Scottish Health Technologies Group: enhancing patient engagement.

OBJECTIVES: The Scottish Health Technologies Group (SHTG) provides evidence support and advice to the National Health Service in Scotland on the use of new and existing health technologies, which, although not medicines, are likely to have significant implications for people's care. The purpose of this paper is to highlight the developments that have taken place in the SHTG's patient involvement processes in the years 2017 to 2019, focusing primarily on specific engagement with patient organizations and considering how the new approaches have been received by stakeholders. METHODS: Feedback from patient organizations that participated in the SHTG submission process, alongside SHTG committee members' views on patient organizations contributions, was gathered primarily via online questionnaires. The number of times that patient organizations were invited and accepted the opportunity to peer-review SHTG advice statements prior to and after the employment of a Public Involvement Advisor (PIA) was analyzed. RESULTS: Completed questionnaires (n = 4) from three case study examples showed high patient organization satisfaction with their experience of the SHTG process. The feedback from SHTG committee members that was gathered indicated that patient organization participation was generally well received. The number of peer reviews from patient organizations for SHTG advice statements in 2018-2019 doubled to 86 percent of the total advice statements (n = 22), compared with 43 percent (n = 14) in 2016-2017. CONCLUSIONS: Significant progress has been made toward improving the SHTG's patient involvement processes. A dedicated PIA post within the SHTG has allowed for a more tailored support to patient organizations and has encouraged their increased participation in SHTG processes.

A high throughput targeted and non-targeted method for the analysis of microcystins and anatoxin-A using on-line solid phase extraction coupled to liquid chromatography-quadrupole time-of-flight high resolution mass spectrometry.

Microcystins are cyclic heptapeptide hepatotoxins produced by cyanobacteria in freshwater. Sample preparation for the analysis of these cyanotoxins in water from algal blooms can take up to several days due to the matrix complexity and the low detection limits required to comply with current legislation. Moreover, there is a large number of unknown microcystins that could potentially exist in the environment resulting from different amino acid substitutions into the microcystin skeletal structure. To tackle these problems, the present study involved the development of a high throughput method based on on-line solid phase extraction coupled to liquid chromatography that could provide quantitative results for 12 microcystin variants (LR, YR, RR, HtyR, HilR, WR, LW, LA, LF, LY, Dha7-LR, and Dha7-RR) and anatoxin-A in less than 3 h with detection limits between 0.004 and 0.01 µg L-1 and expanded uncertainty between 4 and 14%. Data-dependent acquisition was employed for the non-targeted analysis of these cyanotoxins. Filtering the data based on structure diagnostic fragments, two unknown microcystin variants not previously reported in the literature were detected. The structures Leu1-microcystin-Met(O)R and Leu1-microcystin-LY were fully characterized by accurate mass measurement, collision-induced dissociation, and fragmentation prediction software.

EXPERIENCES IN ADAPTING EUROPEAN NETWORK FOR HEALTH TECHNOLOGY ASSESSMENT RAPID REVIEWS TO INFORM LOCAL DECISION MAKING.

OBJECTIVES: The Scottish Health Technologies Group (SHTG) produces rapid reviews on nonmedicine technologies to inform advice for decision making in the National Health Service in Scotland (NHSScotland). This study describes our experiences and lessons learned in adapting for NHSScotland two rapid Relative Effectiveness Assessments (REAs) produced as part of the European Network for Health Technology Assessment (EUnetHTA) project to test collaborative preparation and then local adaptation. METHODS: The REAs were examined for their relevance to NHSScotland and the feasibility of their adaptation evaluated using a screening toolkit. Some supplementary literature searches were conducted and additional background information on epidemiology and the specific technologies was sought. To inform decision making within Scotland, it was also necessary to identify and review cost-effective analyses. RESULTS: Robust evidence reviews were delivered for NHSScotland. Time saved was less than anticipated, partly due to the need to add in health economic information, and partly because of attempts to supplement and update the EUnetHTA material. The preparation of an accompanying advice statement for NHSScotland enabled the inclusion of local contextual information. CONCLUSIONS: Collaborative production and adaptation of HTAs is feasible and would be aided by the inclusion of cost-effectiveness analyses in the original work. Agencies should develop clear processes for adapting such reviews for their context with the focus on selecting appropriate topics for adaptation, avoiding unnecessary supplementation of the original work, and ensuring local ownership of final advice.

