Acceptable Risk Research Articles

Refined Cumulative Risk Assessment of Pb, Cd, and as in TCM Decoction Based on Bioavailability through In Vitro Digestion/MDCK Cells.

In this study, the oral bioavailability of Pb, Cd, and As in three types of traditional Chinese medicines (TCMs) and TCM decoctions were investigated through in vitro PBET digestion/MDKC cell model. Furthermore, a novel cumulative risk assessment model associated with co-exposure of heavy metal(loid)s in TCM and TCM decoction based on bioavailability was developed using hazard index (HI) for rapid screening and target organ toxicity dose modification of the HI (TTD) method for precise assessment. The results revealed that the bioavailability of Pb, Cd, and As in three types of TCM and TCM decoction was 5.32-72.49% and 4.98-51.97%, respectively. After rapid screening of the co-exposure health risks of heavy metal(loid)s by the HI method, cumulative risk assessment results acquired by TTD method based on total metal contents in TCMs indicated that potential health risks associated with the co-exposure of Pb, Cd, and As in Pheretima aspergillum (E. Perrier) and Oldenlandia diffusa (Willd.) Roxb were of concern. However, considering both the factors of decoction and bioavailability, TTD-adjusted HI outcomes for TCMs in this study were <1, indicating acceptable health risks. Collectively, our innovation on cumulative risk assessment of TCM and TCM decoction provides a novel strategy with the main purpose of improving population health.

Risk assessment of citrinin in Chinese dark tea and inhibitory effects of tea polyphenols on citrinin production

The fungus Penicillium citrinum (P. citrinum), which is found in Chinese dark tea, is involved in the production of citrinin (CIT), a secondary metabolite with renal toxicity. In this study, a rapid method was used to detect CIT in Chinese dark tea samples from different regions and years. Of the 216 samples tested, 5 were detected to have CIT contamination, with a concentration ranging from 272.43 ± 16.57 to 649.68 ± 62.16 μg kg−1. Risk assessment for consuming dark tea showed that four heavy intake consumer groups in the deterministic risk assessment had hazard quotients (HQ) > 1, and the HQ for the probabilistic risk assessment was significantly below the acceptable level of 1.0. Furthermore, we found that tea polyphenols (TPs) inhibited the growth of P. citrinum. Transcriptome results showed that there were 483 downregulated and 783 upregulated genes between the TPs and control groups. Of which, orf1 and ctnD were significantly downregulated, demonstrating that TPs can affect CIT biosynthesis. Our research indicates that CIT in dark tea is within an acceptable risk level, and provides new insights into the inhibition of CIT. Furthermore, this study suggests that the suppression of CIT in dark tea by polyphenols make the consumption of dark tea safe.

Pollution level and ecological risk assessment of triazine herbicides in Laizhou Bay and derivation of seawater quality criteria

Triazine herbicides are widely used in agriculture and have become common pollutants in marine environments. However, the spatiotemporal distribution characteristics and water quality criteria (WQC) of triazine herbicides are still unclear. This study found that triazine herbicides had a high detection rate of 100 % in surface seawater of Laizhou Bay, China, with average concentrations of 217.61, 225.13, 21.97, and 1296.72 ng/L in March, May, August, and October, respectively. Moreover, estuaries were important sources, and especially the Yellow River estuary exhibited the highest concentrations of 16,115.86 ng/L in October. The 10 triazine herbicides were detected in the sediments of Laizhou Bay, with a concentration ranging from 0.14−1.68 μg/kg. Atrazine and prometryn accounted for 33.41 %−59.10 % and 28.93 %−50.06 % of the total triazine herbicides in the seawater, and prometryn had the highest proportion (63.50 %) in the sediments. Correlation analysis revealed that triazine herbicides led to the loss of plankton biodiversity, which further decreased the dissolved oxygen. In addition, this study collected 45 acute toxicity data and 22 chronic toxicity data of atrazine, 16 acute toxicity data of prometryn, and supplemented with toxicity experiments of prometryn on marine organisms. Based on the toxicity database, the WQCs of atrazine and prometryn were derived using species sensitivity distribution. The overall risk probability of atrazine and prometryn were both less than 1.75 % in the Laizhou Bay, indicating an acceptable risk. This study not only clarified the pollution status and ecological risk of triazine herbicides, but also provided scientific basis for their environmental management standards.

