Microbial contamination of dental unit waterlines in dental practices in Hesse, Germany: A cross-sectional study.

The quality of water from dental units is of considerable importance since patients and dental staff are regularly exposed to water and aerosols generated from the dental unit. This study analyzed the microbial quality of water obtained for periodical monitoring from 56 dental units in different dental practices in Hesse. Contamination by Legionella spp., Pseudomonas aeruginosa, and increased total colony counts were detected in 27.8%, 3.5%, and 17% of samples. Legionella pneumophila serogroup 1 accounted for 28% of Legionella isolates. The Legionella concentration was >100 cfu/100 ml in 84% of contaminated samples. Samples collected from an instrument channel were more frequently contaminated by Legionella than those from cup filler (41.7% vs. 18.6%, p = 0.02). After release of these results, decontamination measures were performed in units that had revealed unsatisfactory results. The outcome of the intervention was followed-up by microbiological analysis. At follow-up, 65.2% and 72.7% of waterlines that had previously been contaminated by Legionella or had shown increased total colony counts were free of contamination. Our results show a high rate of contamination of water from dental units in dental practices in Hesse. They highlight the risk of exposure for patients and personnel and the need for effective strategies to reduce microbial contamination.

Comparison of five in vitro digestion models to in vivo experimental results: lead bioaccessibility in the human gastrointestinal tract.

This paper presents a multi-laboratory comparison study of in vitro models assessing bioaccessibility of soil-bound lead in the human gastrointestinal tract under simulated fasted and fed conditions. Oral bioavailability data from a previous human in vivo study on the same soil served as a reference point. In general, the bioaccessible lead fraction was significantly (P<0.05) different between the in vitro methods and ranged for the fasted models from 2% to 33% and for the fed models from 7% to 29%. The in vivo bioavailability data from literature were 26.2+/-8.1% for fasted conditions, compared to 2.5+/-1.7% for fed conditions. Under fed conditions, all models returned higher bioaccessibility values than the in vivo bioavailability; whereas three models returned a lower bioaccessibility than bioavailability under fasted conditions. These differences are often due to the method's digestion parameters that need further optimization. An important outcome of this study was the determination that the method for separating the bioaccessible lead from the non-bioaccessible fraction (centrifugation, filtration, ultrafiltration) is crucial for the interpretation of the results. Bioaccessibility values from models that use more stringent separation methods better approximate in vivo bioavailability results, yet at the expense of the level of conservancy. We conclude from this study that more optimization of in vitro digestion models is needed for use in risk assessment. Moreover, attention should be paid to the laboratory separation method since it largely influences what fraction of the contaminant is considered bioaccessible.

Bioavailability of PCDD/F from contaminated soil in young Goettingen minipigs.

For the general population the intake of food of animal origin is the main route of human exposure to polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F). Besides this the ingestion of contaminated soil might be an important exposure path for small children. For risk assessment the knowledge of the bioavailable fraction of soil bound contaminants is important. In a balance study with young Goettingen minipigs the oral bioavailability of PCDD/F from contaminated soil was estimated by determination of the retention of PCDD/F from soil in different organs and tissues. Relative bioavailability was estimated by comparing the retention from soil to the retention of PCDD/F in organs and tissues after oral administration of a PCDD/F mixture extracted from the same soil by solvent. The soil had a PCDD/F-contamination of 5.3 microg I-TEq/kg and originated from a former arable land that had been treated with sludge from the port of Hamburg some years ago. Two groups of each four animals were exposed daily for 28 days via their diet either to 0.5 g soil per kg body weight and day (2.63 ng I-TEq/(kg(bw).d)) or to a daily dose of 1.58 ng I-TEq/(kg(bw).d) given to the diet by solvent. Five unexposed animals were used as a control group. Liver, adipose tissue, muscle, brain and blood were analyzed for their PCDD/F content. Accumulation of PCDD/F from soil or solvent in comparison to control animals was only observed for congeners with 2378-chlorosubstitution and predominantly took place in the liver. Bioavailability of 2378-chlorosubstituted congeners was in the range of 0.64%-21.9% (mean: 10.1%) from soil and 2.8%-59.8% (mean: 31.5%) when administered by solvent. The soil matrix reduced the bioavailability by about 70%. Expressed as I-TEq only 13.8% of the PCDD/F contamination were bioavailable from soil. The relative bioavailability of 2378-chlorosubstituted congeners from soil in relation to administration by solvent was in the range of 2%-42.2% (mean: 28.4%). When not considering the bioavailability, the risk by oral uptake of PCDD/F contaminated soil might be overestimated.

Comparison of soil Pb in vitro bioaccessibility and in vivo bioavailability with Pb pools from a sequential soil extraction.

