Changes of the nutrient loads of the Danube since the late eighties: An analysis based on long term changes along the whole Danube River and its main tributaries

The Danube nutrient loads are affected by human impacts mainly from agriculture and wastewater discharges. Knowledge about the Danube nutrient loads and the changes of these loads over time is essential for understanding the changes within the ecosystem of the Black Sea, induced by these loads. The paper shows the long term changes of the nutrient load along the Danube estimated by measurements from different countries and institutions. The results show large differences between Dissolved Inorganic Nitrogen (DIN) and Total Phosphorus (TP). For TP, the Danube River loads show a strong decrease since 1988-1992, especially in the Middle and Lower basin. This change is probably partly connected to the dramatic economic changes in the Middle and Eastern European countries following the collapse of the communist system. The DIN load does not show a decreasing trend in the last decade. The data indicate that there may be a decreasing trend in the anthropogenic emissions, but that such a trend is counteracted by a significantly increasing trend of the Danube discharge in the last decade. The accuracy of the available data is analysed in the paper as well.

Nutrient emissions from diffuse and point sources into the River Danube and its main tributaries for the period of 1998-2000--results and problems

Nutrient emissions by point and diffuse sources were estimated for 388 sub-catchments of the Danube river basin for the period 1998-2000 by means of the Model MONERIS. For nitrogen total emissions of 684 kt/a N were estimated for the Danube basin. 80% of these emissions were caused by diffuse sources (mainly groundwater, urban areas and tile drainage). For phosphorus the emission was 57 kt/a P, with a contribution of diffuse sources to this sum of 58%. The comparison of calculated and observed loads shows that the mean deviation for the investigated sub-catchments of the Danube river basin is 20% for dissolved inorganic nitrogen and 34% for phosphorus. The spatial resolution of the emission calculations allows the identification of regional hot spots and the derivation of specific regional measures to reduce the emissions into the Danube and consequently into the Western Black Sea.

Lessons learned from investigations on case study level for modelling of nutrient emissions in the Danube basin

In the framework of the project daNUbs (Nutrient Management in the Danube Basin and its Impact on the Black Sea) the MONERIS emission model is used for the basin wide calculation of nutrient (nitrogen and phosphorus) emissions in the Danube Basin. The MONERIS model was developed and successfully applied for German river catchments. Based on investigations in selected test regions (case studies) the daNUbs approach is to check the applicability of the MONERIS emission model for the specific conditions of the Danube Basin in more detail than is possible with a basin wide application. Six case studies with areas of 400-3,500 km2 and several subcatchments have been selected in order to represent different conditions along the Danube Basin. In this study region intensive data collection and enhanced monitoring has been performed in order to raise the database significantly above the generally available data. Water balance as well as nutrient balance calculations have been performed with the MONERIS model as well as with other approaches. Results are compared to each other and to data from monitoring. Results up till now showed the applicability and sensitivity of the MONERIS approach in different conditions of the Danube Basin (e.g. emissions via groundwater). They indicated that the nitrogen retention in the catchments is well described with the MONERIS model.

Nitrogen retention in a river system and the effects of river morphology and lakes

The mean annual transfer (loss and retention) of nitrogen in a river system was estimated using a conceptual approach based on water surface area and runoff. Two different approaches for the calculation of water surface area were applied to determine riverine nitrogen retention in four European catchments, ranging between 860-14,000 km2 in area, and differing considerably in the proportion and distribution of surface waters, specific runoff and specific nutrient emissions. The transfer rate was estimated sequentially as either the mean value for the total catchment, on a sub-catchment scale, or considering the distribution of water surface area within a sub-catchment. For the latter measure, nitrogen retention in larger lakes was calculated separately. Nitrogen emissions modelled with MONERIS and HBV-N were used to calculate nitrogen river loads and compare those with observed loads. Inclusion of the proportion of water area within a sub-catchment improved modelled results in catchment with large lakes in sub-catchments, but not where there was a homogenous distribution of surface waters among sub-catchments.

Atopic disease and its determinants -- a focus on the potential role of childhood infection

BACKGROUND

Atopic diseases develop on a genetic background and are modulated by environmental factors among which some infectious diseases are thought to have a protective influence.

