A commentary on the impacts of metals and metalloids in the environment upon the metabolism of drugs and chemicals

The salient feature of metals is that unlike organic compounds they do not degrade in the environment and barely move from one environmental matrix to another. Human interventions take these compounds from their stable and non-bioavailable geological matrix into situations of biological accessibility. Studies in the 1970s and the 1980s of metal bioavailability and impacts of metals and metalloids were driven by the process of abatement of lead in the environment. Humans have clear and identifiable sources of exposure from fuels, food and leaded water pipes to lead. Interventions started at that time have dramatically lowered human lead exposure. Attention has now shifted to other metals, in particular, cadmium, which has seen increasing use. It is generally accepted that food crops grown on cadmium containing soils or soils naturally rich in this metal are the major source of exposure to humans other than exposure from smoking of cigarettes. This mini-review gives a summary and commentary on early studies on effects of lead on haem metabolism that provide us the clue to why investigations of the impacts of other toxic heavy metals and metalloids such as cadmium and arsenic on different human cytochrome P450 forms have become of great interest at the current time. (C) 2003 Elsevier Ireland Ltd. All rights reserved.

The relationship between acute alcohol consumption and consequent injury type

Aims: The aim of this study was to quantify the relationship between acute alcohol consumption and injury type (nature of injury, body region injured), while adjusting for the effect of known confounders (i.e. demographic and situational variables, usual drinking patterns, substance use and risk-taking behaviour). Methods: A cross-sectional study was conducted between October, 2000 and October, 2001 of patients aged >= 15 years presenting to a Queensland Emergency Department for treatment of an injury sustained in the preceding 24 h. There were three measures of acute alcohol consumption: drinking setting, quantity, and beverage type consumed in the 6 h prior to injury. Two variables were used to quantify injury type: nature of injury (fracture/dislocation, superficial, internal, and CNS injury) and body part injured (head/neck, facial, chest, abdominal, external, and extremities). Both were derived from patient medical records. Results: Five hundred and ninety three patients were interviewed. Logistic regression analyses indicated that, after controlling for relevant confounding variables, there was no significant association between any of the three measures of acute alcohol consumption and injury type. Conclusions: The effects of acute alcohol consumption are not specific to injury type. Interventions aimed at reducing the incidence of alcohol-related injury should not be targeted at specific injury types.

Evidence for induced microsomal bilirubin degradation by cytochrome P450 2A5

Oxidative metabolism of bilirubin (BR) - a breakdown product of haem with cytoprotective and toxic properties - is an important route of detoxification in addition to glucuronidation. The major enzyme(s) involved in this oxidative degradation are not known. In this paper, we present evidence for a major role of the hepatic cytochrome P450 2A5 (Cyp2a5) in BR degradation during cadmium intoxication, where the BR levels are elevated following induction of haem oxygenase-1 (HO-1). Treatment of DBA/2J mice with CdCl2 induced both the Cyp2a5 and HO-1, and increased the microsomal BR degradation activity. By contrast, the total cytochrome P450 (CYP) content and the expression of Cyp1a2 were down-regulated by the treatment. The induction of the HO-1 and Cyp2a5 was substantial at the mRNA, protein and enzyme activity levels. In each case, the up-regulation of HO-1 preceded that of Cyp2a5 with a 5-10 h interval. BR totally inhibited the microsomal Cyp2a5-dependent coumarin hydroxylase activity, with an IC50 approximately equal to the substrate concentration. The 7-methoxyresorufin 7-O-demethylase (MROD) activity, catalyzed mainly by the Cyp1a2, was inhibited up to 36% by BR. The microsomal BR degradation was inhibited by coumarin and a monoclonal antibody against the Cyp2a5 by about 90%. Furthermore, 7-methoxyresorufin, a substrate for the Cyp1a2, inhibited BR degradation activity by approximately 20%. In sum, the results strongly suggest a major role for Cyp2a5 in the oxidative degradation of BR. Secondly, the coordinated up-regulation of the HO-1 and Cyp2a5 during Cd-mediated injury implicates a network of enzyme systems in the maintenance of balancing BR production and elimination.

