[Endocrine disruptors and metabolic diseases: a major public health challenge]

The purpose of this research note is to summarize the current state of knowledge on the impact of environmental exposures on the development of obesity and diabetes. In France, the incidence of diabetes almost doubled between 2000 and 2008 (+ 93%), affecting 1.8 million people. The prevalence of obesity has almost doubled in 10 years. Since the 1980s, the focus of the fight against obesity and diabetes has been on hygienic and dietary measures. However, it is now clear that these measures have failed to reverse the trend. Chronic diseases such as obesity and diabetes have resulted in a dramatic increase in public health spending. A growing body of data has highlighted the important role of chemical pollution in the epidemic of metabolic diseases, particularly substances classified as endocrine disrupting chemicals (EDCs). By altering the endocrine function of organs such as adipose tissue, liver, pancreas, and skeletal muscle, EDCs disrupt the metabolism of carbohydrates and lipids, leading in turn to insulin resistance and diabetes and obesity, which both increase the risk of cardiovascular complications. The traditional toxicological principle that "the dose makes the poison" does not reflect the complexity of the deleterious effect of EDCs either alone or in combination. EDC-induced patho-physiological alterations can be programmed during the fetal period, before appearing later in life. A new paradigm evaluating the toxicological properties of EDCs is needed to support new recommendations in terms of prevention policy, at both national and European levels.

Development of a spatial stochastic multimedia exposure model to assess population exposure at a regional scale

Analyzing the relationship between the environment and health has become a major focus of public health efforts in France, as evidenced by the national action plans for health and the environment. These plans have identified the following two priorities: - identify and manage geographic areas where hotspot exposures are a potential risk to human health; and - reduce exposure inequalities. The aim of this study is to develop a spatial stochastic multimedia exposure model for detecting vulnerable populations and analyzing exposure determinants at a fine resolution and regional scale. A multimedia exposure model was developed by INERIS to assess the transfer of substances from the environment to humans through inhalation and ingestion pathways. The RESPIR project adds a spatial dimension by linking GIS (Geographic Information System) to the model. Tools are developed using modeling, spatial analysis and geostatistic methods to build and discretize interesting variables and indicators from different supports and resolutions on a 1-km(2) regular grid. We applied this model to the risk assessment of exposure to metals (cadmium, lead and nickel) using data from a region in France (Nord-Pas-de-Calais). The considered exposure pathways include the atmospheric contaminant inhalation and ingestion of soil, vegetation, meat, egg, milk, fish and drinking water. Exposure scenarios are defined for different reference groups (age, dietary properties, and the fraction of food produced locally). The two largest risks correspond to an ancient industrial site (Metaleurop) and the Lille agglomeration. In these areas, cadmium, vegetation ingestion and soil contamination are the principal determinants of the computed risk.

[Health and environment: the 2nd public health revolution.]

As of the mid-19th century, most infectious disease epidemics have been fought and slowed down by taking action on the environment (water, housing, waste) and education. This constitutes the 1st public health revolution paradigm. As we face the current epidemic of chronic diseases and the failure of the dominant biomedical model to stop them, a 2nd public health revolution is needed. The vision for this 2nd public health revolution requires a new paradigm built upon an eco-systemic definition of health and the recognition of the legitimacy for citizen participation based on the precautionary principle.

[Volatile Organic Compounds (VOC): definition, classification and properties]

The term volatile organic compounds includes a wide variety of chemical substances with the common feature of being carbon compounds that are volatile at ambient temperature. They can be classified into different families defined by their chemical formulae, each of which possesses common properties, although there may be major differences in terms of toxicity. For that reason the effects of VOC on health have to be considered both in an individual way and also from a global viewpoint on account of their common toxic properties and the role they play in the formation of environmental photo-oxidative pollutants, both outdoors and indoors.

