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Environment International Jun 2024Fusion energy investigation has stepped to a new stage adopting deuterium and tritium as fuels from the previous stage concentrating hydrogen plasma physics. Special... (Review)
Review
Fusion energy investigation has stepped to a new stage adopting deuterium and tritium as fuels from the previous stage concentrating hydrogen plasma physics. Special radiation safety issues would be introduced during this stage. In addition to industrial and military uses, tungsten is also regarded as the most promising plasma facing material for fusion reactors. During the operation of fusion reactors, tungsten-based plasma facing materials can be activated via neutron nuclear reaction. Meanwhile, activated tungsten dust can be produced when high-energy plasma interacts with the tungsten-based plasma facing materials, namely plasma wall interaction. Activated tungsten dust would be an emerging environmental pollutant with radiation toxicity containing various radionuclides in addition to the chemical toxicity of tungsten itself. Nonetheless, the historical underestimation of its environmental availability has led to limited research on tungsten compared to other environmental contaminants. This paper presents the first systematic review on the safety issue of emerging activated tungsten dust, encompassing source terms, environmental behaviors, and health effects. The key contents are as follows: 1) to detail the source terms of activated tungsten dust from aspects of tungsten basic properties, generation mechanism, physical morphology and chemical component, radioactivity, as well as potential release pathways, 2) to illustrate the environmental behaviors from aspects of atmospheric dispersion and deposition, transformation and migration in soil, as well as plant absorption and distribution, 3) to identify the toxicity and health effects from aspects of toxicity to plants, distribution in human body, as well as health effects by radiation and chemical toxicity, 4) based on the research progress, research and development issues needed are also pointed out to better knowledge of safety issue of activated tungsten dust, which would be beneficial to the area of fusion energy and ecological impact caused by the routine tungsten related industrial and military applications.
Topics: Tungsten; Dust; Humans
PubMed: 38810497
DOI: 10.1016/j.envint.2024.108774 -
Environmental Pollution (Barking, Essex... Apr 2024Chronic respiratory diseases are a dealing cause of death and disability worldwide. Their prevalence is steadily increasing and the exposure to environmental... (Meta-Analysis)
Meta-Analysis Review
Chronic respiratory diseases are a dealing cause of death and disability worldwide. Their prevalence is steadily increasing and the exposure to environmental contaminants, including Flame Retardants (FRs), is being considered as a possible risk factor. Despite the widespread and continuous exposure to FRs, the role of these contaminants in chronic respiratory diseases is yet not clear. This study aims to systematically review the association between the exposure to FRs and chronic respiratory diseases. Searches were performed using the Cochrane Library, MEDLINE, EMBASE, PUBMED, SCOPUS, ISI Web of Science (Science and Social Science Index), WHO Global Health Library and CINAHL EBSCO. Among the initial 353 articles found, only 9 fulfilled the inclusion criteria and were included. No statistically significant increase in the risk for chronic respiratory diseases with exposure to FRs was found and therefore there is not enough evidence to support that FRs pose a significantly higher risk for the development or worsening of respiratory diseases. However, a non-significant trend for potential hazard was found for asthma and rhinitis/rhinoconjunctivitis, particularly considering urinary organophosphate esters (OPEs) including TNBP, TPHP, TCEP and TCIPP congeners/compounds. Most studies showed a predominance of moderate risk of bias, therefore the global strength of the evidence is low. The limitations of the studies here reviewed, and the potential hazardous effects herein identified highlights the need for good quality large-scale cohort studies in which biomarkers of exposure should be quantified in biological samples.
Topics: Humans; Flame Retardants; Organophosphorus Compounds; Organophosphates; Asthma; Environmental Monitoring; Dust; Halogenated Diphenyl Ethers
PubMed: 38458527
DOI: 10.1016/j.envpol.2024.123733 -
The Journal of Allergy and Clinical... May 2024Although randomized controlled trials (RCT) are the reference standard of evidence in allergen immunotherapy (AIT), nonrandomized studies (NRS) are needed to confirm...
