1. ENVIRONMENTAL LONG-TERM PCB EXPOSURE OF CHILDREN IN SLOVAKIA Eva Sovcikova, T.Trnovec, A.Kocan, J.Petrik, B.Drobna, L.Wsolova of the 5 th FP Project Evaluating Human Health Risk from Low-dose and Long-term PCB Exposure (PCBRISK) THE FUTURE FOR OUR CHILDREN Central and Eastern European Chapter Meeting of the International Society of Environmental Epidemiology 4-6 September, Balatonföldvár 2003

3. Steps of investigation

4. Michalovce Košice Bratislava Svidnik&Stropkov Hungary Austria Czech RepublicPoland The Ukraine MAP OF SLOVAK REPUBLIC Legend: MICHALOVCE district - polluted area SVIDNIK&STROPKOV district - non-polluted area

5. The neurobehavioral examination Computer version of tests * Simple Reaction Time: self-colored 77 stimuli were applied on display, (cca 5 min training, evaluation: measure of reactions (ms). * Viena Color Determination test: 2 minutes were applied rectangles (1x2 cm) in 6 colors (red, green, blue, yellow, black, white), training, evaluation of correct responses. * Tapping (1 min knocking by preferred hand finger on the computer mouse and 1 min by non preferred hand finger), training, evaluation of taps number by each hand. * Benton Recognition test (10 geometrical pictures were applied on display individually and after 10 sec, similar 4 pictures were applied), without training. Evaluation of correct pictures, number recognition.

6. Non-computer version of tests * Digit Span (WISC - short hearing memory): repeating of randomly read numbers (from 2- 9, forward and backward). Evaluation: the last correct repeated number. * Symbols (WISC – attention, motor and memory processes): completing of correct symbols of randomly ordered numbers after instruction. Evaluation: the number of correct completed symbols, time 90 sec. * Cubes (WISC – hand coordination, attention, memory and solution proccess). Evaluation: speed of correct performance after instruction, each of 10 pictures is evaluated from 45-150 sec. * Raven Color Nonverbal Intelligence test (solution of mental tasks): The solution of 36 pictures in sequence (max time 45 min). Evaluation: number of correct performances. Questionnaire for the filling by parents at home and Scale of child behavior at home. Raven Intelligence test (adult form) for mothers. The solution of 60 pictures (max time 45 min). Evaluation: number of correct performances. Teachers filled the Scale of Behavior at school for each child.

7. Table 1 Collected samples and other examinations from exposed area (Michalovce district) and from non-exposed area (Svidnik & Stropkov district).

8. RESULTS OF NEUROBEHAVIORAL EXAMINATION - Levels of PCBs (with, with ½, and without LOD [ng/g lipi]) were not normal distributed (Fig 1). In continuation of analysis we used only levels of PCBs without LOD [ng/g lipi]. Collected samples and other examinations are in Tab 1. - Descriptive analysis of PCBs in blood of children from both exposed and non- exposed area, distribution by genders are in Tab 2. Minimum of PCBs: 17.6 [ng/g lipi], Maximum of PCBs: 6476.4 [ng/g lipi]. - Children were distributed by Median of sum PCBs: Significantly higher number of children was with sum of PCBs < Me of all children in non-exposed area. Higher number of children with sum of PCBs > Me of all children was in exposed area (Fig 2). Significant difference was in sum between genders. Significantly higher levels of PCBs were in boys. - Significant relations of PCBs levels in children and time of breast feeding (in weeks) were found (Fig 3). - Significant relations between time of mothers´ living in the same area before child was born (in years) (Fig 4A) and significant relations between years when mother worked in chemical production and PCBs level in children were found (Fig 4B).

9. - - Evaluation of PCB congeners (153, 138+163, 180) between genders are in Tab 3. - Spearman Rank Correlation coefficients of measured PCB congeners, performance in behavioral tests and anthropometric parameters showed:  Significantly lower performance in sensomotor (SRT, VDT) and in memory tests (DS, BNT) in children with higher level of measured PCB congeners were found. Levels of PCB congeners distributed by quartiles showed significant tendency of higher levels of congeners and lower performance in tests.  The equivalent relations of PCB congeners and performance were in boys and girls, in boys these differences were stronger. Anthropometric parameters and PCB congeners showed negative significant relations too (Tab 4, Fig 5, 6, 7, 8).

10. Fig 1 Frequencies of sum PCBs in all children. Children with sum of PCB< Me (320.9)) Children with sum of PCB> Me (320.9) Fig 2 Distribution of children by Median of sum PCBs.

11. Table 2 Descriptive analysis of PCBs in blood in all children and distributed by gender.

12. א 2 =38.16 p <0.001 א 2 = 24.63 p <0.001 Expon.grup Control grup Sum of PCBs without LODs [ng/g l] Time of breast feeding (weeks) Fig 3 Relation of PCBs levels in children and time of breast feeding (weeks).

13. Sum of PCBs without LODs [ng/g l] Kruskal-Wallis test א 2 = 7.70 p= 0.0525 Sum PCB without LODs [ng/g] (median) Wilcoxonov test W = 3849 p= 0.0476 1 non-work in chemical production (years) 2 work in chemical production (years) Mothers live in the same area (years) Fig 4 Relations of mothers living in the same area (years) with PCBs levels (A). Work time of mothers in chemical production with PCBs (B). A B

14. Tab 3 The PCBs congeners without LOD [ng/g lipi] in children distributed by gender.

15. EVALUATION OF PSYCHOLOGICAL EXAMINATION AND ANTROPOMETRIC PARAMETERS IN RELATION WITH PCBs CONGENERS Table 4 Spearman Correlation coefficients of congeners 153,138,180 and performance in neurobehavioral tests and antrophometric parameters in all children.

16. Fig 5 Performance in Simple Reaction Time test and PCB congeners in blood distributed by quartiles in all children.

17. Fig 6 Performance in Viena Discrimination sensomotor test and PCB congeners in blood distributed by quartiles in all children.

18. Fig 7 Performance in Digit Span memory test (backward) and PCB congeners in blood distributed by quartiles in all children.

19. Fig 8 Performance in Benton memory test and PCB congeners in blood distributed by quartiles in all children.

20. CONCLUSION Statistical evaluation of PCBs level showed significant differences between children from area environmentally polluted by PCBs and children from non-exposed area. Important factors influenced level of PCBs in children were: time of breast feeding, living of mothers in the same area when child was born, and time of mothers ´work in chemical production. Neurobehavioral parameters and levels of PCBs sum and congeners showed significantly longer reaction times, lower short memory performance and lower eye-hand coordination. In the exposed area the anthropometric parameters of children were lower. Quality of neurobehavioral performances and anthropometric parameters in relation with level of PCBs and other measured parameters between children will show the new relations in multifactor analysis.

21. TASKS PERFORMED BY COMPUTER

22. SAMPLING, THYROID GLAND AND DENTAL EXAMINATION AND ANTHROPOMETRIC MEASURE

23. HEARING: AUDIOMERTRY, BERA test, OTOLARYNGOLOGY examination