Reduction In Exposure Research Articles

Frequency of personal care product use among reproductive-aged Black individuals and associations with socio-demographic characteristics

BackgroundCompared to White women, Black women in the United States are more likely to use personal care products (PCPs) with higher concentrations of endocrine-disrupting chemicals (EDCs) and harsher chemical formulations. This may contribute to differential health outcomes in Black women such as increased risk of breast cancer, cardiometabolic outcomes, adverse birth outcomes, and uterine fibroids.ObjectiveClassify distinct PCP use patterns across multiple types of products and examine how patterns vary by socio-demographic characteristics.MethodsThe Study of Environment, Lifestyle and Fibroids is a cohort study of reproductive-aged Black individuals living around Detroit, Michigan. Using self-reported data on frequency of PCP collected between 2013–2018, we employed latent class analysis to identify distinct groups of participants with similar PCP use. Socio-demographic characteristics were compared across latent classes.ResultsAmong 1562 participants, we identified 6 latent classes: Lower Overall; Higher Nailcare; Higher Skincare; Moderate Overall; Higher Makeup/Haircare/Skincare; Higher Overall. Makeup and nailcare usage were the most predictive for classifying participants into groups. Participants in classes with less frequent use of all PCPs and those with only high use of nailcare products, were more likely to report lower socio-economic status (SES), be current smokers, have a body mass index of ≥35 kg/m2, and have ≥3 births. In comparison, participants in classes with average and more frequent use of PCPs were more likely to report higher SES, be non-smokers, be nulliparous, and have ever used oral contraceptives.Impact statementThis study is one of the first detailed assessments of PCP usage among a large cohort of young adult Black women that considers multiple product categories including makeup, hair, skin, nail, and vaginal products. Latent class analysis was used to capture complex patterns of PCP use and identify distinct groups of individuals with similar product use. Although the latent classes are specific to this study population, the identified socio-demographic characteristics or behaviors associated with latent classes may inform targeted and impactful exposure reduction strategies in similar populations.

What have we learned about risk assessment and interventions to prevent work-related musculoskeletal disorders and support work participation?

The Scandinavian Journal of Work, Environment & Health (SJWEH) was established half a century ago. This paper provides an overview of research on musculoskeletal disorders (MSD) published over these 50 years. Three themes are described: risk assessment, interventions to prevent work-related MSD, and interventions to support work participation. Finally, implications for future research are highlighted. A systematic literature search was performed for all papers on MSD published in SJWEH. Each paper was coded on several criteria including research topic, type of MSD, risk factor(s), and number of citations. Findings were tabulated, and discussions within the author team defined the main results and future research directions. The search resulted in 1056 papers, of which 474 were included. The most reported-on MSD was low-back pain (LBP, 18%) and the most reported-on work-related risk factors were physically demanding work (14%) and psychosocial factors (12%). Research has contributed to improving case definitions, refining work-related exposure criteria, and recognizing the varying importance of physical and psychosocial factors across different MSD. Research on the association between work-related risk factors and LBP continues to emerge. Effective interventions for prevention of MSD are characterised by sufficient exposure reduction, while supporting work participation requires integrating health care, with multidisciplinary actions directed at factors involving the worker, employer, and workplace. Research has provided valuable insights into risk assessment, interventions for preventing work-related MSD, and supporting work participation. Intervention studies remain warranted and new areas include adopting whole-system approaches to prevent work-related MSD and promoting the concept of musculoskeletal health.

Occupational exposure, carcinogenic and non-carcinogenic risk assessment of formaldehyde in the pathology labs of hospitals in Iran

