Probabilistic Reference and 10% Effect Concentrations for Characterizing Inhalation Non-cancer and Developmental/Reproductive Effects for 2,160 Substances

Chemicals assessment and management frameworks rely on regulatory toxicity values, which are based on points of departure (POD) identified following rigorous dose-response assessments. Yet, regulatory PODs and toxicity values for inhalation exposure (i.e., reference concentrations [RfCs]) are available for only ∼200 chemicals. To address this gap, we applied a workflow to determine surrogate inhalation route PODs and corresponding toxicity values, where regulatory assessments are lacking. We curated and selected inhalation in vivo data from the U.S. EPA's ToxValDB and adjusted reported effect values to chronic human equivalent benchmark concentrations (BMCh) following the WHO/IPCS framework. Using ToxValDB chemicals with existing PODs associated with regulatory toxicity values, we found that the 25th %-ile of a chemical's BMCh distribution (POD p 25 BMC h ) could serve as a suitable surrogate for regulatory PODs (Q2 ≥ 0.76, RSE ≤ 0.82 log10 units). We applied this approach to derive POD p 25 BMC h for 2,095 substances with general non-cancer toxicity effects and 638 substances with reproductive/developmental toxicity effects, yielding a total coverage of 2,160 substances. From these POD p 25 BMC h , we derived probabilistic RfCs and human population effect concentrations. With this work, we have expanded the number of chemicals with toxicity values available, thereby enabling a much broader coverage for inhalation risk and impact assessment.

Sub-acute Inhalation Exposure to Aluminum Oxide Nanoparticles and its Effects on Wistar Rats as Opposed to the Micro-sized Chemical Analog

INTRODUCTION

Aluminum oxide nanoparticles (Al2O3 NPs) are widely used in various productions. Simultaneously, many research works report the toxic effects of this nanomaterial. Given that, there is a growing risk of negative effects produced by Al2O3 NPs on public health.

AIMS

This study aims to investigate the toxic effects of Al2O3 NPs as opposed to the micro-sized chemical analogue under sub-acute inhalation exposure.

MATERIALS AND METHODS

We identified the physical properties of Al2O3 NPs as opposed to the micro- sized chemical analogue, including size, specific surface area, and total pore volume. Inhalation exposure to Al2O3 NPs was simulated on Wistar rats in a chamber for whole-body. The animals were exposed for 4 hours each day for 28 days. NPs and MPs concentrations in the chamber were kept at ~ 1/4000 from LC50. Rats' behavior was examined prior to the exposure period and after it; after the last daily exposure, we examined biochemical and hematological blood indicators, NPs and MPs bioaccumulation, and pathomorphological changes in organ tissues.

RESULTS

The tested Al2O3 sample is a nanomaterial according to its analyzed physical properties. Rats' behavior changed more apparently under exposure to NPs compared to MPs. Aluminum levels, which were 1.62-55.20 times higher than the control, were identified in the lungs, liver, brain, and blood under exposure to NPs. These levels were also 1.55-7.65 times higher than the control under exposure to MPs. Biochemical indicators of rats' blood also changed under exposure to NPs against the control. We identified more active ALT, AST, ALP, and LDH, elevated levels of GABA, MDA, and conjugated bilirubin, and a lower level of Glu. As opposed to exposure to MPs, ALT, AST, and ALP were more active; GABA and MDA levels were higher; Glu level was lower. Under exposure to NPs, the number of platelets grew, whereas no similar effect occurred under exposure to MPs. We established pathomorphological changes in tissues of the lungs, brain, heart, and liver under exposure to Al2O3 NPs; similar changes occurred only in the lungs under exposure to MPs. Exposure to NPs induced changes in tissue structures in a wider range of various organs, and these changes were more apparent than under exposure to MPs.

CONCLUSION

Greater toxicity of Al2O3 NPs as opposed to MPs is evidenced by a wider range of organs where their bioaccumulation occurs, more apparent pathomorphological and pathological functional changes. Established peculiarities of toxic effects produced by the analyzed nanomaterial should be considered when developing hygienic recommendations aimed at preventing and mitigating adverse impacts of Al2O3 NPs on human health under inhalation exposure.

Inhalation exposure to toxic heavy metals in nail salon technicians and health risk assessment using Monte Carlo simulation

OBJECTIVE

Nail salons offer a developing and diverse occupation for many women, especially the new generation. Due to the increasing apprehension surrounding heavy metals in dust caused by filing nails containing dried nail polish, the present study was designed aimed to health risk assessment of heavy metals in breathing zone of nail salon technicians (NSTs).

METHODS

This is a cross-sectional study that was conducted in NSTs. The concentration of Cadmium (Cd), Lead (Pb), Nickel (Ni), Chromium (Cr) and Manganese (Mn)in breathing zone of 20 NSTs was determined using ICP-OES.

RESULTS

The metal concentrations were in the following order: Mn > Pb > Ni > Cr > Cd with corresponding arithmetic mean values of0.008, 0.0023, 0.0021, 0.001 and 0.0006 mg m-3, respectively, which are exceeded the recommended levels stated in the indoor air guidelines. The average lifetime carcinogenic risk (LCR) for Cr, Cd, Ni and Pb was calculated 0.0084, 0.00054, 0.00026 and 1.44 E - 05, respectively. The LCR values of all metals (except Pb) exceeded the acceptable level set by the USEPA. The mean of Hazard quotients (HQ) for Mn, Cd, Cr, Ni and Pb were calculated to be23.7, 4.74, 2.19, 0.51 and 0.0.24, respectively. The sensitivity analysis showed that, the exposure frequency (EF) for Cr and Ni had the strong effects on generation of both LCR and HQ. Furthermore, the concentrations of Mn, Cd and Pb had strong impacts on the HQ generation and the concentration of Cd and Pb had main effects on LCR generation.

CONCLUSION

To effectively reduce pollutant concentration, it is recommended to install a ventilation system near nail salon work tables and conduct continuous monitoring and quality control of nail products.

Potent lung tumor promotion by inhaled MWCNT

In the lung, carcinogenesis is a multi-stage process that includes initiation by a genotoxic agent, promotion that expands the population of cells with damaged DNA to form a tumor, and progression from benign to malignant neoplasms. We have previously shown that Mitsui-7, a long and rigid multi-walled carbon nanotube (MWCNT), promotes pulmonary carcinogenesis in a mouse model. To investigate the potential exposure threshold and dose-response for tumor promotion by this MWCNT, 3-methylcholanthrene (MC) initiated (10 μg/g, i.p., once) or vehicle (corn oil) treated B6C3F1 mice were exposed by inhalation to filtered air or MWCNT (5 mg/m3) for 5 h/day for 0, 2, 5, or 10 days and were followed for 17 months post-exposure for evidence of lung tumors. Pulmonary neoplasia incidence in MC-initiated mice significantly increased with each MWCNT exposure duration. Exposure to either MC or MWCNT alone did not affect pulmonary neoplasia incidence compared with vehicle controls. Lung tumor multiplicity in MC-initiated mice also significantly increased with each MWCNT exposure duration. Thus, a significantly higher lung tumor multiplicity was observed after a 10-day MWCNT exposure than following a 2-day exposure. Both bronchioloalveolar adenoma and bronchioloalveolar adenocarcinoma multiplicity in MC-initiated mice were significantly increased following 5- and 10-day MWCNT exposure, while a 2-day MWCNT exposure in MC-initiated mice significantly increased the multiplicity of adenomas but not adenocarcinomas. In this study, even the lowest MWCNT exposure promoted lung tumors in MC-initiated mice. Our findings indicate that exposure to this MWCNT strongly promotes pulmonary carcinogenesis.

Pesticides in Greenhouse Airborne Particulate Matter: Occurrence, Distribution, Transformation Products, and Potential Human Exposure Risks

Pesticides are frequently sprayed in greenhouses to ensure crop yields, where airborne particulate matter (PM) may serve as a carrier in depositing and transporting pesticides. However, little is known about the occurrence and fate of PM-borne pesticides in greenhouses. Herein, we examined the distribution, dissipation, and transformation of six commonly used pesticides (imidacloprid, acetamiprid, prochloraz, triadimefon, hexaconazole, and tebuconazole) in greenhouse PM (PM1, PM2.5, and PM10) after application as well as the associated human exposure risks via inhalation. During 35 days of experiment, the six pesticides were detected in all PM samples, and exhibited size- and time-dependent distribution characteristics, with the majority of them (>64.6%) accumulated in PM1. About 1.0-16.4% of initially measured pesticides in PM remained after 35 days, and a total of 12 major transformation products were elucidated, with six of them newly identified. The inhalation of PM could be an important route of human exposure to pesticides in the greenhouse, where the estimated average daily human inhalation dose (ADDinh) of the six individual pesticides was 2.1-1.2 × 104 pg/kg day-1 after application (1-35 days). Our findings highlight the occurrence of pesticides/transformation products in greenhouse PM, and their potential inhalation risks should be further concerned.

