Health Risk Characterization Research Articles

Cytotoxic Potencies of Zinc Oxide Nanoforms in A549 and J774 Cells.

Zinc oxide nanoparticles (NPs) are used in a wide range of consumer products and in biomedical applications, resulting in an increased production of these materials with potential for exposure, thus causing human health concerns. Although there are many reports on the size-related toxicity of ZnO NPs, the toxicity of different nanoforms of this chemical, toxicity mechanisms, and potency determinants need clarification to support health risk characterization. A set of well-characterized ZnO nanoforms (e.g., uncoated ca. 30, 45, and 53 nm; coated with silicon oil, stearic acid, and (3-aminopropyl) triethoxysilane) were screened for in vitro cytotoxicity in two cell types, human lung epithelial cells (A549), and mouse monocyte/macrophage (J774) cells. ZnO (bulk) and ZnCl2 served as reference particles. Cytotoxicity was examined 24 h post-exposure by measuring CTB (viability), ATP (energy metabolism), and %LDH released (membrane integrity). Cellular oxidative stress (GSH-GSSG) and secreted proteins (targeted multiplex assay) were analyzed. Zinc oxide nanoform type-, dose-, and cell type-specific cytotoxic responses were seen, along with cellular oxidative stress. Cell-secreted protein profiles suggested ZnO NP exposure-related perturbations in signaling pathways relevant to inflammation/cell injury and corresponding biological processes, namely reactive oxygen species generation and apoptosis/necrosis, for some nanoforms, consistent with cellular oxidative stress and ATP status. The size, surface area, agglomeration state and metal contents of these ZnO nanoforms appeared to be physicochemical determinants of particle potencies. These findings warrant further research on high-content "OMICs" to validate and resolve toxicity pathways related to exposure to nanoforms to advance health risk-assessment efforts and to inform on safer materials.

P19-21 Hazard characterization and quantification of health risk from chronic exposure to metofluthrin through contamination of the air environment of human life

P19-21 Hazard characterization and quantification of health risk from chronic exposure to metofluthrin through contamination of the air environment of human life

Compositional-geochemical characterization of lead (Pb) anomalies and Pb-induced human health risk in urban topsoil.

Urban areas are characterized by a constant anthropogenic input, which is manifested in the chemical composition of the surface layer of urban soil. The consequence is the formation of intense anomalies of chemical elements, including lead (Pb), that are atypical for this landscape. Therefore, this study aims to explore the compositional-geochemical characteristics of soil Pb anomalies in the urban areas of Yerevan, Gyumri, and Vanadzor, and to identify the geochemical associations of Pb that emerge under prevalent anthropogenic influences in these urban areas. The results obtained through the combined use of compositional data analysis and geospatial mapping showed that the investigated Pb anomalies in different cities form source-specific geochemical associations influenced by historical and ongoing activities, as well as the natural geochemical behavior of chemical elements occurring in these areas. Specifically, in Yerevan, Pb was closely linked with Cu and Zn, forming a group of persistent anthropogenic tracers of urban areas. In contrast, in Gyumri and Vanadzor, Pb was linked with Ca, suggesting that over decades, complexation of Pb by Ca carbonates occurred. These patterns of compositional-geochemical characteristics of Pb anomalies are directly linked to the socio-economic development of cities and the various emission sources present in their environments during different periods. The human health risk assessment showed that children are under the Pb-induced non-carcinogenic risk by a certainty of 63.59% in Yerevan and 50% both in Gyumri and Vanadzor.

