Risk communication for labeling all ingredients in consumer products

Suspected adverse reactions to medications and food supplements containing Serenoa repens: A worldwide analysis of pharmacovigilance and phytovigilance spontaneous reports

The safety of Serenoa repens (SR)-containing products was evaluated conducting a retrospective worldwide analysis of pharmaco- and phytovigilance report forms of suspected adverse reactions (SARs) collected up to 31 January 2022. Multivariate logistic regression was performed to estimate the odds ratios (ORs) of serious SAR. A total of 1810 report forms were analysed; 92% of subjects were males, with a median age of 69 years; 44% of cases were defined as serious. Subjects exposed to dietary supplements had a higher risk of developing serious SARs (OR: 1.60 [95% CI: 1.20-2.15]), as subjects exposed to 2-5 (OR: 1. 83 [95% CI: 1.30-2.58]) or more than 5 (OR: 3.45 [95% CI: 2.36-5.06]) suspect/interacting products. The probability of experiencing serious SAR was higher for subjects exposed to concomitant products (OR: 1.55 [95% CI: 1.15-2.08]), to more than four active compounds (OR: 4.38 [95% CI: 3.21-5.99]) and to SR for more than 14 days (OR: 1.89 [95% CI: 1.10-3, 22]), and lower for subjects exposed to higher doses of SR (OR: of 0.34 [95% CI: 0.20-0.58]). This evidence improves awareness on safety of SR containing products, suggesting the need of a further update of periodic reviews by national and international regulatory agencies.

Quantitative risk assessment of allergens leaching from menstrual hygiene products

Allergic contact dermatitis (ACD) often associated with the topical use of perfumed products, remains one of the most common chronic skin disorders in Western countries. Since labelling of scented menstrual hygiene products (MHPs) is not mandatory, women might be unknowingly exposed to allergens. Given that vaginal mucosae lack the vital barrier function of the skin, skin allergens can easily penetrate and become systemically available and hence women may experience adverse effects in the anogenital region. The aim of this study was therefore to investigate whether women using scented MHPs are at risk of sensitization and hence developing ACD. Hereto, a Quantitative Risk Assessment (QRA) is performed on four well-known skin sensitizing chemicals (α-isomethyl ionone, benzyl salicylate, hexyl cinnamaldehyde and heliotropine) that were previously found leaching from five different scented MHPs including tampons and sanitary pads. The amounts of heliotropine, leached by one of the investigated tampons, exceeded acceptable exposure levels determined with the QRA and could induce sensitization. In addition, although no sensitization is expected for the other three compounds, an allergenic reaction might be provoked in women who are already sensitized. Labelling of allergens on scented MHPs would therefore help consumers to prevent adverse effects linked to ACD.

Cross Talk between Synthetic Food Colors (Azo Dyes), Oral Flora, and Cardiovascular Disorders

Synthetic food colors are important ingredients in the food industry. These synthetic food colorants are azo dyes, majorly acidic in nature such as Allura red and Tartrazine. They are present in sweets, carbonated drinks, meat products, and candies to attract the consumers. This review article is an attempt to explain the adverse effects of azo dyes and their association with oral cavities and cardiovascular disorders. These synthetic dyes (azo dyes) have staining effects on dentin. Poor dental care accelerates the bacterial accumulation on the dental crown (Gram-negative bacteria P. gingivalis, T. denticola, and T. forsythia and Gram-positive bacteria Strep. Gordonii), causing the washing of enamel, forming dental plaque. Bacterial pathogens (P. ginigivalis and F. nacleatum) release different chemicals (FadA and Fap2) that bind to protein on the cell by producing an inflammatory response through different line-host defenses, such as Gingival epithelial cells (ECs), Hemi-desmosomes, and desmosomes, which helps the bacterium migration from the cell–cell junction. This makes the junctions slightly open up and makes the whole vessel permeable, through which the bacterium enters into the blood stream line. This leads to different major arteries, such as the carotid artery, and causes the accumulation of plaque in major cardiac arteries, which causes different cardiovascular disorders. These bacterial species present in gums cause cardiovascular diseases, such as ischemic heart disease, coronary artery disease, heart attacks and strokes, and arrhythmias, which can lead to death.

