Biomonitoring of exposure to multiple metal components in urine, hair and nails of apprentice welders performing shielded metal arc welding (SMAW).

Welding fumes are associated with various diseases. Increased air levels of metals were reported during welding. However, few multielement biomonitoring studies were conducted to assess the actual dose of metal components absorbed in apprentice welders in a learning environment. This research aimed to establish the nature and level of exposure to welding fumes and their metallic components in apprentice welders performing 'Shielded Metal Arc Welding' (SMAW), based on multi-element and multi-matrix analyses. A total of 86 apprentice welders were recruited in three different schools in Montreal, Québec, Canada. Twenty-one elements were measured in urine, hair, fingernail, and toenail samples collected at the beginning of the program and at the end of SMAW practical training. Concentrations of welding fumes and 12 metals were also determined in personal respirable air samples collected over a typical workday in a subgroup of 19 apprentices. Levels of manganese (Mn), iron (Fe) and nickel (Ni) in urine and Mn in hair were higher in samples taken at the end of the SMAW module compared to the beginning of training, while there was no significant difference for the other elements or for nail concentrations. Geometric mean concentrations [5th-95th percentiles] reached 0.31 [0.032-2.84], 9.4 [3.1-51] and 0.87 [0.35-3.1] µg/g creat. in post-shift urine, respectively, for Mn, Fe and Ni, and 0.37 [0.46-6.4] µg Mn/g hair at the end of SWAW. Median concentrations [5th-95th percentiles] were 29 [4.6-1200], 120 [27-3100] and 0.31 [

Prerequisite for Imputing Non-detects among Airborne Samples in OSHA's IMIS Databank: Prediction of Sample's Volume.

INTRODUCTION: The US Integrated Management Information System (IMIS) contains workplace measurements collected by Occupational Safety and Health Administration (OSHA) inspectors. Its use for research is limited by the lack of record of a value for the limit of detection (LOD) associated with non-detected measurements, which should be used to set censoring point in statistical analysis. We aimed to remedy this by developing a predictive model of the volume of air sampled (V) for the non-detected results of airborne measurements, to then estimate the LOD using the instrument detection limit (IDL), as IDL/V. METHODS: We obtained the Chemical Exposure Health Data from OSHA's central laboratory in Salt Lake City that partially overlaps IMIS and contains information on V. We used classification and regression trees (CART) to develop a predictive model of V for all measurements where the two datasets overlapped. The analysis was restricted to 69 chemical agents with at least 100 non-detected measurements, and calculated sampling air flow rates consistent with workplace measurement practices; undefined types of inspections were excluded, leaving 412,201/413,515 records. CART models were fitted on randomly selected 70% of the data using 10-fold cross-validation and validated on the remaining data. A separate CART model was fitted to styrene data. RESULTS: Sampled air volume had a right-skewed distribution with a mean of 357 l, a median (M) of 318, and ranged from 0.040 to 1868 l. There were 173,131 measurements described as non-detects (42% of the data). For the non-detects, the V tended to be greater (M = 378 l) than measurements characterized as either 'short-term' (M = 218 l) or 'long-term' (M = 297 l). The CART models were complex and not easy to interpret, but substance, industry, and year were among the top three most important classifiers. They predicted V well overall (Pearson correlation (r) = 0.73, P < 0.0001; Lin's concordance correlation (rc) = 0.69) and among records captured as non-detects in IMIS (r = 0.66, P < 0.0001l; rc = 0.60). For styrene, CART built on measurements for all agents predicted V among 569 non-detects poorly (r = 0.15; rc = 0.04), but styrene-specific CART predicted it well (r = 0.87, P < 0.0001; rc = 0.86). DISCUSSION: Among the limitations of our work is the fact that samples may have been collected on different workers and processes within each inspection, each with its own V. Furthermore, we lack measurement-level predictors because classifiers were captured at the inspection level. We did not study all substances that may be of interest and did not use the information that substances measured on the same sampling media should have the same V. We must note that CART models tend to over-fit data and their predictions depend on the selected data, as illustrated by contrasting predictions created using all data vs. limited to styrene. CONCLUSIONS: We developed predictive models of sampled air volume that should enable the calculation of LOD for non-detects in IMIS. Our predictions may guide future work on handling non-detects in IMIS, although it is advisable to develop separate predictive models for each substance, industry, and year of interest, while also considering other factors, such as whether the measurement evaluated long-term or short-term exposure.

Exposure Determinants in the French Database COLCHIC (1987-2019): Statistical Modeling across 77 Chemicals.

