Systematic Review of Potential Health Risks Posed by Pharmaceutical, Occupational and Consumer Exposures to Metallic and Nanoscale Aluminum, Aluminum Oxides, Aluminum Hydroxide and Its Soluble Salts

Aluminum (Al) is a ubiquitous substance encountered both naturally (as the third most abundant element) and intentionally (used in water, foods, pharmaceuticals, and vaccines); it is also present in ambient and occupational airborne particulates. Existing data underscore the importance of Al physical and chemical forms in relation to its uptake, accumulation, and systemic bioavailability. The present review represents a systematic examination of the peer-reviewed literature on the adverse health effects of Al materials published since a previous critical evaluation compiled by Krewski et al. (2007). Challenges encountered in carrying out the present review reflected the experimental use of different physical and chemical Al forms, different routes of administration, and different target organs in relation to the magnitude, frequency, and duration of exposure. Wide variations in diet can result in Al intakes that are often higher than the World Health Organization provisional tolerable weekly intake (PTWI), which is based on studies with Al citrate. Comparing daily dietary Al exposures on the basis of “total Al”assumes that gastrointestinal bioavailability for all dietary Al forms is equivalent to that for Al citrate, an approach that requires validation. Current occupational exposure limits (OELs) for identical Al substances vary as much as 15-fold. The toxicity of different Al forms depends in large measure on their physical behavior and relative solubility in water. The toxicity of soluble Al forms depends upon the delivered dose of Al+ 3 to target tissues. Trivalent Al reacts with water to produce bidentate superoxide coordination spheres [Al(O2)(H2O4)+ 2 and Al(H2O)6 + 3] that after complexation with O2•−, generate Al superoxides [Al(O2•)](H2O5)]+ 2. Semireduced AlO2• radicals deplete mitochondrial Fe and promote generation of H2O2, O2 • − and OH•. Thus, it is the Al+ 3-induced formation of oxygen radicals that accounts for the oxidative damage that leads to intrinsic apoptosis. In contrast, the toxicity of the insoluble Al oxides depends primarily on their behavior as particulates. Aluminum has been held responsible for human morbidity and mortality, but there is no consistent and convincing evidence to associate the Al found in food and drinking water at the doses and chemical forms presently consumed by people living in North America and Western Europe with increased risk for Alzheimer\u27s disease (AD). Neither is there clear evidence to show use of Al-containing underarm antiperspirants or cosmetics increases the risk of AD or breast cancer. Metallic Al, its oxides, and common Al salts have not been shown to be either genotoxic or carcinogenic. Aluminum exposures during neonatal and pediatric parenteral nutrition (PN) can impair bone mineralization and delay neurological development. Adverse effects to vaccines with Al adjuvants have occurred; however, recent controlled trials found that the immunologic response to certain vaccines with Al adjuvants was no greater, and in some cases less than, that after identical vaccination without Al adjuvants. The scientific literature on the adverse health effects of Al is extensive. Health risk assessments for Al must take into account individual co-factors (e.g., age, renal function, diet, gastric pH). Conclusions from the current review point to the need for refinement of the PTWI, reduction of Al contamination in PN solutions, justification for routine addition of Al to vaccines, and harmonization of OELs for Al substances

En analyse av formuesskattens innvirkning på vekstselskaper : en empirisk studie av norske gasellebedrifter

I lys av den fallende produktivitetsveksten i Norge og en pågående debatt rundt formuesskatten, ønsker vi med denne masterutredningen å bidra med en empirisk analyse over formuesskattens innvirkninger på vekstbedrifter og entreprenørskap. Gjennom deskriptiv og empirisk analyse av Dagens Næringslivs (DN) gasellebedrifter i 2012 undersøker vi i hvilken grad formuesskatten skaper økonomiske utfordringer for vekstselskapene. I vår søken etter svar finner vi at kun 15 % av gasellebedriftene utløser formuesskatt på privat hånd for sine respektive aksjonærer. Sett opp mot deres private formuer utgjør formuesskatt fra bedrift en brøkdel av aksjonærenes totale formuesskatt, noe som tilsier at majoriteten av formuesskatten utløses fra andre kilder enn eierskap i gasellebedriftene. På bedriftsnivå finner vi at formuesskatten utgjør en marginal andel av skattetrykket i selskapet, og som andel av utbytte utgjør den under 2 %. Dette underbygger at utbytte tas ut med andre formål enn å betjene formuesskatten. Gjennom regresjonsanalyser og nøkkeltallanalyser utforsker vi påstandene om formuesskatten tapper bedrifter for kapital, om den medfører likviditetsutfordringer for selskapene, og om den utgjør større utfordringer for enkelte type selskaper. Analysen avdekker at de tre selskapene der formuesskatten har potensiale til å tappe selskapet for egenkapital har gode nøkkeltall, og at formuesskatten ikke byr på likviditetsutfordringer som følge av formuesskatten. En finansiell analyse viser at selskapene som utløser en høy formuesskatt er mer solide og mer likvide enn selskapene som utløser lav eller ingen formuesskatt. Regresjonsanalyser ga derimot ingen statistisk signifikans på at det er noen forskjell mellom selskapene som utløser høy og lav formuesskatt blant gasellene i 2012. Vår analyse, basert på 1 835 gasellebedrifter, viser dermed at det ikke er grunnlag for å hevde at formuesskatt blant aksjonærene medfører økonomiske utfordringer for vekstbedrifter som følge av at formuesskatten må betjenes.nhhma

The aetiology and trajectory of anabolic-androgenic steroid use initiation: a systematic review and synthesis of qualitative research

Background: To our knowledge, there has never been a systematic review and synthesis of the qualitative literature on the trajectory and aetiology of nonmedical anabolic-androgenic steroid (AAS) use. Methods: We systematically reviewed and synthesized qualitative literature gathered from searches in PsycINFO, PubMed, ISI Web of Science, Google Scholar, and reference lists of relevant literature to investigate AAS users’ ages of first use and source(s), history prior to use, and motives/drives for initiating use. We adhered to the recommendations of the UK Economic and Social Research Council’s qualitative research synthesis manual and the PRISMA guidelines. Results: A total of 44 studies published between 1980 and 2014 were included in the synthesis. Studies originated from 11 countries: the United States (n =18), England (n =8), Australia (n =4), Sweden (n =4), both England and Wales (n =2), and Scotland (n =2). One study each originated from Brazil, Bulgaria, Canada, France, Great Britain, and Norway. The majority of AAS users initiated use before age 30. Sports participation (particularly power sports), negative body image, and psychological disorders such as depression preceded initiation of AAS use for most users. Sources of first AAS were mainly users’ immediate social networks and the illicit market. Enhanced sports performance, appearance, and muscle/strength were the paramount motives for AAS use initiation. Conclusions: Our findings elucidate the significance of psychosocial factors in AAS use initiation. The proliferation of AAS on the illicit market and social networks demands better ways of dealing with the global public health problem of AAS use