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Traditional Chinese medicine (TCM) is still considered a global complementary or alternative medical system, but exogenous hazardous contaminants remain in TCM even after decocting. Besides, it is time-consuming to conduct a risk assessment of trace elements in TCMs with a non-automatic approach due to the wide variety of TCMs. Here, we present MRTCM, a cloud-computing infrastructure for automating the probabilistic risk assessment of metals and metalloids in TCM. MRTCM includes a consumption database and a pollutant database involving forty million rows of consumption data and fourteen types of TCM potentially toxic elements concentrations. The algorithm of probabilistic risk assessment was also packaged in MRTCM to assess the risks of eight elements with Monte Carlo simulation. The results demonstrated that 96.64% and 99.46% had no non-carcinogenic risk (hazard indices (HI) were < 1.0) for animal and herbal medicines consumers, respectively. After twenty years of exposure, less than 1% of the total carcinogenic risk (CR t) was > 10-4 for TCM consumers, indicating that they are at potential risk for carcinogenicity. Sensitivity analysis revealed that annual consumption and concentration were the main variables affecting the assessment results. Ultimately, a priority management list of TCMs was also generated, indicating that more attention should be paid to the non-carcinogenic risks of As, Mn, and Hg and the carcinogenic risks of As and Cr in Pheretima and Cr in Arcae Conch. In general, MRTCM could significantly enhance the efficiency of risk assessment in TCM and provide reasonable guidance for policymakers to optimize risk management. [Display omitted] • MRTCM is a dataset for metals and metalloids risk assessment in traditional Chinese medicine. • The collected consumption data of individual traditional Chinese medicine could be searched through MRTCM. • The packaged algorithms could automate the probabilistic risk assessment based on the concentration of elements. • The non-carcinogenic risks of As, Mn, and Hg and the carcinogenic risks of As and Cr are priority concerns. [ABSTRACT FROM AUTHOR]

Ochratoxin A (OTA) is a mycotoxin found in a variety of foods and herbal medicines, and several governmental bodies around the world have set maximum allowable levels of OTA in different foods and herbal medicines. This study aims to evaluate the health risk of OTA in Astragali Radix (AR) in China, and to evaluate the effects of different limit levels on the risk control of OTA in AR. The concentrations of OTA in 187 samples of AR were investigated, and 61 (32.6%) samples were positive. The mean, 50th and 95th percentile values of OTA in positive samples were 56.2, 5.1 and 304.5 μg/kg, respectively. A margin of exposure (MOE) approach was applied to assess the risk. Considering other food sources, long-term consumers have a relatively high risk of OTA exposure due to the ingestion of AR. Theoretical limit levels of OTA in AR were evaluated from two dimensions by weighing the costs and the benefits. The results indicated that the limit levels that might be applied to the management of OTA contamination in AR in China could be screened out through risk-based evaluation of limit levels. [Display omitted] • Long-term high consumers have a relatively high risk of ochratoxin A exposure due to the ingestion of Astragali Radix in China. • Theoretical limit levels of ochratoxin A in Astragali Radix could been evaluated from two dimensions by weighing the costs (non-compliant batches) and the benefits (reduction in health risk). • The most appropriate limit level that might be applied to the management of ochratoxin A contamination in Astragali Radix in China could be screened out through risk-based evaluation of limit levels. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To assess the temporal and spatial relationship of risk for total leukemia and AML (acute myelogenous leukemia) among community residents of an area in northeastern (NE) Pennsylvania (PA) affected by the Tranguch Gasoline Spill which occurred in the early 1990s. Methods: Standardized incidence ratios (SIR) were calculated for total leukemia and AML among 625 residents affected by the gasoline spill in relation to both PA and local county cancer incidence rates. The risk of total leukemia and AML among the gasoline exposed population was evaluated for the period prior to the spill, 1985–1989; during the time surrounding the spill, 1990–1994; and for a period subsequent to the spill, 1995–2001. Results: The incidence of total leukemia and AML was significantly elevated subsequent to the spill for the entire period 1990–2001 and was highest for the period 1995–2001, whether comparison was made to PA or local county leukemia rates. Based on comparison to PA rates, the SIRs for total leukemia and AML were 7.69 (95% CI=1.58–22.46) and 11.54 (95% CI=2.38–33.69) for the 1995–2001 period, respectively. Prior to the spill, 1985–1989, and during the period of the spill, 1990–1994, no cases of leukemia were identified among the affected residents. Conclusions: These results suggest a possible association between chronic low level benzene exposure and increased risk of leukemia among residents of the Tranguch Spill Site in NE PA. Our study provides additional support to the growing body of evidence implicating low level benzene exposure and cancer risk. We recommend that other communities contaminated with gasoline vapor through leaking underground storage vessels be monitored for elevated risk of leukemia. [Copyright &y& Elsevier]

