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Journal: International journal of hygiene and environmental health

100

During volcanic eruptions and their aftermath, communities may be concerned about the impacts of inhaling volcanic ash. Access to effective respiratory protection (RP) is therefore important for many people in volcanic areas all over the world. However, evidence to support the use of effective RP during such crises is currently lacking. The aim of this study was to build the first evidence base on the effectiveness of common materials used to protect communities from ash inhalation in volcanic crises. We obtained 17 forms of RP, covering various types of cloth through to disposable masks (typically used in occupational settings), which communities are known to wear during volcanic crises. The RP materials were characterised and subjected to filtration efficiency (FE) tests, which were performed with three challenge dusts: ashes from Sakurajima (Japan) and Soufrière Hills (Montserrat) volcanoes and aluminium oxide (Aloxite), chosen as a low-toxicity surrogate dust of similar particle size distribution. FE tests were conducted at two concentrations (1.5 mg/m3 and 2.5 mg/m3) and two flow rates (equivalent to 40 and 80 l/min through 15.9 cm2 sections of each RP type). Each material was held in a sample holder and PM2.5 dust concentrations were measured both outside the mask material and inside the sample holder to determine FE. A limited number of tests were undertaken to assess the effect on FE of wetting a bandana and a surgical mask, as well as folding a bandana to provide multiple filter layers. Overall, four RP materials performed very well against volcanic ash, with median FEs in excess of 98% (N95-equiv., N99-equiv., PM2.5 surgical (Japan), and Basic flat-fold (Indonesia)). The two standard surgical masks tested had median FEs of 89-91%. All other materials had median FEs ranging from 23 to 76% with no cloth materials achieving >44%. Folding a bandana resulted in better FE (40%; 3× folded) than single-layered material (29%). Wetting the bandana and surgical mask material did not improve FE overall. This first evidence base on the FE of common materials used to protect communities in volcanic crises from ash inhalation has been extended in a companion study (Steinle et al., 2018) on the total inward leakage of the best-performing masks when worn by human volunteers. This will provide a complete assessment of the effectiveness of these RP types.

33

The broadband herbicide glyphosate (N-[phosphonomethyl]-glycine) and its main metabolite aminomethylphosphonic acid (AMPA) were analyzed by GC-MS-MS in 24h-urine samples cryo-archived by the German Environmental Specimen Bank (ESB). Samples collected in 2001, 2003, 2005, 2007, 2009, 2011, 2012, 2013, 2014, and 2015 were chosen for this retrospective analysis. All urine samples had been provided by 20 to 29 years old individuals living in Greifswald, a city in north-eastern Germany. Out of the 399 analyzed urine samples, 127 (=31.8%) contained glyphosate concentrations at or above the limit of quantification (LOQ) of 0.1μg/L. For AMPA this was the case for 160 (=40.1%) samples. The fraction of glyphosate levels at or above LOQ peaked in 2012 (57.5%) and 2013 (56.4%) after having discontinuously increased from 10.0% in 2001. Quantification rates were lower again in 2014 and 2015 with 32.5% and 40.0%, respectively. The overall trend for quantifiable AMPA levels was similar. Glyphosate and AMPA concentrations in urine were statistically significantly correlated (spearman rank correlation coefficient=0.506, p≤0.001). Urinary glyphosate and AMPA levels tended to be higher in males. The possible reduction in exposure since 2013 indicated by ESB data may be due to changes in glyphosate application in agricultural practice. The ESB will continue monitoring internal exposures to glyphosate and AMPA for following up the time trend, elucidating inter-individual differences, and contributing to the ongoing debate on the further regulation of glyphosate-based pesticides.

