Microplastics and phthalate esters release from teabags into tea drink: occurrence, human exposure, and health risks.

Tea, the most common infusion worldwide, is usually sold in teabags due to the ease of usage. The increase in the use of plastic materials in the food packaging industry has led to an increase in released contaminants, such as microplastics (MPs) and phthalates (PAEs), in various food products including teabags. In this research, the abundance and features of MPs as well as PAEs concentration were investigated in 45 teabag samples of different Persian and German brands. The abundance of MPs in the Persian and German teabag samples was averagely 412.32 and 147.28 items/single teabag, respectively. Also, average PAEs levels in the Persian and German teabag samples were 2.87 and 2.37 mg/g, respectively. The predominant size category of MPs was related to 100-250 µm. Fibers and transparent were the dominant shape and color of detected MPs in teabags, respectively. Polyethylene (PE) and nylon were the most common MP polymer types. The most prominent PAEs congeners in teabag samples were diethylhexyl phthalate (DEHP) and diisobutyl phthalate (DiBP). Furthermore, MP exposure hazard through tea ingestion was analyzed for children and adults. DEHP showed the cancer risk (CR) for children and adults. The findings of this research indicated that high MPs and PAEs levels are released from teabags into tea drinks. Considering a daily drinking of a volume of 150 and 250 mL tea by children and adults, 486 and 810 MPs may enter their bodies, respectively. Thus, tea prepared with teabag-packed herbs may pose a significant health risk for consumers.

Release of phthalate esters (PAEs) and microplastics (MPs) from face masks and gloves during the COVID-19 pandemic.

Marine pollution with personal protective equipment (PPE) has recently gained major attention. Multiple studies reported the release of microplastics (MPs) and chemical contaminants from face masks, the most used PPE type. However, not much is known concerning the release of phthalate esters (PAEs) in aquatic media, as well as the hazard posed by other types of PPE. In the present study, we investigated the release of MPs and PAEs from face masks and gloves recovered from the environment. The results indicated that both PPEs release MPs comparable to the literature, but higher concentrations were presented by face masks. In turn, the total concentration of six PAEs was higher in gloves than in face masks. The release of these contaminants is exacerbated over time. The present study allows researchers to understand the contribution of PPE to marine pollution while accounting for gloves, a generally overlooked source of contaminants.

Emerging contaminants migration from pipes used in drinking water distribution systems: a review of the scientific literature.

Migration of emerging contaminants (ECs) from pipes into water is a global concern due to potential human health effects. Nevertheless, a review of migration ECs from pipes into water distribution systems is presently lacking. This paper reviews, the reported occurrence migration of ECs from pipes into water distribution systems in the world. Furthermore, the results related to ECs migration from pipes into water distribution systems, their probable sources, and their hazards are discussed. The present manuscript considered the existing reports on migration of five main categories of ECs including microplastics (MPs), bisphenol A (BPA), phthalates, nonylphenol (NP), perfluoroalkyl, and polyfluoroalkyl substances (PFAS) from distribution network into tap water. A focus on tap water in published literature suggests that pipes type used had an important role on levels of ECs migration in water during transport and storage of water. For comparison, tap drinking water in contact with polymer pipes had the highest mean concentrations of reviewed contaminants. Polyvinyl chloride (PVC), polyamide (PA), polypropylene (PP), polyethylene (PE), and polyethylene terephthalate (PET) were the most frequently detected types of microplastics (MPs) in tap water. Based on the risk assessment analysis of ECs, levels of perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluorohexane sulfonate (PFHxS), and perfluorooctane sulfonate (PFOS) were above 1, indicating a potential non-carcinogenic health risk to consumers. Finally, there are still scientific gaps on occurrence and migration of ECs from pipes used in distribution systems, and this needs more in-depth studies to evaluate their exposure hazards on human health.

Evaluation of occurrence of organic, inorganic, and microbial contaminants in bottled drinking water and comparison with international guidelines: a worldwide review.