Heavy metals and trace minerals in commonly available shark species from North East Arabian Sea: A human health risk perspective

Shark is a seafood commodity that is a good source of minerals and accumulates heavy metals and trace elements through biomagnification, which can pose health risk if taken above the permissible limit. A study was conducted on commonly landed eleven shark species (Scoliodon laticaudus, Rhizopriodon oligolinx, Sphyrna lewini (CR), Carcharhinus macloti, Carcharinus limbatus, Carcharhinus amblyrhynchoides, Carcharhinus sorrah, Carcharinus falciformes(VU), Glaucostegus granulatus, Chiloscyllium arabicum, Loxodon macrorhinus) and analyzed for their heavy metal content, Hazard Index, Total Hazard Quotient, Metal Pollution Index, and also calculated the health risk associated with the consumption. Most of the heavy metals and trace minerals were found to be within the acceptable limit. The Targeted Hazard Quotient (THQ) and the Hazard Index (HI) of all the species except two were less than 1 (HI ≤ 1.0). The Metal Pollution Index (MPI) is showing either no impact or very low contamination. An overall study on hazard identification and health risk characterization in terms of heavy metals shows contamination of some heavy metals in sharks, but there is no potential human health risk associated with consumption.

Hydrochemical characterization and assessment of health risks of trace elements in the Huai River Basin of China.

Basin water pollution is a global problem, especially in the densely populated areas. The Huai River Basin (abbreviated as HRB), including the Huai River system and the Yishu River system, is the sixth-largest and most densely populated watershed in China. However, there is a lack of comprehensive studies of river and well water throughout the Huai River basin, including hydrochemistry characterization and assessment of health risks. This study investigated water quality and pollution sources of river and well water in the HRB based on the hydrochemistry analysis and different water quality indices. The water body in the HRB showed weak alkalinity (pH = 8.4 ± 0.7) and had high TDS values (TDS = 339 ± 186mg/L) with water types of HCO3-Ca-Mg and SO4-Cl-Ca-Mg in the Huai River system, and SO4-Cl-Ca-Mg in the Yishu River system. Atmospheric input and evaporation had less impact on hydrochemistry. Evaporite dissolution and carbonate weathering had a greater impact on hydrochemistry. Carbonate precipitation and cation exchange also influenced the dissolved solutes, especially Ca2+ and Na+. Samples had low to medium salinity hazards and sodium absorption ratios and were suitable for irrigation. For drinking purposes, samples were fresh water and have good or excellent according to the Water Quality Index (WQI). Land use types influenced water quality with the worst river water quality from cropland. Combining different assessment indices, the water quality of the Yishu River system performed betterthanthe Huai River system. Absolute principal component analysis-multiple linear regression and the positive matrix factorization models identified the main pollutants as As, Ba, Cr, Ni, and Mn, with natural sources of As, Ba, and Ni and anthropogenic inputs of Cr, and Mn. Although the water quality of the HRB has improved in recent years, high potential risk from As, Cr, Mn, Ba, and Ni should be noted. This study provided vital information for basin hydrochemistry analysis and water quality assessment.

Health risk assessment and characterization of PM2.5 bound bioaerosols at the municipal solid waste landfill site of Nagpur, India

Landfill being the reservoir of organic waste, serves as the most important source in the generation and emission of bioaerosols in the environment, and these bioaerosols have a significant impact on the environment and public health. In India, there are limited studies on the characterization of culturable bacteria and fungi in the bioaerosols originating from landfills. Therefore, the present study aimed to quantify and identify the bioaerosols and study their characteristics at a landfill site in Nagpur, India. The study describes the seasonal variation of PM2.5, PM2.5-associated bacteria and fungi in the landfill air, their molecular identification, antibiotic resistance, pathogenicity, dispersion and health risk assessment during winter and pre-monsoon seasons at the landfill site and surrounding residential sites in upwind and downwind directions. The study showed PM2.5 concentration was highest in the winter season (265.56 μg/m3) followed by the pre-monsoon season (173.1 μg/m3) at the landfill site. The culturable bioaerosol level was also significantly higher in winter (11056 CFU/m3) in comparison to pre-monsoon season (2244 CFU/m3) at the landfill site. Upon isolating and characterizing the microorganisms in the bioaerosols, some of the bacterial isolates, like Bacillus, Staphylococcus gallinarum, and Streptomyces speibonae were found to be resistant to chloramphenicol, netillin, nitrofurantoin, streptomycin etc. About 30% of the bacterial isolates were found to show β-hemolytic virulence activity. This indicated the presence of multi-drug resistant and potentially pathogenic bacteria in the bioaerosols over the landfill. The health risk assessment in adults indicated that the workers at the landfill site were at risk of bacterial aerosol in the winter season (hazard quotient i.e., HQ>1). The impact of bioaerosols on children needs to be investigated in the further studies and regular monitoring of bioaerosols is suggested to avoid any morbidity. To the best of our knowledge, this is the first study on the characterization of microorganisms from the bioaerosols over an open landfill site in India.

