Insights into uncovered public health risks. The case of asthma attacks among archival workers: a cross-sectional study.

Objective: To ascertain the prevalence of asthma attacks among archivists and identify the associated occupational factors in this understudied professional population. Methods: We conducted a cross-sectional, questionnaire-based study among 1,002 archival workers. A multiple logistic regression was conducted to identify the association between asthma attacks and occupational exposures. The Strobe Protocol was applied. Results: 999 workers were included in the final analysis with the asthma prevalence of 33.3%. Main factors associated with asthma attacks (OR [95% CI]) were the presence of chemically irritating odors (2.152 [1.532-3.024]), mold odors (1.747 [1.148-2.658]), and insects (1.409[1.041-1.907]). A significant synergistic effect was observed between chemical irritants and mold, the odds ratio was 7.098 (95% CI, 4.752-10.603). Conclusion: There was a high prevalence of asthma attacks among archival workers, an under-studied population. Chemical irritants, molds and insects were associated with their asthma attacks. Notably, this study's data analysis has revealed a strong synergy (OR = 7.098) between chemical odors and molds in the workplace. While the existing international literature on this specific interaction remains somewhat limited, previous studies have already demonstrated the potential for chemical irritants, such as sulfur dioxide and ozone, to synergistically interact with inhalable allergens, including fungi, molds and dust mites. Consequently, this interaction seems to exacerbate asthma symptoms and perpetuate untreated exposure. Furthermore, in damp and damaged buildings, the presence of microbial components, such as cellular debris or spores released during fungal growth can trigger an inflammatory response, potentially served as a shared pathway for the development of asthma among individuals exposed to these hazardous factors.

Formaldehyde and the transient receptor potential ankyrin-1 contribute to electronic cigarette aerosol-induced endothelial dysfunction in mice.

Electronic nicotine delivery systems (ENDS) aerosol exposures can induce endothelial dysfunction (ED) in healthy young humans and animals. Thermal degradation of ENDS solvents, propylene glycol, and vegetable glycerin (PG: VG), generates abundant formaldehyde (FA) and other carbonyls. Because FA can activate the transient receptor potential ankyrin-1 (TRPA1) sensor, we hypothesized that FA in ENDS aerosols provokes TRPA1-mediated changes that include ED and "respiratory braking"-biomarkers of harm. To test this, wild-type (WT) and TRPA1-null mice were exposed by inhalation to either filtered air, PG: VG-derived aerosol, or FA (5 ppm). Short-term exposures to PG: VG and FA-induced ED in female WT but not in female TRPA1-null mice. Moreover, acute exposures to PG: VG and FA stimulated respiratory braking in WT but not in TRPA1-null female mice. Urinary metabolites of FA (ie, N-1,3-thiazolidine-4-carboxylic acid, TCA; N-1,3-thiazolidine-4-carbonyl glycine, TCG) and monoamines were measured by LC-MS/MS. PG: VG and FA exposures significantly increased urinary excretion of both TCA and TCG in both WT and TRPA1-null mice. To confirm that inhaled FA directly contributed to urinary TCA, mice were exposed to isotopic 13C-FA gas (1 ppm, 6 h). 13C-FA exposure significantly increased the urine level of 13C-TCA in the early collection (0 to 3 h) supporting a direct relationship between inhaled FA and TCA. Collectively, these data suggest that ENDS use may increase CVD risk dependent on FA, TRPA1, and catecholamines, yet independently of either nicotine or flavorants. This study supports that levels of FA in ENDS-derived aerosols should be lowered to mitigate CVD risk in people who use ENDS.

Identifying vagal bronchopulmonary afferents mediating cough response to inhaled sulfur dioxide in mice.

