Stevens M F, Ebell G F, Psaila-Savona P
Health Department of Western Australia, East Perth.
Med J Aust. 1993 Feb 15;158(4):238-41. doi: 10.5694/j.1326-5377.1993.tb121741.x.
To measure the concentrations of organochlorine (OC) pesticides in nursing mothers in Western Australia and to evaluate the safety of these concentrations for breast-fed infants; to evaluate the need for future monitoring of OC pesticide concentrations and to determine whether breast milk is an accurate substitute for adipose tissue in future monitoring programs.
Two cohorts of nursing mothers were recruited during the period October 1990 to March 1991. Levels of OC pesticides were measured in 128 samples of breast milk and 31 samples each of adipose tissue, maternal blood and cord blood. Laboratory analysis was by gas chromatography with electron capture. Health Department studies since 1974 were collated and levels of OC pesticides compared over time.
DDT (dichlorodiphenyltrichloroethane), HCB (hexachlorobenzene) and dieldrin were found in all samples of breast milk and adipose tissue. A significant fall in the levels of OCs was noted since the 1974 survey, with the current concentrations of the cyclodienes (heptachlor, chlordane and dieldrin) being close to the limit of detection of the assay. The acceptable daily intake for dieldrin was exceeded in 90% of infants and for heptachlor in 2% of infants. The daily intakes of the other OCs were below the respective acceptable levels. HCB was detected at a median level of 0.1 mg/kg in both breast milk and adipose tissue despite being deregistered in 1972. As there is no current acceptable daily intake for HCB, the safety of this level could not be assessed by this method. A low correlation was found between levels of the cyclodiene pesticides in breast milk and adipose tissue, but levels of DDT and HCB were closely correlated.
Restrictions on the use of the OC insecticides (DDT, aldrin, dieldrin, heptachlor and chlordane) have resulted in reduced concentrations of these chemicals in breast milk and adipose tissue as compared with previous studies. The dieldrin intake of breast-fed infants consistently exceeded the acceptable daily intake; the heptachlor intake exceeded the acceptable daily intake in some infants, but the low concentrations of heptachlor in breast milk made accurate measurement difficult. The concentrations of DDT and chlordane in breast milk did not pose a hazard to breast-fed infants. The significance of the levels of the fungicide HCB in breast milk cannot be determined. The widespread distribution of HCB, its marked persistence in the environment and its potential for human toxicity indicate a need for continued monitoring, for which breast milk is a suitable medium. The poor correlation between concentrations of dieldrin, heptachlor and chlordane in breast milk and adipose tissue may reflect the technical difficulty of measuring chemical concentrations close to the limit of detection. As aldrin is a registered pesticide and the dieldrin intake of breast-fed infants is consistently above the acceptable daily intake, monitoring of dieldrin should continue. Further population monitoring of DDT, heptachlor and chlordane is unlikely to be of value.
测定西澳大利亚州哺乳期母亲体内有机氯（OC）农药的浓度，并评估这些浓度对母乳喂养婴儿的安全性；评估未来监测OC农药浓度的必要性，并确定在未来监测项目中母乳是否可作为脂肪组织的准确替代物。
在1990年10月至1991年3月期间招募了两组哺乳期母亲。对128份母乳样本以及各31份脂肪组织、母体血液和脐带血样本进行了OC农药水平测定。采用带电子捕获的气相色谱法进行实验室分析。整理了自1974年以来卫生部门的研究，并对OC农药水平随时间的变化进行了比较。
在所有母乳和脂肪组织样本中均检测到滴滴涕（二氯二苯三氯乙烷）、六氯苯（HCB）和狄氏剂。自1974年调查以来，OCs水平显著下降，目前环二烯类（七氯、氯丹和狄氏剂）的浓度接近检测方法的检测限。90%的婴儿狄氏剂每日摄入量超过可接受水平，2%的婴儿七氯每日摄入量超过可接受水平。其他OCs的每日摄入量均低于各自的可接受水平。尽管HCB于1972年被取消登记，但在母乳和脂肪组织中均检测到其含量中位数为0.1毫克/千克。由于目前没有HCB的可接受每日摄入量，无法通过该方法评估此水平的安全性。母乳中环二烯类农药水平与脂肪组织中的水平之间相关性较低，但滴滴涕和HCB的水平密切相关。
与先前的研究相比，对OC杀虫剂（滴滴涕、艾氏剂、狄氏剂、七氯和氯丹）使用的限制已导致母乳和脂肪组织中这些化学物质的浓度降低。母乳喂养婴儿的狄氏剂摄入量一直超过可接受每日摄入量；七氯摄入量在一些婴儿中超过可接受每日摄入量，但母乳中七氯浓度较低，难以进行准确测量。母乳中滴滴涕和氯丹的浓度对母乳喂养婴儿不构成危害。母乳中杀真菌剂HCB水平的意义尚无法确定。HCB分布广泛，在环境中具有显著持久性且具有潜在人体毒性，这表明需要持续监测，母乳是适合的监测介质。母乳中狄氏剂、七氯和氯丹浓度与脂肪组织中的浓度之间相关性较差，可能反映了测量接近检测限的化学物质浓度的技术难度。由于艾氏剂是一种注册农药，且母乳喂养婴儿的狄氏剂摄入量一直高于可接受每日摄入量，应继续监测狄氏剂。对滴滴涕、七氯和氯丹进行进一步的人群监测可能没有价值。
