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Krokos A, Orfanidis A, Mastrogianni O, Mitsa F, Avgeri M, Eboriadou M, Theodoridis G, Raikos N. Gas chromatography-mass spectrometry determination of nicotine and cotinine in urine: A study of the effect of passive smoking. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2024; 38:e9864. [PMID: 38972852 DOI: 10.1002/rcm.9864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/12/2024] [Accepted: 06/14/2024] [Indexed: 07/09/2024]
Abstract
RATIONALE Recent data suggest that passive smoking has a risk comparable to active smoking. Passive smoking is considered dangerous in children and is suspected as a cause of asthma. However, some reports are opposing such claims, indicating the need for solid results and large-scale studies. This scientific work aims to develop a method for the determination of nicotine (NCOT) and major nicotine's metabolite cotinine (COT) in urine samples, using gas chromatography-mass spectrometry (GC-MS). METHODS Analysis was performed using a gas chromatograph Agilent Technologies 7890A with an MS 5975C inert XL, EI/CI MSD with Triple-Axis detector. For sample preparation, liquid-liquid extraction was applied after an optimization study with different extraction media. Eventually, 1 mL of dichloromethane was selected for the extraction of 0.5 mL of urine. Suitable chromatographic conditions were found for the rapid and accurate determination of NCOT and COT. Injection of 2 μL was performed using GC-MS, and selected ion monitoring (SIM) analysis was performed with the following ions (m/z): 162 (quantifier ion) and 84, 133, 161 qualifier ions for NCOT, and 176 (quantifier ion) and 98, 118, 119, 147 qualifier ions for COT. Nicotine-D4 (NCOT-D4) and cotinine-D3 (COT-D3) were used as internal standards with quantifier ions 101 and 166, respectively. The retention time (Rt) for NCOT was 7.557 min and 9.743 min for COT. RESULTS The method was validated following international principles, assessing characteristics such as absolute recovery, carryover, linearity, specificity, selectivity, accuracy, precision, and stability. The method showed a linear dynamic range from 0.5 to 50 ng/mL, and the limits of detection and quantification were for both NCOT and COT 0.2 and 0.5 ng/mL, respectively. Validation results were found satisfactory. Finally, the method was applied to the analysis of 60 clinical pediatric samples obtained from Aristotle University's pediatric clinic to check for possible exposure to smoke. Concentration levels ranged between 0.5 and 16.2 ng/mL for NCOT and between 1.0 and 25.1 ng/mL for COT. CONCLUSIONS A rapid, sensitive, accurate, and simple method was developed and used as a tool for the confirmation of passive smoking in children. It is the first method applied to the analysis of such samples belonging to nonsmokers of young age. The total runtime of the GC-MS analysis was short (20 min), and the pretreatment protocol was simple, giving the ability for analysis of a large number of samples on a daily routine basis.
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Affiliation(s)
- Adamantios Krokos
- Laboratory of Analytical Chemistry, Department of Chemistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Amvrosios Orfanidis
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | | | - Foteini Mitsa
- Laboratory of Forensic Medicine & Toxicology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Avgeri
- Department of Pediatrics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Eboriadou
- Department of Pediatrics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Theodoridis
- Laboratory of Analytical Chemistry, Department of Chemistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Raikos
- Laboratory of Forensic Medicine & Toxicology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Gurrani S, Prakasham K, Zii Ying JL, Shiea J, Ku YJ, Lin YC, Huang PC, Andaluri G, Lee KC, Ponnusamy VK. A low-cost eco-friendly fast drug extraction (FaDEx) technique for environmental and bio-monitoring of psychoactive drug in urban water and sports-persons' urine samples. ENVIRONMENTAL RESEARCH 2023; 217:114787. [PMID: 36410459 DOI: 10.1016/j.envres.2022.114787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/23/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
Nicotine is the most prominent psychoactive/addictive chemical substance consumed worldwide among young players in team sports. Moreover, urinary nicotine discharge and nicotine-based products disposal in environmental waters has been unavoidable in recent years. Therefore, sensitive monitoring of nicotine content in environmental waters and human urine samples is essential. In this study, we developed a miniaturized novel green, low-cost, sensitive, in-syringe-based semi-automated fast drug extraction (FaDEx) protocol coupled with gas chromatography-flame ionization detection (GC-FID) for the efficient environmental and bio-monitoring of nicotine in aqueous samples. The FaDEx method consists of two steps; firstly, the target analyte was extracted using dimethyl carbonate (a green solvent) and extraction salts. After that, the extraction solvent was passed automatically through the solid-phase extraction cartridge at a constant flow rate for the cleanup process to achieve the sensitive nicotine analysis by GC-FID. Under optimized experimental conditions, the developed method showed excellent linearity over the concentration ranges between 20-2000 ng mL-1 with a correlation coefficient >0.99. The detection and quantification limits were 4 and 20 ng mL-1, respectively. The presented method was applied to monitor and assess nicotine exposure in sports-persons' urine and environmental water samples. The method accuracy and precision in terms of relative recovery and relative standard deviation (for triplicate analysis) were 85.4-110.2% and ≤8%, respectively. Finally, the impact of our procedure on the environment from a green analytical chemistry view was assessed using a novel metric system called AGREE, and obtained the greenness score of 0.87, indicating its an efficient alternative green analytical protocol for routine environmental and bio-monitoring of nicotine in environmental and biological samples.
