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Darago A, Klimczak M, Jurewicz J, Kucharska M, Kilanowicz A. Assessment of lead exposure in indoor shooters in central Poland. Sci Rep 2023; 13:12605. [PMID: 37537329 PMCID: PMC10400594 DOI: 10.1038/s41598-023-39847-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/01/2023] [Indexed: 08/05/2023] Open
Abstract
A steady increase in shooting practices is observed worldwide. Potential lead exposure at shooting ranges poses a risk to their employees and users, which is not widely reported outside of the USA, especially in Poland. Exposure to lead results from the use of bullets containing lead and the main route of exposure to this metal at shooting ranges is inhalation, i.e., during shooting or cleaning. The aim of this study was to assess lead exposure of employees and users in selected indoor shooting ranges in central Poland. Airborne lead concentrations at all locations in the shooting ranges were above Polish occupational exposure limit (OEL, 0.05 mg m-3). Elevated blood and urine lead levels, and decreased 4-aminolevulinic acid dehydratase activity (ALA-D) were found in subjects participating in shooting even for only a few (< 10) hours per week. Lead exposure at shooting ranges in central Poland, as indicated by elevated blood lead levels and decreased ALA-D activity, could represent an elevated risk for adverse health effects. Thus, information on the possible health consequences of lead exposure should be provided at these sites, and biomonitoring appears to be reasonable for regular workers and shooters.
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Affiliation(s)
- Adam Darago
- Department of Toxicology, Medical University of Lodz, Muszyńskiego 1, 90-151, Lodz, Poland
| | - Michał Klimczak
- Department of Toxicology, Medical University of Lodz, Muszyńskiego 1, 90-151, Lodz, Poland.
| | - Joanna Jurewicz
- Department of Chemical Safety, Nofer Institute of Occupational Medicine, Św. Teresy 8, 91-348, Lodz, Poland
| | - Małgorzata Kucharska
- Central Laboratory, Nofer Institute of Occupational Medicine, Św. Teresy 8, 91-348, Lodz, Poland
| | - Anna Kilanowicz
- Department of Toxicology, Medical University of Lodz, Muszyńskiego 1, 90-151, Lodz, Poland
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Schmidt MA, Jones JA, Mason CE. Optimizing human performance in extreme environments through precision medicine: From spaceflight to high-performance operations on Earth. CAMBRIDGE PRISMS. PRECISION MEDICINE 2023; 1:e27. [PMID: 38550927 PMCID: PMC10953751 DOI: 10.1017/pcm.2023.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 04/12/2024]
Abstract
Humans operating in extreme environments often conduct their operations at the edges of the limits of human performance. Sometimes, they are required to push these limits to previously unattained levels. As a result, their margins for error in execution are much smaller than that found in the general public. These same small margins for error that impact execution may also impact risk, safety, health, and even survival. Thus, humans operating in extreme environments have a need for greater refinement in their preparation, training, fitness, and medical care. Precision medicine (PM) is uniquely suited to address the needs of those engaged in these extreme operations because of its depth of molecular analysis, derived precision countermeasures, and ability to match each individual (and his or her specific molecular phenotype) with any given operating context (environment). Herein, we present an overview of a systems approach to PM in extreme environments, which affords clinicians one method to contextualize the inputs, processes, and outputs that can form the basis of a formal practice. For the sake of brevity, this overview is focused on molecular dynamics, while providing only a brief introduction to the also important physiologic and behavioral phenotypes in PM. Moreover, rather than a full review, it highlights important concepts, while using only selected citations to illustrate those concepts. It further explores, by demonstration, the basic principles of using functionally characterized molecular networks to guide the practical application of PM in extreme environments. At its core, PM in extreme environments is about attention to incremental gains and losses in molecular network efficiency that can scale to produce notable changes in health and performance. The aim of this overview is to provide a conceptual overview of one approach to PM in extreme environments, coupled with a selected suite of practical considerations for molecular profiling and countermeasures.
