Public Health Risks, Dermatological Manifestations, and Environmental Justice Associated With Vinyl Chloride Exposure: Narrative Review

BACKGROUND

Environmental vinyl chloride (VC) exposure may result in serious acute and chronic dermatological conditions. Because existing literature largely focuses on exposures in occupational settings, a gap persists in our understanding of the medical consequences of large-scale chemical spills.

OBJECTIVE

This study aims to examine the potential dermatological manifestations of VC exposure in the context of industrial spills and other environmental disasters and to highlight the public health and justice implications of such releases.

METHODS

In this narrative review, relevant evidence-based, peer-reviewed scientific sources, gray literature, and media reports were identified via searches of search PubMed and Google using predetermined keyword search terms related to VC, VC spills and releases, train derailment, cutaneous disease, public health, and vulnerable and marginalized populations.

RESULTS

Contact dermatitis and frostbite may arise acutely, highlighting the importance of swift decontamination. Long-term manifestations from chronic VC exposure due to persistence in environmental reservoirs include Raynaud disease, sclerodermatous skin changes, acro-osteolysis, and cutaneous malignancies. The clinical severity of cutaneous manifestations is influenced by individual susceptibility as well as duration, intensity, and route of exposure. Additionally, chemical releases of VC more frequently impact Communities of Color and those of lower socioeconomic status, resulting in greater rates of exposure-related disease.

CONCLUSIONS

With environmental release events of hazardous chemicals becoming increasingly common and because the skin has increased contact with environmental toxins relative to other organs, an urgent need exists for a greater understanding of the overall short- and long-term health impacts of large-scale, toxic exposures, underscoring the need for ongoing clinical vigilance. Dermatologists and public health officials should also aim to better understand the ways in which the disproportionate impacts of hazardous chemical exposures on lower-income and minority populations may exacerbate existing health disparities. Herein, we describe the health implications of toxic releases with particular consideration paid to marginalized and vulnerable populations. In addition to legal and regulatory frameworks, we advocate for improved public health measures, to not only mitigate the risk of environmental catastrophes in the future, but also ensure timely and effective responses to them.

Para-occupational exposure to chemical substances: a systematic review

Today, many health problems related to work have overshadowed workers and their families. In the meantime, chemicals are among the risk factors that have created many problems due to para-occupational exposure. In para-occupational exposures, family members are exposed to work pollutants transferred to the home environment. This study was conducted to investigate para-occupational exposure to chemicals. To conduct this systematic review, databases such as "Web of Science", "Google Scholar", "Scopus", and "SID" were used. Relevant articles in these databases were extracted by searching keywords such as "take-home exposure", "para-occupational exposure", and "chemicals" from 2000 to 2022. To extract the required data, all parts of the articles were reviewed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020). Among the 44 identified articles, 23 were selected as final articles, of which 10 were related to agriculture workers and their families, and 13 were related to other occupations. These studies mainly investigated para-occupational exposure to pesticides (14 studies) and metals (four studies). Also, contaminated work clothes, the washing place of contaminated clothes, and storage of working clothes, equipment, and chemicals were proposed as the main routes of contamination transmission. As a result of these para-occupational exposures, problems like neuro-behavioral disorders in children, end-stage renal disease, black gingival borders, and autism spectrum disorder were created or aggravated. Limiting the transmission routes and taking measures such as training and providing facilities like devoting places for washing and storing clothes in the workplaces can decrease this type of exposure.

Urinary levels of organophosphate flame retardants metabolites in a young population from Southern Taiwan and potential health effects

Background

Organophosphate flame retardants (OPFRs) are widely distributed in the environment and their metabolites are observed in urine, but little is known regarding OPFRs in a broad-spectrum young population from newborns to those aged 18 years.

Objectives

Investigate urinary levels of OPFRs and OPFR metabolites in Taiwanese infants, young children, schoolchildren, and adolescents within the general population.

Methods

Different age groups of subjects (n=136) were recruited from southern Taiwan to detect 10 OPFR metabolites in urine samples. Associations between urinary OPFRs and their corresponding metabolites and potential health status were also examined.

