Effect Of Cumulative Exposure Research Articles

Radiation induced therapeutic effects in cancerous and tumor cells: A review

Present review article describes use of radiation and radionuclides on cancer and cancer cell therapeutics. It also sketches out cumulative effects of radiation exposure received by the patients during cancer diagnostics. Though, in cancer therapeutics a selected and permissible dose is provided in several cycles to ablate the neoplastic cells and improve the condition of patient, but radiation harms surrounding cells and imparts negative effects on biology of cells. Ionizing radiation (IR) promotes cancer cell death through cytotoxicity. This article emphasizes both remedial effects and biological effects of radiation and radio-resistance in cells. It suggests safe use of radionucleides by encapsulating them in nanomaterials so as to use it alternate to chemotherapy to destroy various cancer types to enhance the survival of normal cells. This article explains effect of ionizing and non-ionizing radiation on cellular metabolism and genetics.

Study protocol: examining the impacts of COVID-19 mitigation measures on pregnancy and birth outcomes in Scotland—a linked administrative data study

IntroductionThis protocol outlines aims to test the wider impacts of the COVID-19 pandemic on pregnancy and birth outcomes and inequalities in Scotland.Method and analysisWe will analyse Scottish linked administrative data...

Does Cumulative Exposure to High-Poverty Schools Widen Test-Score Inequality?

Although there is an abundance of research on the association of school poverty (or socioeconomic status) and test score level, there is very little rigorous longitudinal evidence on the cumulative effects of exposure to differing school contexts. Drawing from methods used first in epidemiology and then in neighborhood effects research, we use population-level longitudinal data from North Carolina to estimate a structural nested mean model that permits proper adjustment for time-varying confounding. Unlike panel data studies using student fixed effects, which often report close to null findings, we find evidence of modest but significant negative effects of school poverty composition on eighth-grade reading and math test scores in models that control for third-grade test scores and baseline treatment status.

Perfluoroalkyl substances exposure in firefighters: Sources and implications

Firefighters are at risk of occupational exposure to long-chain per- and poly-fluoroalkyl substances (PFASs), most notably from PFASs present in Class B aqueous film-forming foam (AFFF). Firefighters have been found to have elevated serum levels of long-chain PFASs. Due to the persistence of PFAS chemicals in the human body and their ability to bioaccumulate, firefighters experience the latent and cumulative effects of PFAS-containing AFFF exposure that occurs throughout their careers. This article summarizes the history of AFFF use by firefighters and current AFFF use practices. In addition, this paper describes PFAS levels in firefighter serum, PFAS serum removal pathways, PFAS exposure pathways, and occupational factors affecting PFAS levels in firefighters. International, national, and state agencies have concluded that PFOA, a long-chain PFAS, is potentially carcinogenic and that carcinogens have an additive effect. From the cancer types that may be associated with PFAS exposure, studies on cancer risk among firefighters have shown an elevated risk for thyroid, kidney, bladder, testicular, prostate, and colon cancer. Thus, exposure to PFAS-containing AFFF may contribute to firefighter cancer risk and warrants further research.

Differential effects of size-specific particulate matter on the number of visits to outpatient fever clinics: A time-series analysis in Zhuhai, China.

While many studies have investigated the adverse effects of particulate matter (PM), few of them distinguished the different effects of PM2.5, PM10, and coarse PM (PMc) on outpatients with fever. Our study aimed to estimate and compare the acute cumulative effects of exposure to three size-specific particles on the number of visits to outpatient fever clinics. To examine the association between daily PM concentrations and outpatients in fever clinics, a generalized additive Poisson model was applied, stratified by sex, age, and season. Our study included 56,144 outpatient visits in Zhuhai, from January 2020 to June 2021. On the current day, each 10 mg/m3 increment of PM10 and PMc were estimated to increase fever clinic visits by 1.74% (95% CI: 0.59%, 2.91%) and 4.42 % (2.30%, 6.58%), respectively. Cumulative effects enhanced from lag01 to lag05 for PM10 and PMc, and PMc had the strongest impact [ER = 8.92% (5.91%, 12.01%) at lag05]. Female outpatients and outpatients aged 14 years and above had an increased PM-related risk. During the cold season, significant effects could be observed for the three-size PM, while only PMc showed the impact during the warm season. Overall, the three size-specific PM exerted different effects on the fever clinic visits. Strategies to control the concentrations of PM are still necessary, especially against PM10 and PMc.