OBJECTIVE

The aim of this study was to determine the influence of infectious diseases in younger ages, bacterial and viral, on atopic diseases and sensitization to aero- and food-allergens in adults.

METHODS

A population-based sample of 4262 subjects aged 25-74 years were interviewed concerning their history of infectious disease within the first 18 years of life. Information about allergic disease, including atopic eczema, allergic rhinitis (AR), and asthma was obtained. A blood sample was drawn and analysed for allergen-specific IgE antibodies against food- and aero-allergens.

RESULTS

Multiple logistic regression analyses identified viral infection to be associated with AR (adjusted odds ratio (OR) = 1.39; 95% confidence interval (95% CI): 1.13-1.72) and sensitization to aeroallergens (OR = 1.21; 95% CI: 1.05-1.41). Bacterial disease was a negative predictor for atopy development in the subgroup of patients sensitized to nutritional allergens with concomitant atopic eczema (OR = 0.34; 95% CI: 0.11-0.99), AR (OR = 0.67; 95% CI: 0.42-1.07), or asthma (OR = 0.41; 95% CI: 0.19-0.87). Influences of viral and bacterial infection on AR differed with regard to family history of atopic disease.

CONCLUSION

In our study population, history of viral infection was consistently positively associated with AR. Our data suggests that bacterial infections might be preventive for specific subgroups of atopy.

The effect of environmental tobacco smoke on eczema and allergic sensitization in children

BACKGROUND

The negative impact of environmental tobacco smoke (ETS) on airway diseases in children is well known. Whether there is an effect on atopic eczema is not clear.

OBJECTIVES

To determine the impact of ETS on atopic eczema, allergic sensitization and allergic airway diseases in 1669 school beginners.

METHODS

The prevalence of atopy-related health outcomes was assessed by questionnaire, dermatological examination, skin prick testing and specific immunoglobulin E measurement. Exposure assessments were based on measurement of cotinine [expressed as cotinine to creatine ratio (CCR)] in spot urine samples (n = 1220) together with questionnaire and interview data on smoking behaviour of the parents.

RESULTS

In the total study group, prevalence of atopic eczema diagnosed on examination was significantly associated with urinary CCR values. The odds ratio (OR) and 95% confidence interval (CI), calculated for an increase of 100 ng mg-1 CCR was 1.97 (95% CI 1.23-3.16). The prevalence of skin manifestations according to questionnaire data as well as a history of asthma, wheezing, and hay fever were positively although not significantly associated with ETS exposure. When genetically predisposed children (defined by the presence of parental atopy) were compared with children whose parents had no atopy, the ORs of allergic outcome variables were generally higher in the first group. In the group of predisposed children, significant associations with urinary CCR were found for allergic sensitization against house dust mites as measured by skin prick test (OR 3.10, 95% CI 1.63-5.90).

CONCLUSIONS

Children are at a higher risk of developing an atopic eczema when exposed to ETS and genetically predisposed children are at higher risk of developing a sensitization against house dust mites.

Decreasing the number of MOPP courses reduces gonadal damage in survivors of childhood Hodgkin disease

BACKGROUND

Children treated for Hodgkin disease are at risk for gonadal damage. Since most children were treated with radiotherapy (RT) in combination with chemotherapy, the presumed detrimental effect of MOPP (mustine, vincristine, procarbazine, and prednisone) (in contrast to schemes with less or without alkylating agents) could not be discerned completely from the effects of RT.

PROCEDURES

Children with Hodgkins disease treated without RT were included in sequential protocols containing six courses of MOPP (n = 24), six courses of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) (n = 17), or three courses of MOPP/ABVD (n = 35). Of these 76 patients, 48, who had completed treatment and had reached puberty, were investigated for gonadal damage.

RESULTS

Of the male patients, 81% of MOPP treated patients had increased follicular stimulating hormone (FSH) values, in 23% luteinizing hormone (LH) values were abnormal. In ABVD treated patients, no elevated levels of FSH or LH were noted. In 30% of patients treated with MOPP/ABVD, FSH values were abnormal, but no abnormal LH values were found. Median testicular volume per group decreased in relation to a higher number of MOPP courses. Sperm analysis revealed azoospermia in nearly all MOPP treated patients. In ABVD and MOPP/ABVD treated patients both oligospermia and azoospermia were noted. The number of sperm samples were too less to make any sound conclusions. Menarche occurred in all females, however in some at a relatively later age. One female patient treated with MOPP/ABVD had a normal pregnancy.

