Future directions for monitoring and human health research for the Arctic Monitoring and Assessment Programme.

For the last two and a half decades, a network of human health experts under the Arctic Monitoring and Assessment Program (AMAP) has produced several human health assessment reports. These reports have provided a base of scientific knowledge regarding environmental contaminants and their impact on human health in the Arctic. These reports provide scientific information and policy-relevant recommendations to Arctic governments. They also support international agreements such as the Stockholm Convention on Persistent Organic Pollutants (POPs) and the Minamata Convention on Mercury. Key topics discussed in this paper regarding future human health research in the circumpolar Arctic are continued contaminant biomonitoring, health effects research and risk communication. The objective of this paper is to describe knowledge gaps and future priorities for these fields.

Thyroid homeostasis in mother-child pairs in relation to maternal iodine status: the MISA study.

BACKGROUND/OBJECTIVES: Iodine deficiency during pregnancy may influence maternal and foetal thyroid function with the risk of causing neurocognitive and psychomotor deficits in the offspring. The objective of this study was to assess iodine status in pregnant women from Northern Norway and to investigate the influence of iodine status on maternal and infant thyroid function. SUBJECTS/METHODS: Women from the Northern Norway Mother-and-Child contaminant Cohort Study (MISA) donated a blood and urine sample at three visits during their pregnancy and postpartum period (in second trimester, 3 days and 6 weeks after delivery. N=197). Women were assigned to iodine status groups according to urine iodine concentrations (UICs) in second trimester and mixed effects linear models were used to investigate potential associations between iodine status and repeated measurements of thyroid-stimulating hormone (TSH), thyroid hormones (THs), TH-binding proteins and thyroid peroxidase antibodies. Associations between maternal iodine status and TSH in heel prick samples from the infants were investigated with linear regression. RESULTS: Median UIC in second trimester was 84 µg/l (range 18-522) and 80% had UIC below recommended level (<150 µg/l). Iodine-deficient women had higher concentrations of T3, FT3 and FT4 (estimated differences (confidence intervals) of 0.10 nmol/l (0.01, 0.17), 0.16 pmol/l (0.05, 0.26) and 0.45 pmol/l (0.10, 0.78), respectively) compared with iodine-sufficient women. The concentrations varied within normal reference ranges, but the majority of women with subclinical hypothyroidism were iodine deficient. Maternal iodine status did not influence infant TSH concentrations. CONCLUSIONS: This study indicate iodine deficiency among pregnant women in Norway. Iodine status during pregnancy influences maternal thyroid homeostasis and is therefore a risk factor for foetal and infant development.

Maternal exposure to perfluoroalkyl acids measured in whole blood and birth outcomes in offspring.

Perfluoralkyl and polyfluoralkyl substances have been measured in plasma and serum of pregnant women as a measure of prenatal exposure. Increased concentrations of individual perfluoroalkyl acids (PFAAs), (typically perfluorooctanoic acid (PFOA) and perfluoroctane sulfonate (PFOS) have been reported to be associated with reductions in birth weight and other birth outcomes. We undertook a study of 14 PFAAs in whole blood (including PFOS, PFHxS, PFHpA, PFOA, PFNA, PFDA and PFUnDA) from 98 pregnant women in Western Australia from 2008 to 2011. Median concentrations (in µg/L) were: PFOS 1.99; PFHxS 0.33; PFOA 0.86; PFNA 0.30; PFDA 0.12 and PFUnDA 0.08. Infants born to women with the highest tertile of PFHxS exposure had an increased odds of being <95% of their optimal birth weight (OR 3.5, 95% CI 1.1-11.5). Conversely, maternal blood concentrations of PFUnDA were associated with non-significant increases in average birth weight (+102g, 95% CI -41, 245) and significant increases in proportion of optimal birth weight (+4.7%, 95% CI 0.7, 8.8) per ln-unit change. This study has reported a range of PFAAs in the whole blood of pregnant women and suggests that PFHxS and PFUnDA may influence foetal growth and warrant further attention. Additional studies are required to identify the sources of PFAA exposure with a view to prevention, in addition to further studies investigating the long term health effects of these ubiquitous chemicals.

