From workplace to home environment: spreading of mouse allergens by laboratory animal workers.

PURPOSE: Laboratory animal workers (LAW) working with laboratory mice are exposed to mouse allergens (MA). If MA are spread to home environments, this might increase the risk for allergies in LAW and their families. This study aimed to assess 1. whether spreading of MA from workplace to home environment takes place; 2. which factors increase spreading of MA. METHODS: In a cross-sectional study, dust samples were taken on the mattress and seating in homes of LAW (n = 105) and an unexposed comparison group (n = 13). From 89 LAW, additional dust samples were taken from their workplaces. Samples were analysed using Mus m1 ELISA kits [detection limit (DL) 0.2 ng mus m1/ml]. Sociodemographic data, personal history of allergies and cleaning habits, as well as work-related characteristics (LAW only) were assessed by questionnaire. Latent factors were assessed via factor analysis. Tobit models were fitted to analyse the latent factors' contribution to MA spreading. RESULTS: MA concentration on the seating was significantly higher in home environments of LAW (median = 1.28 ng mus m1/m2) than in the comparison group (median < DL, p = 0.019). The highest workplace MA concentration was found on the floor of the scullery (median = 140,000.00 ng mus m1/m2), followed by hair-covering caps (median = 76.02 ng mus m1/m2). Cage and mouse facility cleaning tasks and infrequent changing of bed linen at home were statistically significantly associated with higher MA concentrations at home. CONCLUSIONS: Spreading of MA from LAW's workplace to their home environment takes place, especially among LAWs involved in cleaning tasks.

Monitoring of arsenic, mercury and organic pesticides in particulate matter, ambient air and settled dust in natural history collections taking the example of the Museum für Naturkunde, Berlin.

Chemical compounds such as arsenic, mercury and organochlorine pesticides have been extensively used as preventive and curative conservation treatments for cultural and biological collections to protect them from pest and mould infestations. Most of the aforementioned compounds have been classified as carcinogenic, mutagenic and teratogenic and represent a health risk for staff exposed to contaminated objects. A total of 30 compounds were analysed in settled dust, particulate matter and surrounding air collected at several locations in the natural history collections and adjacent rooms of the Museum für Naturkunde, Berlin (MfN, Natural History Museum, Berlin, Germany). Gas chromatography and mass spectrometry techniques were used to quantify dichlorodiphenyltrichloroethane (2,4'-DDT; 4,4'-DDT) and their metabolites (2,4'-DDE; 4,4'-DDE; 2,4'-DDD; 4,4'-DDD), hexachlorobenzene (HCB), 3 isomers of hexachlorocyclohexanes (α-HCH, ß-HCH, γ-HCH), the degradation product of γ-HCH with similar toxicological profile, gamma-pentachlorocyclohexene (γ-PCH) and pentachlorophenol (PCP). Atomic absorption spectrometry was used to analyse arsenic and mercury. In order to assess the pathways of contamination with biocides in dust, formations of particulate matter during individual daily work activities, particle number concentrations (PNCs) were measured. Heavy element concentrations found at the MfN were higher than the organochlorine compounds. The maximum concentration of arsenic and mercury in dust was 3507 mg/kg and 32 mg/kg, respectively, and in air, 48 ng/m3 and 1.6 ng/m3, respectively. The maximum concentration of the sum of DDTs in dust was 2 mg/kg (not detected in air); for PCP, the maximum levels in dust and air were 0.65 mg/kg and 10 ng/m3, respectively; for γ-HCH, 130 mg/kg and 320 ng/m3, respectively; and finally, for γ-PCH, 2.1 mg/kg and 230 ng/m3, respectively. Twelve PNC measurements were obtained from seven different collection rooms and the diaries of the participants' activities. PNCs were highly variable between work activities. Higher personal PNCs were associated with activities like opening storage boxes with prepared animals, reading old books or handling objects. This study has shown that taxidermic objects in museum collection may be a cause for arsenic exposure during handling of objects.

Efficacy of four cleaning solutions for the decontamination of selected cytotoxic drugs on the different surfaces of an automated compounding system.