Effects of Variation at the ALDH2 Locus on Alcohol Metabolism, Sensitivity, Consumption, and Dependence in Europeans

Background: The low-activity variant of the aldehyde dehydrogenase 2 (ALDH2) gene found in East Asian populations leads to the alcohol flush reaction and reduces alcohol consumption and risk of alcohol dependence (AD). We have tested whether other polymorphisms in the ALDH2 gene have similar effects in people of European ancestry. Methods: Serial measurements of blood and breath alcohol, subjective intoxication, body sway, skin temperature, blood pressure, and pulse were obtained in 412 twins who took part in an alcohol challenge study. Participants provided data on alcohol reactions, alcohol consumption, and symptoms related to AD at the time of the study and subsequently. Haplotypes based on 5 single-nucleotide polymorphisms (SNPs) were used in tests of the effects of variation in the ALDH2 gene on alcohol metabolism and alcohol's effects. Results: The typed SNPs were in strong linkage disequilibrium and 2 complementary haplotypes comprised 83% of those observed. Significant effects of ALDH2 haplotype were observed for breath alcohol concentration, with similar but smaller and nonsignificant effects on blood alcohol. Haplotype-related variation in responses to alcohol, and reported alcohol consumption, was small and not consistently in the direction predicted by the effects on alcohol concentrations. Conclusions: Genetic variation in ALDH2 affects alcohol metabolism in Europeans. However, the data do not support the hypothesis that this leads to effects on alcohol sensitivity, consumption, or risk of dependence.

A review of the potential role of tumour-promoting compounds produced by Lyngbya majuscula in marine turtle fibropapillomatosis

Harmful algal blooms (HABs) have increased in abundance and severity in recent decades. Whereas the implications for human impacts and intoxication resulting from blooms have been extensively studied, the ecological implications of these microalgae are less well understood. Many HAB species produce biologically active, secondary metabolites and the fate of these toxins through the foodweb is generally not well understood unless it culminates in extensive fish mortalities or human poisonings. This review focusses on one HAB species, the cyanobacterium Lyngbya majuscula, and presents a hypothetical role for its involvement in fibro-papillornatosis (FP), a neoplastic disease of marine turtles. FP is expressed as benign tumours that grow both internally and externally on marine turtles, preventing vision, movement and organ function. The aetiology of FP is currently not conclusively understood, but virus material has been associated with tumours and previous studies have suggested a role for naturally produced tumour promoters. In this review, we present a hypothesis regarding the involvement of L. majuscula in FP, either through direct intoxication and action of tumour-promoting compounds or indirectly by causing seagrass loss and compromised immune function, thus leaving the turtles more susceptible to disease.

Genotoxicity investigation of chlorinated degradation products of a cyanobacterial toxin, cylindrospermopsin

Cylindrospermopsin (CYN), a potent cyanobacterial hepatotoxin produced by Cylindrospermopsis raciborskii and other cyanobacteria, is regularly found in water supplies in many parts of the world and has been associated with the intoxication of humans and livestock.Water treatment via chlorination can degrade the toxin effectively but result in the production of several byproducts. In this study, male and female Balb/c mice were injected via the intraperitoneal (IP) route with a single dose of 10 mg/kg 5-chlorouracil and 10 mg/kg 5-chloro-6-hydroxymethyluracil; these two compounds are the predicted chlorinated degradation products of CYN.DNA was isolated from the mouse livers and examined for strand breakage by alkaline gel electrophoresis (pH 12). The median molecular length (MML) of the DNA distributed in the gel was determined by estimating the midpoint of the DNA size distribution by densitometry. The toxicity of 5-chlorouracil (as measured by DNA strand breakage) was significantly influenced by time from dosing. There was no significant difference in MML between mice dosed with 5-chloro-6-hydroxymethyluracil and the controls. In another experiment, mice were dosed with 0, 0.1, 1, 10 and 100 mg/kg body weight 5-chlorouracil and 0, 0.1, 1, 10 and 20 mg/kg 5-chloro-6-hydroxymethyluracil via IP injection. The heart, liver, kidney, lung and spleen were removed, fixed and examined under electron microscopy. Liver was the main target organ. The EM results revealed marked distortion on the nuclear membrane of liver cells in mice dosed with 1.0 mg/kg 5-chlorouracil or 10 mg/kg 5-chloro-6-hydroxymethyluracil, or higher.

