We assessed the association of three chlorinated dibenzo- p -dioxins, a chlorinated dibenzofuran, and four dioxin-like polychlorinated biphenyls (PCBs) in human blood with nephropathy (microalbuminuria or macroalbuminuria) among teens and young adults (12–30 years old) having normal glycohemoglobin (A1c <5.7%). The data were derived from the 1999–2004 National Health and Nutrition Examination Survey (unweighted n=1504, population estimate=38,806,338). In this paper, nephropathy refers to normal A1c with nephropathy. In an all-adult sample (Everett CJ, Thompson OM. Dioxins, furans and dioxin-like PCBs in human blood: causes or consequences of diabetic nephropathy? Environ Res 2014;132:126–31), the cut-offs for these chemicals being considered elevated, were defined as the 75th percentile. Using these same cut-offs again, the proportion of those with one or more of the eight dioxin-like compounds elevated was 9.9%. The four chemicals associated with nephropathy were 1,2,3,6,7,8-hexachlorodibenzo- p -dioxin, PCB 126, PCB 169, and PCB 156. The proportion with one or more of these four dioxin-like chemicals elevated was 3.9% (unweighted n=46) and the odds ratio (OR) for nephropathy was 7.1 [95% confidence interval (CI) 1.8–28.1]. The association was strong among females (OR 17.4, 95% CI 3.4–88.6), but among males there were no cases of nephropathy when one or more of the four dioxin-like chemicals were elevated, and therefore no association. In a separate analysis, elevated toxic equivalency, defined using the eight dioxin-like chemicals (TEQ 8 ), was associated with nephropathy. TEQ 8 ≥50.12 fg/g included 2.6% of the sample (unweighted n=28) and had an OR of 5.8 (95% 1.3–25.9) for nephropathy. As found in the analysis of one or more of four dioxin-like chemicals elevated, TEQ 8 ≥50.12 fg/g was associated with nephropathy among females (OR 11.9, 95% CI 1.6–87.2), but not males. Trends for least-squares means also differed by gender, but there were no significant differences in mean TEQ 8 between normal subjects and those having nephropathy in either males or females. We also evaluated pre-diabetes (A1c 5.7–6.4%) without nephropathy and found no associations when one or more of four dioxin-like compounds were elevated, or when TEQ 8 was ≥50.12 fg/g. In this study, associations of dioxin-like chemicals with nephropathy were found among females at an early age. Prospective studies are needed to determine if dioxin-like compounds cause nephropathy, or if these relationships are cases of reverse causation.

May 14, 2016

Asbestos exposure and mesothelioma incidence and mortality in Bulgaria

Katya Vangelova, Irina Dimitrova

Page range: 203-209

Abstract

Bulgaria totally banned the import, production and use of asbestos in 2005, but produced and used asbestos products during the last 3–4 decades of the 20th century. The aim of this study was to follow the incidence and mortality of mesothelioma in Bulgaria in relation to past occupational exposures. A literature search between 1960 and 2014 was conducted to obtain information on asbestos consumption, occupational exposure and asbestos-related diseases (ARDs). Data on registered mesotheliomas were provided by the National Cancer Register and data for recognized occupational ARDs were provided by the National Social Security Institute. An increase in the incidence of mesothelioma from 5 to 58 from 1993 to 2013, with 666 cases in the 21-year period, was registered. Incidence, mortality rates, deaths and male-to-female ratios and were lower in comparison to industrialized countries. The increase in mesothelioma incidence is considered as a consequence of more recent production and use of asbestos and asbestos products and the high occupational exposure between 1977 and 1989, while the lower rate of mesothelioma deaths and male-to-female ratio need to be investigated further.

May 14, 2016

A cautionary approach in transitioning to ‘green’ energy technologies and practices is required

Puleng Matatiele, Mary Gulumian

Page range: 211-223

Abstract

Renewable energy technologies (wind turbines, solar cells, biofuels, etc.) are often referred to as ‘clean’ or ‘green’ energy sources, while jobs linked to the field of environmental protection and energy efficiency are referred to as ‘green’ jobs. The energy efficiency of clean technologies, which is likely to reduce and/or eliminate reliance on fossil fuels, is acknowledged. However, the potential contribution of green technologies and associated practices to ill health and environmental pollution resulting from consumption of energy and raw materials, generation of waste, and the negative impacts related to some life cycle phases of these technologies are discussed. Similarly, a point is made that the green jobs theme is mistakenly oversold because the employment opportunities generated by transitioning to green technologies are not necessarily safe and healthy jobs. Emphasis is put on identifying the hazards associated with these green designs, assessing the risks to the environment and worker health and safety, and either eliminating the hazards or minimizing the risks as essential elements to the design, construction, operation, and maintenance of green technologies. The perception that it is not always economically possible to consider all risk factors associated with renewable energy technologies at the beginning without hampering their implementation, especially in the poor developing countries, is dismissed. Instead, poor countries are encouraged to start implementing environmentally sound practices while transitioning to green technologies in line with their technological development and overall economic growth.