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Affiliation(s)
- Swapnil Gurrani
- Research Center for Precision Environmental Medicine, and Ph.D. Program in Environmental and Occupational Medicine, Kaohsiung Medical University (KMU), Kaohsiung City, 807, Taiwan
| | - Karthikeyan Prakasham
- Research Center for Precision Environmental Medicine, and Ph.D. Program in Environmental and Occupational Medicine, Kaohsiung Medical University (KMU), Kaohsiung City, 807, Taiwan
| | - Jess Lim Zii Ying
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University (KMU), Kaohsiung City, 807, Taiwan
| | - Jentaie Shiea
- Research Center for Precision Environmental Medicine, and Ph.D. Program in Environmental and Occupational Medicine, Kaohsiung Medical University (KMU), Kaohsiung City, 807, Taiwan; Department of Medicinal and Applied Chemistry, Kaohsiung Medical University (KMU), Kaohsiung City, 807, Taiwan; Department of Chemistry, National Sun Yat-Sen University, Kaohsiung City, 804, Taiwan
| | - Yi-Jia Ku
- Research and Development Division, Great Engineering Technology (GETECH) Corporation, No.392, Yucheng Rd., Zuoying District., Kaohsiung City, 813, Taiwan
| | - Yu-Chia Lin
- Research and Development Division, Great Engineering Technology (GETECH) Corporation, No.392, Yucheng Rd., Zuoying District., Kaohsiung City, 813, Taiwan
| | - Po-Chin Huang
- Research Center for Precision Environmental Medicine, and Ph.D. Program in Environmental and Occupational Medicine, Kaohsiung Medical University (KMU), Kaohsiung City, 807, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes (NHRI), Miaoli County, 35053, Taiwan
| | - Gangadhar Andaluri
- Civil and Environmental Engineering Department, College of Engineering, Temple University, Philadelphia, PA 19122, United States
| | - Kung-Che Lee
- Department of Athletic Performace, National University of Kaohsiung, Kaohsiung City, 811, Taiwan.
| | - Vinoth Kumar Ponnusamy
- Research Center for Precision Environmental Medicine, and Ph.D. Program in Environmental and Occupational Medicine, Kaohsiung Medical University (KMU), Kaohsiung City, 807, Taiwan; Department of Medicinal and Applied Chemistry, Kaohsiung Medical University (KMU), Kaohsiung City, 807, Taiwan; Department of Chemistry, National Sun Yat-Sen University, Kaohsiung City, 804, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital (KMUH), Kaohsiung City, 807, Taiwan.
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Liu L, Wei J, Wang Y, Feng Q, Guo S, Liu G, Dong J, Jiang L, Li Q, Nie J, Yang J. Effect of Club cell secretory proteins on the association of tobacco smoke and PAH co-exposure with lung function decline: A longitudinal observation of Chinese coke oven workers. Int J Hyg Environ Health 2023; 247:114058. [PMID: 36334377 DOI: 10.1016/j.ijheh.2022.114058] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/18/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Exposure to polycyclic aromatic hydrocarbons (PAH) and tobacco smoke is associated with epithelial damage and reduced lung function. Club cell secretory protein (CC16) is a known biomarker for lung epithelial cells. However, the potential relationships between PAH and tobacco smoke exposure, CC16 levels, and reduced lung function remain unclear. OBJECTIVES This longitudinal study aimed to explore the potential role of CC16 in the association of tobacco smoke and PAH co-exposure with lung function. METHODS We enrolled 313 workers from a coking plant in China in 2014 and followed them up in 2019. The concentrations of PAH and nicotine metabolites in urine were determined using high-performance liquid chromatography (HPLC) with a fluorescence detector and HPLC-tandem mass spectrometry, respectively. The plasma CC16 concentration was determined using an enzyme-linked immunosorbent assay. RESULTS An analysis of the generalized estimating equation showed that each 1-unit increase in log-transformation of the last tertile of trans-3'-hydroxycotinine (3HC) was associated with a 3.30 ng/ml decrease in CC16. Restricted cubic spline analysis revealed a significant nonlinear dose-effect association between cotinine (COT) and CC16 (Pnonlinear = 0.018). In the low- CC16 subgroup, we found a significant association between total nicotine metabolites and forced vital capacity (FVC%) (β: 1.45, 95% CI: 2.87, -0.03), and the associations of nicotine (NIC), COT, and 3HC with FVC% were all of marginal significance. High levels of total hydroxyl polycyclic aromatic hydrocarbons (ΣOH-PAH) and NIC in the urine had an interactive effect on the decline of CC16 (P < 0.05). Cross-lagged panel analysis indicated that the decrease in CC16 preceded the decrease in FVC%. CC16 mediated the association between elevated nicotine metabolites and decreased FVC% in the low- CC16 subgroup. CONCLUSIONS CC16 plays an essential role in the association of PAH and tobacco smoke exposure with reduced lung function. Coke oven workers with low plasma CC16 levels are more likely to experience decreased lung function after tobacco smoke exposure.
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Affiliation(s)
- Lu Liu
- Department of Occupational Health, School of Public Health, Shanxi Medical University, China; NHC Key Laboratory of Pneumoconiosis, China
| | - Jiajun Wei
- Department of Occupational Health, School of Public Health, Shanxi Medical University, China; NHC Key Laboratory of Pneumoconiosis, China
| | - Yong Wang
- Department of Occupational Health, School of Public Health, Shanxi Medical University, China; NHC Key Laboratory of Pneumoconiosis, China
| | - Quan Feng
- Department of Occupational Health, School of Public Health, Shanxi Medical University, China; NHC Key Laboratory of Pneumoconiosis, China
| | - Shugang Guo
- Shanxi Provincial Center for Disease Control and Prevention, China
| | - Gaisheng Liu
- Center of Occupational Disease Prevention, Xishan Coal Electricity (Group) Co., Ltd, China
| | - Jun Dong
- Center of Occupational Disease Prevention, Xishan Coal Electricity (Group) Co., Ltd, China
| | - Liuquan Jiang
- Center of Occupational Disease Prevention, Xishan Coal Electricity (Group) Co., Ltd, China
| | - Qiang Li
- Center of Occupational Disease Prevention, Xishan Coal Electricity (Group) Co., Ltd, China
| | - Jisheng Nie
- Department of Occupational Health, School of Public Health, Shanxi Medical University, China; NHC Key Laboratory of Pneumoconiosis, China
| | - Jin Yang
- Department of Occupational Health, School of Public Health, Shanxi Medical University, China; NHC Key Laboratory of Pneumoconiosis, China.
