Disentangling biological effects of primary nanoplastics from dispersion paints' additional compounds.

Microplastic particles (MP) and nanoplastic particles (NP) as persistent anthropogenic pollutants may impact environmental and human health. A relevant potential source of primary MP and NP is water-based dispersion paint which are commonly used in any household. Given the worldwide high application volume of dispersion paint and their diverse material composition MP and NP may enter the environment with unforeseeable consequences. In order to understand the relevance of these MP and NP from paint dispersion we investigated the components of two representative wall paints and analyzed their composition in detail. The different paint components were then investigated for their impact on the model organism Daphnia magna and on a murine cell line. Plastic NP, dissolved polymers, titanium dioxide NPs, and calcium carbonate MPs demonstrated adverse effects in both biological test systems, indicating detrimental consequences of several typical components of wall paints upon release into the environment. The outcome of this study may form the basis for the evaluation of impact on other organisms, environmental transport and impact, other related technical materials and for the development of strategies for the prevention of potential detrimental effects on organisms.

Assessing the potential toxicity of paint industry effluents to aquatic organisms using the whole effluent testing (WET) approach.

Point source effluent discharges from industries are major sources of pollutants in aquatic ecosystems. In this study, the whole effluent testing approach was used to assess the toxicity of paint industry effluents to fish. Effluents were collected from three paint industries at point of discharge into the environment. Bioassay procedures were used to assess the toxicity of the effluents to fish. Effluent B was the most acutely toxic to the fish with a 96 h LC50 value of 3.50% dilution (v/v). The acute toxicity ranking of the effluents to the fish was B > C > A. Analysis of the biochemical parameters of fish exposed to sublethal dilutions of the effluents showed that the three effluents significantly (p < 0.05) enhanced the activities of liver function enzymes and oxidative stress enzymes in exposed fish. The levels of malondialdehyde, a substrate of oxidative stress, was also significantly (p < 0.05) higher in fish exposed to the effluents (3.87 ± 0.40, 4.99 ± 0.45, and 3.22 ± 0.57 U mg-1 protein for effluents A, B, and C, respectively) compared to levels in control (1.24 ± 0.31 U mg-1 protein). Results from this study have established that untreated or poorly treated paint industry effluents can be highly toxic to aquatic organisms, having the potential to disrupt normal functioning of organisms at low concentrations. The study highlights the advantages of whole effluent testing as a method that accurately predicts the toxic potentials of industrial effluents. This is vital for the adequate protection aquatic ecosystems.

Antifouling paint particles in soils: toxic impact that goes beyond the aquatic environment.

Antifouling paint particles (APPs) originate from vessel maintenance and cleaning activities and their potentially toxic components are found at high concentrations in nearby soils, yet no studies have investigated their toxicity to soil organisms. We investigated the effects of exposure to soils containing APPs on the mortality, biomass, and reproductive performance of the earthworm Eisenia andrei. Earthworms were exposed to contaminated soil from a boatyard and non-contaminated soils treated with different concentrations of APPs (0.01, 0.14 and 1.50%, w/w) for 56 days. An ecological risk assessment using a Hazard Quotient (HQ) was also carried out. Exposure to contaminated soils reduced worm survival, biomass, and reproductive performance and these effects were concentration-dependent. The HQ was high in soil samples with APPs in both acute and chronic tests, and copper contributed the most to the HQ. Copper, zinc, and lead had the highest concentrations and exceeded the Brazilian legal limits. A principal component analysis (PCA) was performed and showed that biomass and number of juveniles parameters was associated with the metals Cu, Sn and Zn, while the mortality parameter had no association with any analyzed metal. These findings highlighted that the synergistic effects of compounds present in the APPs, such as the booster biocides DCOIT, and metal mixtures should not be overlooked. We conclude that soils contaminated with APPs are toxic to earthworms. This reveals that the ecological impact of APPs goes beyond effects on aquatic environments, compromising key organisms of edaphic ecological processes.

Occupational exposure risk during spraying of biocidal paint containing silver nanoparticles.

