EU alerting and reporting systems for potential chemical public health threats and hazards.

A number of European and international IT platforms are used to notify competent authorities of new potential chemical exposures. Recently the European Parliament and the Council of European Union adopted new legislation that aims to improve the co-ordinated response to cross border health threats (Decision 1082/2013/EU). The Decision, inter alia, sets provisions on notification, ad hoc monitoring and coordination of public health measures following serious cross border threats to health from biological, chemical and environmental events as well as events that have an unknown origin. The legal instrument applies to all European Union Member States and is comparable to the International Health Regulations in its content, requirements and adoption of a multiple hazards approach. An inter-sectoral and multidisciplinary response to events with potentially dangerous cross border exposure pathways is often required. For example, European Poisons Centres may be aware of cases of toxic exposure to a product and, in parallel, trading standards may be aware of the same product due to a breach of consumer product standards. Whilst both cases would have been recorded for separate purposes in different alerting systems, they relate to the same exposure pathway; therefore a process for linking these records would allow a more robust approach to risk assessment and risk mitigation. The Decision seeks to reconcile this issue for serious threats by linking relevant platforms into one overarching higher level risk management IT platform called the Early Warning Response System (EWRS). This system will serve to link other sectors within the European Commission (EC) to public health (e.g. medicines), as well as other EU agencies and international bodies via co-notification features. Other European alert systems will be linked to EWRS to facilitate information sharing at both the assessment and management levels. This paper provides a timely overview of the main systems run by the EC and other international organisations that provide alerts following chemical incidents that have, or may have, the potential to affect public health. The advantages and further considerations of linking these different systems and sectors are also highlighted. Recommendations are made with the purpose of ensuring that modifications to these systems made to satisfy with EU legislation enable a more timely coordinated response and greater awareness of events in Europe, thereby reducing the public health impact from chemical exposures.

The importance of evaluating the physicochemical and toxicological properties of a contaminant for remediating environments affected by chemical incidents.

In the event of a major chemical incident or accident, appropriate tools and technical guidance need to be available to ensure that a robust approach can be adopted for developing a remediation strategy. Remediation and restoration strategies implemented in the aftermath of a chemical incident are a particular concern for public health. As a result an innovative methodology has been developed to help design an effective recovery strategy in the aftermath of a chemical incident that has been developed; the UK Recovery Handbook for Chemical Incidents (UKRHCI). The handbook consists of a six-step decision framework and the use of decision trees specifically designed for three different environments: food production systems, inhabited areas and water environments. It also provides a compendium of evidence-based recovery options (techniques or methods for remediation) that should be selected in relation to their efficacy for removing contaminants from the environment. Selection of effective recovery options in this decision framework involves evaluating the physicochemical and toxicological properties of the chemical(s) involved. Thus, the chemical handbook includes a series of tables with relevant physicochemical and toxicological properties that should be assessed in function of the environment affected. It is essential that the physicochemical properties of a chemical are evaluated and interpreted correctly during the development of a remedial plan in the aftermath of a chemical incident to ensure an effective remedial response. This paper presents a general overview of the key physicochemical and toxicological properties of chemicals that should be evaluated when developing a recovery strategy. Information on how physicochemical properties have impacted on previous remedial responses reported in the literature is also discussed and a number of challenges for remediation are highlighted to include the need to develop novel approaches to remediate sites contaminated by mixtures of chemicals as well as methods for interpreting chemical reactions in different environmental matrices to include how climate change may affect the speciation and mobility of chemicals in the environment.

Factors influencing recovery and restoration following a chemical incident.

