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Velez-Quinones MA, Xu H, Vo N, Gaitens JM, McDiarmid MA, Lewin-Smith MR, Strathmann FG. Simultaneous Determination of Uranium and Depleted Uranium Isotopic Ratio Using Inductively Coupled Mass Spectrometry. ACTA ACUST UNITED AC 2018; 78:e59. [DOI: 10.1002/cptx.59] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Hanna Xu
- Environmental Toxicology Laboratory, The Joint Pathology Center; Silver Spring Maryland
| | - Nhu Vo
- Environmental Toxicology Laboratory, The Joint Pathology Center; Silver Spring Maryland
| | - Joanna M. Gaitens
- Environmental Toxicology Laboratory, The Joint Pathology Center; Silver Spring Maryland
- Division of Occupational and Environmental Medicine, Department of Medicine, University of Maryland School of Medicine; Baltimore Maryland
| | - Melissa A. McDiarmid
- Department of Veterans Affairs, Baltimore VA Medical Center; Baltimore Maryland
- Division of Occupational and Environmental Medicine, Department of Medicine, University of Maryland School of Medicine; Baltimore Maryland
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2
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Petejova N, Martinek A. Renal cell carcinoma: Review of etiology, pathophysiology and risk factors. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2015; 160:183-94. [PMID: 26558360 DOI: 10.5507/bp.2015.050] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 09/18/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND AND AIMS The global incidence of renal cell cancer is increasing annually and the causes are multifactorial. Early diagnosis and successful urological procedures with partial or total nephrectomy can be life-saving. However, only up to 10% of RCC patients present with characteristic clinical symptoms. Over 60% are detected incidentally in routine ultrasound examination. The question of screening and preventive measures greatly depends on the cause of the tumor development. For the latter reason, this review focuses on etiology, pathophysiology and risk factors for renal neoplasm. METHODS A literature search using the databases Medscape, Pubmed, UpToDate and EBSCO from 1945 to 2015. RESULTS AND CONCLUSIONS Genetic predisposition/hereditary disorders, obesity, smoking, various nephrotoxic industrial chemicals, drugs and natural/manmade radioactivity all contribute and enviromental risks are a serious concern in terms of prevention and the need to screen populations at risk. Apropos treatment, current oncological research is directed to blocking cancer cell division and inhibiting angiogenesis based on a knowledge of molecular pathways.
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Affiliation(s)
- Nadezda Petejova
- Department of Internal Medicine, University Hospital Ostrava, Czech Republic.,Department of Clinical Studies, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Arnost Martinek
- Department of Internal Medicine, University Hospital Ostrava, Czech Republic.,Department of Clinical Studies, Faculty of Medicine, University of Ostrava, Czech Republic
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3
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Determination of uranium concentration in urine of workers in an Iraqi phosphate mine and fertilizer plants. J Radioanal Nucl Chem 2013. [DOI: 10.1007/s10967-013-2420-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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4
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Anderson JL, Daniels RD, Fleming DA, Tseng CY. Exposure assessment for a cohort of workers at a former uranium processing facility. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2012; 22:324-330. [PMID: 22534696 DOI: 10.1038/jes.2012.20] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 02/06/2012] [Indexed: 05/31/2023]
Abstract
Exposure was assessed for a cohort of 6409 workers at a former uranium processing facility as part of a mortality study. Workers at the facility had potential for exposure to a wide variety of radiological and chemical agents including uranium, thorium, radon, external ionizing radiation, acid mists, asbestos, and various solvents. Organ dose from internal exposure to uranium was assessed, along with dose from external ionizing radiation and exposure to radon. Qualitative assessment of exposure to thorium, acid mists, asbestos, coal dust, welding fumes, and other chemicals was also performed. Mean cumulative organ dose from internal uranium exposure ranged from 1.1 mGy (lung) to 6.7 μGy (pancreas). Mean cumulative external ionizing radiation dose was 13.4 mGy. Mean cumulative radon exposure was 26 working level months (WLMs). The chemical agents to which the largest numbers of study subjects were exposed were acid mists, machining fluids, and a tributyl phosphate/kerosene mixture used in the refining process.
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Affiliation(s)
- Jeri L Anderson
- Division of Surveillance, Hazard Evaluations and Field Studies (DSHEFS), National Institute for Occupational Safety and Health (NIOSH), Cincinnati, OH, USA.