The study assessed potential to exceed occupational exposure limits while spraying paint with and without a silver nanoparticle biocidal additive. A tradesperson performed the tasks in a sealed chamber with filtered air supply. Integrated air sampling entailed transmission electron microscopy with energy dispersive X-ray analysis, direct-reading of particle number concentrations, and determination of silver mass concentration by NIOSH Method 7300. Silver nanoparticles were primarily embedded in paint spray droplets but also observed as isolated particles. Using an α-level of 0.05, median nanoparticle number concentrations did not differ significantly when spraying conventional vs. biocidal paint, although statistically significant differences were observed at specific particle size ranges <100 nm. The geometric mean concentration of total silver while spraying biocidal paint (n = 6) was 2.1 µg/m3 (95% CI: 1.5-2.8 µg/m3), and no respirable silver was detected (<0.50 µg/m3). The results address a lack of silver nanoparticle exposure data in construction and demonstrate the feasibility of a practical sampling approach. Given similar conditions, the measurements suggest a low probability of exceeding a proposed silver nanoparticle exposure limit of 0.9 µg/m3 as an airborne 8-hr time-weighted average respirable mass concentration. A full workday of exposure to respirable silver at the highest possible level in this study (<0.50 µg/m3) would not exceed the exposure limit, although limitations in comparing short task-based exposures to an 8-hr exposure limit must be noted. There was airflow in the study chamber, whereas exposure levels could increase over time in work environments lacking adequate ventilation. Potential to exceed the exposure limit hinged upon the respirable fraction of the paint mist, which could vary by material and application method. Additional research would improve understanding of silver nanoparticle exposure risks among construction trades, and biological responses to these exposures. Given the potential for exposure variability on construction jobsites, safety and health professionals should be cognizant of methods to assess and control silver nanoparticle exposures.

Household interventions for secondary prevention of domestic lead exposure in children.

BACKGROUND: Lead exposure is a serious health hazard, especially for children. It is associated with physical, cognitive and neurobehavioural impairment in children. There are many potential sources of lead in the environment, therefore trials have tested many household interventions to prevent or reduce lead exposure. This is an update of a previously published review. OBJECTIVES: To assess the effects of household interventions intended to prevent or reduce further lead exposure in children on improvements in cognitive and neurobehavioural development, reductions in blood lead levels and reductions in household dust lead levels. SEARCH METHODS: In March 2020, we updated our searches of CENTRAL, MEDLINE, Embase, 10 other databases and ClinicalTrials.gov. We also searched Google Scholar, checked the reference lists of relevant studies and contacted experts to identify unpublished studies. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs of household educational or environmental interventions, or combinations of interventions to prevent lead exposure in children (from birth to 18 years of age), where investigators reported at least one standardised outcome measure. DATA COLLECTION AND ANALYSIS: Two authors independently reviewed all eligible studies for inclusion, assessed risk of bias and extracted data. We contacted trialists to obtain missing information. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: We included 17 studies (three new to this update), involving 3282 children: 16 RCTs (involving 3204 children) and one quasi-RCT (involving 78 children). Children in all studies were under six years of age. Fifteen studies took place in urban areas of North America, one in Australia and one in China. Most studies were in areas with low socioeconomic status. Girls and boys were equally represented in those studies reporting this information. The duration of the intervention ranged from three months to 24 months in 15 studies, while two studies performed interventions on a single occasion. Follow-up periods ranged from three months to eight years. Three RCTs were at low risk of bias in all assessed domains. The other 14 studies were at unclear or high risk of bias; for example, we considered two RCTs and one quasi-RCT at high risk of selection bias and six RCTs at high risk of attrition bias. National or international research grants or governments funded 15 studies, while the other two did not report their funding sources. Education interventions versus no intervention None of the included studies in this comparison assessed effects on cognitive or neurobehavioural outcomes, or adverse events. All studies reported data on blood lead level outcomes. Educational interventions showed there was probably no evidence of a difference in reducing blood lead levels (continuous: mean difference (MD) -0.03, 95% confidence interval (CI) -0.13 to 0.07; I² = 0%; 5 studies, 815 participants; moderate-certainty evidence; log-transformed data), or in reducing floor dust levels (MD -0.07, 95% CI -0.37 to 0.24; I² = 0%; 2 studies, 318 participants; moderate-certainty evidence). Environmental interventions versus no intervention Dust control: one study in this comparison reported data on cognitive and neurobehavioural outcomes, and on adverse events in children. The study showed numerically there may be better neurobehavioural outcomes in children of the intervention group. However, differences were small and the CI included both a beneficial and non-beneficial effect of the environmental intervention (e.g. mental development (Bayley Scales of Infant Development-II): MD 0.1, 95% CI -2.1 to 2.4; 1 study, 302 participants; low-certainty evidence). The same study did not observe any adverse events related to the intervention during the eight-year follow-up, but observed two children with adverse events in the control group (1 study, 355 participants; very low-certainty evidence). Meta-analysis also found no evidence of effectiveness on blood lead levels (continuous: MD -0.02, 95% CI -0.09 to 0.06; I² = 0%; 4 studies, 565 participants; moderate-certainty evidence; log-transformed data). We could not pool the data regarding floor dust levels, but studies reported that there may be no evidence of a difference between the groups (very low-certainty evidence). Soil abatement: the two studies assessing this environmental intervention only reported on the outcome of 'blood lead level'. One study showed a small effect on blood lead level reduction, while the other study showed no effect. Therefore, we deem the current evidence insufficient to draw conclusions about the effectiveness of soil abatement (very low-certainty evidence). Combination of educational and environmental interventions versus standard education Studies in this comparison only reported on blood lead levels and dust lead levels. We could not pool the studies in a meta-analysis due to substantial differences between the studies. Since the studies reported inconsistent results, the evidence is currently insufficient to clarify whether a combination of interventions reduces blood lead levels and floor dust levels (very low-certainty evidence). AUTHORS' CONCLUSIONS: Based on available evidence, household educational interventions and environmental interventions (namely dust control measures) show no evidence of a difference in reducing blood lead levels in children as a population health measure. The evidence of the effects of environmental interventions on cognitive and neurobehavioural outcomes and adverse events is uncertain too. Further trials are required to establish the most effective intervention for reducing or even preventing further lead exposure. Key elements of these trials should include strategies to reduce multiple sources of lead exposure simultaneously using empirical dust clearance levels. It is also necessary for trials to be carried out in low- and middle-income countries and in differing socioeconomic groups in high-income countries.

