Common Source Of Exposure Research Articles

Community engagement programs on radiation and health: addressing public concerns.

Due to the negative connotations around radiation, there is a great deal of angst in the community regarding radiation exposure and health; especially electromagnetic radiation (EMR) sources such as powerlines, mobile phone towers and the rollout of the 5G network. As such, it is important for health authorities to provide the public with information and assurances regarding radiation safety. The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) set up community engagement programs to address community concerns. Type of program or service: From 2003 until April 2022, ARPANSA operated a Health Complaints Register, which collected reports of health complaints from members of the public related to possible EMR exposures. Collected data was used to produce annual statistical summaries on the nature and level of complaints received. Since 2016, ARPANSA has also run the Talk to a Scientist program, which allows the public to communicate directly with scientists on issues about radiation exposure, health and protection in Australia. Data is collected on the type of radiation and radiation source. There was a low level of interest in the Register, with only 180 reports received over the duration of its operation. Smart meters were the most common source of EMR exposure reported to be responsible for adverse health effects. The most common adverse health effect reported was headaches. The Register was closed in April 2022 due to a lack of interest. In contrast, the Talk to a Scientist program has responded to 6546 enquiries since 2016, most of which have been on EMR sources and the success of the Talk to a Scientist program, which rendered the Register obsolete. The EMR Health Complaints Register never received much interest from the public, potentially due to a perceived lack of engagement with authorities. The Talk to a Scientist program, which facilitated direct interaction with subject matter experts, has been much more successful in engaging with the public and addressing community concerns on radiation safety.

Associations between area-level arsenic exposure and adverse birth outcomes: An Echo-wide cohort analysis

BackgroundDrinking water is a common source of exposure to inorganic arsenic. In the US, the Safe Drinking Water Act (SDWA) was enacted to protect consumers from exposure to contaminants, including arsenic, in public water systems (PWS). The reproductive effects of preconception and prenatal arsenic exposure in regions with low to moderate arsenic concentrations are not well understood. ObjectivesThis study examined associations between preconception and prenatal exposure to arsenic violations in water, measured via residence in a county with an arsenic violation in a regulated PWS during pregnancy, and five birth outcomes: birth weight, gestational age at birth, preterm birth, small for gestational age (SGA), and large for gestational age (LGA). MethodsData for arsenic violations in PWS, defined as concentrations exceeding 10 parts per billion, were obtained from the Safe Drinking Water Information System. Participants of the Environmental influences on Child Health Outcomes Cohort Study were matched to arsenic violations by time and location based on residential history data. Multivariable, mixed effects regression models were used to assess the relationship between preconception and prenatal exposure to arsenic violations in drinking water and birth outcomes. ResultsCompared to unexposed infants, continuous exposure to arsenic from three months prior to conception through birth was associated with 88.8 g higher mean birth weight (95% CI: 8.2, 169.5), after adjusting for individual-level confounders. No statistically significant associations were observed between any preconception or prenatal violations exposure and gestational age at birth, preterm birth, SGA, or LGA. ConclusionsOur study did not identify associations between preconception and prenatal arsenic exposure, defined by drinking water exceedances, and adverse birth outcomes. Exposure to arsenic violations in drinking water was associated with higher birth weight. Future studies would benefit from more precise geodata of water system service areas, direct household drinking water measurements, and exposure biomarkers.

Genomic Analysis of Clostridioides difficile Recovered from Horses in Western Australia.

