Cumulative Exposure Assessment Research Articles

Sunlight optimization in residential area design: Introducing sOSA - A comprehensive indicator for swift assessment of outdoor sunshine exposure

The increasing density and height of residential buildings have heightened the concerns regarding inadequate sunshine exposure in outdoor areas. With multi-objective optimization experiments, existing evaluation measures, such as Sunshine Times (ST), are not able to sufficiently capture the spatial features required to find the best design for outdoor sunlight conditions quickly. Spatial Outdoor Sunshine Autonomy (sOSA) is proposed in this paper as a comprehensive indicator for the rapid assessment of cumulative sunlight exposure in various outdoor scenarios. The definition of the indicator is first presented through formula derivation. Subsequently, the rapid simulation method of the sOSA indicator in Rhino is demonstrated. Utilizing the Maigao Bridge Block in Nanjing as a prototype, the application of this indicator in multi-objective optimization experiments for new residential area planning and design is showcased. Finally, the results are evaluated, and the suggestion is made to combine sOSA with ST maps and wind speed cloud maps for enhanced practical guidance.

American Football On-Field Head Impact Kinematics: Influence of Acceleration Signal Characteristics on Peak Maximal Principal Strain.

Recorded head kinematics from head-impact measurement devices (HIMd) are pivotal for evaluating brain stress and strain through head finite element models (hFEM). The variability in kinematic recording windows across HIMd presents challenges as they yield inconsistent hFEM responses. Despite establishing an ideal recording window for maximum principal strain (MPS) in brain tissue, uncertainties persist about the impact characteristics influencing vulnerability when this window is shortened. This study aimed to scrutinize factors within impact kinematics affecting the reliability of different recording windows on whole-brain peak MPS using a validated hFEM. Utilizing 53 on-field head impacts recorded via an instrumented mouthguard during a Canadian varsity football game, 10 recording windows were investigated with varying pre- and post-impact-trigger durations. Tukey pair-wise comparisons revealed no statistically significant differences in MPS responses for the different recording windows. However, specific impacts showed marked variability up to 40%. It was found, through correlation analyses, that impacts with lower peak linear acceleration exhibited greater response variability across different pre-trigger durations. Signal shape, analyzed through spectral analysis, influenced the time required for MPS development, resulting in specific impacts requiring a prolonged post-trigger duration. This study adds to the existing consensus on standardizing HIMd acquisition time windows and sheds light on impact characteristics leading to peak MPS variation across different head impact kinematic recording windows. Considering impact characteristics in research assessments is crucial, as certain impacts, affected by recording duration, may lead to significant errors in peak MPS responses during cumulative longitudinal exposure assessments.

Cumulative risk assessment of dietary exposure of the adult population in Serbia to pesticides that have chronic effects on the thyroid gland through fresh fruits and vegetables

In contrast to the traditional approach to risk assessment, which focuses on a single chemical, cumulative exposure and risk assessment considers the consequences of exposure to multiple chemical combinations. A cumulative risk assessment of dietary exposure of adult females and adult males to pesticides with chronic effects on the thyroid was conducted by estimation of the Total Margin of Exposure (MOET). Exposure to each active substance was estimated using a second-order Monte Carlo simulation. Input values for the simulation were based on over 2300 conventionally produced fruit and vegetable samples analysed from 2021 to 2023 and consumption data collected using the Food Frequency Questionnaire (FFQ) and 24h recall method. MOET values, for both populations assessed, did not exceed thresholds for regulatory consideration established by risk managers. Considering that MOETs values from consumption of fresh fruits and vegetables were relatively close to the threshold value, total exposure to the pesticides could likely reach risk-associated MOET levels, through the consumption of other food products that may be contaminated.

