Health and environmental risk assessment of organotin pollution in Japan

In the course of developing the Concise International Chemical Assessment Document (CICAD) on triphenyltin compounds for the IPCS, the author assessed health and environmental risks paused by major organotin species, i.e., triphenyltin compounds and tributyltin compounds. Organotin has been used widely as biocide in such applications as antifouling paints of boats and for other purposes, until its use was restricted in 1980's after discovery of severe damages on aquatic ecosystem caused by this agent. Among many other deleterious effects of organotin to aquatic species, imposex is one of the most conspicuous effects which is the development of male reproductive organs by female gastropods at concentrations as low as a few ng/l. Although environmental concentrations of organotin have declined as a result of tight regulations, periodical monitoring in these years shows their levels in the water still range several ng/l in Tokyo bay area which are hazardous to certain aquatic lives. Human intake of organotin in foods has been estimated through market basket surveys in Japan which showed intake of triphenyltin or tributyltin compound in 1997 as 2.29 micrograms/day (as tributyltin chloride) and 2.69 micrograms/day (as triphenyltin chloride), respectively. The intake value for tributyltin chloride corresponds to 5.2% of the provisional acceptable daily intake (ADI) estimated for bis(tributyltin) oxide (TBTO) in Japan, and 28.0% of the guidance value suggested in the CICAD draft for TBTO, respectively. The intake value for triphenyltin chloride corresponds to 10.8% of the ADI estimated by the FAO/WHO Joint Meeting on Pesticide Residues. Potential critical effects on human health observed in animal tests are the effects on immune systems and reproduction. Based on this investigation, needs for future research on mechanism of toxicity and further control of risks are discussed.     

广西环境镉污染地区人群健康影响评估

目的 建立环境镉污染人群健康影响评估技术,评价环境镉污染区居民健康风险及健康危害水平,为政府制定相关防治对策提供科学依据.方法 于2014—2015年,在广西3个重金属污染重点防控区选择污染较严重的4个行政村作为污染区,同时选择3个行政村作为对照区.采集18~75岁常住居民尿液及其家中粮食、蔬菜等食物及饮用水和调查村空气样本,检测样本中镉的含量及尿β2-MG、NAG,应用点评估方法计算居民环境镉暴露量,评价暴露风险和健康危害水平.结果 污染区食物(n=625)中的大米、干豆和蔬菜镉含量中位数分别为0.389 mg/kg、0.216 mg/kg、0.052 mg/kg,均高于对照区;污染区饮用水和空气中的镉含量的中位数分别为0.54μg/L、0.19μg/m3,也高于对照区.居民环境镉暴露主要来源于膳食摄入(约占99%),每月膳食镉摄入量污染区为61.8μg/kg bw、占PTMI的247.31%,对照区为20.9μg/kg bw、占PTMI的83.41%.污染区居民尿镉负荷(平均值4.58μg/g肌酐、中位数3.46μg/g肌酐)和NAG活性(中位数2.18 U/g肌酐)均高于对照区,但未发现尿镉、尿β2-MG含量和NAG活性这三项健康危害指标同时达到判定值的个体,即研究地区未出现镉污染所致慢性早期健康危害的个体.结论 广西环境镉污染区人群健康危害水平处于相对低的状态,但应持续关注居民尿镉高负荷和大米等食物镉富集对人群健康的影响.     

Human health risk in relation to air quality in two municipalities in an industrialized area of Northern Italy

Air quality is one of the major environmental issues related to human health, and people and authorities are increasingly aware and concerned about it, asking to be involved in decisions whose fallout can have consequences on their health. The objectives of the present study were to provide quantitative data on the impact of air pollution on the health of people living in two small municipalities in a highly industrialized, densely populated area of Northern Italy. We applied the approach proposed by the World Health Organization (WHO) using the AirQ 2.2.3 software developed by the WHO European Centre for Environment and Health, Bilthoven Division. Daily concentrations of ozone, nitrogen dioxide, and particulate matter of aerodynamic diameter ≤10 μm (PM₁₀) and ≤2.5 μm (PM_2.5) were used to assess human exposure and health effects in terms of attributable proportion of the health outcome, annual number of excess cases of mortality for all causes, and cardiovascular and respiratory diseases. Long-term effects were estimated for PM_2.5 as years of life lost.Considering short-term effects, PM_2.5 had the highest health impact on the 24,000 inhabitants of the two small towns, causing an excess of total mortality of 8 out of 177 in a year. Ozone and nitrogen dioxide each caused about three excess cases of total mortality. Results on long-term effects showed, respectively, 433, 180, and 72 years of life lost for mortality for all causes, cardiopulmonary diseases and lung cancer, in a year.These results are consistent with other reports of the impact of air quality on human health and the AirQ software seems an effective and easy tool, helpful in decision-making.     