Solvent-based paint and varnish removers: a focused toxicologic review of existing and alternative constituents.

Paint and varnish removers constitute a major potential source of organic solvent exposure to contractors and home improvement enthusiasts. Unfortunately, the leading paint remover formulations have traditionally contained, as major ingredients, chemicals classified as probable human carcinogens (eg, methylene chloride) or reproductive toxicants (eg, N-methylpyrrolidone). In addition, because of its unique toxicology (ie, hepatic conversion to carbon monoxide compounding generic solvent narcosis and arrythmogenesis), high volatility, and rigorous requirements for personal protective equipment, methylene chloride exposures from paint removers have been linked to numerous deaths involving both occupational and consumer usage. The aim of this review is to summarize the known toxicology of solvent-based paint remover constituents (including those found in substitute formulations) in order to provide health risk information to regulators, chemical formulators, and end-users of this class of products, and to highlight any data gaps that may exist.

Neuropsychological effects among workers exposed to organic solvents.

OBJECTIVE: To assess neuropsychological performance among workers at a paint factory in Mexico City. MATERIALS AND METHODS: During 2004 and 2005 we assessed the neuropsychological performance of 208 workers who were exposed to organic solvents at a paint factory, mainly toluene and xylene. We categorized workers into low and high exposure groups using a cumulative index for toluene, based on times spent in different tasks. We evaluated cognitive and motor functions with 13 neuropsychological tests. RESULTS: We found lower attention, longer time to complete the test ß=5.5 (R2=12.3%), and a lower score in the motor-cognitive test ß=-15.7 (R2=19.5%) in the high exposure group through multiple linear regression model analysis, with adjustment for age and education. CONCLUSIONS: Our results are similar to the ones reported in the literature, but the effects are less severe, probably due to lower exposure to organic solvents.