Formaldehyde, a known carcinogenic compound, is commonly used in various medical settings. The objective of this study was to assess the carcinogenic and non-carcinogenic risks associated with occupational exposure to formaldehyde. This study was conducted in the pathology labs of four hospitals in Tehran. Cancer and non-cancer risks were evaluated using the quantitative risk assessment method proposed by the United States environmental protection agency (USEPA), along with its provided database known as the integrated risk information system (IRIS). Respiratory symptoms were assessed using the American thoracic society (ATS) questionnaire. The results indicated that 91.23% of exposure levels in occupational groups exceed the NIOSH standard of 0.016 ppm. Regarding carcinogenic risk, 41.03% of all the studied subjects were in the definite carcinogenic risk range (LCR > 10−4), 23.08% were in the possible carcinogenic risk range (10−5 < LCR < 10−4), and 35.90% were in the negligible risk range (LCR < 10−6). The highest index of occupational carcinogenesis was observed in the group of lab technicians with a risk number of 3.7 × 10−4, followed by pathologists with a risk number of 1.7 × 10−4. Furthermore, 23.08% of the studied subjects were within the permitted health risk range (HQ < 1.0), while 76.92% were within the unhealthy risk range (HQ > 1.0). Overall, the findings revealed significantly higher carcinogenic and non-carcinogenic risks among lab technicians and pathologists. Therefore, it is imperative to implement control measures across various hospital departments to mitigate occupational formaldehyde exposure levels proactively. These findings can be valuable for policymakers in the health sector, aiding in the elimination or reduction of airborne formaldehyde exposure in work environments.

The impact of clinical audits on patient radiation exposure for device procedures

Abstract Background Clinical audits aim to ensure ideal use of ionizing radiation in clinical practice. Since it became mandatory by Swiss law in 2018, such an audit also took place in our Cardiac Pacing and Electrophysiology Division at the University Heart Center. Purpose To establish local diagnostic reference levels (DRLs) for specific procedures and to examine if patient radiation exposure was reduced after the clinical audit. Methods Retrospective cohort study including patients from October 2018 to October 2020 who underwent device implantation, including pacemakers, implantable cardioverter defibrillators (ICD), cardiac resynchronization therapy (CRT), or lead extraction / device explantation. Main measures to reduce radiation exposure after the audit were lower pulsed fluoroscopy frame rates and dose characteristics at baseline. Patient radiation exposure was evaluated with the dose-area product (DAP), cumulative dose, fluoroscopy time, and the number of cine acquisitions. Secondary endpoints included the effective dose, the acute procedural success rate and 30-day complications. Data were collected from a dose management system and cross-checked for accuracy with the patient information system. The third quartiles were set as local DRLs. Data before and after the clinical audit were compared. Results A total of 541 patients (45.7 % before the audit, 54.3% after the audit) were included. 28.3% had a conventional pacemaker, 22.0% a leadless pacemaker, 21.1% an ICD, and 17.2% a CRT implantation. Lead extraction / device explantation was undergone by 11.5% of patients. The local DRLs (including all procedures before and after the audit) for the DAP were significantly lower as compared to national DRLs (6.2 dGy.cm2 versus 300 dGy.cm2 for conventional pacemakers; 7.6 dGy.cm2 versus 200 dGy.cm2 for ICDs, 203 dGy.cm2 versus 570 dGy.cm2 for CRTs). After the audit, DAP (Figure 1), cumulative dose, effective dose and the number of cine acquisition significantly decreased for conventional pacemakers (p-value ≤ 0.04), whereas no significant differences were observed for the other procedures. The acute procedural success rate (98.4 vs 98.9%) and the 30-day complications (4.0 vs 7.8%) were not significantly different before and after the audit. Conclusions The clinical audit in our institution led to a significant reduction of radiation exposure for patients during pacemaker implantations. Regarding DRLs, local values were far below national DRLs, which suggests that national DRLs need to be updated more regularly. Our study highlights the importance of clinical audits and the need for more research in this field.

Near-zero fluoroscopy technique for cardiac electronic device implantation: long-term outcomes

