1. Persistent Organic Chlorinated Compound Residues in the Breast Milk of Female Seasonal Agricultural Workers in Turkey
Prof. Kafiye Eroğlu*, Assoc.Prof.. Yavuz Kürşad DAŞ**, Assoc. Prof. Zehra GÖLBAŞI***, Prof. Zeynep ŞİMŞEK****, Assist Prof. Dr. Fatma GÖZÜKARA***** , Assist Prof. Enes Atmaca**
*Koç University School of Nursing,** Ondokuz Mayıs University Faculty of Veterinary Medicine, ***Cumhuriyet University Health Science Faculty, ****Harran University Faculty of Medicine , *****Harran Üniversitesi School of Health Science

2. INTRODUCTION I
The production of Organic Chlorinated Compounds (OCC), which are contaminants found in the environment, started in the 1930’s* but in time with the appearance of its detrimental effects on the environment and human health, limitations have been imposed on its utilization**
The main characteristics of organochlorine and organophosphore compounds is their solubility. Even if they can not dissolve well in water, they have high solubility in lipids, which makes it easier for them to be absorbed from the skin***
Firstly, here is some background information I would like to share with you.
*Noren and Meironyte, 2000
**Güvenç and Aksoy, 2007
***Al-Targi et. al., 2010

3. INTRODUCTION II
These substances are biologically accumulated in fat-containing tissues of living organisms including humans and represented at higher densities at higher levels of food cycle*
Therefore, even though the use of these substances are forbidden or limited, the likelihood of exposure to these substances is high due to both illegal use and long term maintenance of their effects**
*Crinnion 2009, Şahin 2009
**Kaya et. al, 2002

4. INTRODUCTION III
Various studies show that due to the use of OCCs, chemical contamination increases in nature.*
They remain for long time without decay in soil, water, fruit and vegetables and reach humans via food chain, exerting allergic, carcinogenomutogenic and teratogenic effects.*
* Dilmen et al., 2011; Crinnion, 2009; Şahin, 2009; Gladen et al., 2003; Weisglas-Kuperus et al., 2000; Longnecker et al., 1997; Sonowane 1995).

5. INTRODUCTION VI
Breast milk appears to be the best source in demonstrating the duration of the exposure of women to these compounds.
It is easy to obtain, not spoiled during its collection and it shows the residue level of OCC’s present in body fat.*
* Yu et al., 2003; Devanathan et al., 2009

6. INTRODUCTION V
The density of OCC’s in the milk depends mainly on two factors:
The first factor is the duration of accumulation of compounds in fat tissue
The second one is the production of the milk during the lactation period.
The excretion of OCC’s via milk during the lactation period exceeds the intake of these compounds with diet, which means that deposits in the tissue decrease with successive lactation periods. *
Czaja et al., 2001

7. Aim of the study
This retrospective descriptive study aimed to investigate “persistent organic chlorinated compound residues in the breast milk of female seasonal agricultural workers”(SAW).
Kafiye Eroğlu, International Conference on Enviromental Health and Safety, October 25, 2016

8. Funding
This work was supported (project number: 114S163) by The Scientific and Technological Research Council of Turkey (TUBITAK).
Kafiye Eroğlu, International Conference on Enviromental Health and Safety, October 25, 2016

9. MATERIALS AND METHODS
The present study was carried out in Sanlıurfa and Adıyaman which sends SAWs to 48 other provinces of Turkey.
Let’s move on to materials and methods
Kafiye Eroğlu,
International Conference on Enviromental Health and Safety, October 25, 2016

10. MATERIALS AND METHODS
‘Informed consent’ was received from the participants
and this study was approved by the Ethics Committee of Koç University
(Date: , NO: IRB2.87).
Kafiye Eroğlu
International Conference on Enviromental Health and Safety, October 25, 2016

11. MATERIALS AND METHODS
The sample included 100 women (Sanlıurfa:50, Adıyaman:50) chosen by random sampling method from lists taken from Family Health Centers and who met sample criteria.
The inclusion criteria of our study
Women who:
were currently in lactation period
worked at least one year as a SAW and
lived in Şanlıurfa and Adıyaman cities
Kafiye Eroğlu, International Conference on Enviromental Health and Safety, October 25, 2016