The aim of this study was to evaluate the levels of inorganic and organic substances as well as microbial contaminants in bottled drinking water on a global scale. The findings were compared to WHO guidelines, EPA standards, European Union (EU) directive, and standards drafted by International Bottled Water Association (IBWA). Our review showed that 46% of studies focused on the organic contaminants, 25% on physicochemical parameters, 12% on trace elements, 7% on the microbial quality, and 10% on microplastics (MPs) and radionuclides elements. Overall, from the 54 studies focusing on organic contaminants (OCs) compounds, 11% of studies had higher OCs concentrations than the standard permissible limit. According to the obtained results from this review, several OCs, inorganic contaminants (IOCs), including CHCl3, CHBrCl2, DEHP, benzene, styrene, Ba, As, Hg, pb, Ag, F, NO3, and SO4 in bottled drinking water of some countries were higher than the international guidelines values that may cause risks for human health in a long period of time. Furthermore, some problematic contaminants with known or unknown health effects such as EDCs, DBP, AA, MPs, and some radionuclides (40K and 222Rn) lack maximum permissible values in bottled drinking water as stipulated by international guidelines. The risk index (HI) for OCs and IOCs (CHBrCl2, Ba, As, and Hg) was higher than 1 in adults and children, and the value of HI for CHCl3 in children was more than 1. Thus, further studies are required to have a better understanding of all contaminants levels in bottled drinking water.

Physical and chemical degradation of littered personal protective equipment (PPE) under simulated environmental conditions.

Investigations of the physicochemical degradation of personal protective equipment (PPE) under controlled environmental conditions are largely lacking. Here the chemical and physical changes of face masks and gloves (recovered from the marine environment) were evaluated after exposure time up to 60 days of simulated environmental conditions. The results suggested that the polymer backbone of PPE suffers typical changes induced by sun exposure. Changes in the intensity of diffraction peaks indicated shifts in the crystallinity of PPE, possibly altering their thermal behavior. Signs of physical degradation in PPE, such as ruptures, and rough surfaces, which exacerbated over time were also detected. Additionally, signals of some elements of concern, such as Cu and Mo, and elements typically found in seawater were detected. The results of this study allowed us to better understand the degradation of typical PPE items in the marine environment, ultimately resulting in the release of microplastics and chemical contaminants.

Molecular detection of E. coli and Vibrio cholerae in ballast water of commercial ships: a primary study along the Persian Gulf.

PURPOSE: Ballast water is one of the most important ways for the transfer of aquatic organisms such as Escherichia coli (E. coli) and Vibrio cholerae. The aim of this study was to investigate Mdh gene of E. coli and the OmpW gene of Vibrio cholerae bacteria by PCR technique in the ballast water of commercial ships entering Bushehr port along the Persian Gulf. METHODS: In this study, 34 samples of ballast water entered Bushehr port were studied by using culture and PCR methods to determine Mdh gene of E. coli and OmpW gene of Vibrio cholerae. Genomic DNA of bacterial strains was extracted and PCR was performed by using specific primers of E. coli and Vibrio cholerae. RESULTS: The specific Mdh gene of E. coli was detected in 4 ballast water samples and the positive samples were analyzed by antisera methods for E. coli O157:H7. Results of antisera showed that there were 3 positive samples of O157:H7 serotype. The results of the PCR technique showed that the OmpW gene of Vibrio cholerae was negative for all positive culture samples. CONCLUSIONS: Further studies are highly recommended to monitor other aquatic organisms in ballast water to protect the marine environment.

Vitamin D Resistance as a Possible Cause of Autoimmune Diseases: A Hypothesis Confirmed by a Therapeutic High-Dose Vitamin D Protocol.

Vitamin D3 (cholecalciferol) is a secosteroid and prohormone which is metabolized in various tissues to the biologically most active vitamin D hormone 1,25(OH)2D3 (calcitriol). 1,25(OH)2D3 has multiple pleiotropic effects, particularly within the immune system, and is increasingly utilized not only within prophylaxis, but also within therapy of various diseases. In this context, the latest research has revealed clinical benefits of high dose vitamin D3 therapy in autoimmune diseases. The necessity of high doses of vitamin D3 for treatment success can be explained by the concept of an acquired form of vitamin D resistance. Its etiology is based on the one hand on polymorphisms within genes affecting the vitamin D system, causing susceptibility towards developing low vitamin D responsiveness and autoimmune diseases; on the other hand it is based on a blockade of vitamin D receptor signaling, e.g. through pathogen infections. In this paper, we review observational and mechanistic evidence for the acquired vitamin D resistance hypothesis. We particularly focus on its clinical confirmation from our experience of treating multiple sclerosis patients with the so-called Coimbra protocol, in which daily doses up to 1000 I.U. vitamin D3 per kg body weight can be administered safely. Parathyroid hormone levels in serum thereby provide the key information for finding the right dose. We argue that acquired vitamin D resistance provides a plausible pathomechanism for the development of autoimmune diseases, which could be treated using high-dose vitamin D3 therapy.