Assessment of human health risk due to environmental pollution in the city of Orsk

The established tense ecological situation in the town of Orsk presents a serious human threat. The use of methods for assessing the risk has allowed the authors to determine the values of carcinogenic and noncarcinogenic risks. Due to the influence of all environments polluted by industrial emissions, the total annual carcinogenic risk is 2.31 cases for the adult population of the town and 0.49 for its children. The greatest carcinogenic risk is associated with arsenic in water and foodstuffs, hexavalent chromium, cadmium, and formaldehyde in the air. The high concentrations of dust, phenol, nitrogen dioxide, and carbon oxide cause a major damage to human health. The established specific values of this risk are of relative significance.     

Risk assessment and risk communication in environmental health in Poland

Efficient prevention activities can reduce disease, caused by environmental factors as well as costs to the health-care system, but it is impossible without understanding by the society of when, where, how and why exposures occur. Physicians and other health-care professionals may have an important role to play in communication of these potential dangers as the public requires information from knowledgeable and trusted sources about environmental risks and methods to avoid them. Epidemiological study in Poland shows that the health risk awareness in the society is not satisfactory and improvement of communication processes is essential to reduce individual risk factors.     

Human health risk assessment of long chain alcohols

Representative chemicals from the long chain alcohols category have been extensively tested to define their toxicological hazard properties. These chemicals show low acute and repeat dose toxicity with high-dose effects (if any) related to minimal liver toxicity. These chemicals do not show evidence of activity in genetic toxicity tests or to the reproductive system or the developing organism. These chemicals also are not sensitizers. Irritation is dependant on chain length; generally, alcohols in the range C_6–C₁₁ are considered as irritant, intermediate chain lengths (C_12–C₁₆) alcohols are considered to be mild irritants and chain lengths of C₁₈ and above are considered non-irritants. These chemicals are broadly used across the consumer products industry with highest per person consumer exposures resulting from use in personal care products. Margins of exposure adequate for the protection of human health are documented for the uses of these chemicals.     

Results of two methods to determine health expectancy in The Netherlands in 1981-1985.

Health expectancy is a measure providing summarizing information on mortality on one hand and morbidity and/or disability on the other hand. In this article health expectancy is determined with two approaches: method 1 leads to life expectancy free of disability at birth and at other ages; method 2 leads to life expectancy in good health. Results of the various calculations show that according to method 1 life expectancy free of disability at birth for men in the Netherlands was 58.8 years and for women 57.3 years (based on data from the period 1981-1985). Results of method 2 are different from method 1; life expectancy in good health for men was 58.9 years and for women 60.7 years. Results of both methods are compared with studies which have been carried out in other countries. The comparison shows that method 1 leads to results which deviate from the other studies while results of method 2 are to a large extent similar to the other studies. Reasons are given which explain why the results of method 1 deviate from the other studies. In spite of the fact that the two methods lead to different outcomes, the conclusion is drawn that the difference in health expectancy between men and women is much smaller than the difference in total life expectancy between men and women. The difference in total life expectancy by sex in the period 1981-1985 was 6.7 years.     

The assessment of premature death rates in Byelarus due to environmental air pollution

The attributive death rates due to ambient air pollution were estimated in the urban areas of Byelarus. Estimation used the data of daily atmospheric contamination monitoring made by the Main Hydrometereology Committee of Byelarus in 15 towns from 1990 to 1999. To establish a dose-response relationship, the results of the well-known investigations by Dockery were used, which covering prospective cohort studies in 6 towns of the USA, have demonstrated a statistically significant correlation between atmospheric pollution and mortality rates. In Byelarus, about 7.5 thousand premature deaths or 6% of the total annual death rates may be induced by atmospheric pollution. Possible factors that influence the accuracy of estimates are discussed in the paper.     

Human health risk assessment of 2-mercaptobenzothiazole in drinking water

2-Mercaptobenzothiazole (MBT) is used as a vulcanization accelerator in rubber products that come into contact with potable drinking water. When such products are evaluated for contact with potable water and submitted for ANSI/NSF Standard 61 certification, any chemical extracting from these products must be below an appropriate action level of exposure. As defined by Standard 61, a total allowable concentration (TAC) is the maximum concentration of a nonregulated contaminant allowed in a public drinking water supply, and the single product allowable concentration (SPAC) is 10% of the TAC. Currently, MBT has a TAC of 40 microg/L and a SPAC of 4 microg/L. A comprehensive health effects evaluation of MBT was performed to determine whether these action levels should be revised. Epidemiological investigations indicate that workers occupationally exposed to MBT have an increased risk of death from bladder cancer. Genotoxicity investigations in bacterial and mammalian test systems provide some evidence indicating that MBT has the potential to induce mutations and chromosomal aberrations. Toxicity studies in rats and mice chronically exposed to MBT identified increases in various tumours, such as adrenal gland tumours, pituitary gland tumours, liver tumours and renal pelvis tumours. The biological significance of most of these tumours is questionable due to a variety of factors, such as a lack of dose-response between tumour incidence and dose, and the effect of test article vehicle (corn oil) upon tumour rates. Potential human health effects of exposure to MBT can be predicted from an NTP 2-year cancer study in rats, as well as epidemiological investigations in occupationally exposed workers. A comprehensive review of the epidemiological and toxicological dataset for MBT indicates that the induction of renal pelvis transitional cell tumours is the most sensitive and relevant health effects endpoint upon which to base a revised TAC and SPAC. A multistage model was used to extrapolate to low-dose MBT exposures due to the genotoxicity and clastogenicity of MBT. A TAC of 600 microg/L was derived for MBT, and was based upon an LED10 of 157.681 mg/kg per day. A SPAC of 60 microg/L was derived by multiplying the revised TAC by 0.10, and rounding to one significant figure. These revised action levels are based upon the most sensitive health effects endpoint, as well as current cancer risk assessment methodology.     