A modified QuEChERS approach for the screening of dioxins and furans in sediments.

A rapid extraction and cleanup method for the screening of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans in sediments is described which combines a modified QuEChERS extraction with carbon reversed-phase solid phase extraction cleanup. This approach is compared to the classical Soxhlet extraction and multi-column cleanup method in terms of toxic equivalence quotients (TEQs), precision, instrumental chromatography, method detection limits (MDLs), recovery of (13)C-labelled quantitation standard, sample preparation time, workload capacity, and sustainability factors. TEQs of 32 sediment samples were found to be well correlated and differed by 16 ± 10 % between the two methods. Certified and standard reference sediments differed by 4.1 and 6.7 %, respectively. Precision and instrumental chromatography were comparable. While the modified QuEChERS method had higher MDLs and lower recoveries, in terms of preparation time and workload capacity, the modified QuEChERS approach can prepare approximately 30 samples per day as compared to 10-20 samples in 3 to 4 days for the classic method. The modified QuEChERS method was also found to be safer and greener. The appreciable improvement in capacity makes the modified QuEChERS approach a suitable alternative to the classical method for applications where turnaround time and the number of samples that can be analyzed are more important than minimal detection limits. Graphical Abstract Created using Microsoft Paint for Windows 7 Professional A bar graph with the structures of dioxins and furans on the x axis shows agreement between two sets of data. A legend labels the first set of data as Soxhlet. The Soxhlet set is illustrated as four days crossed off of a calendar page, a Soxhlet extractor, and several packed chromatography columns. The legend identifies the second set of data as QuEChERS. The QuEChERS set is represented by a clock face marked with twenty four hours, two centrifuge tubes containing the sediment and reagents before and after salting out, and a carbon column attached to a reservoir.

INFLUENCE OF HEALTH TECHNOLOGY ASSESSMENT AND ITS MEASUREMENT.

OBJECTIVES: The aim of this study was to obtain information on methods used to measure health technology assessment (HTA) influence, decisions that were influenced, and outcomes linked to HTA. METHODS: Electronic databases were used to locate studies in which HTA influence had been demonstrated. Inclusion criteria were studies that reliably reported consideration by decision makers of HTA findings; comparative studies of technology use before and after HTA; and details of changes in policy, health outcomes, or research that could be credibly linked to an HTA. RESULTS: Fifty-one studies were selected for review. Settings were national (24), regional (12), both national and regional (3) hospitals (9), and multinational (3). The most common approach to appraisal of influence was review of policy or administrative decisions following HTA recommendations (51 percent). Eighteen studies (35 percent) reported interview or survey findings, thirteen (26 percent) reviewed administrative data, and six considered the influence of primary studies. Of 142 decisions informed by HTA, the most common types were on routine clinical practice (67 percent of studies), coverage (63 percent), and program operation (37 percent). The most frequent indications of HTA influence were on decisions related to resource allocation (59 percent), change in practice pattern (31 percent), and incorporation of HTA details in reference material (18 percent). Few publications assessed the contribution of HTA to changing patient outcomes. CONCLUSIONS: The literature on HTA influence remains limited, with little on longer term effects on practice and outcomes. The reviewed publications indicated how HTA is being used in different settings and approaches to measuring its influence that might be more widely applied, such as surveys and monitoring administrative data.

Identification and occurrence of analogues of dechlorane 604 in Lake Ontario sediment and their accumulation in fish.

The dechlorane family of flame retardants, which includes Mirex (also known as Dechlorane), Dechlorane Plus (DP), and Dechloranes (Dec) 602, 603, and 604, were manufactured at a facility along the Niagara River, upstream of Lake Ontario. Some of these compounds remain in use. In a previous study, we found Mirex and Dec602 to have greater bioaccumulation potentials than Dec604 and DP based on calculated biota-sediment accumulation factors (BSAFs). In this study, analogues of Dec604, containing fewer bromines and mixed substitutions of bromine and chlorine, were identified in Lake Ontario sediment and fish using high and ultrahigh resolution mass spectrometric techniques. The tribromo-Dec604 (Br3Dec604) analogue, known as Dechlorane 604 Component B (Dec604 CB), was present in lake trout and whitefish at concentrations of 10-60 ng/g lipid weight, approximately 50-200 times greater than concentrations measured for Dec604. In addition, BrDec604 and Br2Dec604 analogues, and mixed Br2Cl2Dec604, Br3ClDec604, Br2ClDec604, and BrCl2Dec604 analogues were also present. We have shown that solutions of Dec604 and Dec604 CB exposed to UV-light undergo photodebromination and give rise to the analogues found in sediment and fish. Dec604 CB and other lesser halogenated analogues of Dec604 show greater bioaccumulation potentials than Dec604, Dec602 and DP, based on BSAFs, which highlight the need to consider likely impurities and degradation products in the assessment of persistent, bioaccumulative, and toxic compounds.