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Affiliation(s)
- Michael A. Schmidt
- Sovaris Aerospace, Boulder, CO, USA
- Advanced Pattern Analysis & Human Performance Group, Boulder, CO, USA
| | - Jeffrey A. Jones
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Christopher E. Mason
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
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Hammers DB, Miranda M, Abildskov TJ, Tate DF, Wilde EA, Spencer RJ. Consideration of different scoring approaches for a verbal incidental learning measure from the WAIS-IV using hippocampal volumes. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:43-53. [PMID: 33882772 DOI: 10.1080/23279095.2021.1909592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objective: While Spencer's verbal incidental learning (IL) task-from Vocabulary and Similarities subtests of the WAIS-has been validated relative to traditional memory measures and Alzheimer's disease (AD) pathology, the effectiveness of the particular scoring method used has not been assessed relative to alternative scoring weightings. The purpose of this study was to compare original and alternative scoring methods of this IL task by using an AD biomarker-benchmark to arrive at an optimal approach. Methods: Fifty-five memory-clinic patients aged 59-87 received neuropsychological assessment, measures of IL, and quantitative brain imaging. Partial correlation coefficients with total hippocampal volume-controlling for age, sex, and intracranial volume-were assessed across several IL scoring methods, and partial correlations with measures of memory were examined to evaluate convergent validity.Results: IL scoring methods maximizing the contribution of paired-associate-recall-performance were significantly correlated with both hippocampal volumes and traditional memory measures, whereas discrimination-emphasized scoring methods were not.Conclusions: IL scoring methods emphasizing memory paired-associate recall appeared to be preferable to those emphasizing memory discrimination. Administration of the IL- Similarities subtest alone, without IL- Vocabulary, may strike a balance between strength of relationships with both hippocampal volumes and standard memory measures, while also limiting administration time.
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Affiliation(s)
- Dustin B Hammers
- Department of Neurology, Center for Alzheimer's Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
| | - Michelle Miranda
- Department of Neurology, Center for Alzheimer's Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
| | - Tracy J Abildskov
- Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT, USA
| | - David F Tate
- Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT, USA.,George E. Whalen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Elisabeth A Wilde
- Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT, USA.,George E. Whalen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Robert J Spencer
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Department of Psychiatry, Neuropsychology Section, Michigan Medicine, Ann Arbor, MI, USA
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Hammers DB, Kucera A, Spencer RJ, Abildskov TJ, Archibald ZG, Hoffman JM, Wilde EA. Examining the Relationship between a Verbal Incidental Learning Measure from the WAIS-IV and Neuroimaging Biomarkers for Alzheimer's Pathology. Dev Neuropsychol 2020; 45:95-109. [PMID: 32374196 DOI: 10.1080/87565641.2020.1762602] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Convergent validation of a verbal incidental learning (IL) task from the WAIS-IV using neuroimaging biomarkers is warranted to understand its sensitivity to Alzheimer's disease (AD) pathology. Fifty-five memory clinic patients aged 59 to 87 years received neuropsychological assessment, and measures of IL and quantitative brain imaging. Worse IL-Total Score and IL-Similarities performances were significantly associated with smaller hemispheric hippocampal volumes. IL measures were not significantly correlated with cerebral β-amyloid burden, though a trend was present and effect sizes were mild. These hippocampal volume results suggest that this IL task may be sensitive to AD pathology along the AD continuum.
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Affiliation(s)
- Dustin B Hammers
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah , Salt Lake City, UT, USA
| | - Amanda Kucera
- University of Utah Health Care , Salt Lake City, UT, USA
| | - Robert J Spencer
- Mental Health Service, VA Ann Arbor Healthcare System , Ann Arbor, MI, USA
| | - Tracy J Abildskov
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah , Salt Lake City, UT, USA
| | - Zane G Archibald
- Center for Quantitative Cancer Imaging, Huntsman Cancer Institute, University of Utah , Salt Lake City, UT, USA
| | - John M Hoffman
- Center for Quantitative Cancer Imaging, Huntsman Cancer Institute, University of Utah , Salt Lake City, UT, USA
| | - Elizabeth A Wilde
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah , Salt Lake City, UT, USA.,George E. Wahlen Veterans Affairs Medical Center , Salt Lake City, UT, USA
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Hale AC, Tolle KA, Kitchen Andren KA, Spencer RJ. Cross-validation of incidental learning tasks from the WAIS-IV as a measure of memory. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 27:517-524. [PMID: 30793966 DOI: 10.1080/23279095.2019.1570930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although incidental learning (IL) routinely occurs in everyday life, it is infrequently assessed during neuropsychological evaluations. This study aimed to further examine the concurrent validity of IL measures based on the Vocabulary and Similarities subtests from the Wechsler Adult Intelligence Test-Fourth Edition (WAIS-IV). Participants included 43 Veterans referred for outpatient neuropsychological testing. Performances on the IL procedures correlated strongly with performances on the Repeatable Battery for the Assessment of Neuropsychological Status Immediate and Delayed Recall Indices (r = .48 to r = .78). These results indicate that the IL procedures from selected WAIS-IV subtests provided an efficient and valid measure of memory. In particular, the task based on the Similarities subtest provided exceptionally high value as a screen for memory problems. These IL procedures, which require minimal additional administration time, capitalize on the semantic encoding that is inherent in completing the Vocabulary and Similarities subtests, and offer a complementary approach to standard memory assessment.