Review Articles

Publicly Available May 12, 2016

Potential hazards of air pollutant emissions from unconventional oil and natural gas operations on the respiratory health of children and infants

Ellen Webb, Jake Hays, Larysa Dyrszka, Brian Rodriguez, Caroline Cox, Katie Huffling, Sheila Bushkin-Bedient

Page range: 225-243

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Abstract

Research on air pollutant emissions associated with unconventional oil and gas (UOG) development has grown significantly in recent years. Empirical investigations have focused on the identification and measurement of oil and gas air pollutants [e.g. volatile organic compounds (VOCs), particulate matter (PM), methane] and the influence of UOG on local and regional ambient air quality (e.g. tropospheric ozone). While more studies to better characterize spatial and temporal trends in exposure among children and newborns near UOG sites are needed, existing research suggests that exposure to air pollutants emitted during lifecycle operations can potentially lead to adverse respiratory outcomes in this population. Children are known to be at a greater risk from exposure to air pollutants, which can impair lung function and neurodevelopment, or exacerbate existing conditions, such as asthma, because the respiratory system is particularly vulnerable during development in-utero, the postnatal period, and early childhood. In this article, we review the literature relevant to respiratory risks of UOG on infants and children. Existing epidemiology studies document the impact of air pollutant exposure on children in other contexts and suggest impacts near UOG. Research is sparse on long-term health risks associated with frequent acute exposures – especially in children – hence our interpretation of these findings may be conservative. Many data gaps remain, but existing data support precautionary measures to protect the health of infants and children.

Publicly Available October 29, 2015

Environmental pollutions associated to conflicts in Iraq and related health problems

Ahmed Majeed Al-Shammari

Page range: 245-250

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Abstract

Several wars and a 13-year embargo as well as several years of civil war with the recent war on terrorism have cumulatively damaged Iraq’s land, air, water, and health infrastructure. The sand particles in Iraq contain toxic substances, which dates back to the pollution caused by military actions that disassemble the desert sands and turn it into light dust. This dust reaches cities as dust storms that effect most Iraqi cities. The presence of depleted uranium (DU) in the Iraqi food chain is documented by measuring the uranium in animals organs in different Iraqi cities with the highest concentration in the south of Iraq. One of the major sites of pollution in Iraq is the Al-twaitha nuclear research site. The nuclear research reactors were destroyed in the 1991 Gulf War. Barrels containing radioactive materials and sources were stolen from the site in the 2003 war. This resulted in considerable radioactive pollution at the site and in its surrounding areas. Soil sample have been found to be contaminated by Cs-137and Co-60. Cancer and birth defects are most associated with the environmental pollution caused by the conflicts. All studies related to this by Iraqi researchers are discussed in this review. From studying the Iraqi scientific publications, we can conclude that Basrah, Baghdad, Faluja, Mosul and Thi-Qar are the most effected cities in Iraq. This review concludes that the presence of a heavily contaminated environment with war related pollutants in most of the Iraqi cities needs much attention and huge effort to reduce the related health problems.

January 20, 2016

Epidemiology of musculoskeletal injury in the California film and motion picture industry

Nicholas A. Kusnezov, Hamed Yazdanshenas, Eddie Garcia, Arya N. Shamie

Page range: 251-257

Abstract

Introduction: Musculoskeletal injury exerts a significant burden on US industry. The purpose of this study was to investigate the frequency and characteristics of musculoskeletal injuries in the California (CA) film and motion picture (FMP) industry which may result in unforeseen morbidity and mortality. Methods: We reviewed the workers’ compensation (WC) claims database of the Workers’ Compensation Insurance Rating Bureau of California (WCIRB) and employment statistics through the US Bureau of Labor Statistics (BLS). We analyzed the frequency, type, body part affected, and cause of musculoskeletal injuries. Results: From 2003 to 2009, there were 3505 WC claims of which 94.4% were musculoskeletal. In the CA FMP industry, the most common injuries were strains (38.4%), sprains (12.2%), and fractures (11.7%). The most common sites of isolated injury were the knee (18.9%), lower back (15.0%), and ankle (8.6%). Isolated musculoskeletal spine injuries represented 19.3% of all injuries. The most common causes of injury were work-directed activity (36.0%) and falls (25.5%). Conclusion: We present the first report on the unique profile of musculoskeletal injury claims in the FMP industry. This data provides direction for improvement of workplace safety.

