'Halophyte filters': the potential of constructed wetlands for application in saline aquaculture.

World consumption of seafood continues to rise, but the seas and oceans are already over-exploited. Land-based (saline) aquaculture may offer a sustainable way to meet the growing demand for fish and shellfish. A major problem of aquaculture is nutrient waste, as most of the nutrients added through feed are released into the environment in dissolved form. Wetlands are nature's water purifiers. Constructed wetlands are commonly used to treat contaminated freshwater effluent. Experience with saline systems is more limited. This paper explores the potential of constructed saline wetlands for treating the nutrient-rich discharge from land-based saline aquaculture systems. The primary function of constructed wetlands is water purification, but other ancillary benefits can also be incorporated into treatment wetland designs. Marsh vegetation enhances landscape beauty and plant diversity, and wetlands may offer habitat for fauna and recreational areas. Various approaches can be taken in utilizing plants (halophytes, macro-algae, micro-algae) in the treatment of saline aquaculture effluent. Their strengths and weaknesses are reviewed here, and a conceptual framework is presented that takes into account economic and ecological benefits as well as spatial constraints. Use of the framework is demonstrated for assessing various saline aquaculture systems in the southwestern delta region of the Netherlands.

Effects of an anionic surfactant (FFD-6) on the energy and information flow between a primary producer (Scenedesmus obliquus) and a consumer (Daphnia magna).

The effects of a commercially available anionic surfactant solution (FFD-6) on growth and morphology of a common green alga (Scenedesmus obliquus) and on survival and clearance rates of the water flea Daphnia magna were studied. The surfactant-solution elicited a morphological response (formation of colonies) in Scenedesmus at concentrations of 10-100 µl l(-1) that were far below the No Observed Effect Concentration (NOEC) value of 1,000 µl l(-1) for growth inhibition. The NOEC-value of FFD-6 for colony-induction was 3 µl l(-1). Daphnia survival was strongly affected by FFD-6, yielding LC(50-24h) and LC(50-48 h) of 148 and 26 µl l(-1), respectively. In addition, clearance rates of Daphnia feeding on unicellular Scenedesmus were inhibited by FFD-6, yielding a 50% inhibition (EC(50-1.5h)) at 5.2 µl l(-1) with a NOEC of 0.5 µl l(-1). When Daphnia were offered FFD-6-induced food in which eight-celled colonies (43 × 29 µm) were most abundant, clearance rates (~0.14 ml ind.(-1) h(-1)) were only 25% the rates of animals that were offered non-induced unicellular (15 × 5 µm) Scenedesmus (~0.56 ml ind.(-1) h(-1)). As FFD-6 concentrations in the treated food used in the experiments were far below the NOEC for clearance rate inhibition, it is concluded that the feeding rate depression was caused by the altered morphology of the Scenedesmus moving them out of the feeding window of the daphnids. The surfactant evoked a response in Scenedesmus that is similar to the natural chemically induced defensive reaction against grazers and could disrupt the natural information conveyance between these plankton organisms.

Ecological vulnerability in risk assessment--a review and perspectives.

This paper reviews the application of ecological vulnerability analysis in risk assessment and describes new developments in methodology. For generic non-site-specific assessments (e.g. for the requirements of most European directives on dangerous chemicals) risk is characterised just on the basis of the ratio between an effect indicator and an exposure indicator. However, when the actual risk for a specific ecosystem is desired, the concept of ecological vulnerability may be more appropriate. This calls for a change in thinking, from sensitivity at the organism level to vulnerability at higher organization levels, and thus forms the link from laboratory toxicology to field effects at population, community or ecosystem level. To do so, biological and ecological characteristics of the ecosystems under concern are needed to estimate the ecological vulnerability. In this review we describe different vulnerability analysis methods developed for populations (of a single species), communities (consisting of different populations of species) and ecosystems (community and habitat combined). We also give some examples of methods developed for socio-ecological systems. Aspects that all methods share are the use of expert judgment, the input of stakeholders, ranking and mapping of the results, and the qualitative nature of the results. A new general framework is presented to guide future ecological vulnerability analysis. This framework can be used as part of ecological risk assessment, but also in risk management. We conclude that the further quantification of ecological vulnerability is a valuable contribution to vulnerability assessment.