Clostridioides difficile poses an ongoing threat as a cause of gastrointestinal disease in humans and animals. Traditionally considered a human healthcare-related disease, increases in community-associated C. difficile infection (CDI) and growing evidence of inter-species transmission suggest a wider perspective is required for CDI control. In horses, C. difficile is a major cause of diarrhoea and life-threatening colitis. This study aimed to better understand the epidemiology of CDI in Australian horses and provide insights into the relationships between horse, human and environmental strains. A total of 752 faecal samples from 387 Western Australian horses were collected. C. difficile was isolated from 104 (30.9%) horses without gastrointestinal signs and 19 (37.8%) with gastrointestinal signs. Of these, 68 (55.3%) harboured one or more toxigenic strains, including C. difficile PCR ribotypes (RTs) 012 (n = 14), 014/020 (n = 10) and 087 (n = 7), all prominent in human infection. Whole-genome analysis of 45 strains identified a phylogenetic cluster of 10 closely related C. difficile RT 012 strains of equine, human and environmental origin (0-62 SNP differences; average 23), indicating recent shared ancestry. Evidence of possible clonal inter-species transmission or common-source exposure was identified for a subgroup of three horse and one human isolates, highlighting the need for a One Health approach to C. difficile surveillance.

Exposure to phthalate metabolites, bisphenol A, and psychosocial stress mixtures and pregnancy outcomes in the Atlanta African American maternal-child cohort

BackgroundConsumer products are common sources of exposure for phthalates and bisphenol A (BPA), which disrupt the endocrine system. Psychosocial stressors have been shown to amplify the toxic effects of endocrine disruptors but, information is limited among African Americans (AAs), who experience the highest rates of adverse pregnancy outcomes and are often exposed to the highest levels of chemical and non-chemical stressors. We examined the association between an exposure mixture of phthalate metabolites, BPA, and psychosocial stressors with gestational age at delivery and birthweight for gestational age z-scores in pregnant AA women. Study designParticipants were enrolled in the Atlanta African American Maternal-Child Cohort (N = 247). Concentrations of eight phthalate metabolites and BPA were measured in urine samples collected at up to two timepoints during pregnancy (8–14 weeks gestation and 20–32 weeks gestation) and were averaged. Psychosocial stressors were measured using self-reported, validated questionnaires that assessed experiences of discrimination, gendered racial stress, depression, and anxiety. Linear regression was used to estimate individual associations between stress exposures (chemical and psychosocial) and birth outcomes. We leveraged quantile g-computation was used to examine joint effects of chemical and stress exposures on gestational age at delivery (in weeks) and birthweight for gestational age z-scores. ResultsA simultaneous increase in all phthalate metabolites and BPA was associated with a moderate reduction in birthweight z-scores (mean change per quartile increase = −0.22, 95% CI = −0.45, 0.0). The association between our exposure mixture and birthweight z-scores became stronger when including psychosocial stressors as additional exposures (mean change per quantile increase = −0.35, 95% CI = −0.61, −0.08). Overall, we found null associations between exposure to chemical and non-chemical stressors with gestational age at delivery. ConclusionsIn a prospective cohort of AA mother-newborn dyads, we observed that increased prenatal exposure to phthalates, BPA, and psychosocial stressors were associated with adverse pregnancy outcomes.

Characterization of Photothermal Desorption-Compatible Diffusive Samplers for Volatile Organic Compounds.

Products and starting materials containing volatile organic compounds (VOCs) can easily be found in a variety of businesses, making them a common source of occupational exposure. To prevent negative impacts on employee health, field industrial hygienists must conduct regular sampling to ensure exposures remain below the regulatory limits set by governmental and professional associations. As such, the need for sensitive and reliable exposure assessment techniques becomes evident. Over the preceding decade, the industrial hygiene research group at the University of Alabama at Birmingham (UAB) has been working on the development of an emerging, preanalytical technique known as photothermal desorption (PTD) to improve upon the analytical sensitivity of currently employed methods. PTD's novel design uses pulses of high-energy light to desorb analytes from thermally conductive, carbonaceous sorbents, to be delivered to downstream analytical detectors. Since PTD's conception, the theoretical framework and advances in sorbent fabrication have been investigated; however, further work is needed to produce a field-ready sampling device for use with PTD. As such, objectives of the present work were to design a PTD-compatible diffusive sampler prototype and characterize the prototype's sampling efficiencies for toluene, n-hexane, trichloroethylene, and isopropyl alcohol. In pursuit of these objectives, the study empirically quantified the sampled masses of toluene, n-hexane, trichloroethylene, and isopropyl alcohol, at occupationally relevant air concentrations, to be 12.17 ± 0.06, 8.2 ± 0.1, 3.97 ± 0.06, and 8.0 ± 0.1 mg, respectively. Moreover, the analyte sampling efficiencies were found to be 2.2 ± 0.1, 1.7 ± 0.1, 1.2 ± 0.1, and 0.51 ± 0.05 (unitless) when comparing empirically (i.e., laboratory observed) sample mass values to theoretically predicted values. The sampling efficiencies and collected sample masses reported herein demonstrate the promising design of PTD-compatible diffusive samplers. When used in conjunction with the PTD method, the prototype samplers present strong evidence for improving analytical sensitivity in exposure assessments of VOCs in the workplace.