Maternal exposure to alkali, alkali earth, transition and other metals: Concentrations and predictors of exposure.

Most studies of metals exposure focus on the heavy metals. There are many other metals (the transition, alkali and alkaline earth metals in particular) in common use in electronics, defense industries, emitted via combustion and which are naturally present in the environment, that have received limited attention in terms of human exposure. We analysed samples of whole blood (172), urine (173) and drinking water (172) for antimony, beryllium, bismuth, cesium, gallium, rubidium, silver, strontium, thallium, thorium and vanadium using ICPMS. In general most metals concentrations were low and below the analytical limit of detection with some high concentrations observed. Few factors examined in regression models were shown to influence biological metals concentrations and explained little of the variation. Further study is required to establish the source of metals exposures at the high end of the ranges of concentrations measured and the potential for any adverse health impacts in children.

Polychlorinated biphenyl (PCB) and dioxin concentrations in residential dust of pregnant women.

Polychlorinated biphenyls (PCBs) and dioxins are well known for their persistence in the environment. PCBs can be found in the residential environment long after the use of these chemicals in domestic products and industrial processes has ceased. Dioxins have been assessed in Australia as being of very low concentrations. Despite concerns about residential dust as a source of human exposure to persistent chemicals, there has been limited testing of PCBs and dioxins in dust in Australia. As part of an assessment of maternal exposure to a variety of persistent toxic substances, we analysed 30 residential dust samples from a variety of geographical settings for their dioxin and PCB concentrations. PCBs were found in most samples, the median and range concentrations (pg g(-1)) of dominant congeners of PCB were as follows: PCB118 (315; <35.0-29 000), PCB105 (130; 14.0-16 000) and PCB156 (440; <5.00-2800). Dioxin concentrations were generally low with median concentrations for the total sum of dioxin-like polychlorinated dibenzodioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) of 3.75 pg g(-1) each. There was a very high percentage of non-detects. Concentrations of both PCBs and dioxins were low compared with most studies reporting residential dust concentrations internationally. Age of dwelling was the only factor observed to influence both PCB congener concentrations and dioxin isomers in multivariate regression analyses. No other housing or sociodemographic variables, including proximity to industry, were important predictors in multivariate linear regression models.

Maternal exposure to metals--concentrations and predictors of exposure.

A variety of metals are important for biological function but have also been shown to impact health at elevated concentrations, whereas others have no known biological function. Pregnant women are a vulnerable population and measures to reduce exposure in this group are important. We undertook a study of maternal exposure to the metals, aluminium, arsenic, copper, cobalt, chromium, lithium, manganese, nickel, selenium, tin, uranium and zinc in 173 participants across Western Australia. Each participant provided a whole blood and urine sample, as well as drinking water, residential soil and dust samples and completed a questionnaire. In general the concentrations of metals in all samples were low with the notable exception of uranium (blood U mean 0.07 µg/L, range <0.01-0.25 µg/L; urinary U mean 0.018 µg/g creatinine, range <0.01-0.199 µg/g creatinine). Factors that influenced biological concentrations were consumption of fish which increased urinary arsenic concentrations, hobbies (including mechanics and welding) which increased blood manganese concentrations and iron/folic acid supplement use which was associated with decreased concentrations of aluminium and nickel in urine and manganese in blood. Environmental concentrations of aluminium, copper and lithium were found to influence biological concentrations, but this was not the case for other environmental metals concentrations. Further work is underway to explore the influence of diet on biological metals concentrations in more detail. The high concentrations of uranium require further investigation.

Cadmium, lead and mercury exposure in non smoking pregnant women.