A novel gill cell line from pearl gentian grouper (Epinephelus lanceolatus ♂× Epinephelus fuscoguttatus ♀, PGGG cell line) was established, its application in cadmium (Cd) toxicology was demonstrated in this study. Primary cultures and PGGG subcultures were carried out at 25 °C in Dulbecco's Modified Eagle medium/F12 medium (1:1; pH 7.2) supplemented with 15% fetal bovine serum (FBS). Primary PGGG cells were spindle-shaped, proliferated into a confluent monolayer within two weeks and were continuously subcultured over passage 60. The growth of cells at passages 20, 40, and 60 was examined. Chromosome analysis revealed that the chromosomal number of normal PGGG cells was 48, but the number of cells with the normal chromosomes number decreased during the passaging process. Cadmium is one of the most toxic metals in aquatic systems and has been associated with multiple animal and human health problems. To interpret the cytotoxicity and related mechanisms of cadmium, PGGG cells were used as an in vitro model. After treatment with cadmium at concentrations ranging from 1 µM to 500 µM, PGGG cells demonstrated dose- and time-dependent cytotoxicity, manifested as morphological abnormalities and a viability decline. Further, it was found that the reactive oxygen species (ROS) and malondialdehyde (MDA) levels were elevated following cadmium exposure, and related genes involved in the antioxidant system, including those encoding catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR), and Kelch-like- ECH-associated protein 1 (Keap1), were regulated differently. In addition, PGGG cells treated with cadmium had the typical features associated with apoptosis, including phosphatidylserine (PS) externalization; upregulated expression of caspase-3, −8, and −9; and apoptotic body formation. In general, the PGGG cell line may serve as a useful tool for studying the toxic mechanisms of cadmium or other toxicants or for toxicity testing and environment monitoring. • A novel gill cell line from pearl gentian grouper was established and characterized. • Cadmium had toxic effects on the cells in a concentration-dependent manner. • Cadmium could cause cytotoxicity and apoptosis. [ABSTRACT FROM AUTHOR]

Introduction Ozone (O 3 ) has been linked to hypertensive disorders of pregnancy (HDP). However, inconsistent results have been reported, and no study has examined the critical exposure windows during pregnancy. Materials and methods We used Florida birth vital statistics records to investigate the association between HDP and O 3 exposure among 655,529 pregnancies with conception dates between 2005 and 2007. Individual O 3 exposure was assessed at mothers’ home address at the time of delivery using the Hierarchical Bayesian space-time statistical model. We examined the association during three predefined exposure windows including trimester 1, trimester 2, and trimesters 1&2, as well as in each week of the first two trimesters using distributed lag models. Results Pregnancies with HDP had a higher mean exposure to O 3 (39.07 in trimester 1, 39.02 in trimester 2, and 39.06 in trimesters 1&2, unit: ppb) than those without HDP (38.65 in trimester 1, 38.57 in trimester 2, and 38.61 in trimesters 1&2, unit: ppb). In the adjusted logistic regression model, increased odds of HDP were observed for each 5 ppb increase in O 3 (OR Trimester1 =1.04, 95% CI: 1.03, 1.06; OR Trimester2 =1.03, 95% CI: 1.02, 1.04; OR Trimester1&2 =1.07, 95% CI: 1.05, 1.08). In the distributed lag models, elevated odds of HDP were observed with increased O 3 exposure during the 1st to 24th weeks of gestation, with higher odds during early pregnancy. Conclusions O 3 exposure during pregnancy is related to increased odds of HDP, and early pregnancy appears to be a potentially critical window of exposure. [ABSTRACT FROM AUTHOR]