Exposure of Swedish adolescents to elements, persistent organic pollutants (POPs), and rapidly excreted substances - The Riksmaten adolescents 2016-17 national survey.

Adolescence is a period of significant physiological changes, and likely a sensitive window to chemical exposure. Few nation-wide population-based studies of chemical body burdens in adolescents have been published. In the national dietary survey Riksmaten Adolescents (RMA) 2016-17, over 13 chemical substance groups, including elements, chlorinated/brominated/fluorinated persistent organic pollutants (POPs) were analysed in blood, and in urine metabolites of phthalates/phthalate alternatives, phosphorous flame retardants, polycyclic aromatic hydrocarbons (PAHs), and pesticides, along with bisphenols and biocide/preservative/antioxidant/UV filter substances (N=1082, ages 11-21). The aim was to characterize the body burdens in a representative population of adolescents in Sweden, and to compare results with human biomonitoring guidance values (HBM-GVs). Cluster analyses and Spearman's rank order correlations suggested that concentrations of substances with known common exposure sources and similar toxicokinetics formed obvious clusters and showed moderate to very strong correlations (r≥0.4). No clusters were formed between substances from different matrices. Geometric mean (GM) concentrations of the substances were generally less than 3-fold different from those observed among adolescents in NHANES (USA 2015-16) and GerES V (Germany 2014-17). Notable exceptions were brominated diphenyl ethers (PBDEs) with >20-fold lower GM concentrations, and the biocide triclosan and ultraviolet (UV) filter benzophenone-3 with >15-fold lower mean concentrations in RMA compared to NHANES. Exceedance of the most conservative HBM-GVs were observed for aluminium (Al, 26% of subjects), perfluorooctanesulfonic acid (PFOS, 19%), perfluorooctanoic acid (PFOA, 12%), lead (Pb, 12%), MBP (dibutyl phthalate metabolite, 4.8%), hexachlorobenzene (HCB, 3.1%) and 3-phenoxybenzoic acid (PBA, pyrethroid metabolite, 2.2%). Males showed a higher proportion of exceedances than females for Pb, HCB and PFOS; otherwise no gender-related differences in exceedances were observed. A higher proportion of males than females had a Hazard Index (HI) of substances with liver and kidney toxicity and neurotoxicity >1. Industrialized countries with similarly high standards of living, with some exceptions, show comparable average body burdens of a variety of toxic chemicals among adolescents from the general population. The exceedances of HBM-GVs and HIs strongly suggests that further efforts to limit chemical exposure are warranted.

Invited Perspective: PFAS and the Childhood Obesity Phenotype-Challenges and Opportunities.

Invited Perspective: PFAS and the Childhood Obesity Phenotype-Challenges and Opportunities.

Radon Exposure Concentrations in Finnish Workplaces.