IR (index of reactivity)-house dust mite sublingual immunotherapy liquid formulation for allergic rhinoconjunctivitis: Systematic review and meta-analysis of randomized and nonrandomized studies.
BACKGROUND
Although randomized controlled trials (RCT) are the reference standard of evidence in allergen immunotherapy (AIT), nonrandomized studies (NRS) are needed to confirm their results in more representative populations, particularly for treatment duration and persistence. However, when discrepancies are observed between RCT and NRS, NRS reliability decreases because these discrepant results are generally attributed to the methodologic flaws of NRS.
OBJECTIVE
We compared the benefit of sublingual AIT (SLIT) for allergic rhinoconjunctivitis in NRS versus RCT focusing on a single product/allergen to reduce heterogeneity.
METHODS
For meta-analysis, house dust mite (HDM) SLIT liquid formulation studies were sourced from computerized (Medline, Web of Science, and LILACS databases, to January 2023) and manual literature searches. Populations, treatments, and outcome data were combined (DerSimonian-Laird method). Noncomparative NRS were compared to RCT' SLIT arm before and after treatment. Efficacy was determined as the standardized mean difference (SMD) in symptom score (SS) and medication score (MS).
RESULTS
Data from 12 NRS (682 patients) and 8 RCT (176 patients) were analyzed. The benefit with index of reactivity (IR)-HDM SLIT liquid formulation was found significant for, first, SS in both NRS (SMD = -1.27; 95% confidence interval [CI], -1.64, -0.90) and RCT (SMD = -0.56; 95% CI, -0.90, -0.21), and second, MS with SMD equal to -1.35 (95% CI, -1.77, -0.93) and -0.46 (95% CI, -0.67, -0.25), respectively. Metaregression showed that symptom improvement was correlated with treatment duration with consistent results in NRS and RCT with 12-month SS data: -0.87 (interquartile range, -1.02, -0.77) and -0.75 (interquartile range, -0.93, -0.41), respectively.
CONCLUSION
This meta-analysis showed comparable clinical benefit of IR-HDM SLIT liquid formulation increasing over time in both NRS and RCT, suggesting that NRS may reliably integrate RCT results and be considered for guidelines.
PubMed: 38328804
DOI: 10.1016/j.jacig.2024.100208 -
Journal of Occupational Health Jan 2024The purpose of this study was to present a systematic review of the health-related problems of factory workers in the textile and fashion industry. These workers endure...
OBJECTIVES
The purpose of this study was to present a systematic review of the health-related problems of factory workers in the textile and fashion industry. These workers endure long sitting postures, poor workspace conditions, and long working hours to complete their overload of tasks. This situation results in several health problems that affect the productivity, mental health, and well-being of the workers.
METHODS
The relevant data (21 article publications) were obtained from the Scopus database. Analysis of the 21 articles was grouped under 3 research themes based on the critical reading of the content and abstracts: respiratory problems, musculoskeletal disorders, and psychological stressors and other health issues.
RESULTS
The findings show that factory workers are exposed to dust particles of cotton and other raw materials, fumes, and chemicals from manufacturing processes. This prolonged exposure without the use of personal protective equipment (PPE) leads to respiratory diseases like byssinosis that affect the workers' health. Additionally, working in a particular posture due to the workstation design for prolonged hours causes musculoskeletal disorders or pains. Workers also suffer from anxiety, depression, and stress from workload and pressure, hence making them unstable with reduced productivity.
CONCLUSIONS
The findings of the study reinforce the need for a safe workspace and spacious work environment, provision of PPE, training in occupational hazards, frequent health checks, and ergonomic assessment of workstations to reduce prolonged work postures. Stakeholders, employers, policymakers, and governments should collaborate to safeguard and protect the well-being and health of the workers at these factories.
Topics: Humans; Occupational Exposure; Occupational Diseases; Byssinosis; Textiles; Musculoskeletal Diseases; Textile Industry
PubMed: 38289711
DOI: 10.1093/joccuh/uiae007 -
Frontiers in Immunology 2023To systematically compare the efficacy and safety of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) in children with allergic rhinitis (AR). (Meta-Analysis)
Meta-Analysis
AIM
To systematically compare the efficacy and safety of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) in children with allergic rhinitis (AR).