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5
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Que penser de l’uranium sous forme appauvrie ? ARCH MAL PROF ENVIRO 2009. [DOI: 10.1016/j.admp.2009.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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6
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Dorsey CD, Engelhardt SM, Squibb KS, McDiarmid MA. Biological monitoring for depleted uranium exposure in U.S. Veterans. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:953-956. [PMID: 19590689 PMCID: PMC2702412 DOI: 10.1289/ehp.0800413] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2008] [Accepted: 02/25/2009] [Indexed: 05/28/2023]
Abstract
BACKGROUND As part of an ongoing medical surveillance program for U.S. veterans exposed to depleted uranium (DU), biological monitoring of urine uranium (U) concentrations is offered to any veteran of the Gulf War and those serving in more recent conflicts (post-Gulf War veterans). OBJECTIVES Since a previous report of surveillance findings in 2004, an improved methodology for determination of the isotopic ratio of U in urine ((235)U:(238)U) has been developed and allows for more definitive evaluation of DU exposure. This report updates previous findings. METHODS Veterans provide a 24-hr urine specimen and complete a DU exposure questionnaire. Specimens are sent to the Baltimore Veterans Affairs Medical Center for processing. Uranium concentration and isotopic ratio are measured using ICP-MS at the Armed Forces Institute of Pathology. RESULTS Between January 2003 and June 2008, we received 1,769 urine specimens for U analysis. The mean urine U measure was 0.009 microg U/g creatinine. Mean urine U concentrations for Gulf War and post-Gulf War veterans were 0.008 and 0.009 microg U/g creatinine, respectively. Only 3 of the 1,700 (0.01%) specimens for which we completed isotopic determination showed evidence of DU. Exposure histories confirmed that these three individuals had been involved in "friendly fire" incidents involving DU munitions or armored vehicles. CONCLUSIONS No urine U measure with a "depleted" isotopic signature has been detected in U.S. veterans without a history of retained DU embedded fragments from previous injury. These findings suggest that future DU-related health harm is unlikely in veterans without DU fragments.
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Affiliation(s)
- Carrie D. Dorsey
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Veterans Affairs Medical Center, Baltimore, Maryland, USA
| | | | - Katherine S. Squibb
- Veterans Affairs Medical Center, Baltimore, Maryland, USA
- Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Melissa A. McDiarmid
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Veterans Affairs Medical Center, Baltimore, Maryland, USA
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7
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Marco R, Katorza E, Gonen R, German U, Tshuva A, Pelled O, Paz-Tal O, Adout A, Karpas Z. Normalisation of spot urine samples to 24-h collection for assessment of exposure to uranium. RADIATION PROTECTION DOSIMETRY 2008; 130:213-223. [PMID: 18337294 DOI: 10.1093/rpd/ncm498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
For dose assessment of workers at Nuclear Research Center Negev exposed to natural uranium, spot urine samples are analysed and the results are normalised to 24-h urine excretion based on 'standard' man urine volume of 1.6 l d(-1). In the present work, the urine volume, uranium level and creatinine concentration were determined in two or three 24-h urine collections from 133 male workers (319 samples) and 33 female workers (88 samples). Three volunteers provided urine spot samples from each voiding during a 24-h period and a good correlation was found between the relative level of creatinine and uranium in spot samples collected from the same individual. The results show that normalisation of uranium concentration to creatinine in a spot sample represents the 24-h content of uranium better than normalisation to the standard volume and may be used to reduce the uncertainty of dose assessment based on spot samples.
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Affiliation(s)
- R Marco
- Nuclear Research Center Negev, PO Box 9001, Beer-Sheva 84190, Israel
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8
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Abstract
Although human experience with uranium spans more than 200 years, the LD50 for acute intake in humans has not been well established. Large acute doses of uranium can produce death from chemical toxicity in rats, guinea pigs, and other small experimental animals, with variation in sensitivity among species. However, there has never been a death attributable to uranium poisoning in humans, and humans seem to be less sensitive to both acute and chronic toxic effects of uranium than other mammalian species studied. Highly relevant data on uranium toxicity in humans are available from the experience of persons administered large doses of uranium for therapy of diabetes and from acute accidental inhalation intakes. Although the data on which to establish oral and inhalation acute LD50 for uranium in humans are sparse, they are adequate to conclude that the LD50 for oral intake of soluble uranium compounds exceeds several grams of uranium and is at least 1.0 g for inhalation intakes. For intakes of uranium compounds of lesser solubility, acute LD50 values are likely to be significantly greater. It is suggested that 5 g be provisionally considered the acute oral LD50 for uranium in humans. For inhalation intakes of soluble compounds of uranium, 1.0 g of uranium is proposed as the provisional acute inhalation LD50.
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Affiliation(s)
- Ronald L Kathren
- Washington State University at Tri-Cities, Richland, WA 99357, USA.