Sulfur dioxide (SO2), a common environmental and industrial air pollutant, possesses a potent effect in eliciting cough reflex, but the primary type of airway sensory receptors involved in its tussive action has not been clearly identified. This study was carried out to determine the relative roles of three major types of vagal bronchopulmonary afferents [slowly adapting receptors (SARs), rapidly adapting receptors (RARs), and C-fibers] in regulating the cough response to inhaled SO2. Our results showed that inhalation of SO2 (300 or 600 ppm for 8 min) evoked an abrupt and intense stimulatory effect on bronchopulmonary C-fibers, which continued for the entire duration of inhalation challenge and returned toward the baseline in 1-2 min after resuming room air-breathing in anesthetized and mechanically ventilated mice. In stark contrast, the same SO2 inhalation challenge generated a distinct and consistent inhibitory effect on both SARs and phasic RARs; their phasic discharges synchronized with respiratory cycles during the baseline (breathing room air) began to decline progressively within 1-3 min after the onset of SO2 inhalation, ceased completely before termination of the 8-min inhalation challenge, and then slowly returned toward the baseline after >40 min. In a parallel study in awake mice, inhalation of SO2 at the same concentration and duration as that in the nerve recording experiments evoked cough responses in a pattern and time course similar to that observed in the C-fiber responses. Based on these results, we concluded that stimulation of vagal bronchopulmonary C-fibers is primarily responsible for triggering the cough response to inhaled SO2.NEW & NOTEWORTHY This study demonstrated that inhalation of a high concentration of sulfur dioxide, an irritant gas and common air pollutant, completely and reversibly inhibited the neural activities of both slowly adapting receptor and rapidly adapting receptor, two major types of mechanoreceptors in the lungs with their activities conducted by myelinated fibers. Furthermore, the results of this study suggested that stimulation of vagal bronchopulmonary C-fibers is primarily responsible for triggering the cough reflex responses to inhaled sulfur dioxide.

Establishing short-term occupational exposure limits (STELs) for sensory irritants using predictive and in silico respiratory rate depression (RD50) models.

Sensory irritation is a health endpoint that serves as the critical effect basis for many occupational exposure limits (OELs). Schaper 1993 described a significant relationship with high correlation between the measured exposure concentration producing a 50% respiratory rate decrease (RD50) in a standard rodent assay and the American Conference of Governmental Industrial Hygienists (ACGIH®) Threshold Limit Values (TLVs®) as time-weighted averages (TWAs) for airborne chemical irritants. The results demonstrated the potential use of the RD50 values for deriving full-shift TWA OELs protective of irritant responses. However, there remains a need to develop a similar predictive model for deriving workplace short-term exposure limits (STELs) for sensory irritants. The aim of our study was to establish a model capable of correlating the relationship between RD50 values and published STELs to prospectively derive short-term exposure OELs for sensory irritants. A National Toxicology Program (NTP) database that included chemicals with both an RD50 and established STELs was used to fit several linear regression models. A strong correlation between RD50s and STELs was identified, with a predictive equation of ln (STEL) (ppm) = 0.86 * ln (RD50) (ppm) - 2.42 and an R2 value of 0.75. This model supports the use of RD50s to derive STELs for chemicals without existing exposure recommendations. Further, for data-poor sensory irritants, predicted RD50 values from in silico quantitative structure activity relationship (QSAR) models can be used to derive STELs. Hence, in silico methods and statistical modeling can present a path forward for establishing reliable OELs and improving worker safety and health.

Household Use of Green Cleaning Products, Disinfecting Wipes, and Asthma Control Among Adults.

BACKGROUND: The use of household disinfectants and cleaning products (HDCPs) may negatively impact asthma control, but studies remain scarce. Moreover, no study considered green products or wipes, increasingly used during home cleaning. OBJECTIVE: To assess the associations between the use of HDCPs, including disinfecting wipes and green products, and asthma control based on data from the French Web-based NutriNet-Santé cohort. METHODS: Using a standardized questionnaire (2018), we assessed asthma control (never asthma: reference; controlled: Asthma Control Test ≥ 20; uncontrolled: Asthma Control Test < 20) and the use of HDCPs, including 2 types of products (irritants and green products) and 2 application modes (sprays and disinfecting wipes). Cross-sectional associations of the frequency of weekly use of HDCPs at home with asthma control, adjusted for sex, age, smoking status, body mass index, and educational level were assessed by multinomial logistic regressions. RESULTS: Analyses were performed on 37,043 adults (mean age 47 y; 75% women; 62% with a weekly use of at least 1 HDCP). Strong associations were observed between weekly use of HDCPs and uncontrolled asthma. In particular, an almost daily use (4-7 d/wk) of irritants (odds ratio [OR] 2.81; 95% confidence interval [95% CI] 1.97-4.00) and green products (OR 2.40; 95% CI 1.70-3.39) as well as sprays (OR 2.69; 95% CI 1.97-3.68) and disinfecting wipes (OR 3.51; 95% CI 2.31-5.33) was associated with uncontrolled asthma. When not co-used with irritants and sprays, associations remained statistically significant for both disinfecting wipes and green products. CONCLUSIONS: Weekly use of HDCPs, including green products or wipes, was associated with uncontrolled asthma and should be considered by health practitioners in order to improve asthma control.