Results

The mean level of urinary Σ10 OPFR in this broad-spectrum young population is 2.25 μg/L (standard deviation (SD) of 1.91 μg/L). Σ10 OPFR metabolites in urine are 3.25 ± 2.84, 3.06 ± 2.21, 1.75 ± 1.10, and 2.32 ± 2.29 μg/L in the age groups comprising of newborns, 1-5 year-olds, 6-10 year-olds, and 11-18 year-olds, respectively, and borderline significant differences were found in the different age groups (p=0.125). The OPFR metabolites of TCEP, BCEP, DPHP, TBEP, DBEP, and BDCPP predominate in urine and comprise more than 90% of the total. TBEP was highly correlated with DBEP in this population (r=0.845, p<0.001). The estimated daily intake (EDI) of Σ5OPFRs (TDCPP, TCEP, TBEP, TNBP, and TPHP) was 2,230, 461, 130, and 184 ng/kg bw/day for newborns, 1-5 yr children, 6-10 yr children, and 11-17 yr adolescents, respectively. The EDI of Σ5OPFRs for newborns was 4.83-17.2 times higher than the other age groups. Urinary OPFR metabolites are significantly correlated with birth length and chest circumference in newborns.

Conclusion

To our knowledge, this is the first investigation of urinary OPFR metabolite levels in a broad-spectrum young population. There tended to be higher exposure rates in both newborns and pre-schoolers, though little is known about their exposure levels or factors leading to exposure in the young population. Further studies should clarify the exposure levels and factor relationships.

Halochromic Textiles for Real-Time Sensing of Hazardous Chemicals and Personal Protection

Chemical protective clothing (CPC) has become mandatory when performing various tasks to ensure user protection and prevent chemicals from contacting the skin and causing severe injuries. In addition to protection, there is a need to develop a simple mechanism that can be attached to CPC and be capable of detecting and alerting the user to the presence of harmful chemical agents. In this study, a double-sensor strategy was investigated, using six different pH indicators stamped on cotton and polyester knits to detect acidic and alkaline substances, both liquid and gaseous. Functionalized knits underwent microscopic characterization, air permeability and contact angle evaluation. All samples exhibited hydrophobic behavior (contact angle > 90°) and air permeability values above 2400 L/min/cm²/bar, with the best condition demonstrating a contact angle of 123° and an air permeability of 2412.5 L/min/cm²/bar when the sensor methyl orange and bromocresol purple (MO:BP) was stamped on polyester. The performed tests proved the functionality of the sensors and showed a visible response of all knits when contacting with different chemicals (acids and bases). Polyester functionalized with MO:BP showed the greatest potential, due to its preeminent color change. Herein, the fiber coating process was optimized, enabling the industrial application of the sensors via a stamping method, an alternative to other time- and resource-consuming techniques.

Chemical strategies for sustainable medical laboratories

Chemicals are essential components of our daily lives, for the well-being, high living standards and comfort of modern society. They are used in many sectors, including health. However, some chemicals have hazardous properties which can harm the environment and human health. Chemical pollution is significantly contributing to the current global problem of climate change and loss of biodiversity There is an increase in health problems that can be partially explained by the use of chemicals. Some man-made chemicals are found in the most remote places in the environment, but also in our bodies. Chemicals are everywhere. Chemicals strategy for sustainability towards a toxic-free environment will ensure better protection of human health and the environment from hazardous chemicals, boost innovation for safe and sustainable chemicals and enable the transition to chemicals that are safe and sustainable by design. It is a first step towards the Zero pollution ambition for a toxic-free environment announced in the European Green Deal. The strategy proposes comprehensive chemical legislations for the transformation of industry with the aim of attracting investment into safe and sustainable products and production methods. Clinical laboratories must choose safer, more sustainable alternatives to hazardous chemicals, address sustainability issues, and implement official guidelines on how to reduce their carbon footprint.