OBJECTIVES: The COLCHIC database contains workplace exposure results of chemical samples collected by the French prevention network since 1987. We aimed to investigate potential associations between exposure levels and ancillary variables in COLCHIC across a broad range of chemical agents in order to provide insight into how to best interpret and exploit the information in this national database. METHODS: We selected personal and area measurements in COLCHIC and collected outside respiratory personal protective equipment (PPE), restricted to chemical agents that had at least 1000 samples available. We used Tobit models to estimate associations between exposure concentrations and sample year, sampling duration, PPE, workforce size, collective protective equipment, origin of request, and reason for request for each chemical agent for the period 1987-2019. Models for period 2002-2019 also included type of process (open/closed) and exposure frequency. We used separate models for each combination of agent, period, and personal or area samples. We then applied Bayesian meta-analytical methods to assess average effects and effect heterogeneity of exposure factors across agents. RESULTS: COLCHIC contained 720 282 exposure results (62% personal and 38% area samples) to 77 agents, including 346 766 results for the more recent period 2002-2019 (67% personal and 33% area samples). Sample year and duration, PPE, and process type had the strongest and most consistent associations with exposure levels across agents. Personal and area exposure levels decreased yearly (6% for the entire period and 9% since 2002), and 30-min samples were approximately twice as high as 240-min samples. Workers wearing PPE were exposed to levels 1.7 times higher on average than those without PPE for both area and personal samples. Personal exposure levels associated with enclosed or semi-enclosed processes were approximately 20-30% lower compared with open processes. The associations for the other exposure variables were weaker and more inconsistent between agents. Between-agent heterogeneity of estimated effects, based on 80% prediction intervals, was lowest for sampling duration, time trends, and the presence of PPE. CONCLUSIONS: Sampling duration, time trends, and the presence of PPE are important factors to take into account when analyzing COLCHIC and had similar associations with exposure levels across agents. Other variables generally showed weaker associations or variable effects. These results will be used to adjust exposure estimates for the French working population from measurements stored in COLCHIC.

MiXie, an Online Tool for Better Health Assessment of Workers Exposed to Multiple Chemicals.

There is increasing concern for workers facing multiple chemical exposure. The accumulation of information on occupational conditions indicates the need to incorporate the concept of multiple exposures in the risk assessment process and to develop tools for assessing the potential impacts of multiple exposures on workers' health. Our objective is to describe the MiXie online decision-making tool that can be used to assess the risk of exposure to multiple chemicals. The description includes the development of MiXie, the structure of its toxicological database according to the target organ or the mode of action, and the algorithm for quantitative analysis of a mixture. Two case studies of its use in evaluating the risks of multiple exposures in real workplace situations are presented. The case study in the printing industry showed increased risk for four toxicological classes (central nervous system damage, ocular damage, skin damage, and ototoxicity) associated with co-exposure to four chemicals during maintenance operations. The MiXie analysis also showed the presence of carcinogenic substances in the mixture and a risk to the development of the foetus. The case study in nail salons showed the presence of carcinogenic and sensitizing chemicals and an increased risk to upper airways. MiXie helps preventers evaluate the possible additive effects of mixtures, providing an easy-to-read diagnosis to identify risks incurred by co-exposed employees. In addition, MiXie identifies risky occupational situations that would go unnoticed without a multiple substance approach.

Simultaneous modeling of detection rate and exposure concentration using semi-continuous models to identify exposure determinants when left-censored data may be a true zero.

BACKGROUND: Most methods for treating left-censored data assume the analyte is present but not quantified. Biased estimates may result if the analyte is absent such that the unobserved data represents a mixed exposure distribution with an unknown proportion clustered at zero. OBJECTIVE: We used semi-continuous models to identify time and industry trends in 52,457 OSHA inspection lead sample results. METHOD: The first component of the semi-continuous model predicted the probability of detecting concentrations ≥ 0.007 mg/m3 (highest estimated detection limit, 62% of measurements). The second component predicted the median concentration of measurements ≥ 0.007 mg/m3. Both components included a random-effect for industry and fixed-effects for year, industry group, analytical method, and other variables. We used the two components together to predict median industry- and time-specific lead concentrations. RESULTS: The probabilities of detectable concentrations and the median detected concentrations decreased with year; both were also lower for measurements analyzed for multiple (vs. one) metals and for those analyzed by inductively-coupled plasma (vs. atomic absorption spectroscopy). The covariance was 0.30 (standard error = 0.06), confirming the two components were correlated. SIGNIFICANCE: We identified determinants of exposure in data with over 60% left-censored, while accounting for correlated relationships and without assuming a distribution for the censored data.

