Exposure to persistent organochlorines in Canadian breast milk: a probabilistic assessment.

Exposure to persistent organochlorines in breast milk was estimated probabilistically for Canadian infants. Noncancer health effects were evaluated by comparing the predicted exposure distributions to published guidance values. For chemicals identified as potential human carcinogens, cancer risks were evaluated using standard methodology typically applied in Canada, as well as an alternative method developed under the Canadian Environmental Protection Act. Potential health risks associated with exposure to persistent organochlorines were quantitatively and qualitatively weighed against the benefits of breast-feeding. Current levels of the majority of contaminants identified in Canadian breast milk do not pose unacceptable risks to infants. Benefits of breast-feeding are well documented and qualitatively appear to outweigh potential health concerns associated with organochlorine exposure. Furthermore, the risks of mortality from not breast-feeding estimated by Rogan and colleagues exceed the theoretical cancer risks estimated for infant exposure to potential carcinogens in Canadian breast milk. Although levels of persistent compounds have been declining in Canadian breast milk, potentially significant risks were estimated for exposure to polychlorinated biphenyls, dibenzo-p-dioxins, and dibenzofurans. Follow-up work is suggested that would involve the use of a physiologically based toxicokinetic model with probabilistic inputs to predict dioxin exposure to the infant. A more detailed risk analysis could be carried out by coupling the exposure estimates with a dose-response analysis that accounts for uncertainty.