Abundance, composition, and potential intake of microplastics in canned fish.

The existence of microplastics (MPs) in canned fish (tuna and mackerel) samples was investigated and their composition, possible sources and potential intake were assessed. Light and fluorescence microscopy were used for the quantification of potential MPs. Furthermore, micro-Raman microscopy, and scanning electron microscopy coupled with an energy dispersive X-ray were used to identify the polymer types and composition of MPs. The results showed that 80% of samples had at least one plastic particle and fibers were the most abundant shapes of MPs. Moreover, polyethylene terephthalate (32.8%) was the most common polymer type in canned fish samples. The fish, food additives, and contact materials during the cleaning and canning process are possible sources of MPs. Human intake estimation of MPs showed the possibility of plastics absorption by humans who consume canned fish several times/week. Hence, the results of this study showed the importance of MPs' guidelines for food safety and hygiene.

Worldwide bottled water occurrence of emerging contaminants: A review of the recent scientific literature.

Contaminants of emerging concern (CECs) have recently been detected in bottled water and have brought about discussions on possible risks for human health. However, a systematic review of CECs in bottled water is currently lacking due to the relatively new introduction and/or detection of these pollutants. Hence, this paper reviews the existing studies on the presence of six major groups of emerging contaminants including microplastics (MPs), pharmaceuticals and personal care products (PPCPs), bisphenol A (BPA), phthalates, alkylphenols (APs), and perfluoroalkyl and polyfluoroalkyl substances (PFASs) in bottled water from different countries. Also, the findings related to CECs' levels, their possible sources, and their risks are summarized. The gathered data indicate that MPs within the size range of 1-5 µm are the most predominant and potentially toxic classes of MPs in bottled water. In addition, PPCPs, PFASs, APs, and BPA occur in concentration levels of ng/L, while phthalates occur in the µg/L level in bottled water. The bottle type plays an important role in the contamination level. As expected, water in plastic bottles with plastic caps is more polluted than in glass bottles. However, other sources of contamination such as contact materials during cleaning, bottling, and storage are not negligible. Based on the gathered data in this review, the CEC levels except for MPs (no threshold values) in bottled water of most countries do not raise a safety concern for the human. However, the occurrence of individual CECs and their association in bottled water need more accurate data to understand their own/synergistic effects on human health.

Levels and ecological and health risk assessment of PM2.5-bound heavy metals in the northern part of the Persian Gulf.

Bushehr, a port along the northern part of the Persian Gulf, has repeatedly encountered dust storms in recent years but there is not been a comprehensive study on the PM2.5 contents in this region. The present study reports the characteristics and health risks of atmospheric PM2.5-bound heavy metals (HMs) in Bushehr from December 2016 to September 2017. A total of 46 samples were analyzed, and a high volume air sampler equipped with quartz fiber filters was used for sampling. Inductively coupled plasma optical emission spectroscopy (ICP-OES) was also used for HMs analyses. Risk assessment and hazard index (HI) of these metals were computed by using USEPA's exposure parameters. The results showed that the average 24-h mass concentration of PM2.5 ranged from 22.09 to 292.45 µg/m3. The results also indicated that 95.65 and 82.61% of the samples were higher than WHO and EPA guidelines for 24-h PM2.5. Also there was no statistically significant relationship between wind direction and PM2.5.The average concentration levels of seven measured metals (Cd, Co, Cr, Fe, Ni, Pb, and V) in the PM2.5 samples were in the range of 6.03 ng/m3 to 1335.94 ng/m3, and the order of their concentration was Fe > Ni > Pb > Cr > Cd > V > Co. Principal component analysis (PCA) showed that PM2.5-bound heavy metals were categorized in three groups. The ecological risk level of calculated metals was very significant, and the major contribution of the ecological risk was related to Cd. The highest HQ in children and adults was related to Cr, and overall HI in children was higher than adults. Also the RI values of Cr in both groups of children and adults were indicated high risk of developing cancer in human.