The aim of this study was to obtain information on the radon concentrations to which Finnish workers are exposed. Radon measurements were conducted as integrated measurements in 700 workplaces, supplemented by continuous radon measurements in 334 workplaces. The occupational radon concentration was calculated by multiplying the result of the integrated measurements by the seasonal correction factor and the ventilation correction factor (ratio between the working time and the full-time radon concentration obtained from continuous measurement). The annual radon concentration to which workers are exposed was weighted by the actual number of workers in each province. In addition, workers were divided into three main occupational categories (working mainly outdoors, underground, or indoors above ground). Probability distribution of the parameters affecting radon concentration levels were generated to calculate a probabilistic estimate of the number of workers exposed to excessive radon levels. With deterministic methods, the geometric and arithmetic mean radon concentrations in conventional, above-ground workplaces were 41 and 91 Bq m -3 , respectively. The estimated geometric and arithmetic mean annual radon concentrations that Finnish workers are exposed to were assessed as 19 and 33 Bq m -3 , respectively. The generic ventilation correction factor for workplaces was calculated as 0.87. Assessed with probabilistic methods, there are approximately 34,000 workers in Finland whose exposure to radon exceeds the reference level of 300 Bq m -3 . Although radon concentrations are generally low in Finnish workplaces, many workers are exposed to high levels of radon. Radon exposure in the workplace is the most common source of occupational radiation exposure in Finland.

Clinical and Laboratory Characteristics Predicting the Severity of Carbon Monoxide Poisoning in Children: A Single-Center Retrospective Study.

Carbon monoxide poisoning (COP) is extremely common throughout the world. The purpose of this study was to assess the demographic, clinical, and laboratory characteristics predicting the severity COP in children. The study included 380 children diagnosed with COP between January 2017 and January 2021 and 380 healthy controls. Carbon monoxide poisoning was diagnosed based on the medical history and a carboxyhemoglobin (COHb) level of more than 5%. The patients were classified as mild (COHb 10%), moderate (COHb 10%-25%), or severely (COHb > 25%) poisoned. The mean age of the severe group was 8.60 ± 6.30, for the moderate group was 9.50 ± 5.81, for the mild group was 8.79 ± 5.94, and for the control group was 8.95 ± 5.98. The most common place of exposure was at home and all cases were affected accidentally. The coal stove was the most common source of exposure, followed by natural gas. The most common symptoms were nausea/vomiting, vertigo, and headache. Neurologic symptoms such as syncope, confusion, dyspnea, and seizures were more common in the severe group. A total of 91.3% of the children had hyperbaric oxygen therapy, 3.8% were intubated, and 3.8% were transferred to intensive care in the severe group, whereas no death or sequela was observed. Mean platelet volume and red cell distribution width had the highest area under the curve in the receiver operating characteristic analysis (0.659; 0.379). A positive and low statistically significant relationship was found between COHb levels and troponin and lactate levels in the severe group ( P < 0.05). Carbon monoxide poisoning progressed more severely in children presented with neurological symptoms and have elevated red cell distribution width and mean platelet volume. Even in severe COP cases, satisfactory results have been obtained with early and appropriate treatment.

Interspecies Interactions within the Host: the Social Network of Group B Streptococcus.

Group B Streptococcus (GBS) is a pervasive neonatal pathogen accounting for a combined half a million deaths and stillbirths annually. The most common source of fetal or neonatal GBS exposure is the maternal microbiota. GBS asymptomatically colonizes the gastrointestinal and vaginal mucosa of 1 in 5 individuals globally, although its precise role in these niches is not well understood. To prevent vertical transmission, broad-spectrum antibiotics are administered to GBS-positive mothers during labor in many countries. Although antibiotics have significantly reduced GBS early-onset neonatal disease, there are several unintended consequences, including an altered neonatal microbiota and increased risk for other microbial infections. Additionally, the incidence of late-onset GBS neonatal disease remains unaffected and has sparked an emerging hypothesis that GBS-microbe interactions in developing neonatal gut microbiota may be directly involved in this disease process. This review summarizes our current understanding of GBS interactions with other resident microbes at the mucosal surface from multiple angles, including clinical association studies, agriculture and aquaculture observations, and experimental animal model systems. We also include a comprehensive review of in vitro findings of GBS interactions with other bacterial and fungal microbes, both commensal and pathogenic, along with newly established animal models of GBS vaginal colonization and in utero or neonatal infection. Finally, we provide a perspective on emerging areas of research and current strategies to design microbe-targeting prebiotic or probiotic therapeutic intervention strategies to prevent GBS disease in vulnerable populations.

