Source Of Environmental Exposure Research Articles

Circoviridae Survey in Captive Non-Human Primates, Italy.

Circoviruses (CVs) and cycloviruses (CyVs), members of the family Circoviridae, have been identified only occasionally in non-human primates (NHPs). In this study, we investigated the presence and genetic features of these viruses in 48 NHPs housed in the Bioparco-Rome Zoological Garden (Italy) and in the Anima Natura Wild Sanctuary Semproniano (Grosseto, Italy), testing fecal, saliva, and serum samples with a broadly reactive consensus nested PCR able of amplifying a partial region of the replicase (Rep) gene of members of the family Circoviridae. Viral DNA was detected in a total of 10 samples, including a saliva swab and 9 fecal samples collected, respectively from five Japanese macaques (Macaca fuscata) and four mandrills (Mandrillus sphinx), with an overall prevalence of 18.7% (9/48). On genome sequencing, five strains revealed the highest nucleotide identity (98.3-98.6%) to a CyV strain (RI196/ITA) detected in the intestinal content of a Maltese wall lizard (Podarcis filfolensis) in Italy. Although the origin of the Italian NHP strains, genetically distant from previously detected NHP CyVs, is uncertain, our results also highlight that the virome of captive animals is modulated by the different dietary and environmental sources of exposure.

Assessment ofurinary 6-hydroxy-2,4-cyclohexadienyl mercapturic acid as a novel biomarker ofbenzene exposure.

Assessing benzene exposure is a public health priority due to its deleterious health effects and ubiquitous industrial and environmental sources of exposure. Phenyl mercapturic acid (PhMA) is a commonly used urinary biomarker to assess benzene exposure. However, recent work has identified significant interlaboratory variation in urinary PhMA concentrations related to methodological differences. In this study, we present urinary 6-hydroxy-2,4-cyclohexadienyl mercapturic acid (pre-PhMA), a metabolite that undergoes acid-catalyzed dehydration to form PhMA, as a novel and specific urinary biomarker for assessing benzene exposure. We developed and validated the first quantitative liquid chromatography-tandem mass spectrometry assay for measuring urinary concentrations of pre-PhMA. The pH effect on the method of ruggedness testing determined that pre-PhMA is stable across the normal human urine pH range and that neutral conditions must be maintained throughout quantification for robust and accurate measurement of urinary pre-PhMA concentrations. The method exhibited below 2 ng/mL sensitivity for pre-PhMA, linearity over three orders of magnitude, and precision and accuracy within 10%. Urinary pre-PhMA concentrations were assessed in 369 human urine samples. Smoking individuals exhibited elevated levels of pre-PhMA compared to non-smoking individuals. Furthermore, the relationship between benzene exposure and urinary pre-PhMA levels was explored by examining the correlation of pre-PhMA with 2-cyanoethyl mercapturic acid, a smoke exposure biomarker. The urinary biomarkers exhibited a positive correlation (r = 0.720), indicating that pre-PhMA levels increased with benzene exposure. The results of this study demonstrate that urinary pre-PhMA is a rugged and effective novel biomarker of benzene exposure that can be widely implemented for future biomonitoring studies.

Amyotrophic Lateral Sclerosis and Air Pollutants in the Province of Ferrara, Northern Italy: An Ecological Study

The etiopathogenesis of amyotrophic lateral sclerosis (ALS) is still largely unknown, but likely depends on gene-environment interactions. Among the putative sources of environmental exposure are air pollutants and especially heavy metals. We aimed to investigate the relationship between ALS density and the concentration of air pollution heavy metals in Ferrara, northern Italy. An ecological study was designed to correlate the map of ALS distribution and that of air pollutants. All ALS cases diagnosed between 2000 and 2017 (Ferrara University Hospital administrative data) were plotted by residency in 100 sub-areas, and grouped in 4 sectors: urban, rural, northwestern and along the motorway. The concentrations of silver, aluminium, cadmium, chrome, copper, iron, manganese, lead, and selenium in moss and lichens were measured and monitored in 2006 and 2011. Based on 62 ALS patients, a strong and direct correlation of ALS density was observed only with copper concentrations in all sectors and in both sexes (Pearson coefficient (ρ) = 0.758; p = 0.000002). The correlation was higher in the urban sector (ρ = 0.767; p = 0.000128), in women for the overall population (ρ = 0.782, p = 0.000028) and in the urban (ρ = 0.872, p = 0.000047) population, and for the older cohort of diagnosed patients (2000-2009) the assessment correlated with the first assessment of air pollutants in 2006 (ρ = 0.724, p = 0.008). Our data is, in part, consistent with a hypothesis linking copper pollution to ALS.

