Fluorosis and cognitive development among children (6-14 years of age) in the endemic areas of the world: a review and critical analysis.

The fluoride contamination in water is still a live discussion among the scientific community, because of its beneficial and injurious health effects inflicted on the human population. The magnitude of groundwater fluoride contamination is aggravated by increasing anthropogenic activities. Groundwater is supposedly the main source through which people are highly exposed to fluoride, compared with other sources of exposure. Among human populations, fluoride-related health issues span from mild effects on teeth and bones to severe kidney problems, neurotoxicity, and even cancer. Nowadays, fluoride toxicity is gaining much attention in the endemic areas due to its adverse impact on the children's cognitive function, since children are more susceptible to fluoride toxicity as compared to adults. The primary mechanism behind the neurotoxicity of fluoride is still not clearly understood. However, knowingly, fluoride disrupts the biochemical mechanism and thus alters the normal functioning of the brain. Several human studies are suggestive of lowering children's IQ who was exposed to fluoride during their childhood. The conclusive findings of past research suggest that the fluoride concentration in potable water tends to grossly affect the children's IQ level. However, the body of proof is limited, because most of the studies are concentrated in few countries, and have their own limitations and data gaps. The grave implications of fluoride toxicity, therefore, demand extensive and properly designed research to bridging the data gap in developing countries. Furthermore, spanning research work across all the endemic areas of the world could generate larger database, helping resolve the issue on a large scale.

Fluoroquinolones (FQs) in the environment: A review on their abundance, sorption and toxicity in soil.

The use of fluoroquinolones (FQs) antibiotics as therapeutic agents and growth promoters is increasing worldwide; however their extensive uses are also resulting in antibiotic resistance among world communities. FQs have also become one of the major contaminants in the waste water bodies, which are not even completely removed during the treatment processes. Furthermore, their abundance in agricultural resources, such as the irrigation water, the bio-solids and the livestock manure can also affect the soil micro-environment. These antibiotics in soil tend to interact in several different ways to affect soil flora and fauna. The current review endeavors to highlight the some critical aspects of FQs prevalence in the environment. The review presents a detailed discussion on the pathways and abundance of FQs in soil. The discussion further spans the issue of sorption and FQs transformation into the soil better understand of their behavior and their toxicity to soil flora and fauna.

Petrol filling workers as biomonitor of PAH exposure and functional health capacity in resource-limited settings of city Rawalpindi, Pakistan.

This is the first study from Pakistan to report the exposure of petrol filling workers (n = 120) to naphthalene (Nap) and pyrene (Pyr) in relation to their functional capacities and health outcome. A group of non-exposed subjects (controls n = 46) was also recruited for comparison. The perceived health risk of the exposed workers was monitored using a questionnaire based on the self-reporting survey. The observed physical anomalies related to the health disorder included the acidity after meals, eye redness, appetite loss, skin lesions, and dryness of oral cavity, while those related to neurasthenic symptoms included the body aches, energy loss, twitching, fatigue, sleeplessness, fainting, and irritability. Mean Nap level observed in the exposed group (106 µg L-1) was significantly correlated (r = 0.49; p < 0.01) with cigarette smoking, while the average Pyr concentration (19.18 µg L-1) was associated with job duration. Workers exposed for 6 h per day or more had significantly high prevalence of physical disorders (OR = 2.79, 95% CI = 1.28-6.09). Neurasthenic symptoms were found in 65% of the subjects and were associated with years of involvement in job. Ten years or more work duration at petrol pumps could be associated with a substantial development of neurasthenic effects (OR = 2.80, 95% CI = 1.23-6.34). In conclusion, the subjects ascribed the disturbances in physical and neurological behavior to their occupation (petrol filling) and also rated their overall health and functional capacity as poor. To promote health of petrol pump workers, reduction in work hours and provision of masks and gloves could be introduced as occupational health interventions.

Industrial release of fluoroquinolones (FQs) in the waste water bodies with their associated ecological risk in Pakistan.