Contamination status and exposure risk of mycotoxins in Coicis Semen

By investigating the contamination status and predicting the exposure risk of mycotoxin in Coicis Semen, we aim to provide guidance for the safety supervision of Chinese medicinal materials and the formulation(revision) of mycotoxin limit standards. The content of 14 mycotoxins in the 100 Coicis Semen samples collected from five major markets of Chinese medicinal materials in China was determined by UPLC-MS/MS. The probability evaluation model based on Monte Carlo simulation method was established after Chi-square test and One-way ANOVA of the sample contamination data. Health risk assessment was performed on the basis of margin of exposure(MOE) and margin of safety(MOS). The results showed that zearalenone(ZEN), aflatoxin B_1(AFB_1), deoxynivalenol(DON), sterigmatocystin(ST), and aflatoxin B_2(AFB_2) in the Coicis Semen samples had the detection rates of 84%, 75%, 36%, 19%, and 18%, and the mean contamination levels of 117.42, 4.78, 61.16, 6.61, and 2.13 μg·kg~(-1), respectively. According to the limit standards in the Chinese Pharmacopoeia(2020 edition), AFB_1, AFs and ZEN exceeded the standards to certain extents, with the over-standard rates of 12.0%, 9.0%, and 6.0%, respectively. The exposure risks of Coicis Semen to AFB_1, AFB2, ST, DON, and ZEN were low, while 86% of the samples were contaminated with two or more toxins, which needs more attention. It is suggested that the research on the combined toxicity of different mycotoxins should be strengthened to accelerate the cumulative exposure assessment of mixed contaminations and the formulation(revision) of toxin limit standards.

Analysis and management of herbicidal mixtures in a high-intensity agricultural landscape in Belgium.

Water bodies located in anthropogenically influenced environments, such as agricultural landscapes, may be exposed to different chemicals simultaneously or sequentially. Yet, current environmental risk assessments focus on single active substances for unintended mixtures. For 3.5 years, the present study monitored the mixture of herbicides, within an intensively managed agricultural catchment, accompanied by a stewardship program. Twelve herbicides and one metabolite were monitored on a daily to sub-daily basis, generating a unique, high temporal resolution data set, enabling an assessment of cumulative exposure in a worst-case scenario. Analyses focused on the number of events at which the herbicide mixture concentration exceeded the regulatory accepted concentration for algae and macrophytes, based on concentration addition, and the potential factors influencing the frequency of these events are considered. A low number of individual herbicides drove the toxicity and only two of these overlapped for the two organism groups, algae and macrophytes. The observed exceedance events coincided with seasonal influences, and low rainfall during the 2011 season correlated with a highly reduced number of these events. The major influence was found to be the implementation of the stewardship program, which directed farmers to use more advanced farming techniques, avoid spillages, and other point sources. The number of exceedance events was reduced by more than half for algae (9% of the daily mean samples in 2010 and 4% in 2013) and by approximately 10 times for macrophytes (36% in 2010 to 3% in 2013). This high-resolution monitoring data set illustrates how knowledge of the influencing factors can help reduce unintended exposure to chemicals and achieve real-world improvements. Overall, a single-substance assessment is protective of mixture effects. Where mixture effects do play a role, local measures to manage point sources are more effective than changes to the desk-based environmental risk assessments that focus on diffuse sources. Integr Environ Assess Manag 2023;19:1297-1306. © 2022 Cambridge Environmental Assessments RSK ADAS Ltd and Bayer AG. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Detecting the combined toxicity of 18 binary and 24 ternary pesticide combinations to carboxylesterase based on fluorescence probe technology

A rapid test method for the determination of pesticide toxicity was established by using carboxylesterase (CES) and fluorescence probe ACE-NH based on the principle of enzyme inhibition, and this method was applied to detect the combined toxicity of 18 binary and 24 ternary pesticide combinations commonly used for fruits and vegetables to CES. The results show that chlorpyrifos + carbendazim, carbofuran + carbendazim, imidacloprid + carbendazim, imidacloprid + dimethomorph, dimethoate + dimethomorph, prochloraz + carbendazim and imidacloprid + acetamiprid + carbendazim had synergistic effects under three concentration gradients, it indicated that most binary combinations containing carbendazim or imidacloprid had synergistic effects. Based on structure-activity relationship between pesticides and CES, pesticides with phosphate ester bonds had great toxicity to CES, or though they have no toxicity to CES alone, they showed a strong synergistic effect when mixed with other pesticides. Pesticides with amide or ester bond had medium toxicity and little synergistic effect. Pesticides with urea, carbamate or nitrite nitrogen group had little or no toxicity, while there was a strong synergistic effect after mixing with other pesticides. The test method and results in this study can provide scientific basis for risk assessment of cumulative exposure to mixed pesticide residues.