The effects of low-level lead exposure on neuropsychological status in the United States (US) general adult population have been reported, and the relationship between neuropsychiatric dysfunction and health risk behaviors including substance use and sexual risk taking is well established. However, the potential influence of lead exposure on risk-taking behavior has received little attention. Using the National Health and Nutrition Examination Survey (NHANES) 2005–2010, we estimated multivariable logistic regression models to measure odds ratios (ORs) and 95% confidence intervals (CIs) for the cross-sectional associations between blood lead level and risk behaviors including binge drinking, drug use, and indicator of sexually transmitted infection (STI) risk. STI indicators included past 12 month sexual risk behaviors (age mixing with partners who were at least five years younger or older and multiple partnerships), self-reported STI, and biologically-confirmed herpes simplex virus type 2 (HSV-2) infection. Dose–response like relationships were observed between blood lead and substance use, age mixing with younger and older partners, self-reported STI, and HSV-2. In addition, participants with lead levels in highest quartile versus those with levels in the lowest quartile had over three times the odds of binge drinking and over twice the odds of injection drug or cocaine use in the past 12 months, while being in one of the top two quartiles was significantly associated with 30–70% increased odds of multiple partnerships, sex with older partners, and self-reported and biologically confirmed STI. Results from this study suggested that lead exposure may contribute to substance use, sexual risk-taking, and STI. However, given limitations inherent in the cross-sectional nature of the study, additional studies that use longitudinal data and measure detailed temporal information are warranted. [ABSTRACT FROM AUTHOR]

Reported associations between particulate matter with aerodynamic diameter ≤2.5 μm (PM 2.5) and cognitive outcomes remain mixed. Differences in exposure estimation method may contribute to this heterogeneity. To assess agreement between PM 2.5 exposure concentrations across 11 exposure estimation methods and to compare resulting associations between PM 2.5 and cognitive or MRI outcomes. We used Visit 5 (2011–2013) cognitive testing and brain MRI data from the Atherosclerosis Risk in Communities (ARIC) Study. We derived address-linked average 2000–2007 PM 2.5 exposure concentrations in areas immediately surrounding the four ARIC recruitment sites (Forsyth County, NC; Jackson, MS; suburbs of Minneapolis, MN; Washington County, MD) using 11 estimation methods. We assessed agreement between method-specific PM 2.5 concentrations using descriptive statistics and plots, overall and by site. We used adjusted linear regression to estimate associations of method-specific PM 2.5 exposure estimates with cognitive scores (n = 4678) and MRI outcomes (n = 1518) stratified by study site and combined site-specific estimates using meta-analyses to derive overall estimates. We explored the potential impact of unmeasured confounding by spatially patterned factors. Exposure estimates from most methods had high agreement across sites, but low agreement within sites. Within-site exposure variation was limited for some methods. Consistently null findings for the PM 2.5 -cognitive outcome associations regardless of method precluded empirical conclusions about the potential impact of method on study findings in contexts where positive associations are observed. Not accounting for study site led to consistent, adverse associations, regardless of exposure estimation method, suggesting the potential for substantial bias due to residual confounding by spatially patterned factors. PM 2.5 estimation methods agreed across sites but not within sites. Choice of estimation method may impact findings when participants are concentrated in small geographic areas. Understanding unmeasured confounding by factors that are spatially patterned may be particularly important in studies of air pollution and cognitive or brain health. • PM 2.5 estimates from 11 estimation methods agreed across, but not within, study sites. • Findings were generally null for PM 2.5 -cognitive and MRI outcome associations regardless of estimation method used. • If PM2.5 affects outcomes, findings will vary by estimation method if participants are drawn from small geographic areas. • Not accounting for geographic location may bias results due to unmeasured, spatially patterned confounders. [ABSTRACT FROM AUTHOR]