[Glycol ethers reproductive risks]

Glycol ethers (GE) are a family of solvents, the use of which has increased dramatically since the 60's, in domestic and occupational mainly water-based products, such as paintings, inks, varnishes, cleaning agents. There are two subgroups: E series and P series. EGME, among the E series, is the reference substance. This is a reprotoxic chemical causing infertility and genital apparatus atrophy on both sexes, embryofetal toxicity through maternal exposure (malformation, growth alterations and functional deficits). European Union has classified nine other GE as reprotoxic. P series, with the beta isomers exception, has no specific reprotoxicity. Epidemiological studies published from the 80's onwards, have confirmed animal data (malformation, oligoazoospermia, spontaneous abortion, hypofertility). The effects can be observed even after the end of exposure. Risk assessment studies tend to prove that this massive exposure during several decades could have had an important impact on reproductive human health. Even if this exposure has considerably decreased since the last few years, a ban of reprotoxic GE, as required by two official bodies (CSC, CSHPF), seems necessary, due to the high risk level. Classification should be completed for some GE, not classified now (EGBE). Health assessment of past exposure should be carried out. Physicians should look after a possible glycol ethers responsibility when facing this kind of reprotoxic effects.

FIOH-sponsored newsletter misrepresents asbestos hazards in Zimbabwe

The Finnish Institute of Occupational Health (FIOH) has received support from the World Health Organization (WHO) and the International Labor Office (ILO) to publish the African Newsletter on Occupational Health and Safety. The African Newsletter on Occupational Health and Safety should not be a medium for industry propaganda, or the source of misinformation among the workers of Africa. Instead, FIOH should provide the same level of scientific information in Africa that it does in Finland and other developed countries.

Glycol Ethers: A Ubiquitous Family of Toxic Chemicals: A Plea for REACH Regulation

Glycol ethers (GE) are chemicals used since the 1930s as solvents in paints, inks, varnishes, and cleaning agents, mainly in water-based products, cosmetics, and drugs. World production approximates 1 million tons. Nineteen GE are produced or imported each year; over 1000 tons in European Union (EU) have been classified as high production volume chemicals (HPVCs). First animal data were published in 1971 and 1979 showing severe reprotoxicity for some GE. Two alerts were launched in the United States in 1982 and 1983, but the first partial GE regulation only occurred in 1993 in the EU. Although these chemicals may expose a very large population, basic toxicity data, more especially carcinogenicity, are still lacking (3/32 GE). However, experimental data were sufficient to lead developmental toxicity risk assessment since the early 1980s. Risk indices over 1000 have been calculated for consumers and workers exposed to reprotoxic GE in domestic and industrial activities. The first ban was decided in 1999 in France, but was only for drugs and cosmetics. Not surprisingly, since the late 1980s, human studies have found results similar to those in animal data: spontaneous abortions, malformations, testicular toxicity, and hematotoxicity. Despite this highly coherent set of data, and although substitution products are available, reprotoxic GE have been and still remain widely used in the world. The case of GE shows the failure of the present system based on a posteriori risk assessment. This pleads for the change of paradigm through the European REACH regulation based on the "No data, no market" principle. Ethics in REACH management should also be considered.

Health risk assessment after decontamination of the beaches polluted by the wrecked ERIKA tanker