Chemicals are an important part of our society. A wide range of chemicals are discharged into the environment every day from residential, commercial and industrial sources. Many of these discharges do not pose a threat to public health or the environment. However, global events have shown that chemical incidents or accidents can have severe consequences on human health, the environment and society. It is important that appropriate tools and technical guidance are available to ensure that a robust and efficient approach to developing a remediation strategy is adopted. The purpose of remediation is to protect human health from future exposure and to return the affected area back to normal as soon as possible. There are a range of recovery options (techniques or methods for remediation) that are applicable to a broad range of chemicals and incidents. Recovery options should be evaluated according to their appropriateness and efficacy for removing contaminants from the environment; however economic drivers and social and political considerations often influence decision makers on which remedial actions are implemented during the recovery phase of a chemical incident. To date, there is limited information in the literature on remediation strategies and recovery options that have been implemented following a chemical incident, or how successful they have been. Additional factors that can affect the approach taken for recovery are not well assessed or understood by decision makers involved in the remediation and restoration of the environment following a chemical incident. The identification of this gap has led to the development of the UK Recovery Handbook for Chemical Incidents to provide a framework for choosing an effective recovery strategy. A compendium of practical evidence-based recovery options (techniques or methods for remediation) for inhabited areas, food production systems and water environments has also been developed and is included in the chemical handbook. This paper presents the key factors that should be considered when developing a recovery strategy with respect to how these may impact on its effectiveness. The paper also highlights the importance of these factors through an evaluation of recovery strategies implemented following real chemical incidents that have been reported in the literature.

Recent advances to address European Union Health Security from cross border chemical health threats.

The European Union (EU) Decision (1082/2013/EU) on serious cross border threats to health was adopted by the European Parliament in November 2013, in recognition of the need to strengthen the capacity of Member States to coordinate the public health response to cross border threats, whether from biological, chemical, environmental events or events which have an unknown origin. Although mechanisms have been in place for years for reporting cross border health threats from communicable diseases, this has not been the case for incidents involving chemicals and/or environmental events. A variety of collaborative EU projects have been funded over the past 10 years through the Health Programme to address gaps in knowledge on health security and to improve resilience and response to major incidents involving chemicals. This paper looks at the EU Health Programme that underpins recent research activities to address gaps in resilience, planning, responding to and recovering from a cross border chemical incident. It also looks at how the outputs from the research programme will contribute to improving public health management of transnational incidents that have the potential to overwhelm national capabilities, putting this into context with the new requirements as the Decision on serious cross border threats to health as well as highlighting areas for future development.

Countering health threats by chemicals with a potential terrorist background--creating a rapid alert system for Europe.

BACKGROUND: The acronym "ASHT" stands for "Alerting System and Development of a Health Surveillance System for the Deliberate Release of Chemicals by Terrorists". Imagine this scenario: 15 patients with respiratory symptoms following a concert in Rome and 12 patients coughing after lunch in a cafeteria in the Czech Republic; are these events related? Today these events would never be connected as there is no mechanism to allow EU Member States to share this type of information effectively. The main objective of the ASHT project was to improve data sharing between EU Member States. In part, this was achieved by an internet accessible EU-wide alerting system with the aim to detect the deliberate (i.e. criminal or terrorist) or accidental release of chemicals. Nevertheless more information from police, fire brigades and health professionals is needed. METHODS: Description of the design, development, functionality and testing of the relational database system called "RAS-CHEM" (Rapid Alert System for Chemicals). RESULTS: A database structure appropriate for the description of "events" with sophisticated retrieval functions was developed. For evaluation purposes 37 events were entered into the database including 29 scenarios and 8 historical mass intoxications. The alert level was "background information" for 21 events, "suspected mass intoxication" for 6 cases and "confirmed mass intoxication" for 10 events. CONCLUSION: The RAS-CHEM database works and will be integrated into the Health Emergency Operations Facility (HEOF) with other European Rapid Alert Systems. Poisons centres receive a large number of enquiries and could be important sentinels in this field of toxicovigilance.

Benzene in the environment: an assessment of the potential risks to the health of the population.