Environmental Health Risk Analysis of Sulfur Dioxide (SO2) Inhalation Exposure in Ambient Air Among the Tirtonirmolo Community, Bantul.

Introduction: Sulfur dioxide (SO2) is one of the gases that can pollute the ambient air and cause respiratory irritation. This study aims to determine the characterization of health risk and risk management of sulfur dioxide (SO2) exposure to prevent health impact in the Tirtonirmolo community, Bantul. Methods: This study was a quantitative descriptive research with an Environmental Health Risk Analysis (EHRA) approach. The study subjects were the Tirtonirmolo community in Bantul, with a sample of 110 respondents. The sampling method uses purposive sampling. Results and Discussion: Most respondents are female (74%) with ages over 54 years (52%), and the majority work as housewives (44%). The description of EHRA variables consists of an inhalation rate of 0.83 m3/hour, exposure time of 22 hours/day, exposure frequency of 354 days/year, and exposure duration for real-time projections of 35 years and 30 years for lifetime projections. The SO2 measurement results did not exceed the national quality standard, with the highest concentration being on Madukismo Road, with a concentration of 11.72 μg/m3. The dose-response analysis uses data from the US-EPA, which is 0.026 mg/kg/day. The real-time average intake value is 0.0039 mg/kg/day, and the 30-year lifetime average intake value is 0.0033 mg/kg/day. Conclusion: All respondents from this study had an RQ value<1, both in the RQ for real-time and lifetime. Risk management needs to reduce health risk by using masks when doing outdoor activities and installing Flue Gas Desulfurization (FGD) in factories that emit SO2 emissions.

Fungal profile, levels of aflatoxin M1, exposure, and the risk characterization of local cheese ‘wagashi’ consumed in the Ho Municipality, Volta Region, Ghana

Wagashi is a West African type cottage cheese locally prepared from cow milk. Wagashi like other milk products, is prone to microbial contamination, particularly by fungi. Many of these fungal species produce mycotoxins which are of serious public health concern. This work aimed to update the mycoflora profile and determine the concentrations of aflatoxin M1 and its health risk characterization due to the consumption of wagashi. Culturing the wagashi on mycological media (Oxytetracycline Glucose Yeast Extract OGYE, Dichloran Rose Bengal Chloramphenicol DRBC) caused a de-novo growth of the quiescent spores at 28–30 °C for 5–7 days. The analysis of AFM1 levels in the samples was done using High-Performance Liquid Chromatography connected to a Fluorescence detector (HPLC-FLD). The exposure and risk assessment to the AFMI levels were determined using deterministic models prescribed by the European Food Safety Authority (EFSA). The fungal counts ranged between 2.36–4.30 log10 CFU/g. In total, thirteen (13) fungal species from eight (8) genera were isolated from all wagashi samples. They are; Fusarium oxysporum, Aspergillus flavus, Aspergillus niger, Fusarium verticillioides, Penicillium digitatum, Trichoderma harzianum, Aspergillus terreus, Rhodotorula mucilaginosa, Rhizopus stolonifer, Aspergillus fumigatus, Yeast sp., Mucor racemosus and Fusarium oligosporum belonging to the genera Fusarium, Aspergillus, Penicillium, Trichoderma, Rhodotorula, Rhizopus, Yeast, and Mucor. The AFM1 observed in the wagashi samples' analysis was low, ranging from 0.00 (Not Detected) ± 0.00 − 0.06 ± 0.002 µg/Kg. Risk assessments of AFM1 using deterministic models produced outcomes that ranged between 5.92 × 10−3- 0.14 ng/kg bw/day, 1.42 –44.35, 0–0.0323 ng aflatoxins/kg bw/day, and 1.51 × 10−3 − 9.69 × 10−4 cases/100,000 person/yr for estimated daily intake (EDI), margin of exposure (MOE), average potency, and cancer risks, respectively, for the age categories investigated. Fungal counts were interpreted as medium to high. It was also established that the consumption of wagashi may pose adverse health effects on all age categories in the selected zones of the study since all calculated MOE values were less than 100,000.