The association of diastolic arterial pressure and heart rate with mortality in septic shock: a retrospective cohort study

The effects of diastolic arterial pressure (DAP) and heart rate (HR) on the prognosis of patients with septic shock are unclear, and whether these effects persist over time is unknown. We aimed to investigate the relationship between exposure to different intensities of DAP and HR over time and mortality at 28days in patients with septic shock. In this cohort study, we obtained data from the Medical Information Mart for Intensive Care IV, which includes the data of adult patients (≥ 18years) with septic shock who underwent invasive blood pressure monitoring. We excluded patients who received extracorporeal membrane oxygenation (ECMO) or glucocorticoids within 48h of ICU admission. The primary outcome was mortality at 28days. Piece-wise exponential additive mixed models were used to estimate the strength of the associations over time. In total, 4959 patients were finally included. The median length of stay in the ICU was 3.2days (IQR: 1.5-7.1days), and the mortality in the ICU was 12.9%, with a total mortality at 28days of 15.9%. After adjustment for baseline and time-dependent confounders, both daily time-weighted average (TWA) DAP and HR were associated with increased mortality at 28days and strong association, mainly in the early to mid-stages of the disease. The results showed that mortality in patients with septic shock was lowest at a DAP of 50-70mm Hg and an HR of 60-90 beats per minute (bpm). Throughout, a significant increase in the risk of death was found with daily exposure to TWA-DAP ≤ 40mmHg (hazard ratio 0.99, 95% confidence interval (CI) 0.94-1.03) or TWA-HR ≥ 100bpm (hazard ratio 1.16, 95% CI 1.1-1.21). Cumulative and interactive effects of harmful exposure (TWA-DAP ≤ 40mmHg and TWA-HR ≥ 100bpm) were also observed. The optimal ranges for DAP and HR in patients with septic shock are 50-70mmHg and 60-90bpm, respectively. The cumulative and interactive effects of exposure to low DAP (≤ 40mmHg) and tachycardia (≥ 100bpm) were associated with an increased risk of death.

Critical Incidents Scale for Ambulance Work - Denmark (CISAW-D): the development of a screening tool for work exposure to critical events in operative ambulance personnel.

Critical incidents in ambulance work are not easily compared to other risk occupations. Understanding types of incidents that can be considered critical in operational ambulance work is important to prevent work-related post-traumatic stress (PTS). This study aimed to develop a scale of critical incidents in ambulance work and assess its predictive validity in relation to the severity of PTS symptoms. A total of 1092 open-ended descriptions from Danish ambulance personnel were content analysed to develop a categorical scale that identifies types of events perceived as critical to operative ambulance personnel. Multiple regression was used to assess whether the scale predicted PTS symptoms and to assess the cumulative effect of exposure to these events. The study found that the 1092 descriptions of critical events could be condensed into 28 categories of critical events. These ranged from life-threatening situations and deaths, to more daily events such as handling strong emotional reactions from patients' relatives and working with terminally ill children. The frequency of events significantly predicted the severity of PTS symptoms with low to moderate effect (std beta = 0.2, t(375) = 3.7, p < .001), even when adjusting for known risk factors for post-traumatic stress disorder. This study showed that critical events in ambulance work included events that are not normally considered traumatic, and indicated that understanding the cumulative effect of these events is important when trying to prevent traumatic sequalae in ambulance personnel. The study highlighted the importance of increased focus on non-traumatic incidents that have an ongoing impact on paramedics' mental health and well-being. The Critical Incidents Scale for Ambulance Work - Denmark (CISAW-D) is a promising tool for systematic screening for exposure to critical events in ambulance work.

Lost Therapeutic Benefit of Delayed Low-Density Lipoprotein Cholesterol Control in Statin-Treated Patients and Cost-Effectiveness Analysis of Lipid-Lowering Intensification