Mastoid Fascia Tissue Graft as a Tip Camouflage Technique in Rhinoplasty: A Reliable Alternative to Soft Cartilage Grafts.

Traditional rhinoplasty tip grafts often lead to visibility issues, prompting patients to seek revision surgery. The mastoid fascia tissue graft (MFTG) provides a natural-looking alternative with an acceptable risk of complication. MFTG remains less visible through the skin and helps camouflage and conceal tip irregularities. This study of 193 patients examines MFTG's effectiveness in nasal tip refinement, evaluating revision and infection rates. A retrospective analysis of MFTG use for nasal tip aesthetics during open rhinoplasty in the senior author's practice was conducted from January 2019 to June 2022. Inclusion criteria encompassed open rhinoplasty cases using mastoid tissue for tip aesthetics with at least 12 months of follow-up. Among 2003 cases, 193 met these criteria and were evaluated for subsequent revision and infection rates. The average patient age was 34.2 years (175 females, 18 males). Primary rhinoplasties were done on 113 patients, with 80 receiving revision surgeries. Average follow-up was 14.8 months. 6 (3.1%) patients overall needed extended antibiotics, including 1 (0.9%) primary rhinoplasty and 5 (6.3%) secondary rhinoplasty patients. Overall, 6 (3.1%) patients required revision rhinoplasty, comprising of 1 (0.9%) primary and 5 (6.3%) secondary rhinoplasty patients. MFTG use for nasal tip aesthetics is a safe, convenient, and effective technique in camouflaging and concealing nasal tip contour irregularities in both primary and revision rhinoplasty. Use of MTFG is associated with minimal morbidity.

Comparison of NMHC measurements between 2010 and 2020 in Wuxi City, Yangtze River Delta region: Levels, compositions, sources, and impacts

Field observation analyses of volatile organic compounds (VOCs) have gained significant attention due to their potential explaining atmospheric temporal trends. This study measured non-methane hydrocarbons (NMHCs) in Wuxi City, located in the Yangtze River Delta (YRD) of China, in 2010 and 2020. The aim was to gain a better understanding of the ten-year change of VOCs in terms of their mixing ratios, sources, role in ozone, secondary organic aerosol (SOA) formation, and health risks. The average NMHC level 2020 was 20.67 ppbv, which indicated a 20% drop from 2010. A notable shift was observed in the chemical composition of NMHCs. The contribution of alkanes increased from 45% to 62% in 2020, while that of the aromatics decreased from 25% in 2010 to 21% in 2020. Ratio analysis and receptor modelling for 2010 and 2020 were used to identify the source changes of VOC species. The source apportionment model showed that the contribution of vehicle exhaust decreased from 34.5% to 20.9% from 2010 to 2020, and that of the solvent increased from 15.1% to 25.3%. The chemical reactivity results suggested that aromatics played significant roles in photochemical reactions in Wuxi City. The ozone formation potential (OFP) and SOA potential of VOCs also showed decreasing trends from 2010 to 2020. The total OFP of alkenes decreased by 34.0%, from 30.6 to 20.2 ppbvO3/ppbv. The total non-carcinogenic risk value for the key VOC species was 0.034 in 2010 and 0.024 in 2020. Although the carcinogenic risks for benzene have decreased significantly, the value is still above the acceptable carcinogenic risk level. The results of this study demonstrate the effectiveness of air pollution control measures in Wuxi City and highlight the positive impacts on reducing secondary pollution and health risks in this region over one decade.

Global prevalence and determinants associated with the acceptance of monkeypox vaccination.