Seasonal variation of total and biochemically available concentrations of PAHs in a floodplain lake sediment has no effect on the benthic invertebrate community.

Floodplain areas in the Netherlands are moderately to heavily contaminated with trace metals and organic contaminants. The impact of this sediment pollution on benthic invertebrates is best described with so-called 'bioavailable' concentrations instead of total concentrations. Studies into the effect of contaminants on biota are usually a snapshot in time, with one or two samples in a year. In such studies, effect of seasonal variation cannot be detected. Objective of this study was to investigate the temporal variation of sediment PAH contamination in one floodplain lake, and possible consequences for the benthic invertebrate community. This was done by sampling biota, abiotic variables and sediment contaminants every four weeks during one year. We observed a limited seasonal variation in total and bioavailable concentrations of PAHs. Multivariate analysis revealed that the PAH contamination is not a significant factor for the benthic invertebrate community in this floodplain lake. Bioavailable concentrations of PAHs were low and no effects could be expected based on the measured values. No increase of available PAHs was observed in periods where conditions for degradation were absent (low temperature, anaerobic). These results also indicate that in such floodplain lake systems, with historical pollution, the timing of sampling to assess sediment contamination with organic pollutants is of limited importance. This can be useful for planning sampling in risk assessment studies.

Sampling method, storage and pretreatment of sediment affect AVS concentrations with consequences for bioassay responses.

Sediment treatment and sediment storage may alter sediment toxicity, and consequently biotic response. Purpose of our study was to combine these three aspects (treatment-toxicity-biotic response) in one integrated approach. We used Acid Volatile Sulfide (AVS) concentrations as a proxy of the disturbance of the sediment. AVS and Simultaneously Extracted Metal (SEM) concentrations were compared to bioassay responses with the freshwater benthic macroinvertebrate Asellus aquaticus. Storage conditions and sediment treatment affected AVS but not SEM levels. AVS can be used as a proxy for sediment disturbance. The best way to pretreat the sediment for use in a bioassay in order to maintain initial AVS conditions was to sample the sediment with an Ekman grab, immediately store it in a jar without headspace, and freeze it as soon as possible. In a survey using seven different sediments, bioassay responses of A. aquaticus were correlated with SEM and AVS characteristics.

Behavioural responses of Gammarus pulex (Crustacea, Amphipoda) to low concentrations of pharmaceuticals.

The continuous discharge of pharmaceuticals and personal care products into the environment results in a chronic exposure of aquatic organisms to these substances and their metabolites. As concentrations in surface waters are in the ng/L range, and sometimes in the low microg/L range, they are not likely to result in lethal toxicity. However, prolonged exposure to low concentrations of anthropogenic chemicals may lead to sublethal effects, including changes in behaviour. The aim of this study was to assess the effect of three pharmaceuticals, the antidepressant fluoxetine, the analgesic ibuprofen and the anti-epileptic carbamazepine, and one cationic surfactant, cetyltrimethylammonium bromide (CTAB), on the activity of the benthic invertebrate Gammarus pulex (Crustacea: Amphipoda: Gammaridae). We used the multispecies freshwater biomonitor to assess changes in activity of G. pulex in a quantitative manner. Exposure to low concentrations (10-100ng/L) of fluoxetine and ibuprofen resulted in a significant decrease in activity, whereas the activity of G. pulex at higher concentrations (1microg/L-1mg/L) was similar to the control. Response to carbamazepine showed a similar pattern, however, differences were not significant. The tested surfactant CTAB evoked a decrease in activity at increasing concentration. These behavioural effect concentrations were 10(4) to 10(7) times lower than previously reported LOECs and in the range of environmentally occurring concentrations. The potential consequences of this decreased activity for G. pulex population growth and benthic community structure and the exposure to mixtures of pharmaceuticals deserves further attention.

