Severe Disease Burden and the Mitigation Strategy in the Arsenic-Exposed Population of Kaliprasad Village in Bhagalpur District of Bihar, India

The present study was carried out in the village Kaliprasad of Bhagalpur district of Bihar to know the arsenic exposure effect in the exposed population. A total of n = 102 households were studied, and their water and biological samples such as urine and hair were collected and analyzed in a graphite furnace atomic absorption spectrophotometer (GF-AAS). The assessment of arsenic-exposed village population reveals that the villagers were suffering from serious health-related problems such as skin manifestations (hyperkeratosis and melanosis in their palm and soles), breathlessness, general body weakness, mental disorders, diabetes, hypertension (raised blood pressure), hormonal imbalance, neurological disorders, and few cancer cases. About 77% of household hand pump water had arsenic level more than the WHO recommended level of 10 µg/L, with highest level of 523 µg/L. Moreover, in 60% individual's urine samples, arsenic concentration was very high with maximum 374 µg/L while in hair 64% individuals had arsenic concentration above the permissible limit with maximum arsenic concentration of 11,398 µg/kg. The hazard quotient (HQ) was also calculated to know the arsenic risk percentage in children as 87.11%, in females as 83.15%, and in males as 82.27% by groundwater. This has surpassed the threshold value of 1 × 10 - 6 for carcinogenic risk (CR) in children, female, and male population group in the village. Hence, the exposed population of Kaliprasad village are at very high risk of the disease burden.

Risk assessment of Benzene, Toluene, Ethyl benzene, and Xylene (BTEX) in the atmospheric air around the world: A review

Volatile organic compounds, such as BTEX, have been the subject of numerous debates due to their detrimental effects on the environment and human health. Human beings have had a significant role in the emergence of this situation. Even though US EPA, WHO, and other health-related organizations have set standard limits as unhazardous levels, it has been observed that within or even below these limits, constant exposure to these toxic chemicals results in negative consequences as well. According to these facts, various studies have been carried out all over the world - 160 of which are collected within this review article, so that experts and governors may come up with effective solutions to manage and control these toxic chemicals. The outcome of this study will serve the society to evaluate and handle the risks of being exposed to BTEX. In this review article, the attempt was to collect the most accessible studies relevant to risk assessment of BTEX in the atmosphere, and for the article to contain least bias, it was reviewed and re-evaluated by all authors, who are from different institutions and backgrounds, so that the insights of the article remain unbiased. There may be some limitations to consistency or precision in some points due to the original sources, however the attempt was to minimize them as much as possible.

Muller and mutations: mouse study of George Snell (a postdoc of Muller) fails to confirm Muller's fruit fly findings, and Muller fails to cite Snell's findings

In 1931, Hermann J. Muller's postdoctoral student, George D. Snell (Nobel Prize recipient--1980) initiated research to replicate with mice Muller's X-ray-induced mutational findings with fruit flies. Snell failed to induce the two types of mutations of interest, based on fly data (sex-linked lethals/recessive visible mutations) even though the study was well designed, used large doses of X-rays, and was published in Genetics. These findings were never cited by Muller, and the Snell paper (Snell, Genetics 20:545-567, 1935) did not cite the 1927 Muller paper (Muller, Science 66:84, 1927). This situation raises questions concerning how Snell wrote the paper (e.g., ignoring the significance of not providing support for Muller's findings in a mammal). The question may be raised whether professional pressures were placed upon Snell to downplay the significance of his findings, which could have negatively impacted the career of Muller and the LNT theory. While Muller would receive worldwide attention, and receive the Nobel Prize in 1946 "for the discovery that mutations can be induced by X-rays," Snell's negative mutation data were almost entirely ignored by his contemporary and subsequent radiation genetics/mutation researchers. This raises questions concerning how the apparent lack of interest in Snell's negative findings helped Muller professionally, including his success in using his fruit fly data to influence hereditary and cancer risk assessment and to obtain the Nobel Prize.

Retrospective chart analysis to determine the impact of a patient-facing digital risk stratification tool combined with a clinical screener for hereditary cancer genetic risk assessment triage in a community oncology clinic

The purpose of this study was to evaluate the utility of adding a clinical screener to the patient-facing digital risk stratification tool triage process for the identification of patients eligible for a genetic risk assessment for hereditary cancer. Digital risk stratification entries were retrospectively reviewed to determine the overall number of patients eligible for genetic risk assessment. These were also analyzed to determine how many patients were re-contacted by the clinical screener, and how many of those recontacted patients met criteria after their personal and family history was revised by the clinical screener. There was an 89.9% digital risk stratification triage tool completion rate, with 22.6% requiring contact from the clinical screener. Of the 640 patients who completed the digital tool, 5.9% met criteria for testing after their personal and/or family history was revised by the clinical screener. Overall, 51.1% of patients met criteria for a genetic risk assessment. The addition of a clinical screener further increased identification of patients eligible for genetic risk assessment. About half of patients who met criteria after being contacted by the clinical screener met criteria based on their personal diagnosis of cancer alone. Incorporation of a clinical screener to the digital screening process may serve to reduce barriers to patient completion of the tool and increase rates of patient identification for cancer genetic services.

Comet assay and hormesis

The paper provides the first assessment of the occurrence of hormetic dose responses using the Comet assay, a genotoxic assay. Using a priori evaluative criteria based on the Hormetic Database on peer-reviewed comet assay experimental findings, numerous examples of hormetic dose responses were obtained. These responses occurred in a large and diverse range of cell types and for agents from a broad range of chemical classes. Limited attempts were made to estimate the frequency of hormesis within comet assay experimental studies using a priori entry and evaluative criteria, with results suggesting a frequency in the 40% range. These findings are important as they show that a wide range of genotoxic chemicals display evidence that is strongly suggestive of hormetic dose responses. These findings have significant implications for study design issues, including the number of doses selected, dose range and spacing. Likewise, the widespread occurrence of hormetic dose responses in this genotoxic assay has important risk assessment implications.

Hereditary cancer testing in a diverse sample across three breast imaging centers

PURPOSE

Up to 10% of all breast cancers (BC) are attributed to inherited pathogenic variants (PV) in BC susceptibility genes; however, most carriers of PVs remain unidentified. Here, we sought to determine the yield of hereditary cancer gene PVs among diverse women attending breast imaging centers, who could benefit from enhanced surveillance and/or risk reduction interventions.

METHODS

This cross-sectional retrospective cohort study included consecutive women, unselected for personal or family cancer history, who were offered genetic testing for hereditary cancer genes at the time of breast imaging at three centers (November 2020-March 2022).

RESULTS

Among 1943 patients (median age: 66 years), self-reported race/ethnicity was White (34.5%), Hispanic (27.7%), African American (17.9%), Asian (4.5%), Ashkenazi Jewish (0.6%), Other (3.5%), and missing (13.0%). Thirty-nine patients (2%) were identified as carriers of a PV in an autosomal dominant clinically actionable hereditary breast and ovarian cancer (HBOC)-related or Lynch syndrome gene, most frequently, BRCA2 (6/39; 15.4%), PALB2 (8/39; 20.5%), CHEK2 (10/39; 25.6%), and PMS2 (5/39; 12.8%). Of the 34 PVs with known race/ethnicity, 47% were detected among non-White patients. Overall, 354/1,943 (18.2%) of patients met NCCN guidelines for HBOC gene testing and only 15/39 (38.5%) patients with an autosomal dominant clinically actionable PV met guidelines.

CONCLUSION

This population health approach extended the reach of genetic cancer risk assessment in a diverse population and highlighted the limits of a guideline-based approach. This may help address inequity in access to risk-appropriate screening and cancer prevention.

Hermann Muller and his LNT scientific and policy leadership: Private communication reveals uncertainties

The present paper highlights numerous publications of Hermann J. Muller with a focus on his opinions concerning the validity of the linear no-threshold dose response model for hereditary and cancer risk assessment. These comments reflect a very consistent and powerfully supporting position for the LNT model. However, newly discovered correspondence between Muller and Robley D. Evans reveals that Muller was highly uncertain about the supportive science, and therefore hid his real opinions, deliberately misleading the scientific community and governmental agencies. Of further historical value is that in the correspondence with Evans, Muller proposed what might be the first articulation of an environmentally based Precautionary Principle. These perspectives have remained unknown since Muller requested Evans to keep this letter private.

