Cancer risk associated with household exposure to chloroform

Functionalization of Polymer Surface with Antimicrobial Microcapsules

The development of antimicrobial polymers is a priority for engineers fighting microbial resistant strains. Silver ions and silver nanoparticles can assist in enhancing the antimicrobial properties of microcapsules that release such substances in time which prolongs the efficiency of antimicrobial effects. Therefore, this study aimed to functionalize different polymer surfaces with antimicrobial core/shell microcapsules. Microcapsules were made of sodium alginate in shell and filled with antimicrobial silver in their core prior to application on the surface of polymer materials by dip-coating methodology. Characterization of polymers after functionalization was performed by several spectroscopic and microscopic techniques. After the characterization of polymers before and after the functionalization, the release of the active substances was monitored in time. The obtained test results can help with the calculation on the minimal concentration of antimicrobial silver that is encapsulated to achieve the desired amounts of release over time.

Cancer risk assessment from exposure to trihalomethanes in showers by inhalation

In many countries water disinfection for human consumption is still carried out via chlorination which generates by-products such as trihalomethanes (THM). Exposure to THM constitutes a public health risk as such substances are known to be carcinogenic. This study evaluated exposure to THMs by inhalation in showers and assessed the carcinogenic risk for lifetime exposure. The study population involved students at Universidad de los Andes residing in Bogotá, Colombia. The risk assessment was performed stochastically and the exposure parameters were taken as probability distributions. Most variables were measured in relation to the chosen population. The risk was calculated using two different methodologies but no significant variations were obtained. The average risk calculated for men and women was 56 cases in a million (5.6 × 10^-5). A sensitivity analysis was carried out where it was found that the parameters that increase risk the most are the concentration of chloroform in the water, exposure time, and the volume of the shower cubicle.

Monte-Carlo and multi-exposure assessment for the derivation of criteria for disinfection byproducts and volatile organic compounds in drinking water: Allocation factors and liter-equivalents per day

The probability distributions of total potential doses of disinfection byproducts and volatile organic compounds via ingestion, inhalation, and dermal exposure were estimated with Monte Carlo simulations, after conducting physiologically based pharmacokinetic model simulations to takes into account the differences in availability between the three exposures. If the criterion that the 95th percentile estimate equals the TDI (tolerable daily intake) is regarded as protecting the majority of a population, the drinking water criteria would be 140 (trichloromethane), 66 (bromodichloromethane), 157 (dibromochloromethane), 203 (tribromomethane), 140 (dichloroacetic acid), 78 (trichloroacetic acid), 6.55 (trichloroethylene, TCE), and 22 μg/L (perchloroethylene). The TCE criterion was lower than the Japanese Drinking Water Quality Standard (10 μg/L). The latter would allow the intake of 20% of the population to exceed the TDI. Indirect inhalation via evaporation from water, especially in bathrooms, was the major route of exposure to compounds other than haloacetic acids (HAAs) and accounted for 1.2-9 liter-equivalents/day for the median-exposure subpopulation. The ingestion of food was a major indirect route of exposure to HAAs. Contributions of direct water intake were not very different for trihalomethanes (30-45% of TDIs) and HAAs (45-52% of TDIs).

Root canal irrigants

Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are discussed. We performed a Medline search for English-language papers published untill July 2010. The keywords used were ‘root canal irrigants’ and ‘endodontic irrigants.’ The reference lists of each article were manually checked for additional articles of relevance.

An assessment of the interindividual variability of internal dosimetry during multi-route exposure to drinking water contaminants

