Occupational exposure explains the higher COVID-19 deaths amongst the Bangladeshi and Pakistani ethnic groups in the United Kingdom

Occupational exposure explains the higher COVID-19 deaths amongst the Bangladeshi and Pakistani ethnic groups in the United Kingdom Parvez I. Haris Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom, E-Mail: [email protected] COVID-19 mortality data from the UK office of National Statistics (ONS) reveals that the Bangladeshi and Pakistani communities were not only adversely affected during the first and second waves but also showed the largest increase in mortality in the second wave. In the second wave, there was a 60% reduction for black Africans (men and women) but a dramatic increase by 124% and 97% for men and women from Pakistani ethnicity, respectively. As yet, this alarming increase in deaths during the second wave has not been explained although multiple factors are likely to have been responsible. The Bangladeshi and Pakistani ethnic groups suffered economically due to the lockdown as a large proportion of the people from these communities’ own restaurants and takeaways and also work in this sector. To support this badly affected sector, a “eat out to help out” scheme was introduced by the government with the price of meals discounted by 50%. This was a great incentive for the businesses and the community to generate income and also for the public to enjoy meals at discounted prices during the summer of 2020. During the period of the scheme, long queues were seen outside restaurants throughout the country, especially in areas with a high concentration of Bangladeshis and Pakistanis. People from these ethnicities have the highest percentage of people working in the sector that was most directly connected to the “eat out to help out” scheme. According to the ONS data, over 30% of Bangladeshis and Pakistanis work in the distribution, hotels and restaurants sector. This is two-fold higher compared to the Black ethnic group and it is also higher than any other ethnic groups. Furthermore, the Bangladeshis and Pakistanis have the highest percentage of people (17.8%) working in the transport and communication sector compared to the Black ethnic group (11.1%). This category of workers, especially taxi and mini-cab drivers, would have been more active during the “eat out to help out” scheme taking customers to and from restaurants. Small kitchens in restaurants and fast-food outlets were packed with staff serving unusually high number customers taking advantage of heavily discounted meals. Wearing masks, at least properly with the nose and mouth fully covered, in a hot kitchen environment, during busy periods and over several hours of continuous work, is unlikely to have been easy. Social distancing in a kitchen environment is virtually impossible due to space limitation and the need to move around. Furthermore, the ventilation systems in kitchens vary widely and may not have been adequate enough to eliminate virus-laden water droplets exhaled by the restaurant workers. Exposure of virus between workers and customers is likely to have been higher during the “eat out to help out scheme” compared to other periods. All of this may have created an ideal environment for the transmission of the virus between restaurant workers and customers and thereafter being transmitted to family members and others in the community. In the UK, 43.9% of the Black ethnic group work in the public administration, education and health sectors. In contrast, 25.2% of Bangladeshis and Pakistanis work in this sector. The decrease in COVID-19 deaths amongst the Black ethnic groups (both Black African and Black Caribbean) during the second wave is probably due to the fact that a greater percentage of them work in the more well-regulated and financially well supported sectors such as the NHS and education sectors, where risk assessment and adherence to COVID-19 health and safety measures were strongly implemented, especially after the first wave. In contrast, small businesses such as restaurants, which many Bangladeshi and Pakistanis either own and/or work in, may not have sufficient resources for implementing strict health and safety measures such as social distancing, for example in a small kitchen with 5-6 people working in close contact to each other for many hours for 6-7 days a week. This difference in employment environment of Blacks, compared to Bangladeshis and Pakistanis, may explain why the COVID-19 mortality decreased for the Blacks in the second wave but increased for Bangladeshis and Pakistanis. Taxi and mini-cab drivers were badly affected by COVID-19. During the “eat out to help out” this sector will have been very busy taking passengers to and from restaurants. Thus a combination of working in restaurants and driving taxis may explain the higher mortality from COVID-19 in Bangladeshi and Pakistanis and this increased substantially in the second wave due to higher activity in these sectors caused by the “eat out to help out” incentive. To conclude, the key factor responsible for the higher COVID-19 deaths in the Bangladeshi and Pakistani communities is due to higher risk of exposure to the virus as they have higher percentage of people working in restaurants, takeaways and driving taxis and mini-cabs. The frequency and dose of exposure to the virus is likely to be high due to duration of time spent in overcrowded kitchens, taxis and mini-cabs. The well intentioned “eat out to help out” scheme turned out to be an opportunity for making more money for businesses and their staff as well as greater enjoyment for the customers but it created an ideal environment for exposure to COVID-19. Adequate risk assessment and necessary support is needed to protect the health and safety of workers and customers in restaurants, fast-food outlets and those working as taxi and mini-cab drivers. This is particularly urgent as prevention strategies, such as wearing of masks and social distancing, are lifted from 19 July 2021

The elephant in the room: is misuse of Eau de Cologne the missing link in the death of Napoleon ?