In this study, 15 soils ranging in Pb content from 32 to 6330 mg kg(-1) were subjected to in vitro gastrointestinal extractions with and without added powdered milk. Before and after treatment, Pb in the soils was fractionated according to a 7-step sequential extraction procedure. A subset of five soils and Pb acetate was used for a minipig dosing study. The amount of bioaccessible Pb determined with the in vitro system ranged from 3 to 20% without powdered milk and from 11 to 56% with powdered milk. The higher bioaccessibility of Pb in the in vitro model with addition of powdered milk was related to a depletion of Pb in the organic Pb pool and indicates that soluble milk constituents compete with soil organic ligands for Pb. The absolute and relative bioavailabilities of Pb in the minipig dosing experiment were not related to bioaccessible Pb determined in any of the two in vitro systems. However, relative bioavailabilities in liver, kidney, and total uptake were highly correlated to Pb in the third fraction of the sequential extraction that is attributed to easily reducible Mn oxides. These results indicate that reductive processes in the intestine may be more relevant for Pb absorption than the initial solubilization in the acidic stomach.

Effects of developmental exposure to 2,2 ,4,4 ,5-pentabromodiphenyl ether (PBDE-99) on sex steroids, sexual development, and sexually dimorphic behavior in rats.

Increasing concentrations of polybrominated flame retardants, including polybrominated diphenyl ethers (PBDEs), in breast milk cause concern about possible developmental effects in nursed babies. Because previous studies in rats have indicated effects on sex steroids and sexually dimorphic behavior after maternal exposure to polychlorinated biphenyls (PCBs), our goal in the present study was to determine if developmental exposure to 2,2 ,4,4 ,5-pentabromodiphenyl ether (PBDE-99) induces similar endocrine-mediated effects. Pregnant rats were exposed to vehicle or PBDE-99 (1 or 10 mg/kg body weight, daily during gestational days 10-18). For comparison, we also included a group exposed to the technical PCB mixture Aroclor 1254 (30 mg/kg body weight, daily). PBDE exposure resulted in pronounced decreases in circulating sex steroids in male offspring at weaning and in adulthood. Female offspring were less affected. Anogenital distance was reduced in male offspring. Puberty onset was delayed in female offspring at the higher dose level, whereas a slight acceleration was detected in low-dose males. The number of primordial/primary ovarian follicles was reduced in females at the lower dose, whereas decline of secondary follicles was more pronounced at the higher dose. Sweet preference was dose-dependently increased in PBDE-exposed adult males, indicating a feminization of this sexually dimorphic behavior. Aroclor 1254 did not alter sweet preference and numbers of primordial/primary and secondary follicles but it did affect steroid concentrations in males and sexual development in both sexes. PBDE concentrations in tissues of dams and offspring were highest on gestational day 19. These results support the hypothesis that PBDEs are endocrine-active compounds and interfere with sexual development and sexually dimorphic behavior.

Developmental neurotoxicity of PHAHs: Endocrine-mediated and general behavioral endpoints in adult male rats.

During development, gonadal steroids exert effects on the nervous system which are long-lasting or organizational, in contrast to the transient activational actions in adulthood. Therefore, disturbance of neuroendocrine functions by developmental exposure to polyhalogenated aromatic hydrocarbons (PHAHs) is likely to affect sex-dependent behavior in adults. Our previous data revealed effects of maternal PCB exposure on sexual differentiation of the brain and subsequent sweet preference as sexually dimorphic behavior in adult offspring. Present research is focused on brominated flame retardants because of their wide-spread use and accumulation in human breast milk. Pregnant Long Evans rats were SC injected with PBDE 99 (2,2',4,4',5-PBDE) daily from gestational day 10 to 18. For comparison, an additional group was exposed to Aroclor 1254. Preliminary results indicate a dose-related increase in sweet preference in adult male offspring exposed to PBDE. Exposure also led to decreases in testosterone and estradiol serum levels. Additional decreases were detected in male anogenital distance. There were no changes of locomotor activity in the open field. On haloperidol-induced catalepsy, latencies were prolonged in all exposed males. In summary, PBDE induced endocrine effects and concomitant changes of sex-dependent behavior similar to PCBs. Outcome of general behavior suggests an involvement of dopaminergic processes in developmental PBDE exposure.

Risk potentials for humans of original and remediated PAH-contaminated soils: application of biomarkers of effect.