The automated aseptic preparation of ready-to-administer antineoplastic drug solutions with robotic systems reduces the risk of occupational exposure. However, the surfaces in the preparation area of the robot are to be cleaned by wiping with an appropriate cleaning solution. The aim of the study was to evaluate the cleaning efficacy of four cleaning solutions on four surface materials installed in the APOTECAchemo robot. Predefined amounts of cisplatin (Cis), 5-fluorouracil (5-FU), and cyclophosphamide (CP) were intentionally spread on test plates made of stainless steel, aluminium, polyoxymethylene, and polycarbonate just as installed in the robotic system APOTECAchemo. After drying, the plates were cleaned with 0.2% ethanolic NaOH, 0.23% isopropanolic sodium dodecylsulfate (SDS-2P), 0.5% sodium hypochlorite (NaOCl), and 0.1% benzalkonium chloride (BZK) solutions following a standardized wiping protocol. Residual contamination was recovered with wipe tests, Pt was quantified by voltammetry, and 5-FU and CP was quantified by gas chromatography-tandem mass spectrometry (GC-MSMS). The mean residual contamination after cleaning and the cleaning efficacy (CE) rates were calculated and aggregated on different levels. The CE rates varied between 81.5% and 100% and lay in the majority of cases above 90%. The lowest CE rates were registered for Pt contamination. Especially on aluminium surfaces the residual contamination was high. The overall CE rates of the three different drugs and four different surface types amounted to 98.3% for NaOCl, 97.9% for SDS-2P, 96.9% for ethanolic NaOH, and 96.5% for BZK. The tested cleaning solutions proved to be higher than 90% in most cases, but none of them was able to eliminate 100% of the intentional surface contamination of three antineoplastic drugs on the test plates. The cleaning efficacy varied according to the different surface types and antineoplastic drug. Results could be used in the daily clinical practice to develop and implement effective cleaning procedures.

Human-biomonitoring and individual soil measurements for children and mothers in an area with recently detected mercury-contaminations and public health concerns: a cross-sectional study.

In this study, we assessed intracorporal mercury concentrations in subjects living on partially mercury-contaminated soils in a defined area in Switzerland. We assessed 64 mothers and 107 children who resided in a defined area for at least 3 months. Mercury in biological samples (urine and hair) was measured, a detailed questionnaire was administered for each individual, and individual mercury soil values were obtained. Human biomonitoring results were compared with health-related and reference values. Mothers and children in our study had geometric means (GMs) of 0.22 µg Hg/g creatinine in urine (95th percentile (P95) = 0.85 µg Hg/g) and 0.16 µg Hg/g (P95 = 0.56 µg Hg/g), respectively. In hair, mothers and children had GMs of 0.21 µg Hg/g (P95 = 0.94 µg/g) and 0.18 µg/g (P95 = 0.60 µg/g), respectively. We found no evidence for an association between mercury values in soil and those in human specimens nor for a health threat in residential mothers and children.

Occupational exposure to cisplatin/oxaliplatin during Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC)?

INTRODUCTION: Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is a new promising treatment for patients with peritoneal carcinomatosis. It is supposed to provide a higher local drug concentration and deeper penetrate into the tumor tissue compared to systemic chemotherapy or hyperthermic intraperitoneal chemotherapy perfusion (HIPEC). Due to the application of cytotoxic drug aerosols within the operating room (OR), concern has been raised regarding the occupational exposure risk of the involved OR staff. MATERIALS AND METHODS: In this study, an OR workplace monitoring was performed during 14 PIPAC procedures in two hospitals by collecting air samples (n = 14) during PIPAC and wipe samples (n = 223) before and after PIPAC: 56 samples from the OR floor, 84 from the injector, 28 from trocars and 55 from gloves. All samples were analyzed for platinum (Pt). RESULTS: While air Pt concentrations were below 3.1 pg/m³, surface contaminations widely varied between 0.01 pg/cm2 and 1733 pg/cm2 (median 1.04 pg/cm2), with substantial Pt concentrations on injector parts (i.e. syringe holder) and trocars. Floors and particularly injectors were often higher contaminated before compared to after PIPAC, probably due to inefficient cleaning or cross-contamination. Glove samples taken after different tasks ranged between 0.04 and 423 pg/cm2 (median 0.58 pg/cm2). CONCLUSION: Contamination on various OR surfaces widely ranged and can lead to a distribution of cytotoxic drug residues. However, the air contamination was very low. The results indicate that PIPAC performance seems to be possible with low occupational exposure risk, but adequate safety and cleaning standards for PIPAC must be developed and monitored.