Concepts: Spearman's rank correlation coefficient, Correlation and dependence, Pearson product-moment correlation coefficient

31

Viral illnesses have a significant direct and indirect impact on the workplace that burdens employers with increased healthcare costs, low productivity, and absenteeism. Workers' direct contact with each other and contaminated surfaces contributes to the spread of viruses at work. This study quantifies the impact of an office wellness intervention (OWI) to reduce viral load in the workplace. The OWI includes the use of a spray disinfectant on high-touch surfaces and providing workers with alcohol-based hand sanitizer gel and hand sanitizing wipes along with user instructions. Viral transmission was monitored by applying an MS2 phage tracer to a door handle and the hand of a single volunteer participant. At the same time, a placebo inoculum was applied to the hands of four additional volunteers. The purpose was to evaluate the concentration of viruses on workers' hands and office surfaces before and after the OWI. Results showed that the OWI significantly reduced viable phage concentrations per surface area on participants' hands, shared fomites, and personal fomites (p = 0.0001) with an 85.4% average reduction. Reduction of virus concentrations on hands and fomites is expected to subsequently minimize the risk of infections from common enteric and respiratory pathogens. The surfaces identified as most contaminated were the refrigerator, drawer handles and sink faucets in the break room, along with pushbar on the main exit of the building, and the soap dispensers in the women’s restroom. A comparison of contamination in different locations within the office showed that the break room and women’s restrooms were the sites with the highest tracer counts. Results of this study can be used to inform quantitative microbial risk assessment (QMRA) models aimed at defining the relationship between surface contamination, pathogen exposure and the probability of disease that contributes to high healthcare costs, absenteeism, presenteeism, and loss of productivity in the workplace.

29

Spray cleaning and disinfection products have been associated with adverse respiratory effects in professional cleaners and among residents doing domestic cleaning. This review combines information about use of spray products from epidemiological and clinical studies, in vivo and in vitro toxicological studies of cleaning chemicals, as well as human and field exposure studies. The most frequent chemicals in spray cleaning and disinfection products were compiled, based on registrations in the Danish Product Registry. The chemicals were divided into acids, bases, disinfectants, fragrances, organic solvents, propellants, and tensides. In addition, an assessment of selected cleaning and disinfectant chemicals in spray products was carried out. Chemicals of concern regarding respiratory effects (e.g. asthma) are corrosive chemicals such as strong acids and bases (including ammonia and hypochlorite) and quaternary ammonium compounds (QACs). However, the evidence for respiratory effects after inhalation of QACs is ambiguous. Common fragrances are generally not considered to be of concern following inhalation. Solvents including glycols and glycol ethers as well as propellants are generally weak airway irritants and not expected to induce sensitization in the airways. Mixing of certain cleaning products can produce corrosive airborne chemicals. We discuss different hypotheses for the mechanisms behind the development of respiratory effects of inhalation of chemicals in cleaning agents. An integrative assessment is needed to understand how these chemicals can cause the various respiratory effects.

28

We examined the impact of maternal use of different household cooking fuels in India on low birth weight (LBW<2500g), and neonatal mortality (death within 28 days of birth). Using cross-sectional data from India's National Family Health Survey (NFHS-3), we separately analyzed the prevalence of these two outcomes in households utilizing three types of high-pollution fuels for cooking - biomass, coal, and kerosene - using low-pollution fuels (gas and biogas) as the comparison "control" group. Taking socioeconomic and child-specific factors into account, we employed logistic regression to examine the impact of fuel use on fetal and infant health. The results indicate that household use of high-pollution fuels is significantly associated with increased odds of LBW and neonatal death. Compared to households using cleaner fuels (in which the mean birth weight is 2901g), the primary use of coal, kerosene, and biomass fuels is associated with significant decreases in mean birth weight (of -110g for coal, -107g for kerosene, and -78g for biomass). Kerosene and biomass fuel use are also associated with increased risk of LBW (p<0.05). Results suggest that increased risk of neonatal death is strongly associated with household use of coal (OR 18.54; 95% CI: 6.31-54.45), and perhaps with kerosene (OR 2.30; 95% CI: 0.95-5.55). Biomass is associated with increased risk of neonatal death among infants born to women with no more than primary education (OR 7.56; 95% CI: 2.40-23.80). These results are consistent with a growing literature showing health impacts of household air pollution from these fuels.

