Public Health Perspectives on Dioxin Risks: Two Decades of Evaluations

The paper provides an overview of approaches to dioxin risk assessment employed by different agencies worldwide over the past 20 years. Our insights regarding understanding of the toxicity of dioxins have advanced tremendously in recent years; however, important data gaps still exist. More information on topics such as mechanism of interaction, effects at low levels of exposure, interspecies differences, and sensitive populations is needed. Some differences exist between USEPA's approach to dioxin assessment and that of other health organizations around the world. The authors conclude that USEPA's reassessment of dioxin and related compounds may place too much confidence in the ability to accurately predict cancer risks at low doses. Further, it is important to derive health-based guidance values for noncancer end points especially in accordance with emerging reports that reproductive and developmental end points are very sensitive to dioxins. A worldwide convergence on the health assessment value being around 1 to 4?pg/kg/day is noted.     

A Food Scare a Day: Why Aren't We Better at Managing Dietary Risk?

Does the existence of food scares mean that we are bad at risk management? Not necessarily. New information brings new risks to the forefront or puts known risks into a new perspective. But in some cases food scares do indicate poor risk management. There are two key problems that explain why we are not better at managing dietary risks. The first is an imbalance of effort among the three components of risk analysis: we have Hummer risk assessment, Yugo risk management, and tricycle risk communication. The second problem is inadequate risk management. The cases of risks from mad cow disease and dioxins illustrate how the quality of risk management is affected by what we do not know well enough, what we know too well, and what we have not tried to find out. Better risk management requires a two-tier approach: (1) generate broad and shallow information on risks, health outcomes, incentives, options, benefits, and costs (Toyota Prius Hybrid risk management to be used everyday) and (2) generate narrow and in-depth information on high priority risks (Hummer risk assessment to be used sparingly).     

The Croonian Lecture 2004 risk: food, fact and fantasy

We all take risks, but most of the time we do not notice them. We are generally bad at judging the risks we take, and in the end, for some of us, this will prove fatal. Eating, like everything else in life, is not risk free. Is that next mouthful pure pleasure, or will it give you food poisoning? Will it clog your arteries as well as filling your stomach? This lecture weaves together three strands-the public understanding of science, the perception of risk and the role of science in informing government policy-as it explains how food risks are assessed and managed by government and explores the boundaries between the responsibilities of the individual and the regulator. In doing so, it draws upon the science of risk assessment as well as our attitudes to risk in relation to issues such as bovine spongiform encephalopathy, dioxins in salmon and diet and obesity.     

Rethinking Environmental Performance from a Public Health Perspective: A Comparative Industry Analysis

To date the most common measures of environmental performance used to compare industries, and by extension firms or facilities, have been quantity of pollution emitted or hazardous waste generated. Discharge information, however, does not necessarily capture potential health effects. We propose an alternative environmental performance measure that includes the public health risks of toxic air emissions extended to industry supply chains using economic input-output life-cycle assessment. Cancer risk to the U.S. population was determined by applying a damage function to the Toxic Release Inventory (TRI) as modeled by CalTOX, a multimedia multipathway fate and exposure model. Risks were then translated into social costs using cancer willingness to pay. For a baseline emissions year of 1998, 260 excess cancer cases were calculated for 116 TRI chemicals, dominated by ingestion risk from polycyclic aromatic compounds and dioxins emitted by the primary aluminum and cement industries, respectively. The direct emissions of a small number of industry sectors account for most of the U.S. population cancer risk. For the majority of industry sectors, however, cancer risk per $1 million output is associated with supply chain upstream emissions. Ranking industries by total (direct + upstream) supply chain risk per economic output leads to different conclusions about the relative hazards associated with these industries than a conventional ranking based on emissions per economic output.     

