Lessons from the polybrominated diphenyl ethers (PBDEs): precautionary principle, primary prevention, and the value of community-based body-burden monitoring using breast milk.
Lessons from the polybrominated diphenyl ethers (PBDEs): precautionary principle, primary prevention, and the value of community-based body-burden monitoring using breast milk.
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DOI：
10.1289/ehp.5438
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发表时间：
2003-01
影响因子：
10.4
通讯作者：
She J
中科院分区：
文献类型：
--
作者：
Hooper K;She J
人体内的化学品水平（人体负担）是环境质量和社区健康的有用指标。使用从婴儿2-8周大的第一次母亲（初产妇）那里收集的母乳样本，很容易监测身体的化学负荷。目前，在美国还没有使用母乳的身体负担监测计划，尽管一些欧洲国家成功地使用了特设系统。在这篇文章中，我们描述了这种监测的价值和重要的考虑因素，它可能是如何完成的，从我们的经验与试点监测项目。母乳作为采样基质有几个优点：它简单，无创，由母亲收集样本。它监测育龄妇女的身体负担，并估计子宫内和哺乳期婴儿的接触情况，所有这些对社区健康都很重要。母乳监测的时间趋势数据可作为一种预警系统，用于确定体内负荷和人类接触正在增加的化学品。时间趋势也可作为一份报告卡，说明过去的管制行动在多大程度上减少了环境中的化学品接触。使用母乳进行的身体负担监测应包括鼓励母乳喂养的教育计划。最后，也是最重要的一点，清洁母乳对人们很重要，并导致初级预防-限制化学品接触。我们用多溴联苯醚（PBDEs）来说明这些优势，这是一种以前不起眼的溴化阻燃剂，在母乳中发现残留量迅速增加时，在瑞典受到了监管。在美国，可以与妇女、婴儿和儿童特别补充营养计划（WIC）合作，建立一个以社区为基础的使用母乳的身体负担监测计划。WIC有大量的第一次哺乳的母亲：它在全国有6,000个诊所，为美国出生的几乎一半（47%）婴儿提供服务。教育计划（例如，WIC运营的机构）需要鼓励母乳喂养，特别是在母乳喂养率较低的低收入社区，母乳喂养可能有助于保护婴儿免受环境化学品暴露的影响。还需要进行有关减少化学物质身体负担的教育。身体负担监测计划将提供有关时间趋势、背景水平和需要缓解和后续健康研究的社区热点的宝贵数据;为新的关注化学品制定分析方法;并将母乳样本存档，供将来分析其他制剂。
Levels of chemicals in humans (body burdens) are useful indicators of environmental quality and of community health. Chemical body burdens are easily monitored using breast milk samples collected from first-time mothers (primiparae) with infants 2-8 weeks of age. Currently, there is no body-burden monitoring program using breast milk in the United States, although ad hoc systems operate successfully in several European countries. In this article we describe the value of such monitoring and important considerations of how it might be accomplished, drawing from our experiences with pilot monitoring projects. Breast milk has several advantages as a sampling matrix: It is simple and noninvasive, with samples collected by the mother. It monitors body burdens in reproductive-age women and it estimates in utero and nursing-infant exposures, all important to community health. Time-trend data from breast milk monitoring serve as a warning system that identifies chemicals whose body burdens and human exposures are increasing. Time trends also serve as a report card on how well past regulatory actions have reduced environmental chemical exposures. Body-burden monitoring using breast milk should include educational programs that encourage breast-feeding. Finally, and most important, clean breast milk matters to people and leads to primary prevention--the limiting of chemical exposures. We illustrate these advantages with polybrominated diphenyl ethers (PBDEs), a formerly obscure group of brominated flame retardants that rose to prominence and were regulated in Sweden when residue levels were found to be rapidly increasing in breast milk. A community-based body-burden monitoring program using breast milk could be set up in the United States in collaboration with the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). WIC has a large number of lactating first-time mothers: It has 6,000 clinics nationwide and serves almost half (47%) the infants born in the United States. Educational programs (e.g., those run by WIC) are needed that encourage breast-feeding, especially in lower-income communities where breast-feeding rates are low and where breast-feeding may help protect the infant from the effects of environmental chemical exposures. Education is also needed about reducing chemical body burdens. A body-burden monitoring program would provide valuable data on time trends, background levels, and community hot spots in need of mitigation and follow-up health studies; develop analytic methods for new chemicals of concern; and archive breast milk samples for future analyses of other agents.
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影响因子：
2.5
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