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Zhao X, Guo S, Zhang R, Liu L, Guo L, Liu G, Jiang L, Li Q, Pan B, Nie J, Yang J. The interaction effects of secondhand smoke exposure and overweight on the prevalence of hypertension in Chinese coke oven workers and NHANES participants (2013-2016). CHEMOSPHERE 2022; 303:135120. [PMID: 35644234 DOI: 10.1016/j.chemosphere.2022.135120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 05/21/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The prevalence of hypertension may be affected by environmental pollution and personal behavior. OBJECTIVES We aimed to evaluate the interaction effects of secondhand smoke exposure and overweight on hypertension. METHODS In this cross-sectional study, a total of 627 workers from a coking plant in China and 1011 individuals from the NHANES database in the United States from 2013 to 2016 were selected as the research participants. The concentrations of 11 urinary polycyclic aromatic hydrocarbons (PAHs) metabolites and 3 tobacco metabolites were measured. An interaction effect was tested in the modified Poisson regression models. RESULTS For smokers among Chinese coke oven workers, the only statistically significant positive association was with hypertension in the highest tertile of nicotine metabolized ratio (NMR) (PR: 1.539, 95% CI: 1.013-2.337). Nonsmoking Chinese workers with 3rd tertile urinary nicotine levels were associated with a 114.8% significantly increased prevalence of hypertension (PR: 2.148, 95% CI: 1.025-4.500) compared to nonsmokers 1st tertile with nicotine levels. Association between tobacco exposure and hypertension is possibly modified by PAHs exposure (PR: 2.335, 95% CI: 0.933-5.841). Nonsmokers in the NHANES database with high urinary nicotine levels were associated with a 17.3% significantly increased prevalence of hypertension (PR: 1.173, 95% CI: 1.028-1.338) compared to those with low nicotine levels. We observed that overweight people with high nicotine levels had a significantly higher likelihood of hypertension than no overweight people with low nicotine levels among nonsmoking Chinese coke oven workers and NHANES participants (PR = 4.686, 95% CI: 1.488-14.754; PR = 1.251, 95% CI: 1.039-1.506). CONCLUSIONS Tobacco exposure and overweight are important risk factors for hypertension, and secondhand smoke exposure and overweight have an interactive effect on the incidence of hypertension in nonsmoking Chinese coke oven workers and NHANES participants.
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Affiliation(s)
- Xinyu Zhao
- Department of Occupational Health, School of Public Health, Shanxi Medical University, China; NHC Key Laboratory of Pneumoconiosis, China
| | - Shugang Guo
- Shanxi Provincial Center for Disease Control and Prevention, China
| | - Rui Zhang
- Shanxi Provincial Center for Disease Control and Prevention, China
| | - Lu Liu
- Department of Occupational Health, School of Public Health, Shanxi Medical University, China; NHC Key Laboratory of Pneumoconiosis, China
| | - Lan Guo
- Department of Occupational Health, School of Public Health, Shanxi Medical University, China; NHC Key Laboratory of Pneumoconiosis, China
| | - Gaisheng Liu
- Center of Occupational Disease Prevention, Xishan Coal Electricity (Group) Co., Ltd., China
| | - Liuquan Jiang
- Center of Occupational Disease Prevention, Xishan Coal Electricity (Group) Co., Ltd., China
| | - Qiang Li
- Center of Occupational Disease Prevention, Xishan Coal Electricity (Group) Co., Ltd., China
| | - Baolong Pan
- General Hospital of Taiyuan Iron & Steel (Group) Co., Ltd., China
| | - Jisheng Nie
- Department of Occupational Health, School of Public Health, Shanxi Medical University, China; NHC Key Laboratory of Pneumoconiosis, China
| | - Jin Yang
- Department of Occupational Health, School of Public Health, Shanxi Medical University, China; NHC Key Laboratory of Pneumoconiosis, China.