Environmental and biological monitoring on an oncology ward during a complete working week.

Workplace exposure to antineoplastic drugs (AD) is still of evident concern to all occupationally exposed persons in the healthcare sector as residues in relevant concentrations continue to be present. With respect to the carcinogenic and mutagenic potential of ADs and their toxicity on reproduction, occupational exposure should be kept as low as reasonably achievable (ALARA). In the oncology patient care, the medical staff is involved both in chemotherapy administration and handling of AD-contaminated body fluids of the patients. For this purpose, in this study, surface monitoring on an oncology ward and concurrent urine monitoring of the complete healthcare staff was performed during five consecutive days for 5-fluorouracil (5-FU), cyclophosphamide (CP) and platinum (Pt). Contamination was detected on all surfaces in various ranges (5-FU 0.7-12,600 pg/cm2, Pt 0.2-181,800 pg/cm2, CP (

Antineoplastic drug residues inside homes of chemotherapy patients.

Chemotherapy treatment of cancer patients has shifted from inpatient to outpatient administration. Thus, family members are potentially exposed to cytotoxic drug residues from patients' excretions inside their homes. The study's aim was to evaluate the surface contamination and the potential uptake of antineoplastic drug residues by family members at home of chemotherapy patients. Overall, 265 wipe samples from 13 homes were taken at two times after chemotherapy from different surfaces (toilet, bathroom, kitchen). 62 urine samples were collected from patients and family members on three days. Samples were analyzed for cyclophosphamide, 5-fluorouracil (urine: FBAL) and platinum (as marker for cis-, carbo- and oxaliplatin). Substantial contamination was found on every surface type (PT: 0.02-42.5pg/cm2, 5-FU: ND-98.3pg/cm2, CP: ND-283.3pg/cm2) with highest concentrations on toilet and bathroom surfaces. While patients' urinary drug concentrations often were elevated for more than 48h after administration, no drug residues were detectable in the family members' urine. This study provided an insight in the exposure situation against antineoplastic drug residues at home of chemotherapy patients. As contamination could be found on various surfaces adequate hygienic and protective measures are necessary to minimize the exposure risk for cohabitants.

A new method for quasi-reagent-free biomonitoring of mercury in human urine.

A novel analytical method for sampling and extraction of mercury (Hg) from human urine is presented in this work. The method is based on selective accumulation and separation of Hg from fresh urine sample onto active nanogold-coated silica material by highly efficient solid-phase extraction. After thermal desorption of Hg from the extractant, detection is performed by atomic fluorescence spectrometry (AFS). The feasibility and validity of the optimized, quasi-reagent-free approach was confirmed by recovery experiments in spiked real urine (recovery rate 96.13 ± 5.34%) and by comparison of found Hg concentrations in real urine samples - originating from occupationally exposed persons - with values obtained from reference methods cold vapor - atomic absorption spectrometry (CVAAS) and cold vapor - atomic fluorescence spectrometry (CV-AFS). A very good agreement of the found values reveals the validity of the proposed approach. The limit of detection (LOD) was found to be as low as 0.004 µg Hg L-1 and a high reproducibility with a relative standard deviations ≤4.2% (n = 6) is given. Moreover, storage of the samples for up to one week at an ambient temperature of 30 °C reveals no analyte losses or contamination. In conclusion, the proposed method enables easy-to-handle on-site extraction of total Hg from human urine ensuring at the same time reagent-free sample stabilization, providing quick and safe sampling, which can be performed by untrained persons.

Robotic i.v. medication compounding: Recommendations from the international community of APOTECAchemo users.

