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Berman T, Rorman E, Groisman L, Keinan-Boker L, Shimony T, Barnett-Itzhaki Z. Association between parental smoking and child exposure to environmental tobacco smoke in Israel. Isr J Health Policy Res 2023; 12:37. [PMID: 38115120 PMCID: PMC10731699 DOI: 10.1186/s13584-023-00585-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 11/19/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Environmental tobacco smoke (ETS) exposure in children can cause delayed lung development and lifelong cardiovascular damage. The aim of this study was to measure ETS exposure in children in Israel in 2020-2021 using urinary cotinine (UC) measurements and to assess correlates of ETS exposure, including parental smoking. METHODS In the framework of the National Human Biomonitoring Program, spot urine samples and questionnaire data were collected from 166 children aged 4-12 years, during the years 2020-2021. We collected urine samples in 233 adults, 69 of whom were parents of children included in the study. Parents of participating children were asked about parental smoking, child's exposure to ETS and smoking policy at home. Cotinine and creatinine were measured in urine. Creatinine-adjusted and unadjusted urine cotinine (UC) geometric means were calculated. Associations between potential correlates and UC concentrations were analyzed in univariate and multivariate analyses. For 69 child-parent pairs, correlation between child and parental UC was analyzed. RESULTS Based on urinary cotinine measurement, 65.2% of children of smokers are exposed to ETS, compared to 20.7% of children in non-smoking families. Greater numbers of smokers living in the home (beta = 1.27, p < 0.01), and low maternal education (beta = - 2.32, p < 0.01) were associated with higher levels of UC in a multivariate analysis. Spearman correlations showed a positive moderate correlation between UC in 69 child-parent pairs (r = 0.52, p < 0.01). CONCLUSIONS In order to reduce child exposure to ETS, smoking parents should be urgently targeted for smoking cessation and smoke-free home interventions. Further interventions are needed to protect all children from ETS.
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Affiliation(s)
- Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Efrat Rorman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel
| | - Luda Groisman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel.
- Faculty of Engineering, Ruppin Academic Center, Emek Hefer, Israel.
- Research Group in Environmental and Social Sustainability, Ruppin Academic Center, Emek Hefer, Israel.
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Groisman L, Berman T, Quinn A, Pariente G, Rorman E, Karakis I, Gat R, Sarov B, Novack L. Levels of PFAS concentrations in the placenta and pregnancy complications. Ecotoxicol Environ Saf 2023; 262:115165. [PMID: 37348217 DOI: 10.1016/j.ecoenv.2023.115165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 06/12/2023] [Accepted: 06/18/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Recent research has raised concerns about the potential health effects of perfluoroalkyl and polyfluoroalkyl substances (PFAS) exposure, particularly during critical periods of development such as pregnancy. In this study, we sought to investigate the presence and potential impacts of PFAS in the placenta. METHODS We measured 13 PFAS compounds in placental tissue samples among 50 women who gave birth at a tertiary medical center in southern Israel. The sample comprised of 10 women with pregnancy-related complications (preterm birth, preeclampsia, gestational diabetes or small-for-gestational age) and 40 women without complications individually matched to cases by age. RESULTS For five (5) out of 13 PFAS compounds (Perfluorooctane Sulfonate (PFOS), perfluorooctanoic acid (PFOA), Perfluorohexanesulphonic acid (PFHxS), Perfluorononanoic acid (PFNA), Perfluorodecanoic acid (PFDA)) median concentrations were lower or comparable to placental measurements in different international populations. Geometric mean was estimated at 0.09 ng/g (90%CI:0.07;0.10) for PFOA, 0.05 ng/g for PFNA (90%CI:0.04;0.07), 0.03 ng/g for PFDA (90%CI:0.01;0.03), 0.06 ng/g for PFHxS (90%CI:0.05;0.07), 0.23 ng/g for PFOS linear measurement (90%CI:0.20;0.26) and 0.25 ng/g (90%CI:0.22;0.30) for PFOS summed concentrations that included non-linear isomers. Composite outcome of pregnancy-related complications was associated with elevated PFOA placental concentrations at an odds ratio (OR)= 1.82 (90%CI:1.06;3.13) for an increase of one quintile of PFOA value and adjusted to maternal gravidity in a conditional logistic regression. CONCLUSION This pilot study indicates a widespread exposure to multiple PFAS compounds in placental tissue of pregnant women in Israel. These findings warrant further validation through comprehensive national human biomonitoring initiatives.
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Affiliation(s)
- Luda Groisman
- National Public Health Laboratory, Israel Ministry of Health, Tel Aviv, Israel
| | - Tamar Berman
- Department of Health Promotion, Tel Aviv University, Israel; Department of Environmental Health, Israel Ministry of Health, Israel, Tel Aviv University, Israel
| | - Anna Quinn
- Ben-Gurion University of the Negev, Faculty of Health Sciences, Israel
| | - Gali Pariente
- The Division of Obstetrics and Gynecology, Soroka University Medical Center, Israel
| | - Efrat Rorman
- National Public Health Laboratory, Israel Ministry of Health, Tel Aviv, Israel
| | - Isabella Karakis
- Ben-Gurion University of the Negev, Faculty of Health Sciences, Israel; Department of Environmental Epidemiology, Israel Ministry of Health, Israel
| | - Roni Gat
- Ben-Gurion University of the Negev, Faculty of Health Sciences, Israel; Soroka University Medical Center, Negev Environmental Health Research Institute, Israel
| | - Batia Sarov
- Ben-Gurion University of the Negev, Faculty of Health Sciences, Israel
| | - Lena Novack
- Ben-Gurion University of the Negev, Faculty of Health Sciences, Israel; Soroka University Medical Center, Negev Environmental Health Research Institute, Israel.
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Ubong D, Stewart L, Sepai O, Knudsen LE, Berman T, Reynders H, Van Campenhout K, Katsonouri A, Van Nieuwenhuyse A, Ingelido AM, Castaño A, Pedraza-Díaz S, Eiríksdóttir ÁV, Thomsen C, Hartmann C, Gjorgjev D, De Felip E, Tolonen H, Santonen T, Klanova J, Norström K, Kononenko L, Silva MJ, Uhl M, Kolossa-Gehring M, Apel P, Jõemaa M, Jajcaj M, Estokova M, Luijten M, Lebret E, von Goetz N, Holcer NJ, Probst-Hensch N, Cavaleiro R, Barouki R, Tarroja E, Balčienė RM, Strumylaite L, Latvala S, Namorado S, Szigeti T, Ingi Halldorsson T, Olafsdottir K, Wasowicz W. Application of human biomonitoring data to support policy development, raise awareness and environmental public health protection among countries within the HBM4EU project. Int J Hyg Environ Health 2023; 251:114170. [PMID: 37207539 DOI: 10.1016/j.ijheh.2023.114170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 04/16/2023] [Accepted: 04/17/2023] [Indexed: 05/21/2023]
Abstract
Most countries have acknowledged the importance of assessing and quantifying their population's internal exposure from chemicals in air, water, soil, food and other consumer products due to the potential health and economic impact. Human biomonitoring (HBM) is a valuable tool which can be used to quantify such exposures and effects. Results from HBM studies can also contribute to improving public health by providing evidence of individuals' internal chemical exposure as well as data to understand the burden of disease and associated costs thereby stimulating the development and implementation of evidence-based policy. To have a holistic view on HBM data utilisation, a multi-case research approach was used to explore the use of HBM data to support national chemical regulations, protect public health and raise awareness among countries participating in the HBM4EU project. The Human Biomonitoring for Europe (HBM4EU) Initiative (https://www.hbm4eu.eu/) is a collaborative effort involving 30 countries, the European Environment Agency (EEA) and the European Commission (contracting authority) to harmonise procedures across Europe and advance research into the understanding of the health impacts of environmental chemical exposure. One of the aims of the project was to use HBM data to support evidence based chemical policy and make this information timely and directly available for policy makers and all partners. The main data source for this article was the narratives collected from 27 countries within the HBM4EU project. The countries (self-selection) were grouped into 3 categories in terms of HBM data usage either for public awareness, policy support or for the establishment HBM programme. Narratives were analysed/summarised using guidelines and templates that focused on ministries involved in or advocating for HBM; steps required to engage policy makers; barriers, drivers and opportunities in developing a HBM programme. The narratives reported the use of HBM data either for raising awareness or addressing environmental/public health issues and policy development. The ministries of Health and Environment were reported to be the most prominent entities advocating for HBM, the involvement of several authorities/institutions in the national hubs was also cited to create an avenue to interact, discuss and gain the attention of policy makers. Participating in European projects and the general population interest in HBM studies were seen as drivers and opportunities in developing HBM programmes. A key barrier that was cited by countries for establishing and sustaining national HBM programmes was funding which is mainly due to the high costs associated with the collection and chemical analysis of human samples. Although challenges and barriers still exist, most countries within Europe were already conversant with the benefits and opportunities of HBM. This article offers important insights into factors associated with the utilisation of HBM data for policy support and public awareness.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Dragan Gjorgjev
- Institute of Public Health, Republic of North Macedonia, Macedonia
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Ali JH, Abdeen Z, Azmi K, Berman T, Jager K, Barnett-Itzhaki Z, Walter M. Influence of exposure to pesticides on telomere length and pregnancy outcome: Diethylphosphates but not Dimethylphosphates are associated with accelerated telomere attrition in a Palestinian cohort. Ecotoxicol Environ Saf 2023; 256:114801. [PMID: 36989559 DOI: 10.1016/j.ecoenv.2023.114801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
Exposure to environmental pesticides during pregnancy is associated with adverse health outcomes such as low birth weight and impaired neuro-development. In this study, we assessed maternal leukocyte telomere lengths (TL) in Palestinian pregnant women and compared the data with urinary organophosphate concentrations, demographic, lifestyle and dietary factors, birth weight, body length, gestational age, and head circumference. Women with high urine levels of creatinine adjusted diethylphosphate(DE)derived pesticide metabolites DEP, DETP or DEDTP had shorter telomeres (p = 0.05). Women living in proximity to agricultural fields had shorter telomeres compared to women not living in proximity to agricultural fields (p = 0.011). Regular consumption of organic food was associated with shorter telomeres (p = 0.01), whereas the consumption of other vegetables such as artichokes was rather associated with longer telomeres. By contrast, urine levels of dimethylphosphate(DM)-derived pesticide metabolites DMTP and DMDTP were associated with lower birth weight (p = 0.05) but not with shrter telomeres. In conclusion organophosphate pesticides and living in proximity to agriculture are associated with shorter TL, likely due to higher consumption of contaminated fruits and vegetables and/or the transport of pesticides to non-treatment sites. DE and DM substituted pesticides seem to have different effects on telomeres and development.
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Affiliation(s)
- Jaber Haj Ali
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center, Rostock, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité Universitätsmedizin, Berlin, Germany; Consulting Medical Laboratory, Nablus, Palestine
| | - Ziad Abdeen
- Al-Quds Nutrition and Health Research Institute, Al-Quds University, Jerusalem, Palestine
| | - Kifaya Azmi
- Biochemistry and Molecular Biology Department, Faculty of Medicine, Al-Quds University, Abu Deis, The West Bank, Palestine; Al-Quds Public Health Society, Jerusalem, Palestine
| | - Tamar Berman
- Public Health Services, Ministry of Health, Jerusalem, Israel; Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Kathrin Jager
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center, Rostock, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité Universitätsmedizin, Berlin, Germany
| | - Zohar Barnett-Itzhaki
- Ruppin Research Group in Environmental and Social Sustainability, Ruppin Academic Center, Emek Hefer, Israel
| | - Michael Walter
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center, Rostock, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité Universitätsmedizin, Berlin, Germany.
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Berman TS, Barnett-Itzhaki Z, Berman T, Marom E. Antimicrobial resistance in food-producing animals: towards implementing a one health based national action plan in Israel. Isr J Health Policy Res 2023; 12:18. [PMID: 37101188 PMCID: PMC10132406 DOI: 10.1186/s13584-023-00562-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/01/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Development of antimicrobial resistance poses a major threat to human and animal health worldwide. Antimicrobials are frequently used in animal husbandry, making food-producing animals a widespread and important source of antimicrobial resistance. Indeed, recent evidence demonstrates that antimicrobial resistance in food-producing animals poses a threat to the health of humans, animals and the environment. To address this threat, national action plans have been implemented based on a 'One Health' approach, which integrates actions across human and animal health sectors to combat antimicrobial resistance. Although under development, Israel has yet to publish a national action plan against antimicrobial resistance, despite alarming findings of resistant bacteria in food-producing animals in the country. Here we review several national action plans against antimicrobial resistance around the world in order to suggest approaches to develop a national action plan in Israel. MAIN BODY We investigated worldwide national action plans against antimicrobial resistance based on a 'One Health' approach. We also conducted interviews with representatives of relevant Israeli ministries to understand antimicrobial resistance policy and regulatory frameworks in Israel. Finally, we present recommendations for Israel towards implementing a 'One Health' national action plan against antimicrobial resistance. Many countries have developed such plans, however, only a few are currently funded. Furthermore, many countries, especially in Europe, have taken action to reduce the use of antimicrobials and the spread of antimicrobial resistance in food-producing animals by banning the use of antimicrobials to promote growth, reporting data on the use and sales of antimicrobials in food-producing animals, operating centralized antimicrobial resistance surveillance systems and preventing the use of antimicrobials important to human medicine to treat food-producing animals. CONCLUSIONS Without a comprehensive and funded national action plan, the risks of antimicrobial resistance to the public health in Israel will escalate. Thus, several actions should be considered: (1) Reporting data on the use of antimicrobials in humans and animals. (2) Operating a centralized surveillance system for antimicrobial resistance in humans, animals and the environment. (3) Improving awareness regarding antimicrobial resistance in the general public and in health practitioners from both human and animal sectors. (4) Composing a list of critically important antimicrobials to human medicine that's use should be avoided in food-producing animals. (5) Enforcing best practices of antimicrobial use at the farm-level. (6) Reducing incidence of infection through farm biosecurity. (7) Supporting research and development of new antimicrobial treatments, vaccines and diagnostic tools.
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Affiliation(s)
- Tali Sarah Berman
- Mimshak, The Israel Society of Ecology and Environmental Sciences, 19 Kehilat New York St, Tel Aviv, Israel.
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel.
