Incidence, mortality and survival in malignant pleural mesothelioma before and after asbestos in Denmark, Finland, Norway and Sweden.

BACKGROUND: Malignant pleural mesothelioma (MPM) is a rare but fatal cancer, which is largely caused by exposure to asbestos. Reliable information about the incidence of MPM prior the influence of asbestos is lacking. The nationwide regional incidence trends for MPM remain poorly characterized. We use nationwide MPM data for Denmark (DK), Finland (FI), Norway (NO) and Sweden (SE) to assess incidence, mortality and survival trends for MPM in these countries. METHODS: We use the NORDCAN database for the analyses: incidence data were available from 1943 in DK, 1953 in FI and NO and 1958 in SE, through 2016. Survival data were available from 1967 through 2016. World standard population was used in age standardization. RESULTS: The lowest incidence that we recorded for MPM was 0.02/100,000 for NO women and 0.05/100,000 for FI men in 1953-57, marking the incidence before the influence of asbestos. The highest rate of 1.9/100,000 was recorded for DK in 1997. Female incidence was much lower than male incidence. In each country, the male incidence trend for MPM culminated, first in SE around 1990. The regional incidence trends matched with earlier asbestos-related industrial activity, shipbuilding in FI and SE, cement manufacturing and shipbuilding in DK and seafaring in NO. Relative 1-year survival increased from about 20 to 50% but 5-year survival remained at or below 10%. CONCLUSION: In the Nordic countries, the male incidence trends for MPM climaxed and started to decrease, indicating that the prevention of exposure was beneficial. Survival in MPM has improved for both sexes but long-term survival remains dismal.

Inhalation cancer risk assessment for environmental exposure to hexavalent chromium: Comparison of margin-of-exposure and linear extrapolation approaches.

Hexavalent chromium [Cr(VI)] exists in the ambient air at low concentrations (average upperbound ~0.1 ng/m3) yet airborne concentrations typically exceed EPA's Regional Screening Level for residential exposure (0.012 ng/m3) and other similar benchmarks, which assume a mutagenic mode of action (MOA) and use low-dose linear risk assessment models. We reviewed Cr(VI) inhalation unit risk estimates developed by researchers and regulatory agencies for environmental and occupational exposures and the underlying epidemiologic data, updated a previously published MOA analysis, and conducted dose-response modeling of rodent carcinogenicity data to evaluate the need for alternative exposure-response data and risk assessment approaches. Current research supports the role of non-mutagenic key events in the MOA, with growing evidence for epigenetic modifiers. Animal data show a weak carcinogenic response, even at cytotoxic exposures, and highlight the uncertainties associated with the current epidemiological data used in risk assessment. Points of departure from occupational and animal studies were used to determine margins of exposure (MOEs). MOEs range from 1.5 E+3 to 3.3 E+6 with a median of 5 E+5, indicating that current environmental exposures to Cr(VI) in ambient air should be considered of low concern. In this comprehensive review, the divergent results from default linear and MOE assessments support the need for more relevant and robust epidemiologic data, additional mechanistic studies, and refined risk assessment strategies.

Environmental magnetic field in a Neonatal Intensive Care Unit. A relevant verification. / Campo magnético ambiental en una Unidad de Terapia Intensiva Neonatal. Importancia de su verificación.

Preterm infants are born with immature organs, thus affecting the immune system. Electromagnetic fields influence melatonin production with low exposure levels. These infants require medical equipment 24/7 to recover, so they are constantly exposed to magnetic fields during their stay in the Intensive Care Unit. Our objective was to measure magnetic field levels generated around each incubator using a gauss meter and compare our results to the 2010 recommendations by the International Commission on Non-Ionizing Radiation Protection and the IEC 60601-1-2:2004 standard by the International Electrotechnical Commission (IEC). Among 11 hospitalized newborn infants, radiation was found within the recommended limits, but there was electromagnetic interference resulting from medical equipment layout problems in the unit.