OBJECTIVES: Benzene has long been recognised as a carcinogen and recent concern has centred on the effects of continuous exposure to low concentrations of benzene both occupationally and environmentally. This paper presents an overview of the current knowledge about human exposure to benzene in the United Kingdom population based on recently published data, summarises the known human health effects, and uses this information to provide a risk evaluation for sections of the general United Kingdom population. METHOD: Given the minor contribution that non-inhalation sources make to the overall daily intake of benzene to humans, only exposure from inhalation has been considered when estimating the daily exposure of the general population to benzene. Exposure of adults, children, and infants to benzene has been estimated for different exposure scenarios with time-activity patterns and inhalation and absorption rates in conjunction with measured benzene concentrations for a range of relevant microenvironments. Exposures during refuelling and driving, as well as the contribution of active and passive tobacco smoke, have been considered as part of the characterisation of risk of the general population. RESULTS: Infants (<1 years old), the average child (11 years old), and non-occupationally exposed adults, receive average daily doses in the range of 15-26, 29-50, and 75-522 microg of benzene, respectively, which correspond to average ranges to benzene in air of 3.40-5.76 microg/m(3), 3.37-5.67 microg/m(3), and 3.7-41 microg/m(3) for infants, children, and adults, respectively. Infants and children exposed to environmental tobacco smoke have concentrations of exposure to benzene comparable with those of an adult passive smoker. This is a significant source of exposure as a 1995 United Kingdom survey has shown that 47% of children aged 2-15 years live in households where at least one person smokes. The consequence of exposure to benzene in infants is more significant than for children or adults owing to their lower body weight, resulting in a higher daily intake for infants compared with children or non-smoking adults. A worst case scenario for exposure to benzene in the general population is that of an urban smoker who works adjacent to a busy road for 8 hours/day-for example, a maintenance worker-who can receive a mean daily exposure of about 820 microg (equal to an estimated exposure of 41 microg/m(3)). The major health risk associated with low concentrations of exposure to benzene has been shown to be leukaemia, in particular acute non-lymphocytic leukaemia. The lowest concentration of exposure at which an increased incidence of acute non-lymphocytic leukaemia among occupationally exposed workers has been reliably detected, has been estimated to be in the range of 32-80 mg/m(3). Although some studies have suggested that effects may occur at lower concentrations, clear estimates of risk have not been determined, partly because of the inadequacy of exposure data and the few cases. CONCLUSIONS: Overall the evidence from human studies suggests that any risk of leukaemia at concentrations of exposure in the general population of 3.7-42 microg/m(3)-that is at concentrations three orders of magnitude less than the occupational lowest observed effect level-is likely to be exceedingly small and probably not detectable with current methods. This is also likely to be true for infants and children who may be exposed continuously to concentrations of 3.4-5.7 microg/m(3). As yet there is no evidence to suggest that continuous exposures to these environmental concentrations of benzene manifest as any other adverse health effect.

A research strategy for investigating the ecological significance of endocrine disruption: report of a UK workshop.

In May 1997 the MRC Institute for Environment and Health hosted an expert, multidisciplinary workshop on the ecological effects of endocrine disruption, focusing on reproductive function, to identify research priorities. Particular objectives were to discuss the potential for effects at organisational levels higher than that of the individual (i.e. population, community and ecosystem levels), the range of taxa that may plausibly be susceptible, and our current knowledge of the environmental fate and behaviour of potential endocrine disrupters. The conclusions of this workshop are reported, with particular reference to a research strategy developed to ultimately address the significance of endocrine disruption at the level of the population. Specific research project areas considered to be of particular importance to the UK situation are also presented.

Screening the environmental fate of organic contaminants in sewage sludges applied to agricultural soils: 1. The potential for downward movement to groundwaters.

The potential for organic contaminants present in sewage sludge to leach and cause groundwater contamination following sludge application to agricultural land has been assessed. Models used to predict compound mobility in soil on the basis of physico-chemical parameters were applied to a range of contaminants prioritised and/or detected in sludge and a provisional list of potential "leachers' compiled. In addition, theoretical soil water concentrations following sludge application were calculated using mean reported sludge contaminant concentrations and soil/water partition coefficients. These estimated aqueous phase concentrations were compared with Dutch groundwater quality standards in the absence of appropriate UK standards to identify those compounds which could be present in groundwater at levels of concern. The two prioritised lists were used to identify compounds in sludge which could pose a possible threat to groundwater. Appropriate experimental data were not available to qualify model results. However, the screening exercise indicated that under routine operation practice with typical sludge application rates, and the usual range of compound concentrations detected in sludge, groundwater quality standards were unlikely to be exceeded. However, data variability, reliability and scarcity limited the usefulness of this screening approach.

