Burden of cardiovascular disease attributed to air pollution: a systematic review.

BACKGROUND: Cardiovascular diseases (CVDs) are estimated to be the leading cause of global death. Air pollution is the biggest environmental threat to public health worldwide. It is considered a potentially modifiable environmental risk factor for CVDs because it can be prevented by adopting the right national and international policies. The present study was conducted to synthesize the results of existing studies on the burden of CVDs attributed to air pollution, namely prevalence, hospitalization, disability, mortality, and cost characteristics. METHODS: A systematic search was performed in the Scopus, PubMed, and Web of Science databases to identify studies, without time limitations, up to June 13, 2023. Exclusion criteria included prenatal exposure, exposure to indoor air pollution, review studies, conferences, books, letters to editors, and animal and laboratory studies. The quality of the articles was evaluated based on the Agency for Healthcare Research and Quality Assessment Form, the Newcastle-Ottawa Scale, and Drummond Criteria using a self-established scale. The articles that achieved categories A and B were included in the study. RESULTS: Of the 566 studies obtained, based on the inclusion/exclusion criteria, 92 studies were defined as eligible in the present systematic review. The results of these investigations supported that chronic exposure to various concentrations of air pollutants, increased the prevalence, hospitalization, disability, mortality, and costs of CVDs attributed to air pollution, even at relatively low levels. According to the results, the main pollutant investigated closely associated with hypertension was PM2.5. Furthermore, the global DALY related to stroke during 2016-2019 has increased by 1.8 times and hospitalization related to CVDs in 2023 has increased by 8.5 times compared to 2014. CONCLUSION: Ambient air pollution is an underestimated but significant and modifiable contributor to CVDs burden and public health costs. This should not only be considered an environmental problem but also as an important risk factor for a significant increase in CVD cases and mortality. The findings of the systematic review highlighted the opportunity to apply more preventive measures in the public health sector to reduce the footprint of CVDs in human society.

Health risk assessment from inhalation exposure to indoor formaldehyde: A systematic review and meta-analysis.

This systematic review and meta-analysis investigated studies on formaldehyde (FA) inhalation exposure in indoor environments and related carcinogenic (CR) and non-carcinogenic (HQ) risk. Studies were obtained from Scopus, PubMed, Web of Science, Medline, and Embase databases without time limitation until November 21, 2023. Studies not meeting the criteria of Population, Exposure, Comparator, and Outcomes (PECO) were excluded. The 45 articles included belonged to the 5 types of sites: dwelling environments, educational centers, kindergartens, vehicle cabins, and other indoor environments. A meta-analysis determined the average effect size (ES) between indoor FA concentrations, CR, and HQ values in each type of indoor environment. FA concentrations ranged from 0.01 to 1620 µg/m3. The highest FA concentrations were stated in water pipe cafés and the lowest in residential environments. In more than 90% of the studies uncertain (1.00 ×10-6 1.00 ×10-4) due to FA inhalation exposure was reported and non-carcinogenic risk was stated acceptable. The meta-analysis revealed the highest CR values due to inhalation of indoor FA in high-income countries. As 90% of the time is spent indoors, it is crucial to adopt effective strategies to reduce FA concentrations, especially in kindergartens and schools, with regular monitoring of indoor air quality.

Health risk assessment of heavy metals in exposed workers of municipal waste recycling facility in Iran.

