Airborne microplastics: A narrative review of potential effects on the human respiratory system.

There has been growing evidence showing the widespread of airborne microplastics (AMPs) in many regions of the world, raising concerns about their impact on human health. This review aimed to consolidate recent literature on AMPs regarding their physical and chemical characteristics, deposition in the human respiratory tract, translocation, occurrence from human studies, and toxic effects determined in vitro and in vivo. The physical characteristics influence interactions with cell membranes, cellular internalization, accumulation, and cytotoxicity resulting from cell membrane damage and oxidative stress. In addition, prolonged exposure to AMP-associated toxic chemicals might lead to significant health effects. Most toxicological assessments of AMPs in vitro and in vivo have demonstrated that oxidative stress and inflammation are major mechanisms of action for their toxic effects. Elevated reactive oxygen species production could lead to mitochondrial dysfunction, inflammatory responses, and subsequent apoptosis in experimental models. To date, there has been some evidence suggesting exposure in humans. However, the data are still insufficient, and adverse human health effects need to be investigated. Future research on the existence, exposure, and health effects of AMPs is required for developing preventive and mitigation measures to protect human health.

Blood Lead Levels among Non-Occupationally Exposed Pregnant Women in Southern Thailand.

Lead (Pb) is a heavy metal that is toxic to humans, especially children and pregnant women. In Thailand, guidelines exist to minimize lead exposure in pregnant women working in lead-related occupations. However, no guidelines exist for pregnant women who are not employed in these economic sectors. This cross-sectional study aimed to examine blood lead levels (BLLs) and related risk factors among 80 non-occupationally exposed pregnant women from the general population living in Nakhon Si Thammarat province, Southern Thailand. BLLs were determined by graphite furnace atomic absorption spectrophotometry. A validated questionnaire was adopted to interview participants which included demographic, consumer goods, supplement intake, and health factors. The mean BLL was 4.68 ± 1.55 µg/dL (95% CI 4.33-5.02) and 42.50% had BLLs ≥ 5 µg/dL. Higher education was the only demographic factor associated with BLLs ≥ 5 µg/dL (aOR 0.16, 95% CI 0.03-0.80, p = 0.027). Systolic blood pressure was also associated with BLLs ≥ 5 µg/dL (aOR 5.00, 95% CI 1.23-17.16, p = 0.023). However, consumer goods and supplement intake were not associated with BLLs. Our results indicate that pregnant women from the general population who were not in the risk exposure group had lead in their bodies. Except for education, demographics were not associated with pregnant women with BLLs. However, with health factors, even low BLLs had a small effect on systolic blood pressure. These data suggest a need for promoting health education and health interventions to prevent the dangers of lead exposure, especially for pregnant women and children.

The construction and validation of a lead exposure screening tool for pregnant women in Thailand (ThaiL8Is).

Objectives: To construct, validate, and implement a new screening tool for lead exposure in Thai pregnant women. Methods: A cross-sectional study that included three processes: screening tool development, validation, and implementation. The participants were pregnant women who had received antenatal care at district health promotion hospitals. There were 100 pregnant women in Nakhon Si Thammarat province during the validation process, and 30 pregnant women in Phang Nga province during the implementation process. Blood lead levels (BLLs) were analysed by atomic absorption spectrophotometry. The sensitivity and specificity of the screening instrument, as well as the Area Under the Curve (AUC), demonstrate its validity. Results: There were 80 BLL-related items found through the collection of primary and secondary data and examined for validity and inter-rater reliability by five experts. Six items were excluded because the values were less than the criteria set. Seventy-four items remained with the Item Content Validity Index (I-CVI) = 0.80-1.00, the Content Validity Index Average (S-CVI/Ave) = 0.91, and Kappa scores = 0.76-1.00. After using 74 items collected on pregnant women, only 31 items were included in the validation process. Following that, the pooled eight items with cut-off point scores of 1 had the highest validity, which included systolic blood pressure, diastolic blood pressure, urine sugar, haemoglobin level, occupation, drinking coffee, using chemical products, and education level (ThaiL8Is). The ThaiL8Is in the validation process yielded sensitivity = 80.9%, specificity = 69.8%, and an AUC (95%CI) = 0.78 (0.69-0.87). The implementation process has confirmed the validity of the screening tool; sensitivity = 78.9%, specificity = 81.8%, and the AUC (95%CI) = 0.80 (0.63-0.97). Conclusions: The ThaiL8Is a valid screening tool for Thai pregnant women. ThaiL8Is' sensitivity in detecting the risk groups for lead exposure can be enhanced by a combination of biochemical markers used in routine prenatal screening. It can be used to screen pregnant women for early indicators of lead exposure prior to a blood lead test.