Perceptions of skincare ingredients and product labels in pediatric eczema care.

Educating pediatric eczema patients and caregivers on appropriate product selection and avoidance of common irritants or allergens is a crucial aspect of eczema management. This study surveyed 80 pediatric caregivers in an academic pediatric dermatology clinic to assess influential factors in caregivers' selection of pediatric eczema-care products and identify ways to improve patient counseling on appropriate product selection and avoidance of common irritants or allergens. Caregivers frequently reported positive perceptions of commonly recommended ingredients for eczema but had inconsistent perceptions of fragrant plant oils and extracts, regardless of previous counseling on fragrance avoidance. These findings demonstrate uncertainty and misperceptions perpetuated by product labeling and a need for improved counseling strategies for avoiding fragrance and excessive product costs.

Effects of aluminium chloride added to common patch test substances.

BACKGROUND: A modulating effect of aluminium regarding type IV reactions might exist but has not been further investigated. OBJECTIVES: The aim of this study was to investigate the effect on patch test reactions when adding aluminium chloride hexahydrate (Al-Cl) to common test preparations. MATERIALS AND METHODS: Al-Cl in different concentrations was added to nickel sulphate 15.0% aqua (Ni), methylisothiazolinone 0.2% aqua (MI) and fragrance mix I 10.0% aqua/ethanol (FM I). The Ni preparations were tested in 120 consecutive patients. MI and FM I were tested in participants known to have contact allergy to the respective allergen. McNemar's test was used to decide which Ni preparation had the highest sensitivity. Wilcoxon signed-rank test was used to calculate pairwise comparison in summarized test score for the preparations with MI and FM I. RESULTS: Adding Al-Cl 20.0%/30.0% to Ni identified twice as many patients with contact allergy to nickel compared to Ni without Al-Cl. Adding Al-Cl 20.0%/10.0% to MI, decreased the patch test reactivity compared to MI without Al-Cl. No differences in patch reactivity were noticed when adding Al-Cl to FM I. CONCLUSION: Al-Cl 20.0% or 30.0% seems to enhance the patch test reactivity to Ni 15.0% aqua.

Effect of Piperine on Saltiness Perception.

Chemical irritants, like piperine, have the potential to increase human perception of tastes and odours, including saltiness. This cross-modal interaction could help the food industry develop new salt-reduced food products that maintain their salty taste. The objective of this study was: firstly, to determine the detection threshold of piperine (n = 72), secondly to evaluate piperine's influence on saltiness perception in model solutions (n = 78), and lastly to identify piperine's effect on sensory perception of low sodium soup using temporal check-all-that-apply (TCATA; n = 75). The group mean of the individual threshold was 0.55 ± 0.15 ppm. Piperine increased the saltiness perception of the model solutions, but it also increased the bitterness and decreased the sweetness of the solutions. The piperine significantly increased the saltiness intensity of the soups (evaluated using a generalized labelled magnitude), but during the TCATA task, the salty attribute was selected less for the soup with piperine than the control (based on the average proportion of selection). The TCATA indicated that the peppery attribute dominated the participants' perception of the soup with piperine. More studies are needed to assess piperine's cross-modal interactions.

Effects of dietary irritants on intestinal homeostasis and the intervention strategies.

Abundant diet components are unexplored as vital factors in intestinal homeostasis. Dietary irritants stimulate the nervous system and provoke somatosensory responses, further inducing diarrhea, gut microbiota disorder, intestinal barrier damage or even severe gastrointestinal disease. We depicted the effects of food with piquancy, high fat, low pH, high-refined carbohydrates, and indigestible texture. The mechanism of dietary irritants on intestinal homeostasis were comprehensively summarized. Somatosensory responses to dietary irritants are palpable and have specific chemical and neural mechanisms. In contrast, even low-dose exposure to dietary irritants can involve multiple intestinal barriers. Their mechanisms in intestinal homeostasis are often overlapping and dose-dependent. Therefore, treating symptoms caused by dietary irritants requires personalized nutritional advice. The reprocessing of stimulant foods, additional supplementation with probiotics or prebiotics, and enhancement of the intestinal barrier are effective intervention strategies. This review provides promising preliminary guidelines for the treatment of symptoms and gastrointestinal injury caused by dietary irritants.