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Hautekiet P, Nawrot TS, Demarest S, Van der Heyden J, Van Overmeire I, De Clercq EM, Saenen ND. Environmental exposures and health behavior in association with mental health: a study design. Arch Public Health 2020; 78:105. [PMID: 33093954 PMCID: PMC7576706 DOI: 10.1186/s13690-020-00477-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/22/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Air pollution, green space and smoking are known to affect human health. However, less is known about their underlying biological mechanisms. One of these mechanisms could be biological aging. In this study, we explore the mediation of biomarkers of exposure and biological aging to explain the associations between environmental exposures, health behavior and mental health. METHODS The study population of this cross-sectional study (n = 1168) is a subsample of the Belgian 2018 Health Interview Survey (BHIS). Mental health indicators including psychological and severe psychological distress, life satisfaction, vitality, eating disorders, suicidal ideation, subjective health and depressive and anxiety disorders, demographics and health behavior such as smoking are derived from the BHIS. Urine and blood samples are collected to measure respectively the biomarkers of exposure (urinary black carbon (BC) and (hydroxy)cotinine) and the biomarkers of biological aging (mitochondrial DNA content (mtDNAc) and telomere length (TL)). Recent and chronic exposure (μg/m3) to nitrogen dioxide (NO2), particulate matter ≤2.5 μm (PM2.5) and ≤ 10 μm (PM10) and BC at the participants' residence are modelled using a high resolution spatial temporal interpolation model. Residential green space is defined in buffers of different size (50 m - 5000 m) using land cover data in ArcGIS 10 software. For the statistical analysis multivariate linear and logistic regressions as well as mediation analyses are used taking into account a priori selected covariates and confounders. RESULTS As this study combined data of BHIS and laboratory analyses, not all data is available for all participants. Therefore, data analyses will be conducted on different subsets. Data on air pollution and green space exposure is available for all BHIS participants. Questions on smoking and mental health were answered by respectively 7829 and 7213 BHIS participants. For biomarker assessment, (hydroxy) cotinine, urinary BC and the biomarkers of biological aging are measured for respectively 1130, 1120 and 985 participants. CONCLUSION By use of personal markers of air pollution and smoking, as well as biological aging, we will gain knowledge about the association between environmental exposures, health behavior, and the mental health status. The results of the study can provide insights on the health of the Belgian population, making it a nationwide interesting study.
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Affiliation(s)
- Pauline Hautekiet
- Sciensano, Brussels, Belgium
- Centre for Environmental Sciences, Hasselt University, Agoralaan gebouw D, BE-3590 Hasselt, Belgium
| | - Tim S. Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan gebouw D, BE-3590 Hasselt, Belgium
- Centre for Environment and Health, Leuven University, Leuven, Belgium
| | | | | | | | | | - Nelly D. Saenen
- Sciensano, Brussels, Belgium
- Centre for Environmental Sciences, Hasselt University, Agoralaan gebouw D, BE-3590 Hasselt, Belgium
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Liang Y, Zhou T. Recent advances of online coupling of sample preparation techniques with ultra high performance liquid chromatography and supercritical fluid chromatography. J Sep Sci 2018; 42:226-242. [PMID: 30136406 DOI: 10.1002/jssc.201800721] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/02/2018] [Accepted: 08/04/2018] [Indexed: 12/12/2022]
Abstract
Ultra high performance liquid chromatography and supercritical fluid chromatography techniques are favored because of their high efficiency and fast analysis speed. Although many sample preparation techniques have been coupled with common liquid chromatography online, the online coupling of sample preparation with the two popular chromatography techniques have gained increasing attention owing to the increasing requirements of efficiency and sensitivity. In this review, we have discussed and summarized the recent advances of the online coupling of sample preparation with ultra high performance liquid chromatography and supercritical fluid chromatography techniques. The main sample preparation techniques that have been coupled with ultra high performance liquid chromatography online are solid-phase extraction and in-tube solid-phase microextraction, while solid-phase extraction and supercritical fluid extraction are the main techniques that have been coupled with supercritical fluid chromatography online. Especially, the strategies for online coupling of sample preparation with chromatography techniques were summarized. Typical applications and growing trends of the online coupling techniques were also discussed in detail. With the increasing demands of improving the efficiency, throughput, and analytical capability toward complex samples of the analysis methods, online coupling of sample preparation with chromatography techniques will acquire further development.
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Affiliation(s)
- Yanshan Liang
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, P. R. China
| | - Ting Zhou
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, P. R. China
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Yuan Y, Wang Y, Yang M, Xu Y, Chen W, Zou X, Zheng B. Application of response surface methodology to vortex-assisted dispersive liquid-liquid extraction for the determination of nicotine and cotinine in urine by gas chromatography-tandem mass spectrometry. J Sep Sci 2018; 41:2261-2268. [PMID: 29484806 DOI: 10.1002/jssc.201701167] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/18/2018] [Accepted: 02/07/2018] [Indexed: 01/07/2023]
Affiliation(s)
- Yue Yuan
- Department of Sanitary Technology; West China School of Public Health; University of Sichuan; Chengdu P. R. China
| | - Yan Wang
- Department of Sanitary Technology; West China School of Public Health; University of Sichuan; Chengdu P. R. China
| | - Mingqi Yang
- Department of Sanitary Technology; West China School of Public Health; University of Sichuan; Chengdu P. R. China
| | - Yicong Xu
- Department of Sanitary Technology; West China School of Public Health; University of Sichuan; Chengdu P. R. China
| | - Weina Chen
- Department of Sanitary Technology; West China School of Public Health; University of Sichuan; Chengdu P. R. China
| | - Xiaoli Zou