- Department of Entomology, Newe Ya'ar Research Center, ARO, Ramat Yishai, Israel.
| | - Zohar Barnett-Itzhaki
- Ruppin Research Group in Environmental and Social Sustainability, Ruppin Academic Center, 4025000, Emek Hefer, Israel
| | - Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
| | - Eli Marom
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
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Vogel N, Lange R, Schmidt P, Rodriguez Martin L, Remy S, Springer A, Puklová V, Černá M, Rudnai P, Középesy S, Janasik B, Ligocka D, Fábelová L, Kolena B, Petrovicova I, Jajcaj M, Eštóková M, Esteban-Lopez M, Castaño A, Tratnik JS, Stajnko A, Knudsen LE, Toppari J, Main KM, Juul A, Andersson AM, Jørgensen N, Frederiksen H, Thomsen C, Sakhi AK, Åkesson A, Hartmann C, Dewolf MC, Koppen G, Biot P, Den Hond E, Voorspoels S, Gilles L, Govarts E, Murawski A, Gerofke A, Weber T, Rüther M, Gutleb AC, Guignard C, Berman T, Koch HM, Kolossa-Gehring M. Exposure to Phthalates in European Children, Adolescents and Adults since 2005: A Harmonized Approach Based on Existing HBM Data in the HBM4EU Initiative. Toxics 2023; 11:241. [PMID: 36977006 PMCID: PMC10057641 DOI: 10.3390/toxics11030241] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
Phthalates are mainly used as plasticizers and are associated inter alia with adverse effects on reproductive functions. While more and more national programs in Europe have started monitoring internal exposure to phthalates and its substitute 1,2-Cyclohexanedicarboxylic acid (DINCH), the comparability of results from such existing human biomonitoring (HBM) studies across Europe is challenging. They differ widely in time periods, study samples, degree of geographical coverage, design, analytical methodology, biomarker selection, and analytical quality assurance level. The HBM4EU initiative has gathered existing HBM data of 29 studies from participating countries, covering all European regions and Israel. The data were prepared and aggregated by a harmonized procedure with the aim to describe-as comparably as possible-the EU-wide general population's internal exposure to phthalates from the years 2005 to 2019. Most data were available from Northern (up to 6 studies and up to 13 time points), Western (11; 19), and Eastern Europe (9; 12), e.g., allowing for the investigation of time patterns. While the bandwidth of exposure was generally similar, we still observed regional differences for Butyl benzyl phthalate (BBzP), Di(2-ethylhexyl) phthalate (DEHP), Di-isononyl phthalate (DiNP), and Di-isobutyl phthalate (DiBP) with pronounced decreases over time in Northern and Western Europe, and to a lesser degree in Eastern Europe. Differences between age groups were visible for Di-n-butyl phthalate (DnBP), where children (3 to 5-year olds and 6 to 11-year olds) had lower urinary concentrations than adolescents (12 to 19-year-olds), who in turn had lower urinary concentrations than adults (20 to 39-year-olds). This study is a step towards making internal exposures to phthalates comparable across countries, although standardized data were not available, targeting European data sets harmonized with respect to data formatting and calculation of aggregated data (such as developed within HBM4EU), and highlights further suggestions for improved harmonization in future studies.
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Affiliation(s)
- Nina Vogel
- German Environment Agency (UBA), Department of Toxicology, Health-Related Environmental Monitoring, 14195 Berlin, Germany
| | - Rosa Lange
- German Environment Agency (UBA), Department of Toxicology, Health-Related Environmental Monitoring, 14195 Berlin, Germany
| | - Phillipp Schmidt
- German Environment Agency (UBA), Department of Toxicology, Health-Related Environmental Monitoring, 14195 Berlin, Germany
| | | | - Sylvie Remy
- Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Andrea Springer
- German Environment Agency (UBA), Department of Toxicology, Health-Related Environmental Monitoring, 14195 Berlin, Germany
| | - Vladimíra Puklová
- National Institute of Public Health, Centre for Health and Environment, 10000 Prague, Czech Republic
| | - Milena Černá
- National Institute of Public Health, Centre for Health and Environment, 10000 Prague, Czech Republic
| | - Péter Rudnai
- National Public Health Center, Environmental Health Unit of the Department of Public Health Laboratory, 1097 Budapest, Hungary
| | - Szilvia Középesy
- National Public Health Center, Environmental Health Unit of the Department of Public Health Laboratory, 1097 Budapest, Hungary
| | - Beata Janasik
- Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland
| | - Danuta Ligocka
- Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland
| | - Lucia Fábelová
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, 83303 Bratislava, Slovakia
| | - Branislav Kolena
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 94901 Nitra, Slovakia
| | - Ida Petrovicova
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 94901 Nitra, Slovakia
| | - Michal Jajcaj
- Public Health Authority, Department of Environment and Health, 83105 Bratislava, Slovakia
| | - Milada Eštóková
- Public Health Authority, Department of Environment and Health, 83105 Bratislava, Slovakia
| | | | | | - Janja Snoj Tratnik
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova Cesta 39, 1000 Ljubljana, Slovenia
| | - Anja Stajnko
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova Cesta 39, 1000 Ljubljana, Slovenia
| | - Lisbeth E. Knudsen
- Department of Public Health, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Jorma Toppari
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, 20520 Turku, Finland
- Department of Pediatrics, Turku University Hospital, 20521 Turku, Finland
| | - Katharina M. Main
- Department of Growth and Reproduction, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
| | - Hanne Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
| | - Cathrine Thomsen
- Department of Food Safety, Norwegian Institute of Public Health, 0456 Oslo, Norway
| | - Amrit Kaur Sakhi
- Department of Food Safety, Norwegian Institute of Public Health, 0456 Oslo, Norway
| | - Agneta Åkesson
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | | | | | - Gudrun Koppen
- Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Pierre Biot
- Federal Public Service Health, Food Chain Safety and Environment, 1060 Brussels, Belgium
| | - Elly Den Hond
- Department of Environment and Health, Provincial Institute of Hygiene (PIH), 2000 Antwerp, Belgium
| | - Stefan Voorspoels
- Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Liese Gilles
- Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Eva Govarts
- Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Aline Murawski
- German Environment Agency (UBA), Department of Toxicology, Health-Related Environmental Monitoring, 14195 Berlin, Germany
| | - Antje Gerofke
- German Environment Agency (UBA), Department of Toxicology, Health-Related Environmental Monitoring, 14195 Berlin, Germany
| | - Till Weber
- German Environment Agency (UBA), Department of Toxicology, Health-Related Environmental Monitoring, 14195 Berlin, Germany
| | - Maria Rüther
- German Environment Agency (UBA), Department of Toxicology, Health-Related Environmental Monitoring, 14195 Berlin, Germany
| | - Arno C. Gutleb
- Environmental Research and Innovation (ERIN) Department, Luxembourg Institute of Science and Technology, L-4422 Belvaux, Luxembourg
| | - Cedric Guignard
- Environmental Research and Innovation (ERIN) Department, Luxembourg Institute of Science and Technology, L-4422 Belvaux, Luxembourg
| | - Tamar Berman
- Department of Environmental Health, Ministry of Health, Jerusalem 9446724, Israel
| | - Holger M. Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance—Institute of the Ruhr University Bochum (IPA), 44789 Bochum, Germany
| | - Marike Kolossa-Gehring
- German Environment Agency (UBA), Department of Toxicology, Health-Related Environmental Monitoring, 14195 Berlin, Germany
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Mustieles V, Balogh RK, Axelstad M, Montazeri P, Márquez S, Vrijheid M, Draskau MK, Taxvig C, Peinado FM, Berman T, Frederiksen H, Fernández MF, Marie Vinggaard A, Andersson AM. Benzophenone-3: Comprehensive review of the toxicological and human evidence with meta-analysis of human biomonitoring studies. Environ Int 2023; 173:107739. [PMID: 36805158 DOI: 10.1016/j.envint.2023.107739] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Benzophenone-3 (BP-3) and its major metabolite benzophenone-1 (BP-1) are widely used as UV filters in sunscreens and cosmetics to prevent sunburn and skin damage, or as stabilizers to prevent photodegradation in many commercial products. As a result, their presence is ubiquitous in the environment, wildlife and humans. Based on endocrine disruption concerns, international regulatory agencies are performing a closer evaluation. OBJECTIVE AND METHODS This work aimed to comprehensively review the available human relevant evidence for safety issues in MEDLINE/PubMed in order to create a structured database of studies, as well as to conduct an integrative analysis as part of the Human Biomonitoring for Europe (HBM4EU) Initiative. RESULTS A total of 1,635 titles and abstracts were screened and 254 references were evaluated and tabulated in detail, and classified in different categories: i) exposure sources and predictors; ii) human biomonitoring (HBM) exposure levels to perform a meta-analysis; iii) toxicokinetic data in both experimental animals and humans; iv) in vitro and in vivo rodent toxicity studies; and v) human data on effect biomarkers and health outcomes. Our integrative analysis showed that internal peak BP-3 concentrations achieved after a single whole-body application of a commercially available sunscreen (4% w/w) may overlap with concentrations eliciting endocrine disrupting effects in vitro, and with internal concentrations causing in vivo adverse female reproductive effects in rodents that were supported by still limited human data. The adverse effects in rodents included prolonged estrous cycle, altered uterine estrogen receptor gene expression, endometrium hyperplasia and altered proliferation and histology of the mammary gland, while human data indicated menstrual cycle hormonal alterations and increased risk of uterine fibroids and endometriosis. Among the modes of action reported (estrogenic, anti-androgenic, thyroid, etc.), BP-3 and especially BP-1 showed estrogenic activity at human-relevant concentrations, in agreement with the observed alterations in female reproductive endpoints. The meta-analysis of HBM studies identified a higher concern for North Americans, showing urinary BP-3 concentrations on average 10 and 20 times higher than European and Asian populations, respectively. DISCUSSION AND CONCLUSIONS Our work supports that these benzophenones present endocrine disrupting properties, endorsing recent European regulatory efforts to limit human exposure. The reproducible and comprehensive database generated may constitute a point of departure in future risk assessments to support regulatory initiatives. Meanwhile, individuals should not refrain from sunscreen use. Commercially available formulations using inorganic UV filters that are practically not absorbed into systemic circulation may be recommended to susceptible populations.
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Affiliation(s)
- Vicente Mustieles
- University of Granada, Biomedical Research Center (CIBM), Granada, Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Ria K Balogh
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Marta Axelstad
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Parisa Montazeri
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Sandra Márquez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Martine Vrijheid
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Monica K Draskau
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Camilla Taxvig
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Francisco M Peinado
- University of Granada, Biomedical Research Center (CIBM), Granada, Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain
| | - Tamar Berman
- Department of Environmental Health, Ministry of Health, Jerusalem 9101002, Israel
| | - Hanne Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Mariana F Fernández
- University of Granada, Biomedical Research Center (CIBM), Granada, Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
| | | | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
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8
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Andersen HR, Rambaud L, Riou M, Buekers J, Remy S, Berman T, Govarts E. Exposure Levels of Pyrethroids, Chlorpyrifos and Glyphosate in EU-An Overview of Human Biomonitoring Studies Published since 2000. Toxics 2022; 10:789. [PMID: 36548622 PMCID: PMC9788618 DOI: 10.3390/toxics10120789] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Currently used pesticides are rapidly metabolised and excreted, primarily in urine, and urinary concentrations of pesticides/metabolites are therefore useful biomarkers for the integrated exposure from all sources. Pyrethroid insecticides, the organophosphate insecticide chlorpyrifos, and the herbicide glyphosate, were among the prioritised substances in the HBM4EU project and comparable human biomonitoring (HBM)-data were obtained from the HBM4EU Aligned Studies. The aim of this review was to supplement these data by presenting additional HBM studies of the priority pesticides across the HBM4EU partner countries published since 2000. We identified relevant studies (44 for pyrethroids, 23 for chlorpyrifos, 24 for glyphosate) by literature search using PubMed and Web of Science. Most studies were from the Western and Southern part of the EU and data were lacking from more than half of the HBM4EU-partner countries. Many studies were regional with relatively small sample size and few studies address residential and occupational exposure. Variation in urine sampling, analytical methods, and reporting of the HBM-data hampered the comparability of the results across studies. Despite these shortcomings, a widespread exposure to these substances in the general EU population with marked geographical differences was indicated. The findings emphasise the need for harmonisation of methods and reporting in future studies as initiated during HBM4EU.
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Affiliation(s)
- Helle Raun Andersen
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark (SDU), 5000 Odense, Denmark
| | - Loïc Rambaud
- Santé Publique France, Environmental and Occupational Health Division, 94410 Saint-Maurice, France
| | - Margaux Riou
- Santé Publique France, Environmental and Occupational Health Division, 94410 Saint-Maurice, France
| | - Jurgen Buekers
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Tamar Berman
- Israel Ministry of Health (MOH-IL), Jerusalem 9446724, Israel
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
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9
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Ben Mordechay E, Sinai T, Berman T, Dichtiar R, Keinan-Boker L, Tarchitzky J, Maor Y, Mordehay V, Manor O, Chefetz B. Wastewater-derived organic contaminants in fresh produce: Dietary exposure and human health concerns. Water Res 2022; 223:118986. [PMID: 35988339 DOI: 10.1016/j.watres.2022.118986] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 08/07/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
Irrigation with reclaimed wastewater is a growing practice aimed at conserving freshwater sources, especially in arid and semiarid regions. Despite the apparent advantages to water management, the practice of irrigation with reclaimed wastewater exposes the agroenvironment to contaminants of emerging concern (CECs). In this report, we estimated the unintentional dietary exposure of the Israeli population (2808 participants) to CECs from consumption of produce irrigated with reclaimed wastewater using detailed dietary data obtained from a National Health and Nutrition Survey (Rav Mabat adults; 2014-2016). Human health risk analyses were conducted based on acceptable daily intake (ADI) and threshold of toxicological concern (TTC) approaches. The highest unintentional exposure to wastewater-borne CECs was found to occur through the consumption of leafy vegetables. All analyzed CECs exhibited hazard quotients <1 for the mean- and high-exposure scenarios, indicating no human health concerns. However, for the extreme exposure scenario, the anticonvulsant agents lamotrigine and carbamazepine, and the carbamazepine metabolite epoxide-carbamazepine exhibited the highest exposure levels of 29,100, 27,200, and 19,500 ng/person (70 kg) per day, respectively. These exposure levels exceeded the TTC of lamotrigine and the metabolite epoxide-carbamazepine, and the ADI of carbamazepine, resulting in hazard quotients of 2.8, 1.1, and 1.9, respectively. According to the extreme estimated scenario, consumption of produce irrigated with reclaimed wastewater (leafy vegetables in particular) may pose a threat to human health. Minimizing irrigation of leafy vegetables using reclaimed wastewater and/or improving the quality of the reclaimed wastewater using an advanced treatment would significantly reduce human dietary exposure to CECs.
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Affiliation(s)
- Evyatar Ben Mordechay
- The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 7610001, Israel; Phytor Lab for Drug Development, Hadassah Medical Center Hebrew University Biotechnology Park (JBP), Ein Kerem Campus, Jerusalem 91120, Israel
| | - Tali Sinai
- The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 7610001, Israel; Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Tamar Berman
- Department of Environmental Health, Ministry of Health, Jerusalem, Israel
| | - Rita Dichtiar
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel; School of Public Health, University of Haifa, Haifa, Israel
| | - Jorge Tarchitzky
- The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 7610001, Israel
| | - Yehoshua Maor
- Phytor Lab for Drug Development, Hadassah Medical Center Hebrew University Biotechnology Park (JBP), Ein Kerem Campus, Jerusalem 91120, Israel
| | - Vered Mordehay
- The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 7610001, Israel
| | - Orly Manor
- School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Benny Chefetz
- The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 7610001, Israel.