Concepts: Fetus, Demography, Petroleum, Infant mortality, Pediatrics, Biofuel, Fuel, Fuels

27

E-liquids generally contain four main components: nicotine, flavours, water and carrier liquids. The carrier liquid dissolves flavours and nicotine and vaporises at a certain temperature on the atomizer of the e-cigarette. Propylene glycol and glycerol, the principal carriers used in e-liquids, undergo decomposition in contact with the atomizer heating-coil forming volatile carbonyls. Some of these, such as formaldehyde, acetaldehyde and acrolein, are of concern due to their adverse impact on human health when inhaled at sufficient concentrations. The aim of this study was to correlate the yield of volatile carbonyls emitted by e-cigarettes with the temperature of the heating coil. For this purpose, a popular commercial e-liquid was machine-vaped on a third generation e-cigarette which allowed the variation of the output wattage (5-25W) and therefore the heat generated on the atomizer heating-coil. The temperature of the heating-coil was determined by infrared thermography and the vapour generated at each temperature underwent subjective sensorial quality evaluation by an experienced vaper. A steep increase in the generated carbonyls was observed when applying a battery-output of at least 15W corresponding to 200-250°C on the heating coil. However, when considering concentrations in each inhaled puff, the short-term indoor air guideline value for formaldehyde was already exceeded at the lowest wattage of 5W, which is the wattage applied in most 2nd generation e-cigarettes. Concentrations of acetaldehyde in each puff were several times below the short-term irritation threshold value for humans. Acrolein was only detected from 20W upwards. The negative sensorial quality evaluation by the volunteering vaper of the vapour generated at 20W demonstrated the unlikelihood that such a wattage would be realistically set by a vaper. This study highlights the importance to develop standardised testing methods for the assessment of carbonyl-emissions and emissions of other potentially harmful compounds from e-cigarettes. The wide variety and variability of products available on the market make the development of such methods and the associated standardised testing conditions particularly demanding.

Concepts: Evaluation, Tobacco, Nicotine, Electronic cigarette, Diol, Propylene glycol, Glycerol, Thermography

27

Some phthalates are endocrine disruptors and reproductive and developmental toxicants. Data on newborn phthalate exposure and elimination characteristics are scarce. We determined 21 urinary phthalate metabolites (indicating exposure to 11 parent phthalates) in two study approaches: in the first approach we collected the urine of 20 healthy newborns at days 2-5 post partum together with 47 urine samples of 7 women during pregnancy. In the second fine tuned approach we collected first urine samples of 9 healthy newborns together with their mother’s urine shortly before birth. To ensure full and contamination free collection of the newborns first urines we used special adhesive urine bags for children. All urine samples revealed ubiquitous exposures to phthalates comparable to other populations. Metabolite levels in the newborns first day urine samples were generally lower than in all other samples. However, the newborns urines (both first and day 2-5 urines) showed a metabolite pattern distinctly different from the maternal and general population samples: in the newborns urines the carboxy-metabolites of the long chain phthalates (DEHP, DiNP, DiDP) were the by far dominant metabolites with a relative share in the metabolite spectrum up to 6 times higher than in maternal urine. Oppositely, for the short chain phthalates (DBP, DiBP) oxidized metabolites seemed to be less favored than the simple monoesters in the newborns urines. The skewed metabolite distribution in the newborns urine warrants further investigation in terms of early phthalate metabolism, the quantity of internal phthalate exposure of the fetus/newborn and its possible health effects.