PURPOSE: The development of recommendations for advancing automated i.v. medication compounding is described. SUMMARY: Managing the shift from manual to robotic compounding of i.v. therapies requires an awareness of how automation affects practice and how to best implement robotics into current practice. An international panel of pharmacy professionals, researchers, and technology leaders with experience in i.v. robotics collaborated during a two-day meeting in August 2014 to define a general set of principles to broaden the understanding of the fundamental elements of robotic compounding worldwide. Participants were divided into four working groups (technology and safety; drugs and products; personnel; and facilities and quality) to analyze specific aspects of robotic compounding practice. The four working groups produced an initial list of 92 statements. This list was condensed to 35 statements by consolidating similar and overlapping statements from the different work groups. Participants were surveyed again to assess agreement with the 35 statements and solicit additional clarification. Respondents expressed full agreement with 25 recommendations. Six statements received one or more "don't know" responses, with all other respondents in agreement. Four statements had a combination of "don't know" and "disagree" responses. A total of 32 comments were recorded in free-text fields, including requests for clarification and suggestions for rewording the statements. CONCLUSION: An international panel of pharmacy professionals, researchers, and technology leaders with experience in i.v. robotics developed a set of 35 recommendations toward a better understanding of the role of automated i.v. compounding in hospital and health-system pharmacies worldwide.

Exposure of the German general population to platinum and rhodium - Urinary levels and determining factors.

In this study the exposure of the general population in Germany to platinum and rhodium and its determinants was investigated in 259 participants (subdivided in three groups) by urine analyses and assessment of the dental status. Complementary, an interview including questions characterising possible exposure to traffic exhaust was conducted. The median excretion was 2.42ng platinum/g creatinine and 7.27ng rhodium/g creatinine. The detailed analysis of the collected data showed significant higher platinum excretion values with increasing number of surfaces covered with restorations containing precious metals (R=0.389; p<0.001), but also higher values for habitants of urban areas (median=3.43ng/g creatinine; 95th percentile=25.2ng/g) compared with those of rural areas (median=2.06ng/g creatinine; 95th percentile=20.0ng/g). Also, participants working in urban areas showed higher platinum excretion values (median=3.27ng/g; 95th percentile=19.6ng/g). Male participants living and working next to highly frequented roads showed higher rhodium excretion values (median=7.27ng/g; 95th percentile=13.5 ng/g). In summary, the study showed that exhaust emissions have an influence on platinum and rhodium excretion, but for platinum this influence is rather low compared to the influence of precious metals containing restorations.

A preliminary study on health effects in villagers exposed to mercury in a small-scale artisanal gold mining area in Indonesia.

Cisitu is a small-scale gold mining village in Indonesia. Mercury (Hg) is used to extract gold from ore, heavily polluting air, soil, fish and rice paddy fields with Hg. Rice in Cisitu is burdened with mercury. The main staple food of the inhabitants of Cisitu is this polluted rice. Villagers were concerned that the severe diseases they observed in the community might be related to their mining activities, including high mercury exposure. Case report of the medical examinations and the mercury levels in urine and hair of 18 people with neurological symptoms. Typical signs and symptoms of chronic mercury intoxication were found (excessive salivation, sleep disturbances, tremor, ataxia, dysdiadochokinesia, pathological coordination tests, gray to bluish discoloration of the oral cavity and proteinuria). Mercury levels in urine were increased in eight patients (>7µg Hg/L urine). All 18 people had increased hair levels (>1µg Hg/g hair). 15 patients exhibited several, and sometimes numerous, symptoms in addition to having moderately to highly elevated levels of mercury in their specimens. These patients were classified as intoxicated. The situation in Cisitu is special, with rice paddy fields being irrigated with mercury-contaminated water and villagers consuming only local food, especially mercury-contaminated rice. Severe neurological symptoms and increased levels of mercury in urine and hair support are possibly caused by exposure to inorganic mercury in air, and the consumption of mercury-contaminated fish and rice. The mercury exposure needs to be reduced and treatment provided. Further research is needed to test the hypothesis that mercury-contaminated rice from small-scale gold mining areas might cause mercury intoxication.

Mercury and neuromotor function among children in a rural town in Chile.

