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Herrero M, Rovira J, Esplugas R, Nadal M, Domingo JL. Human exposure to trace elements, aromatic amines and formaldehyde in swimsuits: Assessment of the health risks. ENVIRONMENTAL RESEARCH 2020; 181:108951. [PMID: 31784079 DOI: 10.1016/j.envres.2019.108951] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/19/2019] [Accepted: 11/19/2019] [Indexed: 06/10/2023]
Abstract
Nowadays, most of the swimsuits are mainly made of artificial fibres, which have interesting properties such as water repellence and fast drying. Swimsuits contain a wide range of additives, which can mean a hazard for the environment and/or human health. In this study, the concentrations of formaldehyde (free and water soluble), 24 aromatic amines, and 28 trace elements (Ag, Al, As, B, Ba, Be, Bi, Cd, Co, Cr, Cu, Fe, Hg, Mg, Mn, Mo, Ni, Pb, Sb, Sc, Se, Sm, Sr, Sn, Tl, Ti, V and Zn) were analysed in 39 swimsuits covering a wide range of materials, colours and brands. Dermal exposure and health risks were assessed for adults (men and women) aged > 18 years old, babies between 2 and < 3 years old, children (boys and girls) between 3 and < 6 years old and 6 and < 11 years old, and teenagers (boys and girls) between 11 and < 16 years old, wearing swimsuits for 4 h or 8 h. Formaldehyde and aromatic amines were below their respective detection limits in all samples (<16 and < 1.5 mg/kg, respectively). Regarding trace elements, Ti showed the highest mean levels (1844 mg/kg), being significantly higher in polyamide (3759 mg/kg) than in polyester (24.1 mg/kg) swimsuits. These high Ti levels were confirmed by environmental scanning electron microscope in a single sample made of polyamide. Increased concentrations of Cr were also observed, but only in polyamide black fabrics, with values ranging from 624 to 932 mg/kg. Non-cancer risks (hazard quotients) derived from the exposure to trace elements were in a safe zone for all analysed trace elements. Furthermore, the carcinogenic risks were evaluated for As, Cr and Pb, exhibiting values below the 10-5 threshold, with the exception of Cr in babies and children-girls. For Ti, health risks could not be calculated due to the lack of information on toxicological data. However, because Ti was the element with the highest concentrations in swimsuits, and taking into account the potential toxicity of TiO2 nanoparticles, further research is needed to assess the migration of this element from fibres to skin.
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Wang T, Rovira J, Sierra J, Chen SJ, Mai BX, Schuhmacher M, Domingo JL. Characterization and risk assessment of total suspended particles (TSP) and fine particles (PM 2.5) in a rural transformational e-waste recycling region of Southern China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 692:432-440. [PMID: 31351287 DOI: 10.1016/j.scitotenv.2019.07.271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/17/2019] [Accepted: 07/17/2019] [Indexed: 06/10/2023]
Abstract
In 2016, total suspended particles (TSP) and fine particles (PM2.5) were collected near four e-waste recycling parks in a region of Southern China. TSP and PM2.5 levels and composition around these industrial activities were determined and the potential risks for human health due to the exposure to toxic elements contained on fine particles (PM2.5) were evaluated. Levels of TSP and PM2.5 were lower with advanced recycling methods than with small recycling e-waste workshops operating in the sampling region. The main trace elements in particles were Cu, Pb, and Ti, the same as those detected before the transition to advanced dismantling methods in e-waste recycling. Significantly higher levels of Cu, Pb, Sn, Te, Tl and NH4+ in TSP and Cu and Te in PM2.5 were found in e-waste recycling areas than in BG site. Taking Cu as the indicative element emitted from e-waste recycling activities, significant high positive correlations between Cu and W, and Cu and Te were found. These elements are present and can be released from electrical and electronical components during e-waste recycling processes. Exposure to elements for the population living near these e-waste recycling parks means carcinogenic risks above the acceptable threshold (>10-5).
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Bocca B, Ruggieri F, Pino A, Rovira J, Calamandrei G, Martínez MÁ, Domingo JL, Alimonti A, Schuhmacher M. Human biomonitoring to evaluate exposure to toxic and essential trace elements during pregnancy. Part A. concentrations in maternal blood, urine and cord blood. ENVIRONMENTAL RESEARCH 2019; 177:108599. [PMID: 31374401 DOI: 10.1016/j.envres.2019.108599] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/19/2019] [Accepted: 07/19/2019] [Indexed: 06/10/2023]
Abstract
Exposures to toxic elements or deficiencies of essential elements during pregnancy may be associated to various birth complications or even diseases in early life. The aim of this paper was to assess the concentrations of selected toxic (As, Cd, Cr, Hg, Ni, Pb) and essential trace elements (Co, Cu, Mn, Se and Zn) in blood and urine samples of delivering women at different periods of gestation and cord blood, as well as to evaluate the placental permeability for these elements. A total of 53 women participating in the HEALS-EXHES study were enrolled. In particular, 48 blood samples from 1st trimester of pregnancy, 40 blood samples at delivery, and 31 cord blood at delivery were collected. Moreover, mothers' urine were sampled at the 1st (53 samples), 2nd (53 samples) and 3rd trimester (49 samples) of pregnancy. Results showed that Hg and Mn levels in cord blood were about 2.0 times higher than in maternal blood, suggesting that these elements may be transferred from mother to fetus. The cord blood levels of As and Pb were lower (ca. the 65%) than those in maternal blood, showing that the placenta modulates the rate of transfer for these elements. Essential elements as Cu and Zn showed significantly lower levels in cord than in maternal blood suggesting that the transplacental transfer of these nutrients was very limited. In addition, correlation between paired maternal and cord blood samples for As, Hg and Pb was statistically significant indicating that the fetal body burden may reflect the maternal exposure. Cadmium, Co, Cr, Ni and Se levels did not show significant correlations between maternal and cord blood. Maternal urinary concentrations of trace elements, including As, Cr, Cu, Hg, Se and Zn decreased along pregnancy, which may cause variations in fetal exposure. The levels of toxic and essential elements in maternal blood and urine, as well as in cord blood, were for most elements at the lower end of the ranges found in the scientific literature not being of special concern for pregnant women and the unborn.