Recent literature suggests that exposure to low concentrations of heavy metals may affect both maternal and child health. This study aimed to determine the biological heavy metals concentrations of pregnant women as well as environmental and dietary factors that may influence exposure concentrations. One hundred and seventy three pregnant women were recruited from Western Australia, each providing a sample of blood, first morning void urine, residential soil, dust and drinking water samples. Participants also completed a questionnaire which included a food frequency component. All biological and environmental samples were analysed for heavy metals using ICP-MS. Biological and environmental concentrations of lead and mercury were generally low (Median Pb Drinking Water (DW) 0.04 µg/L; Pb soil <3.0 µg/g; Pb dust 16.5 µg/g; Pb blood 3.67 µg/L; Pb urine 0.55; µg/L Hg DW <0.03; Hg soil <1.0 µg/g; Hg dust <1.0 µg/g; Hg blood 0.46 µg/L; Hg urine <0.40 µg/L). Cadmium concentrations were low in environmental samples (Median CdDW 0.02 µg/L; Cdsoil <0.30 ug/g; Cddust <0.30) but elevated in urine samples (Median 0.55 µg/L, creatinine corrected 0.70 µg/g (range <0.2-7.06 µg/g creatinine) compared with other studies of pregnant women. Predictors of increased biological metals concentrations in regression models for blood cadmium were residing in the Great Southern region of Western Australia and not using iron/folic acid supplements and for urinary cadmium was having lower household annual income. However, these factors explained little of the variation in respective biological metals concentrations. The importance of establishing factors that influence low human exposure concentrations is becoming critical in efforts to reduce exposures and hence the potential for adverse health effects.

Determinants of antenatal and postnatal care visits among Indigenous people in Bangladesh: a study of the Mru community.

INTRODUCTION: Antenatal and postnatal care services are significant interventions to improve maternal health and prevent maternal and infant deaths. However, these services are poorly developed in Bangladesh, particularly among Indigenous women. This study examined factors associated with antenatal and postnatal care visits among the Mru, the most underprivileged Indigenous people in Bangladesh. METHODS: This cross-sectional study used both quantitative and qualitative methods. In total, 374 currently married Mru women with at least one child aged 5 years or younger were selected from 3 upazilas (sub-districts) of Bandarban District, Bangladesh for survey. In addition, in-depth interviews were performed with 26 Mru leaders, Mru women, traditional midwives, village 'doctors', school teachers, health and non-government organization workers. Associations between antenatal and postnatal care visits and the women's backgrounds characteristics were assessed by bivariate and multivariate analyses. RESULTS: The traditional Mru prenatal and postnatal practices potentially inhibited women from seeking care. Both antenatal (11.2%) and postnatal (6.4%) care visits among the Mru women were lower than the national level. Most visits were to traditional midwives in their rural villages, rather than to health complexes or hospitals. The main reasons for lack of antenatal and postnatal care were travelling distance to care and transportation problems. Multivariate analysis revealed factors associated with antenatal care were the respondent's place of residence, age, level of education, distance to the service centers and exposure to any mass media. Similar results were obtained with regard to postnatal care visits. CONCLUSIONS: This study suggests that cultural issues, distance, infrastructure and socioeconomic status are important determinants of maternal healthcare-seeking behavior. Healthcare delivery systems and appropriate education programs should be developed at the village level to improve the health of mothers and children in the Mru community.

Levels and patterns of Persistent Organic Pollutants (POPS) in selected food items from Northwest Russia (1998-2002) and implications for dietary exposure.