Occurrence of PBDEs in car and airplane dust in Poland – exposure assessment and health risk characterization for selected age ranges

Occurrence of PBDEs in car and airplane dust in Poland – exposure assessment and health risk characterization for selected age ranges

Health Risk Characterization due to Organochlorine Pesticide Exposure, in Women from Northern Mexico

Health Risk Characterization due to Organochlorine Pesticide Exposure, in Women from Northern Mexico

Potentially harmful elements released by volcanic ash of the 2021 Tajogaite eruption (Cumbre Vieja, La Palma Island, Spain): Implications for human health

This study assesses the potential impacts on human health of volcanic ash emitted during the 2021 Tajogaite eruption (La Palma Island, Spain). Ash samples were physically and chemically characterized and leaching tests (with deionized water and acidic solution) were performed according to the IVHHN protocols to elucidate i) the leachable elements that may affect water quality and represent a potential threat for livestock and humans through drinking water supply; and ii) the bioaccessible fraction of toxicants able to be solubilized from ash surfaces if ashes are incidentally ingested by children. The most abundant readily water-soluble compounds were SO4, F, Cl, Na, Ca, Ba, Mg, and Zn. Fluoride and chloride (up to 1085 and 1347 mg/kg) showed higher values in distal ash samples than closer ones. The potential F availability assessed from water leachates may suggest important environmental and health implications. In addition, long-term health hazard due to a long–term weathering of tephra deposits should be possible as confirmed by the greater amount of F extracted by acidic solution. Concentration of other trace elements (e.g., As, V, Mn, Mo, Cr, Fe, Se, Ti, Pb) were low compared to global medians and within the range globally assessed. Indicative calculation of hazard for water supply showed that F concentration may exceed both the recommended value (1 mg/L) for irrigation purpose and the health-based drinking water limits of 1.5 mg/L (for humans) and 2 mg/L (for livestock). If the predicted concentrations in water were compared with the toxicologically dose, F showed a potential health-risk for children through drinking water. The indicative health-risk characterization via accidental ash ingestion showed that the direct exposure does not represent a primary source of F daily intake for children. This important outcome confirmed F as element with the greatest health threat during Tajogaite 2021 eruption.

Modelling spatiotemporal distributions of Vulcanodinium rugosum and pinnatoxin G in French Mediterranean lagoons: Application to human health risk characterisation

Consumption of seafood contaminated by phycotoxins produced by harmful algae is a major issue in human public health. Harmful algal blooms are driven by a multitude of environmental variables; therefore predicting human dietary exposure to phycotoxins based on these variables is a promising approach in health risk management. In this study, we attempted to predict the human health risks associated with Vulcanodinium rugosum and its neurotoxins, pinnatoxins (PnTXs), which have been regularly found in Mediterranean lagoons since their identification in 2011. Based on environmental variables collected over 1 year in four Mediterranean lagoons, we developed linear mixed models to predict the presence of V. rugosum and PnTX G contamination of mussels. We found that the occurrence of V. rugosum was significantly associated with seawater temperature. PnTX G contamination of mussels was highest in summer but persisted throughout the year. This contamination was significantly associated with seawater temperature and the presence of V. rugosum with a time lag, but not with dissolved PnTX G in seawater. By using the contamination model predictions and their potential variability/uncertainty, we calculated the human acute dietary exposures throughout the year and predicted that 25% of people who consume mussels could exceed the provisional acute benchmark value during the warmest periods. We suggest specific recommendations to monitor V. rugosum and PnTX G.