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9
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Oeh U, Priest ND, Roth P, Ragnarsdottir KV, Li WB, Höllriegl V, Thirlwall MF, Michalke B, Giussani A, Schramel P, Paretzke HG. Measurements of daily urinary uranium excretion in German peacekeeping personnel and residents of the Kosovo region to assess potential intakes of depleted uranium (DU). THE SCIENCE OF THE TOTAL ENVIRONMENT 2007; 381:77-87. [PMID: 17459457 DOI: 10.1016/j.scitotenv.2007.03.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2006] [Revised: 03/05/2007] [Accepted: 03/15/2007] [Indexed: 05/15/2023]
Abstract
Following the end of the Kosovo conflict, in June 1999, a study was instigated to evaluate whether there was a cause for concern of health risk from depleted uranium (DU) to German peacekeeping personnel serving in the Balkans. In addition, the investigations were extended to residents of Kosovo and southern Serbia, who lived in areas where DU ammunitions were deployed. In order to assess a possible DU intake, both the urinary uranium excretion of volunteer residents and water samples were collected and analysed using inductively coupled plasma-mass spectrometry (ICP-MS). More than 1300 urine samples from peacekeeping personnel and unexposed controls of different genders and age were analysed to determine uranium excretion parameters. The urine measurements for 113 unexposed subjects revealed a daily uranium excretion rate with a geometric mean of 13.9 ng/d (geometric standard deviation (GSD)=2.17). The analysis of 1228 urine samples from the peacekeeping personnel resulted in a geometric mean of 12.8 ng/d (GSD=2.60). It follows that both unexposed controls and peacekeeping personnel excreted similar amounts of uranium. Inter-subject variation in uranium excretion was high and no significant age-specific differences were found. The second part of the study monitored 24 h urine samples provided by selected residents of Kosovo and adjacent regions of Serbia compared to controls from Munich, Germany. Total uranium and isotope ratios were measured in order to determine DU content. (235)U/(238)U ratios were within +/-0.3% of the natural value, and (236)U/(238)U was less than 2 x 10(-7), indicating no significant DU in any of the urine samples provided, despite total uranium excretion being relatively high in some cases. Measurements of ground and tap water samples from regions where DU munitions were deployed did not show any contamination with DU, except in one sample. It is concluded that both peacekeeping personnel and residents serving or living in the Balkans, respectively, were not exposed to significant amounts of DU.
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Affiliation(s)
- U Oeh
- GSF-National Research Center for Environment and Health, Institute of Radiation Protection, 85764 Neuherberg, Germany.
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Tolmachev S, Kuwabara J, Noguchi H. Concentration and daily excretion of uranium in urine of Japanese. HEALTH PHYSICS 2006; 91:144-53. [PMID: 16832195 DOI: 10.1097/01.hp.0000203311.85873.61] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
A study was undertaken to investigate uranium concentrations in urine samples for unexposed Japanese individuals and to evaluate uranium daily excretion. Uranium concentrations were measured with inductively coupled plasma mass spectrometry after microwave-assisted digestion and online separation using the UTEVA extraction chromatographic resin. The concentrations ranged from 0.8 to 35.6 ng of uranium per liter of urine (median 4.5 ng L(-1)). Urinary uranium was normalized relative to the creatinine concentration in order to compensate for the degree of urine dilution. Creatinine-normalized values ranged from 1.2 to 17.8 ng of uranium per gram of creatinine (median 7.4 ng g(-1) creatinine). These results corresponded to the lower end of urinary uranium reported for unexposed populations. The level of daily excreted uranium was calculated as 6.45 ng d(-1) (median value) using ICRP recommended values for 24-h creatinine excretion. These data along with literature data on uranium dietary intake for Japanese populations were used to estimate the uranium gastrointestinal absorption fraction (f(1)). The median f(1) value was calculated to be 0.007. Statistical analysis was done to investigate statistical differences and relationships between the studied variables.
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Affiliation(s)
- Sergei Tolmachev
- Internal Dosimetry Laboratory, Department of Health Physics, Japan Atomic Energy Research Institute, Shirakata, Tokai-mura, Ibaraki-ken.
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11
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Squibb KS, McDiarmid MA. Depleted uranium exposure and health effects in Gulf War veterans. Philos Trans R Soc Lond B Biol Sci 2006; 361:639-48. [PMID: 16687268 PMCID: PMC1569622 DOI: 10.1098/rstb.2006.1823] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Health effects stemming from depleted uranium (DU) exposure in a cohort of Gulf War veterans who were in or on US Army vehicles hit by friendly fire involving DU munitions are being carefully monitored through the Baltimore Veterans Affairs (VA) DU Follow-Up Program initiated in 1993. DU exposure in this cohort has been directly measured using inductively coupled plasma-mass spectrometer (ICP-MS) isotopic analysis for DU in urine specimens. Soldiers with embedded DU fragments continue to excrete elevated concentrations of U in their urine, documenting ongoing systemic exposure to U released from their fragments. Biennial surveillance visits provide a detailed health assessment that includes basic clinical measures and surveillance for early changes in kidney function, an expected target organ for U. Tests also include measurements of genotoxicity and neuroendocrine, neurocognitive and reproductive function. With the exception of the elevated urine U excretion, no clinically significant expected U-related health effects have been identified to date. Subtle changes in renal function and genotoxicity markers in veterans with urine U concentrations greater than 0.1 microg(-1) creatinine, however, indicate the need for continued surveillance of these DU-exposed veterans.
