Industrialization and food safety for the Tsleil-Waututh Nation: An analysis of chemical levels in shellfish in Burrard Inlet.

While Indigenous food systems remain critical for community well-being, traditionally harvested foods are a potential source of toxic exposures. The Tsleil-Waututh Nation (TWN) is seeking to restore shellfish harvesting in Burrard Inlet (British Columbia [BC], Canada), where the cumulative effects of industrial activity have nearly eliminated safe harvesting. The Trans Mountain Expansion project would triple the capacity to transport oil through the inlet, threatening TWN's progress to restore shellfish harvesting. To inform ongoing efforts we assessed contamination by heavy metals (arsenic, cadmium, lead, and mercury) and 48 polycyclic aromatic hydrocarbons (PAHs) congeners in different shellfish species (Softshell clams, Varnish clams, and Dungeness crab) in three areas. We compared our results against local screening values (SVs) established by the TWN and BC Ministry of Environment and Climate Change Strategy, as well as provincial and national benchmarks. In total, we analyzed 18 composite samples of Softshell clams and Varnish clams (5 individuals per sample), as well as 17 individual crabs. We found chemical contamination in all species at all sites. PAHs were most frequently detected in Softshell clams, highest in the site closest to the pipeline terminus. Clams presented higher levels of contamination than crabs for PAHs, but not for heavy metals. For Softshell and Varnish clams, all heavy metals across study sites exceeded at least one of the population-specific SVs. Of the 14 PAHs detected, benzo(a)pyrene presented a median concentration in Softshell clams of 3.25 µ/kg, exceeding local SV for subsistence fisher. Our results call for further assessment of human health impacts related to food harvesting within Burrard Inlet and establishing a long-term coordinated program co-led by the TWN to monitor contamination and inform future harvesting programs. The study draws attention to the need to consider locally-relevant toxicity benchmarks, and include potential health impacts of food contamination in appraising development project proposals.

[Contribution of electronic cigarettes in smoking patients with psychotic disorders. A literature review]. / Cigarette électronique chez les patients fumeurs présentant une pathologie psychotique. Revue de la littérature.

OBJECTIVES: This systematic literature review focused on patients suffering from schizophrenia (SZ), psychotic disorders or mental illness (MI) including SZ. It was interested in data on prevalence of electronic cigarette (EC) use, patient perceptions and expectations, as well as caregivers' attitudes towards the EC and its benefit in helping to stop or reduce smoking. METHOD: The research was carried out on Medline for the period 2000-2020. Cross-sectional, case-control, prospective, randomized controlled studies and preliminary studies were included in this review. RESULTS: EC is widely used by MI patients with current and lifetime use from 7.4% to 28.6%. More specifically, patients with SZ and schizoaffective disorders observe current and lifetime use from 7% to 36%, respectively. Many reasons are given by patients for its use including the possibility of using it in places where smoking is prohibited, its lower toxicity compared to cigarettes for oneself and those around, its lower cost, and the help provided to reduce consumption. CONCLUSION: EC is used by smokers with MI; several studies confirm the possibility for these smokers to reduce tobacco consumption through EC and without disturbing their mental state. However, its value in helping to quit smoking remains uncertain.

Historical documentation of lead toxicity prior to the 20th century in English literature.

Lead is a heavy metal that remains a persistent environmental toxin. Although there have been a substantial number of reviews published on the health effects of lead, these reviews have predominantly focused on recent publications and rarely look at older, more historical articles. Old documents on lead can provide useful insight in establishing the historical context of lead usage and its modes of toxicity. The objective of this review is to explore historical understandings and uses of lead prior to the 20th century. One hundred eighty-eight English language articles that were published before the year 1900 were included in this review. Major themes in historical documentation of lead toxicology include lead's use in medical treatments, symptoms of lead poisoning, treatments for lead poisoning, occupational lead poisonings, and lead contamination in food and drinking water. The results of this review indicate that lead's usage was widespread throughout the 19th century, and its toxic properties were well-known. Common symptoms of lead poisoning and suggested treatments were identified during this time period. This review provides important insight into the knowledge and uses of lead before the 20th century and can serve as a resource for researchers looking at the history of lead.