Assessing the acceptance of the monkeypox vaccine is crucial for the success of vaccination programs, yet the prevalence reports remain inconclusive. The aim of this study was to determine the global prevalence of monkeypox vaccine acceptance and identify its associated factors. A meta-analysis was conducted with a comprehensive search strategy on the following databases, including Scopus, Embase, and PubMed, for articles published up to April 5, 2024. This study utilizes a single-arm meta-analysis to calculate the pooled prevalence of monkeypox vaccine acceptance. A Z-test was employed to identify factors associated with the vaccine acceptance. Our study analyzed 51 articles encompassing 98,746 participants, revealing an overall monkeypox vaccine acceptance rate of 65%. Notably, the highest acceptance rates were observed among men who have sex with men (MSMs), while healthcare workers (HCWs) showed the lowest acceptance rates. Additionally, our findings indicated an increased acceptance in individuals with educational attainment beyond a bachelor's degree, a history of COVID-19 and influenza vaccination, homosexual orientation, and HIV-positive status. Conversely, lower acceptance risk was associated with those with educational attainment below a bachelor's degree, heterosexual orientation, and bisexual orientation. In conclusion, our current study has determined the rate of monkeypox vaccine acceptance and identified its associated factors. These findings offer valuable insights as the foundation for targeted policies to manage and increase acceptance rates.

Effects of Government Incentives on Sales Growth of Selected Industrial Firms in South- East, Nigeria

The study focused on the effects of government incentives on sales growth of selected industrial firms in South-East, Nigeria. The objective of the study was to examine the effect of government incentives on sales growth of selected industrial firms in South-East, Nigeria: The significant effect of government incentives on sales growth of selected industrial firms in south east, Nigeria will require management of industrial firms to focus on most lucrative and productive government incentives to improve on their marketing performance. Incentives help firms generate economies of scale in production and they can manage to sell excess domestic capacity with government formulated policies and support with institutional knowledge transfer to facilitate SMEs to industrial development in South East Nigeria. Improved marketing performance of industrial firms in south east, Nigeria will also improve the contribution of industrial firms sector to the gross domestic product of the economy. This will also imply increased tax payment by the firms to government, which will in turn make revenue available for societal development. The study adopted survey research design The population of the study was 12100 selected industrial firms in South-East, Nigeria. A sample size of 387 (Three hundred and eighty-seven) was drawn from the population using Taro yamani statistical formula. One hypothesis was formulated and tested with Simple Linear Regression model.. The major findings in the study showed that: there is a significant effect of government incentive on sales growth of selected industrial firms in South-East, Nigeria; This study has formed a body of knowledge (reference material) which has closed the gap identified in literature and which can also be cited by both present and potential researchers. Results of the study provided direction for management of industrial firms with respect to which government incentive to adopt in order to improve on marketing performance as well as where and how to direct available resources.. Hence, we concluded that successful investments in R&amp;D result in innovative products and services that enable the company to improve its sales revenue. It implies that government subsidies can serve as effective catalyst that can boost the overall productivity of firms located within south east, thereby increasing their sales revenue and also their competitiveness We, therefore, recommended that firms in the south east zone should upgrade their activities relating to cost efficiency, quality, variety/diversification, responsiveness, acceptance of entrepreneurial risks, and a positive attitude towards change and innovation as prerequisites for surviving in a globalized market.

Optimal gestational weight change associated with improved perinatal outcomes in women with gestational diabetes mellitus: a population-based study in the United States

