High levels of polybrominated diphenyl ethers in vacuum cleaner dust from California fire stations.

Firefighters are exposed to chemicals during fire events and may also experience chemical exposure in their fire stations. Dust samples from used vacuum cleaner bags were collected from 20 fire stations in California and analyzed for polybrominated diphenyl ethers (PBDEs), polycyclic aromatic hydrocarbons (PAHs), and polychlorinated biphenyls (PCBs) using gas chromatography-mass spectrometry. Median dust concentrations were higher for PBDEs (e.g., 47 000 ng/g for BDE-209) than for PAHs (e.g., 220 ng/g for benzo[a]pyrene) or PCBs (e.g., 9.3 ng/g for PCB-180). BDE-209 concentrations in dust from California fire stations were among the highest of any previously documented homes or occupational settings in the world. We examined factors such as the frequency of emergency responses, the number of fire vehicles on site, and building age, but we could not account for the high levels of BDE-209 observed in fire station dust. Based on the findings of our pilot study, we hypothesize that possible sources of BDE-209 in fire stations include contaminated ash tracked back from fire events via boots, clothing, and other equipment as well as specialized equipment treated with BDE-209, including turnout gear and fire vehicles. We suggest possible follow-up studies to confirm these hypotheses.

High exposure of California firefighters to polybrominated diphenyl ethers.

Concern about persistent organic pollutants (POPs) in Californians prompted the state's biomonitoring program to conduct a study in firefighters, who are occupationally exposed to high levels of POPs. In this work we present serum concentrations of several classes of POPs (polybrominated diphenyl ethers [PBDEs], polychlorinated biphenyls [PCBs], and organochlorine pesticides [OCPs]) in 101 Southern California firefighters. Despite recently reported declining trends of PBDEs in Californians, high levels were measured in firefighters' serum (Σ5PBDEs: median = 59.1 ng/(g of lipid); range = 18.8-714 ng/(g of lipid)) in comparison to other populations in California during the same period. In addition, nearly one-third of subjects had particularly high serum levels of decabromodiphenyl ether (BDE-209), consistent with other recent results in firefighters; this pattern may be a marker of recent firefighting activity. In contrast, serum levels of PCBs and OCPs measured in firefighters' sera were not elevated compared to U.S. levels. Multivariable analysis indicated that lower levels of serum PBDEs were associated with turnout gear cleaning and storage practices after fires. Our study supports the hypothesis that firefighting activities are likely to increase exposure to PBDEs and that good housekeeping and personal hygiene practices may reduce exposure to these compounds.

Biomonitoring in California firefighters: metals and perfluorinated chemicals.

OBJECTIVE: To assess California firefighters' blood concentrations of selected chemicals and compare with a representative US population. METHODS: We report laboratory methods and analytic results for cadmium, lead, mercury, and manganese in whole blood and 12 serum perfluorinated chemicals in a sample of 101 Southern California firefighters. RESULTS: Firefighters' blood metal concentrations were all similar to or lower than the National Health and Nutrition Examination Survey (NHANES) values, except for six participants whose mercury concentrations (range: 9.79 to 13.42 µg/L) were close to or higher than the NHANES reporting threshold of 10 µg/L. Perfluorodecanoic acid concentrations were elevated compared with NHANES and other firefighter studies. CONCLUSIONS: Perfluorodecanoic acid concentrations were three times higher in this firefighter group than in NHANES adult males. Firefighters may have unidentified sources of occupational exposure to perfluorinated chemicals.

Trends in CT scan rates in children and pregnant women: teaching, private, public and nonprofit facilities.

BACKGROUND: Radiation exposure from medical sources now equals or exceeds that from natural background sources, largely attributable to a 20-fold increase in CT use since 1980. Increasing exposure to children and fetuses is of most concern due to their heightened susceptibility. More recently, CT use may be leveling or decreasing, but it is unclear whether this change is widespread or varies by type of institution. OBJECTIVE: We sought to characterize trends in CT utilization in California hospitals and emergency departments among children and pregnant women, looking at different types of facilities, such as teaching, private, public and nonprofit institutions. MATERIALS AND METHODS: We examined frequency of CT examinations by year from 229 facilities reporting CT usage in routinely collected California statewide data for 2005-2012. We modeled trends overall and by facility type. RESULTS: CT scans for pediatric and pregnant patient visits in the emergency department increased initially, then started to decline after 2008. Among hospital admissions, rates declined or leveled after 2005. In the emergency department, CT rates varied between types of facilities, with teaching hospitals reducing use sooner and more sharply than other types of facilities. CONCLUSION: CT utilization in California among children and pregnant women has begun to level or decline. Still, population exposure remains at historically high levels, warranting consideration of potential public health implications. Further examination of reasons for trends among hospital types, particularly how teaching hospitals have reduced rates of CT utilization, may help identify strategies for CT reduction without compromising patient care.

Recreational exposure to microcystins during algal blooms in two California lakes.

We conducted a study of recreational exposure to microcystins among 81 children and adults planning recreational activities on either of three California reservoirs, two with significant, ongoing blooms of toxin-producing cyanobacteria, including Microcystis aeruginosa (Bloom Lakes), and one without a toxin-producing algal bloom (Control Lake). We analyzed water samples for algal taxonomy, microcystin concentrations, and potential respiratory viruses (adenoviruses and enteroviruses). We measured microcystins in personal air samples, nasal swabs, and blood samples. We interviewed study participants for demographic and health symptoms information. We found highly variable microcystin concentrations in Bloom Lakes (<10 microg/L to >500 microg/L); microcystin was not detected in the Control Lake. We did not detect adenoviruses or enteroviruses in any of the lakes. Low microcystin concentrations were found in personal air samples (<0.1 ng/m(3) [limit of detection]-2.89 ng/m(3)) and nasal swabs (<0.1 ng [limit of detection]-5 ng). Microcystin concentrations in the water-soluble fraction of all plasma samples were below the limit of detection (1.0 microg/L). Our findings indicate that recreational activities in water bodies that experience toxin-producing cyanobacterial blooms can generate aerosolized cyanotoxins, making inhalation a potential route of exposure. Future studies should include collecting nasal swabs to assess upper respiratory tract deposition of toxin-containing aerosols droplets.