METHODS
PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to March 2, 2023. Outcomes included symptom scores (SSs), medication scores (MSs), symptom and medication scores (SMSs), new sensitizations, development of asthma, improvement, and treatment-related adverse events (TRAEs). The quality of the included studies was assessed by the modified Jadad scale and Newcastle-Ottawa scale (NOS). Meta-regression was carried out to explore the source of heterogeneity. Subgroup analysis was further conducted in terms of study design [randomized controlled trials (RCTs), cohort studies], allergen [house dust mites (HDMs), grass pollen], treatment duration (≥ 24, 12-23 or < 12 months), allergen immunotherapy (AIT) modality (drops or tablets), and AIT protocol [continuous, pre-seasonal, co-seasonal, or after the grass pollen season (GPS)]. Sensitivity analysis was conducted for all outcomes. A Bayesian framework and a Monte Carlo Markov Chain (MCMC) model were developed for indirect comparison.
RESULTS
Totally 50 studies with 10813 AR children were included, with 4122 treated with SLIT, 1852 treated with SCIT, and 4839 treated with non-SLIT or non-SCIT therapy. For direct comparison, the SLIT group had a similar SS to the SCIT group [pooled standardized mean difference (SMD): 0.41, 95% confidence interval (CI): -0.46, 1.28, = 0.353]. Comparable MSs were observed in the SLIT and SCIT groups (pooled SMD: 0.82, 95%CI: -0.88, 2.53, = 0.344). For indirect comparison, no significant differences were found in SSs (pooled SMD: 1.20, 95% credibility interval (CrI): -1.70, 4.10), MSs (pooled SMD: 0.57, 95%CrI: -1.20, 2.30), SMSs (pooled SMD: 1.80, 95%CrI: -0.005, 3.60), new sensitizations [pooled relative risk (RR): 0.34, 95%CrI: 0.03, 3.58], and development of asthma (pooled RR: 0.68, 95%CrI: 0.01, 26.33) between the SLIT and SCIT groups; the SLIT group illustrated a significantly lower incidence of TRAEs than the SCIT group (pooled RR: 0.17, 95%CrI: 0.11, 0.26).
CONCLUSION
Considering both efficacy and safety, SLIT might be a more favorable AIT than SCIT in the treatment of pediatric AR, which may serve as a decision-making reference for clinicians.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (CRD42023460693).
Topics: Child; Humans; Allergens; Asthma; Desensitization, Immunologic; Pollen; Rhinitis, Allergic; Immunotherapy; Sublingual Immunotherapy
PubMed: 38162647
DOI: 10.3389/fimmu.2023.1274241 -
Frontiers in Public Health 2023The inclusion of all relevant exposure routes in the exposure assessment is essential for the protection of workers. However, under European chemical regulations but... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The inclusion of all relevant exposure routes in the exposure assessment is essential for the protection of workers. However, under European chemical regulations but also for workplace risk assessments according to occupational safety and health (OSH) requirements, the quantitative assessment of oral exposure is usually neglected assuming good occupational hygiene. In contrast, several studies point to the importance of unintentional ingestion in the workplace. To our knowledge, there is no systematic analysis of the extent of this exposure route.
METHODS
Therefore, the aim of this study was to assess systematically the current knowledge on the relevance of occupational oral exposure using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) method. Five electronic databases and nine institutional websites were searched for all publications on the relevance. The data were extracted into a concept matrix. In the subsequent meta-analysis, the identified conclusions on the relevance were analyzed. In addition, the measurement methods or modeling approaches that were described for occupational oral exposure were determined as well as the potentially relevant workplaces and substances.