Spatio-temporal assessment of water quality of a tropical decaying river in India for drinking purposes and human health risk characterization.

River water pollution and water-related health problems are common issues across the world. The present study aims to examine the Jalangi River's water quality to assess its suitability for drinking purposes and associated human health risks. The 34 water samples were collected from the source to the mouth of Jalangi River in 2022 to depict the spatial dynamics while another 119 water samples (2012-2022) were collected from a secondary source to portray the seasonal dynamics. Results indicate better water quality in the lower reach of the river in the monsoon and post-monsoon seasons. Principal component analysis reveals that K+, NO3-, and total alkalinity (TA) play a dominant role in controlling the water quality of the study region, while, CaCO3, Ca2+, and EC in the pre-monsoon, EC, TDS, Na+, and TA in the monsoon, and EC, TDS and TA in the post-monsoon controlled the water quality. The results of ANOVA reveal that BOD, Ca2+, and CaCO3 concentrations in water have significant spatial dynamics, whereas pH, BOD, DO, Cl-, SO42-, Na+, Mg2+, Ca2+, CaCO3, TDS, TA, and EC have seasonal dynamics (p < 0.05). The water quality index depicts that the Jalangi River's water quality ranged from 6.23 to 140.83, i.e., excellent to unsuitable for drinking purposes. Human health risk analysis shows that 32.35% of water samples have non-carcinogenic health risks for all three groups of people, i.e., adults, children, and infants while only 5.88% of water samples have carcinogenic health risks for adults and children. The gradual decay of the Jalangi River coupled with the disposal of urban and agricultural effluents induces river pollution that calls for substantial attention from the various stakeholders to restore the water quality.

Extending Multi-Pathway Human Health Risk Assessment from Regional to Country-Wide—A Case Study on Kuwait

Air pollution has emerged as a pressing global issue in recent decades. While criteria pollutants and greenhouse gases contribute to the problem, this article explicitly addresses hazardous air pollutants (HAPs). This work estimates the country-wide cumulative human health impacts from exposure to HAPs. Kuwait is used as the case study due to data availability and non-fragmentation of data. At present, the evaluation of multi-pathway human health risks arising from exposure to HAPs is incomplete, as indirect pathways have not been considered. Furthermore, only a few HAPs, such as benzene, have established ambient air quality standards specifically intended to safeguard human health, leaving many HAPs unregulated. This study considers several pathways (both direct and indirect) and various environmental media (air, water, plants, soil, and animal tissue). The findings indicate that cumulative health risks in the coastal air quality zone are within acceptable limits but are notably higher when compared to the other air quality zones. For cancer risks, only the Ahmadi Hospital, with a cancer risk of 1.09 × 10−5 for the resident adult exposure scenario, slightly exceeds the acceptable risk level of 1 × 10−5. The proposed methodology integrates the results from a country-wide emissions inventory composed of different air quality zones, air dispersion and deposition modeling, multi-pathway transport-and-fate analysis, exposure quantification, and health risk and hazard characterization. It also extends and adapts EPA methodologies initially designed for hazardous waste combustion facilities to additional emission sources and provides a case study for a region seldom subjected to such human health risk assessments.

Mental Health Assessment and Risk Characterization in Puerto Rico’s Homeless Post-Hurricane Maria

ABSTRACT This study provides a mental health assessment of the homeless of Puerto Rico, compared to a non-homeless sample, in the aftermath of Hurricane Maria. Multi-stage sampling was used to assess risk of anxiety, depression, and PTSD, as well as provide a demographic profile of the homeless and non-homeless of Puerto Rico. The homeless, compared to non-homeless, had a significantly higher risk for all tested mental disorders. Pre-hurricane homeless had significantly higher risk for Major Depressive Disorder and severe mood and anxiety disorders compared to post. This study highlights the need for disaster preparedness strategies specific to this disproportionately affected population.