The toxic effects of anticholinesterases on muscle

It has been shown that acute administration of ecothiopate iodine in vivo caused an approximate 80% depression of acetylcholinesterase activity in the diaphragms of mice. Inhibition of acetylcholinesterase was accompanied by an influx of calcium at the junctional region of the diaphragm, which continued during subsequent progressive development of a severe myopathy located in the same region. Myopathy was accompanied by loss of creatine kinase from the muscle and was represented, at the light microscope level, by hypercontraction, Procion Yellow staining and loss of cross striations within the muscle fibres. It appeared to reach a point of maximum severity approximately 3-6 hours after ecothiopate administration and then, by means of some repair/regeneration process, regained an apparently normal morphology within 72 hours of the intoxication. At the ultrastructural level, ecothiopate-induced myopathy was recognised by loss of Z-lines, swelling and vacuolation of mitochondria and sarcoplasmic reticulum, dissarray of myofilaments, crystal formation, and sometimes, by the complete obliteration of sarcomeric structure. The development of myopathy in vitro was shown to be nerve-mediated and to require a functional acetylcholine receptor for its development It was successfully treated therapeutically in vivo by pyridine-2-aldoxime methiodide and prophylactically by pyridostigmine bromide. However, the use of a range of membrane-on channel blockers, and of leupeptin, an inhibitor of calcium-activated-neutral-protease, have been unsuccessful in the prevention of ecothiopate-induced myopathy.

The effects of persistent articholinesterase action at the neuromuscular junction

The effects of organophosphorus compounds which form a rapidly-ageing complex with acetylcholinesterase (AChE) (e.g. pinacolyl S-(2- trimethylaminoethyl)methylphosphonothioate (BOS)) and hence exert a persistent anticholinesterase (anti-ChE) action have been compared with other compounds with a shorter time course of inhibition (e.g. ecothiopate iodide (ECO)). Although the inhibition of AChE produced by BOS lasted longer than that seen with ECO, the time course of the myopathy appeared very similar. BOS also possessed a number of properties which have been seen with other anti-ChEs. BOS and ECO produced significant increases in neuromuscular "jitter" 5 days after injection, not only in the diaphragm but also in the soleus and extensor digitorum longus muscles. Increases in "jitter" produced by ECO could be prevented by pyridostigmine prophylaxis or rapid treatment with pyridine-2- aldoxime methiodide. Some protection from the BOS-induced increases in "jitter" could be gained by repeated treatment with pyridine-2-aldoxime methiodide, an effect which could not be accounted for simply by enzyme reactivation. From experiments performed in Rej 129 mice it was determined that increases in "jitter", although demonstrated in some dystrophic muscles, could not be used as an early diagnostic tool. Because sequalae of inhibition were present some time after intoxication, by which time AChE appeared biochemically normal, experiments were performed to investigate inactivation of physiologically important AChE. The time course of extracellular MEPPs was utilised as an indicator of physiologically important AChE and compared with the AChE activity measured by the technique of Ellman et al. (1961). It was concluded that the degree of persistence of anti-ChE action was unimportant for the induction of myopathy with a time course of 3-24 hours, but had some importance in events of longer duration.

Reconstructing alcohol-induced memory blackouts

Many people who drink alcohol have experienced a blackout; whereby they are unable to recall events that occurred during a period of intoxication. Following these blackout episodes individuals may attempt to reconstruct what happened to them. Blackouts therefore afford an excellent opportunity to study the strategies people use to reconstruct forgotten experiences. We conducted a survey of university students to explore how people choose to reconstruct blackouts, and the likely accuracy of these reconstructions. Our findings add to the growing research literature on people's strategies for validating their past experiences, and highlight the important role of external sources in the reconstruction process. The data show that people's desire to "fill in the blanks" can lead them to rely on rather unreliable sources, and may also encourage them to adopt weaker source-monitoring criteria. Indeed, in at least some cases reconstructing blackouts appears to lead to the development of false beliefs or memories. © 2011 Psychology Press.

Hyponatremia in Endurance Athletes

The purpose of this paper was to identify the relationship between hyponatremia, or water intoxication, and endurance athletes. Athletic trainers and paramedics must be educated about this potentially fatal problem and be able to determine the appropriate treatment for a hyponatremic athlete.