Residues of persistent organic pollutants (POPs) were analysed in 70 selected food items from Northwest Russia in 1998-2002. Levels of PCBs ranged from 0.2 to 16ng/g wet weight (ww) in dairy products and fats, 0.2 to 23ng/g ww in meat products, 0.5 to 16ng/g ww in eggs and 0.3 to 30ng/g ww in fish. High levels of DDT (16ng/g ww) were found in locally produced butter from Kola Peninsula, in pork fat from Arkhangels region (10 to 130ng/g ww) and in some fish samples from White Sea and Kargopol region (17 and 30ng/g ww). Findings of low DDE/DDT ratios in many of the studied food items indicated recent contamination to DDTs. Mean levels of sum TEQs(WHO1998) of dioxin-like mono-ortho PCBs: PCBs 105, 118, 156 and 157 (∑mo-PCBs-TEQs(WHO1998)) were highest in dairy products, chicken eggs and fish, with levels of 0.292, 0.245 and 0.254pg/g ww, respectively. The estimated daily intake (EDI) for ∑mo-PCBs-TEQs(WHO1998) was 0.74pg/kgbw/day and in the same range as in Sweden and Denmark. Fish, dairy products, eggs and meat were the main contributors to the EDI of ∑mo-PCBs-TEQs(WHO1998). The EDIs of DDTs, HCHs and HCB were several times higher than in Sweden and Denmark. Consumption of meat and poultry were important sources for intake of DDTs and HCHs, respectively. Contamination of animal feed and agricultural practice were assumed the most important causes for the results in the present study. However, increased control on maximum residue levels in food and feed may have resulted in large changes on levels and patterns of POPs in food in the studied areas.

Concentration of selected persistent organic pollutants in blood from delivering women in South Africa.

Environmental exposure to persistent organic pollutants (POPs) may cause detrimental health effects in the population with the developing foetus and infants being at highest risk. This paper reports on the findings of the pilot study that took place in seven geographical regions of South Africa, 96 pregnant women admitted for delivery participated in the study. The following selected POPs were analysed in maternal plasma: 15 polychlorinated biphenyls (PCBs) congeners (IUPAC No. 28, 52, 99, 101, 105, 118, 138, 149, 153, 156, 170, 180, 183, 187, 194); six DDT metabolites (dichlordiphenyltrichloroethane p,p'-DDT and o,p'-DDT; diphenyldichloroethylene p,p'-DDE and o,p'-DDE, dichlorophenylethane p,p'-DDD o,p'-DDD) and other pesticides such as hexachlorocyclohexanes (alpha-HCH, beta-HCH, gamma-HCH), hexachlorobenzene (HCB), heptachlor, chlordanes (t-CD and c-CD), nanochlors (t-NC and c-NC) and mirex. The overall results showed large regional differences with the rural site having the lowest levels for all measured contaminants. The levels of PCB congeners were found to be low in all samples and across all sites. DDT metabolites were detected in most participants of this study and large regional differences were evident. Two malaria endemic sites, where indoor residual spraying (IRS) with DDT takes place to control malaria vector, were included in the study. The highest levels of DDTs were measured in the coastal malaria site (Indian Ocean) with geometric means of 5177 ng/g lipid and 1797 ng/g lipid for p,p'-DDE and p,p'-DDT, and 1966 ng/g lipid and 726 ng/g lipid for p,p'-DDE and p,p'-DDT in inland malaria site. gamma-HCH was found to be elevated overall, except for the urban community; the highest levels were measured in the inland and coastal malaria sites. p,p'-DDT and gamma-HCH were however not correlated, indicating different sources. The high DDT levels in the malaria spraying regions as well as the elevated gamma-HCH levels are of concern and call for extended monitoring of women and children in selected regions.

Combining data sets of organochlorines (OCs) in human plasma for the Russian Arctic.

As part of AMAP's human circumpolar study of POPs, an international effort was initiated to extend coverage to communities across the Russian Arctic. Two additional laboratories were invited to join the analytical component of this effort, resulting in four participating analytical centres. Although quality assurance measures were put in place, and the level of performance of the laboratories was generally acceptable, deficiencies in the analytical protocols used were recognized subsequent to the collection and analyses of the plasma specimens. The current paper describes the criteria employed to critically appraise the four data bases and guide their integration into a single data set. Summary statistics are presented for plasma concentrations of major PCBs, p,p'-DDE, p,p'-DDT, beta-HCH, and HCB for communities/regions across the arctic/subarctic Russian continent, and for one community located in the Aral Sea area of Uzbekistan (a control group). Highly exposed people were identified in the coastal communities of Chukotka, which appears mainly related to marine mammal intake, but recent pesticide use is also suspected. Other communities with intermediate levels of PCBs had relatively elevated beta-HCH, p,p'-DDT and HCB concentrations and low DDE/DDT ratios (<10), suggesting recent pesticide use.