The objective of this study was to evaluate inter-individual variability in absorbed and internal doses after multi-route exposure to drinking water contaminants (DWC) in addition to the corresponding variability in equivalent volumes of ingested water, expressed as liter-equivalents (LEQ). A multi-route PBPK model described previously was used for computing the internal dose metrics in adults, neonates, children, the elderly and pregnant women following a multi-route exposure scenario to chloroform and to tri- and tetra-chloroethylene (TCE and PERC). This scenario included water ingestion as well as inhalation and dermal contact during a 30-min bathroom exposure. Monte Carlo simulations were performed and distributions of internal dose metrics were obtained. The ratio of each of the dose metrics for inhalation, dermal and multi-route exposures to the corresponding dose metrics for the ingestion of drinking water alone allowed computation of LEQ values. Mean BW-adjusted LEQ values based on absorbed doses were greater in neonates regardless of the contaminant considered (0.129–0.134 L/kg BW), but higher absolute LEQ values were obtained in average adults (3.6–4.1 L), elderly (3.7–4.2 L) and PW (4.1–5.6 L). LEQ values based on the parent compound’s AUC were much greater than based on the absorbed dose, while the opposite was true based on metabolite-based dose metrics for chloroform and TCE, but not PERC. The consideration of the 95th percentile values of BW-adjusted LEQ did not significantly change the results suggesting a generally low intra-subpopulation variability during multi-route exposure. Overall, this study pointed out the dependency of the LEQ on the dose metrics, with consideration of both the subpopulation and DWC.

Evaluation of the impact of the exposure route on the human kinetic adjustment factor

The objective of this study was to assess the impact of the exposure route on the human kinetic adjustment factor (HKAF), for which a default value of 3.16 is used in non-cancer risk assessment. A multi-route PBPK model was modified from the literature and used for computing the internal dose metrics in adults, neonates, children, elderly and pregnant women following three route-specific scenarios to chloroform, bromoform, tri- or per-chloroethylene (TCE or PERC). These include 24-h inhalation exposure, body-weight adjusted oral exposure and 30 min dermal exposure to contaminated drinking water. Distributions for body weight (BW), height (BH) and hepatic cytochrome P450 2E1 (CYP2E1) content were obtained from the literature, whereas model parameters (flows, volumes) were calculated from BW and BH. Monte Carlo simulations were performed and the HKAF was calculated as the ratio of the 95th percentile value of internal dose metrics in subpopulation to the 50th percentile value in adults. On the basis of the area under the parent compound's arterial blood concentration vs time curve (AUC(pc)), highest HKAFs were obtained in neonates for every scenario considered, and were the highest for bromoform (range: 3.6-7.4). Exceedance of the default value based on AUC(PC) was also observed for an oral exposure to chloroform in neonates (4.9). In all other cases, HKAFs remained below the default value. Overall, this study has pointed out the dependency of the HKAF on the exposure route, dose metrics and subpopulation considered, as well as characteristics of the chemicals investigated.

Probabilistic human health risk assessment for quarterly exposure to high chloroform concentrations in drinking-water distribution network of the Province of Quebec, Canada

Because quarterly concentrations of total trihalomethanes (THM) exceeding the 80 μg/L guideline are often tolerated by the public health authorities of the Province of Quebec (Canada), this study examined whether quarterly episodes of high concentrations of THM may pose a risk to the health of its population. Using Monte Carlo simulations, a probabilistic risk assessment was performed for infants (0-<6 mo), toddlers (6 mo-<5 yr) and adults (≥20 yr). Multiroute exposure including ingestion of drinking water as well as inhalation and dermal exposure while showering or bathing was considered. The resulting absorbed doses were compared to short-term reference values for chloroform, used as surrogate for THM, by calculating risk quotients (RQ). On the basis of THM concentrations values in Quebec's drinking water distribution systems during the months of July to October and exceeding the guideline value (>80 μg/L), the 95th percentile value of RQ were 0.65, 0.46, and 0.24 for infants, toddlers, and adults, respectively. Back-calculation allowed determining that a chloroform concentration of 330 μg/L would result in RQ ≤ 1 for 99% of infants, the subgroup considered the most susceptible among the general population. Overall, this study showed that episodes of high THM concentration encountered in Quebec drinking-water distribution network need not be considered as an immediate health concern for the general population. However, these results should not be interpreted as an authorization to exceed the 80 μg/L standard but rather as a risk management tool for public health authorities.

Estimation of chlorination by-products presence in drinking water in epidemiological studies on adverse reproductive outcomes: a review

Chlorination of drinking water is essential to prevent waterborne disease. However, chlorine reacts with organic matter present in surface waters to form various by-products. In the last decade, several epidemiological studies have been conducted to determine the connection between exposure to these chlorination by-products (CBPs) and human health defects, such as adverse reproductive outcomes. However, the methodology used to assess exposure of pregnant women in these studies had serious limitations, particularly in relation to determining CBP presence in the subject's tap water. The purpose of this paper is to critically review of methods used to evaluate the CBP presence in a subject's tap water for exposure assessment purposes in epidemiological studies focused on adverse reproductive outcomes and CBPs in drinking water. Interest is directed more precisely at space-time features related to CBPs for an optimal estimation of their presence in a subject's tap water.