Rapporteur report: implications for exposure guidelines

There is a paucity of information regarding the long-term health effects associated with exposure to static magnetic fields. Perceptual and other acute effects have been demonstrated above a threshold of about 2 T, and these form the basis for human exposure standards at present. Exposures well above this threshold are increasingly becoming more common as the technology associated with magnetic resonance imaging advances. Therefore, priority should be given to assessing the health risks associated with exposures to such fields. Studies should include a prospective cohort study investigating cancer risks of workers and patients exposed to fields in excess of 2 T, a study investigating effects on human cognitive performance from repeated exposures, and a molecular biology study investigating acute changes in genomic responses in volunteers exposed to fields of up to 8 T. Studies investigating the effects of long-term exposure on cancer, and on neurobehavioural development are also recommended using animals, where the use of transgenic models is encouraged. In addition, dosimetric studies should be conducted using high-resolution male, female and pregnant voxel phantoms, as should theoretical studies investigating the local currents induced in the eye and in the heart by movement during exposure. Finally, studies are recommended to investigate further the ability of static magnetic fields to significantly affect radical pair reactions in biological systems.     

Misuse,perceived risk,and safety issues of household insecticides: Qualitative findings from focus groups in Arequipa,Peru

BackgroundThe current body of research on insecticide use in Peru deals primarily with application of insecticides offered through Ministry of Health-led campaigns against vector-borne disease. However, there is a gap in the literature regarding the individual use, choice and perceptions of insecticides which may influence uptake of public health-based vector control initiatives and contribute to the thousands of deaths annually from acute pesticide poisoning in Peru.MethodsResidents (n = 49) of the Alto Selva Alegre and CC districts of peri-urban Arequipa participated in seven focus group discussions (FGD). Using a FGD guide, two facilitators led the discussion and conducted a role-playing activity. this activity, participants insecticides (represented by printed photos of insecticides available locally) and pretended to “sell” the insecticides to other participants, including describing their qualities as though they were advertising the insecticide. The exercise was designed to elicit perceptions of currently available insecticides. The focus groups also included questions about participants’ preferences, use and experiences related to insecticides outside the context of this activity. Focus group content was transcribed, and qualitative data were analyzed with Atlas.ti and coded using an inductive process to generate major themes related to use and choice of insecticides, and perceived risks associated with insecticide use.ResultsThe perceived risks associated with insecticides included both short- and long-term health impacts, and safety for children emerged as a priority. However, in some cases insecticides were reportedly applied in high-risk ways including application of insecticides directly to children and bedding. Some participants attempted to reduce the risk of insecticide use with informal, potentially ineffective personal protective equipment and by timing application when household members were away. Valued insecticide characteristics, such as strength and effectiveness, were often associated with negative characteristics such as odor and health impacts. “Agropecuarios” (agricultural supply stores) were considered a trusted source of information about insecticides and their health risks.ConclusionsIt is crucial to characterize misuse and perceptions of health impacts and risks of insecticides at the local level, as well as to find common themes and patterns across populations to inform national and regional programs to prevent acute insecticide poisoning and increase community participation in insecticide-based vector control campaigns. We detected risky practices and beliefs about personal protective equipment, risk indicators, and safety levels that could inform such preventive campaigns, as well as trusted information sources such as agricultural stores for partnerships in disseminating information.     

Radon sources and impacts: a review of mining and non-mining issues

Radon is a ubiquitous natural carcinogen derived from the three primordial radionuclides of the uranium series (²³⁸U and ²³⁵U) and thorium series (²³²Th). In general, it is present at very low concentrations in the outdoor or indoor environment, but a number of scenarios can give rise to significant radiological exposures. Historically, these scenarios were not recognised, and took many centuries to understand the links between the complex behaviour of radon and progeny decay and health risks such as lung cancer. However, in concert with the rapid evolution in the related sciences of nuclear physics and radiological health in the first half of the twentieth century, a more comprehensive understanding of the links between radon, its progeny and health impacts such as lung cancer has evolved. It is clear from uranium miner studies that acute occupational exposures lead to significant increases in cancer risk, but chronic or sub-chronic exposures, such as indoor residential settings, while suggestive of health risks, still entails various uncertainties. At present, prominent groups such as the BEIR or UNSCEAR committees argue that the ‘linear no threshold’ (LNT) model is the most appropriate model for radiation exposure management, based on their detailed review and analysis of uranium miner, residential, cellular or molecular studies. The LNT model implies that any additional or excess exposure to radon and progeny increases overall risks such as lung cancer. A variety of engineering approaches are available to address radon exposure problems. Where high radon scenarios are encountered, such as uranium mining, the most cost effective approach is well-engineered ventilation systems. For residential radon problems, various options can be assessed, including building design and passive or active ventilation systems. This paper presents a very broad but thorough review of radon sources, its behaviour (especially the importance of its radioactive decay progeny), common mining and non-mining scenarios which can give rise to significant radon and progeny exposures, followed by a review of associated health impacts, culminating in typical engineering approaches to reduce exposures and rehabilitate wastes.     