Tuberculosis infection in children who are contacts of immigrant tuberculosis patients.

The present study aimed to determine what proportion of children who are in close contact with immigrant tuberculosis (TB) patients are infected with Mycobacterium tuberculosis. For 1.5 yrs, 14 municipal health services in The Netherlands collected data from all non-Dutch TB patients and their contacts. Close contacts aged < 16 yrs received a tuberculin skin test (TST). A positive TST was defined as an induration of > or = 10 mm among nonvaccinated children, and > or = 16 mm among bacille Calmette-Guérin-vaccinated children. In total, 244 patients had 359 close contacts aged < 16 yrs. Nine out of the 359 (2.5%) had TB. A TST test was given to 298 out of the 359 (83%). Of the 115 contacts of 44 extrapulmonary TB patients, three (3%) had a positive TST. Of the 186 contacts of 58 positive pulmonary TB patients, 30 (16%) had a positive TST. Contacts of sputum smear-positive patients significantly more often had a positive TST (25%), compared with the contacts of sputum smear-negative patients (7%). Children born abroad significantly more often had a positive TST (20%) than children born in The Netherlands (5%). In conclusion, the prevalence of active tuberculosis and latent tuberculosis infection among children who are close contacts of immigrant tuberculosis patients is high and warrants an expansion of contact investigation.

Contaminated sediments and bioassay responses of three macroinvertebrates, the midge larva Chironomus riparius, the water louse Asellus aquaticus and the mayfly nymph Ephoron virgo.

Bioassays are widely used to estimate ecological risks of contaminated sediments. We compared the results of three whole sediment bioassays, using the midge larva Chironomus riparius, the water louse Asellus aquaticus, and the mayfly nymph Ephoron virgo. We used sediments from sixteen locations in the Dutch Rhine-Meuse Delta that differed in level of contamination. Previously developed protocols for each bioassay were followed, which differed in sediment pretreatment, replication, and food availability. The Chironomus bioassay was conducted in situ, whereas the other two were conducted in the laboratory. The measured endpoints, survival and growth, were related to contaminant levels in the sediment and to food quantity in water and sediment. Only the response of A. aquaticus in the bioassay was correlated with sediment contamination. Food availability in overlying water was much more important for C. riparius and E. virgo, thereby masking potential sediment contaminant effects. We conclude that growth of A. aquaticus was depressed by sediment contamination, whereas growth of E. virgo and C. riparius was stimulated by seston food quantity. We discuss that the trophic state of the ecosystem largely affects the ecological risks of contaminated sediments.

Interferon-alpha does not improve the antineoplastic efficacy of high-dose infusional 5-fluorouracil plus folinic acid in advanced colorectal cancer. First results of a randomized multicenter study by the Association of Medical Oncology of the German Cancer Society (AIO).

