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This study explores the significant variation in test methods used to quantify microplastic release from the domestic laundry of textile fabrics. A wide review of the existing methods is made, with...

The AATCC TM22-2014 spray test (similarly BS EN ISO 4920:2012) is widely used to determine the water repellency of textiles. Given the ongoing move towards non-fluorinated chemistries to provide water repellent finishes on textiles, modifications to the spray test are suggested to discriminate between those which initially demonstrate similar repellency and aid in assessment of performance within laboratory textile testing. An extended shower duration of 60 minutes or 120 minutes is recommended, with additional calculations to objectively quantify surface wetting. This increased test period demonstrated differences in performance between repellent finishes with a 1.37 g mass difference between fluorinated and non-fluorinated chemistries after 120 minutes. Further quantification of repellent performance, as set out in this study, would determine the performance of non-fluorinated durable water repellent (DWR) chemistries and suitability for end use.

Background The United States Environmental Protection Agency (EPA) recently lowered residential floor and windowsill dust lead hazard standards, but maintained previous post-abatement clearance standards. We examined whether the discrepancy in these regulations places children at higher risk of lead poisoning. Methods In 250 children from Cincinnati, Ohio (2004-2008) living in homes built before 1978, we measured residential floor and windowsill dust lead loadings and blood lead concentrations at ages 1 and 2 years. Using linear regression with generalized estimating equations, we estimated covariate-adjusted associations of dust lead levels with blood lead concentrations and risk of lead poisoning. Results An increase in floor dust lead from 10 (revised dust lead hazard standard) to 40 μg/ft2 (post-abatement clearance standard) was associated with 26% higher (95% confidence interval (CI):15, 38) blood lead concentrations and 2.1 times the risk of blood lead concentrations ≥5 μg/dL (95% CI: 1.44, 3.06). Extrapolating our findings to US children age 1-5 years, we estimated that 6.9% (95% CI: 1.5, 17.2) of cases of blood lead concentrations ≥5 μg/dL are attributable to floor dust lead loadings between 10 and ≤40 μg/ft2. Conclusions The EPA's residential dust lead regulations place children at increased risk of lead poisoning. We recommend adopting more protective dust lead standards. Impact We determined whether children are at increased risk of lead poisoning with the 2019 EPA residential post-abatement lead clearance standards being higher than dust lead hazard standards.In this observational study, 2019 EPA dust lead clearance standards were associated with increased risk of lead poisoning compared to the revised dust lead hazard standard. Both EPA standards were associated with increased risk of lead poisoning compared to more stringent standards employed in our study.Extrapolating our findings to US children, the 2019 EPA dust lead clearance standards could place up to 36,700 children at risk of lead poisoning.

We analyze retrospectively/prospectively the transient variations of six different physical parameters in the atmosphere/ionosphere during the M7.8 and M7.3 earthquakes in Nepal, namely: 1) outgoing longwave radiation (OLR) at the top of the atmosphere (TOA); 2) GPS/TEC; 3) the very-low-frequency (VLF/LF) signals at the receiving stations in Bishkek (Kyrgyzstan) and Varanasi (India); 4) Radon observations; 5) Atmospheric chemical potential from assimilation models; and; 6) Air Temperature from NOAA ground stations. We found that in mid-March 2015, there was a rapid increase in the radiation from the atmosphere observed by satellites. This anomaly was located close to the future M7.8 epicenter and reached a maximum on April 21–22. The GPS/TEC data analysis indicated an increase and variation in electron density, reaching a maximum value during April 22–24. A strong negative TEC anomaly in the crest of EIA (Equatorial Ionospheric Anomaly) occurred on April 21, and a strong positive anomaly was recorded on April 24, 2015. The behavior of VLF-LF waves along NWC-Bishkek and JJY-Varanasi paths has shown abnormal behavior during April 21–23, several days before the first, stronger earthquake. Our continuous satellite OLR analysis revealed this new strong anomaly on May 3, which was why we anticipated another major event in the area. On May 12, 2015, an M7.3 earthquake occurred. Our results show coherence between the appearance of these pre-earthquake transient’s effects in the atmosphere and ionosphere (with a short time-lag, from hours up to a few days) and the occurrence of the 2015 M7.8 and M7.3 events. The spatial characteristics of the pre-earthquake anomalies were associated with a large area but inside the preparation region estimated by Dobrovolsky-Bowman. The pre-earthquake nature of the signals in the atmosphere and ionosphere was revealed by simultaneous analysis of satellite, GPS/TEC, and VLF/LF and suggest that they follow a general temporal-spatial evolution pattern that has been seen in other large earthquakes worldwide.

Blood lead (Pb) poisoning remains a global concern, particularly for children in their early developmental years. Broken Hill is Australia's oldest operating silver-zinc-lead mine. In this study, we utilized recent advances in machine learning to assess multiple algorithms and identify the most optimal model for predicting childhood blood Pb levels (BLL) using Broken Hill children's (

Here we detail the soil to vegetable transfer factor (uptake) data and calculation procedures for vegetable trace metal uptake estimation that are presented in Taylor et al. (2021). Firstly, we present the literature review of trace metal uptake data, describing uptake from soil to vegetable produce determined in global experimental studies. After selecting the uptake factors most applicable to the VegeSafe dataset, using similar soil trace metal concentrations and studies that consider only the edible parts of plants, we applied these uptake factors to VegeSafe soils. Using this approach, we were able to estimate trace metal concentrations in home grown produce across the 3,609 homes included in our VegeSafe study. Using Australian and global food standards, we calculated the soil trace metal concentrations that would potentially result in exceedance of Australian and global food safety criteria. Our process followed the method detailed in the Australian soil guidelines (NEPM, 2013). Also presented are the numbers of individual samples and vegetable gardens that are likely to exceed food safety criteria in the three largest cities of Australia: Sydney, Melbourne and Brisbane. Individual household vegetable garden trace metal uptake data were aggregated across standarised geographic areas (Statistical Area Level 3) as established by the Australian Bureau of Statistics to visualise the geospatial distribution of potential trace metal risk from home produce. These modelled data provide the basis for prioritising locations, trace metals and soils for future empirically-based studies of trace metal contamination in home-grown produce.