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Sánchez-Soberón F, Rovira J, Sierra J, Mari M, Domingo JL, Schuhmacher M. Seasonal characterization and dosimetry-assisted risk assessment of indoor particulate matter (PM 10-2.5, PM 2.5-0.25, and PM 0.25) collected in different schools. ENVIRONMENTAL RESEARCH 2019; 175:287-296. [PMID: 31146100 DOI: 10.1016/j.envres.2019.05.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 05/06/2019] [Accepted: 05/22/2019] [Indexed: 06/09/2023]
Abstract
Inhalation of particulate matter (PM) has been linked to serious adverse health effects, such as asthma, cardiovascular diseases and lung cancer. In the present study, coarse (PM10-2.5), accumulation mode (PM2.5-0.25), and quasi-ultrafine (PM0.25) particulates were collected inside twelve educative centers of Tarragona County (Catalonia, Spain) during two seasons (cold and warm). Chemical characterization of PM, as well as risk assessment were subsequently conducted in order to evaluate respiratory and digestive risks during school time for children. Levels and chemical composition of PM were very different among the 12 centers. Average PM levels were higher during the cold season, as well as the concentrations of most toxic metals. In most schools, PM levels were below the daily PM10 threshold established in the regulation (50 μg/m3), with the exception of school number 1 during the cold season. On average, and regardless of season, coarse PM was highly influenced by mineral matter, while organic matter and elemental carbon were prevalent in quasi-ultrafine PM. The concentrations of the toxic elements considered by the legislation (As, Cd, Pb, and Ni) were below their correspondent regulatory annual limits. Calculated risks were below the safety thresholds, being fine fractions (PM2.5-0.25 and PM0.25) the main contributors to both digestive and respiratory risks.
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Rovira J, Martínez MÁ, Sharma RP, Espuis T, Nadal M, Kumar V, Costopoulou D, Vassiliadou I, Leondiadis L, Domingo JL, Schuhmacher M. Prenatal exposure to PFOS and PFOA in a pregnant women cohort of Catalonia, Spain. ENVIRONMENTAL RESEARCH 2019; 175:384-392. [PMID: 31154228 DOI: 10.1016/j.envres.2019.05.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/10/2019] [Accepted: 05/23/2019] [Indexed: 05/20/2023]
Abstract
This study was aimed at assessing the prenatal exposure to perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) in a cohort of pregnant women living in Reus (Tarragona County, Catalonia, Spain). These chemicals were biomonitored in maternal plasma during the first trimester of pregnancy, at delivery, and in cord blood. The dietary exposure of PFOS and PFOA was estimated by using questionnaires of food frequency and water intake, as well as data on food levels previously reported in the same area. In addition, the exposure through air inhalation and indoor dust ingestion was also calculated. Finally, a physiologically-based pharmacokinetic (PBPK) model was applied in order to establish the prenatal exposure of the fetus/child and to adjust exposure assessment vs. biomonitoring results. Probabilistic calculations of fetal exposure were performed by forward internal dosimetry and Monte-Carlo simulation. Mean plasma levels of PFOA were 0.45, 0.13 and 0.12 ng/mL at the first trimester, at delivery and in cord plasma, while those of PFOS were 2.93, 2.21, and 1.17 ng/mL, respectively. Traces of PFOS were found in all samples in the trimester and at delivery, and almost in all cord blood samples. Transplacental transfers of PFOS and PFOA were estimated to be around 70% and 60%, respectively. A temporal decrease trend in plasma levels of PFOS and PFOA was noticed, when comparing current values with data obtained 10 years ago in the same area. In agreement with many other studies, dietary intake was the main route of exposure to PFOS and PFOA in our cohort of pregnant women. It is an important issue to establish the exposure in critical windows periods such as fetal development to perfluoroalkylated substances, but also to other endocrine disrupting chemicals.
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Herrero M, Rovira J, Nadal M, Domingo JL. Risk assessment due to dermal exposure of trace elements and indigo dye in jeans: Migration to artificial sweat. ENVIRONMENTAL RESEARCH 2019; 172:310-318. [PMID: 30825680 DOI: 10.1016/j.envres.2019.02.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 02/20/2019] [Indexed: 06/09/2023]
Abstract
The concentration of a number of trace elements (Ag, Al, As, B, Ba, Be, Bi, Cd, Cr, Co, Cu, Fe, Mg, Mn, Mo, Ni, Pb, Sb, Sc, Se, Sm, Sr, Sn, Tl, Ti, V and Zn) were determined in 42 commercialized denim garments (jeans and shirts), being dermal exposure subsequently assessed. Migration experiments with artificial acid and basic sweat were also conducted to determine the release of these elements, as well as indigo dye. In a similar way than for the total content, Mg (124 and 99.4 µg/g) and Mn (27.1 and 7.20 µg/g) showed the highest concentrations in both artificial sweat, acid and basic, respectively. Indigo dye migrated at levels ranged from 3.22 to 7.76 mg/g, being higher in dark than in light blue fabrics. The levels of trace elements and indigo were analysed according to materials of fabric, colour, brand, and eco-labelling. Using total content and migrations rates, dermal exposure to trace elements for adult men, women and teenagers were calculated under the two sweat extractions. Non-carcinogenic and carcinogenic risks due to dermal exposure to the elements here analysed in cloths were assessed. Both risks were in the limits of safe to according to international regulations. However, the maximum exposure to Sb reached a hazard quotient (HQ) of 0.3 in clothes partially made of polyester. Despite some authors have established that indigo is an agonist of the aril receptor, health risks due to exposure to indigo dye were not calculated due the lack of toxicological data.
