Nanotechnology—Life-Cycle Risk Management

Scientists, risk practitioners, and regulators have debated the need to be proactive in assessing the potential health and environmental risks and benefits of unregulated nano-scale technologies. Many nanotech-based products and applications are already in use or development. Application of a proactive risk-based approach that considers the life cycle of the product, rather than a precautionary principle approach that would likely restrict the progress and advance of nanoscience, will be useful in helping to assess the unknown and unpredictable risks associated with nano-products, nanotoxicity, and nanopollution.

This article summarizes what is currently known regarding the potential toxicity and hazards of nanomaterials. A life-cycle perspective is used to identify important areas for further consideration and research. A conceptual framework is proposed for linking the strategies of life cycle and risk analysis within the same toolbox. This approach allows for prevention and treatment of a material's life-cycle risks, which can be considered in an integrated manner, thereby promoting continuous improvement, proactive risk reduction, and a flexible and adaptive approach to evaluating nanotechnology without stifling innovation.     

Pesticide Residues and Bees – A Risk Assessment

Bees are essential pollinators of many plants in natural ecosystems and agricultural crops alike. In recent years the decline and disappearance of bee species in the wild and the collapse of honey bee colonies have concerned ecologists and apiculturalists, who search for causes and solutions to this problem. Whilst biological factors such as viral diseases, mite and parasite infections are undoubtedly involved, it is also evident that pesticides applied to agricultural crops have a negative impact on bees. Most risk assessments have focused on direct acute exposure of bees to agrochemicals from spray drift. However, the large number of pesticide residues found in pollen and honey demand a thorough evaluation of all residual compounds so as to identify those of highest risk to bees. Using data from recent residue surveys and toxicity of pesticides to honey and bumble bees, a comprehensive evaluation of risks under current exposure conditions is presented here. Standard risk assessments are complemented with new approaches that take into account time-cumulative effects over time, especially with dietary exposures. Whilst overall risks appear to be low, our analysis indicates that residues of pyrethroid and neonicotinoid insecticides pose the highest risk by contact exposure of bees with contaminated pollen. However, the synergism of ergosterol inhibiting fungicides with those two classes of insecticides results in much higher risks in spite of the low prevalence of their combined residues. Risks by ingestion of contaminated pollen and honey are of some concern for systemic insecticides, particularly imidacloprid and thiamethoxam, chlorpyrifos and the mixtures of cyhalothrin and ergosterol inhibiting fungicides. More attention should be paid to specific residue mixtures that may result in synergistic toxicity to bees.     

Portuguese Physical Education Instructors’ Exposure to Noise and Perception of Associated Risk

The purpose of this study was to quantify noise exposure of professional physical education instructors in Portugal, understand how they perceive risk and the effects associated with this exposure as well as examine the existence of health complaints potentially related to the exposure to noise. Quantification of sound level exposure comprised 200 measurements of different sport activities in state schools and private health clubs. Characterization of risk perception as well as symptomatology was performed by a three-part survey that provided to a sample of 48 physical education professionals and a comparison group of 52 non-professionals. Results showed the existence of high noise levels that may endanger physical education teachers’ health. These levels are significantly higher in health clubs. Health complaints were significantly higher in the group of professionals, especially concerning hearing difficulties, muffled hearing, intolerance to loud sounds, constant headaches, and irritability. The majority of the physical education instructors are exposed to high levels of sound pressure on a daily basis, which depending on their working hours may compromise their health. This study also reveals the importance of training as well as organizational and structural measures to reduce exposure to harmful noise levels during the performance of sports activities.     