Exposure to heavy metals (HMs) present in the particulate matter from municipal solid waste during pretreatment and recycling processes may pose a serious health risk to workers. This was the first study on the exposure of municipal solid waste (MSW) recycling workers to toxic metals. The concentrations of HMs (Cd, Pb, As, Co, Cr, Ni, Cu, Fe, Mn, and Zn) during personal exposure to PM2.5 among municipal waste recycling facility workers in Kashan City, Iran, were investigated from January 15 to March 15, 2023. The research was performed in the three main stages of the waste recycling process: dismantling, sorting, and collecting. PM2.5 samples were collected using a personal environmental monitor (PEM) attached to a sampling pump. The non-carcinogenic and carcinogenic health risk values and related uncertainty for waste recyclers from HMs inhalational exposure were calculated using USEPA methodology and Monte Carlo simulations. The results showed that the dismantlers exhibited the highest exposure concentrations of PM2.5 (mean 2148 ± 1257 µg m-3), followed by sorters (mean 1864 ± 965 µg m-3), and collectors (mean 1782 ± 876 µg m-3). Health risk assessment indicated that 95th percentile contents of Ni, As, Co, and Zn were responsible for the non-carcinogenic risk (HQ) values exceeding the acceptable level of 1. The contents of As, Ni, and Cr in PM2.5 caused a non-acceptable carcinogenic risk for waste recyclers due to inhalational exposure, as the carcinogenic risk (CR) values exceeded the acceptable threshold of 1 × 10-6. Monte Carlo simulation results revealed that the mean and median CR values from inhalational exposure to carcinogenic HMs exceeded the acceptable level of 1 × 10-6 for municipal waste recyclers. As results of this study indicated the high-risk to hazardous metals for waste recyclers due to occupational exposure in the MSW recycling sites, it is suggested to consider workers' exposure as the public health concern.

Summer and winter variations of BTEX concentrations in an oil refinery complex and health risk assessment based on Monte-Carlo simulations.

The summer and winter concentrations of BTEX pollutants were investigated in various workplaces of an oil Refinery, Iran. In total 252 air samples from the breathing zones of the following employees were collected: supervisors, safetymen, repairmen, site men, and all workers. Carcinogenic and non-carcinogenic risk values were calculated based on the USEPA methodology using Monte Carlo simulations. BTEX concentrations were higher in the summer than in the winter season for all workstations, especially for toluene and ethylbenzene. The mean values of exposure to benzene for repairmen and site men were higher than threshold limit value of 1.60 mg/m3 for both seasons. Non-carcinogenic risk (HQ) values calculated for summer season for benzene, ethylbenzene, and xylene in all workstations, as well as for toluene for repairmen and site men exceeded acceptable level of 1. In winter season the mean HQ values for benzene and xylene in all workstations, for toluene for repairmen and site men, and for ethylbenzene for supervisors, repairmen, and site men were also > 1. For all workstations definite carcinogenic risk was indicated as calculated LCR values for benzene and ethylbenzene exposure were higher than 1 × 10-4 in both summer and winter seasons.

Inhalational exposure to formaldehyde, carcinogenic, and non-carcinogenic risk assessment: A systematic review.

Formaldehyde is one of the most widely used substances in a variety of industries, although it was classified as a human carcinogen by the International Agency for Research on Cancer (IARC). The present systematic review was conducted to retrieve studies related to occupational exposure to formaldehyde until November 2, 2022. Aims of the study were to identify workplaces exposed to formaldehyde, to investigate the formaldehyde concentrations in various occupations and to evaluate carcinogenic and non-carcinogenic risks caused by respiratory exposure to this chemical among workers. A systematic search was done in Scopus, PubMed and Web of Science databases to find the studies done in this field. In this review, studies that did not meet the criteria specified by Population, Exposure, Comparator, and Outcomes (PECO) approach were excluded. In addition, the inclusion of studies dealing with the biological monitoring of FA in the body and review studies, conference articles, books, and letters to the editors were avoided. The quality of the selected studies was also evaluated using the Joanna Briggs Institute (JBI) checklist for analytic-cross-sectional studies. Finally, 828 studies were found, and after the investigations, 35 articles were included in this study. The results revealed that the highest formaldehyde concentrations were observed in waterpipe cafes (1,620,000 µg/m3) and anatomy and pathology laboratories (4237.5 µg/m3). Carcinogenic and non-carcinogenic risk indicated the potential health effects for employees due to respiratory exposure as acceptable levels of CR = 1.00 × 10-4 and HQ = 1, respectively were reported to be exceeded in more than 71% and 28.57% of the investigated studies. Therefore, according to the confirmation of formaldehyde's adverse health effects, it is necessary to adopt targeted strategies to reduce or eliminate exposure to this compound from the occupational usage.