How does formal and informal industry contribute to lead exposure? A narrative review from Vietnam, Uruguay, and Malaysia.

Lead industries are one of the major sources of environmental pollution and can affect human through different activities, including industrial processes, metal plating, mining, battery recycling, etc. Although different studies have documented the various sources of lead exposure, studies highlighting different types of industries as sources of environmental contamination are limited. Therefore, this narrative review aims to focus mainly on lead industries as significant sources of environmental and human contamination. Based on the keywords searched in bibliographic databases we found 44 relevant articles that provided information on lead present in soil, water, and blood or all components among participants living near high-risk areas. We presented three case scenarios to highlight howlead industries have affected the health of citizens in Vietnam, Uruguay, and Malaysia. Factories conducting mining, e-waste processing, used lead-acid battery recycling, electronic repair, and toxic waste sites were the primary industries for lead exposure. Our study has shown lead exposure due to industrial activities in Vietnam, Uruguay, Malaysia and calls for attention to the gaps in strategic andepidemiologic efforts to understand sources of environmental exposure to lead fully. Developing strategies and guidelines to regulate industrial activities, finding alternatives to reduce lead toxicity and exposure, and empowering the public through various community awareness programs can play a crucial role in controlling exposure tolead.

SENTIERI Project: a systematic review on the association between sources of environmental exposure in contaminated sites and health outcomes

the epidemiological surveillance programme carried out in the Italian Contaminated Sites (SENTIERI Project) is based on an a priori evaluation of the epidemiological evidence of a causal association between environmental exposures and health outcomes. to produce an updated review of the epidemiological evidence (January 2009-May 2020) on the association between environmental exposures and health outcomes predefined and published by the SENTIERI working group. a systematic review was conducted on MEDLINE, EMBASE, and Web of Science. Additional searches were conducted on the websites of relevant organizations. The sources of environmental exposure considered were the ones included in SENTIERI Projects (chemicals, petrochemicals and refineries, steel plants, power plants, port area, waste, mines and source of asbestos). a total of 16,817 records were identified and, after the screening process, 14 systematic reviews were identified: two IARC Monograph, two WHO Reports, one WHO/UNEP Report, and 15 observational studies. Living in proximity of contaminated sites was associated with specific diseases (mortality or incidence), with a high heterogeneity across environmental sources. For some exposures, data suggests a gender differential effect for some causes of disease. compared to a previous evidence evaluation, this systematic review shows a higher number of diseases associated with residential exposure to some contaminated sites (petrochemical facilities, waste, mines, and sources of asbestos). According to the results of this review, the a priori evidence evaluation was updated and used to interpret the epidemiological data of the Sixth SENTIERI Project Report.

Epidemiology and risk factors of nasal carriage of Staphylococcus aureus CC398 in two distinct cohorts in France.

We aimed to determine the prevalence and factors associated with nasal carriage of Staphylococcus aureus CC398 in the community and among hospitalized patients. We conducted a prospective cohort study in a French university hospital and a cross-sectional study in the surrounding region. From June 2019 to July 2020, 591 healthy blood donors (HBDs) and 647 hospitalized patients (HPs) were included. S. aureus CC398 was more prevalent in HBDs than in HPs (7.3% [5.3-9.7] vs. 3.8% [2.4-5.5], p = 0.006). Among S. aureus nasal carriers, the prevalence of CC398 isolates was 24.6% in HBDs and 18.3% in HPs (p = 0.19). No MRSA belonged to CC398. In multivariate analysis, prior antibiotic intake in the past year (OR 3.11 [1.37-7.06]) and active smoking (OR 3.01 [1.00-9.05]) were associated with S. aureus CC398 nasal carriage in the HBD cohort. A history of neurological disease was associated with nasal carriage (OR = 5.43 [1.21-24.2]), whereas an age between 82 and 90 years (OR 0.11 [0.02-0.54]) and diabetes (OR 0.18 [0.04-0.85]) were protective factors in the HP cohort. Contact with livestock was not a risk factor in either cohort. The prevalence of MSSA CC398 was higher in the community than hospitalized patients. Factors associated with nasal carriage of MSSA CC398 were primarily related to general preconditions. No environmental sources of exposure were identified.

