Risk Of Health Effects Research Articles

Transition to Survivorship Care for Adolescents and Young Adults (AYAs) with Acute Leukemia: Provider Perspectives.

Purpose: Adolescent and young adult (AYA) survivors of acute lymphoblastic or myeloid leukemia diagnosed between the ages of 15 and 39 years are at risk for adverse late health effects following cancer treatment and require ongoing survivorship care. This study aims to understand the landscape of transitioning AYAs with leukemia from active treatment to survivorship care. Methods: A cross-sectional, anonymous online survey was sent out via listserv/email. Descriptive analyses were used to identify the proportion of providers whose institutions have AYA and/or survivorship programs, current practices in transitioning care, perspective on barriers and facilitators to transition, and preferred models of survivorship care. Differences by provider (i.e., adult medical oncologist vs. pediatric) were analyzed using chi-square or analysis of variance (ANOVA) analyses. Results: A total of 75 provider responses were analyzed; 51.4% of providers reported their institutions had an AYA program and over 80% had a survivorship program. Providers preferred the primary oncology team or survivorship specialist to address most survivorship care needs, except for the treatment of other comorbid conditions (primary care provider [PCP] preferred). Disease-related risks, lack of a PCP, and insurance concerns were commonly endorsed barriers to transition of care. Medical oncologists were more likely than pediatric providers to transition surveillance of new malignancies to PCPs. Conclusions: Providers preferred survivorship specialists to oversee AYA survivorship care, yet several barriers and concerns remain to implement the transition. Results indicate variability in transition care practices and preferences, particularly between medical and pediatric oncologists. Future work is needed to optimize transition practices to improve care for AYA survivors.

Association between urinary metallothionein concentration and causes of death among cadmium-exposed residents in Japan: a 35-year follow-up study

As research progresses, there is a growing body of evidence indicating that urinary metallothionein (MT) levels may be elevated in individuals exposed to cadmium (Cd). This study aimed to investigate the potential association between urinary MT levels and causes of mortality among residents of the Kakehashi River Basin who have been exposed to Cd. The study involved a total of 1,398 men and 1,731 women were conducted between 1981 and 1982, with follow-up until November 2016. The study employed the Cox proportional-hazards model to examine the association between higher urinary MT concentrations and the risk of all-cause or cause-specific mortality within the population. Furthermore, the Fine and Gray competing risks regression model was used to evaluate the links between specific causes of death. The findings revealed that elevated urinary MT concentrations were linked to increased all-cause mortality and higher mortality rates from renal and urinary tract diseases across all participants. Specifically, in men, higher urinary MT levels were associated with elevated all-cause mortality, while in women, increased concentrations were linked to higher mortality from endocrine, nutritional, and metabolic diseases, as well as cardiovascular diseases. Even after adjusting for competing risks, higher urinary MT concentrations were associated with tumor-related mortality in men and continued to be associated with cardiovascular disease mortality in women. In conclusion, the results suggest that women may face a greater risk of adverse health effects due to prolonged exposure to Cd. Urinary MT levels could potentially serve as a biomarker for mortality from these diseases in populations chronically exposed to Cd.

The Prevalence of Suicidal Behaviors in Childhood, Adolescent and Young Adults Cancer Survivors: A Systematic Review and Meta-Analysis

BackgroundMany studies have shown that Childhood, adolescent and young adult cancer (CAYAC) survivors have an increased risk of late physical and mental health effects. However, comprehensive data on the risks of suicidal behaviors in CAYAC survivors are still lacking. We investigated the evidence of suicidal behaviors in CAYAC survivors. MethodsWe performed a systematic review and meta-analysis. The literature search was conducted using MEDLINE, Embase, CINAHL, PsycINFO, the Cochrane Database, and reference lists from previous relevant reviews. We summarized the characteristics of eligible studies on suicidal behavior. We performed meta-analysis with random-effect model for available data of them and calculated pooled prevalences with 95% confidence intervals (CI). ResultsWe identified 1108 articles from the search and 22 articles from previous review. We identified 38 eligible studies. 26 cohort studies and 12 cross-sectional studies were compromised. The meta-analysis showed pooled prevalence of suicide was 0.152% (95% CI: 0.103-0.209), suicide attempt was 2.2% (95%CI; 1.9-2.6) and suicidal ideation was 9.2% (95%CI: 7.8-10.6). Some studies identified specific CAYAC survivors at risk of suicide as age, type of cancer and treatments. LimitationsOutcome measures could not be identified in some studies in the meta-analysis. ConclusionsThe findings revealed prevalence of suicidal behaviors in CAYAC survivors. Greater awareness and monitoring are needed of these risks, and of issues that affect support to prevent suicidal behaviors in CAYAC survivors.

