Reaching the sustainable development goals through healthy environments: are we on track?

The adoption of the 2030 Agenda for Sustainable Development in 2015 opened new opportunities to work towards healthy environments through 'whole of government' and 'whole of society' approaches. It created a strong policy platform that acknowledges health as a result and an enabler of sustainable policies across all sectors of government. Five years into the process, an initial analysis of emerging trends indicates that, despite some encouraging developments in policy as well as overall progress in economy and technology, there remains a gap between rhetoric, ambition and reality. In particular, the monitoring system for environment and health-related sustainable development goals (SDGs) and targets requires further development; inequalities in environment and health persist and in some areas have increased; equity is not yet a central element of implementation and reporting on the achievement of the SDGs; and, most worrying of all, trends in key environmental indicators that are vital to the survival of the human species, such as those related to climate change and biodiversity, are still on an overall negative path. In summary, governments must significantly and rapidly increase action to secure the habitability and safety of planet Earth. The public health community assumes an unprecedented role in placing and maintaining health and equity at the heart of the political agenda. This demands new governance models conferring on the health sector a clear mandate and legitimacy to operate across sectors. It also requires enhancing capacities among health professionals to embrace this new level of complexity, understand the multiple links between sectoral policies and health, and successfully engage with other government sectors and stakeholders.

Imidazole-induced contractility of vascular smooth muscle cells in the presence of U-73122, ODQ, indomethacin and 7-nitroindazole.

The aim of the study was to assess the impact of modulating factors on vascular smooth muscle cells reactivity. Vascular resistance was induced by the administration of increasing concentrations of imidazole. The experiments were performed on isolated and perfused tail artery of Wistar rats (weight 250 g - 350 g). Rats were been narcotized by urethane (intraperitoneal injection) at a dose of 120 mg/kg, stunned and then sacrificed by cervical dislocation. In the following investigation classical pharmacometric methods were used. Relationships between concentration-response curves (CRCs) for imidazole observed in the presence of ODQ [(1H-(1,2,4)oxadiazolo-[4,3-a]quinoxalin-1-one)], 7-nitroindazole and indomethacin were analyzed. Imidazole-induced contractility of vascular smooth muscle cells was independent from alpha-adrenergic receptors and PLC activity. Reactivity of VSMCsinduced by imidazole, was significantly changed in the presence of ODQ and 7-nitroindazole.

Mortality associated with exposure to carbon monoxide in WHO European Member States.

In closed environments, the concentration of carbon monoxide (CO) can easily rise to health-threatening levels. CO-related incidents are often caused by poor condition or inappropriate use of indoor combustion devices as well as structure fires but are also due to suicides. To evaluate the incidence of CO poisoning in Europe, national data on CO-related mortality and morbidity were compiled from Member States of the WHO European Region using a standardized data collection form. National data on CO poisoning were provided by 28 Member States. Within the maximum reporting period (1980-2008), a total of 140 490 CO-related deaths were reported (annual death rate of 2.2/100 000). The number of hospital admissions available from six countries was 31 473. Unintentional CO deaths accounted for 54.7% of the CO-related deaths (35.9%: unintentional inhalation; 18.8%: related to structure fires). The intentional deaths related to CO exposure account for 38.6% of all CO-related deaths (38.1%: suicides; 0.5%: homicides). CO exposure is preventable but causes a substantial amount of deaths in many European countries. More efficient measures and policies to prevent CO poisoning and better reporting of CO mortality are necessary.

[The main conclusions about the medical aspects of air pollution: the projects REVIHAAP and HRAPIE WHO/EC].

For the time present the World Health Organization (WHO) is coordinating two major international projects aimed to provide the European Union (EU) with science-based information on health aspects of air pollution for a comprehensive analysis of EU policy in the field of air quality, scheduled for 2013. The information provided is structured in the form of answers to 26 policy-forming key questions, defined by the European Commission (EC). The questions cover the both general aspects that are important for air quality management, and also specific topics related to the health effects of certain air pollutants. Texts of the answers to the questions were provided on requests of large group of invited experts from leading specialized institutions around the world. First stages of the overview of existing data have shown that in recent years there has been published a significant amount of information proving adverse health effects of suspended particulate matter (PM), ozone (O3) and nitrogen dioxide (NO2) in an amount, which typically occurs in the air in Europe. These new data confirm the findings reported in renewed in 2005 WHO Guidelines for Air Quality (GAQ), and show that the negative health effects in some cases may take place at concentrations of aeropollutants in the air below mentioned in the GAQ in 2005. In the review there are presented the scientific arguments in favor of adoption of strong measures to improvement air quality and reduction of the burden of diseases associated with air pollution in Europe. The conclusions formulated within a framework of these projects, are equally referred to all Member States and can become a basis for the development and implementation of effective strategies to reduce air pollution and reduction of its negative impact on the health of the population.