Irritant-evoked reflex tachyarrhythmia in spontaneously hypertensive rats is reduced by inhalation of TRPM8 agonists l-menthol and WS-12.

Inhalation of noxious irritants activates nociceptive sensory afferent nerves innervating the airways, inducing reflex regulation of autonomic networks and the modulation of respiratory drive and cardiovascular (CV) parameters such as heart rate and blood pressure. In healthy mammals, irritant-evoked pulmonary-cardiac reflexes cause parasympathetic-mediated bradycardia. However, in spontaneously hypertensive (SH) rats, irritant inhalation also increases sympathetic drive to the heart. This remodeled pulmonary-cardiac reflex may contribute to cardiovascular risk caused by inhalation of air pollutants/irritants in susceptible individuals with cardiovascular disease (CVD). Previous studies have shown that the cooling mimic l-menthol, an agonist for the cold-sensitive transient receptor potential melastatin 8 (TRPM8), can alleviate nasal inflammatory symptoms and respiratory reflexes evoked by irritants. Here, we investigated the impact of inhalation of TRPM8 agonists l-menthol and WS-12 on pulmonary-cardiac reflexes evoked by inhalation of the irritant allyl isothiocyanate (AITC) using radiotelemetry. l-Menthol, but not its inactive analog d-menthol, significantly reduced the AITC-evoked reflex tachycardia and premature ventricular contractions (PVCs) in SH rats but had no effect on the AITC-evoked bradycardia in either SH or normotensive Wistar-Kyoto (WKY) rats. WS-12 reduced AITC-evoked tachycardia and PVCs in SH rats, but this more potent TRPM8 agonist also reduced AITC-evoked bradycardia. l-Menthol had no effect on heart rate when given alone, whereas WS-12 evoked a minor bradycardia in WKY rats. We conclude that stimulation of TRPM8-expressing afferents within the airways reduces irritant-evoked pulmonary-cardiac reflexes, especially the aberrant reflex tachyarrhythmia in SH rats. Airway menthol treatment may be an effective therapy for reducing pollution-associated CV exacerbations.NEW & NOTEWORTHY Irritant-evoked pulmonary-cardiac reflexes are remodeled in spontaneously hypertensive (SH) rats-causing de novo sympathetic reflexes that drive tachyarrhythmia. This remodeling may contribute to air pollution-associated risk in susceptible individuals with cardiovascular disease. We found that inhalation of TRPM8 agonists, l-menthol and WS-12, but not the inactive analog d-menthol, selectively reduces the reflex tachyarrhythmia evoked by allyl isothiocyanate (AITC) inhalation in SH rats. Use of menthol may protect susceptible individuals from pollution-associated CV exacerbations.

Engineered Stone Fabrication Work Releases Volatile Organic Compounds Classified as Lung Irritants.

Engineered stones are often characterized for their crystalline silica content. Their organic composition, particularly that of the emissions generated during fabrication work using hand-held power tools, is relatively unexplored. We forensically screened the emissions from dry-cutting 12 engineered stone products in a test chamber for their organic composition by pyrolysis-gas chromatography-mass spectrometry (GC-MS) plus selected traditional capture and analysis techniques. Phthalic anhydride, which has a Respiratory Sensitization (RSEN) Notation by the American Conference of Governmental Industrial Hygienists (ACGIH), was the most common and abundant compound, at 26-85% of the total organic composition of engineered stone emissions. Benzaldehyde and styrene were also present in all twelve samples. During active cutting, the predominant volatile organic compound (VOC) emitted was styrene, with phthalic anhydride, benzene, ethylbenzene, and toluene also detected. These results have important health implications as styrene and phthalic anhydride are irritants to the respiratory tract. This study suggests a risk of concurrent exposure to high levels of respirable crystalline silica and organic lung irritants during engineered stone fabrication work.

The management of an oral pyogenic granuloma around osseointegrated dental implants.

