Objectives: Many studies have shown consistent associations between evident indoor dampness or mold and respiratory or allergic health effects, but causal links remain unclear. Findings on measured ...microbiologie factors have received little review. We conducted an updated, comprehensive review on these topics. Data Sources: We reviewed eligible peer-reviewed epidemiologic studies or quantitative metaanalyses, up to late 2009, on dampness, mold, or other microbiologie agents and respiratory or allergic effects. Data Extraction: We evaluated evidence for causation or association between qualitative/subjective assessments of dampness or mold (considered together) and specific health outcomes. We separately considered evidence for associations between specific quantitative measurements of microbiologie factors and each health outcome. Data Synthesis: Evidence from epidemiologic studies and meta-analyses showed indoor dampness or mold to be associated consistently with increased asthma development and exacerbation, current and ever diagnosis of asthma, dyspnea, wheeze, cough, respiratory infections, bronchitis, allergic rhinitis, eczema, and upper respiratory tract symptoms. Associations were found in allergic and nonallergic individuals. Evidence strongly suggested causation of asthma exacerbation in children. Suggestive evidence was available for only a few specific measured microbiologic factors and was in part equivocal, suggesting both adverse and protective associations with health. Conclusions: Evident dampness or mold had consistent positive associations with multiple allergic and respiratory effects. Measured microbiologic agents in dust had limited suggestive associations, including both positive and negative associations for some agents. Thus, prevention and remediation of indoor dampness and mold are likely to reduce health risks, but current evidence does not support measuring specific indoor microbiologic factors to guide health-protective actions.
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BFBNIB, DOBA, IZUM, KILJ, NMLJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
► Concentrations of NBFRs, OPFRs and HBCDs are reported in New Zealand indoor dust. ► Concentrations of OPFRs exceed those of PBDEs. ► OPFRs are the major alternative FRs. ► Estimated human exposure ...to alternative FRs is below the reference dose.
Due to worldwide restrictions on polybrominated diphenyl ethers (PBDEs), the demand for alternative flame retardants (AFRs), such as organophosphate flame retardants (OPFRs), novel brominated FRs (NBFRs) and hexabromocyclododecanes (HBCDs), has recently increased. Little is known about human exposure to NBFRs and OPFRs and that their levels in dust have been scarcely evaluated worldwide. To increase the knowledge regarding these chemicals, we measured concentrations of five major NBFRs, ten OPFRs and three HBCD isomers in indoor dust from New Zealand homes. Dust samples were taken from living room floors (n=34) and from mattresses of the same houses (n=16). Concentrations (ngg−1) of NBFRs were: 1,2-bis(2,4,6-tribromophenoxy)ethane (BTBPE) (<2–175), decabromodiphenyl ethane (DBDPE) (<5–1430), 2-ethylhexyl-2,3,4,5-tetrabromobenzoate (TBB) (<2–2285) and bis(2-ethylhexyl)-3,4,5,6-tetrabromophthalate (TBPH) (<2–640). For OPFRs, concentrations (ngg−1) ranged between: tri-ethyl-phosphate (TEP) (<10–235), tri-n-butyl-phosphate (TnBP) (<20–7545), tris-(2-chloroethyl)-phosphate (TCEP) (<20–7605), tris-(1-chloro-2-propyl) phosphate (TCPP) (20–7615), tri-(2-butoxyethyl)-phosphate (TBEP) (50–27325), tris-(2,3-dichloropropyl)-phosphate (TDCPP) (20–16560), tri-phenyl-phosphate (TPhP) (20–35190), and tri-cresyl-phosphate (TCP) (<50–3760). HBCD concentrations fell in the range <2–4100ngg−1. BTBPE, DBDPE, TBPH, TBEP, and TnBP showed significant positive correlation (p<0.05) between their concentrations in mattresses and the corresponding floor dust (n=16). These data were used to derive a range of plausible exposure scenarios. Although the estimated exposure is well below the corresponding reference doses (RfDs), caution is needed given the likely future increase in use of these FRs and the currently unknown contribution to human exposure by other pathways such as inhalation and diet.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Mercury is a widespread persistent environmental pollutant associated with adverse health effects.