Study on Risk Assessment Methods and Zoning of Hazardous Chemicals Leaking into Seas

In China, studies on the regional risk assessment of hazardous chemicals have been carried out for only a few years, and there are few studies on hazardous chemicals leaking into seas. Previous regional-risk-assessment methods considered a single risk factor for most assessment targets, and comprehensive considerations of risk sources and sensitive resources for a study area are not sufficiently included. Based on previous work, this study established a regional-risk-assessment method for hazardous chemicals leaking into seas. This method considered the hazards of hazardous chemicals and the tolerance of the regional environment by means of a case study in Tianjin. The results showed that the risk level of the enterprise was Grade I, classified as a high-risk source of hazardous chemicals; the main reasons were the strong toxicity and large quantity of hazardous chemicals. This method provides technical support for scientifically assessing marine-environmental-risk levels for hazardous-chemical-leakage areas and for carrying out risk-prevention and restoration assessments of hazardous chemicals leaking into seas.

Time to Break the "Lock-In" Impediments to Chemicals Management

Despite enormous national, regional, and global efforts on chemical management, the widespread use of hazardous chemicals continues in many parts of the world even after decades of there being well-known risks to public and/or ecosystem health. This continued supply and use, despite strong evidence of negative impacts, is not unique to chemicals management. In the field of climate change, the concept of "lock-in" has been used to explain the complex interactions among economic, social, technological, and political dynamics that reinforce global reliance on the extraction and use of fossil fuels. Learning from carbon "lock-in" phenomena, this Perspective explores the challenges of chemicals management from the perspective of lock-in through three case studies: paraquat, perfluorooctanesulfonic acid (PFOS), and asbestos. These case studies illustrate that most current chemicals management frameworks fail to address the concerns arising from this complex interplay by not involving all relevant stakeholder groups that are part of lock-in, from producers to consumers. This results in a relatively narrow consideration (e.g., only demand but not supply) of the effectiveness and consequences of regulations. We submit that to break lock-in and address the global threat of chemical pollution, current approaches to managing hazardous chemicals should be broadened to take a comprehensive approach to understanding and managing factors contributing to lock-in, notably both supply and demand on national and international scales.

Greater than the sum of its parts: focusing SRP research through a systems approach lens

The National Institute of Environmental Health Sciences Superfund Research Program (SRP) funds diverse transdisciplinary research to understand how hazardous substances contribute to disease. SRP research focuses on how to prevent these exposures by promoting problem-based, solution-oriented research. SRP's mandate areas encompasses broad biomedical and environmental science and engineering research efforts and, when combined with research translation, community engagement, training, and data science, offers broad expertise and unique perspectives directed at a specific big picture question. The purpose of this commentary is to adapt a systems approach concept to SRP research to accommodate the complexity of a scientific problem. The SRP believes a systems approach offers a framework to understand how scientists can work together to integrate diverse fields of research to prevent or understand environmentally-influenced human disease by addressing specific questions that are part of a larger perspective. Specifically, within the context of the SRP, a systems approach can elucidate the complex interactions between factors that contribute to or protect against environmental insults. Leveraging a systems approach can continue to advance SRP science while building the foundation for researchers to address difficult emerging environmental health problems.

Identifying the Weaker Function Links in the Hazardous Chemicals Road Transportation System in China

Safety of the hazardous chemicals road transportation system (HCRTS) is an important, complex, social, and environmental sensitive problem. The complexity, dynamics, and multi-link features of HCRTS have made it necessary to think beyond traditional risk analysis methods. Based on the relevant literature, Functional Resonance Analysis Method (FRAM) is a relatively new systemic method for modeling and analyzing complex socio-technical systems. In this study, a methodology that integrates FRAM, fuzzy sets, and risk matrix is presented to quantitatively assess the risks factors representing failure function links in HCRTS. As the strength of function links can be illustrated by the RI (risk index) of risk factors identified in failure function links, 32 risk factors representing 12 failure function links were first identified by accident causes analysis and the framework of FRAM. Fuzzy sets were then utilized to calculate the weight of the likelihood and consequence of the risk factors. Finally, according to the assessment results of the identified risk factors by a two-dimensional risk matrix, the weaker function links in the whole HCRTS chain were identified. HCs road companies, regulatory authorities, relevant practitioners, and other stakeholders should pay more attention to these links.

