Relative effects of educational level and occupational social class on body concentrations of persistent organic pollutants in a representative sample of the general population of Catalonia, Spain

Environment International

Volumn 60, Issue , 2013, Pages 190-201

  Gasull, Magda ^a,b   Pumarega, José ^a,b   Rovira, Gemma ^a   López, Tomàs ^a,b,c   Alguacil, Juan ^b,d   Porta, Miquel ^a,b,c  

^a HOSPITAL DEL MAR   (Spain)

^b CIBER EPIDEMIOLOGÍA Y SALUD PÚBLICA CIBERESP   (Spain)

^c UNIVERSITAT AUTÒNOMA DE BARCELONA   (Spain)

^d UNIVERSITY OF HUELVA   (Spain)

Author keywords

Ageing; Educational level; Health survey; Occupational social class; Parity; Persistent organic pollutants (POPs)

Indexed keywords

BLOOD; EDUCATION; HEALTH; SURVEYS;

AGEING; EDUCATIONAL LEVELS; HEALTH SURVEYS; OCCUPATIONAL SOCIAL CLASS; PARITY; PERSISTENT ORGANIC POLLUTANTS;

ORGANIC POLLUTANTS;

1,1 DICHLORO 2,2 BIS(4 CHLOROPHENYL)ETHANE; 1,1 DICHLORO 2,2 BIS(4 CHLOROPHENYL)ETHYLENE; BETA HEXACHLOROCYCLOHEXANE; CHLORPHENOTANE; ENVIRONMENTAL, INDUSTRIAL AND DOMESTIC CHEMICALS; HEXACHLOROBENZENE; ORGANIC POLLUTANT; PERSISTENT ORGANIC POLLUTANT; POLYCHLORINATED BIPHENYL; UNCLASSIFIED DRUG;

BLOOD; BODY MASS; CLASS; CONCENTRATION (COMPOSITION); EDUCATIONAL ATTAINMENT; HEALTH RISK; HEALTH SURVEY; OCCUPATION; ORGANIC POLLUTANT; PUBLIC HEALTH;

ADULT; AGED; AGING; ARTICLE; BIOACCUMULATION; BODY MASS; CONTROLLED STUDY; EDUCATION; ENVIRONMENTAL FACTOR; FEMALE; HEALTH SURVEY; HUMAN; LIFESTYLE; MALE; PARITY; PRIORITY JOURNAL; SEX DIFFERENCE; SOCIAL CLASS; SOCIOECONOMICS; SPAIN;

CATALONIA; SPAIN;

AGEING; BMI; BODY MASS INDEX; CATALAN HEALTH INTERVIEW SURVEY; CHIS; CI; CONFIDENCE INTERVAL; DDE; DDT; DICHLORODIPHENYLDICHLOROETHENE; DICHLORODIPHENYLTRICHLOROETHANE; EDUCATIONAL LEVEL; GEOMETRIC MEAN; GM; HCB; HCH; HEALTH SURVEY; HEXACHLOROBENZENE; HEXACHLOROCYCLOHEXANE; HOSPITAL DEL MAR RESEARCH INSTITUTE; IMIM; OCCUPATIONAL SOCIAL CLASS; PARITY; PCBS; PECB; PENTACHLOROBENZENE; PERSISTENT ORGANIC POLLUTANTS; PERSISTENT ORGANIC POLLUTANTS (POPS); POLYCHLORINATED BIPHENYLS; POPS; PRIMARY (I); PRIMARY (II); PRIMARY SCHOOLING (1ST STAGE); PRIMARY SCHOOLING (2ND STAGE); WFE; WITHOUT FORMAL EDUCATION;

ADOLESCENT; ADULT; AGED; ANALYSIS OF VARIANCE; BODY MASS INDEX; DICHLORODIPHENYL DICHLOROETHYLENE; EDUCATIONAL STATUS; ENVIRONMENTAL MONITORING; ENVIRONMENTAL POLLUTANTS; FEMALE; FOOD CHAIN; FOOD CONTAMINATION; HUMANS; MALE; MIDDLE AGED; MODELS, STATISTICAL; PARITY; POLYCHLORINATED BIPHENYLS; POPULATION SURVEILLANCE; SEX FACTORS; SOCIAL CLASS; SOCIOECONOMIC FACTORS; SPAIN; YOUNG ADULT;

