Search

One of the most common causes of lung cancer is exposure to occupational carcinogens. Free silica, diesel exhaust fumes, dyes, radon and with asbestos at the top of the list, differ by percentage according to the predominant professional activities in each country. The occupational health doctor is directly involved in the surveillance of the exposed worker, during work or post exposure, in the diagnosis and reporting of occupational cancers. Efficient screening followed by reporting and monitoring cases of occupational lung cancer and, last but not least, reintegration into professional activity are important steps in the medical surveillance of the worker exposed to occupational lung carcinogens. Standardised information collected at the level of occupational exposure monitoring systems, separated by carcinogen category and profession, may form the basis of control and prevention plans. Harmonising medical surveillance at European and global level can lead to a decrease in the incidence and mortality of work-related lung cancer. [ABSTRACT FROM AUTHOR]

The article discusses the significant safety and health risks posed by the manufacture and handling of hazardous medicinal products (HMPs) to workers. Topics include the health risks associated with HMP exposure, the importance of implementing closed systems for protection, and the role of regulatory bodies in promoting safer handling practices.

Introduction and Objectives. Bladder cancer is one of the most common malignancies in Europe. Many risk factors for bladder cancer have been identify, with tobacco smoking and exposure to environmental and occupational carcinogens being the most important ones. The objective of this study was to identify the risk factors associated with the development of bladder cancer among patients that underwent radical cystectomy. Materials and Methods. The study included 391 patients that underwent radical cystectomy from January 2017 to December 2018 in our center. According to their smoking status, patients were grouped into non-smokers (patients that didn't smoke any cigarette in the last 10 years), smokers (patients that did smoke in the last 6 months) and ex-smokers (patients that have more than 6 months and less than 10 years since they have quit smoking). Other risk factors analyzed were hereditary factors, history of external beam radiation therapy and exposure to occupational carcinogens. Results. The median age of the patients was 69 years old with 308 men (78.77%) and 83 women (21.23%) included. 170 patients were classified as smokers (43.48%), while 131 patients were ex-smokers (33.50%) and 90 patients were non-smokers (23.02%). The prevalence of occupational carcinogens exposure was 10.74%. Hereditary risk factors associated with the development of bladder cancer were identified in 17 patients (4.35%). External beam radiation therapy was identified as a risk factor in 27 patients (6.90%). Current smokers were more frequently diagnosed with T3b and T4a, while N1 and N2 lymph node stages were more often diagnosed among smokers and ex-smokers. Conclusions. Bladder cancer is a common malignancy that has a big impact on health systems and will continue to be so, due to the high prevalence of its most important risk factor, tobacco smoking. In our study, smoking was the most important risk factor, with a prevalence of 77% among patients that were classified as current smokers and ex-smokers. Prevention of smoking needs to be highlighted and cessation programs must be developed in order to lower the incidence of bladder cancer. More measures for increasing safety at work must be taken in order to decrease the exposure to occupational carcinogens. [ABSTRACT FROM AUTHOR]

Most volatile organic compounds are considered potentially harmful air pollutants to the environment and most importantly human health. The present work investigated the concentrations of 72 volatile organic compounds commonly emitted from the vehicular exhausts at a hospital parking garage. The objective was set to assess the associated health risk due to inhalation of these compounds during weekdays versus weekends. Carcinogenic and non-carcinogenic health risks were assessed using the US Environmental Protection Agency conventional approach. A total of 112 air samples were collected inside the hospital parking garage using six-liter evacuated Silonite™-coated polished stainless steel canisters. Triplicate sampling was used for quality assurance/quality control purposes. The air samples were analyzed using the gas chromatography with flame ionization detection system, which followed the US Environmental Protection Agency TO-15 Method. The overall 24-h concentrations of benzene, toluene, ethylbenzene, and xylenes were 6.78, 31.14, 11.35, and 27.85 μg/m3, respectively. These values were comparable to values reported in Europe, North America, and Asia. The weekend concentrations were lower than the weekday ones. Halogenated compounds had the highest contribution of volatile organic compounds groups to total concentrations in both weekday and weekend. The weekday and weekend concentrations temporal cycles were characterized, and they were correlated with the traffic activity inside the parking garage. Two of the measured compounds (i.e., tetrachloromethane and 1,2-dibromoethane) were discovered to pose definite cancer risk. To our knowledge, this is the first study in the region which looks at volatile organic compound levels in a parking garage and the associated health risks. [ABSTRACT FROM AUTHOR]

Background: Work-related cancer is an important public health issue with a large financial impact on society. The key European legislative instrument is the Carcinogens and Mutagens Directive (2004/37/EC). In preparation for updating the Directive, the European Commission commissioned a study to provide a socioeconomic, health and environmental impact assessment.Methods: The evaluation was undertaken for 25 preselected hazardous substances or mixtures. Estimates were made of the number of cases of cancer attributable to workplace exposure, both currently and in the future, with and without any regulatory interventions, and these data were used to estimate the financial health costs and benefits.Results: It was estimated that if no action is taken there will be >700 000 attributable cancer deaths over the next 60 years for the substances assessed. However, there are only seven substances where the data suggest a clear benefit in terms of avoided cancer cases from introducing a binding limit at the levels considered. Overall, the costs of the proposed interventions were very high (up to [euro ]34 000 million) and the associated monetised health benefits were mostly less than the compliance costs.Conclusions: The strongest cases for the introduction of a limit value are for: respirable crystalline silica, hexavalent chromium, and hardwood dust. [ABSTRACT FROM AUTHOR]

BACKGROUND: Fish are a source of persistent organic pollutants (POPs) in the human diet. Although species, trophic level, and means of production are typically considered in predicting fish pollutant load, and thus recommendations of consumption, capture location is usually not accounted for. OBJECTIVES: Yellowfin tuna (Thunnus albacares) are harvested from across the world's oceans and are widely consumed. Here, we determined geographic variation in the overall mass, concentration, and composition of POPs in yellowfin and examined the differences in levels of several POP congeners of potential relevance to human health. METHODS: We sampled dorsal muscle of 117 yellowfin tuna from 12 locations worldwide, and measured POP levels using combined liquid or gas chromatography and mass spectrometry according to U.S. Environmental Protection Agency standard procedures. RESULTS: POP levels varied significantly among sites, more than 36-fold on a mass basis. Individual fish levels ranged from 0.16 to 138.29 ng/g wet weight and lipid-normalized concentrations from 0.1 to 12.7 μM. Levels of 10 congeners that interfere with the cellular defense protein P-glycoprotein, termed transporter interfering compounds (TICs), ranged from 0.05 to 35.03 ng/g wet weight and from 0.03 to 3.32 μM in tuna lipid. Levels of TICs, and their individual congeners, were strongly associated with the overall POP load. Risk-based analysis of several carcinogenic POPs indicated that the fish with the highest levels of these potentially harmful compounds were clustered at specific geographic locations. CONCLUSIONS: Capture location is an important consideration when assessing the level and risk of human exposure to POPs through ingestion of wild fish. [ABSTRACT FROM AUTHOR]

