Prevention of poisonings by educational intervention aimed at parents of preschool children

The aim of the study was to assess the effectiveness of the specific design of a poisoning prevention intervention. This controlled before-after study followed Solomon design for educational interventions using two groups (the educational intervention group and the control group). Participants comprised parents of children attending kindergartens under the jurisdiction of the City of Zagreb and in the vicinity of Zagreb. The intervention group (N = 336) underwent an educational intervention during parents' meetings comprising oral presentation by the Croatian Poison Control Centre (CPCC) and distribution of gift packages containing child-proof locks, flyers, and stickers with the CPCC contact number. After the intervention they more frequently started keeping the CPCC's number by their telephone or in the list of important numbers than parents in the control group, and this association remained significant when tested by generalized estimating equations for binary outcomes, after the adjustment for parents' characteristics (age, gender and educational level), and clustered by kindergartens (p < 0.001). This means parents acknowledged the CPCC as an adequate and accessible way for initial management of poisoning incidents.

Soluble CD14 and total IgE in the serum of atopic and nonatopic adolescents in relation to environmental factors: a pilot study

The CD14 receptor is expressed on the surfaces of monocytes, macrophages, and, to a lesser extent, of activated granulocytes and B lymphocytes (mCD14). It also exists in soluble form in the serum (sCD14), in which it binds microbial compounds and indoor allergens. The objectives of this study were to see whether serum sCD14 concentrations could be used as a marker of atopic disorders and to estimate the effects of environmental factors (tobacco smoke exposure, childhood residence in urban or rural areas, and having a pet) on sCD14 and IgE values. Mass fraction of sCD14 and total IgE were determined in the sera of atopic (N=53) and non-atopic (N=35) participants using the standard enzyme-linked immunosorbent assay. Exposure to pets and environmental tobacco smoke was estimated based on the International Study of Asthma and Allergies in Childhood questionnaire (ISAAC). Median sCD14 concentration was significantly lower in atopic than in non-atopic girls (3.49 vs. 3.83 μg mL(-1); p<0.010). The number of smokers at home positively correlated with the sCD14 level in atopics, and urban atopics had significantly lower sCD14 levels than rural atopics (3.47 vs. 3.92 μg mL(-1), p=0.028). Median total IgE concentration was significantly lower in atopic pet owners than in atopics with no pets (161 vs. 252 kIU L(-1); p=0.021). In conclusion, while sex and environmental factors might be involved in sCD14 expression, particularly in atopics, we found no correlation between sCD14 and total IgE concentrations. The usefulness of sCD14 as a marker of atopic disorders should be investigated further, particularly in relation to the severity of allergic disorders.

Use of human milk in the assessment of toxic metal exposure and essential element status in breastfeeding women and their infants in coastal Croatia

Pregnant and lactating women and infants are vulnerable population groups for adverse effects of toxic metals due to their high nutritional needs and the resultant increased gastrointestinal absorption of both, essential and toxic elements. Although breastfeeding is recommended for infants worldwide, as human milk is the best source of nutrients and other required bioactive factors, it is also a pathway of maternal excretion of toxic substances including toxic metals and thus a source of infant exposure. The aim of this research was to assess health risks in breastfeeding women in the coastal area of the Republic of Croatia and their infants (N=107) due to maternal exposure to Cd and Pb via cigarette smoking, and Hg via seafood and dental amalgam fillings, and their interaction with essential elements. Biological markers of exposure were the concentrations of main toxic metals Pb, Cd and Hg in maternal blood and three types of breast milk throughout lactation stages. Biological markers of effects were the levels of essential elements Ca, Fe, Cu, Zn and Se in maternal serum and breast milk. With regard to cigarette smoking as a source of exposure to Cd and Pb, there were effects of smoking on Cd concentration in blood and correlations between the smoking index and Cd concentrations in maternal blood (ρ=0.593; P<0.001) and mature milk (ρ=0.271; P=0.011) and Pb concentration in transitional milk (ρ=0.280; P=0.042). Regarding fish, we found correlations between weekly consumption frequency and total Hg concentrations in maternal blood (ρ=0.292; P=0.003) and mature milk (ρ=0.303; P=0.003). The number of dental amalgam fillings correlated with total Hg concentrations in colostrum (ρ=0.489; P=0.005) and transitional milk (ρ=0.309; P=0.018). As for the essential element status, only Se levels in maternal serum decreased by 10% in persons who continued smoking during pregnancy compared to non-smokers. In conclusion, the levels of main toxic metals Cd, Pb and Hg and essential elements Ca, Fe, Cu, Zn and Se in maternal blood and three types of breast milk samples in the studied area of coastal Croatia showed no risk of disrupted essential element levels with regard of toxic metal exposure in both breastfeeding women and their infants.