OBJETIVO: Evaluar el desempeño neuropsicológico de los trabajadores de una fábrica de pintura en la Ciudad de México. MATERIAL Y MÉTODOS: Se evaluó el desempeño neuropsicológico de 208 trabajadores expuestos a disolventes orgánicos, principalmente tolueno y xileno, en una fábrica de pintura en la Ciudad de México durante 2004 y 2005. Se categorizaron en grupos de baja y alta exposición con un índice acumulado de tolueno con base en el tiempo empleado por actividad. Se evaluaron funciones motoras y cognitivas con 13 pruebas neuropsicológicas. RESULTADOS: Se registró un tiempo más largo para completar la prueba ß=5.5 (R2=12.3%) y una puntuación baja en la prueba motor-cognitiva de ß=- 15.7 (R2=19.5%) en el grupo de alta exposición en los modelos de regresión lineal múltiple, ajustados por confusores. CONCLUSIONES: Los presentes resultados son similares a los reportados en la literatura, aunque los efectos son menos graves, probablemente debido a la baja exposición.

Additives for Efficient Biodegradable Antifouling Paints.

The evolution of regulations concerning biocidal products aims to increase protection of the environment (e.g., EU Regulation No 528/2012) and requires the development of new non-toxic anti-fouling (AF) systems. The development of these formulations implies the use of ingredients (polymers, active substances, additives) that are devoid of toxicity towards marine environments. In this context, the use of erodable antifouling paints based on biodegradable polymer and authorized biocides responds to this problem. However, the efficiency of paints could be improved by the use of specific additives. For this purpose, three additives acting as surface modifiers were studied (Tween 80, Span 85 and PEG-silane). Their effects on parameters involved in antifouling efficiency as hydrophobicity, hydration and copper release were studied. Results showed that the addition of 3% of additives modulated hydrophobicity and hydration without an increase of copper release and significantly reduced microfouling development. Efficient paints based on biodegradable polymer and with no organic biocide could be obtained by mixing copper thiocyanate and additives.

Audit of toxic effects of body paint in the tiger dancers (Hulivesha) of Mangalore, India: an investigational study.

INTRODUCTION: Tiger dancing or Hulivesha, where the volunteers paint their bare body like a tiger and dance in a ritual during the Navarathri festival in Mangalore, India. There are no scientific studies done with the Hulivesha dancers at all, and therefore, we investigated the adverse effects of painting body like a tiger and dancing in the volunteers. OBJECTIVE/AIM: In this study, we investigated the clinico-haematological effects of topical application of lead-containing paint and dancing for three consecutive days in these dancers to ascertain the toxic effects of whole body painting and dancing. MATERIALS AND METHODS: This was a case-control study and was conducted during the Dasara festival in 2013 in the Huliveshadaris (study group) and the accompanying drummers (controls). Clinical, dermatological, and musculoskeletal examination were done before (day 0) and after the three days of the function (day 3). Blood was also collected and examined for alterations in the hematological parameters, lead, antioxidant glutathione, and lipid peroxidation levels. RESULTS: The results indicated that the all Hulivesha volunteers had severe musculoskeletal pain, while few also complained of skin reactions (61.6%), headache (25%) and nausea, and vomiting (18.75%). The results also indicated that topical application increased the levels of blood lead, caused a change in the haematological profile, decreased glutathione and increased lipid peroxidation (p < 0.03-0.0001). CONCLUSIONS: The results from this study clearly shows that topical application of the acrylic paint increases lead, changes haematological parameters and imparts adverse skin reactions.

Risk factors of renal dysfunction and their interaction in level-low lead exposure paint workers.

BACKGROUND: To explore the effect of low-level lead exposure on renal dysfunction in paint works, and analyze the interaction between low-level lead exposure and other influence factors of renal dysfunction. METHODS: Seven hundred forty seven workers from Sany Heavy Industry Company and Xiangjiang Kansai Paint Company who have been exposed to paint were chosen by random cluster sampling. Their blood lead level and Urine ß2-micro globulin level (renal dysfunction) were tested,risk factors of renal dysfunction in paint workers and their interactions were analyzed. RESULTS: The prevalence of renal dysfunction was 12.37%. Risk factors of renal dysfunction in paint workers mainly included longer working years (OR = 1.699, 95% CI: 1.226~ 2.355), blood lead positive (OR = 2.847, 95% CI: 1.577~ 5.139) and hypertension (OR = 2.192, 95% CI: 1.103~ 4.359). Positive interaction existed between hypertension and low-level blood lead on renal dysfunction in paint workers, the RERI (Relative excess risk of interaction), API (Attributable proportions of interaction) and S(the synergy index) were 4.758, 54.5% and 2.604 respectively. CONCLUSIONS: Low-level lead exposure and hypertension not only have independent effect on renal dysfunction in paint workers, but also had obvious positive interaction in paint workers. Interventions aimed at blood lead and blood pressure at the same time will better prenvent from renal dysfunction.