BACKGROUND: Mercury (Hg) exposure from artisanal gold mining has adverse effects on the neuromotor function in adults. However, few studies have examined this relationship in children. OBJECTIVES: To investigate the impact of Hg exposure on children's neuromotor function. METHODS: Cross-sectional data on Hg risk factors and demographics were collected from n = 288 children (response = 68.9%). Based on complete cases (CCs) (n = 130) and multiple imputations (n = 288), associations between fingernail Hg and four different neuromotor function components were calculated using multiple logistic regression adjusted for confounders. RESULTS: Of the children, 11.1, 14.9, 63.9, and 10.4% had pathologic pure motor skills, adaptive fine motor skills, adaptive gross motor skills, and static balance, respectively. No significant association between fingernail Hg and any neuromotor component was found. However, Hg burning in the household was significantly associated with children's pathologic pure motor skills (OR 3.07 95% CI 1.03-9.18). CONCLUSION: Elemental Hg exposure in the household might have adverse long-term effects on children's pure motor skills.

Environmental contamination by cyclophosphamide preparation: Comparison of conventional manual production in biological safety cabinet and robot-assisted production by APOTECAchemo.

OBJECTIVES: The aim of this study was to compare environmental contamination of cyclophosphamide (CP) during 1 week of drug compounding by conventional manual procedure in a biological safety cabinet (BSC) with laminar airflow and a new robotic drug preparation system (APOTECAchemo). METHODS: During four consecutive days, similar numbers of infusion bags with cyclophosphamide were prepared with both techniques in a cross-over design. Wipe samples (49 for BSC, 50 for APOTECAchemo) were taken at several locations (gloves, infusion bags, trays, BSC-benches, floor) in the pharmacy and analyzed for CP concentrations by GC-MSMS (LOD 0.2 ng/sample). RESULTS: The detection rate was 70% in the BSC versus 15% in APOTECAchemo. During manual preparation of admixtures using BSC contamination with CP was below 0.001 ng/cm(2) at most locations, but significant on gloves (0.0004-0.0967 ng/cm(2)) and the majority (70%) of infusion bags (<0.0004-2.89 ng/cm(2)). During robotic preparation by APOTECAchemo, gloves (1 of 8: 0.0007 ng/cm(2)) and infusion bags (3 of 20: 0.0005, 0.0019, 0.0094 ng/cm(2)) were considerably less contaminated. Residual contamination was found on the surfaces under the dosing device in the compounding area (0.0293-0.1603 ng/cm(2)) inside the robotic system. CONCLUSIONS: Compared to outcomes of other studies, our results underline good manufacturing procedures in this pharmacy with low contamination for both techniques (BSC and APOTECAchemo). Comparison of both preparation procedures validated that contamination of infusion bags was much lower by using the robotic system.

Cleaning Efficiencies of Three Cleaning Agents on Four Different Surfaces after Contamination by Gemcitabine and 5-fluorouracile.

Occupational exposure to antineoplastic drugs has been documented for decades showing widespread contamination in preparation and administration areas. Apart from preventive measures, efficient cleaning of surfaces is indispensable to minimize the exposure risk. The aim of this study was to evaluate the efficiency of three cleaning agents after intentional contamination by gemcitabine (GEM) and 5-fluorouracile (5-FU) on four different surface types usually installed in healthcare settings. Glass, stainless steel, polyvinylchloride (PVC), and laminated wood plates were contaminated with 20 ng/µl GEM and 2 ng/µl 5-FU solutions. Wipe samples were analyzed for drug residues after cleaning with a) distilled water, b) aqueous solution containing sodium dodecyl sulfate (10 mM) and 2-propanol (SDS-2P), and c) Incides N (pre-soaked) alcoholic wipes. Quantification was performed by high-performance liquid chromatography (HPLC) for GEM and gas chromato-graphy-tandem mass spectrometry (GCMS/MS) for 5-FU. Recovery was determined and cleaning efficiency was calculated for each scenario. Mean recoveries were 77-89% for GEM and 24-77% for 5-FU and calculated cleaning efficiencies ranged between 95 and 100% and 89 and 100%, respectively. Residual drug amounts were detected in the range nd (not detected) - 84 ng GEM/sample and nd - 6.6 ng 5-FU/sample depending on surface type and cleaning agent. Distilled water and SDS-2P had better decontamination outcomes than Incides N wipes on nearly all surface types, especially for GEM. Regarding 5-FU, the overall cleaning efficiency was lower with highest residues on laminated wood surfaces. The tested cleaning procedures are shown to clean glass, stainless steel, PVC, and laminated wood with an efficiency of 89-100% after contamination with GEM and 5-FU. Nevertheless, drug residues could be verified by wipe samples. Pure distilled water and SDS in an alcoholic-aqueous solution expressed an efficient cleaning performance, especially with respect to GEM. The study results demonstrate the need to adapt cleaning procedures to the variety of drugs and surface types to develop effective decontamination strategies.