Following the wreck of the oil tanker ERIKA off the north-west coast of France in December 1999, cleaning up of the beaches involved considerable work, which in any case could not be perfect. This raised the question of the short- and long-term health risks for the future bathers related to the toxicity of the remaining oil polycyclic aromatic hydrocarbons (PAHs). This risk assessment study was conducted to help health authorities plan risk management policies and inform the public. Thirty-six beaches were selected, representing a sample of the most frequently encountered topographic and beach usage situations; seven "control" beaches, unspoiled by ERIKA, were also investigated. Samples of water and sand were taken from each site, as well as from the surface of rocks. The 16 PAHs selected by the U.S. EPA were quantified in each environment. Several scenarios of exposure were contemplated: (1) a child between 2 and 4 years accidentally ingesting a small ball of fuel, (2) a child daily exposed throughout his holiday-time stay, (3) an adult (including a pregnant woman) spending his/her holidays on the coast, (4) an adult working on the beach, (5) and an adult practicing water sports. Among the available and significant toxicological values, the most conservative ones were selected for computing risks. The sand and water, after decontamination, were slightly polluted (respectively, 7.8 microg/kg and 23.3 ng/l of total 16 PAHs), with values similar to those found in the control beaches. By contrast, the rocky areas in some places were still highly polluted (up to 23 mg/kg on the surface layer). No lethal risk was found for a young child who had accidentally ingested a small ball of fuel. The life-long excess risks for skin cancer and for all other cancers were about 10-5 in scenarios including contact with the polluted rocks. In all other cases, excess risks were considerably lower. The hazard quotient for teratogenic effects was very small, except in scenarios where pregnant women would walk among rocks containing high pollution levels. In conclusion, exposure was mainly associated with polluted water among children, and with spoiled rocks for adults. Despite uncertainties, mainly dealing with the prediction of long-term risks following a short-term exposure, this study showed that beaches where pollution was no longer visible after decontamination did not entail any significant health risks and could be opened to the public.

Environmental benzene exposure assessment for parent-child pairs in Rouen, France

There is a lack of data on environmental benzene exposure in children. In this study, we compared personal benzene exposure and inhalation uptake in a group of children to those of their parents. We also compared levels of urinary benzene metabolites, trans,trans-muconic acid (MA) and hydroquinone (HQ), for those two groups, and assessed the correlation between personal benzene exposure and urinary MA and HQ concentrations. The study was performed on 21, 2-3-year-old children and their parents recruited on a voluntary basis among non-smokers from the three largest day-care centers of the town of Rouen in France. Average benzene concentrations were measured over 5 consecutive days with diffusive samplers. The following simultaneous measurements were carried out: personal exposure of the parents, concentrations inside and outside the day care centers, and inside the volunteer's bedrooms. Morning and evening urine samples were collected during the same period. Benzene personal exposure levels were 14.4+/-7.7 microg/m(3) and 11.09+/-6.15 microg/m(3) in parents and children, respectively. Benzene inhalation uptake estimates were 2.51+/-1.23 microg/kg/day in the group of parents and 5.68+/-3.17 microg/kg/day in the group of children. Detectable levels of MA and HQ were found in 85% and 100% of the samples, respectively. Intra-individual variation of urinary MA and HQ concentrations expressed as a coefficient of variation (CV) ranged from 63 to 232% and from 13 to 144%, respectively. Mean values of MA and HQ (in mg/g creatinine) were 1.6- and 1.8-fold higher in the group of children than in the group of parents (P=0.008 and P<0.0001, respectively). Significant correlations between metabolites levels and benzene were not found.

Risk assessment of sensory irritants in indoor air--a case study in a French school

Exposure to airborne pollutants can result in adverse health effects. Acute symptoms can for instance comprise of irritation of the eyes or of the respiratory tract (called sensory irritation). In a recent case, health problems were reported in a French school and supposedly attributed to the presence of airborne irritant pollutants. Based on measured concentrations, the risk of developing the described health effects was assessed. Numerous airborne sensory irritants (aldehydes, organic acids, volatile organic compounds (VOCs), SO(2), NH(3)) were identified and quantified in the indoor air by using active and passive sampling and online monitoring techniques. Reference values based on toxicological properties of compounds (sensory irritants) were taken from the literature. If not available, tentative values were specially developed for this purpose. Concentrations of all sensory irritants remain below their corresponding guideline values and are comparable to literature data. It was concluded that the risk of developing sensory irritation due to the presence of the studied compounds is negligible. This holds both for individual compounds and for the mixture of studied compounds. Limitations of the employed sampling strategy, and of existing sampling and analytical techniques, which do not allow for analysing more reactive compounds-which are strong sensory irritants-may play a role. New sampling techniques need to be developed. Psychosocial factors (group behaviour, increased attention to sensory irritation) should also be taken into account when dealing with health complaints on sensory irritation.

