Vitamin D status in relation to inflammatory risk and albuminuria associated with polycyclic aromatic hydrocarbon exposure in the US population.

Exposure to polycyclic aromatic hydrocarbons (PAHs) has been associated with both systematic inflammation and renal dysfunction. Reports have suggested that anti-inflammatory properties of vitamin D may provide protection against renal injury. This cross-sectional study tested the hypothesis that serum 25-hydroxyvitamin D [25(OH)D] moderates the inflammation and albuminuria associated with PAH exposure. Data were obtained from 5,982 subjects aged 20-79 years in the National Health and Nutrition Examination Survey (2001-2010). PAH exposure was estimated by urinary PAH metabolites. Inflammation was defined as serum C-reactive protein (CRP) > 3 mg/L and albuminuria as urinary albumin-to-creatinine ratio > 30 mg/g. The results found that greater PAH exposure was linked with inflammation and albuminuria. Individuals with PAH exposure also tended to have lower 25(OH)D and lower vitamin D was associated with both elevated CRP (Odds ratio [OR] = 1.28, 95% confidence interval [CI] = 1.07-1.54) and urinary albumin (1.35, 95%CI = 1.03-1.77) for any given PAH exposure. Those with lower serum 25(OH)D-to-urinary PAH ratios were likewise at a greater risk of elevated CRP and albuminuria. The findings support prior suggestions that exposure to PAHs is associated with inflammation and albuminuria but suggests further that the risk is higher when vitamin D is lower. Thus, nutritional status becomes an important variable in PAH risk assessment.

Mysterious outbreaks of gastrointestinal illness associated with burritos supplied through school lunch programs.

From October 1997 through March 1998, three outbreaks of gastrointestinal illness among school children were linked to company A burritos. In September 1998, a similar outbreak occurred in three North Dakota schools following lunches that included company B burritos. We conducted an investigation to determine the source of the North Dakota outbreak, identify other similar outbreaks, characterize the illness, and gather evidence about the cause. The investigation included epidemiologic analyses, environmental investigation, and laboratory analyses. In North Dakota, a case was defined as nausea, headache, abdominal cramps, vomiting, or diarrhea after lunch on 16 September 1998. Case definitions varied in the other states. In North Dakota, 504 students and staff met the case definition; predominant symptoms were nausea (72%), headache (68%), abdominal cramps (54%), vomiting (24%), and diarrhea (16%). The median incubation period was 35 min and median duration of illness was 6 h. Eating burritos was significantly associated with illness (odds ratio, 2.6; 95% confidence interval, 1.6 to 4.2). We identified 16 outbreaks that occurred in seven states from October 1997 through October 1998, affecting more than 1,900 people who ate burritos from two unrelated companies. All tortillas were made with wheat flour, but the fillings differed, suggesting that tortillas contained the etiologic agent. Results of plant inspections, tracebacks, and laboratory investigations were unrevealing. More than two million pounds of burritos were recalled or held from distribution. The short incubation period, symptoms, and laboratory data suggest that these outbreaks were caused by an undetected toxin or an agent not previously associated with this clinical syndrome. Mass psychogenic illness is an unlikely explanation because of the large number of sites where outbreaks occurred over a short period, the similarity of symptoms, the common food item, the lack of publicity, and the link to only two companies. A network of laboratories that can rapidly identify known and screen for unknown agents in food is a critical part of protecting the food supply against natural and intentional contamination.

Overview and summary of the Food Safety and Inspection Service risk assessment for Salmonella enteritidis in shell eggs, October 2005.

In 1998, the United States Department of Agriculture's Food Safety and Inspection Service (FSIS) and the Food and Drug Administration completed a risk assessment that indicated multiple interventions along the farm-to-table chain were needed to reduce the risk of human illness from Salmonella Enteritidis in shell eggs. Based on newly available data and improved modeling techniques, FSIS completed an updated risk assessment to examine the effect of pasteurization and refrigeration on reducing human illnesses from S. Enteritidis in shell eggs. The risk assessment model was written in Visual Basic for Applications (Microsoft, Redmond, WA) and run using Monte Carlo methods. The model estimated that if all shell eggs produced in the United States were pasteurized for a 3-log10 reduction of S. Enteritidis, the annual number of illnesses from S. Enteritidis in eggs would decrease from approximately 130,000 to 40,000. Pasteurization for a 5-log10 reduction of S. Enteritidis was estimated to reduce the annual number of illnesses to 19,000. The model also estimated that if all eggs produced in the United States were stored and held at 7.2 degrees C within 12 hours of lay, the annual number of illnesses from S. Enteritidis in eggs would decrease from 130,000 to 28,000. As a result, rapid cooling and pasteurization of shell eggs were predicted to be highly effective mitigations for reducing illnesses from consumption of S. Enteritidis in shell eggs.