EID: 84884410966     PISSN: 01604120     EISSN: 18736750     Source Type: Journal    
DOI: 10.1016/j.envint.2013.08.001     Document Type: Article

References (72)

1. Agudo A., Goni F., Etxeandia A., Vives A., Millán E., López R., et al. Polychlorinated biphenyls in Spanish adults: determinants of serum concentrations. Environ Res 2009, 109:620-628.
2. Alonso-Magdalena P., Quesada I., Nadal A. Endocrine disruptors in the etiology of type 2 diabetes. Nat Rev Endocrinol 2011, 7:346-353.
3. Armitage P., Berry G., Matthews J.N.S. Statistical methods in medical research 2002, Blackwell, Oxford. 4th. ed.
4. Becker K., Kaus S., Krause C., Lepom P., Schulz C., Seiwert M., et al. German Environmental Survey 1998 (GerES III): environmental pollutants in blood of the German population. Int J Hyg Environ Health 2002, 205:297-308.
5. State of the science of endocrine disrupting chemicals - 2012 2013, United Nations Environment Programme and the World Health Organization, Geneva, [Available: http://www.who.int/ceh/publications/endocrine/en/index.html [accessed 2 March 2013]]. A. Bergman, J.J. Heindel, S. Jobling, K.A. Kidd, R.T. Zoeller (Eds.).
6. Bernert J.T., Turner W.E., Patterson D.G., Needham L.L. Calculation of body "total lipid" concentrations for the adjustment of persistent organohalogen toxicant measurements in human samples. Chemosphere 2007, 68:824-831.
7. Bonefeld-Jorgensen E.C. Biomonitoring in Greenland: human biomarkers of exposure and effects - a short review. Rural Remote Health 2010, 10:1262.
8. Borrell C., Muntaner C., Benach J., Artazcoz L. Social class and self-reported health status among men and women: what is the role of work organisation, household material standards and household labour?. Soc Sci Med 2004, 58:1869-1887.
9. Borrell C., Rohlfs I., Artazcoz L., Muntaner C. Inequalities in health related to social class in women. What is the effect of the measure used?. Gac Sanit 2004, 18:75-82.
10. Borrell L.N., Factor-Litzak P., Wolff M.S., Susser E., Matte T.D. Effect of socioeconomic status on exposures to polychlorinated biphenyls (PCBs) and dichlorodiphenyldichloroethylene (DDE) among pregnant African-American women. Arch Environ Health 2004, 59:250-255.
11. Braveman P., Egerter S., Williams D.R. The social determinants of health: coming of age. Annu Rev Public Health 2011, 32:381-398.
12. Brown P. Race, class and environmental health: a review and systematization of the literature. Environ Res 1995, 69:15-30.
13. Chao H.A., Chen S.C., Chang C.M., Koh T.W., Chang-Chien G.P., Ouyang E., et al. Concentrations of polybrominated diphenyl ethers in breast milk correlated to maternal age, education level, and occupational exposure. J Hazard Mater 2010, 175:492-500.
14. Davey Smith G., Hart C., Hole D., MacKinnon P., Gillis C., Watt G., et al. Education and occupational social class: which is the more important indicator of mortality risk?. J Epidemiol Community Health 1998, 52:153-160.
15. Davies J.E., Edmundson W.F., Raffonelli A., Cassady J.C., Morgade C. The role of social class in human pesticide pollution. Am J Epidemiol 1972, 96:334-341.
16. Department of Health and Human Services Fourth National Report on Human Exposure to Environmental Chemicals 2009, Centers for Disease Control and Prevention, Atlanta, [Available: http://www.cdc.gov/exposurereport/index.html [accessed 2 March 2013]].
17. Domingo-Salvany A., Regidor E., Alonso J., Alvarez-Dardet C. Proposal for a social class measure. Working Group of the Spanish Society of Epidemiology and the Spanish Society of Family and Community Medicine. Aten Primaria 2000, 25:350-363.
18. Engel S.M., Wolff M.S. Causal inference considerations for endocrine disruptor research in children's health. Annu Rev Public Health 2013, 34:139-158.