Experiences of living with long COVID and of accessing healthcare services: a qualitative systematic review.

OBJECTIVE: To explore the experiences of people living with long COVID and how they perceive the healthcare services available to them. DESIGN: Qualitative systematic review. DATA SOURCES: Electronic literature searches of websites, bibliographic databases and discussion forums, including PubMed LitCovid, Proquest COVID, EPPI Centre living systematic map of evidence, medRxiv, bioRxiv, Medline, Psychinfo and Web of Science Core Collection were conducted to identify qualitative literature published in English up to 13 January 2021. INCLUSION CRITERIA: Papers reporting qualitative or mixed-methods studies that focused on the experiences of long COVID and/or perceptions of accessing healthcare by people with long COVID. Title/abstract and full-text screening were conducted by two reviewers independently, with conflicts resolved by discussion or a third reviewer. QUALITY APPRAISAL: Two reviewers independently appraised included studies using the qualitative CASP (Critical Appraisal Skills Programme) checklist. Conflicts were resolved by discussion or a third reviewer. DATA EXTRACTION AND SYNTHESIS: Thematic synthesis, involving line-by-line reading, generation of concepts, descriptive and analytical themes, was conducted by the review team with regular discussion. RESULTS: Five studies published in 2020 met the inclusion criteria, two international surveys and three qualitative studies from the UK. Sample sizes varied from 24 (interview study) to 3762 (survey). Participants were predominantly young white females recruited from social media or online support groups. Three analytical themes were generated: (1) symptoms and self-directed management of long COVID; (2) emotional aspects of living with long COVID and (3) healthcare experiences associated with long COVID. CONCLUSIONS: People experience long COVID as a heterogeneous condition, with a variety of physical and emotional consequences. It appears that greater knowledge of long COVID is required by a number of stakeholders and that the design of emerging long COVID services or adaptation of existing services for long COVID patients should take account of patients' experiences in their design.

Trends in incidence and in short term survival following a subarachnoid haemorrhage in Scotland, 1986-2005: a retrospective cohort study.

BACKGROUND: To examine age and sex specific incidence and 30 day case fatality for subarachnoid haemorrhage (SAH) in Scotland over a 20 year period. METHODS: A retrospective cohort study using routine hospital discharge data linked to death records. RESULTS: Between 1986 and 2005, 12,056 individuals experienced an incident SAH. Of these 10,113 (84%) survived to reach hospital. Overall age-standardised incidence rates were greater in women than men and remained relatively stable over the study period. In 2005, incidence in women was 12.8 (95% CI 11.5 to 14.2) and in men 7.9 (95% CI 6.9 to 9.1). 30 day case fatality in individuals hospitalised with SAH declined substantially, falling from 30.0% in men and 33.9% in women in 1986-1990 to 24.5% in men and 29.1% in women in 2001-2005. For both men and women, the largest reductions were observed in those aged between 40 to 59 years. After adjustment for age, socio-economic status and co-morbidity, the odds of death at 30 days in 2005 compared to odds of death in 1986 was 0.64 (0.54 to 0.76), p < 0.001 for those below 70 years, and 1.14 (0.83 to 1.56), p = 0.4 in those 70 years and above. CONCLUSIONS: Incidence rates for SAH remained stable between 1986 and 2005 suggesting that a better understanding of SAH risk factors and their reduction is needed. 30 day case fatality rates have declined substantially, particularly in middle-age. However, they remain high and it is important to ensure that this is not due to under-diagnosis or under-treatment.

Dechloranes 602, 603, 604, Dechlorane Plus, and Chlordene Plus, a newly detected analogue, in tributary sediments of the Laurentian Great Lakes.