Background radiation and cancer risks: A major intellectual confrontation within the domain of radiation genetics with multiple converging biological disciplines

This paper assesses the judgments of leading radiation geneticists and cancer risk assessment scientists from the mid-1950s to mid-1970s that background radiation has a significant effect on human genetic disease and cancer incidence. This assumption was adopted by the National Academy of Sciences (NAS) Biological Effects of Atomic Radiation (BEAR) I Genetics Panel for genetic diseases and subsequently applied to cancer risk assessment by other leading individuals/advisory groups (e.g., International Commission on Radiation Protection-ICRP). These recommendations assumed that a sizeable proportion of human mutations originated from background radiation due to cumulative exposure over prolonged reproductive periods and the linear nature of the dose-response. This paper shows that the assumption that background radiation is a significant cause of spontaneous mutation, genetic diseases, and cancer incidence is not supported by experimental and epidemiological findings, and discredits erroneous risk assessments that improperly influenced the recommendations of national and international advisory committees, risk assessment policies, and beliefs worldwide.

How self-interest and deception led to the adoption of the linear non-threshold dose response (LNT) model for cancer risk assessment

This paper clarifies scientific contributions and deceptive/self-serving decisions of William L. Russell and Liane Russell that led to the adoption of the linear non-threshold (LNT) model for cancer risk assessment by the US EPA. By deliberately failing to report an extremely large cluster of mutations in the control group of their first experiment, and thereby greatly suppressing its mutation rate, the Russells incorrectly claimed that the male mouse was 15-fold more susceptible to ionizing-radiation-induced gene mutations as compared with fruit flies. This self-serving error not only propelled their research program into one of great prominence, but it also promoted the LNT-based doubling dose (DD) concept in radiation genetics/cancer risk assessment, by the US National Academy of Sciences (NAS) Biological Effects of Atomic Radiation (BEAR) I Genetics Panel (1956). The DD concept became a central element in their recommendation that regulatory agencies switch from a threshold to an LNT model. This error occurred because of a decision by W. Russell not to report that a large cluster of control group mutations found in an experiment for which preliminary results were reported in 1951. This failure to report that cluster and similar clusters continued throughout the careers of the Russells, resulting in massive overestimation of low dose radiation risks supporting the LNT. The Russell database and the repeated claim that those data show that there is no threshold dose rate for mutation in irradiated mouse stem-cell spermatogonia, have provided mechanistic validation supporting the epidemiological LNT hypothesis for radiation-induced leukemias and cancers. This reanalysis supports the threshold model for both males and females, thereby rebutting epidemiological extrapolations from the NAS and EPA claiming support for the LNT hypothesis for cancer risk assessment. The implications of the Russell errors/deceptions, how/why they occurred, and their impact upon society are enormous and need to be addressed by scientific/regulatory agencies, affecting regulatory and litigation activities.

Confirmation that Hermann Muller was dishonest in his Nobel Prize Lecture

In his Nobel Prize Lecture of December 12, 1946, Hermann J. Muller argued that the dose-response for ionizing radiation-induced germ cell mutations was linear and that there was ''no escape from the conclusion that there is no threshold''. However, a newly discovered commentary by the Robert L. Brent (2015) indicated that Curt Stern, after reading a draft of part of Muller's Nobel Prize Lecture, called Muller, strongly advising him to remove reference to the flawed linear non-threshold (LNT)-supportive Ray-Chaudhuri findings and strongly encouraged him to be guided by the threshold supportive data of Ernst Caspari. Brent indicated that Stern recounted this experience during a genetics class at the University of Rochester. Brent wrote that Muller refused to follow Stern's advice, thereby proclaiming support for the LNT dose-response while withholding evidence that was contrary during his Nobel Prize Lecture. This finding is of historical importance since Muller's Nobel Prize Lecture gained considerable international attention and was a turning point in the acceptance of the linearity model for radiation and chemical hereditary and carcinogen risk assessment.

Biomonitoring and Biomathematical Modeling of Health Risks Associated with Dumpsite Grown Vegetables in Lagos State

Conversion of dumpsites to farm lands in several communities is a usual practice in Nigeria. Wastes accumulate heavy metals in a variety of forms. This study assessed the concentration, degrees of contamination, and attendant health risk of heavy metals (HMs), using two major indigenous vegetables (Amaranthus viridis and Talinum triangulare) grown on five major dumpsites in Lagos state. After wet digestion, the mean concentrations of the HMs in the vegetable samples were evaluated using atomic absorption spectrophotometer (AAS). Daily intake of metals (DIM), target hazard quotient (THQ), and hazard index (HI) biomathematics were employed in the assessment of non-carcinogenic health risk. Incremental lifetime cancer risk (ILCR) assessment was used to assess carcinogenicity. The obtained result shows that the concentrations of HMs fell within the following ranges: (0.37 to 0.59), (0.07 to 1.36), (0.30 to 1.92), (0.00 to 0.03), and (0.00 to 0.04) mg/kg; for zinc (Zn), lead (Pb), Iron (Fe), cadmium (Cd), and chromium (Cr), respectively, with low to moderate variability. At Ikorodu dumping site, the Pb concentration was above the World Health Organization (WHO) permissible range and has the highest contamination factor. DIM for Pb was also above threshold values (> 1) in both adults and children, while the THQ values for Fe, Pb, and Cd were above 1 (> 1) in both adults and children. HI values for the vegetables exceeded WHO normal range (> 1), except Abule-Egba dumps' samples (70% HI greater than 1 in adults and 90% HI greater than 1 in children). Additionally, the ILCR values of above 50% of the samples were above the WHO (10-6) limits, with the highest value in children (Cd, 1.064 × 10-3) indicating high risk of carcinogenicity over a life time of exposure. Thus, the results revealed great health risk from consumption of vegetables from the four major dumping sites, with children being at greater risk.

New and legacy pesticidal persistent organic pollutants in the agricultural region of the Sultanate of Oman

Comprehensive air and surface soil monitoring was conducted for new and legacy organochlorine pesticides (OCPs) to fill the knowledge and data gap on the sources and fate of pesticidal persistent organic pollutants (POPs) in the Sultanate of Oman. DDTs in agricultural soil samples ranged from 0.013 to 95.80 ng/g (mean: 8.4 ± 25.06 ng/g), with a median value of 0.07 ng/g. The highest concentration was observed at Shinas, where intensive agricultural practice is prevalent. The dominance of p,p'-DDT in soil and air reflected technical DDT formulation usage in Oman. Among newly enlisted POPs, pentachlorobenzene had the maximum detection frequency in air (47%) and soil (41%). Over 90% of sites reflected extensive past use of hexachlorobenzene. Major OCP isomers and metabolites showed net volatilisation from the agricultural soil, thereby indicating concurrent emission and re-emission processes from the soil of Oman. However, the cleansing effect of oceanic air mass is the possible reason for relatively lower atmospheric OCP levels from a previous study. Although DDT displayed maximum cancer risk, the level is below the permissible limit. DDT primarily stemmed from obsolete stock and inadequate management practices. Hence, we suggest there is a need for DDT regulation in Oman.

Development of a framework for risk assessment of dietary carcinogens

Although there are a number of guidance documents and frameworks for evaluation of carcinogenicity, none of the current methods fully reflects the state of the science. Common limitations include the absence of dose-response assessment and not considering the impact of differing exposure patterns (e.g., intermittent, high peaks vs. lower, continuous exposures). To address these issues, we have developed a framework for risk assessment of dietary carcinogens. This framework includes an enhanced approach for weight of evidence (WOE) evaluation for genetic toxicology data, with a focus on evaluating studies based on the most recent testing guidance to determine whether a chemical is a mutagen. Included alongside our framework is a discussion of resources for evaluating tissue dose and the temporal pattern of internal dose, taking into account the chemical's toxicokinetics. The framework then integrates the mode of action (MOA) and associated dose metric category with the exposure data to identify the appropriate approach(es) to low-dose extrapolation and level of concern associated with the exposure scenario. This framework provides risk managers with additional flexibility in risk management and risk communication options, beyond the binary choice of linear low-dose extrapolation vs. application of uncertainty factors.

Muller mistakes: The linear no-threshold (LNT) dose response and US EPA's cancer risk assessment policies and practices

This paper identifies the occurrence of six major conceptual scientific errors of Hermann Muller and describes how these errors led to the creation of the linear no-threshold (LNT) dose response historically used worldwide for cancer risk assessments for chemical carcinogens and ionizing radiation. The paper demonstrates the significant role that Muller played in the environmental movement, affecting risk assessment policies and practices that are in force even now a half century following his death. This paper lends support to contemporary research that shows significant limitations of the LNT model for cancer risk assessment.