BACKGROUND: High-dose 5-FU given weekly as a 24-h infusion in combination with folinic acid (FA) has been associated with low toxicity and a high response rate. Interferon-alpha (IFN) either alone or in combination with FA has also improved treatment results by modulating 5-FU activity. We therefore initiated a randomized multicenter trial comparing the ability of FA or IFN to modulate infusional 5-FU. The statistical design using a sequential analysis allows us to report on the comparison of 5-FU/FA vs. 5-FU/FA/IFN while randomization of patients into 5-FU/FA vs. 5 FU/IFN continues. METHODS: Chemotherapy-naive patients with advanced progressive colorectal cancer and measurable metastatic lesions were randomized to receive 5-FU 2600 mg/m2 i.v. as a 24-h infusion, combined with either FA 500 mg/m2 as a 2-h infusion (A), or IFN 3 x 10(6) U s.c. 3 x/week (B), or the combination of FA plus IFN as in arms A and B (C). Treatment arms were repeated weekly for 6 weeks followed by a 2-week rest period. These 8-week cycles were administered until tumor progression. Because of the occurrence of 2 toxic deaths among the first 17 patients treated in arm C, 5-FU was reduced to 2000 mg/m2 for all patients in arm C. Sequential analysis according to Whitehead for objective response was planned with alpha = 0.05/3 and a power of 80% (beta = 0.2) to detect a difference of > or = 25% (delta = 0.25) or equivalence of response rates. For pairwise comparison of treatment arms a minimum of 30 patients per arm and a maximum of 90 patients per arm were expected in case of equivalence or difference. RESULTS: An interim analysis was performed after the first 93 of 149 randomized patients were evaluable for response and toxicity (A 31 pts, B 33 pts, C 29 pts). Despite the 5-FU dose reduction in arm C, 28% of patients experienced grade 3/4 toxicity (CTC) including diarrhea, mucositis and handfoot syndrome compared to 16% in arm A and 12% in arm B (not significant). No treatment related toxic death occurred in arms A or B, but 3 patients (10%) in arm C died of diarrhea and septicemia. Among patients treated with 5-FU/FA objective tumor response occurred in 12/31 patients (39%) (21%-56%, 95% confidence interval) (3 CR, 9 PR), no change in 13/31 (42%) and PD in 6/31 (19%) patients. Eleven of 29 patients (38%) (20%-56%, 95% confidence interval) receiving 5-FU/FA/IFN achieved complete (3 patients) or partial (8 patients) remissions, 10/29 patients (34%) had stable disease and 8/29 patients (28%) tumor progression. According to the sequential analysis the rates of objective responses observed in patients treated with 5-FU/FA or 5-FU/FA/IFN were equivalent. CONCLUSION: This interim analysis allows the conclusion that infusional 5-FU plus FA/IFN is no more active than infusional 5-FU plus FA alone. However, 5-FU/FA/IFN despite 5-FU dose reduction was associated with unacceptably high toxicity, including 10% deaths. Therefore, further investigation of this regimen is not justified. The study is continued with the comparison of 5-FU/FA vs. 5-FU/IFN.

Mortality rates in a female cohort following asbestos exposure in Germany.

A cohort study was conducted of 616 German female workers with a history of exposure to asbestos. Standardized proportionate mortality analysis was done except for mesothelioma, for which proportionate mortality was computed based on best evident cause of death. Mortality from lung cancer was increased three times over expected value. Death rates due to mesothelioma were 340 times higher than in the general population. Female mortality rates surpassed those observed in men twofold for lung cancer and fourfold for mesothelioma. In comparison with published data from international cohort studies, the observed mortality for mesothelioma in our female cohort appeared higher than that previously reported. German women with a history of asbestos exposure are considered a high-risk group for developing mesothelioma and lung cancer. They should be a target group for intervention strategies (eg, chemoprevention, smoking cessation, early cancer detection).

Occupational dust exposure and chronic obstructive pulmonary disease. A systematic overview of the evidence.