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10
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Tarazona JV, Cattaneo I, Niemann L, Pedraza-Diaz S, González-Caballero MC, de Alba-Gonzalez M, Cañas A, Dominguez-Morueco N, Esteban-López M, Castaño A, Borges T, Katsonouri A, Makris KC, Ottenbros I, Mol H, De Decker A, Morrens B, Berman T, Barnett-Itzhaki Z, Probst-Hensch N, Fuhrimann S, Tratnik JS, Horvat M, Rambaud L, Riou M, Schoeters G, Govarts E, Kolossa-Gehring M, Weber T, Apel P, Namorado S, Santonen T. A Tiered Approach for Assessing Individual and Combined Risk of Pyrethroids Using Human Biomonitoring Data. Toxics 2022; 10:toxics10080451. [PMID: 36006130 PMCID: PMC9416723 DOI: 10.3390/toxics10080451] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 12/04/2022]
Abstract
Pyrethroids are a major insecticide class, suitable for biomonitoring in humans. Due to similarities in structure and metabolic pathways, urinary metabolites are common to various active substances. A tiered approach is proposed for risk assessment. Tier I was a conservative screening for overall pyrethroid exposure, based on phenoxybenzoic acid metabolites. Subsequently, probabilistic approaches and more specific metabolites were used for refining the risk estimates. Exposure was based on 95th percentiles from HBM4EU aligned studies (2014–2021) covering children in Belgium, Cyprus, France, Israel, Slovenia, and The Netherlands and adults in France, Germany, Israel, and Switzerland. In all children populations, the 95th percentiles for 3-phenoxybenzoic acid (3-PBA) exceeded the screening value. The probabilistic refinement quantified the risk level of the most exposed population (Belgium) at 2% or between 1–0.1% depending on the assumptions. In the substance specific assessments, the 95th percentiles of urinary concentrations in the aligned studies were well below the respective human biomonitoring guidance values (HBM-GVs). Both information sets were combined for refining the combined risk. Overall, the HBM data suggest a low health concern, at population level, related to pyrethroid exposure for the populations covered by the studies, even though a potential risk for highly exposed children cannot be completely excluded. The proposed tiered approach, including a screening step and several refinement options, seems to be a promising tool of scientific and regulatory value in future.
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Affiliation(s)
- Jose V. Tarazona
- European Food Safety Authority (EFSA), 43126 Parma, Italy
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain
- Correspondence: (J.V.T.); (T.S.)
| | - Irene Cattaneo
- European Food Safety Authority (EFSA), 43126 Parma, Italy
| | - Lars Niemann
- Department of Safety of Pesticides, German Federal Institute for Risk Assessment, 10589 Berlin, Germany
| | - Susana Pedraza-Diaz
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain
| | | | | | - Ana Cañas
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain
| | | | - Marta Esteban-López
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain
| | - Argelia Castaño
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain
| | - Teresa Borges
- General-Directorate of Health, Ministry of Health, 1049-005 Lisbon, Portugal
| | | | - Konstantinos C. Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3036, Cyprus
| | - Ilse Ottenbros
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 Bilthoven, The Netherlands
| | - Hans Mol
- Wageningen Food Safety Research (WFSR), 6700 Wageningen, The Netherlands
| | | | - Bert Morrens
- Department of Sociology, University of Antwerp, 2020 Antwerpen, Belgium
| | | | - Zohar Barnett-Itzhaki
- Ruppin Research Group in Environmental and Social Sustainability, Ruppin Academic Center, Emek Hefer 4025000, Israel
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
| | - Samuel Fuhrimann
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
| | - Janja Snoj Tratnik
- Jozef Stefan Institute, Department of Environmental Sciences, 1000 Jubljana, Slovenia
| | - Milena Horvat
- Jozef Stefan Institute, Department of Environmental Sciences, 1000 Jubljana, Slovenia
| | - Loic Rambaud
- Department of Environmental and Occupational Health, Santé Publique France, 12 rue du Val d’Osne, Saint-Maurice, CEDEX, 94415 Paris, France
| | - Margaux Riou
- Department of Environmental and Occupational Health, Santé Publique France, 12 rue du Val d’Osne, Saint-Maurice, CEDEX, 94415 Paris, France
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), 2020 Mol, Belgium
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), 2020 Mol, Belgium
| | | | - Till Weber
- German Environment Agency (UBA), 14195 Berlin, Germany
| | - Petra Apel
- German Environment Agency (UBA), 14195 Berlin, Germany
| | - Sonia Namorado
- Department of Epidemiology, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisbon, Portugal
| | - Tiina Santonen
- Finnish Institute of Occupational Health, Työterveyslaitos, P.O. Box 40, 00032 Helsinki, Finland
- Correspondence: (J.V.T.); (T.S.)
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11
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Tarazona JV, González-Caballero MDC, de Alba-Gonzalez M, Pedraza-Diaz S, Cañas A, Dominguez-Morueco N, Esteban-López M, Cattaneo I, Katsonouri A, Makris KC, Halldorsson TI, Olafsdottir K, Zock JP, Dias J, Decker AD, Morrens B, Berman T, Barnett-Itzhaki Z, Lindh C, Gilles L, Govarts E, Schoeters G, Weber T, Kolossa-Gehring M, Santonen T, Castaño A. Improving the Risk Assessment of Pesticides through the Integration of Human Biomonitoring and Food Monitoring Data: A Case Study for Chlorpyrifos. Toxics 2022; 10:toxics10060313. [PMID: 35736921 PMCID: PMC9228629 DOI: 10.3390/toxics10060313] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 02/05/2023]
Abstract
The risk assessment of pesticide residues in food is a key priority in the area of food safety. Most jurisdictions have implemented pre-marketing authorization processes, which are supported by prospective risk assessments. These prospective assessments estimate the expected residue levels in food combining results from residue trials, resembling the pesticide use patterns, with food consumption patterns, according to internationally agreed procedures. In addition, jurisdictions such as the European Union (EU) have implemented large monitoring programs, measuring actual pesticide residue levels in food, and are supporting large-scale human biomonitoring programs for confirming the actual exposure levels and potential risk for consumers. The organophosphate insecticide chlorpyrifos offers an interesting case study, as in the last decade, its acceptable daily intake (ADI) has been reduced several times following risk assessments by the European Food Safety Authority (EFSA). This process has been linked to significant reductions in the use authorized in the EU, reducing consumers’ exposure progressively, until the final ban in 2020, accompanied by setting all EU maximum residue levels (MRL) in food at the default value of 0.01 mg/kg. We present a comparison of estimates of the consumer’s internal exposure to chlorpyrifos based on the urinary marker 3,5,6-trichloro-2-pyridinol (TCPy), using two sources of monitoring data: monitoring of the food chain from the EU program and biomonitoring of European citizens from the HB4EU project, supported by a literature search. Both methods confirmed a drastic reduction in exposure levels from 2016 onwards. The margin of exposure approach is then used for conducting retrospective risk assessments at different time points, considering the evolution of our understanding of chlorpyrifos toxicity, as well as of exposure levels in EU consumers following the regulatory decisions. Concerns are presented using a color code, and have been identified for almost all studies, particularly for the highest exposed group, but at different levels, reaching the maximum level, red code, for children in Cyprus and Israel. The assessment uncertainties are highlighted and integrated in the identification of levels of concern.
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Affiliation(s)
- Jose V. Tarazona
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
- European Food Safety Authority (EFSA), I-43126 Parma, Italy;
- Correspondence: (J.V.T.); (A.C.)
| | - Maria del Carmen González-Caballero
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
| | - Mercedes de Alba-Gonzalez
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
| | - Susana Pedraza-Diaz
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
| | - Ana Cañas
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
| | - Noelia Dominguez-Morueco
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
| | - Marta Esteban-López
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
| | - Irene Cattaneo
- European Food Safety Authority (EFSA), I-43126 Parma, Italy;
| | | | - Konstantinos C. Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3036, Cyprus;
| | - Thorhallur I. Halldorsson
- Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, 102 Reykjavik, Iceland;
- Department of Epidemiology Research, Statens Serum Institut, DK-2300 Copenhagen, Denmark
| | - Kristin Olafsdottir
- Department of Pharmacology and Toxicology, University of Iceland, 107 Reykjavik, Iceland;
| | - Jan-Paul Zock
- National Institute for Public Health and the Environment (RIVM), Bilthoven, 3720 BA De Bilt, The Netherlands;
| | - Jonatan Dias
- Wageningen Food Safety Research (WFSR), 6700 AE Wageningen, The Netherlands;
| | | | - Bert Morrens
- Department of Sociology, University of Antwerp, 2020 Antwerpen, Belgium;
| | - Tamar Berman
- Ministry of Health, Jerusalem 9446724, Israel; (T.B.); (Z.B.-I.)
| | - Zohar Barnett-Itzhaki
- Ministry of Health, Jerusalem 9446724, Israel; (T.B.); (Z.B.-I.)
- Ruppin Research Group in Environmental and Social Sustainability, Ruppin Academic Center, Emek Hefer 4025000, Israel
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, 22363 Lund, Sweden;
| | - Liese Gilles
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; (L.G.); (E.G.); (G.S.)
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; (L.G.); (E.G.); (G.S.)
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; (L.G.); (E.G.); (G.S.)
- Department of Biomedical Sciences, University of Antwerp, 2020 Antwerp, Belgium
| | - Till Weber
- German Environment Agency (UBA), 14195 Berlin, Germany; (T.W.); (M.K.-G.)
| | | | - Tiina Santonen
- Finnish Institute of Occupational Health, P.O. Box 40 Helsinki, Finland;
| | - Argelia Castaño
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
- Correspondence: (J.V.T.); (A.C.)
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Negev M, Barnett-Itzhaki Z, Berman T, Reicher S, Cohen N, Ardi R, Shammai Y, Zohar T, Diamond ML. Hazardous chemicals in outdoor and indoor surfaces: artificial turf and laminate flooring. J Expo Sci Environ Epidemiol 2022; 32:392-399. [PMID: 34697408 DOI: 10.1038/s41370-021-00396-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Synthetic materials, increasingly used for indoor and outdoor surfaces including homes and playgrounds, may contain toxic chemicals. Infants have a higher potential of exposure to chemicals in these materials, which may pose a risk to their health. OBJECTIVE To understand potential risks related to outdoor surface coverings, based on a review of the literature and regulations, and to assess levels of hazardous chemicals in surface coverings in Israel. METHODS We reviewed the literature and regulations on artificial turf. We tested 46 samples of surfaces for trace metals in synthetic playground surfaces; trace metals, phthalates, and di(2-ethylhexyl) terephthalate (DEHT) in synthetic grass, and phthalates, DEHT and formaldehyde in laminate flooring. RESULTS Twelve studies reporting high levels of polycyclic aromatic hydrocarbons (PAH), and varying levels of trace metals in synthetic playground surfaces were identified, as well as five international regulations on lead with maximum acceptable concentrations in the range 40-500 mg/kg. Surface tests showed that 20 out of 30 samples of synthetic playground surfaces exceeded relevant standards for trace metals, of which five had cadmium levels ≥30 mg/kg and four had chromium levels ≥510 mg/kg. In synthetic grass, three out of eight samples exceeded relevant standards, with lead levels ≥1200 mg/kg. In Laminate flooring (n = 8) formaldehyde levels were in the range of 0.7-1.2 mg/m2 formaldehyde, and five samples contained ~5% DEHT. SIGNIFICANCE The literature on chemicals in surfaces is limited, but indicates some exceedance of regulatory limits. Trace metals in synthetic playground surfaces and synthetic grass, not regulated in Israel, exceeded relevant international standards in 72% of samples. Laminate flooring, regulated for formaldehyde, did not exceed the 3.5 mg/m2 standard, but contained DEHT, a replacement for ortho-substituted phthalates. The results of this preliminary study show that flooring surfaces may be a source of children's exposure to toxic chemicals. IMPACT STATEMENT Synthetic surfaces are increasingly being used in, for example, children's playgrounds and sports fields. Exceedances of regulatory limits from other jurisdictions, of heavy metal levels in most outdoor surfaces sampled in Israel indicates the potential for children's exposure. Domestic regulations should be implemented to reduce the risk to children from exposure to these surfaces.
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Affiliation(s)
- Maya Negev
- School of Public Health, University of Haifa, Mt. Carmel, Haifa, 3498838, Israel.
| | - Zohar Barnett-Itzhaki
- Ministry of Health, Jeremiya Street 39, Jerusalem, 9446724, Israel
- School of Engineering, Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, 4025000, Israel
| | - Tamar Berman
- Ministry of Health, Jeremiya Street 39, Jerusalem, 9446724, Israel
| | - Shay Reicher
- Ministry of Health, Jeremiya Street 39, Jerusalem, 9446724, Israel
| | - Naor Cohen
- The Standards Institution of Israel, 42 Chaim Levanon Street, Tel Aviv, 6997701, Israel
| | - Ruti Ardi
- The Standards Institution of Israel, 42 Chaim Levanon Street, Tel Aviv, 6997701, Israel
| | - Yaniv Shammai
- The Standards Institution of Israel, 42 Chaim Levanon Street, Tel Aviv, 6997701, Israel
| | - Tamar Zohar
- School of Public Health, University of Haifa, Mt. Carmel, Haifa, 3498838, Israel
| | - Miriam L Diamond
- Department of Earth Sciences, University of Toronto, 22 Russell Street, Toronto, M5S 3B1, ON, Canada
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Barnett-Itzhaki Z, Ehrlich D, Troen AM, Rorman E, Groismann L, Blaychfeld-Magnazi M, Endevelt R, Berman T. Results of the national biomonitoring program show persistent iodine deficiency in Israel. Isr J Health Policy Res 2022; 11:18. [PMID: 35346362 PMCID: PMC8960077 DOI: 10.1186/s13584-022-00526-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Adequate iodine intake is essential for human health, for normal thyroid function, and for attainment of full intellectual potential in children. In light of Israel's lack of a mandatory salt fortification policy, heavy reliance on desalination and low iodine intake from dairy products and seafood, there is concern in Israel that the population is iodine deficient. Indeed, the first Israeli National Iodine Survey in 2016 found a median urinary iodine concentration (UIC) of 83 µg/L among school age children, falling below the WHO’s adequacy range of 100–299 µg/L for children.
Methods
In the framework of the National Human Biomonitoring Program in Israel, spot urine samples and questionnaire data were collected from 166 healthy children aged 4–12 years in 2020–2021. Urinary iodine concentrations were measured at the Ministry of Health National Biomonitoring Laboratory, using mass spectrometry. An international comparison of median urinary iodine concentrations (UIC) was performed taking into consideration the levels of desalinated water per capita, and fortification policies.
Results
The overall median (interquartile range [IQR]) UIC was 80.1 µg/L (44.7–130.8 µg/L) indicating that the population’s iodine status has not improved in the five years that have passed since inadequacy was first identified. When comparing 13 countries with population size above 150,000, whose desalinated water per capita was at least 1 m3, Israel and Lebanon were the only countries with median UIC below the WHO adequacy range.