IntroductionPerfluoroalkyl and polyfluoroalkyl substances (PFAS) are a diverse group of compounds that have been used in hundreds of industrial applications and consumer products including aqueous film-forming foam (AFFF) for many years. Multiple national and international health and environmental agencies have accepted that PFAS exposures are associated with numerous adverse health effects. Australian firefighters have been shown to have elevated levels of PFAS in their blood, specifically perfluorooctane sulfonic acid (PFOS) and perfluorohexane sulfonic acid (PFHxS), due to the historical use of AFFF. While PFAS concentrations decline over time once the source of exposure has been removed, their potential adverse health effects are such that it would be prudent to develop an intervention to lower levels at a faster rate than occurs via natural elimination rates.Methods and analysisThis is a randomised controlled trial of current and former Australian firefighters in the Metropolitan Fire Brigade/Fire Rescue Victoria, and contractors, with previous occupational exposure to PFAS and baseline elevated PFOS levels. The study is investigating whether whole blood donation every 12 weeks or plasma donation every 6 weeks will significantly reduce PFAS levels, compared with a control group. We have used covariate-adaptive randomisation to balance participants’ sex and blood PFAS levels between the three groups and would consider a 25% reduction in serum PFOS and PFHxS levels to be potentially clinically significant after 12 months of whole blood or plasma donation. A secondary analysis of health biomarkers is being made of changes between screening and week 52 in all three groups.Ethics and disseminationThis trial has been approved by Macquarie University Human Research Ethics Committee (reference number: 3855), final protocol V.2 dated 12 June 2019. Study results will be disseminated via peer-reviewed publications and presentations at conferences.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12619000204145).

Multiple studies in India have found elevated blood lead levels (BLLs) in target populations. However the data have not yet been evaluated to understand population-wide exposure levels. We used arithmetic mean blood lead data published from 2010 to 2018 on Indian populations to calculate the average BLLs for multiple subgroups. We then calculated the attributable disease burden in IQ decrement and Disability Adjusted Life Years (DALYs). Our Pubmed search yielded 1066 articles. Of these, 31 studies representing the BLLs of 5472 people in 9 states met our study criteria. Evaluating these, we found a mean BLL of 6.86 μg/dL (95% CI: 4.38–9.35) in children and 7.52 μg/dL (95% CI: 5.28–9.76) in non-occupationally exposed adults. We calculated that these exposures resulted in 4.9 million DALYs (95% CI: 3.9–5.6) in the states we evaluated. Population-wide BLLs in India remain elevated despite regulatory action to eliminate leaded petrol, the most significant historical source. The estimated attributable disease burden is larger than previously calculated, particularly with regard to associated intellectual disability outcomes in children. Larger population-wide BLL studies are required to inform future calculations. Policy responses need to be developed to mitigate the worst exposures. Keywords: Blood, Lead, India, Meta-analysis, DALYs, Contamination

A previous experiment showed that blue light (as a component of white light) protected against low temporal frequency dependent eye growth. This experiment investigated the role of temporal contrast. White leghorn chicks were exposed to white (with blue) or yellow (without blue) LED lighting modulated at either low (0.2 Hz) or high (10 Hz) temporal frequencies. Four cone contrast conditions were used: low (16%), medium (32%), medium-high (60%) and very-high (80%). Chicks were exposed to the lighting condition for 3 days (mean 680 lux). Exposure to high temporal frequencies, with very high temporal contrast, reduced eye growth, regardless of spectral content. However, at low temporal frequencies, eye growth was dependent on the illuminant. At lower temporal contrast levels, eye growth increased regardless of temporal or spectral characteristics. To conclude, very high temporal contrast, white light, provides a “stop” signal for eye growth that overrides temporal cues for growth that manifest in yellow light.

Functional segregation and specialization of cortical regions is central to the significant changes that take place during early brain development. We present an automated scheme that harnesses local and long-range connectivity features of the cortex—derived from multiple imaging modalities—for longitudinal parcellation of the early developing human cortex. This is realized by using multi-modal connectome harmonics in a hierarchical agglomerative clustering (HAC) framework to produce group correspondent, individual-specific, and age-dependent parcellation maps for the first two years of development. We observed decreased regularity in cluster size and shape with increasing time, reflecting cortical specialization known to emerge during early development. Investigation of the modularity of structural connectivity defined by our parcellations suggests convergence toward adult resting-state networks as the brain develops.

We argue that normative evaluations of climate engineering responses to climate change have been impoverished by an excessive focus on cost-benefit analyses. We suggest that human rights can serve as an effective foundation for richer deliberations concerning the judiciousness of deploying climate engineering options. This chapter proceeds in four main sections. The first describes cost-benefit analysis, explains its role in evaluating public policy, and lays out its limitations. Then, we develop a human rights framework for the evaluation of climate engineering and consider how it avoids the problems of cost-benefit analysis. Yet, the third section describes why a human rights framework might have limited usefulness, because it does not offer adequate action guidance when making tradeoffs between rights or when weighing concurrent impacts on different groups. As a reaction, in the fourth section, we develop a set of principles and conceptual tools to revise the human rights framework so it is more effective in cases where it is necessary to prioritize certain human rights and evaluate impacts on different groups. We consider whether there is a hierarchy of rights that will assist with tradeoffs, and we examine core and periphery obligations stemming from human rights. We then consider whether a focus on vulnerable or marginalized groups helps to weigh impacts on different groups, and we discuss the principle of non-retrogression. Finally, we consider an approach that combines these ideas to address competing human rights claims and avoid narrowly construed zero-sum games.

Background The United States Environmental Protection Agency (EPA) recently lowered residential floor and windowsill dust lead hazard standards, but maintained previous post-abatement clearance standards. We examined whether the discrepancy in these regulations places children at higher risk of lead poisoning. Methods In 250 children from Cincinnati, Ohio (2004-2008) living in homes built before 1978, we measured residential floor and windowsill dust lead loadings and blood lead concentrations at ages 1 and 2 years. Using linear regression with generalized estimating equations, we estimated covariate-adjusted associations of dust lead levels with blood lead concentrations and risk of lead poisoning. Results An increase in floor dust lead from 10 (revised dust lead hazard standard) to 40 μg/ft2 (post-abatement clearance standard) was associated with 26% higher (95% confidence interval (CI):15, 38) blood lead concentrations and 2.1 times the risk of blood lead concentrations ≥5 μg/dL (95% CI: 1.44, 3.06). Extrapolating our findings to US children age 1-5 years, we estimated that 6.9% (95% CI: 1.5, 17.2) of cases of blood lead concentrations ≥5 μg/dL are attributable to floor dust lead loadings between 10 and ≤40 μg/ft2. Conclusions The EPA's residential dust lead regulations place children at increased risk of lead poisoning. We recommend adopting more protective dust lead standards. Impact We determined whether children are at increased risk of lead poisoning with the 2019 EPA residential post-abatement lead clearance standards being higher than dust lead hazard standards.In this observational study, 2019 EPA dust lead clearance standards were associated with increased risk of lead poisoning compared to the revised dust lead hazard standard. Both EPA standards were associated with increased risk of lead poisoning compared to more stringent standards employed in our study.Extrapolating our findings to US children, the 2019 EPA dust lead clearance standards could place up to 36,700 children at risk of lead poisoning.