Novel oxidative electrophilic coupling reactions of phenoxazine derivatives with MBTH and their applications to spectrophotometric determination of residual chlorine in drinking water and environmental water samples

Novel, sensitive and rapid spectrophotometric methods, using phenoxazine (PNZ), 2-chlorophe-noxazine (CPN) and 2-trifluoromethylphenoxazine (TPN) as chromogenic reagents for the determination of residual chlorine are proposed. The methods are based on the reduction of chlorine by an electrophilic coupling reagent, 3-methyl-2-benzothiazoline hydrazono hydrochloride hydrate (MBTH) in mild hydrochloric acid medium and subsequent coupling with PNZ, CPN or TPN. The blue color formed in the reaction showed maximum absorbance at 680-690 nm and obeyed Beer's law over the range 0.1-2.2 microg ml(-1). The molar absorptivity values with PNZ, CPN and TPN were 2.80 x 10(4), 2.67 x 10(4) and 1.91 x 10(4) l mol(-1)cm(-1) and Sandell's sensitivity values were 0.028, 0.027 and 0.028 microg cm(-2) respectively. The proposed methods were successfully applied in the determination of residual chlorine in drinking water and environmental water samples. The performance of proposed methods was evaluated in terms of Student's t-test and variance ratio F-test which indicated the significance of proposed methods over the standard spectrophotometric method.

Exposure to inhaled THM: comparison of continuous and event-specific exposure assessment for epidemiologic purposes

Trihalomethanes (THMs) (chloroform, bromoform, dibromochloromethane, and bromodichloromethane) are the most abundant by-products of chlorination. People are exposed to THMs through ingestion, dermal contact and inhalation. The objective of this study was to compare two methods for assessing THM inhalation: a direct method with personal monitors assessing continuous exposure and an indirect one with microenvironmental sampling and collection of time-activity data during the main event exposures: bathing, showering and swimming. This comparison was conducted to help plan a future epidemiologic study of the effects of THMs on the upper airways of children. 30 children aged from 4 to 10 years were included. They wore a 3M 3520 organic vapor monitor for 7 days. We sampled air in their bathrooms (during baths or showers) and in the indoor swimming pools they visited and recorded their time-activity patterns. We used stainless steel tubes full of Tenax to collect air samples. All analyses were performed with Gas Chromatography and Mass Spectrometry (GC-MS). Chloroform was the THM with the highest concentrations in the air of both bathrooms and indoor swimming pools. Its continuous and event exposure measurements were significantly correlated (r(s)=0.69 p<0.001). Continuous exposures were higher than event exposures, suggesting that the event exposure method does not take into account some influential microenvironments. In an epidemiologic study, this might lead to random exposure misclassification, thus underestimation of the risk, and reduced statistical power. The continuous exposure method was difficult to implement because of its poor acceptability and the fragility of the personal monitors. These two points may also reduce the statistical power of an epidemiologic study. It would be useful to test the advantages and disadvantages of a second sample in the home or of modeling the baseline concentration of THM in the home to improve the event exposure method.

Approaches for applications of physiologically based pharmacokinetic models in risk assessment

Physiologically based pharmacokinetic (PBPK) models are particularly useful for simulating exposures to environmental toxicants for which, unlike pharmaceuticals, there is often little or no human data available to estimate the internal dose of a putative toxic moiety in a target tissue or an appropriate surrogate. This article reviews the current state of knowledge and approaches for application of PBPK models in the process of deriving reference dose, reference concentration, and cancer risk estimates. Examples drawn from previous U.S. Environmental Protection Agency (EPA) risk assessments and human health risk assessments in peer-reviewed literature illustrate the ways and means of using PBPK models to quantify the pharmacokinetic component of the interspecies and intraspecies uncertainty factors as well as to conduct route to route, high dose to low dose and duration extrapolations. The choice of the appropriate dose metric is key to the use of the PBPK models for the various applications in risk assessment. Issues related to whether uncertainty factors are most appropriately applied before or after derivation of human equivalent dose (or concentration) continue to be explored. Scientific progress in the understanding of life stage and genetic differences in dosimetry and their impacts on variability in susceptibility, as well as ongoing development of analytical methods to characterize uncertainty in PBPK models, will make their use in risk assessment increasingly likely. As such, it is anticipated that when PBPK models are used to express adverse tissue responses in terms of the internal target tissue dose of the toxic moiety rather than the external concentration, the scientific basis of, and confidence in, risk assessments will be enhanced.