19. Espina C., Porta P., Schüz J., Hernández-Aguado I., Percival R.V., Dora C., et al. Environmental and occupational interventions for primary prevention of cancer: a cross-sectorial policy framework. Environ Health Perspect 2013, 10.1289/ehp.1205897.
20. Freire C., Amaya E., Fernández M., González-Galarzo M.C., Ramos R., Molina-Molina J.M., et al. Relationship between occupational social class and exposure to organochlorine pesticides during pregnancy. Chemosphere 2011, 83:831-838.
21. Galobardes B., Shaw M., Lawlor D.A., Lynch J.W., Smith G.D. Indicators of socioeconomic position (part 1). J Epidemiol Community Health 2006, 60:7-12.
22. García A.M. Occupational exposure to pesticides and congenital malformations: a review of mechanisms, methods, and results. Am J Ind Med 1998, 33:232-240.
23. Gasull M., Bosch de Basea M., Puigdomènech E., Pumarega J., Porta M. Empirical analyses of the influence of diet on human concentrations of persistent organic pollutants: a systematic review of all studies conducted in Spain. Environ Int 2011, 37:1226-1235.
24. Geyer S., Hemström Ö., Peter R., Vagerö D. Education, income, and occupational class cannot be used interchangeably in social epidemiology. Empirical evidence against a common practice. J Epidemiol Community Health 2006, 60:804-810.
25. Glynn A., Aune M., Darnerud P.O., Cnattingius S., Bjerselius R., Becker W., et al. Determinants of body concentrations of organochlorine compounds in Swedish pregnant women: a cross-sectional study. Environ Health 2007, 6:2.
26. Henkler F., Luch A. Adverse health effects of environmental chemical agents through non-genotoxic mechanisms. J Epidemiol Community Health 2011, 65:1-3.
27. Hoffmann B., Kolahgar B., Rauchfuss K., Eberwein G., Franzen-Reuter I., Kraft M., et al. Childhood social position and associations between environmental exposures and health outcomes. Int J Hyg Environ Health 2009, 212:146-156.
28. Ibarluzea J., Alvarez-Pedrerol M., Guxens M., Santa Marina L., Basterrechea M., Lertxundi A., et al. Sociodemographic, reproductive and dietary predictors of organochlorine compounds concentrations in pregnant women in Spain. Chemosphere 2011, 82:114-120.
29. INE (Instituto Nacional de Estadística) Clasificación Nacional de Ocupaciones Available:, [accessed 2 March 2013]. http://www.ine.es/clasifi/ficno.htm.
30. Institute of Medicine Dioxins and dioxin-like compounds in the food supply. Strategies to decrease exposure 2003, The National Academies Press, Washington, DC.
31. Jakszyn P., Goñi F., Etxeanía A., Vives A., Millán E., López R., et al. Serum levels of organochlorine pesticides in healthy adults from five regions of Spain. Chemosphere 2009, 76:1518-1524.
32. Kleinbaum D.G., Kupper L.L., Muller K.E., Nizam A. Applied regression analysis and multivariable methods 2007, Duxbury, Pacific Grove, CA. 4th ed.
33. Krieger N., Williams D.R., Moss N.E. Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health 1997, 1:341-378.
34. León-Muñoz L.M., Guallar-Castillón P., Graciani A., López-García E., Mesas A.E., Aguilera M.T., et al. Adherence to the Mediterranean diet pattern has declined in Spanish adults. J Nutr 2012, 142:1843-1850.
35. López-Azpiazu I., Sánchez-Villegas A., Johansson L., Petkeviciene J., Prättälä R., Martínez-González M.A. Disparities in food habits in Europe: systematic review of educational and occupational differences in the intake of fat. J Hum Nutr Diet 2003, 16:349-364.
36. Lu C., Toepel K., Irish R., Fenske R.A., Barr D.B., Bravo R. Organic diets significantly lower children's dietary exposure to organophosphorus pesticides. Environ Health Perspect 2006, 114:260-263.
