Comparison of study subject characteristics between the Kim Bang and Phu Cat areas
Table 3.1. Characteristics of lactacting mothers in Kim Bang and Phu Cat areas
Group Index
Kim Bang Phu Cat n Mean SD n Mean SD p
Age (years) 59 25,8 2,9 51 27,3 3,8 <0,05 Weight (kg) 59 152,2 5,0 51 152,0 5,3 >0,05 Height (cm) 59 48,4 4,9 51 48,4 6,7 >0,05 BMI (kg/m2) 59 20,9 1,9 51 20,9 2,2 >0,05 Residence period (years) 59 21,6 5,6 51 22,7 4,1 >0,05 Table 3.1, which presents the characteristics of lactating women from the two study areas (n=110), shows the age, weight, height and BMI. These values do not differ significantly between the two areas. Likewise, the residence period are similar for both areas.
Table 3.2. Comparisons of the body size of infants and the DDI in the 3 age groups from Kim Bang and Phu Cat areas
Period Index Kim Bang Phu Cat
n Mean SD n Mean SD p
Under 3 months
Age (weeks) 19 9,4 1,6 29 9,0 1,9 >0,05 Height (cm) 19 59,2 2,8 29 60,0 3,2 >0,05 Weight (g) 19 5372,6 661,5 29 5439,3 1018,9 >0,05 Head (cm) 19 39,0 1,3 29 39,1 1,6 >0,05 Chest (cm) 19 39,8 1,9 29 39,4 2,8 >0,05 DDI (TEQ pg/dl) 19 9,4 4,6 29 27,6 13,4 <0,001
3 to 4 months
Age (weeks) 40 15,3 3,5 22 14,3 2,5 >0,05 Height (cm) 40 62,4 2,5 22 62,4 2,7 >0,05 Weight (g) 40 6327,3 832,5 22 6100,9 808,8 >0,05 Head (cm) 40 40,8 1,8 22 40,8 1,7 >0,05 Chest (cm) 40 41,6 2,1 22 40,6 2,2 >0,05 DDI (TEQ pg/dl) 40 7,5 3,1 22 25,1 14,6 <0,001 Table 3.2 shows the comparison of body size of infants of three age groups and the daily dioxin intake from breast milk (DDI). DDI in hot-spot Phu Cat areas were over 3-fold greater than in the Kim Bang area at under 3 to 4 months of age.
However, there were no significant differences in the growth parameter means (height, weight, head and chest) between both area.
Comparisons of dioxin isomers level in maternal breast milk.
Table 3.3. Dioxin isomer levels of maternal breast milk in Kim Bang and Phu Cat areas
TEQ isomers dioxin (pg/g lipid)
Kim Bang Phu Cat
PC/
KB p n Mea
n SD Medi
an n Mea
n SD Medi an
2,3,7,8-TeCDD 59 0,458 0,344 0,337 51 1,455 0,709 1,266 3,8 ***
1,2,3,7,8-PeCDD 59 1,300 0,572 1,211 51 4,241 1,736 4,022 3,3 ***
1,2,3,4,7,8-HxCDD 59 0,064 0,025 0,063 51 0,198 0,081 0,178 2,8 ***
1,2,3,6,7,8-HxCDD 59 0,140 0,064 0,129 51 0,686 0,305 0,625 4,9 ***
1,2,3,7,8,9-HxCDD 59 0,061 0,027 0,058 51 0,261 0,110 0,227 3,9 ***
1,2,3,4,6,7,8-HpCDD 59 0,026 0,019 0,023 51 0,135 0,061 0,128 5,5 ***
OCDD 59 0,004 0,002 0,003 51 0,021 0,009 0,019 5,9 ***
2,3,7,8-TeCDF 59 0,068 0,029 0,066 51 0,063 0,032 0,061 0,9 >0,05 1,2,3,7,8-PeCDF 59 0,014 0,007 0,013 51 0,058 0,033 0,051 4,0 ***
2,3,4,7,8-PeCDF 59 0,921 0,339 0,867 51 1,777 0,607 1,710 2,0 ***