Quantitative ecological risk assessment of accidental oil spills on ship routes nearby a marine national park in Brazil

Fernando de Noronha (FN) is a marine protected area off the coast of Brazil. The study of risks caused by nearby ship routes is new to authorities concerned with preserving FN. We identify nearby ship routes that cause FN to be potentially exposed to oil spills from tankers. A coral species is chosen as a bioindicator of the ecosystem's health, which aids quantitative approaches. We simulate oil leakage scenarios with pessimistic occurrence frequencies and corals' mortality in case of accident. A metapopulation coral model is integrated to quantify measures of ecological risk under the potential occurrence of accidental scenarios. The categorization of risk results according to the International Union for the Conservation of Nature quantitative criteria shows that risks are negligible. Due to the considerable uncertainty in the results, we propose a more conservative categorization of risks based not on total metapopulation extinction, but on half loss. As a result, risks were considered not acceptable. The presented methodology and results are useful in supporting authorities in their preservation efforts such as the prioritization of sources of hazard as well as selection of the best cost-effective conservation measures for maintaining good environmental health on a realistic budget, using this methodology as an exploratory tool.     

Identified and unidentified challenges for reproductive biotechnologies regarding infectious diseases in animal and public health.

The aim of the present paper is to review the known and theoretical risks for in vivo derived and in vitro produced embryos as well as for nuclear transferred or transgenic embryos in terms of animal diseases or diseases of public health consequence. For in vivo derived embryos, a considerable number of experiments and scientific investigations have resulted in recommended guidelines and procedures that ensure a high level of safety. The effectiveness of these measures has been validated by field experience with the safe transfer of several million embryos over the past three decades. In vitro produced embryos have several characteristics that differentiate them from the former, in particular a structure of the zona pellucida that results in a more frequent possible association of pathogens with the embryo. However, the guidelines prescribed by the IETS, the international standard setting body (OIE) and existing national regulatory frameworks are in place to minimize the risk of disease transmission. No specific public health risks have been identified to date with respect to in vivo or in vitro derived embryos. In regard to nuclear transferred and transgenic embryos, theoretical risks have been identified in relation to the potential effects on some intrinsic viruses such as endogenous retroviruses but very little targeted experimental work has been carried out on infectious diseases that could have adverse consequences on animal or human health. Although there has been no report of such adverse consequences associated with the limited number of animals produced to date by such reproductive technologies, a precautionary approach is warranted given the potential negative impacts and it would be prudent to restrict at this stage, the international movement of such "manipulated" embryos.     

三氯生的环境残留、降解代谢及其潜在生态风险

三氯生因具有良好的广谱抗菌性能而被广泛应用于各类洗护日化用品中.随着这些日用品被人类不断消耗,三氯生也会通过多种途径进入环境并引发一系列环境问题.环境中残留的三氯生及其代谢产物具有持久性、生物累积性和生态毒性,进而给生态系统带来一定的潜在风险,甚至会对人类健康产生不良影响.基于此,本文总结和分析了三氯生在环境介质中的残留特征及其可能发生的降解代谢过程和产物,并系统地介绍了三氯生及其代谢产物的生物有效性及其对生物体繁殖、遗传和基因等方面的毒性效应,综合分析了三氯生对生态系统和人类健康可能存在的风险,并对有关三氯生后续的研究工作提出了建议和展望.     

Ethical implications of screening asymptomatic individuals.

