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Helmfrid, Ingela
Publications (7 of 7) Show all publications
Helmfrid, I. (2019). Exposure and body burden of environmental pollution and risk of cancer in a historically contaminated areas. (Doctoral dissertation). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Exposure and body burden of environmental pollution and risk of cancer in a historically contaminated areas
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

There are many villages where environmental contamination is substantial due to historical industrial activities. According to the European Environment Agency, there are about 2.5 million potentially contaminated sites in the European member states. In Sweden, there are about 80 000 more or less contaminated areas. About 1000 of them are classified into the highest risk category, Hazard Class 1, and should be remediated. Population exposure due to these industrially contaminated sites may contribute to adverse health effects and is a global environmental problem.

The general aim of this thesis was to evaluate the occurrence of cancer in populations residing in contaminated areas in relation to indirect exposure via the long-term consumption of locally produced food, taking into account residential, occupational and lifestyle factors. Associations between reported local food consumption frequencies, biomarker concentrations and environmental and lifestyle factors were explored. The Swedish national cancer registers and questionnaire information was used to identify cancer risk groups in the study population. The questionnaire was evaluated regarding how well it reflected measured levels of biomarkers in human biological samples, and how the consumption of local food from contaminated areas contributed to the total body burden of contaminants.

Despite historically high environmental levels of contaminants in the soil and sediments, current contaminant exposure in the studied population living in the contaminated areas was similar to or only moderately higher than that of the general population.

No significant associations with increased cancer risk were detected in the highest tertile of metals concentrations in blood or PAH in urine.

Reported long-term high consumption of certain local foods was associated with higher cadmium (vegetarian food) and lead (fish, meat) concentrations in blood and urine. Long-term high consumption of non-local food from places outside the study areas was not associated with increased concentrations of metals compared with consumers of local food. It was concluded that the questionnaire information on consumption of locally produced food describes differences in food consumption in the study population reasonably well.

An increased risk of cancer was associated with smoking, family history of cancer and obesity. Residing in a contaminated area during the first five years of life was associated with an increased risk of cancer, which may indicate exposure to contaminants in early life. Also, long-term high consumption of particular local foods (fish, chicken, lamb, game meat) was associated with an increased risk of various forms of cancer, while reported high consumption of these foods from non-local sources was not associated with increased risk of cancer. The associations between habitual consumption of local food and different types of cancer may reflect a higher exposure in the past, and thus, if consumption of local food contributes to the risk of acquiring cancer, that contribution is probably lower today than previously. Furthermore, it cannot be ruled out that other contaminants in the food contribute to the increased cancer risks observed.

In conclusion, the questionnaire that was developed for the present thesis can identify risk groups within populations and can be used as a tool in a health-risk assessment.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2019. p. 69
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1699
Keywords
Contaminated area, cancer, exposure, metals, POPs, Consumption of local food
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-160957 (URN)10.3384/diss.diva-160957 (DOI)9789176850060 (ISBN)
Public defence
2019-11-22, Birgittasalen, Universitetssjukhuset, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2019-10-17 Created: 2019-10-16 Last updated: 2019-12-11Bibliographically approved
Helmfrid, I., Ljunggren, S., Nosratabadi, A. R., Augustsson, A., Filipsson, M., Fredrikson, M., . . . Berglund, M. (2019). Exposure of metals and PAH through local foods and risk of cancer in a historically contaminated glasswork area. Environment International, 131, Article ID UNSP 104985.
Open this publication in new window or tab >>Exposure of metals and PAH through local foods and risk of cancer in a historically contaminated glasswork area
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2019 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 131, article id UNSP 104985Article in journal (Refereed) Published
Abstract [en]

Background

Production of crystal glass and colored art glassware have been going on in the south-eastern part of Sweden since the 1700s, at over 100 glassworks and smaller glass blowing facilities, resulting in environmental contamination with mainly arsenic (As), cadmium (Cd), lead (Pb) and polycyclic hydrocarbons (PAH). High levels of metals have been found in soil, and moderately elevated levels in vegetables, mushrooms and berries collected around the glassworks sites compared with reference areas. Food in general, is the major exposure source to metals, such as Cd and Pb, and PAHs. Exposure to these toxic metals and PAH has been associated with a variety of adverse health effects in humans including cancer.