The unchecked production and use of fluoroquinolones (FQs) for the treatment of infections in human and livestock has increased in Pakistan, which resulted in large amount of antibiotics in water bodies. In the current study, the prevalence and associated ecological risk of three FQs were investigated in waste-water bodies and sludge samples of Kahuta and Hattar industrial zones. The average concentrations of ciprofloxacin (CIP), enrofloxacin (ENR) and levofloxacin (LEV) in the waste-water samples were slightly higher in Kahuta (i.e. 58, 32.9, and 36.7µgL-1 respectively), than those in Hattar sites (i.e. 42.1, 41.2, and 48.9µgL-1 respectively). However, the concentrations of CIP, ENR and LEV in the sludge samples were significantly higher (i.e. 159; 153 and 164µgkg-1 respectively) in Hattar sites, compared to those in Kahuta sites (i.e. 129, 58 and 91µgkg-1 respectively). The uses of FQs in the health sector resulted in water pollution and poses the ecological risk to aquatic organisms. The individual risk associated with CIP was highest in Kahuta industrial sites for green algae ranging (2900-9100) followed by M. aeruginosa (5800-18200), cyanobacteria (580-18204) and invertebrates (24.2-75.8). These values suggested that the prevalence of antibiotics in the waste-disposal sites could be potential risk for the aquatic ecosystem, and harmful to biodiversity.

Tracing biomarker of PAH-exposure and susceptibility factor (GSTM-polymorphism) among cancer patients in Pakistan.

We studied cancer patients for possible PAH exposure, using urinary concentration of 1-hydroxypyrene (1-OHP) as a biomarker of internal dose of polycyclic aromatic hydrocarbons (PAHs). The subjects included in this study belonged to various socio-demographic backgrounds, and were diagnosed with cancer (i.e. lung, head and neck or digestive tract cancer). In general, we observed high concentration of urinary 1-OHP among digestive tract cancer patients, compared with the controls (CN) (mean 1.06, median 1.03 and mean 0.62, median 0.63 µmol/mol-Cr in digestive tract cancer patients and controls respectively). The concentrations of urinary 1-OHP were higher than the background level of PAHs; therefore, these groups could have been exposed to PAHs. Highest urinary 1-OHP concentration was observed in digestive tract cancer patients (median 1.25 µmol/mol-Cr) with GSTM-1 genotype. The results of PCA were consistent with qualitative and quantitative data analysis. The contribution of urinary 1-OHP eigenvector revealed a relatively high PAH-exposure among cancer patients compared with CN, while diet and age were influential parameters among cancer patients, which could have a strong link in cancer etiology in the selected exposure groups.

A Review on the Abundance, Distribution and Eco-Biological Risks of PAHs in the Key Environmental Matrices of South Asia.

Polycyclic aromatic hydrocarbons (PAHs) are consistently posing high risks to human/biota in developing countries of South Asia where domestic areas are exposed to biomass burning and commercial/industrial activities. This review article summarized the available data on PAHs occurrence, distribution, potential sources and their possible risks in the key environmental matrices (i.e., Air, Soil/Sediments, Water) from South Asian Region (SAR). Available literature reviewed suggested that PAHs concentration levels were strongly influenced by the monsoonal rainfall system in the region and it has been supported by many studies that higher concentrations were measured during the winter season as compared to summer. Biomass burning (household and brick kilns activities), open burning of solid wastes and industrial and vehicular emissions were categorized as major sources of PAHs in the region. Regional comparison revealed that the contamination levels of PAHs in the water bodies and soil/sediments in SAR remained higher relatively to the reports from other regions of the world. Our findings highlight that there is still a general lack of reliable data, inventories and research studies addressing PAHs related issues in the context of environmental and human health in SAR. There is therefore a critical need to improve the current knowledge base, which should build upon the research experience from other regions which have experienced similar situations in the past. Further research into these issues in South Asia is considered vital to help inform future policies/control strategies as already successfully implemented in other countries.

The relative abundance and seasonal distribution correspond with the sources of polycyclic aromatic hydrocarbons (PAHs) in the surface sediments of Chenab River, Pakistan.