- Department of Sanitary Technology; West China School of Public Health; University of Sichuan; Chengdu P. R. China
| | - Bo Zheng
- Department of Sanitary Technology; West China School of Public Health; University of Sichuan; Chengdu P. R. China
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A high area, porous and resistant platinized stainless steel fiber coated by nanostructured polypyrrole for direct HS-SPME of nicotine in biological samples prior to GC-FID quantification. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1061-1062:5-10. [DOI: 10.1016/j.jchromb.2017.06.042] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 06/23/2017] [Accepted: 06/24/2017] [Indexed: 12/30/2022]
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Simons K, De Smedt T, Stove C, De Paepe P, Bader M, Nemery B, Vleminckx C, De Cremer K, Van Overmeire I, Fierens S, Mertens B, Göen T, Schettgen T, Van Oyen H, Van Loco J, Van Nieuwenhuyse A. Short-term health effects in the general population following a major train accident with acrylonitrile in Belgium. ENVIRONMENTAL RESEARCH 2016; 148:256-263. [PMID: 27085497 DOI: 10.1016/j.envres.2016.03.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/22/2016] [Accepted: 03/23/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Following a train derailment, several tons of acrylonitrile (ACN) exploded, inflamed and part of the ACN ended up in the sewage system of the village of Wetteren. More than 2000 residents living in the close vicinity of the accident and along the sewage system were evacuated. A human biomonitoring study of the adduct N-2-cyanoethylvaline (CEV) was carried out days 14-21 after the accident. OBJECTIVES (1) To describe the short-term health effects that were reported by the evacuated residents following the train accident, and (2) to explore the association between the CEV concentrations, extrapolated at the time of the accident, and the self-reported short-term health effects. METHODS Short-term health effects were reported in a questionnaire (n=191). An omnibus test of independence was used to investigate the association between the CEV concentrations and the symptoms. Dose-response relationships were quantified by Generalized Additive Models (GAMs). RESULTS The most frequently reported symptoms were local symptoms of irritation. In non-smokers, dose-dependency was observed between the CEV levels and the self-reporting of irritation (p=0.007) and nausea (p=0.007). Almost all non-smokers with CEV concentrations above 100pmol/g globin reported irritation symptoms. Both absence and presence of symptoms was reported by non-smokers with CEV concentrations below the reference value and up to 10 times the reference value. Residents who visited the emergency services reported more symptoms. This trend was seen for the whole range of CEV concentrations, and thus independently of the dose. DISCUSSION AND CONCLUSION The present study is one of the first to relate exposure levels to a chemical released during a chemical incident to short-term (self-reported) health effects. A dose-response relation was observed between the CEV concentrations and the reporting of short-term health effects in the non-smokers. Overall, the value of self-reported symptoms to assess exposure showed to be limited. The results of this study confirm that a critical view should be taken when considering self-reported health complaints and that ideally biomarkers are monitored to allow an objective assessment of exposure.
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Affiliation(s)
- K Simons
- Scientific Institute of Public Health, Brussels, Belgium.
| | - T De Smedt
- Scientific Institute of Public Health, Brussels, Belgium.
| | - C Stove
- Ghent University, Laboratory of Toxicology, Department of Bioanalysis, Ghent, Belgium.
| | - P De Paepe
- Ghent University Hospital, Department of Emergency Medicine, Ghent, Belgium.
| | - M Bader
- BASF SE, Occupational Medicine & Health Protection, Ludwigshafen, Germany.
| | - B Nemery
- Katholieke Universiteit Leuven, Department of Public Health and Primary Care, Centre for Environment and Health, Leuven, Belgium.
| | - C Vleminckx
- Scientific Institute of Public Health, Brussels, Belgium.
| | - K De Cremer
- Scientific Institute of Public Health, Brussels, Belgium.
| | | | - S Fierens
- Scientific Institute of Public Health, Brussels, Belgium.
| | - B Mertens
- Scientific Institute of Public Health, Brussels, Belgium.
| | - T Göen
- University of Erlangen-Nuremberg, Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Erlangen, Germany.
| | - T Schettgen
- RWTH Aachen University, Institute for Occupational and Social Medicine, Medical Faculty, Aachen, Germany.
| | - H Van Oyen
- Scientific Institute of Public Health, Brussels, Belgium.
| | - J Van Loco
- Scientific Institute of Public Health, Brussels, Belgium.
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Van Overmeire IP, De Smedt T, Dendale P, Nackaerts K, Vanacker H, Vanoeteren JF, Van Laethem DM, Van Loco J, De Cremer KA. Nicotine Dependence and Urinary Nicotine, Cotinine and Hydroxycotinine Levels in Daily Smokers. Nicotine Tob Res 2016; 18:1813-9. [DOI: 10.1093/ntr/ntw099] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 04/03/2016] [Indexed: 12/25/2022]
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Liachenko N, Boulamery A, Simon N. Nicotine and metabolites determination in human plasma by ultra performance liquid chromatography-tandem mass spectrometry: a simple approach for solving contamination problem and clinical application. Fundam Clin Pharmacol 2015; 29:499-509. [DOI: 10.1111/fcp.12132] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 04/26/2015] [Accepted: 05/18/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Natalia Liachenko
- Service de Pharmacologie Clinique; Faculté de Médecine; Aix-Marseille Université; 27 Bd Jean Moulin F-13385 Marseille Cedex 05 Marseille France
| | - Audrey Boulamery
- Service de Pharmacologie Clinique; Faculté de Médecine; Aix-Marseille Université; 27 Bd Jean Moulin F-13385 Marseille Cedex 05 Marseille France
| | - Nicolas Simon
- Service de Pharmacologie Clinique; Faculté de Médecine; Aix-Marseille Université; 27 Bd Jean Moulin F-13385 Marseille Cedex 05 Marseille France
- INSERM U912 (SESSTIM); Aix-Marseille Université; F-13006 Marseille France
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Lupsa IR, Nunes B, Ligocka D, Gurzau AE, Jakubowski M, Casteleyn L, Aerts D, Biot P, Den Hond E, Castaño A, Esteban M, Kolossa-Gehring M, Fiddicke U, Knudsen LE, Schoeters G, Reis MF. Urinary cotinine levels and environmental tobacco smoke in mothers and children of Romania, Portugal and Poland within the European human biomonitoring pilot study. ENVIRONMENTAL RESEARCH 2015; 141:106-117. [PMID: 25841796 DOI: 10.1016/j.envres.2015.03.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 03/19/2015] [Accepted: 03/21/2015] [Indexed: 06/04/2023]