The importance of variations in in vitro dosimetry to support risk assessment of inhaled toxicants

In vitro methods provide a key opportunity to model human-relevant exposure scenarios for hazard identification of inhaled toxicants. Compared to in vivo tests, in vitro methods have the advantage of assessing effects of inhaled toxicants caused by differences in dosimetry, e.g., variations in con­centration (exposure intensity), exposure duration, and exposure frequency, in an easier way. Variations in dosimetry can be used to obtain information on adverse effects in human-relevant exposure scenarios that can be used for risk assessment. Based on the published literature of exposure approaches using air-liquid interface models of the respiratory tract, supplemented with additional experimental data from the EU H2020 project “PATROLS” and research funded by the Dutch Ministry of Agriculture, Nature and Food Quality, the advantages and disadvantages of dif­ferent exposure methods and considerations to design an experimental setup are summarized and discussed. As the cell models used are models for the respiratory epithelium, our focus is on the local effects in the airways. In conclusion, in order to generate data from in vitro methods for risk assessment of inhaled toxicants it is recommended that (1) it is considered what information really is needed for hazard or risk assessment; (2) the exposure system that is most suitable for the chemical to be assessed is chosen; (3) a deposited dose that mimics deposition in the human respiratory tract is used, and (4) the post-exposure sampling methodology should be carefully considered and relevant to the testing strategy used.

Veno-venous extracorporeal membrane oxygenation for acute respiratory distress syndrome caused by nitrogen dioxide inhalation: A case report

Background

Nitrogen dioxide (NO2) is known to cause lung injury, but there is no established treatment for acute respiratory distress syndrome (ARDS) caused by NO2 inhalation.

Case Presentation

A 35-year-old man was accidentally exposed to NO2 fumes and presented to the emergency department. On admission, his oxygen saturation was 87% on ambient air and he was diagnosed with ARDS caused by NO2 inhalation and immediately intubated; however, hypoxemia and hypercapnia were not ameliorated. Hence, veno-venous extracorporeal membrane oxygenation (V-V ECMO) was introduced and the ventilator settings were set for lung-protective ventilation. Methylprednisolone was also administered. After the initiation of these treatments, oxygenation gradually improved. Therefore, ECMO was weaned off on day 11 and he was extubated on day 12.

Conclusion

Lung injury caused by NO2 inhalation can cause ARDS, and lung-protective ventilation with V-V ECMO induction, as well as glucocorticoid administration, may be effective for this condition.

Low-dose inhalation exposure to trichloroethylene induces dopaminergic neurodegeneration in rodents

Trichloroethylene (TCE) is one of the most pervasive environmental contaminants in the world and is associated with Parkinson disease (PD) risk. Experimental models in rodents show that TCE is selectively toxic to dopaminergic neurons at high doses of ingestion, however, TCE is a highly volatile toxicant, and the primary pathway of human exposure is inhalation. As TCE is a highly lipophilic, volatile organic compound (VOC), inhalation exposure results in rapid diffusion throughout the brain, avoiding first-pass hepatic metabolism that necessitated high doses to recapitulate exposure conditions observed in human populations. We hypothesized that inhalation of TCE would induce significantly more potent neurodegeneration than ingestion and better recapitulate environmental conditions of vapor intrusion or off gassing from liquid TCE. To this end, we developed a novel, whole-body passive exposure inhalation chamber in which we exposed 10-month-old male and female Lewis rats to 50 ppm TCE (time weighted average, TWA) or filtered room air (control) over 8 weeks. In addition, we exposed 12-month-old male and female C57Bl/6 mice to 100 ppm TCE (TWA) or control over 12 weeks. Both rats and mice exposed to chronic TCE inhalation showed significant degeneration of nigrostriatal dopaminergic neurons as well as motor and gait impairments. TCE exposure also induced accumulation of pSer129-αSyn in dopaminergic neurons as well as microglial activation within the substantia nigra of rats. Collectively, these data indicate that TCE inhalation causes highly potent dopaminergic neurodegeneration and recapitulates some of the observed neuropathology associated with PD, providing a future platform for insight into the mechanisms and environmental conditions that influence PD risk from TCE exposure.

Pulmonary Toxicity Assessment after a Single Intratracheal Inhalation of Chlorhexidine Aerosol in Mice

Guanidine disinfectants are important chemical agents with a broad spectrum of activity that are effective against most microorganisms. Chlorhexidine, one of the most used guanidine disinfectants, is added to shampoo and mouthwash and applied in medical device sterilization. During the use of chlorhexidine, aerosols with micron particle size may be formed, which may cause inhalation toxicity. To assess the toxicity of inhaled chlorhexidine aerosol, mice underwent the intratracheal instillation of different concentrations of chlorhexidine (0, 0.125%, 0.25%, 0.5%, and 1%) using a MicroSprayer Aerosolizer. The mice were exposed for eight weeks and then sacrificed to obtain lung tissue for subsequent experiments. Histopathology staining revealed damaged lung tissues and increased collagen exudation. At the same time, pulmonary function tests showed that chlorhexidine exposure could cause restrictive ventilatory dysfunction, consistent with pulmonary fibrosis. The results of transcriptome analyses suggest that chlorhexidine may trigger an inflammatory response and promote the activation of pathways related to extracellular matrix deposition. Further, we identified that chlorhexidine exposure might enhance mucus secretion by up-regulating Muc5b and Muc5ac genes, thereby inducing fibrosis-like injury. These findings underscore the need for standardized use of disinfectants and the assessment of their inhalation toxicity.

Repeated Human Exposure to Semivolatile Organic Compounds by Inhalation: Novel Protocol for a Nonrandomized Study

BACKGROUND

Semivolatile organic compounds (SVOCs) comprise several different chemical families used mainly as additives in many everyday products. SVOCs can be released into the air as aerosols and deposit on particulate matter during use by dispersion, evaporation, or abrasion. Phthalates are SVOCs of growing concern due to their endocrine-disrupting effects. Human data on the absorption, distribution, metabolism, and excretion (ADME) of these compounds upon inhalation are almost nonexistent.

OBJECTIVE

The goal of this study is to develop a method for repeated inhalation exposures to SVOCs to characterize their ADME in humans.

METHODS

We will use diethylhexyl phthalate (DEHP), a major indoor air pollutant, as a model SVOC in this novel protocol. The Swiss official Commission on Ethics in Human Research, Canton de Vaud, approved the study on October 14, 2020 (project-ID 2020-01095). Participants (n=10) will be repeatedly exposed (2 short daily exposures over 4 days) to isotope-labeled DEHP (DEHP-d4) to distinguish administered exposures from background exposures. DEHP-d4 aerosols will be generated with a small, portable, aerosol-generating device. Participants will inhale DEHP-d4-containing aerosols themselves with this device at home. Air concentrations of the airborne phthalates will be less than or equal to their occupational exposure limit (OEL). DEHP-d4 and its metabolites will be quantified in urine and blood before, during, and after exposure.

RESULTS

Our developed device can generate DEHP-d4 aerosols with diameters of 2.5 μm or smaller and a mean DEHP-d4 mass of 1.4 (SD 0.2) μg per puff (n=6). As of May 2023, we have enrolled 5 participants.

CONCLUSIONS

The portable device can be used to generate phthalate aerosols for repeated exposure in human studies.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/51020.

Rapid Environmental Monitoring, Capture, and Destruction Activities of SARS-CoV-2 and Bacterial Pathogens During the COVID-19 Health Emergency

BACKGROUND

The SARS-CoV-2 pandemic is a health emergency for occupational healthcare workers at COVID-19 hospital wards in Italy. The objective of the study was to investigate the bioreactor's effectivity in monitoring and improving air quality via detection, capture, and destruction of the SARS-CoV-2 virus and bacterial pathogens, reducing the risk of transmission among healthcare workers.

METHODS

Bioreactors are a demonstrated effective biomonitoring system. We implemented a methodological approach wherein they were placed at various hospitals treating COVID-19 patients in Italy. The detection of the SARS-CoV-2 virus was achieved through rapid biomonitoring testing of the solutes from the AIRcel bioreactors via SARS-CoV-2 rapid test antigen and consecutive reverse transcription-polymerase chain reaction (RT-PCR) analysis with the multiplex platform (XABT) and the real-time PCR rotor-gene.

RESULTS

The marked presence of the SARS-CoV-2 virus was found in multiple water samples via the detection of ORF1ab + N and/or E gene involved in gene expression and cellular signaling of the SARS-CoV-2 virus. The AIRcel bioreactors were able to neutralize the virus and bacterial pathogens effectively as traces of the viruses and bacteria were no longer found in multiple solute samples after an overnight period.

CONCLUSIONS

Transmission of COVID-19 via bioaerosols, transmitted by infected patients, remains a viable threat for health workers. AIRcel bioreactors allow for rapid biomonitoring testing for early virus detection within the environment, reducing the risk of exponential contagion exposure and maintaining good air quality without endangering health workers. This same protocol can also be extended to public spaces as a bio-monitoring hotspot tool for early detection.