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Martínez MÁ, Castro I, Rovira J, Ares S, Rodríguez JM, Cunha SC, Casal S, Fernandes JO, Schuhmacher M, Nadal M. Early-life intake of major trace elements, bisphenol A, tetrabromobisphenol A and fatty acids: Comparing human milk and commercial infant formulas. ENVIRONMENTAL RESEARCH 2019; 169:246-255. [PMID: 30476748 DOI: 10.1016/j.envres.2018.11.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 05/18/2023]
Abstract
In the present study, the presence of a wide spectrum of major and trace elements (As, Ag, Al, Ba, Cd, Co, Cr, Cu, Hg, Mn, Ni, Sr, Sb, Se, Sn, Pb, V, and Zn), fatty acids, as well as some pollutants like free and total BPA and tetrabromobisphenol A (TBBPA), was analysed in human milk (n = 53) and infant formula (n = 50) samples. In addition, the infant exposure to these chemicals was assessed. The content of free BPA and several elements (Al, Ca, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, Sn, Sr, and Zn) was higher (p < 0.01) in infant formula samples. Furthermore, human milk contained levels of BPA and elements that, in almost all cases, were well below their respective EFSA and/or WHO thresholds, being also independent of the maternal characteristics (e.g., age, BMI or breastfeeding period). The fatty acid profiling also revealed major differences between human milk and infant formulas, which should be taken in account in the development of new formulas as well as in specific recommendations for the diet of breastfeeding mothers. Anyway, the results of this study reinforce that breastfeeding should be always the first feeding option in early life.
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Rovira J, Domingo JL. Human health risks due to exposure to inorganic and organic chemicals from textiles: A review. ENVIRONMENTAL RESEARCH 2019; 168:62-69. [PMID: 30278363 DOI: 10.1016/j.envres.2018.09.027] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 09/21/2018] [Accepted: 09/21/2018] [Indexed: 05/26/2023]
Abstract
It is well known that a number of substances used in the textile industry can mean not only environmental, but also health problems. The scientific literature regarding potential adverse health effects of chemical substances in that industry is mainly related with human exposure during textile production. However, information about exposure of consumers is much more limited. Although most research on the health effects of chemicals in textiles concern allergic skin reactions, contact allergy is not the only potential human health problem. In this paper, we have reviewed the current scientific information regarding human exposure to chemicals through skin-contact clothes. The review has been focused mainly on those chemicals whose probabilities of being detected in clothes were rather higher. Thus, we have revised the presence of flame retardants, trace elements, aromatic amines, quinoline, bisphenols, benzothiazoles/benzotriazoles, phthalates, formaldehyde, and also metal nanoparticles. Human dermal exposure to potentially toxic chemicals through skin-contact textiles/clothes shows a non-negligible presence in some textiles, which might lead to potential systemic risks. Under specific circumstances of exposure, the presence of some chemicals might mean non-assumable cancer risks for the consumers.
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Mari M, Rovira J, Sánchez-Soberón F, Nadal M, Schuhmacher M, Domingo JL. Partial replacement of fossil fuels in a cement plant: Assessment of human health risks by metals, metalloids and PCDD/Fs. ENVIRONMENTAL RESEARCH 2018; 167:191-197. [PMID: 30032002 DOI: 10.1016/j.envres.2018.07.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 06/08/2023]
Abstract
In 2009, a cement plant located in Alcanar (South Catalonia, Spain) started co-processing a special kind of refuse-derived fuel (RDF) called ENERFUEL™. In April 2014 and 2017, 5 and 8 years after RDF co-processing, the concentrations of metals and metalloids (As, Cd, Co, Cr, Cu, Hg, Mn, Ni, Pb, Sb, Tl, V and Zn) and PCDD/Fs were measured in samples of soils, herbage and air collected in the vicinity of the facility. The comparison of the current concentrations with those obtained in a baseline study (2008), when fossil fuels were used solely, has shown that the environmental concentrations of metals, metalloids and PCDD/Fs were not significantly modified. The concentrations of metals, metalloids and PCDD/Fs in soil, vegetation and air of Alcanar are in the low part of the ranges found around other cement plants in Catalonia (in general, below 50th percentile). Non-carcinogenic risks due to exposure to metals, metalloids and PCDD/Fs were lower than the safety value (HQ<1). In turn, carcinogenic risks were below the 10-5 Spanish threshold. The present results corroborate that, from an environmental point of view, the use of wastes as alternative fuels (AF) in a cement plant, which is operating with suitable technical conditions, is a good option for waste management. It contributes towards overcoming challenges such as climate change and fossil fuel depletion, while utilizing principles of circular economy.
