Edible wild plants growing in contaminated floodplains: implications for the issuance of tribal consumption advisories within the Grand Lake watershed of northeastern Oklahoma, USA.

Metal releases from the Tri-State Mining District (TSMD) that is located in southwestern Missouri, southeastern Kansas, and northeastern Oklahoma, have contaminated floodplain soils within the Neosho and Spring river watersheds of the Grand Lake watershed. Since the Oklahoma portion of the watershed lies within ten tribal jurisdictions, the potential accumulation of metals within plant species that are gathered and consumed by tribal members, as well as the resulting metal exposure risks to tribal human health, was a warranted concern for further investigation. Within this study, a total of 36 plant species that are commonly consumed by tribes were collected from floodplain areas that were previously demonstrated to have elevated soil metal concentrations relative to reference sites. A significant, positive correlation was shown for metal concentrations in plant tissues versus soil (n = 258; Cd: R = 0.72, p = 0.00; Pb: R = 0.52, p = 0.00; and Zn: R = 0.70, p = 0.00). Additionally, a significant difference in metal concentration distributions existed between reference and impacted plant samples (n = 210, p = 0.00 for all metals). These results proved that floodplain soils are a major contamination pathway for metal accumulation within plants, and the source of metal contamination is the result of mining releases from the TSMD. Metal accumulation within plants was found to vary according to specific metal and plant species. The lowest dietary exposure out of all plant organs sampled were associated with fruit, whereas the highest was associated with roots, stem/leaves, and low-lying leafy greens. Metals in plants were compared to weekly dietary intake limits established by the Joint FAO/WHO Expert Committee on Food Additives. Based on specific serving sizes established within this study for tribal children and adults, many plant species had sufficient concentrations to warrant tribal consumption restrictions within the floodplains of Elm Creek, Grand Lake, Lost Creek, Spring River, and Tar Creek. Importantly, these results highlighted the necessity for the issuance of plant consumption advisories for tribal communities in the watershed. A consumption restriction guide on the number of allowable servings of each species per week at specific streams was developed within this study for tribal children and adults. Results also demonstrated that soil metal concentrations do not need to be exceptionally elevated relative to reference sites in order for plants to accumulate sufficient metal concentrations to exceed dietary limits for one serving. Therefore, the exposure risk associated with the consumption of plants cannot be accurately predicted solely from metal concentrations within soils, but must be based on metal concentrations within specific plant tissues on a site-by-site basis. A weekly consumption scenario was created within this study in order to better understand the potential metal dietary exposures to child and adult tribal members who consume multiple servings of multiple plant species per day, as well as benthic invertebrates and fish from the watershed. These findings demonstrated that plants pose a greater consumption exposure risk for tribal members than benthic invertebrates or fish. Therefore, without the consideration of exposure risks associated with the consumption of plants within future human health risk assessments, tribal health risks will be severely underestimated.

Screening Level Assessment of Metal Concentrations in Streambed Sediments and Floodplain Soils within the Grand Lake Watershed in Northeastern Oklahoma, USA.

Metal releases have been received by the Grand Lake watershed from the Tri-State Mining District (TSMD) since the mid 1800s. To address data gaps in metal distributions in the Oklahoma portion of the watershed, streambed sediment and floodplain soil was sampled on various streams. The <63-µm fraction was analyzed for Cd, Pb, and Zn concentrations by portable X-ray fluorescence spectroscopy and inductively coupled plasma-mass spectrometry. Mean metal concentration results at reference transects indicated that background sediment/soil concentrations for Cd, Pb, and Zn within the watershed were 0.5, 19, and 68 mg/kg, respectively. A significant difference in the distributions of metal concentrations was found between reference and impacted transects (Cd, Pb, Zn: p = 0.00; Cd: n = 29; Pb, Zn: n = 283). These results demonstrated that concentrations of metals in streambed sediments and floodplain soils were significantly higher in areas downstream of major mining influences relative to upstream reference sites, and the source of metal contamination within these media was the result of mining releases from the TSMD. Toxicity risks to benthic macroinvertebrates were evaluated using a TSMD-specific sediment mixture model (∑PEC-QCd,Pb,Zn) for metals (MacDonald et al. in Development and evaluation of sediment and pore-water toxicity thresholds to support sediment quality assessments in the Tri-State Mining District (TSMD), Missouri, Oklahoma, and Kansas. Draft Final Technical Report. Volume I: Text. Prepared for the U.S. Environmental Protection Agency and the U.S. Fish and Wildlife Service. Prepared by MacDonald Environmental Sciences Ltd., U.S. Geological Survey, and CH2M Hill, Nanaimo, 2009). Toxicity risks to plant populations were also assessed by comparing soil metal concentrations to Ecological Soil Screening Levels (Eco-SSLs). It was found that the survival and/or biomass of benthic invertebrates was highly impacted at Tar Creek, highly to moderately impacted at Spring River and Elm Creek, and unimpacted at Lost Creek and Grand Lake as a result of sediment metal concentrations. It also was found that soil metal concentrations were likely sufficient to impact plant populations at all streams. Within the Oklahoma portion of the watershed, the majority of environmental studies, remediation, and restoration efforts by local, state, and federal agencies have been primarily focused within the Tar Creek Superfund Site (TCSS) boundary. Importantly, the findings of this study highlighted the downstream extent of metals contamination as well as the resulting potential toxicities to benthic invertebrates and plants that is present outside of the TCSS boundary. Because the Oklahoma portion of the watershed comprises the jurisdictional lands of ten tribes, these results emphasized the potential tribal loss of use of benthic invertebrates and plants due to their decline in population as a result of metal toxicity. These overall findings provide an important basis for future data needs in assessing metal concentrations in aquatic and terrestrial biota that are consumed by tribal communities within the watershed to determine if certain organisms are unsafe to consume or warrant consumption advisories. This will allow risk assessors and risk managers to better understand the potential loss of use of tribal biological resources as well as improving risk-based decision making to be protective of these resources and tribal human health.