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Affiliation(s)
- Katherine S Squibb
- Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 21201, USA.
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12
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Tewari BB. Electrophoretic studies on the mixed nitrilotriacetate-penicillamine complexes of Pb2+ and UO2+2. RUSS J INORG CHEM+ 2006. [DOI: 10.1134/s0036023606030272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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13
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McDiarmid MA, Engelhardt SM, Oliver M, Gucer P, Wilson PD, Kane R, Kabat M, Kaup B, Anderson L, Hoover D, Brown L, Albertini RJ, Gudi R, Jacobson-Kram D, Thorne CD, Squibb KS. Biological monitoring and surveillance results of Gulf War I veterans exposed to depleted uranium. Int Arch Occup Environ Health 2005; 79:11-21. [PMID: 16075297 DOI: 10.1007/s00420-005-0006-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2004] [Accepted: 04/06/2005] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To relate medical surveillance outcomes to uranium biomonitoring results in a group of depleted uranium (DU)-exposed, Gulf War I veterans. METHODS Thirty-two veterans of Gulf War I who were victims of 'friendly fire' involving DU weapons, in whom exposure assessment can accurately be measured, had urine uranium concentrations determined using ICP-MS technology. Clinical laboratory parameters were measured and related to urine uranium concentrations. Data were examined by stratifying the cohort into a low U group, <0.10 mug/g creatinine versus a high U group, >/=0.10 mug/g creatinine and assessing differences between groups. RESULTS Over a decade after first exposure, soldiers possessing embedded DU fragments continue to excrete elevated concentrations of uranium in urine. No clinically significant uranium related health effects were observed in blood count, blood chemistries including renal markers, neuropsychological measures, and semen quality or genotoxicity measures. Markers of early changes in renal glomerular and tubular function were not statistically different between groups; however, genotoxicity measures continue to show subtle, mixed results. CONCLUSION Persistent urine uranium elevations continue to be observed more than 12 years since first exposure. Despite this, renal and other clinical abnormalities were not observed, likely due to the 'relatively' low uranium burden in this cohort compared to historical uranium-exposed occupational groups. Continuing surveillance is indicated, however, due to the on-going nature of the exposure. These results are an important finding in light of the on-going controversy regarding health effects observed in soldiers of the Gulf War and other conflicts, whose uranium exposure assessment is unable to be accurately determined.
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Affiliation(s)
- Melissa A McDiarmid
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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Tewari BB. Studies on the Interaction of Lead(II) and Uranyl(II) with Methylcysteine and Penicillamine Bioactive Sulfur-Containing Ligands. RUSS J COORD CHEM+ 2005. [DOI: 10.1007/s11173-005-0097-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Ejnik JW, Todorov TI, Mullick FG, Squibb K, McDiarmid MA, Centeno JA. Uranium analysis in urine by inductively coupled plasma dynamic reaction cell mass spectrometry. Anal Bioanal Chem 2005; 382:73-9. [PMID: 15900454 DOI: 10.1007/s00216-005-3173-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2004] [Revised: 02/11/2005] [Accepted: 02/15/2005] [Indexed: 11/30/2022]
Abstract
Urine uranium concentrations are the best biological indicator for identifying exposure to depleted uranium (DU). Internal exposure to DU causes an increased amount of urine uranium and a decreased ratio of 235U/238U in urine samples, resulting in measurements that vary between 0.00725 and 0.002 (i.e., natural and depleted uranium's 235U/238U ratios, respectively). A method based on inductively coupled plasma dynamic reaction cell mass spectrometry (ICP-DRC-MS) was utilized to identify DU in urine by measuring the quantity of total U and the 235U/238U ratio. The quantitative analysis was achieved using 233U as an internal standard. The analysis was performed both with and without the reaction gas oxygen. The reaction gas converted ionized 235U+ and 238U+ into 235UO2+ (m/z = 267) and 238UO2+ (m/z = 270). This conversion was determined to be over 90% efficient. A polyatomic interference at m/z 234.8 was successfully removed from the 235U signal under either DRC operating conditions (with or without oxygen as a reaction gas). The method was validated with 15 urine samples of known uranium compositions. The method detection limit for quantification was determined to be 0.1 pg U mL(-1) urine and an average coefficient of variation (CV) of 1-2% within the sample measurements. The method detection limit for determining 235U/238U ratio was 3.0 pg U mL(-1) urine. An additional 21 patient samples were analyzed with no information about medical history. The measured 235U/238U ratio within the urine samples correctly identified the presence or absence of internal DU exposure in all 21 patients.