Spatial and temporal changes of chlorinated pesticides, PCBs, dioxins (PCDDs/PCDFs) and brominated flame retardants in human breast milk from Northern Russia.

This study presents for the first time temporal changes of organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) in Russian human breast milk samples. Concentrations of OCPs and PCBs in samples from three locations in the North West of Russia in 2000-2002 (n=42), were compared to corresponding levels measured in 1993-1996 (n=58). In addition brominated flame retardants (BFRs), consisting of polybrominated diphenylethers (PBDEs) (including BDE-209) and hexabromocyclododecane (HBCD) were analysed in samples from 2000-2002 (n=37). The present levels of SigmaDDTs and SigmaHCHs were 5 and 10 times higher than corresponding levels in the neighbouring country Norway. Median concentrations of SigmaHCHs (196 microg/kg lw), SigmaCHBs (19.7 microg/kg lw) and SigmaPCBs(16) (316 microg/kg lw) were highest in Murmansk. The percentage of p,p'-DDT to SigmaDDTs and ratio DDE/DDT suggest possible ongoing use of DDT in Russia. Levels of PBDE were low and dominated by the congeners BDE-47 and BDE-153. The deca brominated BDE-209 was detected in all analysed samples (median concentration 0.19 microg/kg lipid). Levels of SigmaOCPs and SigmaPCBs decreased 56 and 30% in Murmansk and 36 and 43% in Arkhangelsk during the study period. The decline of SigmaOCPs was significant at both locations (p<0.05-p<0.0001). For SigmaPCBs, the decreasing trend was only significant in Arkhangelsk (p<0.0001). In addition, a decline of Sigmatotal TEQs (SigmaTEQs of PCDDs/PCDFs, non-ortho- and mono-ortho PCBs) was observed in Murmansk and Arkhangelsk during the study period. The exposure of infants by PCDDs/PCDFs and dioxin-like PCBs is still exceeding the daily tolerable intake (TDI) in North West Russia. However, the concentrations of PCDDs/PCDFs and dioxin-like PCBs seem to decline very rapidly.

Intra- and intercompartmental associations between levels of organochlorines in maternal plasma, cord plasma and breast milk, and lead and cadmium in whole blood, for indigenous peoples of Chukotka, Russia.

Long-range transport of pollutants towards circumpolar regions emphasizes the need for up-to-date and reliable biological monitoring data. This paper explores the use, reliability and availability of maternal blood (MB) and plasma (MP), cord blood (CB) and plasma (CP) and mother's milk (MM) in terms of assessing exposure to persistent toxic substances (PTSs). It is concluded that MP has the best combination of availability, sensitivity in terms of number of PTSs, their detection frequency and concentrations, and physiological relevance. The study group consisted of 48 pregnant women of indigenous origin from the Chuchki district in the eastern Russian arctic. Blood, CB and MM specimens were collected from all women and MP, CP and MM were analyzed for the Arctic Monitoring and Assessment Programme (AMAP) suite of organochlorines (OCs) and metals (Pb and Cd in MB and CB). Generally speaking, the levels of PTSs coincided with those indicated in several AMAP publications from Chukotka and other areas of northern Russia. The correlations of PTS concentrations between the three body fluid compartments exceeded the minimum statistical requirements of alpha = 0.05 and beta = 0.20 for most of the compounds, with r > 0.46 except for Cd (r = 0.05); lipid adjustments for the OCs did not affect the r-values to any significant extent. The majority of the inter-OC correlations within compartments also fulfilled the indicated statistical condition. Careful consideration is given to the replacement of concentrations below the detection limit, OC detection frequency, the criteria for log-transformation of the data, analytical uncertainty, and biological variability. Practical implications of the findings are explored.

Circumpolar maternal blood contaminant survey, 1994-1997 organochlorine compounds.