Chenab River is one of the most important rivers of Punjab Province (Pakistan) that receives huge input of industrial effluents and municipal sewage from major cities in the Central Punjab, Pakistan. The current study was designed to evaluate the concentration levels and associated ecological risks of USEPA priority polycyclic aromatic hydrocarbons (PAHs) in the surface sediments of Chenab River. Sampling was performed from eight (n = 24) sampling stations of Chenab River and its tributaries. We observed a relatively high abundance of ∑16PAHs during the summer season (i.e. 554 ng g(-1)) versus that in the winter season (i.e. 361 ng g(-1)), with an overall abundance of two-, five- and six-ring PAH congeners. Results also revealed that the nitrate and phosphate contents in the sediments were closely associated with low molecular weight (LMW) and high molecular weight (HMW) PAHs, respectively. Source apportionment results showed that the combustion of fossil fuels appears to be the key source of PAHs in the study area. The risk quotient (RQ) values indicated that seven PAH congeners (i.e. phenanthrene, anthracene, fluoranthene, pyrene, benzo(a)pyrene, chrysene and benzo(a)anthracene) could pose serious threats to the aquatic life of the riverine ecosystem in Pakistan.

Linking mobile source-PAHs and biological effects in traffic police officers and drivers in Rawalpindi (Pakistan).

The aim of this study was to evaluate the effect of traffic related polycyclic aromatic hydrocarbons (PAHs) on blood parameters of subjects, including traffic police officers (TP), drivers (DR) and control subjects (CN) with presumably different levels of exposure. We quantified the urinary 1-hydroxypyrene (1-OHPyr), α-naphthol and ß-naphthol (α- and ß-naph) as biomarkers of exposure to PAHs in relation with biomarkers of effect (Hb, MCV, PCV, PLT, RBCs), biomarkers of inflammation/infection (CRP, WBCs), oxidative stress (SOD) and oxidative DNA damage i.e. 8-hydroxy-2-deoxyguanosine (8-OHdG). Results showed that mean 1-OHPyr, α-naph and ß-naph concentrations were significantly higher in TPs (0.98, 1.55, and 1.9µmolmol-Cr(-1), respectively, p<0.05) than CNs (0.7, 0.6; 0.67µmolmol-Cr(-1), respectively, P<0.05). Furthermore, WBC and CRP were found in higher concentrations in TPs than CNs (7.04×10(3)µL(-1) and 0.95mgL(-1) vs. 5.1×10(3)µL(-1) and 0.54mgL(-1), respectively). The urinary 8-OHdG level, a biomarker of oxidative DNA damage, was higher in TPs than both CN and DR subjects (48ngmg-Cr(-1), 24ngmg-Cr(-1) and 33ngmg-Cr(-1), respectively). Self-reported health assessment indicates that, on the basis of daily time spent in the middle of heavy traffic, TPs and DRs more frequently suffered from adverse head and respiratory symptoms. The PCA analysis evidenced the impact of traffic pollution on exposure biomarkers and DNA damage. The study suggests that traffic pollution may be associated with important health risk, in particular on the respiratory system, not only for workers exposed to traffic exhausts but also for general public. Finally, vehicular air pollution in the city of Rawalpindi should be a high-priority concern for the Pakistan Government that needs to be addressed.

Biomarkers of PAH exposure and hematologic effects in subjects exposed to combustion emission during residential (and professional) cooking practices in Pakistan.

The aim of this study was to evaluate and compare the exposure of household women and professional male workers to combustion emission in the indoor and semi-outdoor environments, respectively, by using biochemical parameters and the biomarkers of exposure to polycyclic aromatic hydrocarbon (PAH). Female (WR n = 60) and male "cooks" (WC n = 60) exposed to the combustion emission of fuel wood and coal in rural/suburban areas of Pakistan were recruited in this study and compared to non-exposed female (CF) and male (CM) groups (n = 32 and 34, respectively). Urinary biomarkers of PAH exposure including 1-hyroxypyrene (1-OHPyr), α-naphthol, and ß-naphthol were analyzed together with the biomarkers of effect, including the serum c-reactive proteins (CRP), white blood cells (WBCs), hemoglobin (Hb), red blood cells (RBC), and platelet (PLT) count. In addition, blood superoxide dismutase (SOD) and urinary level of 8-hydroxydeoxyguanosine (8-OHdG) were evaluated to determine the oxidative stress and DNA damage, respectively. A questionnaire was used to document demographic-, health-, and exposure-related information. The results showed that urinary ß-naphthol was almost 44% higher in WR subjects than WC (median 7.69 vs. 3.39 µmol/mol-Cr, respectively; p = 0.01) and respective controls (CF). Higher urinary 8-OHdG were observed in WR (71.1 ng/mg-Cr) than WC (56.37 ng/mg-Cr) (p < 0.001), and lower life status and higher degree of headache were observed in WR than WC. In WCs, however, a low Hb and high WBC (8.29 × 10(3) µL(-1), ranging between 6.1 and 10.6 × 10(3) µL(-1)) were observed in comparison with CM. The study shows that WC subjects used larger amount of fuel and were subjected to prolonged exposure. It was concluded that the role of ventilation is fundamental and WR were more exposed to PAHs despite the fact that WC spent more time in cooking (due to occupational requirement) than WR.