This first national biomonitoring survey of blood total mercury (tHg) conducted in New Zealand aimed ...to provide baseline data and identify exposure determinants.
Blood was collected from 191 children (age 5-18 years) and 304 adults (20-65) in 2014-2016 and analysed for tHg using inductively coupled plasma mass spectrometry. Linear regression was used to assess associations with demographic and lifestyle factors.
Blood mercury was detected in 93% of children and 99% of adults, with geometric means (GMs) of 0.86 and 1.65 µg/L, respectively. The 60-65-year olds had the highest GM (2.34 µg/L). Regression indicated that tHg was 40% higher in boys compared to girls. Eating fish ≥ 3 times/week (compared to ≤once/week) was associated with 2.7 and 1.7 times higher tHg in children and adults, respectively. Shellfish consumption was also associated with higher tHg. High daily tap water consumption (≥2 L for children, ≥3 L for adults) was associated with lower tHg. In adults, smoking and milk consumption were associated with higher tHg.
Fish and shellfish consumption is a strong determinant of New Zealanders blood tHg levels, with water and milk consumption possibly acting as modulating factors.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Dust-exposed construction workers have an increased risk of respiratory symptoms, but the efficacy of dust-control measures remains unclear. This study compared respiratory symptoms, using a modified ...European Community Respiratory Health Survey questionnaire, between construction workers (n = 208) and a reference group of bus drivers and retail workers (n = 142). Within the construction workers, we assessed the effect of collective (on-tool vacuum/'wet-cut' systems) and personal (respirators) exposure controls on symptom prevalence. Logistic regression assessed differences between groups, adjusted for age, ethnicity, and smoking status. Construction workers were more likely to cough with phlegm at least once a week (OR 2.4, 95% CI 1.2-4.7) and cough with phlegm ≥3 months/year for ≥2 years (OR 2.8, CI 1.2-7.0), but they had similar or fewer asthma symptoms. Construction workers who had worked for 11-20 years reported more cough/phlegm symptoms (OR 5.1, 1.7-15.0 for cough with phlegm ≥3 months/year for ≥2 years) than those who had worked <10 years (OR 1.9, 0.6-5.8), when compared to the reference group. Those who used 'wet-cut' methods reported less cough with phlegm, although the evidence for this association was weak (OR 0.4, CI 0.2-1.1 for cough with phlegm at least once a week); use of on-tool extraction showed a similar trend. No associations between respiratory protective equipment-use and symptoms were found. In conclusion, construction workers reported more symptoms suggestive of bronchitis, particularly those employed in the industry for >10 years. Use of collective dust exposure controls might protect against these symptoms, but this requires confirmation in a larger study.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Extended-spectrum-beta-lactamase (ESBL)- or AmpC beta-lactamase (ACBL)-producing
bacteria are the most common cause of community-acquired multidrug-resistant urinary tract infections (UTIs) in New ...Zealand. The carriage of antimicrobial-resistant bacteria has been found in both people and pets from the same household; thus, the home environment may be a place where antimicrobial-resistant bacteria are shared between humans and pets. In this study, we sought to determine whether members (pets and people) of the households of human index cases with a UTI caused by an ESBL- or ACBL-producing
strain also carried an ESBL- or ACBL-producing
strain and, if so, whether it was a clonal match to the index case clinical strain. Index cases with a community-acquired UTI were recruited based on antimicrobial susceptibility testing of urine isolates. Fecal samples were collected from 18 non-index case people and 36 pets across 27 households. Eleven of the 27 households screened had non-index case household members (8/18 people and 5/36 animals) positive for ESBL- and/or ACBL-producing
strains. Whole-genome sequence analysis of 125
isolates (including the clinical urine isolates) from these 11 households showed that within seven households, the same strain of ESBL-/ACBL-producing
was cultured from both the index case and another person (5/11 households) or pet dog (2/11 households). These results suggest that transmission within the household may contribute to the community spread of ESBL- or ACBL-producing
that produce extended-spectrum beta-lactamases (ESBLs) and AmpC beta-lactamases (ACBLs) are important pathogens and can cause community-acquired illnesses, such as urinary tract infections (UTIs). Fecal carriage of these resistant bacteria by companion animals may pose a risk for transmission to humans. Our work evaluated the sharing of ESBL- and ACBL-producing
isolates between humans and companion animals. We found that in some households, dogs carried the same strain of ESBL-producing
as the household member with a UTI. This suggests that transmission events between humans and animals (or vice versa) are likely occurring within the home environment and, therefore, the community as a whole. This is significant from a health perspective, when considering measures to minimize community transmission, and highlights that in order to manage community spread, we need to consider interventions at the household level.
