Setting maximum limits for trace elements in baby food in European legislation: the outcome of International Measurement Evaluation Programme®-33

The Institute for Reference Materials and Measurements (IRMM) of the Joint Research Centre (JRC), a Directorate-General of the European Commission, operates the International Measurement Evaluation Programme® (IMEP). It organises various types of inter-laboratory comparisons in support of European Union policies. This paper presents the results of a proficiency testing exercise (PT) focusing on the determination of total cadmium (Cd) and total lead (Pb) mass fractions in baby food in support to Commission Regulation (EC) 1881/2006 of 19 December 2006 setting maximum levels for certain contaminants in foodstuffs. The test material used in this exercise was soya-based baby food formula purchased in a local pharmacy and prepared by the Reference Materials Unit of the IRMM for this exercise. Sixty-six laboratories from 23 countries registered to the exercise and 61 of them reported results. Each participant received one bottle containing approximately 15 g of test material. Participants were asked to quantify the measurands in the powder and in the reconstituted formula. Reference values independent from the participants' results were established using isotope dilution inductively coupled plasma mass spectrometry. The total Cd mass fraction was determined by IRMM and LGC Ltd (UK), while the total Pb was determined by IRMM. The standard deviation for proficiency assessment σ^ was set at 22% of the assigned value for all measurands. Laboratories were rated with z- and ζ- (zeta) scores in accordance with ISO 13528. The outcome of this exercise is clearly influenced by the very low level of Cd and Pb content in the test material which triggered: a high number of 'less than' values; overestimated values especially for Pb very likely due to contamination; and a visible method influence in the case of Pb (methods based on atomic absorption were not sensitive enough to attain such low limits of detection). The results were also evaluated with regard to the reported limit of detection and some incoherencies were observed.

Cytological stress and element uptake in moss and lichen exposed in bags in urban area

In this study cytological ultrastructure, total content of C, N and S, and cellular location of major and trace elements (K, Ca, Mg, Cu, Pb and Zn) were investigated in the moss Hypnum cupressiforme and in the lichen Pseudevernia furfuracea exposed in bags for a spring-summer 12-weeks period in the urban area of Naples city. In the moss, severe ultrastructural damages, such as membrane interruptions and dehydration, developed after exposure supporting the occurrence of a dead biomonitor. In the lichen, the post-exposure stress marks, such as the development of lysosome-like vesicles and concentric bodies, or the production of melanin, were overall compatible with life. With exposure, N, S, major and trace element contents all increased in both biomonitors, while C remained substantially unchanged. Copper and Pb were mainly retained in extracellular and particulate forms. Intracellular concentration of Zn consistently increased in both biomonitors, irrespective of their vitality. In transplants, cellular location of elements can better reflect the form in which they occur in the environment.

Improving care, reducing costs. Careful planning and ongoing education are key to a successful care management program

Introduced in 1990, the care management program at St. Peter's Medical Center, New Brunswick, NJ, has had a growing impact on the facility's operations and bottom line. To introduce the program, care managers and nursing administrators conducted in-services for nurses and other personnel. At the same time, the vice president for nursing and the project director for care management introduced the concept to members of the medical staff likely to admit patients who fell into the care management population. Once selected, St. Peter's care managers go through an extensive orientation program consisting of three weeks of classroom instruction and three weeks of on-the-job training. Classroom training emphasizes business skills necessary to facilitate effective utilization of resources while ensuring that patients' needs and concerns are understood and addressed. On-the-job training helps new care managers apply the St. Peter's care management model. This careful preparation, along with continuing education for all practitioners, has helped win support throughout the facility for the care management approach. The St. Peter's care management department currently employs eight nurse care managers who help coordinate care for 16 diagnoses.