Health impacts of fire smoke inhalation

Most fatalities from fires are not due to burns, but are a result of inhalation of toxic gases produced during combustion. Fire produces a complex toxic environment involving flame, heat, oxygen depletion, smoke and toxic gases. As a wide variety of synthetic materials is used in buildings (insulation, furniture, carpeting, and decorative items) the potential for severe health impacts from inhalation of products of combustion during building fires is continuously increasing. In forest fires the burning of biomass leads to smoke emissions, the composition of which, as well as the relative health impacts from their inhalation, depends on the ecosystem's chemical and physical features and the local environmental parameters. In the present review, health problems that appear to people exposed to fire smoke and especially to firefighters are described and suggestions for fire management and prevention are made.

Rice-body formation and tenosynovitis of the wrist: a case report

A 61-year-old woman presented with mild pain and swelling on the volar aspect of the wrist, hand, and little finger. Radiography showed a soft-tissue mass shadow, and magnetic resonance imaging showed acute tenosynovitis of the flexor tendons and an inflammatory mass inside the carpal tunnel. Laboratory test results were normal, except for an elevated erythrocyte sedimentation rate (40 mm/h). The patient had an ambiguous Mantoux test result but no history of mycobacterial exposure. Exhaustive investigations for rheumatic disease were negative. Surgical exploration of the lesion revealed rice bodies in the common flexor tendon synovial sheath, extending distally to the tip of the fifth finger. Removal of the rice bodies and thorough excision of the sheath was performed. The patient regained a full and painless range of motion in about 3 months. One-year follow-up revealed no underlying disorder.

Toxicological aspects of fire

Most fatalities from fires are not due to burns, but are a result of inhalation of toxic gases produced during combustion. Fire produces a complex toxic environment, involving flame, heat, oxygen depletion, smoke and toxic gases. As a wide variety of synthetic materials is used in buildings (insulation, furniture, carpeting, electric wiring covering, decorative items), the potential for poisoning from inhalation of products of combustion is continuously increasing. In the present review, the problems that are present in a fire event, the toxicology of the toxic substances and the specific chemical hazards to firefighters are described. Regulatory toxicology aspects are presented concerning the use of non-flammable building and furnishing materials to prevent fires and decrease of poisonings and deaths resulting from fires.

The toxicology of honey bee poisoning

The use of insecticides continues to be a basic tool in pest management, since there are many pest situations for which there are no known alternative management methods. However, the harmful effects of insecticides against beneficial Insects continuous to be a serious problem. Poisoning of bee pollinators is a serious adverse effect of insecticide use which leads to a decrease in insect population, to reduction of honey yields, to destruction of plant communities, to insecticide residues in food, and to a significant loss of beekeepers' income. In bee poisoning, the identification of the responsible toxicant is necessary by both environmental and biological monitoring, to prevent bee poisoning and for the protection of public health. The different aspects of bee poisoning with anticholinesterase insecticides are discussed in detail.

Occupational exposure to cholinesterase inhibiting pesticides: a Greek case

The determination of plasma or serum cholinesterase is absolute and it is considered as a reliable index of exposure in workers of organophosphorus pesticides industries. In the present study the plasma cholinesterase of 28 persons working in the packaging of an ortho-thio-phosphate was determined, before and after their exposure to this agent. The results of this study showed a plasma cholinesterase depression of 37%, a decrease which was statistically significant (P<0.001).

Lead content of fresh milk samples from different sites in Athens

Milk and dairy products constitute a major food, especially for infants and children, and relatively low levels of toxic elements can contribute significantly to dietary intakes and be hazardous for public health. The purpose of this survey was to define the levels of lead in milk samples of different origin, to establish the presence or absence of contamination. The milks from different sites of the metropolitan area of Athens contained negligible traces of lead and thus are safe for the public health.

Immunomodulative effects of aflatoxins and selenium on human natural killer cells

The possible immunomodulative effects of aflatoxin B1 and selenium (as sodium selenite) at concentrations lower than 5.10(-11) M or 0.05ppb and 10(-5) M, respectively on natural killer (NK) cells from healthy volunteers were evaluated by a 51Cr release natural killer assay. Aflatoxin B1 and selenium separately had an immunosuppressive effect on NK cell activity. When they were studied in combination, they caused a statistically significant increase of the cytotoxic activity of NK cells in the presence of the lowest concentrations of aflatoxin B1 (0.005ppb) and of sodium selenite (10(-8)M).