Effect of beef patties fortification with black garlic on the polycyclic aromatic hydrocarbons (PAHs) content and toxic potency

Nine different black garlic samples aged at varying temperatures and durations were added to the patties at 0.5% and 1% ratios and compared with raw garlic in terms of polycyclic aromatic hydrocarbons (PAHs) formation. The results showed that black garlic caused a reduction in the patties' content of ∑PAH8 by 38.17% to 94.12% compared to raw garlic, with the highest reduction percent in the patties fortified with 1% black garlic aged at 70 °C for 45 days. Beef patties fortified with black garlic reduced human exposure to PAHs from beef patties (from 1.66E to 01 to 6.04E-02 ng-TEQ_BaP kg^-1 bw per day). The negligible cancer risk associated with exposure to PAHs through the consumption of beef patties was confirmed by very low ILCR (incremental lifetime cancer risk) values of 5.44E-14 and 4.75E-12. Finally, patty fortification with black garlic could be suggested as an effective way to reduce PAHs formation and exposure from patties.

Error-corrected next generation sequencing - Promises and challenges for genotoxicity and cancer risk assessment

Error-corrected Next Generation Sequencing (ecNGS) is rapidly emerging as a valuable, highly sensitive and accurate method for detecting and characterizing mutations in any cell type, tissue or organism from which DNA can be isolated. Recent mutagenicity and carcinogenicity studies have used ecNGS to quantify drug-/chemical-induced mutations and mutational spectra associated with cancer risk. ecNGS has potential applications in genotoxicity assessment as a new readout for traditional models, for mutagenesis studies in 3D organotypic cultures, and for detecting off-target effects of gene editing tools. Additionally, early data suggest that ecNGS can measure clonal expansion of mutations as a mechanism-agnostic early marker of carcinogenic potential and can evaluate mutational load directly in human biomonitoring studies. In this review, we discuss promising applications, challenges, limitations, and key data initiatives needed to enable regulatory testing and adoption of ecNGS - including for advancing safety assessment, augmenting weight-of-evidence for mutagenicity and carcinogenicity mechanisms, identifying early biomarkers of cancer risk, and managing human health risk from chemical exposures.

Beyond the cancer slope factor: Broad application of Bayesian and probabilistic approaches for cancer dose-response assessment

Traditional cancer slope factors derived from linear low-dose extrapolation give little consideration to uncertainties in dose-response model choice, interspecies extrapolation, and human variability. As noted previously by the National Academies, probabilistic methods can address these limitations, but have only been demonstrated in a few case studies. Here, we applied probabilistic approaches for Bayesian Model Averaging (BMA), interspecies extrapolation, and human variability distributions to 255 animal cancer bioassay datasets previously used by governmental agencies. We then derived predictions for both population cancer incidence and individual cancer risk. For model uncertainty, we found that lower confidence limits from BMA and from U.S. Environmental Protection Agency (EPA)'s Benchmark Dose Software (BMDS) correlated highly, with 86% differing by <10-fold. Incorporating other uncertainties and human variability, the lower confidence limits of the probabilistic risk-specific dose (RSD) at 10-6 population incidence were typically 3- to 30-fold lower than traditional slope factors. However, in a small (<7%) number of cases of highly non-linear experimental dose-response, the probabilistic RSDs were >10-fold less stringent. Probabilistic RSDs were also protective of individual risks of 10-4 in >99% of the population. We conclude that implementing Bayesian and probabilistic methods provides a more scientifically rigorous basis for cancer dose-response assessment and thereby improves overall cancer risk characterization.

Grape Seed Components as Protectors of Inflammation, DNA Damage, and Cancer

PURPOSE OF REVIEW

Oxidative stress is related to the pathogenesis of several chronic diseases, including inflammatory processes. Free radicals excess increase not only oxidative stress but also genomic instability. Polyphenols are non-enzymatic antioxidants that act as a defense barrier against free radicals and non-radical oxidants. The purpose of this article was to review published articles relating dietary polyphenols contained in grape seed proanthocyanidin extracts with its potential for reversing DNA damage.

RECENT FINDINGS

Proanthocyanidin components exert pleiotropic actions having several biological, biochemical, and significant pharmacological effects and showed the ability to reduce cytotoxicity and genotoxicity. Grape seed proanthocyanidin extracts showed the ability to reduce cytotoxicity and genotoxicity through the comet assay and the micronucleus technique.

Implementing digital systems to facilitate genetic testing for hereditary cancer syndromes: An observational study of 4 clinical workflows

PURPOSE

National efforts have prioritized the identification of effective methods for increasing case ascertainment and delivery of evidence-based health care for individuals at elevated risk for hereditary cancers.

METHODS

This study examined the uptake of genetic counseling and testing following the use of a digital cancer genetic risk assessment program implemented at 27 health care sites in 10 states using 1 of 4 clinical workflows: (1) traditional referral, (2) point-of-care scheduling, (3) point-of-care counseling/telegenetics, and (4) point-of-care testing.

RESULTS

In 2019, 102,542 patients were screened and 33,113 (32%) were identified as at high risk and meeting National Comprehensive Cancer Network genetic testing criteria for hereditary breast and ovarian cancer, Lynch syndrome, or both. Among those identified at high risk, 5147 (16%) proceeded with genetic testing. Genetic counseling uptake was 11% among the sites with workflows that included seeing a genetic counselor before testing, with 88% of patients proceeding with genetic testing after counseling. Uptake of genetic testing across sites varied significantly by clinical workflow (6% referral, 10% point-of-care scheduling, 14% point-of-care counseling/telegenetics, and 35% point-of-care testing, P < .0001).

CONCLUSION

Study findings highlight the potential heterogeneity of effectiveness attributable to different care delivery approaches for implementing digital hereditary cancer risk screening programs.

Cancer risk assessment and source apportionment of the gas- and particulate-phase of the polycyclic aromatic hydrocarbons in a metropolitan region in Brazil

A risk assessment and a source apportionment of the particulate- and gas-phase PAHs were conducted in a high vehicular traffic and industrialized region in southeastern Brazil. Higher concentrations of PAHs were found during summer, being likely driven by the contributions of PAHs in the vapor phase caused by fire outbreaks during this period. Isomer ratio diagnostic and Principal Component Analysis (PCA) identified four potential sources in the region, in which the Positive Matrix Factorization (PMF) model confirmed and apportioned as gasoline-related (31.8%), diesel-related (25.1%), biomass burning (23.4%), and mixed sources (19.6%). The overall cancer risk had a tolerable value, with ∑CR = 4.6 × 10^-5, being ingestion the major via of exposure (64% of the ∑CR), followed by dermal contact (33% of the ∑CR) and inhalation (3%). Mixed sources contributed up to 45% of the overall cancer risk (∑CR), followed by gasoline-related (up to 35%), diesel-related (up to 15%), and biomass burning (up to 10%). The risk assessment for individual PAH species allowed identifying higher CR associated with BaP, DBA, BbF, BaA, and BkF, species associated with gasoline-related and industrial sources. Higher risks were associated with PM_2.5-bound PAHs exposure, mainly via ingestion and dermal contact, highlighting the need for measures of mitigation and control of PM_2.5 in the region.

Health and economic gain attributable to the introduction of the World Health Organization's drinking water standard on arsenic level in Hungary: A nationwide retrospective study on cancer occurrence and ischemic heart disease mortality

The World Health Organization (WHO) estimates that 140 million individuals are at risk from consumption of drinking water containing arsenic at concentrations above the WHO guideline value of 10 μg/l. Arsenic mitigation is considered to be the most effective way to prevent arsenic related diseases. After joining the European Union, Hungary implemented a Drinking Water Quality Improvement Programme (DWQIP) to reduce levels of arsenic in drinking water below the WHO guideline value. But what impact did this have on health? We estimated the change in lifetime excess skin, lung, and bladder cancer risks and mortality from ischaemic heart disease (IHD) associated with chronic arsenic intake among those exposed before (2004-2007) and after (2014-2017) the implementation of DWQIP. A population-based risk assessment approach was used to assess lifetime excess cancer risk applying two scenarios for lung and bladder cancers. The economic benefits of the DWQIP were estimated by the combination of cost of illness and value per statistical life methods. Compared to the period before the DWQIP, its implementation was associated with a significant reduction in arsenic in drinking water [median: 3.0 μg/l interquartile range (IQR): 1.5-12.0 μg/l to median: 2.15 μg/l IQR: 1.0-5.79 μg/l]. The two scenarios were estimated to be associated with 225.2 and 35.9 fewer cancer cases each year. The number of annually prevented IHD deaths was estimated to be 88.9. It was estimated that the benefits of the DWQIP will outweigh its costs. We conclude that reducing arsenic levels in drinking water to 10.0 μg/l resulted in significant health and economic benefits. Our study goes beyond the existing research, offering both new insights into the impact of arsenic mitigation and providing a methodological template for similar studies in the many parts of the world that have yet to reduce arsenic exposure.