RESULTS
In total, 147 studies were included in this analysis that contain a general or several, differentiated assessments of the relevance of occupational oral exposure. Nine of these studies assessed this exposure route as irrelevant. However, 123 studies considered oral exposure as potentially contributing and 80 studies explicitly identified it as relevant. 78 and 94 of the publications described modeling and measurement approaches, respectively. The workplaces frequently identified as potentially or explicitly relevant were other indoor, other industrial or recycling workplaces. Analogously, metals, dust and powders or pesticides were the most frequently investigated substance groups.
DISCUSSION
As several studies assessed occupational oral exposure as relevant in the context of different workplaces and substances, further investigation of this exposure route is needed. This systematic review and meta-analysis serve as a basis for further development of feasible assessment methods for this route of exposure.
Topics: Humans; Occupational Exposure; Risk Assessment; Workplace; Pesticides
PubMed: 38098819
DOI: 10.3389/fpubh.2023.1298744 -
Toxicology Reports Dec 2023Heavy metals in street dust are one of the most important sources of pollutants in urban areas. This urban dust can be caused by industrial activities, traffic, erosion... (Review)
Review
BACKGROUND
Heavy metals in street dust are one of the most important sources of pollutants in urban areas. This urban dust can be caused by industrial activities, traffic, erosion of buildings, and fossil fuels. The aim of this systematic review is to evaluate the ecological risk of heavy metals in the dust of Iran's provinces.
METHODS
This study was conducted in February 2023 in order to investigate the environmental risks associated with heavy metals associated with dust particles in Iran. The present study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Finally, 9 studies were extracted from the search databases.
RESULTS
The ecological risk of heavy metals in the present study was as follows: Cd (258.26؛ CI: 83.53, 433) >Pb (52.58؛ CI: 37.15, 68.02) >Cu (24.44؛ CI: 16.74, 32.14)>Ni (14.75؛ CI: 12.68, 16.82)>As (13.53؛ CI: 10.20, 16.85)>Zn (6.32؛ CI: 3.76, 8.87)>V (3.18؛ CI: 2.65, 3.72)>Cr (2.73؛ CI: 2.19, 3.27)>Co (1.94؛ CI: 1.13, 2.74). The mean ranking of the studied Pb ecological risk is as follows: Shiraz.> Tehran > Ahvaz > Ilam > Abadan > Dezful.
CONCLUSION
The ecological risk potential of Cd in Tehran was also much higher than the standard. Therefore, Tehran was the most polluted city studied in terms of the ecological risk potential of Cd (1611.41؛ CI: 1605.98, 1616.84) and Pb (86.54؛ CI: 71.46, 101.62). The average concentration as well as the ecological risk of Cr, Co, and V metals were lower than the standard. Therefore, controlling the sources of heavy metal emissions (especially lead and cadmium) is highly recommended.
PubMed: 38075013
DOI: 10.1016/j.toxrep.2023.11.007 -
Environmental Health : a Global Access... Nov 2023Respirable crystalline silica (RCS) is associated with the development of lung cancer. However, there is uncertainty around the exposure threshold at which exposure to... (Review)
Review
BACKGROUND
Respirable crystalline silica (RCS) is associated with the development of lung cancer. However, there is uncertainty around the exposure threshold at which exposure to RCS may pose a clear risk for the development of lung cancer. The objective of this study was to review the cut-off points at which the risk of mortality or incidence of lung cancer due to occupational exposure to RCS becomes evident through a systematic review.
METHODS
We conducted a search in PubMed, including cohort and case-control studies which assessed various categories of RCS exposure. A search was also conducted on the webpages of institutional organizations. A qualitative data synthesis was performed.
RESULTS
Twenty studies were included. Studies that assessed lung cancer mortality and incidence displayed wide variability both in RCS exposure categories and related risks. Although most studies found no significant association for RCS exposure categories, it appears to be a low risk of lung cancer for mean concentrations of less than 0.07mg/m. Regulatory agencies set annual RCS exposure limits ranging from 0.025mg/m through 0.1mg/m.
CONCLUSIONS
There is a wide degree of heterogeneity in RCS exposure categories, with most studies observing no significant risk of lung cancer for the lowest exposure categories. Cut-off points differ between agencies but are nonetheless very similar and do not exceed 0.1mg/m.