Abstract Introduction Radiation hazards are a major concern for both patients and staff. We have previously described a near-zero fluoroscopy technique for cardiac electronic device implantation. In this study, we aimed to investigate the long-term safety of this technique and compare outcomes and procedural metrics with a conventional approach in a larger population. Methods Low-dose fluoroscopy technique. Radiation exposure during fluoroscopy is directly proportional to the time the unit is activated. Typically, the pedal switch is depressed for at least a few seconds per imaging sequence in order to visualize "live" movements of either the leads during their positioning or the needle during a fluoroscopy-guided puncture of the subclavian vein. Our technique consists of setting a low frame rate per second (0.5-3.75fps) and momentarily triggering the foot pedal switch only to obtain screenshots of the position of the leads/needle. Use of live electrograms to assist spatial awareness of lead position (e.g. Atrial, Coronary Sinus, Ventricular signals) acts as an adjunct to guidance. Study design We included consecutive patients undergoing permanent pacemaker (PPM) or cardiac defibrillator (ICD) implant at our center from July 2018 to December 2022 using the near-zero fluoroscopy technique. Procedures were performed by three operators (AC, MD, MF). Cumulative radiation dose was measured using dose-area product (DAP). We assessed procedure success and complication rate during long-term follow-up. We compared the procedural metrics and outcomes with a cohort of patients with PPM or ICD implanted in our centre by senior operators, using a traditional fluoroscopic approach. Propensity score was adopted to match baseline characteristics between the study and control group. Results The total population consisted of 412 patients (74.2±13.9 years, 60.9% male). We included 206 who underwent PPM or ICD implantation using the low-dose fluoroscopy technique, and 206 matched-control. A PPM or ICD was successfully implanted in all patients. Fluoroscopy time and DAP were significantly lower in the low-dose fluoroscopy group, mean 2.3±2.0 seconds versus 258.4±252.1 seconds (P&amp;lt;0.001) and 3.4±3.5 µGym2 versus 29.8±55.4 µGym2 (P&amp;lt;0.001), respectively. Mean procedure time was 49.0±20.8 minutes in the low fluoroscopy group and 65.7±26.8 minutes in the control group (P&amp;lt;0.001). Median frame per second setting was 0.5 in the low-dose cohort. After a mean follow-up of 441±470 days, the rate of complications was identical across groups (2.4%, p = 1.0). Conclusion This near-zero dose fluoroscopy technique is effective and safe, enabling a 10x reduction in radiation exposure during device implant. Modification of traditional implant and imaging techniques can provide material reductions in fluoroscopy dose to even below that for a standard PA chest radiograph.

Assessing the impact of 3D imaging assistance on efficiency and safety in atrial fibrillation cryoablation

Abstract Introduction Pulmonary vein (PV) isolation is a cornerstone therapy for symptomatic atrial fibrillation (AF). Current 3D-navigation technologies used with radiofrequency (RF) ablation allow drastic reduction of X-ray exposure and better anatomical characterization improving acute and long-term procedural results. Cryoballoon ablation (CA) procedures typically rely on conventional fluoroscopy, resulting in significant X-ray exposure. Although contemporary fluoroscopy technologies allow for potential 3D imaging integration, their specific utility in improving procedural guidance during CA remains undefined. Method Using semi-automatic segmentation obtained from pre-procedural cardiac computed tomography, 3D segmentations of the left atrium, including PV, spine and primary bronchi walls were fused on the real-time fluoroscopy acquisitions in three standard positions (AP, LAO, RAO), acquired at the beginning of the procedure (Figure1). We compared procedural characteristics of CA performed with 3D-fusion imaging to conventional fluoroscopy-guided procedures. Results Thirty-six patients (aged 60±13 yo, 85% male) with paroxysmal AF treated with CA were included in the study: 18 in the control group (conventional fluoroscopy) and 18 in the 3D-assisted group. Acute PV isolation was achieved in all patients. The 3D-assisted CA was associated with significantly shorter procedure duration (mean 97.8±15.5 vs 82.1±16.1 min, p=0.0048); left-sided dwelling time (mean 77±15.2 vs 65.1±14.4 min, p=0.0351); and lower X-ray energy delivered to the patient (Dose Area product) with mean 661±373.1 vs 378.1±316.8 cGy*cm2 (p=0.013). Interestingly, we found that 72.2% of 3D guided procedures were done in less than 90min, while 77.8% of conventional cases required more than 90min to be completed (Figure 2D). Conclusion 3D-fusion imaging integration is feasible and allows for an exact PV anatomy depiction on fluoroscopy. Our data illustrates that it might significantly improve CA efficiency (shorter procedure duration) and safety (lower X-ray exposure and left-sided dwelling time). Our approach could also impact long-term results since it might reduce the likeability of missing intermediate PVs. Further research is needed to evaluate the incremental value of 3D imaging in long term efficacy.Figure 1Figure 2