Los neonatos pretérminos nacen con inmadurez en los órganos, lo que lleva al compromiso del sistema inmunológico. Los campos electromagnéticos afectan la producción de melatonina a niveles bajos de exposición. Estos niños necesitan equipamiento médico las 24 horas del día para su recuperación, por lo que están expuestos a los campos magnéticos durante todo el tiempo que se encuentren en la Unidad de Terapia Intensiva. El objetivo fue medir los niveles de campo magnético que se generan alrededor de cada una de las incubadoras utilizando un gaussímetro y comparar los resultados con las recomendaciones de la Comisión Internacional para la Protección contra las Radiaciones No Ionizantes de 2010 y la norma de la International Electrotechnical Commission (IEC) IEC 60601-1-2:2004. En 11 neonatos internados, los valores de radiación se encontraban dentro de los recomendados, pero existía interferencia electromagnética por problemas de disposición de los equipos en el área.

Treating the Disease, Not the Symptom: Beyond NSAIDs.

Mitigating inflammation is clearly important in cancer prevention and control. Traditionally, pharmaceuticals have taken the lead in this problem. In an attempt to 'head them off at the pass', this Forum takes a hard look at the concept of 'better living through chemicals' and limiting proinflammatory chemicals entering the body.

Mitigation of rice cadmium (Cd) accumulation by joint application of organic amendments and selenium (Se) in high-Cd-contaminated soils.

A pot experiment was conducted to investigate the possible mediatory effect of organic amendments (vermicompost and biochar) and selenium (Se) on Cd bioaccumulation in both rice cultivars (high-Cd accumulation rice: Yuzhenxiang (YZX) and low-Cd accumulation rice: Changliangyou772 (CLY)) in high-Cd-contaminated soils. The results showed that Cd sensitivity and tolerance were cultivar-dependent, and grain Cd contents for CLY accorded with the Chinese national food safety standards (0.2 mg kg-1), whereas grain Cd levels for YZX were 1.4-5.8 times higher than those for CLY. Soil applications of amendments decreased grain Cd levels by 3.5%-36.9% for YZX and 36.1%-74.4% for CLY. Moreover, vermicompost (VC) was more effective in reducing Cd bioaccumulation than biochar (BC). A combination of Se and organic amendments could significantly increase grain Se contents and help further reduce grain Cd levels by 5.8%-20.8%, compared to the single organic amendments. This mitigation progress could be attributed to the changes of Cd translocation and distribution among rice tissues and the inhibition of Cd bioavailability in soil through the alteration in soil properties. Organic amendments, especially high dose (5%), increased soil pH and organic matter contents, and correspondingly decreased soil Cd bioavailability. A sequential extraction analysis suggested that organic amendments and Se facilitated the transformation of soil Cd from the bioavailable form to the immobilized Cd form, and thus decreased grain Cd levels. Hence, co-applications of organic amendments and Se in combination with low-Cd accumulation cultivar could be an effective strategy for both Se needs of humans and safe utilization of Cd polluted soil.

Toxicity of cadmium in musculoskeletal diseases.

Epidemiological studies have reported that exposure to toxic metals like cadmium (Cd) may promote the development of musculoskeletal diseases, such as osteoporosis, rheumatoid arthritis (RA), and osteoarthritis (OA), among others. The objective of this review is to summarize the molecular mechanisms of inflammation and oxidative stress activated by Cd at the bone level, particularly in osteoporosis, RA, and OA. Cadmium can increase bone resorption, affect the activity of osteoclasts and calcium (Ca) absorption, and impair kidney function, which favors the development of osteoporosis. In the case of RA, Cd interferes with the activity of antioxidant proteins, like superoxide dismutase (SOD) and catalase (CAT). It also promotes an inflammatory state, inducing the process of citrullination, which affects the proteins of immune response. On the other hand, accumulation of Cd in the tissues and blood of smokers has been related to the development of some musculoskeletal diseases. Therefore, knowing the negative impact of Cd toxicity at the articular level can help understand the damage mechanisms it produces, leading to the development of such diseases.

Health effects of radiofrequency electromagnetic energy.

