Vorkommen und gesundheitliche Bedeutung von persistenten organischen Substanzen und Phthalaten in der Muttermilch

Zusammenfassung

Im Rahmen der Untersuchung soll der derzeitige Kenntnisstand zur Belastung der Muttermilch mit Schadstoffen wie den Polychlorierten Dibenzo-p-dioxinen und Dibenzofuranen (PCDD/F), den dioxinähnlichen Polychlorierten Biphenylen (dl-PCB), den Polybromierten Diphenylethern (PBDE), den Perfluorierten Verbindungen (PFC) und den Phthalaten dargestellt werden. Auf der Basis der medianen bzw. 95. Perzentil Belastung wird eine „durchschnittliche” und eine „hohe” Aufnahme für einen 3 Monate alten, ausschließlich gestillten Säugling abgeschätzt. Die vom Säugling aufgenommenen Schadstoffmengen werden mit toxikologischen Beurteilungswerten verglichen und gesundheitlich bewertet. Aufgrund der aktuellen Belastungssituation ergibt sich derzeit für Säuglinge eine „durchschnittliche” bzw. „hohe” Aufnahme von 70 bzw. 140 pg TEQ/kg KG für PCDD/F und dl-PCB, 10 bzw. 20 ng/kg KG für PFOS (Perfluoroctansulfonat), 20 bzw. 50 ng/kg KG für PFOA (Perfluoroctansäure), 1,7 bzw. 7,5 ng/kg KG für BDE 47, 0,6 bzw. 2,1 ng/kg KG für BDE 99, 400 bzw. 2 000 ng/kg KG für Di(2-ethylhexyl)phthalat (DEHP) und 100 bzw. 500 ng/kg KG für Di-n-butylphthalat (DnBP). Für alle vorgenannten Substanzen, mit Ausnahme der PCDD/F und dl-PCB, ergibt sich eine Zufuhr unterhalb der lebenslang duldbaren täglichen Aufnahme (TDI). Sowohl für die PBDE, die perfluorierten Verbindungen als auch die Phthalate liegt die Ausschöpfung selbst beim hohen Aufnahmeszenarium nur im unteren Prozentbereich. Lediglich für die PCDD/F und dl-PCB gibt es noch eine deutliche Überschreitung des TDI-Wertes, die vor dem Hintergrund der begrenzten zeitlichen Aufnahme und der insgesamt rückläufigen Tendenz von der WHO und anderen Expertengremien noch als vertretbar angesehen wird. Bei der derzeitigen Belastungssituation der vorgenannten Fremdstoffe können Mütter bedenkenlos ihre Kinder 6 Monate ausschließlich stillen und somit die nachhaltigen Vorteile des Stillens für die kindliche und ihre eigene Gesundheit nutzen. Mit Einführung der Beikost, bei der die Menge löffelweise gesteigert werden soll, muss die Stillzeit nicht enden, sondern die Kinder sollten weiter gestillt werden, so lange Mutter und Kind das wollen.

Abstract

The aim of this study is to give an overview of the concentrations of persistent organic pollutants like the polychlorinated dibenzo-p-dioxins (PCDD), polychlorinated dibenzofurans (PCDF), polychlorinated biphenyls (PCB), polybrominated diphenyl ether (PBDE), perfluorinated compounds (PFC) and of phthalates in breast milk. On the basis of median and 95^th percentile values an “average” and a “high” intake were calculated for a 3-month-old infant exclusively breast-fed. Moreover, the actual daily intake was compared with tolerable daily intakes (TDI) recommended by scientific institutions. On this basis, we found an “average” (“high”) daily intake of 70 (140) pg TEQ/kg body weight (b. w.) for PCDD/F and dioxin-like PCB (dl-PCB), 10 (20) ng/kg b. w. for PFOS (perfluorooctanesulfonate), 20 (50) ng/kg b. w. for PFOA (perfluorooctanoate), 1.7 (7.5) ng/kg b. w. for BDE 47, and 0.6 (2.1) ng/kg b. w. for BDE 99. For di-2-ethylhexyl phthalate (DEHP) and di-n-butyl phthalate (DnBP) an “average” and “high” intake of 400 ng/kg b. w. and 2 000 ng/kg b. w. and of 100 and 500 ng/kg b.w. were assumed, respectively. For all of these substances we found a daily intake via breast milk below the TDI, established on a livelong basis. On contrary, the daily intake for the sum of the PCDD/F and dl-PCB considerably exceeded the recommended TDI value. Even with regard to the “high” daily intake values the share of PBDE, PFC, and phthalates on the TDI was only in the lower percentage. Scientific organisations assume that an exceeding of the PCDD/F and dl-PCB intake in relation to the TDI value is acceptable only on the basis of the still declining levels in breast milk and the fact that this high exposure only occurs during some months of the entire life when breast milk is consumed. On the basis of the recent exposure situation mothers can exclusively breast-feed their infants for 6 months without any hesitation. The well established health benefits for mothers and infants when exclusively breast-feeding should be utilised. There is also no health concern if the mother decides to breast-feed the baby for longer than 6 months when the infant also receives additional food.

Schlüsselwörter

Muttermilch - PCDD - PCB - PBDE - Phthalate - PFC

Key words

breast milk - PCDD/F - PCB - PBDE - phthalates - PFC

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