Facial makeup cosmetics are commonly used products that are applied to the skin, and their ingredients come into contact with it for many years. Consequently, they should only contain substances that are considered safe or used within an allowable range of established concentrations. According to current European laws, all cosmetics approved for use should be entirely safe for their users, and the responsibility for this lies with manufacturers, distributors, and importers. However, the use of cosmetics can be associated with undesirable effects due to the presence of certain chemical substances. An analysis of 50 random facial makeup cosmetics commercially available on the European Union market and manufactured in six European countries was carried out, concerning the presence of substances with potential carcinogenic properties, as described in recent years in the literature. Nine types of facial makeup cosmetics were selected, and their compositions, as declared on the labels, were analyzed. The carcinogens were identified with information present in the European CosIng database and according to the Insecticide Resistance Action Committee's (IRAC) classification. As a result, the following potential carcinogens were identified: parabens (methylparaben, propylparaben, butylparaben, and ethylparaben), ethoxylated compounds (laureth-4, lautreth-7, or ethylene glycol polymers known as PEG), formaldehyde donors (imidazolidinyl urea, quaternium 15, and DMDM hydantoin), and ethanolamine and their derivatives (triethanolamine and diazolidinyl urea), as well as carbon and silica. In conclusion, all of the analyzed face makeup cosmetics contain potential carcinogenic substances. The literature review confirmed the suppositions regarding the potential carcinogenic effects of selected cosmetic ingredients. Therefore, it seems necessary to carry out studies on the long-term exposure of compounds present in cosmetics and perhaps introduce stricter standards and laws regulating the potential presence of carcinogens and their activity in cosmetics.

Sudan derivatives are widely used as dyes for foods, textiles, plastics, paper, and cosmetics. The wavenumbers in the maximum of the electronic absorption bands of two Sudan derivatives in solvents with varying physicochemical properties were correlated with microscopic and macroscopic parameters of solution components. The molecular parameters of the Sudan derivatives in the excited state were estimated using solvatochromic and quantum-mechanical calculations. [ABSTRACT FROM PUBLISHER]

Objective: The use of measurement data in occupational exposure assessment allows more quantitative analyses of possible exposure-response relations. We describe a quantitative exposure assessment approach for five lung carcinogens (i.e. asbestos, chromium-VI, nickel, polycyclic aromatic hydrocarbons (by its proxy benzo(a)pyrene (BaP)) and respirable crystalline silica). A quantitative job-exposure matrix (JEM) was developed based on statistical modeling of large quantities of personal measurements. Methods: Empirical linear models were developed using personal occupational exposure measurements (n = 102 306) from Europe and Canada, as well as auxiliary information like job (industry), year of sampling, region, an a priori exposure rating of each job (none, low, and high exposed), sampling and analytical methods, and sampling duration. The model outcomes were used to create a JEM with a quantitative estimate of the level of exposure by job, year, andregion. Results: Decreasing time trends were observed for all agents between the 1970s and 2009, ranging from -1.2% per year for personal BaP and nickel exposures to -10.7% for asbestos (in the time period before an asbestos ban was implemented). Regional differences in exposure concentrations (adjusted for measured jobs, years of measurement, and sampling method and duration) varied by agent, ranging from a factor 3.3 for chromium-VI up to a factor 10.5 for asbestos. Conclusion: We estimated time-, job-, and region-specific exposure levels for four (asbestos, chromium-VI, nickel, and RCS) out of five considered lung carcinogens. Through statistical modeling of large amounts of personal occupational exposure measurement data we were able to derive a quantitative JEM to be used in community-based studies. [ABSTRACT FROM AUTHOR]

Through a survey with European companies and expert interviews we study how REACH authorisation affects the phase-out of hazardous chemicals focusing on trichloroethylene, a well-studied solvent used in metal parts cleaning. We find that most of the firms have substituted trichloroethylene by perchloroethylene, which has similar chemical characteristics. This allows them to continue to use the same machines and routines at low costs. Although perchloroethylene is only classified as a suspected rather than a proven carcinogenic substance in Europe, the "improvement" as the result of much regulatory effort must be considered fairly limited, particularly in the light of less hazardous alternatives being used on the market for a long time. Our survey shows that the REACH authorisation process has some effect. Many firms cited as their main reason for substitution that they wanted to avoid the renewed application process. Still, the fact that many firms report using old machines reinforces the impression that some firms are not feeling enough pressure to modify routines and engage in a more fundamental substitution process. The results illustrate the limited effectiveness of a substance by substance approach in chemical risk management. When companies can substitute chemicals of concern to substances with similar chemical characteristics, the health and environmental objectives of chemical regulation are not achieved. An important policy conclusion is that additional incentives need to be introduced in order to realize the ambition of a non-toxic environment in the European Chemicals Strategy for Sustainability. Increased use of measures targeting broader groups of structurally similar hazardous chemicals, in combination with fees that incentivize substitution, are promising avenues for a more sustainable European chemicals strategy. • REACH authorisation has lead to phase out of TCE in European metal parts cleaning. • Perchloroethylene is the main substitute for TCE in European metal parts cleaning. • Low costs for substituting TCE with perchloroethylene in existing machines. • Limited effectiveness of single substance approach to chemical risk management. [ABSTRACT FROM AUTHOR]