During the past 20 years a number of studies have found neurological and immunological effects in the developing fetus and infants exposed to background or only slightly elevated levels of persistent organic pollutants (POPs) such as polychlorinated biphenyls (PCBs). To address concerns arising from possible increased human exposure in the Arctic and possible effects of POPs, all circumpolar countries agreed in 1994 to monitoring of specific human tissues for contaminants in the Arctic under the Arctic Monitoring and Assessment Program (AMAP). Mothers in eight circumpolar countries contributed blood samples that were analysed at a single laboratory for 14 PCB congeners (IUPAC No. 28, 52, 99, 105, 118, 128, 138, 153, 156, 170, 180, 183, 187) and 13 organochlorine pesticides (aldrin, beta-hexachlorocyclohexane (beta-HCH), dichlordiphenyltrichloroethane (p,p'-DDT), diphenyldichloroethylene (p,p'-DDE), dieldrin, heptachlorepoxide, hexachlorobenzene (HCB), mirex, and the chlordane derivatives alpha-chlordane, gamma-chlordane, cis-nonachlor, oxychlordane and trans-nonachlor). Inuit mothers from Greenland and Canada have significantly higher levels of oxychlordane, transnonachlor and mirex than mothers from Norway, Sweden, Iceland and Russia. Inuit mothers from Greenland also have significantly higher levels of these contaminants than Inuit mothers from Canada and Alaska. These differences among Inuit groups may represent regional dietary preferences or different contaminant deposition patterns across the Arctic. Levels of PCBs are also elevated among some arctic populations due to their consumption of marine mammals and are in the range where subtle effects on learning and the immune system have been reported. The Russian mothers who consume mainly food imported from southern Russia have elevated levels of DDT, DDE, beta-HCH and a higher proportion of lower chlorinated PCB congeners. This study has allowed an assessment of the variation of contaminants such as PCBs and various organochlorine pesticides (DDT, chlordane, etc.) in human populations around the circumpolar north.

Atopic dermatitis and respiratory symptoms in Russian and northern Norwegian school children: a comparison study in two arctic areas and the impact of environmental factors.

BACKGROUND: The increase in atopic diseases during recent decades has been related to environmental factors such as indoor and outdoor pollution and the ingestion of certain foods. On the other hand, studies from Eastern Europe (with heavy air pollution) have reported a lower prevalence of atopic diseases and sensitization in their schoolchildren than in children living in Western Europe. OBJECTIVES: This study compares the frequency of atopic diseases and respiratory symptoms in two geographically close arctic areas and points to possible risk factors for development of the diseases. METHODS: A total of 1734 schoolchildren (1183 in Nikel and 551 in Sør-Varanger) were studied using identical, four-page, self-administered questionnaires. RESULTS: Atopic diseases were reported in 38.7% of Norwegian and in 24.2% of Russian children (P < 0.001). Atopic dermatitis (AD) (23.6% vs 7.9%; P < 0.001) and allergic rhinoconjunctivitis (AR) (20.6% vs 14.7%; P < 0.001) occurred more frequently in Sør-Varanger, whereas 'self-reported' asthma (12.3% vs 13.1%) was similar in both areas. However, respiratory symptoms such as coughing, wheezing, breathlessness and bronchitis were 3-4 times more frequent in Nikel (P < 0.001). CONCLUSION: This study disproves a previous hypothesis, i.e. that air pollution must be a major risk factor for the development of atopic diseases. Nevertheless, respiratory tract symptoms may be provoked by environmental pollution. Possible explanations for the higher frequency of atopic diseases in Sør-Varanger may be found in socio-economic and lifestyle differences between the two populations.

The importance of diet on exposure to and effects of persistent organic pollutants on human health in the Arctic.