Elementary Overview of Heavy Metals.

Exposure to heavy metals is common as a result of environmental contamination of air, water, and soil as well as accumulation in food, tobacco, herbal medicines, and occupational contact. However, clinically relevant toxicity is much less prevalent. Toxic effects, when they occur, may present with non-specific symptoms, resulting in a very large differential for clinicians to consider. Arsenic, cadmium, lead, and mercury are four heavy metals with no biological role in humans. However, these metals are commonly used in industrial applications and consumer products. Since these elements are not biodegradeable, their potential toxic effects may be long-lasting within the environment. These heavy metals have the potential to accumulate in vital organs such as the brain, heart, and kidney where they may disrupt normal cellular functioning and if exposures are repetitive or of high concentration, toxicity may result. The objective of this review is to provide an overview of arsenic, cadmium, lead, and mercury physical properties, common sources of exposure, basic toxicokinetics and health effects, and to review clinical guidelines and treatment strategies. Acute and chronic symptoms and recommended laboratory biomarker testing are also discussed.

Trends in human leptospirosis in Denmark, 2012-2021.

Leptospirosis is a zoonotic bacterial infection that can cause influenza-like symptoms and severe disease. In Denmark, leptospirosis is rare, non-endemic, and most commonly transferred to humans from mice and rats. Cases of human leptospirosis in Denmark are by law notifiable to Statens Serum Institut. This study aimed to describe trends in incidence of leptospirosis in Denmark from 2012 to 2021. Descriptive analyses were used to calculate the incidence, geographical distribution and possible routes of infection, as well as testing capacity and serological trends. The overall incidence rate was 0.23 per 100,000 inhabitants, with the highest annual incidence of 24 cases in 2017. Men between 40-49 years old were the demographic group most commonly diagnosed with leptospirosis. August and September were the months with highest incidence over the entire study period. The most common serovar observed was Icterohaemorrhagiae, although over a third of cases were diagnosed via polymerase chain reaction alone. The most common sources of exposure reported were travel abroad, farming, and recreational contact with fresh water, the latter being a new exposure compared to previous studies. Overall, a One Health approach would ensure better detection of outbreaks and milder disease. Additionally, preventative measures should be expanded to include recreational water sports.

PS-P12-11: INFECTION CONTROL PRACTICES OF HEALTHCARE WORKERS INFECTED WITH COVID-19 IN TONDO MEDICAL CENTER FROM MARCH 2020 TO MAY 2021

Background: COVID-19 has put the lives of our healthcare workers at the forefront of the battle against pandemic. Understanding how this pandemic directly affects them is vital in ensuring safe and continuous provision of service to the public. Reviewing their infection control practices is imperative in protecting their health and the patients they serve. This study aimed to determine the infection control practices of healthcare workers infected with COVID-19 in Tondo Medical Center from March 2020 to May 2021. Methodology: This is descriptive retrospective study involving healthcare workers of Tondo Medical Center infected with COVID-19 from March 2020 to May 2021. Demographic data, exposure history, clinical manifestations and infection control practices data were surveyed, encoded and tabulated. Categorical variables were presented as frequencies and percentages. Results: A total of 425 healthcare workers developed COVID-19 from March 2020 to April 2021. Their mean age was 36.4 years; more female (57.4%) and single (56.0%) staff were affected. Most cases (41.4%) came from or low/lowest risk areas. Three clustering of cases were identified. More than half of the respondents (54.4%) had unknown exposure; housemates/relatives (21.0%) were the most common source of known exposure. Three out of 10 respondents were asymptomatic; majority had mild symptoms (62.2%), the most common of which was the loss of taste/smell (26.5%). Adherence to wearing of mask was highest in the community (99.5%) than in the workplace (93.4%) and least at home (78.3%). Majority practiced social distancing in the community (97.9%) and in the workplace (95.5%). Almost half (58.7%) practiced 1-meter social distancing. Respondents practiced frequent handwashing both at home (92.2%) and in the workplace (91.9%). Only 1–2 out of 10 washed their hands for 40 seconds or more. Majority employed hand hygiene with alcohol-based rub for less than 20 seconds in the workplace (71.6%) and at home (69.5%). Majority (98.3%) performed hand hygiene after coughing or sneezing and used tissue (44.4%). Most of the respondents decontaminated their work area before and after work (66.6%). Alcohol was most used in the workplace (70.7%). More than half (59.6%) ate in the pantry, mostly alone (65.5%). Most cleaned their cellphones daily (88.4%). Majority brought alcohol with them (97.2%) and almost half (47.5%) wore a mask for 4–8 hours. Conclusion: Some gaps have been identified in the knowledge and practices of infection control of healthcare workers infected with COVID-19 at Tondo Medical Center; hence reinforcement programs including refresher trainings and policy enhancement are warranted.