Occupational exposure limits for carcinogens are increasingly based on excess lifetime risks of cancer. Acceptable limits in some countries in Europe are set at 4/1000 (=highest tolerable risk level) and 4/100,000 (=acceptable risk level) based on 40 year working exposure for the occupational population. When an exposure metric is used that is fairly new, epidemiology does not offer dose–response data that is needed for the derivation of a science based limit value. The urinary concentration of 1-hydroxypyrene is a fairly new bioindicator of exposure to polycyclic aromatic hydrocarbons (PAH). Nowadays, measurements of 1-hydroxypyrene in urine are routinely applied to control industrial exposure to PAH as present in coke ovens and primary aluminium production and to control exposure of professionals when handling coal tar derived products. Due to lacking dose–response data from epidemiological studies, a cancer risk based limit of 1-hydroxypyrene in urine cannot be derived. An alternative derivation procedure is proposed for the limit value that can be used as guidance for the intermediate period. For the period in-between, it is suggested to take the ‘no observed genotoxic effect level’ (=NOGEL) in PAH-exposed workers as the point-of-departure for setting the limit value. The genotoxic endpoints are genotoxic effects in white blood cells of PAH-exposed workers (chromosomal aberrations, sister chromatid exchanges, micronuclei, comet assay, DNA adducts). In order to assess the point-of-departure for limit setting, cross-sectional studies were searched for that report on the response of early genotoxic effects in white blood cells of workers that could be related to the degree of PAH-exposure (expressed as 1-hydroxypyrene in urine). Nine cross-sectional studies were traced that met these requirements. From each study, the concentration of 1-hydroxypyrene in end-of-shift urine samples was determined, at which no genotoxic effects was found. From 4 out of 9 studies a no-observed genotoxic effect level could be derived, the lowest level was 1.0 μmol/mol creatinine. This limit level is recommended as a state-of-the-art guidance, valid when the PAH-profile in the work environment is similar to that of coke oven with a typical pyrene/BaP ratio of 2.5. For work environments with a deviating PAH-profile an adjustment procedure with the pyrene/BaP ratio is suggested. [ABSTRACT FROM AUTHOR]

Background: New preventive technologies such as vaccines offer insight into psychological, social, and cultural landscapes. Providers have a key role in parents' decisions for vaccinating their children. Yet, perspectives from providers regarding the human papillomavirus (HPV) vaccine, or vaccination in general, are rarely sought Purpose: Our objective in this paper is to understand how the HPV vaccine is perceived by health care providers and the multiple contextual meanings it elicits. Methods: We conducted interviews with 20 health care professionals in Bulgaria about their attitudes and practices related to HPV vaccination and their recommendations for policies. The verbatim-transcribed interviews were analyzed through narrative analysis, with a special focus on language. Results: We illustrate providers' contradictory and contextualized constructions of the vaccine and the narrative strategies they use to manage any uncertainty it elicits. These include being advocates and missionaries for preventive health, confirming their trust in the medical profession and professional organizations, challenging patients' concerns with rational explanations, normalizing the risk of medical innovations, and avoiding the sexual nature of HPV transmission. Conclusions: The introduction of a vaccine to prevent HPV infection, and by implication, possibly cervical and other cancers, created hope, and at the same time, intensified confusion and uncertainty. Providers have been frustrated for years with the rising mortality from cervical cancer in Bulgaria, and their perceived powerlessness in affecting this. HPV vaccination, on the other hand, seems relatively simple and 'taming uncertainty' positions them as instrumental in limiting (or even eliminating) morbidity and mortality in future generations. [ABSTRACT FROM AUTHOR]

Background: Leukemia incidence has increased in recent decades among European children, suggesting that early-life environmental exposures play an important role in disease development. Objectives: We investigated the hypothesis that childhood susceptibility may increase as a result of in utero exposure to carcinogens and hormonally acting factors. Using cord blood samples from the NewGeneris cohort, we examined associations between a range of biomarkers of carcinogen exposure and hormonally acting factors with micronuclei (MN) frequency as a proxy measure of cancer risk. Associations with gene expression and genotype were also explored. Methods: DNA and protein adducts, gene expression profiles, circulating hormonally acting factors, and GWAS (genome-wide association study) data were investigated in relation to genomic damage measured by MN frequency in lymphocytes from 623 newborns enrolled between 2006 and 2010 across Europe. Results: Malondialdehyde DNA adducts (M1dG) were associated with increased MN frequency in binucleated lymphocytes (MNBN), and exposure to androgenic, estrogenic, and dioxin-like compounds was associated with MN frequency in mononucleated lymphocytes (MNMONO), although no monotonic exposure-outcome relationship was observed. Lower frequencies of MNBN were associated with a 1-unit increase expression of PDCD11, LATS2, TRIM13, CD28, SMC1A, IL7R, and NIPBL genes. Gene expression was significantly higher in association with the highest versus lowest category of bulky and M1dG-DNA adducts for five and six genes, respectively. Gene expression levels were significantly lower for 11 genes in association with the highest versus lowest category of plasma AR CALUX® (chemically activated luciferase expression for androgens) (8 genes), ERα';CALUX® (for estrogens) (2 genes), and DR CALUX® (for dioxins). Several SNPs (single-nucleotide polymorphisms) on chromosome 11 near FOLH1 significantly modified associations between androgen activity and MNBN frequency. Polymorphisms in EPHX1/2 and CYP2E1 were associated with MNBN. Conclusion: We measured in utero exposure to selected environmental carcinogens and circulating hormonally acting factors and detected associations with MN frequency in newborns circulating T lymphocytes. The results highlight mechanisms that may contribute to carcinogen-induced leukemia and require further research. [ABSTRACT FROM AUTHOR]

Abstract: Since the ban on some brominated flame retardants (BFRs), phosphorus flame retardants (PFRs), which were responsible for 20% of the flame retardant (FR) consumption in 2006 in Europe, are often proposed as alternatives for BFRs. PFRs can be divided in three main groups, inorganic, organic and halogen containing PFRs. Most of the PFRs have a mechanism of action in the solid phase of burning materials (char formation), but some may also be active in the gas phase. Some PFRs are reactive FRs, which means they are chemically bound to a polymer, whereas others are additive and mixed into the polymer. The focus of this report is limited to the PFRs mentioned in the literature as potential substitutes for BFRs. The physico-chemical properties, applications and production volumes of PFRs are given. Non-halogenated PFRs are often used as plasticisers as well. Limited information is available on the occurrence of PFRs in the environment. For triphenyl phosphate (TPhP), tricresylphosphate (TCP), tris(2-chloroethyl)phosphate (TCEP), tris(chloropropyl)phosphate (TCPP), tris(1,3-dichloro-2-propyl)phosphate (TDCPP), and tetrekis(2-chlorethyl)dichloroisopentyldiphosphate (V6) a number of studies have been performed on their occurrence in air, water and sediment, but limited data were found on their occurrence in biota. Concentrations found for these PFRs in air were up to 47μgm−3, in sediment levels up to 24mgkg−1 were found, and in surface water concentrations up to 379ngL−1. In all these matrices TCPP was dominant. Concentrations found in dust were up to 67mgkg−1, with TDCPP being the dominant PFR. PFR concentrations reported were often higher than polybrominated diphenylether (PBDE) concentrations, and the human exposure due to PFR concentrations in indoor air appears to be higher than exposure due to PBDE concentrations in indoor air. Only the Cl-containing PFRs are carcinogenic. Other negative human health effects were found for Cl-containing PFRs as well as for TCP, which suggest that those PFRs would not be suitable alternatives for BFRs. TPhP, diphenylcresylphosphate (DCP) and TCP would not be suitable alternatives either, because they are considered to be toxic to (aquatic) organisms. Diethylphosphinic acid is, just like TCEP, considered to be very persistent. From an environmental perspective, resorcinol-bis(diphenylphosphate) (RDP), bisphenol-A diphenyl phosphate (BADP) and melamine polyphosphate, may be suitable good substitutes for BFRs. Information on PFR analysis in air, water and sediment is limited to TCEP, TCPP, TPhP, TCP and some other organophosphate esters. For air sampling passive samplers have been used as well as solid phase extraction (SPE) membranes, SPE cartridges, and solid phase micro-extraction (SPME). For extraction of PFRs from water SPE is recommended, because this method gives good recoveries (67–105%) and acceptable relative standard deviations (RSDs) (<20%), and offers the option of on-line coupling with a detection system. For the extraction of PFRs from sediment microwave-assisted extraction (MAE) is recommended. The recoveries (78–105%) and RSDs (3–8%) are good and the method is faster and requires less solvent compared to other methods. For the final instrumental analysis of PFRs, gas chromatography–flame photometric detection (GC–FPD), GC-nitrogen–phosphorus detection (NPD), GC–atomic emission detection (AED), GC–mass spectrometry (MS) as well as liquid chromatography (LC)–MS/MS and GC–Inductively-coupled plasma–MS (ICP–MS) are used. GC–ICP–MS is a promising method, because it provides much less complex chromatograms while offering the same recoveries and limits of detection (LOD) (instrumental LOD is 5–10ngmL−1) compared to GC–NPD and GC–MS, which are frequently used methods for PFR analysis. GC–MS offers a higher selectivity than GC–NPD and the possibility of using isotopically labeled compounds for quantification. [Copyright &y& Elsevier]

