Public health risk assessment from drinking water from vending machines in Seri Kembangan (Malaysia)

This study investigated the public health risk linked with microbial quality of drinking water from vending machines in Seri Kembangan city (Malaysia) using epidemiological and Quantitative Microbial Risk Assessment (QMRA) approaches. This study was also conducted to understand associations between reported health symptoms and daily water intake information. Following WHO guidelines on water safety, QMRA were performed was to estimate burden of disease from E. coli from water vending machines. Triplicate drinking water samples from water vending machines were collected from six sampling areas around the city, analysed for E. coli, information of health symptoms and daily water intake was obtained from 121 respondents by questionnaires. The results indicated the highest numbers of E. coli levels were found in Seri Serdang (45–68 CFU/100 mL) and Taman Pinggiran Putra (45–62 CFU/100 mL). Escherichia coli levels in drinking water samples from water vending machines obtained from Seri Serdang, Taman Pinggiran Putra, Taman Equine, Balakong and Serdang Jaya exceeded both Malaysian Drinking Water Quality and WHO Drinking Water Quality guidelines. Reported health symptoms were only significantly linked to brand which likely to be associated with regular maintenance of water vending machine. All the drinking water samples from water vending machines except from Lestari Perdana have exceeded the health based target outcomes by QMRA. Combination of epidemiology and quantitative microbial risk assessment have provided a clear understanding of public health risks and gateway for a better management of water vending machines

Chlorinated Pool Attendance, Atopy, and the Risk of Asthma during Childhood

The pool chlorine hypothesis postulates that the rise in childhood asthma in the developed world could result at least partly from the increasing exposure of children to toxic gases and aerosols contaminating the air of indoor chlorinated pools. To further assess this hypothesis, we explored the relationships between childhood asthma, atopy, and cumulated pool attendance (CPA). We studied 341 schoolchildren 10–13 years of age who attended at a variable rate the same public pool in Brussels (trichloramine in air, 0.3–0.5 mg/m(3)). Examination of the children included a questionnaire, an exercise-induced bronchoconstriction (EIB) test, and the measurement of exhaled nitric oxide (eNO) and total and aeroallergen-specific serum IgE. CPA by children (range, 0–1,818 hr) emerged among the most consistent predictors of asthma (doctor diagnosed or screened with the EIB test) and of elevated eNO, ranking immediately after atopy and family history of asthma or hay fever. Although the risk of elevated eNO increased with CPA [odds ratio (OR) = 1.30; 95% confidence interval (CI), 1.10–1.43] independently of total or specific serum IgE, the probability of developing asthma increased with CPA only in children with serum IgE > 100 kIU/L (OR for each 100-hr increase in CPA = 1.79; 95% CI, 1.07–2.72). All these effects were dose related and most strongly linked to pool attendance before 6–7 years of age. Use of indoor chlorinated pools especially by young children interacts with atopic status to promote the development of childhood asthma. These findings further support the hypothesis implicating pool chlorine in the rise of childhood asthma in industrialized countries

Mini review of mercury contamination in environment and human with an emphasis on Malaysia: status and needs

This article provides an overview of research on mercury (Hg) contamination in Malaysia and its evolution from 1979 to 2012. The objective of this paper was to review and provide an understanding of Hg exposures in the environment, humans, and food in Malaysia. Hg concentration in the environment is high in areas of West Port, Malacca Straits, Prai, and Johor because these areas receive anthropogenic metal loads brought about by industrial activities. Hg concentration in humans is related to seafood intake (dietary), environmental conditions, and different geographical locations. Hg levels in food showed higher concentration in the West coast of Peninsular Malaysia. Hg concentration is also present in the country’s tropical fruits, which is related to agrochemical and fertilizer usage. This review showed that there is an urgent need to identify Hg toxicology and bioaccumulation as well as the health effects of Hg exposure in different ecological compartments. This review aims to provide helpful recommendations for future Hg biomonitoring and research in Malaysia

Dental amalgam fillings: An under-investigated source of mercury exposure

Dental amalgam fillings, which contain about 50% mercury, have been used since the early 19th century. However, their use has been controversial, particularly because they continually release small amounts of mercury. Inorganic mercury is known to be highly toxic, particularly to the nervous system and kidneys, but exposures from amalgam fillings are generally well below those established as toxic. However, uncertainties about threshold concentrations of effect and the nature of any long-term exposure effects remain. Considering the long-standing and widespread use of these fillings, there has been remarkably little investigation of their safety and most epidemiologic studies have been relatively recent. In general, investigations to date have shown little evidence of effects on general chronic disease incidence or mortality. There have been few studies so far of neurodegenerative diseases and results have been equivocal. Assessments of the safety of dental amalgam have mainly been based on studies of occupationally exposed populations. However, the amalgam-exposed population contains a broader, potentially more susceptible, spectrum of people. In that regard, a number of studies of children that have found no evidence of health effects have provided some reassurance