The issues of real or suspected health effects of radiofrequency fields, produced by cellphones, their base stations and many other devices, are complex and controversial. We believe that the most balanced and valid assessments of these issues are given by the extensive reports produced by reputable, multidisciplinary, expert groups. These use the principles of a comprehensive review to assess all available published literature and form their conclusions by consideration of the strength of the evidence from the available studies. This paper provides links to several of these reports, and shows how others can be accessed. These reports are large and complex, but freely available on websites. We summarise the most recent New Zealand report, which itself refers to and summarises many other reports. The scientific literature on these issues is enormous, particularly in animal and laboratory studies. There are some comprehensive reviews of these, demonstrating that the quality of the studies is very variable, and that, for example, results claiming to show increased genetic damage or other biological effects are much more common in studies of low quality, whereas higher-quality studies predominantly show no significant effects. Thus, while there are many reports which in isolation suggest health effects, there is no consistent evidence supporting important health effects caused by low intensities of radiofrequencies similar to those experienced by the general population. There are certainly many unanswered questions, and new studies need to be assessed carefully and replicated where possible. Thus, expert groups in several countries including New Zealand need to continue to regularly review new studies.

An updated evaluation of potential health hazards associated with exposures to asbestos-containing drywall accessory products.

Following a previously published (2012) evaluation of the potential health hazards related to the use of asbestos-containing drywall accessory products, additional information regarding asbestos exposures during the use of accessory products, as well as studies of chrysotile asbestos risk as a function of exposure, have been published in the peer-reviewed literature. The purpose of this analysis is to update the original evaluation with this new information. It was previously estimated that a professional drywaller performing joint compound-associated tasks could have a lifetime cumulative chrysotile exposure of 12-26 f/cc-year. Using conservative assumptions regarding airborne asbestos levels during different drywalling tasks, task duration, and job tenure, we found that a range of 4.3-36.3 f/cc-year is a plausible estimate of a career drywaller's cumulative asbestos exposure from historical joint compound use. The estimated range for bystander exposures would be below (sometimes significantly below) this range depending on the frequency and duration of work near drywallers. Further, the estimated drywaller and bystander total fiber exposures were well below a recently published "no-observed adverse effect level, best estimate" for predominately chrysotile exposures of 89-168 f/cc-year for lung cancer and 208-415 f/cc-year for mesothelioma. We also determined that, even if the chrysotile or possibly talc ingredients in the drywall products had contained asbestiform tremolite, the cumulative tremolite exposures would have been well below a recently published tremolite no-effect level of 0.5-2.6 f/cc-year. Based on our calculations, typical drywall work using asbestos-containing drywall accessory products is not expected to increase the risk of asbestos-related lung cancer or mesothelioma. These conclusions are consistent with the lack of epidemiological evidence that drywall work resulted in an increased incidence of asbestos-related disease in the drywall trades.

[Rubber granules on synthetic turf pitches: safe or not safe for children?] / Rubbergranulaat op kunstgrasvelden.

Rubber granules from old car tyres used in synthetic turf pitches contain a significant number of carcinogenic and endocrine-disrupting chemicals. In 2017 the Dutch National Institute for Public Health and the Environment (RIVM) and the European Chemical Agency (ECHA) concluded that the risks for children are negligible. However, their reports contain some scientific inaccuracies and omissions which may have led them to underestimate the risks for children. It is therefore premature to conclude that it is safe for children to play on synthetic turf pitches with rubber granules. It is now primarily up to the parents to decide whether or not playing sports is acceptable in these circumstances. The Dutch government should, in accordance with ECHA recommendations, advise parents that their children ought to avoid hand-and-mouth contact with these granules as much as possible.

Exposure index of methyl isocyanate (MIC) gas disaster and a comprehensive spectrum of cytogenetic analysis after 30 years.

Severity of clinical expression and high mortality could not facilitate establishing exposure index/association following MIC disaster in Bhopal. Mortality-based exposure stratification was critiqued by the International Medical Commission on Bhopal (IMCB). IMCB stratified exposure considering distance as surrogate at 2 km intervals after 10 years. The first follow-up cytogenetic screening of the pre-screened survivors after 30 years has demonstrated chromosome abnormalities (CA). Exposure stratification was attempted considering cytogenetic screening conducted during 1986-1988. Elevation of CA appeared proportional to exposure status and authenticated the initial mortality-based stratification. The one-on-one comparison of the previous and present cytogenetics has described the individual response to MIC exposure over 30 years. Chi-square test has been carried out for checking the cytogenetic changes at the individual level statistically, which revealed that differences of chromosomal aberrations collected immediately post-disaster and 30 years later are nonsignificant. The prominence of interindividual variation was noticed in general. The impact of overall exposure was higher in males. Constitutional abnormalities in 8.5% of the study population, including translocation, inversion, deletion, fragile sites, etc., necessitate screening of blood-linked members. The incidence of acrocentric association was prominent in the study population. Normal karyotype in children born to severely exposed parents with congenital anomalies indicates necessity of molecular karyotyping and/or screening of mutations. The study highlights follow-up of the health of the index cases at shorter (3-6 months) intervals. This comprehensive spectrum of cytogenetic report highlights immediate post-disaster chromosomal aberrations, the changes that occurred over 30 years in conjunction with other environmental factors at the individual level, constitutive genomic aberrations, polymorphic variations, and chromosomal patterns in congenitally malformed children of the survivors, which collectively indicate the possibility of acquisition/persistence of stable aberrations in MIC-exposed lymphocytes through interaction with environmental/biological confounders.

