Respiratory afflictions during hairdressing jobs: case history and clinical evaluation of a large symptomatic case series.

OBJECTIVES: Respiratory symptoms at work are common among hairdressers. Various working materials, most notably bleaching ingredients such as ammonium persulfate, have been made responsible. The objective of this study is to achieve a better understanding of work-related respiratory symptoms of hairdressers by describing common features in a large affected collective. METHODS: One hundred forty-eight hairdressers with respiratory symptoms at work presenting between 2012 and 2019 were consecutively included in a case series. Anamnestic and diagnostic data including pulmonary function and allergy testing were retrospectively compiled from records and analysed. Additionally, cases were categorised in five groups with respect to occupational causation certainty. RESULTS: 30% of the predominantly female collective had changed jobs or were on longer sick-leave. Besides respiratory symptoms, 10% also reported contact urticaria to blonde dyes. In 60% an obstructive airway disease was confirmed. A specific hypersensitivity reaction to ammonium persulfate was found in 15%. Group 1 with a proven immunological occupational causation showed significantly lower age (p < 0.001) and tenure time (p = 0.001), higher sensitization rates against environmental allergens as well as a higher total IgE (p = 0.015), compared to group 4 (obstructive airway disease, specific occupational causation unlikely). CONCLUSIONS: This case series contributes to a better characterization of work-related respiratory symptoms in hairdressing as one of the largest examined collectives of symptomatic hairdressers. Ammonium persulfate as the most common specific cause showed signs of a type-I-like hypersensitivity reaction with typical risk factors for atopy. Prick testing is recommended in all symptomatic cases. However, a specific occupational causation often cannot be proved.

The role of dietary factors on blood lead concentration in children and adolescents - Results from the nationally representative German Environmental Survey 2014-2017 (GerES V).

In industrialized nations, human lead exposure has decreased significantly in recent decades. Nevertheless, due to its toxic effects, this heavy metal remains a public health concern with children and adolescents being particularly at risk. In Europe nowadays, oral intake via food and drinking water is the predominant exposure pathway for lead. The objective of the present study was to investigate the association between dietary factors and blood lead (PbB) level of 3- to 17-year-old children and adolescents living in Germany, using data from the fifth German Environmental Health Survey (GerES V) and the Child and Adolescent Health Survey (KiGGS Wave 2). GerES V and KiGGS Wave 2 are two national population-representative studies conducted between 2014 and 2017, including measurement of lead concentrations in blood from 720 children and adolescents aged 3-17 years (mean age = 10.21, SD age = 4.36). Using multiple linear regression, sociodemographic and environmental characteristics as well as dietary factors could be identified as significant exposure determinants of PbB concentrations. Lead intake via domestic tap water was the strongest predictor of elevated PbB levels with 27.6% (p-value< .001) higher concentrations of highest compared to none lead intake via tap water. Other foods which were found to be relevant to PbB levels were meat, fruit, and fruit juice. While meat or fruit consumption were each associated with about 13% (p-value < .05) lower PbB levels, fruit juice drinking was associated with up to 12.2% (p-value = .04) higher PbB levels. In conclusion, results indicate the importance of dietary habits for lead exposure in children and adolescents. To protect vulnerable groups, it is recommended that future research and lead-reducing measures pay more attention to dietary links.

Determination of eleven small selenium species in human urine by chromatographic-coupled ICP-MS methods.

BACKGROUND: The determination of various selenium species in urine enables a specific biomonitoring of the exposure to different selenium compounds. METHODS: For this task a coupling of three chromatographic techniques with ICP-MS was developed for the separate quantification of eleven species in urine. The first procedure was based on reverse phase chromatography and was designed for the separate determination of methyl-2-acetamido-2-deoxy-1-seleno-b-d-galactopyranoside (SeSug1), methyl-2-acetamido-2-deoxy-1-seleno-b-d-glucopyranoside (SeSug2), selenomethionine (SeMet), methylselenocysteine (MeSeC), seleno-D,L-ethionine (SeEt), methylselenic acid (MeSeA) and methylselenoglutathione (MeSeG); the second procedure was based on anion exchange chromatography and measured selenate (Se (VI)) and selenite (Se (IV)); the third procedure was based on cationic exchange chromatography and determined methyl-2-amino-2-deoxy-1-seleno-b-d-galactopyranoside (SeSug3) and the trimethylselenium ion (TMSe). A fourth method for the more sensitive determination of TMSe was upgraded by an on-line after-column reaction process. RESULTS: The validation of the methods yielded sensitive detection limits of the species between 0.03 and 0.10 µg Se/L. For TMSe a detection limit of 0.02 µg Se/L resulted by the fourth method. An intra-day precision of 2.7-10.6% and a relative recovery between 87 % and 108 % confirm the robustness of the methods. CONCLUSION: The developed procedures enable a separate and sensitive determination of eleven selenium species in urine and thus permit the exploring of metabolic factors in the general population and particularly exposed individuals.