A Cumulative Framework for Identifying Overburdened Populations under the Toxic Substances Control Act: Formaldehyde Case Study

Extensive scholarship has demonstrated that communities of color, low-income communities, and Indigenous communities face greater environmental and health hazards compared to communities with more White or affluent people. Low-income, Indigenous, Black, and/or other populations of color are also more likely to lack access to health care facilities, healthy food, and adequate formal education opportunities. Despite the mountains of evidence that demonstrate the existence and significance of the elevated toxic social and environmental exposures experienced by these communities, the inclusion of these factors into chemical evaluations has been scarce. In this paper, we demonstrate a process built with publicly available data and simple geospatial techniques that could be utilized by the U.S. Environmental Protection Agency (USEPA) to incorporate cumulative approaches into risk assessments under the Toxic Substances Control Act. The use of these approaches, particularly as they relate to identifying potentially exposed and susceptible subpopulations, would help USEPA develop appropriate risk estimates and mitigation strategies to protect disproportionately burdened populations from the adverse effects of chemical exposures. By utilizing such approaches to inform risk evaluation and mitigation, USEPA can identify and protect those most burdened and impacted by toxic chemicals, and finally begin to close the gap of environmental health inequities.

Potential Applications of Cucurbit[n]urils and Their Derivatives in the Capture of Hazardous Chemicals

Cucurbit[n]urils (Q[n]s) are a relatively young family of macrocycles, consisting of glycoluril units bridged by methylene groups, and their unique structures have attracted extensive attention from chemists in recent decades. Due to the presence of a rigid hydrophobic inner cavity and two polar outer portals lined with carbonyl groups, Q[n]s not only encapsulate guest species into the cavity, but also coordinate with metal ions/clusters. Considerable achievements have been obtained in the fields of Q[n]s-based host-guest chemistry, coordination chemistry, as well as the combination of host-guest and coordination chemistry. Furthermore, the outer surface of Q[n]s has been demonstrated to be capable of interacting with definite species to generate supramolecular architectures in recent years. With more in-depth research into Q[n]s, their application studies have also emerged as a hot topic. This Minireview focuses on recent advances in the potential applications of solid-state materials based on Q[n]s and their derivatives for the capture and adsorption of hazardous chemicals from a solution or a gas mixture.

Occupational exposures to hazardous chemicals and agents among healthcare workers in Bhutan

BACKGROUND

Occupational exposures to hazardous chemicals among healthcare workers can result in long-term adverse health outcomes. Research on such exposures from low- and middle-income countries is limited. The aim of this study was to estimate the prevalence of exposures to a range of chemicals used in healthcare settings among Bhutanese healthcare workers.

METHODS

A cross-sectional study was conducted among healthcare workers (n = 370) working in three hospitals in the western region of Bhutan. Demographic and occupational information was collected, and exposures to asthmagens, carcinogens, ototoxic and other agents were assessed using a web-based tool. The prevalence of exposure to these chemicals was calculated and the circumstances resulting in such exposures were examined.

RESULTS

The prevalence of exposure to one or more asthmagen, carcinogen, and ototoxic agent was 98.7%, 28.1%, and 7.6%, respectively; and was 6.2% for anesthetic gases and 2.2% for antineoplastic drugs. The most common exposures were to latex, and cleaning and disinfecting agents in the asthmagens group; formaldehyde in the carcinogens group; and p-xylene among ototoxic agents. The circumstances resulting in exposures were using latex gloves, using bleach and chlorhexidine for cleaning, using formaldehyde as a disinfectant and in the laboratory, and using p-xylene in the laboratory.

CONCLUSIONS

The results indicate that a large proportion of Bhutanese healthcare workers are occupationally exposed to chemicals linked to chronic diseases, with exposure prevalence higher than in high-income countries. The study provides information that can be used to formulate policies and to implement control measures to protect healthcare workers.