Environmental sanitation and hygiene of elderly workers in Nakhon Si Thammarat Province, Thailand.

INTRODUCTION: Thailand will become a completely aged society in 2021 and a super-aged society in 2030, resulting in a high proportion of older people. Living environments, especially at home, play an essential health determinant for the elders. METHODS: This cross-sectional analytical study evaluated 319 households in Nakhon Si Thammarat Province according to the standard of housing sanitation for elders and assessed biological contamination in food, water, and indoor air in the homes. RESULTS: The housing assessment results revealed some issues that are necessary to be improved, i.e., the wet and dry areas in bathrooms were not separated (89.4%), there was no anti-slip sheet in the bathrooms (97.2%), and handrails were not suitably installed (96.2%). The proportion of coliform bacteria contamination in the samples of cooked rice, side dish, dish, spoon, elderly hand, and drinking water was 93.3, 83.9, 82.5, 88.1, 78.0 and 97.5%, respectively. The average total bacteria count in bedrooms and kitchens was 111 CFU/m3 and 149 CFU/m3, respectively. The average total fungi count was 83 CFU/m3 in bedrooms and 93 CFU/m3 in kitchens. Most indoor air quality parameters complied with the standards. CONCLUSIONS: Significant health risks for the elderly workers while living at home were injuries due to slipping fall in the house, especially in the bathroom, as well as foodborne and waterborne diseases. The health risks should be communicated to the elders. Prevention of the risks should be performed by the cooperation of relevant government agencies and the older adults in the study area.

Toluene and Heavy Metals in Small Automotive Refinishing Shops and Personal Protection of the Workers in Nakhon Si Thammarat, Thailand.

Chemical contamination and safe work practices of workers in automotive refinishing shops have been extensively studied in industrialized countries, but the evidence in developing countries is limited. This study aimed to evaluate chemical contamination and the use of personal protective equipment (PPE) of workers in local small-scale automotive refinishing shops in Nakhon Si Thammarat, Thailand. Airborne toluene and heavy metals, i.e., lead, chromium, and cadmium, were measured in 3 automotive refinishing shops. Toluene exposure assessed by urinary hippuric acid (n = 27) and metal contamination on workers' hands (n = 24) were also determined. Information on the use of PPE and personal hygiene practices of the workers was collected by questionnaires. Average ambient levels of toluene (0.04-18.26 ppm) and the metals (Pb: ND-26.34, Cr: 0.02-4.46, and Cd: ND-1.44 µg/m3) in all sites did not exceed the national standard levels of 200 ppm for toluene (1998) and 50, 12, and 5 µg/m3 for Pb, Cr, and Cd, respectively (2017). The mean ambient levels of these chemicals were highest in paint spray booths followed by nonpainting areas and office rooms, respectively. The highest level of urinary hippuric acid (1.13 g/g creatinine) was found in a painter but did not exceed the recommended biological exposure index of 1.6 g/g creatinine (2014). In contrast, the highest levels of lead and chromium detected on the workers' hands were found in body repair technicians. Direct hand contact without using gloves was suggested as a primary cause of metal contamination.

Oxidative DNA damage and inflammatory responses in cultured human cells and in humans exposed to traffic-related particles.