A graphical model approach to systematically missing data in meta-analysis of observational studies

When studies in meta-analysis include different sets of confounders, simple analyses can cause a bias (omitting confounders that are missing in certain studies) or precision loss (omitting studies with incomplete confounders, i.e. a complete-case meta-analysis). To overcome these types of issues, a previous study proposed modelling the high correlation between partially and fully adjusted regression coefficient estimates in a bivariate meta-analysis. When multiple differently adjusted regression coefficient estimates are available, we propose exploiting such correlations in a graphical model. Compared with a previously suggested bivariate meta-analysis method, such a graphical model approach is likely to reduce the number of parameters in complex missing data settings by omitting the direct relationships between some of the estimates. We propose a structure-learning rule whose justification relies on the missingness pattern being monotone. This rule was tested using epidemiological data from a multi-centre survey. In the analysis of risk factors for early retirement, the method showed a smaller difference from a complete data odds ratio and greater precision than a commonly used complete-case meta-analysis. Three real-world applications with monotone missing patterns are provided, namely, the association between (1) the fibrinogen level and coronary heart disease, (2) the intima media thickness and vascular risk and (3) allergic asthma and depressive episodes. The proposed method allows for the inclusion of published summary data, which makes it particularly suitable for applications involving both microdata and summary data. Copyright © 2016 John Wiley & Sons, Ltd.

Associations of TNFα -308G>A, TNFα -238G>A, IL-1α -889C>T and IL-10 -1082G>A Genetic Polymorphisms with Atopic Diseases: Asthma, Rhinitis and Dermatitis

BACKGROUND

Polymorphisms of cytokine genes are an interesting focus for association studies involving atopic diseases due to their role in immune cell communications during inflammation. The aim of this study was to investigate associations of TNFα -308G>A, TNFα -238G>A, IL-1α -889C>T and IL-10 -1082G>A polymorphisms with atopic diseases with adjustment for confounding lifestyle and environmental factors.

METHODS

This study was performed on 356 Croatian students. The diagnosis of atopic asthma, atopic rhinitis and atopic dermatitis was based on symptoms reported by the modified International Study of Asthma and Allergies in Childhood questionnaire and a positive skin prick test (SPT) to at least one common inhalatory allergen. Genetic polymorphisms were genotyped using the polymerase chain reaction-based technique. The influence of personal (gender, body mass index, parental history of atopic disease), lifestyle (cigarette smoking, pet ownership) and environmental (urban/rural residency, residency in continental/Mediterranean region) factors reported in the questionnaire was investigated by univariate and multivariate analysis.

RESULTS

Compared to the control subjects, univariate analysis showed a significant negative association of the TNFα -308G>A polymorphism with atopic asthma, atopic dermatitis, asthma and skin symptoms and positive SPT. These observations were confirmed in a multivariate model only for atopic dermatitis and skin symptoms (atopic dermatitis: OR = 0.27; 95% CI 0.07-1.00; p = 0.050; skin symptoms: OR = 0.29; 95% CI 0.10-0.83; p = 0.021).

CONCLUSIONS

The results indicate a protective role of TNFα -308G>A genetic polymorphisms regarding atopic dermatitis and skin symptoms even after controlling for personal, lifestyle and environmental factors. Further studies are needed to elucidate the molecular patterns of this association in atopic dermatitis and other chronic inflammatory skin disorders.

Occupational and non-occupational allergic contact dermatitis: a follow-up study

BACKGROUND/AIMS

The aim of this study was to obtain insight into the clinical course and prognosis of allergic contact dermatitis (ACD), including potential effects of genetic and environmental factors.

METHODS

Eighty-two patients with previously defined ACD acquired occupationally (OACD) or non-occupationally (NOACD) were patch retested and evaluated for the presence of persistent eczema, atopy and filaggrin mutations.

RESULTS

The crude risk for the persistence of a positive patch test (PT) reaction was 6.3 times higher (95% CI 3.63-11.0) for PT reactions assessed as '+++' compared to '++' reactions at the first PT. Among the categories of OACD, NOACD, age, gender, atopy, and the number of positive PT reactions at the first and second PT, only OACD (OR 10.0, 95% CI 1.95-51.2) and number of positive PT reactions at retesting (OR 3.85, 95% CI 1.57-9.44) were found to be predictors of persistent eczema.