Contributes a meta-analysis of recent epidemiological studies investigating the links, if any, between nitrate in drinking water and increased risk of colon, rectal, and colorectal cancers. ...Elucidates commonly misunderstood elements of conclusions that may be drawn from the studies, including in particular the relationship between nitrate and nitrite, the process of endogenous nitrosation, and the conditions that result in endogenous nitrosation. Discusses the positive health effects of nitrate and the comparative impact of nitrate in drinking water to other known risk factors. Touches on the implications for policy and future research. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
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BFBNIB, CEKLJ, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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•Urinary pesticide metabolites are measured in New Zealand children for the first time.•TCPy and PYR levels are higher than measured in other countries.•TCPy levels are higher for ...children living on a farm.•Rural residence, dog ownership, and in-home pest control increase pyrethroid exposure.
This study aimed to assess pesticide exposure and its determinants in children aged 5–14 years. Urine samples (n = 953) were collected from 501 participating children living in urban areas (participant n = 300), rural areas but not on a farm (n = 76), and living on a farm (n = 125). The majority provided two samples, one in the high and one in the low spraying season. Information on diet, lifestyle, and demographic factors was collected by questionnaire. Urine was analysed for 20 pesticide biomarkers by GC–MS/MS and LC-MS/MS. Nine analytes were detected in > 80% of samples, including six organophosphate insecticide metabolites (DMP, DMTP, DEP, DETP, TCPy, PNP), two pyrethroid insecticide metabolites (3-PBA, trans-DCCA), and one herbicide (2,4-D). The highest concentration was measured for TCPy (median 13 μg/g creatinine), a metabolite of chlorpyrifos and triclopyr, followed by DMP (11 μg/g) and DMTP (3.7 μg/g). Urine metabolite levels were generally similar or low compared to those reported for other countries, while relatively high for TCPy and pyrethroid metabolites. Living on a farm was associated with higher TCPy levels during the high spray season. Living in rural areas, dog ownership and in-home pest control were associated with higher levels of pyrethroid metabolites. Urinary concentrations of several pesticide metabolites were higher during the low spraying season, possibly due to consumption of imported fruits and vegetables. Organic fruit consumption was not associated with lower urine concentrations, but consumption of organic food other than fruit or vegetables was associated with lower concentrations of TCPy in the high spray season. In conclusion, compared to other countries such as the U.S., New Zealand children had relatively high exposures to chlorpyrifos/triclopyr and pyrethroids. Factors associated with exposure included age, season, area of residence, diet, in-home pest control, and pets.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
•AGRICOH analyzed cancer incidence in >248,000 agricultural workers from 6 countries.•Cancer overall occurred less in agricultural workers than in the general population.•An excess was found for ...multiple myeloma, melanoma of the skin, and prostate cancer.•Direction of risk was largely consistent across cohorts with a few deviations.•A large deficit of larynx and lung cancers was observed in nearly all cohorts.
Agricultural work can expose workers to potentially hazardous agents including known and suspected carcinogens. This study aimed to evaluate cancer incidence in male and female agricultural workers in an international consortium, AGRICOH, relative to their respective general populations.