Toenail zinc as a biomarker: Relationship with sources of environmental exposure and with genetic variability in MCC-Spain study

BackgroundToenails are commonly used as biomarkers of exposure to zinc (Zn), but there is scarce information about their relationship with sources of exposure to Zn. ObjectivesTo investigate the main determinants of toenail Zn, including selected sources of environmental exposure to Zn and individual genetic variability in Zn metabolism. MethodsWe determined toenail Zn by inductively coupled plasma mass spectrometry in 3,448 general population controls from the MultiCase-Control study MCC-Spain. We assessed dietary and supplement Zn intake using food frequency questionnaires, residential proximity to Zn-emitting industries and residential topsoil Zn levels through interpolation methods. We constructed a polygenic score of genetic variability based on 81 single nucleotide polymorphisms in genes involved in Zn metabolism. Geometric mean ratios of toenail Zn across categories of each determinant were estimated from multivariate linear regression models on log-transformed toenail Zn. ResultsGeometric mean toenail Zn was 104.1 µg/g in men and 100.3 µg/g in women. Geometric mean toenail Zn levels were 7 % lower (95 % confidence interval 1–13 %) in men older than 69 years and those in the upper tertile of fibre intake, and 9 % higher (3–16 %) in smoking men. Women residing within 3 km from Zn-emitting industries had 4 % higher geometric mean toenail Zn levels (0–9 %). Dietary Zn intake and polygenic score were unrelated to toenail Zn. Overall, the available determinants only explained 9.3 % of toenail Zn variability in men and 4.8 % in women. DiscussionSociodemographic factors, lifestyle, diet, and environmental exposure explained little of the individual variability of toenail Zn in the study population. The available genetic variants related to Zn metabolism were not associated with toenail Zn.

Neisseria species as pathobionts in bronchiectasis

Neisseria species are frequently identified in the bronchiectasis microbiome, but they are regarded as respiratory commensals. Using a combination of human cohorts, next-generation sequencing, systems biology, and animal models, we show that bronchiectasis bacteriomes defined by the presence of Neisseria spp. associate with poor clinical outcomes, including exacerbations. Neisseria subflava cultivated from bronchiectasis patients promotes the loss of epithelial integrity and inflammation in primary epithelial cells. Invivo animal models of Neisseria subflava infection and metabolipidome analysis highlight immunoinflammatory functional gene clusters and provide evidence for pulmonary inflammation. The murine metabolipidomic data were validated with human Neisseria-dominant bronchiectasis samples and compared with disease in which Pseudomonas-, an established bronchiectasis pathogen, is dominant. Metagenomic surveillance of Neisseria across various respiratory disorders reveals broader importance, and the assessment of the home environment in bronchiectasis implies potential environmental sources of exposure. Thus, we identify Neisseria species as pathobionts in bronchiectasis, allowing for improved risk stratification in this high-risk group.

Diversity of CRESS DNA Viruses in Squamates Recapitulates Hosts Dietary and Environmental Sources of Exposure.