An extended PFAS profiling of a Swedish subpopulation and mixture risk assessments using multiple approaches.

Per- and polyfluoroalkyl substances (PFAS) have been detected worldwide, from the deep seas to polar regions. A previous review showed that PFAS are risk drivers of the chemical mixture present in human blood. This study focused on establishing the PFAS exposure of a Swedish subpopulation and investigated whether the exposure poses a risk of adverse health effects. Human serum from 60 blood donors in Stockholm, Sweden, was analyzed. A target method including 32 PFAS analytes and over 270 suspect features was used to detect and quantify PFAS. Twenty-six PFAS were quantified, and 7 suspect PFAS features (6 H-PFCAs and PFECHS) were semi-quantified. Nine mixture risk assessment (MRA) strategies were used to assess the risk of health outcomes. Fifteen effect levels were derived and used, along with 15 already established values. The certainty of various derivation techniques was discussed. The MRAs showed that the entire studied population exceeded some of the risk thresholds, with effects including high cholesterol and immune suppression. However, the certainty was lower when deriving these two effect levels. The MRA, using human biomonitoring guidance values (high certainty), concluded that for 63% of the individuals, a risk for adverse health effects cannot be excluded. This study has demonstrated that there is a reason for concern regarding PFAS exposure in the general population of Sweden. To our knowledge, this is the first time the H-PFCAs have been semi-quantified in human blood using a reference standard.

Geospatial monitoring and human health risk assessment of pharmaceutical residues in groundwater and surface water in Kampala and Mbarara Districts, Uganda.

This study investigated the occurrence, concentration and human health risks of five pharmaceutical residues-metronidazole, sulfamethoxazole, ciprofloxacin, carbamazepine, and caffeine-in groundwater and surface water samples from Kampala and Mbarara districts of Uganda. The present study also employed techniques of remote sensing and geographic information system (GIS); thereby, emphasizing the importance of thematic mapping, land use classification, and spatial buffering to evaluate pharmaceutical contaminants in an environmental setting. The risk quotient (RQ) approach was also employed to assess the risk of exposure to the pharmaceutical contaminants. Caffeine was found with the highest average concentration in groundwater (53.515µg/L), whereas carbamazepine had the highest average concentration in surface water (48.635µg/L) during the dry season. Ciprofloxacin consistently recorded the lowest average concentrations in both groundwater and surface water across all seasons. Overall, the data revealed high concentrations of pharmaceutical residues in surface water compared to groundwater during both seasons, except for caffeine which was not detected in surface water across the seasons. Notable seasonal changes were also observed in caffeine and metronidazole concentrations, indicating the role of human activities and environmental factors in influencing contamination patterns during specific seasons. The factor analysis revealed that consumption rate of pharmaceuticals and anthropogenic activities are the main factors responsible for the contamination of groundwater and surface water. Moreover, results revealed thatthe risk of adverse human health effects for carbamazepine and metronidazole during both seasons were high (RQ > 1), thereby highlighting the prioritization of frequent monitoring by the environmental protection agencies. Given that the combined risk of exposure for all the pharmaceuticals exceeded one, adopting stringent pharmaceutical disposal and control measures are essential for mitigating potential human health risks associated with their exposure. Further investigation into optimal and effective pharmaceutical remediation strategies for both groundwater and surface water are highly recommended.

