Analysis of the of Pb, Cd and As in decoction of Lindera aggregata (Sims) Kosterm. by PBET digestion in vitro/Caco-2 cell model and their cumulative risk assessment / 药学学报

Inductively coupled plasma mass spectrometry (ICP-MS) was applied to determine the concentrations of lead (Pb), cadmium (Cd) and arsenic (As) in Lindera aggregata (Sims) Kosterm. The physiologically based extraction test (PBET) digestion in vitro/Caco-2 cell model was established to investigate the bioaccessible contents of Pb, Cd and As in decoction of Lindera aggregata (Sims) Kosterm. The target-organ toxicity dose modification of HI method (TTD) was used to evaluate the cumulative risk caused by the combined exposure of the total levels of Pb, Cd and As in Lindera aggregata (Sims) Kosterm. and the bioaccessible contents in the decoction. The results showed that the total contents of Pb, Cd and As in 4 batches of samples were in the range of 2.901-3.872, 1.299-1.800 and 0.062-0.216 mg·kg-1, respectively. After transportation by Cacco-2 cells, the bioaccessible contents of Pb, Cd, and As in the decoction were in the range of 0.045-0.080, 0.070-0.112 and 0.004-0.018 mg·kg-1. The results of risk assessment showed that calculated by the total amounts of heavy metals in the Lindera aggregata (Sims) Kosterm., for the end points of nervous system, the cumulative risks of co-exposure of heavy metals in 3 batches of samples were of concern. After decoction and transportation by Caco-2 cells, for the end points of cardiovascular system, blood, nervous system, kidney and testis, the TTD modification of HI values of all batches of samples were less than 1, and the health risks were acceptable. The study provided methodology basis for a more objective assessment of the health risks of heavy metals and harmful elements in traditional Chinese medicine and for a more scientific limit standard of heavy metals and harmful elements.

Establishment of air quality health index based on cumulative health risk of air pollution in Tianjin / 环境与职业医学

Background Cumulative risk index (CRI), as a commonly used approach to estimate the joint effects of multiple air pollutants on health, has been used by few studies to construct an air quality health index (AQHI). Objective To construct an AQHI based on the CRI of air pollution in Tianjin and evaluate the validity of the AQHI. Methods Daily data on air pollutants, meteorological factors, and non-accidental deaths during 2015–2019 in Tianjin were collected to create a time-series object. Descriptive statistical analyses were used to describe the characteristics of the data. To determine the best lag day and indicative pollutant, single-pollutant and two-pollutant generalized additive models were fitted to construct the exposure-response relationships between air pollutants and non-accidental deaths. After that we evaluated a CRI of air pollution using multi-pollutant models and constructed an AQHI and its classifications based on the CRI. Finally, we compared the exposure-response associations and coefficients of the AQHI and the conventional air quality index (AQI) with non-accidental deaths, and evaluated the health risk communication validity of the AQHI using generalized cross validation (GCV) values and R2 values. Results We selected lag1 as the best lag day and PM2.5, SO2, NO2 and O3 as the appropriate pollutants according to the unqualified rates of pollutants and significant statistical results. One μg·m−3 increase of PM2.5, SO2, NO2, and O3 was associated with −0.00002, 0.00079, 0.00015, and 0.00042 increase in effect size b of the non-accidental mortality, respectively. Based on these coefficients, we calculated the CRI and AQHI. According to a pre-determined classification scheme of the AQHI, the air quality of 63% study days was low risks and that of 34% study days was median risks. The associations of AQHI and AQI with non-accidental deaths in different populations were evaluated. The results showed that the excess risks of non-accidental deaths in total, female, and male populations for per interquartile range (IQR) increase in AQHI were higher than the corresponding values of AQI. The GCV values of the AQHI model (2.694, 1.819, and 1.938, respectively) were lower than those of the AQI model (2.747, 1.850, and 1.961, respectively), and the R2 values of the AQHI model (0.849, 0.780, and 0.820, respectively) were higher than those of the AQI model (0.846, 0.776, and 0.817, respectively). Conclusion Compared with AQI, the CRI-based AQHI may communicate the air pollution-related health risk to the public more effectively in Tianjin.