Microplastics in the Bronchoalveolar Lavage Fluid of Chinese Children: Associations with Age, City Development, and Disease Features

This study characterized the occurrence patterns of microplastics (MPs) in the bronchoalveolar lavage fluid (BALF) of children with pulmonary diseases. MPs were detected in 89.6% of BALF samples with an average of 4.31 ± 2.77 items/10 mL, supporting the hypothesis that inhalation is a significant pathway of airborne MP exposure to pediatric lungs. Inhaled MPs were predominantly composed of 10 polymer types [e.g., polypropylene (41.9%), polyethylene (19.4%), and polyester (13.6%)], with the majority being smaller than 20 μm. MP levels in BALF exhibited a negative correlation with children's age, probably owing to the preferential crawling and tumbling actions in indoor environments and underdeveloped immune systems of young children. Participants living in urban areas suffered from higher pulmonary MP exposure, likely due to higher environmental levels, compared with suburban/rural residents (P < 0.05). Although no significant differences were found between MP levels in pediatric lungs with community-acquired pneumonia (CAP) and asthma (P > 0.05), the severe CAP group displayed significantly higher MP contamination than the nonsevere group (P < 0.05), indicating that some yet undiscovered relationship(s) between inhaled MPs and pediatric pulmonary diseases may exist.

Can oral toxicity data for PFAS inform on toxicity via inhalation?

Per- and poly-fluoroalkyl substances (PFAS) are ubiquitous in the environment and are detected in wildlife and humans. With respect to human exposure, studies have shown that ingestion is the primary route of exposure; however, in certain settings, exposure via inhalation could also be a significant source of exposure. While many studies examined toxicity of PFAS via ingestion, limited information is available for PFAS toxicity via the inhalation route, translating into a lack of exposure guidelines. Consequently, this article examined whether route-to-route extrapolation to derive guidelines for inhalation exposure is appropriate for PFAS. Perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) were used as exemplary PFAS given the abundance of toxicity data for these two compounds. Our evaluation determined that available toxicity and toxicokinetic data support route-to-route extrapolation for PFAS in order to derive inhalation-based standards. Results from this analysis suggest that an air concentration of 7.0 × 10-5  mg/m3 (or 0.07 μg/m3 ) would be an appropriate RfC for PFOA and PFOS assuming the 2016 EPA RfD of 0.00002 mg/kg-day, whereas use of the interim RfDs proposed in 2022 of 1.5 × 10-9 and 7.9 × 10-9  mg/kg would yield much lower RfCs of 5.25 × 10-9 and 2.77 × 10-8  mg/m3 (or 5.25 × 10-6 and 2.77 × 10-5 μg/m3 ) for PFOA and PFOS, respectively.

Incorporating Bioaccessibility into Inhalation Exposure Assessment of Emamectin Benzoate from Field Spraying

The inhalation exposure of pesticide applicators and residents who live close to pesticide-treated fields is a worldwide concern in public health. Quantitative assessment of exposure to pesticide inhalation health risk highlights the need to accurately assess the bioaccessibility rather than the total content in ambient air. Herein, we developed an in vitro method to estimate the inhalation bioaccessibility of emamectin benzoate and validated its applicability using a rat plasma pharmacokinetic bioassay. Emamectin benzoate was extracted using the Gamble solution, with an optimized solid-to-liquid ratio (1/250), extraction time (24 h), and agitation (200 rpm), which obtained in vitro inhalation bioaccessibility consistent with its inhalation bioavailability in vivo (32.33%). The margin of exposure (MOE) was used to assess inhalation exposure risk. The inhalation unit exposures to emamectin benzoate of applicators and residents were 11.05-28.04 and 0.02-0.04 ng/m³, respectively, varying markedly according to the methods of application, e.g., formulations and nozzles. The inhalation risk assessment using present application methods appeared to be acceptable; however, the MOE of emamectin benzoate might be overestimated by 32% without considering inhalation bioaccessibility. Collectively, our findings contribute insights into the assessment of pesticide inhalation exposure based on bioaccessibility and provide guidance for the safe application of pesticides.

Contributions of particulate and gas phases of simulated burn pit smoke exposures to impairment of respiratory function

OBJECTIVE

Inhalation of smoke from the burning of waste materials on military bases is associated with increased incidences of cardiopulmonary diseases. This study examined the respiratory and inflammatory effects of acute inhalation exposures in mice to smoke generated by military burn pit-related materials including plywood (PW), cardboard (CB), mixed plastics (PL), and a mixture of these three materials (MX) under smoldering (0.84 MCE) and flaming (0.97 MCE) burn conditions.

METHODS

Mice were exposed nose-only for one hour on two consecutive days to whole or filtered smoke or clean air alone. Smoldering combustion emissions had greater concentrations of PM (∼40 mg/m3) and VOCs (∼5-12 ppmv) than flaming emissions (∼4 mg/m3 and ∼1-2 ppmv, respectively); filtered emissions had equivalent levels of VOCs with negligible PM. Breathing parameters were assessed during exposure by head-out plethysmography.

RESULTS

All four smoldering burn pit emission types reduced breathing frequency (F) and minute volumes (MV) compared with baseline exposures to clean air, and HEPA filtration significantly reduced the effects of all smoldering materials except CB. Flaming emissions had significantly less suppression of F and MV compared with smoldering conditions. No acute effects on lung inflammatory cells, cytokines, lung injury markers, or hematology parameters were noted in smoke-exposed mice compared with air controls, likely due to reduced respiration and upper respiratory scrubbing to reduce the total deposited PM dose in this short-term exposure.

CONCLUSION

Our data suggest that material and combustion type influences respiratory responses to burn pit combustion emissions. Furthermore, PM filtration provides significant protective effects only for certain material types.

Inhalation bioaccessibility of inhaled triazole fungicides and health risk assessment during spraying

BACKGROUND

Ambient air pollution caused by pesticide drift has received great attention. To accurately evaluate the health risk of inhaled pesticides, bioaccessibility should be considered. However, methods to reliably assess pesticide residues remain limited, hindering the precise estimation of exposure assessment. We aimed to optimize an in vitro method for the inhalation bioaccessibility (IBA) measurement of triazole fungicides and to incorporate this into inhalation exposure assessment during pesticide spraying.

RESULTS

The IBA of triazole fungicides increased logarithmically with extraction duration, plateauing after 6 h. The frequency of agitation displayed a similar pattern, whereas the ratio of solid to liquid between 1/1500 and 1/250 was considerably negatively associated. The predicted values (35.9-53.5%) for IBA based on optimized methodological parameters determined using a response surface methodology showed an acceptable deviation from experimental values (30.7-50.8%), suggesting feasibility for in vitro IBA measurement. Incorporating IBA into calculations of inhalation exposure amount (IE) yielded a value of 8.5 × 10^-7 -2.1 × 10^-5  mg kg^-1  day^-1 , a 50-68% reduction compared to IE based on total amount. Additionally, the safety exposure threshold was determined for triazole fungicides using benchmark dose modelling of data from lung A549 cell proliferation toxicity assays, and in this context, margin of exposure (MOE) values were calculated to be within an acceptable level.

CONCLUSION

This in vitro method supplements bioaccessibility evaluation based on pesticide inhalation exposure, along with the risk to human health. © 2023 Society of Chemical Industry.

Limited Health Risks in Performing Drug Reconstitution and Handling Tasks in Pharmacies-Results of an Occupational Risk Assessment Study

OBJECTIVE

Some drugs need processing before they can be administered or dispensed. We measured airborne exposure of pharmacy staff to small particles when performing these tasks.

METHODS

Reconstitution of powdered drugs in vials; crushing, splitting, and counting of tablets; and opening of capsules, using different ventilation strategies, were investigated in five pharmacies after in a worst-case approach. Airborne particulate matter was determined for a range of particles sizes.

RESULTS

Mean particle concentrations ranged from not detectable to 1.03 μg/m 3 (<1 μm) and 589.7 μg/m 3 (<10 μm). Dust exhaust made tasks safer. Most hazardous was pouring out tablets from a bulk supply, and least hazardous was reconstitution of a powder for injection.

CONCLUSIONS

Occupational exposure during routine handling of drugs can occur, but the risks vary greatly with the nature and duration of the tasks.

Analysis and risk assessment of vinyl chloride emitted from aerosol products

The objectives of this study were to develop a novel analytical method for quantifying vinyl chloride (VC) emitted from aerosol products, to provide analytical data on VC in aerosol products, and to evaluate consumer VC exposure by aerosol products. Our quantitative method involves absorbing VC into dimethyl sulfoxide and analyzing it using headspace gas chromatography/mass spectrometry. The correlation coefficients of the VC calibration curves were ≥ 0.9994 in the range of 0.16-80 µg/mL VC standard gases, which were prepared under either nitrogen or emission gases containing dimethyl ether or liquid petroleum gas. VC concentrations in these emission gases were calculated using a VC calibration curve from standard gases prepared under nitrogen; they were within ± 10% of the actual concentrations. We analyzed 39 household aerosol products; VC concentrations of 0.095, 0.098, and 0.28 μg/L were detected in three polyvinyl chloride spray paints. Consumer VC inhalation exposure level was estimated through an exposure scenario, and the hazard quotient was confirmed to be very low when comparing the exposure level with a cancer risk level of 10^-5 for inhaled VC. These results suggest that the human health risk from VC in spray paint was low.