One Health, Spatial, and Cumulative Organochlorines and Mercury Exposure Assessment in Steller Sea Lions of Alaska: Emphasizing Pups

One Health, Spatial, and Cumulative Organochlorines and Mercury Exposure Assessment in Steller Sea Lions of Alaska: Emphasizing Pups

Human Metabolism and Urinary Excretion Kinetics of Nonylphenol in Three Volunteers after a Single Oral Dose.

Nonylphenol (NP) is an endocrine-disrupting anthropogenic chemical that is ubiquitous in the environment. Human biomonitoring data and knowledge on internal NP exposure are still sparse, and its human metabolism is largely unknown. Therefore, in this study, we investigated human metabolism and urinary excretion of NP. Three male volunteers received a single oral dose of 1 mg 13C6-labeled NP (10.6-11.7 μg/kg body weight). Consecutive full urine voids were collected for 48 h. A metabolite screening identified nine ring- and/or side chain-oxidized metabolites. We chose the most promising hits, the alkyl chain-oxidized metabolites hydroxy-NP (OH-NP) and oxo-NP, for quantitative investigation next to the parent NP. For this purpose, we newly synthesized specific n - 1-oxidized monoisomeric analytical standards. Quantification of the polyisomeric metabolites was performed via online-solid phase extraction-LC-MS/MS with stable isotope dilution using a previously published consensus method. Alkyl chain hydroxylation (OH-NP) constituted the major metabolism pathway representing 43.7 or 62.2% (depending on the mass transition used for quantification) of the NP dose excreted in urine. The urinary excretion fraction (FUE) for oxo-NP was 6.0 or 9.3%. The parent NP, quantified via an analogous isomeric 13C6-NP standard, represented 6.6%. All target analytes were excreted predominately as glucuronic acid conjugates. Excretion was rather quick, with concentration maxima in urine 2.3-3.4 h after dosing and biphasic elimination kinetics (elimination half-times first phase: 1.0-1.5 h and second phase: 5.2-6.8 h). Due to its high FUE and insusceptibility to external contamination (contrary to parent NP), OH-NP represents a robust and sensitive novel exposure biomarker for NP. The novel FUEs enable to robustly back-calculate the overall NP intakes from urinary metabolite levels in population samples for a well-informed cumulative exposure and risk assessment.

BONE ALUMINUM AS A BIOLOGICAL MONITORING OF OCCUPATIONAL EXPOSURE TO ALUMINUM

ABSTRACTThe current proposed biological monitoring of aluminum is based on the analysis of aluminum concentration in blood/serum or in urine, but both considered to be reflective of short-term exposure. Based on its toxic kinetics, aluminum has been demonstrated to be accumulated in the bone. The aim of this study is to find out whether by analyzing bone aluminum, we might have an overview of aluminum accumulation that might cause health problems in the future. This review was conducted through a method of search and selection of articles from Pubmed, Cochrane Library, and Google Scholar databases aimed to answer question rising from the problem statement of this study. The process of searching articles used the keywords “occupational aluminum” OR “bone aluminum” AND “biological monitoring” OR “biomonitoring”. The selection of articles was performed using the defined inclusion and exclusion criteria. Initially, 61 articles were obtained, but after the selection process and hand searching, four articles remained consisting of two case reports and two cross sectional studies. Based on the selected evidence-based resources, bone can be a promising potential biomarker of aluminum, especially for cumulative exposure assessment. The use of in vivo neutron activation analysis (IVNAA) or X-ray fluorescence (XRF) technology for the purpose of noninvasively quantifying aluminum concentration in the bone, is suitable enough to be performed in occupational settings. Keywords: Bone aluminum, occupational exposure, IVNAA, XRF, biomonitoring, biological monitoring

Risk assessment approaches for evaluating cumulative exposures to multiple pesticide residues in agro-products using seasonal vegetable monitoring data from Hainan, China: a case study.

