Search

Long-term application of biosolids to agricultural soil results in the slow accumulation of potentially toxic elements (PTEs), which are regulated by maximum permitted limit values to protect human health and the environment. Two programmes of UK government-funded (MAFF/DoE) research were commissioned in the 1990s to investigate the safety of the controls on PTEs in relation to the potential transfer to the food chain via the animal ingestion route by sheep grazing biosolids-amended soil. Here, we re-examine this evidence in the light of other recent research and revised food quality standards, to determine the significance of lead (Pb) accumulation in soil from the agricultural use of biosolids. Direct ingestion of biosolids-amended soil is the main transfer pathway of Pb to grazing livestock. The concentrations of Pb in muscle tissue of animals grazing biosolids-amended soil observed in the MAFF/DoE trials, and reported in the scientific literature, were generally small and similar to background, control values. Lambs and ewes ingesting biosolids-amended soil with a total Pb concentration > 200 mg kg -1 dry soil at a rate of 10 % in the diet exceeded the current maximum permitted concentration of Pb in offal (0.5 mg kg -1 fresh weight). However, the decline in PTE concentrations found in biosolids, due to improved industrial practices and stricter controls on the emissions of contaminants to the environment in general and wastewater in particular, has mitigated the risk of Pb accumulation above the food quality standard for this element in offal. Given the significant improvements in biosolids quality, and particularly in the Pb content, regulatory soil and sludge limits for Pb are no longer likely to have a practical or significant impact on the amount of Pb entering the food chain through the animal ingestion route from biosolids-amended agricultural soil., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Stephen Smith reports financial support was provided by the Food Standards Agency. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Recycled bioresources (biosolids, compost-like-output, meat and bonemeal ash, poultry litter ash, paper sludge ash) were added to the feed of dairy cattle to simulate incidental ingestion from agricultural utilisation, to investigate the transfer of organic contaminants from the ingested materials to milk. The bioresources were blended with a loamy sand soil at agronomic rates to simulate a single application to land, which was added to the diet at 5 % of the total intake on a dry matter (DM) basis. Biosolids, and control treatments consisting of unamended soil, were also added directly to the feed at 5 % DM. The cattle were fed the bioresource amended diets for a target period of three to four weeks, depending on material, and monitoring continued for four weeks after treatment withdrawal. Milk samples were taken weekly with chemical analysis of selected samples for a range of organic contaminants including: polychlorinated, polybrominated and mixed-halogenated dioxins, furans and biphenyls, polychlorinated naphthalenes and alkanes (often called chlorinated paraffins), polycyclic aromatic hydrocarbons and chlorobenzenes. No statistically significant additional transfer of organic contaminants to the milk was detected due to the relatively low levels of contaminants present when the bioresources were incorporated with soil at agronomic rates. However, direct biosolids ingestion by cattle significantly increased the transfer of contaminants to milk in comparison to control animals. Although present in larger concentrations in biosolids than their chlorinated counterparts, the carry over rates and bioconcentration factors of brominated dioxins and furans were considerably smaller. Direct ingestion of biosolids resulted in most contaminants approaching, but not always completely reaching, steady state concentrations within the treatment feeding period, however, concentrations generally declined to control values within four-weeks after withdrawing the biosolids-amended diet., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Alan Dowding, co-author, is also an employee of the Food Standards Agency who funded the research. He was involved in the selection of contaminants for analysis, conceiving the scope of the research programme, and in reviewing and editing the paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Many types of bioresource materials are beneficially recycled in agriculture for soil improvement and as alternative bedding materials for livestock, but they also potentially transfer contaminants into plant and animal foods. Representative types of industrial and municipal bioresources were selected to assess the extent of organic chemical contamination, including: (i) land applied materials: treated sewage sludge (biosolids), meat and bone meal ash (MBMA), poultry litter ash (PLA), paper sludge ash (PSA) and compost-like-output (CLO), and (ii) bedding materials: recycled waste wood (RWW), dried paper sludge (DPS), paper sludge ash (PSA) and shredded cardboard. The materials generally contained lower concentrations of polychlorinated dibenzo-p-dioxins/dibenzofurans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (PCBs) relative to earlier reports, indicating the decline in environmental emissions of these established contaminants. However, concentrations of polycyclic aromatic hydrocarbons (PAHs) remain elevated in biosolids samples from urban catchments. Polybrominated dibenzo-p-dioxins/dibenzofurans (PBDD/Fs) were present in larger amounts in biosolids and CLO compared to their chlorinated counterparts and hence are of potentially greater significance in contemporary materials. The presence of non-ortho-polychlorinated biphenyls (PCBs) in DPS was probably due to non-legacy sources of PCBs in paper production. Flame retardent chemicals were one of the most significant and extensive groups of contaminants found in the bioresource materials. Decabromodiphenylether (deca-BDE) was the most abundant polybrominated diphenyl ether (PBDE) and may explain the formation and high concentrations of PBDD/Fs detected. Emerging flame retardant compounds, including: decabromodiphenylethane (DBDPE) and organophosphate flame retardants (OPFRs), were also detected in several of the materials. The profile of perfluoroalkyl substances (PFAS) depended on the type of waste category; perfluoroundecanoic acid (PFUnDA) was the most significant PFAS for DPS, whereas perfluorooctane sulfonate (PFOS) was dominant in biosolids and CLO. The concentrations of polychlorinated alkanes (PCAs) and di-2-ethylhexyl phthalate (DEHP) were generally much larger than the other contaminants measured, indicating that there are major anthropogenic sources of these potentially hazardous chemicals entering the environment. The study results suggest that continued vigilance is required to control emissions and sources of these contaminants to support the beneficial use of secondary bioresource materials., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Alan Dowding, co-author, is also an employee of the Food Standards Agency who funded the research. He was involved in the selection of contaminants for analysis, and in reviewing and editing the paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Uncontrolled burning of municipal solid waste (MSW) is an important source of air pollution and is wide spread in many developing countries, but only limited data quantify the extent of domestic open burning of household waste. Here, we present some of the first field data to be reported on the uncontrolled domestic burning of waste. A representative community of Mexico (Huejutla de Reyes Municipality) was investigated and household surveys, interviews with waste operators and a waste characterisation analysis were completed to assess the extent of, and factors controlling, the open burning of waste. Waste collection provision to rural communities was very limited and, consequently 92% of households in rural areas reported that they disposed of waste by uncontrolled burning in backyards or unofficial dumps. Overall, 24% of the total MSW generated in the Municipality was disposed by uncontrolled burning. Urban and periurban areas received twice-weekly collections and the rate of uncontrolled burning was considerably smaller compared to rural households, corresponding to approximately 2% of total waste generation. Carbon equivalency calculations showed that burning waste in backyards represented approximately 6% of the total and 8.5% of fuel related CO 2 Eq emissions by the municipality. Moreover, the equivalent carbon dioxide (CO 2 Eq) from black carbon (BC) emitted by uncontrolled burning in backyards was over fifteen times larger compared to methane (CH 4 ) potentially released from equivalent amounts of combustible biodegradable waste disposal at the official dumpsite. An assessment of local respiratory health data showed the incidence of disease was higher in rural than in urban areas, when the opposite trend is typically observed in the international literature; given the high rate of burning activity found in rural areas we suggest that open burning of waste could be a major reason for the apparent poorer respiratory health status of the rural population and requires further investigation. The results emphasise the importance of including BC from uncontrolled burning of waste in international emission inventories of greenhouse gases and in the assessment of the health status of local communities in developing countries where this practice is prevalent., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Epidemiologic studies have yielded conflicting results regarding the role of heavy metal exposure in recent epidemics of chronic kidney disease (CKD). In this issue of Kidney International, Tsai et al. examined the combined effects of chromium, lead, and cadmium on kidney function using data from the Nutrition and Health Survey in Taiwan. We add this report to our growing understanding of contemporary epidemics of CKD and highlight considerations for exposure analysis in CKD epidemiologic studies., (Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