ABSTRACTReplication-associated protein (Rep)-encoding single-stranded (CRESS) DNA viruses comprise viruses with covalently closed, circular, single-stranded DNA (ssDNA) genomes, and are considered the smallest known autonomously replicating, capsid-encoding animal pathogens. CRESS DNA viruses (phylum Cressdnaviricota) encompass several viral families including Circoviridae. Circoviruses are classified into two genera, Circovirus and Cyclovirus, and they are known to cause fatal diseases in birds and pigs. Circoviruses have also been identified in human stools, blood, and cerebrospinal fluid (CSF), as well as in various wild and domestic vertebrates, including reptiles. The synanthropic presence of Squamata reptiles has increased in the last century due to the anthropic pressure, which has shifted forested animal behavior to an urban and peri-urban adaptation. In this paper, we explored the diversity of CRESS DNA viruses in Squamata reptiles from different Italian areas representative of the Mediterranean basin. CRESS DNA viruses were detected in 31.7% (33/104) of sampled lizards and geckoes. Different CRESS DNA viruses likely reflected dietary composition or environmental contamination and included avian-like (n = 3), dog (n = 4), bat-like (n = 1), goat-like (n = 1), rodent-like (n = 4), and insect-like (n = 2) viruses. Rep sequences of at least two types of human-associated cycloviruses (CyV) were identified consistently, regardless of geographic location, namely, TN9-like (n = 11) and TN12-like (n = 6). A third human-associated CyV, TN25-like, was detected in a single sample. The complete genome of human-like CyVs, of a rodent-like, insect-like, and of a bat-like virus were generated. Collectively, the results recapitulate hosts dietary and environmental sources of exposure and may suggest unexpected ecological niches for some CRESS DNA viruses.IMPORTANCE CRESS DNA viruses are significant pathogens of birds and pigs and have been detected repeatedly in human samples (stools, serum, and cerebrospinal fluid), both from healthy individuals and from patients with neurological disease, eliciting in 2013 a risk assessment by the European Centre for Disease Prevention and Control (ECDC). Sequences of CRESS DNA viruses previously reported in humans (TN9, TN12, and TN25), and detected in different animal species (e.g., birds, dogs, and bats) were herein detected in fecal samples of synanthropic squamates (geckos and lizards). The complete genome sequence of six viruses was generated. This study extends the information on the genetic diversity and ecology of CRESS DNA viruses. Because geckos and lizards are synanthropic animals, a role in sustaining CRESS DNA virus circulation and increasing viral pressure in the environment is postulated.

Exposure of preschool-aged children to highly-concerned bisphenol analogues in Nanjing, East China

Bisphenol analogues (BPs) have already attracted wide concern owing to the environmental and health risks they pose. The exposure pathways and health risk of preschool-aged children to BPs, however, are still poorly understood. In this study, we choose population survey with 184 preschool-age children from a suburb of Nanjing, eastern China, further reveal the internal and external exposures concentrations, distribution profiles, potential sources and eventually assess health risk of preschool-age children to eight kinds of BPs. The results verify that the 95th percentile (P95) concentrations of Ʃ8BPs ranged from 0.27 to 41.6 ng/mL, with a median concentration of 7.83 ng/mL in the urine samples. BPA, and BPF were the predominant BPs in urine, accounting for 67.3%, and 18.0% of Ʃ8BPs. The urine-based estimated daily intake (EDI) of Ʃ8BPs was 187 ng/kg body weight/day. Similarly, BPA, and BPF were the main BPs in the environmental exposure sources, accounting for 80.8%, and 11.7% of the total BPs. Moreover, the total external exposure dose of Ʃ8BPs via the environmental sources was 68.1 ng/kg body weight/day, including BPA (56 ng/kg body weight/day), BPF (7.68 ng/kg body weight/day) and BPB (2.62 ng/kg body weight/day). The oral intake of drinking water and food (vegetables and rice) was the main exposure pathways of BPs in preschool-age children. Furthermore, the hazard quotient (HQ) of BPs have been evaluated and the results show no occurrence of high risk. Additionally, the urine-based EDI was significantly higher than the total external exposure dose, suggesting the existence of other pathways of BP exposure to be further explored. To the best of our knowledge, this is the first study to conduct both an internal and external exposure assessment of BPs.

Intrusion of inhaled exotic ultrafine particles into the knee joint in humans and animals: A risk to the joint and surrounding tissues

Mounting evidence recognizes a close connection between air pollution and arthropathy. Although the indirect effects of ultrafine particles (UFPs) on the joints, i.e., by inducing the inflammatory cytokines, has been documented, there are still significant knowledge gaps in understanding the direct threat of exotic particles to the joint. In the current study, we uncovered exotic UFPs in human knee joint effusions of osteoarthritis patients, and identified the ambient environmental exposure sources of these UFPs, including natural mineral and metal oxide particles (i.e., donpeacorite and hematite) through figuring out their chemical and structural fingerprints. Furthermore, animal experiments unveiled the translocation of inhaled UFPs into the joint. Histological examination recognized significant injuries to the synovium and cartilage in response to the intrusion of UFPs in the joint. With the aid of isotope-labelling, we substantiated the invasion of UFPs in the joints and obtained the according retention kinetics in mice. Collectively, our combined results provide direct evidence of the intrusion of exotic particles into the joint cavities, and define the translocation for inhaled UFPs from the inhalation system into the joints and impairment of the joint protection system. This work provides additional insights for the continued investigations into the adverse effects of air pollution on the joints, and has crucial implications in public health measures particularly related to air pollution.