In this study, we assessed trends of serum cotinine levels over time among US children ages 3–11 years and compared the risk of asthma in groups exposed to passive tobacco smoke. We utilized National Health and Nutrition Examination Survey (NHANES) data collected from 2003 to 2014 (n = 8064). Serum cotinine level, household smoker status, asthma status, and sociodemographic information were extracted for multiple regression analyses. The adjusted biannual change in log (cotinine) in comparison to earlier NHANES survey cycles was − 0.196 ( p  < 0.001) overall, − 0.055 ( p  = 0.089) among children with household smoker(s), and − 0.129 ( p  < 0.001) among children without. The proportion of children living with household smokers decreased from 24.9% in the 2003–2004 cycle to 11.4% in the 2013–2014 cycle. The adjusted odds ratios (ORs) for asthma were 1.34 (95% confidence interval (CI): 1.00–1.80; 2nd tertile vs 1st tertile) and 1.69 (95%CI: 1.25–2.29; 3rd tertile vs1st tertile), respectively. Highly exposed asthmatic children, in the 3rd cotinine tertile (>0.13 ng/mL), were primarily Non-Hispanic Black (61.0%) and whose family incomes were below poverty guidelines. Overall results reveal passive smoke exposure level among children ages 3–11 in the US decreased over the study period. Nevertheless, higher exposure to passive smoke is still associated with higher odds of childhood asthma. Targeted smoking cessation interventions in clinical practices are needed to reduce tobacco smoke exposure and related asthma risk in children, particularly in low-income and minority groups. [ABSTRACT FROM AUTHOR]

Background Asthma is the most common chronic disease in children and has been linked to high levels of ambient air pollution and certain hazardous air pollutants (HAPs). Outdoor pollutants such as benzene, released by car emissions, and organic chemicals found in diesel exhaust, as well as particles and irritant gases, including nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), and ozone (O 3 ), contribute to an increased prevalence of respiratory diseases such as asthma. Objectives The objectives of this study were to: 1) conduct a screening survey to identify high risk for asthma among school-age children in Hidalgo County, and, 2) study the potential health impact of school-related exposure to HAPs pertaining to asthma risk. Methods We carried out a quantitative cross-sectional study combining a school-based asthma screening survey across 198 schools in Hidalgo County, Texas, with information on school neighborhood environments, including census tract-level information on hazardous air pollutants (HAPs) and socioeconomic status (SES) in the respective school neighborhoods. HAPs levels were assessed based on the EPA 2011 National-Scale Air Toxics Assessment (NATA) while SES information was assessed using data from the 2010–2014 American Community Survey. Results 2930 students completed the asthma screening survey and results showed an overall asthma prevalence of 9.4%, slightly higher than the national and state prevalence. Participants in the 14–18 years old age group showed a much higher asthma prevalence of 16.7%. When assessing school-neighborhood characteristics, our results revealed no significant differences in asthma prevalence across census tracts with different SES levels. For HAPs, in the single-pollutant model, chlorine levels showed a significant linear trend for prevalence of asthma (p=0.03) while hydrochloric acid had a marginally significant linear trend (p=0.08). The association with chlorine remained significant in the multi-pollutant model. Conclusions Asthma prevalence among school-age children in Hidalgo County, Texas, is 9.4%, which is slightly higher than the state rate, especially among young adults, ages 14–18 years who had an asthma rate of 16.7%. Results support an association between exposures to school-neighborhood HAPs and risk for pediatric asthma, especially as related to chlorine. No significant effects of school-level SES on asthma risk were observed. [ABSTRACT FROM AUTHOR]