12. MATERIALS AND METHODS
Data were collected via a questionnaire form at the homes of the women by face-to-face interview and analyzed the residues of 27 items of organochlorine pesticides (OCPs), Dichlorodiphenyltrichloroethane (DDT) metabolits and polychlorinated biphenyls, (PCBs) from persistent organic pollutants (POPs) in mothers’ 50 mL breast milk.
Kafiye Eroğlu, International Conference on Enviromental Health and Safety, October 25, 2016

13. MATERIALS AND METHODS Collection of breast milk:
After the baby was suckled by the mother, 50 ml breast milk was taken by the mother herself and transferred to brown glass bottles with caps.
In cases when there was less than 50 ml, the mother was given liquids (fruit juice, water, etc.) and 2 hours later the procedure was repeated.
Now I would like to explain how the breast milk was collected.
Kafiye Eroğlu, International Conference on Enviromental Health and Safety, October 25, 2016

14. MATERIALS AND METHODS Collection of breast milk:
As milk was collected from 4-5 women daily, collection of milk
lasted 20 days.
The milk samples were transferred to Ondokuz Mayıs University
Faculty of Veterinary Medicine Pharmacology and Toxicology
Department laboratory under cold chain conditions.
The breast milk was kept in the deep freezer in a laboratory at
-80 degrees.
Now I would like to explain how the breast milk was collected.
Kafiye Eroğlu, International Conference on Enviromental Health and Safety, October 25, 2016

15. MATERIALS AND METHODS The analysis of the breast milk showed:
In the breast milk, of OCC, alpha -HCH, beta-HCH, gamma HCH, HCB, aldrin residue and of o,p’-DDT, p,p’-DDT and DDT metabolites, o,p’-DDE, p,p’-DDE, and of PCC, PCB 28, -52, -70, -74, -81, -99, -101, -105, -118, -128, -138, -153, -156, -170, -180, -183, -187 and residues were analysed.
Among the analysed PCB’s, “PCB-28, 52, 101, 138, 153 and 180” are among the indicator PCB’s requested to be screened by the European Union. *
Screened PCB and other compounds were selected from PCBs screened in breast milk and various biological samples in view of the literature**
In the study we analysed a total of 27 residues and now you can see what these residues were in the slide. For example among the analysed PCB’s we found many PCBs which are among the indicator PCB’s requested to be screened by the European Union
*EFSA Journal 2010; 8(7):1701
**Dmitrovic et al., 2002; Dmitrovic and Chan, 2002; Lee et al., 2013

16. MATERIALS AND METHODS For the analysis of the breast milk:
For the milk extraction, the method of Bordet et al. (2002) and Güvenç (2008) was used, and for analysis, the gas chromatography electron capture detector (GC-ECD) was used as reported by Aksoy et al. (2012).
Kafiye Eroğlu, International Conference on Enviromental Health and Safety, October 25, 2016

17. MATERIALS AND METHODS
Data were evaluated as descriptive statistics: the number, percentage average , median and standard deviation on the computer.
Values obtained were compared with standards accepted all over the world and risk analysis was made.*
Van den Berg et al., 2006, Besbelli, 1990, WHO, 1998, Benitez, 1995, Faroon et al., 2003, Turkish Food Codex, 2014 and 2011

18. MATERIALS AND METHODS Limitations of the study
The results of this study is generalized to lactating mothers who are SAWs in Adıyaman and Sanlıurfa only.
Next, I would like to mention the limitations of our study.
Now, I would like to explain the results of our study.
Kafiye Eroğlu, International Conference on Enviromental Health and Safety, October 25, 2016