INTRODUCTION: Oral pyogenic granulomas (PGs) presenting in association with dental implants are uncommon occurrences. While tooth-associated PGs are well-documented in the literature, there are only seven case reports with biopsy-confirmed diagnoses of PG related to dental implants. This case report details the treatment of an intraoral PG related to dental implants that had been osseointegrated and asymptomatic for 10 years. CASE PRESENTATION: A 39-year-old female presented with a hyperplastic erythematous mass that encompassed the dental implants in the position of the maxillary central incisors. Surgical exploration of the site revealed nonintegrated, particulate bone material distributed throughout the peri-implant tissues approximating the granuloma. Treatment involved surgical excision of the lesion, elimination of all nonintegrated bone material, and implant surface debridement. Laser therapy was later used to manage a recurrence. Histology of the biopsied tissue confirmed the diagnosis of PG and described the presence of multiple exogenous, refractile, particulate materials in the specimen. CONCLUSION: The combination of surgical excision, implant debridement, and conservative laser therapy resulted in the elimination of a dental implant-related PG and successful soft tissue management. The localized presence of nonintegrated particulate bone material surrounding the granuloma appears to have functioned as a chronic irritant to the peri-implant soft tissues over time and is likely, along with oral bacteria, the primary etiological agents. KEY POINTS: Why is this case new information? There is a paucity of reports describing the management of dental implant-related pyogenic granulomas especially in the esthetic region. The present case demonstrates that particulate bone materials used in guided bone regeneration have the capacity to behave as a low-grade irritant to the gingival tissues. It also demonstrates the successful elimination of the tissues and management of the peri-implant soft tissues for an esthetic result. What are the keys to successful management of this case? The key to successful management of this case was adequate removal of the exogenous irritant, proper implant surface debridement, and decontamination and adequate gingivoplasty to remove all residual hyperplastic granulomatous tissues. Additionally, patient education and appropriate oral hygiene instructions were important to proper healing and maintenance of the area. What are the primary limitations to success in this case? The ambiguity of the clinical boundaries of PGs makes it challenging to guarantee complete excision beyond the base of the lesion, leading to recurrence.

Occupational Exposures to Irritants and Sensitizers, Asthma and Asthma Control in the Nutrinet-Santé Cohort.

BACKGROUND: The role of chronic occupational exposures to irritants in asthma remains not well-defined. Few studies have examined their associations with asthma and its control. OBJECTIVE: To study the associations of occupational exposures with asthma and its control, with specific interest for irritants, including disinfectants and cleaning products (DCPs) and solvents. METHODS: Analyses included 4,469 adults (3,792 with neither asthma nor respiratory symptoms, 677 with current asthma; 75.9% women, mean age 54 years) of a case-control study (2018) from the French NutriNet-Santé cohort. Current asthma was defined by ever asthma with symptoms, medication or asthma attacks in the past 12 months, adult-onset asthma by age at first asthma attack older than 16 years, and uncontrolled asthma was defined by an Asthma Control Test score less than 20. Ever/current exposures were assessed with the Occupational Asthma-specific Job Exposure Matrix. Associations were evaluated by multinomial logistic regressions adjusted for sex, age, smoking status, and body mass index. RESULTS: Ever exposures to sensitizers (high molecular weight [HMW]: OR 1.53, 95% CI 1.18-2.00; and low molecular weight [LMW]: OR 1.42; 95% CI 1.09-1.87), irritants (OR 1.32; 95% CI 1.03-1.68), and DCPs (OR 1.43; 95% CI 1.10-1.85) were associated with current adult-onset asthma. Significant associations between ever exposures and uncontrolled adult-onset asthma were observed for high molecular weight (OR 2.69; 95% CI 1.52-4.78) and low molecular weight (OR 2.27; 95% CI 1.24-4.37) sensitizers, irritants (OR 2.32; 95% CI 1.36-3.95), and DCPs (OR 2.59; 95% CI 1.48-4.54). Results were similar for current exposures, with higher ORs. No association was observed with solvents. CONCLUSIONS: Occupational exposures to both sensitizers and irritants were associated with current adult-onset asthma and uncontrolled asthma. Irritant and sensitizing agents should be carefully considered in asthma management.

Identification of potentially irritating intravenous medications.