Abstract
The aim of this study was to explore data from the DEMOCOPHES study population for Romania, Portugal and Poland, in order to assess smoking patterns and the extent of ETS exposure and compare the national study samples with reference to the respective anti-smoking laws. The subset of the DEMOCOPHES study sample consisted of 360 children and their mothers (120 in each of the three countries - Romania (RO), Portugal (PT) and Poland (PL). Smoking was assessed using a detailed questionnaire for the participants, which addresses both active and passive smoking. This assessment uses exposure-relevant questionnaire data, in particular on the home environment and residence, socio-demographic characteristics, lifestyle such as nutrition, smoking behavior, other exposure-relevant behavior and occupational history, as well as urinary cotinine and creatinine measurements. We performed general statistical analysis and innovative receiver operating characteristic (ROC) curve analyses. Smoking prevalence as evaluated by the questionnaire was generally high, and higher than official statistics, which suggests some under-reporting in the countries, particularly in Romania. Urinary cotinine levels provided biochemical confirmation of the high and similar smoking prevalence for the three countries. Concerning ETS exposure, Romania presented significantly higher levels, for children as well as for non-smoking mothers, with Portugal showing significantly lower levels. Compared to non-smoking mothers, the children showed relatively higher ETS exposure levels in all three countries. The established country-specific optimal cut-off values in urinary cotinine to distinguish smokers from non-smokers vary more than those to discriminate ETS exposure extent in non-smoking mothers and children. Although different between countries, these values are a valuable output to monitor effectiveness of both national antismoking laws and educational programs in the three countries. The findings of this study point to the urgent need for stronger, more effective and well enforced smoke-free legislation in the three countries.
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Affiliation(s)
- Ioana-Rodica Lupsa
- Environmental Health Center, 58 Busuiocului Street, 400240 Cluj-Napoca, Romania.
| | - Baltazar Nunes
- Instituto de Medicina Preventiva, Faculdade de Medicina da Universidade de Lisboa, Portugal; Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal
| | | | - Anca Elena Gurzau
- Environmental Health Center, 58 Busuiocului Street, 400240 Cluj-Napoca, Romania
| | | | - Ludwine Casteleyn
- University of Leuven, Centrum Menselijke Erfelijkheid, Herestraat 49 bus 602, 3000 Leuven, Belgium
| | - Dominique Aerts
- Federal Public Service Health, Food Chain Safety and Environment, Place Victor Horta 40/10, 1060 Brussels, Belgium
| | - Pierre Biot
- Federal Public Service Health, Food Chain Safety and Environment, Place Victor Horta 40/10, 1060 Brussels, Belgium
| | - Elly Den Hond
- Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium
| | - Argelia Castaño
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III (ISCIII), Ctra. Majadahonda-Pozuelo, km2, E- 28220 Madrid, Spain
| | - Marta Esteban
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III (ISCIII), Ctra. Majadahonda-Pozuelo, km2, E- 28220 Madrid, Spain
| | - Marike Kolossa-Gehring
- Federal Environment Agency (UBA, Federal Environment Agency (UBA), Corrensplatz 1, 14195 Berlin, Germany
| | - Ulrike Fiddicke
- Federal Environment Agency (UBA, Federal Environment Agency (UBA), Corrensplatz 1, 14195 Berlin, Germany
| | - Lisbeth E Knudsen
- University of Copenhagen, Department of Public Health, Øster Farimagsgade 5, DK 1353 Copenhagen K, Denmark
| | - Greet Schoeters
- Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium; University of Southern Denmark, Odense, Denmark
| | - M Fátima Reis
- Instituto de Medicina Preventiva, Faculdade de Medicina da Universidade de Lisboa, Portugal
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13
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Doctor EL, McCord B. The application of supported liquid extraction in the analysis of benzodiazepines using surface enhanced Raman spectroscopy. Talanta 2015; 144:938-43. [PMID: 26452911 DOI: 10.1016/j.talanta.2015.07.036] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 07/10/2015] [Accepted: 07/11/2015] [Indexed: 10/23/2022]
Abstract
Benzodiazepines are among the most frequently prescribed medicines for anxiety disorders and are present in many toxicological screens. These drugs are often administered in the commission of drug facilitated sexual assaults due their effects on the central nervous system. Due to the potency of the drugs, only small amounts are usually given to victims; therefore, the target detection limit for these compounds in biological samples has been set at 50 ng/mL. Currently the standard screening method for detection of this class of drug is the immunoassay; however, screening methods that are more sensitive and selective than immunoassays are needed to encompass the wide range of structural variants of this class of compounds. Surface enhanced Raman spectroscopy (SERS) can be highly sensitive and has been shown to permit analysis of various benzodiazepines with limits of detection as low as 6 ng/mL. This technique permits analytical results in less than 2 min when used on pure drug samples. For biological samples, a key issue for analysis by SERS is removal of exogenous salts and matrix components. In this paper we examine supported liquid extraction as a useful preparation technique for SERS detection. Supported liquid extraction has many of the benefits of liquid-liquid extraction along with the ability to be automated. This technique provides a fast and clean extraction for benzodiazepines from urine at a pH of 5.0, and does not produce large quantities of solvent waste. To validate this procedure we have determined figures of merit and examined simulated urine samples prepared with commonly appearing interferences. It was shown that at a pH 5.0 many drugs that are prevalent in urine samples can be removed, permitting a selective detection of the benzodiazepine of interest. This technique has been shown to provide rapid (less than 20 min), sensitive, and specific detection of benzodiazepines with limits of detection between 32 and 600 ng/mL and dynamic range of 32-25,000 ng/mL. It provides the forensic community with a sensitive and specific screening technique for the detection of benzodiazepines in drug facilitated assault cases.
