Health and environmental risk assessment of mercury in outdoor and indoor dust in artisanal and small-scale gold mining area in Amansie-west district in the Ashanti Region of Ghana.

Mercury (Hg) pollution around artisanal and small-scale gold mining (ASGM) areas has been of much concern. Many studies have reported elevated Hg concentrations in environmental media, but studies on dust relating to inhalation exposure of Hg around ASGM area are limited. In this study, we investigated Hg in indoor and outdoor dust to reveal environmental and human health risk around ASGM in Amansie West district, Ghana. Indoor and outdoor dust samples were collected from Manso Abore and Manso Nkwanta in Ashanti Region. Concentration of Hg in the samples were analyzed using a direct Hg analyzer. The mean and median value of Hg concentration in the indoor dust (n = 31) were 2.2 ± 3.6 mg/kg and 0.72 mg/kg respectively while that of the outdoor dust (n = 60) were 0.19 ± 0.48 mg/kg and 0.042 mg/kg, respectively. The mean and median Hg concentration in indoor dust were about 11 and 17 times higher respectively than that in the outdoor dust. The Hg concentration in the indoor dust was statistically significantly higher than that of the non-miner in Manso Abore (p < 0.05) but was not significant in Manso Nkwanta, probably due to higher mining activity. The geo-accumulation index of the outdoor dust ranged from unpolluted to extremely polluted while that of the indoor dust ranged from moderately polluted to extremely polluted. Health risk assessments suggested that there was no potential non-carcinogenic health effect for Hg exposure relating to the dust to residents living in rooms of miners and non-miners.

Human health risk of mercury in street dust: A case study of children in the vicinity of compact fluorescence lamp factory, Hanoi, Vietnam.

Urban dust has been contaminated with toxic heavy metals from various diffused sources. On August 28, 2019, the compact fluorescence lamp (CFL) factory that generates light for Rang Dong Light Source and Vacuum Flask in Hanoi City in Vietnam was accidentally fired. The assessment for Hg contamination and its human health impact 2 months after the incident was conducted in autumn 2019. The heavy Hg pollution is still found near CFL. Additionally, localized Hg pollution by air and wind direction was identified at sites in the northeast direction from CFL. Namely, in the area located downstream of the southwest monsoon wind, Hg had a trend higher than other directions. The hazard quotient (HQ) and the hazard index (HI) were evaluated by four routes of Hg exposure pathways. The HI values for children and adults in the most polluted site (Site 15) were 0.968 and 0.468, respectively. This meant that children who lived around this site and commuted to schools were the most at risk regarding the potential adverse health effects of Hg in street dust around the polluted areas. This study also showed that Hg levels were affected by wind direction and that the higher Hg levels in the most polluted sites resulted from the wind flow to the sites. This study revealed that street dust may be a useful tool for the assessment of human and environmental health.

The human health risks assessment of mercury in soils and plantains from farms in selected artisanal and small-scale gold mining communities around Obuasi, Ghana.

Food consumption remains the commonest pathway through which humans ingest higher levels of mercury (Hg). Long-term exposure to Hg through Hg-contaminated food may result in acute or chronic Hg toxicity. Incessant discharge of Hg waste from ASGM facilities into nearby farms contaminates food crops. Ingestion of such food crops by residents may lead to detrimental human health effects. The human health risks upon exposure to total mercury (THg) and methylmercury (MeHg) in farmland soils and plantains from farms sited near ASGM facilities were studied in four communities around Obuasi, Ghana. The human health risk assessment was evaluated using hazard quotient (HQ), estimated average daily intake (e AvDI), hazard index (HI) and Hg elimination and retention kinetics. Tweapease, Nyamebekyere and Ahansonyewodea had HQ, e AvDI and HI for THg of plantains for both adults and children below the recommended USEPA limit of 1, 3 × 10-4 mg/kg/day and 1, respectively. Odumase had HQ, e AvDI and HI for THg of plantains for both adults and children, higher than the guideline values. This meant that only Odumase may cause non-carcinogenic human health effects upon repeated exposure. The HQ, e AvDI and HI values of MeHg for all the study areas were far below guideline values, hence may not pose any non-carcinogenic human health risks to residents even upon repeated exposure. Retention and elimination kinetics of Hg also showed that only plantains from Odumase may pose significant non-carcinogenic human health risks to residents because the final amount of inorganic mercury exceeded the extrapolated USEPA guideline value of 0.393 µg/kg/year.