Respiratory functions and health risk assessment in inhalational exposure to vinyl acetate in the process of carpet manufacturing using Monte Carlo simulations.

Vinyl acetate (VA) is a volatile compound and the main compound of the carpenter's glue. VA causes upper respiratory tract irritation, cough, and hoarseness in occupational exposure. As Iran is one of the biggest carpet producers in the world, this study was carried out to determine the inhalational health risk for employees exposed to VA. To the best of our knowledge, this was the first health risk assessment and the first evaluation of the lung functions and respiratory symptoms in employees exposed to VA. In the six finishing shops of carpet manufacturing industry in Kashan city, Iran the cross-sectional studies were conducted in 2022. The subjects comprised of forty male employees exposed to VA and of forty non-exposed employees in the reference group. VA analyses in the workers' breathing zones were performed based on the National Institute for Occupational Safety and Health (NIOSH) 1453 Method. VA concentrations were measured using Gas Chromatography-Mass Spectrometry (GC-MS). Inhalational risk assessment to VA was performed using the United States Environmental Protection Agency method and the Monte Carlo simulations. Respiratory functions were determined using the spirometry indices. In the exposed employees, considerably higher prevalence rates of pulmonary symptoms were observed in comparison with the control group. Statistical analysis showed a remarkable difference between lung function parameters measured in the case and the control groups. The VA Hazard Quotient (HQ) values for all working posts, except the quality control unit, were > 1 indicating the substantial inhalational non-cancerogenic risk. The sensitivity analysis revealed that the VA concentrations and exposure time had the most significant contribution in the uncertainty assessment. Therefore, it is recommended to decrease exposure to VA concentrations and to reduce the working time of exposed employees.

Microbiota analysis for risk assessment of xenobiotics: toxicomicrobiomics, incorporating the gut microbiome in the risk assessment of xenobiotics and identifying beneficial components for One Health.

This work explores three areas of relevance to the gut microbiome in the context of One Health; the incorporation of the microbiome in food safety risk assessment of xenobiotics; the identification and application of beneficial microbial components to various areas under One Health, and specifically, in the context of antimicrobial resistance. We conclude that, although challenging, focusing on the microbiota resilience, function and active components, are critical for advancing the incorporation of the gut microbiome in the risk assessment of xenobiotics. Moreover, research technologies, such as toxicomicrobiomics, culturomics and genomics, especially in combination, have revealed that the human microbiota may be a promising source of beneficial taxa or other components, with the potential to metabolise and biodegrade xenobiotics. These may have possible applications in several health areas, including in animals or plants for detoxification or in the environment for bioremediation. This approach would be of particular interest for antimicrobials, with the potential to ameliorate antimicrobial resistance development. Finally, we propose that the concept of resistance to xenobiotics in the context of the gut microbiome may deserve further investigation in the pursuit of holistically elucidating their involvement in the balance between health and disease.

Microbiota analysis for risk assessment of xenobiotics: cumulative xenobiotic exposure and impact on human gut microbiota under One Health approach.

Human gut microbiota is the microbial community that, through the constant bidirectional communication with its host, plays the critical role of maintaining the state of eubiosis and health balance, contributing to food digestion, detoxification, and proper endocrine, neurological, immunological and potentially reproductive health. To this extent, gut microbiota is called the 'second brain' as well as the 'second liver'. Xenobiotics, including environmental pollutants, are widely spread in the environment and easily accessible in food, cosmetics, personal care products, drugs and medicinal products. Thus, the gut microbiota can be exposed to these xenobiotics, which in turn might alter its composition and metabolism that can trigger dysbiosis, and they seem associated with disorders and diseases in the host. A specific group of xenobiotics, called endocrine-disrupting chemicals, is particularly important due to relevant adverse health effects. A considerable challenge in risk assessment is the combined exposure to xenobiotics, for which the integrated approaches, including the One Health concept, are still under development. Nevertheless, recent research advancements focus on molecular data in the search for elucidating crucial microbiome biomarkers, associated with physiopathology and specific dysfunctions triggered by xenobiotic exposure. In this context, the application of meta-omics and integration of genomics, metagenomics, metabolomics, metatranscriptomics, proteomics and multidisciplinary approaches are particularly important.