Toxicogenic fungal profile, Ochratoxin A exposure and cancer risk characterization through maize (Zea mays) consumed by different age populations in the Volta region of Ghana

Maize (Zea mays) is an important staple food crop for the majority of Ghanaians. Maize is mostly contaminated by fungal species and particularly mycotoxins. This work aimed to identify and quantify the incidence of fungal infection and exposure to Ochratoxin A (OTA) as well as the health risk characterization in different age populations due to maize consumption in the Volta region. Maize samples were plated on Dichloran Rose Bengal Chloramphenicol (DRBC) agar, and Oxytetracycline Glucose Yeast Extract (OGYE) agar. All media were prepared in accordance with the manufacturers' instructions. The plates were incubated at 28±2°C for 5-7 days. High-Performance Liquid Chromatography connected to a fluorescence detector (HPLC-FLD) was used to analyze the ochratoxin A (OTA) levels in maize. Cancer risk assessments were also conducted using models prescribed by the Joint FAO/WHO Expert Committee on Additives (JECFA). The maize samples collected from the Volta region contained fungal population between the range of 3.08-4.58 log10CFU/g. Eight (8) genera were recorded belonging to Aspergillus, Trichoderma, Penicillium, Fusarium, Saccharomyces, Mucor, Rhodotorula and Rhizopus. The species diversity includes A. flavus, A. niger, T. harzianum, P. verrucosum, F. oxysporum, Yeast, F. verticillioides, Rhodotorulla sp, A. fumigatus, R. stolonifer, M. racemosus species. Additionally, the ochratoxins level contained in the samples were very noteworthy and ranged from 1.22 to 28.17 μg/kg. Cancer risk assessments of OTA produced outcomes also ranged between 2.15 and 524.54ng/kgbw/day, 0.03-8.31, 0.0323, and 0.07-16.94 for cases/100,000 person/yr for Estimated Daily Intake (EDI), Margin of Exposure (MOE), Average Potency, and Cancer Risks respectively for all age categories investigated. There was very high mycoflora load on the maize sampled from the Volta region, likewise the range of mycotoxins present in the maize grains, suggesting the potential to pose some adverse health effects with the populace of the Volta region.

Incorporating oral, inhalation and dermal bioaccessibility into human health risk characterization following exposure to Chromated Copper Arsenate (CCA)-contaminated soils

Exposure to potentially toxic metal(loid)s (PTMs) in soil may happen via ingestion, inhalation, and dermal pathway. A more accurate risk characterization should consider PTM bioavailability. Using ten soil samples collected in the Montreal area (Canada) near CCA-treated utility poles, this study aims to characterize non-carcinogenic and carcinogenic human health risks associated with As, Cr, Cu, Pb, and Zn through a multi-pathway exposure approach. This innovative study incorporates, for the first time, the bioaccessible fraction of the metal(loid)s for three exposure routes and two different scenarios. For the residential and industrial scenarios, the oral and dermal pathways yielded a hazard index (HI) much higher than 1 with and without bioaccessibility considerations (range 1.7 – 349 without bioaccessibility and 0.8–134 with bioaccessibility), whereas the inhalation pathway caused a lower hazard (HI < 1). For the dermal pathway, the hazard quotient was higher when bioaccessibility of field-collected samples was considered due to inherent assumptions from the US EPA soil approach to calculate the dermal dose. For carcinogenic risk, As and Pb were the most significant contributors to risk for the oral pathway, followed by the same elements for the dermal pathway. The overall carcinogenic risk was higher than the acceptable risk ( > 10−4) with and without bioaccessibility considerations (range 1.9E-4 – 9.6E-3 without bioaccessibility and 6.8E-5 – 3.8E-3 with bioaccessibility). Bioaccessibility tests provide a more accurate assessment of exposure to PTMs compared to total concentrations in soils.