Quantitative analysis of DNA methylation after whole bisulfitome amplification of a minute amount of DNA from body fluids.

Cell-free circulating DNA isolated from the plasma of individuals with cancer has been shown to harbor cancer-associated changes in DNA methylation, and thus it represents an attractive target for biomarker discovery. However, the reliable detection of DNA methylation changes in body fluids has proven to be technically challenging. Here we describe a novel combination of methods that allows quantitative and sensitive detection of DNA methylation in minute amounts of DNA present in body fluids (quantitative Methylation Analysis of Minute DNA amounts after whole Bisulfitome Amplification, qMAMBA). This method involves genome-wide amplification of bisulphite-modified DNA template followed by quantitative methylation detection using pyrosequencing and allows analysis of multiple genes from a small amount of starting DNA. To validate our method we used qMAMBA assays for four genes and LINE1 repetitive sequences combined with plasma DNA samples as a model system. qMAMBA offered high efficacy in the analysis of methylation levels and patterns in plasma samples with extremely small amounts of DNA and low concentrations of methylated alleles. Therefore, qMAMBA will facilitate methylation studies aiming to discover epigenetic biomarkers, and should prove particularly valuable in profiling a large sample series of body fluids from molecular epidemiology studies as well as in tracking disease in early diagnostics.

Interaction of tiagabine with valproate in the mouse pentylenetetrazole-induced seizure model: an isobolographic analysis for non-parallel dose-response relationship curves.

PURPOSE: To characterize the interaction between tiagabine (TGB) and valproate (VPA)--two antiepileptic drugs in the mouse pentylenetetrazole (PTZ)-induced clonic seizure model, type I isobolographic analysis for non-parallel dose-response relationship curves (DRRCs) was used. MATERIAL AND METHODS: Clonic seizures were evoked in albino Swiss mice by subcutaneous injection of PTZ at its CD97 (100 mg/ kg). To ascertain the nature of interaction between TGB and VPA administered in combination, total brain concentrations of TGB and VPA were estimated by using high-performance liquid chromatography (HPLC) and fluorescence polarization immunoassay (FPIA). RESULTS: TGB and VPA produced clear-cut anticonvulsant effects against PTZ-induced clonic seizures in mice and their DRRCs were not parallel to one another. The type I isobolographic analysis for non-parallel DRRCs revealed that the combination of TGB with VPA at the fixed-ratio of 1:1 exerted additive interaction against PTZ-induced clonic seizures in mice. With FPIA, it was found that TGB did not affect total brain VPA concentrations in experimental animals. Moreover, VPA had no significant impact on total brain concentrations of TGB in mice, as measured with HPLC. CONCLUSION: The additive interaction between TGB and VPA at the fixed-ratio of 1:1 in the mouse PTZ model was pharmacodynamic in nature.

DNA repair polymorphisms and cancer risk in non-smokers in a cohort study.

Environmental carcinogens contained in air pollution, such as polycyclic aromatic hydrocarbons, aromatic amines or N-nitroso compounds, predominantly form DNA adducts but can also generate interstrand cross-links and reactive oxygen species. If unrepaired, such lesions increase the risk of somatic mutations and cancer. Our study investigated the relationships between 22 polymorphisms (and their haplotypes) in 16 DNA repair genes belonging to different repair pathways in 1094 controls and 567 cancer cases (bladder cancer, 131; lung cancer, 134; oral-pharyngeal cancer, 41; laryngeal cancer, 47; leukaemia, 179; death from emphysema and chronic obstructive pulmonary disease, 84). The design was a case-control study nested within a prospective investigation. Among the many comparisons, few polymorphisms were associated with the diseases at the univariate analysis: XRCC1-399 Gln/Gln variant homozygotes [odds ratios (OR) = 2.20, 95% confidence intervals (CI) = 1.16-4.17] and XRCC3-241 Met/Met homozygotes (OR = 0.51, 95% CI = 0.27-0.96) and leukaemia. The recessive model in the stepwise multivariate analysis revealed a possible protective effect of XRCC1-399Gln/Gln in lung cancer (OR = 0.22, 95% CI = 0.05-0.98), and confirmed an opposite effect (OR = 2.47, 95% CI = 1.02-6.02) in the leukaemia group. Our results also suggest that the XPD/ERCC1-GAT haplotype may modulate leukaemia (OR = 1.28, 95% CI = 1.02-1.61), bladder cancer (OR = 1.38, 95% CI = 1.06-1.79) and possibly other cancer risks. Further investigations of the combined effects of polymorphisms within these DNA repair genes, smoking and other risk factors may help to clarify the influence of genetic variation in the carcinogenic process.