Probabilistic human health risk assessment of 1,3-butadiene and styrene exposure using Monte Carlo simulation technique in the carpet production industry.

Chemicals containing Volatile Organic Compounds (VOCs) are commonly used in the machine carpet production. 1,3-butadiene and styrene are main components of the carpenter's glue used in carpet factories. Exposition to these chemicals can lead to a number of adverse health effects. This is the first study of the human health risk assessment due to inhalational exposure to 1,3-butadiene (BD) and styrene (ST) performed among workers in the carpet factories in Kashan city, Iran. The importance of the study was related with the fact of high popularity of carpet production in the South Asia countries. Inhalation exposure to BD and ST were measured based on the National Institute for Occupational Safety and Health (NIOSH) 1024 and 1501 methods, respectively. The cancerogenic risk (CR) and non-cancerogenic risk described as Hazard Quotient (HQ) values were calculated based on the United States Environmental Protection Agency (USEPA) method. The sensitivity and uncertainty analysis were performed by the Monte Carlo simulation (MCS) technique. The average concentration measured of BD and ST during work shifts of employees were 0.039 mg m-3 (0.017 ppm) and 12.108 mg m-3 (2.84 ppm), respectively. The mean ± SD value of estimated cancerogenic risk in inhalation exposure to BD and ST were equal to 5.13 × 10-3 ± 3.85 × 10-4 and 1.44 × 10-3 ± 2.36 × 10-4, respectively exceeding the acceptable risk level of 10-6 defined by USEPA. The average non-carcinogenic risk (HQ) values of BD and ST were equal to 8.50 × 100 and 5.13 × 100, respectively exceeding the acceptable risk level of 1. As the results of our studies exceeded both cancerogenic and non-carcinogenic risk values it indicates that adverse health effects due to inhalational exposure to BD and ST for workers in the machine carpet industry are very likely. To avoid negative health effects protective measures for employees in the factories should be introduced immediately and furher detailed research are recommended.

Incorporating the Gut Microbiome in the Risk Assessment of Xenobiotics and Identifying Beneficial Components for One Health.

Three areas of relevance to the gut microbiome in the context of One Health were explored; the incorporation of the microbiome in food safety risk assessment of xenobiotics; the identification and application of beneficial microbial components to various areas under One Health, and; specifically, in the context of antimicrobial resistance. Although challenging, focusing on the microbiota resilience, function and active components is critical for advancing the incorporation of microbiome data in the risk assessment of xenobiotics. Moreover, the human microbiota may be a promising source of beneficial components, with the potential to metabolize xenobiotics. These may have possible applications in several areas, e.g., in animals or plants for detoxification or in the environment for biodegradation. This approach would be of particular interest for antimicrobials, with the potential to ameliorate antimicrobial resistance development. Finally, the concept of resistance to xenobiotics in the context of the gut microbiome may deserve further investigation.

Impact of Cumulative Environmental and Dietary Xenobiotics on Human Microbiota: Risk Assessment for One Health.