Using transcriptomics, proteomics and phosphoproteomics as new approach methodology (NAM) to define biological responses for chemical safety assessment

Omic-based technologies are of particular interest and importance for hazard identification and health risk characterization of chemicals. Their application in the new approach methodologies (NAMs) anchored on cellular toxicity pathways is based on the premise that any apical health endpoint change must be underpinned by some alterations at the omic levels. In the present study we examined the cellular responses to two chemicals, caffeine and coumarin, by generating and integrating multi-omic data from multi-dose and multi-time point transcriptomic, proteomic and phosphoproteomic experiments. We showed that the methodology presented here was able to capture the complete chain of events from the first chemical-induced changes at the phosphoproteome level, to changes in gene expression, and lastly to changes in protein abundance, each with vastly different points of departure (PODs). In HepG2 cells we found that the metabolism of lipids and general cellular stress response to be the dominant biological processes in response to caffeine and coumarin exposure, respectively. The phosphoproteomic changes were detected early in time, at very low doses and provided a fast, adaptive cellular response to chemical exposure with 7-37-fold lower points of departure comparing to the transcriptomics. Changes in protein abundance were found much less frequently than transcriptomic changes. While challenges remain, our study provides strong and novel evidence supporting the notion that these three omic technologies can be used in an integrated manner to facilitate a more complete understanding of pathway perturbations and POD determinations for risk assessment of chemical exposures.

Occurrence of contaminants of emerging concern in the Eerste River, South Africa: Towards the optimisation of an urban water profiling approach for public- and ecological health risk characterisation

The study evaluated the presence and fate of various contaminants of emerging concern (CECs) from a South African wastewater treatment works (WWTW) and surface waters located around an urban setting. A total of 45 CECs were quantified from nine sampling locations over an 11-month period. Daily loads (g/day) of the target analytes in the WWTW showed persistence of some CECs, along with population-normalised daily loads (mg/day/1000inh) of pharmaceuticals and drugs of abuse (DOA) that were estimated for the first time in the study area. Multiple chemical markers were recorded in river water located upstream of the WWTW discharge throughout the study period, suggesting a high degree of diffuse pollution from urban communities in the study area that are not connected to sewage networks or where sanitation services are limited. The potential of using defined surface water locations to perform community-wide substance use profiling for non-sewered communities was also explored. Environmental risk characterisation for the WWTW effluent and surface waters throughout the study period provided multiple risk quotients (RQ) for the target list of CECs spanning over various sentinel trophic levels. High risk profiles (RQ > 1.0) with a frequency of exceedance (FoE) larger than 75 % were recorded for several CECs in both WWTW effluent and surface water locations that suggest potential long-term ecological health risk impacts of pollution hotspot areas in the river catchment situated around the urban area. We present challenges in surface water quality within the study area that is relatable, or may even present more challenging, in other low- or middle-income country (LMICs) settings. The study also highlighted some challenges and limitations associated with the much-needed application of wastewater-based epidemiology (WBE) intervention in non-sewered communities that can inform on public health and communal substance use profiles of the entire urban setting.

The interpretation of chemical epidemiology studies requires integration with experts on the nature of the reported adverse outcome and toxicologists

Chemical Epidemiology Studies (CES) can be both protective for humans of adverse health effects of chemicals as well as cause alarm leading to unwarranted remedial action and litigation. Inherent problems in conducting CES especially related to the study design goals and assessment of exposure are recognized. Many CES report adverse health outcomes at very low exposure levels implying that humans are uniquely or especially sensitive to the toxicity of these chemicals. Such unique sensitivity to humans would be especially important to scientists in human physiology, medical and toxicology communities. CES are currently appearing in the open literature more frequently and it is expected that they will be appearing even more frequently in the future especially if animal toxicity testing is reduced or eliminated. Experts on the nature of the reported adverse health outcomes should be playing a more critical role in the interpretation of CES because they are best suited to understand the many factors affecting natural and induced variability. Should animal toxicity testing be reduced, the role of toxicologists in the interpretation of CES will need to evolve. This manuscript addresses the need for more uniform standards in conducting, reporting, and review by independent, fully focused experts if CES studies reported in the open literature will be included in the health risk characterization and litigation of chemicals.