A State-of-the-Science Review on Metal Biomarkers Used in Epidemiological Mixtures Analyses: Best Practices and Common Pitfalls

BACKGROUND AND AIM: Researchers are increasingly using innovative statistical methods to understand how exposure to real-world metal mixtures may affect human health. Although these new statistical approaches, such as Bayesian Kernel Machine Regression and Weighted Quantile Sums Regression, allow for researchers to include a wide panel of metals in their analysis, metals have unique sources and routes of exposure, different adsorption and elimination pathways and not all biomarkers are effective measures of exposure. This review aims to move the field of metal epidemiology forward by summarizing the most up-to-date research available on several metals, particularly highlighting the strengths and limitations of metal biomarkers and discussing potential existing evidence of interactions with other metals and environmental exposures. METHODS: We reviewed observational and experimental studies from database searches and citations regarding exposure to 12 different metals, including 8 non-essential elements (arsenic, barium, cadmium, lead, mercury, nickel, tin, uranium) and 4 essential trace elements (manganese, molybdenum, selenium, and zinc). We included more than 500 studies. RESULTS:In this review, we discuss in depth major environmental sources of exposure, biotransformation and elimination, biomarkers of exposure, and known interactions with other metals and environmental exposures for 12 metals increasingly used in metal-mixtures analyses. CONCLUSIONS:As metal epidemiology moves towards embracing a multi-metal approach it is important for researchers to have a strong knowledge base about the metals they are including in their analysis. This review provides researchers with sufficient background knowledge on several metals to appropriately inform their analysis planning, statistical approach, and interpretation of results. KEYWORDS: Heavy metals, Chemical exposures, Biomarkers of exposure, Mixtures, Toxicology

Incremental lifetime cancer risk associated with airborne arsenic, nickel and lead exposure in the megacity of Sao Paulo

BACKGROUND AND AIM: Particulate matter (PM) emitted by the burning of fuels is the main source of environmental exposure to toxic elements present in atmospheric air in urban centers. Therefore, this study aimed to investigate the incremental lifetime cancer risk (IRLT) associated with airborne arsenic, nickel and lead exposure in PM10 (diameter ≤10 µm) in the megacity of Sao Paulo, Brazil, an area with more than 7 million vehicles. METHODS: Concentrations of metals in the filter samples used in this study were provided by the São Paulo State Environmental Protection Agency (CETESB), sampled at Cerqueira Cesar station, near a busy street in the megacity, for the years 2002, 2006, 2009, and 2012. ProUCL software was used to estimate the upper confidence limits (95%UCL). The cancer risk assessment was carried out for each age group (1 to 70 years old), by inhalation route, and IRLT was calculated according to the methods of the USEPA. RESULTS:Airborne arsenic and lead concentrations showed higher means during the winter than in other seasons (p0.05). During this season, arsenic concentration was the highest one, even above international regulations. IRLT mean (UCL95%) for the exposed population to arsenic was 1.60E-05 (2.11E-05) in winter and 8.30E-06 (1.20E-05) for other seasons. For nickel, it was 1.58E-06 (1.98E-06) in winter and 1.48E-06 (2.21E-06) for other seasons. For lead, it was found 4.52E-07 (5.33E-07) in winter and 2.79E-07 (3.15E-07) for other seasons. Therefore, arsenic showed the highest risk, followed by nickel and lead. CONCLUSIONS:IRLT of airborne arsenic exposure was found to be greater than the value considered tolerable in many countries (1E-06). These findings highlight the importance of air pollution as a risk factor for population health, especially in urban centers with high vehicular traffic. Actions to reduce air pollution exposure should be prioritized in environmental and health policies agendas. Funded: FAPESP (2018/18391-0) and CAPES. KEYWORDS: particulate matter, heavy metals, risk assessment

Elevated blood lead and metal/metalloid levels and environmental exposure sources in urban Ecuadorian school-age children and mothers.