Association between serum copper and blood glucose: a mediation analysis of inflammation indicators in the NHANES (2011–2016)

BackgroundThe rising prevalence of diabetes underscores the need for identifying effective prevention strategies. Recent research suggests environmental factors, particularly heavy metals like copper, significantly influence health outcomes, including diabetes, through mechanisms involving inflammation and oxidative stress. This study aims to explore how serum copper levels affect blood glucose, employing NHANES data from 2011 to 2016, to provide insights into environmental health’s role in diabetes prevention and management.MethodsThe study analyzed data from 2,318 NHANES participants across three cycles (2011–2016), focusing on those with available data on serum copper, inflammatory markers, and blood glucose levels. We utilized principal component analysis for selecting inflammatory markers, mediation analysis to examine direct and indirect effects, multiple linear regression for assessing relationships between markers and glucose levels, and weighted quantile sum regression for evaluating individual and collective marker effects, adjusting for demographic variables and serum copper.ResultsParticipants averaged 42.70 years of age, with a near-even split between genders. Average serum copper was 119.50 μg/dL, white blood cell count 6.82 × 109/L, and fasting blood glucose 107.10 mg/dL. Analyses identified significant mediation by inflammatory markers (especially white blood cells: 39.78%) in the copper-blood glucose relationship. Regression analyses highlighted a positive correlation between white blood cells (estimate: 1.077, 95% CI: 0.432 to 2.490, p = 0.013) and copper levels and a negative correlation for monocyte percentage (estimate: −1.573, 95% CI: 0.520 to −3.025, p = 0.003). Neutrophil percentage was notably influential in glucose levels. Sensitive analyses confirmed the study’s findings.ConclusionSerum copper levels significantly impact blood glucose through inflammatory marker mediation, highlighting the importance of considering environmental factors in diabetes management and prevention. These findings advocate for public health interventions and policies targeting environmental monitoring and heavy metal exposure reduction, emphasizing the potential of environmental health measures in combating diabetes incidence.

Pre-asthma: a useful concept? A EUFOREA paper. Part 2-late onset eosinophilic asthma.

The concept of pre-diabetes has led to provision of measures to reduce disease progression through identification of subjects at risk of diabetes. We previously considered the idea of pre-asthma in relation to allergic asthma and considered that, in addition to the need to improve population health via multiple measures, including reduction of exposure to allergens and pollutants and avoidance of obesity, there are several possible specific means to reduce asthma development in those most at risk (pre- asthma). The most obvious is allergen immunotherapy (AIT), which when given for allergic rhinitis (AR) has reasonable evidence to support asthma prevention in children (2) but also needs further study as primary prevention. In this second paper we explore the possibilities for similar actions in late onset eosinophilic asthma.

Le Fort fractures: a review

Rene Le Fort proposed 3 classifications to determine the type of facial fracture based on the main facial lines with the least resistance, these being the places where facial fractures are most located. These fractures occur mainly because of high-velocity impact mechanisms. Le Fort fractures are difficult to manage and at the same time challenging, although it is not a common pathology, it is potentially lethal, and its initial approach and resuscitation are critical in the first hours. As in any other trauma, an initial evaluation must be carried out exhaustively and following the ABC, which mainly includes evaluation of the airway, breathing and circulation. Once a facial fracture is suspected, its extension and location must be determined through images such as x-ray or computed tomography. CT being the gold standard. Once the patient is stabilized, reconstructive surgery will be the indicated approach in most cases, with the main objective being the restoration of occlusion, direct exposure and manual reduction of the fractures, reconstruction of the medial and lateral bone buttresses, restoring the projection of the face and restore the width of the maxillary arch, nose and orbit. In general, some of the most frequently described postoperative complications are hemorrhage, infection, foreign body reaction, malunion, among others; however, these will vary depending on their classification.

