Chemicals in European residences - Part I: A review of emissions, concentrations and health effects of volatile organic compounds (VOCs).

One of the more important classes of potentially toxic indoor air chemicals are the Volatile Organic Compounds (VOCs). However, due to a limited understanding of the relationships between indoor concentrations of individual VOCs and health outcomes, there are currently no universal health-based guideline values for VOCs within Europe including the UK. In this study, a systematic search was conducted designed to capture evidence on concentrations, emissions from indoor sources, and health effects for VOCs measured in European residences. We identified 65 individual VOCs, and the most commonly measured were aromatic hydrocarbons (14 chemicals), alkane hydrocarbons (9), aldehydes (8), aliphatic hydrocarbons (5), terpenes (6), chlorinated hydrocarbons (4), glycol and glycol ethers (3) and esters (2). The pathway of interest was inhalation and 8 individual aromatic hydrocarbons, 7 alkanes and 6 aldehydes were associated with respiratory health effects. Members of the chlorinated hydrocarbon family were associated with cardiovascular neurological and carcinogenic health effects and some were irritants as were esters and terpenes. Eight individual aromatic hydrocarbons, 7 alkanes and 6 aldehydes identified in European residences were associated with respiratory health effects. Of the 65 individual VOCs, 52 were from sources associated with building and construction materials (e.g. brick, wood products, adhesives and materials for flooring installation etc.), 41 were linked with consumer products (passive, electric and combustible air fresheners, hair sprays, deodorants) and 9 VOCs were associated with space heating, which may reflect the relatively small number of studies discussing emissions from this category of sources. A clear decrease in concentrations of formaldehyde was observed over the last few years, whilst acetone was found to be one of the most abundant but underreported species. A new approach based on the operational indoor air quality surveillance will both reveal trends in known VOCs and identify new compounds.

Screening and Treatment of Sexually Transmitted Infections Among Medicaid Populations-A 2-State Analysis.

BACKGROUND: Chlamydia, gonorrhea, and syphilis are common, treatable sexually transmitted infections (STIs) that are highly prevalent in the general US population. Costs associated with diagnosing and treating these conditions for individual states' Medicaid participants are unknown. The purpose of this study was to estimate the cost of screening and treatment for 3 common STIs for state Medicaid program budgets in Maryland and South Carolina. METHODS: A retrospective, cross-sectional study was conducted using Medicaid administrative claims data over a 2-year period. Claims were included based on the presence of one of the 3 study conditions in either diagnosis or procedure codes. Descriptive analyses were used to characterize the participant population and expenditures for services provided. RESULTS: Total Medicaid expenditures for STI care in state fiscal years 2016 and 2017 averaged $43.5 million and $22.3 million for each year in Maryland and South Carolina, respectively. Maryland had a greater proportion of costs associated with outpatient hospital and laboratory settings. Costs for care provided in the emergency department were highest in South Carolina. CONCLUSIONS: Diagnosis and treatment of commonly reported STIs may have a considerable financial impact on individual state Medicaid programs. Public health activities directed at STI prevention are important tools for reducing these costs to states.

A mutation in the F-box gene, Fbxo11, causes otitis media in the Jeff mouse.

Otitis media (OM), inflammation of the middle ear, is the most common cause of hearing impairment and surgery in children. Recurrent and chronic forms of OM are known to have a strong genetic component, but nothing is known of the underlying genes involved in the human population. We have previously identified a novel semi-dominant mouse mutant, Jeff, in which the heterozygotes develop chronic suppurative OM (Hardisty, R.E., Erven, A., Logan, K., Morse, S., Guionaud, S., Sancho-Oliver, S., Hunter, A.J., Brown, S.D. and Steel, K.P. (2003) The deaf mouse mutant Jeff (Jf) is a single gene model of otitis media. J. Assoc. Res. Otolaryngol., 4, 130-138.) and represent a model for chronic forms of OM in humans. We demonstrate here that Jeff carries a mutation in an F-box gene, Fbxo11. Fbxo11 is expressed in epithelial cells of the middle ears from late embryonic stages through to day 13 of postnatal life. In contrast to Jeff heterozygotes, Jeff homozygotes show cleft palate, facial clefting and perinatal lethality. We have also isolated and characterized an additional hypomorphic mutant allele, Mutt. Mutt heterozygotes do not develop OM but Mutt homozygotes also show facial clefting and cleft palate abnormalities. FBXO11 is one of the first molecules to be identified, contributing to the genetic aetiology of OM. In addition, the recessive effects of mutant alleles of Fbxo11 identify the gene as an important candidate for cleft palate studies in the human population.