Risks from combined exposure to multiple chemicals in food have prompted a growing concern for their effect on human health. Risk management of chemical mixtures should be based on developing and harmonizing methodologies to scientifically evaluate their cumulative adverse effects. In this study, a simplified tiered approach of cumulative exposure assessment is described along with a case study of vegetables in China's Hainan province during 2012-2014. This case study could be a reference for the Chinese National Risk Assessment Programs for vegetable and fruit products. In the proposed assessment approach, Tier 1 acts as a screening tier to categorize and evaluate chemicals under a conservative scenario, and it prioritizes the pesticides of most concern. Tier 2 refines the grouping of substances from Tier 1 and normalizes the toxic potency of the chemicals to sum the exposure of chemical mixtures in a given assessment group. Tier 3 applies the refined exposure model and the input parameter distribution to create probabilistic models using Monte Carlo simulation. This approach will be helpful in the cumulative exposure assessment where data on pesticide residues are sufficient, but the individual dietary consumption is inadequate.

Integration of 103 Semivolatile Organic Compounds into One Multianalyte Method for Human Serum Analysis: An Innovative Approach within Exposure Assessment

Semivolatile organic compounds (SVOCs) are frequently detected in the environment, and humans are exposed to a mixture of chemicals via multiple exposure pathways. However, there are few data on health outcomes caused by the cumulative exposure or toxicological interactions, due to the absence of simultaneous analytical methods. Herein, we present a method for simultaneous determination of 103 SVOCs, including seven phthalate esters, seven polychlorinated biphenyls, 16 polycyclic aromatic hydrocarbons, five polybromodiphenyl ethers, and 68 pesticides, in 0.5 mL of serum. The two-step extraction coupled with gas chromatography-tandem mass spectrometry was described with a single chromatographic run within 36.65 min. Methodological parameters such as recovery rates, matrix effects, and limits of detection were studied and complied with the validation guidelines. The absolute and relative recoveries ranged from 65.45% to 123.83%, and the relative standard deviations were ≤21.43%. The detection limits were <0.41 μg L–1. This method was then successfully applied to the analysis of 99 real serum samples. The developed protocol achieved a limit of quantification at a level of parts per billion for all compounds and presented benefits for the control of confounding factors, cumulative exposure, and risk assessment in population studies.

Potential impact of prioritisation methods on the outcome of cumulative exposure assessments of pesticides

This report describes the potential impact of a prioritisation method on the outcome of cumulative exposure assessments of pesticides. The method aims to reduce the laborious task of the establishment of cumulative assessment groups (CRAs). The prioritisation method consisted of two steps: 1) identification of low-priority substances and 2) identification of priority organs. The first step aimed to identify low-priority substances based on hazard quotient (HQ) thresholds for single substances relevant for acute effects on the nervous system or chronic effects on the thyroid. For this, probabilistic calculations of chronic and acute HQs were performed for 210 substancesand 10 surveys. Priority pesticides were retained according to four different thresholds, namely an HQ larger than0.1 at the 99th percentile of exposure, or an HQ larger than 0.01, 0.1 or 0.2 at the 99.9th percentile of exposure. In the second step, AGs for the nervous system and the thyroid were compiled and risk metrics obtained for those organs was compared with the risk of higher tier AGs at the specific effect. It was concluded that risk assessment of AGs at the target organ level using critical effects (i.e. using the health-based guidance value of substances) is feasible. The prioritisation thresholds were applied for AGs at the target organ level and for AGs at the specific effect level. The prioritisation threshold of having an HQ larger than 0.1 at 99.9th percentile to retain substances could be used for those AGs. It reduced the number of substances in the AG nervous system to 50% and the number of substances in the AG thyroid to 70% without having a substantialimpact on the total margin of exposure. In conclusion, the prioritisation method could be used to simplify CRA and may contribute to a cost-effective approach whilst still providing a high level of protection.