Flavonols, flavanones and flavones (FLAV) are sub-classes of flavonoids that exert cardioprotective and anti-carcinogenic properties in vitro and in vivo. We aimed to estimate the FLAV dietary intake, their food sources and associated lifestyle factors in ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. FLAV intake and their food sources for 36 037 subjects, aged between 35 and 74 years, in twenty-seven study centres were obtained using standardised 24 h dietary recall software (EPIC-SOFT). An ad hoc food composition database on FLAV was compiled using data from US Department of Agriculture and Phenol-Explorer databases and was expanded using recipes, estimations and flavonoid retention factors in order to increase its correspondence with the 24 h dietary recall. Our results showed that the highest FLAV-consuming centre was the UK health-conscious group, with 130·9 and 97·0 mg/d for men and women, respectively. The lowest FLAV intakes were 36·8 mg/d in men from Umeå and 37·2 mg/d in women from Malmö (Sweden). The flavanone sub-class was the main contributor to the total FLAV intake ranging from 46·6 to 52·9 % depending on the region. Flavonols ranged from 38·5 to 47·3 % and flavones from 5·8 to 8·6 %. FLAV intake was higher in women, non-smokers, increased with level of education and physical activity. The major food sources were citrus fruits and citrus-based juices (especially for flavanones), tea, wine, other fruits and some vegetables. We concluded that the present study shows heterogeneity in intake of these three sub-classes of flavonoids across European regions and highlights differences by sex and other sociodemographic and lifestyle factors. [ABSTRACT FROM PUBLISHER]

State of the art is a legal concept that describes what was known as knowable by experts including manufacturer's state of knowledge about the potential hazards of their product(s) at a point in time. In 2004, Paustenbach et al. published a state-of-the-art review that describes the development of knowledge about asbestos hazards to brake mechanics performing asbestos brake installation and maintenance. Paustenbach et al's review, however, omits important pieces of corporate knowledge, dismisses several historical scientific conclusions and ignores the way experts have applied the results of scientific research to protect workers and consumers handling asbestos brakes. By taking their state-of-the-art review out of the legal liability context, Paustenbach et al. create a misleading version of events that fails to properly address the question of what asbestos brake manufacturers knew or should have known about the potential hazards of their brakes to mechanics over time. Without proper presentation of this information, judges and juries cannot adequately assess whether these companies had a duty to warn or take other action to prevent injury to those exposed to their asbestos brakes. [ABSTRACT FROM AUTHOR]

Background: Occupational exposures to dusts have generally been examined in relation to cancers of the respiratory system and have rarely been examined in relation to other cancers, such as renal cell carcinoma (RCC). Although previous epidemiological studies, though few, have shown certain dusts, such as asbestos, to increase renal cancer risk, the potential for other occupational dust exposures to cause kidney damage and/or cancer may exist. We investigated whether asbestos, as well as 20 other occupational dust exposures, were associated with RCC risk in a large European, multi-center, hospital-based renal case-control study.Methods: General occupational histories and job-specific questionnaires were reviewed by occupational hygienists for subject-specific information. Odds ratios (ORs) and 95% confidence intervals (95% CIs) between RCC risk and exposures were calculated using unconditional logistic regression.Results: Among participants ever exposed to dusts, significant associations were observed for glass fibres (OR: 2.1; 95% CI: 1.1-3.9), mineral wool fibres (OR: 2.5; 95% CI: 1.2-5.1), and brick dust (OR: 1.5; 95% CI: 1.0-2.4). Significant trends were also observed with exposure duration and cumulative exposure. No association between RCC risk and asbestos exposure was observed.Conclusion: Results suggest that increased RCC risk may be associated with occupational exposure to specific types of dusts. Additional studies are needed to replicate and extend findings. [ABSTRACT FROM AUTHOR]

Abstract: Approaches for the risk assessment of carcinogens in food have evolved as scientific knowledge has advanced. Early methods allowed little more than hazard identification and an indication of carcinogenic potency. Evaluation of the modes of action of carcinogens and their broad division into genotoxic and epigenetic (non-genotoxic, non-DNA reactive) carcinogens have played an increasing role in determining the approach followed and provide possibilities for more detailed risk characterisation, including provision of quantitative estimates of risk. Reliance on experimental animal data for the majority of risk assessments and the fact that human exposures to dietary carcinogens are often orders of magnitude below doses used in experimental studies has provided a fertile ground for discussion and diverging views on the most appropriate way to offer risk assessment advice. Approaches used by national and international bodies differ, with some offering numerical estimates of potential risks to human health, while others express considerable reservations about the validity of quantitative approaches requiring extrapolation of dose–response data below the observed range and instead offer qualitative advice. Recognising that qualitative advice alone does not provide risk managers with information on which to prioritise the need for risk management actions, a “margin of exposure” approach for substances that are both genotoxic and carcinogenic has been developed, which is now being used by the World Health Organization and the European Food Safety Authority. This review describes the evolution of risk assessment advice on carcinogens and discusses examples of ways in which carcinogens in food have been assessed in Europe. [Copyright &y& Elsevier]