BackgroundOptimal gestational weight change (GWC) is little known among pregnant women with gestational diabetes mellitus (GDM). ObjectivesThis study aimed to explore the optimal GWC ranges for women with GDM and validate these ranges compared with the Institute of Medicine (IOM) guidelines. MethodsA population-based cohort study using natality data from the National Center for Health Statistics in the United States included 1,338,460 mother–infant pairs with GDM from 2014 to 2020. Poisson regression models were performed to identify GWC ranges (GDM targets) associated with acceptable risks (<10% increase) for a severity-weighted composite outcome including preterm birth (PTB) <37 wk, large for gestational age (LGA, birthweight >90th percentile) and small for gestational age (SGA, birthweight <10th percentile). These targets were validated in individual outcomes including PTB, LGA, SGA, hypertensive disorders of pregnancy, neonatal intensive care unit admission, and neonatal respiratory morbidity, and compared with the IOM guidelines using logistic regression models with population-attributable fractions (PAFs) calculated. ResultsThe severity-weighted composite outcome had a U-shaped or a J-shaped relationship with GWC across body mass index categories. The GDM targets were 14.1 to 20.3 kg, 9.0 to 17.0 kg, 4.8 to 13.8 kg, –0.8 to 10.8 kg, –2.4 to 8.2 kg, and –8.3 to 6.0 kg for underweight, normal weight, overweight, class 1 obesity, class 2 obesity, and class 3 obesity, respectively. GWC outside the GDM or the IOM targets was associated with increased adverse perinatal outcomes in validation analyses. PAFs indicated that the IOM guidelines reduced a similar or higher proportion of adverse perinatal outcomes compared with the GDM targets for women with GDM, except for those with class 2 and 3 obesity. ConclusionsThe IOM guidelines are generally applicable for women with GDM, except for women with moderate and severe obesity. The optimal GWC ranges for women with GDM and moderate to severe obesity may be lower than the IOM guidelines.

Development and internal validation of the Cleveland Clinic Bleeding Model to predict major bleeding risk at admission in medical inpatients

BackgroundGuidelines recommend pharmacologic VTE prophylaxis for acutely ill medical patients at acceptable bleeding risk, but only the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) model has been validated for bleeding risk assessment. ObjectivesWe developed and internally validated a risk assessment model (RAM) to predict major in-hospital bleeding using risk factors at admission and compared our model with IMPROVE. MethodsWe selected patients admitted to medical services at 10 hospitals in the Cleveland Clinic Health System from 2017 to 2020. We identified major bleeding according to the International Society on Thrombosis and Haemostasis criteria, using a combination of diagnostic codes and laboratory values, and confirmed events with chart review. We fit a least absolute shrinkage selection operator logistic regression model in the training set and compared the discrimination and calibration of our model with the IMPROVE model in the validation set. ResultsAmong 46 314 admissions, 268 (0.58%) had a major bleed. The final RAM included 16 risk factors, of which prior bleeding (odds ratio [OR] = 4.83), peptic ulcer (OR = 3.82), history of sepsis (OR = 3.26), and steroid use (OR = 2.59) were the strongest. The Cleveland Clinic Bleeding Model had better discrimination than IMPROVE (area under the receiver operating characteristics curve = 0.85 vs 0.70; P < .001) and, at equivalent sensitivity (52%), categorized fewer patients as high risk (7.2% vs 11.8%; P < .001). Calibration was adequate (Brier score = 0.0057). ConclusionUsing a large population of medical inpatients with verified major bleeding events, we developed and internally validated a RAM for major bleeding whose performance surpassed the IMPROVE model.

Working conditions and health effects of workers in a microware manufacturer of medical furniture, Maracay 2019

The present study aimed to determine the working conditions and health effects of the workers of a medical furniture manufacturing microenterprise. For this purpose, a quantitative and descriptive research was carried out, applied to 6 workers, the data collection technique was based on non-participant structured observation to know the work process and a structured interview in which the guide questionnaire was applied Colombian technique 450 to identify risk factors, their level and acceptability; To recognize the health effects, the questionnaire on risks and damages by Pere and Laurent was applied with the body diagram of pain. The hazardous work processes identified were: inadequate lighting, sharp objects, moving machines and tools, particle projection, welding smoke, wood dust, vibrations, gases and vapors, lifting and transporting loads, inappropriate positions. The risk factors identified were: physical and chemical with a level of risk III being acceptable, as well as dysergonomic and mechanical with a level of risk II being not acceptable, likewise the health conditions identified were injuries by accident, eye and respiratory problems and muscle aches, the most frequent areas of pain being legs, neck and lumbar region