Lead and other toxic and potentially toxic metals and metalloids are significant contributors to the global burden of disease and disability. Studies characterizing blood metal/metalloid levels and potential sources of environmental exposures are limited for populations living in the major urban centers of Andean-area countries. We used ICP-MS to quantify blood levels of lead (PbB), cadmium (CdB), manganese (MnB), total arsenic (AsB), and total mercury (HgB) in school-age children (n=47) and their reproductive-age mothers (n=49) from low-resource households in Quito, Ecuador. These were compared to published 95th percentile reference values (RV95) and for PbB, also to CDC reference values. We used a detailed environmental questionnaire to examine the contribution of residential and neighborhood environmental exposure sources with participant blood metal/metalloid levels. We used ICP-MS to measure Pb levels in residential windowsill dust, floor dust, and drinking water samples and used XRF for paint samples. Forty-five percent of the mothers had PbBs ≥ 5μg/dL; 14.3% had PbBs ≥10μg/dL. Maternal blood levels exceeded RV95s for PbB (76%), CdB (41%), MnB (88%), HgB (57%), and AsB (90%). Of children, 68% had PbBs ≥ 5μg/dL, and 21.3% had PbB ≥10μg/dL. Most child blood levels exceeded the RV95s for PbB (100%), CdB (100%), MnB (94%), and total HgB (94%) and AsB (98%). Most mothers (97%) and all children had blood levels indicating exposure to multiple metal/metalloid mixtures. Maternal and child PbBs were moderately correlated with each other but the other four metals/metalloids were not. Factors associated with maternal blood metal/metalloid levels were residence in a home with an earthen floor (PbB) or bare cement block walls (MnB), living near a dirt-paved or cobblestone street (PbB), <50m from a heavily trafficked major roadway (PbB, HgB), living in the Los Chillos (PbB) or Cotocollao neighborhoods (PbB, HgB), or in areas where street vendors grilled food using charcoal (MnB). Factors associated with child blood metal/metalloid levels were residence in a dirt floor home (PbB, CdB, AsB), living near a dirt-paved or cobblestone street (PbB), living in the El Camal or Cotocollao neighborhoods (AsB), or in local neighborhoods where scrap metal smelters (MnB) and LPG gas depositories (PbB) were present. The elevated blood levels of PbB, other metal/metalloids, and metal/metalloid mixtures identified mothers and children in this exploratory study is an urgent public health and clinical concern. The exposure patterns suggest that traffic-related exposures, especially the resuspension of legacy Pb in dust, as well as other anthropogenic and geogenic sources may be important environmental contributors to metal/metalloid exposures in urban Ecuadorian mothers and children. Future studies are needed to confirm these findings and explore other potential exposure sources. Biomonitoring is also needed in order to formulate effective intervention strategies to reduce population exposure to toxic levels of environmental metals/metalloids.

Quantitative assessment of specific serum IgGs may verify source of environmental exposure in extrinsic allergic alveolitis (EAA)

Abstract: Assessment of humoral response to inhalation antigens is currently the most frequently used method to confirm exposure. It may be useful in extrinsic allergic alveolitis (EAA) patients, ...

Exposure to household pet cats and dogs in childhood and risk of subsequent diagnosis of schizophrenia or bipolar disorder.

BackgroundSerious psychiatric disorders such as schizophrenia and bipolar disorder have been associated with environmental exposures in early life. Contact with household pets such as cats and dogs can serve as a source of environmental exposure during these time periods.MethodsWe investigated the relationship between exposure to a household pet cat or dog during the first 12 years of life and having a subsequent diagnosis of schizophrenia or bipolar disorder. These studies were performed in a cohort of 396 individuals with schizophrenia, 381 with bipolar disorder, and 594 controls. The hazards of developing schizophrenia or bipolar disorder associated with first exposure to a household pet cat or dog were calculated using Cox Proportional Hazard and multivariate logistic regression models including socio-demographic covariates.ResultsWe found that exposure to a household pet dog was associated with a significantly decreased hazard of having a subsequent diagnosis of schizophrenia (Hazard Ratio .75, p < .002) Furthermore, a significant decreased relative risk of schizophrenia was detected following exposure at birth and during the first years of life. There was no significant relationship between household exposure to a pet dog and bipolar disorder. There were no significant associations between exposure to a household pet cat and subsequent risk of either a schizophrenia or bipolar disorder diagnosis. However, there were trends towards an increased risk of both disorders at defined periods of exposure.ConclusionsExposure to household pets during infancy and childhood may be associated with altered rates of development of psychiatric disorders in later life.