Health and carcinogenic risk evaluation for cohorts exposed to PAHs in petrochemical workplaces in Rawalpindi city (Pakistan).

This study presents the analyses of urinary biomarkers (1-OHPyr, α- and ß-naphthols) of polycyclic aromatic hydrocarbons (PAHs) exposure and biomarkers of effect (i.e. blood parameters) in petroleum-refinery workers (RFs) and auto-repair workers (MCs). Exposed subjects had higher concentrations of white blood cell (WBC) count than control subjects (CN) subjects (5.31 × 10(3) µL(-1) in exposed vs. 5.15 × 10(3) µL(-1) in CN subjects), while the biomarker of oxidative DNA damage (8-OHdG) was significantly higher in MCs. The exposure among these two cohorts could be influenced by the ambience of the workplaces; in fact, MCs' shops are relatively damp and enclosed workplaces in comparison with the indoor environment of refineries. PAHs in the dust samples from mechanical workshops probably originated from mixed sources (traffic exhaust and petroleum spills), while the incremental lifetime cancer risk (ILCR) for MCs showed moderate-to-low cancer risk from exposure to dust-bound PAHs. The study shows that increasing PAH exposure can be traced in MC workstations and needs to be investigated for the safety of public health.

Reverse phase high performance liquid chromatographic method development based on ultravioletvisible detector for the analysis of 1-hydroxypyrene (PAH biomarker) in human urine.

OBJECTIVES: 1-hydroxypyrene is an important biomarker of exposure to polycyclic aromatic hydrocarbons (PAHs), which appears in the urine of exposed human subjects. In developing countries, where advanced instruments are not available, the importance of this biomarker demands convenient and sensitive methods for determination purposes. This study aimed at developing a methodology to quantify 1-hydroxypyrene (a biomarker of PAHs exposure) based on the UV-visible detector in the reverse phase high pressure liquid chromatography (HPLC). MATERIAL AND METHODS: A 20 µl injection of sample was used for manual injection into the HPLC Shimadzu, equipped with the SPD-20 A UV-visible detector, the LC-20AT pump and the DGU-20A5 degasser. The C-18 column was used for the purpose of the analysis. RESULTS: The method showed a good linearity (the range: R2 = 0.979-0.989), and high detectability up to the nmol level. The average retention was 6.37, with the accuracy of 2%, and the percentage of recovery remained 108%. The overall performance of this method was comparable (in terms of detection sensitivity) and relatively better than previously reported studies using the HPLC system equipped with the UV-detector. CONCLUSIONS: This method is suitable and reliable for the detection/quantification of the 1-OHP in human urine samples, using the UV-detector, however, it is less sensitive as compared to the results of a florescence detector.

Exposure to dust-bound PAHs and associated carcinogenic risk in primitive and traditional cooking practices in Pakistan.

The aim of this study was to determine the abundance and distribution of polycyclic aromatic hydrocarbons (PAHs) in dust samples collected from the selected professional cooking workplaces (WCs) and residential household cooking areas (WRs), where traditional and primitive cooking practices are still prevelent. Another aim of this study was to investigate the carcinogenic risk for Pakistani human exposure to dust-bound PAHs via the routes of inhalation, ingestion, and dermal contact. Generally, the concentration of individual congeners of PAHs in surface dust samples of WC sites was higher than those measured in WR sites (p < 0.05). The benzo(a)pyrene (B(a)P), a very high carcinogenic compound, was present in the dust samples from WC sites in the highest mean concentration (630 ng g(-1) dry weight (d.w.)). The BaP mean concentration in WC workplaces was almost eight times higher than the mean value found in WR exposure sites. Moreover, the average concentration of ∑PAHs, combustion origin PAHs (∑COMB) and sum total of 7-carcinogenic PAHs (∑7-carcinogens) were also significantly higher in WC dusts samples than that in WR workplaces. Principal component analysis (PCA) and diagnostic ratios suggested coal/wood combustion as major PAH emission sources in both exposure sites. The average incremental lifetime cancer risk (ILCR) suggested a moderate to potential high cancer risk for adults and children exposed to dust-bound PAHs in both exposure sites, in particular via both dermal and ingestion contact pathways.