Conclusions
There is an urgent need for mandatory salt fortification in Israel. Based on our international comparison, we conclude that the potential impact of desalination on iodine intake can be compensated for using the implementation of salt fortification policy. This study highlights the critical need for public health surveillance of nutritional and environmental exposures using human biomonitoring, with emphasis on vulnerable populations such as pregnant women and children.
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Rousselle C, Meslin M, Berman T, Woutersen M, Bil W, Wildeman J, Chaudhry Q. Using Human Biomonitoring Data to Support Risk Assessment of Cosmetic Ingredients—A Case Study of Benzophenone-3. Toxics 2022; 10:toxics10020096. [PMID: 35202282 PMCID: PMC8877280 DOI: 10.3390/toxics10020096] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 12/10/2022]
Abstract
Safety assessment of UV filters for human health by the Scientific Committee on Consumer Safety (SCCS) is based on the estimation of internal dose following external (skin) application of cosmetic products, and comparison with a toxicological reference value after conversion to internal dose. Data from human biomonitoring (HBM) could be very useful in this regard, because it is based on the measurement of real-life internal exposure of the human population to a chemical. UV filters were included in the priority list of compounds to be addressed under the European Human Biomonitoring Initiative (HBM4EU), and risk assessment of benzophenone-3 (BP-3) was carried out based on HBM data. Using BP-3 as an example, this study investigated the benefits and limitations of the use of external versus internal exposure data to explore the usefulness of HBM to support the risk assessment of cosmetic ingredients. The results show that both approaches did indicate a risk to human health under certain levels of exposure. They also highlight the need for more robust exposure data on BP-3 and other cosmetic ingredients, and a standardized framework for incorporating HBM data in the risk assessment of cosmetic products.
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Affiliation(s)
- Christophe Rousselle
- European and International Affairs Department, Anses, 94701 Maisons-Alfort, France;
| | - Matthieu Meslin
- Risk Assessment Department, Anses, 14 rue Pierre et Marie Curie, 94701 Maisons-Alfort, France
- Correspondence:
| | | | - Marjolijn Woutersen
- RIVM National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands; (M.W.); (W.B.); (J.W.)
| | - Wieneke Bil
- RIVM National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands; (M.W.); (W.B.); (J.W.)
| | - Jenna Wildeman
- RIVM National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands; (M.W.); (W.B.); (J.W.)
| | - Qasim Chaudhry
- Department of Clinical Sciences and Nutrition, University of Chester, Parkgate Road, Chester CH1 4BJ, UK;
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15
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Negev M, Berman T, Goulden S, Reicher S, Barnett-Itzhaki Z, Ardi R, Shammai Y, Diamond ML. Lead in children's jewelry: the impact of regulation. J Expo Sci Environ Epidemiol 2022; 32:10-16. [PMID: 33654269 DOI: 10.1038/s41370-021-00308-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In 2016 we identified a regulatory gap in Israel reflecting a lack of restrictions on lead in children's jewelry. We conducted surveys that found high levels of lead in children's jewelry. Following the findings, a new standard restricting lead content was introduced in 2018. OBJECTIVE The goal of this study is to assess whether the new standard had an impact on lead concentrations in children's jewelry on the market 4 months after entry into force, and to examine factors that influenced the standard's effectiveness. METHODS Thirty-five items of children's jewelry were sampled from stores in Israel in 2018. Lead content of 130 subsamples of these items was tested with X-ray Fluorescence Spectrometry (XRF). We compared these findings to those before the introduction of the standard. We also conducted five structured interviews with professionals from government ministries, industry and expert bodies to examine factors influencing the standard's enactment and implementation. RESULTS 17% of jewelry samples exceeded the ASTM lead standard in 2018 compared with 50% in 2016. The mean of the jewelry subsamples analyzed in 2018 was 936 (±1700) compared to 1420 (±5740) ppm in 2016. Scientific and regulatory consensus among those setting the new standard led to its swift enactment. However, enforcement challenges may reduce the standard's impact. SIGNIFICANCE A new standard on lead in children's jewelry was followed by a decline in lead concentrations, but some products with lead exceedances remained available on the market. Public health campaigns, standards and compliance monitoring, and higher penalties will all help to reach the goal of protecting public health.
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Affiliation(s)
- Maya Negev
- School of Public Health, University of Haifa, Mt. Carmel, Haifa, 3498838, Israel.
| | - Tamar Berman
- Ministry of Health, Jeremiya Street 39, Jerusalem, 9446724, Israel
| | - Shula Goulden
- School of Public Health, University of Haifa, Mt. Carmel, Haifa, 3498838, Israel
| | - Shay Reicher
- Ministry of Health, Jeremiya Street 39, Jerusalem, 9446724, Israel
| | - Zohar Barnett-Itzhaki
- Ministry of Health, Jeremiya Street 39, Jerusalem, 9446724, Israel
- School of Engineering, Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, 4025000, Israel
| | - Ruti Ardi
- The Standards Institution of Israel, 42 Chaim Levanon Street, Tel Aviv, 6997701, Israel
| | - Yaniv Shammai
- The Standards Institution of Israel, 42 Chaim Levanon Street, Tel Aviv, 6997701, Israel
| | - Miriam L Diamond
- Department of Earth Sciences, University of Toronto, 22 Russell Street, Toronto, M5S 3B1, ON, Canada
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Roydhouse JK, Menapace LA, Xia H, Song P, Berman T, Agarwal R, Suzman DL, Wright K, Beaver JA, Kluetz PG. Concomitant botanical medicine use among patients participating in commercial prostate cancer trials. Complement Ther Med 2020; 54:102549. [PMID: 33183667 DOI: 10.1016/j.ctim.2020.102549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Patients with cancer frequently use botanical medications. The concomitant use of such medications by patients on commercial trials has not been well-described, despite the importance of these trials for evaluating the safety and efficacy of new agents. We sought to describe the use of botanical medications taken by patients with prostate cancer enrolled on global commercial trials. DESIGN Retrospective study. SETTING Regulatory repository of commercial clinical trial data. INTERVENTIONS Anti-cancer therapy. MAIN OUTCOME MEASURES Botanical and medication use data were pooled across six international commercial randomized trials for metastatic prostate cancer with detailed information on medication and indications. Botanical products were considered to have potential for drug interaction if they led to a change in drug exposure in human trials. Potential for interaction was ascertained by PubMed review. Descriptive statistics were used for analysis. RESULTS Of 7318 enrolled patients, 700 (10 %) reported botanical use at any time and 653 (9%) reported use of botanical products while on trial. Nearly half of botanical product types were not classified by plant (43 %). The highest proportion of botanical use was among patients in Asian countries (32 %), followed by patients in North America (13 %). Eighty-six different types of botanical products were used; of these, nineteen had a patient-reported anti-cancer indication. CONCLUSIONS Botanical medicine use among patients with prostate cancer in commercial trials is moderate, although it varies by region. Practitioners should be aware of the use of botanical interventions in a clinical trial context.
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Affiliation(s)
- J K Roydhouse
- ORISE Fellow, Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, Food and Drug Administration (US FDA), Silver Spring, MD, USA; Menzies Institute for Medical Research, University of Tasmania, Hobart TAS, Australia.
| | - L A Menapace
- Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA; National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - H Xia
- Division of Clinical Pharmacology, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - P Song
- Division of Clinical Pharmacology, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - T Berman
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - R Agarwal
- New Drug Products Branch II, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - D L Suzman
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - K Wright
- Office of Prescription Drug Promotion, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - J A Beaver
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, US FDA, Silver Spring, MD, USA
| | - P G Kluetz
- Oncology Center of Excellence, US FDA, Silver Spring, MD, USA
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17
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Berman T, Barnett-Itzhaki Z, Göen T, Hamama Z, Axelrod R, Keinan-Boker L, Shimony T, Goldsmith R. Organophosphate pesticide exposure in children in Israel: Dietary associations and implications for risk assessment. Environ Res 2020; 182:108739. [PMID: 32069760 DOI: 10.1016/j.envres.2019.108739] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Human biomonitoring (HBM) data is increasingly being compared to risk-based screening values to assess human health risk. However, as screening values have not been established for assessing biomarker concentrations of organophosphate (OP) pesticide metabolites, there are few studies using HBM data on urinary OP concentrations to assess human health risk. The purpose of the current study was to measure OP exposure in a sample of children in Israel; to explore associations between dietary patterns and OP exposure; and to assess risk of OP pesticides using urinary metabolite concentrations. METHODS We recruited 103 children in Israel and collected demographic and dietary data and urinary samples, and measured creatinine and dialkyl phosphate (DAP) concentrations. We compared urinary DAP concentrations to international populations and analysed associations between fruit and vegetable consumption and urinary DAP concentrations. Using urinary DAP concentrations, we calculated estimated daily intakes (EDI) of OP pesticides in each child and compared those to the acceptable daily intake (ADI). RESULTS Concentrations of several dialkyl phosphate metabolites (dimethylphosphate (DMP) and dimethylthiophosphate (DMTP)) were higher in our study population of Israeli children (geometric mean concentrations of DMP and DMTP were 6.6 μg/L and 7.6 μg/L, respectively) compared to children in the US, Canada, Spain, and Denmark. We found positive correlations between total fruit consumption and creatinine adjusted log transformed urinary DMP, DMTP, diethylthiophopshate (DETP), total dimethyl (DM) and total DAP concentrations (p < 0.05), positive correlations between cucumber consumption and diethylphosphate (DEP), DETP and diethyl (DE) concentrations (p < 0.05), and positive correlations between apple consumption and DETP concentrations (p = 0.02). Based on urinary DAP concentrations, we found that a portion of the children in our study had EDIs above the ADI, ranging from 2.9% to 79.4% of the children, depending on the active OP ingredient. CONCLUSIONS We found that Israeli children in our study are widely exposed to OP pesticides; that levels of dimethyl metabolites were high compared to other international populations; and that fruit consumption was associated with higher urinary DAP levels. Using urinary DAP concentration data, we found that a portion of the children in our study may be exposed to OP pesticides at levels above those considered safe.
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Affiliation(s)
- Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, 9446724, Israel; Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, 9446724, Israel; Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel.
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Ziva Hamama
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, 9446724, Israel
| | - Rachel Axelrod
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621, Ramat Gan, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621, Ramat Gan, Israel
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621, Ramat Gan, Israel
| | - Rebecca Goldsmith
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, 9446724, Israel
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Levy I, Karakis I, Berman T, Amitay M, Barnett-Itzhaki Z. A hybrid model for evaluating exposure of the general population in Israel to air pollutants. Environ Monit Assess 2019; 192:4. [PMID: 31797164 DOI: 10.1007/s10661-019-7960-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 11/07/2019] [Indexed: 06/10/2023]
Abstract
Exposure to air pollution is associated with a wide range of health effects, including increased respiratory symptoms, cancer, reproductive and birth defects, and premature death. Air quality measurements by standardized measuring equipment, although accurate, can only provide an estimate for part of the population, with decreasing accuracy further away from the monitoring sites. Estimating pollution levels over large geographical domains requires the use of air quality models which ideally incorporate air quality measurements. In order to estimate actual exposure of the population to air pollution (population-weighted concentrations of air pollutants), there is a need to combine data from air quality models with population density data. Here we present the results of exposure estimates for the entire population of Israel using a chemical transport model combined with measurements from the national monitoring network. We evaluated the individual exposure levels for the entire population to several air pollutants based on census tract units. Using this hybrid model, we found that the entire population of Israel is exposed to concentrations of PM10 and PM2.5 that exceed the target values but are below the environmental values according to the Israeli Clean Air Law. In addition, we found and that over 1.5 million residents are exposed to NOx at concentrations higher than the target values. This data may help decision makers develop targeted interventions to reduce the concentrations of specific pollutants, based on population-weighted exposure.
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Affiliation(s)
- Ilan Levy
- Division of Air Quality and Climate Change, Ministry of Environmental Protection, 125 Menachem Begin Road, 61071, Tel Aviv, Israel
| | - Isabella Karakis
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel
- Ashkelon Academic College, Ashkelon, Israel
| | - Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Amitay
- School of Engineering, Ruppin Academic Center, Emek Hefer, Israel
- Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel.
- School of Engineering, Ruppin Academic Center, Emek Hefer, Israel.
- Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel.
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel.
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Ein-Mor E, Berman T, Barnett-Itzhaki Z, Göen T, Ergaz-Shaltiel Z, Natsheh J, Ben-Chetrit A, Haimov-Kochman R, Calderon-Margalit R. Newborn infant urinary cotinine and birth outcomes in the Jerusalem Environment Mother and Child Cohort Study. Int J Hyg Environ Health 2019; 222:1054-1058. [PMID: 31324382 DOI: 10.1016/j.ijheh.2019.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/07/2019] [Accepted: 07/11/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Environmental tobacco smoke (ETS) exposure during pregnancy can cause preterm delivery and childhood cancer. The aim of this study was to measure ETS exposure in pregnant women and in newborn infants in Israel using urinary cotinine measurements, to assess predictors of ETS exposure in these vulnerable groups, and to assess associations with birth effects (birth weight, birth length, head circumference) in newborn infants. METHODS We analyzed urinary cotinine and creatinine in 265 non-smoking pregnant women and 97 newborns, and analyzed associations with self-reported exposure to ETS, paternal smoking, sociodemographic variables and with birth outcomes (birth weight, birth length, head circumference). RESULTS 37.7% of pregnant women and 29.0% of infants had urinary cotinine concentrations above the level of quantification (LOQ) of 1 μg/L, whereas 63.8% and 50.5%, respectively, had urinary cotinine concentrations above the level of detection (LOD) of 0.5 μg/L. Median unadjusted and creatinine adjusted urinary concentrations of cotinine in pregnant women were 0.7 μg/L, and 0.9 μg/g creatinine, respectively, and in newborn infants were 0.5 μg/L, and 1.3 μg/g creatinine, respectively. We did not find an association between maternal and infant urinary cotinine level. Maternal (but not infant) urinary cotinine was significantly associated with paternal smoking (p < 0.05). Infant (but not maternal) cotinine above the LOQ was negatively associated with birth weight (p < 0.05). CONCLUSIONS In this high socioeconomic cohort, almost a third of newborn infants born to non-smoking mothers had quantifiable levels of urinary cotinine. This is the first study showing that newborns with quantifiable urinary cotinine levels have lower birth weight.
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Affiliation(s)
- Eliana Ein-Mor
- Hadassah-Hebrew University Braun School of Public Health, POB 12272, Jerusalem, 91120, Israel
| | - Tamar Berman
- Public Health Services, Ministry of Health, Jerusalem, Israel; Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, Jerusalem, Israel; Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel.
