Health risks associated with the production and usage of charcoal: a systematic review.

Charcoal production and utilisation are linked to various health issues and occupational hazards. However, to our knowledge, no systematic review has primarily focused on the health implications of charcoal production and its use while distinguishing charcoal from other solid fuels such as wood and coal. OBJECTIVES: This systematic review presents a synthesis of the evidence on the health risks associated with producing and using charcoal across the world. DESIGN: Systematic review using a systematic narrative synthesis approach. DATA SOURCES: MEDLINE (through Ovid interface), CINAHL, Embase, Web of Science, PsycINFO, Cochrane Library and SCOPUS, from inception to 26 February 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Peer-reviewed journal articles reporting empirical findings on the associations between charcoal usage/production and health parameters. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data and assessed the quality of primary studies. RESULTS: Our findings showed that charcoal production and usage are linked with specific adverse health outcomes, including respiratory diseases (n=21), cardiorespiratory and neurological diseases (n=1), cancer (n=3), DNA damage (n=3), carbon monoxide (CO) poisoning (n=2), physical injury (n=2), sick house syndrome (n=1), unintentional weight loss and body mass index (BMI) reduction (n=2), increase in blood pressure (n=1) and CO death (n=1). Among the included articles that reported respiratory diseases (n=21), there was one case of asthma and tuberculosis and two cases of chronic obstructive pulmonary disease. CONCLUSIONS: This review links charcoal production/usage and some associated human health risks. These include respiratory diseases and other non-respiratory illnesses such as sick-building syndrome, cardiovascular diseases, DNA damage, CO poisoning and death, unintentional weight loss and BMI reduction, and physical injuries.

Development and validation of an ELISA method for quantification of the anti-HER3 antibody HMBD-001 in human serum.

Background: HMBD-001 is an IgG1 humanized monoclonal antibody specifically targeting HER3, a receptor highly expressed on cancer cells in certain tumors. A bioanalytical method was required to quantify HMBD-001 in human serum, with high selectivity and without interference from HER3. Methods and results: A bridging ELISA using an anti-idiotypic monoclonal capture and detection was developed and validated for quantitative measurement of HMBD-001 in human serum. The assay is sensitive, with a lower limit of quantification of 250 ng/ml, has a broad dynamic range of 250-7000 ng/ml HMBD-001, and exhibits excellent precision and overall accuracy. Conclusion: We have developed and validated a sensitive and selective method for measuring HMBD-001 in human serum. This assay is now being used in a clinical trial setting.

Biomarkers for the Assessment of Exposure to Fluoride in Adults.

To monitor deficient or excessive intakes of biologically available fluoride (F), various biological samples have been tested for use as biomarkers of human exposure to F. Most such studies have concerned children and often have only involved measurement of F in 1 or 2 types of sample. The present study investigated the relationships of F concentrations in biomarkers of F exposure; including plasma, saliva, hair, finger- and toenails, and daily urinary F excretion (UFE) with the total daily F intake (TDFI) of adults. TDFI was assessed in 60 healthy adults, aged ≥20 years; 31 lived in a low-F water area (LFA, 0.04 mg F/L) and 29 in a high-F water area (HFA, 3.05 mg F/L) of Nigeria. All volunteers provided at least 1 biomarker sample from the above list and completed a questionnaire to evaluate F intake from the diet and toothpaste ingestion. TDFI, UFE and F concentrations of biomarkers were statistically significantly higher in the HFA than in the LFA. There were strong statistically significant positive correlations between TDFI and UFE (ρ = 0.730, p < 0.001); plasma F (ρ = 0.729, p < 0.001); fasting whole saliva F (ρ = 0.653, p < 0.001) and hair F (ρ = 0.603, p < 0.001). The statistically significant positive correlations between TDFI and fingernail F (ρ = 0.502, p < 0.001) and between TDFI and toenail F (ρ = 0.556, p < 0.001) were moderate. In conclusion, this study has indicated the usefulness of 24-h UFE as well as F concentration in plasma, fasting whole saliva and hair as biomarkers of contemporary or sub-chronic F exposure in groups of adults. However, they do not appear to have the necessary sensitivity to predict F exposure in individuals.