Age-sex specific disability-adjusted life years (DALYs) attributable to elevated levels of fluoride in drinking water: A national and subnational study in Iran, 2017.

National and subnational burden of disease attributable to elevated fluoride levels in drinking water apportioned by sex, age group, province, and community type in Iran, 2017 were quantified based on disability-adjusted life years (DALYs). The attributable burden of disease was estimated using four input data: (1) effect size of elevated drinking water fluoride levels for dental and skeletal fluorosis, (2) population distribution of drinking water fluoride levels, (3) the threshold levels of fluoride in drinking water for contribution in dental and skeletal fluorosis, and (4) age-sex distribution of population. The attributable burden of disease was only related to dental fluorosis, because the fluoride levels were lower than the threshold value for skeletal fluorosis (4.0 mg/L) in all of the cases. The national attributable prevalence (per 100,000 people), DALYs, and DALY rate in 2017 were calculated to be 60 (95% uncertainty interval 48-69), 3443 (1034-6940), and 4.31 (1.29-8.68), respectively. The national attributable burden of disease was not significantly different by sex, but was affected by age and community type in a manner that the highest DALY rate was related to the age group 10-14 y (6.06 [1.82-12.21]) and over 66% of the national attributable DALYs occurred in rural communities. The attributable burden of disease occurred only in 10 out of 31 provinces and about 94% of the attributable DALYs were concentrated in four provinces Fars (1967 [592-3964]), Bushehr (414 [124-836]), West Azarbaijan (400 [120-808]), and Hormozgan (377 [113-761]). Implementation of fluoride-safe drinking water supply schemes in the four leading provinces can prevent most of the national health losses and partly compensate the increasing trend of disease burden from oral conditions at the national level.

Phthalate acid esters (PAEs) accumulation in coastal sediments from regions with different land use configuration along the Persian Gulf.

Phthalate acid esters (PAEs) are widely used as plasticizers in various plastic products and have aroused considerable concern over their ubiquitous presence and potentially hazardous effects on the environment. This research provides the first data on PAEs distribution in the sediments of northern part of the Persian Gulf. To determine the concentration of 16 PAEs, 26 samples of sediments were collected from industrial stations (IS), urban stations (US), agricultural stations (AGS), and natural field stations (NS) from Asalouyeh Harbor coasts from Nov 2016 to Jan 2017. The mean values of Æ©16PAEs in the samples taken from IS, AGS, US, and NS were 78.08, 11.69, 46.56, and 5.180 µg/g, respectively. The results indicated that the mean concentrations of Æ©16PAEs in the samples taken from IS and AGS areas were significantly higher (p < 0.05) than the ones taken from US and NS areas. The order of PAEs concentrations in sediment samples were as di(2-ethylhexyl) phthalate (DEHP), di-n-butyl phthalate (DnBP), butylbenzyl phthalate (BBP), and di-n-octyl phthalate (DnOP), respectively. DEHP was detected in all collected samples and the mean ±â€¯SD of its concentration in the IS, US, AGS, and NS regions were as 28.15 ±â€¯4.9, 4.040 ±â€¯0.53, 11.58 ±â€¯1.2, and 1.780 ±â€¯0.78 µg/g, respectively. The major sources of PAEs in the sediments collected from the study region were associated with the industrial and agricultural activities. The findings of this study indicated that the sediments of the Asalouyeh coasts are heavily contaminated with PAEs. They have shown potential ecotoxicological effects on the aquatic organisms and benthic. Therefore, more attention should be paid to prediction of the marine ecosystem in this region by the authorities.

Trace metals in zooplankton from the northern Persian Gulf.

This work is the first study on the spatial and temporal distribution of metals in zooplankton collected along the Persian Gulf. The rank order distribution of metals in terms of their overall average concentration in the zooplankton was observed to be Fe > Zn > Cu > Cd > Ni > Cr > Pb > Co > V. No clear pattern and no statistical differences were detected among the areas and the sampling stations. The highest concentrations of Cu, Zn, and Pb were observed in summer while the highest concentration levels of Fe and Ni were observed in winter. The highest mean zooplankton metal concentration level was found to be Fe with 10.42 µg/g (in winter) and the lowest levels were for V (in spring and summer) and Co (in winter), both of which had a level of 0.01 µg/g. The results can be used to establish base-line data for the trace metal content of zooplankton in the northern region of the Persian Gulf.