Source, profile, and carcinogenic risk assessment for cohorts occupationally exposed to dust-bound PAHs in Lahore and Rawalpindi cities (Punjab province, Pakistan).

In this study, the occurrence and concentrations of PAHs in dust samples, which were collected from the traffic police cabins/working spots, located on the main busy roads of Lahore (TP-L) and Rawalpindi (TP-R) cities (Punjab province, Pakistan) and from the public transport vehicles in the same cities (named as AM-L and AM-R, respectively) were determined. The mean and median concentrations of ∑PAHs were observed in the following descending order: AM-L (1340 and 774 ng g(-1) d.w., respectively), TP-L (866 and 854 ng g(-1) d.w.), TP-R (504 and 379 ng g(-1) d.w.), and AM-R (393 and 290 ng g(-1) d.w. Source apportionment of the soil/dust-bound PAHs was also performed. In all the sampling areas, the diagnostic ratios, principal component analysis (PCA) followed by multiple linear regression (MLR) analysis indicated signatures of mixed sources of PAHs (including vehicular exhaust emission, gasoline/diesel, and coal/wood combustion). Estimated results of incremental lifetime cancer risk (ILCR) indicated that the traffic policemen and drivers, especially those in the urban area of Lahore, were at high risk of cancer via routes of dust ingestion and dermal contact. The results of this research could be very useful for the local Government in order to control the exposure and promote actions to alleviate PAH contamination and to manage health both at work places in the big cities of Pakistan.

A review of PAH exposure from the combustion of biomass fuel and their less surveyed effect on the blood parameters.

Many epidemiological studies from all over the world have reported that populations of rural and urban environments differ in their health issues due to the differences in the countrywide pollution pattern. In developing countries, various occupational cohorts and subsections of the population in urban and rural areas are routinely exposed to several environmentally widespread contaminants. Polycyclic aromatic hydrocarbons (PAHs) are a group of over hundred different compounds and have ubiquitous presence in rural and urban environments. Smoke from the combustion of biomass fuel contains a high concentration of carcinogenic PAHs, which are related with several human morbidities. The sources and types of biomass fuel are diverse and wide in distribution. Limited numbers of literature reports have focused the significant impact of PAHs on several components of blood, both in human and wildlife. The toxicity of PAHs to rapidly dividing cells (e.g., bone marrow cells) and other tissues is largely attributed to their reactive oxygenated metabolites, potential of causing oxidative stress, and the adducts of their metabolites with DNA. This review aims to encompass the blood-related effects of PAHs and associated human health risks-an aspect that needs further research-on the population of developing countries of the world in particular.

PAH exposure and oxidative stress indicators of human cohorts exposed to traffic pollution in Lahore city (Pakistan).

Pollution from road traffic is not only a major source of exposure to polycyclic aromatic hydrocarbons (PAHs) but also a growing problem in the city of Lahore (Pakistan). In this study, we evaluated exposure to traffic-related PAHs, among subjects including traffic police officers (TPs), rickshaw drivers (RKs) shopkeepers working near main roads (SKs) and a control group (CN) for comparative analyses. We monitored the 1-hydroxypyrene (1-OHP) as biomarkers of exposure to PAHs and its probable association with catalase (CAT), glutathione (GSH) glutathione peroxidase (GSHPx) activity as biomarkers of oxidative stress in selected cohorts from the city Lahore. Results showed that median 1-OHP concentration was significantly higher in TPs than CN (med 1.21 vs. 0.51 µmol mol-C(-1) respectively, P=0.046), followed by RKs (0.68 µmol mol-C(-1), P=0.19 vs. CN). Furthermore, GSH, GSHPx, and CAT activities were also higher in exposed subjects than CN, which indicated that they experienced oxidative stress. Similar, but less severe observations were recorded in SKs. Observation of self-reported health status showed that, on the basis of daily time spent in the middle of heavy traffic, TPs and RKs most frequently suffered from adverse head and respiratory symptoms. The study shows that increasing traffic pollution can be associated with important health risk factor not only for the workers in transport industry but also for the public. Finally, the issue of traffic pollution in Lahore city needs to be addressed on priority.