Comparative immunologic and kinetic evaluation of AMP-deaminase isolated from normal human liver and hepatocellular carcinoma (HCC).

In the present paper physico-chemical properties of AMP-deaminase purified from human liver neoplasm-hepatocellular carcinoma (HCC) were investigated and compared with these obtained for the enzyme from normal, unaffected tissue.

Selenium concentrations in human renal cortex, liver, and hair in northern Poland.

The aim of this study was to (1) determine the selenium concentration in the renal cortex, liver, and hair in 64 residents from northern Poland (Gdansk region) aged 17-81 yr, who died suddenly, and (2) assess whether a correlation between the selenium concentration in hair and in the renal cortex and liver occurs. Selenium was determined by atomic absorption spectrometry using the hydride generation method. The mean selenium concentration in the renal cortex, liver, and hair in the investigated persons was 0.791+/-0.191 microg/g (wet weight), 0.289+/-0.084 microg/g (wet weight), and 0.443+/-0.128 microg/g, respectively. No age-dependent differences in selenium level in the investigated tissues was found. Also, no correlation between the selenium concentrations in hair and in renal cortex and liver was assessed.

Health impact assessment of air pollution: providing further evidence for public health action.

Many epidemiological studies have demonstrated the importance of air pollution as a risk factor and characterised dose-response relationships between health endpoints and pollutants. The association between particulate matter (PM) and health is generally regarded as causal, and a nonthreshold linear relationship with, for example, mortality and hospital admission has been observed in several settings. The ubiquitous PM air pollution is likely to have a large overall impact on human health, even if risks are relatively small. There have recently been a large number of papers reporting quantitative estimations of the health impact of PM on health, as measured by the proportion of excess events that are attributable to PM exposures in the general population, mainly in industrialised countries. For example, in the eight largest Italian cities it has been estimated that concentrations beyond 30 microg x m(-3) are responsible for about 3,500 extra deaths per year. A similar study has been carried out for France, Austria and Switzerland. These evaluations fill a knowledge gap between the laboratory and clinical studies on the pathophysiological mechanisms, the epidemiological research on the nature and strength of the association at the population level, and the risk management needs for developing appropriate preventive policies. Some limitations in the methodology deserve further research, however health impact assessment type studies are informative and effective tools of communication with the general public and policy makers.

The right to healthy indoor air: status by 2002.

One of the reasons for the inadequate quality of indoor air arises from the poor articulation, appreciation and understanding of basic principles underlying the policies and actions related to indoor air quality. A WHO Working Group derived nine statements on rights to healthy indoor air. The discussions and statements are available as a WHO report. It informs the individuals and groups responsible for healthy indoor air about their rights and obligations, and empowers the general public by making people familiar with those rights. One year after their publication the statements have been adopted as the base for future regulation and guidance. The Board of Directors of the International Society of Indoor Air Quality (ISIAQ) and the participants of two international conferences endorse the use of the statements. No opposition to the statements have been registered. The statements have entered curricula of training courses and have been used in lawsuits.

Regional distribution of glutamate in the central nervous system of rat terminated by carbon dioxide euthanasia.

Carbon dioxide euthanasia is an established method for the termination of small laboratory animals. It has also been employed by the authors in neurobiological research on the post-mortem glutamate concentration in the structures of rat brains. The following investigations were aimed at optimizing the termination procedure based on the CO2 saturation rate of the inhaled air. Two rates of CO2 flow were applied, and the higher one significantly augmented the glutamate level in the hippocampus and cerebellum. The relationship between this finding and signs of central fear reaction is discussed. The authors conclude that lower rather than higher CO2 flow in euthanasia procedures is gentler and is therefore preferable for use with laboratory animals.

The post-mortem concentration of glutamate in the structures of rat brain as an exponent of short aversive sensory stimulation preceding death.

The problem of post-mortem assessment of short central fear reaction preceding death has been obscure till now. The preliminary results obtained by authors have encouraged them to further research on this topic. Time of aversive sensory stimulation in the presented study was considerably decreased in comparison to the preliminary investigations. The concentration of glutamate was assayed in the selected structures of limbic system and in the cerebellum. The rats were subjected to different simultaneous modalities of sensory stimulation. The involvement of the hippocampi and the cerebellum was revealed as measured by glutamate concentration increase in the whole structures homogenates. The dominant role of mechanical stimulus has been suggested based on the measured increase of glutamate concentration in the whole cerebellum homogenate. By using the presented experimental paradigm a possible application of the biochemical assessment of human brain tissue might be developed in the future for implementing in the field of forensic pathology. The biochemical evaluation of "frozen frames" of neurotransmission can possibly help reconstruct the events which had happened just before sudden and violent death.