[Assessment of human papillomavirus testing on liquid-based Cyto-screen system for women with atypical squamous cells of undetermined significance. Effect of age]. / Evaluation du test de détection des papillomavirus humains en milieu liquide Cyto-screen après diagnostic d'atypies des cellules malpighiennes de signification indéterminée. Effet de l'âge.

OBJECTIVE: Analyse the performance of human papillomavirus testing with hybrid capture II on liquid-based CYTO-screen system for women diagnosed with atypical squamous cells of undetermined significance according to the age. PATIENTS AND METHODS: Were included all women diagnosed with atypical squamous cells of undetermined significance for whom human papillomavirus testing was performed and cytological and histological procedures were available over a follow-up period of 6 to 18 months. RESULTS: Human papillomavirus testing was performed in 3,047 patients, and results were compared to cytological and histological follow-up diagnosis in 1,880 cases (61.7%). The sensitivity for diagnosing cervical intraepithelial neoplasia was 93.3% in women less than 30 of age and 89.7% in women more than 30 of age. Specificity was 44.9% in women less than 30 of age and 64.4% in women more than 30 of age. Likelihood ratios confirmed these results as they show a low discriminatory power in case of positive result specifically in women less than 30 of age but an excellent performance in case of negative result. DISCUSSION AND CONCLUSION: The use of human papillomavirus testing after a diagnosis of atypical squamous cells of undetermined significance with the residual material of Cyto-screen system is a possible triage procedure to identify patients needing a colposcopy. Its specificity is better for women over 30.

Accuracy of thin-layer cytology in patients undergoing cervical cone biopsy.

OBJECTIVE: To compare the accuracy of thin-layer cytology with Autocyte PREP (TriPath Imaging Inc., Burlington, North Carolina, U.S.A.) with conventional smears in 500 women undergoing cervical cone biopsy. STUDY DESIGN: The study was performed among 500 consecutive women presenting for cone biopsy for high grade cervical intraepithelial neoplasia (CIN) on biopsy in 350 (70%) and discrepant cytology/colpohistology in 150 (30%). Before performing a cone biopsy, two cervical samples were collected for conventional smears and thin-layer cytologic slides, with randomization of the order. Conventional smears were stained and diagnosed at Pasteur Cerba, while thin-layer cytologic slides were processed at a local TriPath office (Meylan, France) and sent in a masked fashion for screening at Pasteur Cerba. Any slides initially read as normal were reviewed again and reported without knowledge of the other cytologic or cone biopsy data. The final cytologic diagnoses for the two methods were compared with histopathology of the cone biopsy. RESULTS: The conventional smear was unsatisfactory in 58 (11.6%) of cases, while there were 4 (0.8%) unsatisfactory thin-layer cytologic slides (P < .001). Endocervical cells were missing from 31 (6.2%) of conventional smears and 34 (6.8%) of thin-layer cytologic slides. For the pooled data, sensitivities of conventional smear and thin layer for detecting high grade CIN (0.82% and 0.86%, respectively) were similar as were specificities (0.40% and 0.43%, respectively). When first samples were compared, the sensitivities of the conventional smear and thin layer for high grade CIN were 0.79% and 0.89%, respectively (P = .02), with corresponding specificities of 0.41% and 0.36% (P < .01). CONCLUSION: When controlled for sample order, the sensitivity of thin-layer cytology for detecting high grade CIN was significantly higher than that of conventional smears in patients with previous abnormal cytology, but at the expense of specificity.