AIMS: To identify commonly used intravenous drugs that may produce endothelial damage. METHODS: An experimental research study was performed using a sample of 62 intravenous drugs commonly used in emergency care, pH and osmolarity were measured. Subsequently, based on these values, the theoretical capacity to cause irritation or endovascular damage was determined and classified as high, moderate, and low. RESULTS: Samples from 19 drugs for fluid therapy, 21 antibiotics and 22 drugs for intravenous use were studied. Glucose solutions, sodium bicarbonate 1M and mannitol 10% showed a high capacity to cause venous irritation. Vancomycin, ciprofloxacin, amiodarone, haloperidol, and labetalol solution presented a high capacity for irritation based on their acidic pH. The antibiotics, dexketoprofen, diazepam, digoxin, etomidate, phenytoin, levetiracetam and metamizole also showed high osmotic values in their reconstituted or undiluted presentations. Moreover, osmolarity of diazepam, digoxin and phenytoin remained high despite being diluted in 100 ml of saline. CONCLUSIONS: Knowing the pH and osmolarity of intravenous drugs allows their capacity to cause endothelial damage to be assessed. The use of comprehensive tables based on the chemical properties of the drugs can be a useful tool to help prevent chemically-induced phlebitis.

Household use of green and homemade cleaning products, wipe application mode, and asthma among French adults from the CONSTANCES cohort.

While exposure to irritant and sprayed cleaning products at home is known to have a harmful role in asthma, the potential health effect of other categories or forms has not been investigated. We studied the associations of household use of cleaning products, including green, homemade products, and disinfecting wipes, with asthma based on data from the large French population-based CONSTANCES cohort. Participants completed standardized questionnaires on respiratory health and household use of cleaning products. Cross-sectional associations of cleaning products with current asthma, adjusted for gender, age, smoking status, BMI, and educational level, were evaluated by logistic regressions. Analyses were conducted in 41 570 participants (mean age: 47 years, 56% women, weekly use of the six specific products/forms studied varied from 11% to 37%). Weekly use of irritants (OR = 1.23 [1.13-1.35]), scented (OR = 1.15 [1.06-1.26]), green (OR = 1.09 [1.00-1.20]), and homemade products (OR = 1.19 [1.06-1.34]), as well as sprays (OR = 1.18 [1.08-1.29]), disinfecting wipes (OR = 1.21 [1.09-1.34]) were significantly associated with asthma, with significant trends according to the frequency of use. When they were not co-used with irritants/sprays, associations were reduced and persisted only for disinfecting wipes. Weekly use of disinfecting wipes at home was associated with current asthma, but fewer risks were observed for the use of green and homemade products.

Inclusive DFT insight into sensing mechanism of cyclotetrapyrole towards lung irritants.

The development of smart sensing devices for toxic analytes detection especially lung irritants is much essential. The cyclic conducting polymers having infinite π-conjugation are proved to be highly sensitive for toxic analytes. Herein, by using the DFT approach, we investigated the sensing mechanism of cyclotetrapyrole (CTPy) for accurate detection of phosgene, diphosgene, chloropicrin and chlorine at the B3LYP-D3/6-31 + G (d, p) level. The calculated interaction energies show the physisorption of analytes over the CTPy surface. Natural bond orbital (NBO) and charge decomposition (CDA) analyses predict charge transfer interactions in the complexes. The reduced density gradient (RDG) approach reveals that hydrogen bonding interactions dominate in the complexes. The sensitivity of CTPy towards lung irritants is further illustrated by the reduction in HOMO-LUMO energy gaps, red shifting of [Formula: see text] in UV-Visible spectra. Density of state (DOS) analysis affirm that enhanced conductivity upon complexation is due to the origination of new energy states in occupied and virtual orbitals nearer to the Fermi level. Moreover, PDOS spectra show that CTPy primarily contributes to the energy of HOMO. The outcome of the current study depicts appreciable sensitivity of CTPy towards lung irritants. Moreover, the competing role of naturally occurring atmospheric water is also investigated. We believe that the upshot of the current findings and their forecasts will provide useful guidelines for an experimentalist to design highly sensitive sensors for toxic analytes using CTPy. HIGHLIGHTS: • The highest QNBO transfer towards the analyte (- 0.121) is seen in the chlorine@CTPy complex. • The highest reduction in Eg (61%) between occupied and virtual orbitals is noticed in chlorine@CTPy. • The orbital overlap results in a 41% red shifting of [Formula: see text] in chlorine@CTPy. • Cyclotetrapyrole is highly sensitive for chlorine.

ISO 10993-23 In vitro irritation testing for medical devices: Substantiating applicability to mild irritants and non-extractables.