Determination of Arsenic Species in Water and Grape-Based Beverages

Arsenic is a human carcinogen that has been found in various waters and wines throughout the world. Therefore, close examination of these liquids is necessary to prevent the intoxication of animals and humans. Wines and waters often contain significant amounts of toxic arsenic species. The source of arsenic in wines and waters is generally believed to be the result of arsenic-based pesticides and herbicides. Recent studies have also shown that toxic arsenic may be used in the cultivation and acceleration of the ripening process of fruit, ultimately contaminating fruit-based beverages. The determination of total arsenic can be found by using several methods, including AFS or ICP/MS. No pretreatment of water is necessary, except for filtering by means of a Fisherbrand PTFE 0.45 connected to a Becton-Dickinson 10 mL syringe to filter particles from water. The pretreatment of the wine includes ethanol evaporation and an addition of 0.1% nitric acid. A number of commercial drinking waters and regional lake water were analyzed. Since we have confirmed the presence of arsenic in a variety of waters and wines from different countries, we decided to test a number of commercially available beverages for the presence of arsenic. The focus ofthis project is to establish the presence of arsenic in various commercially available beverages. ICP-MS was used to determine total arsenic using certified standards. Internal standards Indium and Yttrium were also used to verify the concentration readings, which varied from 0- 20 ppb.

Magnitude da morbidade relacionada ao trabalho no Rio Grande do Norte

Diseases and disorders related to work sets up an important public health problem in Brazil and worldwide. However, the reality of these diseases still constitutes a gap with regard to its characterization and epidemiological situation, especially in Brazil. In this context, this study aims to analyze the magnitude of morbidity related to work from the injuries and illnesses reported by Health the Diseases Notifiable of Health of the State Public River Health Department worker Reference Center Information System services Grande do Norte from 2007 to 2014. It is ecological study, quantitative cross-sectional study in which the analysis unit of the municipalities of Rio Grande do Norte. Data were collected from the state base of Diseases Notifiable Information System Centre of the Secretariat of State Workers' Health Reference Public Health of Rio Grande do Norte, between March and June 2015, after the approval of the Committee of Ethics in Research of the Federal University of Rio Grande do Norte, Opinion 014/2014. The population was represented by the universe of cases of diseases and disorders related to work that were reported and shut down the system from 2007 to 2014. Data were analyzed using descriptive and inferential statistics, presented in tables, graphs, charts and figures. For this, we used the Microsoft Excel 2007 and SPSS version 20.0. To check the significance level we opted for the application of the chi-square or Fisher tests. We adopted the significance level of p <0.05. Of the 10,161 cases of diseases related to the reported work, the biological work accidents had the highest percentage (52.84%) followed by serious occupational accidents (37.49%). For diseases, the highlights were musculoskeletal (4.82%), mental disorders (2.19%) and exogenous intoxication (1.97%). Among men, there was a predominance of major accidents (91.80%), mental disorders (70.00%) and exogenous poisoning (52.84%). Women were most affected by biological accidents (77.50%) and musculoskeletal diseases (64.10%). Among workers who have suffered injuries predominated mulatto (%), mean age of 35.86 years, low education (%) and workers in the formal sector (%). Among the accidents, biological (n = 5,369) accounted for 52.84% of cases occurred predominantly among nursing professionals (48.31%). The percutaneous exposure was the most frequent (73.05%) and the occurrence of circumstances was improper disposal of sharps (45.28%), the needle the most common agent (66.62%) and the organic material was blood (72.99%). Most injured workers were vaccinated against hepatitis B (68.13%), but no information as to the assessment of the vaccine response. In the course of the disease predominated ignored the situation with loss of monitoring of clinical follow-up (55.62%). There was also an increase in the notification of serious industrial accidents predominantly male (91.80%) workers aged 25-44 years (54.3%) and typical accidents (76.3%). The temporary disability was the most common outcome (55.53%) and hand the most affected part (33.00%); the mining and construction industry had the highest number of cases (25.1%) in registered employee (34.2%). The findings of this study show a positive result in relation to increased mandatory reporting of injuries and illnesses related to work together to health services that meet victimized workers, towards the occurrence of knowledge of these accidents for decision making in public plans and policies of health. However, the information system still needs improvement in both the coverage and the quality of the data to demonstrate with greater reliability the magnitude of events to support the planning of workers' health into shares in the state.

