Recent global trends and physiologic origins of dioxins and furans in human milk.

Restrictions on releases of polychlorinated dibenzo-dioxins and polychlorinated dibenzofurans (PCDDs/Fs) to the environment from industrial practices have resulted in an attendant decrease in levels of these compounds in the environment. Continued environmental monitoring and biomonitoring of PCDDs/Fs ensure that exposures do not increase unexpectedly or unnoticed. Perhaps the most highly exposed part of the population, however, is the breastfed infant and a periodic assessment of levels of dioxins and furans in human milk provides exposure information for infants. A previous international review of levels of PCDDs/Fs in human milk based on data from the 1970's to the mid-1990's showed a decline in many countries for which data were available. In this paper, recent (1998-2005) global data on PCDDs/Fs in human milk are described. A comparison of these recent data to pre-1998 data suggests a continuing decline in global levels of PCDDs/Fs in human milk. In addition, this paper explores research on physiological origins of these compounds in human milk (e.g., adipose tissue mobilization, recent dietary exposures). The question of whether the presence of PCDDs/Fs in milk is from the lifetime accumulation of PCDDs/Fs in adipose tissue or current diet (or, as is more likely, a complex combination of both) remains unanswered. Whether diet during lactation has a greater influence on milk levels PCDDs/Fs levels than previously suspected, and whether infant exposures to PCDDs/Fs via breastfeeding could be reduced by changes in diet during lactation, are important--and currently unexplored--lines of inquiry.