Purpose Assess feasibility and interexaminer reliability of a new test of contrast sensitivity (CS) for pediatric populations. Methods The Double Happy (DH) measures CS using a method similar to the Teller Acuity Cards. The schematic DH face is 16 degrees in diameter with features of 0.3 c/d and a channel frequency of 0.8 c/d. DH log10 CS is in 0.15 log unit steps, 0.05 to 2.1. Participants were 43 unselected patients, ages 2 to 18 years: 23 were diagnosed with ocular disorders only; 20 were diagnosed with cerebral visual impairment (CVI). Two examiners measured DH log10 CS. Visual acuity (VA) was also measured. Results All 43 participants were tested for binocular DH log10CS. Cohen's kappa values for interexaminer reliability were fair. The between examiner ICC was +0.92 (P < 0.001). The mean difference between examiners was near zero, and the 95% CI was -0.44 to 0.45 log10CS. DH log10CS was near normal in the ocular disorder group and reduced in the CVI group. VA was reduced in both groups. DH log10 CS and VA were correlated (r = -0.65). DH log10 CS was a marginally better predictor of diagnosis than VA. Conclusions DH log10CS test was successful in a diverse pediatric population diagnosed with ocular disorders or CVI. Interexaminer reliability was comparable to that of adults tested previously using the same stimuli and methods. Both CS and VA are reduced in CVI. Translational Relevance CS and VA both should be tested in pediatric clinical populations, especially in those at risk of CVI.

This paper develops a novel, neo-republican account of just state surveillance in the information age. The goal of state surveillance should be to avoid and prevent domination, both public and private. In light of that conception of justice, the paper makes three substantive points. First, it argues that modern state surveillance based upon information technology and predicated upon a close partnership with the tech sector gives the state significant power and represents a serious potential source of domination. Second, it argues that, nonetheless, state surveillance can serve legitimate republican ends and so unilateral and private technological attempts to block it may be wrongful. Third, it argues that, despite the serious normative failings of current institutions, state surveillance can be justly regulated and made accountable through a legal liability regime that incentivizes tech company intermediaries to ally with civil society groups in order to safeguard the privacy rights of potential subjects of state surveillance.

Summary Background Since the global phase-out of leaded petrol, reports have suggested that lead exposure remains substantial or is increasing in some low-income and middle-income countries (LMICs). However, few studies have attempted to systematically assess blood lead levels over the full range of LMICs. We aimed to describe values for blood lead level in LMICs. Methods In this systematic review, we searched PubMed for studies published between Jan 1, 2010, and Oct 31, 2019, that reported blood lead levels in the 137 countries in World Bank LMIC groupings. Studies were reviewed for inclusion if they contained blood lead level data from human populations residing in any given country; comprised at least 30 participants; presented blood lead level data derived from venous, capillary, or umbilical cord samples of whole blood; had data that were collected after Dec 31, 2004; and were published in English. Data on blood lead level were extracted and pooled, as appropriate, to make country-specific estimates of the distribution of background blood lead levels among children and adults, along with information on specific sources of exposure where available. This study is registered with PROSPERO, number CRD42018108706. Findings Our search yielded 12 695 studies, of which 520 were eligible for inclusion (1100 sampled populations from 49 countries comprising 1 003 455 individuals). Pooled mean blood lead concentrations in children ranged from 1·66 μg/dL (SD 3·31) in Ethiopia to 9·30 μg/dL (11·73) in Palestine, and in adults from 0·39 μg/dL (1·25) in Sudan to 11·36 μg/dL (5·20) in Pakistan. Background values for blood lead level in children could be pooled in 34 countries and were used to estimate background distributions for 1·30 billion of them. 632 million children (95% CI 394 million–780 million; 48·5%) were estimated to have a blood lead level exceeding the US Centers for Disease Control's reference value of 5 μg/dL. Major sources of lead exposure were informal lead acid battery recycling and manufacture, metal mining and processing, electronic waste, and the use of lead as a food adulterant, primarily in spices. Interpretation Many children have a blood lead level exceeding 5 μg/dL in LMICs, despite leaded petrol phase-outs. Given the toxicity of lead, even at low amounts of exposure, urgent attention is required to control exposures and to expand population-based sampling in countries with no or scant data. Funding This work was supported by the United States Agency for International Development (Cooperative Agreement number AID-OAA-A-16-00019).

As a result of longitudinal chromatic aberration (LCA), longer wavelengths are blurred when shorter wavelengths are in focus, and vice versa. As a result, LCA affects the color and temporal aspects of the retinal image with hyperopic defocus. In this experiment, we investigated how the sensitivity to temporal color contrast affects emmetropization. Ten-day-old chicks were exposed for three days to sinusoidal color modulation. The modulation was either blue/yellow flicker (BY) (n = 57) or red/green flicker (RG) (n = 60) simulating hyperopic defocus with and without a blue light component. The color contrasts tested were 0.1, 0.2, 0.3, 0.4, 0.6, and 0.8 Michelson contrast. The mean illuminance of all stimuli was 680 lux. Temporal modulation was either of a high (10 Hz) or low (0.2 Hz) temporal frequency. To test the role of short- and double-cone stimulation, an additional condition silenced these cones in RG_0.4 (D-) and was compared with RG_0.4 (D+) (n = 14). Changes in ocular components and refractive error were measured using Lenstar and a photorefractometer. With high temporal frequency BY representing an in-focus condition for shorter-wavelengths, we found that high temporal frequency BY contrast was positively correlated with vitreous expansion (R2 = 0.87, p

Pollution from multiple sources causes significant disease and death worldwide. Some sources are legacy, such as heavy metals accumulated in soils, and some are current, such as particulate matter. Because the global burden of disease from pollution is so high, it is important to identify legacy and current sources and to develop and implement effective techniques to reduce human exposure. But many limitations exist in our understanding of the distribution and transport processes of pollutants themselves, as well as the complicated overprint of human behavior and susceptibility. New approaches are being developed to identify and eliminate pollution in multiple environments. Community‐scale detection of geogenic arsenic and fluoride in Bangladesh is helping to map the distribution of these harmful elements in drinking water. Biosensors such as bees and their honey are being used to measure heavy metal contamination in cities such as Vancouver and Sydney. Drone‐based remote sensors are being used to map metal hot spots in soils from former mining regions in Zambia and Mozambique. The explosion of low‐cost air monitors has allowed researchers to build dense air quality sensing networks to capture ephemeral and local releases of harmful materials, building on other developments in personal exposure sensing. And citizen science is helping communities without adequate resources measure their own environments and in this way gain agency in controlling local pollution exposure sources and/or alerting authorities to environmental hazards. The future of GeoHealth will depend on building on these developments and others to protect a growing population from multiple pollution exposure risks., Key Points Legacy and current pollutants are a major global cause of disease and deathMany detection and mitigation tools are not adequate for identifying pollution hot spots in communities, particularly vulnerable onesThe next century of AGU will usher in novel, community‐focused techniques and approaches to mapping pollutants and reducing exposure

