Childhood poisonings: Effects of ambiguous product characteristics on preschool children's categorization of household chemicals.

This study investigated preschool children's categorization and risk perception of products with ambiguous product characteristics (e.g., food-like packaging). These characteristics make it difficult for preschool children to categorize household chemicals correctly. This, therefore, increases the risk of unintentional poisoning. We hypothesized that ambiguity arises from different product characteristics, such as the type of packaging, the products' scent, or the packaging's color and transparency. In four behavioral tasks, N = 108 preschool children (M = 43 months, SD = 3) categorized different products and household chemicals with various types of packaging, colors, and scents. Individually wrapped dishwasher tablets were more likely to be categorized as edible than unwrapped ones. Furthermore, children who had interacted with any type of dishwasher tablet in the last 6 months performed better in identifying dishwasher tablets, regardless of packaging type. Household chemicals with a fruity scent were more likely to be categorized as drinkable than those with a chlorine scent. Finally, the children considered black bottles more dangerous and preferred them less than bottles of a different color. In contrast, bottle transparency generally did not seem to affect risk perception and preference. These findings confirm that ambiguous product characteristics influence children's categorization of unknown products and, thus, their risk perception and decision-making. Manufacturers and caregivers are advised to reduce the ambiguity of household chemicals by designing more neutral product packaging and choosing products with more neutral elements, respectively.

Pharmacokinetics and toxicity evaluation following oral exposure to bisphenol F.

Bisphenol F is a substitute material for bisphenol A and is widely used in household products as a raw material for polycarbonate resin, epoxy resin, and plastic reinforcement. It is known to be mainly used in food containers, thermal paper for receipts, and coatings for water pipes. In some countries, bisphenol F has been detected in drinking water and human urine samples. However, due to the lack of safety evaluation data on bisphenol F, it is difficult to establish appropriate guidelines for the proper use of the substance, and social anxiety is increasing accordingly. This study investigated the use, exposure route, and distribution flow of bisphenol F, a household chemical. To determine the no-observed-adverse-effect level (NOAEL) and target organ of bisphenol F after exposure, a single-dose oral toxicity, dose-range finding (28 day oral), repeated dose toxicity (90 day oral), and genotoxicity (reverse mutation, chromosomal abnormality, in vivo micronucleus test) tests were performed. The pharmacokinetic profile was also obtained. The test results are as follows: in the pharmacokinetic study, it was confirmed that single oral exposure to BPF resulted in systemic exposure; in single oral dose toxicity test, the approximate lethal dose was found to be 4000 mg/kg and confusion and convulsion was shown in the test animals; NOAEL was determined to be 2 mg/kg/day for male and 5 mg/kg/day for female, and the no-observed-effect level (NOEL) was determined to be 2 mg/kg/day for males and 1 mg/kg/day for females, and the target organ was the small intestine; genotoxicity tests confirmed that BPF does not induce genotoxicity.

Barriers to the safe use of chemical household products: A comparison across European countries.

Chemical household products, such as cleaning and washing products or pest control and garden chemicals, are frequently involved in poisonings in private households. Consumer research has identified a number of barriers that impede the safe use of these products, ranging from unfamiliarity, to misconceptions and a lack of risk perception, to behavioural or situational barriers. This study aimed at investigating these barriers for consumers in eight European countries. Participants from eight European countries were recruited and asked to fill out an online questionnaire on their familiarity with hazard pictograms, perceptions and self-reported behaviour (Total: N = 5631, Austria: N = 731, Switzerland: N = 698, Germany: N = 711, France: N = 708, Italy: N = 695, Poland: N = 693, Sweden: N = 682, UK: N = 713). Across all countries, the lowest consumer familiarity was found for the meaning of the pictogram for "health hazard" (65% indicated having never seen it before). Small-sized differences between the eight countries were observed regarding people's familiarity, perceptions and self-reported behaviour. The results suggest that people apply hazard-related as well as product- and marketing-related strategies to judge the dangerousness of a chemical household product. These findings suggest a number of starting points for risk regulation and communication regarding hazardous household chemical products. Further, the results suggest that positive outcome expectancies and rules of thumb for judging the risks of a chemical household product are particularly relevant for people's self-reported safe use of chemical household products.

Implications of Applying Minimal Risk Standards in Clinical Research to Information Provision in Prenatal and Pre-conception Care.