Biomarkers for the Assessment of Fluoride Exposure in Children.

Due to practical difficulties in quantifying fluoride exposure, the ability of various biomarkers to predict exposure has been investigated previously. However, the results are inadequate for validation of their application and usefulness. This study aimed to investigate the association between contemporary/recent biomarkers of fluoride exposure and total daily fluoride intake (TDFI) of children with large differences in fluoride exposure through drinking water. TDFI was assessed in 61 healthy 4- to 5-year-old children who provided at least 1 biomarker sample; 32 lived in a low-fluoride area (0.04 mg F/L) and 29 lived in a high-fluoride area (3.05 mg F/L). Validated questionnaires were administered to evaluate fluoride intake from diets (including water) and toothpaste ingestion. Daily urinary fluoride excretion (UFE) and fluoride concentrations in plasma, fasting whole saliva, hair, and nails (toenails/fingernails) were evaluated and related to total fluoride exposure. TDFI, UFE, and fluoride concentrations of biomarkers were statistically significantly higher in the high-fluoride area than in the low-fluoride area. There was a strong statistically significant positive correlation between TDFI and UFE (ρ = 0.756, p < 0.001); plasma fluoride concentration (ρ = 0.770, p < 0.001); and toenail fluoride concentration (ρ = 0.604, p < 0.001). The statistically significant positive correlation between TDFI and fingernail fluoride concentration (ρ = 470, p < 0.001) as well as between TDFI and fasting whole saliva fluoride concentration (ρ = 0.453, p = 0.001) was moderate, whereas it was weak between TDFI and hair fluoride concentration (ρ = 0.306, p = 0.027). In conclusion, the current study confirmed the suitability of 24-h urine samples for estimating fluoride exposure in children. The strong correlations between TDFI and fluoride in plasma and toenails also suggest these biomarkers may be considered for health risk assessments of fluoride in children who are susceptible to development of dental fluorosis.

The use of urinary fluoride excretion to facilitate monitoring fluoride intake: A systematic scoping review.

BACKGROUND: As a recognised effective and economical agent for dental caries prevention, fluoride has been used in many different fluoridation schemes implemented across the world. Considering the narrow 'dose-gap' between the benefit of caries reduction and the risk of dental fluorosis, it is recommended that fluoride intake is monitored by measuring urinary fluoride excretion. The aim of this scoping review is to map the current literature/evidence on fluoride intake and excretion studies in relation to the study population, settings, type of study design, methodology, and analytical approach. METHODS: Embase/Ovid, MEDLINE/Ovid, CINAHL/EBSCO, Scopus/Elsevier were searched for relevant articles until April 2018. Studies were included if they reported intake and excretion of fluoride in healthy humans of all age groups. Findings were explored using a narrative synthesis to summarise studies characteristics and outcome measures. RESULTS: Removal of duplicates from the originally 2295 identified records yielded 1093 studies of which 206 articles were included. Only 21.6% of the studies were conducted in children (<8-year-olds). Most studies (38.8%) used drinking water concentration as a proxy for fluoride intake, whereas only 11.7% measured fluoride intake from all sources. Of the 72 studies that measured dietary fluoride intake, only 10 reported the validity of the employed dietary assessment method. Only 14 studies validated the urine sample collection methods. No information on the validity of the employed analytical method was reported by the majority (64.6%) of studies. Only a small proportion (8.7%) of the included studies investigated the association between fluoride intake and excretion. CONCLUSION: The findings reveal much variability in terms of conducting the studies and reporting the findings, illustrating a high heterogeneity in data collection across settings and populations. Future studies should provide more detail on sampling technique, measurement protocols (including validation), and on clearly defining the relationship between intake and urinary excretion of fluoride.