Search

The levels of nitrate in 52 drinking water wells in rural Central Java, Indonesia were evaluated in April 2014, and the results were used for a health risk assessment for the local populations by using probabilistic techniques. The concentrations of nitrate in drinking water had a range of 0.01–84 mg/L, a mean of 20 mg/L and a medium of 14 mg/L. Only two of the 52 samples exceeded the WHO guideline values of 50 mg/L for infant methaemoglobinaemia. The hazard quotient values as evaluated against the WHO guideline value at the 50 and 95 percentile points were HQ 50 at 0.42 and HQ 95 at 1.2, respectively. These indicated a low risk of infant methaemoglobinaemia for the whole population, but some risk for the sensitive portion of the population. The HQ 50 and HQ 95 values based on WHO acceptable daily intake dose for adult male and female were 0.35 and 1.0, respectively, indicating a generally a low level of risk. A risk characterisation linking birth defects to nitrate levels in water consumed during the first three months of pregnancy resulted in a HQ 50/50 values of 1.5 and a HQ 95/5 value of 65. These HQ values indicated an elevated risk for birth defects, in particular for the more sensitive population. A sanitation improvement program in the study area had a positive effect in reducing nitrate levels in wells and the corresponding risk for public health. For example, the birth defect HQ50/50 values for a subset of wells surveyed in both 2014 and 2015 was reduced from 1.1 to 0.71. [ABSTRACT FROM AUTHOR]

Background & Aims IgG subclass 4–related disease (IgG4-RD) is characterized by increased serum levels of IgG4 and infiltration of biliary, pancreatic, and other tissues by IgG4-positive plasma cells. We assessed the prevalence of allergy and/or atopy, serum, and tissue IgE antibodies, and blood and tissue eosinophils in patients with IgG4-RD. We investigated the association between serum IgE and diagnosis and relapse of this disease. Methods We performed a prospective study of 48 patients with IgG4-RD, 42 patients with an increased serum level of IgG4 with other inflammatory and autoimmune conditions (disease control subjects), and 51 healthy individuals (healthy control subjects) recruited from Oxford, United Kingdom from March 2010 through March 2014, and followed for a median of 41 months (range, 3–73 months). Serum levels of immunoglobulin were measured at diagnosis, during steroid treatment, and at disease relapse for patients with IgG4-RD; levels at diagnosis were compared with baseline levels of control subjects. Allergen-specific IgEs were measured using the IgE ImmunoCAP. Levels and distribution of IgG4 and IgE antibodies in lymphoid, biliary, and pancreatic tissues from patients with IgG4-RD and disease control subjects were measured by immunohistochemistry. We analyzed data using the Spearman rank correlation and receiver operating characteristic curves. Results Serum levels of IgG4 increased to 1.4 g/L or more, and IgE increased to 125 kIU/L or more, in 81% and 54% of patients with IgG4-RD, respectively, compared with 6% and 16% of healthy control subjects ( P < .0001). Peripheral blood eosinophilia was detected in 38% of patients with IgG4-RD versus 9% of healthy control subjects ( P = .004). Of patients with IgG4-RD, 63% had a history of allergy and 40% had a history of atopy with an IgE-specific response; these values were 60% and 53% in patients with increased serum levels of IgE ( P < .05). Level of IgE at diagnosis >480 kIU/L distinguished patients with IgG4-RD from disease control subjects with 86% specificity, 36% sensitivity, and a likelihood ratio of 3.2. Level of IgE at diagnosis >380 kIU/L identified patients with disease relapse with 88% specificity, 64% sensitivity, and a likelihood ratio of 5.4. IgE-positive mast cells and eosinophilia were observed in lymphoid, biliary, and pancreatic tissue samples from 50% and 86% of patients with IgG4-RD, respectively. Conclusions In a prospective study, we associated IgG4-RD with allergy, atopy, eosinophilia, increased serum levels of IgE, and IgE-positive mast cells in lymphoid, biliary, and pancreatic tissue. An IgE-mediated allergic response therefore seems to develop in most patients with IgG4-RD; levels of IgE might be used in diagnosis and predicting relapse. [ABSTRACT FROM AUTHOR]