Screening the environmental fate of organic contaminants in sewage sludges applied to agricultural soils: II. The potential for transfers to plants and grazing animals.

This is the second of two papers which screen the environmental fate of sludge organic contaminants when applied to agricultural land. A simple screening model has been developed to assess the likelihood of organic contaminants accumulating into the food-chain following the application of sludge into arable and pasture land. The purpose of this exercise is to highlight those compounds that have the potential to accumulate into plants and animal tissues using data on physico-chemical properties of the compounds of interest. Over 300 organic compounds or groups of compounds which have been identified as potential pollutants in sludge have been screened for their potential to transfer from sludge-amended soils to plants via retention by root surfaces, root uptake and translocation, foliar uptake and animal intake via soil and herbage ingestion. Various organic contaminants have been identified as having a high potential to transfer into the food-chain through plant and animal accumulation. Two priority lists have been produced to include (a) those compounds which are shown as being of sufficient or suspected importance, but for which further sludge concentration data and fate studies would be necessary to check on their status, and (b) those compounds which have been highlighted in the screening processes as having a high potential to accumulate up the food-chain. This screening approach can be adapted to other chemicals as information on new chemicals and their physico-chemical properties becomes available.

Polychlorinated biphenyls (PCBs) in the UK population: estimated intake, exposure and body burden.

This paper presents a detailed congener-specific estimate of PCB exposure to the UK population. The average sigma PCB intake (i.e. the sum of IUPAC congeners No. 28, 44, 52, 61/74, 66, 99, 101, 105, 110, 118, 138, 151, 153, 156, 170, 180, 183, 187, 189, 194/205, 201, 202, 206 and 209) for the contemporary UK population was estimated to be 0.53 micrograms/person/day. Food consumption accounted for 97% of the sigma PCB exposure, with fish, milk and dairy products, vegetables and meat and animal fat accounting for 32, 24, 24 and 15%, respectively. The congener pattern for different food products varied, with vegetables playing a major part in the intake of lower chlorinated compounds, whilst fatty foods such as fish, dairy products and meat, were of greater importance for the intake of higher chlorinated compounds. Theoretical body burdens and body fat concentrations of selected PCB congeners were derived for the UK population, based on the estimated contemporary human daily intake of PCBs and a number of assumptions. PCB body burdens and adipose tissue concentrations were generally predicted to increase with age. However, adipose concentrations increased at a slower rate in the older population, due to a dilution effect caused by the increase in body fat weight with age. These theoretical estimates were then compared with measured values for adipose tissue from the Welsh population. Theoretical body burdens and adipose tissue concentrations (not accounting for any metabolic losses) were below the actual values measured for the contemporary Welsh population by between a factor of 2.5 and 4. This discrepancy becomes greater when metabolic losses are included, and probably occurs because present day exposure to PCBs through foodstuffs is likely to be lower than in the past. The lower chlorinated congener No. 28 is more readily removed from the body and is predicted to reach an equilibrium concentration in humans. In contrast, the higher chlorinated No. 153 was predicted to accumulate in the body throughout life. The effect of PCB transfer via breast milk is shown to be important in lowering the body burden of the mother (by approximately 20% over 3 months) and substantially increasing that in the offspring.

Polychlorinated biphenyls (PCBs) in the British environment: sinks, sources and temporal trends.