Cleaning Products,Environmental Awareness and Risk Perception in Mérida,Mexico

Cleaning products are associated with many health and environmental problems. Contamination of water resources by cleaning products is more likely to occur with septic tanks as sewage treatment systems especially in karstic terrains. We explored women’s ideas about water sources and the risk cleaning products pose to health and sewage in Mérida, a city in the Yucatán peninsula of Mexico. Women were unaware of the city’s water management system. We found a positive and statistically significant association between risk perception and environmental awareness, education level and employment status. We suggest developing education and risk communication strategies to inform residents about the hydro-geological features in the Yucatán, the vulnerability of its karstic aquifer and the health and environmental risks associated with cleaning agents.     

Type-II Myocardial Infarction – Patient Characteristics,Management and Outcomes

Background

Type-II MI is defined as myocardial infarction (MI) secondary to ischemia due to either increased oxygen demand or decreased supply. This categorization has been used for the last five years, yet, little is known about patient characteristics and clinical outcomes. In the current work we assessed the epidemiology, causes, management and outcomes of type II MI patients.

Methods

A comparative analysis was performed between patients with type-I and type-II MI who participated in two prospective national Acute Coronary Syndrome Israeli Surveys (ACSIS) performed in 2008 and 2010.

Results

The surveys included 2818 patients with acute MI of whom 127 (4.5%) had type-II MI. The main causes of type-II MI were anemia (31%), sepsis (24%), and arrhythmia (17%). Patients with type-II MI tended to be older (75.6±12 vs. 63.8±13, p<0.0001), female majority (43.3% vs. 22.3%, p<0.0001), had more frequently impaired functional level (45.7% vs. 17%, p<0.0001) and a higher GRACE risk score (150±32 vs. 110±35, p<0.0001). Patients with type-II MI were significantly less often referred for coronary interventions (36% vs. 89%, p<0.0001) and less frequently prescribed guideline-directed medical therapy. Mortality rates were substantially higher among patients with type-II MI both at thirty-day (13.6% vs. 4.9%, p<0.0001) and at one-year (23.9% vs. 8.6%, p<0.0001) follow-ups.

Conclusions

Patients with type-II compared to type-I MI have distinct demographics, increased prevalence of multiple comorbidities, a high-risk cardiovascular profile and an overall worse outcome. The complex medical condition of this cohort imposes a great therapeutic challenge and specific guidelines with recommended medical treatment and invasive strategies are warranted.     

eCOMPAGT – efficient Combination and Management of Phenotypes and Genotypes for Genetic Epidemiology

Background  

High-throughput genotyping and phenotyping projects of large epidemiological study populations require sophisticated laboratory information management systems. Most epidemiological studies include subject-related personal information, which needs to be handled with care by following data privacy protection guidelines. In addition, genotyping core facilities handling cooperative projects require a straightforward solution to monitor the status and financial resources of the different projects.     

ABO Blood Group and Dementia Risk – A Scandinavian Record-Linkage Study

Background

Dementia includes a group of neuro-degenerative disorders characterized by varying degrees of cognitive impairment. Recent data indicates that blood group AB is associated with impaired cognition in elderly patients. To date there are no large-scale studies that have examined the relationship between ABO blood group and dementia-related disorders in detail.

Methods

We used data from the SCANDAT2 database that contains information on over 1.6 million blood donors from 1968 in Sweden and 1981 from Denmark. The database was linked with health outcomes data from nationwide patient and cause of death registers to investigate the relationship between blood groups and risk of different types of dementia. The incident rate ratios were estimated using log-linear Poisson regression models.

Results

Among 1,598,294 donors followed over 24 million person-years of observation we ascertained 3,615 cases of Alzheimer’s disease, 1,842 cases of vascular dementia, and 9,091 cases of unspecified dementia. Overall, our study showed no association between ABO blood group and risk of Alzheimer’s disease, vascular dementia or unspecified dementia. This was also true when analyses were restricted to donors aged 70 years or older except for a slight, but significantly decreased risk of all dementia combined in subjects with blood group A (IRR, 0.93; 95% confidence interval [CI], 0.88-0.98), compared to those with blood group O.

Conclusions

Our results provide no evidence that ABO blood group influences the risk of dementia.     