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich- Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | - Juma Natsheh
- Neonatology Department Hadassah Medical Center, Jerusalem, Israel
| | | | - Ronit Haimov-Kochman
- Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ronit Calderon-Margalit
- Hadassah-Hebrew University Braun School of Public Health, POB 12272, Jerusalem, 91120, Israel
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20
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Barnett-Itzhaki Z, Eaton J, Hen I, Berman T. Heavy metal concentrations in drinking water in a country heavily reliant on desalination. Environ Sci Pollut Res Int 2019; 26:19991-19996. [PMID: 31089993 DOI: 10.1007/s11356-019-05358-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 04/11/2019] [Accepted: 05/01/2019] [Indexed: 06/09/2023]
Abstract
Desalination is an important strategy for adapting to the global shortage in safe drinking water. Israel relies heavily on desalinated water (over 50% of supplied drinking water). However, desalinated water may be more corrosive than water from other sources and may cause leaching of heavy metals from materials in contact with water. In this study, we measured heavy metal concentrations (copper, iron, lead) in 1379 drinking water samples in educational institutions in Israel and compared heavy metal concentrations in drinking water from different sources (desalination, groundwater, desalinated and groundwater mixture). 99.9% of the samples met the standard for copper (1400 μg/l), 99.7% for iron (1000 μg/l), and 99.6% for lead (10 μg/l). As expected, heavy metal concentrations were higher in first flush samples compared to flushed samples (significant findings for lead, copper, and iron). Heavy metal concentrations were not higher in desalinated water, or desalinated and groundwater mixture, compared to groundwater. In first flush samples, lead concentrations in groundwater were significantly higher than in desalinated-groundwater mixtures (p = 0.005). In flushed samples, lead concentrations in groundwater were higher than in desalinated-groundwater mixtures but the difference was not significant (p = 0.07). We suggest that regulatory requirements for stabilization of desalinated water and restrictions on lead content of plumbing materials appear to have been effective in preventing increased exposure to lead in desalinated drinking water in Israel. Further study should focus on potential heavy metal leaching in pure desalinated water samples.
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Affiliation(s)
- Zohar Barnett-Itzhaki
- Ministry of Health, Jeremiya Street 39, 9446724, Jerusalem, Israel.
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel.
| | | | - Irit Hen
- Ministry of Health, Jeremiya Street 39, 9446724, Jerusalem, Israel
| | - Tamar Berman
- Ministry of Health, Jeremiya Street 39, 9446724, Jerusalem, Israel
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21
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Portnoy S, Mimouni-Bloch A, Rosenberg L, Offek H, Berman T, Kochavi M, Orman G, Friedman J. Graphical Product Quality and Muscle Activity in Children With Mild Disabilities Drawing on a Horizontally or Vertically Oriented Tablet. Am J Occup Ther 2019; 72:7206205040p1-7206205040p7. [PMID: 30760396 DOI: 10.5014/ajot.2018.027532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We compared performance level and muscle activity patterns during shape copying and tracing in two positions, while sitting at a desk and while standing in front of a wall, between typically developing (TD) preschool children and children with mild disabilities (MD). METHOD Twenty-two TD children (8 boys, 14 girls; mean [M] age = 5.2 yr, standard deviation [SD] = 0.1) and 13 children with MD (9 boys, 4 girls; M age = 4.9 yr, SD = 0.5) participated in this study. RESULTS The children performed faster and smoother movements when copying shapes on the vertical surface, with no reduction of accuracy, than on the horizontal surface. Children with MD exerted their upper trapezius while performing the short tasks on the vertical surface compared with their muscle activity on the horizontal surface. CONCLUSION Incorporating short copying or drawing tasks on a vertical surface may increase the control of proximal muscles and ease graphomotor performance in children with MD.
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Affiliation(s)
- Sigal Portnoy
- Sigal Portnoy, PhD, is Lecturer, Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
| | - Aviva Mimouni-Bloch
- Aviva Mimouni-Bloch, MD, is Director, Pediatric Neurology and Developmental Unit, Loewenstein Rehabilitation Hospital, Raanana, Israel, and Senior Lecturer, Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Limor Rosenberg
- Limor Rosenberg, PhD, OT, is Senior Teacher, Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hagar Offek
- Hagar Offek, MSc, is Researcher, Pediatric Neurology and Developmental Unit, Loewenstein Rehabilitation Hospital, Raanana, Israel
| | - Tamar Berman
- Tamar Berman is Occupational Therapy Student, Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Kochavi
- Michal Kochavi is Occupational Therapy Student, Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gal Orman
- Gal Orman is Occupational Therapy Student, Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jason Friedman
- Jason Friedman, PhD, is Senior Lecturer, Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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22
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Berman T, Barnett-Itzhaki Z, Axelrod R, Keinan-Boker L, Shimony T, Goldsmith R, Göen T, Geva H, Rosen L. Socioeconomic inequalities in exposure to environmental tobacco smoke in children in Israel. Environ Int 2018; 121:643-648. [PMID: 30316179 DOI: 10.1016/j.envint.2018.09.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/17/2018] [Accepted: 09/20/2018] [Indexed: 05/11/2023]
Abstract
BACKGROUND Environmental tobacco smoke (ETS) exposure in infants and children causes more frequent and severe asthma attacks, respiratory infections, ear infections, and sudden infant death syndrome. The aim of this study was to measure ETS exposure in children in Israel (ages 4-11 years) using urinary cotinine measurements, in order to compare exposure levels to other international populations, and to assess predictors of ETS exposure in children in Israel. METHODS A subset of children who participated in the National Health and Nutrition Survey (RAV- MABAT) in 2015-2016 were invited to participate in the Second Israel Biomonitoring Survey. We analyzed urinary cotinine and creatinine concentrations in 103 children. Parents of study participants were interviewed in person on children's exposure to ETS at home and in other environments and on sociodemographic variables. We calculated creatinine-adjusted and unadjusted urinary cotinine geometric means in children and analyzed associations in univariable and multivariable analyses, between sociodemographic variables and parental - reported exposure, and urinary cotinine concentrations. RESULTS Based on urinary creatinine measurement, over 60% of children are exposed to ETS (compared to <40% based on parental report). Linear regression showed a positive association between urinary cotinine concentration and reported ETS exposure (p = 0.001). Mean cotinine concentration among children whose parents reported that they are exposed to ETS at home (5.1 μg/l) was significantly higher than the concentration among children whose parents reported they are not exposed to ETS at home (1.6 μg/l, p < 0.001). There was an inverse relationship between total family income and urinary cotinine concentration (p < 0.05). In a multivariable model adjusted for ethnicity and other factors, family income was a significant predictor of urinary cotinine level (p = 0.04, slope = -0.49). Geometric mean creatinine adjusted concentrations in children in the current study were higher than in children in Canada and selected European countries. CONCLUSIONS We found evidence of widespread exposure to ETS in children in the study. There is an urgent need to protect children in Israel from exposure to ETS.
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Affiliation(s)
- Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem 9446724, Israel; Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem 9446724, Israel; Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel.
| | - Rachel Axelrod
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621 Ramat Gan, Israel.
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621 Ramat Gan, Israel.
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621 Ramat Gan, Israel.
| | - Rebecca Goldsmith
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem 9446724, Israel.
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.
| | - Haim Geva
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem 9446724, Israel.
| | - Laura Rosen
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
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Berman T, Barnett-Itzhaki Z, Reicher S, Ardi R, Shammai Y, Aruas L, Negev M. Lead in spray paint and painted surfaces in playgrounds and public areas in Israel: Results of a pilot study. Sci Total Environ 2018; 637-638:455-459. [PMID: 29754080 DOI: 10.1016/j.scitotenv.2018.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 04/30/2018] [Accepted: 05/01/2018] [Indexed: 06/08/2023]
Abstract
Exposure to low levels of lead in children can cause cognitive deficits (reduced IQ) and behavioral changes such as reduced attention span and increased antisocial behavior. There are no mandatory limits on lead in paint in Israel, with the exception of paints used on toys and children's furniture. However, paints in playgrounds and public areas may be a source of exposure to lead in young children. In this study, we quantified lead concentrations in painted surfaces in public playgrounds and public areas, and in spray paints in Israel, using X-ray fluorescence (XRF). Lead was detected in 43/48 (90%) of surfaces; concentrations exceeded the US regulatory limit for lead in paint (90 ppm) in 4/5 (80%) of tested surfaces on wooden picnic tables and benches, and 22/25 (88%) of surfaces in playgrounds. In 15 surfaces, lead concentrations were 10-700 times higher than the US limit. Out of 11 spray paints sampled, three (27%) had concentrations above the US standard for residential paints. In order to prevent exposure of the general public to lead in playgrounds and public areas and in spray paints, we recommend an integrated approach, including regulatory restrictions (mandatory lead limit of 90 ppm in all paints except labeled industrial paints); awareness raising in the public and in national agencies and local authorities responsible for maintenance in playgrounds, schools and public areas; and encouragement of voluntary measures by industry to prevent sale of industrial paints for use in areas accessible to the public.
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Affiliation(s)
- Tamar Berman
- Ministry of Health, Jeremiya Street 39, Jerusalem 9446724, Israel
| | - Zohar Barnett-Itzhaki
- Ministry of Health, Jeremiya Street 39, Jerusalem 9446724, Israel; Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel.
| | - Shay Reicher
- Ministry of Health, Jeremiya Street 39, Jerusalem 9446724, Israel
| | - Ruti Ardi
- Standards Institution of Israel, Tel Aviv, Israel
| | | | - Lior Aruas
- Standards Institution of Israel, Tel Aviv, Israel
| | - Maya Negev
- School of Public Health, University of Haifa, Mt. Carmel 3498838, Israel
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Machtinger R, Berman T, Adir M, Mansur A, Baccarelli AA, Racowsky C, Calafat AM, Hauser R, Nahum R. Urinary concentrations of phthalate metabolites, bisphenols and personal care product chemical biomarkers in pregnant women in Israel. Environ Int 2018; 116:319-325. [PMID: 29754027 PMCID: PMC5983044 DOI: 10.1016/j.envint.2018.04.022] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 04/14/2018] [Accepted: 04/16/2018] [Indexed: 05/13/2023]
Abstract
Mounting evidence suggests possible adverse effects of intrauterine exposure to certain phenols and phthalates, two classes of endocrine disruptor chemicals, on the developing fetus, with consequences into later life. These findings have contributed to the replacement of some chemicals, such as di‑2‑ethylhexyl phthalate (DEHP) and bisphenol A (BPA), in consumer products. For the current study we quantified urinary concentrations of biomarkers of exposure among 50 pregnant women in Israel to several phthalates, bisphenols and personal care product chemicals, as well as DEHP and BPA alternatives. We detected 14 of the 31 biomarkers in more than 90% of the women. We detected biomarkers of 1,2‑cyclohexane dicarboxylic acid, diisononyl ester (DINCH), bisphenol S, and bisphenol F not as frequently (27-56%). This study is the first to evaluate exposure to triclosan, bisphenols, parabens, and phthalates and BPA alternatives among Israeli pregnant women.
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Affiliation(s)
- Ronit Machtinger
- Department of Obstetrics and Gynecology, Sheba Medical Center, Derech Sheba Ramat-Gan and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | - Tamar Berman
- Public Health Services, Israel Ministry of Health, 39 Jeremiya Street, Jerusalem, Israel
| | - Michal Adir
- Department of Obstetrics and Gynecology, Sheba Medical Center, Derech Sheba Ramat-Gan and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Abdallah Mansur
- Department of Obstetrics and Gynecology, Sheba Medical Center, Derech Sheba Ramat-Gan and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Columbia University, Mailman School of Public Health, New York, NY, USA
| | | | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ravit Nahum
- Department of Obstetrics and Gynecology, Sheba Medical Center, Derech Sheba Ramat-Gan and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Barnett-Itzhaki Z, Esteban López M, Puttaswamy N, Berman T. A review of human biomonitoring in selected Southeast Asian countries. Environ Int 2018; 116:156-164. [PMID: 29684824 DOI: 10.1016/j.envint.2018.03.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 03/28/2018] [Accepted: 03/30/2018] [Indexed: 06/08/2023]
Abstract
Rapid development and industrialization in Southeast (SE) Asia has led to environmental pollution, potentially exposing the general population to environmental contaminants. Human biomonitoring (HBM), measurement of chemical and/or their metabolites in human tissues and fluids, is an important tool for assessing cumulative exposure to complex mixtures of chemicals and for monitoring chemical exposures in the general population. While there are national HBM programs in several developed countries, there are no such national programs in most of the SE Asian countries. However, in recent years there has been progress in the field of HBM in many of the SE Asian countries. In this review, we present recent HBM studies in five selected SE Asian countries: Bangladesh, Indonesia, Malaysia, Myanmar and Thailand. While there is extensive HBM research in several SE Asian countries, such as Thailand, in other countries HBM studies are limited and focus on traditional environmental pollutants (such as lead, arsenic and mercury). Further development of this field in SE Asia would be benefited by establishment of laboratory capacity, improving quality control and assurance, collaboration with international experts and consortiums, and sharing of protocols and training both for pre-analytical and analytical phases. This review highlights the impressive progress in HBM research in selected SE Asian countries and provides recommendations for development of this field.
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Affiliation(s)
- Zohar Barnett-Itzhaki
- Ministry of Health, Jeremiya Street 39, Jerusalem 9446724, Israel; Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel.
| | - Marta Esteban López
- Área de Toxicología Ambiental, Centro Nacional de Sanidad Ambiental, Instituto de Salud Carlos III, Madrid, Spain
| | - Naveen Puttaswamy
- Center for Air Quality, Climate and Health, Department of Environmental Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Tamar Berman
- Ministry of Health, Jeremiya Street 39, Jerusalem 9446724, Israel
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Berman T, Barnett-Itzhaki Z, Mery N, Keinan-Boker L, Shimony T, Goldsmith R, Göen T, Geva H, Rosen L. Exposure to environmental tobacco smoke in non - smoking adults in Israel: results of the second Israel biomonitoring survey. Isr J Health Policy Res 2018; 7:33. [PMID: 29936912 PMCID: PMC6016141 DOI: 10.1186/s13584-018-0229-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 06/08/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Exposure to environmental tobacco smoke (ETS) increases the risk of heart and respiratory disease, cancer, and premature mortality in non-smoking individuals. Results from the first Israel Biomonitoring Study in 2011 showed that over 60% of non-smoking adults are exposed to ETS. The purpose of the current study was to assess whether policies to restrict smoking in public places have been associated with reductions in exposure to ETS, and to examine predictors of exposure. METHODS We analyzed urinary cotinine and creatinine concentrations in 194 adult participants in the National Health and Nutrition (RAV MABAT) Survey in 2015-2016. Study participants were interviewed in person on smoking status and exposure to ETS. We calculated creatinine-adjusted and unadjusted urinary cotinine geometric means and medians among smokers and non-smokers. We analyzed associations in univariable analyses, between socio-demographic variables and self - reported exposure, and urinary cotinine concentrations. RESULTS There was no reduction in geometric mean urinary cotinine levels in non-smokers in the current study (1.7 μg/g) compared to that in 2011 (1.6 μg/g). Median cotinine levels among the non - smoking Arab participants were higher in comparison to the Jewish and other participants (2.97 versus 1.56 μg/l, p = 0.035). Participants who reported that they were exposed to ETS at home had significantly higher median levels of creatinine adjusted urinary cotinine than those reporting they were not exposed at home (4.19 μg/g versus 2.9 μg/g, p = 0.0039). CONCLUSIONS Despite additional restrictions on smoking in public places in 2012-2016, over 60% of non-smoking adults in Israel continue to be exposed to ETS. Urinary cotinine levels in non-smokers have not decreased compared to 2011. Results indicate higher exposure to ETS in Arab study participants and those reporting ETS exposure at home. There is an urgent need: (1) to increase enforcement on the ban on smoking in work and public places; (2) for public health educational programs and campaigns about the adverse health effects of ETS; and (3) to develop and disseminate effective interventions to promote smoke free homes. Periodic surveys using objective measures of ETS exposure (cotinine) are an important tool for monitoring progress, or lack thereof, of policies to reduce exposure to tobacco smoke in non-smokers.