Assessment of Pb and Ni and potential health risks associated with the consumption of vegetables grown on the roadside soils in District Swat, Khyber Pakhtunkhwa, Pakistan

Vegetables cultivated near roads absorb toxic metals from polluted soil, which enter the human body through the food chain and cause serious health problems to humans. The present study investigated the concentration of lead (Pb) and nickel (Ni) in soils and vegetables grown along the roadside of District Swat, Pakistan, and the health risks associated with the consumption of the tested vegetables. In results, Pb concentration was higher in plants located at the distance between 0-10 m away from the roadside than the WHO permissible limit. In such plants, Pb concentration was higher than Ni. Rumex dentatus contained the highest concentration of Pb (75.63 mg kg^-1 DW) among the tested vegetables while Ni concentration (27.57 mg kg^-1 DW) was highest in Trachyspermum ammi as compared to other plants. Concentration and accumulation of both the metals decreased in soil and plants with increasing distance from the road. Similarly, target hazard quotient values noted for Pb (up to 3.37) were greater than unity, which shows that there is a potential risk associated with the consumption of tested vegetables near the road. Moreover, the values of target cancer risk (up to 0.8413) were greater than 0.0001, which shows that there is a risk of cancer with the consumption of tested vegetables. In conclusion, the consumption of tested vegetables was very dangerous as it may lead to higher risks of cancer. Strict regulatory control is recommended on the cultivation of these vegetables along the roadside to avoid any contamination due to roadside exhaust.

Can the Indian national ambient air quality standard protect against the hazardous constituents of PM2.5?

Globally, exposure to ambient fine particulate matter (PM_2.5) pollution claims ∼9 million lives, yearly, and a quarter of this deaths occurs in India. Regulation of PM_2.5 pollution in India is based on compliance with its National Ambient Air Quality Standard (NAAQS) of 40 μg/m³, which is eight times the revised global air quality guideline (AQG) of 5 μg/m³. But, whether the NAAQS provides adequate protection against the hazardous components in PM_2.5 is still not clear. Here, we examined the risk to health associated with exposure to PM_2.5-bound polychlorinated biphenyls (PCB), heavy metals and polycyclic aromatic hydrocarbons (PAHs) in an Indian district averaging below the NAAQS. The annual average concentrations of PM_2.5 mass, Σ₂₈PCB and Σ₁₃PAHs were 34 ± 17 μg/m³, 21 ± 12 ng/m³ and 458 ± 246 ng/m³, respectively. Concentrations of As, Cr, Mn and Ni in PM_2.5 surpassed the screening levels for residential air. Substantial level of risks to health were associated with exposure to dioxin-like PCBs (Σ₁₂dlPCB), PAHs, As, Cr and Ni. The hazard index or lifetime cancer risk were 240, or 9 cases per 1000 population, respectively. The estimated risks to health through exposure to hazardous components, except Ni, were greatest in rural areas, having a lower average PM_2.5 concentration, than urban or peri-urban areas, suggesting higher toxicity potential of rural combustion sources. The large disparity between the estimated risk values and the acceptable risk level suggests that it would take a more stringent standard, such as the global AQG, to protect vulnerable populations in India from hazardous components in PM_2.5.

Ethical challenges of the linear non-threshold (LNT) cancer risk assessment revolution: History, insights, and lessons to be learned

This paper provides historical review and evaluation of the development, adoption, and advocacy of the linear non-threshold (LNT) dose response model for cancer risk assessment as applied in practices and policies worldwide. It extends previous historical assessments and provides novel insights regarding: 1) how LNT bias became institutionalized in US governmental agencies, 2) how improper editorial practices at the journal Science promoted the adoption of LNT, 3) how a Nobel Prize winning scientist unjustifiably espoused and influenced support for replacing the threshold dose response model with the LNT model, 4) how the cover-up of striking and substantial experimental cancer data by US government scientists reduced support for the threshold dose response model at a critical period of cancer risk assessment policy adoption, and 5) how these events have negatively influenced cancer risk assessment practices and environmental and public health decisions for decades. These findings are presented to illustrate how profound and recognized mistakes, biases and unethical activities, inclusive of frank scientific misconduct, converged, and should motivate regulatory agencies worldwide to critically evaluate any existing policies that apply the LNT model as well as to serve as object lessons for current and future ethical conduct of research, and the provision of ethico-legal education in and across scientific curricula and institutions.

Determination of whole mixture-based potency factors for cancer risk assessment of complex environmental mixtures by in vitro testing of standard reference materials

Whole mixture-based testing using in vitro new approach methodologies (NAMs) has been suggested to facilitate the hazard and risk assessment of complex environmental mixtures. Previous studies have shown that phosphorylation of DNA damage signaling proteins checkpoint kinase 1 (pChk1) and histone 2AX (γH2AX) are sensitive markers that can be used for estimating carcinogenicity potencies in vitro. Here, and with the aim to better validate the applicability, in vitro-based Mixture Potency Factors (MPFs) of Standard Reference Materials (SRMs) from environmental polycyclic aromatic hydrocarbon (PAH)-containing mixtures were determined and compared to published mutagenicity and tumorigenicity data. Also, genotoxicity was assessed by a flow cytometry-based micronucleus (MN) assay which showed that only benzo[a]pyrene (B[a]P) and coal tar SRM (SRM1597a) caused dose-dependent increases of MN formation, while extracts of diesel particulate matter (SRM1650b), diesel particulate extract (SRM1975), and urban dust (SRM1649b) did not. However, a dose-dependent activation of DNA damage signaling was observed for all PAHs and SRMs. The results demonstrated that all SRMs were more potent than B[a]P, at B[a]P-equivalent concentrations, to induce pChk1 and γH2AX, and that western blot was more sensitive than the In-Cell Western assay in detecting their activation in response to these complex mixtures. Relative MPFs, based on dose-response modelling of pChk1 and γH2AX, ranged 113 - 5270 for the SRMs, indicating several orders of magnitude higher genotoxic potential than B[a]P. Moreover, these MPFs were in good agreement with potency values based on published data from Salmonella mutagenicity and in vivo carcinogenicity studies. In conclusion, these comparisons further validate the feasibility of applying in vitro NAMs, such as whole-mixture based MPFs, in cancer risk assessment of complex mixtures.

Cover up and cancer risk assessment: Prominent US scientists suppressed evidence to promote adoption of LNT

This paper reports that William Russell, Oak Ridge National Laboratory (ORNL), conducted a large-scale lifetime study from 1956 to 1959 showing that exposure of young adult male mice to a large dose of acute X-rays had no treatment effects on male and female offspring concerning longevity or the frequency, severity, or age distribution of neoplasms and other diseases. Despite the scientific, societal and crucial timing significance of the study, Russell did not publish the findings for almost 35 years, nor did he inform governmental advisory committees, thereby significantly biasing decisions made during this period which supported the adoption of LNT for risk assessment. Of further significance, Arthur Upton, an ORNL colleague of Russell during this study and later Director of the US National Cancer Institute (NCI), was also fully knowledgeable of this study, its findings and its negative impact on the acceptance of LNT. Upton later worked along with Russell to publish these data (i.e., Cosgrove et al., 1993) to dispute the case-specific claim that children developed cancer because of the radiation exposure of their fathers as workers at the Sellafield nuclear plant. Thus, while Russell's data were available, but were not used to challenge the key radiation and leukemia paper of Edward B. Lewis, (1957) when LNT was being adopted by regulatory agencies, they were used in a major trial in the United Kingdom (UK) for the client (i.e., British Nuclear Fuels Plc) that hired Upton. While the duplicity of Russell's and Upton's actions is striking, the key finding of the present paper is that Russell and Upton intentionally orchestrated and sustained an LNT cover up during the key period of LNT adoption by regulatory agencies, thereby showing an overwhelming bias to enhance the adoption of LNT.

Effect of mineral fertilisers application on the transfer of natural radionuclides from soil to radish (Raphanus sativus L.)

Non-controlled usage of mineral fertilisers in agriculture land of Kazakhstan is a concerning issue, due to possible contamination of the soil by radionuclides. Pot experiment of growing of R. sativus with application of mineral fertilisers was carried out under natural conditions. Two commonly used mineral fertilisers, mono-potassium phosphate and ammonium nitrate, were chosen in the frame of current research to determine the impact of mineral fertiliser on transfer of natural radionuclides from soil to R. sativus edible part. For this goal, the activity concentrations of natural radionuclides U-234, U-238, Th-230, Th-232 and Ra-226, were determined in both R. sativus edible part and the investigated soil by using alpha-particle spectrometry. The highest activity concentrations were found for R. sativus edible part growing on soil that was fertilised by mono-potassium phosphate and were equal to 174 ± 17, 134 ± 15, 62 ± 4, 15 ± 2 and 2.8 ± 0.6 Bq/kg for U-234, U-238, Th-230, Th-232 and Ra-226, respectively. The results of soil-to- R. sativus edible part transfer factor for different radionuclides varied depending on the mineral fertiliser used. For evaluation of impact during consumption of R. sativus edible part by a population of Kazakhstan, annual effective ingestion dose and excess lifetime cancer risk were determined. The highest annual effective ingestion dose was found for R. sativus edible part cultivated in mono-potassium phosphate-fertilised soil and was equal to 4.4 μSv year^-1.