BACKGROUND: There have long been minimal risk thresholds beneath which risks may not need to be discussed in clinical research. This threshold concept may be applied to clinical practice. Our research explored application of minimal risk standards in research regulations to providing information in prenatal and pre-conception care. METHODS: A case study approach applied minimal risk standards in research regulations to prenatal and pre-conception care with respect to the risks of excess alcohol consumption, folic acid insufficiency, exposure to phthalate plasticizers, and exposure to brominated flame retardants (BFRs). RESULTS: Excess alcohol consumption and folic acid insufficiency were found to be above the minimal risk standards as outlined in research regulations, while exposure to phthalates and BFRs requires more evidence to determine whether they are above minimal risk. However, applying the minimal risk standard based on the daily life of a healthy adult or a fetus in a healthy pregnant woman, phthalates and BFRs are at the minimal risk threshold regardless of their potential harm since all pregnant women may be exposed to these chemicals in their daily life. Nevertheless, if there is demonstration of sufficient evidence of harm, they may be above minimal risk if such harm can be reduced by individual choice to avoid exposure. CONCLUSION: The minimal risk concept in research regulations as applied to clinical practice may be useful to help clinicians and professional organizations determine what risks need be discussed in prenatal and pre-conception care.

Pregnant Women's perceptions of exposure to brominated flame retardants.

BACKGROUND: Recent media reports on human studies associating brominated flame retardants (BFRs) in household products in pregnancy with urogenital anomalies in boys and endocrine disruption in both sexes. We sought to explore the perceptions of pregnant women of brominated flame retardant (BFR) exposure, in light of recent media reports on the adverse health effects of BFR exposure prenatally. METHODS: Pregnant women were recruited for interviews through posters and pamphlets in prenatal clinics, prenatal fairs and community centres. Interviews were audiotaped and transcribed verbatim for Charmaz-based qualitative analysis supported by NVIVO 10™. RESULTS: Theoretical sufficiency was reached after analyzing the interviews of 23 pregnant women. Themes co-constructed were: I-Lack of Awareness of BFRs; II-Factors Influencing BFR Exposure; III-Responsibility; IV-Informed Choice. Almost all participants felt it was difficult to make informed choices to avoid BFRs, and wanted communication from clinicians and regulation from governments regarding decreasing BFR exposure. CONCLUSION: Pregnant women in Canada may be unaware of the potential risks of exposure to BFRs. Professional organizations and governments should further study risk associated with BFR exposure in pregnancy and provide educational materials for pregnant women and clinicians regarding BFR exposure.

Avoiding unintentional injuries from household chemicals: Comparing the appeal to children from the perspectives of children, caregivers, and experts.

This study investigated whether caregivers and regulatory experts can predict the appeal of household chemicals for children and explored determinants of differences between adults' and children's child-appeal rating. We invited N = 95 4-year-old children and their caregivers to a laboratory study. Both independently ranked 16 household chemicals from the least to the most child-appealing product. In addition to the laboratory study, we sent an online adaptation of this ranking task to N = 46 experts involved in the monitoring and authorizing of household chemicals. Our findings show that the aggregated child-appeal rating of household chemicals was highly similar among caregivers, experts, and children. When comparing child-appeal ratings of household chemicals with and without child-appealing images, caregivers and experts did well in predicting which products might appeal to children. Finally, our findings show that the similarity between individual caregivers' and their own children's child-appeal ratings of household chemicals varied substantially. To conclude, although adults can assess the general child-appeal of household chemicals, they need to consider that the actual appeal of a household chemical can vary considerably among individual children. Instead of regulating specific product attributes, policymakers should prioritize educating caregivers about pitfalls and misconceptions that hinder effective injury prevention.

Protecting the children -a virtual reality experiment on consumers' risk perceptions of household chemicals.

Warnings on the labels of hazardous household chemicals (e.g. warning pictograms and use instructions) should create risk awareness and thus encourage safe storage, handling and disposal. However, scientific findings have called into question the effectiveness of warnings to prevent accidents, albeit mostly based on consumers' self-reports. This study aimed to contribute to existing data on household chemicals and consumer safety by applying a novel observational method using virtual reality (VR). The study participants (N = 119) were observed after receiving a task to childproof a virtual apartment from various interactable neutral and hazardous objects (i.e. knives, lighters and household chemicals with and without warnings) that were placed in the virtual apartment. For the analysis, the object placement (i.e. accessible or inaccessible to the children) and the level of interaction with the objects were coded, and the observational data were supplemented with data gathered through a questionnaire. The results showed that most hazardous household chemicals were moved to spots that were inaccessible to the children without any interactions of the participants with the warnings. Instead, they used their pre-existing knowledge and intuitive strategies to judge the objects' risks. These potentially misleading intuitive strategies should be increasingly considered in the regulation of hazardous household chemicals. This study also discussed the use and limitations of VR for the observation of human behaviour and decision making under uncertainty.