Asthma and the hygiene hypothesis. Does cleanliness matter?

RATIONALE: The early hygiene hypothesis explained the development of allergies by a lack of infections; nowadays, the aspect of excessive cleanliness in affluent populations seems to have replaced this concept. Yet, no investigation has shown that home or personal cleanliness relate to allergic diseases. OBJECTIVES: To relate personal and home cleanliness to risk of asthma and allergies. METHODS: Comprehensive questionnaire information on home or personal cleanliness and allergic health conditions at school age was collected in 399 participants of the urban Perinatale Asthma Umwelt Langzeit Allergie Studie (PAULA) birth cohort. Bacterial markers were assessed in floor and mattress dust and were related to cleanliness and allergic diseases. MEASUREMENTS AND MAIN RESULTS: Personal cleanliness was inversely related to bacterial compounds on floors and mattresses, whereas home cleanliness effectively reduced dust amount but not microbial markers. Exposure to muramic acid related to a lower prevalence of school-age asthma (adjusted odds ratio, 0.59 [95% confidence interval, 0.39; 0.90]). Mattress endotoxin in the first year of life was inversely associated with atopic sensitization (0.73 [0.56-0.96]) and asthma at school age (0.72 [0.55-0.95]). Despite the associations of dust parameters both with cleanliness and allergic health conditions, the development of allergies was not related to home and personal cleanliness. CONCLUSIONS: Bacterial exposure in house dust determined childhood asthma and allergies. Personal cleanliness, such as washing hands, and home cleanliness were objectively reflected by dust parameters in homes. However, neither personal nor home cleanliness was associated with a risk for asthma and allergies. Other microbial components in house dust not affected by personal hygiene are likely to play a role.

Silicone implants--a possible confounder for urinary platinum background concentrations?

INTRODUCTION: Urinary platinum excretion from occupationally unexposed population is very low. Up to now, in Germany, dental noble metal alloys and a platinum based chemotherapy have been identified as reason for elevated urine concentrations. As fabrication of silicone involves platinum as catalyst, this study examines the potential release of platinum from silicone breast implants by quantifying urinary platinum concentration. METHODS AND RESULTS: Platinum release from three different types of silicone implants into saline solution was measured in a laboratory experiment. It showed a strong increase of platinum concentration during the first 30 min and high platinum concentrations even after 60 h. In the following field study urinary platinum concentrations were determined from 30 women with dental gold alloy restorations and 28 women without such dental inlays. Median platinum concentrations were 5.2 ng/l urine (21.2 ng/g creatinine) for the women with dental gold inlays and 6.0 ng/l urine (5.4 ng/g creatinine) for those without. Compared with the urinary platinum concentrations provided by the German Environmental Survey (GerES) for the general female population the urinary platinum levels of women with silicone implants of the presented study were significantly higher, both for the study groups with and without dental gold alloy inlays. CONCLUSIONS: Silicone breast implants must be considered as a new confounder and as a further contributor to elevated urinary platinum concentrations in human platinum background reference values of women.

Perinatal influences on the development of asthma and atopy in childhood.

