Polonium and lung cancer

Use of air things radon detector in liquid samples (serum and urine)

This study involved the assessment of 222Rn concentrations in liquid samples (namely serum and urine) obtained from individuals who were smokers and non-smokers across five distinct age groups in the Najaf Governorate of Iraq. The measurements were conducted using a portable digital Air Things device commonly employed for detecting radon gas in residential environments. This device was placed in a container that is placed in liquid samples, which makes it work to capture the existing radon. The mean value of radon concentrations in serum and urine samples for smokers was 5.64 ± 2.80 Bq/m3 and 3.56 ± 2.31 Bq/m3, respectively. While, the mean value of radon concentrations in serum and urine samples for non-smokers was 2.32 ± 0.67 Bq/m3 and 1.61 ± 1.00 Bq/m3, respectively. By comparing the radon concentrations for serum and urine samples with age and smoking groups, the value of P-Value (p < 0.01) was increased significantly statistically. Also, it is found that a positive and good correlation for radon concentrations between serum and urine. Although the levels of radon were found to be under the globally accepted thresholds, the results of 222Rn in all samples of serum and urine in smokers were higher than in non-smokers. Thus, it may be concluded that cigarette smoking is used as a biomarker of the presence of radon gas.

Smoking Modifies the Association Between Radon Exposure and Incident Ischemic Stroke: The REGARDS Study

BACKGROUND

Exposure to radon has been linked to lung cancer and other lung diseases. Although biologically plausible, research of residential radon exposure in relation to stroke risk is scarce.

METHODS

Study participants were from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) cohort (n=30 239), which consisted of male and female non-Hispanic Black and White adults aged 45 and older. After excluding participants with baseline stroke and transient ischemic attack, and missing information on exposure and outcome of interest, the final sample size was 26 950. The primary outcome was time to the first ischemic stroke through September 30, 2020. County-level radon measures from Lawrence Berkeley National Laboratory were linked to each participant based on their geocoded residential history. We used Cox proportional hazards regression models with a time-dependent exposure to estimate hazard ratios and 95% CIs for the association.

RESULTS

After controlling for potential confounding factors including demographic, lifestyle, clinical variables, and PM2.5, radon exposure was significantly associated with incident ischemic stroke among never-smokers (hazard ratio, 1.39 [95% CI, 1.01-1.90]) but not ever-smokers. The results were generally consistent in the sensitivity analysis when using radon measures from state/Environmental Protection Agency residential radon survey.

CONCLUSIONS

Findings from this study suggest that the association between residential radon exposure and incidence of ischemic stroke varies by smoking status and may be prominent in never-smokers. Further studies incorporating indoor-radon measures are needed to confirm these findings.

Verification of radon, radium, polonium concentrations and lung cancer rates in blood of female hookah smokers

Hookah smoking has become very popular in Iraq among women and men. Hookah tobacco contains natural radioactive elements, such as radon, radium, and uranium, as well as toxic elements, such as polonium, which are released during the combustion of tobacco and are inhaled by smoking. Most reviews focus on hookah tobacco, and only a few have investigated the blood of hookah smokers. In this study, a CR-39 detector was used to measure radon, radium, and polonium concentrations and conduct risk assessments in female hookah smokers of different ages. The results show that the concentrations of radon-222, polonium-218, and polonium-214 varied between 61.62 and 384.80, 5.45–33.64 on the wall of the can, and 2.43–15.00 Bq/m3 on the surface of the detector, respectively. The effective radium-226 concentration varied between 4.52 and 56.31 Bq/kg. The absorbed effective dose varied between 1.55 and 9.71 mSv/y, which is within the recommended limit (3–10 mSv/y) by International Commission on Radiological Protection (ICRP). The average case of lung cancer 107.91 cppp, which exceeds the European Union (EU) limit (96.9–104.8 cppp). The rates of radon activity and radon exhalation from the intake of a natural radionuclide due to hookah smoking in a female’s blood were calculated and discussed. This study aimed to establish preliminary results on the risks of radioactivity concentrations and assess the dose in the blood of women who smoke hookah and assess the possibility of developing cancer.