CONCLUSIONS

Occupationally acquired contact allergy was emphasized as the most important factor in predicting poor prognosis of ACD.

Low frequency of filaggrin null mutations in Croatia and their relation with allergic diseases

Filaggrin gene (FLG) null mutations are considered associated with atopic dermatitis. This study was conducted to determine the prevalence of FLG null mutations R501X, 2282del4, R2447X and S3247X in the Croatian population and their role in the occurrence of allergic diseases including atopic dermatitis, allergic rhinitis, asthma and allergic contact dermatitis (ACD). Study enrolled 440 freshmen with defined allergic diseases by means of both present symptoms in International Study of Asthma and Allergies in Childhood questionnaire (relevant respiratory and/or skin symptoms) and markers of allergic sensitization (positive skin prick and/or patch test). FLG null mutations were successfully genotyped in 423 students of which 11 (2.6%) were carriers of FLG null mutation: 1/423 (0.2%) was heterozygous for R501X and 10/423 (2.4%) were heterozygous for 2282del4. No carriers of R2447X and S3247X mutations were identified. In wild-type FLG carriers (412 subjects), atopic dermatitis was present in 45 (11%), allergic rhinitis in 70 (17%) and allergic asthma in 29 (7%) students. Twenty-five of 393 (7%) patch-tested wild-type FLG carriers had ACD. Among 11 FLG null mutation carriers, four had one or more allergic diseases, and five had reported skin symptoms without defined allergic sensitization (positive skin prick test and/or patch test). FLG null mutations were not confirmed as a predictor of analysed allergic diseases, but were confirmed as an independent predictor of skin symptoms (OR 17.19, 95% CI 3.41-86.6, P < 0.001). Our results in general indicate a low frequency of FLG null mutations in the studied Croatian population supporting a theory of a latitude-dependent distribution of FGL null mutations in Europe, with a decreasing north-south gradient of R501X and 2282del4 mutation frequency. The relation between FLG null mutations and skin disorders was confirmed.

Respiratory health and breath condensate acidity in sawmill workers

PURPOSE

The aim of the study was to evaluate exhaled breath condensate acidity (EBC pH) as a biomarker of airway response to occupational respiratory hazards present in sawmill.

METHODS

Sixty-one sawmill workers in total (26 from Sawmill 1 and 35 from Sawmill 2) provided EBC samples at the beginning and at the end of the working week. Respiratory symptoms, lung function, bronchodilator test and atopy status were assessed. Occupational environment was checked for the levels of respiratory hazards.

RESULTS

Airborne dust concentrations were below threshold limit value. Endotoxin in Sawmill 1 and Sawmill 2, and moulds in Sawmill 1 were at the levels able to induce inflammatory response in the airways. Mould levels were 2.5 times higher in Sawmill 1 than in Sawmill 2. Compared to Sawmill 2 workers, lower spirometry values, higher prevalence of dry cough and positive bronchodilator test were found in Sawmill 1 workers. Monday EBC pH values did not differ between sawmills, but declined after one working week in Sawmill 1 workers (from 7.88 to 7.49, P = 0.012) and not in Sawmill 2 workers. Similar results were obtained when only respiratory healthy non-smokers were analysed. Monday-to-Friday change of other respiratory parameters was not observed.

CONCLUSION

The results suggest EBC pH as a biomarker of acute respiratory effects related to occupational exposure to respiratory hazards in sawmills, presumably increased mould levels. The effect was present even at subclinical level, namely in respiratory healthy subjects. The long-term health implications remain unclear and should be evaluated in a follow-up study.

Induced sputum evaluation in restorers and conservators of cultural heritage

The objective of this study was to examine induced sputum (IS) cells profile from restorers/conservators of cultural heritage (restorers) with no lower airway symptoms and normal ventilatory lung function. The study involved 22 restorers and 48 control workers. Medical interview, physical examination, spirometry, skin prick testing to inhalatory allergens, and IS collection were performed. Compared with control workers, restorers demonstrated higher percentage of neutrophils (34% vs 15.5%; p = .004). This pattern was found only in male workers. They had almost 9 times greater chance to have increased proportion of sputum neutrophils than male controls (odds ratio [OR] 8.98, 95% confidence interval [CI] 1.98-40.7). The mobilization of eosinophils or macrophages into the airways was not established regardless of workers sex. Additional gender difference in sputum cells distribution was found for occupationally unexposed subjects, with higher proportion of sputum neutrophils in women.