Recovering nutrients and rejecting trace organic compounds in human urine by a forward osmosis-membrane distillation (FO-MD) hybrid system.

Urine is a major source of reclaimed water and fertilizer. Urine treatment involves two key processes: the recovery of nutrients and the rejection of trace organic compounds (TOrCs). In this study, we investigated the rejection of TOrCs and the recovery of nutrients in human urine using a seawater-driven forward osmosis and membrane distillation (FO-MD) hybrid system. Three 24 h experiments were conducted at draw solution temperatures of 30, 40, and 50 °C. The average rejection rates of cations, anions, and dissolved organic carbon were more than 93.7% and 79.5% in the FO-MD system and FO side, respectively. Ten types of TOrCs were detected in the feed solution, whereas none were detected in the product water, indicating that the TOrCs were completely rejected. The precipitates, i.e., the recovered nutrients in the FO side, were extremely close to magnesium ammonium phosphate (struvite, MgNH4PO4·6H2O), according to their electron microscopic images, elemental composition, and X-ray diffraction spectra, and it was estimated that approximately 85% of the nutrients in the feed solution were recovered. The rejection and recovery efficiencies were unaffected by the draw solution temperature. These results indicate the potential for the sustainable use of FO-MD-based treatments for human urine.

Combination of Vortex Agitation and Ultrasonic Irradiation for Mercury Removal from Sediment by Acid Extraction.

The removal of Hg from solid waste plays a key role in environmental protection. In this study, a fast, simple, and effective method for the removal of Hg by acid extraction, using a combination of vortex agitation and ultrasonic irradiation along with hydrobromic acid (HBr), was established using Hg-containing solid wastes. The optimal durations of vortex agitation and ultrasonic irradiation with 48% v/v of HBr were 5 and 6 min, respectively, and total Hg (T-Hg) extraction was achieved within 21 min. The proposed method was validated using the Certified Reference Material (CRM) ERM CC580 (estuarine sediment) and CRM NMIJ 7302-a (marine sediment). Under the optimized conditions, the efficiency rates of T-Hg extraction in both CRMs were 99.5% and 94.2%, with repeatabilities of 3.21% RSD and 2.31% RSD, respectively. The proposed extraction method can also be used for the remediation of Hg in other environmental matrices.

Poor self-rated health predicts the incidence of functional disability in elderly community dwellers in Japan: a prospective cohort study.

BACKGROUND: Although previous large population studies showed elderly with poor self-rated health (SRH) to be at a high risk of functional disability in Western countries, there have been few studies in which the association between SRH and functional disability was investigated in Japanese community dwellers. The association between SRH and functional disability, defined as certification of the long-term care insurance (LTCI) system, in Japanese elderly community dwellers was examined in this study. METHODS: A total of 10,690 individuals (39.5% men, mean age of 71.4 years) who were 65 years of age or more who did not have a history of cardiovascular disease or LTCI certification were followed in this prospective study for 10.5 years. SRH was classified into four categories: good, rather good, neither good nor poor, and poor. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) for the incidence of functional disability among the SRH groups for each sex. RESULTS: The number of individuals with functional disability was 3377. Men who rated poor for SRH scored significantly higher for functional disability (HR [95% confidence interval]: poor = 1.74 [1.42, 2.14]) while women who rated rather good, neither good nor poor, and poor scored significantly higher for functional disability (rather good =1.12 [1.00, 1.25], neither good nor poor = 1.29 [1.13, 1.48], poor = 1.92 [1.65, 2.24]: p for trend < 0.001 in both sexes). CONCLUSION: Self-rated health, therefore, might be a useful predictor of functional disability in elderly people.