CONCLUSIONS

Limitation of MOPP therapy to three courses, in children treated without any RT, results in less gonadal damage as compared with six MOPP courses. From our data, MOPP damages Sertoli cells and may also damage Leydig cells as suggested by the higher LH values in conjunction with normal testosterone levels.

Groundwater-borne nitrate intakes into surface waters in Germany

The nitrogen loads entering the surface waters in Germany via the groundwater path were quantified. For this purpose, the results of a nitrogen balance model (Bach et al., 2000), which considers the most important N-inputs to the soil (manure, inorganic fertiliser, atmospheric deposition) and N-removals from the soil through crop harvest, were combined with the groundwater residence time/denitrification model WEKU (Kunkel and Wendland, 1997; Wendland et al., 2001). The modelled groundwater-borne nitrogen inputs into surface waters were validated using results from the MONERIS model (Behrendt et al., 2000) concerning riverine nitrogen retention, nitrogen inputs from point sources as well as nitrogen inputs through direct run-off (drainage etc.). In the vicinity of surface waters and in solid rock areas, the groundwater borne nitrogen inputs into surface waters are considerably high compared to the inputs into the aquifer due to predominantly unfavourable de-nitrification conditions and short residence times of groundwater. In the North German lowlands, however, the groundwater-borne nitrate inputs into surface waters are considerably low compared to the inputs into the aquifer. There, the residence time of groundwater in the aquifer is high and the groundwater is predominantly oxygen free and contains pyrite and/or organic carbon compounds, allowing a halving of the nitrate loads in the groundwater within a period of 1 to 4 years (see Wendland and Kunkel, 1999).

Use of CD63 expression as marker of in vitro basophil activation in identifying the culprit in insect venom allergy

BACKGROUND

The diagnosis of insect venom allergy and the indication for specific immunotherapy is based on history, skin tests and demonstration of hymenoptera venom specific IgE-antibodies. In cases with contradictory test results additional cellular tests are recommended.

OBJECTIVE

We evaluated the usefulness of a newly introduced test based on basophil CD63 expression as marker of activation in comparison with the basophil histamine release test (BHR) and the cellular antigen stimulation test (CAST) measuring leukotriene release.

METHODS

In 14 patients (10 males, 4 females; age; 12 to 67 years, mean: 42.5 +/- 15.1 years) with systemic reactions to hymenoptera stings in their history skin tests and determination of specific IgE-antibodies (CAP-RAST-FEIA) had shown inconsistent results: No demonstration of specific IgE-antibodies (n = 4), one sting by an unknown insect together with positive skin test and/or positive RAST to both bee and wasp venom (n = 4), several stings of partly unknown insects with positive skin test and/or demonstrable specific IgE-antibodies to more than one insect venom (n = 4), uncertain history and divergent results in skin test and/or RAST (n = 2). BHR, CAST and basophil activation test (BAT) were done according to the manufacturers with negative and positive controls and different concentrations of bee and wasp venom. The BAT is based on double staining with anti-IgE antibodies and anti-CD63 and subsequent determination of the percentage of activated basophils by flow cytometry.

RESULTS

BAT and skin test were concordant in 42.9%, BAT and RAST in 57.1%. Concordance of all three cellular tests was seen in 57.1%, of BAT and BHR in 69.1%, of BAT and CAST in 78.6% and of BHR and CAST in 64.3%. In 6 cases where the three cellular tests (BHR, CAST, BAT) were not in accordance the addition of BAT led to a more reliable diagnostic result concerning the relevant insect in 3 cases and added no further information in 3 cases. BAT in controls always was negative. Correlation between CAST and BAT was higher than between CAST and BHR.

CONCLUSIONS

In difficult cases of hymenoptera allergy, where history, skin tests and determination of specific antibodies do not allow a clear decision regarding the relevant insect species for immunotherapy, the additional performance of cellular tests (CAST and BAT) may be helpful.