Study on the relationship between RDW-SD and the risk of recurrent ischemic stroke / 中风与神经疾病杂志

@#Objective To study the relationship between the red blood cell distribution width-standard deviation（RDW SD） and the risk of recurrent ischemic stroke（IS）. Methods We conducted a retrospective case-control study in 187 patients with recurrent IS who were admitted to neurology department of affiliated hospital of Inner Mongolia medical university，the time of first-ever IS and other baseline characteristic were recorded. The relationship between recurrent IS time and RDW-SD was analyzed by polynomial regression analysis. 187 patients were divides into two groups according to the quartile level of RDW-SD. Kaplan-Meier analysis was used to calculate the cumulative risk of recurrent IS in different groups，and log rank method（χ2 test） was used to compare the differences between groups to study the relationship between RDWSD and recurrent IS risk.Results The results from polynomial regression analysis showed that there was a significant U shaped correlation between RDW-SD level and the recurrent IS time，and its regression coefficient was significantly different from 0 at P<0.05.The median RDW-SD of 187 patients with recurrent IS was 41.80 FL.According to the RDW-SD quartile level，187 patients were divided into 2 groups，including 98 patients corresponding to the highest quartile and the lowest quartile（Q1+Q4）and 89 patients corresponding to the second and third quartiles（Q2+Q3）. There was no significant difference in baseline characteristics between the two groups. Kaplan-Meier analysis illustrated that the patients with the first quartile and the firth quartile（Q1+Q4）of RDW SD levels had a significantly increased cumulative risk of recurrent IS compared to patients with middle quartile（Q2+Q3）of RDW-SD levels（Log Rank=5.047，P=0.02），especially for female patients（Log Rank=6.143，P=0.013）.For male patients，the cumulative risk of recurrent IS was higher in patients with Q1+Q4 group than patients in Q2+Q3 group，but no significant difference was found among two groups（Log Rank=1.325，P=0.25）.Conclusion AU shaped association was found between RDW SD levels and the cumulative risk of recurrent IS，especially for female patients.

Aplicação dos princípios do RISK21 na avaliação do risco de inseticidas da classe dos piretróides / The use of RISK21 principles in the risk assessment of pyrethroids

A avaliação do risco é um processo científico e sistemático que incorpora quantitativamente o perigo e a exposição a diversos agentes. O processo de avaliação do risco tem evoluído nos últimos anos, indo além da exposição a únicos agentes e vias de exposição para a caracterização do risco cumulativo a múltiplos agentes. As metodologias para avaliação do risco cumulativo não são harmonizadas o que pode tornar o processo complexo. Nesta linha, a abordagem do RISK21 promovida pelo Health Environmental Science Institute (HESI) pode contribuir para desmistificar o tema. A exposição combinada da ingestão de resíduos de praguicidas através da dieta e do uso residencial de produtos a base de piretróides pela população brasileira não são conhecidas. Os piretróides são praguicidas utilizados na lavoura, bem como em ambiente doméstico no controle de pragas. O mecanismo de toxicidade destes agentes é bem conhecido e de relevância para a saúde humana, pois atuam sobre a permeabilidade iônica dos canais de sódio sensíveis a voltagem (CSSV), produzindo efeitos na excitabilidade das terminações nervosas. Como os seres humanos são potencialmente expostos a estes agentes, portanto, torna-se importante compreender os riscos cumulativos da exposição a estes praguicidas pela população brasileira. O objetivo deste trabalho foi conduzir a avaliação do risco dos piretróides registrados no Brasil com base nos princípios do RISK21. A abordagem em etapas proposta pelo RISK21 demonstrou que o risco da ingestão crônica e aguda de resíduos de piretróides foi considerado aceitável. Além disso, não foi observada qualquer preocupação toxicológica decorrente da exposição residencial a estes agentes. Quando combinados os cenários da dieta aguda e residencial, também não foram observados níveis de preocupação, portanto, o risco foi considerado aceitável. A avaliação do risco dos piretróides registrados para o uso agrícola e residencial no Brasil com base nos principios do RISK21 foi uma importante etapa neste trabalho, uma vez que foi possível avaliar o risco e preocupações para cada um dos praguicidas de maneira rápida e visual. Além disso, mesmo considerando premissas altamente conservadoras, observou-se que a população exposta de maneira combinada a estes agentes não demonstrou um nível de preocupação para o cenário brasileiro