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Affiliation(s)
- Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel. .,Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel.,Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel
| | - Nisim Mery
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621, Ramat Gan, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621, Ramat Gan, Israel
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621, Ramat Gan, Israel
| | - Rebecca Goldsmith
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel
| | - Thomas Göen
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine of the University Erlangen-Nuremberg, Erlangen, Germany
| | - Haim Geva
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel
| | - Laura Rosen
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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Ein-Mor E, Ergaz-Shaltiel Z, Berman T, Göen T, Natsheh J, Ben-Chetrit A, Haimov-Kochman R, Calderon-Margalit R. Decreasing urinary organophosphate pesticide metabolites among pregnant women and their offspring in Jerusalem: Impact of regulatory restrictions on agricultural organophosphate pesticides use? Int J Hyg Environ Health 2018; 221:775-781. [PMID: 29706435 DOI: 10.1016/j.ijheh.2018.03.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/23/2018] [Accepted: 03/29/2018] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Maternal urinary levels of dialkyl phosphate (DAP) metabolites of organophosphate pesticides (OP) during pregnancy are associated with adverse outcomes in the offspring. Between 2012 and 2014, eighteen active OP ingredients were restricted or banned in Israel for agricultural use. AIM We aimed to study trends of urinary DAP metabolites among pregnant women and their offspring in the era of the new regulations. METHODS Pregnant women were recruited at 11-18 weeks of gestation and provided spot urine samples (n = 273). Soon after birth, neonatal urine samples were collected (n = 107). All urine specimens analyzed for DAP metabolites. Trends in DAP metabolites were tested using Mann-Kendall trend statistic (M-K S) and linear regression models were constructed to estimate the association between calendar period and DAP levels between September 2012 and March 2016. RESULTS Over the study period, median maternal ∑DAP levels decreased from 248 nmol/L to 148 nmol/L. Time of recruitment was associated with a statistically significant decrease in DAP metabolites, which remained significant after multivariate adjustment. Overall, the results for the analysis of before and after June 2014 showed a significant decrease in ∑DAP of -0.198 log10 nmol/L (95%CI: -0.311,-0.084) which corresponds with a decrease of 36.6% in ∑DAP. A similar trend was found for DAP metabolites in neonatal urine. Compared to other studies, pregnant women in Jerusalem had higher ∑DAP levels, even at the end of the study period. CONCLUSION We observed significant reductions in maternal and neonatal DAP urinary levels during the period of 2012-2016. Regulations restricting agricultural use of OP seem to be effective in reducing population exposure to OP, in an era when residential use of OP is banned.
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Affiliation(s)
- Eliana Ein-Mor
- Hadassah-Hebrew University, Braun School of Public Health, POB 12272, Jerusalem, 91120, Israel.
| | | | - Tamar Berman
- Public Health Services, Ministry of Health, Jerusalem, Israel.
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Juma Natsheh
- Neonatology Department Hadassah Medical Center, Jerusalem, Israel.
| | | | - Ronit Haimov-Kochman
- Reproductive Endocrinology and IVF Unit, Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| | - Ronit Calderon-Margalit
- Hadassah-Hebrew University, Braun School of Public Health, POB 12272, Jerusalem, 91120, Israel.
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Negev M, Berman T, Reicher S, Balan S, Soehl A, Goulden S, Ardi R, Shammai Y, Hadar L, Blum A, Diamond ML. Regulation of chemicals in children's products: How U.S. and EU regulation impacts small markets. Sci Total Environ 2018; 616-617:462-471. [PMID: 29127800 DOI: 10.1016/j.scitotenv.2017.10.198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/18/2017] [Accepted: 10/19/2017] [Indexed: 05/04/2023]
Abstract
Toys and children's products may contain trace metals and organic compounds that are potentially harmful to the health and development of infants and young children. Intergovernmental organizations and individual countries regulate chemicals in consumer products, but a coordinated international approach is lacking. This paper examines the implications of chemical regulation in children's products in large markets for a smaller market, namely Israel. We compared chemical regulations in children's products in the U.S., EU and Israel, and conducted in-depth interviews with diverse stakeholders in the Israeli product standardization process. Israel adopted EU chemical standards for certain chemicals (e.g., trace metals, phthalates) but not others (e.g., bisphenol A, flame retardants, trace metals in children's jewelry). Israeli regulation of chemicals in consumer products relies on regulations in large markets such as the U.S. and EU, which therefore have impacts beyond their territories. However, Israel adopts only product-specific standards and has regulatory gaps due to the lack of an overarching regulatory approach that exists in the U.S. and the EU. Furthermore, Israeli policy is to adopt parallel standards from large markets in order to remove trade barriers, despite their different approaches to chemical regulation, an approach which prioritizes trade considerations over health considerations. We conclude with policy recommendations for Israel, which have relevance for other small markets.
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Affiliation(s)
- Maya Negev
- School of Public Health, University of Haifa, Mt. Carmel, 3498838, Israel.
| | - Tamar Berman
- Ministry of Health, Jeremiya Street 39, Jerusalem 9446724, Israel.
| | - Shay Reicher
- Ministry of Health, Jeremiya Street 39, Jerusalem 9446724, Israel.
| | - Simona Balan
- California Department of Toxic Substances Control, 1001 I Street, Sacramento, CA 95814, USA.
| | - Anna Soehl
- Green Science Policy Institute, 1400 Shattuck Ave., Store 8, Berkeley, CA 94709, USA.
| | - Shula Goulden
- Technion Israel Institute of Technology, Haifa, Israel.
| | - Ruti Ardi
- Standards Institute of Israel, Tel Aviv, Israel.
| | | | - Laura Hadar
- School of Public Health, University of Haifa, Mt. Carmel, 3498838, Israel.
| | - Arlene Blum
- Green Science Policy Institute, 1400 Shattuck Ave., Store 8, Berkeley, CA 94709, USA; Department of Chemistry, University of California at Berkeley, CA 94720, USA.
| | - Miriam L Diamond
- Department of Earth Sciences, 22 Russell Street, Toronto M5S 3B1, Canada.
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Negev M, Berman T, Reicher S, Sadeh M, Ardi R, Shammai Y. Concentrations of trace metals, phthalates, bisphenol A and flame-retardants in toys and other children's products in Israel. Chemosphere 2018; 192:217-224. [PMID: 29102866 DOI: 10.1016/j.chemosphere.2017.10.132] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 10/23/2017] [Accepted: 10/24/2017] [Indexed: 06/07/2023]
Abstract
Trace metals and synthetic chemicals including phthalates, bisphenol A and flame retardants, are widely used in toys and childcare products, and may pose acute or chronic adverse health effects in children. In Israel, certain chemicals are regulated in childcare products, but there are still regulatory gaps. We tested regulated and unregulated contaminants in 174 item parts from 70 childcare items with potentially high oral or dermal exposure, including 22 children's jewelry items, 14 toys, 7 diaper-changing mats, 6 baby mattresses, 7 baby textiles and 14 feeding and bathing items. In children's jewelry, an unregulated product in Israel, 23% of samples exceeded the US standard for lead. In toys, a regulated product, we did not detect trace metals above the Israeli standard. In textiles, baby mattresses and diaper-changing mats, phthalates exceeded the European Union standard in 14-45% of tests with a mean of 6.74% by mass for diisononyl phthalate, and 1.32% by mass for di(2-ethylhexyl) phthalate. BPA migration exceeded the EU standard in 14-45% of tests with a mean of 1.03 ppm. The flame retardants polybrominated biphenyls, pentabromodiphenyl, octabromodiphenyl ether, tris(2,3-dibromopropyl) phosphate and tris-(aziridinyl)-phosphine oxide were not detected. For products regulated in Israel, our findings suggest general compliance with mandatory standards. However, a lack of comprehensive chemical regulation means that there are regulatory gaps, and products not regulated in Israel may contain high levels of chemical contamination, exceeding US or EU regulations. The results of this study have prompted the development of an Israeli safety standard for children's jewelry.
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Affiliation(s)
- Maya Negev
- School of Public Health, University of Haifa, Mt. Carmel, 3498838 Israel.
| | - Tamar Berman
- Ministry of Health, 39 Jeremiya St., Jerusalem, 9446724 Israel.
| | - Shay Reicher
- Ministry of Health, 39 Jeremiya St., Jerusalem, 9446724 Israel.
| | - Maya Sadeh
- School of Public Health, Tel Aviv University, 30 Chaim Levanon St., Tel Aviv, 69978 Israel.
| | - Ruti Ardi
- The Chemistry, Health & Environment Laboratory, The Standards Institution of Israel, 42 Chaim Levanon St., Tel Aviv, 69977 Israel.
| | - Yaniv Shammai
- The Chemistry, Health & Environment Laboratory, The Standards Institution of Israel, 42 Chaim Levanon St., Tel Aviv, 69977 Israel.
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Berman T, Goldsmith R, Levine H, Grotto I. Human biomonitoring in Israel: Recent results and lessons learned. Int J Hyg Environ Health 2017; 220:6-12. [DOI: 10.1016/j.ijheh.2016.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/08/2016] [Accepted: 09/15/2016] [Indexed: 12/12/2022]
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Tordjman K, Grinshpan L, Novack L, Göen T, Segev D, Beacher L, Stern N, Berman T. Exposure to endocrine disrupting chemicals among residents of a rural vegetarian/vegan community. Environ Int 2016; 97:68-75. [PMID: 27792907 DOI: 10.1016/j.envint.2016.10.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/23/2016] [Accepted: 10/18/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND & AIMS Endocrine-disrupting chemicals (EDCs) are increasingly thought to be involved in the rising prevalence of disorders such as obesity, diabetes, and some hormone-dependent cancers. Several lines of evidence have indicated that vegetarian and vegan diets may offer some protection from such diseases. We hypothesized that exposure to selected EDCs among residents of the unique vegetarian/vegan community of Amirim would be lower than what has recently been reported for the omnivorous population in the first Israel Biomonitoring Study (IBMS). METHODS We studied 42 Amirim residents (29 vegetarians/13 vegans; 24 women/18men, aged 50.7±13.7y). Subjects answered detailed lifestyle, and multipass, memory-based 24-hr dietary recall questionnaires. Concentrations of bisphenol A (BPA), 11 phthalate metabolites, and the isoflavone phytoestrogens (genistein and daidzein) were determined by GC or LC tandem mass-spectrometry on a spot urine sample. The results were compared to those obtained following the same methodology in the Jewish subgroup of the IBMS (n=184). RESULTS While a vegetarian/vegan nutritional pattern had no effect on exposure to BPA, it seemed to confer a modest protection (~21%) from exposure to high molecular weight phthalates. Furthermore, the summed metabolites of the high molecular weight phthalate DiNP were 36% lower in vegans compared to vegetarians (P<0.05). In contrast, Amirim residents exhibited a level of exposure to isoflavone phytoestrogens about an order of magnitude higher than in the IBMS (P<0.001). CONCLUSIONS In Israel, a country whose inhabitants demonstrate exposure to EDCs comparable to that of the US and Canada, a voluntary lifestyle of vegetarianism and preference for organic food has a modest, but possibly valuable, impact on exposure to phthalates, while it is associated with a very steep increase in the exposure to phytoestrogens. Major reduction in exposure to EDCs will require regulatory actions.
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Affiliation(s)
- Karen Tordjman
- Institute of Endocrinology, Metabolism, and Hypertension, Tel Aviv-Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Laura Grinshpan
- Robert H. Smith Faculty of Agriculture, Food and Environment, Hebrew University, Rehovot, Israel
| | - Lena Novack
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Dar Segev
- Biotechnology Engineering, Braude College, Karmiel, Israel
| | - Lisa Beacher
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Naftali Stern
- Institute of Endocrinology, Metabolism, and Hypertension, Tel Aviv-Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamar Berman
- Department of Environmental Health, Ministry of Health, Jerusalem, Israel
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Berman T, Göen T, Novack L, Beacher L, Grinshpan L, Segev D, Tordjman K. Urinary concentrations of organophosphate and carbamate pesticides in residents of a vegetarian community. Environ Int 2016; 96:34-40. [PMID: 27588700 DOI: 10.1016/j.envint.2016.08.027] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 08/28/2016] [Accepted: 08/28/2016] [Indexed: 06/06/2023]
Abstract
Few population studies have measured urinary levels of pesticides in individuals with vegan, vegetarian, or organic diets. The objectives of this study were to evaluate whether a vegan/vegetarian diet was associated with increased exposure to organophosphate and carbamate pesticides, and to evaluate the impact of organic consumption on pesticide exposure in vegans and vegetarians. In the current pilot study conducted in 2013-2014, we collected spot urine samples and detailed 24h recall dietary data in 42 adult residents of Amirim, a vegetarian community in Northern Israel. We measured urinary levels of non-specific organophosphate pesticide metabolites (dialkylphosphates, (DAPs)) and specific metabolites of the current-use pesticides chlorpyrifos (3,5,6-trichloro-2-pyridinol (TCPy)), propoxur (-isopropoxyphenol (IPPX)), and carbaryl (1-naphthol). Six DAP metabolites were detected in between 67 and 100% of urine samples, with highest geometric mean concentrations for dimethylphosphate (19.2μg/g). Creatinine-adjusted median concentrations of total DAPs and of TCPy were significantly higher in Amirim residents compared to the general Jewish population in Israel (0.29μmol/g compared to 0.16, p<0.05 for DAPs and 4.32μg/g compared to 2.34μg/g, p<0.05 for TCPy). Within Amirim residents, we observed a positive association between vegetable intake and urinary TCPy levels (rho=0.47, p<0.05) and lower median total dimethyl phosphate levels in individuals reporting that >25% of the produce they consume is organic (0.065μmol/L compared to 0.22, p<0.05). Results from this pilot study indicate relatively high levels of urinary organophosphate pesticide metabolite concentrations in residents of a vegetarian community, a positive association between vegetable intake and urinary levels of a chlorpyrifos specific metabolite, and lower levels of total dimethyl phosphate in individuals reporting higher intake of organic produce. Results suggest that consumption of organic produce may offer some protection from increased exposure to organophosphate pesticide residues in vegetarians.