Feral Horse Population Model and Body Condition: Useful Management Tools in Tornquist Park,Argentina?

Feral invasive mammals challenge management strategies worldwide including the feral horse (Equus caballus) population in Tornquist Park, Argentina. In this study, I constructed population matrix models using demography data collected between 1995 and 2002. I validated the models with independent counts from 2008 to 2016. I individually identified feral horses and recorded them as I walked a fixed path that covered 20 km². I performed an elasticity analysis to estimate the influence of the demographic parameters on population growth rate. In addition, I explored whether body condition score could be a proxy for carrying capacity. Model projections with the highest values of fecundity and survival exhibited by females of all ages during 1995–2002 fit the counts from 2008 to 2016, when growth rate was moderate (λ = 1.10), very well. Elasticity of adult female survival (0.54) was 4 times higher than for fecundity and survival of all other ages. Body condition of adult females at the end of winter, 2012–2013, after reductions in density, was improved compared with 2001–2002 when the population approached carrying capacity. The validated population model together with body condition score could allow managers to take more informed decisions when planning the control of feral horses in Tornquist Park. This approach could also be applied to other small, closed, feral horse populations and other large-mammal populations. © 2020 The Wildlife Society.     

Self-disclosure with Dogs: Dog Owners’ and Non-dog Owners’ Willingness to Disclose Emotional Topics

Many owners talk to their pets about a wide range of issues, but there is very little research that has considered the content of this, or its impact on owner wellbeing. Verbal disclosure brings a range of potential health benefits, yet a number of factors may prevent individuals from confiding in their partners or friends (confidants). As such, in some circumstances, dogs may provide a more favorable alternative focus for disclosure. In a survey, we assessed dog owners’ (n = 286) and non-dog owners’ (n = 64) self-reported willingness to talk to their dog (dog owners only), their partner and their confidant. We used the Emotional Self Disclosure Scale (ESDS) for non-dog owners, and an adapted version of this for dog owners: Emotional Self Disclosure Scale–Dog Owners (ESDS-DO). Both dog owners and non-dog owners demonstrated a greater willingness to disclose to their partner than a confidant. For dog owners, their dog appeared to play a similar role as their partner, with greater willingness to talk to their dog about depression, jealousy, anxiety, calmness, apathy, and fear-related emotions, compared with a confidant. When talking about jealousy and apathy, dog owners reported greater willingness to talk to their dog than their partner or a confidant, but between-group comparisons (dog owner vs non-dog owner) revealed that dog owners and non-dog owners did not significantly differ in their willingness to talk to their partner or confidant, suggesting human relationships were not negatively affected by confiding to the dog. Participant age and length of relationship with their partner did not affect disclosure patterns for dog owners or non-dog owners. Males and females showed different willingness to disclose to confidants, but not to dogs. The results have implications for considering the value of dogs for human psychological health.     

Does Litter Size Variation Affect Models of Terrestrial Carnivore Extinction Risk and Management?

Background

Individual variation in both survival and reproduction has the potential to influence extinction risk. Especially for rare or threatened species, reliable population models should adequately incorporate demographic uncertainty. Here, we focus on an important form of demographic stochasticity: variation in litter sizes. We use terrestrial carnivores as an example taxon, as they are frequently threatened or of economic importance. Since data on intraspecific litter size variation are often sparse, it is unclear what probability distribution should be used to describe the pattern of litter size variation for multiparous carnivores.

Methodology/Principal Findings

We used litter size data on 32 terrestrial carnivore species to test the fit of 12 probability distributions. The influence of these distributions on quasi-extinction probabilities and the probability of successful disease control was then examined for three canid species – the island fox Urocyon littoralis, the red fox Vulpes vulpes, and the African wild dog Lycaon pictus. Best fitting probability distributions differed among the carnivores examined. However, the discretised normal distribution provided the best fit for the majority of species, because variation among litter-sizes was often small. Importantly, however, the outcomes of demographic models were generally robust to the distribution used.