Exposure to multiple mycotoxins in domestic and imported rice commercially traded in Tehran and possible risk to public health.

Mycotoxins are secondary fungi metabolites that induce acute and chronic toxic effects in humans and animals. In the present study, nine mycotoxins including aflatoxins (AFB1, AFB2, AFG1 and AFG2), fumonisins (FB1 and FB2), Ochratoxin A (OTA), deoxynivalenol (DON), and zearalenone (ZEN) were determined in one hundred rice samples collected from Tehran using high performance liquid chromatography (HPLC) with fluorescence or photodiode array detector. In addition, possible risk to public health was investigated by assessing dietary exposure through rice consumption, the margin of exposure (MOE), respective risk of cancer and hazard index (HI) of the monitored mycotoxins in children and adults. The higher mean levels were determined for DON (102.22 μg.Kg-1), followed by FB1 (85.00 μg.Kg-1). For the rests of mycotoxins the levels did not exceed 20 μg.Kg-1. The estimated AFB1 intake for the adults and children through rice consumption exceeds the safe levels established for both carriers and non-carriers of hepatitis B virus. The mean and median determined exposure levels of OTA, DON ZEN and FB1, were found lower than the Provisional Maximum Tolerable Daily Intake (PMTDI) value for both adults and children of Tehran that consuming domestic and imported rice. The mean HI for adults and median HI for adults and children were below one, and mean HI for children was close to one. All the mean, median and maximum MoE values were <10,000 in adults and children, indicating a risk due to AFB1 exposure through rice consumption in Tehran. In addition, the calculated mean cancer risk in adult and child populations of Tehran were 0.27 and 0.64 cases per year per 105 individuals, respectively, that shows population in Tehran could be at risk of cancer due to AFB1 exposure through rice consumption as calculated. So further studies are necessary for the monitoring mycotoxins in rice and different food products as well as estimating average dietary exposure and cumulative exposure assessment of mycotoxins for main foods in IR Iran.

Cumulative exposure assessment of neonicotinoids and an investigation into their intake-related factors in young children in Japan

Exposure levels of neonicotinoids (NEO) in young children remain unknown, despite their widespread use and the plausible vulnerability of toddlers to environmental toxicants. Herein we aimed to clarify the exposure levels and sources of NEOs in young Japanese children. Disposable diapers were collected from 1036 children (16–23 months old) participating in an adjunct study of the Japan Environment and Children's Study between 2015 and 2016. Six NEOs and one metabolite in urine extracted from a diaper from each child were analyzed using high-performance liquid chromatography-tandem mass spectrometry. A relative potency factor approach was used to assess the cumulative exposure to NEOs equivalent to dinotefuran levels (DINRPF). The 95th percentile urinary concentration of DINRPF was 157 μg/L and 380 μg/g creatinine (Cr). Receiver operating characteristic curve analyses for the propensity scores of the possible exposure-related factors revealed that the discriminatory powers determining whether Cr-adjusted and Cr-unadjusted DINRPF concentrations exceeding the 95th percentile values were higher for the amount of each foodstuff ingested on the survey day (areas under the curve were 0.62 and 0.75, respectively) than for the exposure-related behaviors (0.60 and 0.71, respectively) or for mothers' attitudes toward food selection and preparation (0.54 and 0.57, respectively). Use of a mosquito coil, insect repellent, and mothproof net for a screen door, and playing on a lawn were associated with increased urinary NEO levels (odds ratio [OR]: 2.0–2.9), while care about the child's nutritional balance by mothers reduced urinary NEO levels (OR: 0.23–0.41). To the best of our knowledge, this is the first study that dealt with urinary concentrations and possible exposure sources of NEOs in a large number of young children. Attention to the children's behavior and diet might result in the reduction of a high exposure to NEOs in young children.

Cumulative dietary risk characterisation of pesticides that have acute effects on the nervous system.