International controls for biosolids application to agricultural land ensure the protection of human health and the environment, that it is performed in accordance with good agricultural practice and that nitrogen (N) inputs do not exceed crop requirements. Data from the scientific literature on the total, mineral and mineralizable N contents of biosolids applied to agricultural land under a wide range of climatic and experimental conditions were collated. The mean concentrations of total N (TN) in the dry solids (DS) of different biosolids types ranged from 1.5% (air-dried lime-treated (LT) biosolids) to 7.5% (liquid mesophilic anaerobic digestion (LMAD) biosolids). The overall mean values of mineralizable N, as a proportion of the organic N content, were 47% for aerobic digestion (AeD) biosolids, 40% for thermally dried (TD) biosolids, 34% for LT biosolids, 30% for mesophilic anaerobic digestion (MAD) biosolids, and 7% for composted (Com) biosolids. Biosolids air-dried or stored for extended periods had smaller total and mineralizable N values compared to mechanically dewatered types. For example, for biosolids treated by MAD, the mean TN (% DS) and mineralizable N (% organic N) contents of air-dried materials were 3% and 20%, respectively, compared to 5% and 30% with mechanical dewatering. Thus, mineralizable N declined with the extent of biological stabilization during sewage sludge treatment; nevertheless, overall plant available N (PAN=readily available inorganic N plus mineralizable N) was broadly consistent across several major biosolids categories within climatic regions. However, mineralizable N often varied significantly between climatic regions for similar biosolids types, influencing the overall PAN. This may be partly attributed to the increased rate, and also the greater extent of soil microbial mineralization of more stable, residual organic N fractions in biosolids applied to soil in warmer climatic zones, which also raised the overall PAN, compared to cooler temperate areas. It is also probably influenced by differences in upstream wastewater treatment processes that affect the balance of primary and secondary, biological sludges in the final combined sludge output from wastewater treatment, as well as the relative effectiveness of sludge stabilization treatments at specific sites. Better characterization of biosolids used in N release and mineralization investigations is therefore necessary to improve comparison of system conditions. Furthermore, the review suggested that some international fertilizer recommendations may underestimate mineralizable N in biosolids, and the N fertilizer value. Consequently, greater inputs of supplementary mineral fertilizer N may be supplied than are required for crop production, potentially increasing the risk of fertilizer N emissions to the environment. Thus greater economic and environmental savings in mineral N fertilizer application are potentially possible than are currently realized from biosolids recycling programmes., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Focal segmental glomerulosclerosis (FSGS) is a histological lesion with many causes, including inherited genetic defects, with significant proteinuria being the predominant clinical finding at presentation. Mutations in COL4A3 and COL4A4 are known to cause Alport syndrome (AS), thin basement membrane nephropathy, and to result in pathognomonic glomerular basement membrane (GBM) findings. Secondary FSGS is known to develop in classic AS at later stages of the disease. Here, we present seven families with rare or novel variants in COL4A3 or COL4A4 (six with single and one with two heterozygous variants) from a cohort of 70 families with a diagnosis of hereditary FSGS. The predominant clinical finding at diagnosis was proteinuria associated with hematuria. In all seven families, there were individuals with nephrotic-range proteinuria with histologic features of FSGS by light microscopy. In one family, electron microscopy showed thin GBM, but four other families had variable findings inconsistent with classical Alport nephritis. There was no recurrence of disease after kidney transplantation. Families with COL4A3 and COL4A4 variants that segregated with disease represent 10% of our cohort. Thus, COL4A3 and COL4A4 variants should be considered in the interpretation of next-generation sequencing data from such patients. Furthermore, this study illustrates the power of molecular genetic diagnostics in the clarification of renal phenotypes.