Effects of inhaled CdO particles on the sphingolipid synthesis of rat lungs

Surfactant lipids of the alveolar space protect the lung from various environmental stimuli. We investigated the influence of ultrafine (UF) CdO particles inhalation on two key enzymes involved in lung sphingolipid metabolism, serine palmitoyltransferase (SPT), and sphingomyelinase (SMase). Rats inhaled either 0.63 mg UF-CdO/m(3) for 6 h (group 1), or 1.08 mg UF-CdO/m(3) 12 h/day for 10 days (group 2). Two corresponding control groups inhaled filtered clean air. Additional rats intratracheally instilled with lipopolysaccharide (LPS) were used as positive controls. Semiquantitative reverse-transcription polymerase chain reaction (RT-PCR) of lung tissue showed a significant increase in the level of SPT mRNA (LCB2 subunit) expression in group 2 compared to the corresponding controls (p <.01). Group 1 and LPS were not statistically different from control. No alteration in the mRNA level of SMase was detected in any exposure group. The immunohistochemical analysis showed that SPT (LCB2 subunit) localization was stronger in the alveolar type II cells of group 2 lungs compared to the corresponding controls. These results were correlated with alterations in BALF cellular and biochemical parameters and lung morphology. Since SPT is the key enzyme for de novo sphingolipid synthesis in lung surfactant and SMase is responsible for sphingomyelin catabolism, we can postulate that high-dose UF-CdO exposure for 10 days induces an increase in sphingolipid synthesis in the type II cells of rat lungs that would not be promptly followed by its degradation.

Emissions of heavy metals into river basins of Germany

The input of seven heavy metals (Cd, Cr, Cu, Hg, Ni, Pb and Zn) into the large river basins of Germany via various point and diffuse pathways were estimated for the period of 1985 through 2000. To quantify the emissions via point sources a nationwide survey on heavy metal data of municipal wastewater treatment plants and industrial direct discharges was carried out. The input via diffuse pathways was calculated using an adapted version of the model MONERIS. This model accounts for the significant transport processes, and it includes a Geographical Information System (GIS) that provides digital maps as well as extensive statistical information. For a comparison of the calculated heavy metal emission with the measured heavy metal load at monitoring stations the losses of heavy metals due to retention processes within the river systems have to be considered. Therefore heavy metal retention was calculated according to the retention functions given by Vink and Behrendt. For the large river basins a good correspondence could be found between estimated and measured heavy metal loads in rivers. The total emission into the North Sea decreased for each metal during the period of 1986 to 2000. The reduction varies between 87% for Hg and 41% for Ni mainly caused by the decline via point sources. Today's emissions of heavy metals into river basins of Germany are dominated by the input via diffuse pathways. The most important diffuse emission pathways are "paved urban areas" and "erosion".

[Studying school beginners in western and eastern Germany: allergy trends and sensitisations 1991-2000]

AIM

Aim of the study is to examine the hypotheses of a steeper increase in allergies and allergic sensitisations in East than in West German children between 1991 and 2000.

METHOD

Between 1991 and 2000 we yearly repeated cross-sectional studies (SAWO: Study on school beginners) and asked 36,645 parents about diagnoses and symptoms of allergies in their six-year old children (response: 79 %). The study was done in Leipzig, Halle, Merseburg, Magdeburg, small towns in the Altmark region, Duisburg, Essen, Köln and Borken during spring. An allergological investigation was included 1991, 1994, 1997 and 2000. Dermatologists diagnosed a prevalent atopic eczema, administered a skin prick test (n = 7,229) and blood was taken for the determination of specific IgE antibodies against common allergens (n = 7,714, RAST). Odds Ratios (OR) for trend were calculated separately for the data from East and West Germany and are given along with their 95% confidence intervals.