Optimizing the management of multiple water resources in irrigation area under uncertainty: A novel scenario-based multi-objective fuzzy-credibility constrained programming model

Effective water resources management is vital for sustainable development, healthy ecosystems, stable socio-economic, and human well-being. However, managing water resources faces challenges due to the involvement of multiple stakeholders and uncertainties in various hydrologic fluxes. This complexity makes it rare for research to simultaneously address the hidden uncertainties in both objectives and constraints. Here, we developed a scenario-based multi-objective fuzzy-credibility constrained programming approach and applied it to the water resource management system (SMOFCP-WRMS) of the Zhaokou Yellow River Diversion Irrigation Area Phase II Project (ZKID-II). This method handles uncertainties represented by scenarios and fuzzy sets, while also resolving fuzzy uncertainty parameters within the multiple objectives and constraints of the model. We solve the SMOFCP-RWMS model by integrating the Nondominated sorting genetic algorithm III (NSGA-III) and compromise programming (CP) method. The results show that: (1) An increase in constraints violation risks (credibility level from 0.5 to 1.0) results in a decrease in water resources allocation and pollutant discharge by 25.95 × 106 m3 and 207.63 tonne, respectively, accompanied by a decline in net economic income by 68.04 × 106 CNY; (2) From extraordinary dry year to normal year (design frequencies from 95 % to 50 %) leads to a reduction in water shortage by 167.07 × 106 m3. Incorporating ‘credibility levels’ and ‘design frequencies’ would be beneficial for addressing uncertainties, including fuzzy information and discrete possibilities for the future; (3) Regarding the multi-objective model solution, the combined NSGA-III and CP approach demonstrates an average increase of 1.71 % in net economic benefits and 5.91 % in total pollution discharge, along with a 6.77 % reduction in the water deficit ration compared to the traditional CP method. Although the ecological benefits decrease slightly in the compromise-optimal solutions using the combined NSGA-III and CP method, the economic and social benefits are improved compared to those from the combined NSGA-II and CP method. This study provides valuable decision-making guidance for water resources managers in irrigated areas, aiding them in balancing economic, social, and ecological benefits, and enabling the section of an optimal water resources management scheme based on acceptable risk levels under various uncertain conditions.

Trace elements in the Upper Indus River Basin (UIRB) of Western Himalayas: Quantification, sources modeling, and impacts

This study conducted a comprehensive analysis of trace element concentrations in the Upper Indus River Basin (UIRB), a glacier-fed region in the Western Himalayas (WH), aiming to discern their environmental and anthropogenic sources and implications. Despite limited prior data, 69 samples were collected in 2019 from diverse sources within the UIRB, including mainstream, tributaries, and groundwater, to assess trace element concentrations. Enrichment factor (EF) results and comparisons with regional and global averages suggest that rising levels of Zn, Cd, and As may pose safety concerns for drinking water quality. Advanced multivariate statistical techniques such as principal component analysis (PCA), absolute principal component scores (APCS-MLR), Monte Carlo simulation (MCS), etc were applied to estimate the associated human health hazards and also identified key sources of trace elements. The 95th percentile of the MCS results indicates that the estimated total cancer risk for children is significantly greater than (>1000 times) the USEPA’s acceptable risk threshold of 1.0 × 10−6. The results classified most of the trace elements into two distinct groups: Group A (Li, Rb, Sr, U, Cs, V, Ni, TI, Sb, Mo, Ge), linked to geogenic sources, showed lower concentrations in the lower-middle river reaches, including tributaries and downstream regions. Group B (Pb, Nb, Cr, Zn, Be, Al, Th, Ga, Cu, Co), influenced by both geogenic and anthropogenic activities, exhibited higher concentrations near urban centers and midstream areas, aligning with increased municipal waste and agricultural activities. Furthermore, APCS-MLR source apportionment indicated that trace elements originated from natural geogenic processes, including rock-water interactions and mineral dissolution, as well as anthropogenic activities. These findings underscore the need for targeted measures to mitigate anthropogenic impacts and safeguard water resources for communities along the IRB and WH.

