account PCDDs-PCDFs and dl-PCBs as endogenous variables and age, waste fires, risk area and smoking as exogenous variables. Results: All milk samples were contaminated by PCDDs-PCDFs (8.6 pg WHO-TEQ/98g fat ± 2.7; range 3.8–19) and dl-PCBs (8.0 pg WHO-TEQ/98g fat ± 3.7; range 2.5–24), with their concentrations being associated with age and exposure to waste fires (p < 0.01). Exposure to fires resulted in larger increases of dioxins concentrations in people living in low risk areas than those from high risk areas (p < 0.01). Conclusions: A diffuse human exposure to persistent organic pollutants was observed in the Caserta and Naples areas. Dioxins concentration in women living in areas classified at low environmental pressure in 2007 WHO report was significantly influenced by exposure to burns.
Keywords: dioxins; dioxin-like polychlorobiphenyls; persistent organic pollutants; human exposure; breastfeeding; environment; waste emergency
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Rivezzi, G.; Piscitelli, P.; Scortichini, G.; Giovannini, A.; Diletti, G.; Migliorati, G.; Ceci, R.; Rivezzi, G.; Cirasino, L.; Carideo, P.; Black, D.M.; Garzillo, C.; Giani, U. A General Model of Dioxin Contamination in Breast Milk: Results from a Study on 94 Women from the Caserta and Naples Areas in Italy. Int. J. Environ. Res. Public Health 2013, 10, 5953-5970.
Rivezzi G, Piscitelli P, Scortichini G, Giovannini A, Diletti G, Migliorati G, Ceci R, Rivezzi G, Cirasino L, Carideo P, Black DM, Garzillo C, Giani U. A General Model of Dioxin Contamination in Breast Milk: Results from a Study on 94 Women from the Caserta and Naples Areas in Italy. International Journal of Environmental Research and Public Health. 2013; 10(11):5953-5970.
Rivezzi, Gaetano; Piscitelli, Prisco; Scortichini, Giampiero; Giovannini, Armando; Diletti, Gianfranco; Migliorati, Giacomo; Ceci, Roberta; Rivezzi, Giulia; Cirasino, Lorenzo; Carideo, Pietro; Black, Dennis M.; Garzillo, Carmine; Giani, Umberto. 2013. "A General Model of Dioxin Contamination in Breast Milk: Results from a Study on 94 Women from the Caserta and Naples Areas in Italy." Int. J. Environ. Res. Public Health 10, no. 11: 5953-5970.