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Affiliation(s)
- John W Ejnik
- Chemistry Department, Northern Michigan University, 1401 Presque Isle Avenue, Marquette, MI 49855, USA
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16
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McDiarmid MA, Squibb K, Engelhardt SM. Biologic monitoring for urinary uranium in gulf war I veterans. HEALTH PHYSICS 2004; 87:51-56. [PMID: 15194922 DOI: 10.1097/00004032-200407000-00006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Biologic monitoring for total uranium in urine of Gulf War I veterans concerned about past exposure to depleted uranium (DU) has been offered by the Departments of Veterans Affairs and Defense since the late 1990's. DU, a component of U.S. munitions and tank armor, was first used during that conflict. Two hundred and twenty-seven veterans submitted samples for analysis from January 2000 through December 2002, which included a 24-h urine sample for determination of total urinary uranium concentration and completed questionnaires describing their wartime exposure experiences. Thirty questionnaire items characterizing DU exposure opportunities were collapsed into 19 exposure categories. Urine uranium (U) results were stratified into low and high uranium groups with 0.05 microg U g creatinine as the cut point. Exposure scenarios in the high and low uranium groups were similar in frequency and type with only the presence of retained shrapnel being predictive of a high urine uranium value, as found in the first phase of this surveillance of 169 veterans performed prior to 2000. Twenty-two veterans exhibited U levels in the high range. Isotopic analysis, available for 21 of these 22, revealed that all but three of these samples contained natural and not depleted uranium. These three participants had retained DU shrapnel as a result of their past injuries. Thus, even with an enlarged cohort, elevated urine uranium values in the absence of retained DU fragments are unlikely. The utility of isotopic analysis to more fully characterize uranium biomonitoring results is also demonstrated.
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Affiliation(s)
- Melissa A McDiarmid
- Department of Medicine, University of Maryland School of Medicine, 2nd Floor, 05 W. Redwood Street, Baltimore, MD 21201, USA.
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17
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McDiarmid MA, Engelhardt S, Oliver M, Gucer P, Wilson PD, Kane R, Kabat M, Kaup B, Anderson L, Hoover D, Brown L, Handwerger B, Albertini RJ, Jacobson-Kram D, Thorne CD, Squibb KS. Health effects of depleted uranium on exposed Gulf War veterans: a 10-year follow-up. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2004; 67:277-296. [PMID: 14713562 DOI: 10.1080/15287390490273541] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Medical surveillance of a group of U.S. Gulf War veterans who were victims of depleted uranium (DU) "friendly fire" has been carried out since the early 1990s. Findings to date reveal a persistent elevation of urine uranium, more than 10 yr after exposure, in those veterans with retained shrapnel fragments. The excretion is presumably from ongoing mobilization of DU from fragments oxidizing in situ. Other clinical outcomes related to urine uranium measures have revealed few abnormalities. Renal function is normal despite the kidney's expected involvement as the "critical" target organ of uranium toxicity. Subtle perturbations in some proximal tubular parameters may suggest early although not clinically significant effects of uranium exposure. A mixed picture of genotoxic outcomes is also observed, including an association of hypoxanthine-guanine phosphoribosyl transferase (HPRT) mutation frequency with high urine uranium levels. Findings observed in this chronically exposed cohort offer guidance for predicting future health effects in other potentially exposed populations and provide helpful data for hazard communication for future deployed personnel.
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Affiliation(s)
- Melissa A McDiarmid
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
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Abstract
Testing for food and chemical sensitivities usually becomes necessary as part of the evaluation of otolaryngology patients who have chronic illness. The more complex the patient, and the more recalcitrant the problem is to treatment, the more likely it is that allergies, and especially food or chemical sensitivities, are involved in the pathogenesis of the illness. Failure to consider all major allergen contacts, including foods and chemicals, can lead to inadequate therapy. Similarly, failure to understand total allergic and oxidant load and the effects of chemical toxicity can lead to inappropriate or ineffective treatment. Clinically, food allergies occur in two different types: immediate, anaphylactic, fixed reactions and delayed, chronic, cyclic reactions. Different test methods have been developed for the two types. Fixed food allergies can be safely and efficiently detected by in vitro specific IgE or histamine release tests. Cyclic food allergies are best detected by either oral food challenges or by the IPDFT test. Choosing the best test for a particular patient requires a clear understanding of the two food allergy types and how their clinical presentations differ. Other tests for food allergies are compared and contrasted with these primary tests. Chemical sensitivity also occurs in two different clinical types: allergic, and toxic. True allergy to chemical haptens, either type I, IgE-mediated, or type IV, delayed hypersensitivity, occurs with significant frequency but is often unsuspected. Chemical toxicity can be caused by the aftereffects of an acute exposure or as a result of chronic, low-level exposure, but is even more frequently unsuspected and will not be diagnosed without a high index of suspicion. Both types of chemical sensitivity need to be addressed in any patients who have either a high allergen or chemical exposure load [105]. Either in vitro or in vivo tests can be used for chemical allergy detection; the advantages of each are outlined. Chemical toxicity screening tests are available and useful but do not detect all possible toxicants. Definitive toxic chemical tests usually require specialized laboratory facilities and expert consultation, for which possible sources are specified. The most important point in testing for food or chemical sensitivity is to be aware that food or chemical sensitivity can be contributing to a specific patient's clinical problems. Only then can appropriate investigations be undertaken to understand and then, perhaps, to intervene successfully in that illness.
