RESUMEN
Concentrations of polybrominated diphenyl ethers, hexabromocyclododecane (HBCDD), and novel brominated flame retardants (NBFRs) were measured in indoor dust, indoor air, and outdoor air in Birmingham, UK. Concentrations of ΣBFRs ranged from 490 to 89,000 ng/g, 46-14,000 pg/m3, and 22-11,000 pg/m3, respectively, in UK indoor dust, indoor air, and outdoor air. BDE-209 and decabromodiphenyl ethane (DBDPE) were the main contributors. The maximum concentration of DBDPE (10,000 pg/m3) in outdoor air is the highest reported anywhere to date. In contrast with previous studies of outdoor air in Birmingham, we observed significant correlations between concentrations of tri- to hepta-BDEs and HBCDD and temperature. This may suggest that primary emissions from ongoing use of these BFRs have diminished and that secondary emissions (e.g., evaporation from soil) are now a potentially major source of these BFRs in outdoor air. Conversely, the lack of significant correlations between temperature and concentrations of BDE-209 and DBDPE may indicate that ongoing primary emissions from indoor sources remain important for these BFRs. Further research to clarify the relative importance of primary and secondary sources of BFRs to outdoor air is required. Comparison with earlier studies in Birmingham reveals significant (p < 0.05) declines in concentrations of legacy BFRs, but significant increases for NBFRs over the past decade. While there appear minimal health burdens from BFR exposure for UK adults, dust ingestion of BDE-209 may pose a significant risk for UK toddlers.
Asunto(s)
Contaminación del Aire Interior , Retardadores de Llama , Hidrocarburos Bromados , Adulto , Humanos , Contaminación del Aire Interior/análisis , Polvo/análisis , Monitoreo del Ambiente , Retardadores de Llama/análisis , Éteres Difenilos Halogenados/análisis , Reino Unido , Bromo/análisisRESUMEN
Coronavirus disease 2019 (COVID-19) remains a serious global threat. The metabolic analysis had been successfully applied in the efforts to uncover the pathological mechanisms and biomarkers of disease severity. Here we performed a quasi-targeted metabolomic analysis on 56 COVID-19 patients from Sierra Leone in western Africa, revealing the metabolomic profiles and the association with disease severity, which was confirmed by the targeted metabolomic analysis of 19 pairs of COVID-19 patients. A meta-analysis was performed on published metabolic data of COVID-19 to verify our findings. Of the 596 identified metabolites, 58 showed significant differences between severe and nonsevere groups. The pathway enrichment of these differential metabolites revealed glutamine and glutamate metabolism as the most significant metabolic pathway (Impact = 0.5; -log10P = 1.959). Further targeted metabolic analysis revealed six metabolites with significant intergroup differences, with glutamine/glutamate ratio significantly associated with severe disease, negatively correlated with 10 clinical parameters and positively correlated with SPO2 (rs = 0.442, p = 0.005). Mini meta-analysis indicated elevated glutamate was related to increased risk of COVID-19 infection (pooled odd ratio [OR] = 2.02; 95% confidence interval [CI]: 1.17-3.50) and severe COVID-19 (pooled OR = 2.28; 95% CI: 1.14-4.56). In contrast, elevated glutamine related to decreased risk of infection and severe COVID-19, the pooled OR were 0.30 (95% CI: 0.20-0.44), and 0.44 (95% CI: 0.19-0.98), respectively. Glutamine and glutamate metabolism are associated with COVID-19 severity in multiple populations, which might confer potential therapeutic target of COVID-19, especially for severe patients.
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COVID-19 , Ácido Glutámico , Humanos , Ácido Glutámico/metabolismo , Glutamina/metabolismo , Metabolómica , BiomarcadoresRESUMEN
Investigations into the impacts of regulated electrical and electronic waste (e-waste) recycling activities on urban environments in Europe remain rather scarce. In this study, dust samples taken both inside and outside of five UK e-waste recycling facilities were analysed for concentrations of polybrominated diphenyl ethers (PBDEs), novel brominated flame retardants (NBFRs), and hexabromocyclododecane (HBCDD). Average concentrations of ∑BFRs in dust inside and outside UK e-waste recycling facilities were 12,000 ng/g and 180 ng/g, with median concentrations of 7500 ng/g and 85 ng/g, respectively. BDE-209 and decabromodiphenyl ethane (DBDPE) were the most abundant BFRs in both indoor and kerb dust, making a combined contribution to ∑BFRs of ~90 % on average. While four out of the five studied e-waste facilities showed a lack of significant impact on BFR contamination in surrounding environment, one of the studied e-waste recycling facilities was identified as a likely source of BFR contamination to UK urban environments, with industrial activities as another potential source of NBFRs. Occupational exposure of UK e-waste recycling workers to BFRs via dust ingestion was generally lower than that estimated for e-waste recyclers from other countries, but was comparable to BFR exposure via dust ingestion of UK office workers. Our estimates suggested that health burdens posed by dust ingestion of BFRs were minimal for UK e-waste recycling workers.