The elephant in the room: is misuse of Eau de Cologne the missing link in the death of Napoleon ? Parvez I. Haris Faculty of Health & Life Sciences, De Montfort University, The Gateway, Leicester, LE1 9BH, E-Mail: [email protected] Conspiracy theories about Napoleon Bonaparte’s death started immediately after his death on the 5th of May 1821. A publication in Nature suggested he was murdered by arsenic poisoning due to detection of high arsenic levels in his hair [1] although this was refuted by later research. The ‘elephant in the room’ is Napoleon’s misuse of Eau de Cologne that has not been discussed in terms of its toxic effects. He consumed 2-3 bottles daily. It was rubbed on his body, poured on his head, and he drank and inhaled it as medication. After his death, Napoleon’s body was washed with Eau de Cologne [2] which contains 2-5% essential oils from citrus fruits and other plants dissolved in alcohol. Essential oils can act as endocrine disruptors [3] and many of the symptoms displayed by Napoleon can be attributed to this, including him developing breasts and having a hairless body. His suffering from seizures and feeling cold all the time can also be attributed to endocrine disrupting effects of the essential oils. Many years of exposure to excessively high concentrations of essential oil may have led him to develop gastric cancer. There are studies linking essential oil and endocrine disrupting chemicals to gastrointestinal cancer. Eau de Cologne was a double-edged sword for Napoleon. Due to its high alcohol content, its antiseptic property protected him from bacterial and viral infections during his military campaigns but the endocrine disrupting property of essential oils caused changes in his physical appearance, leading to illness and eventually death. References: [1] Forshufvud, S., Smith, H. and Wassén, A., 1961. Arsenic content of Napoleon I's hair probably taken immediately after his death. Nature, 192(4798), pp.103-105. [2] Weider, B. and Hapgood, D., 1998. The murder of Napoleon. iUniverse., pp. 4 [3] Henley, D.V., Lipson, N., Korach, K.S. and Bloch, C.A., 2007. Prepubertal gynecomastia linked to lavender and tea tree oils. New England Journal of Medicine, 356(5), pp.479-485

Can a healthy “water cycle” in the body prevent or delay dementia ?

Several factors that have been shown to be beneficial for protection against Alzheimer’s disease and other type of dementia appears to have in common the enhancement of water movement in the body through a cycle of “water loss” and “water gain”. Factors that contribute to this “water loss” and “water gain” cycle include physical exercise, sleep, Mediterranean diet, coffee, green tea, sauna, diuretic medications, etc. There is a link with water in all of these factors. Physical exercise leads to loss of water through breathing and sweating. This loss is compensated by drinking water after exercise and often water is also consumed before exercise. Sleeping leads to greater water loss, compared to the awake state, due to abstinence from food and water. This causes mild dehydration leading to shrinking of cells which increases the volume of the interstitial space enhancing the clearance of wastes from the brain. Water is consumed after waking up and this leads to swelling of cells and this circadian rhythm of cell shrinking and cell swelling may act like a “pump” that enhances waste clearance from the body. The Mediterranean diet contains water-rich foods which is beneficial for hydration. Coffee and green tea contain caffeine that has diuretic properties which assists in removing water from the body. Taking sauna enhances water loss (sweating) which is followed by “water gain” (drinking of water). Research have shown that those who take the diuretic medication, bumetanide, have significantly lower prevalence of Alzheimer's disease. According to the arguments presented here, this is also due to removal of water from the body that enhances a healthy movement of water in the body. A daily cycle of healthy “water gain” and “water loss” through sleep, physical activity & diet may offer a strategy for prevention and treatment of dementia

We must not forget that 99% of the total number of molecules present in a living organism is water

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Conversion of solid waste to activated carbon to improve landfill sustainability

