-
1.
Glyphosate's Synergistic Toxicity in Combination with Other Factors as a Cause of Chronic Kidney Disease of Unknown Origin.
Gunatilake, S, Seneff, S, Orlando, L
International journal of environmental research and public health. 2019;(15)
Abstract
Chronic kidney disease of unknown etiology (CKDu) is a global epidemic. Sri Lanka has experienced a doubling of the disease every 4 or 5 years since it was first identified in the North Central province in the mid-1990s. The disease primarily affects people in agricultural regions who are missing the commonly known risk factors for CKD. Sri Lanka is not alone: health workers have reported prevalence of CKDu in Mexico, Nicaragua, El Salvador, and the state of Andhra Pradesh in India. A global search for the cause of CKDu has not identified a single factor, but rather many factors that may contribute to the etiology of the disease. Some of these factors include heat stroke leading to dehydration, toxic metals such as cadmium and arsenic, fluoride, low selenium, toxigenic cyanobacteria, nutritionally deficient diet and mycotoxins from mold exposure. Furthermore, exposure to agrichemicals, particularly glyphosate and paraquat, are likely compounding factors, and may be the primary factors. Here, we argue that glyphosate in particular is working synergistically with most of the other factors to increase toxic effects. We propose, further, that glyphosate causes insidious harm through its action as an amino acid analogue of glycine, and that this interferes with natural protective mechanisms against other exposures. Glyphosate's synergistic health effects in combination with exposure to other pollutants, in particular paraquat, and physical labor in the ubiquitous high temperatures of lowland tropical regions, could result in renal damage consistent with CKDu in Sri Lanka.
-
2.
Neurotoxic effects of mercury exposure in dental personnel.
Bjørklund, G, Hilt, B, Dadar, M, Lindh, U, Aaseth, J
Basic & clinical pharmacology & toxicology. 2019;(5):568-574
-
-
Free full text
-
Abstract
Numerous studies have reported neurobehavioural effects in dental personnel occupationally exposed to chronic low levels of mercury (Hg). Hg exposure from dental work may also induce various chronic conditions such as elevation of amyloid protein expression, deterioration of microtubules and increase or inhibition of transmitter release at motor nerve terminal endings. Therefore, clinical studies of Hg toxicity in dentistry may provide new knowledge about disturbed metal homeostasis in neurodegenerative diseases such as Alzheimer's disease, multiple sclerosis and mood disorders. The purpose of this MiniReview is to evaluate the evidence of possible relevance between Hg exposure in dentistry and idiopathic disturbances in motor functions, cognitive skills and affective reactions, as well as dose-response relationships.
-
3.
Low-dose computed tomography screening for lung cancer in people with workplace exposure to asbestos.
Maisonneuve, P, Rampinelli, C, Bertolotti, R, Misotti, A, Lococo, F, Casiraghi, M, Spaggiari, L, Bellomi, M, Novellis, P, Solinas, M, et al
Lung cancer (Amsterdam, Netherlands). 2019;:23-30
Abstract
OBJECTIVES Smoking is the main risk factor for lung cancer, but environmental and occupational exposure to carcinogens also increase lung cancer risk. We assessed whether extending low-dose computed tomography (LDCT) screening to persons with occupational exposure to asbestos may be an effective way reducing lung cancer mortality. MATERIALS AND METHODS We conducted a nested case-control study within the COSMOS screening program, assessing past asbestos exposure with a questionnaire. LDCT scans of asbestos-exposed participants were reviewed to assess the presence of pulmonary, interstitial and pleural alterations in comparison to matched unexposed controls. We also performed an exhaustive review, with meta-analysis, of the literature on LDCT screening in asbestos-exposed persons. RESULTS Exposure to asbestos, initially self-reported by 9.8% of COSMOS participants, was confirmed in 216 of 544 assessable cases, corresponding to 2.6% of the screened population. LDCT of asbestos-exposed persons had significantly more pleural plaques, diaphragmatic pleural thickening and pleural calcifications, but similar frequency of parenchymal and interstitial alterations to unexposed persons. From 16 papers, including this study, overall lung cancer detection rates at baseline were 0.81% (95% CI 0.50-1.19) in asbestos-exposed persons, 0.94% (95% CI 0.47-1.53) in asbestos-exposed smokers (12 studies), and 0.11% (95% CI 0.00-0.43) in asbestos-exposed non-smokers (9 studies). CONCLUSION Persons occupationally exposed to asbestos should be monitored to gather more information about risks. Although LDCT screening is effective in the early detection lung cancer in asbestos-exposed smokers, our data suggest that screening of asbestos-exposed persons with no additional risk factors for cancer does is not viable due to the low detection rate.