Factors Associated with Teenage Pregnancy: A Hospital-Based Case-Control Study

Background: Teenage pregnancy is a major public health problem and is considered to be high risk for maternal health, pregnancy outcomes, and long-term effects. This study aims to determine the factors associated with teenage pregnancy among pregnant teenagers and non-teenagers in a tertiary hospital of Nepal. Methods: A hospital-based case-control study was conducted using 1:2 case-control ratio among 109 pregnant teenagers and 218 non-teenage pregnant women attending antenatal service at a tertiary hospital of Rupandehi, Nepal, from October 2020 to February 2021. Two controls were selected on the same day when a case was identified. Variables found significance (p<0.05) in bivariate analysis were entered into multivariable logistic regression to identify final associated factors. Results: The mean age of cases was 17.81± 1.01 years, while controls were 25.35 ± 2.46 years. Women from Dalit caste (AOR=3.04, CI=1.02-9.07), engaged in business work (AOR= 0.23, CI= 0.10-0.57), food sufficiency for more than 12 months per year (AOR =2.83, CI= 1.09-7.31), family planning (AOR=2.38, CI=1.33-4.25) and anemia (AOR= 2.58, CI: 1.56-4.27) were positively associated with teenage pregnancy. Conversely, primary (AOR= 0.18, CI= 0.06-0.57), secondary (AOR= 0.13, CI= 0.06-0.26) and SLC and above education (AOR= 0.36, CI= 0.15-0.85) were found to be negatively associated. Conclusions: Ethnicity, education, occupation, food sufficiency, family planning use and hemoglobin were found to be independently associated factors of teenage pregnancy. Thus, policy makers and administrators should focus on informal educational intervention, intervention for utilization skills of family planning, and nutrition promotion during pregnancy especially for disadvantages people.

Probabilistic Health Risk Assessment of Heavy Metals in People Living Near the Mine-Closure in Tak Province

Heavy metals including lead (Pb), zinc (Zn), and cadmium (Cd) can damage the kidney, liver, brain, lungs, blood composition, and other vital organs. As a result, their toxicity, especially when contaminated in food, water, and soil, can be harmful to human health. This study evaluated the risk of adverse health effects to residents near closed zinc mines in Tak Province, Thailand. Data was collected from three subdistrict sites and analyzed for probable health risk. Scenario pathways were oral and dermal contact of heavy metals; including Pb, Zn, and Cd, in four age groups with average daily dose and hazard quantification; hazard index (HI); and cancer risk (CR) considered. Results were that carcinogen risk quantification exceeded the recommended limit (CR ≤10-6) in all scenarios, and the hazard index for non-carcinogenic risk was below the acceptable level (HQ ≤1), in which Cd dominated for all categories. These findings suggest that all medias and food products should be appropriately monitored, especially with carcinogenic surveillance, to mitigate health effects on residents.

The effects and possible mechanisms of whole-body vibration on cognitive function: A narrative review.

Whole-body vibration (WBV) is a physical stimulation method that transmits mechanical oscillations to the entire body through a vibration platform or device. Biokinetic and epidemiologic studies have shown that prolonged exposure to high-intensity WBV increases health risks, primarily to the lumbar spine and the nervous system connected to it. There is currently insufficient evidence to demonstrate a quantitative relationship between vibration exposure and risk of health effects. The positive effects of WBV on increasing muscle strength and improving balance and flexibility are well known, but its effects on cognitive function are more complex, with mixed findings, largely related to vibration conditions, including frequency, amplitude, and duration. Studies have shown that short-term low-frequency WBV may have a positive impact on cognitive function, demonstrates potential rehabilitation benefits in enhancing learning and memory, possibly by promoting neuromuscular coordination and enhancing neural plasticity. However, long term exposure to vibration may lead to chronic stress in nerve tissue, affecting nerve conduction efficiency and potentially interfering with neuroprotective mechanisms, thereby having a negative impact on cognitive ability, even causes symptoms such as cognitive decline, mental fatigue, decreased attention, and drowsiness. This literature review aimed to explore the effects of WBV on cognitive function and further to analyze the possible mechanisms. Based on the analysis of literatures, we came to the conclusion that the impact of WBV on cognitive function depends mainly on the frequency and duration of vibration, short-term low-frequency WBV may have a positive impact on cognitive function, while long term exposure to WBV may lead to cognitive decline, and the mechanisms may be involved in neuroinflammation, oxidative stress, synaptic plasticity, and neurotransmitter changes. This review may provide some theoretical foundations and guidance for the prevention and treatment of WBV induced cognitive impairment.