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Rovira J, Hernández-Aguilera A, Luciano-Mateo F, Cabré N, Baiges-Gaya G, Nadal M, Martín-Paredero V, Camps J, Joven J, Domingo JL. Trace Elements and Paraoxonase-1 Activity in Lower Extremity Artery Disease. Biol Trace Elem Res 2018. [PMID: 29525848 DOI: 10.1007/s12011-018-1298-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Oxidative stress and inflammation are candidate mechanisms to explain the potential role of exposure to metals and reduced activity of paraoxonase-1 (PON1) in age-related diseases. Both may be risk factors contributing to atherosclerosis. In the present study, inductively coupled mass spectrometry was used to explore multiple trace elements, while in-house methods were employed to measure PON1-related variables in patients with lower extremity artery disease (LEAD). Healthy controls were matched for sex, age, body weight, and relevant genotype variants. Serum concentrations of As, Ba, Cu, and Sr were higher in patients than those in controls, with a strong predictive ability to discriminate between groups. Differences in serum Pb, Cd, and Zn were negligible. Serum Cu increased when the disease was more severe, but a negative trend was noted for serum As, B, Ba, and Zn. The only variable associated with ankle-brachial index was serum Zn. Serum PON1 activity was significantly lower in LEAD patients. When the ability of serum trace elements to modulate PON1 activity was explored, the analysis revealed a unique association with serum Zn. The current results strongly suggest that Zn may have a protective effect in non-coronary atherosclerosis and indicate that this element may exert its anti-inflammatory and antioxidant functions through interactions with PON1 activity. These findings deserve confirmation and further research. In particular, the periodic evaluation of serum trace elements and the prescription of Zn supplements are easy measures to implement and that can improve the treatment of patients with LEAD.
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Martinez M, Rovira J, Sharma RP, Nadal M, Schuhmacher M, Kumar V. Prediction and evaluation of the internal dosimetry of two wide spread endocrine disruptors in fetus using a physiologically based pharmacokinetic model. Toxicol Lett 2018. [DOI: 10.1016/j.toxlet.2018.06.709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Martínez MA, Rovira J, Prasad Sharma R, Nadal M, Schuhmacher M, Kumar V. Comparing dietary and non-dietary source contribution of BPA and DEHP to prenatal exposure: A Catalonia (Spain) case study. ENVIRONMENTAL RESEARCH 2018; 166:25-34. [PMID: 29859370 DOI: 10.1016/j.envres.2018.05.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/04/2018] [Accepted: 05/08/2018] [Indexed: 06/08/2023]
Abstract
Bisphenol A (BPA) and Di-(2-ethylhexyl) phthalate (DEHP) are two wide spread chemicals classified as endocrine disruptors (ED). The present study aims to estimate the non-dietary (dermal, non-dietary ingestion and inhalation) exposure to BPA and DEHP for a pregnant women cohort. In addition, to assess the prenatal exposure for the fetus, a physiologically based pharmacokinetic (PBPK) model was used. It was adapted for pregnancy in order to assess the internal dosimetry levels of EDs (BPA and DEHP) in the fetus. Estimates of exposure to BPA and DEHP from all pathways along with their relative importance were provided in order to establish which proportion of the total exposure came from diet and which came from non-dietary exposures. In this study, the different oral dosing scenarios (dietary and non-dietary) were considered keeping inhalation as a continuous exposure case. Total non-dietary mean values were 0.002 µg/kgbw/day (0.000; 0.004 µg/kgbw/day for 5th and 95th percentile, respectively) for BPA and 0.597 µg/kgbw/day (0.116 µg/kgbw/day and 1.506 µg/kgbw/day for 5th and 95th percentile, respectively) for DEHP. Indoor environments and especially dust ingestion were the main non-dietary contributors to the total exposure of BPA and DEHP with 60% and 81%. However, as expected, diet showed the higher contribution to total exposure with > 99.9% for BPA and 63% for DEHP. Although diet was considered the primary source of exposure to BPA and phthalates, it must be taken into account that with non-dietary sources the first-pass metabolism is lacking, so these may be of equal or even higher toxicological relevance than dietary sources. The present study is in the framework of "Health and environmental-wide associations based on large population surveys" (HEALS) project (FP7-603946).
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Rovira J, Sierra J, Nadal M, Schuhmacher M, Domingo JL. Main components of PM 10 in an area influenced by a cement plant in Catalonia, Spain: Seasonal and daily variations. ENVIRONMENTAL RESEARCH 2018; 165:201-209. [PMID: 29727820 DOI: 10.1016/j.envres.2018.04.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/11/2018] [Accepted: 04/11/2018] [Indexed: 06/08/2023]
Abstract
Particulate matter (PM) composition has a key role in a wide range of health outcomes, such as asthma, chronic obstructive pulmonary disease, lung cancer, cardiovascular disease, and death, among others. Montcada i Reixac, a municipality located in the Barcelona metropolitan area (Catalonia, Spain), for its location and orography, is an interesting case- study to investigate air pollution. The area is also characterized by the presence of different industrial emission sources, including a cement factory and a large waste management plant, as well as an intense traffic. In this study, PM10 levels, trace elements, ions, and carbonaceous particles were determined for a long time period (2013-2016) in this highly polluted area. PM10 samples were collected during six consecutive days in two campaigns (cold and warm) per year. A number of elements (As, Ba, Be, Bi, Ca, Cd, Ce, Co, Cr, Cs, Cu, Dy, Er, Eu, Fe, Ga, Gd, Ge, Hf, Hg, Ho, K, La, Li, Hg, Mg, Mn, Mo, Nb, Nd, Ni, Pb, Pr, Rb, Sb, Sc, Se, Sm, Sn, Sr, Tb, Th, Ti, Tl, U, V, W, Y, Yb, and Zr), ions (Cl-, SO42-, NO3-, and NH4+), and carbonaceous content (total carbon, organic plus elemental carbon, and CO32-), were analysed. These data were used to identify the PM10 main components: mineral matter, sea spray, secondary inorganic aerosols, organic matter plus elemental carbon, trace elements or indeterminate fraction. Although a clear seasonality (cold vs. warm periods) was found, there were no differences between working days and weekends. Obviously, the cement plant influences the surrounding environment. However, no differences in trace elements related with the cement plant activity (Al, Ca, Ni and V) between weekdays and weekends were noted. However, some traffic-related elements (i.e., Co, Cr, Mn, and Sb) showed significantly higher concentrations in weekdays.