1,2,3,4,7,8-HxCDF 59 0,193 0,072 0,184 51 1,447 0,784 1,289 7,0 ***
1,2,3,6,7,8-HxCDF 59 0,166 0,065 0,161 51 0,850 0,416 0,769 4,8 ***
1,2,3,7,8,9-HxCDF 59 0,014 0,007 0,012 51 0,037 0,027 0,027 2,2 ***
2,3,4,6,7,8-HxCDF 59 0,056 0,030 0,050 51 0,147 0,061 0,133 2,7 ***
1,2,3,4,6,7,8-HpCDF 59 0,017 0,023 0,013 51 0,164 0,116 0,135 10,8 ***
1,2,3,4,7,8,9-HpCDF 59 0,002 0,001 0,002 51 0,017 0,012 0,013 8,4 ***
OCDF 59 0,000 0,000 0,000 51 0,000 0,001 0,000 3,7 ***
Total PCDDs 59 2,053 0,910 1,849 51 6,997 2,715 6,563 3,5 ***
Total PCDFs 59 1,451 0,495 1,319 51 4,561 1,835 4,304 3,3 ***
Total PCDDs +
PCDFs 59 3,505 1,356 3,140 51 11,55
8 4,079 11,03
9 3,5 ***
The toxic equivalent dioxin isomer levels in the milk of lactating mothers in Phu Cat and Kim Bang area are shown in table 3.4. The levels of 17 dioxin isomers were higher in Phu Cat than in Kim Bang area (p<0,001) excepting the level of 2,3,7,8-TeCDF. The total toxic equivalent PCDDs/PCDFs levels were higher in Phu Cat than in Kim Bang.
Table 3.4. Dioxin isomer levels between primipara and multipara in Kim Bang and Phu Cat areas
TEQ isomers dioxin (pg/g lipid)
Primipara Multipara
P/M p n Mean SD Medi
an n Mea
n SD Medi an
2,3,7,8-TeCDD 37 1,203 0,813 1,052 73 0,777 0,656 0,559 1,5 **
1,2,3,7,8-PeCDD 37 3,499 2,338 2,810 73 2,240 1,539 1,855 1,6 **
1,2,3,4,7,8-HxCDD 37 0,155 0,111 0,105 73 0,112 0,071 0,096 1,4 * 1,2,3,6,7,8-HxCDD 37 0,510 0,421 0,324 73 0,334 0,286 0,212 1,5 * 1,2,3,7,8,9-HxCDD 37 0,194 0,152 0,132 73 0,134 0,107 0,093 1,4 * 1,2,3,4,6,7,8-HpCDD 37 0,093 0,083 0,055 73 0,068 0,060 0,040 1,4 >0,05 OCDD 37 0,013 0,011 0,010 73 0,011 0,010 0,006 1,2 >0,05 2,3,7,8-TeCDF 37 0,064 0,030 0,059 73 0,067 0,030 0,065 1,0 >0,05 1,2,3,7,8-PeCDF 37 0,035 0,033 0,022 73 0,034 0,031 0,023 1,0 >0,05 2,3,4,7,8-PeCDF 37 1,632 0,675 1,512 73 1,158 0,568 0,992 1,4 ***
1,2,3,4,7,8-HxCDF 37 0,933 0,886 0,412 73 0,694 0,785 0,286 1,3 * 1,2,3,6,7,8-HxCDF 37 0,574 0,470 0,335 73 0,437 0,429 0,220 1,3 * 1,2,3,7,8,9-HxCDF 37 0,029 0,025 0,016 73 0,023 0,021 0,015 1,3 >0,05 2,3,4,6,7,8-HxCDF 37 0,111 0,075 0,087 73 0,092 0,060 0,076 1,2 >0,05 1,2,3,4,6,7,8-HpCDF 37 0,097 0,106 0,051 73 0,080 0,110 0,020 1,2 >0,05 1,2,3,4,7,8,9-HpCDF 37 0,010 0,012 0,004 73 0,008 0,010 0,003 1,3 >0,05 OCDF 37 0,000 0,000 0,000 73 0,000 0,000 0,000 1,0 >0,05 Total PCDDs 37 5,668 3,805 4,138 73 3,675 2,545 3,150 1,5 **
Total PCDFs 37 3,487 2,179 2,688 73 2,592 1,887 1,916 1,3 **
Total PCDDs +
PCDFs 37 9,154 5,846 7,080 73 6,268 4,212 5,064 1,5 **
Table 3.4 shows the dioxin levels of toxic equivalent PCDDs, PCDFs and total PCDDs/PCDFs in the breast milk of primipara and multipara.