Chicks respond to two signals from longitudinal chromatic aberration (LCA): a wavelength defocus signal and a chromatic signal. Wavelength defocus predicts reduced axial eye growth in monochromatic short-wavelength light, compared to monochromatic long-wavelength light. Wavelength defocus may also influence growth in broadband light. In contrast, a chromatic signal predicts increased growth when short-wavelength contrast > long-wavelength contrast, but only when light is broadband. We aimed to investigate the influence of blue light, temporal frequency and contrast on these signals under broadband conditions. Starting at 12 to 13 days-old, 587 chicks were exposed to the experimental illumination conditions for three days for 8h/day and spent the remainder of their day in the dark. The stimuli were flickering lights, with a temporal frequency of 0.2 or 10 Hz, low (30%) or high contrast (80%), and a variety of ratios of cone contrast simulating the effects of defocus with LCA. There were two color conditions, with blue contrast (bPlus) and without (bMinus). Stimuli in the “bPlus” condition varied the amounts of long- (L-), middle- (M-) and double- (D-) cone contrast, relative to short- (S-) and ultraviolet (UV-) cone contrast, to simulate defocus. Stimuli in the “bMinus” condition only varied the relative modulations of the L+D vs. M cones. In all cases, the average of the stimuli was white, with an illuminance of 777 lux, with cone contrast created through temporal modulation. A Lenstar LS 900 and a Hartinger refractometer were used to measure ocular components and refraction. Wavelength defocus signals with relatively high S-cone contrast resulted in reduced axial growth, and more hyperopic refractions, under low-frequency conditions (p = 0.002), in response to the myopic defocus of blue light. Chromatic signals with relatively high S-cone contrast resulted in increased axial growth and more myopic refractions, under high frequency, low contrast, conditions (p < 0.001). We conclude that the chromatic signals from LCA are dependent on the temporal frequency, phase, and relative contrast of S-cone temporal modulation, and recommend broadband spectral and temporal environments, such as the outdoor environment, to optimize the signals-for-defocus in chick.

Background: Mental imagery abnormalities feature across affective disorders including bipolar disorder (BD) and unipolar depression (UD). Maladaptive emotional imagery has been proposed as a maintenance factor for affective symptomatology and a target for mechanism-driven psychological treatment developments. Where imagery abnormalities feature beyond acute affective episodes, further opportunities for innovation arise beyond treatments, such as for tertiary/relapse prevention (e.g., in remitted individuals) or primary prevention (e.g., in non-affected but at-risk individuals). The aim of our study was to investigate for the first time the presence of possible mental imagery abnormalities in affected individuals in remission and at-risk individuals for affective disorders using a familial risk design.Methods: A population-based cohort of monozygotic twins was recruited through linkage between the Danish national registries (N=204). Participants were grouped as: affected (remitted BD/UD; n = 115); high-risk (co-twin with history of BD/UD; n = 49), or low-risk (no co-twin history of BD/UD; n = 40). Twins completed mental imagery measures spanning key subjective domains (spontaneous imagery use and emotional imagery) and cognitive domains (imagery inspection and imagery manipulation).Results: Affected twins in remission reported enhanced emotional mental imagery compared to both low- and high-risk twins. This was characterized by greater impact of i) intrusive prospective imagery (Impact of Future Events Scale) and ii) deliberately-generated prospective imagery of negative scenarios (Prospective Imagery Task). There were no significant differences in these key measures between affected BD and UD twins in remission. Additionally, low- and high-risk twins did not significantly differ on these emotional imagery measures. There were also no significant differences between the three groups on non-emotional measures including spontaneous imagery use and cognitive stages of imagery.Conclusions: Abnormalities in emotional prospective imagery are present in monozygotic twins with affective disorders in remission—despite preserved cognitive stages of imagery—but absent in unaffected high-risk twins, and thus do not appear to index familial risk (i.e., unlikely to qualify as “endophenotypes”). Elevated emotional prospective imagery represents a promising treatment/prevention target in affective disorders.

As demand for data scientists in audit/Governance, risk management and compliance (GRC), and industry in general, outpaces supply, data science in a box—packaged analytics powered by artifi...

Environmental remediation efforts in low‐ and middle‐income countries have yet to be evaluated for their cost effectiveness. To address this gap we calculate a cost per Disability Adjusted Life Year (DALY) averted following the environmental remediation of the former lead smelter and adjoining residential areas in Paraiso de Dios, Haina, the Dominican Republic, executed from 2009 to 2010. The remediation had the effect of lowering surface soil lead concentrations to below 100 mg/kg and measured geometric mean blood lead levels (BLLs) from 20.6 μg/dL to 5.34 ug/dL. Because BLLs for the entire impacted population were not available, we use environmental data to calculate the resulting disease burden. We find that before the intervention 176 people were exposed to elevated environmental lead levels at Paraiso de Dios resulting in mean BLLs of 24.97 (95% CI: 24.45–25.5) in children (0–7 years old) and 13.98 μg/dL (95% CI: 13.03–15) in adults. We calculate that without the intervention these exposures would have resulted in 133 to 1,096 DALYs and that all of these were averted at a cost of USD 392 to 3,238, depending on assumptions made. We use a societal perspective, meaning that we include all costs regardless of by whom they were incurred and estimate costs in 2009 USD. Lead remediation in low‐ and middle‐income countries is cost effective according to World Health Organization thresholds. Further research is required to compare the approach detailed here with other public health interventions., Key Points Pollution remediation in low‐ and middle‐income countries has yet to be evaluated for its cost effectivenessWe calculate DALYs averted by the lead remediation in Paraiso de Dios, Haina, the Dominican Republic completed in 2010Pollution remediation is cost effective according to WHO thresholds

Purpose Longitudinal chromatic aberration can provide luminance and chromatic signals for emmetropization. A previous experiment examined the role of temporal sensitivity to luminance flicker in the emmetropization response. In the current experiment, we investigate the role of temporal sensitivity to color flicker. Methods Five-day-old chicks were exposed to sinusoidal color modulation of blue/yellow (N = 73) or red/green LEDs (N = 84) at 80% contrast for 3 days. The modulation frequencies used were as follows: 0, 0.2, 1, 2, 5, and 10 Hz. There were 5 to 16 chicks per condition. Mean illumination was 680 lux. Changes in ocular components were measured using Lenstar, and refraction was measured with a Hartinger refractometer. Results Eyes grew less when exposed to high temporal frequencies and more at low temporal frequencies. With blue/yellow modulation, the temporal variation was small; eyes grew 268 ± 15 μm at 0 Hz and 224 ± 12 μm at 10 Hz, representing a 16.4% growth reduction. With red/green modulation, eyes grew 336 ± 31 μm at 0 Hz and 218 ± 20 μm at 10 Hz, representing a 35% growth reduction. Choroidal and anterior chamber changes compensated for eye growth, reducing refractive effects; blue/yellow refraction changes ranged from -0.63 to 1.04 diopters. Conclusions At high temporal frequencies, color is not a factor, but at low temporal frequencies, red/green modulation produced maximal growth. The pattern of changes observed in each ocular component with changes in the temporal frequency and/or the color of the stimulus was consistent with the idea that the natural sunlight spectrum may be optimal for emmetropization.