Objective

The aim of the present study was to evaluate the occurrence of cancer in a cohort from the contaminated glasswork area in relation to long-term dietary intake of locally produced foods, while taking into account residential, occupational and life styles factors.

Methods

The study population was extracted from a population cohort of 34,266 individuals who, at some time between the years 1979–2004, lived within a 2 km radius of a glassworks or glass landfill. Register information on cancer incidence and questionnaire information on consumption of local foods (reflecting 30 years general eating habits), life-time residence in the area, life style factors and occupational exposure was collected. Furthermore, blood (n = 660) and urine (n = 400) samples were collected in a subsample of the population to explore associations between local food consumption frequencies, biomarker concentrations in blood (Cd, Pb, As) and urine (PAH metabolite 1-OHPy) as well as environmental and lifestyle factors. The concurrent exposure to persistent organic pollutants (POPs) from food was also considered. A case-control study was performed for evaluation of associations between intakes of local food and risk of cancer.

Results

Despite high environmental levels of Cd, Pb and As at glasswork sites and landfills, current metal exposure in the population living in the surrounding areas was similar or only moderately higher in our study population compared to the general population. Reported high consumption of certain local foods was associated with higher Cd and Pb, but not As, concentrations in blood, and 1-OHPy in urine. An increased risk of cancer was associated with smoking, family history of cancer, obesity, and residence in glasswork area before age 5 years. Also, a long-term high consumption of local foods (reflecting 30 years general eating habits), i.e. fish and meat (game, chicken, lamb), was associated with increased risk of various cancer forms.

Conclusions

The associations between consumption of local food and different types of cancer may reflect a higher contaminant exposure in the past, and thus, if consumption of local food contributes to the risk of acquiring cancer, that contribution is probably lower today than before. Furthermore, it cannot be ruled out that other contaminants in the food contribute to the increased cancer risks observed.

Place, publisher, year, edition, pages
Elsevier, 2019
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:liu:diva-160953 (URN)10.1016/j.envint.2019.104985 (DOI)000493550200042 ()31319292 (PubMedID)2-s2.0-85068874468 (Scopus ID)
Note

Funding agencies: Swedish Environmental Protection Agency; Medical Research Council of Southeast Sweden; Kamprad Family Foundation, Sweden; Occupational and Environmental Medicine, Linkoping University Hospital, Sweden

Available from: 2019-10-16 Created: 2019-10-16 Last updated: 2019-12-04Bibliographically approved
Augustsson, A., Uddh-Söderberg, T., Filipsson, M., Helmfrid, I., Berglund, M., Karlsson, H., . . . Alriksson, S. (2018). Challenges in assessing the health risks of consuming vegetables in metal-contaminated environments. Environment International, 113, 269-280, Article ID S0160-4120(17)31204-7.
Open this publication in new window or tab >>Challenges in assessing the health risks of consuming vegetables in metal-contaminated environments
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2018 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 113, p. 269-280, article id S0160-4120(17)31204-7Article in journal (Refereed) Published
Abstract [en]

