Evaluation of chemicals leached from PET and recycled PET containers into beverages.

The use of recycled polyethylene terephthalate (rPET) containers, a recent shift in the beverage industry, poses new potential human health concerns including contamination from the original container; use of additives, detergents, and catalysts during recycling; and improper recycling practices. The purpose of this analysis was to evaluate available data regarding: (1) chemicals leached from PET and rPET in bottle form; (2) concentration of these chemicals; and (3) trends between rPET percent and concentration of chemicals leached. This analysis identified 211 scientific articles related to recycled plastic and leachables. Three articles met the inclusion criteria: (1) plastic was in bottle form; (2) plastic was made of PET or rPET; and (3) the study analyzed both PET and rPET using the same methods. This evaluation demonstrated that only nine compounds - benzene, styrene, acetaldehyde, 2-methyl-1,3-dioxolane, furan, bisphenol A (BPA), 2-buta-none, acetone, and limonene - have been studied. Notably, the leachable concentration of benzene, styrene, and BPA increased as the percent of recycled content increased from 0 to 100%. However, 2-methyl-1,3-dioxolane and furan implied a reverse trend, where the leachable concentration decreased as the percent of recycled content increased from 0 to 100%. The concentrations of 2-butanone, acetone, and limonene did not follow any suggested trend. Evidently, recycling PET can lead to changes in the leachables profile. This analysis further identified key areas of research, including testing a variety of liquid types, that need to be addressed to adequately conduct a human health risk assessment.

Non-high-density lipoprotein cholesterol and treatment targets in vascular surgery patients.

INTRODUCTION: Low-density lipoprotein cholesterol (LDL) is a known contributing factor to atherosclerotic cardiovascular disease (ASCVD) and a primary therapeutic target for medical management of ASCVD. Non-high-density lipoprotein cholesterol (non-HDL) has recently been identified as a secondary therapeutic target but is not yet widely used in vascular surgery patients. We sought to assess if vascular surgery patients were undertreated per non-HDL therapeutic guidelines. METHODS: This was an observational study that used a single-center database to identify a cohort of adult patients who received care from a vascular surgery provider from 01/2001 to 07/2021. ICD-9/10-CM codes were used to identify patients with a medical history of hyperlipidemia (HLD), coronary artery disease (CAD), cerebrovascular occlusive disease (CVOD), peripheral artery disease (PAD), hypertension (HTN), or diabetes mellitus (DM). Patient smoking status and medications were also identified. Lab values were obtained from the first and last patient encounter within our system. Primary outcomes were serum concentrations of LDL and non-HDL, with therapeutic thresholds defined as 70 mg/dL and 100 mg/dL, respectively. RESULTS: The cohort included 2465 patients. At first encounter, average age was 59.3 years old, 21.4% were on statins, 8.4% were on a high-intensity statin, 25.7% were diagnosed with HLD, 5.2% with CAD, 15.3% with PAD, 26.3% with DM, 18.6% with HTN, and 2.1% with CVOD. At final encounter, mean age was 64.8 years, 23.5% were on statins with 10.1% on high-intensity statin. Diagnoses frequency did not change at final encounter. At first encounter, nearly two-thirds of patients were not at an LDL <70 mg/dL (62.3%) or non-HDL <100 mg/dL (66.0%) with improvement at final encounter to 45.2 and 40.5% of patients not at these LDL or non-HDL treatment thresholds, respectively. Patients on statins exhibited similar trends with 51.1 and 50.1% of patients not at LDL or non-HDL treatment thresholds at first encounter and 39.9 and 35.4% not at LDL or non-HDL treatment thresholds at last encounter. Importantly, 6.9% of patients were at LDL but not non-HDL treatment thresholds. DISCUSSION: Among vascular surgery patients, over half did not meet non-HDL targets. These results suggest that we may be vastly under-performing adequate medical optimization with only about one-fourth of patients on a statin at their final encounter and approximately one-tenth of patients being treated with a high-intensity statin. With recent evidence supporting non-HDL as a valuable measurement for atherosclerotic risk, there is potential to optimize medical management beyond current high-intensity statin therapy. Further investigation is needed regarding the risk of adverse events between patients treated with these varied therapeutic targets.

Critical review and probabilistic health hazard assessment of cleaning product ingredients in all-purpose cleaners, dish care products, and laundry care products.

Though numerous chemical ingredients are used in cleaning products, empirical mammalian toxicology information is often limited for many substances. Such limited data inherently presents challenges to environmental health practitioners performing hazard and risk assessments. Probabilistic hazard assessment using chemical toxicity distributions (CTDs) is an alternative approach for assessments of chemicals when toxicity information is lacking. The CTD concept allows for derivation of thresholds of toxicological concern (TTCs) to predict adverse effect thresholds for mammalian species. Unfortunately, comparative health hazard assessment of cleaning product ingredients in common use categories such as all-purpose cleaners (APC), dish care products (DCP) and laundry care products (LCP) has not been well studied. However, APC, DCP, and LCP are used routinely for household and industrial applications, resulting in residential and industrial occupational exposures. Therefore, we reviewed and then examined hazard information (median lethal dose (LD50), lowest-observed-adverse-effect level (LOAEL), and no-observed-adverse-effect level (NOAEL)) from different types of standard mammalian toxicity studies for oral toxicity in the rat model from the unique Cleaning Product Ingredient Safety Initiative mammalian toxicology database. Probabilistic distributions (CTDs) were subsequently constructed using LD50, NOAEL and LOAEL data from a specific toxicity study type for all available ingredients in these three use categories. Based on data availability, product type-specific and chemical category-specific CTDs were also generated and compared. For each CTD, threshold concentrations (TCs) and their 95% confidence intervals (95% CIs) at 1st, 5th, 10th, 50th, 90th, 95th and 99th percentiles were calculated using the log-normal model. To test whether the common default uncertainty factor (UF) approach (e.g., 3, 10) in mammalian health risk assessment provides sufficient protection, UFs were also derived for LOAEL-to-NOAEL and exposure duration (e.g., subchronic-to-chronic) extrapolations. Relationships between CTDs of acute LD50s and sublethal LOAELs/NOAELs were also examined for acute-to-chronic ratio calculations, which may be useful in extreme circumstances. Results from our critical review and meta-analysis appear particularly useful for hazard and risk practitioners when identifying TTCs for ingredients in product use categories, and other chemical classes. This approach can also support development of regulatory data dossiers through read across, chemical substitutions and screening-level health risk assessments when limited or no empirical toxicity information exists for industrial chemicals.