Contaminated fish such as those from the Baltic Sea are an important source of exposure to polychlorinated dibenzofurans and dibenzodioxins in persons who eat fish regularly. However, the clinical consequences of such exposure remain uncertain.

Fatty fish species, e.g., salmon and herring, in the Baltic Sea have high levels of polychlorinated biphenyls (PCBs) and 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (p,p'-DDT), and its main metabolite: 1,1-dichloro-2,2-bis(p-chlorophenyl)-ethylene (p,p'-DDE). We determined levels of 10 different PCB congeners, including non- and mono-ortho-PCBs, as well as DDT and DDE, in human blood plasma from 37 subjects with varying intake of fish (0-1 750 g/wk) from the Baltic Sea. With respect to all of the PCB congeners we investigated, as well as for DDT and DDE, there were statistically significant associations with fish intake. Thus, fish from the Baltic Sea is a major source of exposure to these compounds in Swedes. Polychlorinated dibenzo-p-dioxins (PCDD) and dibenzofurans (PCDF) had been determined earlier in 29 of the subjects. The PCB contribution to "dioxin-like" effects among high consumers of fish (calculated as Nordic TCDD equivalents) was almost 80%, whereas that from PCDD and PCDF was only 20%.

Key terms: cancer incidence; dietary intake; fish consumption; fisherman; IHD; ischemic heart disease; mortality; multiple myeloma; n-3 polyunsaturated fatty acid; PCP; persistent organochlorine compound; polychlorinated biphenyl; polychlorinated dibenzo-p-dioxin; polychlorinated dibenzofuran; selenium; squamous-cell skin cancer; stomach neoplasms; Sweden Objectives The objective of this study was to determine mortality and cancer incidence in two cohorts of Swedish fishermen with different dietary intakes of persistent organochlorine compounds. Methods The following two cohorts of Swedish fishermen were established: a cohort of 2896 subjects from the Swedish east coast (on the Baltic Sea), and a cohort of 8477 subjects froin the Swedish west coast. Mortality and cancer incidence were studied in these cohorts and comparisons were made both with the regional populations and between the cohorts. Results The incidences of stomach and squamous cell skin cancers among the eastcoast fishermen were elevated as compared with those of the regional population [standardized incidence ratio (SIR) 1.6, 95% confidence interval (95% CI) 1.0-2.4 and SIR 2.3, 95% CI 1.5-3.5 respectively] and with the westcoast cohort (IRR 2.2, 95% CI 1.3-3.5 and IRR 1.9, 95% CI 1.2-3.1, respectively), while that of colon cancer was decreased. Moreover, mortality from multiple myelomas was increased among the eastcoast fishermen as compared with that of the general population [standardized mortality ratio (SMR) 3.1,95% CI 1.2-6.4) and the westcoast fishermen (IRR 3.2, 95% CI 1.2-8.7). A 12% decreased mortality in ischemic heart disease was found for the eastcoast cohort. A slight, but significant increase in such deaths was noted among the westcoast fishermen. C O~C~U S~O~S High consumers of fatty fish, contaminated with organochlorine compounds, had an increased risk for stomach and skin cancer. They also had a suggestive decrease in mortality from ischemic heart diseases.Key terms fish consumption, ischemic heart disease, multiple myeloma, n-3 polyunsaturated fatty acids, polychlorinated biphenyls, polychlorinated dibenzo p-dioxins and furans, selenium, squamous cell skin cancer, stomach neoplasms.

Higher air lead levels (time-weighted average 660, range 112-2238 micrograms/m3) were measured in firing ranges where powder charges were employed than in ranges where air guns were used (4.6, range 1.8-7.2 micrograms/m3); levels in the latter were in turn higher than those in ranges used for archery (0.11, range 0.10-0.13 micrograms/m3). Twenty-two marksmen who used powder charges had significantly increased blood lead levels during the indoor shooting season (before: median 106, range 32-176 micrograms/l; after: 138; range 69-288 micrograms/l; P = 0.0001), while 21 subjects who mainly used air guns displayed no significant increase (before: median 91, range 47-179 micrograms/l; after: 84; range 20-222 micrograms/l). Thirteen archers had significantly lower levels than the pistol shooters before the season (P = 0.006), and showed a significant decrease during the season (before: median 61, range 27-92 micrograms/l; after: 56; range 31-87 micrograms/l; P = 0.04). At the end of the indoor season, there was a significant association between weekly pistol shooting time and blood lead levels.

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