Occupational exposure to airborne fungi in two Croatian sawmills and atopy in exposed workers

Airborne fungi were collected over a one year period at 2-month intervals at 2 sawmills in Croatia (SM 1 and SM 2) processing mainly beech wood and oak wood. A questionnaire concerning respiratory symptoms and skin prick test (SPT) with common inhalatory allergens and moulds Cladosporium herbarum, Alternaria alternata, Aspergillus niger, Penicillium notatum, and Rhizopus nigricans were performed in 96 workers from the same sawmills. Average concentrations of airborne fungi were 1,696-7,316 cfu/m(3) in SM 1 and 1,706-4,819 cfu/m(3) in SM 2, respectively. Health hazardous levels of airborne fungi (above 10 4 /m(3)) were present only in SM 1. These levels were related to saw working sites and were season-dependent, i.e. present only during the summer. Penicillium (50-100%), Paecilomyces (43-100%) and Chrysonilia (33-100%) dominated among 17 fungal genera identified in both sawmills. Symptoms of rhinitis, asthma, and dry cough were most frequently recorded among analysed workers. SPT to moulds was negative in all tested workers, except one positive to R. nigricans, indicating that moderate airborne fungi levels found in the analysed sawmills were not related to IgE-mediated sensitization to moulds in exposed workers, even in atopics. Atopy was present among woodworkers in similar proportions to the general population of Croatia, suggesting that the wood-processing industry is not selective for atopic workers.

Upper respiratory impairment in restorers of cultural heritage

BACKGROUND

There is a paucity of data regarding respiratory health in restorers of cultural heritage or similar occupations, such as visual artists or museum workers, although they are exposed to a complex mixture of various respiratory hazards.

AIMS

To evaluate atopy and respiratory health parameters, including bronchial and nasal non-specific reactivity, in restorers and conservators of cultural heritage (restorers).

METHODS

Fifty-six restorers and 62 controls provided general data and data on ever experienced rhinitic or asthma-like symptoms, spirometry, non-specific bronchial and nasal responsiveness to histamine, skin prick testing to common inhalational allergens and serum total IgE levels.

RESULTS

Spirometry values were in the range of normal values in 55 of 56 restorers and did not differ significantly from those in control subjects. However, restorers had more than two times higher prevalence of nasal hyper-responsiveness (NHR), with 2.3 times higher risk of NHR compared to controls [95% confidence interval (CI): 1.4-3.6, P < 0.001]. The risk of NHR was slightly reduced by increasing age (odds ratio 0.95, 95% CI: 0.91-0.99, P < 0.05). NHR was not associated with gender, smoking status, bronchial hyperresponsiveness (BHR), upper or lower respiratory symptoms or atopy status.

CONCLUSIONS

Compared with controls, the studied group of workers occupationally exposed to respiratory hazards during restoration/conservation activities had no deterioration of lung function but had an increased non-specific nasal responsiveness that was not correlated with upper and lower respiratory symptoms, BHR or atopy. The relationship of this finding to future clinical outcome should be investigated in a longitudinal study.

Association of toxic and essential metals with atopy markers and ventilatory lung function in women and men

The association of age, smoking, alcohol, superoxide dismutase (SOD), glutathione peroxidase (GPx), blood lead (BPb) and cadmium (BCd) levels, and serum levels of copper (SCu), zinc (SZn) and selenium (SSe) with atopic status and ventilatory function was examined in the groups of 166 women and 50 men with no occupational exposure to metals or other xenobiotics. Markers of atopy included serum total IgE, skin prick test (SPT) to common inhalatory allergens, non-specific nasal reactivity (NNR) and non-specific bronchial reactivity (NBR). Parameters of ventilatory function included forced vital capacity (FVC) and forced expiratory volume in the first second (FEV(1)). Significantly higher BPb, SZn, IgE and prevalence of positive SPT, and lower SCu and NNR was found in men than in women. Fifteen women taking female sex hormones (HT) had significantly higher SCu than women without HT. Regression models showed significant inverse associations between IgE and SCu (P=0.021) and NNR and SCu (P=0.044) in women. When excluding women with HT, the association of SCu and total IgE became of borderline significance (P=0.051), association between SCu and NNR disappeared, and significant positive association between total IgE and BPb emerged (P=0.046). In men, significant inverse association was found between positive SPT and SSe, and between NBR and SSe. A decrease in FVC% and FEV(1)% was associated with an increase in smoking intensity (P<0.001) and a decrease in SZn (P=0.043 and P=0.053, respectively). These results were observed at the levels of the metals comparable to those in general populations worldwide. The observed differences between men and women may partly be explained by different levels of relevant toxic and essential metals, and their combination. The role of female HT in associations of atopy markers and SCu should be further investigated.

