Dietary intakes of dioxins and polychlorobiphenyls (PCBs) and mortality: EPIC cohort study in 9 European countries

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  • Thibault Fiolet
  • Geneviève Nicolas
  • Corinne Casagrande
  • Zsuzsanna Horvath
  • Pauline Frenoy
  • Elisabete Weiderpass
  • Marc J. Gunter
  • Jonas Manjer
  • Emily Sonestedt
  • Domenico Palli
  • Vittorio Simeon
  • Rosario Tumino
  • Bas Bueno-de-Mesquita
  • José María Huerta
  • Miguel Rodriguez-Barranco
  • Eunate Abilleira
  • Carlotta Sacerdote
  • Matthias B. Schulze
  • Alicia K. Heath
  • Charlotta Rylander
  • Guri Skeie
  • Therese Haugdahl Nøst
  • Anja Olsen
  • Valeria Pala
  • Marina Kvaskoff
  • Inge Huybrechts
  • Francesca Romana Mancini
Dioxins and polychlorinated biphenyls (PCBs) are toxic, endocrine disruptors and persistent chemicals for which the main exposure source is diet due to their bioaccumulation and biomagnification in food chains. Cohort studies in the general populations have reported inconsistent associations between these chemicals in serum/plasma and mortality. Our objective was to study the association between dietary intake of 17 dioxins and 35 PCBs and all-cause, cancer-specific and cardiovascular-specific mortalities were assessed in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Dietary intake of dioxins and PCBs was assessed combining EPIC food consumption data with European food contamination data provided by the European Food Safety Authority. We applied multivariable Cox regressions. The analysis included 451,390 adults (mean ± SD age:51.1 ± 9.7 years) with 46,627 deaths and a median follow-up of 17.4 years (IQR = 15.2–19.1). A U-shaped non-linear association with all-cause mortality for dietary intake of dioxins (Pnon-linearity<0.0001), DL-PCB (Pnon-linearity = 0.0001), and NDL-PCBs (Pnon-linearity<0.01) was observed. For example, the hazard ratios (95%Confidance interval) for all-cause mortality obtained with the spline model was equal to 1.03 (1.02–1.05) for low levels of intake to dioxins (7 pg TEQ/day), 0.93 (0.90–0.96) for moderate levels of intake (25 pg TEQ/day), while for high levels of intake (55 pg TEQ/day) it was 1.03 (0.97–1.09). Intake of dioxins, DL-PCBs and NDL-PCBs was not associated with cardiovascular mortality. There was no association between intakes of dioxins and cancer mortality, but a U-shaped association was observed for intake of DL-PCBs and intakes of NDL-PCBs and cancer mortality. The PCBs and dioxins are known to have endocrine disrupting properties which can lead to non-monotonic dose responses. These results need to be interpreted with caution and further studies are needed to better clarify the association between dietary intake of dioxins and PCB and mortality in the general population.
OriginalsprogEngelsk
Artikelnummer114287
TidsskriftInternational Journal of Hygiene and Environmental Health
Vol/bind255
Antal sider12
ISSN1438-4639
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
This work was supported by the Fondation pour la Recherche Médicale , grant number n° ECO201906009060 to TF. The coordination of EPIC is financially supported by International Agency for Research on Cancer (IARC) and also by the Department of Epidemiology and Biostatistics , School of Public Health, Imperial College London which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC) . The national cohorts are supported by: Danish Cancer Society (Denmark) ; Ligue Contre le Cancer , Institut Gustave Roussy , Mutuelle Générale de l’Education Nationale , Institut National de la Santé et de la Recherche Médicale (INSERM) (France) ; German Cancer Aid , German Cancer Research Center (DKFZ) , German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) , Federal Ministry of Education and Research (BMBF) (Germany) ; Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy , Compagnia di SanPaolo and National Research Council (Italy) ; Dutch Ministry of Public Health, Welfare and Sports (VWS) , Netherlands Cancer Registry (NKR) , LK Research Funds , Dutch Prevention Funds , Dutch ZON (Zorg Onderzoek Nederland) , the National Institute for Public Health and the Environment (RIVM, the Netherlands) , World Cancer Research Fund (WCRF) , Statistics Netherlands (The Netherlands) ; Health Research Fund (FIS) — Instituto de Salud Carlos III (ISCIII) , Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology — ICO (Spain) ; Swedish Cancer Society , Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden) ; Cancer Research UK (14136 to EPIC-Norfolk; C8221/A29017 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk; MR/M012190/1 to EPIC-Oxford) (United Kingdom). The French National Research Program for Environmental and Occupational Health of Anses with financial support from ITMO Cancer of Aviesan within the framework of the 2021–2030 Cancer Control Strategy, on funds administered by Inserm (ANSES-21-EST-020). The funders of this study had no role in the decisions about the analysis or interpretation of the data; or preparation, review or approval of the manuscript.

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