-
4.
Spacecraft Maximum Allowable Concentrations for Manganese Compounds in Mars Dust.
Romoser, AA, Ryder, VE, McCoy, JT
Aerospace medicine and human performance. 2019;(8):709-719
Abstract
INTRODUCTION Exposure to excess manganese (Mn) can cause multiple toxicological outcomes in humans, most notably neurotoxicity. Ample epidemiological evidence suggests that chronic, low-level exposure causes subclinical cognitive effects. Because NASA astronauts will be exposed to Mars regolith, Spacecraft Maximum Allowable Concentrations (SMACs) were developed following an extensive literature review.METHODS Multiple databases were searched for information relevant to derivation of Mn SMAC values. An additional search for Mars dust data was performed. Risk assessment approaches were applied, including adjustments for space-relevant susceptibility to Mn effects, to develop limits for 1-h to 1000-d exposures. Rover data informed the assessment and enabled calculation of allowable total dust exposure based on Mn content.RESULTS Over 400 relevant sources were identified. Applicability of exposure characteristics and data collection methods influenced key study choice. SMACs ranging from 3 mg · m-3 (1 h) - 0.0079 mg · m-3 (1000 d) were set to protect primarily against neurocognitive and respiratory effects. Considering 0.38 wt% total Mn presence in the dust, maximum recommended total dust exposure should not exceed 790 mg · m-3 (1 h) - 2 mg · m-3 (1000 d).DISCUSSION This literature review allowed for identification of relevant studies to inform SMAC development. Manganese is one of several components to consider when developing an appropriate total dust limit for Martian dust; other dust elements may alter Mn bioavailability. Mission-specific activities may require alteration of assumptions regarding Mn dust concentration and exposure duration. However, based on expected toxicity of particulate matter itself, the acute SMACs are protective, even with transient exposure during activities that could produce higher concentrations.Romoser AA, Ryder VE, McCoy JT. Spacecraft maximum allowable concentrations for manganese compounds in Mars dust. Aerosp Med Hum Perform. 2019; 90(8):709-719.
-
5.
Acute Respiratory Failure from Cement Exposure: A Case Report and Review of the Literature.
Ali, S, Wightman, R, Hack, J
Rhode Island medical journal (2013). 2019;(1):55-57
Abstract
Cement is widely used in construction. Acute exposures with immediate sequelae have been infrequently described. This case report describes a man who developed multifocal pneumonitis with acute respiratory distress syndrome (ARDs) and respiratory failure one day after cement dust exposure. Chromium, cobalt, and nickel components in cement may cause pulmonary tissue irritation. Sand and gravel in cement may cause direct abrasive injury. Inhalation may cause direct thermal injury through an exothermic reaction. The silicon dioxide component has been shown to cause pulmonary injury through cytokine-mediated inflammation. Cement batches for smaller-scale construction jobs are often mixed onsite increasing exposure risk. Implementation of personal protective equipment has been shown to reduce respiratory symptoms among cement workers, underscoring the need for occupational health standards and further research. [Full article available at http://rimed.org/rimedicaljournal-2019-02.asp].
-
6.
Urinary concentrations of permethrin metabolites in US Army personnel in comparison with the US adult population, occupationally exposed cohorts, and other general populations.