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Contaminación del Aire Interior , Residuos Electrónicos , Retardadores de Llama , Exposición Profesional , Humanos , Retardadores de Llama/análisis , Residuos Electrónicos/análisis , Contaminación del Aire Interior/análisis , Exposición Profesional/análisis , Polvo/análisis , Éteres Difenilos Halogenados/análisis , Reciclaje , Reino Unido , Monitoreo del Ambiente , Exposición a Riesgos Ambientales/análisisRESUMEN
Global restrictions on use of legacy brominated flame retardants (BFRs) such as polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecane (HBCDD) have generated demand for novel BFRs (NBFRs) as substitutes. Our research group has previously reported decreased concentrations of PBDEs and HBCDD and increased concentrations of NBFRs in UK indoor environments, suggesting that restrictions on PBDEs and HBCDD are exerting an impact. In this study, we analysed UK foodstuffs collected in 2020-21 and compared the BFR concentrations found with those found in similar samples collected in 2015 to investigate whether similar trends in BFR concentrations would be observed. Concentrations of PBDEs and HBCDD isomers detected in our samples had declined by 78-92 % and 59-97 % since the 2015 study, respectively. Moreover, concentrations of NBFRs (dominated by 1,2-bis(2,4,6-tribromophenoxy) ethane (BTBPE or TBE), and bis(2-ethyl hexyl) tetrabromophthalate (BEH-TEBP or TBPH)) in UK foodstuffs increased significantly (28-1400 %) between 2015 and 2020-21. Combined, these findings suggest that restrictions on use of PBDEs and HBCDD have had a discernible impact on concentrations of these legacy BFRs and their NBFR replacements in UK foodstuffs. Interestingly, given recent reports of a significant increase in concentrations of decabromodiphenyl ethane (DBDPE) in UK house dust between 2014 and 2019, a significant decline (70-84 %) in concentrations of DBDPE was observed in UK foodstuffs.
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Retardadores de Llama , Hidrocarburos Bromados , Éteres Difenilos Halogenados/análisis , Monitoreo del Ambiente , Retardadores de Llama/análisis , Hidrocarburos Bromados/análisis , Polvo/análisis , Reino UnidoRESUMEN
Although diet is an important route of exposure for brominated flame retardants (BFRs), little is known of their presence in US food. Therefore, we purchased meat, fish, and dairy product samples (n = 72) in Bloomington, IN, from 3 stores representing national retail chains at different price levels. Composite samples (n = 42) were analyzed for polybrominated diphenyl ethers (PBDEs), hexabromocyclododecane (HBCDD), novel BFRs (NBFRs), and dechlorane plus (DP). Concentrations of total halogenated flame retardants (HFRs) ranged between 54 and 1,400 pg/g ww, with PBDEs being the predominant compounds. Concentrations of NBFRs, but not PBDEs, in US food items were significantly impacted by price, raising the issue of environmental justice. Nonorganic food generally had a higher abundance of BDE-209 than organic food items. Estimates of dietary exposure revealed that meat and cheese consumption contribute most to the overall HFR intake and that intakes are highest for children and for non-Hispanic Asians. Taking into account several caveats and limitations of this study, these results as a whole suggest that health burdens from dietary exposure to HFRs have become minimal for US citizens, highlighting the positive impact of regulatory efforts.
RESUMEN
Extensive use of halogenated flame retardants (HFRs) and organophosphate esters (OPEs) has generated great concern about their adverse effects on environmental and ecological safety and human health. As well as emissions during use of products containing such chemicals, there are mounting concerns over emissions when such products reach the waste stream. Here, we review the available data on contamination with HFRs and OPEs arising from formal waste treatment facilities (including but not limited to e-waste recycling, landfill, and incinerators). Evidence of the transfer of HFRs and OPEs from products to the environment shows that it occurs via mechanisms such as: volatilisation, abrasion, and leaching. Higher contaminant vapour pressure, increased temperature, and elevated concentrations of HFRs and OPEs in products contribute greatly to their emissions to air, with highest emission rates usually observed in the early stages of test chamber experiments. Abrasion of particles and fibres from products is ubiquitous and likely to contribute to elevated FR concentrations in soil. Leaching to aqueous media of brominated FRs (BFRs) is likely to be a second-order process, with elevated dissolved humic matter and temperature of leaching fluids likely to facilitate such emissions. However, leaching characteristics of OPEs are less well-understood and require further investigation. Data on the occurrence of HFRs and OPEs in outdoor air and soil in the vicinity of formal e-waste treatment facilities suggests such facilities exert a considerable impact. Waste dumpsites and landfills constitute a potential source of HFRs and OPEs to soil, and improper management of waste disposal might also contribute to HFR contamination in ambient air. Current evidence suggests minimal impact of waste incineration plants on BFR contamination in outdoor air and soil, but further investigation is required to confirm this.