Particulate pollution is a major public health concern because epidemiological studies have demonstrated that exposure to particles is associated with respiratory diseases and lung cancer. Diesel exhaust particles (DEP), which is classified as a human carcinogen (IARC, 2012), are considered a major contributor to traffic-related particulate matter (PM) in urban areas. DEP consists of various compounds, including PAHs and metals which are the principal components that contribute to the toxicity of PM. The present study aimed to investigate effects of PM on induction of oxidative DNA damage and inflammation by using lymphocytes in vitro and in human exposed to PM in the environment. Human lymphoblasts (RPMI 1788) were treated with DEP (SRM 2975) at various concentrations (25-100 µg/ml) to compare the extent of responses with alveolar epithelial cells (A549). ROS generation was determined in each cell cycle phase of DEP-treated cells in order to investigate the influence of the cell cycle stage on induction of oxidative stress. The oxidative DNA damage was determined by measurement of 8-hydroxy-deoxyguanosine (8-OHdG) whereas the inflammatory responses were determined by mRNA expression of interleukin-6 and -8 (IL-6 and IL-8), Clara cell protein (CC16), and lung surfactant protein-A (SP-A). The results showed that RPMI 1788 and A549 cells had a similar pattern of dose-dependent responses to DEP in terms of particle uptake, ROS generation with highest level found in G2/M phase, 8-OHdG formation, and induction of IL-6 and IL-8 expression. The human study was conducted in 51 healthy subjects residing in traffic-congested areas. The effects of exposure to PM2.5 and particle-bound PAHs and toxic metals on the levels of 8-OHdG in lymphocyte DNA, IL-8 expression in lymphocytes, and serum CC16 were evaluated. 8-OHdG levels correlated with the exposure levels of PM2.5 (P<0.01) and PAHs (P<0.05), but this was not the case with IL-8. Serum CC16 showed significantly negative correlations with B[a]P equivalent (P<0.05) levels, but positive correlation with Pb (P<0.05). In conclusion, a similar pattern of the dose-dependent responses to DEP in the lymphoblasts and lung cells suggests that circulating lymphocytes could be used as a surrogate for assessing PM-induced oxidative DNA damage and inflammatory responses in the lung. Human exposure to PM leads to oxidative DNA damage whereas PM-induced inflammation was not conclusive and should be further investigated.

Low level occupational exposure to styrene: its effects on DNA damage and DNA repair.

The present study aimed to evaluate the effects of styrene exposure at levels below the recommended standards of the Threshold Limit Value (TLV-TWA(8)) of 20 ppm (ACGIH, 2004) in reinforced-fiberglass plastics workers. Study subjects comprised 50 exposed workers and 40 control subjects. The exposed workers were stratified by styrene exposure levels, i.e. group I (<10 ppm, <42.20 mg/m(3)), group II (10-20 ppm, 42.20-84.40 mg/m(3)), and group III (>20 ppm, >84.40 mg/m(3)). The mean styrene exposure levels of exposed workers were significantly higher than those of the control workers. Biomarkers of exposure to styrene, including blood styrene and the urinary metabolites, mandelic acid (MA) and phenylglyoxylic acid (PGA), were significantly increased with increasing levels of styrene exposure, but were not detected in the control group. DNA damage, such as DNA strand breaks, 8-hydroxydeoxyguanosine (8-OHdG), and DNA repair capacity, were used as biomarkers of early biological effects. DNA strand breaks and 8-OHdG/10(5)dG levels in peripheral leukocytes of exposed groups were significantly higher compared to the control group (P<0.05). In addition, DNA repair capacity, determined by the cytogenetic challenge assay, was lower in all exposed groups when compared to the control group (P<0.05). The expression of CYP2E1, which is involved in styrene metabolism, in all styrene exposed groups, was higher than that of the control group at a statistically significant level (P<0.05). Levels of expression of the DNA repair genes hOGG1 and XRCC1 were significantly higher in all exposed groups than in the control group (P<0.05). In addition to styrene contamination in ambient air, a trace amount of benzene was also found but, the correlation between benzene exposure and DNA damage or DNA repair capacity was not statistically significant. The results obtained from this study indicate an increase in genotoxic effects and thus health risk from occupational styrene exposure, even at levels below the recommended TLV-TWA(8) of 20 ppm.