Reported association of air pollution and suicide rate could be confounded.

A statistical association between ambient air pollution and suicide mortality has been recently reported in Environmental Health, which seems not to be scientifically supported by their data.In this article, very low (unrealistic) suicide rate is reported, which is subjected to selection bias. Their justification is also flawed as high exposure to ambient air pollution in rural areas is lower as compared to urban residents. Weekends, holidays, time of death … are also both air pollution and suicide rate related. Reported statistical association of air pollution and suicide in this study is heavily confound.Please see article under discussion: https://ehjournal.biomedcentral.com/articles/10.1186/s12940-016-0177-1 .

Carbon monoxide poisoning in Northeast of Iran.

BACKGROUND: CO poisoning is still a public health concern especially in developing countries. We aimed to focus on CO poisoning secular trends based on registry data for the recent 7 years in Northeast of Iran. METHODS: Registry database of Imam Reza Hospital in Mashhad, Iran was analyzed. All admitted cases with CO exposure during 2004-2011 were included. Data from two national censuses were used for calculating rates. Data analyses was performed by SPSS 11.5. P < 0.05 was considered statistically significant. RESULTS: There were 443 CO related admissions (0.9% of all poisonings which equals to a prevalence rate of 1.9 per 100,000) during the 7-year period. Mean age was 32.3 ± 18.2 years and 60% of subjects were male. CO prevalence rate was not changed during this period. Case fatality rate was higher in men (5.4% vs. 4.4%). Self-employment and manual or office workers were at greatest risk. Age specific prevalence and mortality rates were highest in >60 age group. (2.9 and 3.1 per 100,000, respectively). CONCLUSION: As it seems that current health prevention studies are not effectively working, these secular trends can enlighten health policy makers to implement proper population based interventions like education or regulations for CO detectors. We believe that almost all cases of accidental CO poisoning can be prevented.

Ten-year disease burden of acute poisonings in northeast Iran and estimations for national rates.

BACKGROUND: Acute poisoning is a common health problem worldwide. Traditionally, the frequency of admitted cases, number of deaths or online resources were used to measure the volume of this problem. In this study, the burden of acute poisoning is addressed for the first time. METHODS: Data related to 44,340 poisoned patients from 2004 to 2013 were analysed. Two sources including hospital information and forensic medicine data of the Khorasan Razavi catchment area. The disability-adjusted life years (DALY) method - including years of life lost (YLL) and years lived with disability (YLD) - was used to estimate the burden. RESULTS: In this period and for all acute poisonings, the mean (SD, minimum-maximum) incidence of acute poisoning was 30,485 (3049 per year). In total, 29,208 DALY were lost, including 8499 YLD and 20,709 YLL. DALY have increased from 1808 in 2004 to 4283 in 2013. Among the total DALY over this 10-year period, 17,592 (60%) were related to males. Narcotic use accounted for the largest percentage of DALY (19.6%), followed by analgesics-sedative use (16.3%) and illegal drug use (11.41%). The health loss due to these causes was large (YLD = 8499 and YLL = 20,709) and showed a rapidly increasing trend. CONCLUSIONS: Estimating DALY is more informative than using the frequency of death. If we expect the same ratio in the country, we would expect a DALY rate of 729,750 years for the 75,000,000 inhabitants of this country in this time period or 72,975 DALY lost per year for poisonings.

Comparison of serum and urine lead levels in opium addicts with healthy control group.

CONTEXT: Lead-contaminated opium is one of the new sources of lead exposure in our region. As far as the literature review is concerned, there are limited comparative studies about comparison of blood lead level (BLL) in addict patients with healthy controls. OBJECTIVE: We aimed to compare BLL and urine lead level (ULL) between opium addicts with the healthy control group. MATERIALS AND METHODS: Forty opium addict subjects (mean age: 43 ± 10 years) as the patient group and 40 healthy subjects (mean age: 41 ± 9 years) as the control group participated. Three milliliter of whole blood and urine was obtained from both groups and lead level was assessed using atomic absorption spectrophotometry. RESULTS: The mean value of BLL in patient group was 7.14 ± 1.41 mcg/dL and that in the healthy control group was 5.42 ± 1.46 mcg/dL. The mean value of ULL was 2.62 ± 0.83 mcg/dL in the patient group and 2.50 ± 0.76 mcg/dL in the healthy control group.BLL was different in the two groups (p < 0.001), but ULL was not (p = 0.5). There was a significant correlation between BLL with duration of opium addiction in the patient group (r = -0.403, p = 0.01). BLL and ULL were significantly correlated in controls (r = 0.436, p = 0.005) and not in patients. DISCUSSION AND CONCLUSION: It was observed that the BLL in opium addicts was significantly higher than that in the healthy control group. This can be due to use of adulterated opium with lead. Therefore, screening of blood lead concentration is helpful for opium-addict patients especially with nonspecific symptoms.