Ten-Year Cerebrovascular Disease Trend Occurrence by Population-based Stroke Registry in an Aging Japan Local Prefecture.

BACKGROUND: Cerebrovascular diseases are a major cause of death for Japanese people, but up-to-date national or prefectural incidences are unknown. We calculated the last 10-year cerebrovascular diseases incidence in an aging local prefecture in Japan with 1.2 million inhabitants and used the data to predict the future incidence. METHODS: We retrospectively analyzed inventory surveys from the Iwate Stroke Registry (data from the whole Iwate Prefecture) from 2008 to 2017. We compared age-adjusted and age-specific incidence rates between the first half period from 2008 to 2012 and the last half period from 2013 to 2017. We used the incidence change rate and the forecasted population number to predict the future incidence. RESULTS: In a decade, the age-adjusted cerebrovascular diseases incidence rate per 100,000 person-years in the Japan standard population decreased from 212.1 to 176.8 in men and from 123.1 to 97.0 in women. The age-specific incidence rates and the number of incidences of those younger than 55 years decreased only slightly, but those of people 55 years or older decreased. The total number of incidence in 2040 will decrease to two-thirds of the value in 2015, but the number of incidence of those 85 years and older will increase by 2040. CONCLUSIONS: The cerebrovascular diseases rate and number of incidence decreased during the last decade and will decrease in the future, but the incidence in the oldest-old will increase. Specific nursing care and social measures to treat cerebrovascular diseases in the oldest-old will be needed.

Ability of B-Type Natriuretic Peptide Testing to Predict Cardioembolic Stroke in the General Population　- Comparisons With C-Reactive Protein and Urinary Albumin.

BACKGROUND: The ability of cardiovascular biomarkers to predict the incidence of stroke subtypes remains ill-defined in the general population.Methods and Results:The blood levels of B-type natriuretic peptide (BNP) and high-sensitivity C-reactive protein (hs-CRP) and urinary albumin corrected by urinary creatinine (UACR) were determined in a general population (n=13,575). The ability to predict the incidence of ischemic stroke subtypes (lacunar, atherothrombotic, cardioembolic) for each biomarker was assessed based on the area under the receiver-operating characteristic curve (AUC-ROC) and using Cox proportional hazard modeling. The predictive abilities of UACR and hs-CRP for any subtype of ischemic event were found to be suboptimal. However, the ability of BNP to predict the incidence of cardioembolic stroke was excellent (AUC-ROC=0.81). When BNP was added to established stroke risk factors, the ability to predict cardioembolic stroke in terms of the AUC-ROC significantly improved (4-year follow-up, P=0.018; 8-year follow-up, P=0.009). Furthermore, when BNP was added to the JPHC score, the ability to predict cardioembolic stroke was significantly improved (net reclassification improvement=0.968, P<0.0001: integrated discrimination improvement=0.039, P<0.05). CONCLUSIONS: In the general population, plasma BNP was an excellent biomarker for predicting the incidence of cardioembolic stroke when used alone or in combination with established stroke risk factors.

Risk of stroke and heart failure attributable to atrial fibrillation in middle-aged and elderly people: Results from a five-year prospective cohort study of Japanese community dwellers.