Potential ecotoxicity of metals leached from antifouling paint particles under different salinities.

Antifouling paint particles (APPs) are residues generated during maintenance of vessels. In boat maintenance areas of South America, waste generation and disposal are not completely regulated. Therefore, APPs can enter into the aquatic environment and act as a source of contamination by metals and other biocides. Thus, the aim of the present study was to evaluate the potential ecotoxicity of the metal mixture present in APPs leached under different salinities. Therefore, the copepod Acartia tonsa was exposed to different concentrations of a leachate solution prepared by the addition of APPs (1.25g/L) in artificial saline water (salinities 5, 15 and 30). Thereafter, complexing agents (EDTA and sodium thiosulfate) were added to the experimental media in order to evaluate metal influence in APPs toxicity. APPs leachate solutions were very toxic to A. tonsa, reaching an estimated LC50 of 1% at salinities 5% and 15%, and 2% at salinity 30. The addition of the chelators in leachate solutions showed that metals are the major responsible compounds for the observed toxicity. Moreover, results from the calculated toxic units suggested a slightly synergic effect between Cu and Zn in the paint formulation. A metal speciation modelling showed that Zn was predominant as a free ion at all salinities, therefore, explaining the high leachate toxicity. Furthermore, the release of Zn was observed more at lower salinities, whereas Cu was observed at higher salinities. APPs are frequently released in estuarine systems, under conditions of salinity gradients. Therefore, navigated estuaries might be under the threat of this neglected residue.

The neuro-ophthalmological effects related to long-term occupational exposure to organic solvents in painters.

PURPOSE: Organic solvents are widely used in many industries, and usually, exposure occurs with mixtures of solvents. Organic solvent mixtures are known for their ability to affect tissues of high lipid content including the myelin sheath in the nervous system. The purpose of this work was to study the evidence that long-term (more than 10 years) exposure to organic solvent mixtures among painters can induce neuro-ophthalmological effects on the function of retinal ganglion cells and the optic tract. METHODS: Twenty workers with long-term occupational exposure to mixed organic solvents were compared to 40 control subjects. The controls were matched for age, gender, and demographic characteristics but were not occupationally exposed to any known organic solvents, using the following comparators: visual evoked potential (VEP), electroretinogram (ERG), color vision (CV), and contrast sensitivity (CS) testing. Environmental monitoring was done in the work environment with consideration to the American Conference of Governmental Industrial Hygienists Threshold Limit Values (ACGIH-TLVs). RESULTS: The exposed group had significantly longer latency and higher amplitude of VEP waves especially P100, higher Color Confusion Index (CCI), especially affecting the blue-yellow spectrum, and lower Log CS. There was no significant difference between exposed and nonexposed groups in full-field flash ERG response; however, in the pattern ERG, the exposed group had significantly longer latency of P50, which reflects changes in the retinal ganglion cell. CONCLUSION: Long-term occupational exposure to mixed organic solvents appeared to affect the optic tract functions in the form of increasing latency of VEP response, affecting the quality of CV and decreasing CS. It also affects the retinal ganglion cell layer with increased latency of P50 of the pattern ERG response.

The effect of low-volatile organic compounds, water-based paint on aggravation of allergic disease in schoolchildren.

Whether indoor painting aggravates preexisting allergic diseases remains unclear. We aimed to evaluate the impact of new classroom painting on aggravation of asthma, allergic rhinitis (AR), and atopic dermatitis (AD) in children. Studied school was previously painted with conventional water-based paint 20 years ago and had natural ventilation system. We identified a total of 172 children aged 10-12 years with allergic diseases in 17 classrooms, which were allocated to newly painted rooms with low-volatile organic compounds (VOC), water-based paint, or existing rooms. After painting, there was no intervention or internal airflow to influence indoor air environment in both classrooms. We prospectively assessed the symptom severity and serious events of allergic diseases between both classrooms at baseline and after one and eight weeks after painting. At one and eight weeks, there were no significant changes in the Childhood Asthma Control Test scores, the fractional nitric oxide levels, lung function in asthmatic children in either classroom. There were also no significant changes in the severity score of AR or AD, or serious events in all allergic diseases. These findings suggest classroom painting with this new paint at the levels encountered in this study might not be a major aggravating factor for school-aged children with allergic diseases.