Primary care clinics can be a source of exposure to virulent Clostridium (now Clostridioides) difficile: An environmental screening study of hospitals and clinics in Dallas-Fort Worth region.

C. difficile is an endospore-forming pathogen, which is becoming a common cause of microbial health-care associated gastrointestinal disease in the United States. Both healthy and symptomatic patients can shed C. difficile spores into the environment, which can survive for long periods, being resistant to desiccation, heat, and disinfectants. In healthcare facilities, environmental contamination with C. difficile is a major concern as a potential source of exposure to this pathogen and risk of disease in susceptible patients. Although hospital-acquired infection is recognized, community-acquired infection is an increasingly recognized health problem. Primary care clinics may be a significant source of exposure to this pathogen; however, there are limited data about presence of environmental C. difficile within clinics. To address the potential for primary care clinics as a source of environmental exposure to virulent C. difficile, we measured the frequency of environmental contamination with spores in clinic examination rooms and hospital rooms in Dallas-Fort Worth (DFW) area of Texas. The ribotypes and presence of toxin genes from some environmental isolates were compared. Our results indicate primary care clinics have higher frequencies of contamination than hospitals. After notification of the presence of C. difficile spores in the clinics and an educational discussion to emphasize the importance of this infection and methods of infection prevention, environmental contamination in clinics was reduced on subsequent sampling to that found in hospitals. Thus, primary care clinics can be a source of exposure to virulent C. difficile, and recognition of this possibility can result in improved infection prevention, potentially reducing community-acquired C. difficile infections and subsequent disease.

Epidemiology of multi drug resistant gram negative bacteria in Kathmandu, Nepal

Purpose: Multi drug resistant (MDR) bacterial infections are considered to be hospital-acquired in high income countries. Little data are available regarding the epidemiology of MDR bacteria in low and middle-income countries. Our study looked at the epidemiology of gram negative bacterial infections in Kathmandu, Nepal. Methods & Materials: Kathmandu Model Hospital is a 125 bed tertiary care hospital, in Kathmandu, Nepal. All patients hospitalized with MDR bacterial infections over a 12 month period were retrospectively evaluated. MDR bacteria included those with extended spectrum beta lactamase (ESBL), carbapenem (CRE) or colistin resistance. Age matched controls of patients with clinical infection but negative cultures were selected during the same time period. Water surveillance was performed to identify a potential source of environmental exposure. 55 vials were filled from various drinking water sources in Kathmandu; including bottled water, home reservoirs, and community taps. Water samples were analyzed by centrifugation and conventional culture techniques. Results: No significant differences in patient characteristics were noted between the groups (Table 1). Among the cases, 73% had E. coli, 15% had Acinetobacter sp (ACBC), and 12% had K. pneumoniae. The majority of infections in both groups were community acquired. 5 water samples from 4 locations were found to have ACBC.Tabled 1CasesControlsAge years mean (range)54 (23-95)54 (18-89)Sex Male13 (32%)17 (43%) Female27 (68%)23 (57%)Admission Diagnosis Respiratory7 (18%)18 (45%) Genitourinary17 (43%)5 (13%) Skin and Soft Tissue4 (10%)0 (0%) Abdominal9 (22%)5 (13%) Unknown source3 (7%)12 (29%)Comorbidities Cardiac1211 Respiratory213 Renal52 Endocrine135 Other83Hospital Ward Medicine25 (64%)27 (68%) Surgery9 (23%)10 (25%) Gynecology5 (13%)3 (7%)Organism E. coli290 K. pneumoniae50 ACBC60 No growth040Community Acquired3936Hospital Acquired14 Open table in a new tab Conclusion: Gram negative bacterial resistance is a prevalent concern in low and middle-income countries. Our study demonstrated gram negative bacteria in the drinking water in various locations throughout Kathmandu. This is a possible source of community acquired MDR bacterial infection.