BACKGROUND: The relative and absolute risks of stroke and heart failure attributable to atrial fibrillation (AF) have not been sufficiently examined. METHODS: A prospective study of 23,731 community-dwelling Japanese individuals was conducted. Participants were divided into two groups based on the presence or absence of prevalent AF (n = 338 and n = 23,393, respectively). Excess events (EE) due to AF and relative risks (RRs) determined using the non-AF group as the reference for incident stroke and heart failure were estimated using Poisson regression stratified by age groups (middle-aged: 40-69 years old; elderly: 70 years of age or older) after adjustment for sex and age. RESULTS: There were 611 cases of stroke and 98 cases of heart failure during the observation period (131,088 person-years). AF contributed to a higher risk of stroke both in middle-aged individuals (EE 10.4 per 1000 person-years; RR 4.88; 95% confidence interval [CI], 2.88-8.29) and elderly individuals (EE 18.3 per 1000 person-years; RR 3.05; 95% CI, 2.05-4.54). AF also contributed to a higher risk of heart failure in middle-aged individuals (EE 3.7 per 1000 person-years; RR 8.18; 95% CI, 2.41-27.8) and elderly individuals (EE 15.4 per 1000 person-years; RR 7.82; 95% CI, 4.11-14.9). Results obtained from multivariate-adjusted analysis were similar (stroke: EE 8.9 per 1000 person-years; RR 4.40; 95% CI, 2.57-7.55 in middle-aged and EE 17.4 per 1000 person-years; RR 2.97; 95% CI, 1.99-4.43 in elderly individuals; heart failure: EE 3.1 per 1000 person-years; RR 7.22; 95% CI, 2.06-25.3 in middle-aged and EE 14.1 per 1000 person-years; RR 7.41; 95% CI, 3.86-14.2 in elderly individuals). CONCLUSIONS: AF increased the risk of stroke by the same magnitude as that reported previously in Western countries. AF increased the RR of heart failure more than that in Western populations.

The Impact and Effectivity of an Inventory Survey for a Stroke Registry in Iwate Prefecture.

BACKGROUND: The accuracy of a stroke registration program in Iwate prefecture was greatly affected by cooperation from medical facilities and doctors in the field. The number of registered cases from noncore hospitals was less, but the accuracy of registration was unknown. This report presents the impact and effectivity of an inventory survey of the stroke registry. SUBJECTS AND METHODS: Details of subjects living in coastal and northern regions of Iwate Prefecture who developed a cerebrovascular attack between 2012 and 2014 were obtained from the Iwate Stroke Registry through an inventory survey. Annual incidence rate from core hospitals and noncore hospitals were compared. To evaluate factors registered from noncore hospitals, multivariate analyses were performed for sex, age, living area, type of stroke, and past history of cerebrovascular diseases. RESULTS: Annual crude incidence rate for 100,000 residual populations were 428.8 in men and 351.2 in women from core hospitals and 38.5 in men and 43.7 in women from noncore hospitals. Ratios of noncore hospitals against all the hospitals were 8.3% for men and 11.1% for women. Multivariate analyses for age, ischemic type of stroke, past history of cerebrovascular diseases, and living in areas without a core hospital were significant; however, sex was not a significant factor. CONCLUSION: The inventory survey of the stroke registry program in the Iwate prefecture was useful to prevent missing data of stroke cases from noncore hospitals, including patients who are elderly, with ischemic stroke onset, with a past history of stroke, or living in areas without core hospitals.

Standardized Prevalence Ratios for Atrial Fibrillation in Adult Dialysis Patients in Japan.

BACKGROUND: While it is assumed that dialysis patients in Japan have a higher prevalence of atrial fibrillation (AF) than the general population, the magnitude of this difference is not known. METHODS: Standardized prevalence ratios (SPRs) for AF in dialysis patients (n = 1510) were calculated compared to data from the general population (n = 26 454) living in the same area. RESULTS: The prevalences of AF were 3.8% and 1.6% in dialysis patients and the general population, respectively. In male subjects, these respective values were 4.9% and 3.3%, and in female subjects they were 1.6% and 0.6%. The SPRs for AF were 2.53 (95% confidence interval [CI], 1.88-3.19) in all dialysis patients, 1.80 (95% CI, 1.30-2.29) in male dialysis patients, and 2.13 (95% CI, 0.66-3.61) in female dialysis patients. CONCLUSIONS: The prevalence of AF in dialysis patients was twice that in the population-based controls. Since AF strongly contributes to a higher risk of cardiovascular mortality and morbidity in the general population, further longitudinal studies should be conducted regarding the risk of several outcomes attributable to AF among Japanese dialysis patients.