A retrospective acute cumulative risk assessment of dietary exposure to pesticide residues, supported by an uncertainty analysis based on expert knowledge elicitation, was conducted for two effects on the nervous system: brain and/or erythrocyte acetylcholinesterase inhibition, and functional alterations of the motor division. The pesticides considered in this assessment were identified and characterised in the scientific report on the establishment of cumulative assessment groups of pesticides for their effects on the nervous system. Cumulative exposure assessments were conducted through probabilistic modelling by EFSA and the Dutch National Institute for Public Health and the Environment (RIVM) using two different software tools and reported separately. These exposure assessments used monitoring data collected by Member States under their official pesticide monitoring programmes in 2014, 2015 and 2016 and individual consumption data from 10 populations of consumers from different countries and different age groups. This report completes the characterisation of cumulative risk, taking account of the available data and the uncertainties involved. For each of the 10 populations, it is concluded with varying degrees of certainty that cumulative exposure to pesticides that have the acute effects on the nervous system mentioned above does not exceed the threshold for regulatory consideration established by risk managers.

Cumulative dietary risk characterisation of pesticides that have chronic effects on the thyroid.

A retrospective chronic cumulative risk assessment of dietary exposure to pesticide residues, supported by an uncertainty analysis based on expert knowledge elicitation, was conducted for two effects on the thyroid, hypothyroidism and parafollicular cell (C‐cell) hypertrophy, hyperplasia and neoplasia. The pesticides considered in this assessment were identified and characterised in the scientific report on the establishment of cumulative assessment groups of pesticides for their effects on the thyroid. Cumulative exposure assessments were conducted through probabilistic modelling by EFSA and the Dutch National Institute for Public Health and the Environment (RIVM) using two different software tools and reported separately. These exposure assessments used monitoring data collected by Member States under their official pesticide monitoring programmes in 2014, 2015 and 2016 and individual consumption data from 10 populations of consumers from different countries and different age groups. This report completes the characterisation of cumulative risk, taking account of the available data and the uncertainties involved. For each of the 10 populations, it is concluded with varying degrees of certainty that cumulative exposure to pesticides that have the chronic effects on the thyroid mentioned above does not exceed the threshold for regulatory consideration established by risk managers.

Low-Dose Silver Nanoparticle Surface Chemistry and Temporal Effects on Gene Expression in Human Liver Cells.

Silver nanoparticles (AgNPs) are widely incorporated into consumer and biomedical products for their antimicrobial and plasmonic properties with limited risk assessment of low-dose cumulative exposure in humans. To evaluate cellular responses to low-dose AgNP exposures across time, human liver cells (HepG2) are exposed to AgNPs with three different surface charges (1.2 µg mL-1 ) and complete gene expression is monitored across a 24 h period. Time and AgNP surface chemistry mediate gene expression. In addition, since cells are fed, time has marked effects on gene expression that should be considered. Surface chemistry of AgNPs alters gene transcription in a time-dependent manner, with the most dramatic effects in cationic AgNPs. Universal to all surface coatings, AgNP-treated cells responded by inactivating proliferation and enabling cell cycle checkpoints. Further analysis of these universal features of AgNP cellular response, as well as more detailed analysis of specific AgNP treatments, time points, or specific genes, is facilitated with an accompanying application. Taken together, these results provide a foundation for understanding hepatic response to low-dose AgNPs for future risk assessment.

Identification of a pesticide exposure based market basket suitable for cumulative dietary risk assessments and food monitoring programmes

ABSTRACT Consideration of cumulative dietary risks is a requirement in the European legislation for setting maximum residue levels for pesticides. Current cumulative exposure assessment methodologies strongly rely on representative occurrence data from food monitoring programmes. This study provides a sensitivity analysis, utilising (i) European consumption data expressed as raw agricultural commodity (RAC) equivalents from 23 different countries as published by the European Food Safety Authority and (ii) all maximum residue levels established for pesticides under European Regulation (EC) No 396/2005. Based on two different degrees of conservatism, market baskets consisting of 16 or 41 RACs, respectively, were identified, covering the majority of the total chronic and acute daily exposure. The coverage of the exposure by these market baskets was tested by comparison of cumulative probabilistic exposure assessments for the German population using all food commodities and those using the reduced sets. It was demonstrated that ≥85% of the total chronic exposure is already covered by 16 RACs, while 41 RACs are required to reach a similarly satisfying coverage of the total acute exposure. Results from this study support resource efficient modelling of complex cumulative assessment scenarios and may help to improve the design of food monitoring programmes with respect to a more efficient assessment of potential consumer risks.