Systemic availability of lipophilic organic UV filters through dermal sunscreen exposure.

BACKGROUND: Chemical UV filters are common components in sunscreens and cosmetic products and used to protect the skin against harmful effects of sunlight like sunburn. However, the effectiveness of sunscreens in the prevention of skin cancer is in some parts still controversial. Meanwhile, questions about negative effects of the chemical UV filters on human health arise and request an effective risk assessment. Real-life exposure data in humans after application of these products are still rare. Thus, we explored whether and to what extent UV filters are absorbed through the skin into the human body. MATERIAL AND METHODS: Plasma and urine samples from 20 healthy volunteers were collected before, during and after a real-life exposure scenario (1st application: 2 mg/cm2; 2nd and 3rd (after 2 and 4 h): 1 mg/cm2 each) using a commercial sunscreen formulation for one day. These samples were analyzed for their content of the currently prominent UV filters octocrylene and avobenzone as well as 2-cyano-3,3-diphenylacrylic acid (CDAA) as the main octocrylene metabolite by using different liquid chromatography electrospray-ionization tandem mass spectrometric procedures. RESULTS: Following dermal sunscreen exposure, avobenzone, octocrylene and CDAA reached concentrations up to 11 µg/L, 25 µg/L and 1352 µg/L in plasma. In urine detection rates of avobenzone and octocrylene were low while CDAA showed a high detection rate and reached up to 5207 µg/g creatinine. Kinetic models could be fitted for octocrylene and CDAA in plasma and CDAA in urine. Concentration peaks were reached between 10 and 16 h after first application and half-life periods were in the range of 1.5 to 2 days. The lipophilic UV filter octocrylene and its metabolite CDAA showed a much slower elimination than other more hydrophilic UV filters. Concordantly, the metabolite CDAA in particular showed a markedly increased renal excretion over the whole sampling period and indicated high internal exposure to OC. DISCUSSION: Real-life sunscreen usage leads to considerable bioavailability of organic UV filters and their metabolites which is rarely seen for other environmental exposures. A combined monitoring of the parent compound and its metabolites is important to fully address internal exposure to the UV filter in humans. Considering the kinetic profiles a prolonged systemic release due to depot formation in skin and a potential accumulation through multi-day exposure is presumed. High in-vivo loads call for a critical toxicological assessment of the UV filters and their metabolites.

Toxicokinetics of urinary 2-ethylhexyl salicylate and its metabolite 2-ethyl-hydroxyhexyl salicylate in humans after simulating real-life dermal sunscreen exposure.

Chemical UV filters are common components in sunscreens and cosmetic products. The question of adverse health risks is not completely resolved, partly owing to lacking human data from dermal exposure, which are essential for sound risk assessment. Therefore, we investigated the urinary toxicokinetics of 2-ethylhexyl salicylate (EHS) after a 1-day dermal real-life sunscreen application scenario. Twenty human volunteers were dermally exposed to a commercial sunscreen for 9 h under real-life conditions (2 mg/cm2 body surface area; double re-application; corresponding to 3.8 g EHS). Urine samples were analyzed for EHS and one of its specific metabolites 2-ethyl-5-hydroxyhexyl salicylate (5OH-EHS) using a two-dimensional liquid chromatographic electrospray-ionization tandem mass spectrometric procedure. EHS and 5OH-EHS were excreted after sunscreen application and reached up to 525 µg/g and 213 µg/g creatinine, respectively. The toxicokinetic models showed concentration peaks between 7 and 8 h after first application. First-phase terminal half-lives were 8-9 h. For 5OH-EHS, a second-phase terminal half-life could be determined (87 h). EHS and 5OH-EHS showed a faster elimination with 70-80% of the overall excretion occurring within 24 h after application compared to more lipophilic UV filters. Cumulative excreted amounts over 24 h reached up to 334 µg EHS and 124 µg of 5OH-EHS. Simulated real-life sunscreen use for 1 day leads to the bioavailability of the UV filter EHS in humans. The kinetic profiles with a prolonged systemic availability indicate a skin depot and make accumulation during consecutive multi-day exposure likely.