Comparison between urine albumin-to-creatinine ratio and urine protein dipstick testing for prevalence and ability to predict the risk for chronic kidney disease in the general population (Iwate-KENCO study): a prospective community-based cohort study.

BACKGROUND: This study compared the combination of estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) vs. eGFR and urine protein reagent strip testing to determine chronic kidney disease (CKD) prevalence, and each method's ability to predict the risk for cardiovascular events in the general Japanese population. METHODS: Baseline data including eGFR, UACR, and urine dipstick tests were obtained from the general population (n = 22 975). Dipstick test results (negative, trace, positive) were allocated to three levels of UACR (<30, 30-300, >300), respectively. In accordance with Kidney Disease Improving Global Outcomes CKD prognosis heat mapping, the cohort was classified into four risk grades (green: grade 1; yellow: grade 2; orange: grade 3, red: grade 4) based on baseline eGFR and UACR levels or dipstick tests. RESULTS: During the mean follow-up period of 5.6 years, 708 new onset cardiovascular events were recorded. For CKD identified by eGFR and dipstick testing (dipstick test ≥ trace and eGFR <60 mL/min/1.73 m(2)), the incidence of CKD was found to be 9 % in the general population. In comparison to non-CKD (grade 1), although cardiovascular risk was significantly higher in risk grades ≥3 (relative risk (RR) = 1.70; 95 % CI: 1.28-2.26), risk predictive ability was not significant in risk grade 2 (RR = 1.20; 95 % CI: 0.95-1.52). When CKD was defined by eGFR and UACR (UACR ≥30 mg/g Cr and eGFR <60 mL/min/1.73 m(2)), prevalence was found to be 29 %. Predictive ability in risk grade 2 (RR = 1.41; 95 % CI: 1.19-1.66) and risk grade ≥3 (RR = 1.76; 95 % CI: 1.37-2.28) were both significantly greater than for non-CKD. Reclassification analysis showed a significant improvement in risk predictive abilities when CKD risk grading was based on UACR rather than on dipstick testing in this population (p < 0.001). CONCLUSIONS: Although prevalence of CKD was higher when detected by UACR rather than urine dipstick testing, the predictive ability for cardiovascular events from UACR-based risk grading was superior to that of dipstick-based risk grading in the general population.

Gene expression analyses of vitellogenin, choriogenin and estrogen receptor subtypes in the livers of male medaka (Oryzias latipes) exposed to equine estrogens.

In the present study, we investigated transcriptional profiles of estrogen-responsive genes, such as vitellogenins (Vtg1 and Vtg2), choriogenins (ChgL and ChgH) and estrogen receptor subtypes (ERα, ERß1, and ERß2), in the liver of male medaka fish (Oryzias latipes) that were exposed to six equine estrogens (1-300 ng l(-1) ) for 3 days. Our quantitative reverse transcription-polymerase chain reaction (RT-PCR) analyses revealed that the expression levels of hepatic Vtg, Chg and ERα genes in male medaka responded to various types and concentrations of equine estrogens. The estrogenic potentials of the tested chemicals were in the order of equilin > 17ß-estradiol > equilenin > 17ß-dihydroequilin > 17ß-dihydroequilenin > 17α-dihydroequilin > 17α-dihydroequilenin, showing the higher estrogenic potential of equilin than that of 17ß-estradiol. Our results also showed that the estrogenicities of 17ß-dihydroequilin and 17ß-dihydroequilenin were more potent than that of 17α-dihydroequilin and 17α-dihydroequilenin. Furthermore, in gene expression analyses of hepatic ER subtypes, observations were made to note that 17ß-estradiol and equilin induced ERα transcription in male medaka, and the ERα transcription level had significantly positive correlations with the expression of Vtg and Chg genes. In contrast, in the same 17ß-estradiol and equilin treatment groups, it was shown that the transcription levels of hepatic ERß1 and/or ERß2 had significantly negative correlations with the expression of Vtg and Chg genes. These results suggested some potential involvement of the ER subtypes in the regulation of Vtg and Chg gene expressions in the liver. This is the first report describing the comprehensive analyses of in vivo estrogenicity of the equine estrogens in male medaka. Copyright © 2016 John Wiley & Sons, Ltd.