Firefighters’ occupational exposure to air pollution: impact on COPD and asthma—study protocol

IntroductionFirefighting continues to be among the most hazardous yet least studied occupations in terms of the impact of exposure to occupational disease. In particular, firefighters are at increased risk of...

Geoenvironmental determinants influencing chronic kidney disease of unknown etiology in the dry zone of Sri Lanka: a study based on a cohort of at-risk communities.

Chronic kidney disease of unknown origin (CKDu) has emerged as a serious health risk for farming communities in remote semi-arid lowland regions of Sri Lanka, with geoenvironmental factors widely believed to be associated with the etiology. Although numerous case-control studies have been carried out to determine the causes of CKDu, none have been conducted in at-risk communities. The main objective of this study is to identify the potential geo-environmental risk factors associated with the at-risk community in the Wilgamuwa region, a CKDu endemic area in Sri Lanka. The study collected and analyzed 92 water sources currently or previously used in the study area for major cations, anions, and trace elements, mainly As, Cd, Pd, Mn, Zn, Ba and Sr. The major cations and anions in CKDu-susceptible groundwater varied Si4+ > Ca2+ > Na+ > Mg2+ > K+ and HCO3- > Cl- > SO42- > NO3- > F- > PO43- > Br-. The higher average values of Si4+, F- and total hardness (TH) were reported in groundwater consumed by communities at risk of CKDu, with average values (in mg/L) of Si4+-46, F--0.62, and TH-178. Considering the Water Quality Index (WQI) values, 73% of groundwater sources are classified as poor water quality, and the groundwater quality mainly depends on the fluoride distribution in the region. According to the Hazard Quotient (HQ), the risk of adverse health effects from exposure to F- and SiO2 increased in magnitude in the order of male < female < children. Health hazards due to As, Cd and Pb exposure fell between the 'no-risk' and 'low-risk' categories. As outlined in this study, continuous monitoring of vulnerable communities for environmental exposures to key groundwater constituents is important in the dry zone of Sri Lanka.

Evaluation of Cadmium, Lead, Chromium, and Nickel Content in Various Types of Nuts: Almonds, Cashews, Hazelnuts, Peanuts, and Walnuts - Health Risk of Polish Consumers.

World production and consumption of nuts continue to rise year on year. Nuts, due to their high nutrient content, are becoming increasingly popular among consumers. A potential health risk may result from the consumption of nuts contaminated with metallic trace elements like cadmium or lead. In this research, we measured the content of Cd, Pb, Cr, and Ni in various edible nuts. All elements were detected using the electrothermal atomic absorption spectrometry analytical technique (ETAAS). The study material comprised 69 nut samples including almonds, cashews, hazelnuts, peanuts, and walnuts available on the Polish market. Indicators such as the hazard quotient (HQ) and hazard index (HI) were used to assess the health risk of consumers. The concentrations of elements in all analyzed samples of nuts were as follows: Cd: peanuts > almonds > hazelnuts > walnuts > cashews, Pb: peanuts > almonds > hazelnuts > walnuts > cashews, Ni: cashews > peanuts > walnuts > hazelnuts > almonds, Cr: almonds > cashews & hazelnuts > peanuts > walnuts. Health risk indicators estimated for consumers whose diet is rich in nuts, in which metallic trace elements were recorded, indicate that an unacceptable impact may occur, and the risk of negative health effects (non-cancer) will be moderate to high.

The Effects of Wildfires on the Mental and Physical Health of School-Age Children in North America: A Scoping Review.

Wildfires are occurring more often and with greater intensity, leading to longer and harsher fire seasons. As a result, children are more frequently exposed to wildfire smoke, which increases their risk of mental and physical health effects. The purpose of our scoping review is to explore the current literature on what is known about the direct and indirect impacts of wildfires on the mental and physical health of school-age children in North America (5 to 18-year-olds). A health sciences librarian-assisted literature search, with input from the research team, was performed. A total of 16 studies were selected. Common mental health symptoms such as anxiety, depression, suicidal thinking, and post-traumatic stress disorder have been identified. The findings of this review are in line with recent studies showing a connection between adult wildfire exposure and respiratory conditions; however, no cardiovascular health effects in children were identified. The available studies in our review demonstrate that wildfires do increase the impacts on both mental and physical health postexposure in school-age children. Future research should specifically include larger samples, more qualitative and longitudinal studies that can more effectively analyze the effects of wildfire events on psychological factors over time, conceptual frameworks, and exposure metrics specific for PM2.5 from wildfire smoke.