Systematic evidence mapping of potential correlates of exposure for per- and poly-fluoroalkyl substances (PFAS) based on measured occurrence in biomatrices and surveys of dietary consumption and product use

Per- and poly-fluoroalkyl substances (PFAS) are widely observed in environmental media and often are found in indoor environments as well as personal-care and consumer products. Humans may be exposed through water, food, indoor dust, air, and the use of PFAS-containing products. Information about relationships between PFAS exposure sources and pathways and the amounts found in human biomatrices can inform source-contribution assessments and provide targets for exposure reduction. This work collected and collated evidence for correlates of PFAS human exposure as measured through sampling of biomatrices and surveys of dietary consumption and use of consumer products and articles. A systematic evidence mapping approach was applied to perform a literature search, conduct title-abstract and full-text screening, and to extract primary data into a comprehensive database for 16 PFAS. Parameters of interest included: sampling dates and locations, cohort descriptors, PFAS measured in a human biomatrix, information about food consumption in 11 categories, use of products/articles in 11 categories, and reported correlation values (and their statistical strength). The literature search and screening process yielded 103 studies with information for correlates of PFAS exposures. Detailed data were extracted and compiled on measures of PFAS correlations between biomatrix concentrations and dietary consumption and other product/article use. A majority of studies (61/103; 59%) were published after 2015 with few (8/103; 8%) prior to 2010. Studies were most abundant for dietary correlates (n = 94) with fewer publications reporting correlate assessments for product use (n = 56), while some examined both. PFOA and PFOS were assessed in almost all studies, followed by PFHxS, PFNA, and PFDA which were included in >50% of the studies. No relevant studies included PFNS or PFPeS. Among the 94 studies of dietary correlates, significant correlations were reported in 83% of the studies for one or more PFAS. The significant dietary correlations most commonly were for seafood, meats/eggs, and cereals/grains/pulses. Among the 56 studies of product/article correlates, significant correlations were reported in 70% of the studies. The significant product/article correlations most commonly were for smoking/tobacco, cosmetics/toiletries, non-stick cookware, and carpet/flooring/furniture and housing. Six of 11 product/article categories included five or fewer studies, including food containers and stain- and water-resistant products. Significant dietary and product/article correlations most commonly were positive. Some studies found a mix of positive and negative correlations depending on the PFAS, specific correlate, and specific response level, particularly for fats/oils, dairy consumption, food containers, and cosmetics/toiletries. Most of the significant findings for cereals/grains/pulses were negative correlations. Substantial evidence was found for correlations between dietary intake and biomatrix levels for several PFAS in multiple food groups. Studies examining product/article use relationships were relatively sparse, except for smoking/tobacco, and would benefit from additional research. The resulting database can inform further assessments of dietary and product use exposure relationships and can inform new research to better understand PFAS source-to-exposure relationships. The search strategy should be extended and implemented to support living evidence review in this rapidly advancing area.

The health benefits of solar power generation: Evidence from Chile

Renewable energy can yield social benefits through local air quality improvements and their subsequent effects on human health. We estimate some of these benefits using data gathered during the rapid adoption of large-scale solar power generation in Chile over the last decade. Relying on exogenous variation from solar irradiation and incremental solar generation capacity over time, we find that solar energy displaces coal generation and curtails hospital admissions due to respiratory diseases. These effects are largely manifested in cities downwind of and near coal plants that are displaced by the introduction of new solar. The reduction in exposure to air pollution from these displaced coal plants seems to be driving this relationship. Our results help quantify the health benefits that can be achieved through greater renewable energy investments.

Recovery of lead, iron, and copper from point-of-use-filters to examine performance

Over the last few decades, reliance on point-of-use (POU) treatment for removing actual or perceived contaminants in drinking water has increased within the United States. Understanding POU treatment removal performance, and accurately estimating metals exposure at the tap, is critical for understanding POU water treatment device effectiveness and potential reductions in contaminant exposure. Previous bench-scale efforts have documented significant removal of dissolved Pb using faucet-mounted POU filters; however, limited efforts have challenged these filters with extreme water quality conditions which are more common in homes reliant on private well water. Characterization of typical rates of metals uptake by POU filters would support: improved exposure estimates and predictions, a better understanding of long-term filter performance under different conditions, and identification of conditions where POU use is recommended. In the current study, standard faucet-mount activated carbon POU filters were tested in a laboratory setting in order to: 1) determine removal of Pb, Cu, and Fe under low and high concentration conditions designed to reflect previous observations of residential water quality; and 2) evaluate the effectiveness of an acid flow-through procedure in recovering metals from used POU filters exposed to varying concentrations of Pb, Cu, and Fe. Although the filters tested here successfully removed Pb and Cu from waters of both high and low-level concentrations (>91% removal), Fe removal varied considerably. The acid flow-through procedure yielded mixed results: while 25.1-70.4% of influent Pb mass was recovered, recovery of Cu and Fe from the dosed filters was unpredictable. This was attributed in part to leaching from the filter media itself; in addition to Cu and Fe, concentrations of several other elements (e.g., Ti, Si, Al) increased and appeared to leach from control filters during the acid flow-through procedure. Given these results, alternative methods for assessing uptake of metals to POU filters should be explored.