A chlorinated compound (Chlordene Plus, CP), structurally related to Dechloranes (Dec) 602, 603, 604, and Dechlorane Plus (DP), was identified, and concentrations and spatial trends of Dec 602, 603, 604, CP, and DP in tributary sediments of the Laurentian Great Lakes are reported. The dechloranes were widely detected with their concentrations varying considerably across the Great Lakes basin. Spatial trends of Dec 602, 604, and DP in Canadian tributary sediments were similar to that of BDE 209, which suggested these flame retardant chemicals in tributaries were associated with industrial and urban areas. The highest concentrations of Dec 602, 604, and DP observed in tributaries of the Niagara River confirmed that past or ongoing manufacturing of these compounds at plants along the river were important sources to Lake Ontario. Dec 603 was detected in technical products of aldrin and dieldrin, and its spatial trend was consistent with historic pesticide usage. Similarly, CP was detected in technical products of chlordene and chlordane, and it was found in higher concentrations in sediments near urban areas, possibly related to past chlordane use in home termite control.

Historic trends of dechloranes 602, 603, 604, dechlorane plus and other norbornene derivatives and their bioaccumulation potential in lake ontario.

Temporal trends and seasonal variation of Dechloranes (Dec) 602, 603, 604, and Chlordene Plus (CP) in Niagara River suspended sediment, a Lake Ontario sediment core, and Lake Ontario lake trout were investigated, with Mirex and Dechlorane Plus (DP) included for comparison. Temporal concentration trends were generally consistent in each of the media for all compounds with the lowest concentrations observed in or after the late 1990s. In Niagara River suspended sediments, all compounds showed seasonal variation over a year with distinct profiles observed. The relative concentration patterns observed were total DP > Mirex > Dec 602 and Dec 604 > Dec 603 > CP in suspended sediments and sediment cores, whereas Mirex was highest in lake trout, followed by Dec 602 and DP. Dec 602 concentrations were 50 to 380 times greater than those of DP in lake trout, indicating Dec 602 has a greater bioaccumulation potential. The estimated biota-sediment accumulation factor (BSAF) for Dec 602 was much greater than for DP in Lake Ontario, and was greater than those calculated for PBDEs, indicating that assessment of some dechlorane compounds is merited if use is ongoing or planned.

A scoping review of patient and public perspectives on cell and gene therapies.

Aim: The development and introduction of cell and gene therapies presents complex social and economic issues. Fully addressing these challenges requires engagement with patients and the public. Materials & methods: A systematically conducted scoping review was undertaken to gauge current patient and public knowledge and perspectives, and as such inform requirements for future research, education and engagement activities. Results: A heterogeneous collection of 35 studies were identified. Levels of knowledge among patients and the public were extremely variable. Studies indicated general acceptance of therapies. Conclusion: The review identified the need for tailored educational activities, and in particular the importance of addressing misconceptions. There is also a need for robust qualitative research considering perspectives on current and forthcoming licensed therapies.

Development of liquid chromatography atmospheric pressure chemical ionization tandem mass spectrometry for analysis of halogenated flame retardants in wastewater.

Until recently, atmospheric pressure photoionization (APPI) has typically been used for the determination of non-polar halogenated flame retardants (HFRs) by liquid chromatography (LC) tandem mass spectrometry. In this study, we demonstrated the feasibility of utilizing liquid chromatography atmospheric pressure chemical ionization (APCI) tandem mass spectrometry (LC-APCI-MS/MS) for analysis of 38 HFRs. This developed method offered three advantages: simplicity, rapidity, and high sensitivity. Compared with APPI, APCI does not require a UV lamp and a dopant reagent to assist atmospheric pressure ionization. All the isomers and the isobaric compounds were well resolved within 14-min LC separation time. Excellent instrument detection limits (6.1 pg on average with 2.0 muL injection) were observed. The APCI mechanism was also investigated. The method developed has been applied to the screening of wastewater samples for screening purpose, with concentrations determined by LC-APCI-MS/MS agreeing with data obtained via gas chromatography high resolution mass spectrometry.

Patient and public perspectives on cell and gene therapies: a systematic review.

Cell and gene therapies offer opportunities for treating disease with potential to restore function, and cure disease. However, they are not without risk and pose complex logistical, economic, ethical and social challenges for health systems. Here we report our systematic review of the current evidence on patient and public knowledge and perspectives of cell and gene therapies, to inform future research, education and awareness raising activities. We screened 10,735 titles and abstracts, and evaluated the full texts of 151 publications. The final selection was 35 publications. Four themes were generated from the narrative synthesis of the study findings namely: (1) Knowledge and understanding of cell and gene therapies, (2) Acceptance of cell and gene therapies (3) Understanding of risk and benefits of therapy, and (4) Information needs and current sources of information. As potential funders or future recipients, it is important that the public and patients are aware of these therapies, understand the issues involved, and can contribute to the debate. This review highlights the need for appropriate patient and public education on the various aspects of cell and gene therapies. High quality studies exploring patient and public opinions and experiences of cell and gene therapy are required. Patient and public perceptions of these therapies, alongside evidence of clinical and cost-effectiveness, will be central to their uptake and use.