UNIVERSAL RADIATION PROTECTION SYSTEM (URPS); A NATURAL GLOBAL STANDARDISED TREND FOR HUMAN EXPOSURE CONTROL IN 21st CENTURY.

In order to address the many deficiencies with current radiological protection system worldwide, this paper proposes a new Universal Radiation Protection System (URPS) Hypothesis with novel philosophy, concepts and methodologies of applying principles of equal human health-effect risks of an individual per unit radiation dose either from environmental natural background (NBG) or man-made sources; a 'standardised integrated dose system' for integrating all individual doses with emphasis on national NBG doses; considering worker as a member of public; and a 'cause-effect conservation principle' for epidemiology risk estimation. The URPS also a radiation hypothesises fractionation weighting factors (WF); a 'URPS Model' for bridging 'linear no-threshold and hormesis models'; example dose limit for workers; as well as new terms and definitions. State-of-the-art developments on URPS hypothesis are presented and discussed with simple global natural trends for standardised human exposure control in order to protect workers, patients, public and environment by standardised methods independent of source and country of origin in the 21st century.

Spatial analysis of chromium in southwestern part of Iran: probabilistic health risk and multivariate global sensitivity analysis.

This study was concerned with chromium as a potential carcinogenic contaminant in 64 wells located in five aquifers, southwest of Iran. A probabilistic health risk assessment indicated a high risk to the local residents including adults and children in the study area. A sequential sensitivity analysis and a novel approach known as multivariate global sensitivity analysis using both principal component analysis and B-spline were applied to investigate the behavior of health risk model along time considering four independent input parameters in the risk equation. In this context, based on the results of sensitivity analysis, concentration of chromium in drinking water (Cw) and body weight (W) were the most influential parameters. Random forest (RF) was used as a variable selection method to choose the most influential parameters for the prediction of chromium. Five parameters, among 13 water quality variables, including phosphate, nitrate, fluoride, manganese and iron were selected by RF as the most important parameters for spatial prediction. Hybrid methods of RF and ordinary kriging (RFOK) and RF and inverse distance weighting (RFIDW) were then applied for spatial prediction of Cr using the secondary variables. The RFOK and RFIDW were more efficient than that of ordinary kriging (OK) with respect to a cross-validation algorithm. For instance, in terms of relative root mean squared error, the performance of OK was improved from 31.72 to 23.21 and 23.61 for RFOK and RFIDW, respectively.

Applying Integrated Exposure-Response Functions to PM2.5 Pollution in India.

Fine particulate matter (PM2.5, diameter ≤2.5 µm) is implicated as the most health-damaging air pollutant. Large cohort studies of chronic exposure to PM2.5 and mortality risk are largely confined to areas with low to moderate ambient PM2.5 concentrations and posit log-linear exposure-response functions. However, levels of PM2.5 in developing countries such as India are typically much higher, causing unknown health effects. Integrated exposure-response functions for high PM2.5 exposures encompassing risk estimates from ambient air, secondhand smoke, and active smoking exposures have been posited. We apply these functions to estimate the future cause-specific mortality risks associated with population-weighted ambient PM2.5 exposures in India in 2030 using Greenhouse Gas-Air Pollution Interactions and Synergies (GAINS) model projections. The loss in statistical life expectancy (SLE) is calculated based on risk estimates and baseline mortality rates. Losses in SLE are aggregated and weighted using national age-adjusted, cause-specific mortality rates. 2030 PM2.5 pollution in India reaches an annual mean of 74 µg/m³, nearly eight times the corresponding World Health Organization air quality guideline. The national average loss in SLE is 32.5 months (95% Confidence Interval (CI): 29.7⁻35.2, regional range: 8.5⁻42.0), compared to an average of 53.7 months (95% CI: 46.3⁻61.1) using methods currently applied in GAINS. Results indicate wide regional variation in health impacts, and these methods may still underestimate the total health burden caused by PM2.5 exposures due to model assumptions on minimum age thresholds of pollution effects and a limited subset of health endpoints analyzed. Application of the revised exposure-response functions suggests that the most polluted areas in India will reap major health benefits only with substantial improvements in air quality.