Lung cancer is the leading cause of cancer mortality worldwide. A possible carcinogenic role of human papillomavirus (HPV) has been investigated for >20 years and has major clinical and public health implications. We performed a meta-analysis to assess the prevalence of HPV16 and HPV18 in primary lung cancers (2435 subjects from 37 published studies). The overall HPV prevalence ranged from 0.0 to 78.3% with large heterogeneity across geographic regions and histological tissue types. A higher proportion, 50% (7/14), of the European studies reported low or no HPV prevalence (0–10%) compared with the Asian studies, 22% (4/18). When the analysis was limited to HPV16 and HPV18 prevalence, a higher prevalence in Asia (HPV16 = 11.6% and HPV18 = 8.8%) than in Europe (HPV16 = 3.5% and HPV18 = 3.6%) was observed. Studies using HPV-specific primers resulted in higher prevalence rates than consensus HPV primers (HPV16: Asia = 13% and Europe = 6%; HPV18: Asia = 13% and Europe = 5%). Further studies are needed to elucidate the role of HPV in lung carcinogenesis with careful thought given to study design and laboratory detection methods for a more accurate assessment of HPV status in lung tumors. [ABSTRACT FROM PUBLISHER]

The article discusses the European Union's (EU) Registration, Evaluation, Authorization, and Restriction of Chemicals (REACH) regulation. A brief historical overview of the constitution of REACH is presented. REACH plays a role in assessing the chemicals produce by several businesses and makes sure that these chemicals are safe for human and for the environment. The requirements of REACH is applicable to those who manufactures and imports chemicals. REACH covers chemicals which are substances of very high concern (SVHCs) including carcinogens, mutagens, and reproductive toxins. It discusses the four basic elements of the REACH regulatory approach including registration, evaluation, authorization, and restriction.

Setting standards, such as occupational exposure limits (OELs) for carcinogenic substances must consider modes of action. At the European Union level, the scientific committee on occupational exposure limits (SCOEL) has discussed a number of chemical carcinogens and has issued recommendations. For some carcinogens, health-based OELs were recommended, while quantitative assessments of carcinogenic risks were performed for others. For purposes of setting limits this led to the consideration of the following groups of carcinogens. (A) Non-threshold genotoxic carcinogens; for low-dose assessment of risk, the linear non-threshold (LNT) model appears appropriate. For these chemicals, regulations (risk management) may be based on the ALARA principle (“as low as reasonably achievable”), technical feasibility, and other socio-political considerations. (B) Genotoxic carcinogens, for which the existence of a threshold cannot be sufficiently supported at present. In these cases, the LNT model may be used as a default assumption, based on the scientific uncertainty. (C) Genotoxic carcinogens with a practical threshold, as supported by studies on mechanisms and/or toxicokinetics; health-based exposure limits may be based on an established NOAEL (no observed adverse effect level). (D) Non-genotoxic carcinogens and non-DNA-reactive carcinogens; for these compounds a true (“perfect”) threshold is associated with a clearly founded NOAEL. The mechanisms shown by tumour promoters, spindle poisons, topoisomerase II poisons and hormones are typical examples of this category. Health-based OELs are derived for carcinogens of groups C and D, while a risk assessment is carried out for carcinogens of groups A and B. Substantial progress is currently being made in the incorporation of new types of mechanistic data into these regulatory procedures. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate existing research on the environmental health of children and provide a prioritised list of risk factors and policy recommendations for action, the Policy Interpretation Network on Children's Health and Environment (PINCHE) was set up within EU FP5 (QLK4-2002-02395). The project focused on air pollutants, carcinogens, neurotoxicants and noise. PINCHE was a multidisciplinary and multinational network of representatives from science, industry, NGOs, and consumer and patient organisations in Europe. Materials and methods: A literature search was performed using the Pubmed, Embase and Toxline databases. The quality of the gathered articles was assessed and their information and relevance was interpreted within a systematic framework. Information related to exposure, epidemiology, and toxicology was analysed separately and then a risk evaluation of particular environmental factors was made. Socioeconomic factors were specifically taken into account. The results were compiled, and considering the present regulatory situation, policy recommendations for action were made. Finally, the risk factors and policy recommendations were prioritised through a process of discussion between all the partners. Results and conclusions: PINCHE concluded that outdoor air pollutants (especially traffic-related), environmental tobacco smoke, allergens, and mercury were high priorities with an urgent need for action. Brominated flame retardants, lead, PCBs and dioxins, ionising and solar radiation, and some noise sources were classified as being of medium priority. Some toxins were given low priority, based on few exposed children, relatively mild health effects or an improving situation due to past policy measures. We recognise the shortcomings of such a prioritisation and, though some measures are more urgent than others, emphasise that ideally all policy measures should be carried out without delay for all toxins. This priority list must be continuously revised, the precautionary principle should be central to all decisions, and the focus should be on safe exposure levels for children. [ABSTRACT FROM AUTHOR]

There is a growing recognition in the United States and Europe that health care is driven to a significant extent by an emphasis on consumer choice and demand. As consumers, people regularly choose their own solutions for health promotion and maintenance, solutions which may or may not be sanctioned by mainstream medicine. Radioactive radon therapy exemplifies a non-sanctioned treatment eagerly sought by certain patients, but scorned or dismissed by many physicians. This is certainly the case in the United States, where well-publicized Environmental Protection Agency (EPA) warnings portray radon as a potential carcinogen. Between 1997 and 2001, I worked with a population of arthritis sufferers who expose themselves to radon gas in Montana radon health mines in order to alleviate their symptoms. In this paper I discuss the decision-making process involved in using radon, and compare the Montana radon health mine facilities with selected radon mines and spas in Europe. [ABSTRACT FROM AUTHOR]

Hair dyes have been evaluated as possibly being mutagenic and carcinogenic in animals. Studies of the association between human cancer risk and use of hair dyes have yielded inconsistent results. The authors evaluated the risk of lymphoid malignancies associated with personal use of hair dyes. The analysis included 2,302 incident cases of lymphoid neoplasms and 2,417 hospital- or population-based controls from the Czech Republic, France, Germany, Ireland, Italy, and Spain (1998–2003). Use of hair dyes was reported by 74% of women and 7% of men. Lymphoma risk among dye users was significantly increased by 19% in comparison with never use (odds ratio (OR) = 1.19, 95% confidence interval (CI): 1.00, 1.41) and by 26% among persons who used hair dyes 12 or more times per year (OR = 1.26, 95% CI: 1.00, 1.60; p for linear trend = 0.414). Lymphoma risk was significantly higher among persons who had started coloring their hair before 1980 (OR = 1.37, 95% CI: 1.09, 1.72) and persons who had used hair dyes only before 1980 (OR = 1.62, 95% CI: 1.10, 2.40). Personal use of hair dyes is associated with a moderate increase in lymphoma risk, particularly among women and persons who used dyes before 1980. Specific compounds associated with this risk remain to be elucidated. [ABSTRACT FROM AUTHOR]