Evaluation of Workplace Exposures to Volatile Chemicals During COVID-19 Building Disinfection Activities with Proton Transfer Reaction Mass Spectrometry

We conducted an experimental case study to demonstrate the application of proton transfer reaction time-of-flight mass spectrometry (PTR-TOF-MS) for mobile breathing zone (BZ) monitoring of volatile chemical exposures in workplace environments during COVID-19 disinfection activities. The experiments were conducted in an architectural engineering laboratory-the Purdue zero Energy Design Guidance for Engineers (zEDGE) Tiny House, which served as a simulated workplace environment. Controlled disinfection activities were carried out on impermeable high-touch indoor surfaces, including the entry door, kitchen countertop, toilet bowl, bathroom sink, and shower. Worker inhalation exposure to volatile organic compounds (VOCs) was evaluated by attaching the PTR-TOF-MS sampling line to the researcher's BZ while the disinfection activity was carried out throughout the entire building. The results demonstrate that significant spatiotemporal variations in VOC concentrations can occur in the worker's BZ during multi-surface disinfection events. Application of high-resolution monitoring techniques, such as PTR-TOF-MS, are needed to advance characterization of worker exposures towards the development of appropriate mitigation strategies for volatile disinfectant chemicals.

Exposure to Volatile Organic Compounds in Paint Production Plants: Levels and Potential Human Health Risks

A wide range of volatile organic solvents, including aliphatic and aromatic hydrocarbons, alcohols, and ketones, are used in the production of paints, and they comprise more than 30% of the ingredients of paints. The present study was designed to evaluate the occupational exposure to 15 volatile organic compounds (VOCs, including benzene, toluene, ethylbenzene, xylene, styrene, n-hexane, n-heptane, n-nonane, trichloroethylene, tetrachloroethylene, n-butyl acetate, n-octane, n-decane, dichlorofluoromethane, and acetone) in Iranian paint production factories and subsequently, the associated health risks. The samples were collected from the respiratory zone of workers using the NIOSH 1501 method, and their qualitative and quantitative characterization was performed using gas chromatography-mass spectrometry and gas chromatography-flame ionization detector, respectively. The individual concentrations of VOCs ranged from 23.76 ± 0.57 µg m^-3 (acetone) to 92489.91 ± 0.65 µg m^-3 (m,p-xylene). The predominant compounds were m,p-xylene (up to 92489.91 ± 0.65 µg m^-3), ethylbenzene (up to 91188.95 ± 0.34 µg m^-3), and toluene (up to 46088.84 ± 0.14 µg m^-3). The non-cancer risks of benzene, n-nonane, trichloroethylene, tetrachloroethylene, xylene, and ethylbenzene surpassed the reference value in most of the sectors. In addition, total lifetime risks of cancer were in the range of 1.8 × 10^-5-3.85 × 10^-3, suggesting that there was a risk of carcinogenesis in all studied sections, mainly due to ethylbenzene and benzene. Considering their high exposure concentrations and their associated non-carcinogenic and carcinogenic risks, biological monitoring of workers and the use of technical and modern engineering control measures are recommended.

Real-time characterization of chemical threat agent aerosols for improvement of inhalation studies

OBJECTIVES

Deliberate or accidental release of chemical treat agents in the aerosol form can cause an inhalation hazard. Since the relationship between aerosol properties and health hazards is poorly understood, research into the toxicological consequences of exposure to aerosols is needed. The aim of the present study was to improve the characterization of particles for inhalation studies.

METHODS

Several aerosol measurement technologies were compared for their potential to physically and chemically characterize particles in the inhalation size range in real-time. For that purpose, we compared the performance of an aerodynamic particle sizer (APS), a scanning mobility particle sizer (SMPS) and an electrical low-pressure impactor (ELPI) in an experimental set-up in which particles were generated by a Collison nebulizer and subsequently delivered into a nose-only inhalation exposure system.

RESULTS

We found that more than 95% of the number of particles, equating to more than 83% of the mass generated by the 6-jet Collison nebulizer, were below 0.5 µm. To characterize the entire size range, the APS as single detector has only limited value, therefore the addition of supplementary instrumentation such as the SMPS or the ELPI is required. After real-time measurements in the size range of 30 nm to 10 µm, ex-situ chromatographic chemical analysis is essential for quantification of the delivered mass concentration.

CONCLUSIONS

In summary, the present work demonstrates the utility of the ELPI technology, in combination with off-line analysis, for characterizing aerosols with various size, shape, charge, and composition. This makes the aerosol generation and analysis suite described a promising tool for quantitative inhalation exposure studies.

Chronic Inhalation Exposure to Antimony Trioxide Exacerbates the MAPK Signaling in Alveolar Bronchiolar Carcinomas in B6C3F1/N Mice

Antimony trioxide (AT) is used as a flame retardant in fabrics and plastics. Occupational exposure in miners and smelters is mainly through inhalation and dermal contact. Chronic inhalation exposure to AT particulates in B6C3F1/N mice and Wistar Han rats resulted in increased incidences and tumor multiplicities of alveolar/bronchiolar carcinomas (ABCs). In this study, we demonstrated Kras (43%) and Egfr (46%) hotspot mutations in mouse lung tumors (n = 80) and only Egfr (50%) mutations in rat lung tumors (n = 26). Interestingly, there were no differences in the incidences of these mutations in ABCs from rats and mice at exposure concentrations that did and did not exceed the pulmonary overload threshold. There was increased expression of p44/42 mitogen-activated protein kinase (MAPK) (Erk1/2) protein in ABCs harboring mutations in Kras and/or Egfr, confirming the activation of MAPK signaling. Transcriptomic analysis indicated significant alterations in MAPK signaling such as ephrin receptor signaling and signaling by Rho-family GTPases in AT-exposed ABCs. In addition, there was significant overlap between transcriptomic data from mouse ABCs due to AT exposure and human pulmonary adenocarcinoma data. Collectively, these data suggest chronic AT exposure exacerbates MAPK signaling in ABCs and, thus, may be translationally relevant to human lung cancers.

Health Risk Assessment of Inhalation Exposure to Airborne Particle-Bound Nitrated Polycyclic Aromatic Hydrocarbons in Urban and Suburban Areas of South China

Airborne particulates (PM_2.5 and TSP) were collected from outdoor and indoor areas at urban (Haizhu District) and suburban (Huadu District) sites from 2019 to 2020 in Guangzhou. Three nitro-polycyclic aromatic hydrocarbons (nitro-PAHs) in the airborne particulates were identified by a gas chromatograph equipped with a triple-quadrupole mass spectrometer. In the Haizhu District and Huadu District, the nitro-PAH concentrations in PM_2.5 and TSP did not show a significant decrease from winter to summer. From 2019 to 2020, the difference in the average concentration of nitro-PAHs in PM_2.5 and TSP in Guangzhou was relatively low and had no statistical significance. The diagnostic ratios of 2-nitrofluorene (2-NF)/1-nitropyrene (1-NP) in TSP are less than five, while for 2-NF/1-NP in outdoor PM_2.5 in the summer of 2019 and 2020 are more than five, which indicates that nitro-PAHs in the atmospheric PM_2.5 in Guangzhou during summer mainly originated from the secondary formation of atmospheric photochemical reactions between parent PAHs and oxidants (·OH, NO₃, and O₃). 9-Nitroanthracene (9-NT) made the most significant contribution to the total nitro-PAH concentration. The incremental lifetime cancer risks (ILCRs) of nitro-PAHs in PM_2.5 and TSP by inhalation exposure indicated low potential health risks in the urban-suburban of Guangzhou.

Burden of Disease (BoD) Assessment to Estimate Risk Factors Impact in a Real Nanomanufacturing Scenario

An industrial nanocoating process air emissions impact on public health was quantified by using the burden of disease (BoD) concept. The health loss was calculated in Disability Adjusted Life Years (DALYs), which is an absolute metric that enables comparisons of the health impacts of different causes. Here, the health loss was compared with generally accepted risk levels for air pollution. Exposure response functions were not available for Ag nanoform. The health loss for TiO₂ nanoform emissions were 0.0006 DALYs per 100,000 persons per year. Moreover, the exposure risk characterization was performed by comparing the ground level air concentrations with framework values. The exposure levels were ca. 3 and 18 times lower than the derived limit values of 0.1 μg-TiO₂/m³ and 0.01 μg-Ag/m³ for the general population. The accumulations of TiO₂ and Ag nanoforms on the soil top layer were estimated to be up to 85 μg-TiO₂/kg and 1.4 μg-Ag/kg which was considered low as compared to measured elemental TiO₂ and Ag concentrations. This assessment reveals that the spray coating process air emissions are adequately controlled. This study demonstrated how the BoD concept can be applied to quantify health impacts of nanoform outdoor air emissions from an industrial site.