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Affiliation(s)
- Erika L Doctor
- Department of Chemistry and biochemistry, Florida International University, 11200 SW 8th Street CP304, Miami, FL 33183, United States.
| | - Bruce McCord
- Department of Chemistry and biochemistry, Florida International University, 11200 SW 8th Street CP304, Miami, FL 33183, United States.
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14
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Recent advances in MS methods for nicotine and metabolite analysis in human matrices: clinical perspectives. Bioanalysis 2015; 6:2171-83. [PMID: 25331861 DOI: 10.4155/bio.14.176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Tobacco smoking is a major global health issue and represents the leading cause of preventable death in the developed countries. Nicotine is a major alkaloid found in tobacco products and its detection with its metabolites in human matrices is generally used for assessing tobacco consumption and second hand exposure. Several analytical techniques have been developed for the detection of nicotine and its metabolites, and MS coupled with chromatography is considered the standard reference method because of its superior sensitivity and specificity. In this work, we reviewed nicotine metabolism, clinical MS and the latest (2009-2014) development of MS-based techniques for measurement of nicotine and metabolites in human matrices. Appropriate biomarker and matrix selection are also critically discussed.
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Fischer L, Mikus F, Jantos R, Skopp G. Simultaneous quantification of tobacco alkaloids and major phase I metabolites by LC-MS/MS in human tissue. Int J Legal Med 2015; 129:279-87. [PMID: 25304849 DOI: 10.1007/s00414-014-1093-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 10/01/2014] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Insurance agencies might request laboratories to differentiate whether a deceased has been a smoker or not to decide about refunding of his nonsmoker rate. In this context, the question on a solid proof of tobacco alkaloids and major metabolites in tissues came up. Currently, an appropriate assay is still lacking to analyze tissue distribution in smokers or nonsmokers. Nicotine (NIC), nornicotine (NNIC), anatabine (ATB), anabasine (ABS), and myosmine (MYO) are naturally occurring alkaloids of the tobacco plant; most important phase I metabolites of NIC are cotinine (COT), norcotinine (NCOT), trans-3'-hydroxycotinine (HCOT), nicotine-N'-oxide (NNO), and cotinine-N-oxide (CNO). An analytical assay for their determination was developed and applied to five randomly selected autopsy cases. METHODS Homogenates using 500 mg aliquots of tissue samples were analyzed by liquid chromatography/tandem mass spectrometry following solid phase extraction. The method was validated according to current international guidelines. RESULTS NIC, COT, NCOT, ABS, ATB, and HCOT could be detected in all tissues under investigation. Highest NIC concentrations were observed in the lungs, whereas highest COT concentrations have been found in the liver. MYO was not detectable in any of the tissues under investigation. CONCLUSIONS The assay is able to adequately separate isobaric analyte pairs such as NIC/ABS/NCOT and HCOT/CNO thus being suitable for the determination of tobacco alkaloids and their phase I metabolites from tissue. More autopsy cases as well as corresponding body fluids and hair samples will be investigated to differentiate smokers from nonsmokers.
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Affiliation(s)
- Lisa Fischer
- Institute of Legal and Traffic Medicine, University Hospital Heidelberg, Voss-Strasse 2, 69115, Heidelberg, Germany
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16
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Shastri MD, Lu W, Ferguson SG, Narkowicz CK, Davies NW, Jacobson GA. Determination of Cotinine, 3′-Hydroxycotinine, and Their Glucuronides in Urine by Ultra-high Performance Liquid Chromatography. ANAL LETT 2014. [DOI: 10.1080/00032719.2014.979363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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17
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Mahpishanian S, Sereshti H. Graphene oxide-based dispersive micro-solid phase extraction for separation and preconcentration of nicotine from biological and environmental water samples followed by gas chromatography-flame ionization detection. Talanta 2014; 130:71-7. [DOI: 10.1016/j.talanta.2014.06.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/04/2014] [Accepted: 06/05/2014] [Indexed: 01/03/2023]
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18
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De Smedt T, De Cremer K, Vleminckx C, Fierens S, Mertens B, Van Overmeire I, Bader M, De Paepe P, Göen T, Nemery B, Schettgen T, Stove C, Van Oyen H, Van Loco J, Van Nieuwenhuyse A. Acrylonitrile exposure in the general population following a major train accident in Belgium: A human biomonitoring study. Toxicol Lett 2014; 231:344-51. [DOI: 10.1016/j.toxlet.2014.09.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 09/08/2014] [Accepted: 09/09/2014] [Indexed: 11/28/2022]
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19
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Acrylonitrile exposure assessment in the emergency responders of a major train accident in Belgium: A human biomonitoring study. Toxicol Lett 2014; 231:352-9. [DOI: 10.1016/j.toxlet.2014.08.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 08/08/2014] [Accepted: 08/11/2014] [Indexed: 11/20/2022]
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20
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Pan J, Zhang C, Zhang Z, Li G. Review of online coupling of sample preparation techniques with liquid chromatography. Anal Chim Acta 2014; 815:1-15. [DOI: 10.1016/j.aca.2014.01.017] [Citation(s) in RCA: 136] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 12/05/2013] [Accepted: 01/07/2014] [Indexed: 11/16/2022]