Using exterior housing conditions to predict elevated pediatric blood lead levels

Housing-based lead paint dust is the most common source of lead exposure for US-born children. Although year of housing construction is a critical indicator of the lead hazard to US children, not all housing of the same age poses the same risk to children. Additional information about housing condition is required to differentiate the housing-based lead risk at the parcel level. This study aimed to identify and assess a method for gathering and using observations of exterior housing conditions to identify active housing-based lead hazards at the parcel level. We used a dataset of pediatric blood lead observations (sample years 2000–2013, ages 6–72 months, n = 6,589) to assess associations between observations of exterior housing conditions and housing-based lead risk. We used graphical and Lasso regression methods to estimate the likelihood of an elevated blood lead observation (≥3.5 μg/dL). Our methods estimate a monotonic increase in the likelihood of an elevated blood lead observation as housing conditions deteriorate with the largest changes associated with homes in the greatest disrepair. Additionally we estimate that age of home construction works in consort with housing conditions to amplify risks among those houses built before 1952. Our analysis indicates that a survey of external housing conditions can be used in combination with age of housing in the identification process, at the parcel level, of homes that pose a housing-based lead hazard to children.

Health risk assessment of phthalates exposure through lipid peroxidation in children with asthma

Background: Global prevalence of asthma in children has dramatically increased in the past decades. Recent studies revealed that Taiwanese children are still exposed to considerable amounts of phthalates after the 2011 incident of phthalates-tainted food products. Up-to-date findings indicated that phthalates may increase malondialdehyde (MDA), a lipid peroxidation marker, in asthma patients. The role of phthalates in the increased occurrence of childhood asthma through lipid peroxidation remains unclear. We want to assess the association between phthalates exposure and MDA in children with asthma. Methods: We recruited 125 children with clinically-diagnosed asthma and around 98 controls from Taipei Hospital since January 2019. Participants provided urine specimen and questionnaire. Eleven phthalate metabolites and MDA were analyzed by liquid chromatography tandem-mass spectrometry (LC-MS/MS) and ELISA, respectively. Pearson correlation and related statistical method were used to analyze the relationship of urinary phthalate metabolites or MDA in asthma children. Results: BMI in asthma children was significantly higher than that in control (p=0.005) whereas no similar phenomena was observed for other demographic factors. Mother ever had cigarette smoking in pregnancy and current burn incense at home in the case group were marginally significantly higher than those in control. Meanwhile, the median levels of urinary MEHP (72.18 v.s 68.81 ng/mL), MiNP (28.75 v.s 23.51 ng/mL), and MDA (6.87 v.s. 5.86) in asthma children were higher than those in control, though failed to reach statistical significance. Age was positively correlated with urinary MDA (r=0.159, p=0.018) and MEP (r=0.13, p=0.058). Urinary MEP was highly correlated with the other phthalate metabolites which indicated a common exposure source. Conclusion. Certain phthalates may increase lipid peroxidation markers in asthma children. Keyword: Phthalate metabolites; lipid peroxidation; asthma.