The dioxin isomers including 2,3,7,8-TeCDD, 1,2,3,7,8-PeCDD, 1,2,3,4,7,8-HxCDD, 1,2,3,6,7,8-HxCDD, 1,2,3,7,8,9-HxCDD, 2,3,7,8-TeCDF, 1,2,3,4,7,8-HxCDF and 1,2,3,6,7,8-HxCDF in primiparas were significantly higher than those in multiparas. The other compounds showed a relatively high trend.
Comparisons of steroid hormone concentrations in saliva
Comparisons of steroid hormone concentrations in saliva of mother Table 3.5. Steroid hormone concentrations in saliva of lactating mothers after 4-16 weeks of birth in Kim Bang and Phu Cat areas
Area Hormone
Kim Bang Phu Cat
n Mean SD Median n Mean SD Median p
Cortisol (ng/ml) 36 1,76 1,10 1,74 38 2,95 2,06 2,56 <0,01 Cortisone (ng/ml) 36 9,76 5,17 9,54 38 14,59 6,37 13,03 <0,01 DHEA (pg/ml) 36 130,41 74,28 124,0 38 204,39 121,32 160,0 <0,01 A-dione (pg/ml) 36 45,09 20,76 43,75 38 43,82 17,59 42,0 >0,05 Estradiol (pg/ml) 17 0,14 0,08 0,13 38 0,15 0,16 0,12 >0,05 Table 3.5 shows the salivary concentrations of the five steroid hormones studied for the two areas including cortisol, cortisone, DHEA, A-dione and estradiol. Cortisol, cortisone and DHEA concentrations can be seen to be significantly higher in lactating mothers from Phu Cat area than in those from Kim Bang area (p<0,01). There were no significant differences in saliva A-dione and estradiol levels.
Table 3.6. Steroid hormone concentrations in saliva of primiparas after 4-16 weeks of birth in Kim Bang and Phu Cat areas
Area Hormone
Kim Bang Phu Cat
n Mean SD Median n Mean SD Median p
Cortisol (ng/ml) 9 1,68 1,44 1,67 18 3,08 2,79 2,34 >0,05 Cortisone (ng/ml) 9 8,93 6,87 8,47 18 14,99 7,45 13,03 >0,05 DHEA (pg/ml) 9 100,9 90,8 75,9 18 187,3 99,9 154,3 <0,05 A-dione (pg/ml) 9 49,80 28,47 49,35 18 43,58 18,31 41,35 >0,05 Estradiol (pg/ml) 5 0,20 0,09 0,20 18 0,14 0,15 0,11 >0,05 Table 3.6 shows the salivary concentrations of five steroid hormones (cortisol, cortisone, DHEA, A-dione and estradiol) for primipara study subjects from the both areas. DHEA concentrations was significantly higher in primipara in Phu Cat than in Kim Bang area (p<0,05). There were no significant differences between the two areas for any of the other salivary hormones.
Table 3.7. Steroid hormone concentrations in saliva of multiparas after 4-16 weeks of birth in Kim Bang and Phu Cat areas
Area Hormone
Kim Bang Phu Cat
n Mean SD Median n Mean SD Median p
Cortisol (ng/ml) 27 1,81 1,03 1,89 20 3,03 1,40 3,23 <0,01 Cortisone (ng/ml) 27 10,09 4,77 10,30 20 14,64 5,41 15,24 <0,05 DHEA (pg/ml) 27 136,90 68,93 141,00 20 214,69 144,54 153,00 >0,05 A-dione (pg/ml) 27 42,64 17,82 37,90 20 45,91 17,58 47,90 >0,05 Estradiol (pg/ml) 12 0,12 0,06 0,12 20 0,17 0,18 0,12 >0,05 Table 3.7 shows the five steroid hormones concentrations in saliva for multiparas in the Kim Bang and Phu Cat areas. Salivary cortisol and cortisone concentrations were found to be significantly higher in women from Phu Cat than those from Kim Bang area. There were no significant differences between the two areas for any of the other salivary hormones.