DNA damage, serum metabolomic alteration and carcinogenic risk associated with low-level air pollution

Outdoor air pollution has been classified as carcinogenic to humans (Group 1) for lung cancer, but the underlying mechanism and key toxic components remain incompletely understood. Since DNA damage and metabolite alterations are associated with cancer progression, exploring potential mechanisms linking air pollution and cancer might be meaningful. In this study, a real-time ambient air exposure system was established to simulate the real-world environment of adult male SD rats in Beijing from June 13th, 2018, to October 8th, 2018. 8-OHdG in the urine, γ-H2AX in the lungs and mtDNA copy number in the peripheral blood were analyzed to explore DNA damage at different levels. Serum non-targeted metabolomics analysis was performed. Pair-wise spearman was used to explore the correlation between DNA damage biomarkers and serum differential metabolites. Carcinogenic risks of heavy metals and PAHs via inhalation were assessed according to US EPA guidelines. Results showed that PM_2.5 and O₃ were the major air pollutants in the exposure group and not detected in the control group. Compared with control group, higher levels of 8-OHdG, mtDNA copy number, γ-H2AX and PCNA-positive nuclei cells were observed in the exposure group. Histopathological evaluation suggested ambient air induced alveolar wall thickening and inflammatory cell infiltration in lungs. Perturbed metabolic pathways identified included glycolysis/gluconeogenesis metabolism, purine and pyrimidine metabolism, etc. γ-H2AX was positively correlated with serum ADP, 3-phospho-D-glyceroyl phosphate and N-acetyl-D-glucosamine. The BaPeq was 0.120 ng/m³. Risks of Cr(VI), As, V, BaP, BaA and BbF were above 1 × 10^-6. We concluded that low-level air pollution was associated with DNA damage and serum metabolomic alterations in rats. Cr(VI) and BaP were identified as key carcinogenic components in PM_2.5. Our results provided experimental evidence for hazard identification and risk assessment of low-level air pollution.

Emission, dispersion, and potential risk of volatile organic and odorous compounds in the exhaust gas from two sludge thermal drying processes

Emissions of odorous and volatile organic compounds (VOCs) were investigated between two sludge drying methods. A total of 37 chemical compounds were identified and quantified from the off-gases from sludge drying by indirect drying method. The total number of VOCs detected ranged from 3.45 × 10^-3 to 4.53 mg/m³, which includes benzene series, volatile organic sulfur, and nitrogenous organic compounds. High emissions were found in the exhaust gas released from drying workshop that used direct drying method. Sulfur dioxide, aromatics, and chlorinated compounds were dominant. Based on the olfactory effect analysis and cancer risk assessment, the main odor-causing gaseous pollutants were methyl mercaptan and methyl sulfide (for indirect sludge drying process) and SO₂ (for direct sludge drying process), while the dominant carcinogens were benzene, carbon tetrachloride, chloroform, and methylene. This study provides new insights into the emission characteristics, olfactory effects, and cancer risks of VOCs and odorous compounds in the exhaust gas from thermal sludge drying processes.

Health risk and source assessment of semi-volatile phenols, p-chloroaniline and plasticizers in plastic packaged (sachet) drinking water

The presence of U.S. EPA priority organic contaminants in drinking water poses a dire health risk on consumers. Packaged drinking water such as plastic sachet drinking water has significantly gained market in both developed and developing countries, especially, its dominance in the Ghanaian market. The treatment process, packaging, and storage of the sachet drinking water contribute to the levels of genotoxic semi-volatile phenols, p-chloroaniline, and plasticizers contamination in the drinking water. The study thus sought to investigate the levels of semi-volatile phenols, p-chloroaniline, and plasticizer contaminants in sachet drinking water on the Ghanaian market and the associated health risk of exposure. The study also investigated the possible sources of the contaminants. A total of thirty (30) different brands of sachet water on the Ghanaian market were studied. The samples were extracted in replicates (n = 3) using Solid Phase Extraction (SPE) cartridges and further analysed with GC-MS (SIM mode). The source apportionment was conducted using absolute principal component analysis coupled with multiple, linear regression (APCA-MLR) and automatic linear regression (APCA-MALR) modelling. The mean total levels for the phenols, p-chloroaniline, and plasticizers were between 210.2 and 18,914.9, 11.2 and 18,871.0, and 21.2 and 69,834.1 ng/L respectively. The cumulative non-cancer risk (hazard quotient) and cancer risk upon exposure were computed to range between 2.1 × 10^-3 and 1.2 and 1.5 × 10^-7 and 1.3 × 10^-4 respectively. About 37% of the samples had elevated cancer risk (>10^-6) which may contribute to the existing incidence, cause for concern. The five sources found for the contaminants were apportioned as "environmental background (major)", "water treatment/disinfectant", "plastic/plasticizers", "storage and preservation", and "residual inter-conversion/degradation sources".

Inhalation cancer risk assessment for environmental exposure to hexavalent chromium: Comparison of margin-of-exposure and linear extrapolation approaches

Hexavalent chromium [Cr(VI)] exists in the ambient air at low concentrations (average upperbound ~0.1 ng/m³) yet airborne concentrations typically exceed EPA's Regional Screening Level for residential exposure (0.012 ng/m³) and other similar benchmarks, which assume a mutagenic mode of action (MOA) and use low-dose linear risk assessment models. We reviewed Cr(VI) inhalation unit risk estimates developed by researchers and regulatory agencies for environmental and occupational exposures and the underlying epidemiologic data, updated a previously published MOA analysis, and conducted dose-response modeling of rodent carcinogenicity data to evaluate the need for alternative exposure-response data and risk assessment approaches. Current research supports the role of non-mutagenic key events in the MOA, with growing evidence for epigenetic modifiers. Animal data show a weak carcinogenic response, even at cytotoxic exposures, and highlight the uncertainties associated with the current epidemiological data used in risk assessment. Points of departure from occupational and animal studies were used to determine margins of exposure (MOEs). MOEs range from 1.5 E+3 to 3.3 E+6 with a median of 5 E+5, indicating that current environmental exposures to Cr(VI) in ambient air should be considered of low concern. In this comprehensive review, the divergent results from default linear and MOE assessments support the need for more relevant and robust epidemiologic data, additional mechanistic studies, and refined risk assessment strategies.

Pesticides driven pollution in Kuwait: The first evidence of environmental exposure to pesticides in soils and human health risk assessment

Soil pollution from pesticide residues is a key concern due to the high soil accumulation of pesticides and their human toxicity. Pesticide concentration of surface soil samples from the Sulaibiya agricultural field located in Kuwait was assessed in the present study. The study also investigated health risk assessment for both children and adults based on the residual concentrations. The average concentration of ƩOCPs (sum of organochlorine pesticides) along the present study was 3062 pg/g. The residual concentration of ƩOCPs was comparatively lower as compared to other locations around the world. Out of the 11 observed locations, A, B, and D locations indicated higher concentrations of ƩOCPs. The results indicated that DDT showed higher concentrations 692.87 pg/g in soil samples as compared to the other pesticides. Cancer risks of OCP via ingestion, dermal contact and inhalation of soil particles suggested that all stations were in a safe zone. However, locations A, B and D were closer to the low-risk band. The distribution pattern for each form of organochlorine pesticides (OCP) was different in Sulaibiya, indicating the non-simultaneous use of different groups of OCPs in this region. Multivariate statistical analysis based on cluster analysis identified three classes, 1, 2 and 3 of pesticides, suggesting these are from the same sources. Principle component analysis (PCA) showed that soil physicochemical properties influence the pesticides in soil samples. The results provides the baseline data of pesticides in soils from Kuwait.