April 21, 2016

Respiratory health outcomes and air pollution in the Eastern Mediterranean Region: a systematic review

Nour Abdo, Yousef S. Khader, Mostafa Abdelrahman, Ashley Graboski-Bauer, Mazen Malkawi, Munjed Al-Sharif, Ahmad M. Elbetieha

Page range: 259-280

Abstract

Exposure to air pollution can cause detrimental health and be an economic burden. With newly developed equipment, monitoring of different air pollutants, identifying the sources, types of air pollutants and their corresponding concentrations, and applying mitigation intervention techniques became a crucial step in public health protection. Countries in the Eastern Mediterranean Region (EMR) are highly exposed to dust storms, have high levels of particulate matter (PM) concentrations, and have a unique climatic as well as topographic and socio-economic structure. This is the first study conducted to systemically and qualitatively assess the health impacts of air pollution in the EMR, identify susceptible populations, and ascertain research and knowledge gaps in the literature to better inform decisions by policy makers. We screened relevant papers and reports published between 2000 and 2014 in research databases. A total of 36 published studies met the inclusion criteria. A variety of indoor and outdoor exposures associated with various acute and chronic respiratory health outcomes were included. Respiratory health outcomes ranged in severity, from allergies and general respiratory complaints to lung cancer and mortality. Several adverse health outcomes were positively associated with various indoor/outdoor air pollutants throughout the EMR. However, epidemiological literature concerning the EMR is limited to a few studies in a few countries. More research is needed to elucidate the health outcomes of air pollution. Standardized reliable assessments on the national level for various air pollutants in different regions should be implemented and made publically available for researchers to utilize in their research. Moreover, advancing and utilizing more sound epidemiological designs and studies on the effect of air pollution on the respiratory health outcomes is needed to portray the actual situation in the region.

Publicly Available April 22, 2016

Fibromyalgia syndrome pathology and environmental influences on afflictions with medically unexplained symptoms

Phillip J. Albrecht, Frank L. Rice

Page range: 281-294

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Abstract

Fibromyalgia syndrome (FMS) is a clinical disorder predominant in females with unknown etiology and medically unexplained symptoms (MUS), similar to other afflictions, including irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS), post-traumatic stress disorder (PTSD), Gulf War illness (GFI), and others. External environmental stimuli drive behavior and impact physiologic homeostasis (internal environment) via autonomic functioning. These environments directly impact the individual affective state (mind), which feeds back to regulate physiology (body). FMS has emerged as a complex disorder with pathologies identified among neurotransmitter and enzyme levels, immune/cytokine functionality, cortical volumes, cutaneous innervation, as well as an increased frequency among people with a history of traumatic and/or emotionally negative events, and specific personality trait profiles. Yet, quantitative physical evidence of pathology or disease etiology among FMS has been limited (as with other afflictions with MUS). Previously, our group published findings of increased peptidergic sensory innervation associated with the arterio-venous shunts (AVS) in the glabrous hand skin of FMS patients, which provides a plausible mechanism for the wide-spread FMS symptomology. This review focuses on FMS as a model affliction with MUS to discuss the implications of the recently discovered peripheral innervation alterations, explore the role of peripheral innervation to central sensitization syndromes (CSS), and examine possible estrogen-related mechanisms through which external and internal environmental factors may contribute to FMS etiology and possibly other afflictions with MUS.

About this journal

Objective
Reviews on Environmental Health is an international peer-reviewed journal that aims to fill the need for publication of review articles on hot topics in the field of environmental health. It is intended to be an inspiring forum for scientists, environmentalists, physicians, engineers, and students who are concerned with aspects of human health, including quality of life, that are determined by physiological and psychosociological interactions between humans and physical, chemical, biological, and social factors in the environment.
Reviews on Environmental Health is an important niche not served by any other journal, namely, a place to publish thoughtful reviews on a variety of topics related to both health and the environment. One challenge is to link the research on environmental causes of disease to the clinical practice of medicine. Reviews on Environmental Health is a source of integrated information on environmental health topics that will be of value to the broad scientific community, whether students, junior and senior professionals, or clinicians.

Topics

Environmental toxicology
Neurotoxicology
Immunology
Oncology
Dermatology
Epidemiology
Molecular biology
Pharmacogenetics
Child health
Medicine, occupational health and risk assessment
Water, air, and soil quality control
Methods for biomonitoring and remediation

Article formats
Reviews, Letters to the Editor, Editorials