Unlabelled: Tumour volume (Tv) measurements obtained from pre-treatment CT and MRI have increasingly shown to be more reliable predictors of outcome than TNM stage. The aim of this study was to determine the correlation of MRI calculated maxillary complex tumour volume with patient outcome., Methods: The medical records of 39 patients with squamous cell carcinoma involving the maxillary sinus, maxilla, hard palate and maxillary alveolus were reviewed and tumour volume measurements completed on pre-treatment MRI., Results: The mean tumour volume was 12.79 ± 24.31 cm(3). Independent samples t test was significant for increasing overall all-cause survival and decreasing tumour volume (1 year: p = 0.003; 5-year: p = 0.031). Cox regression was significant for stratified tumour volume, nodal involvement and peri-neural invasion for predicting disease-free survival., Conclusions: MRI measured tumour volume assessment appears to be a reliable predictor of survival in patients with maxillary complex SCC treated by surgical resection., (Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Objective: The objectives of this study were to determine the benefit of pretreatment magnetic resonance imaging (MRI)-based tumor volume (Tv) measurements in patients presenting with squamous cell carcinomas (SCCs) involving the oral cavity subsites most frequently associated with mandibular bone invasion., Study Design: A 10-year retrospective study of all patients undergoing surgical resection for primary SCC of the retromolar trigone, mandible, or floor of mouth (with bone involvement) was completed. In total, 62 patients met the inclusion criteria, and Tv measurements completed on their pretreatment MRI., Results: Tumor volume was significant at predicting all-cause survival and disease-free survival at 5 years. Tv stratification to correlate with the TNM staging system resulted in down-staging in 40 of the 62 cases., Conclusions: Tumor volume was a more useful predictor of outcome than the current clinical or pathologic TNM staging, considering the automatic up-staging of tumors involving mandibular bone to T4 tumors., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Angioleiomyomas are benign solitary smooth muscle tumors originating in the tunica media of vessels. They are rarely encountered within the oral cavity, and the number of reported cases specifically involving the hard palate remains small. A 39-year-old man presented with a 2-cm painless swelling on the left anterior hard palate. The mass had been present for ≈ 5 years before presentation, during which time it had slowly enlarged. Magnetic resonance imaging (MRI) showed a uniform signal pattern with T1 signal intensity slightly higher than surrounding soft tissues and marked hyperintensity on T2-weighted sequences. Although the MRI characteristics of angioleiomyomas affecting the extremities have previously been reported, this is the first reported case describing the MRI features of an oral-cavity angioleiomyoma. In view of the inability to differentiate angioleiomyoma from other pathologies with similar MRI features, simple local excision for definitive histopathologic diagnosis remains recommended., (Copyright © 2012 Mosby, Inc. All rights reserved.)