Soil to tobacco component transfer factors for natural radionuclides 40K, 226Ra, and 232Th and the risk assessment of tobacco leaf in smoking

This study determined the activity concentrations and corresponding transfer factors (TF) of ⁴⁰K, ²²⁶Ra, and ²³²Th in three tobacco components (root, stem, and leaf). The radiation hazard index parameters were assessed for the tobacco leaf. The activity concentrations in the soil were 589-762, 32-43, and 49-59 Bq kg-dw^-1 (dry weight) for ⁴⁰K, ²²⁶Ra, and ²³²Th, respectively. The average activity concentrations of ⁴⁰K, ²²⁶Ra, and ²³²Th were 447, 5.41 and 5.69 Bq/kg-dw for the root, 670, 9.64 and 7.61 Bq kg-dw^-1 for the stem, and 793, 6.79 and 6.15 Bq kg-dw^-1 for the leaf, respectively. The TF values were 0.42-1.42, 0.10-0.49 and 0.06-0.23 for ⁴⁰K, ²²⁶Ra, and ²³²Th, respectively. The stem and leaf ⁴⁰K TF values were significantly higher than the root values. The stem ²²⁶Ra TF values were significantly higher than the root values. The ²²⁶Ra and ²³²Th activity concentrations and TFs of tobacco components had a significant positive correlation. Based on the activity concentrations of the tobacco leaves, the annual inhalation effective dose to the lungs for an adult smoker was 0.32-0.81 mSv y^-1 (average 0.60 mSv y^-1). The Excess Lifetime Cancer Risk (ELCR) caused by smoking was an average of 2.39 × 10^-3.

Does protracted radon exposure play a role in the development of dementia?

Radon is a ubiquitous radioactive gas that decays into a series of solid radioactive decay products. Radon, and its decay products, enter the human body primarily through inhalation and can be delivered to various tissues including the brain through systemic circulation. It can also reach the brain by neuronal pathways via the olfactory system. While ionizing radiation has been suggested as a risk factor of dementia for decades, studies exploring the possible role of radon exposure in the development of Alzheimer's Diseases (AD) and other dementias are sparse. We systematically reviewed the literature and found several lines of evidence suggesting that radon decay products (RDPs) disproportionally deposit in the brain of AD patients with selective accumulation within the protein fractions. Ecologic study findings also indicate a significant positive correlation between geographic-level radon distribution and AD mortality in the US. Additionally, pathologic studies of radon shed light on the potential pathways of radon decay product induced proinflammation and oxidative stress that may result in the development of dementia. In summary, there are plausible underlying biological mechanisms linking radon exposure to the risk of dementia. Since randomized clinical trials on radon exposure are not feasible, well-designed individual-level epidemiologic studies are urgently needed to elucidate the possible association between radon (i.e., RDPs) exposure and the onset of dementia.

Same pollution sources for climate change might be hyperactivating the NLRP3 inflammasome and exacerbating neuroinflammation and SARS mortality

We have reviewed a considerable amount of recent scientific papers relating inflammation caused by air pollution with chronic and severe medical conditions. Furthermore, there are evidences relating organ inflammation caused by not only outdoor long-term but also short-term inhaled radioisotopes contained in high polluted air or in household natural radioactive background aerosols, in addition to SARS-COV-2 attached to bioaerosols, which are related with a worst evolution of severe acute respiratory syndrome patients. Reactive oxygen species (ROS) production induced by the interaction with environmental ionizing radiation contained in pollution is pointed out as a critical mechanism that predispose mainly to elder population, but not excluding young subjects, presenting previous chronic conditions of lung inflammation or neuroinflammation, which can lead to the most serious consequences.

210PO IN SOIL AND TOBACCO LEAVES IN QUANG XUONG, VIETNAM AND ESTIMATION OF ANNUAL EFFECTIVE DOSE TO SMOKERS

210Po is the main radiotoxic chemical in tobacco smoke and one of the primary causes of lung cancer. Investigating 210Po concentration in tobacco is important in estimating the annual effective dose (AED) due to smoking. In this study, the 210Po concentrations in tobacco leaves and soil in Quang Xuong, Vietnam were measured using a high-resolution passivated and implanted planar silicon detector. Based on these data the AEDs to smokers were estimated. The 210Po activity concentration in tobacco varied significantly from 28.7 to 254.0 mBq g-1, whereas its variation in soil was insignificant. The AED due to smoking fresh tobacco leaves in Vietnam (average 565 μSv y-1) was significantly higher than the values reported for other countries (36-361 μSv y-1).