On-site comparison of the OSHA 47, Asset EZ4-NCO, Iso-Chek, DAN, and CIP10 methods for measuring methylene diphenyl diisocyanate (MDI) at an oriented-strand board (OSB) factory.

Diisocyanates are occupational contaminants and known sensitizers causing irritation (skin and respiratory tract) as well as occupational asthma. Because of their physicochemical properties (semi-volatile and high reactivity) and low occupational limits, diisocyanate exposure evaluation is still a challenge nowadays for industrial hygienists and laboratories. The objective of this study was to compare the methylene diphenyl diisocyanate (MDI) concentrations measured by five methods using different collection or derivatization approaches in an oriented-strand board (OSB) factory. The methods used were: OSHA 47 (filter, 1-(2-pyridyl)piperazine) (OSHA), Asset EZ4-NCO (denuder and filter, dibutylamine) (Asset), Iso-Chek (double-filter, 9-(N-methylaminomethyl) anthracene and 1,2-methoxyphenylpiperazine), DAN (filter, 1,8-diaminonaphthalene), and CIP10 (centrifugation, 1,2-methoxyphenylpiperazine). Real-time monitoring of particle concentration and size distribution was performed to explain the potential bias between methods. The comparison study was performed over 3 consecutive days, generating at least 18 replicates for each of the 5 methods. The results of each methods were compared using linear mixed effect modeling. Compared to Asset, which yielded the highest concentrations overall, the OSHA method provided the smallest bias with -18% (95% CI [-61;24]) (not significant) for MDI monomer and the DAN method provided the smallest bias with -30 (95% CI [-70;9]) (not significant) for Total Reactive Isocyanate Group (TRIG). The CIP10 and Iso-Chek methods provided the largest biases for MDI monomer (-83% (95% CI [-115;-51]) and -78% (95% CI [-110;-46]), respectively) as well as for TRIG (-87% (95% CI [-120;-55]) and -75% (95% CI [-107;-44]), respectively). The underestimations of the CIP10 and Iso-Chek were explained by its inefficient sampling principle for fines particles and the use of a non-impregnated filter to collect aerosol MDI, respectively. This study confirms that impregnated filter, including denuding device such as the Asset EZ4-NCO sampler, collects the MDI-coated wood particles and MDI vapor with similar efficiency. It also demonstrates for the first time in this type of MDI emission a significant agreement for TRIG concentration between the DAN method in the impregnated filter configuration and an international standard one such as Asset.

On site comparison of the OSHA 42, Asset EZ4-NCO, Iso-Chek, DAN and CIP10 methods for measuring toluene diisocyanate (TDI) at a polyurethane foam factory.

Because of the semi-volatile nature of diisocyanates (being airborne in both physical vapor and particulate phases), their high reactivity and low occupational exposure limits, diisocyanate exposure evaluation has been challenging for industrial hygienists and laboratories. The objective of this study was to compare the toluene diisocyanate (2,4 and 2,6 isomers, TDI) concentration measured by five methods in a flexible polyurethane foam factory using different collection or derivatization approaches. The methods used were: OSHA 42 modified (filter, 1-(2-pyridyl)piperazine) (OSHA), Asset EZ4-NCO (denuder and filter, dibutylamine) (Asset), Iso-Chek (double-filter, 9-(N-methylaminomethyl) anthracene and 1,2-methoxyphenylpiperazine), DAN (filter, 1,8-diaminonaphthalene), and CIP10 (centrifugation, 1,2-methoxyphenylpiperazine). Particle real-time monitoring for concentration and size distribution was performed in parallel to improve the understanding of the potential bias between methods. The comparison study was performed over 3 days, providing 18 replicates for each of the 5 methods. Isocyanate concentrations collected for each sampling method were compared using linear mixed effect modeling. Compared to OSHA, which yielded the highest concentrations overall, the Asset and DAN methods provided the smallest biases (-29% (95% CI [-52;-6]) and -45% (95% CI [-67;-23]), respectively), while the CIP10 and Iso-Chek methods provided the largest biases (-82% (95% CI [-105;-66]) and -96% (95% CI [-118;-75]), respectively). The substantial bias of Iso-Chek and CIP10 seemed to be explained by the predominance of TDI in the form of sub-micron particles that were inadequately captured by these two methods due to their sampling principle, which are particle filtration without derivatizing agent and centrifugation respectively. Asset and DAN performance seemed to decrease as the sampling time increased. While DAN's bias could be related to a reagent deficiency on the filter, the disparities between OSHA and Asset, both considered as reference methods, highlight the fact that the mechanisms of collection, derivation and extraction do not seem to be completely controlled. Finally, an upward trend has been observed between concentrations of particles below 300 nm in size and concentration levels of TDI. It has also been observed that TDI levels increased with the TDI foam index produced at the facility.