Analysis of total mercury in human tissues prepared by microwave decomposition using a hydride generator system coupled to an atomic absorption spectrometer

A fast and efficient procedure has been developed for the analysis of total mercury in human tissues and blood using a hydride vapor generator system coupled to an atomic absorption spectrometer (HVG-AA). Tissue and blood samples were digested in a pressurized microwave decomposition system and the digest diluted prior to formation of free mercury vapor and analysis by atomic absorption. Recovery studies performed on 10 spiked/unspiked pairs of human liver and on 10 spiked/unspiked pairs of human blood samples yielded average recoveries of 99.7% (CV=0.4%) and 101.2% (CV=0.5%), respectively. The method detection limit for liver and blood was 50 microg Hg/kg and 12.5 microg Hg/l, respectively. The "normal" concentrations of mercury in human liver and blood are 33-490 microg Hg/kg and 0.6-59 microg Hg/l, respectively [1]. This method is able to determine mercury poisoning levels and may also be applied to detect mercury near the lower levels of these "normal" ranges, using the standard addition method approach.

The importance of performing in vitro cytotoxicity testing before immunomodulation evaluation

This study uses the well known sensitive and reproducible human peripheral blood lymphocyte (PBL) assay as a model for the possible discrimination between cytotoxic and/or immunomodulative properties of 5 reference compounds: cadmium chloride (CdCl2): didodecyl-dimethyl ammonium bromide (DDAB); cyclosporin (CsA); dexamethasone (DEXA); and theophylline. Two colorimetric cytotoxicity assays were employed, the thiazolyl blue tetrazolium bromide and neutral red, and the H-thymidine DNA incorporation assay on phytohemagglutinin stimulated or non-stimulated PBL was used, as a parameter of cell mediated immunity. This study demonstrated the importance of performing colorimetric or other cytotoxicity assays before any investigation of mechanisms of action of different substances on immunomodulation and relative human risk assessment. This study showed that CdCl2 and DDAB have a cytotoxic rather than immunomodulative effect on PBL and that CsA, DEXA and to a lesser extent theophylline have immunomodulative rather than cytotoxic effects on PBL within the range of the concentrations studied.

Cytotoxic and immunomodulative effects of flunitrazepam, zipeprol and trihexyphenidyl on human peripheral blood lymphocytes

The cytotoxic effects of flunitrazepam, zipeprol and trihexyphenidyl on cell viability of peripheral blood mononuclear cells from healthy volunteers were studied at concentrations from 10(-2) to 10(-8) M by 2 colorimetric in vitro assays: the neutral red uptake assay and thiazolyl blue tetrazolium bromide assay. All tested drugs of abuse were non-cytotoxic at concentrations lower than 10(-5) M. Possible immunomodulative effects of these substances were evaluated through phytohemagglutinin induced lymphocyte proliferation ([3H]-thymidine DNA incorporation assay) and by a 51Cr release natural killer assay. The 3 drugs studied produced statistically significant immunomodulative alterations on both immunological parameters.

Delat9-tetrahydrocannabinol content in cannabis plants of greek origin

The delta9-tetrahydrocannabinol (delta9-THC) content was identified and determined quantitatively using a Gas Chromatography Detector (Gas Chromatography-Electron Ion Detector) instrument in samples of illicit herbal cannabis. Law enforcement authorities sent the samples to the Department of Forensic Medicine and Toxicology, University of Athens, for toxicological analysis. The concentrations of delta9-THC in these samples ranged from 0.08% to 4.41%. Such concentrations suggest that Greece might be at high risk, as an area for the illicit cultivation of "pedigree" cannabis plants. The forensic aspects of cannabis classification are discussed.