Endocrine-disrupting potentials of equine estrogens equilin, equilenin, and their metabolites, in the medaka Oryzias latipes: in silico and DNA microarray studies.

Although several previous studies have demonstrated the presence of equine estrogens in the aquatic environment, limited data are currently available on the endocrine-disrupting potentials in fish and the risks they pose to aquatic organisms. To investigate the interactions of major equine estrogens equilin (Eq) and equilenin (Eqn), as well as their metabolites 17α-dihydroequilin, 17ß-dihydroequilin, 17α-dihydroequilenin and 17ß-dihydroequilenin, with the estrogen receptor α (ERα) of medaka (Oryzias latipes), a three-dimensional model of the ligand-binding domain (LBD) of ERα was built in silico, and docking simulations were performed. The docking simulation analysis indicated that the interaction of 17ß-dihydroequilenin with the ERα LBD is the most potent, followed by those of 17α-dihydroequilin and 17ß-dihydroequilin, whereas those of Eq and Eqn were least potent. We further analyzed gene expression profiles in the livers of male medaka exposed to Eq and Eqn. A DNA microarray representing 6000 genes revealed that 24-h exposure to Eq and Eqn (100 ng/L) upregulated the expression of 6 and 34 genes in the livers of males, respectively. Genes upregulated by Eq included the estrogenic biomarker genes vitellogenins and choriogenins, suggesting the estrogenic potential of Eq. In contrast, Eqn exposure upregulated several cancer-related genes, such as mediator complex subunit 16 and RAS oncogene family members, suggesting a carcinogenic potential for Eqn. These results suggest that equine estrogens may have not only endocrine-disrupting potentials via the ERα signaling pathway but also carcinogenic potency in male medaka.

Elevated blood pressure at the first measurement predicts cardiovascular disease independently from the subsequent second reading in men, but not in women.

BACKGROUND AND METHODS: There have been no investigations concerning the association of each blood pressure (BP) reading with future cardiovascular disease (CVD) when multiple measurements are taken on one occasion. This community-based, prospective cohort study (n = 23 344, mean age = 62.4 years) investigated the associations between the BP obtained from the first and second of two consecutive measurements on one occasion and future cardiovascular events in men and women. RESULTS: During the mean follow-up of 5.5 years, 624 CVD events were identified. On the Cox regression analysis of age- and BP-adjusted models, the increased CVD risk of a hypertensive first measurement (systolic BP ≥ 140 mmHg) was independent from the second measurement in men. Even in subjects without a hypertensive second measurement, the CVD risk of the hypertensive first measurement was increased in men. In women, despite a hypertensive first measurement, subjects with a systolic BP < 130 mmHg on the second measurement showed a significantly reduced risk for CVD compared with subjects who retained a hypertensive level during the two measurements. CONCLUSIONS: An elevated BP on the first measurement should not be disregarded for CVD risk estimation in men, even if the second BP moves to the normal range. In women, elevated BP on the first measurement may have relatively less meaning for CVD prediction if the second BP shifts to a normal range.

Extent of flood damage increased cerebrovascular disease incidences in Iwate prefecture after the great East Japan earthquake and tsunami of 2011.