The "Polonium In Vivo" Study: Polonium-210 in Bronchial Lavages of Patients with Suspected Lung Cancer

Few studies have reported on polonium-210, a decay breakdown product of radon-222 and lead-210, in human lungs and there has been no study in patients with suspected lung cancer. The main aim of this “Polonium in vivo” study was to evaluate polonium-210 radioactivity in bronchopulmonary systems of smoker, ex-smoker and never smoker patients with suspected lung cancer. Alpha-spectrometric analyses were performed on bronchial lavage (BL) fluids from two Italian hospitals in 2013–2016. Socio-demographic, smoking, occupational and spirometric characteristics, lung cancer confirmation and histologic type and radon-222 concentration in patients’ homes were collected. Seventy BL samples from never (n = 13), former (n = 35) and current smokers (n = 22) were analyzed; polonium-210 was detected in all samples from current and former smokers and in 54% of samples from never smokers (p < 0.001; median values: 1.20, 1.43 and 0.40 mBq, respectively). Polonium-210 levels were significantly higher in COPD versus no COPD patients (median value: 3.60 vs. 0.97 mBq; p = 0.007); former and current smokers, without and with COPD, had significantly increased polonium-210 levels (p = 0.012); 96% of confirmed versus 69% of non-confirmed lung cancer patients recorded detectable polonium-210 levels (p = 0.018). A polonium-210 detectable activity was measured in BL samples from all current and former smokers. Polonium-210 in the lungs could be the result of lead-210 entrapment, which, with its half-life of 22 years, could provide a continuous emission of alpha radioactivity, even many years after quitting, thus proposing a possible explanation for the onset of lung cancer, particularly in former smokers.

Radon Exposure and Neurodegenerative Disease

Background: To carry out a systematic review of scientific literature about the association between radon exposure and neurodegenerative diseases. Methods: We performed a bibliographic search in the following databases: Pub med (Medline), Cochrane, BioMed Central and Web of Science. We collected the data by following a predetermined search strategy in which several terms werecombined. After an initial search, 77 articles were obtained.10 of which fulfilled the inclusion criteria. Five of these 10 studies were related to multiple sclerosis (MS), 2 were about motor neuron diseases (MND), in particular amyotrophic lateral sclerosis (ALS) and 3 were related to both Alzheimer's disease (AD) and Parkinson's disease (PD). Results: The majority of the included articles, suggested a possible association between radon exposure and a subsequent development of neurodegenerative diseases. Some of the studies that obtained statistically significant resultsrevealed a possible association between radon exposure and an increase in MS prevalence. Furthermore, it was also suggested that radon exposure increases MND and AD mortality. Regarding AD and PD, it was observed that certainde cay products of radon-222 (²²²Rn), specifically polonium-210 (²¹⁰Po) and bismuth-210 (²¹⁰Bi), present a characteristic distributionpattern within the brain anatomy. However, the study with the highest scientific evidence included in this review, which investigated a possible association between the concentration of residential radon gas and the MS incidence, revealed no significant results. Conclusions: It cannot be concluded, although it is observed, that there is a possible causal association between radon exposure and neurodegenerative diseases. Most of the available studies are ecological so, studies of higher statistical evidence are needed to establish a causal relationship. Further research is needed on this topic.

The activities of 210Po and 210Pb in cigarette smoked in Tunisia

In this study, the activity concentration of polonium 210 in cigarette for Tunisian consumers was investigated by alpha spectrometry. After chemical digestion of tobacco, ²¹⁰Po was extracted, auto-deposited on disc and measured. The activity of ²¹⁰Pb was assessed after radioactive equilibrium was achieved. The activity levels of ²¹⁰Po ranged between 7.8 ± 0.3 and 17 ± 0.5 mBq per cigarette with an average of 12.9 ± 0.4 mBq per cigarette. Effective doses per year due to cigarette smoking were calculated assuming that 22% of the ²¹⁰Pb and ²¹⁰Po in tobacco were retained in the lungs of the smokers. It is concluded that for a smoker in Tunisia, the average effective dose is about 90.6 ± 3.3 μSv per year for a cigarette consumption of one pack of cigarettes per day. This value is somewhat lower than 106.4 ± 5.3 μSv per year estimated as the mean global effective dose from smoking.

