| Associations of Serum Concentrations of Persistent Organic Pollutants with the Prevalence of Periodontal Disease and Subpopulations of White Blood Cells Duk-Hee Lee,1,2 David R. Jacobs Jr.,2,3 and Thomas Kocher4 1Department of Preventive Medicine and Health Promotion Research Center, School of Medicine, Kyungpook National University, Daegu, Korea; 2Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA; 3Department of Nutrition, University of Oslo, Oslo, Norway; 4Unit of Periodontology, School of Dentistry, Ernst Moritz Arndt University Greifswald, Greifswald, Germany Abstract
Background: Persistent organic pollutants (POPs) , which are endocrine disruptors that accumulate in adipose tissue, can increase the risk of periodontal disease through the disturbance of the immune system. Objective: We examined associations of background exposure to POPs with periodontal disease in the general population. Design: Cross-sectional associations of concentrations of serum POPs with the prevalence of periodontal disease were investigated in 1,234 adults ≥ 20 years of age in the National Health and Nutrition Examination Survey 1999–2002. Results: Among several POPs, organochlorine (OC) pesticides were most strongly associated with periodontal disease. Adjusted odds ratios across quintiles of OC pesticides were 1.0, 1.3, 1.7, 2.4, and 2.7 (p for trend < 0.01) for the presence in any site of clinical attachment loss ≥ 4 mm and 1.0, 1.7, 2.6, 3.4, and 3.7 (p for trend < 0.01) for the presence of pocket depth ≥ 4 mm. Polychlorinated biphenyls and polychlorinated dibenzo-p-dioxins also showed significant positive associations with one or both definitions of periodontal disease. Results did not materially change when continuous variables of clinical attachment loss or pocket depth were used as outcomes. Although participants with periodontal disease had higher white blood cell and neutrophil counts, neutrophil counts were inversely related to OC pesticides (p for trend < 0.01) . These inverse associations did not change after excluding subjects with C-reactive protein ≥ 3 mg/L. Conclusion: POPs, especially OC pesticides, were positively associated with periodontal disease, possibly through immunomodulation due to OC pesticides. Key words: immune system, neutrophil, organochlorine pesticides, periodontitis, persistent organic pollutants. Environ Health Perspect 116:1558–1562 (2008) . doi:10.1289/ehp.11425 available via http://dx.doi.org/ [Online 3 July 2008]
Address correspondence to D-H. Lee, Department of Preventive Medicine, School of Medicine, Kyungpook University, 101 Dongin-dong, Jung-gu, Daegu, Korea 700-422. Telephone: 82 53 420 6960. Fax: 82 53 425 2447. E-mail: lee_dh@knu.ac.kr This study was supported in part by the Korea Research Foundation Grant funded by the Korean Government (MOEHRD ; KRF-2007-531-E00024) . The authors declare they have no competing financial interests. Received 27 February 2008 ; accepted 3 July 2008.
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