The object of this study was to assess the relationship between occupational dust exposure and chronic obstructive pulmonary disease (COPD). Studies were identified using MEDLINE (January 1966 to July 1991), SCISEARCH, manual review of reference lists, and personal contact with more than 30 international experts. Studies of COPD, lung function, emphysema, chronic bronchitis, or mortality in workers exposed to nonorganic dust were retrieved. Studies were included if dust exposure was measured quantitatively, and a quantitative relationship between dust exposure and one of the outcomes of interest was calculated while controlling at least for smoking and age. Methodological rigor was assessed, and data regarding the study populations, prognostic factors, and outcomes were extracted independently by two reviewers. Thirteen reports derived from four cohorts of workers met our inclusion criteria. Three of the cohorts were of coal miners and one was of gold miners. All of the studies found a statistically significant association between loss of lung function and cumulative respirable dust exposure. It was estimated that 80 (95% CI, 34 to 137) of 1,000 nonsmoking coal miners with a cumulative respirable dust exposure of 122.5 gh/m3 (considered equivalent to 35 years of work with a mean respirable dust level of 2 mg/m3) could be expected to develop a clinically important (> 20%) loss of FEV1 attributable to dust. Among 1,000 smoking miners the comparable estimate was 66 (95% CI, 49 to 84). The risk of a clinically important loss of lung function attributable to dust among nonsmoking gold miners was estimated to be three times as large as for coal miners at less than one fifth of the cumulative respirable dust exposure (21.3 gh/m3), the maximal exposure observed among the cohort of gold miners. We conclude that occupational dust is an important cause of COPD, and the risk appears to be greater for gold miners than for coal miners. One possible explanation of the greater risk among gold miners is the higher silica content in gold mine dust.

The validation of cervical cytology. Sensitivity, specificity and predictive values.

Statistics and methods for the validation of the results of cytologic screening for cervical cancer and its precursors were examined. Many of the methods commonly used, including the calculation of sensitivity and specificity on raw data, contain flaws that undermine their conclusions. Using a large computerized database of 748,871 cytologic screenings of 277,842 women over a ten-year period, the value of screening was examined. Only subsequent histologic examinations within one year were accepted to validate positive initial cytologic diagnoses; only two subsequent cytologic screenings within the next three years were accepted to validate negative initial cytologic diagnoses that had not been followed by a histologic examination. Cases not meeting these criteria were excluded from the initial analysis. From these data, the predictive value of a negative cytologic examination was determined to be 99.8%; the predictive value of a positive cytologic examination was 73.4% for an initial diagnosis of mild-to-moderate dysplasia, 90.6% for a diagnosis of severe dysplasia/carcinoma in situ, 94.5% for a diagnosis of carcinoma in situ or microinvasive carcinoma and 95.5% for an initial diagnosis of invasive carcinoma. Cases with an initial "questionable" cytologic diagnosis had a positive predictive value of only 64.0%. Extrapolation from the validated cases to the entire screened population showed an overall sensitivity of 80% and a specificity of 99.4% for cytologic screening for cervical cancer. The sensitivity was slightly lower for mild and moderate dysplasia (78.1%) and slightly higher for carcinoma in situ and severe dysplasia (81.4%) and invasive carcinoma (82.3%).

A multicentre mortality study of workers exposed to ethylene oxide.

A multicentre cohort study was carried out to study the possible association between exposure to ethylene oxide and cancer mortality. The cohort consisted of 2658 men from eight chemical plants of six chemical companies in the Federal Republic of Germany who had been exposed to ethylene oxide for at least one year between 1928 and 1981. The number of subjects in the separate plants varied from 98 to 604. By the closing date of the study (31 December 1982) 268 had died, 68 from malignant neoplasms. For 63 employees who had left the plant (2.4%) the vital status remained unknown. The standardised mortality ratio for all causes of death was 0.87 and for all malignancies 0.97 compared with national rates. When local state rates were used the SMRs were slightly lower. Two deaths from leukaemia were observed compared with 2.35 expected (SMR = 0.85). SMRs for carcinoma of the oesophagus (2.0) and carcinoma of the stomach (1.38) were raised but not significantly. In one plant an internal "control group" was selected matched for age, sex, and date of entry into the factory and compared with the exposed group. In both groups a "healthy worker effect" was observed. The total mortality and mortality from malignant neoplasms was higher in the exposed than in the control group; the differences were not statistically significant. There were no deaths from leukaemia in the exposed group and one in the control group.

[Occupational cancer study of asbestos: possibilities and limits of epidemiologic studies on the causes of death in West Germany]. / Berufskrebsstudie Asbest: Möglichkeiten und Grenzen epidemiologischer Todesursachenforschung in der Bundesrepublik Deutschland.