Human Exposure to Radioactivity From Tobacco Smoke: Systematic Review

INTRODUCTION

Tobacco has been known to contain radioactive polonium and lead for 50 years but the literature is divided as to the public health significance. I review the data on tobacco radioactivity and its internalization by smokers.

METHODS

Data sources: Reports of lead-210 and polonium-210 content of tobacco leaf, cigarettes, cigarette smoke, and human respiratory tissues, published between 1964 and September 2017. Study selection: Any identified study that reported values for lead-210 and polonium-210 content. Data extraction: Data quality was addressed by comparative review of analytic methods.

RESULTS

The data about radiation content of tobacco and smoke are robust. Early reports suggesting microsievert lifetime doses of inhaled radioactivity to smokers were not borne out. The results remain sensitive to pharmacological assumptions around absorption and redistribution of inhaled radionuclides, and radiobiological assumptions about interaction with human tissues.

CONCLUSIONS

Literature on tobacco radioactivity has not fully contended with pharmacological and radiobiological uncertainty, and is therefore divided as to health significance. This does much to explain regulatory inaction over the last half century. Before radiation safety law can offer a vehicle for tobacco control, more must be learnt about the pharmacology and radiobiology of inhaled radionuclides in tobacco smoke.

IMPLICATIONS

This work makes it apparent that the study of tobacco smoke radioactivity has been scientifically stagnant for the last 40 years. The field cannot advance until we improve understanding of the pharmacology and radiobiology of inhaled radionuclides in tobacco smoke. Despite this, a subset of contemporary authors is still suggesting individual health risks about 1000 times higher than can be supported by internationally accepted models.

Levels of Polonium-210 in brain and pulmonary tissues: Preliminary study in autopsies conducted in the city of Sao Paulo, Brazil

The accumulation of detectable amounts of radon progeny in human tissues may be a risk factor for development and progression of chronic diseases. In this preliminary study, we analyzed the levels of alpha-emitting radon progeny Polonium-210 (²¹⁰Po) in the olfactory epithelium, olfactory bulb, frontal lobe, and lung tissues in cadavers from the city of Sao Paulo, SP, Brazil. We also assessed the association between ²¹⁰Po levels and exposure parameters for urban air pollution using linear regression models adjusted for age, sex, smoke, time living in Sao Paulo, daily commuting, socioeconomic index, and anthracosis (traffic-related black carbon accumulation in the pleural region and in lymph). Our findings show that the concentration of ²¹⁰Po was associated with anthracosis in lungs of non-smokers (coefficient = 6.0; standard error = 2.9; p = 0.04). Individuals with lower socioeconomic status also had significantly higher ²¹⁰Po levels in lungs (coefficient = -1.19; standard error = 0.58; p = 0.042). The olfactory bulb had higher ²¹⁰Po levels than either olfactory epithelium (p = 0.071), frontal lobe (p < 0.001), or lungs (p = 0.037). Our findings of the deposition of ²¹⁰Po in autopsy tissues suggest that airborne radionuclides may contribute to the development of chronic diseases, including neurodegenerative diseases.

Effects of Inhaled Tobacco Smoke on the Pulmonary Tumor Microenvironment

Tobacco smoke is a multicomponent mixture of chemical, organic, and inorganic compounds, as well as additive substances and radioactive materials. Many studies have proved the carcinogenicity of various of these compounds through the induction of DNA adducts, mutational potential, epigenetic changes, gene fusions, and chromosomal events. The tumor microenvironment plays an important role in malignant tumor formation and progression through the regulation of expression of key molecules which mediate the recruitment of immune cells to the tumor site and subsequently regulate tumor growth and metastasis. In this chapter, we discuss the effects of inhaled tobacco smoke in the tumor microenvironment of the respiratory tract. The mechanisms underlying these effects as well as their link with tumor progression are analyzed.