Past and current asbestos exposure and future mesothelioma risks in Britain: The Inhaled Particles Study (TIPS).

Background: Occupational and environmental airborne asbestos concentrations are too low and variable for lifetime exposures to be estimated reliably, and building workers and occupants may suffer higher exposure when asbestos in older buildings is disturbed or removed. Mesothelioma risks from current asbestos exposures are therefore not known. Methods: We interviewed and measured asbestos levels in lung samples from 257 patients treated for pneumothorax and 262 with resected lung cancer, recruited in England and Wales. Average lung burdens in British birth cohorts from 1940 to 1992 were estimated for asbestos-exposed workers and the general population. Results: Regression analysis of British mesothelioma death rates and average lung burdens in birth cohorts born before 1965 suggests a lifetime mesothelioma risk of approximately 0.01% per fibre/mg of amphiboles in the lung. In those born since 1965, the average lung burden is ∼1 fibre/mg among those with no occupational exposure. Conclusions: The average lifetime mesothelioma risk caused by recent environmental asbestos exposure in Britain will be about 1 in 10 000. The risk is an order of magnitude higher in a subgroup of exposed workers and probably in occupants in the most contaminated buildings. Further data are needed to discover whether asbestos still present in buildings, particularly schools, is a persistent or decreasing hazard to workers who disturb it and to the general population, and whether environmental exposure occurs predominantly in childhood or after beginning work. Similar studies are needed in other countries to estimate continuing environmental and occupational mesothelioma hazards worldwide, including the contribution from chrysotile.

Risk Assessment of Benzene, Toluene, Ethyl Benzene, and Xylene Concentrations from the Combustion of Coal in a Controlled Laboratory Environment.

A D-grade type coal was burned under simulated domestic practices in a controlled laboratory set-up, in order to characterize the emissions of volatile organic compounds (VOCs); namely, benzene, toluene, ethylbenzene, and xylenes (BTEX). Near-field concentrations were collected in a shack-like structure constructed using corrugated iron, simulating a traditional house found in informal settlements in South Africa (SA). Measurements were carried out using the Synspec Spectras GC955 real-time monitor over a three-hour burn cycle. The 3-h average concentrations (in µg/m³) of benzene, toluene, ethylbenzene, p-xylene, and o-xylene were 919 ± 44, 2051 ± 91, 3838 ±19, 4245 ± 41 and 3576 ± 49, respectively. The cancer risk for adult males and females in a typical SA household exposure scenario was found to be 1.1 and 1.2 respectively, which are 110- and 120-fold higher than the U.S. Environmental Protection Agency (EPA) designated risk severity indicator (1 × 10-6). All four TEX (toluene, ethylbenzene, p-xylene and o-xylene) compounds recorded a Hazard Quotient (HQ) of less than 1, indicating a low risk of developing related non-carcinogenic health effects. The HQ for TEX ranged from 0.001 to 0.05, with toluene concentrations being the lowest, and ethylbenzene the highest. This study has demonstrated that domestic coal burning may be a significant source of BTEX emission exposure.

Carcinogenic and non-carcinogenic risk assessments of arsenic contamination in drinking water of Ardabil city in the Northwest of Iran.