Stuck in the mangrove mud: The risk of trace element exposure to shore crabs in restored urban mangroves

The restoration of mangroves in urban environments can increase the risk of contaminant exposure and subsequent health effects to resident biota, yet this risk is rarely considered in mangrove restoration programs. Here we assessed the influence of sediment chemistry on contaminant bioaccumulation in shore crabs from restored and natural mangroves in urban environments compared to a reference site. The concentrations of some trace elements were several-fold higher in the sediment and crab tissues of the urban restored site compared to the natural reference site (Cd = 6×, Co = 7×, Cr = 4×, Mn = 30×, and Ni = 18× greater in sediments, while Cd = 4×, Co = 2×, Cr = 2×, Mn = 6×, and Ni = 3× greater in crab tissues). NMR-based metabolomics on crabs revealed higher abundances of proline and glutamate at urban sites, which may be indicative of physiological stress from trace element contamination. Choice experiments were used to test habitat selectivity by crabs from each population, and showed that crabs avoided sediments from the contaminated urban sites. Our results suggest that restoring mangroves in contaminated environments could create ecological sinks, where animals take residence in the new habitat but are exposed to sediment-based contaminants, with potential implications for organism and population health.

Comparison of noise exposure cost and annoyance-related indicators in microscopic traffic simulations

Road traffic noise is one of the major sources of environmental noise and has been shown to increase risk of adverse health effects. For this reason, noise mapping is an efficient tool to assess and monitor city-wide noise levels in accordance with the Environmental Noise Directive (END). To relate these noise levels to the associated health effects, the noise map may be further analysed using exposure-response models, or with cost models that calculate the noise-related externalities of the traffic. With the use of microscopic traffic simulations, this assessment may be performed at a vehicle-specific level. A recently introduced methodology, the noise exposure cost, calculates the vehicle-specific contribution to the long-term social cost estimated at a macro-level based on the vehicle-specific noise contributions. However, the noise exposure cost methodology may not reflect the relative noise impact of individual vehicles, but rather solely reflect the noise contribution regardless of its relative impact to the noise levels at the time. The aim of this study is to investigate the possibility to use the linear sensitivity indicator as a basis for a non-linear weighting function in the noise exposure cost methodology, to allow the vehicle-specific noise exposure cost to better reflect the relative impact.

Climate Anxiety: Current Evidence and Future Directions.

Challenging cognitive, somatic, and behavioral responses to climate change are often conceptualized as climate anxiety (CA). Due to the increased recognition of the impacts of climate change on mental health, a growing body of scientific literature is developing. The purpose of this manuscript is to review the current evidence base for CA and propose future research needs for this emerging construct. Early evidence supports underlying psychological mechanisms in the development and maintenance of CA, which are similar to other anxiety-related conditions. However, the study of CA poses unique challenges to researchers. The psychological impacts that occur in the context of climate change may be adaptive depending on the imminent threat of natural disasters, forced migration, or other climate-related challenges. Due to the potentially adaptive nature of CA and limited current evidence, a coordinated research program of climate-related distress is necessary. A review of the extant literature identified current gaps in understanding the epidemiology and individual differences that promote CA. Current evidence supports the prominent role of neuroticism, intolerance of uncertainty, and rumination. The development of evidence-based models of climate-related distress may provide a more valid and comprehensive depiction of the impacts of climate change on mental health. Transdiagnostic treatment methods are likely the most appropriate intervention for climate-related distress. As models, measures, and treatments of climate-related distress are developed, it is crucial to incorporate studies of populations most at risk for climate change-related mental health effects.

Healthcare providers' expected barriers and facilitators to the implementation of person-centered long-term follow-up care for childhood cancer survivors: A PanCareFollowUp study.