Uncertainty and sensitivity analyses for the reduction factor of sheltering for radiation exposures

Sheltering is one of the countermeasures used to mitigate radiation exposure during nuclear power plant accidents. The effectiveness of sheltering for inhalation exposure is often expressed by the reduction factor, which is defined as the ratio of the indoor to the outdoor cumulative radioactivity concentrations or doses. The indoor concentration is mainly controlled by the air exchange rate, penetration factor, and indoor deposition rate. Meanwhile, the air exchange rate depends on surrounding environmental conditions: the wind speed, leakage area normalised by the floor area of the house, and gross building coverage ratio. In this study, the ranges of the uncertainty of the reduction factors for particles and iodine in reactive gas form were investigated under various environmental conditions, and sensitivity analyses were conducted to understand the parameter with the most influence on the uncertainty of the reduction factor. From the results of the uncertainty analyses, the calculated reduction factor was highly variable depending on the environmental condition and the airtightness of the houses. The median and 95th percentile of the reduction factors for the older houses were 0.5 and 0.9 for particles and 0.07 and 0.4 for iodine in reactive gas form, respectively and these ranges were smaller for newer houses. From the results of the sensitivity analyses, the wind speed was the most influential parameter determining the reduction factor. Additionally, the wind speed was less influential for the reduction factor in newer houses.

Sampling Volatile Organic Compound Emissions from Consumer Products: A Review

Volatile organic compounds (VOCs) are common constituents of many consumer products. Although many VOCs are generally considered harmless at low concentrations, some compound classes represent substances of concern in relation to human (inhalation) exposure and can elicit adverse health effects, especially when concentrations build up, such as in indoor settings. Determining VOC emissions from consumer products, such as toys, utensils or decorative articles, is of utmost importance to enable the assessment of inhalation exposure under real-world scenarios with respect to consumer safety. Due to the diverse sizes and shapes of such products, as well as their differing uses, a one-size-fits-all approach for measuring VOC emissions is not possible, thus, sampling procedures must be chosen carefully to best suit the sample under investigation. This review outlines the different sampling approaches for characterizing VOC emissions from consumer products, including headspace and emission test chamber methods. The advantages and disadvantages of each sampling technique are discussed in relation to their time and cost efficiency, as well as their suitability to realistically assess VOC inhalation exposures.

Occurrence and Risk Assessment of Personal PM2.5-Bound Phthalates Exposure for Adults in Hong Kong

We performed personal PM_2.5 monitoring involving 56 adult residents in Hong Kong. Additionally, paired personal and residential indoor fine particle (PM_2.5) samples were collected from 26 homes and from 3 fixed monitoring locations (i.e., outdoor samples). Six PM_2.5-bound phthalate esters (PAEs)-including dimethyl phthalate (DMP), diethyl phthalate (DEP), di-n-butyl phthalate (DnBP), butyl benzyl phthalate (BBP), di(2-ethylhexyl) phthalate (DEHP), and di-n-octyl phthalate (DnOP)-were measured using a thermal desorption-gas chromatography/mass spectrometer method. Average ∑₆PAEs (i.e., summation of six PAE congeners) concentrations in personal PM_2.5 exposure (699.4 ng/m³) were comparable with those in residential indoors (646.9 ng/m³), and both were slightly lower than the outdoor levels. DEHP was the most abundant PAE congener (80.3%-85.0%) and found at the highest levels in different exposure categories, followed by BBP, DnBP, and DnOP. Strong correlations were observed between DEHP with DnBP (r_s: 0.81-0.90; p < 0.01), BBP (r_s: 0.81-0.90; p < 0.01), and DnOP (r_s: 0.87-0.93; p < 0.01) in each exposure category. However, no apparent intercorrelations were shown for PAE congeners. Higher indoor concentrations and a stronger correlation between DMP and DEP were found compared with outdoor concentrations. Principal component analysis affirmed heterogeneous distribution and notable variations in PAE sources across different exposure categories. The average daily intakes of ∑₆PAEs and DEHP via inhalation were 0.14-0.17 and 0.12-0.16 μg/kg-day for adults in Hong Kong. A time-weighted model was used to estimate PAE exposures incorporating residential indoor and outdoor exposure and time activities. The inhalation cancer risks attributable to measured and estimated personal exposure to DEHP exceeded the U.S. EPA's benchmark (1 × 10^-6). The results provide critical information for mitigation strategies, suggesting that PAEs from both ambient and indoor sources should be considered when exploring the inhalation health risks of PAEs exposure.

Indoor dryness and humidification-induced arsenic inhalation exposure above 4200 m in Ngari, China

Ngari Prefecture, Tibet, China, features its ultrahigh altitude above 4200 m, very little annual precipitation and extremely low relative humidity. Residents who have migrated to Tibet from the plains use indoor humidification to reduce the respiratory discomfort caused by prolonged exposure to dry indoor air. In this study, field investigations and analysis of residential indoor environments and humidification methods in Ngari Prefecture revealed that ninety-eight percent of humidifier consumers in the prefecture used low-cost ultrasonic humidifiers filled with indoor tap water. The results revealed that the arsenic (As) concentration of the tap water was 41.6 μg/L, over four times China's standards for drinking water quality (10 μg/L). The source As concentration in the air humidified by the tap water-filled ultrasonic humidifier is (619.8 ± 59.1) (ng/m³ ·air), while no As was detected in the air humidified by the evaporative humidifier. For ultrasonic humidifier with tap water-filled, the inhalation dose of a healthy adult was 45.4 ng/d. The minute ventilation volume of migrated residents who had been in Ngari for less than two years (12.5 ± 4.3 L/min) was greater than those of the long-term residents (10.0 ± 4.5 L/min), which may exacerbate the short-term inhalation exposure risk for migrated residents. To reduce the health risks associated with As exposure, evaporative humidifiers are recommended for households using domestic water. If ultrasonic humidifiers are used, the tap water must be purified with terminal filters.

Exposure to Airborne Pesticides and Its Residue in Blood Serum of Paddy Farmers in Malaysia

Background: Pesticides manage pests and diseases in agriculture, but they harm the health of agricultural workers. Concentrations of thirteen pesticides were determined in personal air and blood serum of 85 paddy farmers and 85 non-farmers, thereafter associated with health symptoms. Method: Samples were analyzed using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). Results: The median concentration of pesticides in personal air samples ranged from 10.69 to 188.49 ng/m3 for farmers and from 5.79 to 73.66 ng/m3 for non-farmers. The median concentration of pesticides in blood serum was from 58.27 to 210.12 ng/mL for farmers and 47.83 to 62.74 ng/mL for non-farmers. Concentration of eleven pesticides in personal air and twelve pesticides in blood serum were significantly higher in farmers than non-farmers (p < 0.05). All pesticides detected in personal air correlated significantly with concentration in the blood serum of farmers (p < 0.05). Health symptoms reported by farmers were dizziness (49.4%), nausea (47.1%), cough (35.3%), chest pain (30.6%), breathing difficulty (23.5%), sore throat (22.4%), vomiting (18.8%), phlegm (16.5%), and wheezing (15.3%). Concentration of pesticides in personal air, blood serum, and health symptoms were not significantly associated. Conclusion: Occupational exposure to pesticides significantly contaminates blood serum of farmers compared to non-farmers.

Does the Geographic Difference of Soil Properties Matter for Setting Up the Soil Screening Levels in Large Countries Like China?

China issued the unified national soil screening levels (NSSLs) in 2018 to assist the regulation of contaminated sites, but the applicability of NSSLs was not thoroughly evaluated. Datasets from the National Qinghai-Tibet Plateau Scientific Data Center indicated great variability of soil organic matter (0.8-173 g/kg), soil water content (0.05-0.6), soil porosity (0.4-0.6), and soil bulk density (1.11-1.59 kg/m³). We analyzed the effects of soil properties on the derivation of SSLs by using Monte Carlo simulations. The soil factors mainly affected the inhalation exposure pathway of volatile organic compounds (VOCs). They had an effect of more than two orders of magnitude on SSLs for most selected VOCs, particularly with the parameters 0.35 > Henry's law constant > 0.1 and carbon-water distribution coefficient of >100. We compared NSSLs with the recommended SSLs assuming fifth percentile by using Monte Carlo simulations. In general, NSSLs were not sufficient to identify contaminated sites that require additional investigation in the south, central, and northwest regions but were too conservative in screening sites out that required no further action in the east and northeast regions. Our framework and findings may contribute to more scientific and effective soil quality management in other large countries.

Airborne SARS-CoV-2 in hospitals - effects of aerosol-generating procedures, HEPA-filtration units, patient viral load and physical distance

BACKGROUND

Transmission of covid-19 can occur through inhalation of fine droplets or aerosols containing infectious virus. The objective of this study was to identify situations, patient characteristics, environmental parameters and aerosol-generating procedures (AGPs) associated with airborne SARS-CoV-2 virus.

METHODS

Air samples were collected near hospitalised covid-19 patients and analysed by RT-qPCR. Results were related to distance to the patient, most recent patient diagnostic PCR Ct-value, room ventilation and ongoing potential AGP.

RESULTS

In total 310 air samples were collected, and of these 26 (8%) were positive. Of the 231 samples from patient rooms, 22 (10%) were positive for SARS-CoV-2. Positive air samples were associated with a low patient Ct-value (OR 5.0 for a Ct-value <25 vs >25, p=0.01, 95% confidence interval 1.18 to 29.5) and a shorter physical distance to the patient (OR 2.0 for every meter closer to the patient, p=0.05, CI 1.0 to 3.8). A mobile HEPA-filtration unit in the room decreased the proportion of positive samples (OR 0.3, p=0.02, CI 0.12 to 0.98). No association was observed between SARS-CoV-2 positive air samples and mechanical ventilation, high flow nasal cannula, nebulizer treatment or non-invasive ventilation. An association was found with positive expiratory pressure (PEP) training (p<0.01) and a trend towards association for airway manipulation, including bronchoscopies and in- and extubations.