The measurement of disability weights for 18 prevalent acute poisoning conditions.

BACKGROUND: Disability weights (DWs) are used in disease burden studies, with the calculation of the weight of the disability as years lived with disability versus years of lost life accounting for mortalities. Currently, there is a single DW score available for poisoning, which is considered to be a single health state. This makes it difficult to evaluate the differing burdens of poisonings involving various substances/conditions in comparison with other health states in countries with different patterns of substance abuse. The aim of this study is therefore to estimate the DWs of 18 common poisonings based on the expert elicitation method. METHODS: A panel of 10 medical clinicians who were familiar with the clinical aspects of different poisonings estimated the DWs of 50 health states by interpolating them on a calibrated Visual Analogue Scale. The DWs of some poisonings, such as alcohol, cannabis and heroin, had been estimated in previous studies and so were used to determine the external consistency of our panel. As a matter of routine, the DWs could vary on a scale between 0 (best health state) and 1 (worst health state). RESULTS: Statistical analysis showed that both the internal (Cronbach's α = 0.912) and external consistency of the panel were acceptable. The DWs for the different poisonings were estimated along a range from 0.830 for severe aluminium phosphide to 0.022 for mild benzodiazepine. CONCLUSIONS: Different poisonings should be weighted differently since they vary widely. Unfortunately, they are currently all weighted the same.

Recreational use and overdose of ingested processed cannabis (Majoon Birjandi) in the eastern Iran.

In the eastern Iran including Birjand and Greater Khorasan areas, a special traditional solid pie, locally called Majoon Birjandi (MB), is frequently abused by youngsters to induce a feel of high, special, euphoria, and energy. Cannabioid ingredients of this illicit solid lozenge are confirmed by clinical findings as well as positive urinary delta-q-tetrahydrocannabinol (THC) test. Because of its solid nature, it is easily smuggled and stored for a long time. Due to its localized usage in the eastern Iran, diagnosis of MB abuse is not known to toxicologists even from other parts of this country. We would like to bring to the attention of the readers the effects and cannabioid composition of this concoction and present the potential recreational ingestion root of processed cannabis for the first time.

Metal mercury poisoning in two boys initially treated for brucellosis in Mashhad, Iran.

Elemental mercury (Hg) is the only metal which evaporates in room temperature and its inhalation may cause toxicity. Hg poisoning may occur by mishandling the metal, particularly in children who play with it. Wide-spectrum of the clinical presentations of chronic Hg poisoning may cause misdiagnosis, particularly when history of exposure is unknown. We report two cases of accidental Hg poisoning, which initially had been diagnosed and treated for brucellosis. The patients were two brothers (7 and 14 years old) who presented with pain in their lower extremities, sweating, salivation, weight loss, anorexia and mood changes on admission. Meticulous history taking revealed that they had played with a ball of Hg since 3 months before admission. The level of urinary Hg was 125.9 and 54.2 9 g/L in the younger and older brother, respectively (normal ≤25 g/L). The patients were successfully treated by dimercaprol and discharged in good condition 24 days after admission. These cases are being reported to emphasize the importance of acrodynia as a differential diagnosis for brucellosis in endemic areas.

Population-based severity, onset and type of drug-drug interactions in prescriptions.