LNT and cancer risk assessment: Its flawed foundations part 2: How unsound LNT science became accepted

This paper argues that Edward B. Lewis served as a type of independent academic radiation LNT-cancer risk assessment-stalking horse for the BEAR Genetics Panel, a task for which he had no expertise or experience (e.g. radiation, leukemia, epidemiology and statistical modelling). His efforts produced an insufficiently documented, strongly biased, and high-profile paper in Science (May 17, 1957), whose principal conclusions had not been proven, he asserted privately, in writing. This inconclusive perspective was well camouflaged in the published paper by means of sophisticated wordsmithing. At the time his academic department head George Beadle came to chair the BEAR Genetics Panel in the summer of 1956, the Beadle-inspired-Lewis LNT activity acquired an urgency when a study of 70,000 offspring from survivors of the A-bombs failed to show genetic damage after a decade of careful study, undercutting Panel recommendations. With Beadle's guidance, the Lewis effort redirected the Panel's focus from the atomic bomb genetic damage study, which had acrimoniously disrupted Panel relationships and priorities, to more immediate disciplinary/professional opportunities with concerns about fallout, leukemia risks and a new cancer causation role for mutation. The serious limitations of the Lewis paper affected neither its publication in Science nor its receiving an editorial endorsement, possibly due to influence by powerful Panel members, such as Bentley Glass, one of only six senior editors for Science. The Science publication restored, even though improperly, the scientific and moral initiatives of the Panel and led directly to multiple high level LNT recommendations for cancer risk assessment based on the Precautionary Principle, which Lewis asserted, and which remains in place today in essentially all countries. The present paper explores how such a scientific long-shot and quasi-stalking horse, who was unsupported by BEAR Panel members during the withering criticism prompted by his Science article, nevertheless endured in the pursuit of his LNT goal, becoming strikingly successful in achieving a global cancer risk assessment revolution which remains in place.

LNT and cancer risk assessment: Its flawed foundations part 1: Radiation and leukemia: Where LNT began

This paper evaluates the scientific basis for the adoption of the linear non-threshold (LNT) dose response model for radiation-induced leukemia. This LNT risk assessment application for leukemia is significant because it: (1) was generalized for all tumor types induced by ionizing radiation and chemical carcinogens at relatively high doses and; (2) it was based on the mechanistic assumption of low dose linearity for somatic cell mutations as determined from responses in mature spermatozoa of fruit flies. A serious problem with the latter assumption is that those spermatozoa lack DNA repair. The acceptance of the LNT dose response model for cancer risk assessment was based on the convergence of recommendations of the BEAR I Genetics Panel (1956a) for reproductive cell gene mutations and those of Lewis (1957a) for somatic cell mutation and its capacity to explain apparent and/or predicted linear dose responses of ionizing radiation-induced leukemia in multiple and diverse epidemiological investigations. Use of that model and related dose response beliefs achieved rapid, widespread and enduring acceptance in the scientific and regulatory communities. They provide the key historical foundation for the sustained LNT-based policy for cancer risk assessment to the present. While previous papers in this series have challenged key scientific assessments and ethical foundations of the BEAR I Genetics Panel, the present paper provides evidence that Lewis: 1) incorrectly interpreted the fundamental scientific studies used to support the LNT conclusion even though such studies show consistent hormetic-J-shaped dose response relationships for leukemia in Hiroshima and Nagasaki survivors; and, 2) demonstrated widespread bias in support of an LNT conclusion and related policies, which kept him from making an objective and fair assessment. The LNT recommendation appears to have been uncritically accepted and integrated into scientific and regulatory practice in large part because it inappropriately appealed to existing authority and it garnered the support of those who were willing to risk greatly exaggerating the public's fears of environmentally-induced disease, such as enhanced risk of leukemia, with the goal of stopping the atmospheric testing of atomic bombs. Adoption of the LNT recommendation demonstrated extensive penetration of ideological influence affecting governmental, scientific and regulatory evaluation at the highest levels in the United States. This paper demonstrates that the scientific foundations for cancer risk assessment were inappropriately and inaccurately assessed, unethically adopted and require significant historical, scientific and regulatory remediation.

Cancer risk assessment from exposure to trihalomethanes in showers by inhalation

In many countries water disinfection for human consumption is still carried out via chlorination which generates by-products such as trihalomethanes (THM). Exposure to THM constitutes a public health risk as such substances are known to be carcinogenic. This study evaluated exposure to THMs by inhalation in showers and assessed the carcinogenic risk for lifetime exposure. The study population involved students at Universidad de los Andes residing in Bogotá, Colombia. The risk assessment was performed stochastically and the exposure parameters were taken as probability distributions. Most variables were measured in relation to the chosen population. The risk was calculated using two different methodologies but no significant variations were obtained. The average risk calculated for men and women was 56 cases in a million (5.6 × 10^-5). A sensitivity analysis was carried out where it was found that the parameters that increase risk the most are the concentration of chloroform in the water, exposure time, and the volume of the shower cubicle.

Historical perspective on the role of cell proliferation in carcinogenesis for DNA-reactive and non-DNA-reactive carcinogens: Arsenic as an example

Our understanding of the etiology of cancer has developed significantly over the past fifty years, beginning with a single-hit linear no-threshold (LNT) conceptual model based on early studies conducted in Drosophila. Over the past several decades, multiple lines of evidence have accumulated to support a contemporary model of chemical carcinogenesis: a multi-hit model involving a prolonged stress environment that over time may drive the mutation of multiple cells into an injured state that ultimately could lead to uncontrolled proliferation via clonal expansion of mutation-carrying daughter cells. Arsenic carcinogenicity offers a useful case study for further exploration of advanced conceptual models for chemical carcinogenesis. A threshold for arsenic carcinogenicity is supported by its mode of action, characterized by repeating cycles of cytotoxicity and cellular regeneration. Furthermore, preliminary meta-analyses of epidemiology dose-response data for inorganic arsenic (iAs) and bladder cancer, correlated to dose-response data measured in vitro, support a threshold of effect in humans on the order of 50-100 μg/L in drinking water. In light of recent developments in our understanding of cancer etiology, we urge strong consideration of the existing mode-of-action evidence supporting a threshold of effect for arsenic carcinogenicity, as well as consideration of the potential methodological pitfalls in evaluating epidemiology dose-response data that could potentially bias in the direction of low-dose linearity.

Thresholds for carcinogens

Current regulatory cancer risk assessment principles and practices assume a linear dose-response relationship-the linear no-threshold (LNT) model-that theoretically estimates cancer risks occurring following low doses of carcinogens by linearly extrapolating downward from experimentally determined risks at high doses. The two-year rodent bioassays serve as experimental vehicles to determine the high-dose cancer risks in animals and then to predict, by extrapolation, the number of carcinogen-induced tumors (tumor incidence) that will arise during the lifespans of humans who are exposed to environmental carcinogens at doses typically orders of magnitude below those applied in the rodent assays. An integrated toxicological analysis is conducted herein to reconsider an alternative and once-promising approach, tumor latency, for estimating carcinogen-induced cancer risks at low doses. Tumor latency measures time-to-tumor following exposure to a carcinogen, instead of tumor incidence. Evidence for and against the concept of carcinogen-induced tumor latency is presented, discussed, and then examined with respect to its relationship to dose, dose rates, and the dose-related concepts of initiation, tumor promotion, tumor regression, tumor incidence, and hormesis. Considerable experimental evidence indicates: (1) tumor latency (time-to-tumor) is inversely related to the dose of carcinogens and (2) lower doses of carcinogens display quantifiably discrete latency thresholds below which the promotion and, consequently, the progression and growth of tumors are delayed or prevented during a normal lifespan. Besides reconciling well with the concept of tumor promotion, such latency thresholds also reconcile favorably with the existence of thresholds for tumor incidence, the stochastic processes of tumor initiation, and the compensatory repair mechanisms of hormesis. Most importantly, this analysis and the arguments presented herein provide sound theoretical, experimental, and mechanistic rationales for rethinking the foundational premises of low-dose linearity and updating the current practices of cancer risk assessment to include the concept of carcinogen thresholds.

Ethical failings: The problematic history of cancer risk assessment

This paper demonstrates that unethical conduct by the US National Academy of Sciences (NAS) Biological Effects of Atomic Radiation (BEAR) I Genetics Panel led to their recommendation of the Linear Non-Threshold (LNT) Model for radiation risk assessment and its subsequent adoption by the US and the world community. The analysis, which is based largely on preserved communications of the US NAS Genetics Panel members, reveals that Panel members and their administrative leadership at the NAS displayed an integrated series of unethical actions designed to ensure, (1) the acceptance of the LNT and (2) funding to radiation geneticist panel members and professional colleagues. These findings are significant because major public policies in open democracies, such as cancer risk assessment and other issues impacted by public fears of radiation or chemical exposures, require ethical foundations. Recognition of these ethical failures of the BEAR I Genetics Panel should require a high level administrative, legislative and scientific reassessment of the scientific foundations of cancer risk assessment, with the likely result necessitating revision of current policies and practices. The BEAR I Genetics Panel, 1956 Science journal publication should immediately be retracted because it contains deliberate misrepresentations of the scientific record that were designed to manipulate scientific and public opinion on radiation risk assessment in a dishonest manner.