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Rovira J, Nadal M, Schuhmacher M, Domingo JL. Concentrations of trace elements and PCDD/Fs around a municipal solid waste incinerator in Girona (Catalonia, Spain). Human health risks for the population living in the neighborhood. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 630:34-45. [PMID: 29471189 DOI: 10.1016/j.scitotenv.2018.02.175] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 02/14/2018] [Accepted: 02/14/2018] [Indexed: 06/08/2023]
Abstract
Previously to the modernization of the municipal solid waste incinerator (MSWI) of Campdorà (Girona, Catalonia, Spain) two sampling campaigns (2015 and 2016) were conducted. In each campaign, 8 soil and 4 air samples (PM10 and total particle phase and gas phase) were collected. The levels of As, Cd, Co, Cr, Cu, Hg, Mn, Ni, Pb, Sb, Sn, Tl and V, and PCDD/Fs were analysed at different distances and wind directions around the MSWI. Environmental levels of trace elements and PCDD/Fs were used to assess exposure and health risks (carcinogenic and non-carcinogenic) for the population living around the facility. In soils, no significant differences were observed for trace elements and PCDD/Fs between both campaigns. In air, significant higher levels of As, Cd, Co, Mn, Ni, Pb, Tl and V were detected in 2016. Regarding soil levels, only Cd (distances) and As, Cu, Mn, and Ni (wind directions) showed significant differences. No differences were noted in the concentrations of trace elements and PCDD/Fs in air levels with respect to distances and directions to the MSWI. No differences were registered in air levels (elements and PCDD/Fs) between points influenced by MSWI emissions and background point. However some differences in congener profile were noted regarding from where back-trajectories come from (HYSPLIT model results), pointing some influence of Barcelona metropolitan area. The concentrations of trace elements and PCDD/Fs were similar -or even lower- than those reported around other MSWIs in Catalonia and various countries. Non-carcinogenic risks were below the safety limit (HQ<1). In turn, carcinogenic risks due to exposure to trace elements and PCDD/Fs were in acceptable ranges, according to national and international standard regulations.
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Steckling N, Gotti A, Bose-O'Reilly S, Chapizanis D, Costopoulou D, De Vocht F, Garí M, Grimalt JO, Heath E, Hiscock R, Jagodic M, Karakitsios SP, Kedikoglou K, Kosjek T, Leondiadis L, Maggos T, Mazej D, Polańska K, Povey A, Rovira J, Schoierer J, Schuhmacher M, Špirić Z, Stajnko A, Stierum R, Tratnik JS, Vassiliadou I, Annesi-Maesano I, Horvat M, Sarigiannis DA. Biomarkers of exposure in environment-wide association studies - Opportunities to decode the exposome using human biomonitoring data. ENVIRONMENTAL RESEARCH 2018; 164:597-624. [PMID: 29626821 DOI: 10.1016/j.envres.2018.02.041] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 02/09/2018] [Accepted: 02/28/2018] [Indexed: 05/20/2023]
Abstract
BACKGROUND The European Union's 7th Framework Programme (EU's FP7) project HEALS - Health and Environment-wide Associations based on Large Population Surveys - aims a refinement of the methodology to elucidate the human exposome. Human biomonitoring (HBM) provides a valuable tool for understanding the magnitude of human exposure from all pathways and sources. However, availability of specific biomarkers of exposure (BoE) is limited. OBJECTIVES The objective was to summarize the availability of BoEs for a broad range of environmental stressors and exposure determinants and corresponding reference and exposure limit values and biomonitoring equivalents useful for unraveling the exposome using the framework of environment-wide association studies (EWAS). METHODS In a face-to-face group discussion, scope, content, and structure of the HEALS deliverable "Guidelines for appropriate BoE selection for EWAS studies" were determined. An expert-driven, distributed, narrative review process involving around 30 individuals of the HEALS consortium made it possible to include extensive information targeted towards the specific characteristics of various environmental stressors and exposure determinants. From the resulting 265 page report, targeted information about BoE, corresponding reference values (e.g., 95th percentile or measures of central tendency), exposure limit values (e.g., the German HBM I and II values) and biomonitoring equivalents (BEs) were summarized and updated. RESULTS 64 individual biological, chemical, physical, psychological and social environmental stressors or exposure determinants were included to fulfil the requirements of EWAS. The list of available BoEs is extensive with a number of 135; however, 12 of the stressors and exposure determinants considered do not leave any measurable specific substance in accessible body specimens. Opportunities to estimate the internal exposure stressors not (yet) detectable in human specimens were discussed. CONCLUSIONS Data about internal exposures are useful to decode the exposome. The paper provides extensive information for EWAS. Information included serves as a guideline - snapshot in time without any claim to comprehensiveness - to interpret HBM data and offers opportunities to collect information about the internal exposure of stressors if no specific BoE is available.