Lead substances selection using GHS approach for the classification of mixtures: Case study of painting in the work environment.

We developed a lead substances selection approach based on the concept of mixture classification of UN GHS for the purpose of efficient risk assessment of mixtures consisting of multiple components. Lead substances selection methods are being actively developed in Europe, but these methods are predicated on the regulations and information sources available within Europe and are therefore not readily applicable to countries outside Europe. In this study, the features of the GHS-based approach and the risk assessment results for outdoor painting work as a specific utilization example of the GHS-based approach were described. Comparison with the DPD + method and the CCA method proposed in Europe revealed that the GHS-based approach resulted in the selection of the safest lead substances. The GHS method, like the DPD + method, is a classification-based approach. We believe that a classification-based approach based on the GHS method can be an appropriate tool to efficiently implement risk assessment of mixtures for countries outside Europe. Some tools for business operators to conduct the management of chemicals using the GHS classification have been established in Japan. We plan to propose the GHS-based approach as a standardized assessment tool.

Household interventions for preventing domestic lead exposure in children.

BACKGROUND: Lead poisoning is associated with physical, cognitive and neurobehavioural impairment in children, and trials have tested many household interventions to prevent lead exposure. This is an update of the original review, first published in 2008. OBJECTIVES: To assess the effects of household interventions for preventing or reducing lead exposure in children, as measured by improvements in cognitive and neurobehavioural development, reductions in blood lead levels and reductions in household dust lead levels. SEARCH METHODS: In May 2016 we searched CENTRAL, Ovid MEDLINE, Embase, nine other databases and two trials registers: the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov. We also checked the reference lists of relevant studies and contacted experts to find unpublished studies. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs of household educational or environmental interventions, or combinations of interventions to prevent lead exposure in children (from birth to 18 years of age), where investigators reported at least one standardised outcome measure. DATA COLLECTION AND ANALYSIS: Two authors independently reviewed all eligible studies for inclusion, assessed risk of bias and extracted data. We contacted trialists to obtain missing information. We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS: We included 14 studies involving 2643 children: 13 RCTs (involving 2565 children) and one quasi-RCT (involving 78 children). Children in all studies were under six years of age. Thirteen studies took place in urban areas of North America, and one was in Australia. Most studies were in areas with low socioeconomic status. Girls and boys were equally represented in all studies. The duration of the intervention ranged from 3 months to 24 months in 12 studies, while 2 studies performed interventions on a single occasion. Follow-up periods ranged from 6 months to 48 months. Three RCTs were at low risk of bias in all assessed domains. We rated two RCTs and one quasi-RCT as being at high risk of selection bias and six RCTs as being at high risk of attrition bias. For educational interventions, we rated the quality of evidence to be high for continuous blood lead levels and moderate for all other outcomes. For environmental interventions, we assessed the quality of evidence as moderate to low. National or international research grants or governments funded 12 studies, while the other 2 did not report their funding sources.No studies reported on cognitive or neurobehavioural outcomes. No studies reported on adverse events in children. All studies reported blood lead level outcomes.We put studies into subgroups according to their intervention type. We performed meta-analyses of both continuous and dichotomous data for subgroups where appropriate. Educational interventions were not effective in reducing blood lead levels (continuous: mean difference (MD) 0.02, 95% confidence interval (CI) -0.09 to 0.12, I² = 0%; 5 studies; N = 815; high quality evidence (log transformed); dichotomous ≥ 10.0 µg/dL (≥ 0.48 µmol/L): risk ratio (RR) 1.02, 95% CI 0.79 to 1.30; I² = 0%; 4 studies; N = 520; moderate quality evidence; dichotomous ≥ 15.0 µg/dL (≥ 0.72 µmol/L): RR 0.60, 95% CI 0.33 to 1.09; I² = 0%; 4 studies; N = 520; moderate quality evidence). Meta-analysis for the dust control subgroup also found no evidence of effectiveness on blood lead levels (continuous: MD -0.15, 95% CI -0.42 to 0.11; I² = 90%; 3 studies; N = 298; low quality evidence (log transformed); dichotomous ≥ 10.0 µg/dL (≥ 0.48 µmol/L): RR 0.93, 95% CI 0.73 to 1.18; I² = 0; 2 studies; N = 210; moderate quality evidence; dichotomous ≥ 15.0 µg/dL (≥ 0.72 µmol/L): RR 0.86, 95% CI 0.35 to 2.07; I² = 56%; 2 studies; N = 210; low quality evidence). After adjusting the dust control subgroup for clustering in meta-analysis, we found no evidence of effectiveness. We could not pool the studies using soil abatement (removal and replacement) and combination intervention groups in a meta-analysis due to substantial differences between studies, and generalisability or reproducibility of the results from these studies is unknown. Therefore, there is currently insufficient evidence to clarify whether soil abatement or a combination of interventions reduces blood lead levels. AUTHORS' CONCLUSIONS: Based on current knowledge, household educational interventions are ineffective in reducing blood lead levels in children as a population health measure. Dust control interventions may lead to little or no difference in blood lead levels (the quality of evidence was moderate to low, meaning that future research is likely to change these results). There is currently insufficient evidence to draw conclusions about the effectiveness of soil abatement or combination interventions. No study reported on cognitive or neurobehavioural outcomes or adverse events. These patient-relevant outcomes would have been of great interest to draw conclusions for practice.Further trials are required to establish the most effective intervention for preventing lead exposure. Key elements of these trials should include strategies to reduce multiple sources of lead exposure simultaneously using empirical dust clearance levels. It is also necessary for trials to be carried out in low- and middle-income countries and in differing socioeconomic groups in high-income countries.