Vitamin D: Update 2013: From rickets prophylaxis to general preventive healthcare.

Vitamin D has received a lot of attention recently as a result of a meteoric rise in the number of publications showing that vitamin D plays a crucial role in a plethora of physiological functions and associating vitamin D deficiency with many acute and chronic illnesses including disorders of calcium metabolism, autoimmune diseases, some cancers, type 2 diabetes mellitus, infectious diseases and cardiovascular disease. The recent data on vitamin D from experimental, ecological, case-control, retrospective and prospective observational studies, as well as smaller intervention studies, are significant and confirm the sunshine vitamin's essential role in a variety of physiological and preventative functions. The results of these studies justify the recommendation to improve the general vitamin D status in children and adults by means of a healthy approach to sunlight exposure, consumption of foods containing vitamin D and supplementation with vitamin D preparations. In general, closer attention should therefore be paid to vitamin D deficiency in medical and pharmaceutical practice than has been the case hitherto.

Radiosynoviorthesis in osteoarthritis and other disorders with concomitant synovitis in comparison to rheumatoid arthritis.

AIM: The aim of this study was to evaluate the effectiveness of radiosynoviorthesis (RSO) in osteoarthritis and other disorders with concomitant synovitis versus rheumatoid arthritis by means of a standardized questionnaire. METHODS: Eight-hundred and three RSO treatments were monitored in 691 patients by seven centers in three countries, using standardized questionnaires. Patients were assigned to three groups according to their age (20-40, 41-60, and 61-80 years). Additionally, the data was analyzed separately for patients with rheumatoid arthritis (group A) and those with osteoarthritis, psoriasis arthritis, pigmental villonodular synovitis, or persistent effusions after joint replacement (group B). RESULTS: Quality of life improved in 78% of group A and 59% of group B (p < 0.01). Ameliorations of joint pain, swelling/effusion, or flexibility were found in 80% of group A and 56% of group B (p < 0.01). The response rate was similar for small- and large-sized joints in group A, but was significantly higher for large-sized joints in group B (p < 0.01). The positive effects on joint pain, swelling/effusion, or flexibility lasted longer in group A (p < 0.01). Repeated RSOs were as effective as initial RSOs. The clinical outcome was not influenced by age, gender, or transient immobilization for 48 hours after RSO. CONCLUSION: Although slightly more efficient in rheumatoid arthritis, RSO represents an effective treatment option also in osteoarthritis and other disorders with concomitant synovitis.

Positron emission tomography with [(18)F]FDG in the diagnosis of Creutzfeldt-Jakob disease (CJD).

The aim of this study was to explore the sites of metabolic changes with [(18)F]2-fluoro-2-desoxy-D-glucose (FDG) and positron emission tomography (PET) in patients with Creutzfeldt-Jakob disease and to correlate the findings with clinical symptoms. Static [(18)F]FDG-PET studies of eight patients with the diagnosis of confirmed or probable CJD were retrospectively analysed by two physicians from departments of nuclear medicine independently with a strong interrater agreement (kappa=0,98). The clinical data of the patients, based on a standardized evaluation by physicians from the German Creutzfeldt-Jakob disease surveillance study, was correlated with the PET findings. [(18)F]FDG-PET shows widespread hypometabolism in CJD. All patients had a reduction of cerebral glucose metabolism in at least one temporal or parietal region. Additionally in 7 of our own 8 cases and 3 of 4 cases from the literature the occipital lobe, the cerebellum or the basal ganglia were involved. These findings differ from typical patterns of hypometabolism in Alzheimer's disease and other neurodegenerative disorders. In two thirds of the cases the distribution was markedly asymmetric. Myoclonus was present in five out of our eight own cases. Our data suggest that myoclonus might correlate with metabolic impairment of contralateral parietal and temporal lobes. In three of four patients with visual symptoms FDG uptake was reduced in the visual cortex bilaterally. Typical hyperintensities on MRI were only found in two of the eight cases at the time of PET-studies. Our results demonstrate that [(18)F]FDG-PET appears to be a sensitive investigation in CJD and could be useful to differentiate CJD from other neurodegenerative disorders.