Irritation testing is an integral part of the biocompatibility assessment of medical devices and has historically been conducted on animals, either by direct contact or with polar and non-polar solvent extracts. In 2018 an ISO-sponsored interlaboratory validation study demonstrated that two reconstituted human epidermis (RhE) based assays, which were adapted from validated methods used for industrial chemicals, produced results essentially equivalent to those obtained with in vivo tests. This led to the publication of the ISO 10993-23:2021 standard on irritation testing, which states that RhE-based assays are now the preferred method. The 2018 validation study evaluated strong irritants, so we tested nine mild irritants (GHS Category 3), neat and spiked at different concentrations into medical device extracts, per ISO 10993-23:2021. The results substantiated the applicability of RhE-based assays for evaluating mild irritants in medical device extracts. Moreover, the 2018 validation study tested solid extractable medical device materials but did not consider non-extractable medical device materials (e.g., creams, gels, or sprays). By testing nine marketed non-extractable materials, either neat or spiked with irritants, we also confirmed that RhE-based assays are readily applicable to such medical device materials.

Clinical Characteristics of Irritant-Induced Occupational Asthma.

BACKGROUND: Work is a substantial contributing factor of adult-onset asthma. A subtype of occupational asthma (OA) is caused by irritant agents, but knowledge of the clinical outcomes of irritant-induced asthma (IIA) is incomplete. OBJECTIVES: To evaluate whether the clinical picture of IIA differs from that of sensitizer-induced OA. METHODS: This retrospective study analyzed acute and subacute IIA patients diagnosed in an occupational medicine clinic during 2004 to 2018. Sixty-nine patients fulfilled the inclusion criteria, and their characteristics were analyzed at the time of the diagnosis and 6 months later. The results were compared with those of 2 subgroups of sensitizer-induced OA: 69 high-molecular-weight (HMW) and 89 low-molecular-weight (LMW) agent-induced OA patients. RESULTS: Six months after the diagnosis, 30% of the patients with IIA needed daily short-acting ß-agonists (SABA), 68% were treated with Global Initiative for Asthma, 2020 report (GINA) step 4-5 medication, and 24% of the patients had asthma exacerbation after the first appointment. IIA depicted inferiority to LMW-induced OA in daily need for SABA (odds ratio [OR]: 3.80, 95% confidence interval [CI]: 1.38-10.46), treatment with GINA step 4-5 medication (OR: 2.22, 95% CI: 1.08-4.57), and exacerbation (OR: 3.85, 95% CI: 1.35-11.04). IIA showed poorer results than HMW-induced OA in the latter 2 of these features (OR: 2.49, 95% CI: 1.07-5.79 and OR: 6.29, 95% CI: 1.53-25.83, respectively). CONCLUSIONS: Six months after the OA diagnosis, a significant proportion of the patients with IIA remain symptomatic and the majority of these patients use asthma medications extensively suggesting uncontrolled asthma. The short-term outcomes of IIA appear poorer than that of sensitizer-induced OA.

Potential factors affecting chronic chemical intolerance associated with constitutional predisposition or lifestyle and environment during childhood: From a six-year follow-up study.

OBJECTIVE: The Japanese chemical intolerance (JCI) study was conducted in January 2012 with a cohort of 7245 adults from population-based sampling. This study aimed to investigate the childhood constitutional and environmental factors involved in the development of chronic CI from the prospective cohort study. METHODS: In the cohort, 4683 persons were identified after six years. Self-reported questionnaires were administered to the subjects to obtain information on CI status; medical history; constitution, lifestyle, and housing environment during childhood; and recent psychosomatic states. We assessed the differences between individuals with persisting CI status during the follow-up (defined as chronic CI) and controls not having CI status during the follow-up. RESULTS: A total of 2500 individuals responded. Multiple logistic regression analyses revealed significant associations between chronic CI and motion sickness to car or bus and allergic conjunctivitis during childhood. Significant associations between a possible increased risk of CI and the existence of high-voltage power lines close to housing, the use of vinyl covering in wall material, the use of strong perfume by a family member, and the experience of stinky odor of paint or wax at elementary school were observed. However, the use of carpet in floor material and plaster coating in wall material was associated with a possible decreased risk of CI. CONCLUSIONS: Some potential constitutional predisposition from childhood, including inherent susceptibility in the autonomic nervous system may be involved in the development of CI.