Sick building syndrome: psychological, somatic, and environmental determinants

The authors aimed to examine potential relationships between work-related symptoms attributed to sick building syndrome (SBS) and certain psychological, somatic, and environmental factors. The multidisciplinary, cross-sectional study comprised 171 female subjects working in air-conditioned and naturally ventilated nonindustrial office buildings. The authors collected information concerning symptoms related to SBS and made assessments of quality of life by using appropriate questionnaires. They assessed the women's levels of emotional stability or neuroticism using the Cornell Index. They determined skin and airway reactivity markers and indoor microclimate data by using standardized methods. The study showed that the subjects had a high prevalence of fatigue (60.2%), sore and dry eyes (57.9%), and headache (44.4%), as well as a generally high score according to the SBS Index. Neuroticism and subjectively estimated physical health as well as the type of building ventilation significantly contributed to the prediction of the SBS Index, explaining 15% of the variance.

[Household gas poisonings]

Exposure to toxic gases which can induce serious health effects, can occur in the working as well as in general environment, including home. The severity of gas poisoning is determined by its physical and chemical characteristics, intensity and duration of exposure, and concomitant diseases and injuries in the poisoned person. Manifestations of gas toxic action involve simple asphyxia, local irritation of respiratory mucosa, systemic toxicity, and a combination of these mechanisms. This article describes the characteristics, modes of exposure and health effects of most common gases causing poisoning at home. These include gas fuels, carbon monoxide, ammonia, chlorine, and fire gases such as nitrogen and sulphur oxides, hydrogen cyanide and phosgene. First aid as well as preventive measures to avoid exposure to toxic gases and prevent fire at home are also given. The Croatian Poison Control Centre gathered data on toxic gas exposures in households between November 2005 and July 2006. During this period 30 persons (3 % of the total number of cases) were exposed to toxic gases at home, including carbon monoxide, irritating vapours from cleaning agents and disinfectants, gas fuels, septic tank gases, tear-gas, and chlorofluorocarbons from refrigerators.

[Health effects of pyrethrins and pyrethroids]

Pyrethrins, natural extracts of Chrysanthemum cinerariaefolium and Chrysanthemum cocineum flowers, and pyrethroids, synthetic analogues and derivatives of pyrethrins, are powerful insecticides. They are widely used in households and insect control in pets or livestock, in textiles such as carpets, wallpapers, furniture and clothes, as well as in agriculture, forestry and public health services. This article brings a list of pyrethrin and pyrethroid insecticides registered for use in plant protection in Croatia. Pyrethrins and pyrethroids can enter the organism by ingestion (accidental or suicidal ingestion or in food), by inhalation and/or by skin contact. Although these pesticides pose a relatively low risk to mammals due to rapid metabolism with no significant accumulation, they can induce adverse health effects, more often in acute poisoning, but also due to chronic exposure. The primary target of pyrethrin and pyrethroid toxicity is the nervous system, since they act directly on the sodium channels of nerve cell axons, leading to hyperexcitation. Another important toxicological mechanism is allergenicity, which is more pronounced with pyrethrins than with synthetic pyrethroids. Because there is no antidote for pyrethrin and pyrethroid poisoning, treatment is symptomatic and supportive. The article discusses the measures for poisoning prevention and alleviation of exposure to pyrethrins and pyrethroids in occupational settings and in general population.

Comparison of organic and inorganic mercury distribution in suckling rat

Thiomersal is used as a preservative in vaccines given to small children. The metabolic product of thiomersal is ethylmercury and its distribution and kinetics are still not known, especially at this early age. The purpose of this study was to compare the body distribution of two forms of mercury: organic (thiomersal) and inorganic (mercury(2+) chloride) in very young, suckling rats. Mercury was applied subcutaneously three times during the suckling period on days 7, 9 and 11 of pups age, imitating the vaccination of infants. A single dose of mercury was equimolar in both exposed groups, i.e. 0.81 micromol Hg kg(-1). At 14 days of age the animals were killed and the total mercury analysed in blood and organs (kidney, liver and brain). The analytical method applied was total decomposition, amalgamation, atomic absorption spectrometry. The results showed that the level of mercury was higher in the liver and kidney of the inorganic mercury group than in the thiomersal exposed group. However, the brain and blood concentrations of mercury were higher in the thiomersal exposed group. These results need to be clarified by additional data on the kinetic pathways of ethylmercury compared with inorganic mercury.