RESULTS

Allergies and their symptoms (exception: atopic eczema) were less prevalent in East German children born before the reunification than in West German ones. In East as well as in West Germany bronchial asthma was diagnosed more often in 2000 than in 1991 (OR East: 2.42 [1.78-3.28] West: 2.07 [1.43-3.00]). In contrast the prevalence of atopic eczemas was more than halved between 1991 and 2000. Of all symptoms and diagnoses of allergies only hay fever and its symptoms showed an upward trend in East Germany which was steeper than the trend in West Germany (OR East: 4.41 [3.17-6.13] West: 1.74 [1.19-2.57]). This can partly be explained by a parallel trend in sensitisation against grass pollen.

CONCLUSION

The spatial and temporal pattern of the allergic diseases bronchial asthma, hay fever and atopic eczema in six-year old children from Germany is different. The expected steeper increase of allergies in East than in West Germany could only be shown for hay fever.

Why are allergies increasing?

The incidence of atopic allergy is increasing in certain 'Western' countries but this remains unexplained. Various hypotheses with differing amounts of evidence and/or relevance have been assessed, including increased awareness of the diseases, improved diagnostics, genetic susceptibility, psycho-social influences, allergen exposure, decreased immune-system stimulation, underlying disease, anti-allergic therapy and pollution.

Environmental pollution and allergy

OBJECTIVES

Among the theories supporting the increase of allergic diseases in modern western countries during the last several decades is the concept that environmental pollutants may play a vital role. Reading this article will enable the reader to recognize the effect of different types of environmental pollution on the development, modulation, and persistence of allergic reactions.

DATA SOURCES

Data sources include references to relevant articles and texts. To characterize the influence of environmental pollutants on allergic reactions (allergotoxicology), epidemiologic, clinical, and experimental data are considered.

RESULTS

The investigations show that air pollution patterns differ with respect to their effect upon allergies. Classical air pollution (type I) with high sulfur dioxide and dust particles seems not to be associated with allergic disease in humans. However, type II pollution characterized by elevation of oxides of nitrogen (NOx), ozone (O3), tobacco smoke, fine and ultrafine particulate matter, and diesel exhaust particles seems to enhance allergic disease.

CONCLUSIONS

The data suggest that environmental pollution can act at different levels and by complex interactions both outside and inside the individual and influence allergic diseases.

Localization, release and bioavailability of pollen allergens: the influence of environmental factors

Allergens are integral constituents of plants or animals and their normal functions and localization are being characterized. To trigger responses in humans, allergens must become bioavailable and the role of air pollutants--for example diesel-exhaust particles --in this process is causing concern. Finally, the fact that some pollen releases eicosanoid-like proinflammatory mediators may have wide implications.

Haemoglobin adducts from aromatic amines in children in relation to area of residence and exposure to environmental tobacco smoke

OBJECTIVE

The influence of area of residence on haemoglobin (Hb) adducts of 4-aminobiphenyl (4-ABP), o-, m-, p-toluidine and o-anisidine was investigated in children from three different-sized Bavarian cities - Munich, Augsburg and Eichstätt, with 1,300,000, 250,000 and 13,000 inhabitants, respectively--and was compared with that of exposure to environmental tobacco smoke (ETS).

METHODS

Blood samples from Munich (n = 34) and Eichstätt (n = 64) were from children attending the Paediatric Clinic of the Technical University of Munich (TUM) or a practice in Eichstätt, respectively. Blood samples (n = 126) together with urine samples (n = 88) were collected from Augsburg children during school medical examination. Personal data including possible sources of ETS exposure were obtained at the interview. Hb adduct levels were analysed by a gas chromatographic method, using mass spectrometry with selected-ion monitoring. Urinary cotinine was determined by radioimmunoassay.

RESULTS

4-ABP Hb adduct levels in children from Munich were 1.5 and 1.2 times higher than those in children from Eichstätt and Augsburg (P < 0.001). Children from Munich also had significantly higher Hb adduct levels of monocyclic aromatic amines than did children from Eichstätt and, except for o-toluidine, children from Augsburg (P < 0.005). Compared with children from Eichstätt, children from Augsburg had higher Hb adduct levels of 4-ABP, o- and m-toluidine (P < 0.01) but not p-toluidine and o-anisidine. In a multivariate analysis, gender, age and body mass index had no consistent influence on Hb adducts. ETS exposure resulted in a slight, nonsignificant increase in 4-ABP Hb adduct levels. In contrast, adduct levels from monocyclic aromatic amines were consistently decreased in ETS-exposed children (significant for o- and m-toluidine, P<0.05).