Childhood cancer survivors face high risks of adverse late health effects. Long-term follow-up care for childhood cancer survivors is crucial to improve their health and quality of life. However, implementation remains a challenge. To support implementation of high-quality long-term follow-up care, we explored expected barriers and facilitators for establishing this follow-up care among healthcare providers from four European clinics. A qualitative study was conducted using four focus groups comprising 30 healthcare providers in total. The semi-structured interview guide was developed based on the Grol and Wensing framework. Data was analyzed following a thematic analysis, combining both inductive and deductive approaches to identify barriers and facilitators across the six levels of Grol and Wensing: innovation, professional, patient, social, organizational and economic and political. Most barriers were identified on the organizational level, including insufficient staff, time, capacity and psychosocial support. Other main barriers included limited knowledge of late effects among healthcare providers outside the long-term follow-up care team, inability of some survivors to complete the survivor questionnaire and financial resources. Main facilitators included motivated healthcare providers and survivors, a skilled hospital team, collaborations with important stakeholders like general practitioners, and psychosocial care facilities, utilization of the international collaboration and reporting long-term follow-up care results to convince hospital managers. This study identified several factors for successful implementation of long-term follow-up care for childhood cancer survivors. Our findings showed that specific attention should be given to knowledge, capacity, and financial issues, along with addressing psychosocial issues of survivors.

Assessment of Ecological and Health Risks of Potentially Toxic Elements in Soil and Plant Under Long-Term Sewage Wastewater Irrigation.

This paper aimed to evaluate the ecological and health risks for some potentially toxic trace elements (PTEs) in agricultural soils irrigated with sewage wastewater for more than 50 years. Therefore, soil and plant samples were collected from 21 sites at sewage wastewater irrigated area and these samples were analyzed for their contents of PTEs i.e. Cd, Cr, Cu, Ni, and Pb. The risks of PTEs pollution in the study area were analyzed using indices such as the individual and comprehensive potential ecological risk indices (Eri and RI, respectively), hazard quotient (HQ), hazard index (HI), and carcinogenic risk (CR) model. The results showed that the PTEs in soil samples ranged from 1.70 to 9.90mg/kg for Cd, from 39.9 to 183.4mg/kg for Cr, from 31.5 to 655.1mg/kg for Cu, from 18.8 to 113.1mg/kg for Ni and from 5.4 to 65.4mg/kg for Pb. The results also demonstrated that the soil samples were characterized by high to very high ecological risk for Cd. According to the health risk assessment, the mean HQ and HI of the PTEs in soil for adults and children were below the risk threshold of 1, indicating no risk for non-carcinogenic health effects. However, the HI of PTEs via plant consumption was > 1, suggesting a non-carcinogenic health risk. The CR for most plant samples was above the acceptable range. These findings may offer helpful information regarding the ecological and human risks related to PTEs exposure in soil and plants irrigated with wastewater under arid conditions.

Exposure assessment and semi-quantitative risk analysis of histamine in tuna and tuna-like fish from Indonesia

This study aimed to investigate histamine exposure associated with consumption of fresh tuna and tuna-like species in West Java, and to estimate risk of Scombroid Fish Poisoning (SFP) in Indonesia. A range of species, including tuna (Thunnus spp.), bullet tuna ( Auxis sp.), and skipjack ( Katsuwonus pelamis ) were collected from local markets and fish landing sites. Subsequently, histamine concentrations were determined using NMR analysis and exposure was calculated in mg/day for toddlers, children, and adults. The results showed that skipjack had the highest histamine exposure for all age groups, followed by bullet and regular tuna. The highest EDI for histamine was from skipjack consumption, accounting for 38.67; 37.77 and 20.74 percentage of exposure for toddlers, children and adults, respectively. These values are below the defined thresholds levels (ARfD), indicating no potential risk of acute health effect. Cooked bullet tuna and skipjack were estimated to cause similar illnesses, accounting for 6–7 cases per 100,000 individuals, which was higher than cooked tuna at 1–2 cases per 100,000 individuals. Considering the preparation of raw tuna in restaurants following Good Hygienic Practices (GHP), the predicted annual cases decreased significantly to 4–5 cases per million individuals. This risk estimation only considered histamine levels in fresh fish, without including data from fish preparation. Therefore, further studies were recommended to estimate the risk level in raw/fresh tuna and similar species before consumption.