Integrating arsenic bioaccessibility uncertainty and human exposure variability for setting up site-specific remedial goals

Arsenic is a highly toxic soil contaminant, which is a major public concern. The universal health risk models and global efforts on deriving remedial goals for arsenic-contaminated soil have not yielded the desired or very satisfactory results. In this study, we developed a probabilistic risk-assessment method with a two-dimensional Monte Carlo simulation by integrating arsenic bioaccessibility uncertainty and human exposure variability. We found that arsenic bioavailability significantly varied in gastric (0.59–43.20%) and intestinal (0.72–44.22%) phases owing to arsenic fractions and total iron content. We showed that the mean carcinogenic risk at the 95th percentile was 7.64 × 10−5, exceeding the acceptable risk level (10−6), and the non-carcinogenic risk was 3.48, exceeding the acceptable risk level (1.0). Finally, we recommend 25.72 mg/kg as a remedial goal for the site based on this new approach. Overall, this study demonstrated that the improved method effectively mitigates the conservative nature of the existing regulatory approach. The improved approach helps prevent unnecessary remediation actions, supporting SDG 13 climate action by lowering pollutant and carbon emissions.

Microbial Health Risks of Cryptosporidium parvum and Giardia lamblia in Tropical Coastal Water in Araromi, Nigeria.

Giardia and Cryptosporidium are enteric protozoa that can cause a variety of gastrointestinal diseases, especially in vulnerable people like children, the elderly, and those with impaired immune systems. In order to ascertain the microbiological quality of the recreational water from Araromi Beach in Ilaje Local Government Area, Ondo State, Nigeria. This risk assessment is of great significance to human health protection against waterborne diseases. The aim of this study was to determine the microbial quality of recreational water from Araromi Beach in Ilaje Local Government Area, Ondo State, Nigeria. Microscopic examination of Cryptosporidium and Giardia oocysts were done. Results revealed maximum occurrence of Cryptosporidium parvum (20 oocysts/100 mL) of water sample in the month of April and maximum occurrence of Giardia lamblia (300 cysts/100 mL) of water sample in the month of June. Additionally, according to Kolmogorov-Smirnov tests for normalcy Ho =0.05, Giardia lamblia and Cryptosporidium parvum were not regularly distributed in the water samples collected from the beach throughout the study period. The average likelihood of contracting Giardia lamblia and Cryptosporidium parvum infections after consuming 100 mL of beach water was 0.96 and 0.35, respectively. The risks of infection associated with Cryptosporidium parvum was lower than those associated with Giardia lamblia in water from the beach, but were both above the acceptable risk limit of 10-4. The results of this study indicate that Giardia and Cryptosporidium may represent serious health hazards to people who engage in aquatic activities. Adopting a comprehensive strategy that includes regular inspections, enhanced detection techniques, and the prevention of aquatic environment pollution may provide clean and safe recreational water for all, thereby safeguarding the public's health.

Heavy metal concentrations in fishes from Zakrzówek Reservoir and the Vistula River near Kraków: Human risk assessment

Abstract The aim of this study was to compare tissue concentrations of heavy metals (copper (Cu), manganese (Mn), iron (Fe), nickel (Ni), zinc (Zn)) in roach (Rutilus rutilus (L.)), chub (Squalius cephalus (L.)), and bleak (Alburnus alburnus (L.)) from two locations on the Vistula River upstream from Kraków and Zakrzówek Reservoir, a former limestone quarry flooded over 30 years ago that is located close to the center of Kraków. The findings showed that heavy metal concentrations in fishes from the Vistula River upstream from Kraków were higher compared to those in fishes from Zakrzówek Reservoir. The highest heavy metal concentrations were found in hard tissues, such as bone and scales, and the lowest was in muscle tissue. Metal pollution index (MPI), estimated daily intake (EDI), target hazard quotient (THQ), and hazard index (HI) analyses showed no significant non-carcinogenic risk to human health from the consumption of the muscle meat of the fishes analyzed. Cancer risk (CR) values, calculated based on maximum Ni concentrations in fish muscle tissue, did not exceed the upper limit of the acceptable cancer risk range. The findings show that the assessment of heavy metal contamination of fishes should be continued and extended to include other water bodies used for fishing and other xenobiotics that accumulate in fishes and may pose risks to human health.