BACKGROUND: Several studies have reported on increases in the incidence of cardiovascular and cerebrovascular diseases after huge earthquakes. An increase in the incidence of cerebrovascular diseases was observed after the Great East Japan Earthquake and Tsunami of 2011. To assess whether tsunami damage or the earthquake was responsible for this trend, we assessed the relative impact of earthquake magnitude and flood damage on cerebrovascular disease. METHODS: A total of 12 coastal municipalities facing the epicenter were divided into 4 flood severity groups according to the percentage of people living in the flooded areas (<20, 20-40, 40-60, and ≥60%) and 3 groups according to the Japanese Meteorological Agency seismic intensity of the main shock (<4.5, 4.5-5.0 and ≥5.0). The standard incidence ratios (SIRs) of cerebrovascular diseases in the first 4 weeks after the disaster compared with the same periods in 2008-2010 were calculated for each flood severity group and each earthquake severity group. Odds ratios (ORs) of disease incidence and the adjusted ORs for seismic intensity (using the Mantel-Haenszel method) between the higher (≥40%) and the lower flooded area (<40%) were compared with the same periods in 2008-2010. Likewise, ORs and adjusted ORs for flood severity in the high seismic intensity area (≥4.9) were compared with those in the low seismic intensity area (<4.9). RESULTS: SIRs increased with the increased flood severity: 0.94 (0.59-1.30) at <20%, 1.02 (0.70-1.34) at 20-40%, 1.26 (0.66-1.86) at 40-60% and 1.98 (1.25-2.72) at ≥60%. However, SIRs did not increase with increased seismic intensity: 0.95 (0.60-1.29) at <4.5, 1.52 (1.07-1.98) at 4.5-5.0 and 1.17 (0.80-1.54) at ≥5.0. ORs and adjusted ORs for seismic intensity in the high flood area compared with the low flood area were significant: 1.68 (1.07-2.65) and 1.78 (1.08-2.96), respectively. However, ORs and adjusted ORs for flood severity in the high seismic intensity area compared with the low intensity area were not significant: 1.33 (0.82-2.17) and 1.19 (0.62-2.31), respectively. CONCLUSIONS: Cerebrovascular disease incidences after the Great East Japan Earthquake and Tsunami of 2011 increased because of tsunami damage and not because of the earthquake magnitude.

Human Health Risk Assessment from Mercury-Contaminated Soil and Water in Abu Hamad Mining Market, Sudan.

Artisanal and small-scale gold mining (ASGM) poses a significant global threat due to mercury emissions and resulting health hazards. This study focuses on assessing these risks in the Abu Hamad ASGM community in Sudan. Utilizing the Mercury Analyzer 3000 (NIC), analyses of twelve soil samples (including one tailings sample) and seven water samples revealed the highest concentrations near amalgam burning locations: 34.8 mg/kg in soil (S06) and 3.26 µg/L in water (W03). Concentrations decrease with distance, with soil near burning exceeding tailings (S05 = 19.0 mg/kg). Hazard quotients indicate mercury vapor inhalation as the primary exposure route from soil, with the Hazard Index reaching 5.34 for adults and 33.4 for children close to amalgam burning sites. Water samples generally pose little risk except for W03, where children face potential danger via ingestion (HI = 1.74). These findings emphasize the urgent need for adopting retorts and eco-friendly practices to reduce mercury emissions and protect ASGM communities.

Influence of the great East Japan earthquake and tsunami 2011 on occurrence of cerebrovascular diseases in Iwate, Japan.

BACKGROUND AND PURPOSE: Little information is available regarding the occurrence of cerebrovascular diseases after tsunamis. This study was performed to determine the influence of the tsunami damage caused by the Great East Japan earthquake on occurrence of cerebrovascular diseases. METHODS: Subjects from the coastline and inland areas of Iwate Prefecture who developed cerebrovascular diseases before and after the disaster were included in the analysis. Standardized incidence ratios of 2011 against the previous 3 years were calculated in two 4-week periods before and four 4-week periods after the disaster, according to stroke subtype, sex, age group, and flood damage. RESULTS: The standard incidence ratio for cerebrovascular diseases was 1.20 (1.00-1.40) in the first 4-week period after the disaster and was not significant in other periods. The standard incidence ratios in the first 4-week period for cerebral infarction, intracerebral hemorrhage, and subarachnoid hemorrhage were 1.22 (0.98-1.46), 1.15 (0.76-1.55), and 1.20 (0.52-1.88), respectively. These values were 1.51 (1.19-1.88) for men, 1.35 (1.06-1.64) for subjects aged ≥ 75 years, and 1.35 (1.06-1.64) for the high flooding areas. The standard incidence ratio of cerebral infarction in the first 4-week period for men aged ≥ 75 years in the high flooding areas was 2.34 (1.34-3.34). CONCLUSIONS: In the areas highly flooded by the tsunami caused by the Great East Japan earthquake, the occurrence of cerebral infarction among elderly men more than doubled in the first 4 weeks after the disaster.