CONCLUSIONS

Our results show that major risk factors for airborne SARS-CoV-2 include short physical distance, high patient viral load and poor room ventilation. AGPs, as traditionally defined, seem to be of secondary importance.

Automated crude oil vapor inhalation exposure system

Objective: Inhalation exposure systems are tools for delivering compounds (particles, vapors, and gases) under well-controlled conditions for toxicological testing. The objective of this project was to develop an automated computer-controlled system to expose small laboratory animals to precise concentrations of crude oil vapor (COV).Materials and Methods: Vapor from heated Deepwater Horizon surrogate oil was atomized into a fine mist then diluted with filtered air, then the air/droplet mixture was routed into an evaporation column with an high efficiency particulate air (HEPA) filter on its exit port. The HEPA filter was used to remove oil particles, thus ensuring only vapor would pass. The vapor was then introduced into a custom-built exposure chamber housing rats. A calibrated flame ionization detector was used to read the total volatile organic compounds (TVOC) in real time, and custom software was developed to automatically adjust the amount of oil entering the atomizer with a syringe pump. The software also controlled relative humidity and pressure inside the exposure chamber. Other exposure chamber environmental parameters, e.g. temperature and CO₂ levels, were monitored. Four specific components within the COV were monitored during each exposure: benzene, toluene, ethylbenzene, and xylenes.Results: The TVOC vapor concentration control algorithm maintained median concentrations to within ±2 ppm of the target concentration (300 ppm) of TVOC during exposures lasting 6 h. The system could reach 90% of the desired target in less than 15 min, and repeat exposures were consistent and reproducible.Conclusion: This exposure system provided a highly automated tool for conducting COV inhalation toxicology studies.

Relationship between styrene exposure and prolactin secretion in human and animal studies: A systematic review

Styrene is widely used in industrial applications. Inhalation exposure occurs in the industry. Some studies indicated that serum prolactin concentrations increased after exposure to styrene, while other studies found no change. In this systematic review, the search was done with the keywords styrene and prolactin in the PubMed, Science Direct, Web of Science and Scopus databases, regardless of the publication period. 118 studies were obtained and only seven articles were finally selected according to exclusion and inclusion criteria. The effect of styrene on prolactin secretion was selected in both human and animal studies. The increased response was seen in inhalation exposures. Subcutaneous exposure has no significant effect on prolactin levels. The observed responses were both dose-dependent and gender-dependent. Changes in serum prolactin were more frequent in women compared to exposed men. Dopamine depletion was not observed in all studies, so more tests on laboratory animals are necessary to clarify the possible mechanism.

Negative Ion Purifier Effects on Indoor Particulate Dosage to Small Airways

Indoor air quality is an important health factor as we spend more than 80% of our time indoors. The primary type of indoor pollutant is particulate matter, high levels of which increase respiratory disease risk. Therefore, air purifiers are a common choice for addressing indoor air pollution. Compared with traditional filtration purifiers, negative ion air purifiers (NIAPs) have gained popularity due to their energy efficiency and lack of noise. Although some studies have shown that negative ions may offset the cardiorespiratory benefits of air purifiers, the underlying mechanism is still unclear. In this study, we conducted a full-scale experiment using an in vitro airway model connected to a breathing simulator to mimic inhalation. The model was constructed using computed tomography scans of human airways and 3D-printing technology. We then quantified the effects of NIAPs on the administered dose of 0.5-2.5 μm particles in the small airway. Compared with the filtration purifier, the NIAP had a better dilution effect after a 1-h exposure and the cumulative administered dose to the small airway was reduced by 20%. In addition, increasing the negative ion concentration helped reduce the small airway exposure risk. NIAPs were found to be an energy-efficient air purification intervention that can effectively reduce the small airway particle exposure when a sufficient negative ion concentration is maintained.

A mechanistic evaluation of the potential for octamethylcyclotetrasiloxane to produce effects via endocrine modes of action

This review is a hypothesis driven, mechanistic evaluation of the potential for octamethylcyclotetrasiloxane (D4) to produce any effects via endocrine modes of action. D4 is a volatile, lipophilic liquid used in the production of high molecular weight dimethylsiloxane polymers. These are used in a variety of industrial, medical, cleaning, and personal care products, and they may contain low levels of residual D4. Low concentrations of D4 are found in the environment and there is potential for low level human exposure. All of the measured environmental and workplace levels of D4 fall below no observed effect levels (NOEL). Most of the effects of high dose D4 involve the female reproductive system. In the mature intact female rat following chronic high dose exposure, D4 may cause inhibition of mating and ovulation, decreased live litter sizes, small increases in the estrogen to progesterone ratio primarily through decreases in progesterone, and increases in uterine hyperplasia. When endogenous estrogens are very low, high dose D4 causes increases in some uterine parameters. To assess whether these high dose effects can be attributed to an endocrine mode of action, endpoints are ranked for relevance and strength, consistent with published concepts. When sufficient information is available the level of activity of D4 for producing the observed effect is compared with that of potent endocrines. The conclusions reached are that all of the effects of D4 fall well short of any established criteria for D4 to be capable of producing any adverse effect via an endocrine mode of action.

Mast Cells Promote Nitrogen Mustard-Mediated Toxicity in the Lung Associated With Proinflammatory Cytokine and Bioactive Lipid Mediator Production

Sulfur mustard (SM) has been widely used as a chemical warfare agent including most recently in Syria. Mice exposed to SM exhibit an increase in pro-inflammatory cytokines followed by immune cell infiltration in the lung, however, the mechanisms leading to these inflammatory responses has not been completely elucidated. Mast cells are one of the first responding innate immune cells found at the mucosal surfaces of the lung and have been reported to be activated by SM in the skin. Therefore, we hypothesized that nitrogen mustard (NM: a surrogate for SM) exposure promotes activation of mast cells causing chronic respiratory inflammation. To assess the role of mast cells in NM-mediated pulmonary toxicity, we compared the effects of NM exposure between C57BL/6 and B6.Cg-KitW-sh/HNihrJaeBsmJ (KitW-sh; mast cell deficient) mice. Lung injury was observed in C57BL/6J mice following NM exposure (0.125 mg/kg) at 72 h, which was significantly abrogated in KitW-sh mice. Although both strains exhibited damage from NM, C57BL/6J mice had higher inflammatory cell infiltration and more elevated prostaglandin D2 (PGD2) present in bronchoalveolar lavage fluid compared with KitW-sh mice. Additionally, we utilized murine bone marrow-derived mast cells to assess NM-induced early and late activation. Although NM exposure did not result in mast cell degranulation, we observed an upregulation in PGD2 and IL-6 levels following exposure to NM. Results suggest that mast cells play a prominent role in lung injury induced by NM and may contribute to the acute and potentially long-term lung injury observed caused by SM.

High pesticide inhalation exposure from multiple spraying sources amongst applicators in Eswatini, Southern Africa

BACKGROUND

Serious concerns surround the potential risks resulting from inhalation exposure to pesticides amongst agricultural workers when mixing and applying these compounds. In Eswatini (formerly known as Swaziland), Southern Africa, pesticides are widely used to improve the yield and quality of sugar cane production, the largest contributor to the country's economy. We assessed applicators' inhalation exposures from multiple spraying sources to four commonly used herbicides in Eswatini.

RESULTS

Analysis of 76 personal air samples by liquid chromatography with tandem mass spectrometry (LC-MS/MS) revealed four pesticides: ametryn, atrazine, pendimethalin and 2,4-dichlorophenoxyacetic acid, with mean concentrations of 36.91, 21.57, 31.05 and 0.89 μg m^-3 , respectively. These inhalation exposures are much higher than those recorded in previous similar studies.

CONCLUSION

Although all applicators in this study used personal protective equipment (PPE), they nevertheless recorded high levels of inhalation exposure to commonly used pesticides. Our findings suggest that in addition to observing mandated regular changing and cleaning practices with PPE for ultimate personal protection, pesticide applicators should distance themselves from each other when spraying to effectively reduce their exposure to pesticides from multiple spraying sources. Further studies are needed to determine the optimal spraying distance between pesticide applicators. © 2021 Society of Chemical Industry.