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Rovira J, Schuhmacher M, Nadal M, Domingo JL. Contamination by Coal Dust in the Neighborhood of the Tarragona Harbor (Catalonia, Spain): A Preliminary Study. ACTA ACUST UNITED AC 2018. [DOI: 10.2174/1874282301812010014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
In February 2017, some buildings of La Pineda (Catalonia, NE Spain) a rather small town, located near to the Tarragona harbor, were affected by a contamination episode that dirtied external walls, windows, doors and floors of these buildings with a black dust. This study was aimed at assessing the origin of the black dust appeared in the buildings.
Methods:
Black dust samples were collected in the railings of balconies, windows, and exterior doors of two buildings in La Pineda, as well as in the ground of the breakwater of the Tarragona harbor, at few meters from the open air coal storage area. Elemental analysis of the black dust (C, N, H and S) was performed. A daily sample of PM10 was also collected and analyzed for five consecutive days.
Results:
The total carbon content of the collected dust was 25.8%, 29.4% and 33.9% in the two buildings of La Pineda and the breakwater, respectively. In turn, the contribution of carbon from carbonates was 0.0%, 1.3% and 5.1%, in the samples of the two buildings and the breakwater, respectively. PM10 showed levels between 18 and 39 µg/m3, with mean and median levels of 29 µg/m3.
Conclusion:
The elemental analysis indicated that the two black dust samples collected in the two buildings of La Pineda were similar to the sample collected at the breakwater of the port of Tarragona, showing a common origin: The bulk coal storage area of Tarragona harbor. Because information on the human health risks derived from the important activities conducted in the port of Tarragona is currently non-existent, an exhaustive assessment of all pollutants involved in the activities of the port is strongly recommended.
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Rovira J, Domínguez-Morueco N, Nadal M, Schuhmacher M, Domingo JL. Temporal trend in the levels of polycyclic aromatic hydrocarbons emitted in a big tire landfill fire in Spain: Risk assessment for human health. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2018; 53:222-229. [PMID: 29111871 DOI: 10.1080/10934529.2017.1387023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In May 2016, a big fire occurred in an illegal landfill placed in Seseña (Toledo, Spain), where between 70,000 and 90,000 tons of tires had been accumulated during years. Just after the fire, and because of the increase of airborne PAHs, we found that cancer risks for the population living in the neighborhood of the landfill were 3-5 times higher than for the rest of inhabitants of Seseña. Some months after our initial (June 2016) study, two sampling campaigns (December 2016 and May 2017) were performed to assess the temporal trends of the environmental levels of PAHs, as well as to reassure that these chemicals did not pose any risk for the human health of Seseña inhabitants. In soils, the total concentrations of the 16 PAHs (December 2016), as well as the sum of the seven carcinogenic PAHs, showed values between 8.5 and 94.7 ng g-1 and between 1.0 and 42.3 ng g-1, respectively. In May 2017, a significant decrease (between 4 and 38 times) in the levels of PAHs in air was observed, with total concentrations ranging between 3.49 and 5.06 ng m-3. One year after the fire, the cancer risk at different zones of Seseña was similar, being lower than that found in June 2016, and negligible according to national and international agencies.
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Domingo JL, Rovira J, Nadal M, Schuhmacher M. High cancer risks by exposure to PCDD/Fs in the neighborhood of an Integrated Waste Management Facility. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 607-608:63-68. [PMID: 28686896 DOI: 10.1016/j.scitotenv.2017.06.272] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 06/30/2017] [Accepted: 06/30/2017] [Indexed: 06/07/2023]
Abstract
In 2014, we conducted a study aimed at screening the concentrations of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), polychlorinated biphenyls (PCBs) and various trace elements in air and soil samples collected in an urban area of Sant Adrià de Besòs (Barcelona, Spain) in the vicinity of an Integrated Waste Management Facility (IWMF). It consists of a mechanical-biological treatment plant (MBT) and an old municipal solid waste incinerator (MSWI). Human health risks for the population living in the area were also assessed. The most worrying result was the high cancer risks estimated for the area (2.5×10-6). In March 2017, we have carried out a new survey to check if the authorities had taken the necessary and urgent measures to reduce the environmental concentrations of PCDD/Fs -and the human health risks- until acceptable levels. Although the concentrations of PCDD/Fs in soils are currently lower (mean value: 1.66 vs. 3.6ng WHO-TEQ/kg in 2014), they are still are notably higher than those found near other MSWIs of Catalonia. In turn, the levels of PCDD/Fs in air are even higher than in 2014 (mean value: 0.044 vs. 0.026pgWHO-TEQ/m3 in 2014), being also the highest detected in similar zones of Catalonia. The current cancer risk due to PCDD/F exposure for the residents in the neighborhood of the IWMF is 2.3×10-6, a worrying fact as the 10-6 threshold continues to be exceeded.