The investigation of SO2, NO2, soot and benzo(a)pyrene (BP) has been performed at the background station on the eastern coast of the Baltic Sea since 1980. A significant decreasing trend has been observed for SO2 and NO2, while soot and BP concentrations were changing insignificantly. The decreasing SO2 and NO2 high concentrations (>10µg·m-3) have been determined in the air masses coming from the Western and Central Europe to Lithuania since 1900. The concentration of SO2 in a range of 0–5µg·m-3 and the concentration of NO2 in a range of 0–10µg·m-3 are characteric of the background atmospheric air. [ABSTRACT FROM AUTHOR]

Objectives: Radon, a radioactive gas, is among the leading causes of lung-cancer worldwide. While public health authorities emphasize radon's health risks, there are spas across Europe which claim health benefits of radon. This study investigates how websites of European radon spas frame radon gas, in order to understand the potential controversy between "radon as carcinogen" and "radon as cure," and its potential impact on public health interventions. Methods: A two-phased frame analysis of websites of radon spas ( n = 26) situated in the European Union. Results: Five frames are identified, which present radon as a 1) source of health, 2) natural gas, 3) (non) risk, 4) luxury and 5) fountain of youth. These five partly overlapping frames are at times in clear contrast with the ways in which radon is presented in a public health context. Conclusion: Being aware of the existence and contents of radon frames, which potentially challenge or contradict public health interventions, helps responsible authorities in designing more effective campaigns and interventions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Geysmans, Perko, Keser, Pölzl-Viol, Fojtíková and Mihók.)

Objectives: To investigate the relation between lung cancer and exposure to occupational carcinogens in a highly industrialised region in western Europe.Methods: In a case-control study 478 cases and 536 controls, recruited from 10 hospitals in the Antwerp region, were interviewed. Cases were male patients with histologically confirmed lung cancer; controls were male patients without cancer or primary lung diseases. Data were collected by questionnaires to obtain information on occupations, exposures, and smoking history. Job titles were coded with the Office of Populations, Censuses and Surveys industrial classification. Exposure was assessed by self report and by job-task exposure matrix. Exposure odds ratios were calculated with logistic regression analysis adjusted for age, smoking history, and marital and socio-economic status.Results: A job history in the categories manufacturing of transport equipment other than automobiles (for example, shipyard workers), transport support services (for example, dockers), and manufacturing of metal goods (for example, welders) was significantly associated with lung cancer (odds ratios (ORs) 2.3, 1.6, and 1.6 respectively). These associations were independent of smoking, education, civil, and economic status. Self reported exposure to potential carcinogens did not show significant associations with lung cancer, probably due to nondifferential misclassification. When assessed by job-task exposure matrix, exposure to molybdenum, mineral oils, and chromium were significantly associated with lung cancer. A strong association existed between smoking and lung cancer: OR of ex-smokers 4.2, OR of current smokers 14.5 v non-smokers. However, smoking did not confound the relation between occupational exposure and lung cancer.Conclusions: The study has shown a significant excess risk of lung cancer among workers in manufacturing of metal goods, manufacturing of transport equipment (other than automobiles), and transport support services. Assessment of exposure to specific carcinogens resulted in significant associations of chromium, mineral oils, and molybdenum with lung cancer. This study is, to our knowledge, the first study reporting a significant association between occupational exposure to molybdenum and lung cancer. [ABSTRACT FROM AUTHOR]

The article discusses various issues concerning the exposure of hospital pharmacists and oncology nurses to chemotherapy drugs used to treat cancer patients. According to the U.S. Centers for Disease Control and Prevention (CDC), only 56 percent of workers in large cancer centers wear gloves despite risks of infertility, congenital malformations and cancers. Also discussed are the failure to implement guidelines on handling hazardous drugs and the need for nurses to demand standards and surveillance.

The number of male deaths from pleural cancer in France, Germany and Italy increased from about 8750 in 1990-1994 to 9550 in 1995-1999, suggesting that mesothelioma deaths in males may be levelling off in most of Western Europe.British Journal of Cancer (2004) 90, 1022-1024. doi:10.1038/sj.bjc.6601638 www.bjcancer.com [ABSTRACT FROM AUTHOR]

An informed opinion to a hugely important question, whether the food on the Europeans' plate is safe to eat, is provided. Today, the Europeans face food-borne health risks from non-communicable diseases induced by excess body weight, outbreaks caused by pathogens, antimicrobial resistance and exposures to chemical contaminants. In this review, these risks are first put in an order of importance. Then, not only potentially injurious dietary chemicals are discussed but also beneficial factors of the food. This review can be regarded as an attempt towards a dietary-exposome evaluation of the chemicals, the average European adult consumers could chronically expose to during their life-times. Risk ranking reveals that currently the European adults are chronically exposed to a mixture of potentially genotoxic-carcinogenic contaminants, particularly food process contaminants, at the potential risk levels. Furthermore, several of the contaminants whose dietary exposures pose risks appear to be carcinogens operating with a genotoxic mode of action targeting the liver. This suggests that combined health risks from the exposure to a mixture of the chemical contaminants poses a greater potential risk than the risks assessed for single compounds. Over 100 European-level risk assessments are examined. Finally, the importance of a diversified and balanced diet is emphasized.