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Affiliation(s)
- Andrew C Hale
- VA Center for Clinical Management Research, Ann Arbor, Michigan, USA.,VA Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Kathryn A Tolle
- VA Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Katherine A Kitchen Andren
- VA Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA.,Saint Joseph Mercy Health System, Rehabilitation Service, Ypsilanti, Michigan, USA
| | - Robert J Spencer
- VA Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
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Laidlaw MAS, Filippelli G, Mielke H, Gulson B, Ball AS. Lead exposure at firing ranges-a review. Environ Health 2017; 16:34. [PMID: 28376827 PMCID: PMC5379568 DOI: 10.1186/s12940-017-0246-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 03/30/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND Lead (Pb) is a toxic substance with well-known, multiple, long-term, adverse health outcomes. Shooting guns at firing ranges is an occupational necessity for security personnel, police officers, members of the military, and increasingly a recreational activity by the public. In the United States alone, an estimated 16,000-18,000 firing ranges exist. Discharge of Pb dust and gases is a consequence of shooting guns. METHODS The objectives of this study are to review the literature on blood lead levels (BLLs) and potential adverse health effects associated with the shooting population. The search terms "blood lead", "lead poisoning", "lead exposure", "marksmen", "firearms", "shooting", "guns", "rifles" and "firing ranges" were used in the search engines Google Scholar, PubMed and Science Direct to identify studies that described BLLs in association with firearm use and health effects associated with shooting activities. RESULTS Thirty-six articles were reviewed that included BLLs from shooters at firing ranges. In 31 studies BLLs > 10 μg/dL were reported in some shooters, 18 studies reported BLLs > 20 μg/dL, 17 studies > 30 μg/d, and 15 studies BLLs > 40 μg/dL. The literature indicates that BLLs in shooters are associated with Pb aerosol discharge from guns and air Pb at firing ranges, number of bullets discharged, and the caliber of weapon fired. CONCLUSIONS Shooting at firing ranges results in the discharge of Pb dust, elevated BLLs, and exposures that are associated with a variety of adverse health outcomes. Women and children are among recreational shooters at special risk and they do not receive the same health protections as occupational users of firing ranges. Nearly all BLL measurements compiled in the reviewed studies exceed the current reference level of 5 μg/dL recommended by the U.S. Centers for Disease Control and Prevention/National Institute of Occupational Safety and Health (CDC/NIOSH). Thus firing ranges, regardless of type and user classification, currently constitute a significant and unmanaged public health problem. Prevention includes clothing changed after shooting, behavioural modifications such as banning of smoking and eating at firing ranges, improved ventilation systems and oversight of indoor ranges, and development of airflow systems at outdoor ranges. Eliminating lead dust risk at firing ranges requires primary prevention and using lead-free primers and lead-free bullets.
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Affiliation(s)
- Mark A. S. Laidlaw
- Centre for Environmental Sustainability and Remediation (EnSuRe), School of Science, RMIT University, PO Box 71, Bundoora, VIC 3083 Australia
| | - Gabriel Filippelli
- Department of Earth Sciences and Center for Urban Health, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN USA
| | - Howard Mielke
- Tulane University School of Medicine, New Orleans, LA USA
| | - Brian Gulson
- Department of Environmental Sciences, Macquarie University, Sydney, Australia
| | - Andrew S. Ball
- Centre for Environmental Sustainability and Remediation (EnSuRe), School of Science, RMIT University, PO Box 71, Bundoora, VIC 3083 Australia
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Hammers DB, Kucera AM, Card SJ, Tolle KA, Atkinson TJ, Duff K, Spencer RJ. Validity of a verbal incidental learning measure from the WAIS-IV in older adults. APPLIED NEUROPSYCHOLOGY-ADULT 2017. [DOI: 10.1080/23279095.2017.1295968] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | | | | | | | | | - Kevin Duff
- Neurology, University of Utah, Salt Lake City, Utah, USA
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Incidental Learning: A Brief, Valid Measure of Memory Based on the WAIS–IV Vocabulary and Similarities Subtests. Cogn Behav Neurol 2016; 29:206-211. [DOI: 10.1097/wnn.0000000000000108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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