Hazardous wastes treatment technologies

A review of the literature published in 2019 on topics related to hazardous waste management in water, soils, sediments, and air. The review covered treatment technologies applying physical, chemical, and biological principles for the remediation of contaminated water, soils, sediments, and air. PRACTICAL POINTS: This report provides a review of technologies for the management of waters, wastewaters, air, sediments, and soils contaminated by various hazardous chemicals including inorganic (e.g., oxyanions, salts, and heavy metals), organic (e.g., halogenated, pharmaceuticals and personal care products, pesticides, and persistent organic chemicals) in three scientific areas of physical, chemical, and biological methods. Physical methods for the management of hazardous wastes including general adsorption, sand filtration, coagulation/flocculation, electrodialysis, electrokinetics, electro-sorption ( capacitive deionization, CDI), membrane (RO, NF, MF), photocatalysis, photoelectrochemical oxidation, sonochemical, non-thermal plasma, supercritical fluid, electrochemical oxidation, and electrochemical reduction processes were reviewed. Chemical methods including ozone-based, hydrogen peroxide-based, potassium permanganate processes, and Fenton and Fenton-like process were reviewed. Biological methods such as aerobic, anoxic, anaerobic, bioreactors, constructed wetlands, soil bioremediation and biofilter processes for the management of hazardous wastes, in mode of consortium and pure culture were reviewed. Case histories were reviewed in four areas including contaminated sediments, contaminated soils, mixed industrial solid wastes and radioactive wastes.

The Influence of Social Capital on Protective Action Perceptions Towards Hazardous Chemicals

The stigmatized character of hazardous chemicals has caused individuals in hazards to take excessive protective actions. Here, social capital is introduced to discuss its influence on the protective action decision model (PADM), considering this variable has a relatively high individual trust level in regards to information on hazardous chemicals. A model was constructed by taking protective action perceptions as the dependent variable, social capital as the independent variable, the pre-decision process as the mediating variable, and socioeconomic status as the moderating variables. Data were collected with a neighborhood sampling method, and a total of 457 questionnaires were obtained from neighboring residents near a large cold ammonia storage house in Haidian District, Beijing. Results: While the family and friendship networks produced a larger positive influence, the kinship network produced a smaller positive influence; furthermore, the influence of social capital must be brought through the pre-decision process; finally, socioeconomic status has a directional moderation on the friendship network, an enhancing moderation on the kinship network, and a weakening moderation on the family network.

Hazardous waste treatment technologies

This is a review of the literature published in 2018 on topics related to hazardous waste management in water, soils, sediments, and air. The review covers treatment technologies applying physical, chemical, and biological principles for contaminated water, soils, sediments, and air. PRACTITIONER POINTS: The management of waters, wastewaters, and soils contaminated by various hazardous chemicals including inorganic (e.g., oxyanions, salts, and heavy metals), organic (e.g., halogenated, pharmaceuticals and personal care products, pesticides, and persistent organic chemicals) was reviewed according to the technology applied, namely, physical, chemical and biological methods. Physical methods for the management of hazardous wastes including adsorption, coagulation (conventional and electrochemical), sand filtration, electrosorption (or CDI), electrodialysis, electrokinetics, membrane (RO, NF, MF), photocatalysis, photoelectrochemical oxidation, sonochemical, non-thermal plasma, supercritical fluid, electrochemical oxidation, and electrochemical reduction processes were reviewed. Chemical methods including ozone-based, hydrogen peroxide-based, persulfate-based, Fenton and Fenton-like, and potassium permanganate processes for the management of hazardous were reviewed. Biological methods such as aerobic, anaerobic, bioreactor, constructed wetlands, soil bioremediation and biofilter processes for the management of hazardous wastes, in mode of consortium and pure culture were reviewed.

Study Design, Rationale and Procedures for Human Biomonitoring of Hazardous Chemicals from Foods and Cooking in Korea

Objectives: A nationwide biomonitoring program identified the long-term trends of environmental exposures to hazardous chemicals in the general population and found geographical locations where body burdens of an exposed group significantly differed from those of the general population. The purpose of this study is to analyze the hazardous compounds associated with foods and cooking in the nationwide general population for evaluation of the environmental exposures and health risk factors and for the establishment of the reference levels at the national level. Methods: During 2009–2010, the National Institute of Food and Drug Safety Evaluation (NIFDS) conducted a nationwide human biomonitoring study, including a questionnaire survey and environmental exposure assessments for specific hazardous compounds from foods and cooking among the general population in South Korea. Results: A total of 2139 individuals voluntarily participated in 98 survey units in South Korea, including 889 (41.6%) men and 1250 women (58.4%). Bio-specimens (serum and urine) and questionnaires were collected from the study population. Acrylamides, heterocyclic amines (HCAs), phenols, and phthalates were analyzed from urine, and perfluorinated compounds (PFCs) and organic chloride pesticides (OCPs) were analyzed from serum samples. The information on exposure pathway and geographical locations for all participants was collected by questionnaire interviews, which included demographic characteristics, socioeconomic status, history of family diseases, conditions of the indoor and outdoor environment, lifestyles, occupational history, and food and dietary information. Conclusion: We describe the design of the study and sampling of human biospecimen procedures including bio-sample repository systems. The resources produced from this nationwide human biomonitoring study and survey will be valuable for use in future biomarkers studies and for the assessment of exposure to hazardous compounds associated with foods and cooking.