Inappropriate drug combinations occur frequently and may lead to serious adverse events. In Iran, drug overdose and interactions are relatively common but rarely reported and are mainly derived from admitted subjects. The aim of this study was to determine the prevalence of possible drug-drug interactions via a population database survey in Mashhad, Iran. In this survey all prescriptions paid by insurance companies in the period 21rst March 2006 to 20th March 2008 were studied retrospectively. Data were gathered from the Division of Rational Use Drug, Food and Drug Vice Chancellor of Mashhad University of Medical Sciences, Iran. Drug interactions were categorized based on severity, onset and dynamic/kinetic nature. Incidence was calculated based on the number of interactions/1000 prescriptions. In total 11,562,808 prescriptions were studied, among which 5% showed interactions. Two hundred and four types of potential interactions were detected. Belladonna, phenytoin sodium, cimetidine, propranolol hydrochloride, gentamicin, acetylsalicylic acid (ASA), Antacid, theophylline and carbamazepine were the most common medications. Among them, 54% showed dynamic and 34% kinetic interactions, 11% were categorized to be both and 76% displayed rapid-onset interactions. Moderate interactions were the most dominant (70%) phenomenon. Dynamic and kinetic interactions significantly differed with respect to the onset of interactions (P < 0.001). A rather different pattern of drug-drug interaction exists in Iran, highlighting the need for a nationwide program on related education and a stronger focus on severe and rapid-onset interactions. Further studies warrant the need to explore high-risk patients.

Occupational lead poisoning in workers of traditional tile factories in Mashhad, Northeast of Iran.

BACKGROUND: Occupational lead poisoning is a health problem in Iran. It has not previously been studied in traditional tile makers. OBJECTIVE: To determine the prevalence of lead poisoning and its complications in traditional tile workers in Mashhad, Northwest of Iran. METHODS: We visited workers in two traditional tile factories and collected data by direct history taking and physical examination. Blood and urine lead concentrations were measured by heated graphite atomization technique. RESULTS: Overall, 108 men with mean±SD age of 37±7.8 years were studied. The mean±SD length of daily lead exposure was 9.8±6 years. The mean±SD blood lead concentration was 520.5±323.2 µg/L. The main objective clinical findings were the presence of lead line (64.8%), peripheral neuropathy of the upper extremities (37%), depressed deep tendon reflexes in the upper extremities (25.7%), tremor (23.3%), peripheral neuropathy of the lower extremities (17%) and abdominal tenderness (15.1%). The subjective findings were mainly attributed to the central nervous system and included loss of memory (57%), moodiness (56.1%), agitation (47.7%), drowsiness (36.4%) and headache (29.9%). There was no statistically significant correlation between the blood lead concentration and glomerular filtration rate. However, there were significant correlations between the blood lead concentration and each of the urine lead concentration (p<0.001), diastolic blood pressure (p = 0.04), serum triglyceride level (p = 0.043), high density lipoprotein level (p = 0.012), and basophilic stippling (p = 0.048). Blood lead level, however, did not have any significant correlation with the presence of lead line. CONCLUSION: In traditional tile workers, lead toxicity is not uncommon and the toxic effects of lead were found more often on the teeth (bone), central and peripheral nervous system, hematological and lipid profiles than on the renal function.

Spider bite (latrodectism) in Mashhad, Iran.

BACKGROUND: Spider (Latrodectus tredecimguttatus) bites are relatively common in North East Iran. They induce morbidity and rarely mortality. We aimed to investigate clinical, electrocardiographic and para-clinical changes in patients with this bite. METHODS: All consecutive patients admitted with suspected spider bites between September 2005 and September 2006 were studied prospectively. RESULTS: Spider bites accounted for 56 cases (0.5% of all poisoning, 21% of all admitted envenomated). The patients' mean (SD) age was 32 (16) years. The most common findings were pain (90%) mainly in their back (45%), stomach (35%), lower limbs (33%), upper limbs (19%) and chest (14%). Other clinical findings included were sweating (55%), chills (29%), dyspnea (25%), flushing (14%), spasm (12%), headache (12%), nausea (12%) and vertigo (12%). On electrocardiograph (ECG); ST segments were depressed in 25% of cases in at least two of the pre-cordial leads. Laboratory findings were in normal ranges. All the patients recovered following supportive and symptomatic treatment (no anti-toxin available in Iran), with a mean hospitalization period of 1.9 (1.3) days. CONCLUSIONS: Spider (L. Tredecimguttatus) bite is relatively common in Mashhad, which induces latrodectism with relatively different findings and cardiac toxicity. ECG monitoring should be considered, particularly when specific anti-toxin is not available.

