Should silicone prostheses be considered for specimen banking? A pilot study into their use for human biomonitoring

Abstract

Persistent organic pollutant (POP) biomonitoring in humans is challenging and generally carried out using blood, breast milk or adipose tissue, with concentrations normalised to the lipid content of the sample matrix. The goal of this cross-sectional pilot study was to evaluate the validity and feasibility of explanted silicone prostheses as a matrix for persistent organic pollutant biomonitoring in humans. We postulate that pollutant concentrations in silicone prostheses inserted in the body will equilibrate with that in the body over time and provide a measure of the overall body burden. This study included silicone prostheses from 22 female patients of the Colosseum clinic (Oslo, Norway) collected between September 2010 and April 2012. Absorption of chlorinated and brominated POPs into silicone prostheses during implantation was observed. Relative levels of the different contaminants measured in prostheses were in agreement with those from serum and breast milk analyses from the general Norwegian population. The comparison of serum and breast milk-based literature data with prosthesis concentrations transposed into lipid-normalised concentrations supports the validity of the prosthesis measurements. The median of relative percent differences between measurements with replicate silicone prostheses from 11 patients was below 30%. Observed increases in prosthesis concentrations with patients' age were found to be very similar to literature data from studies of the Norwegian population. Silicone prostheses therefore represent a promising matrix for the biomonitoring of nonpolar and non-ionic pollutants in humans. Sample accessibility and body burden representativeness of the silicone prostheses suggest that specimen banking should be initiated.

In vivo contaminant partitioning to silicone implants: Implications for use in biomonitoring and body burden

“…Implants had roughly 3 to 6-fold less trans-nonachlor than p,p′-DDE (SI-Table 2), which is very similar to tissue data reported by Brauner et al (2012). Compared with the previous human implant study, p,p′-DDE is also the compound with the highest concentrations (Allan et al 2013b). Furthermore, the magnitude and range of p,p′-DDE concentrations measured in this study (1.2–34 ng/g silicone) are very similar to Allan et al (~0.2–37 ng/g silicone), despite potential differences in methodology and demographics of the population (2013b).…”

“…Out of the 14 compounds reported in Table 1, thirteen are unique to this study compared with the only other report of environmental contaminants in silicone implants (Allan et al 2013b). Caffeine was the only compound to be detected in all 8 implants, but is not surprising considering that caffeine is present in many widely consumed products (Somogyi 2010).…”

Endocrine activity of persistent organic pollutants accumulated in human silicone implants — Dosing assays by partitioning from silicone

“…1. POP concentrations in silicone in the tested mixtures in this study (circles) and in human breast silicone prostheses (boxes) as published by Allan et al, 2013. Borders of boxes indicate the 25th and 75th percentiles; whiskers extend from the minimum to the maximum.…”

“…For instance, lipid normalization assumes lipids to be the only sorption phase and disregards differences in lipid composition (La Merrill et al, 2013). A recent study by Allan et al (2013) explored the feasibility of measuring POPs in explanted human silicone prostheses. Silicone is a well-defined partitioning phase, hence minimizing interfering matrix effects and facilitating chemical analysis and data interpretation.…”

“…In the present study, passive dosing was applied to reconstitute in vivo human POP exposure levels in an in vitro system by spiking silicone with POPs to levels as found in explanted human breast silicone prostheses (Allan et al, 2013). Thereby silicone functions not only as dosing donor for the POPs but also as a reference partitioning phase, allowing linking in vivo and in vitro exposure.…”