Doing Research with Vulnerable Populations: The Case of Intravenous Drug Users

Article

Doing Research with Vulnerable Populations: The Case of Intravenous Drug Users

Article

Étude d’évaluabilité et évaluation des processus et des effets d’un programme de prévention de l’usage de substances psychoactives lors de la transition primaire-secondaire

La mise en œuvre d’activités de prévention de la consommation de substances psychoactives (SPA) (tabac, alcool et cannabis) en milieu scolaire est une stratégie couramment utilisée pour rejoindre un grand nombre de jeunes. Ces activités s’inspirent, soit de programmes existant, soit d’innovations dictées par le contexte d’implantation ou l’existence de données de recherche. Dans un cas comme dans l’autre, l’évaluation de ces programmes représente la meilleure voie pour mesurer leur efficacité et/ou connaître comment ceux-ci sont implantés. C’est cet impératif qui a motivé une commission scolaire du Québec a recommandé l’évaluation de l’Intervention en Réseau (IR), un programme développé en vue de retarder l’âge d’initiation et de réduire la consommation problématique de SPA chez les élèves. Ce programme adopte une approche novatrice avec pour principal animateur un intervenant pivot (IP) qui assure le suivi des élèves de la 5e année du primaire jusqu’en 3e secondaire. Inspiré des modèles en prévention de la santé et de l’Approche École en santé (AES), le rôle de l’IP ici se démarque de ceux-ci. Certes, il est l’interface entre les différents acteurs impliqués et les élèves mais dans le cadre du programme IR, l’IP est intégré dans les écoles primaires et secondaires qu’il dessert. C’est cet intervenant qui assure la mobilisation des autres acteurs pour la mise en œuvre des activités. Cette thèse vise à rendre compte de ce processus d’évaluation ainsi que des résultats obtenus. L’approche d’évaluation en est une de type participatif et collaboratif avec des données quantitatives et qualitatives recueillies par le biais de questionnaires, d’entrevues, de groupes de discussion, d’un journal de bord et de notes de réunions. Les données ont été analysées dans le cadre de trois articles dont le premier concerne l’étude d’évaluabilité (ÉÉ) du programme. Les participants de cette ÉÉ sont des acteurs-clés du programme (N=13) rencontrés en entrevues. Une analyse documentaire (rapports et journal de bord) a également été effectuée. Cette ÉÉ a permis de clarifier les intentions des initiateurs du programme et les objectifs poursuivis par ces derniers. Elle a également permis de rendre la théorie du programme plus explicite et de développer le modèle logique, deux éléments qui ont facilité les opérations d’évaluation qui ont suivi. Le deuxième article porte sur l’évaluation des processus en utilisant la théorie de l’acteur-réseau (TAR) à travers ses quatre moments du processus de traduction des innovations (la problématisation, l’intéressement, l’enrôlement et la mobilisation des alliés), l’analyse des controverses et du rôle des acteurs humains et non-humains. Après l’analyse des données obtenues par entrevues auprès de 19 informateurs-clés, les résultats montrent que les phases d’implantation du programme passent effectivement par les quatre moments de la TAR, que la gestion des controverses par la négociation et le soutien était nécessaire pour la mobilisation de certains acteurs humains. Cette évaluation des processus a également permis de mettre en évidence le rôle des acteurs non-humains dans le processus d’implantation du programme. Le dernier article concerne une évaluation combinée des effets (volet quantitatif) et des processus (volet qualitatif) du programme. Pour le volet quantitatif, un devis quasi-expérimental a été adopté et les données ont été colligées de façon longitudinale par questionnaires auprès de 901 élèves de 5e et 6e année du primaire et leurs enseignants de 2010 à 2014. L’analyse des données ont montré que le programme n’a pas eu d’effets sur l’accessibilité et les risques perçus, l’usage problématique d’alcool et la polyconsommation (alcool et cannabis) chez les participants. Par contre, les résultats suggèrent que le programme pourrait favoriser la réduction du niveau de consommation et retarder l’âge d’initiation à l’alcool et au cannabis. Ils suggèrent également un effet potentiellement positif du programme sur l’intoxication à l’alcool chez les élèves. Quant au volet qualitatif, il a été réalisé à l’aide d’entrevues avec les intervenants (N=17), de groupes de discussion avec des élèves du secondaire (N=10) et d’une analyse documentaire. Les résultats montrent que le programme bénéficie d’un préjugé favorable de la part des différents acteurs ayant participé à l’évaluation et est bien acceptée par ces derniers. Cependant, le roulement fréquent de personnel et le grand nombre d’écoles à suivre peuvent constituer des obstacles à la bonne marche du programme. En revanche, le leadership et le soutien des directions d’écoles, la collaboration des enseignants, les qualités de l’IP et la flexibilité de la mise en œuvre sont identifiés comme des éléments ayant contribué au succès du programme. Les résultats et leur implication pour les programmes et l’évaluation sont discutés. Enfin, un plan de transfert des connaissances issues de la recherche évaluative est proposé.