Impacts of heat and wildfire on preterm birth

BackgroundClimate change continues to increase the frequency, intensity, and duration of heat events and wildfires, both of which are associated with adverse pregnancy outcomes. Few studies simultaneously evaluated exposures to these increasingly common exposures. ObjectivesWe investigated the relationship between exposure to heat and wildfire smoke and preterm birth (PTB). MethodsIn this time-stratified case-crossover study, participants consisted of 85,806 California singleton PTBs (20–36 gestational weeks) from May through October of 2015–2019. Birthing parent ZIP codes were linked to high-resolution daily weather, PM2.5 from wildfire smoke, and ambient air pollution data. Heat day was defined as a day with apparent temperature >98th percentile within each ZIP code and heat wave was defined as ≥2 consecutive heat days. Wildfire-smoke day was defined as a day with any exposure to wildfire-smoke PM2.5. Conditional logistic regression was used to calculate the odds ratio (OR) and 95% confidence intervals (CI) comparing exposures during a hazard period (lags 0–6) compared to control periods. Analyses were adjusted for relative humidity, fine particles, and ozone. ResultsWildfire-smoke days were associated with 3.0% increased odds of PTB (ORlag0: 1.03, CI: 1.00–1.05). Compared with white participants, associations appeared stronger among Black, Hispanic, Asian, and American Indians/Alaskan Native participants. Heatwave days (ORlag2: 1.07, CI: 1.02–1.13) were positively associated with PTB, with stronger associations among those simultaneously exposed to wildfire smoke days (ORlag2: 1.19, CI: 1.11–1.27). Similar findings were observed for heat days and when other temperature metrics (e.g., maximum, minimum) were used. DiscussionHeat and wildfire increased PTB risk with evidence of synergism. As the occurrence and co-occurrence of these events increase, exposure reduction among pregnant people is critical, especially among racial/ethnic minorities.

Streets classification models by urban features for road traffic noise estimation

Road traffic is the primary source of environmental noise pollution in cities. This problem is also spreading due to inadequate urban expansion planning. Hence, integrating road traffic noise analysis into urban planning is necessary for reducing city noise in an effective, adaptable, and sustainable way. This study aims to develop a methodology that applies to any city for the stratification of urban roads by their functionality through only their urban features. It is intended to be a tool to cluster similar streets and, consequently, traffic noise to enable urban and transportation planners to support the reduction of people's noise exposure. Three multivariate ordered logistic regression statistical models (Model 1, 2, and 3) are presented that significantly stratify urban roads into five, four, and three categories, respectively. The developed models exhibit a McFadden pseudo-R2 between 0.5 and 0.6 (equivalent to R2 >0.8). The choice between Model 1 or 2 depends on the scale of the city. Model 1 is recommended for developed cities with an extensive road network, while Model 2 is most suitable in intermediate and growing cities. On the other hand, Model 3 could be applied at any city scale but focused on local management of transit routes and for designing acoustic sensor installations, urban soundwalks, and identification of quiet areas. Urban features related to road width and length, presence of transport infrastructure, and public transport routes are associated with increased traffic noise in all three models. These models prove useful for future action plans aimed at reducing noise through strategic urban planning.

Protecting Our Own: A Method for Reducing Breast Radiation Exposure in Healthcare Workers.