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Retardadores de Llama , Monitoreo del Ambiente , Ésteres , Retardadores de Llama/análisis , Éteres Difenilos Halogenados/análisis , Humanos , Organofosfatos , Suelo , Instalaciones de Eliminación de ResiduosRESUMEN
Background: The coronavirus disease 2019 (COVID-19) is a highly infectious respiratory disease. There is no recommended antiviral treatment approved for COVID-19 in Sierra Leone, and supportive care and protection of vital organ function are performed for the patients. This study summarized the clinical characteristics, drug treatments, and risk factors for the severity and prognosis of COVID-19 in Sierra Leone to provide evidence for the treatment of COVID-19. Methods: Data of 180 adult COVID-19 patients from the 34th Military Hospital in Freetown Sierra Leone between March 31, 2020 and August 11, 2020 were retrospectively collected. Patients with severe and critically ill are classified in the severe group, while patients that presented asymptomatic, mild, and moderate disease were grouped in the non-severe group. The clinical and laboratory information was retrospectively collected to assess the risk factors and treatment strategies for severe COVID-19. Demographic information, travel history, clinical symptoms and signs, laboratory detection results, chest examination findings, therapeutics, and clinical outcomes were collected from each case file. Multivariate logistic analysis was adopted to identify the risk factors for deaths. Additionally, the clinical efficacy of dexamethasone treatment was investigated. Results: Seventy-six (42.22%) cases were confirmed with severe COVID-19, while 104 patients (57.78%) were divided into the non-severe group. Fever (56.67%, 102/180) and cough (50.00%, 90/180) were the common symptoms of COVID-19. The death rate was 18.89% (34/180), and severe pneumonia (44.12%, 15/34) and septic shock (23.53%, 8/34) represented the leading reasons for deaths. The older age population, a combination of hypertension and diabetes, the presence of pneumonia, and high levels of inflammatory markers were significantly associated with severity of COVID-19 development (Pâ<â0.05 for all). Altered level of consciousness [odds ratio (OR)â=â56.574, 95% confidence interval (CI) 5.645-566.940, Pâ=â0.001], high levels of neutrophils (ORâ=â1.341, 95%CI 1.109-1.621, Pâ=â0.002) and C-reactive protein (CRP) (ORâ=â1.014, 95%CI 1.003-1.025, Pâ=â0.016) might be indicators for COVID-19 deaths. Dexamethasone treatment could reduce mortality [30.36% (17/56) vs. 50.00% (10/20)] among severe COVID-19 cases, but the results were not statistically significant (Pâ>â0.05). Conclusions: The development and prognosis of COVID-19 may be significantly correlated with consciousness status, and the levels of neutrophils and CRP.
RESUMEN
Informal electrical and electronic waste (e-waste) handling activities constitute a potentially important source of halogenated (HFRs) and organophosphate flame retardants (OPFRs) to the environment and humans. In this review, two electronic databases (ScienceDirect and Web of Science Core Collection) were searched for papers that addressed this topic. A total of 82 relevant studies (including 72 studies selected from the two databases and 10 studies located from the references of the first 72 selected studies) were identified that reported on human external and internal exposure to HFRs and OPFRs arising as a result of informal e-waste handling activities. Compared to the general population, higher levels of external exposure (i.e., inhalation, ingestion, and dermal absorption) and internal exposure (i.e., blood serum, hair, breast milk, urine, and other human matrices) to HFRs and OPFRs were identified for e-waste recyclers and residents inhabiting e-waste dismantling and recycling zones, especially for younger adults and children. Food intake and dust ingestion were the dominant exposure pathways for the majority of brominated flame retardants (BFRs) and dechlorane plus (DP); while inhalation was identified as the most significant pathway of human exposure to OPFRs in informal e-waste sites. The majority of research to date has focused on China and thus future studies should be conducted in other regions such as Africa and South Asia. Other suggested foci of future research are: examination of exposure via dermal contact with e-waste, dietary exposure of local populations to OPFRs, confirmation of the existence of and cause(s) of the higher body burdens of females compared with males amongst populations impacted by informal e-waste handling, and characterisation of exposure of such populations to chlorinated paraffins.
