Chemical exposures at hazardous waste sites: Experiences from the United States and Poland.

The U.S. Agency for Toxic Substances and Disease Registry (ATSDR) and the Polish Nofer Institute of Occupational Health collaborate on issues related to hazardous chemical exposure at or near hazardous waste sites. This paper outlines the scope of hazardous chemical exposure in the United States and in Poland and identifies priority chemicals and chemical mixtures. Special attention is paid to exposures to metals and to evaluation of the health risks associated with those exposures. Studies in the United States indicate that exposure to hazardous waste site chemicals may be associated with an increased risk of adverse developmental - specifically cardiovascular and neurodevelopmental - effects.

Environmental exposure and birth outcomes.

The influence of environmental hazards on the health of children is one of the major current concerns in environmental health. Scientific investigations are now focusing on identifying and understanding the role of environmental hazards in the development of birth outcomes that result from in utero exposure to environmental contaminants. This paper reviews the published literature with provided evidence concerning the impact of environmental exposures to chemicals on the incidence of birth outcomes in the areas of environmental pollution originating from various sources. In spite of methodological limitations in a number of reviewed studies, the present body of knowledge calls for a precautionary approach and for preventive measures in order to reduce the risk of environmental exposures to chemicals with a recognized or suspected potential to cause birth outcomes.

Occupational exposure to organic dust associated with municipal waste collection and management.

The aim of the study was to assess the occupational exposure of workers employed in the municipal waste collection and management industry. Air samples were collected in the workers' breathing zone; two samples were collected parallely. The assessment concerned exposure to organic dust, endotoxins, bacteria and fungi. The questionnaire data showed that workers found themselves in good or very good health. They also regarded noise, dustiness, odor, physical effort and changeable atmospheric conditions as the most strenuous factors. The highest dust concentrations were observed on the sites of waste collection (mean, 7.7 mg/m3) and composting (mean, 4.6 mg/m3). Samples collected on the composting site contained the largest amount of endotoxins (mean concentration, 76 ng/m3). This was followed by sorting facility (61 ng/m3) and waste collection area (36 ng/n3). Gram-negative rods (primarily intestinal) were found in all samples collected at workposts, which justified the adoption of the air concentrations of endotoxins as a criterion for assessing their hygienic conditions. Taking MAC for total suspended dust (4.0 mg/m3) and the concentration of 10 ng/m3 for endotoxin as the criteria for the exposure evaluation, it must be considered that waste collectors and composting site workers are working in poor hygienic conditions. Workers employed at the most hazardous workposts did not use personal protective equipment (glasses, antirespirators), thus infringing a fundamental condition for limiting health hazards (Directive 2000/54/EC).

Risk assessment of chemicals -- the role of epidemiological methods.

OBJECTIVES: The paper discusses methodological approaches in the evaluation of epidemiological data for health risk assessment. METHODS: The discussion is based on the overviews of epidemiological evidence for health hazard characterisation from primary and multiple studies and for health impact assessment. RESULTS: Evaluation of the epidemiological evidence requires a systematic review of relevant studies with the aim of achieving transparency with regard to applied methods and procedures, avoidance of bias and validity of conclusions. Epidemiological studies are useful for health hazard characterisation if they provide estimates for exposure-response relationships. Epidemiological evidence plays a key role in health impact assessment of complex causes such as industrial emissions or urban traffic. The WHO Expert Group identified ten major steps in the quantification of the health impact assessment. CONCLUSIONS: There is a continuous need that future epidemiological studies should seek, where possible, to provide results that enhance the health impact assessment at the interface of epidemiology, other fields of research, and decision making.

The Spanish toxic oil syndrome 20 years after its onset: a multidisciplinary review of scientific knowledge.

In 1981, in Spain, the ingestion of an oil fraudulently sold as olive oil caused an outbreak of a previously unrecorded condition, later known as toxic oil syndrome (TOS), clinically characterized by intense incapacitating myalgias, marked peripheral eosinophilia, and pulmonary infiltrates. Of the 20,000 persons affected, approximately 300 died shortly after the onset of the disease and a larger number developed chronic disease. For more than 15 years, a scientific committee supported by the World Health Organization's Regional Office for Europe and by the Institute of Health Carlos III in Madrid has guided investigation intended to identify the causal agent(s), to assess toxicity and mode of action, to establish the pathogenesis of the disease, and to detect late consequences. This report summarizes advances in research on this front. No late mortality excess has been detected. Among survivors, the prevalence of some chronic conditions (e.g., sclerodermia, neurologic changes) is high. Attempts to reproduce the condition in laboratory animals have been unsuccessful, and no condition similar to TOS has been reported in the scientific literature. Laboratory findings suggest an autoimmune mechanism for TOS, such as high levels of seric soluble interleukin-2 receptor. Epidemiologic studies integrated with chemical analyses of case-related oils have shown that the disease is strongly associated with the consumption of oils containing fatty acid esters of 3-(N-phenylamino)-1,2-propanediol (PAP). These chemicals have also been found in oils synthesized under conditions simulating those hypothesized to have occurred when the toxic oil was produced in 1981. Whether PAP esters are simply markers of toxicity of oils or have the capability to induce the disease remains to be elucidated.