BTX concentrations near a stage II implemented petrol station

A combined monitoring and dispersion modelling methodology was applied for assessing air quality at three different levels of proximity to the selected service station: (I) next to the fuel pumps, (II) in the surrounding environment, and (III) in the background. Continuous monitoring and passive sampling were used for achieving high temporal and spatial resolution, respectively. A Gaussian dispersion model (CALINE4) was used for assessing the road traffic contribution to the local concentrations under different meteorological conditions. It was established that Stage 2 vapour recovery reduces BTX concentrations not only near the pumps, but also in their surrounding environment. However, there is evidence that the efficiency of the system is wind speed dependent. The modelling simulation of the worst case wind scenario revealed the significance of local traffic emissions. It was shown that the traffic contribution even from a single road in the vicinity of the station can, under certain conditions, be higher than the contribution of the station itself to the local BTX levels. Finally, after comparison with previous studies, the concentrations measured near the service station (which was situated in a rural environment) appear to be lower than those observed in busy street canyons in city centres. It can be concluded, although Stage 2 recovery system effectively reduces working VOC losses in service stations, that it will only have a limited positive impact on local air quality if the service station is located in a heavily polluted area.

Pilot study of personal, indoor and outdoor exposure to benzene, formaldehyde and acetaldehyde

There is a lack of data for health risk assessment of long term personal exposure to certain ubiquitous air pollutants present particularly in urban atmospheres. The relationship between ambient background concentrations and personal exposure is often unknown. A pilot campaign to measure indoor concentrations, outdoor concentrations and personal exposure to benzene, formaldehyde and acetaldehyde was conducted in a medium sized French town. A strong contribution to total personal exposure was observed from indoor sources, especially for formaldehyde and acetaldehyde, suggesting that indoor sources are dominant for these compounds. For benzene, the average personal exposure exceeded a 10 microgm(-3) limit value, although this was not the case for the ambient background concentration. For formaldehyde, the limit level was also exceeded. Observations suggest that true personal exposure cannot be determined directly from measurements pertaining from fixed ambient background monitoring stations. It is hoped that this will be taken into consideration by the bodies responsible for monitoring air pollution and the future European Air Quality Directive.

[Evaluation of risks of glycol ethers for the reproductive health]

Glycol ethers (Ge) are a family of substances with a growing use in industrial and domestic products for the two last decades. Ge (group 1 and 2) are experimentally toxic for reproduction and development, at various levels. That begins to be found in humans. Epidemiological studies confirm toxicokinetic data showing humans are more sensitive than animals, because of a low excretion rate of the toxic metabolites. Occupational and consumer exposures are frequently higher than reference concentrations deducted from animal data. They may be involved in the growing number of genital reproductive system and reproduction anomaly, observed in most developed countries. Genetic toxicity is suspected from experimental data, but further investigations are needed.

Occupational exposure to organic solvents during paint stripping and painting operations in the aeronautical industry