Benzene exposure among auto-repair workers from workplace ambience: a pioneer study from Pakistan.

OBJECTIVES: In Pakistan, the reports on benzene exposure among workers in chemical industries are almost non-existing due to limited research work in the field of exposure science. This study aimed to investigate such exposure in a widely adopted occupation in Rawalpindi city. MATERIAL AND METHODS: In this cross-sectional study, 60 blood samples (N = 20/group) of mechanics (MCs), spray painters (PNs) and control participants (CN) were analyzed. The socio-economic and demographic information of workers and that of workplaces was documented using a short questionnaire. RESULTS: We identified that the workers in spray-painting occupation are highly at risk of benzene exposure. The results showed that PNs were more at risk of exposure to benzene than MCs, and this exposure was significantly correlated with long working hours (r = 0.68, p < 0.001). Moreover, there are several limitations in workplace setups, which need to be addressed in order to mitigate workers health risk in this occupation. In addition to the reckless use of chemicals, other identified predictors of exposure included active and passive smoking, poor workplace hygiene and substandard ventilation. CONCLUSIONS: To mitigate workplace exposure, it is necessary to reduce working hours and encourage regular use of self-protective equipments and adoption of proper hygiene in chemical workplaces.

Levels and profile of several classes of organic contaminants in matched indoor dust and serum samples from occupational settings of Pakistan.

Dust ingestion is an important route of human exposure to organic contaminants, especially for flame retardants (FRs) in occupational settings. Several classes of organic contaminants were analyzed in matched dust and serum samples from academics and workers in electronics and clothing stores of Faisalabad, Pakistan. The concentrations of contaminants varied in dust as follow: organophosphate FRs (∑PFRs) > novel brominated FRs (∑NBFRs) > polybrominated diphenyl ethers (∑PBDEs) > organochlorine pesticides (∑OCPs) > polychlorinated biphenyls (∑PCBs), while, in serum, concentration varied: ∑OCPs > bromophenols (∑BPs) > ∑PCBs > ∑HO-PCBs ≈ ∑PBDEs. Two NBFRs, namely 1,2-bis(2,4,6-tribromophenoxy)-ethane (BTBPE) and bis(2-ethylhexyl) tetrabromophthalate (TBPH), were detected in <10% of the serum samples. p,p'-DDE was the major contaminant in serum contributing to ∼75% of the total contaminant burden. Levels of Penta-BDE congeners in serum and dust were significantly correlated (r = 0.64, p < 0.01) for the academics, suggesting dust ingestion as an important determinant for their serum levels.

Cancer risk evaluation of brick kiln workers exposed to dust bound PAHs in Punjab province (Pakistan).

Principal objective of this study was to evaluate the health risks of brick kiln workers to dust bound PAHs exposure in Punjab province (Pakistan). To this aim, surface dust samples were collected from brick kiln units located in Chung Khurd (Lahore city), Gujranwala city and Sohra village (in the vicinity of Gujranwala). The highest ΣPAH levels were measured in the dust samples collected in Sohdra village (mean 2578 ng g(-1) d.w., range 302-6757 ng g(-1) d.w.) followed by Gujranwala city (mean 957, range 16.1-1963 ng g(-1) d.w.) and Chung Khurd (mean 882, range 692-1007 ng g(-1) d.w.). Source identification using diagnostic ratios and principal component analysis identified coal and wood combustion as the major PAHs sources. The cancer risk model (CR-Model 1) and the Incremental Lifetime Cancer Risk model (ILCR-Model 2) were used to evaluate the cancer risk assessment via ingestion, inhalation and dermal contact pathways. Both models suggested that brick kiln workers (including adults and children) were exposed to high-potential carcinogenic risk via both ingestion and dermal contact pathways during the brick making process. This study also emphasizes the need for pollution control in the brick kiln industry of Pakistan.