Optimization of an MMPB Lemieux Oxidation method for the quantitative analysis of microcystins in fish tissue by LC-QTOF MS.

Microcystins are toxic heptapeptides produced by cyanobacteria in marine and freshwater environments. In biological samples such as fish, microcystins can be found in the free form or covalently bound to protein phosphatases type I and II. Total microcystins in fish have been quantified in the past using the Lemieux Oxidation approach, where all toxins are oxidated to a common fragment (2-methyl-3-methoxy-4-phenylbutyric acid, MMPB) regardless of their initial amino acid configuration or form (free or protein bound). These studies have been carried out using different experimental conditions and employed different quantification strategies. The present study has further investigated the oxidation step using a systematic approach, to identify the most important factors leading to a higher, more robust MMPB generation yield from fish tissue in order to reduce the method detection limit. Field samples were quantified using an in-situ generated MMPB matrix matched calibration curve by isotope dilution with d3-MMPB via liquid chromatography coupled to time-of-flight mass spectrometry (LC-QTOF MS). This approach improves method's accuracy by taking into account of potential matrix effects that could affect the derivatization, sample prepation and instrumental analysis steps. The validated method showed 16.7% precision (RSD) and +6.7% accuracy (bias), with calculated method detection limits of 7.28 ng g-1 Performance of the method was assessed with the analysis of laboratory exposed Rainbow Trout (Oncorhynchus mykiss) to cyanobacteria as a positive control, where no microcystins were detected in the pre-exposure fish liver and fillet, low levels in the exposed fillet (65.0 ng g-1) and higher levels in the exposed liver (696 ng g-1). Finally, the method was employed for the analysis of 26 fillets (muscle) and livers of Walleye (Sander vitreus) and Yellow Perch (Perca flavescens) from Lake Erie, showing very low concentrations of microcystins in the fillet and higher concentrations in liver, up to 3720 ng g-1.

The analysis of halogenated flame retardants by GC-HRMS in environmental samples.

The analytical conditions required to determine polybrominated diphenylethers (PBDEs) and a variety of other halogenated flame retardants (HFRs) by gas chromatography-high resolution mass spectrometry (HRMS) in environmental samples are reported. HRMS can be used to analyze brominated diphenylethers (BDEs), 2,2',4,4',5,5'-hexabromobiphenyl (BB-153) as well as for a number of other emerging HFRs like allyl 2,4,6-tribromophenyl ether (ATE), 2-bromoallyl 2,4,6-tribromophenyl ether (BATE), 2,3-dibromopropyl 2,4,6-tribromophenyl ether (DPTE), octabromotrimethylphenylindane (OBIND), pentabromoethylbenzene (PBEB), hexabromobenzene (HBB), 1,2-bis (2,4,6-tribromophenoxy) ethane (BTBPE), decabromodiphenylethane (DBDPE), Dechlorane Plus (DP), hexachlorocyclopentadienyl-dibromocyclooctane (HCDBCO), tetrabromoethylcyclohexane (TBECH), 1,2,5,6-tetrabromocylcooctane (TBCO), 2-ethylhexyl-2,3,4,5-tetrabromobenzoate (EHTeBB), and bis(2-ethly-1-hexyl)tetrabromophthalate (BEHTBP). The detection in environmental matrices and use of these non-BDE flame retardants is reviewed. A method for the analysis of PBDEs by isotope dilution HRMS and 16 other halogenated compounds primarily used as flame retardants is reported. A survey of selected environmental samples, which included Lake Ontario surface and tributary sediments, municipal wastewater effluent, sludge, and mussel tissues, detected PBDEs, DP, DBDPE, BTBPE, PBEB, BB-153, and HBB.

Dioxins in Great Lakes fish: Past, present and implications for future monitoring.