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Cucchiari D, Rovira J, Paredes D, Ventura-Aguiar P, Sanchez-Escuredo A, Solé M, Adalia R, Oppenheimer F, Diekmann F, Revuelta I. Association of Brain-Dead Donors' Terminal Inflammation With Delayed Graft Function in Kidney Transplant Recipients. Transplant Proc 2017; 49:2260-2264. [PMID: 29198657 DOI: 10.1016/j.transproceed.2017.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Systemic inflammation affects kidney function in a wide range of diseases. Even in kidney transplant recipients, higher levels of C-reactive protein (CRP) are invariably associated with both worse short- and long-term graft outcomes. However, little is known about systemic inflammation in kidney donors and, notably, brain death causes a strong systemic inflammatory response. OBJECTIVE To analyze the role of systemic inflammation of brain-dead donors on short-term kidney graft outcomes (ie, delayed graft function [DGF], defined as the need of dialysis during the first week after transplantation). MATERIALS AND METHODS Retrospective analysis of clinical and biochemical characteristics of all brain-dead kidney donors generated in the Hospital Clínic of Barcelona in the 2006 to 2015 period (n = 194). Donors who were tested for CRP in the 24 hours before BD declaration were included (n = 97, 50% of initial population). Clinical and biochemical features of their respective recipients (n = 165) were analyzed, comparing recipients who developed DGF (n = 30) with recipients who did not (n = 135). RESULTS Donors whose recipients later developed DGF had much higher CRP values (10.58 [5.1-18.21] vs 4.81 [1.42-12.2] mg/dL, P = .025). Other characteristics associated with the development of DGF were renal biopsy score and recipient dialysis vintage (P = .025 and P = .002, respectively). In logistic regression analysis, PCR maintained significance in the non-expanded criteria donor (ECD) group (odds ratio [OR], 1.102; P = .027), but it lost significance in the ECD group (P = .67). CONCLUSIONS Terminal donor CRP was associated with DGF in kidney transplant recipients and proved to be mostly significant in younger donors.
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Magnano L, Balagué O, Dlouhy I, Rovira J, Karube K, Pinyol M, Rivas-Delgado A, Costa D, Martínez-Trillos A, González-Farre B, Martínez-Pozo A, Giné E, Colomer D, Delgado J, Villamor N, Campo E, López-Guillermo A. Clinicobiological features and prognostic impact of diffuse large B-cell lymphoma component in the outcome of patients with previously untreated follicular lymphoma. Ann Oncol 2017; 28:2799-2805. [PMID: 29045517 DOI: 10.1093/annonc/mdx407] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND The co-existence at diagnosis of follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL) components (FL/DLBCL) has been considered a transformed lymphoma and accordingly treated although clinicobiological information on these patients is scarce. The aim of this study was to analyze the initial features and outcome of FL/DLBCL patients in the rituximab era. PATIENTS AND METHODS All patients consecutively diagnosed at a single institution with FL/DLBCL (n = 40), as well as those with pure FL (n = 328) or de novo DLBCL (n = 510) as controls. RESULTS The proportion of the DLBCL component was highly variable (median 50%). In 29 FL/DLBCL cases analyzed, the cell of origin was GCB in 86%, ABC in 10% and unclassifiable in 4%. NOTCH1-2 was mutated in 10% of these cases. The proportion of DLBCL component did not impact on overall survival (OS). Regarding initial characteristics, patients with FL/DLBCL were closer to FL in terms of primary nodal origin, good performance status and advanced stage, whereas the other features were intermediate between FL and DLBCL. FL/DLBCL patients were treated as DLBCL with no further intensification. Complete response and primary refractory rates were 65% and 20%, respectively, with these figures being similar to DLBCL and worse than FL. Progression-free survival and OS were intermediate between FL and DLBCL (5-year OS: 85%, 73% and 63% for FL, FL/DLBCL and DLBCL, respectively). FL/DLBCL histology did not reach independent prognostic value for OS in the multivariate analyses. CONCLUSIONS The outcome of FL/DLBCL patients is not worse than that of de novo DLBCL. These cases should be treated with immunochemotherapy as DLBCL, but intensification with ASCT may not be necessary. The biological insights of FL/DLBCL warrants further genetic and molecular studies.
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MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Case-Control Studies
- Female
- Follow-Up Studies
- Humans
- Lymphoma, Follicular/complications
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/mortality
- Lymphoma, Follicular/pathology
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Neoplasm Recurrence, Local/complications
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Prognosis
- Survival Rate
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Martínez MA, Rovira J, Sharma RP, Nadal M, Schuhmacher M, Kumar V. Prenatal exposure estimation of BPA and DEHP using integrated external and internal dosimetry: A case study. ENVIRONMENTAL RESEARCH 2017; 158:566-575. [PMID: 28715785 DOI: 10.1016/j.envres.2017.07.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/06/2017] [Accepted: 07/07/2017] [Indexed: 06/07/2023]
Abstract
Prenatal exposure to Endocrine disruptors (EDs), such as Bisphenol A (BPA) and di (2-ethylhexyl) phthalate (DEHP), has been associated with obesity and diabetes diseases in childhood, as well as reproductive, behavioral and neurodevelopment problems. The aim of this study was to estimate the prenatal exposure to BPA and DEHP through food consumption for pregnant women living in Tarragona County (Spain). Probabilistic calculations of prenatal exposure were estimated by integrated external and internal dosimetry modelling, physiologically based pharmacokinetic (PBPK) model, using a Monte-Carlo simulation. Physical characteristic data from the cohort, along with food intake information from the questionnaires (concentrations of BPA and DEHP in different food categories and the range of the different food ratios), were used to estimate the value of the total dietary intake for the Tarragona pregnancy cohort. The major contributors to the total dietary intake of BPA were canned fruits and vegetables, followed by canned meat and meat products. In turn, milk and dairy products, followed by ready to eat food (including canned dinners), were the most important contributors to the total dietary intake of DEHP. Despite the dietary variations among the participants, the intakes of both chemicals were considerably lower than their respective current tolerable daily intake (TDI) values established by the European Food Safety Authority (EFSA). Internal dosimetry estimates suggest that the plasma concentrations of free BPA and the most important DEHP metabolite, mono (2-ethylhexyl) phthalate (MEHP), in pregnant women were characterized by transient peaks (associated with meals) and short half-lives (< 2h). In contrast, fetal exposure was characterized by a low and sustained basal BPA and MEHP concentration due to a lack of metabolic activity in the fetus. Therefore, EDs may have a greater effect on developing organs in young children or in the unborn child.