Investigating paternal preconception risk factors for adverse pregnancy outcomes in a population of internet users.

BACKGROUND: Paternal preconception risk factors such as smoking, exposure to environmental substances, medication use, overweight and advanced age correlate with the occurrence of malformations and birth defects in the offspring. Nonetheless, the prevalence of risk factors for adverse pregnancy outcomes in the male population has been scarcely investigated and no report on preconception interventions targeting prospective fathers is available. We conducted a web-based survey to measure the prevalence of paternal preconception risk factors for adverse pregnancy outcomes in an Italian population of Internet users. METHODS: Prospective or expectant fathers were enrolled during a four-week period through two of the main Italian web-sites dedicated to preconception, pregnancy, childhood and family care. Participants filled in a web questionnaire regarding preconception risk factors for adverse pregnancy outcomes. Logistic regression analysis was used to explore the predictors of paternal preconception risk factors. RESULTS: We enrolled 131 prospective and 205 expectant fathers. More than half of the total participants used medications during the preconception period, 35% were smokers and 8% were obese. Exposure to environmental substances was declared by almost 20% of the participants, with the group including pesticides/herbicides/professional paints being the most prevalent. More than a half of the study sample included men aged over 35 years. According to the multivariate analysis, smoking and exposure to environmental toxics were less frequent among individuals with a university degree (respectively: OR = 0.52; 95% CI 0.32-0.84; OR = 0.52; 95% CI 0.29-0.93). Paternal obesity and medication use in the preconception period were not associated with any of the independent variables. CONCLUSIONS: The prevalence of preconception risk factors among male population should not be neglected when planning preconception interventions, confirming that preconception health must be focused on the couple, rather than on women only.

Studying the effect of antioxidants on cytogenetic manifestations of solvent exposure in the paint industry.

OBJECTIVE: To investigate the antioxidant role in reversing cytogenetic changes caused by solvent exposure in paint industry. SUBJECTS AND METHODS: A prospective controlled clinical trial was performed on 39 workers exposed to solvents and 39 workers not exposed to solvents by supplying a mixture of antioxidant vitamins (A, C, E and selenium) and the after effects of such regimen were analyzed. Environmental monitoring was carried out for air concentrations of different solvents at workplace. Exposed group was cytogenetically tested before and after giving the mixture of antioxidant vitamins for 1 month duration. RESULTS: Frequency of chromosomal aberrations (CAs) and the mean of sister chromatid exchanges (SCEs) were statistically significantly higher among exposed workers than among controls. After the supplementation of antioxidants, there was a statistically significant decrease in the frequency of CAs, and 88% abnormal levels of SCEs were back to normal levels. CONCLUSION: Antioxidant supplementation decreases the frequency of CAs and SCEs among exposed workers.