Exposure of Ophthalmologists to Patients' Exhaled Droplets in Clinical Practice: A Numerical Simulation of SARS-CoV-2 Exposure Risk

Background: Lack of quantification of direct and indirect exposure of ophthalmologists during ophthalmic diagnostic process makes it hard to estimate the infectious risk of aerosol pathogen faced by ophthalmologists at working environment. Methods: Accurate numerical models of thermal manikins and computational fluid dynamics simulations were used to investigate direct (droplet inhalation and mucosal deposition) and indirect exposure (droplets on working equipment) within a half-minute procedure. Three ophthalmic examination or treatment scenarios (direct ophthalmoscopic examination, slit-lamp microscopic examination, and ophthalmic operation) were selected as typical exposure distance, two breathing modes (normal breathing and coughing), three levels of ambient RH (40, 70, and 95%) and three initial droplet sizes (50, 70, and 100 μm) were considered as common working environmental condition. Results: The exposure of an ophthalmologist to a patient's expiratory droplets during a direct ophthalmoscopic examination was found to be 95 times that of a person during normal interpersonal interaction at a distance of 1 m and 12.1, 8.8, and 9.7 times that of an ophthalmologist during a slit-lamp microscopic examination, a surgeon during an ophthalmic operation and an assistant during an ophthalmic operation, respectively. The ophthalmologist's direct exposure to droplets when the patient cough-exhaled was ~7.6 times that when the patient breath-exhaled. Compared with high indoor RH, direct droplet exposure was higher and indirect droplet exposure was lower when the indoor RH was 40%. Conclusion: During the course of performing ophthalmic examinations or treatment, ophthalmologists typically face a high risk of SARS-CoV-2 infection by droplet transmission.

An Integrated Approach to Testing and Assessment to Support Grouping and Read-Across of Nanomaterials After Inhalation Exposure

Introduction: Here, we describe the generation of hypotheses for grouping nanoforms (NFs) after inhalation exposure and the tailored Integrated Approaches to Testing and Assessment (IATA) with which each specific hypothesis can be tested. This is part of a state-of-the-art framework to support the hypothesis-driven grouping and read-across of NFs, as developed by the EU-funded Horizon 2020 project GRACIOUS.

Development of Grouping Hypotheses and IATA: Respirable NFs, depending on their physicochemical properties, may dissolve either in lung lining fluid or in acidic lysosomal fluid after uptake by cells. Alternatively, NFs may also persist in particulate form. Dissolution in the lung is, therefore, a decisive factor for the toxicokinetics of NFs. This has led to the development of four hypotheses, broadly grouping NFs as instantaneous, quickly, gradually, and very slowly dissolving NFs. For instantaneously dissolving NFs, hazard information can be derived by read-across from the ions. For quickly dissolving particles, as accumulation of particles is not expected, ion toxicity will drive the toxic profile. However, the particle aspect influences the location of the ion release. For gradually dissolving and very slowly dissolving NFs, particle-driven toxicity is of concern. These NFs may be grouped by their reactivity and inflammation potency. The hypotheses are substantiated by a tailored IATA, which describes the minimum information and laboratory assessments of NFs under investigation required to justify grouping.

Conclusion: The GRACIOUS hypotheses and tailored IATA for respiratory toxicity of inhaled NFs can be used to support decision making regarding Safe(r)-by-Design product development or adoption of precautionary measures to mitigate potential risks. It can also be used to support read-across of adverse effects such as pulmonary inflammation and subsequent downstream effects such as lung fibrosis and lung tumor formation after long-term exposure.

A novel sulfur mustard (HD) vapor inhalation exposure model of pulmonary toxicity for the efficacy evaluation of candidate medical countermeasures

OBJECTIVE

To develop a novel inhalation exposure system capable of delivering a controlled inhaled HD dose through an endotracheal tube to anesthetized rats to investigate the lung pathophysiology and evaluate potential medical countermeasures.

MATERIALS AND METHODS

Target HD vapor exposures were generated by a temperature-controlled vapor generator, while concentration was monitored near real-time by gas chromatography. Animal breathing parameters were monitored real-time by in-line EMKA/SciReq pulmonary analysis system. Individual exposures were halted when the target inhaled doses were achieved. Animals were observed daily for clinical observations and lethality with scheduled termination at 28 days post-exposure. Upon scheduled or unscheduled death, animals underwent a gross necropsy and lung and trachea were collected for histopathology.

RESULTS

Controlled HD concentrations ranged from 60 to 320 mg/m³. Delivered inhaled doses range from 0.3 to 3.20 mg/kg with administered doses within 3% of the target. The 28-day inhaled LD₅₀ is 0.80 mg/kg (95% CI = 0.42-1.18 mg/kg). Post exposure respiratory abnormalities were observed across all dose levels though the higher dose levels had earlier onset and higher frequency of occurrence. Histopathologic alterations were not qualitatively altered in accordance with dose but instead showed a relationship to an animals' time of death, with early deaths demonstrating acute damage and later deaths displaying signs of repair.

DISCUSSION/CONCLUSION

This novel exposure system administers targeted HD inhaled doses to generate a small animal model that can be used to evaluate physiological toxicities of inhaled HD on the lungs and for evaluation of potential medical countermeasure treatments.

Contribution of Pulmonary CYP-mediated Bioactivation of Naphthalene to Airway Epithelial Injury in the Lung

Previous studies have established that cytochrome P450 enzymes (CYPs) in both liver and lung are capable of bioactivating naphthalene (NA), an omnipresent air pollutant and possible human carcinogen, in vitro and in vivo. The aim of this study was to examine the specific contribution of pulmonary CYPs in airway epithelial cells to NA-induced airway toxicity. We used a lung-Cpr-null mouse model, which undergoes doxycycline-induced, Cre-mediated deletion of the Cpr (a redox partner of all microsomal CYPs) gene specifically in airway epithelial cells. In 2-month-old lung-Cpr-null mice, Cpr deletion occurred in 75%-82% of epithelial cells of conducting airways. The extent of NA-induced acute lung toxicity (as indicated by total protein concentration and lactate dehydrogenase activity in bronchoalveolar lavage fluid collected at 24-h after initiation of a 4-h, nose-only, 10-ppm NA inhalation exposure) was substantially lower (by 37%-39%) in lung-Cpr-null mice, compared with control littermates. Moreover, the extent of cellular proliferation (as indicated by 5-bromo-2'-deoxyuridine incorporation) was noticeably lower in both proximal and distal airways (by 59% and 65%, respectively) of NA-treated lung-Cpr-null mice, compared with control littermates, at 2-day post-NA inhalation exposure. A similar genotype-related difference in the extent of postexposure cell proliferation was also observed in mice exposed to NA via intraperitoneal injection at 200 mg/kg. These results directly validate the hypothesis that microsomal CYP enzymes in airway epithelial cells play a large role in causing injury to airway epithelia following exposure to NA via either inhalation or intraperitoneal route.

Assessment of exposure determinants and exposure levels by using stationary concentration measurements and a probabilistic near-field/far-field exposure model

Background: The Registration, Evaluation, Authorization and Restriction of Chemicals (REACH) regulation requires the establishment of Conditions of Use (CoU) for all exposure scenarios to ensure good communication of safe working practices. Setting CoU requires the risk assessment of all relevant Contributing Scenarios (CSs) in the exposure scenario. A new CS has to be created whenever an Operational Condition (OC) is changed, resulting in an excessive number of exposure assessments. An efficient solution is to quantify OC concentrations and to identify reasonable worst-case scenarios with probabilistic exposure modeling. Methods: Here, we appoint CoU for powder pouring during the industrial manufacturing of a paint batch by quantifying OC exposure levels and exposure determinants. The quantification was performed by using stationary measurements and a probabilistic Near-Field/Far-Field (NF/FF) exposure model. Work shift and OC concentration levels were quantified for pouring TiO 2 from big bags and small bags, pouring Micro Mica from small bags, and cleaning. The impact of exposure determinants on NF concentration level was quantified by (1) assessing exposure determinants correlation with the NF exposure level and (2) by performing simulations with different OCs. Results: Emission rate, air mixing between NF and FF and local ventilation were the most relevant exposure determinants affecting NF concentrations. Potentially risky OCs were identified by performing Reasonable Worst Case (RWC) simulations and by comparing the exposure 95 th percentile distribution with 10% of the occupational exposure limit value (OELV). The CS was shown safe except in RWC scenario (ventilation rate from 0.4 to 1.6 1/h, 100 m 3 room, no local ventilation, and NF ventilation of 1.6 m 3/min). Conclusions: The CoU assessment was considered to comply with European Chemicals Agency (ECHA) legislation and EN 689 exposure assessment strategy for testing compliance with OEL values. One RWC scenario would require measurements since the exposure level was 12.5% of the OELV.

Blastomycosis in Minnesota, USA, 1999-2018

Blastomycosis is a systemic disease caused by Blastomyces spp. fungi. To determine its epidemiology in blastomycosis-endemic Minnesota, USA, we evaluated all cases reported to public health officials during 1999-2018. We focused on time to diagnosis, exposure activities, and exposure location. A total of 671 cases and a median of 34 cases/year were reported. Median time to diagnosis was 31 days; 61% of patients were not tested for blastomycosis until they were hospitalized. The case-fatality rate was 10%, and patients who died were 5.3 times more likely to have a concurrent medical condition. Outdoor activities and soil exposure were reported by many patients, but no specific activity or exposure was common to most. Almost one third of patients were probably exposed in geographic areas other than their home county. Providers should consider alternative etiologies for patients with pneumonia not responding to antibacterial treatment, and public health officials should increase awareness in blastomycosis-endemic areas.