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Affiliation(s)
- Bruce R Gordon
- Department of Otology and Laryngology, Harvard University, Cambridge, MA, USA
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Galletti M, D'Annibale L, Pinto V, Cremisini C. Uranium daily intake and urinary excretion: a preliminary study in Italy. HEALTH PHYSICS 2003; 85:228-235. [PMID: 12938971 DOI: 10.1097/00004032-200308000-00013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
An estimate was made of daily uranium intake in Italy through human diet and drinking water. The uranium concentration was determined in food, drinking water, and other beverages. Uranium concentration was also determined in a "total diet" sampled in 1999. The total daily dietary intake was estimated to be in the range 2.9-4.8 microg d(-1). The contribution of drinking water to the total uranium intake is sometimes significant as the uranium concentration range in 29 analyzed tap and bottled "mineral" waters is 0.04-5.86 microg L(-1) and the drinking water consumption about 1 L d(-1) or more. Data obtained in this study were compared with data from literature on the uranium daily intake in other countries. Urine samples were collected from 24 male and 14 female occupationally unexposed subjects, 20-50 y of age, living and working in the district of Rome (Italy). The mean concentration found was 10 +/- 7.0 ng L(-1); the inter-subject variability and the daily variability was evaluated. Analyses were performed using ICP-MS.
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Affiliation(s)
- M Galletti
- ENEA PROT-CHIM, C.R. Casaccia, via Anguillarese 301-00060 S. Maria di Galeria, Rome, Italy
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Bagatti D, Cantone MC, Giussani A, Veronese I, Roth P, Werner E, Höllriegl V. Regional dependence of urinary uranium baseline levels in non-exposed subjects with particular reference to volunteers from Northern Italy. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2003; 65:357-364. [PMID: 12573865 DOI: 10.1016/s0265-931x(02)00107-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Knowledge of the level of natural uranium (U) in the human body is fundamental in order to estimate the potentially hazardous incorporation in accidentally exposed subjects. A constant monitoring of exposed workers needs reliable reference baseline values, which can be determined by measuring the U concentration in urine. ICPMS has proven to be a fast, reliable and highly sensitive technique for this purpose. Non-uniformity in the distribution of U levels in various regions and differences in dietary habits account for the significant regional variations of U concentration in urine in non-exposed subjects. In this paper, the determination of daily uranium urinary excretion levels in a group of 12 non-exposed subjects from Northern Italy is presented and compared to data present in the published literature and to values obtained in a larger group of German volunteers. The urinary U output values observed in the Italian subset are generally higher than the corresponding levels measured in other groups. This could be the result of a higher intake of U from liquids, as assessed by the determination of U concentration in drinking waters.
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Affiliation(s)
- D Bagatti
- Dipartimento di Fisica, Università degli Studi di Milano, Sezione di Fisica Medica, via Celoria 16 I-20133 Milano, Italy
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Shawky S, Amer HA, Hussein MI, el-Mahdy Z, Mustafa M. Uranium bioassay and radioactive dust measurements at some uranium processing sites in Egypt--health effects. JOURNAL OF ENVIRONMENTAL MONITORING : JEM 2002; 4:588-91. [PMID: 12196006 DOI: 10.1039/b202691k] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The safety of radiation workers in the uranium mining industry requires close and continuous monitoring of their working conditions. In this study, external radiation surveillance, radioactive dust monitoring and the bioassay of uranium were carried out in some processing sites. As dust represents one of the most important sources of radiation exposure in mills and mines, dust monitoring and bioassays were performed for a sample of workers on the production lines. The concentration of uranium in air ranged from 22.6 x 10(-7) to 11.1 x 10(-5) Bq cm-3, and the exposure levels ranged from 1 to 80 microSv h-1. Laser fluorimetric determination of uranium in urine samples showed concentrations in the range 8.4-29.2 micrograms L-1. Renal function parameters, such as serum creatinine and urea, and hematological parameters were determined in an attempt to correlate them with radiation exposure and the health status of the workers. Urine specimens collected from workers at the ore crushing and separation site showed elevated concentrations of uranium (up to 29.2 micrograms L-1) and a strong correlation between these concentrations and the registered serum creatinine. The mean uranium excretion in the investigated group was more than 20 times the occupational exposure decision level for urine uranium of 0.8 microgram L-1.