Background Ambient fine particulate matter (PM 2.5 ) air pollution has been associated with increased airway inflammation, but the roles of various PM 2.5 constituents remain to be determined. Objectives To investigate the acute effects of PM 2.5 constituents on fractional exhaled nitric oxide (FeNO), a well-established biomarker of respiratory inflammation. Methods A longitudinal panel study was performed among 32 healthy young adults in Shanghai, China from January 12th to February 6th, 2015. FeNO was repeatedly measured, 6–8 times per subject. Real-time mass concentration of ambient PM 2.5 and chemical constituents were obtained from a nearby monitoring station. Linear mixed-effect models were applied to evaluate the association between FeNO and PM 2.5 constituents, with the adjustment of age, gender, body mass index, temperature, relative humidity and day of week. The robustness of constituents’ effects was also evaluated. Results A total of 234 effective measurements of FeNO were obtained with a geometric mean of 13.1 ppb. The PM 2.5 -FeNO associations were strongest at lags of 0–6 h and diminished at lags longer than 12 h. An interquartile range increase in PM 2.5 constituents (NH 4 + , NO 3 − , K + , SO 4 2− and elemental carbon) at lags of 0–6 h were significantly associated with increments in FeNO by 12.3%, 11.3%, 11.1%, 9.6% and 10.7%, respectively. After controlling for PM 2.5 total mass and the colinearity, only elemental carbon remained significant. Conclusion Several chemical constituents of PM 2.5 may impact FeNO following acute exposure. Elemental carbon in particular may be the primary component responsible for increased airway inflammation. [ABSTRACT FROM AUTHOR]

Background Short-term associations between size-fractionated particulate matter (PM) air pollution and circulating biomarkers are not well established, especially among diabetes patients. Methods We conducted a longitudinal panel study involving 6 repeated measurements of 12 circulating biomarkers among 35 diabetes patients from April to June, 2013 in Shanghai, China. Real-time number and mass concentrations of PM with multiple size fractions between 0.25 and 10 μm were measured. Linear mixed-effect models were used to explore the associations between size-fractionated PM concentrations and blood biomarkers at different time windows. Results Short-term exposure to PM was significantly associated with elevated levels of 5 biomarkers of inflammation, 3 biomarkers of coagulation and 1 vasoconstrictor. The effects varied considerably by particle size and time windows. Overall, PM with smaller size had stronger associations, and the most significant size fractions were 0.25–0.40 μm. Even 2 h exposure to PM can lead to a significant increase in biomarkers. The effects on biomarkers of inflammation and vasoconstriction were restricted to the first 12 h after exposure, but the effects on coagulation persisted for 24–72 h. For example, an interquartile range increase in 2 h average exposure to PM 0.25–0.40 was associated with 6–20% increase in biomarkers of inflammation, 19–38% in coagulation and 17% in vasoconstriction. PM had a stronger effect among male patients than female patients. Conclusions Our results provided important evidence on the roles of the size and time windows of exposure in the PM-mediated effects on circulating biomarkers of inflammation, coagulation and vasoconstriction in diabetes patients in China. [ABSTRACT FROM AUTHOR]

Background Existing studies found paradoxical effects of carbon monoxide (CO) on human health. Carbon monoxide (CO), at high concentrations, is a well-known toxicant, but recent studies suggest that CO at low concentrations may have protective health effects under certain conditions. Objectives To investigate the acute effect of ambient CO on hospital admission for chronic obstructive pulmonary disease (COPD) in Shanghai, China. Methods Daily data on COPD admissions and CO concentrations between 2006 and 2008 were collected. We applied over-dispersed generalized additive Poisson models, adjusted for weather conditions, day of the week and public holidays, long-term and seasonal trends. Results During the study period, the average CO concentration was 1.3 mg/m 3 , well below the international health-based standard. Negative associations were found between ambient CO concentration and daily COPD hospitalization. An interquartile range increase (0.6 mg/m 3 ) in CO concentration at lag 3 day corresponded to −2.97% (95% confidence interval: −4.63%, −1.31%) change in COPD hospitalization. The negative associations were robust after adjustment for co-pollutants (PM 10 , NO 2 and SO 2 ). The protective effect of CO appeared to be more evident in the cool season. Conclusion Short-term exposure to CO at low ambient concentration may be associated with reduced risk of COPD hospitalization. Our results may contribute to a comprehensive understanding on the health effects of ambient CO. [ABSTRACT FROM AUTHOR]