The exposure of workers to methylene chloride and phenol in an aeronautical workshop was measured during stripping of paint from a Boeing B 747. Methylene chloride exposure was measured during two work days by personal air sampling, while area sampling was used for phenol. During paint stripping operations, methylene chloride air concentrations ranged from 299.2 mg/m3 (83.1 ppm) to 1888.9 mg/m3 (524.7 ppm). The exposures to methylene chloride calculated for an 8-h work day ranged from 86 mg/m3 (23.9 ppm) to 1239.5 mg/m3 (344.3 ppm). In another aeronautical workshop, exposure to organic solvents, especially ethylene glycol monoethylether acetate (EGEEA), was controlled during the painting of an Airbus A 320. The external exposure to solvents and EGEEA was measured by means of individual air sampling. The estimation of internal exposure to EGEEA was made by measuring its urinary metabolite, ethoxyacetic acid (EAA). Both measurements were made during the course of 3 days. The biological samples were taken pre- and post-shift. During painting operations, methyl ethyl ketone, ethyl acetate, n-butyl alcohol, methyl isobutyl ketone, toluene, n-butyl acetate, ethylbenzene, xylenes and EGEEA were detected in working atmospheres. For these solvents, air concentrations ranged from 0.1 ppm to 69.1 ppm. EGEEA concentrations ranged from 29.2 mg/m3 (5.4 ppm) to 150.1 mg/m3 (27.8 ppm). For biological samples, the average concentrations of EAA were 108.4 mg/g creatinine in pre-shift and 139.4 mg/g creatinine in post-shift samples. Despite the fact that workers wore protective respiratory equipment during paint spraying operations, EEA urinary concentrations are high and suggest that percutaneous uptake is the main route of exposure for EGEEA.(ABSTRACT TRUNCATED AT 250 WORDS)

Ethylene glycol ethers as hemopoietic toxins--in vitro studies of acute exposure

Ethylene glycol ethers and their acetate derivatives were analyzed for their toxicity in vitro on several hemopoietic cell lines, either growth-factor-dependent or leukemic, in mouse, rat, and human species. Considering the concentrations that reduced the cell viability in culture by 50%, most of the ethylene glycol ethers and in particular ethylene glycol monoethyl ether (EGEE) or ethylene glycol monobutyl ether (EGBE) should be considered as hemopoietic toxins. EGBE was found to be the most potent toxin on the human promyelocytic cell line, NB4 (median inhibitory concentration (IC50) 5 mM at 6 h; IC50 0.1 mM at 96 h) but also on the factor-dependent cell line DA1 (IC50 80 microM at 48 h). Factor-dependent cell lines were not significantly more sensitive than leukemic cell lines. The toxicity of these compounds falls in the same range of concentration as benzene or phenol, but hydroquinone was significantly more toxic in the same assay (IC50 3-15 microM at 48 h). Toxic effects increased linearly with time. The toxicity of ethylene glycol ethers was confirmed by both assays for colony-forming units in culture medium (CFU-C) (human blood cord cells) and murine bone marrow long-term culture (IC50 5-10 mM). Stromal cells in the adherent layer were more resistant than hemopoietic cells. An all or none toxicity was found within a narrow range of concentration (2-5 mM for EGBE), and chronic exposure over two months did not show cumulative effects on the culture cellularity. The possibility that fibroblastic or macrophage cells worked at the detoxification of the culture is suggested. Results are discussed with regard to epidemiological and in vivo experimental data presently available.

Workplace pollution in two viscose plants

The CS2 and H2S pollution was evaluated in two viscose plants: a sponge factory and a rayon spinning mill. Two kinds of sampling were used: background samples with the help of a laboratory van equipped with a Gas Phase Chromatograph and an Air Sampler allowing sequential workplace monitoring. personal samples. The results show the H2S pollution is not negligible and can even be equal to that with CS2 in some workshops (e.g. the spinning-room). The proposed methodology permits an accurate description of the pollution.

Impaired Blood and Tissue Fibrinolysis in Patients With Recurrent Venous Thrombosis

Blood and tissue fibrinolysis were studied in 70 patients(p.) with recurrent venous thrombosis. The fibrinolytic activity and the release of plasminogen activators “fibrinolytic capacity” by 10 min. venous occlusion were detected by using acetate-buffered diluted clot lysis time, euglobulin lysis time and resuspended euglobulin precipitate on unheated fibrin plates. Plasminogen activator content in the wall of superficiel hand veins in 40 p, was measured by Pandolfi’s modified histochemical technique. Our studies showed a significantly low content of plasminogen activators in the vessel walls in, more then 60% of p. in good correlation with blood defective fibrinolytic activity and/or capacity.