A great deal of research has been devoted to the characterization of metal exposure due to the consumption of vegetables from urban or industrialized areas. It may seem comforting that concentrations in crops, as well as estimated exposure levels, are often found to be below permissible limits. However, we show that even a moderate increase in metal accumulation in crops may result in a significant increase in exposure. We also highlight the importance of assessing exposure levels in relation to a regional baseline. We have analyzed metal (Pb, Cd, As) concentrations in nearly 700 samples from 23 different vegetables, fruits, berries and mushrooms, collected near 21 highly contaminated industrial sites and from reference sites. Metal concentrations generally complied with permissible levels in commercial food and only Pb showed overall higher concentrations around the contaminated sites. Nevertheless, probabilistic exposure assessments revealed that the exposure to all three metals was significantly higher in the population residing around the contaminated sites, for both low-, median- and high consumers. The exposure was about twice as high for Pb and Cd, and four to six times as high for As. Since vegetable consumption alone did not result in exposure above tolerable intakes, it would have been easy to conclude that there is no risk associated with consuming vegetables grown near the contaminated sites. However, when the increase in exposure is quantified, its potential significance is harder to dismiss - especially when considering that exposure via other routes may be elevated in a similar way.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Arsenic, Cadmium, Contaminated sites, Exposure, Lead, Vegetable
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-146041 (URN)10.1016/j.envint.2017.10.002 (DOI)000428976700030 ()29157867 (PubMedID)2-s2.0-85034022603 (Scopus ID)
Available from: 2018-03-23 Created: 2018-03-23 Last updated: 2018-05-17Bibliographically approved
Helmfrid, I., Salihovic, S., van Bavel, B., Wingren, G. & Berglund, M. (2015). Exposure and body burden of polychlorinated biphenyls (PCB) and metals in a historically contaminated community.. Environment International, 76, 41-8
Open this publication in new window or tab >>Exposure and body burden of polychlorinated biphenyls (PCB) and metals in a historically contaminated community.
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2015 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 76, p. 41-8Article in journal (Refereed) Published
Abstract [en]

There are many small villages where environmental contamination is substantial due to historical industrial activities. The aim of the present study was to investigate if long-term or current consumption of local foods, as reported in food frequency questionnaires, co-vary with measured concentrations of polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), lead (Pb), cadmium (Cd) and mercury (Hg) in blood, urine and hair from a population living in a historically contaminated village. Blood, urine and hair were provided by men (n=38) and women (n=57), who had participated in a previous case-control study in the contaminated area, and were analyzed for PCB, OCPs, Pb, Cd and Hg. A detailed food frequency questionnaire, used in the previous epidemiological study, was repeated, and up-dated information of life-style, exposure factors and other covariates was collected. Associations between reported consumption of local foods and exposure biomarkers were explored in relation to age, gender, life-style factors and other covariates. A large part of the population in the area reported consumption of local food, and thus, was potentially exposed to the contaminants. Despite the limited number of participants and other weaknesses described, it was possible to link reported consumption of different foods to biomarker concentrations. Reported consumption of local vegetables, forest berries and mushrooms co-varied with urinary Cd, indicating an influence from the contaminated area on the Cd exposure. We found no associations between PCB plasma concentrations with reported consumption of local fish, but with consumption of herring (non-local sea fish) which is typically high in PCB. Pesticide (HCB, p,p'-DDE, trans-nonachlor) exposure was mainly associated with agricultural work and having a private well the first five years of life, but we found no associations between pesticide concentrations in plasma and consumption of local vegetables or fish. Exposure to Hg was associated with consumption of fish, both local and non-local, and Pb exposure was associated with the consumption of game. Overall, the contaminant concentrations measured in blood, urine and hair varied substantially among study participants, but on average, the concentrations were similar to concentrations measured in other groups of the general Swedish population in the same age range. Larger studies are needed to evaluate health risks (and causality) associated with historical environmental contamination.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:liu:diva-113646 (URN)10.1016/j.envint.2014.12.004 (DOI)000349585600004 ()25529270 (PubMedID)
Note

We express our gratitude to the participating population. We thank the research nurse Louice Eskilsson for an excellent assistance in sample collection and for the dispatch of questionnaires together with Anna-Lena Hallsten. The study was partially financed by the Swedish Environmental Protection Agency, grant no. 502-4531-09.