Endotoxin measurement in house dust using the end-point Limulus amoebocyte lysate method

Endotoxin is a lipopolysaccharide, a part of gram-negative bacteria cell membrane commonly present in general and many occupational environments. This paper describes sample preparation and endotoxin measurement in 16 samples of house dust from urban homes (Zagreb, Croatia) using end-point chromogenic Limulus amoebocyte lysate (LAL) bioassay. House dust was collected on cellulose filters by vacuuming bedroom and living room floors, and was kept frozen until assayed. Samples were extracted from filters with a 0.05% solution of Tween-20 in endotoxin-free water. Serial dilutions of samples were measured in duplicates. The linearity of the standard curve was satisfying (r=0.983), as well as the recovery (92 and 110%) and repeatability (coefficient of variation from 0 to 8.5%). The endotoxin levels found in the house dust samples ranged from 4.8 to 200 EU/mg, with the arithmetic mean of 49.5 EU/mg (standard error of the mean of 12.1 EU/mg), and were in the range of house dust endotoxin values obtained by other authors.

Combined Early Treatment with Chelating Agents DMSA and CaDTPA in Acute Oral Cadmium Exposure

The influence of chelating agents: meso-2,3-dimercaptosuccinic acid (DMSA); calcium trisodium diethylenetriaminepentaacetate (CaDTPA) and their combination on mobilisation of cadmium (Cd) was compared in female albino rats. After oral Cd administration chelators were applied either orally (DMSA) or intraperitoneally (CaDTPA) at various short time intervals after Cd. Three experiments were carried out with four treatment groups in each: 1) Cd (control); 2) Cd+DMSA; 3) Cd+CaDTPA; 4) Cd+DMSA+CaDTPA. Time intervals for chelator treatment after Cd administration were: immediate application in the first, half an hour in the second and one hour in the third experiment. At the end of each experiment cadmium was analysed in kidney and liver. Additionally in experiment 3 essential elements (Fe, Cu, Zn) were also determined in the same organs. In experiment 2 the effect of the treatment on urinary elimination of cadmium, copper and zinc were analysed. Results showed that the efficiency of Cd removal from the body (kidneys and liver) is lower when the time between Cd and chelating agents administration is longer. The two chelators differ in efficiency in mobilizing Cd, with DMSA being more efficient than CaDTPA. The combined therapy with the two chelators gave generally better results. It seems that DMSA which is given orally after oral Cd administration removes this element very efficiently from the gastrointestinal tract. CaDTPA, however, which is given parenterally removes absorbed Cd less efficiently, Organs are not significantly depleted in iron and copper after chelation treatment. Only zinc concentration was, however, significantly lower in the liver and higher in kidneys only after CaDTPA and combined DMSA+CaDTPA chelation.

Succimer treatment and calcium supplementation reduce tissue lead in suckling rats

The effect of combined treatment with meso-2,3-dimercaptosuccinic acid (DMSA) and calcium supplementation in reducing lead absorption and enhancing lead elimination was evaluated in suckling rats under two experimental conditions: during ongoing oral lead exposure (lead acetate, 2 mg Pb kg(-1) day(-1), total dose 16 mg Pb kg(-1)) or after lead exposure (72 h after a 2-day lead exposure, total dose 12 mg Pb kg(-1) s.c.). The artificial feeding method was used for calcium supplementation, with 6% Ca (as CaHPO(4)) suspension in cow's milk to increase the daily calcium intake about three times above control values. Artificial feeding lasted for 7 h a day over eight consecutive days. During this period DMSA was administered on 6 days twice a day (0.5 mmol kg(-1) day(-1) p.o.). At the end of the experiments, Pb, Ca and Zn in the carcass and Pb, Fe and Cu in the liver, kidneys and brain were analysed by atomic absorption spectrometry. Calcium supplementation during lead exposure reduced tissue lead but had no effect when applied after lead exposure, and DMSA administered either during or after lead exposure lowered the tissue lead. Combined treatment during ongoing lead exposure caused a greater reduction in tissue lead than either DMSA or calcium treatment alone. When administered after lead exposure, it had no advantage over DMSA treatment alone but did not impair its efficacy. Combined treatment had no influence on growth and did not seriously disturb essential element status. It is concluded that calcium supplementation could be applied during DMSA therapy, when indicated.