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Affiliation(s)
- S Shawky
- National Center for Nuclear Safety and Radiation Control, Atomic Energy Authority, Nasr City 11762, Cairo, Egypt.
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Abstract
Recently, several studies have reported on the health and environmental consequences of the use of depleted uranium. Depleted uranium is a heavy metal that is also radioactive. It is commonly used in missiles as a counterweight because of its very high density (1.6 times more than lead). Immediate health risks associated with exposure to depleted uranium include kidney and respiratory problems, with conditions such as kidney stones, chronic cough and severe dermatitis. Long-term risks include lung and bone cancer. Several published reports implicated exposure to depleted uranium in kidney damage, mutagenicity, cancer, inhibition of bone, neurological deficits, significant decrease in the pregnancy rate in mice and adverse effects on the reproductive and central nervous systems. Acute poisoning with depleted uranium elicited renal failure that could lead to death. The environmental consequences of its residue will be felt for thousands of years. It is inhaled and passed through the skin and eyes, transferred through the placenta into the fetus, distributed into tissues and eliminated in urine. The use of depleted uranium during the Gulf and Kosovo Wars and the crash of a Boeing airplane carrying depleted uranium in Amsterdam in 1992 were implicated in a health concern related to exposure to depleted uranium.
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Affiliation(s)
- Aqel W Abu-Qare
- Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC 27710, USA
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Meddings DR, Haldimann M. Depleted uranium in Kosovo: an assessment of potential exposure for aid workers. HEALTH PHYSICS 2002; 82:467-472. [PMID: 11906135 DOI: 10.1097/00004032-200204000-00005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND During the Kosovo conflict approximately 11 tons of depleted uranium munitions were used against armored targets, predominantly in the west. Potential exposure to uranium amongst employees of the International Red Cross and Red Crescent Movement in western Kosovo was assessed. METHODS Individuals (n = 31) who had resided at least 3 mo in western Kosovo provided 24-h urine collections and completed an administered questionnaire. Specimens were analyzed for creatinine concentration, and uranium concentration was determined using inductively coupled mass spectrometry. FINDINGS Subjects ranged in age from 22 to 45 y, and 77% were male. Mean duration of residency was 11 mo, and 14 individuals were in western Kosovo throughout the hostilities. Almost three quarters of subjects reported seeing destroyed tanks or vehicles, predominantly while passing by within a vehicle. Two individuals spent time within 50 m of a destroyed tank or vehicle while outside of a vehicle. Urinary uranium concentrations ranged from 3.5 to 26.9 ng of uranium per liter of urine (median 8.9 ng L(-)). Creatinine normalized values ranged from 2.9 to 21.1 ng of uranium per gram of creatinine (median 7.4 ng g(-1) creatinine). These results fall toward the lower end of urinary uranium determinations made amongst non-exposed populations drawn from a literature review. INTERPRETATION These results do not indicate an increased exposure to uranium amongst adults living and working in western Kosovo who do not spend time in proximity to destroyed vehicles. Environmental sampling and replication of these results amongst a sample including children and individuals reporting intensive exposure to destroyed vehicles would further develop the exposure assessment.
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Affiliation(s)
- David R Meddings
- Unit of the Chief Medical Officer, International Committee of the Red Cross, Geneva, Switzerland.
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McDiarmid MA, Engelhardt SM, Oliver M. Urinary uranium concentrations in an enlarged Gulf War veteran cohort. HEALTH PHYSICS 2001; 80:270-273. [PMID: 11219540 DOI: 10.1097/00004032-200103000-00010] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Depleted uranium was first used on a large scale as a major component of munitions and armaments employed by the U.S. armed forces during the Gulf War in 1991. In response to concern that exposure to depleted uranium may have been a cause of health problems suffered by returning veterans of that war, an already existing surveillance program following depleted uranium "friendly fire" victims was enlarged to assess the wider veteran community's exposure to depleted uranium. Between August 1998 and December 1999, 169 Gulf War veterans submitted 24-h urine samples for determination of urinary uranium concentration and questionnaires describing their potential exposures to depleted uranium while in the Gulf War theatre. Depleted uranium exposure assessment was determined from 30 separate questionnaire items condensed into 19 distinct exposure scenarios. Results of urine uranium analysis were stratified into high and low uranium groups with 0.05 microg uranium/g creatinine being the cut point and approximate upper limit of the normal population distribution. Twelve individuals (7.1%) exhibited urine uranium values in the high range, while the remaining 157 had urine uranium values in the low range. A repeat test of urine for 6 of these 12 produced uranium results in the low range for 3 of these individuals. Exposure scenarios of the high and low uranium groups were similar with the presence of retained shrapnel being the only scenario predictive of a high urine uranium value. Results emphasize the unlikely occurrence of an elevated urine uranium result and consequently any uranium-related health effects in the absence of retained depleted uranium metal fragments in the veterans.