The study is based on 3990 men and women exposed to asbestos dust for at least three years at their place of work, and prospectively and epidemiologically examined since 1 January, 1977. By 31 December, 1983, 336 had been registered as having died. Calculation of standard mortality rates indicates that the incidence of malignant tumour as cause of death was much higher than in the general population of the FRG, that of fatal mesothelioma about 100 times as high. Standard mortality rate for lung cancer was increased by 48% and 175%, respectively, depending on whether exposure to asbestos dust had ended after (subgroup I) or before (subgroup II) 1 January, 1972. Proportional mortality rate of 43% of tumours at all locations, with about 14% lung cancer and about 9% fatal mesothelioma cases in subgroup II, approaches the internationally recognized frequency of asbestos-associated tumours.

Mortality rates in the Federal Republic of Germany following previous occupational exposure to asbestos dust.

In 1972, a procedure was introduced by the Industrial Injuries Insurance Institutes (Berufsgenossenschaften) of the Federal Republic of Germany, which is to be used by the special occupational health service for employees exposed to asbestos dust. Since 1 January 1972, occupational health examinations are performed when exposure to asbestos dust has been of at least 3 years' duration. On 1 January 1977, a prospective cohort study was started with employees formerly exposed to asbestos dust whilst working for companies manufacturing or using asbestos. Data on these persons are collected in the Central Register of Employees Exposed to Asbestos Dust of the Industrial Injuries Insurance Institutes. A total of 3,070 male and female employees in whom asbestos exposure terminated after 1 January 1972 formed subcohort I of the study. For comparison, 665 persons whose exposure terminated before 1 January 1972 served as subcohort II. In addition to several other inclusion criteria, each individual's permission was required before personal data could be evaluated. Of the subjects in the two subcohorts, 185 and 71, respectively, had died by 31 December 1982. Tumours were more frequently than this cause of death is expected in the general population. In addition to a high incidence of mesothelioma, the standard mortality rate was especially increased for lung cancer. The proportional mortality rates of about 40% for tumours of all sites (with about 17% lung cancer and 8% mesothelioma) especially in subcohort II, seemed to be comparable to the international figures for epidemiological mortality.

The effect of various interventions during a typhoid epidemic. Results of a simulation study.

This paper presents an epidemiological model for typhoid fever epidemics or paratyphoid diseases with an enteric course, as well as a deterministic approach for the quantitative representation of this model. The model has been tested against one typhoid and two paratyphoid epidemics which occurred in the Federal Republic of Germany. It was possible to simulate the course of these epidemics with sufficient precision, and to obtain information on the effects of various interventions (e.g. oral vaccination or hygiene measures).

Asbestos-related diseases in the Federal Republic of Germany.

Until recently, in the Federal Republic of Germany there has been a lack of epidemiological data on asbestos-related tumors. Only the numbers of occupational diseases accepted for compensation by the German industrial injuries insurance institutes (Berufsgenossenschaften) can be stated. These show, for 1979, 94 cases of asbestosis, 21 cases of asbestosis associated with lung cancer, and 34 cases of mesothelioma. Since 1972 employees exposed to asbestos dust have been included in a central register by the industrial injuries insurance institutes and are medically examined periodically. By December 31, 1979, 28,476 persons were registered. Of those, 6,582 were still being followed medically, although they were no longer working with asbestos dust exposure. In January 1, 1977, a prospective epidemiological study was started with these people who were formerly exposed to asbestos dust. Up to December 31, 1980, altogether 2,944 people were enrolled in the study. Besides several other enrollment criteria, the individual's permission was required to evaluate his personal data. Of the people enrolled, 85 had died by December 31, 1980. Even if five questionable cases of lung cancer are excluded (n = 80), the observed rates of about 43% tumours of all sites, with 15% lung cancer and 6% mesothelioma, seem to be comparable to the international epidemiological mortality pattern.