Chemical risk assessment in the context of the risk analysis framework was initially designed to evaluate the impact of hazardous substances or xenobiotics on human health. As the need of multiple stressors assessment was revealed to be more reliable regarding the occurrence and severity of the adverse effects in the exposed organisms, the cumulative risk assessment started to be the recommended approach. As toxicant mixtures and their "cocktail effects" are considered to be main hazards, the most important exposure for these xenobiotics would be of dietary and environmental origin. In fact, even a more holistic prism should currently be considered. In this sense, the definition of One Health refers to simultaneous actions for improving human, animal, and environmental health through transdisciplinary cooperation. Global policies necessitate going beyond the classical risk assessment for guaranteeing human health through actions and implementation of the One Health approach. In this context, a new perspective is proposed for the integration of microbiome biomarkers and next generation probiotics potentially impacting and modulating not only human health, but plant, animal health, and the environment.

The Condition of Air Pollution in Kraków, Poland, in 2005-2020, with Health Risk Assessment.

AIMS: Air quality changes with human health risk assessment were investigated. METHODS: The measurement results obtained by the Regional Environmental Protection Inspectorate (REPI) in Kraków and our deposited particulate-matter (PM) analysis, as well as United States Environmental Protection Agency (USEPA) methodology of risk assessment were used in the study. RESULTS: Annual pollutant contents kept decreasing, with the exception of O3. However, the permissible annual levels were exceeded in the cases of PM10, PM2.5, and NO2. Increased contents of SO2, CO, C6H6, PM10, and PM2.5, as well as of As, Pb, Cd, Ni, and polycyclic aromatic hydrocarbons (PAHs) in PM particles during winter months indicated that house heating was the source of pollution. Due to no significant change in the monthly NO2 contents, this measurement was used as an indicator of traffic sources of pollution. In winter months, the allowable 24 h PM2.5 and PM10 contents were constantly exceeded. PM was identified as the most significant air pollutant. Enrichment factors revealed that deposited PM was enriched with heavy metals. The potential ecological risk (ERI) was determined to be very high for Cd, considerable for Zn, and low for As, Co, Cr, Cu, Ni, Pb, and Tl. The total non-carcinogenic risk indices (HQ) for both adults (HQ = 15.0) and children (HQ = 26.4) exceeded the acceptable value of 1. The total carcinogenic risk indices (CR) for both adults (CR = 1.51 × 10-4) and children (CR = 1.77 × 10-4) exceeded the acceptable level of 1 × 10-4. CONCLUSIONS: In the years 2005-2020, a general decreasing tendency of annual pollutant contents was observed. However, the permissible contaminant contents were still exceeded. PM2.5, BaP, PM10, and NO2 were determined as the most dangerous pollutants in inhalational pathway.

Human Health Risk Assessment and Potentially Harmful Element Contents in the Cereals Cultivated on Agricultural Soils.

Potentially harmful element (PHE) contents were investigated in six species of cereals in southern Poland, with human health risk implications assessed afterwards. The PHE contents belonged to the following ranges (mg/kg wet weight): As below the limit of detection ( oat (HQ = 0.38) > maize (HQ = 0.02). The total non-carcinogenic risk value of the statistical daily consumption of cereals was acceptable low (HQ = 0.58). The acceptable cancer risk (CR) level of 1.0 × 10-5 investigated only for As was not exceeded under any of the intake scenarios. Concerning the mean As content in cereals consumed daily in statistical amounts the CR value was equal to 5.1 × 10-8. The health risk value according to the Pb content in cereals using the margin of exposure (MOE) approach was equal to 1.27, indicating an acceptable low risk.

The contents of the potentially harmful elements in the arable soils of southern Poland, with the assessment of ecological and health risks: a case study.