19. Table 1. Socio-Demographic and Obstetric Characteristics of Female Seasonal Agricultural Workers
Adıyaman (n=50)
Şanlıurfa (n=50)
Total (n=100) n %
Age group (year)
18 ↓
18-34
35 ↑ 6 39 5
12.0
78.0
10.0 3 28 9
6.0
76.0
18.0 67 14
9.0
77.0
14.0
The mean age (min:max)
24.72 ± 6.66 (16-46)
27.90 ± 6.01 (17-42)
26.31 ± 6.51 (16 -46)
Educational level
Does not speak Turkish
Illiterate
Literate
Elementary school not completed
Secondary school
High school
Graduate 2 30 - 15 1
4.0
60.0
30.0
2.0 29
58.0 4 59
59.0
3.0
1.0
Health Insurance No
Yes 48
96.0 42 8
84.0
16.0 90 10
90.0
Intermarriage 7 43 86 20
40.0 37 63
37.0
63.0
Marriage age (year)
13-18
19 and > 45 21
42.0 66 34
66.0
34.0
Mean marriage age
16.00 ± (13 -27)
19.10 ± 2.99 (15- 31)
17.55 ±3.32 (13-31)
Table 1 shows the socio-demographic and obstetrics data of our study’s participants.
I would like to point out that the majority of participants were older than 18 years old and the mean age was 26.7.
When we look at the educational level, more than half of the women were Illiterate.
Only 10 percent of the participants did health insurance, the rest did not have any health insurance at all.
Overall, considering two cities, three marriages in five were intermarriage which are generally first cousins’s marriage.
And almost same percent of these marriage were adolescent marriages which occured under 18 years old.

20. Table 1. Socio-Demographic and Obstetric Characteristics of Female Seasonal Agricultural Workers ( Continue )
Characteristics
Adıyaman (n=50)
Şanlıurfa (n=50)
Total (n=100) n
(%)
n (%)
Number of pregnancies±SD*
3.12±2.12
(Min:1, Max:9)
3.58±2.09
3.35±2.10
Number of live births±SD*
3.06±2.12
3.32±2.11
Number of living children±SD*
3.04±2.10
3.54±2.02
3.29±2.07
Mean working years as SAW±SD*
15.06 ± 5.38
(Min:4, Max:25)
14.52 ± 7.07
(Min:2, Max:30)
14.79 ± 6.26
Mean working months as SAW in a year±SD*
5.80 ± 1.19*
(Min:3, Max:7)
6.10 ± 1.58
(Min:2, Max:10)
5.94 ± 1.40
When we look at the obstetric characteristis of women, it was found that number of pregnancy, number of live birth and number of living children were greater than 3.
Approximately 6 months per year, and almost for 15 years, women have been working as agricultural workers.
Note:*Standart Deviation

21. Table 2. Some characteristics of women related to working duration and the status of agricultural spraying during the latest pregnancy
Characteristics
Adıyaman (n=49)
Şanlıurfa (n=48)
Total (n=97) n %
Working in agriculture during the latest pregnancy *
Yes No 41 8
83.7
16.3 38 10
79.2
20.8 79 18
81.4
18.6
Working duration in agriculture during the latest pregnancy (month)*
5.34±1.55
(Min:1, Max:9)
5.13±1.83
(Min:1, Max:8)
5.24±1.68
Agricultural spraying in the field during the latest pregnancy *
n=45
n=40
n=85
I did the spraying 2 1 42
4.4
2.2
93.3 4 35
10.0
2.5
87.5 6 77
7.1
2.4
90.6
Table 2 shows some characteristics of women related to working in agriculture data.
I would like to point out that 81 percent of women had worked as agricultural workers during their last pregnancy.
Almost for 5 months they worked as agricultural workers during the pregnancy, and 90 percent of them said that they had been there during agricultural spraying.

