Is short-term training useful in international environmental and occupational health projects? Experience from the Balkans and Latin America.

Short courses/workshops for international training in environmental and occupational health are an important tool for supplementing longer-term training at the graduate-degree level. Considerable collective and shared experiences in short-term training have been accumulated among these 13 projects sponsored by the Fogarty International Center of the National Institutes of Health (NIH), the International Training and Research in Environmental and Occupational Health (ITREOH) program. This article presents general aspects and considerations of short-term training and highlights guidelines drawn from specific experiences with such training activities in Balkan and Latin American countries.

Ochratoxin A concentrations in food and feed from a region with Balkan Endemic Nephropathy.

Balkan Endemic Nephropathy (BEN), a chronic renal disease of unknown aetiology, is found in geographically close areas of Bulgaria, Romania, Serbia, Croatia, Bosnia and Herzegovina, Slovenia, and the former Yugoslav Republic of Macedonia. Ochratoxin A (OTA), a secondary metabolite of Aspergillus and Penicillium species and a natural contaminant of food and feed, is a putative cause of BEN. Some studies have found a geographic covariation between OTA content in food/feed and BEN manifestation; others have not. In May 2000, using a competitive direct ELISA assay for OTA (detection limit 1 microg kg(-1)), we investigated OTA contamination in 165 samples of home-produced food (beans, potatoes, corn, wheat, flour) and feed from households in villages from the BEN region (Vratza district) of north-western Bulgaria. Samples were collected from: (a) BEN villages (n = 8), and therein from BEN households (20), and BEN-free households (16) (within-village controls, WVC households); and (b) BEN-free villages (7) and therein BEN-free households (22) (between-village controls, BVC). BEN households consistently had a higher proportion of OTA-positive samples than WVC households, but similar (for some foods) or lower (for other foods) proportions to BVC households. The proportion of OTA-positive samples was also higher in BVC than in WVC households. Furthermore, BEN households had a similar proportion of OTA-positive samples to the pooled, WVC and BVC, group of households. OTA-exposure estimates, derived from our OTA-concentration findings and the reported average per capita monthly consumption of basic foods in rural Bulgaria, showed the highest OTA intake in BEN households (1.21 microg day(-1)), versus 1.03 microg day(-1) in BVC and 0.71 microg day(-1) in WVC households. These OTA intakes are higher than those in the EU, and are close to the upper limits acceptable to several food-safety organizations. The results indicate that OTA may not alone cause BEN; only synergistically with other environmental toxicants and/or predisposing genotypes may do so.