Risk assessment is a scientific and systematic approach that quantitatively incorporates hazard and exposure to agents' evaluation. The risk assessment process has evolved in recent years, going beyond exposure to single agents and pathways to characterize multiple agents' cumulative risk. Cumulative risk assessment methodologies are not harmonized, which can make the process complex. In this line, the RISK21 approach promoted by the Health Environmental Science Institute (HESI) can demystify the subject. The combined exposure of residue intake through diet and residential use of pyrethroid-based products by the Brazilian population is unknown. Pyrethroids are pesticides used in the crop as well as in a domestic environment in pest control. The mechanism of toxicity of these agents is well known and relevant to human health, as they act on the ionic permeability of voltage-sensitive sodium channels (VSSC), producing effects on the excitability of nerve endings. As human beings are potentially exposed to these agents, it is essential to understand the cumulative risks derived from the exposure to these pesticides by the Brazilian population. The objective of this research was to conduct the risk assessment based on the principles of RISK21 of pyrethroids registered in Brazil. The stepwise approach proposed by RISK21 demonstrated that the risk of chronic and acute ingestion of pyrethroid residues was considered acceptable. Furthermore, no toxicological concern stemming from residential exposure to these agents was observed. When acute and residential diet scenarios were combined, no levels of concern were also observed, so the risk was considered acceptable. The risk assessment based on the principles of RISK21 of pyrethroids registered for agricultural and residential use in Brazil was an essential step in this research since it was possible to assess the risk and concerns for each of the pesticides in a fast and visual way. Moreover, from highly conservative premises, it was observed that the population exposed in combination with these agents did not demonstrate a level of concern for the Brazilian scena

Cumulative risk assessment of phthalates exposure in preschool children / 中华流行病学杂志

Objective@#The urine concentrations of phthalate metabolites were used to estimate the cumulative risk assessment in preschool children in Ma’anshan of Anhui province.@*Methods@#Based on the China-Anhui Birth Cohort, the demographic information and urine samples of 3 743 children were collected in Ma’anshan from April 2014 to April 2015. The concentrations of 7 metabolites’ [monomethyl phthalate (MMP), monoethyl phthalate (MEP), monobutyl phthalate (MBP), monobenzyl phthalate (MBzP), mono (2-ethylhexyl) phthalate (MEHP), mono (2-ethyl- 5-oxohexyl) phthalate (MEOHP) and mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP)] of 5 phthalates [dimethyl phthalate (DMP), diethyl phthalate (DEP), dibutyl phthalate (DBP), butyl benzyl phthalate (BBzP), and di (2-ethylhexyl) phthalate (DEHP)] in the urine samples of the children were measured by solid-phase extration-triple quadrupole high performance liquid chromatography-tandem mass spectrometry-isotope method. In addition, the estimated daily intakes (EDIs) of 5 phthalates were calculated according to the metabolites’ concentrations. Cumulative risk assessment was performed using hazard quotient (HQ) and hazard index (HI) methods.@*Results@#The M (QR) of seven metabolite concentrations were 29.58 (18.69-48.26), 26.65 (13.44-56.09), 256.86 (150.99-438.51), 0.12 (0.04-0.32), 6.27 (3.71-11.13), 17.94 (11.94-28.42) and 24.80 (16.05-40.32) μg/g creatinine, respectively. For the EDIs of 5 phthalates, DBP ranked first, followed by DEHP, DMP, DEP and BBzP with the M (QR) of 7.54 (4.41-12.85), 3.35 (2.20-5.42), 0.75 (0.47-1.24), 0.71 (0.36-1.52) and 0.003 (0.001-0.009) μg/(kg·d), respectively. The HQ and HI varied with age, gender and sampling season, the differences were significant (P<0.05).@*Conclusions@#These results indicated that risk of cumulative exposure to phthalates was high in preschool children aged 3-6 years in Ma’anshan. Age, gender and sampling season were influencing factors.

Prediction of Future Occurrence and Probability of Developing Breast Cancer over Lifespan in Korean Women / 한국유방암학회지

PURPOSE: Although female breast cancer remains relatively rare in Korea, its incidence and mortality have been rising quite rapidly. In this study, we estimated the probability of developing breast cancer, and examined the trend of its incidence using the proportion of cases with breast cancer among the total female cancer cases in the Korean Central Cancer Registry. METHODS: The probability of developing breast cancer was estimated for Korean women using a method based on the cumulative risk. The number of future breast cancer cases for the year 2020 was estimated by extrapolating the secular trend of the proportions of those with breast cancer between 1995 and 2002, using a logistic regression model. RESULTS: With an expected average life span of 84 years, Korean female has a 2.36% chance of developing breast cancer during her lifetime. The predicted expected age-adjusted proportions of breast cancer among the total female cancer cases were 19.5, 24.3, 29.9 and 36.1% for the years 2005, 2010, 2015 and 2020, respectively. The predicted expected crude proportions for the same years were 17.4, 19.7, 21.7 and 23.4%, respectively. The expected number of breast cancer cases to the 2020 would be 19,791, which is at least five times than that in 1996. CONCLUSION: Based on our results, female breast cancer in Korea will increase further and cumulative rate of breast cancer is highest at 40s and 50s. Lifestyle modification and prevention strategy especially for younger or high risk women might be essential to reduce breast cancer incidence.