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Residuos Electrónicos , Retardadores de Llama , Adulto , África , Asia , Niño , China , Residuos Electrónicos/análisis , Monitoreo del Ambiente , Femenino , Retardadores de Llama/análisis , Éteres Difenilos Halogenados/análisis , Humanos , Masculino , OrganofosfatosRESUMEN
BACKGROUND: HIV rapid diagnostic test (RDT) algorithms have been successfully employed worldwide to accelerate critically important HIV testing. Deviations from the algorithm and processing errors have been associated with inaccurate algorithm results. Positive RDT algorithm results should be confirmed prior to HIV clinic enrollment, but compliance varies. We sought to retest HIV status of patients in three West African military HIV clinics. SETTING: Military HIV clinics in Lome, Togo; Freetown, Sierra Leone; and Monrovia, Liberia METHODS: Patients coming for routine HIV clinic visits were approached for enrollment. Consenting participants completed a 15-minute questionnaire and provided blood samples for both national and WHO-recommended HIV RDT algorithms, and HIV ELISA (plus HIV PCR if HIV ELISA negative). RESULTS: In total, 817 participants provided data: 374 in Togo, 360 in Sierra Leone, and 83 in Liberia. One participant from Liberia was HIV-negative (although follow-up testing was positive). Two of 807 participants on antiretroviral treatment (ART) had inconclusive algorithms, while 2 of 10 participants not on ART had algorithms, for 4 total based on the WHO-approved algorithm. Using the national algorithms, only 3 were inconclusive. A substantial proportion of the cohort had taken ART for over 6 years (25-46%, depending on the site). CONCLUSION: HIV RDT retesting in three military HIV clinics did not uncover significant numbers of misclassified HIV patients. There was no significant difference between national and WHO-recommended RDT algorithms, although the study was underpowered to detect a difference. Antiretroviral treatment was not associated with increased rates of inconclusive RDT algorithm results.
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Infecciones por VIH , Personal Militar , Algoritmos , Antirretrovirales/uso terapéutico , Pruebas Diagnósticas de Rutina , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Humanos , Sensibilidad y EspecificidadRESUMEN
OBJECTIVE: To ascertain the value of relatively simple quantitative radiologic measurements after head injury. Despite major advances in neuroradiology, analysis and reporting of imaging studies is based primarily on individual subjective and local experience, rather than on reproducible, standardized parameters; reliance on newer technologies can improve care, but also raises diagnostic costs. DESIGN: Blinded, retrospective, quantitative assessment of computerized tomography studies done some 14 years post-injury. OUTCOME MEASURES: Frontal horn width (FHW); septum-caudate distance (SCD); temporal horn width (THW); interuncal distance (IUD); third ventricle width (3VW); ventricular score (VS); sulcal width (SW); gray-white matter discriminability (GWMD) and subjective assessment of atrophy (SAOA). RESULTS: Diffuse and frontal damage was noted in both closed (CHI) and penetrating (PHI) head injury groups. Enlargement of frontal lobe parameters (septum caudate distance and frontal horn width suggest frontal injury in both closed and penetrating traumatic brain injury (TBI). Temporal horn width and inter-uncal distance were related to VS, 3VW and FHW in closed, but not in penetrating head injury. CONCLUSIONS: Simple linear CSF space measurements are correlated with volumetric and parenchymal measures, and can represent valuable and reliable low-cost quantitative measures of long term brain damage after TBI.
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Encéfalo/diagnóstico por imagen , Traumatismos Cerrados de la Cabeza/diagnóstico por imagen , Traumatismos Penetrantes de la Cabeza/diagnóstico por imagen , Atrofia , Encéfalo/patología , Ventrículos Cerebrales/patología , Ventriculografía Cerebral , Traumatismos Cerrados de la Cabeza/patología , Traumatismos Penetrantes de la Cabeza/patología , Humanos , Masculino , Tomografía Computarizada por Rayos XRESUMEN
CONTEXT: Functional outcome in relation to CT findings in traumatic brain injured (TBI) patients is not well established in relation to cognitive and vocational outcome. OBJECTIVE: To investigate the possible correlation between relatively simple quantitative radiological measurements and cognitive and vocational outcome. DESIGN: Retrospective analysis of quantitative assessment of CT studies in relation to post-injury cognitive changes and vocational outcome. SETTING: US Army Medical Centre. PATIENTS: 74 penetrating head injured (PHI) and 37 closed head injured (CHI) Vietnam war veterans. OUTCOME MEASURES: The Armed Forces Qualification Test (AFQT); Disability score; Return to work. RESULTS: Total brain volume loss, third ventricle width (3VW), ventricular score (VS), and septum-caudate distance (SCD) were significantly related to cognitive change and return to work in PHI patients. Volume loss and 3VW were the most valuable radiologic predictors of outcome in multivariate linear and logistic regression models for both CHI and PHI. CONCLUSION: 3VW on late CT scans following traumatic brain injury is a powerful predictor of overall long-term cognitive outcomes and potential for return to work.