22. Table 3. Distribution of persistent organic chlorinated compound residues in breast milk
Compounds
Adıyaman (n=50)
n %
Şanlıurfa (n=50)
n %
Total (n=100)
n %
Alfa-HCH
6 (12.0)
3 (6.0)
9 (9.0)
HCB
36 (72.0)
33 (66.0)
69 (69.0)
Beta HCH
42 (84.0)
43 (86.0)
85 (85.0)
Gamma-HCH
30 (60.0)
29 (58.0)
59 (59.0)
PCB28
48 (96.0)
50 (100.0)
98 (98.0)
PCB52
40 (80.0)
44 (88.0)
84 (84.0)
PCB128
22 (44.0)
29 (58.0)
51 (51.0)
Aldrin
21 (42.0)
17 (34.0)
38 (38.0)
PCB74
10 (20.0)
8 (16.0)
18 (18.0)
PCB70
32 (64.0)
61 (61.0)
op’-DDE
18 (36.0)
22 (44.0)
40 (40.0)
pp’-DDE
38 (76.0)
40 (80.0)
79 (79.0)
pp’-DDT
35 (70.0)
68 (68.0)
Table 3 shows distribution of residues in breast milk .
I would like to point out that, overall, Polychlorinated biphenyl (PCB)28 component was found in almost all women’s milk and more than half of the collected milk contained Beta-Hexachlorocyclohexane (HCH), PCB52, pp’-Dichlorodiphenyldichloroethylene (DDE), Hexachlorobenzene (HCB), PCB70, pp’-Dichlorodiphenyltrichloroethane (DDT) ve Gamma HCH respectively.

23. residues in breast milk (Continued)
Table 3. Distribution of persistent organic chlorinated compound
residues in breast milk (Continued)
Compounds
Adıyaman (n=50)
n %
Şanlıurfa (n=50)
n %
Total (n=100)
n %
PCB81
7 (14.0)
8 (16.0)
15 (15.0)
PCB101
1 (2.0)
1 (2.0)
2 (2.0)
PCB118
3 (6.0)
2 (4.0)
5 (5.0)
op’-DDT
12 (24.0)
9 (18.0)
21 (21.0)
PCB153
10 (20.0)
17 (17.0)
PCB105
4 (8.0)
PCB99
13 (26.0)
12 (24.0)
25 (25.0)
PCB138
16 (16.0)
PCB187
5 (10.0)
12 (12.0)
PCB183
4 (4.0)
PCB156
16 (32.0)
PCB180
7 (14.0)
6 (12.0)
13 (13.0)
PCB170
7 (7.0)
PCB208
6 (6.0)
As you can see in this slide , polychlorinated biphenyl (PCB )101 (2%) was found in a few women’s milk and others (PCB-183 (4%), -118 (5%), -105 (5%), (6%), (7%) and Alpha -HCH (9%) respectively.)

24. in the breast milk (ng/g fat)
Table 4. Concentrations of persistent organic chlorinated compound residues
in the breast milk (ng/g fat)
Compounds n
Min
Max
Median
M**
SE*
PCB153 17
3,22
117,32
13,79
26,43
7,83
PCB105 5
1,94
50,06
4,01
13,83
9,17
pp’-DDT 68
13,77
245,31
45,33
58,50
5,13
PCB138 16
4,15
805,50
87,87
176,99
60,63
PCB187 12
370,73
43,49
101,97
33,99
PCB183 4
2,47
25,01
11,15
12,44
4,67
PCB128 51
6,13
406,30
15,57
29,67
8,02
PCB156 25
0,99
98,01
7,81
15,21
4,72
PCB28 98
91,66
7278,63
1353,90
1597,3
125,44
Ʃ OCC
100
25,53
14353,64
3048,70
3287,3
267,67
pp’-DDE 79
69,94
5480,12
296,95
566,96
90,30
PCB52 84
74,20
3663,77
575,21
822,16
81,84
Ʃ OCP
8,46
6102,65
598,46
805,87
99,70
Ʃ PCBs
13793,74
2207,60
2497,5
227,78
Ʃ DDT 85
38,41
5494,03
366,51
633,71
89,79
Ʃ HCH 90
6,41
4254,09
171,68
235,78
47,03
Table 4 shows concentrations of residues in the breast milk (ng/g fat).
I would like to point out overall the highest five residues.
The highest consantration was found for total OCC which was 3048,7 ng/g fat and respectively total PCBs, PCB28, total OCP, and PCB52.
The median values of compounds detected in the milk were found overall OCP 598,46 ng/g, overall PCB 2207,6 ng/g, overall OCC 3048,7 ng/g, overall DDT, 366,7 ng/g and overall HCH 171,68 ng/g fat.
Note:*Standard error, ** Mean