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Affiliation(s)
- T Berman
- Public Health Services, Ministry of Health, Israel.
| | - T Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
| | - L Novack
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - L Beacher
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - L Grinshpan
- Robert H. Smith Faculty of Agriculture, Food and Environment, Hebrew University, Rehovot, Israel
| | - D Segev
- Braude College, Karmiel, Israel
| | - K Tordjman
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Abstract
BACKGROUND Large amounts of expired and unused medications accumulate in households. This potentially exposes the public to hazards due to uncontrolled use of medications. Most of the expired or unused medications that accumulate in households (household medical waste) is thrown to the garbage or flushed down to the sewage, potentially contaminating waste-water, water resources and even drinking water. There is evidence that pharmaceutical active ingredients reach the environment, including food, however the risk to public health from low level exposure to pharmaceuticals in the environment is currently unknown. In Israel, there is no legislation regarding household medical waste collection and disposal. Furthermore, only less than 14 % of Israelis return unused medications to Health Maintenance Organization (HMO) pharmacies. METHODS In this study, we investigated world-wide approaches and programs for household medical waste collection and disposal. RESULTS In many countries around the world there are programs for household medical waste collection. In many countries there is legislation to address the issue of household medical waste, and this waste is collected in hospitals, clinics, law enforcement agencies and pharmacies. Furthermore, in many countries, medication producers and pharmacies pay for the collection and destruction of household medical waste, following the "polluter pays" principle. CONCLUSIONS Several approaches and methods should be considered in Israel: (a) legislation and regulation to enable a variety of institutes to collect household medical waste (b) implementing the "polluter pays" principle and enforcing medical products manufactures to pay for the collection and destruction of household medical waste. (c) Raising awareness of patients, pharmacists, and other medical health providers regarding the health and environmental risks in accumulation of drugs and throwing them to the garbage, sink or toilet. (d) Adding specific instructions regarding disposal of the drug, in the medication label and leaflet. (e) Examining incentives for returning medications to pharmacies. (f) Examining drug collection from deceased in retirement homes and hospitals.
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Affiliation(s)
- Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
- Mimshak, The Israel society of ecology and environmental sciences, 19 Kehilat New York St, Tel Aviv, Israel
| | - Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
| | - Itamar Grotto
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, Beer-Sheva, Israel
| | - Eyal Schwartzberg
- Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, Beer-Sheva, Israel
- Pharmaceutical Division, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
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Schilt Y, Berman T, Wei X, Barenholz Y, Raviv U. Using solution X-ray scattering to determine the high-resolution structure and morphology of PEGylated liposomal doxorubicin nanodrugs. Biochim Biophys Acta Gen Subj 2016; 1860:108-19. [DOI: 10.1016/j.bbagen.2015.09.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 09/02/2015] [Accepted: 09/15/2015] [Indexed: 11/28/2022]
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Freeman S, Kaufman-Shriqui V, Berman T, Varsano R, Shahar DR, Manor O. Children's diets, pesticide uptake, and implications for risk assessment: An Israeli case study. Food Chem Toxicol 2016; 87:88-96. [DOI: 10.1016/j.fct.2015.11.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 09/29/2015] [Accepted: 11/09/2015] [Indexed: 10/22/2022]
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Abdeen Z, Berman T, Azmi K, Abu Seir R, Agha H, Ein-Mor E, Göen T, Stein Y, Richter E, Calderon-Margalit R. Urinary organophosphate metabolite levels in Palestinian pregnant women: results of the Middle East Regional Cooperation Project. Int J Environ Health Res 2015; 26:254-266. [PMID: 26578062 DOI: 10.1080/09603123.2015.1109067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of the study was to measure urinary organophosphate (OP) metabolites in Palestinian pregnant women, and to compare levels with those in pregnant women in Jerusalem and women from the general population in Israel. We measured six dialkyl phosphates in urine samples collected from 148 pregnant women from the West Bank area. Median total dimethyl phosphate (DM(total)) levels were significantly lower in Palestinian women compared to Jerusalem pregnant women and women in Israel (p = 0.041). In Palestinian women reporting that their place of residence was near an agricultural field, DM(total) levels were significantly higher (p = 0.037). Lower urinary excretion of dimethyl phosphate pesticide metabolites in Palestinian women compared to Israeli women may result from lower consumption of fruits and vegetables in the Palestinian population. Our findings highlight differences in OP pesticide exposure in populations with close geographical proximity but with differences in culture, diet, lifestyle, and regulatory oversight of pesticides.
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Affiliation(s)
- Ziad Abdeen
- a Al-Quds Nutrition and Health Research Institute , Al-Quds University , Jerusalem , Palestine
| | - Tamar Berman
- b Public Health Services , Ministry of Health , Jerusalem , Israel
| | - Kifaya Azmi
- a Al-Quds Nutrition and Health Research Institute , Al-Quds University , Jerusalem , Palestine
| | - Rania Abu Seir
- a Al-Quds Nutrition and Health Research Institute , Al-Quds University , Jerusalem , Palestine
| | - Hazem Agha
- a Al-Quds Nutrition and Health Research Institute , Al-Quds University , Jerusalem , Palestine
| | - Eliana Ein-Mor
- c The Hebrew University-Hadassah School of Public Health , Jerusalem , Israel
| | - Thomas Göen
- d Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine , Friedrich-Alexander-Universität Erlangen-Nürnberg , Germany
| | - Yael Stein
- c The Hebrew University-Hadassah School of Public Health , Jerusalem , Israel
| | - Elihu Richter
- c The Hebrew University-Hadassah School of Public Health , Jerusalem , Israel
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Wasser J, Berman T, Lerner-Geva L, Grotto I, Rubin L. Biological monitoring of Persistent Organic Pollutants in human milk in Israel. Chemosphere 2015; 137:185-191. [PMID: 26246042 DOI: 10.1016/j.chemosphere.2015.07.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/19/2015] [Accepted: 07/12/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND The Stockholm Convention on Persistent Organic Pollutants (POPs) aims to eliminate or restrict the production and use of POPs around the globe. The Ministry of Health, collaborating with the Ministry of Environmental Protection, measured the exposure of the population to POPs as part of the WHO-coordinated exposure study. Human milk, with a relatively high fat content is a preferred matrix for the monitoring of exposure. METHODS Donors of breast milk were recruited from three hospitals after signing informed consent forms. Breast milk was collected from 52 primipara women, aged 23-35, living in Israel for the last 10 years who gave birth to singleton full term healthy infants. Samples, collected at 3-17 weeks postpartum, were stored at -20 °C until sent to the WHO Reference Laboratory, State Laboratory for Chemical and Veterinary Analysis of Food (CVUA), in Frieburg, Germany for a single pooled analysis. Mothers were provided with the pooled analysis results. RESULTS Out of over 50 Persistent Organic Pollutants listed in the analysis, 16, including aldrin, endrin, parlar and mirex were not found at detectable levels in the Israeli pooled sample. For the indicator compounds found at detectable levels, most were lower than those reported in European countries. DISCUSSION Since 1982, levels of POPs contamination as measured in breast milk have declined significantly. This is likely due to restrictions on agricultural, industrial, and other uses of many POPs in Israel. Ongoing biomonitoring in Israel and inter-ministerial collaboration supports the elimination of POPs in the environment and human milk.
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Affiliation(s)
- Janice Wasser
- Public Health Services, Ministry of Health, Israel, 39 Yirmiyahu St., P.O. Box 1176, Jerusalem 9101002, Israel.
| | - Tamar Berman
- Public Health Services, Ministry of Health, Israel, 39 Yirmiyahu St., P.O. Box 1176, Jerusalem 9101002, Israel.
| | - Liat Lerner-Geva
- Women and Children's Health Research Unit, Gertner Institute for Epidemiology & Health Policy Research (Ltd), Tel Hashomer 52621, Israel; School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
| | - Itamar Grotto
- Public Health Services, Ministry of Health, Israel, 39 Yirmiyahu St., P.O. Box 1176, Jerusalem 9101002, Israel.
| | - Lisa Rubin
- Public Health Services, Ministry of Health, Israel, 39 Yirmiyahu St., P.O. Box 1176, Jerusalem 9101002, Israel; School of Public Health, Haifa University, 199 Aba Khoushy Ave., Mount Carmel, Haifa 3498838, Israel.
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Levine H, Berman T, Goldsmith R, Göen T, Spungen J, Novack L, Amitai Y, Shohat T, Grotto I. Urinary concentrations of polycyclic aromatic hydrocarbons in Israeli adults: demographic and life-style predictors. Int J Hyg Environ Health 2014; 218:123-31. [PMID: 25456148 DOI: 10.1016/j.ijheh.2014.09.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 09/11/2014] [Accepted: 09/13/2014] [Indexed: 10/24/2022]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous environmental pollutants associated with adverse health outcomes, including cancer, asthma, and reduced fertility. Because data on exposure to these contaminants in Israel and the Middle East are very limited this study was conducted to measure urinary levels of PAHs in the general adult population in Israel and to identify demographic and life-style predictors of exposure. We measured concentrations of five PAH metabolites: 1-hydroxypyrene (1OH_pyrene) and four different hydroxyphenanthrenes (1-hydroxyphenanthrene, 2-hydroxyphenanthrene, 3-hydroxyphenanthrene, 4-hydroxyphenanthrene), as well as cotinine in urine samples collected from 243 Israeli adults from the general population. We interviewed participants using structured questionnaires to collect detailed demographic, smoking and dietary data. For over 99% of the study participants, urinary concentration of at least one of the PAHs was above both the limit of detection (LOD) and the limit of quantification (LOQ). All PAHs were significantly correlated (rho=0.67-0.92). Urinary concentration of hydroxyphenanthrenes, but not 1OH_pyrene, was significantly higher among Arabs and Druze study participants (N=56) compared to Jewish participants (N=183). For 4-hydroxyphenanthrene, concentration in Arabs and Druze was 1.95 (95% CI 1.50-2.52) that of Jews, after controlling for creatinine, age and cotinine levels. Urinary concentrations of all PAHs were significantly higher among current smokers or participants with higher cotinine levels and increased significantly with smoking frequency. While PAHs concentrations were not associated with cotinine concentrations in nonsmokers in the overall study population, PAHs concentration was significantly higher among nonsmoking Jews with cotinine ≥LOQ (1μg/L), which represents exposure to environmental tobacco smoking, compared to nonsmoking Jews with cotinine concentrations <LOQ, with the highest ratio for 1OH_pyrene (Ratio=2.38, 95% CI 1.47-3.85). Among nonsmoking Arabs and Druze, higher hydroxyphenanthrenes concentrations were found for those consuming grilled food once a month or more. For 3-hydroxyphenanthrene, concentration in those consuming grilled food once a month or more was 2.72 (95% CI 1.01-4.98) times that of those consuming grilled food less than once a month or not at all, after controlling for creatinine, age and cotinine levels. In conclusion, we found that the general adult population in Israel is widely exposed to PAHs. Exposure differed by ethnic sub-groups both in magnitude and sources of exposure. The finding of higher exposure among Arabs and Druze highlights disparities in environmental exposures across subpopulations and suggests that further research and preventive measure are warranted to reduce PAHs exposure and associated health outcomes, especially in the Arab population in the Middle East.
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Affiliation(s)
- Hagai Levine
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah and The Hebrew University Center of Excellence in Agriculture and Environmental Health, Jerusalem, Israel.
| | - Tamar Berman
- Public Health Services, Ministry of Health, Jerusalem, Israel.
| | | | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Judith Spungen
- Public Health Services, Ministry of Health, Jerusalem, Israel.
| | - Lena Novack
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Yona Amitai
- Department of Management, Bar Ilan University, Ramat Gan, Israel.
| | - Tamar Shohat
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel.
| | - Itamar Grotto
- Public Health Services, Ministry of Health, Jerusalem, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Berman T, Goldsmith R, Göen T, Spungen J, Novack L, Levine H, Amitai Y, Shohat T, Grotto I. Demographic and dietary predictors of urinary bisphenol A concentrations in adults in Israel. Int J Hyg Environ Health 2014; 217:638-44. [DOI: 10.1016/j.ijheh.2013.11.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 11/27/2013] [Accepted: 11/30/2013] [Indexed: 11/24/2022]
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Safra T, Lai WC, Borgato L, Nicoletto MO, Berman T, Reich E, Alvear M, Haviv I, Muggia FM. BRCA mutations and outcome in epithelial ovarian cancer (EOC): experience in ethnically diverse groups. Ann Oncol 2014; 24 Suppl 8:viii63-viii68. [PMID: 24131973 DOI: 10.1093/annonc/mdt315] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Epithelial ovarian cancer (EOC) patients with BRCA mutations have better prognosis than nonhereditary cases matched for histology and stage and age at diagnosis, especially Ashkenazi Jews (AJ). MATERIALS AND METHODS We retrospectively reviewed data on 700 highly ethnically heterogeneous patients diagnosed with stage Ic-IV EOC and evaluated for BRCA status between 1995 and 2009 in American, Israeli, and Italian medical centers. RESULTS The ethnicities of the 190 patients (median age 55.5 years, range 31-83 years) were AJ, Jewish non-Ashkenazi, Caucasian, African-American, Hispanic, or unknown. Ninety were BRCA1/2 carriers (71 BRCA1 and 19BRCA2). The most common mutations in AJ and non-AJ origins were 185delAG and 6174delT. Non-Jewish Caucasians exhibited the widest variation (>20 mutation subtypes). BRCA carriers had significantly prolonged median overall survival (93.6 months) compared with noncarriers (66.6 months; 95% confidence interval 44.5-91.7, P = 0.0081). There was no difference in progression-free survival. CONCLUSIONS Our data demonstrate a wide variety of BRCA mutations in a highly ethnically diverse EOC population, and confirm that EOC BRCA mutation carriers have better prognosis with longer median survival than patients with nonhereditary disease. The contribution of unclassified BRCA variants to cancer etiology remains undetermined.
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Affiliation(s)
- T Safra
- New York University Cancer Institute, New York, NY, USA
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Levine H, Berman T, Goldsmith R, Göen T, Spungen J, Novack L, Amitai Y, Shohat T, Grotto I. Exposure to tobacco smoke based on urinary cotinine levels among Israeli smoking and nonsmoking adults: a cross-sectional analysis of the first Israeli human biomonitoring study. BMC Public Health 2013; 13:1241. [PMID: 24377966 PMCID: PMC3879425 DOI: 10.1186/1471-2458-13-1241] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 12/20/2013] [Indexed: 11/18/2022] Open
Abstract
Background Cotinine levels provide a valid measure of exposure to environmental tobacco smoke (ETS). The goal of this study was to examine exposure to tobacco smoke among smoking and nonsmoking Israeli adults and to identify differences in ETS exposure among nonsmokers by socio-demographic factors. Methods We analyzed urinary cotinine data from the first Israeli human biomonitoring study conducted in 2011. In-person questionnaires included data on socio-demographic and active smoking status. Cotinine levels were measured using a gas chromatography–mass spectrometry procedure. We calculated creatinine-adjusted urinary cotinine geometric means (GM) among smokers and nonsmokers, and by socio-demographic, smoking habits and dietary factors. We analyzed associations, in a univariable and multivariable analysis, between socio-demographic variables and proportions of urinary cotinine ≥1 μg/l (Limit of Quantification = LOQ) or ≥4 μg/l. Results Cotinine levels were significantly higher among 91 smokers (GM = 89.7 μg/g creatinine; 95% confidence interval [CI]: 47.4-169.6) than among 148 nonsmokers (GM = 1.3; 1.1-1.7). Among exclusive waterpipe smokers, cotinine levels were relatively high (GM = 53.4; 95% CI 12.3-232.7). ETS exposure was widespread as 62.2% of nonsmokers had levels ≥ LOQ, and was higher in males (75.8%) than in females (52.3%). In a multivariable model, urinary cotinine ≥ LOQ was higher in males (Prevalence ratio [PR] = 1.30; 95% CI: 1.02-1.64, p = 0.032) and in those with lower educational status (PR = 1.58; 1.04-2.38, p = 0.031) and decreased with age (PR = 0.99; 0.98-1.00, p = 0.020, per one additional year). There were no significant differences by ethnicity, residence type or country of birth. Conclusions Our findings indicate widespread ETS exposure in the nonsmoking Israeli adult population, especially among males, and younger and less educated participants. These findings demonstrate the importance of human biomonitoring, were instrumental in expanding smoke-free legislation implemented in Israel on July 2012 and will serve as a baseline to measure the impact of the new legislation.