Metagenomic analysis of microbial communities and antibiotic resistance genes in spoiled household chemicals.

Numerous attempts have been utilized to unveil the occurrences of antibiotic resistance genes (ARGs) in human-associated and non-human-associated samples. However, spoiled household chemicals, which are usually neglected by the public, may be also a reservoir of ARGs because of the excessive and inappropriate uses of industrial drugs. Based upon the Comprehensive Antibiotic Research Database, a metagenomic sequencing method was utilized to detect and quantify Antibiotic Resistance Ontology (AROs) in six spoiled household chemicals, including hair conditioner, dishwashing detergent, bath shampoo, hand sanitizer, and laundry detergent. Proteobacteria was found to be the dominant phylum in all the samples. Functional annotation of the unigenes obtained against the KEGG pathway, eggNOG and CAZy databases demonstrated a diversity of their functions. Moreover, 186 types of AROs that were members of 72 drug classes were identified. Multidrug resistance genes were the most dominant types, and there were 17 AROs whose resistance mechanisms were categorized into the resistance-nodulation-cell division antibiotic efflux pump among the top 20 AROs. Moreover, Proteobacteria was the dominant carrier of AROs with the primary resistance mechanism of antibiotic efflux. The maximum temperature of the months of collection significantly affected the distributions of AROs. Additionally, the isolated individual bacterium from spoiled household chemicals and artificial mixed communities of isolated bacteria demonstrated diverse resistant abilities to different biocides. This study demonstrated that there are abundant microorganisms and a broad spectrum profile of AROs in spoiled household chemicals that might induce a severe threat to public healthy securities and merit particular attention.

Incidence and profile of acute intoxication among adult population in Najran, Saudi Arabia: A retrospective study.

Acute poisoning is considered one of the most important medical emergencies, resulting in severe morbidity and mortality, and is an economic burden on governments. This study aimed to determine the extent of acute adult intoxication among the population located in the Najran area, Saudi Arabia, over the last 3 years (from January 2017 to December 2019). The study is a hospital-based retrospective observational study. The data of all acutely intoxicated adult patients were collected from patients' files of King Khalid Hospital, the main hospital in the Najran area. In this study, the total number of intoxicated patients was 852. Patients were divided into three groups according to their age: 15-25 years, 26-35 years and >35 years. Accidental intoxication was predominant (64.6%), especially with therapeutic drugs (60.2%), predominantly acetaminophen and amphetamine, which intoxicated 24.5% and 23.4% of the patients, respectively. Moreover, this study showed that 10.6% of patients were intoxicated with overdoses of alcohol, mostly among patients aged over 35 years. Furthermore, the present study revealed that 23.9% of patients were intoxicated with household chemicals, especially Clorox bleach or Flash. Patients presented with a wide range of symptoms; some were even asymptomatic. Overall, patients' outcomes were good; mortalities were few (1.2%), and most fatalities were found in patients aged over 35 years (60%). The present study showed that pharmaceutical drugs constituted the most common causative agents in acute intoxication. Household chemicals, especially Clorox bleach, Flash and pesticides, are highly implicated in the acute toxicity problem. Drug abuse, especially amphetamine and alcohol, still represents a great threat facing people from the Najran region. It is crucial to deliver effective public health education programmes to increase community awareness about the predisposing risk factors of acute toxicity, whether as overdoses or suicide attempts.

Sociodemographic Characteristics and Risk Factors for Childhood Poisoning Reported by Parents at a Tertiary Care Teaching Hospital.

Background Childhood poisoning is a major health problem. Mostly, it is accidental and associated with low morbidity and mortality. The association between sociodemographic factors and childhood injury rates could be used for improvement to prevent and reduce such injuries. Childhood poisoning is preventable through appropriate education and judicious storage of drugs and household chemicals that might help in reducing and eliminating the accidental ingestion of toxic materials at home. Objectives To recognize the potential risk factors that might be associated with childhood home poisoning in Riyadh City, Kingdom of Saudi Arabia. Design A survey-based questionnaire study. Setting A tertiary care teaching hospital in Riyadh City. Patients and methods A structured questionnaire was created, which included questions on the poisoning incidence, home medication history, and possible risk factors for poisoning and the sociodemographic characteristics, and was disseminated to individuals who visited the King Khalid University Hospital. Main outcome measures Demographic characteristics of participants and risk factors related to childhood poisoning. Results The study included 152 randomly selected participants, 62 men (40.79%) and 90 women (59.21%). Self-ingestion was reported to be the most common mode of poisoning 28/44 (63.6%). The appearance of clinical manifestations suggesting poisoning was reported to be the most frequent method of discovery of children poisoning 20/44 (45.5%). Thirty-six out of the 44 respondents (81.8%) with a positive history of childhood poisoning in their family transferred their children to a hospital immediately. Drugs were the most common causative agent reported for poisoning among the respondents 21/44 (47.7%). Conclusion Accidental and non-intentional self-ingestion still presents as a major mode of childhood home poisoning. Despite the significant advancement in the lifestyle among the majority of Saudi Arabian regions, especially the capital city Riyadh, childhood poisoning remains a significant cause of morbidity and possible mortality. Creating health education and prevention programs might help to prevent such serious preventable problems. Limitations The limited number of participants may not reflect the whole population living in Riyadh City, hence, interpretation of the study results might be taken cautiously. Conflict of interest There was no conflict of interest.