Sequential health effect study in relation to air pollution in Bombay. India

A health study done for 4 years in 4129 subjects from 3 urban (High, medium and low according to SO₂ levels) and a rural community showed a higher morbidity with raised levels. Initially in the respective 4 areas standardised prevalences (in percent) were: for dyspnoea 7.3, 6, 3.2 and 5.5; for chronic cough 5.1, 2.7, 1. 7 and 3.3; for intermittent cough 15.6, 5.8, 0.4 and 3.7 and frequent colds 18.0, 20.8, 12.1 and 11 percent. The diagnosis of chronic bronchitis was done in 4.5, 4.5, 2,3 and 5.0 percent and cardiac disorders 6.8, 4.3, 8.2 and 2.7 percent in respective 4 areas.After 3 years, 55–60% of urban and 44% of rural subjects were reassessed. Several minor symptoms, besides above ones were related closely to the urban air pollutant profile. Increased greenery protected only at lower levels of pollution. Initial lung functions were best in « urban low » area but in all urban areas, yearly declines were larger than in rural subjects.A cross sectional study for effect of slums in 4 areas on 22272 subjects revealed generally higher morbidity in slum residents, particularly in « urban medium » area for frequent colds, cough and dyspnoea. Daily health diaries maintained in 2232 subjects revealed high morbidity in 2 more polluted areas; monthly trends correlated to SO₂ and S.P.M. and daily fluctuations with SO₂ revealed a threshold between 50 to 100 g/C M/day.There were greater mortality (S.M.R.) in cardiorespiratory and malignant diseases related to pollution. The major factors affecting morbidity were pollution, nutrition, occupation, smoking and age.     

BenMAP-CE软件在中国空气污染健康风险评估中的应用

目的 促进美国环保署研发设计的空气污染健康风险评估软件BenMAP-CE在中国空气污染健康风险评估中的应用。方法 根据中国的空气质量及健康影响监测数据特征,从该软件的运算分析流程与原理、适用范围、所需数据、导出和导入设置以及应用示例等几部分进行了系统介绍。结果 通过该软件,将中国研究区域的各项参数输入模块,可针对空气质量的变化进行健康收益分析。结论 BenMAP-CE适用于中国空气污染健康风险评估,对于制定环境政策具有指导意义和参考价值。     

Assessing the impact of health technology assessment in The Netherlands

OBJECTIVES: Investments in health research should lead to improvements in health and health care. This is also the remit of the main HTA program in the Netherlands. The aims of this study were to assess whether the results of this program have led to such improvements and to analyze how best to assess the impact from health research. METHODS: We assessed the impact of individual HTA projects by adapting the "payback framework" developed in the United Kingdom. We conducted dossier reviews and sent a survey to principal investigators of forty-three projects awarded between 2000 and 2003. We then provided an overview of documented output and outcome that was assessed by ten HTA experts using a scoring method. Finally, we conducted five case studies using information from additional dossier review and semistructured key informant interviews. RESULTS: The findings confirm that the payback framework is a useful approach to assess the impact of HTA projects. We identified over 101 peer reviewed papers, more than twenty-five PhDs, citations of research in guidelines (six projects), and implementation of new treatment strategies (eleven projects). The case studies provided greater depth and understanding about the levels of impact that arise and why and how they have been achieved. CONCLUSIONS: It is generally too early to determine whether the HTA program led to actual changes in healthcare policy and practice. However, the results can be used as a baseline measurement for future evaluation and can help funding organizations or HTA agencies consider how to assess impact, possibly routinely. This, in turn, could help inform research strategies and justify expenditure for health research.     

Exposure assessment as a component of observational health studies and environmental risk assessment

Assessing pesticide and nonpesticide exposures in agricultural settings is a daunting task. This is especially the case when such assessments are undertaken as a component of health studies to evaluate cancer risk. In this review, key exposure assessment issues are outlined and discussed in the context of pesticide-specific health risk assessments and three recent studies of large, geographically defined farmer and farm family populations. The specific topics addressed include the assessment of cumulative exposures to both older and more recently registered pesticides, the role of biomarker studies in exposure assessment, and uses of data on nonroutine high-exposure events.