Digestive tract absorption of PCDD/Fs, PCBs, and HCB in humans: mass balances and mechanistic considerations

Gastrointestinal absorption of polychlorinated dibenzo-p-dioxins (PCDDs), dibenzofurans (PCDFs), biphenyls (PCBs) and hexachlorobenzene (HCB) from food was investigated in seven individuals aged 24 to 81 years with different contaminant body burdens using a mass balance approach. The difference between the ingested and excreted amounts of the chlorinated compounds was defined as net absorption. No analyzed compound was absorbed completely, and some were excreted to a greater extent than ingested, resulting in a net excretion. The absorption behavior was predominantly controlled by blood lipid levels: good correlations were obtained between the net absorption and the lipid-based concentrations in the blood for almost all of the persistent compounds studied. Expressed in international toxicity equivalents (I-TEq), the maximum absorption of PCDD/Fs among the volunteers was 63% and, for the three oldest volunteers, a net excretion of I-TEq was found. The high absorption levels of many compounds could not be explained on the basis of diffusive gradients estimated from the difference between the lipid-based food and blood concentrations; the diffusive gradient was consistently negative. Adding a factor to account for the reduction in the lipid content of the food during passage through the digestive tract did not resolve this problem. To explain this discrepancy, a "fat-flush" theory was postulated, which hypothesizes that the fat compartment of the absorbing tissue expands due to the uptake of dietary fat, resulting in a decrease of this compartment's lipid-based concentrations below the food's, hence facilitating absorption. The fat-flush hypothesis provides a theoretical basis for a two-step model of organic pollutant transfer in the gastrointestinal tract, with absorption and excretion as distinct processes occurring at different locations.