Based on the environmental health assessment framework of the United State Environmental Protection Agency, a quantitative health risk assessment of arsenic in contaminated drinking water in a city in the northwest of Iran has been carried out. In the exposure assessment step, arsenic concentrations in drinking water were determined during four seasons. In addition, the water ingestion rate for different age groups in this region was determined. The concentration of arsenic in 163 collected samples from different locations during four seasons ranged from 0 to 99 µg L-1. Furthermore, a high percentage of the samples manifested higher levels than the permissible limit of 10 µg L-1. The total daily water intake rates of four age groups 1 to <2 (group 1), 2 to <6 (group 2), 6 to <16 (group 3), and ≥16 years (group 4) were estimated as 0.86, 1.49, 2.00, and 2.33 L day-1, respectively. Calculating the lifetime average daily dose of arsenic indicated that adults (group 4) had the highest and children (group 1) had the lowest daily intake of arsenic in their entire life. The results of risk characteristic showed that the order of excess lifetime cancer risk via arsenic exposure in the four groups was 4 > 3 > 2 > 1. The estimated risks for all age groups were higher than the acceptable range (1E-6 to 1E-4). The hazard quotient values for all of the classified groups were lower than the recommended limit values (<1), but it cannot be concluded that potential non-carcinogenicity risks are non-existent since the possible exposure to arsenic via food and skin may also pose the risk.

Development of an inhalation unit risk factor for ethylene dibromide.

The Texas Commission on Environmental Quality (TCEQ) follows standard scientific methods to develop up-to-date toxicity factors for chemicals emitted in the state of Texas. An inhalation unit risk factor (URF) was developed for ethylene dibromide (EDB, CAS 106-93-4) based on an increased incidence of nasal cavity adenocarcinomas observed in female rats in a 2-year inhalation cancer bioassay conducted by the National Toxicology Program (NTP). The NTP study provided evidence of several EDB-induced tumors in male and female rats and in female mice. Tumor incidences that were statistically increased at the low dose and that showed a statistically significant increasing trend were considered in identifying the critical effect. Following benchmark concentration (BMC) modeling and animal-to-human dosimetric adjustments, the increased incidence of nasal cavity adenocarcinomas observed in female rats was determined to be the most sensitive tumorigenic effect in the most sensitive species and sex and was utilized as the carcinogenic endpoint for the development of the URF. The 95% lower confidence limit of the BMC at the 10% excess risk level (BMCL10 of 292.8 ppb) was determined for calculation of the URF. The resulting URF based on increased nasal cavity adenocarcinomas observed in female rats is 3.4E-04 per ppb (4.4E-05 per µg/m3). The lifetime air concentration corresponding to a no significant excess risk level of one in 100,000 is 0.029 ppb (0.22 µg/m3), which is considered sufficiently health-protective for use in protecting the general public against the potential carcinogenic effects of chronic exposure to EDB in ambient air.

The skin aging exposome.

The term "exposome" describes the totality of exposures to which an individual is subjected from conception to death. It includes both external and internal factors as well as the human body's response to these factors. Current exposome research aims to understand the effects all factors have on specific organs, yet today, the exposome of human skin has not received major attention and a corresponding definition is lacking. This review was compiled with the collaboration of European scientists, specialized in either environmental medicine or skin biology. A comprehensive review of the existing literature was performed using PubMed. The search was restricted to exposome factors and skin aging. Key review papers and all relevant, epidemiological, in vitro, ex vivo and clinical studies were analyzed to determine the key elements of the exposome influencing skin aging. Here we propose a definition of the skin aging exposome. It is based on a summary of the existing scientific evidence for the role of exposome factors in skin aging. We also identify future research needs which concern knowledge about the interaction of distinct exposomal factors with each other and the resulting net effects on skin aging and suggest some protective measures.

Current and future risks of asbestos exposure in the Australian community.

BACKGROUND: Australia mined asbestos for more than 100 years and manufactured and imported asbestos products. There is a legacy of in situ asbestos throughout the built environment. METHODS: The aim of this study was to identify the possible sources of current and future asbestos exposure from the built environment. Telephone interviews with environmental health officers, asbestos removalists, and asbestos assessors in Australia sought information about common asbestos scenarios encountered. RESULTS: There is a considerable amount of asbestos remaining in situ in the Australian built environment. Potential current and future sources of asbestos exposure to the public are from asbestos-containing roofs and fences, unsafe asbestos removal practices, do-it-yourself home renovations and illegal dumping. CONCLUSION: This research has highlighted a need for consistent approaches in the regulation and enforcement of safe practices for the management and removal of asbestos to ensure that in situ asbestos in the built environment is managed appropriately.