37. Martikainen P., Blomgren J., Valkonen T. Change in the total and independent effects of education and occupational social class on mortality: analyses of all Finnish men and women in the period 1971-2000. J Epidemiol Community Health 2007, 61:499-505.
38. Mesas A.E., León-Muñoz L.M., Guallar-Castillón P., Graciani A., Gutiérrez-Fisac J.L., López-García E., et al. Obesity-related eating behaviours in the adult population of Spain, 2008-2010. Obes Rev 2012, 413:858-867.
39. Morrens B., Bruckers L., Hond E.D., Nelen V., Schoeters G., Baeyens W., et al. Social distribution of internal exposure to environmental pollution in Flemish adolescents. Int J Hyg Environ Health 2012, 215:474-481.
40. NRC (National Research Council), Committee on Human Biomonitoring for Environmental Toxicants Human biomonitoring for environmental chemicals 2006, The National Academies Press, Washington, DC, [Available: http://www.nap.edu/catalog/11700.html [accessed 2 March 2013]].
41. Patterson D., Wong L., Turner W., Caudill S., Dipietro E.S., McClure P., et al. Concentrations in the U.S. population of those persistent organic pollutants (2003-2004) included in the Stockholm Convention or in other long range transboundary air pollution agreements. Environ Sci Technol 2009, 43:1211-1218.
42. Phillips D.L., Pirkle J.L., Burse V.W., Bernert J.T., Henderson L.O., Needham L.L. Chlorinated hydrocarbon concentrations in human body: effects of fasting and feeding. Arch Environ Contam Toxicol 1989, 18:495-500.
43. Porta M. Persistent toxic substances: exposed individuals and exposed populations. J Epidemiol Community Health 2004, 58:534-535.
44. Porta M. Human contamination by environmental chemical pollutants: can we assess it more properly?. Prev Med 2012, 55:560-562.
45. Porta M., Bosch de Basea M., Benavides F.G., López T., Fernandez E., Marco E., et al. Differences in body concentrations of organochlorine compounds by occupational social class in pancreatic cancer. Environ Res 2008, 108:370-379.
46. Porta M., Puigdomènech E., Ballester F., Selva J., Ribas-Fitó N., Llop S., et al. Monitoring concentrations of persistent organic pollutants in the general population: the international experience. Environ Int 2008, 34:546-561.
47. Porta M., Jariod M., López T., Pumarega J., Puigdomènech E., Marco E., et al. Correcting body concentrations of organochlorine compounds by lipids: alternatives to the organochlorine/total lipids ratio. Environ Int 2009, 35:1080-1085.
48. Porta M., Gasull M., Puigdomènech E., Garí M., Bosch de Basea M., Guillén M., et al. Distribution of blood concentrations of persistent organic pollutants in a representative sample of the population of Catalonia. Environ Int 2010, 36:655-664.
49. Porta M., López T., Gasull M., Rodríguez-Sanz M., Garí M., Pumarega J., et al. Distribution of blood concentrations of persistent organic pollutants in a representative sample of the population of Barcelona in 2006, and comparison with levels in 2002. Sci Total Environ 2012, 423:151-161.
50. Porta M., Pumarega J., Gasull M. Number of persistent organic pollutants detected at high concentrations in a general population. Environ Int 2012, 44:106-111.
51. Quinn C.L., Wania F. Understanding differences in the body burden-age relationships of bioaccumulating contaminants based on population cross sections versus individuals. Environ Health Perspect 2012, 120:554-559.
52. Quinn C.L., Wania F., Czub G., Breivik K. Investigating intergenerational differences in human PCB exposure due to variable emissions and reproductive behaviors. Environ Health Perspect 2011, 119:641-646.
53. Rohlfs I., Borrell C., Anitua C., Artazcoz L., Colomer C., Escribá V., et al. The importance of a gender perspective in health interview surveys. Gac Sanit 2000, 14:146-155.