ObjectivesAttainment of low-density lipoprotein cholesterol (LDL-C) therapeutic goals in statin-treated patients remains suboptimal. We quantified the health economic impact of delayed lipid-lowering intensification from an Australian healthcare and societal perspective. MethodsA lifetime Markov cohort model (n = 1000) estimating the impact on coronary heart disease (CHD) of intensifying lipid-lowering treatment in statin-treated patients with uncontrolled LDL-C, at moderate to high risk of CHD with no delay or after a 5-year delay, compared with standard of care (no intensification), starting at age 40 years. Intensification was tested with high-intensity statins or statins + ezetimibe. LDL-C levels were extracted from a primary care cohort. CHD risk was estimated using the pooled cohort equation. The effect of cumulative exposure to LDL-C on CHD risk was derived from Mendelian randomization data. Outcomes included CHD events, quality-adjusted life-years (QALYs), healthcare and productivity costs, and incremental cost-effectiveness ratios (ICERs). All outcomes were discounted annually by 5%. ResultsOver the lifetime horizon, compared with standard of care, achieving LDL-C control with no delay with high-intensity statins prevented 29 CHD events and yielded 30 extra QALYs (ICERs AU$13 205/QALY) versus 22 CHD events and 16 QALYs (ICER AU$20 270/QALY) with a 5-year delay. For statins + ezetimibe, no delay prevented 53 CHD events and gave 45 extra QALYs (ICER AU$37 271/QALY) versus 40 CHD events and 29 QALYs (ICER of AU$44 218/QALY) after a 5-year delay. ConclusionsDelaying attainment of LDL-C goals translates into lost therapeutic benefit and a waste of resources. Urgent policies are needed to improve LDL-C goal attainment in statin-treated patients.

Inhaled particulate accumulation with age impairs immune function and architecture in human lung lymph nodes.

Older people are particularly susceptible to infectious and neoplastic diseases of the lung and it is unclear how lifelong exposure to environmental pollutants affects respiratory immune function. In an analysis of human lymph nodes (LNs) from 84 organ donors aged 11-93 years, we found a specific age-related decline in lung-associated, but not gut-associated, LN immune function linked to the accumulation of inhaled atmospheric particulate matter. Increasing densities of particulates were found in lung-associated LNs with age, but not in the corresponding gut-associated LNs. Particulates were specifically contained within CD68+CD169- macrophages, which exhibited decreased activation, phagocytic capacity, and altered cytokine production compared with non-particulate-containing macrophages. The structures of B cell follicles and lymphatic drainage were also disrupted in lung-associated LNs with particulates. Our results reveal that the cumulative effects of environmental exposure and age may compromise immune surveillance of the lung via direct effects on immune cell function and lymphoid architecture.

Effect of cumulative exposure to tacrolimus on the recurrence of hepatocellular carcinoma after liver transplantation

Effect of cumulative exposure to tacrolimus on the recurrence of hepatocellular carcinoma after liver transplantation

The evaluation of students’ progression in lower secondary education in Brazil: Exploring the path for equity

Improving the access to and quality of compulsory education among children is one of the most promising measures to tackle poverty in the medium-long run. This study examines the individual sociodemographic and educational attributes related to the probability of students’ progression through lower secondary public education in Brazil. Based on the longitudinal design track of a cohort of Brazilian 5th grade public-school students, multilevel logistic regression models are applied to merged databases of the Educational Census and Prova Brasil, which have a national coverage. The response variable is whether the pupil was steadily promoted from the 5th to 9th grade, or not. The predicting variables include students’ prior achievement in reading and mathematics, early experience of grade repetition, preschool attendance, and several sociodemographic attributes such as gender, self-declared race/skin color, socioeconomic status, and proxies of being exposed to extreme poverty. A distinctive aspect of this study is the use of big identifiable data collected by the institute in charge of Brazilian educational evaluation. Our findings show that lower secondary education completion in due time is strongly associated with prior achievement, and that the main effect of students’ socioeconomic status is modest, having a moderator effect with maths. Estimates obtained also give emphasis to the cumulative effect of early grade repetition, preschool attendance, and extreme poverty exposure. Gender and race/ethnicity gaps are shown. Moreover, the students’ progression varies randomly across schools, municipalities, and states; this provides an opportunity for compelling insights into school and higher levels of public policy design, implementation, and evaluation. Results highlight the role of preschool and primary education in the path for equity. Policy and practice implications to reduce the educational equity gap are discussed.

Assessment of cumulative cancer risk attributable to diagnostic X-ray radiation: a large cohort study.