Comparison of predictability of future cardiovascular events between chronic kidney disease (CKD) stage based on CKD epidemiology collaboration equation and that based on modification of diet in renal disease equation in the Japanese general population--Iwate KENCO Study.

BACKGROUND: Whether estimated glomerular filtration rate (eGFR) calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Study equation (eGFRCKDEPI) improves risk prediction compared to that calculated using the Modification of Diet in Renal Disease (MDRD) study equation (eGFRMDRD) has not been examined in a prospective study in Japanese people. METHODS AND RESULTS: Participants (n=24,560) were divided into 4 stages (1, ≥90; 2, 60-89 (reference); 3a, 45-59; 3b+ <45 ml·min(-1)·1.73 m(-2)) according to eGFRCKDEPI or eGFRMDRD. Endpoints were all-cause death, myocardial infarction (MI) and stroke. Area under the receiver operating characteristic curves (95% confidence intervals) for predicting all-cause death, MI and stroke by eGFRCKDEPI vs. eGFRMDRD were 0.680 (0.662-0.697) vs. 0.582 (0.562-0.602); 0.718 (0.665-0.771) vs. 0.642 (0.581-0.703); and 0.656 (0.636-0.676) vs. 0.576 (0.553-0.599), respectively. Multivariate-adjusted Cox regression and Poisson regression analysis results were similar for adjusted incidence rates and adjusted hazard ratios in each corresponding stage between the 2 models and no differences were found in model assessment parameters. Net reclassification improvement (NRI) for predicting all-cause death, MI and stroke were estimated to be 6.7% (P<0.001), -1.89% (P=0.029) and -0.20% (P=0.421), respectively. CONCLUSIONS: Better discrimination was achieved using eGFRCKDEPI than eGFRMDRD on univariate analysis. NRI analysis indicated that the use of eGFRCKDEPI instead of eGFRMDRD offered a significant improvement in reclassification of death risk.

Factors related to tooth loss among community-dwelling middle-aged and elderly Japanese men.

BACKGROUND: Using data from a large-scale community-based Japanese population, we attempted to identify factors associated with tooth loss in middle-aged and elderly men. METHODS: A total of 8352 men aged 40 to 79 years who lived in the north of the main island of Japan and underwent health checkups were enrolled between 2002 and 2005. Number of teeth was assessed by the question, "How many teeth do you have (0, 1-9, 10-19, or ≥20)?". On the basis of the answer to this question, participants were classified into 2 groups (≤19 teeth or ≥20 teeth). Using multivariate logistic regression, factors related to having 19 or fewer teeth were estimated. RESULTS: The numbers (percentages) of participants who had 0, 1 to 9, 10 to 19, and 20 or more teeth were 1764 (21.1%), 1779 (21.3%), 1836 (22.0%), and 2973 (35.6%), respectively. Among the participants overall and those aged 65 to 79 years, having 19 or fewer teeth was significantly associated with older age, smoking status (current smoking and ex-smoking), and low education level. In addition, men with 19 or fewer teeth were more likely to have a low body mass index and low serum albumin level and less likely to be current alcohol drinkers. Among men aged 40 to 64 years, but not men aged 65 to 79 years, those with 19 or fewer teeth were more likely to have a low serum high-density lipoprotein cholesterol level and high glycosylated hemoglobin (HbA1c) level. CONCLUSIONS: Smoking, low education level, and poor nutritional status were associated with tooth loss among middle-aged and elderly Japanese men.