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21
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Pirard C, Koppen G, De Cremer K, Van Overmeire I, Govarts E, Dewolf MC, Van De Mieroop E, Aerts D, Biot P, Casteleyn L, Kolossa-Gehring M, Schwedler G, Angerer J, Koch HM, Schindler BK, Castaño A, Esteban M, Schoeters G, Den Hond E, Sepai O, Exley K, Horvat M, Bloemen L, Knudsen LE, Joas R, Joas A, Van Loco J, Charlier C. Hair mercury and urinary cadmium levels in Belgian children and their mothers within the framework of the COPHES/DEMOCOPHES projects. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 472:730-740. [PMID: 24333995 DOI: 10.1016/j.scitotenv.2013.11.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 11/05/2013] [Accepted: 11/05/2013] [Indexed: 06/03/2023]
Abstract
A harmonized human biomonitoring pilot study was set up within the frame of the European projects DEMOCOPHES and COPHES. In 17 European countries, biomarkers of some environmental pollutants, including urinary cadmium and hair mercury, were measured in children and their mothers in order to obtain European-wide comparison values on these chemicals. The Belgian participant population consisted in 129 school children (6-11 years) and their mothers (≤ 45 years) living in urban or rural areas of Belgium. The geometric mean levels for mercury in hair were 0.383 μg/g and 0.204 μg/g for respectively mothers and children. Cadmium in mother's and children's urine was detected at a geometric mean concentration of respectively 0.21 and 0.04 μg/l. For both biomarkers, levels measured in the mothers and their child were correlated. While the urinary cadmium levels increased with age, no trend was found for hair mercury content, except the fact that mothers hold higher levels than children. The hair mercury content increased significantly with the number of dental amalgam fillings, explaining partially the higher levels in the mothers by their higher presence rate of these amalgams compared to children. Fish or seafood consumption was the other main parameter determining the mercury levels in hair. No relationship was found between smoking status and cadmium or mercury levels, but the studied population included very few smokers. Urinary cadmium levels were higher in both mothers and children living in urban areas, while for mercury this difference was only significant for children. Our small population showed urinary cadmium and hair mercury levels lower than the health based guidelines suggested by the WHO or the JECFA (Joint FAO/WHO Expert Committee on Food Additives). Only 1% had cadmium level slightly higher than the German HBM-I value (1 μg/l for adults), and 9% exceeded the 1 μg mercury/g hair suggested by the US EPA.
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Affiliation(s)
- Catherine Pirard
- CHU of Liege, Laboratory of Clinical, Forensic and Environmental Toxicology, CHU (B35), 4000 Liege, Belgium.
| | - Gudrun Koppen
- Flemish Institute of Technological Research, Environmental Risk and Health Unit, Boeretang 200, 2400 Mol, Belgium.
| | - Koen De Cremer
- Scientific Institute of Public Health, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | - Ilse Van Overmeire
- Scientific Institute of Public Health, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | - Eva Govarts
- Flemish Institute of Technological Research, Environmental Risk and Health Unit, Boeretang 200, 2400 Mol, Belgium.
| | - Marie-Christine Dewolf
- Provincial Institute Hainaut Vigilance Sanitaire - Hainaut Hygiène Publique en (HVS-HPH), Boulevard Sainctelette, 55, 7000 Mons, Belgium.
| | - Els Van De Mieroop
- Provincial Institute for Hygiene (PIH), Boomgaardstraat 22 bus 1, 2600 Antwerpen, Belgium.
| | - Dominique Aerts
- Federal Public Service Health, Food Chain Safety and Environment, Place Victor Horta 40/10, 1060 Brussels, Belgium.
| | - Pierre Biot
- Federal Public Service Health, Food Chain Safety and Environment, Place Victor Horta 40/10, 1060 Brussels, Belgium.
| | - Ludwine Casteleyn
- University of Leuven, Center for Human Genetics, Herestraat 49, 3000 Leuven, Belgium.
| | | | - Gerda Schwedler
- Federal Environment Agency, Corrensplatz 1, 14195 Berlin, Germany.
| | - Jürgen Angerer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
| | - Birgit K Schindler
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
| | - Argelia Castaño
- Instituto de Salud Carlos III (ISCIII), Ctra. Majadahonda - Pozuelo, Km. 2, 28220, Madrid, Spain.
| | - Marta Esteban
- Instituto de Salud Carlos III (ISCIII), Ctra. Majadahonda - Pozuelo, Km. 2, 28220, Madrid, Spain.
| | - Greet Schoeters
- Flemish Institute of Technological Research, Environmental Risk and Health Unit, Boeretang 200, 2400 Mol, Belgium.
| | - Elly Den Hond
- Flemish Institute of Technological Research, Environmental Risk and Health Unit, Boeretang 200, 2400 Mol, Belgium.
| | - Ovnair Sepai
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire OX11 0RQ, United Kingdom.
| | - Karen Exley
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire OX11 0RQ, United Kingdom.
| | - Milena Horvat
- Jožef Stefan Institute, Jamova cesta 39, 1000 Ljubljana, Slovenia.
| | - Louis Bloemen
- Environmental Health Science International, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.
| | - Lisbeth E Knudsen
- University of Copenhagen, Department of Public Health, Øster Farimagsgade 5, 1353 København, Denmark.
| | - Reinhard Joas
- BiPRO GmbH, Grauertstrasse 12, 81545 Munich, Germany.
| | - Anke Joas
- BiPRO GmbH, Grauertstrasse 12, 81545 Munich, Germany.
| | - Joris Van Loco
- Scientific Institute of Public Health, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | - Corinne Charlier
- CHU of Liege, Laboratory of Clinical, Forensic and Environmental Toxicology, CHU (B35), 4000 Liege, Belgium.
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