Study of radiotoxic 210Po in Indian tobacco using liquid scintillation spectrometry

A fast radioanalytical method has been developed to measure 210Po in tobacco samples. After microwave digestion polonium is extracted quantitatively from a 1 M hydrochloric acid solution into a solution of triisooctylamine in toluene. The extract was measured by liquid scintillation counting in α mode. Caused by the high counting efficiency the counting time per sample can be reduced significantly compared to conventional α spectrometry, allowing for high sample throughput. The method was applied to 11 brands of cigarettes, beedis and or chewing tobaccos from India. Based on the resulting activity concentrations and typical consumption habits, annual and lifetime equivalent doses were calculated. They were found to be ~100–700 μSv/a or ~5–35 mSv, respectively.

Health Risk of Polonium 210 Ingestion via Drinking Water: An Experience of Malaysia

The presence of toxic polonium-210 (Po-210) in the environment is due to the decay of primordial uranium-238. Meanwhile, several studies have reported elevated Po-210 radioactivity in the rivers around the world due to both natural and anthropogenic factors. However, the primary source of Po-210 in Langat River, Malaysia might be the natural weathering of granite rock along with mining, agriculture and industrial activities. Hence, this is the first study to determine the Po-210 activity in the drinking water supply chain in the Langat River Basin to simultaneously predict the human health risks of Po-210 ingestion. Therefore, water samples were collected in 2015⁻2016 from the four stages of the water supply chain to analyze by Alpha Spectrometry. Determined Po-210 activity, along with the influence of environmental parameters such as time-series rainfall, flood incidents and water flow data (2005⁻2015), was well within the maximum limit for drinking water quality standard proposed by the Ministry of Health Malaysia and World Health Organization. Moreover, the annual effective dose of Po-210 ingestion via drinking water supply chain indicates an acceptable carcinogenic risk for the populations in the Langat Basin at 95% confidence level; however, the estimated annual effective dose at the basin is higher than in many countries. Although several studies assume the carcinogenic risk of Po-210 ingestion to humans for a long time even at low activity, however, there is no significant causal study which links Po-210 ingestion via drinking water and cancer risk of the human. Since the conventional coagulation method is unable to remove Po-210 entirely from the treated water, introducing a two-layer water filtration system at the basin can be useful to achieve SDG target 6.1 of achieving safe drinking water supplies well before 2030, which might also be significant for other countries.

Investigation of a new “N2S2O2” chelating agent with high Po(iv) affinity

A water-soluble complexing agent for 210-polonium decorporation was designed and synthesised with a high conditional stability constant.

(210)Po in drinking water, its potential health effects, and inadequacy of the gross alpha activity MCL

Polonium-210 ((210)Po) is a naturally-occurring, carcinogenic member of the (238)U decay series and the granddaughter of (210)Pb. It has a half life of 138.4days and is rarely found in drinking water at levels exceeding 5mBq/L because it strongly binds to aquifer sediment. When the current US Maximum Contaminant Level (MCL) covering (210)Po was promulgated in December 2000, very little was known about its occurrence and the processes responsible for mobilizing it. More is now known about the processes that mobilize (210)Po from sediments and a review of recent occurrence data show that it may not be as rare in the US as the US Environmental Protection Agency (USEPA) thought in 2000. Worldwide, only about 2200 analyses for (210)Po in drinking water were identified, with activities exceeding 500mBq/L being found only in Finland, India, Sweden, and the US. The median of 400 (210)Po analyses from the US is 4.75mBq/L and >10% of the samples exceed 500mBq/L. Current compliance-monitoring regulations in the US essentially guarantee that (210)Po contamination will not be detected except in very contaminated wells. Major problems with the US Gross Alpha Activity MCL include the volatility of (210)Po and extended holding times and sample-compositing methods that can allow the majority of (210)Po in a sample bottle to decay before analysis. In light of new information, the radionuclide rule should be changed and direct measurements of (210)Po should be made in all public-water supply wells to rule out its presence. Much of the important biological and toxicological research on (210)Po is more than four decades old and new laboratory research using modern tools is needed. Biological and epidemiological investigations of known contaminated areas are needed to assess the effect (210)Po exposure is having on animals and humans consuming the water.