Agricultural soil samples were collected from the areas where edible plants had been cultivated in southern Poland. The PHE content decreased in proportion to the median value specified in brackets (mg/kg d.m.) as follows: Zn (192) > Pb (47.1) > Cr (19.6) > Cu (18.8) > Ni (9.91) > As (5.73) > Co (4.63) > Sb (0.85) > Tl (0.04) > Cd (0.03) > Hg (0.001) > Se (< LOQ). No PHE concentrations exceeded the permissible levels defined in the Polish law. The PHE solubility (extracted with CaCl2) in the total concentration ranged in the following order: Fe (3.3%) > Cd (2.50%) > Ni (0.75%) > Zn (0.48%) > Cu (0.19%) > Pb (0.10%) > Cr (0.03%). The soil contamination indices revealed moderate contamination with Zn, ranging from uncontaminated to moderately contaminated with Pb, and, practically, no contamination with other PHEs was identified. The ecological risk indices revealed that soils ranged from uncontaminated to slightly contaminated with Zn, Pb, As, Cu, and Ni. The PCA indicated natural sources of origin of Co, Cu, Hg, Sb, Zn, Cr, and Pb, as well as anthropogenic sources of origin of Cd, Ni, As, and Tl. The human health risk assessment (HHRA) for adults and children decreased in the following order of exposure pathways: ingestion > dermal contact > inhalation of soil particles. The total carcinogenic risk values for both adults and children were at the acceptable level under residential (1.62E-05 and 6.39E-05) and recreational scenario (5.41E-06 and 2.46E-05), respectively, as well as for adults in agricultural scenario (1.45E-05). The total non-carcinogenic risk values for both adults and children under residential scenario (1.63E-01 and 4.55E-01, respectively), under recreational scenario (2.88E-01 and 6.69E-01, respectively) and for adults (1.03E-01) under agricultural scenario indicated that adverse health effects were not likely to be observed. Investigated soils were fully suitable for edible plant cultivation.

Significance of Environmental Input Data in Risk Assessment Analyses.

The environment is becoming more and more polluted [...].

Human Health Risk Assessment and Potentially Harmful Element Contents in the Fruits Cultivated in the Southern Poland.

The presence of potentially harmful elements (PHEs) in popularly consumed fruits in Poland was determined by inductively coupled plasma mass spectrometry. The As, Cd, Co, Cr, Cu, Hg, Ni, Pb, Se, Sb, Tl, and Zn contents were investigated in 21 fruit species grouped as berry, pome, stone, and shell fruits. The PHE contents belonged to the following ranges (mg/kg wet weight): Cd < limit of detection (LOD)-0.116, Co < LOD-0.062, Cu < LOD-15.5, Ni < LOD-2.23, Pb < LOD-2.07, Sb < LOD-0.240, Tl < LOD-0.110, and Zn 0.37-37.7. Their concentrations exceeded the maximum allowable concentration (MAC) set by European Union regulation for Pb only. Bioconcentration coefficient (BC) values, calculated in accordance to the PHE contents in exchangeable and acid soluble forms in soil after first step of the Community Bureau of Reference (BCR) sequential extraction procedure, revealed that berry fruits had potential for accumulation of Cu, Ni, Sb, and Tl; stone fruits-Cu, Sb, and Tl; pome fruits-Cu, Ni, and Sb, and shell fruit (walnut)-Cu. Human health risk assessment associated with the intake of PHEs in fruits was evaluated in terms of daily intake rates (DIR), and carcinogenic and non-carcinogenic risk by cancer risk (CR) and hazard quotient (HQ), respectively. For Pb margin of exposure (MOE) approach was used for health risk evaluation. Daily intake rates for all PHEs were below the provisional maximum tolerable daily intake (PMTDI) values. The mean total non-carcinogenic risk values were the following: berry fruits HQ = 0.47, pome fruits HQ = 0.36, stone fruits HQ = 0.42, and shell fruits (walnut) HQ = 0.22, indicating no health hazards. The carcinogenic risk for As in walnut only under an adult intake scenario (CR = 1.98 × 10-6) was found to be above the acceptable risk level. The mean Pb health risk, according to Polish statistical intake rates, was acceptable low as the MOE value was equal to 15.7 for adults. In reference to the intake rates recommended by United States Environmental Protection Agency (USEPA), MOE values for Pb indicated acceptable low risk both for adults (MOE = 14.0) and children (MOE = 1.64). In general, the finding of this research revealed no health risk arising from PHE consumption with fruits for the population of Poland.