In broadband light, longitudinal chromatic aberration (LCA) provides emmetropization signals from both wavelength defocus and the resulting chromatic cues. Indoor illuminants vary in their spectral output, potentially limiting the signals from LCA. Our aim is to investigate the effect that artificial illuminants with different spectral outputs have on chick emmetropization with and without low temporal frequency modulation. In Experiment 1, two-week-old chicks were exposed to 0.2 Hz, square-wave luminance modulation for 3 days. There were 4 spectral conditions: LED strips that simulated General Electric (GE) LED "Soft" (n = 13), GE LED "Daylight" (n = 12), a novel "Equal" condition (n = 12), and a novel "High S" condition (n = 10). These conditions were all tested at a mean level of 985 lux. In Experiment 2, the effect of intensity on the "Equal" condition was tested at two other light levels (70 lux: n = 10; 680 lux: n = 7). In Experiment 3, the effect of temporal modulation on the "Equal" condition was tested by comparing the 0.2 Hz condition with 0 Hz (steady). Significant differences were found in axial growth across lighting conditions. At 985 lux, birds exposed to the "Equal" condition showed a greater reduction in axial growth (both p 0.01) and a greater hyperopic shift compared to "Soft" and "Daylight" (both p 0.01). The "High S" birds experienced more axial growth compared to "Equal" (p 0.01) but less than in "Soft" and "Daylight" (p 0.01). Axial changes in "Equal" were only observed at 985 lux with 0.2 Hz temporal modulation, and not with lower light levels or steady light. We conclude that axial growth and refraction were dependent on the lighting condition in a manner predicted by wavelength defocus signals arising from LCA.

Intensifying legislation and increased research on the toxicological and persistent nature of per- and polyfluoroalkyl substances (PFASs) have recently influenced the direction of liquid repellent chemistry use; environmental, social, and sustainability responsibilities are at the crux. Without PFAS chemistry, it is challenging to meet current textile industry liquid repellency requirements, which is a highly desirable property, particularly in outdoor apparel where the technology helps to provide the wearer with essential protection from adverse environmental conditions. Herein, complexities between required functionality, legislation and sustainability within outdoor apparel are discussed, and fundamental technical performance of commercially available long-chain (C8) PFASs, shorter-chain (C6) PFASs, and non-fluorinated repellent chemistries finishes are evaluated comparatively. Non-fluorinated finishes provided no oil repellency, and were clearly inferior in this property to PFAS-finished fabrics that demonstrated good oil-resistance. However, water repellency ratings were similar across the range of all finished fabrics tested, all demonstrating a high level of resistance to wetting, and several non-fluorinated repellent fabrics provide similar water repellency to long-chain (C8) PFAS or shorter-chain (C6) PFAS finished fabrics. The primary repellency function required in outdoor apparel is water repellency, and we would propose that the use of PFAS chemistry for such garments is over-engineering, providing oil repellency that is in excess of user requirements. Accordingly, significant environmental and toxicological benefits could be achieved by switching outdoor apparel to non-fluorinated finishes without a significant reduction in garment water-repellency performance. These conclusions are being supported by further research into the effect of laundering, abrasion and ageing of these fabrics.

Study design/setting This report is a retrospective case series that examined the acute complications of patients aged 70 years and older undergoing spinal deformity surgery that required fusion of at least 6 levels. Objective To determine the acute complications that patients in the eighth decade of their life experience after spinal reconstructive surgery, and how these complication rates compare with other patient populations undergoing similar procedures. Summary of background data As the mean age of the United States population rises, more older patients with painful spinal deformities can be expected. Although there are similar studies in the literature examining acute complications of patients undergoing major spinal deformity surgery, the complication rates of this unique patient population have not been adequately studied. Methods Twenty patients had complete medical records with at least 6 months of follow-up. All the 20 patients underwent instrumented posterior spinal fusions performed by the same surgeon. Comorbidities, weighted comorbidity index, duration, number of hospital days, estimated blood loss, intensive care unit days, American Society of Anesthesiologist score, and intraoperative and postoperative complications were recorded. Results The mean age of our patient cohort was 76.6 years (range, 70-84 y). Patients had an average of 4 comorbidities and an American Society of Anesthesiologist score of 2.7. Although the group of patients had a large number of comorbidities, their weighted comorbidity index, according to Charlson and colleagues, was fairly low at 1.05 (range, 0-4). All of the patients were fused at least 6 levels, with the average being 10.75 (range, 6-15). Ninety-five percent of patients experienced a complication of some type. Nine major complications occurred in 7 patients. Conclusions Spinal deformity surgery in patients at any age has associated risks. These risks are believed to increase with age and the complexity of the procedure. Our results show that, although the risks of major complications are significant, the risk is not greater than in a younger population undergoing the similar procedures. We feel that age alone should not be a contraindication for patients in their eighth decade of life who are incapacitated by their painful spinal deformity.

Industrial sources, including iron ore sintering, municipal waste incineration and non-ferrous metal processing have been prominent emitters of dioxins to the environment. With the expanding industrial sectors, many international conventions were established in order to reduce the emission of dioxins in the past two decades. The Stockholm convention, a global monitoring treaty, entered into force in 2004 with the aim to promote development of strategies to reduce or eliminate dioxin emissions. According to the convention, parties are required to develop national inventory databases to report emission levels and develop a national implementation plan (NIP) to reduce further dioxin emissions. In order to understand the trend of dioxin emissions since 1990s this study provides a comparative assessment of dioxin emissions from different industrial sources by deriving emission data from the national inventory databases of Australia, Canada and the 28 European countries (EU-28). According to the data collected, iron and steel production and electricity generation were the highest emitters of dioxins in 2017 for Europe, Canada and Australia, when compared to other stationary industrial sources. The change in the trend of dioxin emissions from the iron and steel industry and the public electricity sector was also assessed. The emission of dioxins during 1990-2017 from both iron and steel production and electricity generation revealed a relative decreasing trend, except for Spain and Italy who showed higher level of emissions from iron and steel production in 2017. Furthermore, comparing emission data for metal production revealed that the blast furnace process was the prominent emitter of dioxins comparing to electric arc furnace process. Further investigation was performed to compare the amount of dioxin emitted from three different fuel types, black coal, brown coal and natural gas, used for electricity generation in Australia. The study showed that dioxin emissions from brown coal were higher than black coal for the last two years, while power production from natural gas emits the lowest amounts of dioxins to the environment.