Approaches for evaluating the relevance of multiroute exposures in establishing guideline values for drinking water contaminants

In establishing the guideline values for chemical contaminants in drinking water, the contribution of inhalation and dermal routes associated with showering/bathing needs to be evaluated. The present article reviews the current approaches available for evaluating the importance of inhalation and dermal routes of exposure to drinking water contaminants (DWCs) and integrates them within a 2-tier approach. Accordingly, tier 1 would evaluate whether the dermal or inhalation route is likely to contribute to at least 10% of the dose received from ingestion of drinking water (i.e., 0.15 L-equivalent per day based on the daily water intake rate of 1.5 L/day typically used in Health Canada assessments). Based on the route-specific exposure parameters (i.e., area of skin exposed, effective skin permeability coefficient [K(p)], and air to water concentration ratio during use conditions [F(air-water)], breathing rate, duration of contact, and fraction absorbed), it was determined that for DWCs with K(p) less than 0.024 cm/hr and F(air - water) less than 0.0063, the dermal and inhalation routes during showering or bathing are unlikely to contribute significantly to the total dose. For DWCs with K(p) value equal to or greater than 0.025 cm/hr, dermal notation is implied, and as such, tier 2 calculation of L-equivalent associated with dermal exposure needs to be performed. Similarly, for DWCs with F(air-water) greater than 0.00063, inhalation notation is implied, and detailed evaluation of the L-equivalent associated with inhalation exposure (i.e., tier 2) is suggested. In general, data from human volunteer studies, observational measurements, and targeted modeling studies are useful for deriving L-equivalents, reflective of the magnitude of dose received via dermal and inhalation routes relative to the oral route. However, in resource-limited situations, these approaches can be integrated within a 2-tier approach for prioritizing and providing quantitative evaluations of the relevance of dermal and inhalation routes for developing exposure guidelines for DWCs.

Reverse dosimetry: interpreting trihalomethanes biomonitoring data using physiologically based pharmacokinetic modeling

Biomonitoring data provide evidence of exposure of environmental chemicals but are not, by themselves, direct measures of exposure. To use biomonitoring data in understanding exposure, physiologically based pharmacokinetic (PBPK) modeling can be used in a reverse dosimetry approach to assess a distribution of exposures possibly associated with specific blood or urine levels of compounds. Reverse dosimetry integrates PBPK modeling with exposure pattern characterization, Monte Carlo analysis, and statistical tools to estimate a distribution of exposures that are consistent with biomonitoring data in a population. The present study used an existing PBPK model for chloroform as a generic framework to develop PBPK models for other trihalomethanes (THMs). Using Monte Carlo sampling techniques, probabilistic information about pharmacokinetics and exposure patterns was included to estimate distributions of THMs concentrations in blood in relation to various exposure patterns in a diverse population. In addition, the possibility of inhibition of hepatic metabolism among THMs was evaluated under the scenarios of household exposure. These studies demonstrated how PBPK modeling can be used as a tool to estimate a population distribution of exposures that could have resulted in particular biomonitoring results. When toxicity level is known, this tool can also be used to estimate proportion of population above levels associated with health risk.