Background Air pollution has been shown to have adverse effects on many health outcomes including cardiorespiratory diseases and cancer. However, evidence on the effects of prenatal exposure is still limited. The purpose of this retrospective cohort study is to evaluate the effects of prenatal exposure to air pollutants including particulate matter with aerodynamic diameter less than 2.5 μm (PM 2.5 ) and ozone (O 3 ) on the risk of adverse birth outcomes (ABOs) including term low birth weight (LBW), preterm delivery (PTD) and very PTD (VPTD). Methods singleton births from 2004 to 2005 in Florida were included in the study ( N =423,719). Trimester-specific exposures to O 3 and PM 2.5 at maternal residence at delivery were estimated using the National Environmental Public Health Tracking Network data, which were interpolated using Hierarchical Bayesian models. Results After adjustment for potential confounders such as demographics, medical and lifestyle factors PM 2.5 exposures in all trimesters were found to be significantly and positively associated with the risk of all ABOs. Second-trimester exposure had the strongest effects. For an interquartile range (IQR) increase in PM 2.5 during the second trimester, the risk of term LBW, PTD and VPTD increased by 3% [95% confidence interval (CI): 1–6%)], 12% (11–14%) and 22% (18–25%), respectively. O 3 was also found to be positively associated with PTD and VPTD with the strongest effects over the whole pregnancy period [3% (1–5%) for PTD and 13% (7–19%) for VPTD for each IQR increase]. However, O 3 was observed to have protective effects on term LBW. Results were consistent for multi-pollutant models. Conclusion PM 2.5 has consistent adverse effects on ABOs whereas O 3 has inconsistent effects. These findings warrant further investigation. [ABSTRACT FROM AUTHOR]

Abstract: Background Studies show that active smoking may be associated with cognitive decline. However, the consequence of secondhand smoke on cognitive and physical performance remains unclear. The purpose of this study was to assess the association of secondhand smoke with cognitive performance and physical function using a population-based sample. Methods: Data of 2,542 non-smoking participants from the 1999–2002 National Health and Nutrition Examination Survey were analyzed. Secondhand smoke exposure level was estimated using blood cotinine concentrations. Cognitive performance was assessed with the Digit Symbol Substitution Test and self-reported confusion/memory problems. Physical performance was analyzed using visual gait speed (m/s) and self-reported physical function. Multivariate linear and logistic regression models were used to assess the association. Results: In never smokers, cognitive performance score decreased by 2.03 points (95% confidence interval (CI): −3.00, –1.05) per one unit increase in log-transformed blood cotinine level. After adjusting for potential confounders, including diabetes, hypertension, body mass index, alcohol, and blood lead level, change in cognitive performance score was still statistically significant (−1.17 95% CI: −2.32, –0.02). Similar trends were observed in former smokers. Gait speed decreased by 0.02m/s for one unit increase in log-transformed blood cotinine level. This was evident in both never and former smokers. The relationship remained significant after adjusting for potential confounders in former smokers. Conclusions: Our study suggests that secondhand smoke may contribute to cognitive decline in never and former smokers. Considering the cross-sectional design and the limitations of this study, the relationship warrants further assessment. [Copyright &y& Elsevier]

Abstract: There is only limited monitoring data of black carbon for epidemiologic analyses. In the current study, we used the distributed lag models to evaluate the association between mortality outcomes (both total and cause-specific) and exposure to black carbon and fine particle (PM2.5) in Shanghai, China. During our research period, the mean daily concentrations of black carbon and PM2.5 were 3.9μg/m3 and 53.9μg/m3, respectively. The regression results showed that black carbon was significantly associated with total and cardiovascular mortality, but not with respiratory mortality. An inter-quartile range increase (2.7μg/m3) of black carbon corresponded to a 2.3% (95% confidence interval [CI]: 0.6–4.1), 3.2% (95% CI: 0.6–5.7), and 0.6% (95% CI: −4.5 to 5.7) increase in total, cardiovascular and respiratory mortality, respectively. When adjusted for PM2.5, the effects of black carbon increased and remained statistically significant; in contrast, the associations of PM2.5 with daily mortality decreased and became statistically insignificant after adjustment for black carbon. To our knowledge, this is the first study in China, or even in Asian developing countries, to report the acute effect of black carbon and PM2.5 on daily mortality simultaneously. Our findings suggest that black carbon is a valuable additional air quality indicator to evaluate the health risks of ambient particles. [Copyright &y& Elsevier]