Spatial variability of ecosystem exposure to home and personal care chemicals in Asia.

It is well recognized that there are currently limitations in the spatial and temporal resolution of environmental exposure models due to significant variabilities and uncertainties in model inputs and parameters. Here we present the updated Pangea multi-scale multimedia model based on the more spatially resolved, catchment-based hydrological HydroBASINS dataset covering the entire globe. We apply it to predict spatially-explicit exposure concentrations of linear alkylbenzene sulphonate (LAS) and triclosan (TCS) as two chemicals found in homecare (HC) and personal care (PC) products in river catchments across Asia, and test its potential for identifying/prioritizing catchments with higher exposure concentrations. In addition, we also identify the key parameters in the model framework driving higher concentrations and perform uncertainty analyses by applying Monte Carlo simulations on emissions and other non-spatial model inputs. The updated combination of Pangea with the HydroBASINS hydrological data represents a substantial improvement from the previous model with the gridded hydrological dataset (WWDRII) for modelling substance fate, with higher resolution and improved coverage in regions with lower flows, with the results demonstrating good agreement with monitored concentrations for TCS in both the freshwater (R2 = 0.55) and sediment (R2 = 0.81) compartments. The ranking of water basins by Predicted Environmental Concentrations (PECs) was similar for both TCS and LAS, with highest concentrations (Indus, Huang He, Cauvery, Huai He and Ganges) being one to two orders of magnitude greater than the water basins with lowest predicted PECs (Mekong and Brahmaputra). Emissions per unit volume of each catchment, chemical persistence, and river discharge were deemed to be the most influential factors on the variation of predicted PECs. Focusing on the Huang He (Yellow River) water basin, uncertainty confidence intervals (factor 31 for LAS and 6 for TCS) are much lower than the variability of predicted PECs across the Huang He catchments (factors 90,700 for LAS and 13,500 for TCS).

Effect of urine adulterants on commercial drug abuse screening test strip results.

Immunochromatographic strips for urine drug screening tests (UDSTs) are common and very suitable for drug abuse monitoring, but are also highly susceptible to adulterants kept in the household, which can significantly alter test results. The aim of this study was to see how some of these common adulterants affect UDST results in practice and whether they can be detected by sample validity tests with pH and URIT 11G test strips. To this end we added household chemicals (acids, alkalis, oxidizing agents, surfactants, and miscellaneous substances) to urine samples positive for amphetamine, 3,4-methylenedioxymethamphetamine (MDMA), tetrahydrocannabinol, heroin, cocaine, or benzodiazepines (diazepam or alprazolam) and tested them with one-component immunochromatographic UDST strips. The UDST for cocaine resisted adulteration the most, while the cannabis test produced the most false negative results. The most potent adulterant that barely changed the physiological properties of urine specimens and therefore escaped adulteration detection was vinegar. Besides lemon juice, it produced the most false negative test results. In conclusion, some urine adulterants, such as vinegar, could pass urine specimen validity test and remain undetected by laboratory testing. Our findings raise concern about this issue of preventing urine tampering and call for better control at sampling, privacy concerns notwithstanding, and better sample validity tests.

Early-life exposure to household chemicals and wheezing in children.