Development of a screening approach to interpret human biomonitoring data on volatile organic compounds: reverse dosimetry on biomonitoring data for trichloroethylene

A screening approach is developed for volatile organic compounds (VOCs) to estimate exposures that correspond to levels measured in fluids and/or tissues in human biomonitoring studies. The approach makes use of a generic physiologically-based pharmacokinetic (PBPK) model coupled with exposure pattern characterization, Monte Carlo analysis, and quantitative structure property relationships (QSPRs). QSPRs are used for VOCs with minimal data to develop chemical-specific parameters needed for the PBPK model. The PBPK model is capable of simulating VOC kinetics following multiple routes of exposure, such as oral exposure via water ingestion and inhalation exposure during shower events. Using published human biomonitoring data of trichloroethylene (TCE), the generic model is evaluated to determine how well it estimates TCE concentrations in blood based on the known drinking water concentrations. In addition, Monte Carlo analysis is conducted to characterize the impact of the following factors: (1) uncertainties in the QSPR-estimated chemical-specific parameters; (2) variability in physiological parameters; and (3) variability in exposure patterns. The results indicate that uncertainty in chemical-specific parameters makes only a minor contribution to the overall variability and uncertainty in the predicted TCE concentrations in blood. The model is used in a reverse dosimetry approach to derive estimates of TCE concentrations in drinking water based on given measurements of TCE in blood, for comparison to the U.S. EPA's Maximum Contaminant Level in drinking water. This example demonstrates how a reverse dosimetry approach can be used to facilitate interpretation of human biomonitoring data in a health risk context by deriving external exposures that are consistent with a biomonitoring data set, thereby permitting comparison with health-based exposure guidelines.

Estimating risk during showering exposure to VOCs of workers in a metal-degreasing facility

The incremental risk of workers in a metal-degreasing facility exposed to volatile organic compounds (VOCs) present in the water supply during showering was estimated. A probabilistic and worst-case approach using specific-site concentration data and a generalized multipathway exposure model was applied. Estimates of hazard index and lifetime cancer risk were analyzed for each chemical and each route of exposure (inhalation and dermal absorption). The results showed that dermal exposure to trichloroethylene (TCE) and tetrachloroethylene (perchloroethylene, PCE) represented the main contribution to total risk. Although the inhalation route did not produce significant exposure, it was mainly influenced by the liquid flow rate of the shower. Lower values of this parameter during showering resulted in a significant reduction of both carcinogenic and noncarcinogenic risk, while decreasing water temperature produced a minimal effect on exposure by this pathway. The results obtained in the present study indicated that significant exposures of workers may be produced during showering in metal degreasing installations where releases to water of VOCs occur. A sensitivity analysis was developed for investigating the effect of scenario parameters on exposure. Although site-specific data were employed, the exposure of workers was assessed in a model scenario and thus the quantification of risk is associated with uncertainty. Considering that occupational exposure to organic solvents of workers in metal-degreasing facilities may also be significant, risk assessment must be included in the planning of this kind of industrial installation.

Use of a physiologically based pharmacokinetic model to identify exposures consistent with human biomonitoring data for chloroform

Biomonitoring data provide evidence of human exposure to environmental chemicals by quantifying the chemical or its metabolite in a biological matrix. To better understand the correlation between biomonitoring data and environmental exposure, physiologically based pharmacokinetic (PBPK) modeling can be of use. The objective of this study was to use a combined PBPK model with an exposure model for showering to estimate the intake concentrations of chloroform based on measured blood and exhaled breath concentrations of chloroform. First, the predictive ability of the combined model was evaluated with three published studies describing exhaled breath and blood concentrations in people exposed to chloroform under controlled showering events. Following that, a plausible exposure regimen was defined combining inhalation, ingestion, and dermal exposures associated with residential use of water containing typical concentrations of chloroform to simulate blood and exhaled breath concentrations of chloroform. Simulation results showed that inhalation and dermal exposure could contribute substantially to total chloroform exposure. Next, sensitivity analysis and Monte Carlo analysis were performed to investigate the sources of variability in model output. The variability in exposure conditions (e.g., shower duration) was shown to contribute more than the variability in pharmacokinetics (e.g., body weight) to the predicted variability in blood and exhaled breath concentrations of chloroform. Lastly, the model was used in a reverse dosimetry approach to estimate distributions of exposure consistent with concentrations of chloroform measured in human blood and exhaled breath.