Currently, there are >11,000 synthetic turf athletic fields in the United States and >13,000 in Europe. Concerns have been raised about exposure to carcinogenic chemicals resulting from contact with synthetic turf fields, particularly the infill material ("crumb rubber"), which is commonly fabricated from recycled tires. However, exposure data are scant, and the limited existing exposure studies have focused on a small subset of crumb rubber components. Our objective was to evaluate the carcinogenic potential of a broad range of chemical components of crumb rubber infill using computational toxicology and regulatory agency classifications from the United States Environmental Protection Agency (US EPA) and European Chemicals Agency (ECHA) to inform future exposure studies and risk analyses. Through a literature review, we identified 306 chemical constituents of crumb rubber infill from 20 publications. Utilizing ADMET Predictor™, a computational program to predict carcinogenicity and genotoxicity, 197 of the identified 306 chemicals met our a priori carcinogenicity criteria. Of these, 52 chemicals were also classified as known, presumed or suspected carcinogens by the US EPA and ECHA. Of the remaining 109 chemicals which were not predicted to be carcinogenic by our computational toxicology analysis, only 6 chemicals were classified as presumed or suspected human carcinogens by US EPA or ECHA. Importantly, the majority of crumb rubber constituents were not listed in the US EPA (n = 207) and ECHA (n = 262) databases, likely due to an absence of evaluation or insufficient information for a reliable carcinogenicity classification. By employing a cancer hazard scoring system to the chemicals which were predicted and classified by the computational analysis and government databases, several high priority carcinogens were identified, including benzene, benzidine, benzo(a)pyrene, trichloroethylene and vinyl chloride. Our findings demonstrate that computational toxicology assessment in conjunction with government classifications can be used to prioritize hazardous chemicals for future exposure monitoring studies for users of synthetic turf fields. This approach could be extended to other compounds or toxicity endpoints., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The article reports on the petition of the Center for Science in the Public Interest (CSPI) to ban the use of artificial food dyes due to its connection to behavioral problems in children in the U.S. It mentions that the report from CSPI depicted the nine artificial dyes which are carcinogenic. Meanwhile, the food that contain artificial dyes would carry labels of warning in Europe.

Acrylamide is a suspected human carcinogen. The purpose of this cross-sectional study was to determine the acrylamide exposure in a subgroup of the EPIC study population by measuring hemoglobin adducts of acrylamide (HbAA) and its metabolite glycidamide (HbGA) as biomarkers of acrylamide exposure. These biomarkers were measured by HPLC/MS/MS. The investigated population consists of 510 persons form 9 different European countries: Sweden, Denmark, United Kingdom (UK), The Netherlands, France, Germany, Italy, Greece and Spain. These randomly selected persons where stratified on gender, smoking and centre In the whole population, values ranged between 15-23 pmol/g Hb for HbAA and 8-377 pmol/g Hb for HbGA. HbAA and HbGA values are significantly higher in smokers than in non-smokers. In non-smokers, values ranged between 15-177 pmol/g Hb for HbAA and 8-151 pmol/g Hb for HbGA. Significant differences were observed in HbAA and HbGA values between countries. In non-smokers, highest median HbAA and HbGA values were observed in the group from the UK, and lowest median HbAA and HbGA values were found in the Swedish and Danish group, respectively. In non-smokers, highest HbAA and HbGA values were observed in the group from Denmark and the UK, respectively. In conclusion, large heterogeneity in acrylamide exposure was reported between the different European countries participating in this cross-sectional study. [ABSTRACT FROM AUTHOR]

The article reports on the results of the study on the carcinogenic effect of aspartame. Research shows that the potential carcinogenic effects of aspartame were evident at daily doses as low as 20 milligrams per kilogram body weight (mg/kg). The dosage is less than the acceptable daily intake in the U.S. and in Europe, which is 2-3 mg/kg. Since, the study did not take into account in utero and perinatal exposures, the author recommends the chemical's potential cancer effects deserve a thorough study.

Botanicals and botanical preparations, including plant food supplements (PFS), are widely used in Western diets. The growing use of PFS is accompanied by an increasing concern because the safety of these PFS is not generally assessed before they enter the market. Regulatory bodies have become more aware of this and are increasing their efforts to ensure the safety of PFS. The present review describes an overview of the general framework for the safety assessment of PFS, focusing on the different approaches currently in use to assess the safety of botanicals and/or botanical compounds, including their history of safe use, the tiered approach proposed by the European Food Safety Authority (EFSA), the Threshold of Toxicological Concern (TTC) and the Margin of Exposure (MOE) concept. Moreover, some examples of botanical compounds in PFS that may be of concern are discussed. Altogether, it is clear that "natural" does not equal "safe" and that PFS may contain compounds of concern at levels far above those found in the regular diet. In addition, the traditional use of a PFS compound as a herb or tea does not guarantee its safety when used as a supplement. This points at a need for stricter regulation and control of botanical containing products, especially given their expanding market volume.

(1) When an antidepressant is considered a necessary addition to psychological support in treating patients with depression, the first-line drug is a tricyclic such as clomipramine or a selective serotonin reuptake inhibitor (SSRI) such as paroxetine; (2) Agomelatine, a melatonin receptor agonist, is approved in the European Union for the treatment of depression; (3) Available evaluation does not include any clinical trials designed to compare the efficacy of agomelatine with that of a tricyclic or a selective serotonin reuptake inhibitor. Most data come from 7 placebo-controlled trials; (4) Agomelatine (25 mg/day) was statistically more effective (on a rating scale) than placebo in only 3 of these 7 trials. The clinical relevance of the score improvements is questionable. No data are available on the cure rate or on suicide prevention; (5) In one trial, increasing the daily dose from 25 mg to 50 mg provided no supplementary benefit; (6) A trial in 367 patients failed to show that agomelatine was any more effective than placebo in preventing new depressive episodes (29% after one year). In another trial including 339 patients, the relapse rate was statistically lower after 6 months on agomelatine (20.6%) than on placebo (41.4%); (7) Very high doeses of agomelatine are oncogenic in animals. The risk in humans is not known. Dizziness, gastrointestinal and cutaneous disorders have been observed. Agomelatine is probably hepatotoxic; (8) In summary, agomelatine has unproven efficacy and poorly documented adverse effects. It is better to continue to use older antidepressants such as tricyclics or serotonin reuptake inhibitors.

In this article, the issue of occupational cancer is discussed by studying the correlation between work conditions and health-related social disparity.Without aiming to furnish a review of the pertinent scientific literature in this field, some matters for discussion will be advanced to initiate scientific and political debate. Keeping in mind the major socio-health disparities still present in European countries, the objective is to address the issue of knowledge generation pertinent to occupational cancer in a complex scenario with numerous obstacles posed both by employers and by the issue of differing methodological approaches, which require cooperation between various disciplines such as epidemiology, toxicology, statistics, and sociology of health. Such cooperation cannot be effective unless both the political and the scientific aspects are addressed in the investigative process and the decisive role of mobilization of the workforce is acknowledged. Finally, the article discusses the particular condition of women, highly underestimated in the scientific literature concerning health issues in the workplace. We have observed that albeit current understanding in this field is insufficient, intervention strategies and prevention policies are inadequate even when measured against this knowledge base. In order for prevention to be effective, public policies on industry, territorial health, environmental protection, and the workplace must be integrated, figures able to act as prime movers in the change process need to be identified, and replacement of carcinogenic substances and production processes must be favoured.