Meaningful division of the human cortex into distinct regions is a longstanding goal in neuroscience. Many of the most widely cited parcellations utilize anatomical priors or depend on functional magnetic resonance imaging (MRI) data while there exists a relative dearth of parcellations that use only structural data based on diffusion MRI. In light of this, and the fact that structural connectivity represents the underlying substrates of functional connectivity, we employ a novel high-resolution, vertex-level graph model of the whole-brain structural connectome and show that the harmonic modes of this graph can be used to achieve parcellations that qualitatively agree with the widely accepted atlases in the literature. Further, we detail a multi-layer formulation of the structural connectome graph and demonstrate that hierarchical clustering of its harmonic modes yields subject-specific parcellations at varying resolutions with ensured and tunable group-level correspondence.

Background: Broken Hill, the oldest silver (Ag) –zinc (Zn) –lead (Pb) mining community in Australia, has an ongoing and legacy problem of environmental Pb exposure that began as early as 1893. To reduce Pb exposure risks, identifying potential exposure pathways and related factors is a critical first step. Methods: This study examined PbB levels of children ≤ 60 months old (n = 24,106 samples), along with corresponding soil (n = 10,160 samples), petri-dish dust (n = 106 houses) and ceiling dust (n = 80 houses) Pb concentrations at homes over a 25-year period from 1991-2015. Regression analysis was used to identify potential factors driving blood Pb exposures as well as the relationship between environmental Pb sources and children’s blood lead (PbB) outcomes. Findings: Analysis of the dataset showed there were multiple statistically significant (p 10 µg/dL was seemingly unavoidable irrespective of residential address. In terms of moving forward and mitigating harmful early-life Pb exposures, the data show that children aged 24–36 months and Aboriginal children should be prioritised for feasible intervention practices. The primary intervention must focus on mitigating contemporary ongoing dust emissions from the mining operations and the associated mine-lease areas followed by household soil remediation, to help prevent recontamination of homes. Additional practices of dust cleaning using wet mopping and wiping techniques, vacuuming of carpets and furnishings, ongoing monitoring of children and household dust remain important short-lived abatement strategies, but the key aim should be to eliminate risk by removing contamination in the wider environment as well as in individual homes. Funding Statement: C. Dong was funded via an International Macquarie University Research Excellence Scholarship (iMQRES No. 2014098). He received technical and practical support from the Broken Hill Environmental Lead Program (BHELP) as part of a Macquarie University-BHELP collaboration agreement, which included funding support from NSW EPA to MP Taylor. Declaration of Interests: The authors declare no competing financial interests. M.P. Taylor has completed an independent Review of the New South Wales Environment Protection Authority’s Management of Contaminated Sites for the NSW Minister for the Environment (available at: http://www.epa.nsw.gov.au/resources/epa/Contaminated-Sites-Review-2016.pdf) and is also an occasional advisor to the NSW EPA’s Broken Hill Environmental Lead Program. M.P. Taylor is also the lead author of an independent review (in progress) of the scientific evidence related to PbB exposures and sources for the NSW EPA’s Broken Hill Environmental Lead Program. B. Gulson has been nominated as an independent reviewer of that report. Ethics Approval Statement: Data access and its subsequent analysis were subject to ethics approval from NSW Health and Macquarie University.

Lead concentrations and lead isotopic compositions were determined in historic central and southern Victoria, Australia lichen (Cladonia and Usnea) and fungi (Trametes) samples collected between 1852 and 2008 to evaluate long-term atmospheric lead contamination sources. The data are grouped into four time intervals of 1850–1931, 1932–1984, 1985–2001 and 2002–2008 corresponding to the history of leaded petrol use in Australia. Elevated lichen and fungi lead concentrations and relatively high isotopic compositions from the period 1850–1931 are attributed to lithogenic sources, gold mining activities and early industrialisation. Significant increases in lichen and fungi lead concentrations and concomitant lower lead isotopic compositions correspond to the marked increase in lead emissions from leaded petrol use after 1932. Following the end of leaded petrol use in 2002 lead isotopic composition values ‘recover’ toward more lithogenic values. However, the lead isotopic composition data indicate that the environmental impact from leaded petrol emissions persists in contemporary samples dated to 2002–2008. Overall, the data reveal that herbarium lichens and fungi from central and southern Victoria can be used as proxies for environmental lead emissions over the past 150 years.

Australia has a long history of metal mining and smelting. Extraction and processing have resulted in elevated levels of toxic metals surrounding mining operations, which have adverse health effects, particularly to children. Resource companies, government agencies and employees often construct 'myths' to down play potential exposure risks and responsibility arising from operating emissions. Typical statements include: contaminants are naturally occurring, the wind blows emissions away from residential areas, contaminants are not bioavailable, or the problem is a legacy issue and not related to current operations. Evidence from mining and smelting towns shows that such 'myths' are exactly that. In mining towns, the default and primary defence against contamination is that elevated metals in adjacent urban environments are from the erosion and weathering of the ore bodies over millennia-hence 'naturally occurring'. Not only is this a difficult argument to unravel from an evidence-based perspective, but also it causes confusion and delays remediation work, hindering efforts to reduce harmful exposures to children. An example of this situation is from Broken Hill, New South Wales, home to one of the world's largest lead-zinc-silver ore body, which has been mined continuously for over 130 years. Environmental metal concentration and lead isotopic data from soil samples collected from across Broken Hill are used to establish the nature and timing of lead contamination. We use multiple lines of evidence to unravel a 'miner's myth' by evaluating current soil metal concentrations and lead isotopic compositions, geological data, historical environmental assessments and old photographic evidence to assess the impacts from early smelting along with mining to the surface soils in the city.

Blur is a useful cue for depth. Natural images contain objects at a range of depths whose depth can be signaled by their perceived blur. Here, to evaluate the usefulness of blur as a depth cue, we estimate the number blur levels that observers can perceive simultaneously. To estimate this value, observers discriminated and classified dead leaves patterns that contained a controlled distribution of blur levels but are more complex or naturalistic than stimuli typically used in blur research. We used a 2-IFC discrimination task, in which observers reported the interval that contained more blur levels and a classification task, in which observers reported the number of perceived blur levels. In both tasks, observers could not discriminate or classify more than four levels of blur in the stimulus reliably. In isolation from other cues, blur may provide only a coarse cue to depth and add limited depth information when present in natural scenes with complex distributions of blur and multiple depth cues.