Maule, AL, Scarpaci, MM, Proctor, SP
International journal of hygiene and environmental health. 2019;(3):355-363
Abstract
Permethrin is used to treat clothing as a personal protective measure against insect bites in military and recreational settings, and along with other pyrethroid insecticides, is sprayed in agricultural and residential sites for pest control. The widespread use of permethrin and other pyrethroid insecticides creates a potential for human exposure in occupational and non-occupational populations. This study aims to compare urinary biomarkers of pyrethroid exposure in two US military cohorts to the general US adult population from the 2009-2010 Nutritional Health and Nutrition Examination Survey (NHANES). Additional comparisons are made to previously published biomonitoring data from occupational and population cohort studies. Urine samples from two US military cohorts were analyzed for 3 permethrin metabolites: 3-phenoxybenzoic acid (3-PBA), and cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid (DCCA). Biomarker concentrations were adjusted for creatinine. Geometric means were calculated and then compared to creatinine-adjusted concentrations of 3-PBA and trans-DCCA in US adults (aged 20-59) using data collected as part of the 2009-2010 NHANES. Sex- and race-standardized geometric means were calculated separately for each of the US military groups using the demographic distributions from NHANES 2009-2010. Data from other military, occupational, and non-occupational population studies were extracted from the literature for further comparison. The two US military cohorts' geometric mean values, non-standardized and standardized, were markedly higher than what was observed in the general US adult population. Biomarkers of permethrin exposure were detected at a high frequency in military personnel wearing treated uniforms (90-100%). Detection rates of these biomarkers were similarly high in other studies of occupational exposure (67-100%) to pyrethroid insecticides. Adjusting for creatinine, the concentrations observed in the military groups were generally higher than levels seen in the general US adult population (NHANES, 2009-2010), other occupational groups (e.g., farmworkers, flight attendants, and pest control workers), and population cohorts from other countries.
-
7.
Health risk in transport workers. Part II. Dietary compounds as modulators of occupational exposure to chemicals.
Kozłowska, L, Gromadzińska, J, Wąsowicz, W
International journal of occupational medicine and environmental health. 2019;(4):441-464
Abstract
Professional drivers are exposed to a number of factors that have a negative influence on their health status. These include vibrations, noise, the lack of fresh air in the car cabin, shift work (frequently at night), monotony resulting from permanent repetition of certain actions, static loads due to immobilization in a sitting position, stress resulting from the need to ensure safety in heavy traffic, as well as air pollution (dust, volatile organic substances, nitrogen and sulfur oxides, polycyclic aromatic hydrocarbons, heavy metals, dioxins, furans and others). Factors associated with the specificity of the profession of a driver, including exposure to chemical substances, result in an increased risk of the development of many diseases, i.e., obesity, diabetes, heart disease, hypertension, extensive genitourinary pathology experienced by taxi drivers, lung cancer and other forms of cancer. In the case of drivers, especially those covering long distances, there are also actual difficulties related to ensuring a proper diet. Although attempts at interventional research that would change the principles of nutrition, as well as ensure physical activity and weight reduction, have been made, their results have not been satisfactory. The paper focuses on the discussion on the role of a diet and dietary phytochemicals in the prevention of adverse health effects of such chemicals as a mix of chemicals in the polluted air, benzo(a)pyrene, benzene and metals (lead, cadmium, chromium, nickel), which are the main sources of exposure in the case of transport workers. Int J Occup Med Environ Health. 2019;32(4):441-64.
-
8.
Progression of intervention-focused research for Gulf War illness.