Topics: Humans; Air Pollutants, Occupational; Inhalation Exposure; Dust; Occupational Exposure; Silicon Dioxide; Lung Neoplasms
PubMed: 38031062
DOI: 10.1186/s12940-023-01036-0 -
Canadian Journal of Surgery. Journal... 2023The number of total knee arthroplasty (TKA) procedures performed annually is increasing for reasons not fully explained by population growth and increasing rates of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The number of total knee arthroplasty (TKA) procedures performed annually is increasing for reasons not fully explained by population growth and increasing rates of obesity. The purpose of this study was to determine the role of patient functional status as an indication for surgery and to determine if patients are undergoing surgery with a higher level of preoperative function than in the past.
METHODS
A systematic review and meta-analysis of the MEDLINE, Embase and Cochrane databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Functional status was assessed using the 36-Item Short Form Health Survey's physical component summary (PCS) score. Only primary procedures were included. Articles were screened by 2 independent reviewers, with conflicts resolved with a third reviewer. Meta-regression analysis was performed to determine the effect of time, age and sex on preoperative PCS score. Subgroup analysis was performed to compare results for the United States with those for the rest of the world.
RESULTS
A total of 1502 articles were identified, of which 149 were included in the study. Data from 257 independent groups including 57 844 patients recruited from 1991 to 2015 were analyzed. The mean preoperative PCS score was 31.1 (95% confidence interval 30.6-31.7) with a 95% prediction interval of 22.8-39.5. The variance across studies was found to be significant ( < 0.001) with 99.01% true variance. Year of enrolment, age, the percentage of female patients and geographic region did not have any significant effect on preoperative PCS score.
CONCLUSION
Patients are undergoing TKA with a level of preoperative function similar to their level of function in the past. Patient age, sex and location did not influence the functional status at which patients were considered to be candidates for surgery.
Topics: Female; Humans; Arthroplasty, Replacement, Knee; Osteoarthritis, Knee; Treatment Outcome; Male
PubMed: 37875301
DOI: 10.1503/cjs.013222 -
PLOS Global Public Health 2023An estimated 44 million artisanal and small-scale miners (ASM), largely based in developing economies, face significant occupational risks for respiratory diseases which...
An estimated 44 million artisanal and small-scale miners (ASM), largely based in developing economies, face significant occupational risks for respiratory diseases which have not been reviewed. We therefore aimed to review studies that describe silicosis and tuberculosis prevalence and respirable crystalline silica (RCS) exposures among ASM and use background evidence to better understand the relationship between exposures and disease outcomes. We searched PubMed, Web of Science, Scopus and Embase for studies published before the 24th March 2023. Our primary outcome of interest was silicosis or tuberculosis among ASM. Secondary outcomes included measurements of respirable dust or silica, spirometry and prevalence of respiratory symptoms. A systematic review and narrative synthesis was performed and risk of bias assessed using the Joanna Briggs Prevalence Critical Appraisal Tool. Logistic and Poisson regression models with predefined parameters were used to estimate silicosis prevalence and tuberculosis incidence at different distributions of cumulative silica exposure. We identified 18 eligible studies that included 29,562 miners from 13 distinct populations in 10 countries. Silicosis prevalence ranged from 11 to 37%, despite four of five studies reporting an average median duration of mining of <6 years. Tuberculosis prevalence was high; microbiologically confirmed disease ranged from 1.8 to 6.1% and clinical disease 3.0 to 17%. Average RCS intensity was very high (range 0.19-89.5 mg/m3) and respiratory symptoms were common. Our modelling demonstrated decreases in cumulative RCS are associated with reductions in silicosis and tuberculosis, with greater reductions at higher mean exposures. Despite potential selection and measurement bias, prevalence of silicosis and tuberculosis were high in the studies identified in this review. Our modelling demonstrated the greatest respiratory health benefits of reducing RCS are in those with highest exposures. ASM face a high occupational respiratory disease burden which can be reduced by low-cost and effective reductions in RCS.
PubMed: 37733799
DOI: 10.1371/journal.pgph.0002085