To evaluate the Spot Vision Screener in detecting targeted vision disorders compared to cycloplegic retinoscopy in children3 years of age.Children, ages 6 months to 36 months underwent vision screening using the Spot Vision Screener. Results were compared to results of comprehensive eye examinations. Validity of the Spot was evaluated by calculating the area under the curve (AUC); the receiver operating characteristics (ROC) were used to determine optimal sensitivity and specificity for detection of targeted vision disorders.A total of 249 children were included. The AUC for detecting targeted vision disorders as defined by the study specific criteria using the Spot was 0.790. Compared to cycloplegic retinoscopy, the Spot underestimated hyperopia by 1.02 D (95% CI, 0.86-1.17 D). For hyperopia ≥4.5 D spherical equivalent (n = 10), the mean difference between the Spot and cycloplegic retinoscopy was 3.46 D (95% CI, 1.95-4.98 D). In contrast, the Spot overestimated astigmatism compared to cycloplegic retinoscopy (-1.00 D vs -0.48 D; P 0.001) by -0.52 D (95% CI, 0.43-0.62 D).The Spot Vision Screener showed good overall validity in detecting targeted vision disorders. It was within 0.5 D and 1 D of cycloplegic retinoscopy with regard to low hyperopia and astigmatism. Higher hyperopic spherical equivalent refractive errors showed larger differences in mean values between the Spot and cycloplegic retinoscopy.

Combustion emissions are of growing concern across all Pacific Island Countries, which account for >10,000 km2 of the earth's surface area; as for many other small island states globally. Apportioning emissions inputs for Suva, the largest Pacific Island city, will aid in development of emission reduction strategies. Total suspended particulate (TSP) and fine particulate (PM2.5) samples were collected for Suva City, a residential area (Kinoya, TSP) and a mainly ocean-influenced site (Suva Point, TSP) from 2014 to 2015. Percentages of contemporary and fossil carbon were determined by radiocarbon analysis (accelerator mass spectrometry); for non‑carbonate carbon (NCC), elemental carbon (EC) and organic carbon (OC). Source contributions to particulate matter were identified and the accuracy of previous emissions inventory and source apportionment studies was evaluated. Suva Point NCC concentrations (2.7 ± 0.4 μg/m3) were four times lower than for City (13 ± 2 μg/m3 in TSP) and Kinoya (13 ± 1 μg/m3 in TSP); demonstrating the contribution of land-based emissions activities in city and residential areas. In Suva City, total NCC in air was 81% (79%–83%) fossil carbon, from vehicles, shipping, power generation and industry; whilst in the residential area, 48% (46%–50%) of total NCC was contemporary carbon; reflecting the higher incidence of biomass and waste burning and of cooking activities. Secondary organic fossil carbon sources contributed >36% of NCC mass at the city and >29% at Kinoya; with biogenic carbon being Kinoya's most significant source (approx. 30% of NCC mass). These results support the previous source apportionment studies for the city area; yet show that, in line with emissions inventory studies, biomass combustion contributes more PM2.5 mass in residential areas. Hence air quality management strategies need to target open burning activities as well as fossil fuel combustion.

This study utilises a range of scientific approaches, including lead isotopic compositions, to differentiate unknown sources of ongoing lead contamination of a drinking water supply in north-eastern Tasmania, Australia. Drinking water lead concentrations are elevated above the Australian Drinking Water Guideline (10 μg/L), reaching 540 μg/L in the supply network. Water lead isotopic compositions from the town of Pioneer ((208)Pb/(207)Pb 2.406, (206)Pb/(207)Pb 1.144 to (208)Pb/(207)Pb 2.360, (206)Pb/(207)Pb 1.094) and Ringarooma ((208)Pb/(207)Pb 2.398, (206)Pb/(207)Pb 1.117) are markedly different from the local bedrock ((208)Pb/(207)Pb 2.496, (206)Pb/(207)Pb 1.237). The data show that the lead in the local waters is sourced from a combination of dilapidated drinking water infrastructure, including lead jointed pipelines, end-of-life polyvinyl chloride pipes and household plumbing. Drinking water is being inadvertently contaminated by aging infrastructure, and it is an issue that warrants investigation to limit the burden of disease from lead exposure.

Overview: We model energy constraints in a network of spiking neurons, while exploring general questions of resource limitation on network function abstractly. Background: Metabolic states like dietary ketosis or hypoglycemia have a large impact on brain function and disease outcomes. Glia provide metabolic support for neurons, among other functions. Yet, in computational models of glia-neuron cooperation, there have been no previous attempts to explore the effects of direct realistic energy costs on network activity in spiking neurons. Currently, biologically realistic spiking neural networks assume that membrane potential is the main driving factor for neural spiking, and do not take into consideration energetic costs. Methods: We define local energy pools to constrain a neuron model, termed Spiking Neuron Energy Pool (SNEP), which explicitly incorporates energy limitations. Each neuron requires energy to spike, and resources in the pool regenerate over time. Our simulation displays an easy-to-use GUI, which can be run locally in a web browser, and is freely available. Results: Energy dependence drastically changes behavior of these neural networks, causing emergent oscillations similar to those in networks of biological neurons. We analyze the system via Lotka-Volterra equations, producing several observations: (1) energy can drive self-sustained oscillations, (2) the energetic cost of spiking modulates the degree and type of oscillations, (3) harmonics emerge with frequencies determined by energy parameters, and (4) varying energetic costs have non-linear effects on energy consumption and firing rates. Conclusions: Models of neuron function which attempt biological realism may benefit from including energy constraints. Further, we assert that observed oscillatory effects of energy limitations exist in networks of many kinds, and that these findings generalize to abstract graphs and technological applications.

Globally, childhood blood lead levels have fallen precipitously in developed countries since the 1970s following action by international bodies such as the WHO and Food and Agricultural Organization (FAO) of the United Nations. These reductions have been affected by the activities of national agencies such as the US EPA and US Centers for Disease Control and Prevention in the establishment of air lead and blood lead standards, the introduction of legislation to remove lead from petrol, paint and consumer products and tighter restrictions on lead emissions. The outcome of recent major international reviews of research into the effects of low-level lead exposures (e.g. by WHO, USA health and environmental agencies, German and Canadian health bodies) has resulted in recommendations to reduce and eliminate lead exposures. By contrast, Australian policy responses to the incontrovertible evidence that adverse neurocognitive and behavioural effects that occur at levels well below the current national goal of 10 μg/dL have stalled. The delayed response by Australia occurs at a time when blood lead levels in two of Australia's three primary lead mining and smelting cities: Port Pirie, South Australia and Broken Hill, New South Wales, are rising. In the third city, Mount Isa, Queensland, there is still no systematic, annual testing of childhood blood lead values. This is despite the fact that Mount Isa has the highest lead (and other toxic metals such as cadmium and arsenic) emissions to the environment (120 tonnes of lead in 2011/12) from any single point source in Australia. It is clear that both state and national policy approaches to the ongoing risks of lead exposure need to be revised urgently and in line with contemporary international standards. Recommended changes should include a new lower blood lead intervention level of no more than 5 μg/dL, with a national goal for all children under 5 years of age to have a blood lead level of below 1 μg/dL by 2020. In order to achieve any new lower exposure goals other relevant lead standards including air, dust, soil and water must also be revised downwards. Keywords: Blood lead, Children, Exposure, Lead, Policy