Changes in breath trihalomethane levels resulting from household water-use activities

Common household water-use activities such as showering, bathing, drinking, and washing clothes or dishes are potentially important contributors to individual exposure to trihalomethanes (THMs), the major class of disinfection by-products of water treated with chlorine. Previous studies have focused on showering or bathing activities. In this study, we selected 12 common water-use activities and determined which may lead to the greatest THM exposures and result in the greatest increase in the internal dose. Seven subjects performed the various water-use activities in two residences served by water utilities with relatively high and moderate total THM levels. To maintain a consistent exposure environment, the activities, exposure times, air exchange rates, water flows, water temperatures, and extraneous THM emissions to the indoor air were carefully controlled. Water, indoor air, blood, and exhaled-breath samples were collected during each exposure session for each activity, in accordance with a strict, well-defined protocol. Although showering (for 10 min) and bathing (for 14 min), as well as machine washing of clothes and opening mechanical dishwashers at the end of the cycle, resulted in substantial increases in indoor air chloroform concentrations, only showering and bathing caused significant increases in the breath chloroform levels. In the case of bromodichloromethane (BDCM), only bathing yielded a significantly higher air level in relation to the preexposure concentration. For chloroform from showering, strong correlations were observed for indoor air and exhaled breath, blood and exhaled breath, indoor air and blood, and tap water and blood. Only water and breath, and blood and breath were significantly associated for chloroform from bathing. For BDCM, significant correlations were obtained for blood and air, and blood and water from showering. Neither dibromochloromethane nor bromoform gave measurable breath concentrations for any of the activities investigated because of their much lower tap-water concentrations. Future studies will address the effects that changes in these common water-use activities may have on exposure.

Physiologically-based pharmacokinetic and toxicokinetic models in cancer risk assessment

Physiologically-based pharmacokinetic (PBPK) and toxicokinetic models are increasingly being used for the conduct of high dose to low dose and interspecies extrapolations required in cancer risk assessment. These models, by simulating tissue dose of toxic chemicals, help address the uncertainty associated with the default approaches for interspecies and high dose to low dose extrapolations. The applicability of PBPK models in cancer risk assessment has been demonstrated with a number of chemicals (e.g., acrylonitrile, 2-butoxyethanol, chloroform, 1,4-dioxane, methyl chloroform, methylene chloride, styrene, trichloroethylene, tetrachloroethylene, vinyl chloride, vinyl acetate). Recent advances in PBPK modeling facilitate the consideration of population distribution of parameter values, age-dependent changes in physiology and metabolism, multi-route exposures as well as multichemical interactions for application in cancer risk assessment. Whereas the average values for various input parameters have been used to evaluate the age-dependency of tissue dose, the Markov Chain Monte Carlo technique can be applied to address variability and uncertainty in parameter estimates, thus facilitating a more accurate estimation of cancer risk in the population. The PBPK models also uniquely facilitate the simulation of tissue dose, and thereby cancer risks, associated with multi-route and multichemical exposure situations. Overall, the recent advances reviewed in this article point to the continued enhancement of the scientific basis and applicability of PBPK models in cancer risk assessment.

Toxic nephropathy: environmental chemicals

The kidney is the target of numerous xenobiotic toxicants, including environmental chemicals. Anatomical, physiological, and biochemical features of the kidney make it particularly sensitive to many environmental compounds. Factors contributing to the sensitivity of the kidney include: large blood flow, the presence of a variety of xenobiotic transporters and metabolizing enzymes, and concentration of solutes during urine production. In many cases, the conjugation of environmental chemicals to glutathione and/or cysteine targets these chemicals to the kidney where inhibition of renal function occurs through a variety of mechanisms. For example, heavy metals such as mercury and cadmium target the kidney after glutathione/cysteine conjugation. Trichloroethlene and bromobenzene are metabolized and conjugated to glutathione in the liver before renal uptake and toxicity. In contrast, renal injury produced by chloroform and aristolochic acids is dependent on renal cytochrome P450 metabolism to toxic metabolites. Other compounds, such as paraquat or diquat, damage the kidney via the production of reactive oxygen species. Finally, the low solubility of ethylene glycol metabolites causes crystal formation within the tubular lumen and nephrotoxicity. This chapter explores mechanisms of nephrotoxicity by environmental chemicals, using these example compounds. What remains to be accomplished and by far the most difficult process is the elucidation of the detailed mechanisms of tubular cell injury after toxicant uptake and metabolism. The large number of individuals experiencing a decline in renal function with age makes the search for these mechanisms very compelling.