This paper estimates the present UK environmental loading of polychlorinated biphenyls (PCBs). Of the estimated approximately 40,000 t SigmaPCB sold in the UK since 1954, only an estimated 1% (400 t) are now present in the UK environment. Comparisons of estimated production and current environmental loadings of congeners 28, 52, 101, 138, 153 and 180 suggest that PCB persistence broadly increases with increasing chlorination. Those PCBs that are not now present in the UK environment are considered to have been destroyed--by natural or anthropogenic mechanisms, to be still in use, to reside in landfills or to have undergone atmospheric and/or pelagic transport from the UK. The dramatic fall in PCB levels in archived UK soils and vegetation between the mid-1960s and the present is evidence that the latter mechanism is the most important and that a significant proportion of PCBs released into the UK environment in the 1960s have subsequently undergone environmental transport away from the UK. The bulk (93.1%) of the estimated contemporary UK environmental burden of SigmaPCBs is associated with soils, with the rest found in seawater (3.5%) and marine sediments (2.1%). Freshwater sediments, vegetation, humans and sewage sludge combined account for 1.4% of the present burden, whilst PCB loadings in air and freshwater are insignificant. Although consideration of individual congeners does not reveal any major deviations from the relative partitioning of Sigma PCBs, the importance of sinks other than soils is enhanced for individual congeners, particularly 138 and 180. In particular, around 2% of the total UK burden of congener 180 is present in humans, implying that biodata as a whole may constitute an important sink for the higher chlorinated congeners. The contemporary flux of SigmaPCBs to the UK surface is estimated at 19 t yr(-1), compared with an estimated annual flux to the atmosphere of 44-46 t. This implies that the major sources of PCBs to the UK atmosphere have been identified and that there is currently a net loss of these compounds from the UK. These sources are: volatilisation from soils (88.1%), leaks from large capacitors (8.5%), the production of refuse-derived fuel (RDF) (2.2%), leaks from transformers (0.6%), the recovery of contaminated scrap metal (0.5%) and volatilisation from sewage sludge-amended land (0.2%). Interestingly, whilst large excesses of estimated annual fluxes to the atmosphere over deposition fluxes for individual congeners exist for congeners 28, 52 and 101, estimates of fluxes in both directions across the soil-atmosphere interface agree closely for congeners 138, 153 and 180. This suggests that lower chlorinated congeners are more susceptible to both long-range environmental transport beyond the UK and to atmospheric degradation. Retrospective analysis of dated sediment cores, vegetation and soils indicates that environmental transport from North America and continental Europe introduced PCBs into the British environment well before the onset of their commercial production in the UK in 1954. Since that time, the input of PCBs to the UK environment has essentially reflected temporal trends in UK use. After peaking in the 1960s they declined rapidly through the 1970s following restrictions on PCB use. Recent evidence, however, is that the rate of decrease has diminished and that further significant reductions in fresh environmental input will take some time to occur. Such reductions will be especially slow for humans and other biota with long life-spans. This stems partly from cross-generational transfer from parents to offspring and also because the persistence of PCBs in biota means that present body burdens will reflect past as well as current exposure.

PCBs and other organochlorines in human tissue samples from the Welsh population: I--Adipose.

The general exposure of humans to polychlorinated biphenyls (PCBs) and SigmaDDT (i.e., p,p'-DDT + p,p'DDE = p,p'-DDD) in Wales (UK) was determined through the analysis of adipose tissue samples collected from 75 individuals during post-mortem examinations in 1990-1991. Fifty PCB congeners were screened, of which 29 were identified in most of the samples. Congener IUPAC numbers 138, 153 and 180 were the most abundant compounds, accounting for an average of 55% of the SigmaPCB congeners analysed. SigmaPCB concentrations varied between 0.2 and 1.8 microg g(-1) of adipose tissue and were positively correlated with the donors age and negatively associated with the percentage of lipid in the adipose tissue. A progressive change in the congener pattern was noted with increasing subject age. Tissue from older individuals generally contained a relatively high proportion of the more persistent and higher chlorinated congeners. SigmaDDT concentrations ranged from 0.11 to 5.6 microg g(-1) adipose tissue, with p,p'-DDE contributing 96% towards the SigmaDDT concentration. SigmaDDT levels were also positively correlated with age. No significant differences in the SigmaPCB and SigmaDDT concentrations were noted between males and females, between people living in rural and urban locations or with the subjects' body weight at the time of their death.