The prevalence of the asthmatic symptoms among children increases globally over the time. Reduced exposure to pathogens in early childhood and increased exposure to anthropogenic irritants result in increased risk of wheezing in children, and all of this may be related to the usage of household chemicals. Objective of this analysis thus was to study the potential effects of overall exposure to home chemicals in the early life on the phenotypes of wheezing from birth until five years of age. 3411 mother-infant pairs from the Czech part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC-CZ) participated in the study. The exposure was estimated by the composite household chemical score from 18 chemical-based products. Social, medical and environmental factors were taken into account as covariates in multivariable multinomial logistic regression using phenotypes of wheezing as a study outcome. We were able to determine the association between several wheezing childhood phenotypes and the frequent usage of household chemicals in the fully adjusted model. Statistically significant odds ratios (OR) for increasing exposures per 1 SD of exposure score were obtained for the intermediate onset transient (OR 1.27, 95% CI 1.10-1.47), intermediated onset persistent (OR 1.23, 95% CI 1.03-1.46), and early onset persistent phenotypes (OR 1.36, 95% CI 1.04-1.77) in comparison to never wheezing children. Moreover, the persistent phenotypes were significantly associated with school age asthma. Our study has shown the negative role of the increased household chemicals usage on the respiratory outcomes in children up to five years of age. Overall evaluation of the household chemical exposure may be useful tool for any large epidemiological studies.

Toxico-vigilance - An inevitable prerequisite to keep a watch on toxins around you.

India has got a handful of poison centers to compensate about 1.25 billion population of India. Hence, a lot of under-reporting of poisoning cases occurs due to limited resources. Gujarat being an upcoming industrial centre of India has got many key industries like textiles, automobiles, chemicals, diamonds, pharmaceuticals etc. This magnificent industrial growth has resulted upon increased exposure of various hazardous chemicals among the general and working population. This study reflects trends of poisoning observed in a poison center named Center For Education Awareness and Research On Chemicals and Health (CEARCH) at Ahmedabad. A retrospective study of around 659 cases were analytically analyzed which have been reported at CEARCH. Variables considered for analysis are age, gender, route of exposure, intention, agent group, agent subgroup and agent name. Out of which 274 cases of females, 384 cases were of males and one case of a transgender was reported. Maximum poisoning cases reported were of pesticides (57.35%) followed by pharmaceuticals (21.24%), industrial chemicals (6.22%), metals (5%), substance of abuse (3.94%), plant poisons (1.82%), household chemicals (1.36%), mixture of more than one agent (1.36%), herbicides (0.75%), animal poisons (0.45%), bacterial poisons (0.30%) and other poisons (0.15%). The data analysis reports that among all the routes of exposure, Oral route (94%) is the major route of exposure followed by inhalation (4%), dermal and injections respectively clearly emphasizing the need for appropriate steps towards the protection of the most vulnerable populations from the consequences of the pervasive poisons exposure.

Organic micropollutants in the Yangtze River: seasonal occurrence and annual loads.

Twenty percent of the water run-off from China's land surface drains into the Yangtze River and carries the sewage of approximately 400 million people out to sea. The lower stretch of the Yangtze therefore offers the opportunity to assess the pollutant discharge of a huge population. To establish a comprehensive assessment of micropollutants, river water samples were collected monthly from May 2009 to June 2010 along a cross-section at the lowermost hydrological station of the Yangtze River not influenced by the tide (Datong Station, Anhui province). Following a prescreening of 268 target compounds, we examined the occurrence, seasonal variation, and annual loads of 117 organic micropollutants, including 51 pesticides, 43 pharmaceuticals, 7 household and industrial chemicals, and 16 polycyclic aromatic hydrocarbons (PAHs). During the 14-month study, the maximum concentrations of particulate PAHs (1-5 µg/g), pesticides (11-284 ng/L), pharmaceuticals (5-224 ng/L), and household and industrial chemicals (4-430 ng/L) were generally lower than in other Chinese rivers due to the dilution caused of the Yangtze River's average water discharge of approximately 30,000 m(3)/s. The loads of most pesticides, anti-infectives, and PAHs were higher in the wet season compared to the dry season, which was attributed to the increased agricultural application of chemicals in the summer, an elevated water discharge through the sewer systems and wastewater treatment plants (WWTP) as a result of high hydraulic loads and the related lower treatment efficiency, and seasonally increased deposition from the atmosphere and runoff from the catchment. The estimated annual load of PAHs in the river accounted for some 4% of the total emission of PAHs in the whole Yangtze Basin. Furthermore, by using sucralose as a tracer for domestic wastewater, we estimate a daily disposal of approximately 47 million m(3) of sewage into the river, corresponding to 1.8% of its average hydraulic load. In summary, the annual amounts flushed by the Yangtze River into the East China Sea were 2.9×10(6)tons of dissolved and particulate organic carbon (DOC and POC), 369 tons of PAHs, 98 tons of pesticides, 152 tons of pharmaceuticals, and 273 tons of household and industrial chemicals. While the concentrations seem comparably moderate, the pollutant loads are considerable and pose an increasing burden to the health of the marine coastal ecosystem.