Nowadays tumours represent one of the major problems of public health, both for their epidemiological dimension as for the causes that are at their origin, represented by three important factors: people ageing, general and occupational environmental pollution, including incongruous individual behaviour, and individual genetic susceptibility. The strategies followed till today in order to check tumours have privileged the role of therapeutic interventions: the results achieved show the great limits. On the contrary, current scientific experiences indicate the need to re-orientate present strategies, developing prevention programmes for the identification of carcinogenic risks (primary prevention), and early diagnosis of preneoplastic and neoplastic lesions (secondary prevention). In this review we discuss the importance of primary prevention in tumour control and specifically we present: - the role of long-term carcinogenic bioassays on rodents (rats and mice) in order to identify and predict the carcinogenic risks and then the great value that these studies have for public health; - the two major programmes of carcinogenic bioassays: the National Toxicological Program (NTP) of the US government, and the one performed by the European Ramazzini Foundation (ERF), in Italy; - the importance of observing the experimental animals until spontaneous death in order to improve the sensitivity and specificity of the assays, a way of working followed by ERF from the beginning.

(1) Chloroform is strongly absorbed by the pulmonary, oral and cutaneous routes. (2) It has adverse cardiac, hepatic, renal, dermatological, neurological and ophthalmological effects. Deaths related to chloroform use have occurred. In animals, chloroform is carcinogenic and embryotoxic. (3) Since 1997, the European and French medicines agencies have no longer considered chloroform to be a simple solvent. Only minimal amounts are authorised in drug preparations (no more than 0.6 mg/day).

Epidemiologic evidence on the relation between nutrition and bladder cancer is reviewed. A role of diet and nutrition in bladder carcinogenisis is plausible since most substances or metabolites, including carcinogens, are excreted through the urinary tract. Ecologic studies on populations have found positive correlations between fats and oils and bladder cancer, but these are reflected only partly in the international differences in bladder cancer rates, which are systematically higher in Europe than in the United States. Ten case-control and three cohort studies of bladder cancer published in English between 1979 and 1994, and including some information on dietary factors, were reviewed. Of seven studies which considered various types and measures of fruit and vegetable consumption, six found a reduced risk with increasing consumption, which was more consistent for vegetables, with relative risk (RR) estimates between 0.5 and 0.7 for the highest cf the lowest consumption level. There is, therefore, suggestive evidence that a diet rich in fresh fruit and vegetables is a correlate--or an indicator--of reduced bladder cancer risk. No clear association emerged for other foods investigated, including meat and milk. With reference to nutrients, total fat intake was related to bladder cancer risk in three case-control studies, with relative risks between 1.4 and 1.7 for the highest cf the lowest consumption level. However, no relationship between fats and bladder cancer emerged in a cohort study on Japanese-Americans in Hawaii. No consistent association emerged between protein or carbohydrate consumption and bladder cancer risk. Among micronutrients, vitamin A, and particularly carotenoids, showed an inverse association with bladder cancer risk in four case-control studies, including one allowing for a measure of total caloric intake, but were not related consistently in two other studies. There were only scattered and inconclusive data on vitamin C and E. Finally, two studies suggested that calcium and sodium may be related to bladder cancer risk. Thus, available data on diet and bladder cancer are still inconclusive. This is at least partly attributable to the limited number of cohort studies and the paucity of case-control studies, including satisfactorily detailed and validated dietary questionnaires. Despite these limitations, available data suggest that a diet rich in fresh fruit and vegetables, and, hence, possibly in carotenoids, is a correlate of reduced bladder cancer risk.

The French paradox is a dietary anomaly which has focused attention on the Mediterranean diet. Epidemiological studies revealed that this diet, replete in flavonoid-rich foods (Allium and Brassica vegetables, and red wine), correlated with the increased longevity and decreased incidence of cardiovascular disease seen in these populations. The most frequently studied flavonoid, quercetin, has been shown to have biological properties consistent with its sparing effect on the cardiovascular system. Quercetin and other flavonoids have been shown to modify eicosanoid biosynthesis (antiprostanoid and anti-inflammatory responses), protect low-density lipoprotein from oxidation (prevent atherosclerotic plaque formation), prevent platelet aggregation (antithrombic effects), and promote relaxation of cardiovascular smooth muscle (antihypertensive, antiarrhythmic effects). In addition, flavonoids have been shown to have antiviral and carcinostatic properties. However, flavonoids are poorly absorbed from the gut and are subject to degradation by intestinal micro-organisms. The amount of quercetin that remains biologically available may not be of sufficient concentration, theoretically, to explain the beneficial effects seen with the Mediterranean diet. The role of flavonoids may transcend their presence in food. The activity of flavonoids as inhibitors of reverse transcriptase suggests a place for these compounds in the control of retrovirus infections, such as acquired immunodeficiency syndrome (AIDS). In addition to specific effects, the broad-modulating effects of flavonoids as antioxidants, inhibitors of ubiquitous enzymes (ornithine carboxylase, protein kinase, calmodulin), and promoters of vasodilatation and platelet disaggregation can serve as starting material for drug development programmes.

Several epidemiological, clinical and experimental studies have been carried out to determine whether there is an aetiological role for schistosomiasis in the multi-stage process of bladder carcinogenesis. Lines of evidence supporting the association between bladder cancer and schistosomiasis include indications from the geographical correlation between the two conditions, the distinctive patterns of gender and age at diagnosis, the clinicopathological identity of schistosome-associated bladder cancer and the extensive experimental evidence in infected laboratory animals. Although the causative role of schistosomiasis is now accepted, various associated factors have been proposed in the induction of this particular type of cancer. While all may contribute to the carcinogenic process taking place in the infected bladder, none of these has yet been confirmed. Most attention has been directed at theories proposing possible roles for urinary chemical carcinogens, particularly tryptophan metabolites, N-nitroso compounds and of beta-glucuronidase, as factors that are primarily involved in the initiation of bladder carcinogenesis in areas endemic for schistosomiasis.

A large proportion of compounds studied for their neurotoxic potential are at the same time suspected or proven carcinogens. This is demonstrated using the International Neurotoxicology Association (INA) Professional Interest Directory and publications from the field of neurotoxicology as examples. In addition to listing these compounds, the classification scheme used by the International Agency for Research on Cancer (IARC), the Commission of the European Communities (EC), the U.S. Environmental Protection Agency (EPA), the German MAK-Commission of the Deutsche Forschungsgemeinschaft (DGF) and the U.S. National Institute of Occupational Safety and Health (NIOSH) to make qualitative risk assessments is explained. Finally, a short initiation to quantitative risk assessment as performed by the US EPA and the World Health Organization (WHO) is given in order to put the reader into a position as to assess the cancer risk incurred by his/her co-workers and by himself.