To assess the risk of cancer induced by diagnostic X-ray exposure in multiple radiological examinations and to explore the relevant influences to provide a reference for rational usage of X-ray examinations. Data for all adult patients who underwent X-ray examinations from August 2004 to April 2020 in a general hospital was collected, including sex, age, primary diagnosis, and X-ray examination. Based on the Biological Effects of Ionizing Radiations report, age and sex and effective dose for a single X-ray examination were used to calculate the lifetime attributable risk (LAR). Patients whose cancer LAR values were in the top 5% were considered to have a high cancer risk; the factors influencing this status were explored by using multivariate logistic regression analyses. In total, 1,143,413 patients with 3,301,286 X-ray examinations were included. LARs of cancer incidence and death were < 0.2% and < 0.13% among 95% of patients and they were > 1% among 0.21% and 0.07% of patients. High risks of incidence and death were significantly associated with corrected exposure frequency (odds ratio [OR], 1.080 and 1.080), sex (OR, male vs. female, 0.421 and 0.372), and year of birth (OR, 1.088 and 1.054), with all p values < 0.001. Among 20 disease categories, congenital disease (OR, 3.792 and 4.024), genitourinary disease (OR, 3.608 and 3.202), digestive disease (OR, 3.247 and 3.272), and tumor disease (OR, 2.706 and 2.767) had the strongest associations with high risks of incidence and death (all p values < 0.001). Cancer risk induced by diagnostic X-ray examinations can be considered acceptable clinically. Patients having certain diseases are potentially at a relative higher risk due to recurrent examinations. • It was the first large-scale investigation of cumulative X-ray exposure in China, involving more than 3.3 million X-ray scans of all types of diagnostic X-ray examinations for about 1.1 million patients during the past 16 years. • The study revealed that the incidence risk of cancer induced by X-ray-related examinations was 0.01% on average, which was substantially lower than that of cancer induced by non-X-ray radiation. The risk could be considered acceptable clinically. • Patients having certain diseases were potentially at a relatively higher cancer risk due to recurrent X-ray examinations. The cumulative effect of X-ray exposure could not be ignored and was worthy of attention.

Radiation Cataract as an Occupational Disease Due to Cumulative Effects of Chronic Radiation Exposure in Ophthalmological Evaluation

Radiation Cataract as an Occupational Disease Due to Cumulative Effects of Chronic Radiation Exposure in Ophthalmological Evaluation

Predicting cumulative lead (Pb) exposure using the Super Learner algorithm

Chronic lead (Pb) exposure causes long term health effects. While recent exposure can be assessed by measuring blood lead (half-life 30 days), chronic exposures can be assessed by measuring lead in bone (half-life of many years to decades). Bone lead measurements, in turn, have been measured non-invasively in large population-based studies using x-ray fluorescence techniques, but the method remains limited due to technical availability, expense, and the need for licensing radioactive materials used by the instruments. Thus, we developed prediction models for bone lead concentrations using a flexible machine learning approach--Super Learner, which combines the predictions from a set of machine learning algorithms for better prediction performance. The study population included 695 men in the Normative Aging Study, aged 48 years and older, whose bone (patella and tibia) lead concentrations were directly measured using K-shell-X-ray fluorescence. Ten predictors (blood lead, age, education, job type, weight, height, body mass index, waist circumference, cumulative cigarette smoking (pack-year), and smoking status) were selected for patella lead and 11 (the same 10 predictors plus serum phosphorus) for tibia lead using the Boruta algorithm. We implemented Super Learner to predict bone lead concentrations by calculating a weighted combination of predictions from 8 algorithms. In the nested cross-validation, the correlation coefficients between measured and predicted bone lead concentrations were 0.58 for patella lead and 0.52 for tibia lead, which has improved the correlations obtained in previously-published linear regression-based prediction models. We evaluated the applicability of these prediction models to the National Health and Nutrition Examination Survey for the associations between predicted bone lead concentrations and blood pressure, and positive associations were observed. These bone lead prediction models provide reasonable accuracy and can be used to evaluate health effects of cumulative lead exposure in studies where bone lead is not measured.