54. Rothman K.J., Stein Z., Susser M. Rebuilding bridges: what is the real role of social class in disease occurrence?. Eur J Epidemiol 2011, 26:431-432.
55. Schnittker J. Education and the changing shape of the income gradient in health. J Health Soc Behav 2004, 45:286-305.
56. Schug T.T., Barouki R., Gluckman P.D., Grandjean P., Hanson M., Heindel JJ.PPTOX III. Environmental stressors in the developmental origins of disease-evidence and mechanisms. Toxicol Sci 2013, 131:343-350.
57. Serra Majem L., Ribas Barba L., Salvador Castell G., Castell Abat C., Román Viñas B., Serra Farró J., et al. Avaluació de l'estat nutricional de la població catalana 2002-2003. Evolució dels hàbits alimentaris i del consum d'aliments i nutrients a Catalunya (1992-2003) 2006, Departament de Salut, Generalitat de Catalunya, Barcelona, [http://www.aesan.mspsi.gob.es/AESAN/docs/docs/evaluacion_riesgos/Cataluna.pdf [accessed 2 March 2013]].
58. Sorensen A. Women, family and class. Annu Rev Sociol 1994, 20:27-47.
59. Stein R.A. Epigenetics and environmental exposures. J Epidemiol Community Health 2012, 66:8-13.
60. Subramanyam M.A., Diez-Roux A.V., Pilsner J.R., Villamor E., Donohue K.M., Liu Y., et al. Social factors and leukocyte DNA methylation of repetitive sequences: the multi-ethnic study of atherosclerosis. PLoS One 2013, 8:e54018.
61. Thayer Z.M., Kuzawa C.W. Biological memories of past environments: epigenetic pathways to health disparities. Epigenetics 2011, 6:798-803.
62. Thornton J.W., McCally M., Houlihan J. Biomonitoring of industrial pollutants: health and policy implications of the chemical body burden. Public Health Rep 2002, 117:315-323.
63. Umweltbundesamt German Environmental Survey (GerES) Available:, [accessed 2 March 2013]. http://www.umweltbundesamt.de/gesundheit-e/survey/index.htm.
64. Vandenberg L.N., Colborn T., Hayes T.B., Heindel J.J., Jacobs D.R., Lee D.H., et al. Hormones and endocrine-disrupting chemicals: low-dose effects and nonmonotonic doses responses. Endocr Rev 2012, 33:378-455.
65. Vrijheid M., Martinez D., Aguilera I., Ballester F., Basterrechea M., Esplugues A., et al. Socioeconomic status and exposure to multiple environmental pollutants during pregnancy: evidence for environmental inequity?. J Epidemiol Community Health 2012, 66:106-113.
66. WHO (World Health Organization) Health risks of persistent organic pollutants from long-range transboundary air pollution 2003, World Health Organization, Copenhagen, [Available: http://www.euro.who.int/__data/assets/pdf_file/0009/78660/e78963.pdf [accessed 2 March 2013]].
67. Wolff M.S. Occupational exposure to polychlorinated biphenyls (PCBs). Environ Health Perspect 1985, 60:133-138.
68. Wolff M.S., Deych E., Ojo F., Berkowitz G.S. Predictors of organochlorines in New York City pregnant women, 1998-2001. Environ Res 2005, 97:170-177.
69. Woodruff T.J., Schwartz J., Giudice L.C. Research agenda for environmental reproductive health in the 21st century. J Epidemiol Community Health 2010, 64:307-310.
70. Wu H., Bertrand K.A., Choi A.L., Hu F.B., Laden F., Grandjean P., et al. Persistent organic pollutants and type 2 diabetes: a prospective analysis in the Nurses' Health Study and meta-analysis. Environ Health Perspect 2012, 10.1289/ehp.1205248.
71. Yang J.H., Lee Y.M., Bae S.G., Jacobs Jr D.R., Lee D.H. Associations between organochlorine pesticides and vitamin D deficiency in the U.S. population. PLoS One 2012, 7(1):e30093.
72. Zubero M.B., Ibarluzea J.M., Aurrekoetxea J.J., Ibarluzea J.M., Goñi F., López R., et al. Body concentrations of polychlorinated dibenzodioxins and dibenzofurans and PCBs in the general population living near an urban waste treatment plant in Biscay, Basque Country. Chemosphere 2009, 76:784-791.