There has been a long-standing consensus on the principles that should guide screening asymptomatic individuals whether for treatment, counseling, or research. Advances in molecular biology will increase the rate of new opportunities for such screening. The benefits and risks, for individuals as well as the public health, will vary with each new test. As with all new technologies, these benefits and risks will have to be assessed in well-designed and well-reviewed studies if individuals are to be allowed to make informed decisions regarding whether or not to be tested.     

Compounds in urban air compete with 2,3,7,8-tetrachlorodibenzo-p-dioxin for binding to the receptor protein

Acetone extracts of filter-collected urban airborne particulate matter contain compounds which can competitively inhibit 2,3,7,8-[1,6-3H]tetrachlorodibenzo-p-dioxin (TCDD) binding to the rat liver TCDD-receptor protein. The concentration of conventional polycyclic aromatic hydrocarbons (PAHs) or chlorinated dioxins and dibenzofurans cannot account for more than 1-30% of the observed competition for [3H]TCDD binding to the receptor protein. The difference in potency between samples collected in urban areas during different periods of the year and a background sample is 25-400-fold. Collecting samples in the presence of increased concentrations of nitrogen dioxide, nitrous acid, nitric acid or ozone did not increase the amount of compounds with receptor affinity. However, with nitrogen dioxide and especially with nitric acid, a substantial increase of the mutagenic effects in the Ames Salmonella assay in the absence of mammalian activation as well as a degradation of several PAHs were noted. Affinity for the TCDD-receptor protein, mutagenicity in the absence of mammalian metabolic activation in the Ames Salmonella assay and PAH-content are characteristics of urban particulate matter showing the presence of compounds, that represent potential health risks. The compounds with affinity for the receptor may constitute a group of substances different from both conventional PAHs and direct-acting mutagens.     

The Precautionary Principle,Science and Human Health Protection

As technology advances rapidly, so do applications with potential adverse implications on human health. The possible threats include risks that can be substantial, far-reaching and irreversible, and currently available methods of investigation, designed to deal with direct exposure-disease associations, are not always suitable. Growing interest is being paid to health effects that may be the consequence of distal, “upstream” determinants. Considering the complex chain of events that links such determinants with health can be extremely difficult, and exposes severe limitations in science. Thus, there is often a mismatch between what is known and what would be required to inform rational, evidence-based decision making, which is increasingly called for. It has become apparent how production and use of scientific evidence in decision making must be accompanied by precaution, especially in those circumstances, more and more common in recent times, where there is an uncertain possibility that serious health consequences might take place. Several cautionary approaches have been proposed, but the Precautionary Principle (PP) has been the object of especially intense debate in recent years. Developed in the field of environmental health, the PP has been clarified, and has been applied or called for in several instances in public health. Although a unique definition is not available, the principle has been characterised, and criteria for its application have been proposed. However, many questions remain open on general as well as specific issues. In this paper, we address some of the questions that are relevant for the PP to support rational decision making in environment and health and more in general to strengthen its contribution towards human health protection.     

Climate change and health with an emphasis on interactions with ultraviolet radiation: a review

Climate change is increasingly recognized as a major risk to human health, and health concerns are assuming more importance in international debates on mitigation and adaptation strategies. Health consequences of climate change will occur through direct and indirect routes, and as a result of interactions with other environmental exposures. Heatwaves will become more common and are associated with higher mortality particularly in the elderly and those with pre‐existing cardiovascular and respiratory illnesses. Warmer ambient temperatures will result in more dehydration episodes and increased risks of renal disease and, through effects on pollen seasons, there may be an increase in allergic disease such as asthma and hayfever. Other adverse effects including on air quality, food safety and security and an expanding distribution of some infectious diseases, including vector‐borne diseases, are postulated. A related but separate environmental exposure is that of ultraviolet radiation (UVR). Interactions between climate change and stratospheric ozone (and the causes of ozone depletion) will cause changes to levels of ambient UVR in the future and warmer temperatures are likely to change sun exposure behaviour. Co‐occurring effects on aquatic and terrestrial ecosystems have potential consequences for food safety, quality and supply. Climate change‐related exposures are likely to affect the incidence and distribution of diseases usually considered as caused by UVR exposure; and changes in UVR exposure will modulate the climate change effects on human health. For example, in some regions warmer temperatures due to climate change will encourage more outdoor behaviour, with likely consequences for increasing skin cancer incidence. Although many of the health outcomes of both climate change and the interaction of climate change and UVR exposure are somewhat speculative, there are risks to over‐ or under‐estimations of health risks if synergistic and antagonistic effects of co‐occurring environmental changes are not considered.     