Available from: 2015-01-27 Created: 2015-01-27 Last updated: 2019-10-16
Ljunggren, S. A., Helmfrid, I., Salihovic, S., van Bavel, B., Wingren, G., Lindahl, M. & Karlsson, H. (2014). Persistent organic pollutants distribution in lipoprotein fractions in relation to cardiovascular disease and cancer.. Environment International, 65, 93-9
Open this publication in new window or tab >>Persistent organic pollutants distribution in lipoprotein fractions in relation to cardiovascular disease and cancer.
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2014 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 65, p. 93-9Article in journal (Refereed) Published
Abstract [en]

Persistent organic pollutants (POPs) are lipophilic environmental toxins that have been associated with cardiovascular disease (CVD) and cancer. The aim of this study was to investigate the concentrations of POPs in human high and low/very low-density lipoproteins (HDL and LDL/VLDL) and the possible association with CVD and cancer occurrence in individuals living in a contaminated area. Lipoproteins from 28 individuals (7 healthy controls, 8 subjects with cancer, 13 subjects with CVD) were isolated and the fraction-specific concentration of 20 different POPs was analyzed by high resolution gas chromatography/high resolution mass spectrometry. The activity of Paraoxonase 1 (PON1), an anti-oxidant in HDL, was determined in plasma of these 28 subjects and additional 50 subjects from the same area excluding diseases other than cancer or CVD. Fourteen polychlorinated biphenyls (PCBs) and three organochlorine pesticides were detected, and especially highly chlorinated PCBs were enriched in lipoproteins. Significantly higher concentrations of POPs were found among individuals with CVD or cancer compared to controls. Principal component analyses showed that POP concentrations in HDL were more associated with CVD, while POP concentrations in LDL/VLDL were more associated with cancer. PON1 activity was negatively correlated to sumPCB and a co-variation between decreased arylesterase-activity, increased PCB concentrations and CVD was found. This study shows that POPs are present in lipoproteins and were more abundant in individuals with CVD or cancer compared to healthy controls. The results also indicate that PCB exposure is accompanied by reduced PON1 activity that could impair the HDL function to protect against oxidation.

Place, publisher, year, edition, pages
Elsevier, 2014
National Category
Clinical Medicine Other Basic Medicine
Identifiers
urn:nbn:se:liu:diva-104755 (URN)10.1016/j.envint.2013.12.017 (DOI)000334728500010 ()24472825 (PubMedID)
Available from: 2014-02-25 Created: 2014-02-25 Last updated: 2018-01-11
Helmfrid, I., Berglund, M., Lofman, O. & Wingren, G. (2012). Health effects and exposure to polychlorinated biphenyls (PCBs) and metals in a contaminated community. Environment International, 44, 53-58
Open this publication in new window or tab >>Health effects and exposure to polychlorinated biphenyls (PCBs) and metals in a contaminated community
2012 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 44, p. 53-58Article in journal (Refereed) Published
Abstract [en]

Environmental measurements carried out by local authorities during the 1970s, 80s and 90s in an area contaminated by hundreds of years of industrial activities have revealed high levels of zinc (Zn), copper (Cu), lead (Pb) and cadmium (Cd) in soil, vegetables, root crops, berries and mushrooms. In 1972, a large quantity of oil contaminated with polychlorinated biphenyls (PCBs) was accidentally spilled into the river running through the village. To investigate the possible health effects of exposure from local sources, all cancer diagnoses, registered in 1960-2003 for individuals living in the study area, were collected from the regional cancer register of southeast Sweden. The total cancer incidence was non-significantly decreased both among males and females as compared to national rates (SIR = 0.91) for each gender. Among males, increased risks, of border-line significance, were seen for testicular cancer and lymphomas as well as significantly decreased risks for cancer in the rectum, respiratory system and brain. Information on lifetime residence, occupation, smoking habits, diseases, childbirth and food consumption, was collected via questionnaires from cancer cases and randomly selected controls. In both genders combined, significant associations were found for total cancer and high consumption of local perch, and for lymphomas and high consumption of both perch and pikeperch. Female breast cancer was significantly associated with high consumption of local perch and pike as well as with work in metal production. Mothers residing in the parish before the age of five reported significantly more preterm child deliveries. In spite of study limitations, the results indicate that residing in a rural contaminated area may contribute to the development of certain cancers and reproductive effects. In females, high consumption of local fish was shown to be the strongest determinant for total cancer, while in males, the strongest determinant was residing in the study area the first five years of life. Further research including validation of exposure using biomarkers is required to verify the findings as well as future studies in other polluted areas in Sweden with larger population bases.