Occupational Co-exposures to Multiple Chemical Agents from Workplace Measurements by the US Occupational Safety and Health Administration.

OBJECTIVES: The occupational environment represents an important source of exposures to multiplehazards for workers' health. Although it is recognized that mixtures of agents may have differenteffects on health compared to their individual effects, studies generally focus on the assessment ofindividual exposures. Our objective was to identify occupational co-exposures occurring in the United States using the multi-industry occupational exposure databank of the Occupational Safety and Health Administration (OSHA). METHODS: Using OSHA's Integrated Management Information System (IMIS), measurement data from workplace inspections occurring from 1979 to 2015 were examined. We defined a workplace situation (WS) by grouping measurements that occurred within a company, within the same occupation (i.e. job title) within 1 year. All agents present in each WS were listed and the resulting databank was analyzed with the Spectrosome approach, a methodology inspired by network science, to determine global patterns of co-exposures. The presence of an agent in a WS was defined either as detected, or measured above 20% of a relevant occupational exposure limit (OEL). RESULTS: Among the 334 648 detected exposure measurements of 105 distinct agents collected from 14 513 US companies, we identified 125 551 WSs, with 31% involving co-exposure. Fifty-eight agents were detected with others in >50% of WSs, 29 with a proportion >80%. Two clusters were highlighted, one for solvents and one for metals. Toluene, xylene, acetone, hexone, 2-butanone, and N-butyl acetate formed the basis of the solvent cluster. The main agents of the metal cluster were zinc, iron, lead, copper, manganese, nickel, cadmium, and chromium. 68 556 WS were included in the analyses based on levels of exposure above 20% of their OEL, with 12.4% of co-exposure. In this analysis, while the metal cluster remained, only the combinations of toluene with xylene or 2-butanone were frequently observed among solvents. An online web application allows the examination of industry specific patterns. CONCLUSIONS: We identified frequent co-exposure situations in the IMIS databank. Using the spectrome approach, we revealed global combination patterns and the agents most often implicated. Future work should endeavor to explore the toxicological effects of prevalent combinations of exposures on workers' health to prioritize research and prevention efforts.

Characterization of the Selective Recording of Workplace Exposure Measurements into OSHA's IMIS Databank.

Objectives: The Integrated Management Information System (IMIS) is the largest multi-industry source of exposure results available in North America. In 2010, the Occupational Safety and Health Administration (OSHA) released the Chemical Exposure Health Data (CEHD) that contains analytical results of samples collected by OSHA inspectors. However, the two databanks only partially overlap, raising suspicion of bias in IMIS data. We investigated the factors associated with selective recording of CEHD results into the IMIS databank. Methods: This analysis was based on personal exposure measurements of 24 agents from 1984 to 2009. The association between nine variables (level of exposure coded as detected versus non-detected (ND), whether a sampling result was part of a panel of chemicals, duration of sampling, issuance of a citation, presence of other detected levels during the same inspection, year, OSHA region, amount of penalty, and establishment size) and a CEHD sampling result being reported in IMIS was analyzed using modified Poisson regression. Results: A total of 461900 CEHD sampling results were examined. The proportion of CEHD sampling results recorded into IMIS was 38% (51% for detected and 28% for ND measurements). In the models, the detected sampling results were associated with a higher probability of recording into IMIS than ND sampling results, and this difference was similar for panel versus non-panel samples. Probability of recording remained constant from 1984 to 2009 for sampling results measured on panels but increased for sampling results of single determinations of an agent. Some OSHA regions had probability of recording two times higher than others. No other variables that we examined were associated with a CEHD sampling result being reported in IMIS. Conclusions: Our results indicate that the under-reporting of sampling results in IMIS is differential: ND results (especially those determined from the panels) seem less likely to be recorded in IMIS than other results. It is important to consider both IMIS and CEHD data in order to reduce bias in evaluation of exposures in workplaces inspected by OSHA.

Use of the Novel Derivatizing Agent 1,8-Diaminonapthalene With the CIP10 Sampler to Measure 4,4'-Methylene Diphenyl Diisocyanate Atmospheres.