Dioxins/furans are considered among the most toxic anthropogenic chemicals, and are ubiquitous in the environment including in the North American Great Lakes, which contain one fifth of the world's surface freshwater. Our exposure to dioxins/furans is mainly through contaminated diet. Elevated levels of dioxins/furans in Great Lakes fish have resulted in issuance of fish consumption advisories. Here we examine spatial/temporal trends of dioxins/furans in the edible portion (fillet) of fish from the Canadian waters of the Great Lakes using the data collected by the Province of Ontario, Canada. Our analyses show that the Toxic Equivalent (TEQ) dioxin/furan concentrations declined between 1989 and 2013 in Lake Trout from Lakes Ontario, Huron and Superior by 91%, 78% and 73%, respectively, but increased in Lake Whitefish from Lake Erie by 138%. An expanded dataset created by combining our data with historical Lake Ontario Lake Trout measurements from the literature showed a greater decline of >96% (from 64 to 2.3 pg/g) between 1977 and 2013. Measurements collected for 30 types of fish show overall low levels but local/regional concerns at some locations in Lakes Huron, Erie and Ontario. Dioxins/furans are globally present in foodstuff and "zero concentration" target is considered impractical. Based on the observations for the Great Lakes in the context of risk to human health from eating fish, it is concluded that comprehensive monitoring of dioxins/furans can be replaced with targeted locations and/or indicator species, and the saved resources can be more efficiently utilized for monitoring of other priority or emerging contaminants.

Converting Toxic Equivalents (TEQ) of dioxins and dioxin-like compounds in fish from one Toxic Equivalency Factor (TEF) scheme to another.

Toxic Equivalency Factors (TEFs) are an essential part of the Toxic Equivalent (TEQ) concept and have evolved for dioxins/dioxin-like compounds over the last two and half decades. Therefore, it is difficult to compare past and current TEQs that are reported using different TEFs without explicitly mentioning underlying congener concentrations. Using what likely is the largest known dioxin/furan (PCDD/F) and dioxin-like polychlorinated biphenyl (dl-PCB or DLP) fish database, here we present regression models that can facilitate conversion of a fish TEQ from an old to a newer TEF scheme. The results show that the mammalian PCDD/F-TEQ based on the latest TEF(WHO-05) is about 7.5% lower than that based on TEF(WHO-98). The mammalian DLP-TEQ(WHO-05) is on average 25-26% lower than almost identical DLP-TEQ(WHO-94) and DLP-TEQ(WHO-98). Total-TEQ(WHO-05) is on average 22% lower than Total-TEQ(WHO-98). According to the current toxicological standards for dioxins/furans, all previous major TEF schemes except TEF(Germany-85) and TEF(USEPA-87) were conservative (i.e., higher) in estimating TEQs. The major (> 75%) contribution to PCDD/F-TEQ(WHO-05) is from 2,3,7,8-TCDD (33%), 1,2,3,7,8-PCDD (26%), 2,3,7,8-TCDF (10%), and 2,3,4,7,8-PCDF (9%). The DLP-TEQ(WHO-05) is dominated by PCB-126 which on average contributes about 88%. The DLP-TEQ generally contribute > 70% of Total-TEQ. When reporting TEQs, we recommend that the underlying congener specific concentrations are presented, TEF scheme used is clearly stated, names of compounds included are explicitly expressed, and TEQs are identified accordingly (e.g., DLP-TEQ, PCDD/F-TEQ, Total-TEQ).

Temporal trends and spatial distribution of dioxins and furans in lake trout or lake whitefish from the Canadian Great Lakes.

Concentrations of the seventeen 2,3,7,8-substituted, most toxic congeners of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) were measured in lake trout (Salvelinus namaycush) or lake whitefish (Coregonus clupeaformis) collected between 1989 and 2003 from the Canadian Great Lakes as a part of the on-going Sport Fish Contaminant Monitoring Program of the Ontario Ministry of the Environment. These monitoring data were used to assess temporal trends and spatial variations of these compounds in the Canadian Great Lakes. Toxic equivalents (TEQs) were calculated using the measured congener concentrations and toxicity equivalency factors (TEFs) published by the World Health Organization in 1998. Five congeners, namely 2,3,7,8-TCDD, 2,3,7,8-TCDF, 1,2,3,7,8-PeCDD, 1,2,3,7,8-PeCDF, and 2,3,4,7,8-PeCDF, were the most dominant congeners among the 17 congeners analyzed. The highest TEQs were found for Lake Ontario lake trout (22-54 pg g(-1)) while the TEQs for the other Canadian Great Lakes were 60-95% lower. Non-parametric Mann-Kendall and Sen's tests performed on TEQs and PCDD/Fs standardized at a mean lake trout length of 60 cm suggest a linearly decreasing trend for PCDD/Fs in lake trout from Lakes Ontario and Huron. There was no monotonously increasing or decreasing trend found for Lake Superior lake trout. The ratios of 2,3,7,8-TCDD to 2,3,7,8-TCDF concentrations were generally constant during the 1989-2003 period with the values being in the order of Lakes Superior (0.05-0.3)

Levels, patterns, trends and significance of polychlorinated naphthalenes (PCNs) in Great Lakes fish.