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Landfills’ heterogeneous composites waste were evaluated as precursors for generation of activated carbon (AC). A single step chemical activation process was applied involving irradiation with microwave energy and impregnation with KOH. The average percentage yield of AC from active landfill precursor was higher than that from closed landfill for all depths sampled. Increase in impregnation ratio and irradiation power decreased the average percentage yield for both landfill precursors (Active: 38.1 to 33.1%) (Closed 42.1: to 33.3%). The optimum pH range for adsorption of methylene blue was pH 6-7, while adsorption increased with increase in temperature over the range 30 to 50oC. Carbonyl and hydroxyl groups were the major functional groups on the surface of AC. The properties of the AC are potentially suitable for the removal of cationic dyes and pollutants. AC generated from the landfill composite were comparable to that from some other biomass being managed through AC generation. This is the first report to demonstrate the possible reuse of landfill composite as AC. The reuse option of landfill composite could provide a means of sustainable management of landfilled municipal waste

Multivariate analysis of the effects of age, particle size and landfill depth on heavy metals pollution content of closed and active landfill precursors

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Multivariate analysis of a heavy metal pollution survey of closed and active landfill precursors was carried out in order to compare environmental risk levels in relation to age, particle size and depth of the precursors. Landfill precursors (77) were collected and analyzed for 15 USEPA toxic heavy metals using ICP-MS. Heavy metals concentrations in closed landfill precursors were significantly higher than those in the active landfill for 11 of 15 heavy metals investigated (closed landfill order: Fe > Al > Mn > Cu > Pb > Ba> Co > Cr > Ni > Cd > As > Se > Ti). Cluster analysis and correlation studies indicated the distribution of the metals was more influenced by landfill precursor size than by depth of the sample. Principal component analysis (PCA) showed that 10 of 15 of heavy metals of both landfill precursors were from similar anthropogenic sources. Heavy metals pollution indices (Igeo > 5, EF > 40 and CF > 7) of both active and closed landfill precursors exceeded limits in the order of Zn > Cd > Pb > Cu > Ag, indicating a major potential health risk influenced by age and particle size of precursor. Zn, Cd, Cu and Pb of both landfill precursors exceeded the USEPA set standard for assessment of human health risk for each of the metals (1×10 -4 to 1× 10-3). This study highlights the need for the integration of a clean-up process for precursors from both types of landfill to reduce possible environmental pollution during a reuse process

Intake of Arsenic and Selenium in a Bangladeshi population investigated using Inductively Coupled Plasma Mass Spectrometry

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Millions of people in Bangladesh are exposed to high concentration of the toxic element arsenic (As) through drinking water and consumption of foods. It has also been reported that Bangladeshis have a low intake of the essential element selenium (Se), which is known to be important as an antioxidant and has been suggested to counteract the toxicity of As. We report here on total intake of As and Se in a Bangladeshi population, based on inductively coupled plasma mass spectrometric (ICP-MS) analysis of a range of Bangladeshi foods. The total daily intake of As and Se from foods was estimated to be 74.2 and 87.7 µg/day, respectively. If As from water, used for drinking and cooking rice, is included the TDI increases to 385 µg of total As per day. An important finding of our study, contrary to suggestions given in other reports, is that the Bangladeshi diet does not appear to be deficient in Se and this may explain why the blood Se concentrations in Bangladeshis is similar to the USA population. This requires further investigation and detailed dietary and human biomonitoring studies on the Bangladeshi population should be conducted. Rice and fish were the main sources of dietary As and Se for Bangladeshis. Leafy vegetables could also be a significant contributor of high concentration of As in the Bangladeshi diet. The flesh and eggs of Hilsha (Tenualosa ilisha) species of fish were found to contain particularly high levels of total arsenic (range 0.77 - 6.15 mg/kg) although this is likely to be dominated by the non-toxic organoarsenic species

Chemical pretreatment of cells for enhanced MALDI-TOF-MS discrimination of clinical staphylococci including MRSA