Standard lead aprons do not protect the female breast adequately from radiation exposure, which has been associated with breast cancer in healthcare workers. A novel lead shield was designed to reduce radiation to the breast, axilla, and thyroid (BAT). A procedure room was simulated with an anthropomorphic phantom representing the operator. Dosimeters were positioned on the outer quadrant of each breast, the chest, the thyroid, and deep inside of a phantom acrylic female torso with neck and head. Standard lead vest plus a thyroid shield was used as control and compared to standard lead vest plus BAT shield. Three operator and two image receptor positions were tested. The reductions in radiation exposure were calculated. The standard vest plus BAT shield provided significant reductions in radiation exposure for all anatomic locations compared to control. When averaging all operator positions, the BAT provided reductions of 91% (p < 0.0001) for near breast. Reductions for far breast, chest, thyroid, and deep tissues were 76% (p = 0.016), 94% (p < 0.0001), 52% (p = 0.026), and 60% (p = 0.004). With operator 90° to the table using a cross-table lateral beam, the BAT provided a 97.7% reduction in radiation to the near breast and significant reduction in radiation to the chest, thyroid, and deep tissues. The BAT shield reduces radiation exposure to the breast, chest, thyroid and deep hematopoietic tissues. Such shields could benefit healthcare workers to reduce the risk of breast cancer and other radiation-associated cancers.

Advanced Antimicrobial and Anti-Infective Strategies to Manage Peri-Implant Infection: A Narrative Review.

Despite reductions in bacterial infection and enhanced success rate, the widespread use of systemic antibiotic prophylaxis in implant dentistry is controversial. This use has contributed to the growing problem of antimicrobial resistance, along with creating significant health and economic burdens. The basic mechanisms that cause implant infection can be targeted by new prevention and treatment methods which can also lead to the reduction of systemic antibiotic exposure and its associated adverse effects. This review aims to summarize advanced biomaterial strategies applied to implant components based on anti-pathogenic mechanisms and immune balance mechanisms. It emphasizes that modifying the dental implant surface and regulating the early immune response are promising strategies, which may further prevent or slow the development of peri-implant infection, and subsequent failure.

Effect of Heat Acclimatization, Heat Acclimation, and Intermittent Heat Training on Maximal Oxygen Uptake.

Maximal oxygen uptake (VO2max) is an important determinant of endurance performance. Heat acclimation/acclimatization (HA/HAz) elicits improvements in endurance performance. Upon heat exposure reduction, intermittent heat training (IHT) may alleviate HA/HAz adaptation decay; however, corresponding VO2max responses are unknown. VO2max is maintained after HAz/HA; IHT mitigates decrements in aerobic power after HAz/HA. Interventional study. Level 3. A total of 27 male endurance runners (mean ± SD; age, 36 ± 12 years; body mass, 73.03 ± 8.97 kg; height, 178.81 ± 6.39 cm) completed VO2max testing at 5 timepoints; baseline, post-HAz, post-HA, and weeks 4 and 8 of IHT (IHT4, IHT8). After baseline testing, participants completed HAz, preceded by 5 days of HA involving exercise to induce hyperthermia for 60 minutes in the heat (ambient temperature, 39.13 ± 1.37°C; relative humidity, 51.08 ± 8.42%). Participants were assigned randomly to 1 of 3 IHT groups: once-weekly, twice-weekly, or no IHT. Differences in VO2max, velocity at VO2max (vVO2), and maximal heart rate (HRmax) at all 5 timepoints were analyzed using repeated-measure analyses of variance with Bonferroni corrections post hoc. No significant VO2max or vVO2 differences were observed between baseline, post-HAz, or post-HA (P = 0.36 and P = 0.09, respectively). No significant group or time effects were identified for VO2max or vVO2 at post-HA, IHT4, and IHT8 (P = 0.67 and P = 0.21, respectively). Significant HRmax differences were observed between baseline and post-HA tests (P < 0.01). No significant group or time HRmax differences shown for post-HA, IHT4, and IHT8 (P = 0.59). VO2max was not reduced among endurance runners after HA/HAz and IHT potentially due to participants' similar aerobic training status and high aerobic fitness levels. HAz/HA and IHT maintain aerobic power in endurance runners, with HAz/HA procuring reductions in HRmax.

Biomarkers of Organophosphate and Polybrominated Diphenyl Ether (PBDE) Flame Retardants of American Workers and Associations with Inhalation and Dermal Exposures.