Table 3.8. Steroid hormone concentrations in saliva of lactating mothers after 1 year of breastfeeding in Kim Bang and Phu Cat areas
Area Hormone
Kim Bang Phu Cat
n Mean SD Median n Mean SD Median p
Cortisol (ng/ml) 58 1,41 1,01 1,10 50 2,48 1,58 1,97 <0,001 Cortison (ng/ml) 58 8,08 3,32 7,74 50 11,89 4,58 10,99 <0,001 DHEA (pg/ml) 58 148,83 67,19 133,75 49 170,30 86,44 154,70 >0,05 A-dione (pg/ml) 58 63,29 31,97 55,45 50 61,75 32,40 55,05 >0,05 Estradiol (pg/ml) 58 0,29 0,30 0,18 50 0,34 0,33 0,22 >0,05 Estron (pg/ml) 58 1,35 1,31 0,85 50 1,55 1,42 1,14 >0,05 Table 3.8 shows the salivary concentrations of six steroid hormones (cortisol, cortisone, DHEA, A-dione, estrone, and estradiol) for all study subjects (n=110) from Phu Cat and Kim Bang areas. Salivary cortisol and cortisone concentrations were found to be significantly higher in women from the dioxin hot-spot area than those from the non-exposed area (p<0,001). There were no significant differences between the two areas for any of the other salivary hormones.
Table 3.9. Comparisons of steroid hormone concentrations in saliva of primiparas after 1 year of breastfeeding in Kim Bang and Phu Cat areas.
Area Hormone
Kim Bang Phu Cat
n Mean SD Median n Mean SD Median p
Cortisol (ng/ml) 16 1,41 0,84 1,13 20 2,43 1,44 1,97 <0,05 Cortison (ng/ml) 16 8,36 3,25 8,42 20 12,38 4,11 11,59 <0,01 DHEA (pg/ml) 16 131,51 59,31 115,40 20 188,25 90,34 184,00 >0,05 A-dione (pg/ml) 16 71,62 51,31 52,95 20 65,75 38,01 57,65 >0,05 Estradiol (pg/ml) 16 0,31 0,25 0,27 20 0,40 0,41 0,26 >0,05 Estron (pg/ml) 16 1,56 1,70 0,94 20 1,83 1,92 1,12 >0,05
Table 3.9 shows the steroid hormones concentrations in saliva for multiparas after 1 year of breastfeeding. Salivary cortisol and cortisone concentrations were found to be significantly higher in women from Phu Cat than those from Kim Bang area. There were no significant differences between the two areas for any of the other salivary hormones.
Table 3.10. Comparisons of steroid hormone concentrations in saliva of multiparas after 1 year of breastfeeding in Kim Bang and Phu Cat areas
Area Hormone
Kim Bang Phu Cat
n Mean SD Median n Mean SD Median p
Cortisol (ng/ml) 42 1,41 1,07 1,10 30 2,51 1,69 1,97 <0,01 Cortison (ng/ml) 42 7,97 3,38 7,66 30 11,57 4,92 10,61 <0,01 DHEA (pg/ml) 42 155,42 69,48 140,90 29 157,92 82,96 144,10 >0,05 A-dione (pg/ml) 42 60,12 20,50 55,45 30 59,08 28,44 52,35 >0,05 Estradiol (pg/ml) 42 0,29 0,32 0,15 30 0,29 0,25 0,21 >0,05 Estron (pg/ml) 42 1,27 1,14 0,84 30 1,37 0,95 1,20 >0,05 Table 3.10 shows the steroid hormones concentrations in saliva for multiparas after 1 year of breastfeeding. Salivary cortisol and cortisone concentrations were found to be significantly higher in women from Phu Cat than those from Kim Bang area. There were no significant differences between the two areas for any of the other salivary hormones.
Comparisons of steroid hormone concentrations in saliva of infant Table 3.11. Steroid hormone concentrations in saliva of infants in the Kim Bang and Phu Cat areas
Area Hormone
Kim Bang Phu Cat
n Mean SD Median n Mean SD Median p
Cortisol (ng/ml) 59 3,33 1,94 2,95 51 3,86 2,88 2,86 >0,05 Cortison (ng/ml) 59 0,62 0,76 0,38 51 0,61 0,53 0,45 >0,05 DHEA (pg/ml) 57 83,30 48,83 73,00 50 45,30 28,58 37,50 <0,001 Table 3.12 shows the steroid hormones concentrations in saliva for all infants in the Kim Bang and Phu Cat areas. Salivary DHEA concentration was found to be significantly lower in infant from Phu Cat than in Kim Bang area. There were no significant differences between the two areas for cortisol and cortisone salivary hormones.