Web of microbes (WoM): a curated microbial exometabolomics database for linking chemistry and microbes.

BACKGROUND: As microbiome research becomes increasingly prevalent in the fields of human health, agriculture and biotechnology, there exists a need for a resource to better link organisms and environmental chemistries. Exometabolomics experiments now provide assertions of the metabolites present within specific environments and how the production and depletion of metabolites is linked to specific microbes. This information could be broadly useful, from comparing metabolites across environments, to predicting competition and exchange of metabolites between microbes, and to designing stable microbial consortia. Here, we introduce Web of Microbes (WoM; freely available at: http://webofmicrobes.org ), the first exometabolomics data repository and visualization tool. DESCRIPTION: WoM provides manually curated, direct biochemical observations on the changes to metabolites in an environment after exposure to microorganisms. The web interface displays a number of key features: (1) the metabolites present in a control environment prior to inoculation or microbial activation, (2) heatmap-like displays showing metabolite increases or decreases resulting from microbial activities, (3) a metabolic web displaying the actions of multiple organisms on a specified metabolite pool, (4) metabolite interaction scores indicating an organism's interaction level with its environment, potential for metabolite exchange with other organisms and potential for competition with other organisms, and (5) downloadable datasets for integration with other types of -omics datasets. CONCLUSION: We anticipate that Web of Microbes will be a useful tool for the greater research community by making available manually curated exometabolomics results that can be used to improve genome annotations and aid in the interpretation and construction of microbial communities.

Low internal exposure and absence of adverse effects in workers exposed to high air levels of inorganic selenium.

Selenium is an essential trace element for humans, but adverse health effects may occur after elevated intake. The margin between it is small. This study aimed to assess external and internal exposure in workers of a selenium-processing plant, in which elemental and inorganic selenium occurred. Selenium was analyzed in the form of the selenium concentration in plasma (Se-P), in erythrocytes (Se-RBC) and in personal air samples (Setotal-Air) of 17 exposed workers. Internal exposure was compared to 20 controls without occupational selenium exposure. For potential effects, glucose, HbA1c, proinsulin, prothrombin time and GPX were determined. Setotal-Air had a maximum of 2394 µg/m3 (median 319 µg/m3), containing a small water-soluble fraction (median 12.7 µg/m3, range 0.07-975 µg/m3). Se-P of the exposed ranged from 62 to 123 µg/L (median 105 µg/L), whereas the median of Se-RBC was 63.4 µg/L blood (range 51.9-92.7 µg/L). Both were significantly higher than the controls. No significant difference was found for the effect parameters. Biological effect monitoring of employees occupationally exposed to very high levels of selenium and inorganic selenium compounds did not show any indication of adverse health effects. The moderate increase of the internal selenium exposure compared to the high ambient exposure to selenium and its compounds suggests an efficient air protection or an extremely low resorption of elemental and inorganic species of selenium via inhalation.

Unnecessary Investigations in Environmental Medicine.