This study evaluated workers' exposures to flame retardants, including polybrominated diphenyl ethers (PBDEs), organophosphate esters (OPEs), and other brominated flame retardants (BFRs), in various industries. The study aimed to characterize OPE metabolite urinary concentrations and PBDE serum concentrations among workers from different industries, compare these concentrations between industries and the general population, and evaluate the likely route of exposure (dermal or inhalation). The results showed that workers from chemical manufacturing had significantly higher (p <0.05) urinary concentrations of OPE metabolites compared to other industries. Spray polyurethane foam workers had significantly higher (p <0.05) urinary concentrations of bis(1-chloro-2-propyl) phosphate (BCPP) compared to other industries. Electronic scrap workers had higher serum concentrations of certain PBDE congeners compared to the general population. Correlations were observed between hand wipe samples and air samples containing specific flame-retardant parent chemicals and urinary metabolite concentrations for some industries, suggesting both dermal absorption and inhalation as primary routes of exposure for OPEs. Overall, this study provides insights into occupational exposure to flame retardants in different industries and highlights the need for further research on emerging flame retardants and exposure reduction interventions.

Genetic diversity of murine norovirus populations less susceptible to chlorine.

High genetic diversity in RNA viruses contributes to their rapid adaptation to environmental stresses, including disinfection. Insufficient disinfection can occur because of the emergence of viruses that are less susceptible to disinfection. However, understanding regarding the mechanisms underlying the alteration of viral susceptibility to disinfectants is limited. Here, we performed an experimental adaptation of murine norovirus (MNV) using chlorine to understand the genetic characteristics of virus populations adapted to chlorine disinfection. Several MNV populations exposed to an initial free chlorine concentration of 50 ppm exhibited reduced susceptibility, particularly after the fifth and tenth passages. A dominant mutation identified using whole-genome sequencing did not explain the reduced susceptibility of the MNV populations to chlorine. Conversely, MNV populations with less susceptibility to chlorine, which appeared under higher chlorine stress, were accompanied by significantly lower synonymous nucleotide diversity (πS) in the major capsid protein (VP1). The nonsynonymous nucleotide diversity (πN) in VP1 in the less-susceptible populations was higher than that in the susceptible populations, although the difference was not significant. Therefore, the ability of MNV populations to adapt to chlorine was associated with the change in nucleotide diversity in VP1, which may lead to viral aggregate formation and reduction in chlorine exposure. Moreover, the appearance of some nonsynonymous mutations can also contribute to the alteration in chlorine susceptibility by influencing the efficiency of viral replication. This study highlights the importance of understanding the genetic characteristics of virus populations under disinfection, which can contribute to the development of effective disinfection strategies and prevent the development of virus populations less susceptible to disinfectants.

Efficiency of working coveralls and chemical resistant gloves in reducing operator exposure to pesticides

Personal Protective Equipment (PPE) is used to reduce exposure when working with chemicals. For pesticides, exposure scenarios comprise mixing and loading (M&L) and application. The exposure prediction model recommended by European regulatory agencies for operator risk assessments—the Agricultural Operator Exposure Model (AOEM) – is based on 48 operator exposure studies involving over 500 professional operators from 10 European countries in typical working situations to assess exposure under realistic field conditions. We used the AOEM data to assess the efficiency of exposure reduction resulting from wearing chemical-resistant nitrile gloves and non-certified working coveralls during M&L (tank and backpack sprayer), applications using groundboom and airblast spraying, and outdoor and indoor (greenhouse) applications using handheld sprayers. All studies indicated consistent and high exposure reduction > 90% for gloves and non-certified coveralls across all investigated scenarios. Exceptions were almost exclusively observed when an operator incorrectly used the PPE. The mean exposure reduction from all operators, including those that used PPE incorrectly, was 95.0% for gloves and 96.4% for polyester/cotton working coveralls during M&L, and 91.1% for gloves and 94.9% for non-certified coveralls during all application scenarios. This analysis confirms the essential role of PPE and non-certified working coveralls in reducing operator exposure to pesticides. Outliers indicate that operators need to be properly trained and adhere to label instructions to apply pesticides according to good agricultural practices.