DAN is a novel derivatizing agent for isocyanate sampling which targets total reactive isocyanate group (TRIG). Field evaluations have been conducted for 4,4'-Methylene diphenyl diisocyanate (MDI) sampling using DAN as the derivatizing agent in a CIP10. The perimidone formed, selective of TRIG, was analyzed in laboratory by liquid chromatography coupled to tandem mass spectrometry. Workplaces using MDI-based polyurethane spray foam and MDI wood product binder were studied. Each study compared the data obtained between the CIP10/DAN, the CIP10/MP, and a reference method. As a first evaluation, the CIP10/DAN sampled simulated MDI spray foam atmosphere in parallel with impingers (reference method) and CIP10/MP. The mean of the TRIG concentration values measured was 16% (95% confidence interval [CI], [1, 31]) higher for the CIP10/MP samples as compared to the impinger samples, while the mean TRIG concentrations found were 98% (95% CI [63, 133]) higher for the CIP10/DAN samples as compared to the impinger samples. For sampling done in a real workplace using MDI-based spray foam, the CIP10/DAN method showed lower results than the CIP10/MP method. The presence of hygroscopic DMSO used in the DAN approach is a limitation and may prevent obtaining accurate results in the spray foam atmosphere. CIP10/DAN was also studied in MDI wood product binder atmosphere. Mean TRIG concentrations found were 80% (95% CI [51, 110]) and 79% (95% CI [50, 108]) lower for the CIP10/MP and CIP10/DAN method, respectively, as compared to the reference method (a 13-mm filter coated with MP). In this case, the CIP10 may have reached its limit in this last evaluation where vapors and particles below 1 µm were not collected as efficiently as they were with the reference method.

Trends in OSHA Compliance Monitoring Data 1979-2011: Statistical Modeling of Ancillary Information across 77 Chemicals.

OBJECTIVES: The Integrated Management Information System (IMIS) is the largest multi-industry source of exposure measurements available in North America. However, many have suspected that the criteria through which worksites are selected for inspection are related to exposure levels. We investigated associations between exposure levels and ancillary variables in IMIS in order to understand the predictors of high exposure within an enforcement context. METHODS: We analyzed the association between nine variables (reason for inspection, establishment size, total amount of penalty, Occupational Safety and Health Administration (OSHA) plan, OSHA region, union status, inspection scope, year, and industry) and exposure levels in IMIS using multimodel inference for 77 agents. For each agent, we used two different types of models: (i) logistic models were used for the odds ratio (OR) of exposure being above the threshold limit value (TLV) and (ii) linear models were used for exposure concentrations restricted to detected results to estimate percent increase in exposure level, i.e. relative index of exposure (RIE). Meta-analytic methods were used to combine results for each variable across agents. RESULTS: A total of 511,047 exposure measurements were modeled for logistic models and 299,791 for linear models. Higher exposures were measured during follow-up inspections than planned inspections [meta-OR = 1.61, 95% confidence interval (CI): 1.44-1.81; meta-RIE = 1.06, 95% CI: 1.03-1.09]. Lower exposures were observed for measurements collected under state OSHA plans compared to measurements collected under federal OSHA (meta-OR = 0.82, 95% CI: 0.73-0.92; meta-RIE = 0.86, 95% CI: 0.81-0.91). A 'high' total historical amount of penalty relative to none was associated with higher exposures (meta-OR = 1.54, 95% CI: 1.40-1.71; meta-RIE = 1.18, 95% CI: 1.13-1.23). CONCLUSIONS: The relationships observed between exposure levels and ancillary variables across a vast majority of agents suggest that certain elements of OSHA's process of selecting worksites for inspection influence the exposure levels that OSHA inspectors encounter. Nonetheless, given the paucity of other sources of exposure data and the lack of a more demonstrably representative data source, our study considers the use of IMIS data for the estimation of exposures in the broader universe of worksites in the USA.

Comparison between the ASSET EZ4 NCO and Impinger Sampling Devices for Aerosol Sampling of 4,4'-Methylene Diphenyl Diisocyanate in Spray Foam Application.