BACKGROUND: In most children with asthma and atopy, onset of disease occurs early in life, indicating a crucial role of in utero and early childhood environment. However, only a small part of this burden of disease established early in life has been explained. OBJECTIVE: To examine the effects of early environmental exposures on the development of asthma and atopy within the setting of an affluent urban population. METHODS: The authors followed 526 German children from birth to 5 years of age. Parental interviews in pregnancy and then yearly assessed the health of the child and environmental characteristics. Endotoxin and allergens in house dust were measured at 3 months. Atopic sensitization was assessed at 1 and 5 years. RESULTS: In atopic mothers, acute atopic symptoms during pregnancy were associated with increased risk of early atopic dermatitis (adjusted odds ratio [aOR] 1.74, 95% confidence interval [CI] 1.00-3.02) and allergic rhinitis at 5 years (aOR 2.11, 95% CI 1.01-4.41). Further, maternal illnesses during pregnancy (ie, repeated common colds) increased the risk of asthma at 5 years (aOR 2.31, 95% CI 1.12-4.78). Endotoxin in the child's mattress was inversely associated with atopic sensitization (aOR 0.79, 95% CI 0.64-0.97) and asthma (aOR 0.71, 95% CI 0.55-0.93). A contrasting effect of early endotoxin and mite exposure was observed for mite sensitization: mite exposure increased the risk of mite sensitization at 5 years (aOR 1.30, 95% CI 1.11-1.53), whereas endotoxin exposure was inversely associated with mite sensitization (aOR 0.73, 95% CI 0.57-0.95). CONCLUSION: Factors affecting the in utero environment, such as maternal atopy and infections, and bacterial exposure in pregnancy or early life may act as immunomodulators enhancing or inhibiting the development of asthma and atopy in childhood.

Risk factors for mercury exposure of children in a rural mining town in northern Chile.

OBJECTIVE: Traditional gold mining is associated with mercury exposure. Especially vulnerable to its neurotoxic effects is the developing nervous system of a child. We aimed to investigate risk factors of mercury exposure among children in a rural mining town in Chile. METHODS: Using a validated questionnaire distributed to the parents of the children, a priori mercury risk factors, potential exposure pathways and demographics of the children were obtained. Mercury levels were measured through analyzing fingernail samples. Logistic regression modeling the effect of risk factors on mercury levels above the 75(th) percentile were made, adjusted for potential confounders. RESULTS: The 288 children had a mean age of 9.6 years (SD = 1.9). The mean mercury level in the study population was 0.13 µg/g (SD 0.11, median 0.10, range 0.001-0.86 µg/g). The strongest risk factor for children's odds of high mercury levels (>75(th) percentile, 0.165 µg/g) was to play inside a house where a family member worked with mercury (OR adjusted 3.49 95% CI 1.23-9.89). Additionally, children whose parents worked in industrial gold mining had higher odds of high mercury levels than children whose parents worked in industrial copper mining or outside mining activities. CONCLUSION: Mercury exposure through small-scale gold mining might affect children in their home environments. These results may further help to convince the local population of banning mercury burning inside the households.

Airborne allergens, endotoxins, and particulate matter in elementary schools, results from Germany (LUPE 2).

Allergic disorders are the most common childhood-related chronic diseases in developed countries. It is essential to assess the exposure, especially in schools, where children spend a large portion of their time. We aimed to investigate allergen and endotoxin levels in the air of schools and to observe seasonal variations of these factors. We evaluated airborne concentrations of house dust mites allergens (Der p 1, Der f 1), cat allergen (Fel d 1), and endotoxin in PM10 in 14 classrooms during the school days in the region of Munich, each over 20 consecutive days and in 1 classroom over the course of a year (at 83 days); we also tested outdoor air close to the schools. Endotoxin levels were quantified using two different analytical methods. In addition, indoor air climate parameters were measured. The median daily indoor CO2 and PM10 concentrations in the classrooms ranged from 423 to 3,135 ppm (median: 1,211 ppm) and 9 to 390 µg/m(3) (median: 127 µg/m(3)), respectively. Fel d 1 in the PM10 samples was the most frequently detected allergen, with levels from 0.02 to 1.15 ng/m(3) in a total of 301 samples (median: 0.19 ng/m(3), 95th percentile: 0.57 ng/m(3)). Der p 1 and Der f 1 were detected in only 51% and 19% of the samples, with 95th percentiles at 0.5 and 0.3 ng/m(3). Endotoxin levels in the PM10 and inhalable dust samples ranged from 0.5 to 84.1 EU/m(3) (median: 15.3 EU/m(3); 95th percentile: 58.2 EU/m(3)) and from 0.03 to 115 EU/m(3) (median: 8.4 EU/m(3); 95th percentile: 27.9 EU/m(3)). Fel d 1 and endotoxin were found in higher levels in the winter months. The results of the two different indoor sampling techniques for endotoxin were statistically significantly correlated. The results of airborne allergens indicate a generally low exposure level in classrooms. With regard to endotoxin, our study showed higher levels in schools compared with residences.