Synthetic Microplastics in UK tap and bottled water; Implications for human exposure

There is increasing concern for public health over inadvertent human exposure to MPs due to potential adverse health effects linked to MPs polymeric composition, toxic chemical additives, and/or harmful microorganisms adsorbing onto their surfaces. While numerous studies have reported MPs occurrence and risk in the freshwater aquatic environment and drinking water sources (e.g., rivers, lakes, and reservoirs), the current state-of-knowledge on MPs pollution in drinking water (i.e., tap water and bottled water) remains limited at a global level. This paper provides the first comprehensive study of the occurrence, concentrations, size distribution, shape, and polymer type of MPs in 177 tap water samples from 13 cities in the United Kingdom, as well as 85 samples of bottled water from 17 popular brands, with various packaging materials, on the UK market.MPs were detected in all tap water samples (range 6–100 MP/L) and bottled water samples (range 12–62 MP/L). Average MPs concentration in tap water (40 ± 16 MP/L) was statistically indistinguishable from that in bottled water (37 ± 11 MP/L). However, the average MPs particle size in tap water (32.4 μm) exceeded significantly (p < 0.05) that in bottled water (26.5 μm), indicating the various purification processes applied to bottled water may help remove larger MPs, but raises concern over the potential adverse health effects from exposure to smaller MPs. The most frequently detected polymer types were: polypropylene (PP), polyethylene (PE), and polyvinyl chloride (PVC) in tap water, and PE, PP and polyethylene terephthalate (PET) in bottled water. A strong correlation was observed (r = 0.68, P = 0.049) between the plastic cap material (PE) and the predominant polymer type in the bottled water. In terms of morphology, fragments and fibres were the most abundant MPs, together constituting 92 % and 96 % of MPs detected in tap and bottled water samples, respectively.Using EFSA (European Food Safety Authority) recommended daily water intakes, the corresponding exposures to MPs in different UK age groups were estimated. On a body weight (BW) basis, infants and toddlers were exposed (4 MP/kg BW/day) at a higher level than adults (1 MP/kg BW/day). This raises concern, given the former's incompletely developed immune/nervous systems rendering them at higher risk of adverse health effects from such exposure.

Preliminary human health risk assessment of antibiotic exposures in human waste handling occupations

Exposure to biosolids in human waste handling occupations is associated with a risk for illness due to microbial infections. Although several years of exposure to biosolids might be hypothesized to be a prophylaxis against infection, the risks associated with infections from antibiotic-resistant organisms can also be a potential concern. Therefore, this study aimed to conduct a screening level risk assessment by deriving occupational exposure limits (OELs) characterizing the risks of adverse health effects among workers in human waste handling occupations with a focus on exposure to two pharmaceuticals commonly found in biosolids: ciprofloxacin (CIP) and azithromycin (AZ). Epidemiological and exposure studies of workers exposed to biosolids were identified through searches of major scientific databases. Screening OELs (sOELs) for these antibiotics were derived using a standardized methodology. The airborne concentrations of CIP and AZ antibiotics were determined using an exposure factors approach. The health-based exposure limits (i.e., sOELs) and the acceptable daily exposure (ADE) values for both of these antibiotics were derived as 80 μg/m3 and 12 μg/kg-day, respectively. An exposure factor approach suggested that inhalation route exposures to CIP and AZ are well below the sOELs and ADE daily doses, and likely too low to cause direct adverse health effects through antibiotic inhalation. A critical review of epidemiological studies on different occupations handling biosolids showed that the workers in industries with potential biosolids exposure have experienced an increased incidence of microbial-exposure-related illness. The health effects seen in the workers have been attributed to bacterial, viral, and protozoan infections. To the extent that bacteria are the pathogen of concern, it is not clear whether these bacteria are resistant to antibiotics commonly found in biosolids. It is also unclear whether the presence of antibiotics or antibiotic-resistant bacteria increases the susceptibility of these workers. Additional studies will provide more definitive estimates of inhalation and dermal exposures to CIP and AZ and could verify the exposure estimates in this study based on the literature and common exposure factors.