BACKGROUND: Patients in environmental medicine often want a thorough diagnostic evaluation of nonspecific symptoms. Unconventional testing, as well as conventional testing for indications other than the established ones, can lead to false diagnoses and, in turn, to substantial emotional, social, and financial harm. The goal of this single-center study was to assess inappropriate diagnostic testing among the patients of a specialized university outpatient clinic for environmental medicine. METHODS: The charts of 653 consecutive outpatients seen in the institute and outpatient clinic of occupational, social, and environmental medicine in Erlangen from 2010 to 2015 were evaluated, and inappropriate diagnostic tests were assessed. RESULTS: 9% of the patients had received at least one inappropriate diagnostic test. The most common one was an inappropriate heavy-metal test (26%), followed by an inappropriately ordered hair analysis (15%) and biomonitoring in the blood or urine with an erroneous choice of the testing matrix or an erroneous interpretation of the findings (15%). Biomonitoring performed by us did not confirm the suspected environmental diagnosis in any case. Laboratory values exceeding the normal limits were rarer among these patients than in the patients for whom we considered biomonitoring to be indicated without any pretesting. CONCLUSION: An appreciable number of patients in environmental medicine were subjected to inappropriate diagnostic testing. When this happens, proper testing often needs to be done thereafter in order to confirm or refute the findings. This phenomenon should be more thoroughly assessed and quantified.

OpenMSI: a high-performance web-based platform for mass spectrometry imaging.

Mass spectrometry imaging (MSI) enables researchers to directly probe endogenous molecules directly within the architecture of the biological matrix. Unfortunately, efficient access, management, and analysis of the data generated by MSI approaches remain major challenges to this rapidly developing field. Despite the availability of numerous dedicated file formats and software packages, it is a widely held viewpoint that the biggest challenge is simply opening, sharing, and analyzing a file without loss of information. Here we present OpenMSI, a software framework and platform that addresses these challenges via an advanced, high-performance, extensible file format and Web API for remote data access (http://openmsi.nersc.gov). The OpenMSI file format supports storage of raw MSI data, metadata, and derived analyses in a single, self-describing format based on HDF5 and is supported by a large range of analysis software (e.g., Matlab and R) and programming languages (e.g., C++, Fortran, and Python). Careful optimization of the storage layout of MSI data sets using chunking, compression, and data replication accelerates common, selective data access operations while minimizing data storage requirements and are critical enablers of rapid data I/O. The OpenMSI file format has shown to provide >2000-fold improvement for image access operations, enabling spectrum and image retrieval in less than 0.3 s across the Internet even for 50 GB MSI data sets. To make remote high-performance compute resources accessible for analysis and to facilitate data sharing and collaboration, we describe an easy-to-use yet powerful Web API, enabling fast and convenient access to MSI data, metadata, and derived analysis results stored remotely to facilitate high-performance data analysis and enable implementation of Web based data sharing, visualization, and analysis.

Variance of landmarks in digital evaluations: comparison between CT-based and conventional digital lateral cephalometric radiographs.

AIM: The aim of this study was to examine whether bony, dental and soft tissue landmarks could be placed in CT-based lateral cephalograms with the same precision as in conventional digital lateral cephalograms. MATERIALS AND METHODS: Nine patients without craniofacial dysplasia (2 female, 7 male, aged 12.8-32.3) who had undergone a lateral cephalogram and CT examination within an interval of a maximum of 6.5 months were selected in retrospect. The lateral cephalograms were done with the ORTHOPHOS Plus DS Ceph, and the CT examination with the SOMATOM Sensation 16 or 64 scanner. The CT-based cephalograms were generated with the VoXim 4.3 program based on axial CT reconstructions in the bone window. The cephalograms were analyzed using the Onyx Ceph 2.7 software by 2 orthodontists and 5 postgraduate students, each cephalogram being examined five times by each examiner on different days. Statistics were compiled with SPSS 13.0 and 14.0 based on the deviation from the individual mean value of each landmark. RESULTS: The descriptive statistics showed in the conventional cephalogram, averaged over all 61 landmarks, a mean quartile range of on average 0.62 mm in the horizontal and 0.67 mm in the vertical axes. The CT-based cephalograms ranged between 0.64 mm horizontally and 0.74 mm vertically. The statistics comparing the two types of images with the Wilcoxon test for paired samples showed no significant difference. CONCLUSION: When a CT scan is necessary for assessment of complex craniofacial dysplasias, an orthodontic-specific diagnosis is possible without having to resort to conventional X-rays of the skull. The data from this study demonstrate that it is possible to construct a cephalogram from CT data, which can be analyzed in the same way as a conventional cephalogram provided that the CT's field of view is large enough.