4,4'-methylene diphenyl diisocyanate (MDI) aerosol exposure evaluation in spray foam insulation application is known to be a challenge. Current available techniques are either not user-friendly or are inaccurate or are not validated for this application. A new sampler has recently been developed to address the user-friendliness issues with other samplers: the ASSET EZ4-NCO, but the use of this sampler in spray foam insulation applications has not been demonstrated or validated. Because of this, the current work was undertaken to provide a comparison of the ASSET sampler with an impinger method, considered to be the best available method in the context of spray foam insulation, and hence the pertinence of comparing this sampler to an impinger method, considered to be the best available method for measuring MDI monomer and oligomers for this particular application. Liquid chromatography coupled with tandem mass spectrometry method for MDI monomer and oligomer analysis was implemented based on the Supelco literature. It allows the analysis of MDI-dibutylamine (DBA) and MDI 3-ring-DBA with a minimum reported value of 5ng ml(-1), a dynamic range of 5-140ng ml(-1), precision <15% and accuracy >80%. This method was used to quantify MDI aerosols collected with the ASSET sampler in an MDI spray foam environment in parallel with the toluene/MOPIP impinger reference method. The ASSET sampler significantly underestimated the levels of MDI monomer and oligomers when compared to the reference method. The estimated bias was 72% (95% confidence interval [CI] 54-89%) for the monomer and 96% (95% CI 76-115%) for the oligomers. These results demonstrate the importance of evaluating each new sampler for each isocyanate application prior to a formal worker exposure evaluation.

CIP10 optimization for 4,4-methylene diphenyl diisocyanate aerosol sampling and field comparison with impinger method.

4,4-methylene diphenyl diisocyanate (MDI) aerosol exposure evaluation in spray foam insulation application is known as being a challenge because the spray foam application actually involves a fast-curing process. Available techniques are either not user-friendly or are inaccurate or not validated for this application. To address these issues, a new approach using a CIP10M was developed to appropriately collect MDI aerosol in spray foam insulation while being suitable for personal sampling. The CIP10M is a commercially available personal aerosol sampler that has been validated for the collection of microbial spores into a liquid medium. Tributylphosphate with 1-(2-methoxyphenyl)piperazine (MOPIP) was introduced into the CIP10M to collect and stabilize the MDI aerosols. The limit of detection and limit of quantification of the method were 0.007 and 0.024 µg ml(-1), respectively. The dynamic range was from 0.024 to 0.787 µg ml(-1) (with R (2) ≥ 0.990), which corresponds to concentrations in the air from 0.04 to 1.3 µg m(-3), assuming 60 min of sampling at 10 l min(-1). The intraday and interday analytical precisions were <2% for all of the concentration levels tested, and the accuracy was within an appropriate range of 98 ± 1%. No matrix effect was observed, and a total recovery of 99% was obtained. Parallel sampling was performed in a real MDI foam spraying environment with a CIP10M and impingers containing toluene/MOPIP (reference method). The results obtained show that the CIP10M provides levels of MDI monomer in the same range as the impingers, and higher levels of MDI oligomers. The negative bias observed for MDI monomer was between 2 and 26%, whereas the positive bias observed for MDI oligomers was between 76 and 113%, with both biases calculated with a confidence level of 95%. The CIP10M seems to be a promising approach for MDI aerosol exposure evaluation in spray foam applications.

Stereoselective interactions of peptide inhibitors with the beta-amyloid peptide.

Residues 16-20 of the beta-amyloid peptide (A beta) function as a self-recognition element during A beta assembly into fibers. Peptides containing this motif retain the ability to interact with A beta and, in some cases, potently inhibit its assembly. Replacing L- with D-amino acids could stabilize such peptides and permit their evaluation as therapeutic agents for Alzheimer's disease. Here we have assessed the effect that such a chiral reversal has on inhibitory potency. D-enantiomers of five peptides, KLVFFA, KKLVFFA, KFVFFA, KIVFFA, and KVVFFA, were unexpectedly more active as inhibitors in an in vitro fibrillogenesis assay. Circular dichroism showed that D-KLVFFA more effectively prevented A beta adopting the beta-sheet secondary structure correlated with fibrillogenesis. Electron microscopy showed that fiber formation was also more strongly inhibited by D-KLVFFA. Heterochiral inhibition was confirmed using D-A beta, on the principle that enantiomeric proteins exhibit reciprocal chiral biochemical interactions. With D-Abeta, L-KLVFFA was the more potent inhibitor, rather than d-KLVFFA. Most significantly, D-peptides were more potent at reducing the toxicity of both A beta1-40 and A beta 1-42 toward neuronal cells in culture. This unforeseen heterochiral stereoselectivity of A beta for D-peptide inhibitors should be considered during future design of peptide-based inhibitors of A beta neurotoxicity and fibrillogenesis.