Generally, there is limited information on pesticide absorbed dose levels and health risk attributable to the dermal route of exposure among applicators. The objective of this study was to evaluate the absorbed dose levels and consequent health risk from dermal exposure to chlorpyrifos among applicators on rice farms in Ghana. The whole-body dosimetry technique was used to capture chlorpyrifos residues penetrating the applicators’ clothing and reaching their skin, as well as residues reaching uncovered body areas of the applicators. Acute (ADD D ) and chronic (LADD D ) absorbed dose levels of chlorpyrifos were estimated from the residues and plotted as cumulative probability distributions. Health risk from chlorpyrifos exposure was characterized using the Hazard Quotient (HQ) technique. Three of the four acute exposure guideline values used in the study indicated that applicators, represented by the median-exposed (ADD D , 15 μg/kg/day) and the 5% - highly exposed (ADD D , 27 μg/kg/day) groups were at high risk of acute adverse health effects due to chlorpyrifos exposure, with HQ values ranging from 1.5 to 5 and 2.7 to 9, respectively. Regarding chronic adverse health effects, none of the guideline values suggested risk among the median-exposed group (LADD D , 0.3 μg/kg/day), with HQ values ranging from 0.03 to 1. However, two of the chronic exposure guideline values suggested that the 5%- highly exposed group (LADD D , 0.6 μg/kg/day) may be adversely affected, with HQ values ranging from 1.2 to 2. These findings highlight the importance of the dermal route as a major pesticide exposure pathway and suggest possible exposure minimization strategies. [ABSTRACT FROM AUTHOR]

• Mass spectrometry has an advantage over serum protein electrophoresis at screening. • Additional monoclonal proteins seen by mass spectrometry may be clinically relevant. • Higher sensitivity when screening for monoclonal gammopathies has clinical utility. • Mass spectrometry should be investigated at all stages of monoclonal gammopathies. Mass spectrometry has recently been proposed as a novel sensitive screening tool for monoclonal gammopathies. In a small study we have tested the ability of quantitative immunoprecipitation mass spectrometry (QIP-MS) to identify low level monoclonal immunoglobulins not currently detected by the initial serum protein electrophoresis (SPEP) screen. QIP-MS positively identified the primary monoclonal immunoglobulins in all 11 patient samples alongside additional monoclonal immunoglobulins in a subset of patient samples. We conclude that QIP-MS has clinical utility as a first-line screening tool for monoclonal gammopathy investigation, identifying monoclonality in patients with higher sensitivity and resolution compared to the current standard methods. [ABSTRACT FROM AUTHOR]

Studies evaluating dermal exposure to pesticides among applicators in tropical countries have largely been conducted using the patch dosimetry and hand wiping/washing techniques. This study used the more accurate whole-body dosimetry technique to evaluate dermal exposure to chlorpyrifos among applicators on rice farms in Ghana. The exposure levels were plotted as Cumulative Probability Distribution (CPD). Total Dermal Exposure (TDE) of chlorpyrifos among the median exposed and the 5% highly exposed groups during a spray event were 24 mg and 48 mg, respectively. When these were converted as a percentage of the quantity of active ingredient applied (Unit Exposure, UE), UE values of 0.03% and 0.06% were found among the median exposed and the 5% highly exposed groups, respectively. Overall, the hands were the most contaminated anatomical regions of the applicators, both in terms of proportion of TDE (39%) and skin loading (13 μg/cm 2 ). Also, the lower anatomical region was more contaminated (82% of TDE) compared to the upper anatomical region (18% of TDE). The levels of chlorpyrifos TDE among the applicators were found to be influenced by the quantity of insecticide applied and the height of the crops sprayed (p < 0.05). The pesticide UE data of the present study can be used to estimate the levels of dermal exposure under similar pesticide use scenarios among applicators. The findings of the present study suggest that protecting the hands and the lower anatomical regions with appropriate PPE may significantly reduce exposure among applicators. [ABSTRACT FROM AUTHOR]

Abstract: A referee analysis method for the detection and quantification of Pacific ciguatoxins in fish flesh has recently been established by the public health analytical laboratory for the State of Queensland, Australia. Fifty-six fish samples were analysed, which included 10 fillets purchased as negative controls. P-CTX-1 was identified in 27 samples, and P-CTX-2 and P-CTX-3 were found in 26 of those samples. The range of P-CTX-1 concentrations was 0.04–11.4μg/kg fish flesh; coefficient of variation from 90 replicate analyses was 7.4%. A liquid chromatography/tandem mass spectrometry (HPLC-MS/MS) method utilising a rapid methanol extraction and clean-up is reliable and reproducible, with the detection limit at 0.03μg/kg fish flesh. Some matrix effects are evident, with fish oil content a likely signal suppression factor. Species identification of samples by DNA sequence analysis revealed some evidence of fish substitution or inadvertent misidentification, which may have implications for the management and prevention of ciguatera poisoning. Blinded inspection of case notes from suspect ciguatera poisoning cases showed that reporting of ciguatera-related paraesthesias was highly predictable for the presence of ciguatoxins in analysed fish, with 13 of 14 expected cases having consumed fish that contained P-CTX-1 (p <0.001, Fishers Exact Test). [ABSTRACT FROM AUTHOR]