Introduction: Ewings sarcoma (ES) is a rare tumor, most commonly encountered within the long bones during the first 20 years of life., Case Report: We report the sixth case of ES of the zygoma, occurring in a 31-year-old male, and presenting a unique reconstructive opportunity. Diagnosis and preoperative planning were aided by CT/MR coregistration. Surgical reconstruction using 3D reconstructed CT images to produce an anatomically correct model provided the basis for a gold prosthesis construction., Discussion: Delayed definitive reconstruction provided opportunity for adequate tumor recurrence surveillance, and definitive histological diagnosis. The artefact produced on MR imaging from gold implants is minimal, permitting the unrestricted identification of potential future recurrence., Conclusion: This case highlights the benefits of coregistration of radiological imaging, and custom-made gold prostheses providing the advantage of artefact-free MR imaging, which should be considered in patients requiring resection of zygomatic tumors and subsequent reconstruction., (Copyright 2010 Mosby, Inc. All rights reserved.)

The incidence, predictors and clinical significance of acute renal failure (ARF) after lung transplantation are not well described. We retrospectively collected data on 296 patients transplanted at our center between April 1992 and December 2000; follow-up was extended until December 2002. Patients were initially divided into two groups: ARF (doubling of baseline creatinine within 2 weeks after surgery) and NoARF. The ARF group was subdivided into ARFD (dialyzed) and ARFnD (not dialyzed). The incidence of ARF was 56% (166/296), but most cases were ARFnD (n = 143). Independent predictors of ARFD (n = 23) were: baseline GFR (OR 0.98, CI 0.96-0.99, p = 0.012), pulmonary diagnosis other than COPD (OR 6.80, CI 1.5-30.89, p = 0.013), mechanical ventilation > 1 d (OR 6.16, CI 1.70-22.24, p = 0.006) and parenteral amphotericin B use (OR 3.04, CI 1.03-8.98, p = 0.045). Both ARFnD and ARFD were associated with longer duration of mechanical ventilation, increased hospital stay and increased early mortality. One-year patient survival was 92.3%, 81.8% and 21.7% in the NoARF, ARFnD and ARFD groups, respectively (p < 0.0001). After controlling for important covariates, ARFD remained associated with an increased hazard of dying (HR 6.77, CI 4.00-11.44, p < 0.0001). In conclusion, ARF occurs commonly after lung transplantation and affects important clinical outcomes, especially when dialysis is required.

In vitro data suggest that calcium plays an important role in normal and disordered erythropoiesis. The purpose of this study is to determine whether there is an association between serum calcium, various hormone levels, and the development of post transplant erythrocytosis (PTE). Data were collected on 283 patients who underwent renal transplantation between 1994 and 1998. The relationship between serum calcium and PTE development was tested using the chi-square test. Univariate and multivariable adjusted models were employed to determine predictors of maximum hematocrit. Selected patients underwent measurement of intact parathyroid hormone (PTH), 1,25-dihydroxy vitamin D, and erythropoietin (EPO). Seventy-three patients (26%) developed PTE. Post transplant erythrocytosis was more common in patients with hypercalcemia compared with patients with normal serum calcium (34% vs. 18%, p = 0.002). In multivariable analyses, serum calcium was a strong independent predictor of maximum hematocrit post transplant, even after adjustment for renal function. A serum calcium of >or=10.2 mg/dL was associated with greater than two-fold increased odds of PTE. There were no differences in hormone levels between subjects with hypercalcemia and PTE, subjects with PTE alone, and subjects with hypercalcemia alone. Hypercalcemia is associated with the development of PTE in renal transplant recipients.

A racial disparity in graft survival for renal transplant recipients has been documented for both cadaveric and living-donor transplants. In the present single-center study we analyzed graft survival by race for recipients of living-donor kidney transplants in three eras: 1985-89, 1990-94, and 1995-2000. There was an intensification of the immunosuppressant regimen beginning in 1996, such that all patients received cyclosporine or tacrolimus with mycophenolate and prednisone. Graft survival was analyzed using the Cox proportional hazards model. There were 79 black recipients and 210 white recipients with no difference in mean age, degree of HLA matching, or proportion of recipients with diabetes as the cause of end-stage renal disease. Using all data from 1985 to 2000, graft survival was significantly better for whites vs. blacks adjusted for age, gender, diabetes, era of the transplant, and haplotype match (p = 0.05). However, when analyzed by era, there was a temporal trend for a progressive decrease in the racial disparity in graft survival. In confirmation of this effect, there was a significant race-era interaction (p = 0.01) on multivariable Cox proportional hazards analysis. The most recent data from the United States Renal Data System (USRDS) show a similar decrease in the racial difference in 1-year graft survival. We conclude that the influence of race on living-donor graft survival is diminishing over time.