An unusual case of lead poisoning in an infant: nursing-associated plumbism

Lead poisoning remains a common environmental threat for children today. The majority of cases of lead poisoning are caused by oral intake of lead dust or lead-containing paint flakes and thus occur during the second and third years of life. An unusual case of severe lead poisoning in a breast-feeding infant girl is here presented; the source proved to be a nipple shield made of a lead-containing metal. Despite the severity of the intoxication, by the end of treatment and for a year afterwards the infant has been well and her psychokinetic development has been normal.

Immunomodulative effects of some drugs of abuse on human peripheral blood lymphocytes

The cytotoxic effects of opiates, cocaine and their metabolites on peripheral blood mononuclear cells from healthy volunteers, concerning cell viability, were studied in a wide range of concentrations (ranging from 10-(2) to 10-(8) M), by 2 colorimetric in vitro assays, the neutral red uptake assay and thiazolyl blue tetrazolium bromide assay. All tested drugs of abuse and their metabolites were non-cytotoxic at concentrations lower than 10-(5) M. The possible immunomodulative effects of these substances were evaluated through phytohemagglutinin-induced lymphocyte proliferation ([3H]-thymidine DNA incorporation assay) as well as by a 51Cr release natural killer assay. The results showed immunomodulative effects of all the opiates tested. Cocaine, freebase cocaine and benzoylecgonine produced a statistically non-significant decrease of phytohemagglutinin proliferation. Cocaine induced a statistically non-significant increase, whereas freebase cocaine and benzoylecgonine showed a non-significant decrease of natural killer cell activity.

The use of alcohol and other psychoactive substances by victims of traffic accidents in Greece

Alcohol is one of the main causes of traffic accidents worldwide. Its use decreases significantly the driving ability of an individual as well as the reflexes of a pedestrian increasing in this way the possibilities of their involvement in motor-vehicle accidents. The above possibilities are increased when a psychoactive substance has been taken in combination with alcohol due to their synergistic effect. The Laboratory of Forensic Medicine and Toxicology of the University of Athens is authorized to perform the toxicological investigation of traffic accidents that happen in the major part of Greece. The findings of the toxicological analyses that were performed in our laboratory during the years 1995 to 1997 are classified according to the alcohol concentration and the kind of psychoactive substance detected as well as to the gender and the age of the victims, drivers or pedestrians. The results of the above classification are evaluated and the conclusions regarding alcohol, drugs and traffic accidents in Greece are discussed thoroughly.

Testing for drugs of abuse in saliva and sweat

The detection of marijuana, cocaine, opiates, amphetamines, benzodiazepines, barbiturates, PCP, alcohol and nicotine in saliva and sweat is reviewed, with emphasis on forensic applications. The short window of detection and lower levels of drugs present compared to levels found in urine limits the applications of sweat and saliva screening for drug use determination. However, these matrices may be applicable for use in driving while intoxicated and surveying populations for illicit drug use. Although not an illicit drug, the detection of ethanol is reviewed because of its importance in driving under the influence. Only with alcohol may saliva be used to estimate blood levels and the degree of impairment because of the problems with oral contamination and drug concentrations varying depending upon how the saliva is obtained. The detection of nicotine and cotinine (from smoking tobacco) is also covered because of its use in life insurance screening and surveying for passive exposure.

Analysis and identification of zipeprol and its metabolites during drug abuse screening

Zipeprol and its two main metabolites were identified in urine samples from drug abusers. Their analytical behavior during screening procedures for drugs of abuse was examined, and their basic thin-layer chromatographic and gas chromatographic-mass spectrometric analytical parameters were determined.

Immunomodulative effects of aflatoxins and selenium on human peripheral blood lymphocytes

We investigated the antagonist immunomodulative properties of aflatoxin B1 and selenium on human peripheral blood lymphocytes by 2 colorimetric in vitro cytotoxicity assays, the neutral red uptake and the thiazolyl blue tetrazolium bromide assay. Immunotoxic properties of these substances were determined by a (3H)-thymidine DNA incorporation assay on phytohemagglutinin (PHA) stimulated and non-stimulated lymphocytes. Aflatoxin B1 and selenium, when studied separately, had an immunosuppressive effect on PHA stimulated and non-stimulated human peripheral blood lymphocytes. When they were studied together, they had an antagonistic effect on this immunological parameter.