Agricultural practices, if not managed correctly, can have a negative impact on receiving environments via waste disposal and discharge. In this study, a chicken slaughter facility on the rural outskirts of Sydney, Australia, has been identified as a possible source of persistent effluent discharge into a peri-urban catchment. Questions surrounding the facility's environmental management practices go back more than four decades. Despite there having never been a definitive determination of the facility's impact on local stream water quality, the New South Wales Environment Protection Authority (NSW EPA) has implemented numerous pollution reduction requirements to manage noise and water pollution at the slaughter facility. However, assessment of compliance remains complicated by potential additional sources of pollution in the catchment. To unravel this long-standing conundrum related to water pollution we apply a forensic, multiple lines of evidence approach to delineate the origin of the likely pollution source(s). Water samples collected between 2014 and 2016 from irrigation pipes and a watercourse exiting the slaughter facility had elevated concentrations of ammonia (max: 63,000µg/L), nitrogen (max: 67,000µg/L) and phosphorus (max: 39,000µg/L), which were significantly higher than samples from adjacent streams that did not receive direct runoff from the facility. Arsenic, sometimes utilised in growth promoting compounds, was detected in water discharging from the facility up to ~4 times (max 3.84µg/L) local background values (0.5µg/L), with inorganic As

This study investigates the concentration and spatial distribution of Cu, Zn, Hg and Pb in the surface (0–2 cm) soils of a regional city in Australia. Surface soils were collected from road sides and analysed for their total Cu, Zn, Hg and Pb concentrations in the NEPC (1999) 300 mg/kg guideline for Pb in residential soils. Strong positive correlations between Cu, Zn and Pb, coupled with the spatial distribution of elevated soil concentrations towards the city centre and main roads suggest traffic and older housing as major sources of contamination. No spatial relationships were identified between elevated metal loadings and locations of past or present industries.

© 2016 Taylor et al. Background: Many populations have been exposed to environmental lead from paint, petrol, and mining and smelting operations. Lead is toxic to humans and there is emerging evidence linking childhood exposure with later life antisocial behaviors, including delinquency and crime. This study tested the hypothesis that childhood lead exposure in select Australian populations is related to subsequent aggressive criminal behaviors. Methods: We conducted regression analyses at suburb, state and national levels using multiple analytic methods and data sources. At the suburb-level, we examined assault rates as a function of air lead concentrations 15-24 years earlier, reflecting the ubiquitous age-related peak in criminal activity. Mixed model analyses were conducted with and without socio-demographic covariates. The incidence of fraud was compared for discriminant validity. State and national analyses were conducted for convergent validity, utilizing deaths by assault as a function of petrol lead emissions. Results: Suburb-level mixed model analyses showed air lead concentrations accounted for 29.8 % of the variance in assault rates 21 years later, after adjusting for socio-demographic covariates. State level analyses produced comparable results. Lead petrol emissions in the two most populous states accounted for 34.6 and 32.6 % of the variance in death by assault rates 18 years later. Conclusions: The strong positive relationship between childhood lead exposure and subsequent rates of aggressive crime has important implications for public health globally. Measures need to be taken to ameliorate exposure to lead and other environmental contaminants with known neurodevelopmental consequences.

Increasing awareness of the environmental value and importance of catchment systems, coupled with the emergence of legislative demands encouraging a holistic approach to environmental management, has forced practitioners to have a sound understanding of the fluvial systems with which they are working. The collection and interpretation of information regarding the functioning of riparian processes is an integral component of this understanding. This paper details the methods and application of the rapid riparian assessment, which was designed to assess urban stream networks. This tool was developed for Ku-ring-gai Council, Sydney, to aid environmental decisions and management processes by collecting meaningful data to identify specific pressures at individual reaches and how these affect catchment processes. These data have been used to identify individual reach and overall catchment condition, and are now guiding capital maintenance programmes to maximise the benefits to natural systems.

There is significant emerging evidence showing life-long negative health, intellectual and socio-behavioural impacts as a result of childhood blood lead concentrations well below the widely used intervention level of 10 mg/dL. This issue raises serious health concerns for children in several Australian smelting and mining towns. Routine educational and home cleanliness advice to wet mop floors rather than to use a brush and pan to reduce lead exposure risks have been shown to have limited efficacy. This paper argues, as advocated 100 years ago by Queensland doctor Alfred Jefferis Turner, that childhood lead poisoning can only be mitigated via primary prevention and reduction of contami- nants at source. Given that the effects of lead exposure are irreversible, there is a strong argument for the application of the precautionary principle to dealing with childhood lead exposure. There is a clear need to improve regulatory controls and emissions management to reduce environmental lead exposure risks.

142 Background: The pain syndromes, both acute and chronic are prevalent and often the only complaints affecting the patients’ quality of life and functional capacity. Here we describe our experience of successful integration of palliative care service into multiple myeloma (MM) management in a form of the disease specific multidisciplinary clinic. Methods: We have established a dedicated monthly multidisciplinary clinic for all patients diagnosed with symptomatic MM as a pilot project to incorporate different specialties involved in MM care with the goal to improve on disease management, increase compliance with office visits, reduce emergency department visits and benefit a healthcare system. Patients were able to have the same day visits with medical oncologist, radiation oncologists, palliative care physician, integrative medicine and medical psychologist. Over the course of two years (April 2015 through March 2017), we provided care to 39 unique MM patient. Results: After medical/transplant oncology encounters (N = 601), the most encountered specialists were palliative care (N = 208), followed by radiation oncology (N = 34) and integrative medicine/medical psychology (N = 33). The rate of missed office visits for multidisciplinary clinic was 5%, compared to average 7% for all cancer patients at our center. The rates of emergency department visits were rising in proportion to non-compliance with multidisciplinary clinic visits (correlation coefficient 0.43) Conclusions: Patients with MM cared for at the multidisciplinary clinic had better compliance with office visits and fewer unplanned emergency department visits in comparison patients with other oncologic disorders. The rates of emergency departmentvisits were proportional to non-compliance with multidisciplinary clinic visits. The degree of utilization of integrative medicine and psychology was comparable to radiation oncology encounters suggesting that psychological, behavioral, dietary interventions, complementary, physical therapies and rehabilitation have an important and growing role in MM management.