Ascorbic Acid Supplementation Does Not Improve Efficacy of meso -Dimercaptosuccinic Acid Treatment in Lead-Exposed Suckling Rats

It was suggested that ascorbic acid as a natural chelating agent can influence lead toxicokinetics and improve chelating properties of dimercaptosuccinic acid (DMSA) in adult rats. In this paper potential benefits of ascorbic acid supplementation, alone or combined with DMSA, in decreasing lead retention in suckling rats were evaluated. Such data in young mammals are not available. L-Ascorbic acid (daily dose 650 mg/kg b.wt.) and/or DMSA (daily dose 91 mg/kg b.wt.) were administered orally to suckling Wistar rats either during ongoing 8-day oral lead exposure (as acetate; daily dose 2 mg lead/kg b.wt.) or after 3-day lead exposure (total dose 12 mg lead/kg b.wt.). Lead concentrations were analysed in the carcass (skeleton), liver, kidneys and brain by atomic absorption spectrometry. By ascorbic acid supplementation lead retention was not reduced under either lead exposure condition. Lead concentration was even increased in the carcass. Treatment with DMSA under both exposure conditions significantly reduced lead in all analysed tissues. Combined treatment with ascorbic acid and DMSA during ongoing lead exposure was substantially less effective than DMSA treatment alone, and did not affect DMSA efficacy when administered after lead exposure. It was concluded that ascorbic acid administered either during or after lead exposure in suckling rats has no beneficial effect on either lead retention or DMSA chelation effectiveness.

The effect of dietary supplementation with calcium salts on skeletal calcium in suckling rats

This study aimed at identifying a calcium compound which could serve as an effective and safe dietary supplement in suckling rats over the period of intense growth and development. The main objective was to assess the effect of additional calcium intake on skeletal calcium in suckling pups. Suckling Wistar rats were fed using a pipettor with one of the following calcium salts from day 6 to 14 after the birth: gluconate, hydrogenphosphate, carbonate (each suspended in cow's milk), or chloride (in demineralized water). Control rats received only cow's milk. Calcium in the carcass (body without organs and skin) was analysed by atomic absorption spectrometry. The only effective dietary supplement that produced no risk for the suckling pups' growth was calcium hydrogenphosphate in cow's milk in the total amount of 340 mg. That dose increased the daily calcium intake 3 to 4 times compared to non-supplemented controls, increasing carcass calcium content by about 16 per cent. Other calcium compounds were either inefficient (carbonate) or had adverse effects on pups' growth (chloride and gluconate).

Effect of dietary calcium on cadmium absorption and retention in suckling rats

The effect of calcium supplementation on absorption and retention of cadmium in the suckling period was evaluated in Wistar rat pups of both sexes. Animals were maintained in the litters with the mother rats and supplemented with 1%, 3% or 6% calcium (as CaHPO4 x 2H2O) in cow's milk by artificial feeding from day of birth 6 through 14. All rats were exposed to cadmium (as CdCl2 x H2O) either orally or parenterally. Oral cadmium dose of 0.5 mg/kg body weight a day was administered through nine-day period of calcium supplementation and parenteral cadmium dose was injected subcutaneously in a single dose of 0.5 mg Cd/kg body weight prior to calcium supplementation. On experimental day 10 (at the age of pups of 15 days) all animals were killed and the liver, kidneys, brain and carcass (body without organs and skin) were removed for element analyses. Cadmium and essential elements calcium, zinc and iron were analysed in the tissues by atomic absorption spectrometry. Results showed that after oral exposure cadmium concentrations in all calcium-supplemented groups were significantly decreased in the organs and carcass and that the effect was dose-related. No such effect of calcium was found after parenteral cadmium exposure. Calcium supplementation per se significantly increased calcium concentration in the carcass and had no effect on iron in organs and zinc in carcass. It was concluded that calcium supplementation during the suckling period could be an efficient way of reducing oral cadmium absorption and retention without affecting tissue essential trace element concentrations.

Commercial rodent feed as an occasional cause of morbidity and mortality in a rat breeding colony

In the last fifteen years there were several feed-related outbreaks of morbidity and mortality in the Institute's breeding colony of Wistar rats. The last event took place in April 1999, one month after the use of a new supply of the usual standard rodent feed. Animals did not thrive and manifested generalised oedema, hypoalbuminaemia, elevated liver enzymes, and high mortality. The effect of feed was assessed first by feeding a group of sick females during 14 days with either suspected feed (A-March) or with the earlier supply of feed (A-January) of the same producer. Then a group of healthy male rats Y59 from another breeding colony was fed either suspected feed (A-March) or feed from another producer (feed B). Although neither chemical nor microbiological deviation in feed analysis had been detected, decreased consumption and slower body weight gain in all animals fed with feed A-March suggested an association between this batch of feed and the increased morbidity in those animals. Eventually, the entire rat colony was put down and replaced with a new breed which was given a new brand of feed.