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Karube K, Enjuanes A, Dlouhy I, Jares P, Martin-Garcia D, Nadeu F, Ordóñez GR, Rovira J, Clot G, Royo C, Navarro A, Gonzalez-Farre B, Vaghefi A, Castellano G, Rubio-Perez C, Tamborero D, Briones J, Salar A, Sancho JM, Mercadal S, Gonzalez-Barca E, Escoda L, Miyoshi H, Ohshima K, Miyawaki K, Kato K, Akashi K, Mozos A, Colomo L, Alcoceba M, Valera A, Carrió A, Costa D, Lopez-Bigas N, Schmitz R, Staudt LM, Salaverria I, López-Guillermo A, Campo E. Integrating genomic alterations in diffuse large B-cell lymphoma identifies new relevant pathways and potential therapeutic targets. Leukemia 2017; 32:675-684. [PMID: 28804123 PMCID: PMC5843901 DOI: 10.1038/leu.2017.251] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/24/2017] [Accepted: 07/27/2017] [Indexed: 02/08/2023]
Abstract
Genome studies of diffuse large B-cell lymphoma (DLBCL) have revealed a large number of somatic mutations and structural alterations. However, the clinical significance of these alterations is still not well defined. In this study, we have integrated the analysis of targeted next-generation sequencing of 106 genes and genomic copy number alterations (CNA) in 150 DLBCL. The clinically significant findings were validated in an independent cohort of 111 patients. Germinal center B-cell and activated B-cell DLBCL had a differential profile of mutations, altered pathogenic pathways and CNA. Mutations in genes of the NOTCH pathway and tumor suppressor genes (TP53/CDKN2A), but not individual genes, conferred an unfavorable prognosis, confirmed in the independent validation cohort. A gene expression profiling analysis showed that tumors with NOTCH pathway mutations had a significant modulation of downstream target genes, emphasizing the relevance of this pathway in DLBCL. An in silico drug discovery analysis recognized 69 (46%) cases carrying at least one genomic alteration considered a potential target of drug response according to early clinical trials or preclinical assays in DLBCL or other lymphomas. In conclusion, this study identifies relevant pathways and mutated genes in DLBCL and recognizes potential targets for new intervention strategies.
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Mari M, Rovira J, Sánchez-Soberón F, Nadal M, Schuhmacher M, Domingo JL. Environmental trends of metals and PCDD/Fs around a cement plant after alternative fuel implementation: human health risk assessment. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2017; 19:917-927. [PMID: 28561821 DOI: 10.1039/c7em00121e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study aimed at evaluating the potential impact of a cement plant after 4 years of the employment of alternative fuel. In June 2015, concentrations of PCDD/Fs and metals were determined in soils, vegetation and air in order to measure potential changes with respect to previous surveys before (July 2011) and after (June 2013) the employment of alternative fuel. Risks to human health were also assessed. In soils, metal levels were similar to those observed in June 2013 (p > 0.05). In comparison with July 2011, the increment was only statistically significant for As and Cd (p < 0.05). A notable increase in levels of PCDD/Fs was noted when current levels in soils (1.14 ng WHO-TEQ per kg) were compared with those observed in July 2011 (0.37 ng WHO-TEQ per kg) (p > 0.05) and June 2013 (0.41 ng WHO-TEQ per kg) (p < 0.05). This increase was mainly caused by the increase in PCDD/F levels at one sampling site, which showed the heterogeneity of PCDD/F levels in soils, possibly as a result of different point emissions over the years. On the other hand, temporal trends in levels of metals and PCDD/Fs in vegetation showed a clear decrease, which indicated that the particle fraction of these pollutants would potentially be removed from leaf surfaces by wash-off. In air, levels were similar to those found in previous surveys. The results of PCA showed that the change in fuel had not affected the environmental profiles of metals and PCDD/Fs around the cement plant. The exposure of the population living in the surroundings of the plant was measured and it was shown that diet was the major contributor for both metals and PCDD/Fs, with percentages of over 97%, the only exceptions being As and Pb, for which dietary intake accounted for 43% and 71% of the total exposure, respectively. Environmental non-cancer and cancer risks were within the limits considered as acceptable by international standards.
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Rivas-Delgado A, Magnano L, Moreno-Velazquez M, Garcia O, Mozas P, Dlouhy I, Baumann T, Rovira J, Gonzalez B, Martinez A, Balague O, Delgado J, Villamor N, Campo E, Gine E, Sancho J, Lopez-Guillermo A. Progression-free survival shortens after each relapse in patients with follicular lymphoma treated in the rituximab era. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Dlouhy I, Karube K, Enjuanes A, Salaverría I, Pérez-Galán P, Jares P, Martín-García D, Nadeu F, Rivas-Delgado A, Rovira J, Gonzalez B, Mozos A, Clot G, Sancho J, Salar A, Mercadal S, Escola L, Briones J, Colomo L, Alcoceba M, Valera A, Campo E, López-Guillermo A. GENE MUTATIONS AND COPY NUMBER ALTERATIONS (CNA) PREDICT FOR EARLY FAILURE IN PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL) TREATED WITH R-CHOP. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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