CONCLUSIONS

Hb adducts from aromatic amines in children were strongly influenced by site of residence, whereas ETS exposure did not significantly increase the adduct levels.JECT

The Société Française d'Oncologie Pédiatrique LMB89 protocol: highly effective multiagent chemotherapy tailored to the tumor burden and initial response in 561 unselected children with B-cell lymphomas and L3 leukemia

This study was undertaken to show that a high survival rate can be obtained in B-cell (Burkitt and large B-cell) lymphoma and L3 leukemia with multiagent chemotherapy adapted to the tumor burden (stage, resection status, percentage of blasts in bone marrow, and central nervous system [CNS] involvement) and early response to chemotherapy, to investigate actual prognostic factors, and to see if large B-cell lymphoma can be treated with the same regimen as Burkitt lymphoma. Patients were classified into 3 risk groups. Group A (resected stage I and abdominal stage II) received 2 courses of vincristine, cyclophosphamide, doxorubicin, and prednisone. Group B (patients not eligible for groups A or C) received 5 courses of chemotherapy with, in addition, high-dose methotrexate, 3 g/m(2) over 3 hours; infusional cytarabine; and intrathecal (IT) methotrexate. Group C (patients with CNS involvement and acute lymphoblastic leukemia with at least 70% of blasts in bone marrow) received 8 courses with, in addition, high-dose methotrexate, 8 g/m(2); high-dose cytarabine; etoposide; and triple IT. Except in group A, treatment started with a prephase (COP, low-dose vincristine and cyclophosphamide). It was intensified for patients who did not respond to COP in group B and any patient with residual viable cells after the consolidation phase. A total of 561 patients were enrolled in the SFOP LMB89 protocol (July 1989-June 1996). Five-year survival is 92.5% (95% confidence interval [CI], 90%-94%) and event-free survival (EFS) 91% (95% CI, 89%-93%). EFS is 98% (95% CI, 90%-100%), 92% (95% CI, 89%-95%), and 84% (95% CI, 77%-90%) for group A, B, and C, respectively. In group B, multivariate analysis of prognostic factors showed that a lactate dehydrogenase level more than 2-fold the normal value, no response after COP, and age of at least 15 years were associated with a lower EFS. CNS involvement was the only prognostic factor in group C. (Blood. 2001;97:3370-3379)

Adverse reactions to foods

Allergic reactions to foods represent a prominent, actual and increasing problem in clinical medicine. Symptoms of food allergy comprise skin reactions (urticaria, angioedema, eczema) respiratory (bronchoconstriction, rhinitis), gastrointestinal (cramping, diarrhea) and cardiovascular symptoms with the maximal manifestation of anaphylactic shock. They can be elicited by minute amounts of allergens. The diagnosis of food allergy is done by history, skin test, in vitro allergy diagnosis and--if necessary--oral provocation tests, if possible placebo-controlled. Avoidance of respective allergens for the allergic patient, however, is often complicated or impossible due to deficits in declaration regulations in many countries. Increasing numbers of cases including fatalities, due to inadvertent intake of food allergens are reported. It is therefore necessary to improve declaration laws and develop methods for allergen detection in foods. Allergens can be detected by serological methods (enzyme immunoassays, in vitro basophil histamine release or in vivo skin test procedures in sensitized individuals). The problem of diagnosis of food allergy is further complicated by cross-reactivity between allergens in foods and aeroallergens (pollen, animal epithelia, latex etc.). Elicitors of pseudo-allergic reactions with similar clinical symptomatology comprise low-molecular-mass chemicals (preservatives, colorings, flavor substances etc.). For some of them (e.g. sulfites) detection assays are available. In some patients classic allergic contact eczema can be elicited systemically after oral intake of low-molecular-mass contact allergens such as nickel sulfate or flavorings such as vanillin in foods. The role of xenobiotic components in foods (e.g. pesticides) is not known at the moment. In order to improve the situation of the food allergic patient, research programs to elucidate the pathophysiology and improve allergen detection strategies have to be implemented together with reinforced declaration regulations on a quantitative basis.