Water-Stable Chemical-Protective Textiles via Euhedral Surface-Oriented 2D Cu-TCPP Metal-Organic Frameworks

Abatement of chemical hazards using adsorptive metal-organic frameworks (MOFs) attracts substantial attention, but material stability and crystal integration into functional systems remain key challenges. Herein, water-stable, polymer fiber surface-oriented M-TCPP [M = Cu, Zn, and Co; H₂ TCPP = 5,10,15,20-tetrakis(4-carboxyphenyl)porphyrin] 2D MOF crystals are fabricated using a facile hydroxy double salt (HDS) solid-source conversion strategy. For the first time, Cu-TCPP is formed from a solid source and confirmed to be highly adsorptive for NH₃ and 2-chloroethyl ethyl sulfide (CEES), a blistering agent simulant, in humid (80% relative humidity (RH)) conditions. Moreover, the solid HDS source is found as a unique new approach to control MOF thin-film crystal orientation, thereby facilitating radially arranged MOF crystals on fibers. On a per unit mass of MOF basis in humid conditions, the MOF/fiber composite enhances NH₃ adsorptive capacity by a factor of 3 compared to conventionally prepared MOF powders. The synthesis route extends to other MOF/fiber composite systems, therefore providing a new route for chemically protective materials.

An Intervention Study on the Implementation of Control Banding in Controlling Exposure to Hazardous Chemicals in Small and Medium-sized Enterprises

Background

Management and workers in small and medium-sized enterprises (SMEs) often find it hard to comprehend the requirements related to controlling risks due to exposure to substances. An intervention study was set up in order to support 45 SMEs in improving the management of the risks of occupational exposure to chemicals, and in using the control banding tool and exposure model Stoffenmanager in this process.

Methods

A 2-year intervention study was carried out, in which a mix of individual and collective training and support was offered, and baseline and effect measurements were carried out by means of structured interviews, in order to measure progress made. A seven-phase implementation evolutionary ladder was used for this purpose. Success and failure factors were identified by means of company visits and structured interviews.

Results

Most companies clearly moved upwards on the implementation evolutionary ladder; 76% of the companies by at least one phase, and 62% by at least two phases. Success and failure factors were described.

Conclusion

Active training and coaching helped the participating companies to improve their chemical risk management, and to avoid making mistakes when using and applying Stoffenmanager. The use of validated tools embedded in a community platform appears to support companies to organize and structure their chemical risk management in a business-wise manner, but much depends upon motivated occupational health and safety (OHS) professionals, management support, and willingness to invest time and means.

TOXMAP: a GIS-based gateway to environmental health resources

The National Library of Medicine (NLM) has an extensive collection of environmental health information, including bibliographic and technical data on hazardous chemical substances, in its TOXNET databases. TOXNET also provides access to the United States Environment Protection Agency (EPA)'s Toxics Release Inventory (TRI) data, which covers release of specific chemicals via air, water, and land, and by underground injection, as reported by industrial facilities around the United States. NLM has developed a Web-based geographic information system (GIS), TOXMAP , which allows users to create dynamic maps that show where TRI chemicals are released and that provides direct links to information about the chemicals in TOXNET. By extracting the associated regional geographic text terms from the displayed map (e.g., rivers, towns, county, state), TOXMAP also provides customized chemical and/or region-specific searches of NLM's bibliographic biomedical resources. This paper focuses on TOXMAP's features, data accuracy issues, challenges, user feedback techniques, and future directions.