Chester, JE, Rowneki, M, Van Doren, W, Helmer, DA
Military Medical Research. 2019;(1):31
Abstract
The Persian Gulf War of 1990 to 1991 involved the deployment of nearly 700,000 American troops to the Middle East. Deployment-related exposures to toxic substances such as pesticides, nerve agents, pyridostigmine bromide (PB), smoke from burning oil wells, and petrochemicals may have contributed to medical illness in as many as 250,000 of those American troops. The cluster of chronic symptoms, now referred to as Gulf War Illness (GWI), has been studied by many researchers over the past two decades. Although over $500 million has been spent on GWI research, to date, no cures or condition-specific treatments have been discovered, and the exact pathophysiology remains elusive.Using the 2007 National Institute of Health (NIH) Roadmap for Medical Research model as a reference framework, we reviewed studies of interventions involving GWI patients to assess the progress of treatment-related GWI research. All GWI clinical trial studies reviewed involved investigations of existing interventions that have shown efficacy in other diseases with analogous symptoms. After reviewing the published and ongoing registered clinical trials for cognitive-behavioral therapy, exercise therapy, acupuncture, coenzyme Q10, mifepristone, and carnosine in GWI patients, we identified only four treatments (cognitive-behavioral therapy, exercise therapy, CoQ10, and mifepristone) that have progressed beyond a phase II trial.We conclude that progress in the scientific study of therapies for GWI has not followed the NIH Roadmap for Medical Research model. Establishment of a standard case definition, prioritized GWI research funding for the characterization of the pathophysiology of the condition, and rapid replication and adaptation of early phase, single site clinical trials could substantially advance research progress and treatment discovery for this condition.
-
9.
The role of selected environmental factors and the type of work performed on the development of urolithiasis - a review paper.
Wróbel, G, Kuder, T
International journal of occupational medicine and environmental health. 2019;(6):761-775
Abstract
Urolithiasis is a disease of the genitourinary system, which is defined as the presence of urinary stones at any place in the urinary tract, resulting from the precipitation reaction of chemical compounds. The aim of this study is to demonstrate the important role of selected environmental factors (climate, ambient temperature) and the type of profession performed in the development of urolithiasis. In this field, the literature including original and review papers related to the epidemiology, pathogenesis and risk factors of urolithiasis was analyzed. The study used electronic databases such as Medline, Web of Science and Google Scholar. The prevalence of urolithiasis has increased in recent decades in both developed and developing countries. It is believed that this growing trend is associated with lifestyle changes such as the lack of physical activity, poor eating habits and global warming. Many factors are responsible for the formation of urinary stones. In literature, there is a division into individual and environmental factors. Today, external factors in the form of climate changes (global warming), geographical conditions and seasonal fluctuations, and the type of profession performed are becoming more and more important in the context of the occurrence of urinary stones. Currently, the presence of urolithiasis is becoming a significant problem all over the world and searching for causes is not easy, but particular attention should be paid to certain predispositions resulting from environmental factors, such as ambient temperature and the type of work performed. Int J Occup Med Environ Health. 2019;32(6):761-75.
-
10.
The emerging spectrum of exposure-related bronchiolitis.
Krefft, SD, Cool, CD, Rose, CS
Current opinion in allergy and clinical immunology. 2018;(2):87-95
Abstract
PURPOSE OF REVIEW Exposure-related bronchiolitis is increasingly recognized as an important but challenging clinical diagnosis. Acute and chronic inhalational exposures are associated with variable clinical presentations and a spectrum of histopathologic abnormalities affecting the small airways. This review provides an overview of the histologic patterns and occupational settings for exposure-related bronchiolitis, along with recent advances in disease diagnosis and management. RECENT FINDINGS The entire histopathologic spectrum of bronchiolitis (constrictive, obliterative, proliferative, lymphocytic, respiratory) has been reported in exposure-related bronchiolitis. Recent studies have shown that lung clearance index testing and impulse oscillometry are more sensitive than spirometry in detecting small airways abnormalities and may augment the diagnosis of occupational bronchiolitis. Prognosis in indolent occupational bronchiolitis appears more favorable than some other types of bronchiolitis but is variable depending on the extent of bronchiolar inflammation and the stage of disease at which exposure removal occurs. SUMMARY No specific histopathologic pattern of bronchiolitis is pathognomonic for occupational bronchiolitis as one or more histologic patterns may be present. A high index of suspicion is needed for exposure and disease recognition. Recent advances that may aid in diagnosis include transbronchial cryobiopsy, lung clearance index testing, and impulse oscillometry, although further research is needed.