Parental Tobacco Smoking and Acute Myeloid Leukemia: The Childhood Leukemia International Consortium

The association between tobacco smoke and acute myeloid leukemia (AML) is well established in adults but not in children. Individual-level data on parental cigarette smoking were obtained from 12 case-control studies from the Childhood Leukemia International Consortium (CLIC, 1974-2012), including 1,330 AML cases diagnosed at age <15 years and 13,169 controls. We conducted pooled analyses of CLIC studies, as well as meta-analyses of CLIC and non-CLIC studies. Overall, maternal smoking before, during, or after pregnancy was not associated with childhood AML; there was a suggestion, however, that smoking during pregnancy was associated with an increased risk in Hispanics (odds ratio = 2.08, 95% confidence interval (CI): 1.20, 3.61) but not in other ethnic groups. By contrast, the odds ratios for paternal lifetime smoking were 1.34 (95% CI: 1.11, 1.62) and 1.18 (95% CI: 0.92, 1.51) in pooled and meta-analyses, respectively. Overall, increased risks from 1.2- to 1.3-fold were observed for pre- and postnatal smoking (P < 0.05), with higher risks reported for heavy smokers. Associations with paternal smoking varied by histological type. Our analyses suggest an association between paternal smoking and childhood AML. The association with maternal smoking appears limited to Hispanic children, raising questions about ethnic differences in tobacco-related exposures and biological mechanisms, as well as study-specific biases.

Association of CYP3A4, CYP3A5 polymorphisms with lung cancer risk in Bangladeshi population

The rate of direct smoking, second hand smoking, and smokeless tobacco users as well as the amount of environmental pollutant like polycyclic aromatic hydrocarons is increasing in Bangladesh. Therefore, the prevalence of lung cancer is increasing day by day. To the best of our knowledge, no pharmacogentic study of CYP3A4, CYP3A5 genes has been reported on Bangladeshi population relating those with lung cancer. The present study was conducted to determine the association of CYP3A4, CYP3A5 gene polymorphisms and tobacco smoking in the development of lung cancer in Bangladeshi population. A case-control study was carried out on 106 lung cancer patients and 116 controls to investigate three allelic variants-CYP3A4*1B, CYP3A5*3, and CYP3A5*6 using Polymerase Chain Reaction Restriction Fragment Length Polymorphism. Risk of lung cancer was estimated as odds ratio (OR) and 95 % confidence interval (CI) using unconditional logistic regression models. The variant allele frequencies for CYP3A4*1B (*1A/*1B + *1B/*1B) were 2.83 % and 0.86 % and that of CYP3A5*3 (*1A/*3 + *3/*3) were 88.68 % and 85.34 % in cases and controls, respectively. Individual carrying at least one variant allele of CYP3A4*1B (CYP3A4*1A/1B + *1B/1B) has a 3.35 times more risk (OR = 3.35, 95 % Cl = 0.34-32.71, p = 0.271) for developing lung cancer whereas individual carrying at least one variant allele of CYP3A5 (CYP3A5*1A/3 + *3/3) has a 1.26 times more risk (OR = 1.35, 95 % Cl = 0.61-2.97) and both are statistically non-significant (p > 0.05). CYP3A5*6 was absent in the study population. No association of lung cancer with the mentioned polymorphisms was found both in heavy and light smokers. In the cases of all three major types of lung cancer-squamous cell carcinoma, adenocarcinoma, and small cell carcinoma-significantly strong relationships (p ˂ 0.05) have been found. To confirm the association of lung cancer with the mentioned polymorphisms, large number volunteers (patients and controls) will be required.

Tobacco smoke exposure and the risk of childhood acute lymphoblastic and myeloid leukemias by cytogenetic subtype

BACKGROUND

Tobacco smoke contains carcinogens known to damage somatic and germ cells. We investigated the effect of tobacco smoke on the risk of childhood acute lymphoblastic leukemia (ALL) and myeloid leukemia (AML), especially subtypes of prenatal origin such as ALL with translocation t(12;21) or high-hyperdiploidy (51-67 chromosomes).