Identification of DREB homologous genes in bread wheat via CODEHOP PCR primer design.

In this study, we exploit the useful described CODEHOP primer design and RT-PCR strategy for targeted isolation of homologues in large gene families. The method was tested with two different objectives. The first was to apply CODEHOP strategy for design degenerate oligonucleotide primers in a broad range of plant species. The second was to isolate an orthologus of the transcription factor of dehydration-responsive element binding protein (DREB) and to determine the complexity of gene family in bread wheat. We used a new primer design strategy for PCR amplification of unknown targets that are related to multiply-aligned protein sequences. Each primer consists of a short 3' degenerate core region and a longer 5' consensus clamp region. Only 3-4 highly conserved amino acid residues are necessary for design of the core, which is stabilized by the clamp annealing to templates molecules. This provides the possibility of isolating numerous additional DREB genes by Polymerase Chain Reaction (PCR) with degenerate oligonucleotide primers. The relationship of the amplified products to DREB genes was evaluated by several sequence and genetic criteria. Present data show that expression of DREB and its homologues, is induced by low temperature stress. Towards this step, it found that the expression of DRE-regulated genes increased freezing tolerance in plants.

Hemodynamic effects of methadone and dihydrocodeine in overdose.

BACKGROUND: Opioid overdose is an increasing health problem worldwide. The cardiovascular toxicity of opioids contributes to morbidity and mortality in overdose but the hemodynamic effects of opioids reported in animal and human studies are contradictory. METHODS: We performed a prospective observational study of patients admitted to hospital following an overdose of methadone, dihydrocodeine, or low dose paracetamol (10 each). Basic cardiovascular indices including peripheral blood pressure, pulse rate, radial augmentation index and derived measures of aortic systolic, diastolic, pulse, and mean and end systolic pressures were measured every six hours for up to 18-23 hours after exposure or until hospital discharge. RESULTS: Dihydrocodeine and methadone significantly reduced peripheral and aortic systolic, mean and end systolic pressures. Both opioids significantly decreased peripheral pulse pressure, but only methadone decreased aortic blood pressure. Dihydrocodeine reduced systemic and aortic diastolic blood pressure, an effect not induced by methadone. Methadone significantly reduced peripheral pulse pressure. Augmentation index and heart rate, however, did not change. Both opioids decreased arterial oxygen saturation. CONCLUSION: These results suggest that dihydrocodeine and methadone in overdose both have a significant effect on central and peripheral hemodynamics. These effects might be expected to reduce cardiac afterload, providing a pharmacological explanation for the apparent benefit of opioids in cardiovascular diseases.

Effects of osmopriming on seed germination of canola (Brassica napus L.) under salinity stress.

Canola has good yield and performance in weak and saline soils that other oil crops can not be cultivated in them. Performance and production of this crop can be improved by increasing the vigor of its seeds. Priming is one of the techniques for enhancing seed vigor under stress condition. Pretreatment of seeds in osmotic solutions is called osmopriming, which is used to increase the seed moisture content and speed of germination. In this study, seeds of three varieties of canola (SLM046, Okapi and Licord) were primed in osmotic solutions and then were germinated under salinity stress at laboratory conditions. Osmotic solutions were made by polyethylene glycol 6000 in osmotic potentials of -10, -12, -14, -16 and -18 bar for 24 h. NaCl solutions with electrical conductivities of 0, 6, 12 and 18 ds/m were used to make salinity stress. Results of this study showed that osmopriming could be used to increase the performance of seeds under normal and salinity stress.

Co-proxamol overdose is associated with a 10-fold excess mortality compared with other paracetamol combination analgesics.