Analysis of THM formation potential in drinking water networks: Effects of network age, health risks, and seasonal variations in northwest of Iran

Various factors influence the formation of disinfection by-products (DBPs) in drinking water. Therefore, it is crucial to study the formation of DBPs and identify the associated influencing agents in water distribution networks (WDNs) to effectively prevent and control the health risks posed by DBPs. This research aimed to examine THM concentrations in the WDNs of Maragheh, Iran, focusing on seasonal variations. It also compared THM levels between new and old WDNs and assessed the health risks associated with exposure to THMs through various exposure routes. The mean concentrations of Chloroform, BDCM, DBCM, and Bromoform were 44.28 ± 18.25, 12.66 ± 5.19, 3.16 ± 0.89, and 0.302 ± 0.89 μg/L, respectively. Therefore, Chloroform was the predominant compound among the THM species, accounting for over 72 % of the total THMs (TTHMs). The average TTHMs concentration in summer (69.89 μg/L) was significantly higher than in winter (50.97 μg/L) (p < 0.05). Except for Bromoform, concentrations of other THM species in the new WDNs were considerably lower than in the old WDN (p < 0.05). The mean lifetime cancer risk (LTCR) rates for oral and dermal exposure routes to THMs were negligible and within acceptable risk levels. However, the LTCR mean values for inhalation exposure routes to THMs in winter and summer were within low (1 × 10−6 ≤ LTCR <5.1 × 10−5) and high acceptable risk levels (5.1 × 10−5 ≤ LTCR <10−4), respectively. Inhalation exposure presented the highest cancer risk among the various exposure routes. The hazard index values for oral and dermal contact with THMs were less than 1. Finally, sensitivity analysis revealed that the ingestion rate and exposure duration of THMs had the most significant positive effect on chronic daily intake (CDI) values and cancer risk. However, further comprehensive investigations are needed to develop effective solutions for reducing and controlling the precursors of DBP formation, as well as identifying suitable alternative disinfection compounds that minimize by-product formation.

Quantifying microbial risk from drinking water production process under changing climate and socio-economic conditions

Consumption of drinking water containing pathogenic microorganisms may pose serious health risks from waterborne diseases. Quantifying such risks is essential for guiding interventions and policy decisions. Quantitative microbial risk assessment (QMRA) is a very useful method to estimate the public's risk of infection from disease-causing microorganisms in water sources. QMRA of drinking water production process is limited worldwide and so far no such QMRA study has been conducted in Bangladesh. Moreover, climate and socio-economic changes may impact waterborne pathogens and associated health risks, but to what extent remains unclear, because comprehensive QMRA by taking into account combined impact of climatic and socio-economic factors has never been done worldwide so far. In this study, the Swedish QMRA tool was applied to evaluate public health risk from drinking water production process in Dhaka, Bangladesh as a case study. At first, current risk was quantified, and then the potential future risk was projected by taking into account climate and socio-economic factors. The results revealed that the annual infection risks at the current (2020s) baseline condition were below the acceptable risk threshold 10–4 infections per person per year (as proposed by several USEPA scientists) for all three pathogens Salmonella, norovirus and Giardia. However, after extreme events with sewer overflow and agricultural runoff, norovirus violates the acceptable risk thresholds, and the risks for Salmonella and Giardia are in borderline. The selected sustainable future scenario showed some improvement in terms of annual infection risks, while the uncontrolled scenario resulted in substantially higher infection risks both in the near and far future compared to the current scenarios. installment of a UV treatment step as an additional treatment barrier resulted in significant infection risk reduction. According to the sensitivity analysis results, socio-economic factors such as human population, livestock, and pathogen removal in wastewater were found to have greater influence on the infection risks, compared to climate change. The study can help policy makers and water managers to identify interventions to reduce the burden of disease on the population. The tool can be used to assess the health risk associated with drinking water production process in other areas of the world with similar characteristics.