METHODS

We collected information on exposures to tobacco smoking before conception, during pregnancy, and after birth in 767 ALL cases, 135 AML cases, and 1,139 controls (1996-2008). Among cases, chromosome translocations, deletions, or aneuploidy were identified by conventional karyotype and fluorescence in situ hybridization.

RESULTS

Multivariable regression analyses for ALL and AML overall showed no definite evidence of associations with self-reported (yes/no) parental prenatal active smoking and child's passive smoking. However, children with history of paternal prenatal smoking combined with postnatal passive smoking had a 1.5-fold increased risk of ALL [95% confidence interval (CI), 1.01-2.23], compared to those without smoking history (ORs for pre- or postnatal smoking only were close to one). This joint effect was seen for B-cell precursor ALL with t(12;21) (OR = 2.08; 95% CI, 1.04-4.16), but not high hyperdiploid B-cell ALL. Similarly, child's passive smoking was associated with an elevated risk of AML with chromosome structural changes (OR = 2.76; 95% CI, 1.01-7.58), but not aneuploidy.

CONCLUSIONS

Our data suggest that exposure to tobacco smoking was associated with increased risks of childhood ALL and AML; and risks varied by timing of exposure (before and/or after birth) and cytogenetic subtype, based on imprecise estimates.

IMPACT

Parents should limit exposures to tobacco smoke before and after the child's birth.

Occurrence of ²¹⁰Po and biological effects of low-level exposure: the need for research

BACKGROUND

Polonium-210 (²¹⁰Po) concentrations that exceed 1 Bq/L in drinking-water supplies have been reported from four widely separated U.S. states where exposure to it went unnoticed for decades. The radionuclide grandparents of ²¹⁰Po are common in sediments, and segments of the public may be chronically exposed to low levels of ²¹⁰Po in drinking water or in food products from animals raised in contaminated areas.

OBJECTIVES

We summarized information on the environmental behavior, biokinetics, and toxicology of ²¹⁰Po and identified the need for future research.

METHODS

Potential linkages between environmental exposure to ²¹⁰Po and human health effects were identified in a literature review.

DISCUSSION

²¹⁰Po accumulates in the ovaries where it kills primary oocytes at low doses. Because of its radiosensitivity and tendency to concentrate ²¹⁰Po, the ovary may be the critical organ in determining the lowest injurious dose for ²¹⁰Po. ²¹⁰Po also accumulates in the yolk sac of the embryo and in the fetal and placental tissues. Low-level exposure to ²¹⁰Po may have subtle, long-term biological effects because of its tropism towards reproductive and embryonic and fetal tissues where exposure to a single alpha particle may kill or damage critical cells. ²¹⁰Po is present in cigarettes and maternal smoking has several effects that appear consistent with the toxicology of ²¹⁰Po.

CONCLUSIONS

Much of the important biological and toxicological research on ²¹⁰Po is more than four decades old. New research is needed to evaluate environmental exposure to ²¹⁰Po and the biological effects of low-dose exposure to it so that public health officials can develop appropriate mitigation measures where necessary.

Comparison of the effects of the US Clean Air Act and of smoking prevention and cessation efforts on the risk of acute myelogenous leukemia

OBJECTIVES

We used 2 approaches based on published information to compare the impacts on leukemia incidence and benzene exposure of the 1990 US Clean Air Act (CAA) amendments and smoking prevention and cessation efforts.

METHODS

We extrapolated leukemia mortality related to community air pollution levels and to cigarette smoking from data from the US Environmental Protection Agency and the US Surgeon General. We also estimated relative decline in total exposures to benzene (a known human leukemogen) owing to the CAA amendments and to smoking prevention and cessation efforts.

RESULTS

We estimated that because of the CAA, there will be approximately 300 fewer leukemia deaths in the United States during the period 2000 through 2020. During the closest comparable period (1987-2007), we estimated that decline in cigarette smoking led to 7120 fewer leukemia deaths, of which 1282 to 3702 were attributable to benzene. Similarly, the decline in smoking led to about a tenfold greater decrease in total-population benzene exposure than did the 1990 CAA amendments.

CONCLUSIONS

Both the CAA and smoking cessation activities contribute to a decrease in leukemia incidence. Smoking cessation activities have had a greater effect in the past.