Comparisons of steroid hormone concentrations in maternal breast milk Table 3.12. Comparisons of steroid hormone concentrations in breast milk of mother in Kim Bang and Phu Cat
Area Hormone
Kim Bang Phu Cat
n Mean SD Median n Mean SD Median p
Cortisol (ng/ml) 35 1,92 1,61 1,52 35 3,36 2,24 3,31 <0,01 Cortison (ng/ml) 35 7,52 3,30 7,55 35 8,99 2,44 8,65 <0,05 A-dione (pg/ml) 35 246,69 142,36 209,40 34 218,66 133,71 190,50 >0,05 Estradiol (pg/ml) 35 0,12 0,15 0,07 34 0,11 0,16 0,07 >0,05 Table 3.12 shows the steroid hormone concentrations in breast milk for all mothers in two areas including cortisol, cortisone, A-dione and estradiol. Cortisol and cortisone concentrations can be seen to be significantly higher in lactating mothers from Phu Cat area than in those from Kim Bang area. There were no significant differences for A-dione and estradiol concentrations in breast milk.
Table 3.13. Comparisons of steroid hormone concentrations in breast milk of primiparas in Kim Bang and Phu Cat areas
Area Hormone
Kim Bang Phu Cat
n Mean SD Median n Mean SD Median p
Cortisol (ng/ml) 8 1,78 1,69 1,32 14 3,41 2,78 2,21 >0,05 Cortison (ng/ml) 8 6,41 4,76 6,44 14 8,38 2,53 8,15 >0,05 A-dione (pg/ml) 8 210,6 112,5 237,7 14 172,4 85,81 171,7 >0,05 Estradiol (pg/ml) 8 0,14 0,12 0,09 14 0,09 0,07 0,07 >0,05 Table 3.13 shows the steroid hormone concentrations in breast milk primiparas in two areas. There were no significant differences for any of all hormones concentrations in breast milk.
Table 3.14. Comparisons of steroid hormone concentrations in breast milk of multiparas in Kim Bang and Phu Cat areas
Area Hormone
Kim Bang Phu Cat
n Mean SD Median n Mean SD Median p
Cortisol (ng/ml) 26 2,01 1,62 1,54 18 3,19 1,86 3,45 <0,05 Cortison (ng/ml) 26 7,95 2,77 7,77 18 9,25 2,34 9,48 >0,05 A-dione (pg/ml) 26 253,08 151,53 207,00 17 256,46 160,27 239,40 >0,05 Estradiol (pg/ml) 26 0,12 0,16 0,04 17 0,13 0,23 0,07 >0,05
Table 3.14 shows the steroid hormone concentrations in breast milk multiparas in two areas. Cortisol concentration was higher significant in Phu Cat than in Kim Bang area There were no significant differences for any of other hormones concentrations in breast milk.
Comparisons of steroid hormone concentrations in serum of mother Table 3.15. Comparisons of steroid hormone concentrations in serum of mother in Kim Bang and Phu Cat
Area Hormone
Kim Bang Phu Cat
n Mean SD Median n Mean SD Median p
Cortisol (ng/ml) 58 78,54 37,07 66,25 50 114,28 52,81 96,70 <0,001 Cortison (ng/ml) 58 22,35 6,92 21,95 50 27,57 6,30 27,55 <0,001 DHEA (pg/ml) 58 4805,32 2090,86 4446,35 50 5042,99 2614,83 4504,65 >0,05 A-dione (pg/ml) 58 1799,58 745,46 1649,80 50 1611,81 784,76 1463,65 >0,05 Estradiol (pg/ml) 58 39,78 49,93 21,90 50 34,39 36,05 19,35 >0,05 Estron (pg/ml) 58 39,92 36,72 26,20 50 29,89 25,09 21,55 >0,05 Table 3.15 shows the serum levels of the six steroid hormones studied for the two areas. Cortisol and cortisone concentrations were significantly higher in Phu Cat than those in Kim Bang (p<0,001). There were no significant differences in serum DHEA, A-dione, estrone, and estradiol l concentrations.