BACKGROUND: Limited success has been reported for matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) differentiation of staphylococci, including methicillin resistant Staphylococcus aureus (MRSA) strains. Chemical pretreatment of cells prior to MALDI-TOF-MS analysis has not been systematically investigated for enhanced discrimination of S.aureus strains. OBJECTIVES: To evaluate various chemical pretreatment of cells for MALDI-TOF-MS discrimination of clinical staphylococcal isolates, with a focus on differentiation of MRSA from methicillin sensitive S. aureus (MSSA) strains and from other staphylococcal species. METHOD: MALDI-TOF-MS of a well-characterised S. aureus strain(s) was optimised with respect to matrix chemical(s), matrix solvent and target plating method. Various chemical pretreatments (solvents, reductants, detergents) and pretreatment application methods were then evaluated for enhancement of spectral richness. The three most promising pretreatments were applied to MALDI-TOF-MS discrimination of three set of clinical isolates comprising non-S.aureus staphylococci (77 isolates ), MSSA (36) and MRSA (43), with analysis by total or set specific resolved peaks. RESULTS: The optimized MALDI-TOF-MS protocol involved α-cyano-4-hydroxycinnamic acid (CHCA) as matrix chemical (in 1:2 acetonitrile:H2O and 2% trifluoroacetic acid), with application as an overlay onto smeared cells (on-probe). On-probe application of chemical pretreatment was most effective at enhancing MALDI-TOF-MS spectral richness. Use of reductants and detergents as pretreatments were ineffective. The three most effective solvents/acid pretreatments - ethanol:formate, ethanol:acetate and formate:isopropanol - each generated reproducible and distinct spectra over the 2,000 -10,000 m/z range. For the combined sets of clinical isolates (114), all three of these pretreatments increased the total number of resolved peaks in comparison with no pretreatment controls. The ethanol:formate pretreatment gave 100% clustering of non-S. aureus staphylococci, based on total resolved peaks. The formate:isopropanol pretreatment generated the largest increase in number of MRSA set specific peaks (from 18 to 32; 78% increase) and clustered the majority (77%) of the MRSA strains together, although compete discrimination of the MSSA and MRSA was not achieved. CONCLUSION: MALDI-TOF-MS discrimination of clinical isolates of staphylococci is enhanced through chemical pretreatment of cells. Three chemical pretreatments, not previously applied to staphylococci, are highlighted for enhancing spectral richness and offering new opportunities for improved discrimination of staphylococci, including MRSA and MSSA strains

Chemical pretreatment of cells for enhanced MALDI-TOF-MS discrimination of clinical staphylococci including MRSA

BACKGROUND: Limited success has been reported for matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) differentiation of staphylococci, including methicillin resistant Staphylococcus aureus (MRSA) strains. Chemical pretreatment of cells prior to MALDI-TOF-MS analysis has not been systematically investigated for enhanced discrimination of S.aureus strains. OBJECTIVES: To evaluate various chemical pretreatment of cells for MALDI-TOF-MS discrimination of clinical staphylococcal isolates, with a focus on differentiation of MRSA from methicillin sensitive S. aureus (MSSA) strains and from other staphylococcal species. METHOD: MALDI-TOF-MS of a well-characterised S. aureus strain(s) was optimised with respect to matrix chemical(s), matrix solvent and target plating method. Various chemical pretreatments (solvents, reductants, detergents) and pretreatment application methods were then evaluated for enhancement of spectral richness. The three most promising pretreatments were applied to MALDI-TOF-MS discrimination of three set of clinical isolates comprising non-S.aureus staphylococci (77 isolates ), MSSA (36) and MRSA (43), with analysis by total or set specific resolved peaks. RESULTS: The optimized MALDI-TOF-MS protocol involved α-cyano-4-hydroxycinnamic acid (CHCA) as matrix chemical (in 1:2 acetonitrile:H2O and 2% trifluoroacetic acid), with application as an overlay onto smeared cells (on-probe). On-probe application of chemical pretreatment was most effective at enhancing MALDI-TOF-MS spectral richness. Use of reductants and detergents as pretreatments were ineffective. The three most effective solvents/acid pretreatments - ethanol:formate, ethanol:acetate and formate:isopropanol - each generated reproducible and distinct spectra over the 2,000 -10,000 m/z range. For the combined sets of clinical isolates (114), all three of these pretreatments increased the total number of resolved peaks in comparison with no pretreatment controls. The ethanol:formate pretreatment gave 100% clustering of non-S. aureus staphylococci, based on total resolved peaks. The formate:isopropanol pretreatment generated the largest increase in number of MRSA set specific peaks (from 18 to 32; 78% increase) and clustered the majority (77%) of the MRSA strains together, although compete discrimination of the MSSA and MRSA was not achieved. CONCLUSION: MALDI-TOF-MS discrimination of clinical isolates of staphylococci is enhanced through chemical pretreatment of cells. Three chemical pretreatments, not previously applied to staphylococci, are highlighted for enhancing spectral richness and offering new opportunities for improved discrimination of staphylococci, including MRSA and MSSA strains