25. in the breast milk (ng/g fat) (continued)
Table 4. Concentrations of persistent organic chlorinated compound residues
in the breast milk (ng/g fat) (continued)
Compounds n
Min
Max
Median
M**
SE*
Alfa-HCH 9
3,56
3430,13
25,75
403,57
378,35
HCB 69
4,67
327,30
12,23
20,64
4,76
Beta HCH 85
2,85
726,81
147,36
177,72
11,99
Gamma-HCH 59
10,36
542,67
23,41
42,06
9,90
PCB170 7
7,90
76,23
25,53
33,49
11,24
PCB208 6
1,79
188,67
39,51
59,46
29,10
Aldrin 38
15,90
652,24
37,45
64,89
16,86
PCB74 18
1,45
271,99
26,56
46,20
16,41
PCB70 61
11,75
182,81
58,83
63,14
4,73
op’-DDE 40
27,07
1049,62
63,49
102,62
25,57
PCB101 2
53,63
359,87
206,75
153,12
PCB99 25
8,15
7629,56
109,35
429,03
300,81
PCB180 13
0,76
84,68
30,28
33,62
8,57
PCB81 15
2,17
150,75
26,27
38,99
9,98
PCB118 5
12,07
78,54
38,61
39,77
11,38
op’-DDT 21
4,60
427,32
16,10
47,28
20,39
In this table, you can see other consentrations of compound residues that lower value HCB and PCBs some derivates
Note:*Standard error, ** Mean

26. Table 5. Comparison of maksimum residue limit( MRL) and maximum values of residues in the breast milk
Name of compound n
Min
Max
Median
M**
SE*
MRL
ƩIndicator PCBg 98
166,65
10942,40
1874,0
2344,2
198,62
40 ng/g fata
ƩDDT and derivativese 82
38,41
5494,03
333,53
606,84
89,43
20 ng /g fatb
HCB
69 (42)d
4,76
327,30
12,23
20,33
4,75
10 ng/g fatc
Alfa-HCH
9 (8)d
3,56
3430,13
25,75
403,57
378,35
4 ng/g fatc
Beta-HCH
85 (84)d
2,85
726,81
147,36
177,72
11,98
3 ng/g fatc
Gamma-HCH (Lindan) 59
10,36
542,67
23,41
42,06
9,89
1 ng/g fatc
Aldrin 38
15,90
652,24
37,44
64,89
16,86
6 ng / g fatb
ƩDB-PCBs TEQ** (pg/g fat)f
40 (10)d
0.03
45,22
0,44
4,87
1,39
5.5 pg / fata
Table 5 shows comparison of maksimum residue limit and maximum values of residues in the breast milk.
Accordingly, in 98 of women, overall indicator PCB was detected and all values were found above MRL. Overall DDT and derivatives were found to positive in 82 women, Gamma-HCH in 59 women and Aldrin in 38 women and it was established that obtained values were over MRL in all women and HCC was positive in 69 women, in 42 of whom the value obtained was over MRL. Finally, Alpha -HCH 9 and, Beta HCH were found to be positive in 85 women and in both groups values were over MRL except in one woman.
Table bottom Note:
*Standard error
**Mean
**TEQ: Toxic Equivalency Quantity
a Turkish Food Codex, 2011, Van den Berg et al. 2006
b Codex Alimentarius, 2015
c Turkish Food Codex, 2014
d The number of samples on MRL
e Total of p,p’-DDT, o,p’-DDT and p,p’-DDE.
f Total of PCB81, 105, 118 and 156
g Total of PCB28,52,101,138,153 and 180.

27. all values were found above MRL.
CONCLUSION
In our study, ahigh amount of residues of OCPs was detected in the SAW’s women breast milk and
all values were found above MRL.
Lastly, I would like to mention some conclusions of our study and recommendations for the future.
Kafiye Eroğlu, International Conference on Enviromental Health and Safety, October 25, 2016

28. CONCLUSION
It is recommended that necessary legal regulations and public information policy about this subject be implemented.
Follow-up studies investigating the health status of mothers and their babies should be carried out.
Kafiye Eroğlu, International Conference on Enviromental Health and Safety, October 25, 2016

29. THANKS Thank you for your time and attention.
Kafiye Eroğlu, International Conference on Enviromental Health and Safety, October 25, 2016