AIM: To describe the importance of diet on exposure to and possible health effects of persistent organic pollutants (POPs) in the Arctic. METHODS: The study is based on a literature review. RESULTS: Minor decreases in POPs and minor increases in Hg levels in Arctic populations in Greenland, Eastern Russia, Western Alaska and Eastern Canada are likely to occur by the year 2010 and major decreases in both POPs and Hg levels in these same populations by 2030. Levels of POPs and metals in populations in the Faeroe Islands and the Scandinavian countries are already reasonably low and are only likely to decline marginally by 2030. Estimating the effects on the basis of current knowledge is difficult, but the combination of improved methodology and selection of risk groups will be a progressive step in the process. Any strategies based on traditional food substitution should ensure that the value of the dietary components is sustained. CONCLUSIONS: To improve our understanding of the health effects associated with exposure to contaminants in the Arctic, we recommend that circumpolar epidemiological studies should be implemented on a larger scale. MeHg- and POPs-related effects are still the key issues. However, the role of newly discovered contaminants, such as PBDEs (polybrominated diphenyl ethers) and PCNs (polychlorinated naphthalenes), should be investigated. For exposure assessment, mixtures and nutritional interactions should be considered in epidemiological studies. Epidemiological studies on nutritional benefits of traditional foods should be incorporated in risk-assessment profiles. We need a more nuanced view on human dietary exposure to xenobiotics. Risk should not be evaluated alone, but seen in relation to benefits from specific diets. It is essential that countries ratify and implement multinational environmental agreements.

Geographic variation of chlorinated pesticides, toxaphenes and PCBs in human milk from sub-arctic and arctic locations in Russia.

The concentrations of HCB, alpha-, beta- and gamma-HCH, 3 chlordanes (CHLs), p,p'-DDE, p,p'-DDD, p,p'-DDT, and 30 PCBs (polychlorinated biphenyls) were determined in 140 human milk samples from Kargopol (n=19), Severodvinsk (n=50), Arkhangelsk (n=51) and Naryan-Mar (n=20). Pooled samples were used for determination of three toxaphenes (chlorobornanes, CHBs). The concentrations of HCB, beta-HCH and p,p'-DDE in Russian human milk were 2, 10 and 3 times higher than corresponding levels in Norway, respectively, while concentrations of sum-PCBs and sum-TEQs (toxic equivalent quantities) of the mono-ortho substituted PCBs were in the same range as corresponding levels in Norway. The PCB-156 contributed most to the sum-TEQs. Highest mean concentrations of HCB (129 microg/kg milk fat) and sum-PCBs (458 microg/kg milk fat) were detected in Naryan-Mar, while highest mean concentrations of sum-HCHs (408 microg/kg milk fat), sum-CHLs (48 microg/kg milk fat), sum-DDTs (1392 microg/kg milk fat) and sum-toxaphenes (13 microg/kg milk fat) were detected in Arkhangelsk. An eastward geographic trend of increasing ratios of alpha/beta-HCH, gamma/beta-HCH, p,p'-DDT/p,p'-DDE and PCB-180/28 was observed. In all areas the levels of sum-HCHs decreased with parity (number of children born). Considerable variation in levels of the analysed organochlorines (OCs) was found in all the studied areas. Breast milk from mothers nursing their second or third child (multiparas) in Naryan-Mar showed a significant different PCB profile compared to mothers giving birth to their first child (primiparas) from the same area and to primi- and multiparas in the other areas. Both p,p'-DDE and p,p'-DDT showed a significant, but weak, negative correlation with the infants birth weight.

Intercommunity and temporal variation of eleven essential and five toxic elements in human placentas from deliveries in thirteen arctic and sub-arctic areas of Russia and Norway.