Polychlorinated naphthalenes (PCNs) were introduced to market about a century ago and their production is thought to have ceased by the early 1980s. However, relatively limited knowledge exists on their abundance in the edible portion of a variety of Great Lakes fish to aid in understanding their potential risk to human consumers. We studied levels, patterns, trends and significance of PCNs in a total 470 fillet samples of 18 fish species collected from the Canadian waters of the Great Lakes between 2006 and 2013. A limited comparison of fillet and wholebody concentrations in Carp and Bullhead was also conducted. The ∑PCN ranged from 0.006-6.7ng/g wet weight (ww) and 0.15-190ng/g lipid weight (lw) with the dominant congeners being PCN-52/60 (34%), -42 (21%) and -66/67 (15%). The concentrations spatially varied in the order of the Detroit River>Lakes Erie>Ontario>Huron>Superior. PCN-66/67 was the dominating congener contributing on average 76-80% of toxic equivalent concentration (TEQPCN). Contribution of TEQPCN to TEQTotal (TEQDioxins+Furans+dioxin-likePCBs+PCNs) was mostly <15%, especially at higher TEQTotal, and PCB-126 remains the major congener contributing to TEQTotal. The congener pattern suggests that impurities in PCB formulations and thereby historical PCB contamination, instead of unintentional releases from industrial thermal processes, could be an important source of PCNs in Great Lakes fish. A limited temporal change analysis indicated declines in the levels of PCN-66/67 between 2006 and 2012, complemented by previously reported decrease in PCNs in Lake Ontario Lake Trout between 1979 and 2004. The whole body concentrations were 1.4-3.2 fold higher than the corresponding fillets of Carp and Bullhead. Overall, the study results suggest that only targeted monitoring of PCNs in Great Lakes fish, especially at the Detroit River, Lake Erie and Lake Ontario, is necessary to assess continued future improvements of this group of contaminants of concern.

Temporal trends in polychlorinated dibenzo-p-dioxins and dibenzofurans, dioxin-like PCBs, and polybrominated diphenyl ethers in Niagara river suspended sediments.

Archived suspended sediment samples collected over the period 1980-2002 at Niagara-on-the-Lake in the Niagara river were analyzed to assess temporal trends in contaminants associated with historical industrial activities in the watershed (PCDDs/PCDFs, DLPCBs), compared to more modern industrial chemicals (PBDEs). The temporal trends for PCDDs/PCDFs and DLPCBs were generally similar, and showed a general trend toward decreasing concentrations, which was presumably due to implementation of control measures in the Niagara river watershed, including the remediation of hazardous waste facilities. The temporal trend in PBDEs contrasted with those of PCDDs/PCDFs and DLPCBs. Prior to 1988, PBDEs (sum of 16 congeners including deca-BDE) were generally detected at low-ppb concentrations, but showed a trend toward increasing concentrations over the period 1980-1988. After 1988, PBDE concentrations in the Niagara river showed a more rapidly increasing trend to a maximum of approximately 35 ng/g in 1995, with deca-BDE as the predominant congener detected. Samples collected over the period February 2003 to March 2004 at the head and mouth of the Niagara river were also analyzed for PBDEs; in all cases PBDE concentrations were higher at the mouth of the river at the outflow to Lake Ontario, indicating the Niagara river watershed is a source of PBDE contamination to Lake Ontario. However, PBDE concentrations in suspended sediments of the Niagara river were comparable to, or lower than, concentrations in bottom sediments in other industrialized/urbanized areas of the world. Based on these comparisons of global PBDE bottom sediment concentrations, the Niagara river watershed does not appear to be a significant local source of PBDEs to Lake Ontario, and concentrations in suspended sediments appear to be indicative of general PBDE contamination from a contamination of local, regional, and continental sources.