Conclusion/Significance

These results provide reassurance for those using demographic modelling for the management of less studied carnivores in which litter size variation is estimated using data from species with similar reproductive attributes.     

High Prevalence of Hepatitis E Virus in Swedish Moose – A Phylogenetic Characterization and Comparison of the Virus from Different Regions

Background

Hepatitis E virus (HEV) infects a range of species, including humans, pigs, wild boars and deer. Zoonotic transmission may contribute to the high HEV seroprevalence in the human population of many countries. A novel divergent HEV from moose (Alces alces) in Sweden was recently identified by partial genome sequencing. Since only one strain was found, its classification within the HEV family, prevalence in moose and zoonotic potential was unclear. We therefore investigated samples from 231 moose in seven Swedish counties for HEV, and sequenced a near complete moose HEV genome. Phylogenetic analysis to classify this virus within the family Hepeviridae and to explore potential host specific determinants was performed.

Methods and Findings

The HEV prevalence of moose was determined by PCR (marker for active infection) and serological assays (marker of past infection) of sera and 51 fecal samples from 231 Swedish moose. Markers of active and past infection were found in 67 (29%) animals, while 34 (15%) were positive for HEV RNA, 43 (19%) were seropositive for anti-HEV antibodies, and 10 (4%) had both markers. The number of young individuals positive for HEV RNA was larger than for older individuals, and the number of anti-HEV antibody positive individuals increased with age. The high throughput sequenced moose HEV genome was 35-60% identical to existing HEVs. Partial ORF1 sequences from 13 moose strains showed high similarity among them, forming a distinct monophyletic clade with a common ancestor to HEV genotype 1-6 group, which includes members known for zoonotic transmission.

Conclusions

This study demonstrates a high frequency of HEV in moose in Sweden, with markers of current and past infection demonstrated in 30% of the animals. Moose is thus an important animal reservoir of HEV. The phylogenetic relationship demonstrated that the moose HEV belonged to the genotype 1-6 group, which includes strains that also infect humans, and therefore may signify a potential for zoonotic transmission of this HEV.     

Maternal Smoking and the Risk of Cancer in Early Life – A Meta-Analysis

BackgroundIn spite of the well-known harmful effects on the fetus, many women continue smoking during pregnancy. Smoking as an important source of toxic chemicals may contribute to the developmental origin of diseases.ObjectivesThe aim of this work was to pursue the possible association between maternal smoking and cancer in early life. Specifically, we wanted to identify the associated early life cancer types, and to quantify the associations.MethodsIn a systematic literature search 825 articles were identified in PubMed and Web of Science, and 55 more through the reference lists. Of these 62 fulfilled the criteria for inclusion in meta-analyses. Using Mantel-Haenszel or DerSimonian and Laird method, depending on heterogeneity of the studies, pooled estimates and 95% confidence intervals for eight cancer types were calculated.ResultsSmoking during pregnancy was associated with an increased risk for for brain and central nervous system tumors (OR = 1.09; 95% CI = 1.02–1.17). Although the risk for lymphoma was also associated (OR = 1.21; 95% CI = 1.05–1.34), it did not hold up in subgroup analyses. Leukemia was not found to be associated with maternal smoking. Five other cancer types (bone, soft tissue, renal, hepatic, and germ cell cancer) were also examined, but the number of studies was too limited to exclude the possibility of maternal smoking as a risk factor for cancer in offspring.ConclusionsAccording to our meta-analyses, maternal smoking is associated with nervous system cancers, but not with leukemia in early life. Confirming or rejecting associations of maternal smoking with lymphoma and the five other cancer types requires further studies.     