Reduction of dioxin emissions from thermal waste treatment plants: a brief survey

Since 1977 dioxins were detected in fly ashes from waste incineration plants; this class of compounds is of major importance concerning the acceptance of this technology. Extended research and development revealed in short time the main formation mechanism of dioxins, the importance of good combustion control, the influence of halogens and sulphur, and paved the way for strategies for minimisation of formation, and efficient abatement. The main steps in this development as well as the current situation are described.     

Health risk perception in Canada II: Worldviews,attitudes and opinions

In this article, we present the results of a national survey of 1500 Canadians on their attitudes and opinions about health risks. Ratings of perceived risk, sources of information on health risks and responsibility for risk management were also investigated, with findings reported separately. A high degree of concern about health risks was associated with industrial pollution and chemical products (with the exception of medicines), with almost complete agreement that the land, air and water are more contaminated than ever. In addition, there was widespread belief that a risk‐free environment was an achievable goal, and an unwillingness to accept some health risks to improve the economy. Lifestyle factors such as diet, exercise, and tobacco smoking were perceived to be important modifiers of health risk. On the other hand, many respondents endorsed the idea that they had little control over the risks to their health.     

Ethnic elders.

The numbers of elderly people from ethnic groups within Britain is rising rapidly as postwar immigrants age. Ethnic elders face problems owing to age-associated increased risks of common chronic diseases, racial discrimination, and poor access to many health services and social services. This disadvantage will be alleviated through increased understanding of health beliefs held by ethnic elders and ensuring better access to services through mechanisms such as employment of more staff from ethnic minority groups in senior positions, better training of staff, and more appropriate and sensitive environments. The myths that family care is sufficient, that no use of services implies no need, and that assimilation into the majority population will occur must be discounted.     

Potential hazards associated with the consumption of Scombridae fish: Infection and toxicity from raw material and processing

Scombridae fish (tuna, bonito and mackerel) have significant ecological and economic values. They are very appreciated by consumers worldwide for their high-quality flesh and for their high nutritional value. However, consumption of Scombridae fish is potentially hazardous. Indeed, several cases of infections and toxicity linked to the consumption of Scombridae fish as raw, or processed food products have been reported worldwide. In this review, we presented the most common health risks associated with Scombridae fish consumption. Diseases associated with the consumption of these fish are generally infectious or toxic and are caused by biological hazards, such as bacteria, viruses, parasites or chemicals hazards that enter the body through contaminated fish (polycyclic aromatic hydrocarbons, histamine) or by physical contaminants, such as heavy metals. The risks of contamination exist throughout the food chain, from primary production to the preparation of products for consumption.     

Wetlands and human health: an overview

This paper provides an introduction to the Wetlands and Human Health special issue and an overview of the papers. It identifies the disjunct that can exist between managing wetland health and human health. There is a need to resolve the potential conflict between managing wetlands for their values and managing them for positive human health outcomes. All authors have used the Ramsar definition of wetlands and the World Health Organization definition of human health. The papers (several are reviews) cover a range of wetlands and diseases from mosquito-borne to snail or pathogen vectors. Mosquito management is a common theme, illustrating, for the eastern USA, that wetland damage from the early to mid twentieth century can be ameliorated by careful restoration and, for Australia, that damage may be avoided. Constructed wetlands provide an opportunity to create ecosystem services and wetland value such that careful design and operation can minimise mosquito risks. Although the papers focus on negative health impacts of wetlands they deal with these to minimise health risks while restoring or maintaining wetland function or by exploring knowledge needs that would facilitate wise management.