Research is described that constitutes an extension of an earlier paper (J. Environ. Monit., 2001, 3, 177-184), in which concentrations were measured in 263 human placentas of 11 essential elements (P, Ca, Mg, Cu, S, Na, Fe, Zn, K, Se, Mn) and 5 toxic elements (Ba, Sr, Pb, Ni, Cd). The additional data considered derive from earlier visits to 4 of the original 6 communities and 3 others, all but one of which are located in northern Norway and neighbouring areas of Russia. This more than doubled the number of placental samples available (263 to 571). Unfortunately, the personal, life-style and morphometric information obtained for the first study group was not available for the additional mothers. Country differences were evident for all elements except Ba, Fe and Zn; Cd, Cu, Mn, Na, Se, Ni, Pb, Sr and S were higher and K, P, Ca and Mg were lower in Russia (p < 0.03). Not unexpectedly, the highest median lead concentration was observed for the largest city in the western arctic region of Russia, namely Murmansk. Similarly, the higher median nickel level observed for Russia reflects the established observation that urinary nickel concentrations are higher in the Russian than in the Norwegian communities. Even though sampling was performed at different times of the year and before and after a 3-year interval in four centres, inter-collection differences were of relatively small magnitude and appear not to be linked to seasonal or temporal changes. Principal component analysis (PCA) confirmed the prominence of Factor 1, which grouped those metals that are known to form insoluble phosphate complexes and whose concentrations showed a dependence on gestational age and maternal smoking in the earlier study. It is concluded that PCA is a powerful statistical tool for exploring and identifying fundamental pathways and processes involved in governing the inorganic elemental composition of placental tissue. It also has the potential of identifying study limitations and quality assurance shortfalls. Further our findings show promise that placental concentrations of toxic elements may serve as an index of exposure and of nutritional intake for selected essential micro-elements.

Seropositivity of cytomegalovirus, parvovirus and rubella in pregnant women and recurrent aborters in Leningrad County, Russia.

BACKGROUND: The objectives of this paper were to assess the prevalence of different viral infections in relation to late abortions, stillbirths, and congenital malformations in sera from Russian pregnant women and recurrent aborters in order to establish basic knowledge for future pregnancy care. METHODS: Patients were recruited at the Women's Clinic, Leningrad Regional Hospital during the period March-June 1995. One group of normally pregnant women (Group 1; n=182) and one group of recurrent aborters (Group 2; n=127) were evaluated, including demographic, medical, clinical, and serological data. RESULTS AND CONCLUSIONS: The mean age of the two groups was 27.1 and 28.2 years, respectively. The mean number of deliveries was low (0.4 and 0.5, respectively). Thirty-one point six percent of Group 1 and 41.9% of Group 2 were daily smokers. The group of normally pregnant women had a significantly increased frequency of induced abortions compared to the recurrent aborters, while the recurrent aborters reported more genital infections. There was little difference in total antibodies to cytomegalovirus (CMV) (78.0% and 81.1%, respectively) or B19 IgG (75.3% and 66.9%, respectively) between the groups, while the normal pregnant women had a significantly higher prevalence of rubella antibodies (77.5% and 59.8%, respectively). Our results indicate that less women remain susceptible to primary CMV infection in pregnancy in Russia compared to western Europe and North America. The prevalence of B19 IgG was slightly lower than data from Sweden. Natural immunization against rubella virus was lower than in other, unvaccinated female populations. Vaccination strategies for rubella are now initiated in the Russian Federation. Results from this study are utilized in a federally supported, comprehensive pregnancy care project of North-West Russia.

Atopic diseases among schoolchildren in Nikel, Russia, an Arctic area with heavy air pollution.

The objective of this study was to describe the prevalence rate of atopic diseases among schoolchildren living in the heavily polluted Arctic town of Nikel, Russia. A self-administered questionnaire was distributed to the parents of 1,800 children aged 8-17 years, 1,684 of whom (93.6%) completed and returned the questionnaire. Atopic diseases were reported in 508 (30.2%) of the children and prevalence was similar for both sexes. Atopic dermatitis occurred most frequently (15.5%), followed by allergic rhinoconjunctivitis (13.9%) and asthma (3.9%). The most pronounced influence on atopic diseases in children was having parents with asthma. Indoor dampness was a significant risk factor eliciting atopic diseases, whereas furred pets, passive smoking and carpets did not influence the prevalence of allergy. We conclude that although atopic diseases are a common health problem in Nikel, they are less prevalent than has been reported in recent studies of Northern European countries. Air pollution does not seem to be a major risk factor for the development of atopic diseases.