The Muller-Neel dispute and the fate of cancer risk assessment

The National Academy of Sciences (NAS) Atomic Bomb Casualty Commission (ABCC) human genetic study (i.e., The Neel and Schull, 1956a report) showed an absence of genetic damage in offspring of atomic bomb survivors in support of a threshold model, but was not considered for evaluation by the NAS Biological Effects of Atomic Radiation (BEAR) I Genetics Panel. The study therefore could not impact the Panel's decision to recommend the linear non-threshold (LNT) dose-response model for risk assessment. Summaries and transcripts of the Panel meetings failed to reveal an evaluation of this study, despite its human relevance and ready availability, relying instead on data from Drosophila and mice. This paper explores correspondence among and between BEAR Genetics Panel members, including James Néel, the study director, and other contemporaries to assess why the Panel failed to use these data and how the decision to recommend the LNT model affected future cancer risk assessment policies and practices. This failure of the Genetics Panel was due to: (1) a strongly unified belief in the LNT model among panel members and their refusal to acknowledge that a low dose of radiation could exhibit a threshold, a conclusion that the Néel/Schull atomicbomb study could support, and (2) an excessive degree of self-interest among panel members who experimented with animal models, such as Hermann J. Muller, and feared that human genetic studies would expose the limitations of extrapolating from animal (especially Drosophila) to human responses and would strongly shift research investments/academic grants from animal to human studies. Thus, the failure to consider the Néel/Schull atomic bomb study served both the purposes of preserving the LNT policy goal and ensuring the continued dominance of Muller and his similarly research-oriented colleagues.

Emission characteristics and associated assessment of volatile organic compounds from process units in a refinery

The accuracy and reliability of volatile organic compound (VOC) emission data are essential for assessing emission characteristics and their potential impact on air quality and human health. This paper describes a new method for determining VOC emission data by multipoint sampling from various process units inside a large-scale refinery. We found that the emission characteristics of various production units were related to the raw materials, products, and production processes. Saturated alkanes accounted for the largest fraction in the continuous catalytic reforming and wastewater treatment units (48.0% and 59.2%, respectively). In the propene recovery unit and catalytic cracking unit, alkenes were the most dominant compounds, and propene provided the largest contributions (57.8% and 23.0%, respectively). In addition, n-decane (12.6%), m,p-xylene (12.4%), and n-nonane (8.9%) were the main species in the normal production process of the delayed coking unit. Assessments of photochemical reactivity and carcinogenic risk were carried out, and the results indicate that VOC emissions from the propene recovery unit and catalytic cracking unit should be controlled to reduce the ozone formation potential; in addition, alkenes are precedent-controlled pollutants. The cancer risk assessments reveal that 1,2-dibromoethane, benzene, 1,2-dichloroethane, and chloroform were the dominant risk contributors, and their values were much higher than the standard threshold value of 1.0 × 10^-6 but lower than the significant risk value defined by the US Supreme Court. Based on the VOC composition and a classification algorithm, the samples were classified into eight main groups that corresponded to different process units in the petroleum refinery. In conclusion, this work provides valuable data for investigating process-specific emission characteristics of VOCs and performing associated assessments of photochemical reactivity and carcinogenic risk in petrochemical refineries.

PAHs in Chinese atmosphere Part II: Health risk assessment

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous pollutants in atmosphere, which attracted more attentions due to their influence on human health. In this study, a national scale cancer risk (CR) assessment with atmospheric PAHs were conducted based on one year monitoring program at 11 cities across China. The annual mean concentrations of benzo[a]pyrene (BaP) and BaP equivalency (BaP_eq) were 4.56 ± 7.78 ng/m³ and 8.45 ± 14.1 ng/m³, respectively, which were both higher than the new ambient air quality standards of China (GB 3095-2012, 1 ng/m³). Concentrations of BaP and BaP_eq in northern Chinese cities were almost 2 times higher than those in southern Chinese cities. The CR values induced by the dermal contact exposure were two orders of magnitude higher than that by the inhalation exposure. Children and adults were the most sensitive age groups with the dermal contact exposure and the inhalation exposure to atmospheric PAHs, respectively. For the total CR values, 99.7% of its values were higher than the reference level of 10^-6. No significant difference of the total CR values was observed between northern Chinese and southern Chinese cities for children and adults. In order to quantify the uncertainties of CR assessment, Monte Carlo Simulation was applied based on the specific distributions of the exposure factors cited from the Exposure Factors Handbook of Chinese Population. The results indicated that almost 90% probability of the total CR values were higher than 10^-6, indicating potential cancer risk. Sensitive analysis indicated that atmospheric concentration, outdoor exposure fraction, particle amount adhered to skin, and cancer slope factor should be carefully considered in order to increase the accuracy of CR assessment with PAHs in atmosphere.

Profiling and potential cancer risk assessment on children exposed to PAHs in playground dust/soil: a comparative study on poured rubber surfaced and classical soil playgrounds in Seoul

Children can get affected by polycyclic aromatic hydrocarbons (PAHs) while they interact with play area soil/rubber surfacing and exposed to PAHs by dermal contact, inhalation and hand-to-mouth activity. A comparative study has been conducted on PAHs profiling and probable cancer risk of children from PAHs present in uncovered playground surface soil and poured rubber surfaced playground dust. Surface soil and dust samples have been collected from 14 different children parks around the Korea University campus, Seoul, Republic of Korea. Concentrations of 16 PAHs in the soils/dust were found to be in a range of 2.82-57.93 μg g^-1. Profiling of the PAHs from the playground soils/dust reveals 3-ring PAHs are dominating with 79.9% of total PAHs content, on an average. The diagnostic ratio analysis confirms that vehicular exhaust and fossil fuel burning are likely the main sources of high molecular weight carcinogenic PAHs, whereas low molecular weight PAHs have pyrogenic origin. The probabilistic health risk assessment using Monte Carlo simulations for the estimation of the 95% cancer risk exposed to the PAHs from the surfaced playgrounds shows a little higher value than the USEPA safety standard (1.3 × 10^-5). Sensitivity analysis revealed exposure duration and relative skin adherence factor for soil as the most influential parameters of the assessment. Noticeably, cancer risk is approximately 10 times higher in poured rubber surfaced playgrounds than in uncovered soil playgrounds.

Risk-based principles and incompleteness theorems for linear dose-response extrapolation for carcinogenic chemicals

To conduct better health risk assessments, this study introduced two risk-based principles and a series of line-lognormal-intersection theorems that helped derive the safe ranges of the cancer slope factors (CSFs) for 708 carcinogenic chemicals. The extrapolated linear dose-response relationships presented in this study can ensure safety with respect to both static and dose-based instantaneous risks compared to the lognormal dose-response model. The theorems proved that the maximum static and dose-based hazard risk ratios of a lognormal curve and a linear model are independent of a chemical's toxicity (the effect dose that corresponds to a 50% response, or ED₅₀), where the selected linear extrapolation (m value) and the individual variability (σ) of the responses to carcinogenic chemicals are two determining factors. The theorems also indicated that individual variability determines the range of m if the acceptable risk ratios were regulated. When σ was 1.36 (i.e., the 50th percentile of the individual variability's lognormal distribution), the safe range of m was derived as [11.22, 21.46] (i.e., from ED_11.22 to ED_21.46); if the 95th percentile of the σ lognormal distribution was used, the safe range of m was [1.13, 4.57] (i.e., from ED_1.13 to ED_4.57). This study also showed that for a relatively homogenous population (i.e., σ is relatively small) that has similar characteristics, the linear dose-response extrapolation method might not be completely effective due to the shape shift of the lognormal curve that draws the static risk of the extrapolated linear model away from the lognormal model.

Precise exposure assessment revealed the cancer risk and disease burden caused by trihalomethanes and haloacetic acids in Shanghai indoor swimming pool water

Swimming pool disinfection byproducts (DBPs) are becoming increasingly common worldwide. Precise exposure and health risk assessment for DBPs in swimming pool water with optimized parameters for local and specific population is more urgently needed. This study aimed to determine the levels of trihalomethanes (THMs) and haloacetic acids (HAAs) in 16 public indoor swimming pools in Shanghai, China. Swimming habits were also investigated to obtain more accurate exposure assessment parameters. Precise exposure assessment through multiple pathways, resulting cancer risk, and disability-adjusted life years (DALYs) were assessed. Results indicated that the highest total level of THMs and HAAs occurred in autumn. The surveyed swimmers 9-17 years of age had higher average daily dose (ADD) of DBPs than swimmers ≥18 years of age. The total lifetime cancer risk (LCR) attributable to THMs and HAAs exceeded 10^-6, which represents a negligible risk level (NRL). The cancer risk from inhalation exposure predominantly by THMs contributed more than 99% of the total risk. Annual disease burden was 19.0 person-years attributed to exposure of DBPs in swimming pool water in Shanghai. This study provides a paradigm and strategic reference of precise exposure assessments, risk assessments, and disease burden estimation of hazards in swimming pool water for other regions.