A unified risk field-based driving behavior model for car-following and lane-changing behaviors simulation

The modeling of driving behavior is pivotal for the accurate simulation of traffic scenarios and for providing human-like decision-making of autonomous driving systems. Car-following (CF) and lane-changing (LC) behaviors are continuous maneuvers within traffic flow, generally modeled separately in the literature. The coherence between these two behaviors may be ignored, leading to unrealistic behavioral simulations. Therefore, this paper establishes a risk field-based driving behavior model for two-dimensional motion, ensuring coherent modeling of CF and LC behaviors under a unified framework. First, a risk quantification method is developed to calculate the risk in two-dimensional scenarios, accounting for risk over the preview time. A cubic polynomial is applied to generate path curves that align with vehicle dynamics. Second, the enhanced behavior model primarily comprises two integral components: path and trajectory planning. These two components aim to identify the path or trajectory that maximizes the benefit while meeting the desired risk. Third, the maximum acceptable risk, representing a higher risk than the desired risk, is defined to facilitate path adjustment and avoid frequent path adjustment. Finally, the proposed model is proved through comparisons with existing models using driving data. Several cases are employed for further analysis to show the model's rationality and potential in various aspects. This study develops the previous risk field-based behavior model from one-dimensional to two-dimensional scenarios, furnishes a unified framework for elucidating driving behavior in various scenarios, and contributes to the progress of behavior modeling.

Principles and elements of patient-centredness in mental health services: a thematic analysis of a systematic review of reviews

IntroductionMental health disorders, particularly depression and anxiety, are widespread globally and necessitate effective solutions. The patient-centred approach has been identified as a viable and effective method for addressing these challenges....

ANALYSIS OF RISK MANAGEMENT TERMINOLOGY IN EMPLOYEE HEALTH AND SAFETY MANAGEMENT SYSTEMS

An analysis of the main provisions and terms in accordance with domestic and international standards in the field of occupational health and safety of employees (hereinafter referred to as OSH) and risk management was carried out in order to avoid different interpretations in the draft Law on Occupational Safety and Health of Employees. To achieve this goal, the continuous sampling method, the descriptive method, the method of analyzing dictionary definitions, the method of word formation analysis, and the comparative method of component analysis were used. The study was conducted in four stages: analysis of the literature on occupational safety and health protection of workers; selection of terms for analysis; analysis of approaches to defining the concepts of "term", "terminology", analysis of lexical-semantic and structural features of terms; formation of general conclusions and prospects for further research. The justification of the change in the definitions of the main terms in OSH was carried out. It is proposed to present OSH at work as a part of the overall management system of the employer's activities, which is aimed at creating safe working conditions for employees and preserving their health by managing occupational risks. We recommend adding the concept of accident to the terms in the draft Law of Ukraine on occupational safety and health of workers, since the Procedure for Investigations and The Civil Protection Code of Ukraine defines the specified term. It is proposed to define occupational risk as a combination of the probability of occurrence of a work-related hazardous event(s) or exposure(s) and the severity of injury and health impairment that may be caused by this event(s) or exposure(s); occupational risk assessment as a process of comparing the results of occupational risk analysis with risk criteria to determine whether the occupational risk and/or its magnitude is acceptable (acceptable); occupational risk management is preventive and protective measures that reduce and/or modify (change) occupational risk to an acceptable (acceptable) level. The justification of the semantic load of the most used terms in the field of occupational safety and health protection of workers: risk, risk management, acceptable risk, dangerous event, incident was carried out for their qualitative use in the draft Law on Occupational Safety and Health of Workers. Recommendations for the description of terms and definitions for the draft Law of Ukraine on occupational safety and health of workers have been developed.