Oxidative stress responses after exposure to triclosan sublethal concentrations: an integrated biomarker approach with a native (Corydoras paleatus) and a model fish species (Danio rerio)

Triclosan (TCS) is a synthetic broad-spectrum antimicrobial agent commonly used world-wide in a range of personal care and sanitizing products detected frequently in aquatic ecosystems. The aim of this study was to examine biochemical markers responses triggered by TCS in Danio rerio and in a native South American fish species (Corydoras paleatus). Further, an integrated approach comparing both test fish species was undertaken. These fish organisms were exposed to 100 or 189 µg TCS/L for 48 h. The activities of catalase (CAT), glutathione-s-transferase (GST), superoxide dismutase (SOD), and lipid peroxidation levels (LPO) and total antioxidant capacity against peroxyl radicals (ACAP) were determined in liver, gills, and brain. Acetylcholinesterase activity (AChE) was measured in the brain. Multivariate analysis showed that the most sensitive hepatic parameters were activities of GST and SOD for C. paleatus while LPO levels were for D. rerio. In gills the same parameters were responsive for C. paleatus but CAT in D. rerio. ACAP and GST activity were responsive parameters in brain of both species. Integrated biomarker responses (IBR) index demonstrated similar trends in both species suggesting this parameter might serve as a useful tool for quantification of integrated responses induced by TCS.

Validation of Quantitative Structure-Activity Relationship (QSAR) and Quantitative Structure-Property Relationship (QSPR) approaches as alternatives to skin sensitization risk assessment

The aim of this study was conducted to validate the physicochemical properties of a total of 362 chemicals [305 skin sensitizers (212 in the previous study + 93 additional new chemicals), 57 non-skin sensitizers (38 in the previous study + 19 additional new chemicals)] for skin sensitization risk assessment using quantitative structure-activity relationship (QSAR)/quantitative structure-property relationship (QSPR) approaches. The average melting point (MP), surface tension (ST), and density (DS) of the 305 skin sensitizers and 57 non-sensitizers were used to determine the cutoff values distinguishing positive and negative sensitization, and correlation coefficients were employed to derive effective 3-fold concentration (EC3 (%)) values. QSAR models were also utilized to assess skin sensitization. The sensitivity, specificity, and accuracy were 80, 15, and 70%, respectively, for the Toxtree QSAR model; 88, 46, and 81%, respectively, for Vega; and 56, 61, and 56%, respectively, for Danish EPA QSAR. Surprisingly, the sensitivity, specificity, and accuracy were 60, 80, and 64%, respectively, when MP, ST, and DS (MP+ST+DS) were used in this study. Further, MP+ST+DS exhibited a sensitivity of 77%, specificity 57%, and accuracy 73% when the derived EC3 values were classified into local lymph node assay (LLNA) skin sensitizer and non-sensitizer categories. Thus, MP, ST, and DS may prove useful in predicting EC3 values as not only an alternative approach to animal testing but also for skin sensitization risk assessment.

Current opinion on risk assessment of cosmetics

Risk assessment of cosmetic ingredients is a useful scientific method to characterize potential adverse effects resulting from using cosmetics. The process of risk assessment consists of four steps: hazard identification, dose-response assessment, exposure assessment, and risk characterization. Hazard identification of chemicals refers to the initial stage of risk assessment and generally utilizes animal studies to evaluate toxicity. Since 2013, however, toxicity studies of cosmetic ingredients using animals have not been permitted in the EU and alternative toxicity test methods for animal studies have momentum to be developed for cosmetic ingredients. In this paper, we briefly review the alternative test methods that are available for cosmetic ingredients including read-across, in silico, in chemico, and invitro methods. In addition, new technologies such as omics and artificial intelligence (AI) have been discussed to expand or improve the knowledge and hazard identification of cosmetic ingredients. Aggregate exposure of cosmetic ingredients is another safety issue and methods for its improvement were reviewed. There have been concerns over the safety of nano-cosmetics for a long time, but the risk of nano-cosmetics remains unclear. Therefore, current issues of cosmetic risk assessment are discussed and expert opinion will be provided for the safety of cosmetics.

The dark side of skin lightening: An international collaboration and review of a public health issue affecting dermatology

Skin lightening (SL) for cosmetic reasons is associated with profound negative impacts on well-being and adverse effects on the skin, resulting in immense challenges for dermatologists. Despite current regulations, lightening agents continue to dominate the cosmetic industry. In this review, our international team of dermatologists tackles the topic of SL as a global public health issue, one of great concern for both women's health and racial implications. We have examined SL in Africa, Asia, the Middle East, and the Americas. We aim to inspire a global discourse on how modern dermatologists can utilize scientific evidence and cultural competency to serve and protect patients of diverse skin types and backgrounds. In doing so, we hope to promote healthy skin and inclusive concepts of beauty in our patients and society.