Outcome after Reconstruction of the Proximal Tibia – Complications and Competing Risk Analysis

Background and Objectives

The proximal tibia (pT) is a common site for bone tumors. Improvements in imaging, chemotherapy and surgical technique made limb salvage surgery the treatment of choice. Yet, reconstructions of the pT have been associated with less favorable outcome compared to other parts of the extremities. The aim of this study was to evaluate the outcome of patients with a modular endoprosthetic reconstruction of the pT.

Methods

Eighty-one consecutive patients with an average age of 29 years underwent endoprosthetic reconstruction of the pT. Postoperative complications were categorized according to the ISOLS classification, and revision-free survival until first complication (any Type 1–5), soft tissue failure (Type 1), aseptic loosening (Type 2), structural failure (Type 3), infection (Type 4), and local tumor progression (Type 5) was estimated by using a Fine-Gray model for competing risk analyses for univariate and multivariable regression with Firth’s bias correction.

Results

A total of 45 patients (56%) had at least one complication. Cumulative incidence for complication Types 1 to 5 at 5 years with death and amputation as competing events revealed a risk of 41% for the first complication, 14% for Type 1, 16% for Type 2, 11% for Type 3, 17% for Type 4, and 1% for Type 5.

Conclusion

Despite inclusion of amputation and death as strong competing events, pT replacements are still associated with a high risk of postoperative failures. The results suggest that infection and soft tissue failures (Type 1 and 5) seem to depend from each other. Sufficient soft tissue reconstruction and closure allow better function and reduce the risk of infection as the most prominent complication. The use of a rotating hinge design has significantly reduced structural failures over time.     

Distance to High-Voltage Power Lines and Risk of Childhood Leukemia – an Analysis of Confounding by and Interaction with Other Potential Risk Factors

We investigated whether there is an interaction between distance from residence at birth to nearest power line and domestic radon and traffic-related air pollution, respectively, in relation to childhood leukemia risk. Further, we investigated whether adjusting for potential confounders alters the association between distance to nearest power line and childhood leukemia. We included 1024 cases aged <15, diagnosed with leukemia during 1968–1991, from the Danish Cancer Registry and 2048 controls randomly selected from the Danish childhood population and individually matched by gender and year of birth. We used geographical information systems to determine the distance between residence at birth and the nearest 132–400 kV overhead power line. Concentrations of domestic radon and traffic-related air pollution (NO_x at the front door) were estimated using validated models. We found a statistically significant interaction between distance to nearest power line and domestic radon regarding risk of childhood leukemia (p = 0.01) when using the median radon level as cut-off point but not when using the 75^th percentile (p = 0.90). We found no evidence of an interaction between distance to nearest power line and traffic-related air pollution (p = 0.73). We found almost no change in the estimated association between distance to power line and risk of childhood leukemia when adjusting for socioeconomic status of the municipality, urbanization, maternal age, birth order, domestic radon and traffic-related air pollution. The statistically significant interaction between distance to nearest power line and domestic radon was based on few exposed cases and controls and sensitive to the choice of exposure categorization and might, therefore, be due to chance.     

Precautionary Defaults—A New Strategy for Chemical Risk Management

In order to give adequate support to risk managers, new risk assessment methods should be developed that are (1) scientifically sound, (2) simplified, and (3) suited for precautionary risk management. In this Perspective we propose that the notion of a precautionary default can be a useful tool in the development of such methods. A precautionary default is a cautious or pessimistic assumption that is used in the absence of adequate information and that should be replaced when such information is obtained. Furthermore, we point out some promising research areas for the development of such indicators, viz. connections between chemical characteristics such as persistence and effect parameters, monitoring of contaminants in polar regions, monitoring of contaminants in breast milk, application of results from (human) toxicology in ecotoxicology and vice versa, (eco)toxicological test systems that are sensitive to effects on reproduction, and the application of bioinformatic methods to complex data, both in genomic research and in ecotoxicology. We conclude that precautionary decision-making does not require less science, but to the contrary it requires more science and improved communication between scientists and risk managers.