Calcium supplementation efficiently reduces lead absorption in suckling rats

The effect of calcium supplementation on tissue lead was evaluated in suckling Wistar rats. Such data are not yet available in the literature. The following artificial feeding regimen was used for calcium supplementation: cow's milk by addition of 1%, 3% or 6% Ca as CaHPO(4)x2H(2)O suspension to increase the daily calcium intake about 1.4, 2 or 3 times above control values. Artificial feeding was applied during 7 hr each day for nine consecutive days (from day 6 through 15 after birth). The effect of such treatment on lead absorption and elimination was evaluated in two separate experiments: calcium supplementation during oral lead exposure (as acetate; daily dose 2 mg Pb/kg body wt.; total Pb dose 18 mg/kg body wt.) or after a single intraperitoneal lead administration (5 mg/kg body wt.). At the end of experiments, lead in tissues (liver, kidneys, brain and carcass), and essential elements (Ca, Fe, Zn, Cu) were analysed by atomic absorption spectrometry. Calcium supplementation caused a statistically significant decrease of lead in all tissues of sucklings orally exposed to lead. This decrease was dose-related being about 1.3, 1.5 and 2 times lower in groups supplemented with 1%, 3%, or 6% calcium compared to controls, respectively. Increased calcium intake had no effect on incorporated lead after parenteral lead exposure. Calcium supplementation increased carcass calcium and had no effect on trace elements in tissues, pups' general appearance and body weight gain. It is concluded that higher calcium intake might be a way of efficient reduction of lead absorption during the suckling period.

Succimer treatment during ongoing lead exposure reduces tissue lead in suckling rats

There is a concern that oral treatment with succimer (meso-2, 3-dimercaptosuccinic acid, DMSA) can promote gastrointestinal lead absorption if not performed in a lead-safe environment. The scope of our investigation was to evaluate the efficacy of oral DMSA treatment during oral lead exposure on tissue lead in suckling rats. Six-day-old Wistar rats of both genders were divided into two groups-untreated (Pb) and treated (Pb + DMSA)-with 10 animals per group. Lead (as acetate) was given orally at a dose of 2 mg kg(-1) body weight day(-1) for eight consecutive days (total dose 16 mg kg(-1), i.e. 0.08 mmol kg(-1)). During this period the treated group received a daily dose of 0.5 mmol DMSA kg(-1) body weight p.o. six times on days 1-3 and 6-8 of the experiment (total dose 3 mmol kg(-1)). Tissue lead was determined by means of atomic absorption spectrometry. The DMSA efficiently reduced the lead concentration in the analysed tissues (carcass, liver, kidneys and brain) by approximately 50% compared with untreated controls. The pups' growth and organ weights were not affected. In conclusion, our results indicate that DMSA is an efficient oral lead chelator in sucklings even if challenged with ongoing lead exposure.

Chelation of aluminium by combining DFO and L1 in rats

The hypothesis that two known chelators 1, 2-dimethyl-3-hydroxypyrid-4-one (L1) and desferrioxamine (DFO) might be more efficient as combined treatment than as monotherapies in removing aluminium from the body was tested in a new acute rat model. Five-week old female rats received chelators: L1 (p.o.), DFO (i.p.) or L1+DFO as 100 or 200 mg/kg dose half an hour after a single i.p. administration of 6 mg Al/kg body weight in the form of chloride. Serum aluminium concentration and urinary aluminium and iron excretions were determined by electrothermal or flame atomic absorption spectrometry. Both chelators were effective only at the higher dose level. While DFO was more effective than L1 in enhancing urinary aluminium excretion, L1 was more effective than DFO in enhancing urinary iron excretion. In the combined treatment group L1 did not increase the DFO effect on aluminium and DFO did not increase the effect of L1 on iron elimination. However, in this group a simultaneous increase in both aluminium and iron elimination was observed. Our results support the usefulness of this animal model for preliminary in vivo testing of aluminium chelators. Urinary values were more useful because of the high variability of serum results. Result of combined chelators treatment should be confirmed in a different experimental model before extrapolation to other systems. This testing procedure of course does not provide all the relevant answers for evaluating the efficiency of chelating agents in aluminium toxicity.