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Affiliation(s)
- M A McDiarmid
- University of Maryland, Occupational Health Project, Baltimore 21201, USA
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Ejnik JW, Carmichael AJ, Hamilton MM, McDiarmid M, Squibb K, Boyd P, Tardiff W. Determination of the isotopic composition of uranium in urine by inductively coupled plasma mass spectrometry. HEALTH PHYSICS 2000; 78:143-146. [PMID: 10647980 DOI: 10.1097/00004032-200002000-00003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A simple method based on inductively coupled plasma mass spectrometry (ICP-MS) was developed to identify exposure to depleted uranium by measuring the isotopic composition of uranium in urine. Exposure to depleted uranium results in a decreased percentage of 235U in urine samples causing measurements to vary between natural uranium's 0.72% and depleted uranium's 0.2%. Urine samples from a non-depleted uranium exposed group and a suspected depleted uranium exposed group were processed and analyzed by ICP-MS to determine whether depleted uranium was present in the urine. Sample preparation involved dry-ashing the urine at 450 degrees C followed by wet-ashing with a series of additions of concentrated nitric acid and 30% hydrogen peroxide. The ash from the urine was dissolved in 1 M nitric acid, and the intensity of 235U and 238U ions were measured by ICP-MS. After the samples were ashed, the ICP-MS measurements required less than 5 min. The 235U percentage in individuals from the depleted uranium exposed group with urine uranium concentrations greater than 150 ng L(-1) was between 0.20%-0.33%, correctly identifying depleted uranium exposure. Samples from the non-depleted uranium exposed individuals had urine uranium concentration less than 50 ng L(-1) and 235U percentages consistent with natural uranium (0.7%-1.0%). A minimum concentration of 14 ng L(-1) uranium was required to obtain sufficient 235U to allow calculating a valid isotopic ratio. Therefore, the percent 235U in urine samples measured by this method can be used to identify low-level exposure to depleted uranium.
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Affiliation(s)
- J W Ejnik
- Armed Forces Radiobiology Research Institute, Bethesda, MD 20889-5603, USA.
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Hedaya MA, Birkenfeld HP, Kathren RL. A sensitive method for the determination of uranium in biological samples utilizing kinetic phosphorescence analysis (KPA). J Pharm Biomed Anal 1997; 15:1157-65. [PMID: 9215968 DOI: 10.1016/s0731-7085(96)01957-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Kinetic phosphorescence analysis is a technique that provides rapid, precise and accurate determination of uranium concentration in aqueous solutions. This technique utilizes a laser source to excite an aqueous solution of uranium, and measures the emission luminescence intensity over time to determine the luminescence decay profile. The lifetime of the luminescence decay profile and the linearity of the log luminescence intensity versus time profile are indications of the specificity of the technique for uranium determination. The luminescence intensity at the onset of decay (the initial luminescence intensity), which is the luminescence intensity at time zero after termination of the laser pulse used for excitation, is proportional to the uranium concentration in the sample. Calibration standards of known uranium concentrations are used to construct the calibration curve between the initial luminescence intensity and uranium concentration. This calibration curve is used to determine the uranium concentration of unknown samples from their initial luminescence intensity. We developed the sample preparation method that allows the determination of uranium concentrations in urine, plasma, kidney, liver, bone spleen and soft tissue samples. Tissue samples are subjected to dry-ashing in a muffle furnace at 600 degrees C and wet-ashing with concentrated nitric acid and hydrogen peroxide twice to destroy the organic component in the sample that may interfere with uranium determination by KPA. Samples are then solubilized in 0.82 M nitric acid prior to analysis by KPA. The assay calibration curves are linear and cover the range of uranium concentrations between 0.05 micrograms l-1 and 1000 micrograms l-1 (0.05-1000 ppb). The developed sample preparation procedures coupled with the KPA technique provide a specific, sensitive, precise and accurate method for the determination of uranium concentration in tissue samples. This method was used to quantify uranium in different tissue samples obtained over a period of 90 days following a single intraperitoneal uranium dose of 0.1 mg kg-1 in rats.
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Affiliation(s)
- M A Hedaya
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman 99164-6510, USA.
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Flow injection method for determination of uranium in urine and serum by inductively coupled plasma mass spectrometry. Anal Chim Acta 1996. [DOI: 10.1016/s0003-2670(96)00278-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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