Timing and magnitude of net methylmercury effects on waterbird reproductive output are dependent on food availability

Mercury (Hg) is a globally distributed pollutant. Its sub-lethal effects on reproduction of birds have been used as indicators of contamination and of potential demographic effects. However, studies typically used single endpoints that might not be representative of entire reproductive cycle. To estimate timing and net cumulative effects of Hg exposure under field conditions, we used observational data over 11 years from >1200 nests of great egrets breeding under temporally and spatially varying food availability and Hg exposures in the Florida Everglades. We collected measures of fish biomass and availability (>100 locations annually) and used four avian reproductive endpoints that represented the entire breeding cycle. We calculated net reproductive loss by adding estimated Hg effects on failures prior to egg laying, clutch size, hatching success and nestling survival in response to food availability and Hg exposure. To validate and assess results of the observational egret study, we ran the same analyses with data of captive breeding white ibises experimentally exposed to Hg with ad libitum food over 3 years. We found large (>50 %) reductions in great egret offspring with high Hg exposure (18 μg/g dw THg nestling feather, ~0.7 μg/g ww whole egg THg) and high food availability, and even larger reductions (up to 100 %) with high Hg exposure and low food. Timing and the relative contribution of different endpoints to overall reproductive failure varied with food availability. Failures prior to egg laying were relevant at all food availabilities and proportionally most important during high food availability (~70 % of total losses). Under high food, post-hatching failures increased moderately with increasing exposure (~10 % of total losses), and under low food, hatching failures became dominant (~50 % of total losses). Patterns of failure of captive white ibis fed ad libitum resembled those of great egrets under high food availability but differed in total magnitude. We suggest that, a) net reproductive effects of Hg in free-ranging animals are probably much higher than generally reported in studies using single endpoints, b) Hg effect sizes vary considerably among different endpoints and c) food availability is a strong driver of timing and net effects of Hg exposure.

Effect of cumulative body mass index exposure and long-term related change on incident non-alcoholic fatty liver disease.

To evaluate the association between cumulative body mass index (BMI) and long-term BMI change with non-alcoholic fatty liver disease (NAFLD). We included 19 477 adult participants (12 556 men and 6921 women) from the Kailuan study from January 2006 to December 2013. Cumulative BMI was assessed using a quadratic mixed-effects method by sex before the index year; then, the NAFLD outcome was followed till December 2019. The long-term BMI change was calculated as the percentage change in average cumulative BMI from the baseline BMI. During a median follow-up of 5.63 years, 6229 individuals developed incident NAFLD. Independent of baseline BMI, the NAFLD risk escalated with the cumulative BMI with adjusted hazard ratios (HRs) (95% confidence interval [CI]) of 1.60 (1.48-1.73) and 2.28 (2.06-2.53) for the intermediate tertile and the highest tertile (Ptrend <0.001). The association is amplified in women and the young. Compared to a stable weight (BMI change: -3% to 3%), NAFLD risk increased in the baseline BMI < 24 kg/m2 group with weight gain (BMI change: >3%) and decreased in BMI ≥24 kg/m2 group with weight loss (BMI change: <-3%) for men and women. However, we only observed a decreased NAFLD risk in men (HR: 0.82, 95% CI: 0.69-0.97) with BMI < 24 kg/m2 and weight loss. Monitoring cumulative BMI may help to identify high-risk NAFLD populations. The association between weight gain or loss varies by sex and baseline BMI, suggesting the importance of individualized weight management for NAFLD prevention.

Acoustic treatments for indoor and outdoor firing ranges

Small-caliber firearms can produce impulse noises that frequently exceed 150 dB peak sound pressure level (dB pSPL) and can approach 185 dB pSPL. These impulse noises can present a significant risk for noise-induced hearing loss for the unprotected ear and pose a risk for persons wearing hearing protection that is possibly poorly fitted or insufficient. For range safety officers and personnel who work in the firing range on a regular basis, the daily cumulative effects of noise exposure can lead to increased fatigue and stress. Acoustic treatments of the reflective surfaces can mitigate these health risks. This paper will review some community noise guidelines as well as health and safety regulations. As a manufacturer of acoustic range treatments, the Troy System materials will be reviewed with regards to their laboratory performance and their capabilities to reduce noise in various firing ranges. One aspect of performance that may be overlooked is the safety features of the materials which Troy Acoustics provides, such as flammability, ability to be cleaned, and the resistance to moisture and mold.