Application of Risk-Oriented Approach for Improvement of the Environmental Security of the Urban Area

Improved comfort of urban environment is inseparably related with consumption and transfer of various types of energy for illumination and heating of buildings, provision of radio and TV broadcasts, mobile communications and transport. Energy transfer is accompanied by generation of electric fields, which propagate in ambient environment and affect human and biota. In this regard, the safety of urban environment becomes more and more urgent issue, especially along highways. This work describes a risk-oriented approach to analysis and estimation of risks of electromagnetic safety of urban territories with consideration for combined action of electromagnetic fields of various frequency range on humans. The authors have analyzed electromagnetic pollution from three most common sources of exposure, and the territories of urban environment have been selected with the highest level of electromagnetic hazard for population. Application of risk-oriented approach to estimation of electromagnetic hazard demonstrates the necessity of improvement of valid normalization system with accounting for simultaneous impact of electromagnetic fields from several sources on human and environment, which would provide development of more efficient measures of city population protection against this negative factor.

A literature review of the use of phenol for nail matrix ablation on pregnant and breastfeeding patients: implications for safe use

Background Nail surgery using phenol to chemically ablate the nail matrix is a technique that has been performed for many years. The phenolic technique of nail surgery has been refined and established as a safe and effective procedure. Although it is used in small quantities podiatrically, phenol is readily absorbed through multiple routes such as ingestion, dermal absorption, and inhalation - the latter two being the most likely in podiatric practice. However, given its pervasiveness as a caustic agent in nail surgery, there is a paradoxically small narrative on the safety aspects of phenol's use in pregnant and breastfeeding patients. This paper reviews the available literature to provide a narrative response to this concern. Method A literature search to identify research evidence from electronic databases and reference lists was performed. Evidence was also sought using Google Scholar free text keywords. A narrative review of the literature was then performed, with agreement from all authors. Discussion Although patient safety concerns have been raised for the clinical use of a range of phenols, humans are environmentally exposed to such compounds in food, cosmetics, plastics, and resins. For the general population, cigarette smoke and smoked food products are the most common sources of phenol exposure. The data on phenol exposure during nail surgery and potential health consequences to the foetus are discussed. Conclusion Following calculations for the potential absorption of phenol via an EZ swab, the authors suggest that the purported risks associated with the podiatric use of phenol are overly cautious given that there is no clear association between occupational exposure to phenol and adverse pregnancy outcomes. Although phenols are ubiquitous in the environment, these exposures have previously not been compared to those of phenol matricectomy. Future research in this area would be highly beneficial, for example, the urinalysis of phenol before and after nail surgery in non-pregnant females.

Single-centre, randomized, clinical trial of opioid-free analgesia versus routine opioid-based analgesia regimen for the management of acute post-operative pain following caesarean section: study protocol

&lt;p class="abstract"&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pain management post-caesarean section is a common source of exposure to opioids in women. To address the rising opioid addiction associated with peri-operative administration, trend in operative analgesia is moving towards opioid-free, multimodal analgesia. We present our protocol for this study so that it may be replicated in other settings and possibly modified for future studies.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In a Single-centre, non-inferiority, parallel, randomized, controlled, clinical trial with balanced allocation [1:1] into two arms, we compared a peri-operative opioid-free analgesia regimen with a routine post-operative opioid-based analgesia regimen in women undergoing caesarean section under spinal anaesthesia. Primary outcome measures were post-operative pain intensity at 4, 8 and 24 hours (using Numerical Rating Scale) and post-operative pentazocine use. Secondary outcome measures were the incidence of adverse events and Apgar score. Results will be published in a peer-reviewed, open access journal.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; This protocol adopted the use of intravenous paracetamol and intravenous NSAID as baseline analgesics. Magnesium sulphate was introduced peri-operatively as part of our opioid-free multimodal analgesia regimen because of its established effect in decreasing post-operative pain and opioid use. We also relied on the preventive analgesic effect of administration of intravenous paracetamol and intravenous magnesium sulphate before surgical incision, continued intraoperatively and post-operatively. In addition, magnesium sulphate is a familiar drug to the obstetrician, readily available and affordable in most settings where comprehensive emergency obstetric care is offered, easy to administer and it has been well tolerated clinically.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Trial registration:&lt;/strong&gt; This protocol was registered with clinicaltrials.gov (Identifier: NCT04539249) on September 3, 2020, prospectively.&lt;/p&gt;