Nonlinear dose-time-response functions and health-protective exposure limits for inflammation-mediated diseases

Why have occupational safety regulations in the United States not been more successful in protecting worker health from mesothelioma risks, while apparently succeeding relatively well in reducing silicosis risks? This paper briefly discusses biological bases for thresholds and nonlinearities in exposure-response functions for respirable crystalline silica (RCS) and asbestos, based on modeling a chronic inflammation mode of action (mediated by activation of the NLRP3 inflammasome, for both RCS and asbestos). It applies previously published physiologically based pharmacokinetic (PBPK) models to perform computational experiments illuminating how different time courses of exposure with the same time-weighted average (TWA) concentration affect internal doses in target tissues (lung for RCS and mesothelium for asbestos). Key conclusions are that (i) For RCS, but not asbestos, limiting average (TWA) exposure concentrations also tightly constrains internal doses and ability to trigger chronic inflammation and resulting increases in disease risks (ii) For asbestos, excursions (i.e., spikes in concentrations); and especially the times between them are crucial drivers of internal doses and time until chronic inflammation; and hence (iii) These dynamic aspects of exposure, which are not addressed by current occupational safety regulations, should be constrained to better protect worker health. Adjusting permissible average exposure concentration limits (PELs) and daily excursion limits (ELs) is predicted to have little impact on reducing mesothelioma risks, but increasing the number of days between successive excursions is predicted to be relatively effective in reducing worker risks, even if it has little or no impact on TWA average concentrations.

A cross-sector call to improve carcinogenicity risk assessment through use of genomic methodologies

Robust genomic approaches are now available to realize improvements in efficiencies and translational relevance of cancer risk assessments for drugs and chemicals. Mechanistic and pathway data generated via genomics provide opportunities to advance beyond historical reliance on apical endpoints of uncertain human relevance. Published research and regulatory evaluations include many examples for which genomic data have been applied to address cancer risk assessment as a health protection endpoint. The alignment of mature, robust, reproducible, and affordable technologies with increasing demands for reduced animal testing sets the stage for this important transition. We present our shared vision for change from leading scientists from academic, government, nonprofit, and industrial sectors and chemical and pharmaceutical safety applications. This call to action builds upon a 2017 workshop on "Advances and Roadblocks for Use of Genomics in Cancer Risk Assessment." The authors propose a path for implementation of innovative cancer risk assessment including incorporating genomic signatures to assess mechanistic relevance of carcinogenicity and enhanced use of genomics in benchmark dose and point of departure evaluations. Novel opportunities for the chemical and pharmaceutical sectors to combine expertise, resources, and objectives to achieve a common goal of improved human health protection are identified.

In vitro gastrointestinal mobilization and oral bioaccessibility of PAHs in contrasting soils and associated cancer risks: Focus on PAH nonextractable residues

The gastrointestinal mobilization and oral bioaccessibility of polycyclic aromatic hydrocarbon (PAH) nonextractable residues (NERs) from soils remain unexplored, including associated incremental lifetime cancer risks. This study investigated the gastrointestinal mobilization of PAHs and their NERs from contrasting soils, using a physiologically based extraction test that incorporates a silicone-rod (Si-Org-PBET) as PAH sink. Associated cancer risks following soil ingestion were also evaluated. Four solvent-spiked and aged soils, and four long-term contaminated manufactured gas plant (MGP) soils, were utilized. Total-extractable PAH concentrations were measured after exhaustive solvent extractions of soils. We evaluated the PAH sorption efficiency of the silicone rods and associated sorption kinetics, using PAH-spiked silica sand as the contaminated matrix. We then assessed gastrointestinal mobilization of benzo[a]pyrene and benzo[a]pyrene NERs from the solvent-spiked soils, and mobilization of six PAHs and their NERs from the MGP soils. PAH oral bioaccessibility was determined. The incremental lifetime cancer risks (ILCRs), using Si-Org-PBET- and total-extractable PAH concentrations from the MGP soils, were calculated. Sorption kinetics modelling showed that 95% of mobilized PAHs sorbed to the silicone rods within 2-19 h, depending on PAH physico-chemical properties. Total-extractable and Si-Org-PBET extractable PAH concentrations exceeded health investigation levels (3 mg/kg based on benzo[a]pyrene toxic equivalent quotients) in soils. PAH oral bioaccessibility approached 100% for solvent-spiked soils, but only 24-36% for the MGP soils. Associated ILCRs exceeded target levels (10^-5) for one MGP soil, particularly for 2-3 year olds, despite oral bioaccessibility considerations. In contrast, mobilized PAH NERs did not exceed health investigation and ILCR levels, as the NERs were highly sequestered, especially in the MGP soils. PAH nonextractable residues in long-term contaminated soils are unlikely to be mobilized in concentrations that pose cancer risks to humans following soil ingestion, and do not need to be considered in risk assessments.

Inhalation bioaccessibility of polycyclic aromatic hydrocarbons in heavy PM2.5 pollution days: Implications for public health risk assessment in northern China

Airborne (PM_2.5) with aerodynamic diameter ≤ 2.5 μm was collected from 4 types of cities in northeast China during the heating period. The objectives of this study were to assess the concentrations variation of PM_2.5-bound 12 carcinogenic polycyclic aromatic hydrocarbons (PAH₁₂), to study the influence of simulated lung fluids on bioaccessibility of PAH₁₂ and to estimate the variation of lifetime excess cancer risk to the residents, artificial lysosomal fluid (ALF) and Gamble's solution were used. The number of lifetime excess cancer cases (determined by California Environmental Protection Agency method) as a result of PAH₁₂ exposure (total concentration) was 4.00-430 (provincial central cities), 24.0-261 (energy-mining cities), 17.0-109 (forested city), and 20.0-69.0 (agricultural city) per million people, which relatively corresponded to a 92.2% and 96.2%, 92.6% and 97.3%, 92.2% and 94.2%, and 86.5% and 92.6% decrease after considering bioaccessibility following 24-h of Gamble's solution and ALF extraction, respectively. Phenanthrene (Phe), dibenz[a,h]anthracene (DahA) and benzo[a]pyrene (BaP) were found to be the most bioaccessible types of PAH₁₂ after the Gamble's solution and ALF extraction in the PM_2.5 samples from all the studied cities. Based on the point-estimate approach, short-term predictions of pulmonary toxicity caused by potential inhalation of airborne PM into the pulmonary system might be overestimated if bioaccessibility of PM_2.5-bound PAH₁₂ is not fully evaluated.

Exploring Asian Indian views about cancer and participation in cancer research: an evaluation of a culturally tailored educational intervention

Asian Indians (AIs) are a growing population in the United States (US) with increased cancer incidence and mortality. However, screening rates among this population are low, and the population has been underrepresented in clinical research. This pilot study aims to address gaps in the literature in order to understand if a culturally tailored educational intervention will improve knowledge, risk perceptions, and awareness of cancer risk assessments among AIs. We delivered an educational intervention comprised of culturally tailored case studies describing risk factors for developing cancer in both males and females. We assessed knowledge gaps about cancer risk and genetic testing, cancer risk perceptions, and willingness to participate in medical research studies, pre- and post-intervention. Among 23 participants, knowledge of genetic testing use and screening recommendations significantly improved post-intervention, with increased willingness to discuss cancer with family members, participate in medical research, and undergo genetic testing for cancer risk assessment. However, findings at the 1-month follow-up time did not show significant changes, except for one knowledge item. Culturally tailored educational interventions, delivered in a community setting, can influence knowledge and risk perceptions about cancer risk and genetics among AIs. Our findings lay the groundwork to continue educational efforts in the area of cancer risk and genetic testing in the AI population, a growing population that has been understudied in the US.

Muller's Nobel Prize data: Getting the dose wrong and its significance

This paper evaluates the significant historical paper of Muller and Mott-Smith (1930), which successfully disputed the proposal of Olson and Lewis (1928) that background ionizing radiation is the driving mechanism of evolution. While the present analysis supports the general conclusion that background radiation is not a quantifiable factor affecting evolution, the paper reveals methodological errors and questionable conclusions in the Muller and Mott-Smith (1930) paper, which may have impacted the acceptance of the linear non-threshold (LNT) model. Most importantly, this paper reveals that in Muller's (1927) Nobel Prize research he used a treatment exposure (total dose) that was 95 million-fold greater than the average background exposure, a value far greater than the 200,000 fold reported by Muller and Mott-Smith (1930). Such a large exposure rate discrepancy may be historically important as it may have led to the over-reliance on Muller's research in support of the derivation and use of the LNT single-hit model.