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Affiliation(s)
- Hagai Levine
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah Faculty of Medicine, Kiryat Hadassah, Ein Kerem, Jerusalem, Israel.
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Berman T, Goldsmith R, Göen T, Spungen J, Novack L, Levine H, Amitai Y, Shohat T, Grotto I. Urinary concentrations of organophosphate pesticide metabolites in adults in Israel: demographic and dietary predictors. Environ Int 2013; 60:183-189. [PMID: 24064379 DOI: 10.1016/j.envint.2013.08.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 07/30/2013] [Accepted: 08/08/2013] [Indexed: 06/02/2023]
Abstract
Exposure to organophosphate pesticides (OPs) in agricultural and urban populations has been associated with a range of adverse health effects. The purpose of the current study was to estimate exposure to OPs in the general adult population in Israel and to determine dietary and demographic predictors of exposure. We measured six non-specific organophosphate pesticide metabolites (dialkyl phosphates) in urine samples collected from 247 Israeli adults from the general population. We collected detailed demographic and dietary data from these individuals, and explored associations between demographic and dietary characteristics and urinary dialkyl phosphate concentrations. OP metabolites were detectable in all urine samples. Concentrations of several dialkyl phosphate metabolites (dimethylphosphate, dimethylthiophosphate, diethylphosphate) were high in our study population relative to the general populations in the US and Canada and were comparable to those reported in 2010 in France. Total dialkyl phosphates were higher in individuals with fruit consumption above the 75th percentile. In a multivariate analysis, total molar dialkyl phosphate concentration increased with age and was higher in individuals with high income compared to individuals with the lowest income. Total diethyl metabolite concentrations were higher in females and in study participants whose fruit consumption was above the 75th percentile. In conclusion, we found that levels of exposure to OP pesticides were high in our study population compared to the general population in the US and Canada and that intake of fruits is an important source of exposure.
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Affiliation(s)
- T Berman
- Public Health Services, Ministry of Health, Israel.
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Berman T, Goldsmith R, Göen T, Spungen J, Novack L, Levine H, Amitai Y, Shohat T, Grotto I. Urinary concentrations of environmental contaminants and phytoestrogens in adults in Israel. Environ Int 2013; 59:478-484. [PMID: 23962452 DOI: 10.1016/j.envint.2013.07.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 07/16/2013] [Accepted: 07/19/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND The Ministry of Health Biomonitoring Study estimated exposure of individuals in the Israeli population to bisphenol A (BPA), organophosphate (OP) pesticides, phthalates, cotinine, polycyclic aromatic hydrocarbons (PAHs), and the phytoestrogenic compounds genistein and daidzein. METHODS In 2011, 250 individuals (ages 20-74) were recruited from five different regions in Israel. Urine samples were collected and questionnaire data were obtained, including detailed dietary data (food frequency questionnaire and 24hour recall). Urinary samples were analyzed for BPA, OP metabolites (dialkyl phosphates), phthalate metabolites, cotinine, PAH metabolites, genistein, and daidzein. RESULTS AND DISCUSSION BPA urinary concentrations were above the limit of quantification (LOQ) in 89% of the samples whereas urinary concentrations of phthalate metabolites were above the LOQ in 92-100% of the samples. PAH metabolites were above the LOQ in 63-99% of the samples whereas OP metabolites were above the LOQ in 44-100% of the samples. All non-smoking participants had detectable levels of cotinine in their urine; 63% had levels above the LOQ, and the rate of quantification was high compared to the general non-smoking population in Canada. Median creatinine adjusted concentrations of several OP metabolites (dimethyl phosphate, dimethyl thiophosphate) were high in our study population compared to the general US and Canadian populations. Median creatinine adjusted urinary BPA concentrations in the study population were comparable to those in Belgium and Korea; higher than those reported for the general US, German, and Canadian populations; and very low compared to health-based threshold values. Phthalate concentrations were higher in our study population compared to the general US population but values were very low compared to health-based threshold values. Median creatinine adjusted PAH concentrations were generally comparable to those reported for the general US population; median creatinine adjusted daidzein concentrations were high in our population compared to the general US population whereas genistein concentrations were comparable. CONCLUSIONS We interpreted observed urinary contaminant levels observed in our study by comparing values with health-based threshold values and/or values from international human biomonitoring studies. Using this data interpretation scheme, we identified two contaminants as being of potential public health concern and high priority for public health policy intervention: environmental tobacco smoke (ETS) and OP pesticides. We used the data collected in this study to support public health policy interventions. We plan to conduct a follow-up biomonitoring study in 2015 to measure ETS and OP exposure in the general population in Israel, to evaluate the effectiveness of relevant policy interventions.
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Affiliation(s)
- T Berman
- Public Health Services, Ministry of Health, Israel.
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Berman T, Levine H, Gamzu R, Grotto I. Trends in reproductive health in Israel: implications for environmental health policy. Isr J Health Policy Res 2012; 1:34. [PMID: 22929018 PMCID: PMC3443022 DOI: 10.1186/2045-4015-1-34] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Accepted: 07/15/2012] [Indexed: 11/24/2022] Open
Abstract
Nearly two decades ago, researchers first reported that endocrine disrupting chemicals in the environment were affecting reproductive health in the general population. The purpose of this article is to examine the evidence of adverse reproductive health trends in Israel and to explore implications for environmental health policy in Israel. We reviewed studies and data in Israel regarding trends in reproductive health indices, specifically: breast and testis cancer, hypospadias, sperm quality, male factor infertility, and age at menarche. The data provide some evidence of adverse reproductive trends in the Israeli population: an increase in testicular cancer from 1990 to 2007, a decrease in age at menarche from 1986 to 2000, an increase in the prevalence of male factor infertility, and some evidence of decreasing sperm counts. However, we note that much of the evidence is limited.The policy implications of reported adverse reproductive health trends possibly related to environmental exposure have been radically different in Europe and the United States. In Europe, such reports led the Parliament of the European Community to adopt a resolution on endocrine disruptors, which emphasizes the application of the Precautionary Principle. U.S. Environmental Protection Agency policy is focused on screening chemicals for endocrine disrupting properties and does not specifically refer to the Precautionary Principle. To date, there has been no formal governmental policy or strategy in Israel regarding endocrine disrupting chemicals. Environmental health policy on endocrine disruptors requires integrating evidence on human reproductive health trends, evidence on adverse reproductive outcomes in wildlife and experimental systems, and data from biomonitoring studies. Despite gaps in evidence and current data, we support a precautionary approach to regulating potential endocrine disrupting chemicals and reducing public exposures, especially in sensitive groups such as children and pregnant women.
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Affiliation(s)
- Tamar Berman
- Public Health Services, Israel Ministry of Health, Jerusalem, Israel
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, Hebrew University – Hadassah, POB 12272, Jerusalem, 91120, Israel
| | | | - Itamar Grotto
- Public Health Services, Israel Ministry of Health, Jerusalem, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Berman T, Amitai Y, Almog S, Richter ED. Human biomonitoring in Israel: Past, present, future. Int J Hyg Environ Health 2012; 215:138-41. [DOI: 10.1016/j.ijheh.2011.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 08/10/2011] [Accepted: 09/12/2011] [Indexed: 11/30/2022]
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Berman T, Hochner-Celnikier D, Barr DB, Needham LL, Amitai Y, Wormser U, Richter E. Pesticide exposure among pregnant women in Jerusalem, Israel: results of a pilot study. Environ Int 2011; 37:198-203. [PMID: 20952069 DOI: 10.1016/j.envint.2010.09.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Revised: 09/14/2010] [Accepted: 09/17/2010] [Indexed: 05/30/2023]
Abstract
BACKGROUND Pesticides have been shown to disrupt neurodevelopment in laboratory animals and in human populations. To date, there have been no studies on exposure to pesticides in pregnant women in Israel, despite reports of widespread exposure in other populations of pregnant women and the importance of evaluating exposure in this susceptible sub-population. METHODS We measured urinary concentrations of organophosphorus (OP) insecticide metabolites and plasma concentrations of OP and other pesticides in 20 pregnant women, recruited in Jerusalem, Israel in 2006, and collected questionnaire data on demographic factors and consumer habits from these women. We compared geometric mean concentrations in subgroups using the Mann-Whitney U-test for independent samples. We compared creatinine-adjusted OP pesticide metabolite concentrations, as well as plasma pesticide concentrations, with other populations of pregnant women. RESULTS Creatinine-adjusted total dimethyl (DM) metabolite concentrations were between 4 and 6 times higher in this population compared to other populations of pregnant women in the United States while total diethyl (DE) metabolite concentrations were lower. Dimethylphosphate (DMP) was detected in 74% of the urine samples whereas dimethylthiophosphate (DMTP) was detected in 90% of the urine samples. The carbamate bendiocarb was detected in 89% of the plasma samples, while the OP insecticide chlorpyrifos was detected in 42% of the samples. Mean plasma concentrations of bendiocarb and chlorpyrifos in our sample were 4.4 and 3.9 times higher, respectively, than that of an urban minority cohort from New York City. Twelve women (63%) reported using some form of household pest control during their pregnancy and five (26%) reported using household pest control during the past month. Women with a graduate degree had significantly higher geometric mean concentrations of total urinary DM metabolite concentrations compared to other women (P=0.006). Finally, one woman in the study had exceptionally high concentrations of DMP, DMTP, DMDTP compared to the other women in the study, despite reporting no current occupational exposure to OP pesticides and no other significant exposure sources. CONCLUSIONS Pregnant women in the Jerusalem area are exposed to OP pesticides and to the carbamate pesticide bendiocarb. It is unclear why total DM metabolites concentrations were much higher in this population compared to other populations of pregnant women in the United States and Netherlands. Finally, the finding of very high DM metabolite concentrations in one woman who reported being moved from her regular laboratory work to administrative work upon becoming pregnant, raises questions about the adequacy of measures to protect pregnant women from pesticide exposures during pregnancy.
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Affiliation(s)
- Tamar Berman
- Institute of Drug Research, School of Pharmacy, Faculty of Medicine, Hebrew University of Jerusalem, Israel.
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Berman T, Young J. Response to "Endocrine disruptors--with special emphasis on sexual development". Pediatr Endocrinol Rev 2009; 7:59. [PMID: 20183934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Friedman LS, Berman T, Barchana M, Richter ED. Flawed exposure analysis and conflicts of interest. Int J Occup Environ Health 2009; 15:239-240. [PMID: 19496490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Berman T, Hochner-Celnikier D, Calafat AM, Needham LL, Amitai Y, Wormser U, Richter E. Phthalate exposure among pregnant women in Jerusalem, Israel: results of a pilot study. Environ Int 2009; 35:353-7. [PMID: 18824263 DOI: 10.1016/j.envint.2008.08.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Revised: 08/21/2008] [Accepted: 08/21/2008] [Indexed: 05/03/2023]
Abstract
BACKGROUND Phthalates can disrupt endocrine function and induce reproductive and developmental toxicity in laboratory animals. Few studies have evaluated exposure to phthalates in pregnant women, despite the potential sensitivity of the developing fetus to adverse effects of phthalates. METHODS We measured urinary concentrations of 11 phthalate metabolites in 19 pregnant women, recruited in Jerusalem, Israel in 2006, and collected questionnaire data on demographic factors and consumer habits from these women. We compared geometric mean concentrations in subgroups and used the Mann-Whitney U-test for independent samples to determine significant differences between groups. RESULTS Nine metabolites were detected in at least 95% of the samples: mono(2-ethyl-5-carboxypentyl) phthalate, mono(2-ethyl-5-hydroxyhexyl) phthalate, mono(2-ethyl-5-oxohexyl) phthalate, mono(3-carboxypropyl) phthalate, mono(n-butyl) phthalate, monobenzyl phthalate (MBzP), monoethyl phthalate (MEP), mono(2-ethylhexyl) phthalate and monoisobutyl phthalate. Phthalate metabolite concentrations in these pregnant women were remarkably similar to those in the general United States female population. MBzP geometric mean concentrations were higher in women living in buildings existing 40 years or more (P=0.04). In women who used four or more personal care products (perfume, deodorant, lipstick, nail polish, or hand/face cream) in the 48 h prior to providing the urine sample, geometric mean MEP concentrations were more than 4 times higher than concentrations in women using only two or three of the aforementioned products (P=0.07). CONCLUSIONS Pregnant women in Jerusalem are exposed to a wide range of phthalates. Building materials used in old constructions may be a source of exposure to benzylbutyl phthalate, the parent compound of MBzP. Personal care products may be sources of exposure to diethyl phthalate, the parent compound of MEP.
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Affiliation(s)
- Tamar Berman
- Department of Pharmacology, School of Pharmacy, Faculty of Medicine, Hebrew University of Jerusalem 91120, Israel.
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Abstract
Historical models postulate that genocide cannot occur without the ideology and decisions of its authoritarian perpetrators and the indifference of bystanders. These models do not address genocidal risks from ecocide. Study objectives were to assess 1) the role of Malthusian pressures in recent genocides, 2) the role of ecocide and ecologic abuse in creating these pressures, and 3) strategies for prevention and deterrence. Analysis of reports, demographic studies, and time trends in recent genocides and recent ecocidal events from ecologic abuse suggests that Malthusian pressures and zero-sum rivalries over water, arable land, or natural resources by themselves do not lead to genocide. Such pressures may have exacerbated the political and socioeconomic predictors in Rwanda and Darfur, but not in former Yugoslavia. However, collapse of socioeconomic and governmental infrastructures following genocide can leave behind massive sustained damage to carrying capacity and sustainability. Surviving victims, if they return to their environments, will remain at risk for persecution. Ecocide--the large-scale destruction, depletion, or contamination of natural ecosystems--can result in widespread damage to health, survival, fertility, reproduction, and sustenance, and forced flight. International early warning and effective response systems are needed to deter or prevent political decisions to carry out genocide. Such systems must include long-term measures to resolve zero-sum conflicts over environmental resources and to prevent toxic risks to vulnerable populations and destruction of habitat by deliberate or wanton ecologic abuse, which itself should be redefined as a crime against humanity.
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