Arsenolipids in raw and cooked seafood products in southwest China: A non-targeted analysis

Arsenolipids are the primary form of arsenic in the fat of marine organisms. Because seafood is a common source of arsenic exposure and some arsenolipids are toxic, studying the abundance and species of arsenolipids in seafood is crucial for health risk assessment. Current arsenolipid research is confined by analytical techniques and limited to raw seafood analysis, despite the fact that most seafood is ingested cooked. Therefore, the aim of this study is to evaluate which seafood contributes to arsenolipid dietary intake and investigate the changes in arsenolipids before and after cooking. In Chongqing, China, popular seafood such as clam, shrimp, oyster, abalone, hairtail, and yellow croaker were collected. The raw and cooked samples prepared from these seafood products were examined using a non-targeted screening approach established for arsenolipids, which coupled high-performance liquid chromatography with data-independent high-resolution quadrupole-time-of-flight electrospray ionization tandem mass spectrometry. Arsenic-containing hydrocarbons (AsHC330, AsHC332, and AsHC360), arsenic-containing fatty acids (AsFA362, AsFA390, AsFA404, AsFA418, and AsFA422), trimethylarsine oxide, and thiolated trimethylarsinic acid were detected. The species of arsenolipids in each type of seafood remained intact after heating in the microwave oven. In cooked samples, the concentrations of AsFA362 and AsFA390 were significantly lower than in raw samples, whereas the concentrations of other arsenolipids were unchanged. Microwave cooking did not result in the thiolation of the detected arsenolipids. The most detected species in raw and cooked samples were AsFA362, AsFA390, and AsFA418. Most arsenolipid species were found in the highest levels in hairtails and yellow croakers. It is the first time that arsenolipids have been found in the oyster, abalone, abalone liver, and yellow croaker. The present study contributes to a better understanding of arsenolipids exposure from seafood, which is useful for assessing the health risks of arsenic.

Risk of lead exposure from wild game consumption from cross-sectional studies in Madre de Dios, Peru

SummaryBackgroundStudies have shown elevated blood lead levels (BLL) in residents of remote communities in the Amazon, yet sources of lead exposure are not fully understood, such as lead ammunition consumed in wild game.MethodsData was collected during two cross-sectional studies that enrolled 307 individuals in 26 communities. Regression models with community random effects were used to evaluate risk factors for BLLs, including diet, water source, smoking, sex, age, and indigenous status. The All-Ages Lead Model (AALM) from the Environmental Protection Agency (EPA) was used to estimate background and dose from wild game consumption.FindingsIndigenous status and wild game consumption were associated with increased BLLs. Indigenous participants had 2.52 μg/dL (95% CI: 1.95−3.24) higher BLLs compared to non-indigenous. Eating wild game was associated with a 1.41 μg/dL (95% CI: 1.20−1.70) increase in BLLs. Two or more portions per serving were associated with increased BLLs of 1.66 μg/dL (95% CI: 1.10−2.57), compared to smaller servings. Using the AALM, we estimate background lead exposures to be 20 μg/day with consumption of wild game contributing 500 μg/meal. Lastly, we found a strong association between BLLs and mercury exposure.InterpretationConsumption of wild game hunted with lead ammunition may pose a common source of lead exposure in the Amazon. Communities that rely on wild game and wild fish may face a dual burden of exposure to lead and mercury, respectively.