Place, publisher, year, edition, pages
Elsevier, 2012
Keywords
Contaminated area, Polychlorinated biphenyls, Heavy metals, Cancer, Reproduction
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-79086 (URN)10.1016/j.envint.2012.01.009 (DOI)000304745900007 ()
Note

Funding Agencies|Cancer and Allergy Fund, Sweden||

Available from: 2012-06-29 Created: 2012-06-29 Last updated: 2019-10-31
Strom, S., Helmfrid, I., Glynn, A. & Berglund, M. (2011). Nutritional and toxicological aspects of seafood consumption-An integrated exposure and risk assessment of methylmercury and polyunsaturated fatty acids. ENVIRONMENTAL RESEARCH, 111(2), 274-280
Open this publication in new window or tab >>Nutritional and toxicological aspects of seafood consumption-An integrated exposure and risk assessment of methylmercury and polyunsaturated fatty acids
2011 (English)In: ENVIRONMENTAL RESEARCH, ISSN 0013-9351, Vol. 111, no 2, p. 274-280Article in journal (Refereed) Published
Abstract [en]

Seafood consumption is associated with both risks and beneficial effects to human health. Consequently, an integrated exposure assessment of intake of toxic and nutritious agents in seafood is of importance prior to determination of dietary advisories. We have developed a probabilistic model for the estimation of simultaneous intake of methylmercury (MeHg) and long-chain n-3 polyunsaturated fatty acids (LC-n3 PUFAs) from seafood, to estimate the population proportion at risk for exceeding tolerable MeHg intake and not reaching adequate intake of PUFAs. Seafood consumption data was collected among women of childbearing age using a food frequency questionnaire. A database of mercury and fatty acids concentration in seafood was constructed. A Latin Hypercube simulation was used to calculate the intake of MeHg and LC n-3 PUFAs. Eleven percent of the population exceeded the MeHg reference dose of 0.1 mu g/kg bw/day, whereas only 44% reached an adequate PUFA intake. A small proportion (3.7%) exceeded the MeHg reference dose while at the same time did not reach an adequate PUFA intake. Furthermore, we simulated two scenarios in which seafood is consumed according to a general recommendation of three servings per week, whereof one serving of oily seafood. The first scenario included seafood with typically low MeHg concentrations (mean 0.056 and 0.027 mu g MeHg/g fish in lean and oily species, respectively), and the second included seafood typically high in MeHg concentrations (mean 0.50 and 0.26 mu g MeHg/g fish in lean and oily species, respectively). In the "high"scenario, almost 100% of the population exceeded the reference dose, whereas the corresponding proportion was only 5% in the "low" scenario. Overall, the results stress the importance of communicating species specific seafood consumption advisories for women of childbearing age in general and for pregnant women in particular, while at the same time encourage them to consume more seafood.

Place, publisher, year, edition, pages
Elsevier Science B.V., Amsterdam, 2011
Keywords
Methylmercury, PUFA, Probabilistic, Risk-benefit analysis, Fish consumption
National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-66141 (URN)10.1016/j.envres.2010.12.003 (DOI)000287179200012 ()
Available from: 2011-03-04 Created: 2011-03-04 Last updated: 2012-03-25
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