Spatial Uncertainty in Modeling Inhalation Exposure to Volatile Organic Compounds in Response to the Application of Consumer Spray Products

(1) Background: Mathematical exposure modeling of volatile organic compounds (VOCs) in consumer spray products mostly assumes instantaneous mixing in a room. This well-mixed assumption may result in the uncertainty of exposure estimation in terms of spatial resolution. As the inhalation exposure to chemicals from consumer spray products may depend on the spatial heterogeneity, the degree of uncertainty of a well-mixed assumption should be evaluated under specific exposure scenarios. (2) Methods: A room for simulation was divided into eight compartments to simulate inhalation exposure to an ethanol trigger and a propellant product. Real-time measurements of the atmospheric concentration in a room-sized chamber by proton transfer reaction mass spectrometry were compared with mathematical modeling to evaluate the non-homogeneous distribution of chemicals after their application. (3) Results: The well-mixed model overestimated short-term exposure, particularly under the trigger spray scenario. The uncertainty regarding the different chemical proportions in the trigger did not significantly vary in this study. (4) Conclusions: Inhalation exposure to aerosol generating sprays should consider the spatial uncertainty in terms of the estimation of short-term exposure.

Toxicological approaches for the quantitative inhalation risk assessment of toxic metals from tobacco smoke: application on the deterministic and probabilistic inhalation risk assessment of cadmium for Austrian smokers

OBJECTIVE

The objective of this study was the assessment of risks from inhalation exposure of Austrian smokers to cadmium through established toxicological approaches with emphasis on the exposure assessment component, which is challenging regarding the actual amount of metal that is inhaled and the simulation of the smoking pattern.

MATERIALS AND METHODS

Exposure assessment comprised an estimation of the proportion of cadmium inhaled through smoking and actual occurrence data in tobacco products and survey smoking habits, which were integrated in alternative scenarios through a deterministic and a probabilistic Monte Carlo simulation method. Risks were characterized through the comparison of the exposure with health-based guidance values, as well as through the assessment of the excess lifetime cancer risk (ELCR), the non-cancer hazard quotient (NCHQ), and the margin of exposure (MOE). The strengths, the uncertainties, and the limitations of the different methodologies were discussed.

RESULTS AND DISCUSSION

Upper exposures are close or exceed the Permitted Daily Exposure. Respiratory ELCRs are unacceptable compared to the benchmark range of 1.0E-06 to 1.0E-04. Renal and respiratory NCHQs exceed the target value of 1.0 by 3- to 17-fold. MOEs are not protective enough for cancer and non-cancer effects. The amount of cadmium that reaches the lung is a key source of uncertainty.

CONCLUSION

Probabilistic estimates provide a refined capture of the actual inhalation exposure. Risk estimates and gender and age profiles are alarming, especially for young smokers. Application of toxicological approaches, combined with realistic assessment of the inhalation exposure levels, can support risk communication and management.

Development of a Method for Simultaneous Analysis of Allergenic Flavoring Agents in Cigarettes and Quantitative Risk Assessment for Consumer Safety

Flavoring agents are added to cigarettes to improve taste. There are mostly permitted food additives, but some of them are restricted for use in food, cosmetics, and toys, since they can cause allergic reactions. Previous studies have investigated the levels of flavoring agents in tobacco but none has focused on their content in filter tips and capsules. Moreover, no studies have assessed the risk of adding allergenic flavoring agents in cigarettes. Here, we developed and validated a simultaneous analysis method for 25 allergenic flavoring agents and menthol with gas chromatography–tandem mass spectrometry to determine levels of flavoring agents in the tobacco, filter tips, and capsules of 54 commercial cigarettes in Korea. All cigarettes contained at least one allergenic flavoring agent regardless of the inclusion of flavoring capsules. Importantly, the filter tips and the capsules contained higher levels of flavoring agents than tobacco, highlighting the importance of the quantification of flavoring agents in these parts of cigarettes. Nevertheless, the risk assessment based on their levels in cigarettes suggested that their exposure was maintained at a safe level. However, the risk assessed from maximum menthol, linalool, and cinnamaldehyde exceeded one-tenth of derived no-effect levels, suggesting the need for further studies on their risk to human health.

Development of a personal passive air sampler for estimating exposure to effective chlorine while using chlorine-based disinfectants

With an increasing use of indoor disinfectants such as chlorine (Cl₂ ) and hypochlorous acid, a convenient sampler for estimating exposure to oxidants, such as effective chlorine, is necessary. Here, we developed a personal passive air sampler (PPAS) composed of a redox dye, o-dianisidine, in a polydimethylsiloxane (PDMS) sheet. o-Dianisidine readily reacts with gaseous oxidants generated by bleach usage, and its color changes as the reaction progresses; hence, personal exposure to effective chlorine could be easily detected by the naked eye, while cumulative exposure could be determined by measuring concentrations of o-dianisidine reacting with it. The PPAS was calibrated, and a sampling rate of 0.00253 m³ /h was obtained using a small test chamber. The PPAS was tested with the help of ten volunteers whose personal exposure to Cl₂ -equivalent gas was estimated after bathrooms were cleaned using spray and liquid-type household disinfection products, and the accumulated exposure-gas concentrations ranged from 69 to 408 ppbv and 148 to 435 ppbv, respectively. These PPAS-derived exposure concentrations were approximately two orders lower than those estimated using ConsExpo, suggesting a significant overestimation by prevailing screening models, possibly due to the ignorance of transformation reactions.

Multi-Scale Airborne Infectious Disease Transmission

Airborne disease transmission is central to many scientific disciplines including agriculture, veterinary biosafety, medicine, and public health. Legal and regulatory standards are in place to prevent agricultural, nosocomial, and community airborne disease transmission. However, the overall importance of the airborne pathway is underappreciated, e.g.,, US National Library of Medicine's Medical Subjects Headings (MESH) thesaurus lacks an airborne disease transmission indexing term. This has practical consequences as airborne precautions to control epidemic disease spread may not be taken when airborne transmission is important, but unrecognized. Publishing clearer practical methodological guidelines for surveillance studies and disease outbreak evaluations could help address this situation.To inform future work, this paper highlights selected, well-established airborne transmission events - largely cases replicated in multiple, independently conducted scientific studies. Methodologies include field experiments, modeling, epidemiology studies, disease outbreak investigations and mitigation studies. Collectively, this literature demonstrates that airborne viruses, bacteria, and fungal pathogens have the capability to cause disease in plants, animals, and humans over multiple distances - from near range (< 5 m) to continental (> 500 km) in scale. The plausibility and implications of undetected airborne disease transmission are discussed, including the notable underreporting of disease burden for several airborne transmitted diseases.

Estimates of particulate matter inhalation doses during three-dimensional printing: How many particles can penetrate into our body?

Harmful emissions including particulates, volatile organic compounds, and aldehydes are generated during three-dimensional (3D) printing. Ultrafine particles are particularly important due to their ability to penetrate deep into the lung. We modeled inhalation exposure by particle size during 3D printing. A total of six thermoplastic filaments were used for printing under manufacturer's recommended conditions, and particle emissions in the size range between 10 nm and 10 μm were measured. The inhalation exposure dose including inhaled and deposited doses was estimated using a mathematical model. For all materials, the number of particles between 10 nm and 1 μm accounted for a large proportion among the released particles, with nano-sized particles being the dominant size. More than 1.3 × 10⁹ nano-sized particles/kgbw/g (95.3 ± 104.0 ng/kgbw/g) could be inhaled, and a considerable amount was deposited in respiratory regions. The total deposited dose in terms of particle number was 3.1 × 10⁸ particles/kgbw/g (63.6% of the total inhaled dose), and most (41.3%) were deposited in the alveolar region. The total mass of particles deposited was 19.8 ± 16.6 ng/kgbw/g, with 10.1% of the total mass deposited in the alveolar region. Given our findings, the inhalation exposure level is mainly determined by printing conditions, particularly the filament type and manufacturer-recommended extruder temperature.

Numerical analysis of nanoparticle transport and deposition in a cynomolgus monkey nasal passage

Environmental exposure to toxic agents is commonly encountered by occupational and residential populations. However, in vivo exposure data in human subjects is limited by measurement and ethical restrictions. Monkey represents a suitable surrogate for human exposure studies, but the particle transport and deposition features in monkey airways are still not well understood. As a response to this research challenge, this paper presents a virtual exposure study that numerically investigated the nanoparticle transport process through a realistic cynomolgus monkey nasal airway. Particles with size of 1 nm to 1 μm were considered and the transport process was modelled by the Lagrangian discrete phase model. Overall and local deposition as well as particle dispersion along the airway were examined by using a variety of non-dimensional parameters including combined diffusion parameter, deposition enhancement factor and particle flux enhancement factor. Consistent deposition patterns were observed in present and literature nasal models. Most particles tended to pass the nasal airway through certain spatial regions, including the middle section of the nasal valve, the lower half of the middle coronal plane, and the central regions of the choana. While naturally inhaled nanoparticles can hardly be delivered to the olfactory region as it is located apart from the mainstream with high particle flux. Research findings provide insight into nanoparticle inhalation exposure characteristics in the monkey airway and can contribute in formulating data extrapolation schemes between monkey and human airways.