Total, methyl and inorganic mercury concentrations in blood and environmental exposure sources in newcomer women in Toronto, Canada

Measurements of total blood Hg (tHg), often used as a proxy for methyl Hg (MeHg) concentrations, are most commonly the focus of population-based studies. Data on Hg species in biomarkers can allow for a more nuanced characterization of environmental exposure sources and risk but their availability is limited, especially for newcomer populations. The purpose of the Metals in Newcomer Women (MNW) study was to address existing data gaps on metal concentrations and exposure sources in newcomer women (19–45 years) and to examine tHg, MeHg and inorganic Hg (iHg) in the blood of East and South Asian women recently arrived to Toronto. Study participants were recruited in 2015 (n = 211). Total Hg concentrations were determined using both ICP-Q-MS and isotope dilution (ID)-SPME-GC-ICP-MS. A sample subset (n = 76) was chosen for the analysis of blood MeHg and iHg concentrations (also using ID-SPME-GC-ICP-MS). Hierarchical regression models were used to assess associations between blood tHg concentrations and environmental exposure factors for MNW participants. For the sample subset, a log-linear model was used to examine associations between blood iHg and MeHg concentrations and fish consumption patterns. The geometric mean (GM) blood tHg concentration was 1.05 µg/L (95% CI: 0.88–1.25), which was elevated compared to Canadian-born women (GM: 0.57 µg/L; 95% CI: 0.49–0.66), in a specialized data analysis of the Canadian Health Measures Survey (CHMS). GM concentrations for iHg and MeHg were 0.21 µg/L (95% CI: 0.16–0.28) and 2.66 µg/L (95% CI: 2.00–3.55), respectively. Significant distal determinants associated with blood tHg concentrations were: level of educational attainment, having lived in a coastal/fishing community prior to arrival, and global region of origin. Use of iron supplements and consumption of higher mercury fish species were also associated with tHg concentrations in the fully adjusted model. The study results demonstrate that blood Hg concentrations in newcomer women are slightly elevated, with some individuals in exceedance of recommended concentrations for women of reproductive age. The consumption of fish species low in Hg is recommended for newcomer women, especially those who consume fish frequently.

Modeled exposure to tetrachloroethylene-contaminated drinking water and the occurrence of birth defects: a case-control study from Massachusetts and Rhode Island

BackgroundResidents of Massachusetts and Rhode Island were exposed to tetrachloroethylene-contaminated drinking water from 1968 through the early 1990s when it leached from the vinyl lining of asbestos cement water distribution pipes. While occupational exposure to solvents during pregnancy has consistently been linked to an increased risk of certain birth defects, mixed results have been observed for environmental sources of exposure, including contaminated drinking water. The present case-control study was undertaken to examine further the association between prenatal exposure to tetrachloroethylene-contaminated drinking water and the risk of central nervous system defects, oral clefts and hypospadias.MethodsCases were comprised of live- and stillborn infants delivered between 1968 and 1995 to mothers who resided in 28 Massachusetts and Rhode Island cities and towns with some PCE-contaminated water supplies. Infants with central nervous system defects (N = 268), oral clefts (N = 112) and hypospadias (N = 94) were included. Controls were randomly selected live-born, non-malformed infants who were delivered during the same period and geographic area as cases (N = 771). Vital records and self-administered questionnaires were used to gather identifying information, birth defect diagnoses, and other relevant data. PCE exposure during the first trimester was estimated using water distribution system modeling software that incorporated a leaching and transport model. Prenatal PCE exposure was dichotomized as “high” or “low” exposure at the level corresponding to an estimated average concentration of 40 μg/L, the criterion for remediation when PCE contamination was discovered in 1980.ResultsMothers with “high” levels of exposure to PCE-contaminated drinking water during the first trimester (> 40 μg/L) had increased odds of having a child with spina bifida (OR: 2.0, 95% CI: 0.8–5.4), cleft lip with or without cleft palate (OR: 3.8, 95% CI: 1.2–12.3) and hypospadias (OR: 2.1, 95% CI:0.5–8.3). No increases in the odds of other defects were observed in relation to “high” exposure levels.ConclusionsThe results of the present study suggest that mothers with “high” PCE exposure levels during the first trimester have increased odds of having a child with spina bifida, cleft lip with or without cleft palate, and hypospadias. These findings support several prior studies that observed an increased risk of selected birth defects following prenatal exposure to solvents in occupational and environmental settings. Even though PCE contamination from vinyl lined pipes was remediated many years ago, it remains a widespread contaminant across the U.S and so environmental regulations must be guided by a precautionary perspective that safeguards pregnant women and their offspring.