Anthropogenic Electromagnetic Fields and Cancer: A Perspective

The authors review findings of a recent National Research Council report and conclude that, e.g., until a cancer promotion model can be identified for effective testing, the EMF issue will remain open to debate

EXPOSURE CONCENTRATIONS OF PHARMACEUTICAL ESTROGENS AND XENOESTROGENS IN MUNICIPAL WASTEWATER TREATMENT PLANT SOURCES, THE AQUATIC ENVIRONMENT AND AN AQUATIC HAZARD ASSESSMENT OF BISPHENOL-A: IMPLICATIONS FOR WILDLIFE AND PUBLIC HEALTH

Humans are exposed daily to both pharmaceutical estrogens and xenoestrogens (PEXE) due to their presence in many household products, food products, soil, air, water and estrogen based medications. These PEXEs have been implicated in various human health outcomes, such as breast cancer in women and testicular dysgenesis syndrome including testicular cancer. They also can have adverse reproductive effects on aquatic wildlife through sex reversals, production of intersex individuals, alterations in mating, and prevention of gonadal maturation. There are many sources and types of PEXEs in air, water, soil, household products and food products, but the focus for this research is on the transport and fate of PEXEs from all media into surface water, especially through municipal waste water treatment plant (WWTP) sources. This dissertation consists of three related research papers. The first examines the sources and types of PEXEs in municipal WWTPs. The second documents and compares aquatic exposure concentrations of PEXEs to their Predicted No effect concentration (PNECs) to determine aquatic species protectiveness or risk. The third paper conducts an aquatic hazard assessment of the xenoestrogen, Bisphenol A (BPA). The findings of the research suggest that PEXEs; contain compounds that can mimic estrogens, are mostly introduced into the environment through municipal WWTP effluent sources, and are discharged directly into rivers and lakes at environmentally relevant concentrations. Specifically, BPA, a compound widely used in plastics may be present in surface waters at hazardous concentrations that may present a risk for aquatic receptors. The public health significance of this research is that approximately sixty percent of Americans obtain their drinking water from surface water sources. Thus, understanding PEXEs and their concentrations present of WWTP effluents is imperative for environmental public health tracking of associated disease states, and in the regulation of fish or wildlife consumption from rivers and lakes. Further, to examine adverse health effects in the biotic aquatic system is to indirectly explore possible exposure and health effects on humans since species in the wild are sentinels for human exposure ("the canary in the mine"). Sentinel animals may provide early warning of potential risks before disease develops in human populations

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment

MUNICIPAL WASTEWATER CONCENTRATIONS OF PHARMACEUTICAL AND XENO- ESTROGENS: WILDLIFE AND HUMAN HEALTH IMPLICATIONS

ABSTRACT: Most pharmaceutical estrogens and xenoestrogens are introduced into the environment through municipal waste water treatment plant (WWTP) effluent sources. These effluents contain synthetic compounds; surfactants, flame retardants and halogenated hydrocarbons that can mimic estrogens; and are discharged directly into rivers and lakes. As rivers and lakes are used for water and food supply, and recreation, and wastewater effluent usage increases, the presence and concentration of xenoestrogens in surface water becomes a valid public health concern. Additionally, many USA cities have significant combined sewer overflows releasing untreated sewage directly into surface waters, thus increasing the amounts of xenoestrogens finding their way into drinking water supplies and commercial and subsistence fishing habitat. In the United States, humans are exposed daily to both pharmaceutical and xenoestrogens which have been implicated in various human health outcomes, such as testicular dysgenesis syndrome including testicular cancer and breast cancer in women. Also, they can have adverse reproductive effects in aquatic wildlife through sex reversals, production of intersex individuals, alterations in mating, and prevention of gonadal maturation. Combinations of estrogenic compounds are present in municipal WWTP effluents but, the natural estrogens, 17β-estradiol (E2) and estrone (E1), and the synthetic E