Concepts: Pregnancy, Childbirth, Infant, Metabolism, Phthalates, Phthalate, Plasticizer, Bis(2-ethylhexyl) phthalate

27

High fish consumption and extended breastfeeding are hallmarks of traditional lifestyle in Western Amazonia. We studied sources of mercury exposure, fish-methylmercury (meHg) and dental-amalgam filling, in 75 urban and 82 rural lactating mothers. Total mercury was determined in all samples while meHg concentrations were determined in subsamples of milk (45) and hair (27) of urban mothers living in Porto Velho (PV) and in hair (46) and milk (37) of mothers living in traditional communities (TC) of the Rio Madeira. The TC mothers showed significantly higher median hair-Hg concentrations (8.2μgg(-1)) than PV mothers (1.3μgg(-1)). Median total Hg in milk of PV mothers (0.36ngg(-1)) was significantly lower (p=0.0000) than that found in milk of TC mothers (2.30ngg(-1)). The median meHg concentrations in milk of TC mothers were also significantly higher (1.0ngg(-1)) than in milk of PV mothers (0.07ngg(-1)). For urban mothers with low fish consumption rates (and relatively higher dental amalgam fillings) the proportion of inorganic Hg in milk was higher (85%) than in TC (62%). In TC mothers 51% of breast milk Hg concentrations were above 2ngg(-1) (world median concentrations), contrasting with 8% in PV mothers. Despite this, there was no significant correlation between total Hg concentrations in milk and either amalgam filling or daily fish consumption. Socioeconomic changes occurring in Western Amazonia are causing changes in fish-eating habits of urban mothers. However, traditional lifestyle and attendant high fish consumption in riverine populations can still impact total Hg and methylmercury concentrations in mothers' milk and hair.

Concepts: Mercury, Amazon River, Mercury poisoning, Amalgam, Dental amalgam controversy, Porto Velho

27

The distribution characteristics of Enterococcus spp., which are indicators of fecal pollution, were investigated at 33 sites within the 3 major water systems of Korea. Enterococci were detected at concentrations ranging from 1 to 37 CFU/100mL in 41 of 132 samples (31.1%) from the 3 major water systems. The overall average detected concentration was 1.2 CFU/100mL, while the average concentration for all detection sites was 5.3 CFU/100mL. After optimized multiplex polymerase chain reaction (PCR) was performed with newly developed VanA, VanB, VanC-1, and VanC-2/3 primers, concentrations of vancomycin-resistant Enterococcus spp. (VRE) ranging from 1 to 23 CFU/100mL were detected in 17 of 132 samples (12.9%). Of 216 individual enterococcal colonies, 64 (29.6%) displayed the VanC genotype. The results of a susceptibility test to vancomycin showed that the range of the minimal inhibitory concentration (MIC), an indicator of bacterial resistance, was 4 to 24μg/mL, with the average MIC at 9.2±4.5μg/mL. Of the bacterial isolates, 1 colony with the VanC-1 genotype was identified as E. gallinarum by 16S rDNA sequencing, whereas the other 63 colonies had the VanC-2/3 genotype and were identified as E. casseliflavus. Although these results imply that the major head bays of Korea are not contaminated with the highly vancomycin-resistant VanA- or VanB-type VREs, the misuse of antibiotics should be prohibited to minimize the presence of VREs and to maintain a safe water supply for protecting the health of the general population. Based on the study results, we also recommend the implementation of a continuous, broad-spectrum inspection program for Enterococcus spp. and VRE contamination in the major head bays. Furthermore, the multiplex PCR method described in this study can be used effectively for this purpose.

Concepts: DNA, Polymerase chain reaction, Molecular biology, Antibiotic resistance, Vancomycin, Enterococcus, Vancomycin-resistant enterococcus, Thermus aquaticus

25

In utero exposure to perfluorooctanoic acid (PFOA) has been associated with decreases in birth weight. We aimed to estimate the proportion of PFOA-attributable low birth weight (LBW) births and associated costs in the US from 2003 to 2014, a period during which there were industry-initiated and regulatory activities aimed at reducing exposure.

Concepts: Acids, Perfluorooctanoic acid