Investigating the “two-hit hypothesis”: Effects of prenatal maternal immune activation and adolescent cannabis use on neurodevelopment in mice

Prenatal exposure to maternal immune activation (MIA) and chronic adolescent cannabis use are both risk factors for neuropsychiatric disorders. However, exposure to a single risk factor may not result in major mental illness, indicating that multiple exposures may be required for illness onset. Here, we examine whether combined exposure to prenatal MIA and adolescent delta-9-tetrahydrocannabinol (THC), the main psychoactive component of cannabis, lead to enduring neuroanatomical and behavioural changes in adulthood.Mice were prenatally exposed to viral mimetic, poly I:C (5 mg/kg), or vehicle at gestational day (GD) 9, and postnatally exposed to chronic THC (5 mg/kg, intraperitoneal) or vehicle during adolescence (postnatal day [PND]28–45). Longitudinal magnetic resonance imaging (MRI) was performed pre-treatment, PND 25, post-treatment, PND 50, and in adulthood, PND85, followed by behavioural tests for anxiety-like, social, and sensorimotor gating. Post-mortem assessment of cannabinoid (CB)1 and 2 receptor expressing cells was performed in altered regions identified by MRI (anterior cingulate and somatosensory cortices, striatum, and hippocampus).Subtle deviations in neurodevelopmental trajectory and subthreshold anxiety-like behaviours were observed in mice exposed to both risk factors. Sex-dependent effects were observed in patterns of shared brain-behaviour covariation, indicative of potential sex differences in response to MIA and THC. Density of CB1 and CB2 receptor positive cells was significantly decreased in all mice exposed to MIA, THC, or both.These findings suggest that there may be a cumulative effect of risk factor exposure on gross neuroanatomical development, and that the endocannabinoid system may be sensitive to both prenatal MIA, adolescent THC, or the combination.

Hysteresis light curves: a protocol for characterizing the time dependence of the light response of photosynthesis.

Photosynthesis vs. light curves (LCs) have played a central role in photosynthesis research for decades. They are the commonest form of describing how photosynthesis responds to changes in light, being frequently used for characterizing photoacclimation. However, LCs are often interpreted exclusively regarding the response to light intensity, the effects of time of exposure not being explicitly considered. This study proposes the use of 'hysteresis light curves' (HLC), an experimental protocol focused on the cumulative effects of light exposure to obtain information on the time dependence of photosynthetic light responses. HLC are generated by exposing samples to a symmetrical sequence of increasing and decreasing light levels. The comparison of the light-increasing and the light-decreasing phases allows the quantification of the hysteresis caused by high-light exposure, the magnitude and direction of which inform on the activation, and subsequent relaxation of high-light-induced photosynthetic processes. HLCs of the chlorophyll fluorescence indices rETR (relative electron transport rate of photosystem II) and Y(NPQ) (index of non-photochemical quenching) were measured on cyanobacteria, algae, and plants, with the aim of identifying main patterns of hysteresis and their diversity. A non-parametric index is proposed to quantify the magnitude and direction of hysteresis in HLCs of rETR and Y(NPQ). The results of this study show that HLCs can provide additional relevant information on the time dependence of the light response of photosynthetic samples, not obtainable from conventional LCs, useful for phenotyping photosynthetic traits, including photoacclimation state and kinetics of light activation and relaxation of electron flow and energy dissipation processes.

The effects of co-exposure to methyl paraben and dibutyl phthalate on cell line derived from human skin

Data on the cumulative effects of chemical substances are necessary for the proper risk assessment, but their availability is still insufficient. The aim of the study was to evaluate the cytotoxic effect of methyl paraben (MePB) and dibutyl phthalate (DBP) on the cells of the skin line (A431) and to compare the cytotoxic effects of the tested substances after single application to A431 cells with the effects of an equimolar/equitoxic (1:1) binary mixture of these compounds as well as their mixtures in ratio 1:3: and 3:1. On the basis of the obtained results, it was found that there were interactions between the tested compounds in terms of cytotoxic effect on A431, assessed on the basis of metabolic activity of cells (MTT test) and integrity of their cell membranes (NRU test). The obtained values of synergy coefficients (SI) and isobolographic analysis indicate that between the tested chemicals in a two-component equimolar mixture (1:1) there is a synergism of action, which, at a high DBP content in the mixture (> 50%) turned into antagonism. Observations using a holotomographic microscope show morphological changes in A431 cells after exposure to both DBP and MePB separately and binary mixtures of these compounds, compared to untreated cells. The observed changes in cell morphology seem to be more pronounced when the cells are exposed to the binary mixtures of DBP and MePB than when exposed to these substances individually, which may confirm the synergy of cytotoxic activity between them (this phenomenon was observed for the higher of the tested concentrations in all tested proportions). It is important to consider such effects when considering the effects of cumulative exposure in the risk assessment in order not to underestimate the risk of adverse effects associated with exposure to chemical mixtures.