AIMS: To assess the relative toxicity of co-proxamol in overdose in comparison to the 2 other paracetamol-opioid combination products, co-codamol and co-dydramol. METHODS: Data collected over a 2-year period (July 2000-June 2002) was used to estimate the frequency of overdose and death for the three most popular paracetamol-opioid compound analgesics. Prescription data for Scotland and Edinburgh, the number of overdoses (derived from overdose admissions in Edinburgh) or Poisons Information Service contacts in Scotland, and national death records were used to calculate a series of indicators relating morbidity (admissions), surrogates of morbidity (poisons enquiries by telephone or internet) and mortality to prescriptions. RESULTS: When related to prescription volume overdoses involving co-proxamol in Scotland were 10 times more likely to be fatal (24.6 (19.7, 30.4)) when compared with co-codamol (2.0 (0.88, 4.0)) or co-dydramol (2.4 (0.5, 7.2)). In contrast there was no difference in the presentation rate or enquiry rates for these analgesics when corrected for prescriptions. CONCLUSIONS: The excess hazard from co-proxamol is due to inherent toxicity rather than increased use in overdose. We estimate from this study that withdrawal of co-proxamol would prevent 39 excess deaths per annum in Scotland alone.

ECG abnormalities in co-proxamol (paracetamol/dextropropoxyphene) poisoning.

OBJECTIVES: 1) To investigate ECG changes following co-proxamol (paracetamol 325 mg and dextropropoxyphene 32.5 mg) overdose in comparison to co-codamol (paracetamol and codeine) or co-dydramol (paracetamol and dihydrocodeine) in a prospective study. 2) To examine the relationship between estimated dextropropoxyphene dose and ECG changes in a larger patient population. BACKGROUND: Co-proxamol is a common cause of drug-induced death and hospital admission in the United Kingdom. ECG changes following dextropropoxyphene have been reported in animals and man, including QRS prolongation. METHODS: The prospective study was conducted on 15 patients and controls with overdose. A retrospective study of a cohort of 159 co-proxamol overdoses from a combined data set from Edinburgh and Newcastle, Australia was also conducted. The measured or estimated "four hour" plasma paracetamol level was used as a surrogate of the amount of dextropropoxyphene ingested. RESULTS: In the prospective study co-proxamol overdose caused statistically significant QRS prolongation (mean [95% CI] 99.36 [96.19, 102.53] msec), compared to the other combination opioid-paracetamol products (82.84 [80.81, 84.88] msec) but no effect on PR or QTc. QRS duration increase was evident soon after exposure and remained prolonged and stable over the following 24 h. In the retrospective cohort study a dose dependency of effect on QRS was documented, although the correlation coefficient relating paracetamol level to effect was relatively weak (r = 0.338, Sig. [2-tailed] 0.003, n = 74). CONCLUSIONS: QRS is significantly prolonged in co-proxamol overdose, and this prolongation is dose dependent. These findings have clinical relevance to the management of patients with co-proxamol poisoning.

Pattern of acute poisonings in Mashhad, Iran 1993-2000.

Drugs and chemicals are almost easily available in Iran. Natural toxins as poisonous plants and animals also exist in most parts of the country. Therefore, acute poisonings, either intentional or accidental and also drug abuse/addiction are common in Iran. In spite of these difficulties there is no center for poison control and surveillance in this country to gather information and analyse data. The files of a systematic randomised ten percent of all hospital-referred poisoned patients from 21 March 1993 to 20 March 2000 in Imam Reza (p) University Hospital of Mashhad (71589 cases) were screened retrospectively. Young adults (40.3%) and school children (22.9%) were the most vulnerable group. Mean age was 22.3 (S.D. 14.38) years with a minimum of less than one and a maximum of 98 years old. A female predominance was found (53.4%). Intentional poisoning was more common (54.4%) than accidental exposures (45.2%). Fourteen cases were classified as criminal poisoning. 79.7% of exposures were via ingestion, followed by dermal exposures (14.1%), and inhalation (6.2%). The majority (83.7%) of patients were from urban areas. Most patients (68.6%) were treated in the Emergency Toxicology Clinic and discharged, 19.2% were temporarily hospitalized and 11.3% were hospitalized for 24 hr. Main groups of poisons were pharmaceuticals (61.4%), chemicals (22.8%), and natural toxins (16.6%). The overall number of poisoned patients was higher in spring and summer (62.8%). In conclusion, acute poisonings, particularly self-poisonings, are common in Iran. Since medical documentation is not routinely provided in this country the results of this retrospective study can be used for surveillance. Establishment of fluent data gathering and analysis within the local health system are challenges for the future.