Table 3.16. Comparisons of steroid hormone concentrations in serum of primiparas in Kim Bang and Phu Cat
Area Hormone
Kim Bang Phu Cat
n Mean SD Median n Mean SD Median p
Cortisol (ng/ml) 16 77,67 37,37 73,45 20 112,77 54,00 96,10 <0,05 Cortison (ng/ml) 16 21,78 5,65 21,95 20 29,93 5,73 29,15 <0,001 DHEA (pg/ml) 16 4670,28 2086,34 4507,10 20 5366,45 2641,46 4832,05 >0,05 A-dione (pg/ml) 16 2011,19 1127,11 1610,00 20 1720,26 845,61 1527,10 >0,05 Estradiol (pg/ml) 16 43,62 38,98 30,15 20 35,76 33,03 21,30 >0,05 Estron (pg/ml) 16 49,75 45,38 27,60 20 28,68 24,31 20,90 >0,05 Table 3.16 shows the steroid hormones concentrations in serum for primiparas. Serum cortisol and cortisone concentrations were significantly higher in primiparas from Phu Cat than those from Kim Bang area. There were no significant differences between the two areas for any of the other serum hormones.
The ratios of salivary hormone and serum hormone concentrations of lactating mothers after 1 year of breastfeeding
Table 3.17. The ratios of salivary hormone and serum hormone concentrations in Kim Bang and Phu Cat
Area Hormone
Kim Bang Phu Cat
n Ratio n Ratio p
Cortisol 58 1,71±0,66 50 2,26±0,94 <0,01 Cortison 58 35,8±10,3 50 45,2±16,8 <0,01
DHEA 58 3,25±1,12 49 4,08±2,84 >0,05
A-dion 58 3,48±0,57 50 4,41±2,43 <0,05 Estradiol 58 0,90±0,39 50 1,52±2,13 <0,05 Estron 58 3,66±1,91 50 6,94±6,78 <0,001 Table 3.17 shows the ratio of salivary to serum steroid hormone concentrations. These ratios are significantly higher in Phu Cat than those in Kim Bang area.
Correlation between dioxin level in breast milk and steroid hormones concentration.
Fig. 3.1. The correlation between cortisol (A), cortisone (B) concentration in saliva and dioxin level in breast milk of primiparas after 4-16 weeks of birth.
Fig. 3.1 shows the correlation between salivary cortisol (A) or cortisone (B) and breast milk dioxin levels (p<0,05). These correlations are expressed by way of a nonlinear as dose–response curve as inverse U-shape between cortisol or cortisone and dioxin levels.
Fig. 3.2. The correlation between cortisol (A), cortisone (B) concentration in saliva and dioxin level in breast milk of lactating mothers after 1 year of breastfeeding.
Fig. 3.2 shows the correlation between salivary cortisol (A) or cortisone (B) and dioxin levels in Phu Cat and Kim Bang area. Significant and positive correlations between salivary cortisol or cortisone and breast milk dioxin levels can be seen (p<0,001).
Fig. 3.3. The correlation between cortisol (A), cortisone (B) and DHEA (C) concentration in saliva of infant 3 years and dioxin level in breast milk.
The fig 3.3 shown the correlations of nonlinear as dose–response curve as inverse U-shape between salivary cortisol or cortisone and breast milk dioxin levels can be seen in infant 3 years. There was significant negative correlation between the salivary DHEA and dioxin levels in maternal breast milk (p<0,001).
Fig. 3.4. The correlation between dioxin level and cortisol (A), cortisone (B) concentration in breast milk.
These correlation is expressed by way of a nonlinear as dose–response curve as inverse U-shape between cortisol and dioxin levels in breast milk.
Fig. 3.5. The correlation between cortisol (A), cortisone (B) concentration in serum and dioxin level in breast milk.
Fig. 3.5 shows the correlation between serum cortisol (A) or cortisone (B) and breast milk dioxin levels (p<0,001). These correlations are expressed by way of a linear equation as y = Ax + B, where x is the dioxin levels in maternal breast milk and y the steroid hormone levels