Contaminated soils represent a potential health risk for the human population. Risk assessment for humans requires specific methods, which must reflect the peculiarities of human behaviour, physiology and biochemistry with respect to contaminant uptake and processing. Biomarkers of effect or exposure have become an appropriate tool. Organic pollutants influence the expression profile of cytochromes P450 (CYP), and CYP1A1 has been shown to be a suitable biomarker for polycyclic aromatic hydrocarbons (PAH). The latter are widely distributed in soils and constitute an important soil contamination. Upon intake of PAH-contaminated soils, CYP1A1 is induced in various organs of rats and minipigs. Increased CYP1A1-levels in lung, kidney and spleen, after oral soil intake, indicate that contaminants escape the primary duodenal and hepatic metabolism and reach further organs. Dose-response relationships reveal that induction effects are to be expected in children based on known exposure conditions. Generally, CYP1A1-induction does not correlate with results of toxicity tests with lower organisms, performed with the same soils. The organic carbon content is largely responsible for this discrepancy. It severely affects the toxicity of soil bound PAH for microorganisms, but obviously affects the mobilization efficiency for PAH in the gastro-intestinal tract of mammals to a minor extent. Soil remediation by different methods may result in a significant reduction of the PAH content and of toxicity. Ingestion of remediated soils by rats shows, however, that the induction potential for CYP1A1 is only slightly decreased after remediation. This means that the major inducing components resist biological remediation or soil washing and remain in the soil. Because data obtained with experimental animals form the guiding principle for in vitro tests to be developed, the suitability of the animal model used for extrapolations to humans has to be proven. Upon soil ingestion, minipigs show a tissue-specific response pattern, which substantially differs from that of rats, which are widely used as animal models. It is not known which response pattern resembles that of man. In summary, cytochromes P450, in particular CYP1A1, are suitable biomarkers to assess the bioavailability of soil bound contaminants and their effects on mammalian species. There are, however, a number of questions to be answered in order to develop an in vitro test for human risk assessment. This concerns, for example, the identification of the suitable animal model, the identification of biomarkers for other contaminants and concepts to transpose the in vivo data to in vitro technologies or to mathematical modelling.

Comparison of five in vitro digestion models to study the bioaccessibility of soil contaminants.

Soil ingestion can be a major exposure route for humans to many immobile soil contaminants. Exposure to soil contaminants can be overestimated if oral bioavailability is not taken into account. Several in vitro digestion models simulating the human gastrointestinal tract have been developed to assess mobilization of contaminants from soil during digestion, i.e., bioaccessibility. Bioaccessibility is a crucial step in controlling the oral bioavailability for soil contaminants. To what extent in vitro determination of bioaccessibility is method dependent has, until now, not been studied. This paper describes a multi-laboratory comparison and evaluation of five in vitro digestion models. Their experimental design and the results of a round robin evaluation of three soils, each contaminated with arsenic, cadmium, and lead, are presented and discussed. A wide range of bioaccessibility values were found for the three soils: for As 6-95%, 1-19%, and 10-59%; for Cd 7-92%, 5-92%, and 6-99%; and for Pb 4-91%, 1-56%, and 3-90%. Bioaccessibility in many cases is less than 50%, indicating that a reduction of bioavailability can have implications for health risk assessment. Although the experimental designs of the different digestion systems are distinct, the main differences in test results of bioaccessibility can be explained on the basis of the applied gastric pH. High values are typically observed for a simple gastric method, which measures bioaccessibility in the gastric compartment at low pHs of 1.5. Other methods that also apply a low gastric pH, and include intestinal conditions, produce lower bioaccessibility values. The lowest bioaccessibility values are observed for a gastrointestinal method which employs a high gastric pH of 4.0.

Induction of cytochrome P450 1A1 in multiple organs of minipigs after oral exposure to soils contaminated with polycyclic aromatic hydrocarbons (PAH).

We have used the minipig as a prospective animal model for human risk characterization to study primary biochemical alterations upon oral contaminant intake. The effects of three orally administered soils containing polycyclic aromatic hydrocarbons (PAH) on the expression pattern of the cytochrome P450 enzyme CYP1A1 in various organs have been analyzed. Dependent on the soil sample, subchronic daily oral PAH doses ranged from 0.38 to 1.90 mg PAH(EPA)/kg body weight. In all cases, soil administration lead to significant CYP1A1 induction in several organs of minipigs to a different extent, following the order liver approximately = duodenum >lung >kidney approximately = spleen. Hepatic ethoxyresorufin- O-deethylase activities were elevated to 310, 1250 and 1780 compared with a background level of 200 pmol resorufin/mg protein per min. Induced duodenal activities appear to be even higher than in the liver, namely 405, 1280 and 2500 compared with a basal activity of 11 pmol resorufin/mg protein per min. CYP1A1 induction in several organs is clear evidence for successful contaminant mobilization and absorption in the duodenum and subsequent distribution of contaminant into diverse body compartments. As is shown in one case, impairment of CYP1A1 induction in the liver and thus breakdown of its PAH-metabolizing activity appears to have no effect on induced CYP1A1 levels in other organs. It appears important with respect to risk assessment that induction of CYP1A1 is particularly sensitive in the duodenum of minipigs and is achieved with soil doses which are in the range of amounts ingested by playing children due to hand-to-mouth activities. Induced duodenal CYP1A1 activities obtained in minipigs by oral exposure to PAH largely exceed maximal duodenal activities so far observed in rats. This is equally relevant for risk assessment and for selection of a suitable animal model that reflects effects of PAH exposure in humans.