The usefulness of CBF brain SPECT in forensic medicine. A description of four cases.

BACKGROUND: The aim of this study was to show the applications of cerebral blood flow SPECT scanning in forensic medicine using four cases: two suspects and two victims of crime. MATERIAL AND METHODS: Cerebral blood flow studies were performed with the use of (99m)Tc-ECD and a triple head gammacamera. Qualitative and quantitative analysis was performed, utilising an asymmetry index for unilateral perfusion deficits and a comparison to cerebellar perfusion for assessing the regional cerebral perfusion. For assessing the normal values, a control group of 30 patients was studied. RESULTS: In these cases CBF SPECT scanning proved its usefulness in medico-legal argument and played an important role in formulating the final forensic expert's opinion. CONCLUSIONS: Radionuclide cerebral blood flow studies may play a role in forensic medicine, where this method it is mostly under-utilised at present.

Haemorrhages in head tissues during the asphyxiation process.

Two rates of carbon dioxide flow into the termination chamber were applied for the euthanasia of rats. The classical phases of asphyxia were observed in both groups of animals although their course was prolonged in rats exposed to the lower gas flow. The haemorrhages were assessed histologically in the following structures: the pericranium, compact bone and diploë of the skull, sagittal suture, nape muscle and its attachment, and the dura. The haemorrhages appeared regularly in the sagittal suture in all cases from both experimental groups. The possible significance of this phenomenon for the forensic practice was pointed out.

Total mercury in human renal cortex, liver, cerebellum and hair.

The aim of this study was: (a) to estimate the concentration of total mercury in the renal cortex, liver, cerebellum and hair of 46 persons who died suddenly in the Gdansk region, northern Poland, between the ages of 17 and 90; and (b) to assess whether a correlation occurs between mercury content in the investigated biological media. The mean concentrations of mercury in the human hair, renal cortex, liver and cerebellum were: 378 +/- 315.4 ng/g; 68.6 +/- 92.3 ng/g; 29.9 +/- 22 ng/g and 5.3 +/- 6.9 ng/g respectively. Positive correlations were found between mercury levels in: cerebellum and liver (r = 0.873), cerebellum and hair (r = 0.853), cerebellum and renal cortex (r = 0.578), hair and liver (r = 0.771), hair and renal cortex (r = 0.478) liver and renal cortex (r = 0.66). The geometric mean levels of mercury in the renal cortex, liver, cerebellum and hair in the residents of the Gdansk region are 15-19 times lower than in the population of Tokyo and its environs [Suzuki T, Hongo T, Yoshinaga J et al. The hair-organ relationship in mercury concentration in contemporary Japanese. Arch Environ Health 1993;44:361-365].

Measurements of the Obersteiner-Redlich zone of the vagus nerve and their possible clinical applications.

The aim of our study was to describe anatomical variability of the root entry zone (REZ), also called the Obersteiner-Redlich zone, that represents the "junction zone" of glia and Schwann sheath of the cranial nerves. This zone has some clinical implications. The pulsatile compression of REZ by a vessel may produce clinical symptoms, such us trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia torticollis spasmodicus or even symptoms of essential hypertension when a vascular cross compression of REZ of a left vagus nerve is present. The vessel--cranial nerve contact in the skull base cysterns may be visualized in radiologic examinations, most accurately in magnetic resonance imaging. Because, we cannot distinguish the REZ from the rest of the vagus nerve in radiologic examinations we decided to measure the length of its REZ. The microanatomical study of the length of REZ zone of the vagus nerve was performed on 21 nerves taken from 17 human brain stems (12 men, 5 women, 14 left, 7 right), fixed with 8% buffered formalin solution. Paraffin embedded tissue was cut into 10-micron-thick sections parallel to the nerve longitudinal axis and stained with hematoxilin & eosin. Each of the nerves showed the presence of a zone of oligodendrocyte myelination, mean length 2 +/- 0.3 mm. In 17 nerves the transitional zone formed a cone-like process, in 4 nerves was shaped irregularly. The length of REZ (oligodendrocyte myelination plus "glial dome") had the mean length 3.5 +/- 0.9 mm.

The concentration of glutamate in cerebral tissue as a factor for the assessment of the emotional state before death. A preliminary report.

In this paper the concentration of glutamate in the hemispheres of the brain, the cerebellum and the brain stems of rats exposed to sensory stimulation before death and of control rats are presented. Statistically significant differences in the concentration of this neurotransmitter were found in the hemispheres of the brain in the cases of stress lasting 10 min and 1 min and in the cerebellum after a stress of 10 min. This suggests that it may be possible to diagnose the post-mortem state of emotional tension related to sensoric aversive input which takes place directly before death.