PCBs and other organochlorines in human tissue samples from the Welsh population: II--Milk.

Polychlorinated biphenyl (PCB) and SigmaDDT (i.e. p,p'-DDT + p,p'-DDE = p,p'-DDD) concentrations were determined from the analysis of 115 Welsh breast milk samples collected in 1990 and 1991. Fifty PCB congeners were screened, of which 24 were identified in most samples. The PCB congener pattern was consistent between individual milk samples, with IUPAC congeners 28, 138, 153 and 180 being the most abundant and accounting for an average of 50% of the SigmaPCB concentrations determined. PCB concentrations varied between 2 and 70 ng g(-1) whole milk, were positively correlated with age, and negatively correlated with the total lactation period and with the percent lipid content of the milk. PCB pattern distributions differed between milk and adipose tissue samples. Human milk had a higher proportion of tri- (18 and 28), tetra- (44, 52 and 66) and pentachlorinated biphenyls (101) compared to human adipose tissue. SigmaDDT concentrations ranged from 0.3 to 71 ng g(-1) of whole milk, with p,p'-DDE contributing towards an average of 92% of the SigmaDDT concentrations. SigmaDDT levels were also positively correlated with age and negatively associated with the lactation period, though these correlations were rather weak. No significant differences in the SigmaPCB and SigmaDDT concentrations were noted between milk samples from donors living in rural and urban locations, or between the subjects' body weight, smoking habits or diet.

Polychlorinated dibenzo-p-dioxins (PCDDs) and furans (PCDFs) in urban air and deposition in the United Kingdom.

Polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs) have been monitored in air and deposition at four UK urban sites (London, Cardiff, Manchester and Stevenage) since the beginning of 1991; data from the first 2 years are presented here. Median Σ2,3,7,8-substituted PCDD/F concentrations in air were 3.2, 4.0, 3.5 and 2.6 pg/m(3) respectively for London, Cardiff, Manchester and Stevenage. Median Σ2,3,7,8-substituted PCDD/F deposition fluxes were 1.5 ng/m(2)/day in London, 1.4 ng/m(2)/day in Cardiff and Manchester and 0.79 ng/m(2)/day in Stevenage. Seasonal variations in the PCDD/F concentrations were observed at all sites for both air and deposition, with concentrations/fluxes generally elevated during the winter.

The relative contribution of individual polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzo-p-furans (PCDFs) to toxic equivalent values derived for bulked human adipose tissue samples from Wales, United Kingdom.

Five bulked human adipose tissue samples were analyzed for individual polychlorinated biphenyl (PCB) congeners (including selected non-ortho-substituted compounds) and polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs). Mean sigma PCB and sigma PCDD/F (tetra-through octachlorinated homologues) concentrations were 0.75 microgram/g and 1.22 ng/g adipose tissue respectively. Both the congener patterns and levels detected were similar to those reported by laboratories in other industrialised countries. Each sample comprised of tissue taken from donors within a given locality. However, no obvious relationships were apparent between sampling area, absolute concentrations and congener pattern of PCBs and PCDD/Fs. The contribution of individual PCDD/F and non-ortho-(o), mono-o-, and di-o-substituted PCB congeners to the total calculated toxic equivalent values (sigma TEQ) was assessed for each sample. The main contributions to the sigma TEQ were the mono-o-substituted PCB congeners #118 (TEQ = 42.5 pg/g of lipid), #156 (TEQ = 24.8 pg/g) and #105 (TEQ = 20.7 pg/g), followed by 1,2,3,6,7,8-HxCDD (TEQ = 18.2 pg/g), 2,3,4,7,8-P5CDF (TEQ = 12 pg/g), 1,2,3,7,8-P5CDD (TEQ = 11.5 pg/g), and the non-o-substituted PCB congener #126 (TEQ = 11.3 pg/g). Collectively, these compounds accounted for 80% of the sigma TEQ values. Based on the TEFs proposed by Safe (1990), the overall TEQs calculated for the monitored PCBs, were twice those due to sigma PCDD/Fs.