Heavy metal contamination in urban surface soil of Klang district (Malaysia)

This study aimed to determine bioavailability of heavy metal concentrations (Al, Fe, Zn, Cu, Co, Cd, Pb and Cr) in 76 urban surface soil samples of Klang district (Malaysia). This study also aimed to determine health risks posed by bioavailability of heavy metals in urban soil on adults and children. For bioavailability of heavy metal concentrations, a physiologically bioavailability extraction test in vitro digestion model was used. Mean values of bioavailability heavy metal concentrations for this study were found to be the highest in Al (25.44 mg/kg) and lowest in Cr (0.10 mg/kg). Results of Spearman correlation coefficient (r) values showed significant correlations were observed for Al-Fe (r = 0.681), Cd-Co (r = 0.495), Cu-Zn (r = 0.232), Fe-Pb (r = 0.260), Fe-Zn (r = 0.239). For cluster analysis, output showed that these heavy metals could be classified into four clusters: Cluster 1 consisted of Cd, Cr, Co, and Pb; Cluster 2 consisted of Zn and Cu; Cluster 3 consisted of Fe; and Cluster 4 consisted of Al. For Clusters 1 and 2, anthropogenic sources were believed to be the sources, while for Clusters 3 and 4 the heavy metals originated from natural sources. Health risks were determined in adults and children through health risk assessment. For adults, Hazard Quotient (HQ) value was 1, indicating a non-carcinogenic risk. Meanwhile, for carcinogenic risk, heavy metal contamination in the Klang district might not pose a carcinogenic risk to adults while it may pose a carcinogenic risk to children because TR values in this study were >1.0E-04 for children. Output has identified the general health risk in the Klang district. Moreover, this study's findings will contribute to fill in the gap of knowledge on heavy metals' impacts on human health and urban development in the Klang District

Renal and Neurologic Effects of Cadmium, Lead, Mercury, and Arsenic in Children: Evidence of Early Effects and Multiple Interactions at Environmental Exposure Levels

Lead, cadmium, mercury, and arsenic are common environmental pollutants in industrialized countries, but their combined impact on children’s health is little known. We studied their effects on two main targets, the renal and dopaminergic systems, in > 800 children during a cross-sectional European survey. Control and exposed children were recruited from those living around historical nonferrous smelters in France, the Czech Republic, and Poland. Children provided blood and urine samples for the determination of the metals and sensitive renal or neurologic biomarkers. Serum concentrations of creatinine, cystatin C, and β(2)-microglobulin were negatively correlated with blood lead levels (PbB), suggesting an early renal hyperfiltration that averaged 7% in the upper quartile of PbB levels (> 55 μg/L; mean, 78.4 μg/L). The urinary excretion of retinol-binding protein, Clara cell protein, and N-acetyl-β-d-glucosaminidase was associated mainly with cadmium levels in blood or urine and with urinary mercury. All four metals influenced the dopaminergic markers serum prolactin and urinary homovanillic acid, with complex interactions brought to light. Heavy metals polluting the environment can cause subtle effects on children’s renal and dopaminergic systems without clear evidence of a threshold, which reinforces the need to control and regulate potential sources of contamination by heavy metals

Integrating Susceptibility into Environmental Policy: An Analysis of the National Ambient Air Quality Standard for Lead

Susceptibility to chemical toxins has not been adequately addressed in risk assessment methodologies. As a result, environmental policies may fail to meet their fundamental goal of protecting the public from harm. This study examines how characterization of risk may change when susceptibility is explicitly considered in policy development; in particular we examine the process used by the U.S. Environmental Protection Agency (EPA) to set a National Ambient Air Quality Standard (NAAQS) for lead. To determine a NAAQS, EPA estimated air lead-related decreases in child neurocognitive function through a combination of multiple data elements including concentration-response (CR) functions. In this article, we present alternative scenarios for determining a lead NAAQS using CR functions developed in populations more susceptible to lead toxicity due to socioeconomic disadvantage. The use of CR functions developed in susceptible groups resulted in cognitive decrements greater than original EPA estimates. EPA’s analysis suggested that a standard level of 0.15 µg/m3 would fulfill decision criteria, but by incorporating susceptibility we found that options for the standard could reasonably be extended to lower levels. The use of data developed in susceptible populations would result in the selection of a more protective NAAQS under the same decision framework applied by EPA. Results are used to frame discussion regarding why cumulative risk assessment methodologies are needed to help inform policy development