Comparison Between a Job-Exposure Matrix (JEM) Score and Self-Reported Exposures for Carrying Heavy Loads Over the Working Lifetime in the CONSTANCES Cohort.

Job-exposure matrices (JEMs) were developed to allow assessment of past work exposure for large population-based studies where better exposures data are unavailable. Few studies have directly compared biomechanical JEMs to self-administered questionnaires. We compared assessments of cumulative exposure to carrying heavy loads based on 'JEM Constances' to individually self-reported (SR) exposures. In the French CONSTANCES cohort at inception, past SR exposure to carrying heavy loads (ever/never and durations) and a detailed job history were available for 26 929 subjects. JEM Constances, an existing biomechanical JEM based on SR current exposures from 26 821 asymptomatic workers, was combined with job history to build a cumulative biomechanical exposure score. Using individual SR exposure as the reference, Area Under the Curve (AUC) of Receiver Operating Characteristic (ROC) curves, sensitivity, and specificity were calculated. For both methods, associations with low back pain and knee pain were computed using multinomial logistic models. Additional analyses compared older (>10 years) to more recent (≤10 years) exposures. AUCs ranged from 0.795 (0.789-0.800) when all periods were considered, to 0.826 (0.820-0.833) for more recent biomechanical exposure (≤10 years). Associations between carrying heavy loads and low back pain or knee pain were less strong using JEM assessment than individually SR exposure: for low back pain ORSR = 3.02 (2.79-3.26) versus ORJEM = 1.70 (1.59-1.82) and for knee pain ORSR = 2.27 (2.10-2.46) versus ORJEM = 1.64 (1.53-1.77). JEM Constances' assessment of cumulative exposure of carrying heavy loads seems to be a useful method compared to a self-administrated questionnaire for large population-based studies where other methods are not available.

Compound health risk assessment of cumulative heavy metal exposure: a case study of a village near a battery factory in Henan Province, China.

The concentrations of the heavy metals Hg, As, Ni, Pb, Cd, Cr, Cu and Zn in soil, groundwater, air, and locally produced grain (wheat and corn) and vegetables were determined in a village near a battery factory in Xinxiang, Henan Province, China. A multimedia, multipathway health risk assessment of heavy metal exposure was carried out using the health risk model recommended by the United States Environmental Protection Agency (US EPA). The results showed that the concentrations of Cd in soil, Cd and Pb in wheat, Hg in corn, Cd, Hg, and Pb in vegetables, and Cd and As in PM2.5, PM10, and TSP were all higher than the corresponding limits for heavy metals in China. The non-carcinogenic risks (HIs) for all environmental media were higher in children than in adults, and the carcinogenic risks (TCRs) of heavy metal exposure in other media except for soil were higher in adults than in children. The total HI and TCR in adults and children were higher than the standard limit values because of heavy metal exposure through soil, groundwater, PM10, grain and vegetables. Cd was the most significant heavy metal in terms of HI and TCR factors; among the evaluated pathways, the contribution of diet was the largest. The HI and TCR caused by dietary crops account for 96.7% and 98.9% of the total in adults and 90.2% and 96.2% of the total in children, respectively. To maintain the health of the residents in the study area, it is strongly recommended to stop planting edible agricultural products immediately, start buying grain and vegetables from outside the study area, and strictly strengthen the control of heavy metal pollution in the study area. The source apportionment results show that Cd, Ni and As were mainly from industrial sources, which was related to sewage irrigation and battery plant deposition, and Pb and Cr were mainly from agricultural activities.