The analysis included eight cohorts that were linked to their respective cancer registries: France (AGRICAN: n = 128,101), the US (AHS: n = 51,165, MESA: n = 2,177), Norway (CNAP: n = 43,834), Australia (2 cohorts combined, Australian Pesticide Exposed Workers: n = 12,215 and Victorian Grain Farmers: n = 919), Republic of Korea (KMCC: n = 8,432), and Denmark (SUS: n = 1,899). For various cancer sites and all cancers combined, standardized incidence ratios (SIR) and 95% confidence intervals (CIs) were calculated for each cohort using national or regional rates as reference rates and were combined by random-effects meta-analysis.
During nearly 2,800,000 person-years, a total of 23,188 cancers were observed. Elevated risks were observed for melanoma of the skin (number of cohorts = 3, meta-SIR = 1.18, CI: 1.01–1.38) and multiple myeloma (n = 4, meta-SIR = 1.27, CI: 1.04–1.54) in women and prostate cancer (n = 6, meta-SIR = 1.06, CI: 1.01–1.12), compared to the general population. In contrast, a deficit was observed for the incidence of several cancers, including cancers of the bladder, breast (female), colorectum, esophagus, larynx, lung, and pancreas and all cancers combined (n = 7, meta-SIR for all cancers combined = 0.83, 95% CI: 0.77–0.90). The direction of risk was largely consistent across cohorts although we observed large between-cohort variations in SIR for cancers of the liver and lung in men and women, and stomach, colorectum, and skin in men.
The results suggest that agricultural workers have a lower risk of various cancers and an elevated risk of prostate cancer, multiple myeloma (female), and melanoma of skin (female) compared to the general population. Those differences and the between-cohort variations may be due to underlying differences in risk factors and warrant further investigation of agricultural exposures.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Because of the similarities in European and North American dietary exposure, it has been suggested that the order of magnitude higher body burdens in North Americans may be due to international ...variations in exposure via ingestion of indoor dust. Furthermore, ingestion of indoor dust has been suggested as a possible source of PBDEs in the blood serum of New Zealanders. Hence, polybrominated diphenyl ethers (PBDEs) were measured in domestic indoor dust from: Amarillo/Austin, Texas, US; Birmingham, UK; Toronto, Canada; and Wellington, New Zealand. Concentrations of BDE 209 in two UK samples were – at 520,000 and 100,000 ng g−1 – the highest ever recorded in a domestic (or office) indoor dust sample. Median concentrations in ng g−1 were: in Canada 620 and 560 for Σtri–hexa-BDEs and BDE 209 respectively; in New Zealand 96, BDE 209 not determined; in the UK 59 and 2,800; and in the US 1600 and 1300. With respect to BDE 209, concentrations were in the order: UK∼US>Canada. For Σtri–hexa-BDEs, the order of concentrations was US∼Canada≫New Zealand∼UK. Combined with principal component analysis of congener patterns, this suggests that, while North American dusts are contaminated by both Deca- and Penta-BDE commercial formulations, UK dusts are contaminated predominantly by Deca-BDE. The Octa-BDE formulation appears of minimal importance in accordance with available market demand figures. Despite the commercial formulations of PBDEs never having been manufactured in, nor imported into New Zealand, their presence in dusts from that country suggests international trade in PBDE-containing goods is an important pathway effecting their global distribution.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Human papillomavirus (HPV) is a common sexually transmitted infection that is implicated in 99.7% of cervical cancers and several other cancers that affect both men and women. Despite the role that ...HPV plays in an estimated 5% of all cancers and the evolving role of HPV vaccination and testing in protecting the public against these cancers, preliminary research in New Zealand health professionals suggest knowledge about HPV may not be sufficient.
A total of 230 practice nurses, smear takers and other clinical and laboratory staff who attended a range of training events completed a cross-sectional survey between April 2016 and July 2017. The survey explored four broad areas: demographics and level of experience, HPV knowledge (general HPV knowledge, HPV triage and test of cure (TOC) knowledge and HPV vaccine knowledge), attitudes towards the HPV vaccine and self-perceived adequacy of HPV knowledge.
The mean score on the general HPV knowledge questions was 13.2 out of 15, with only 25.2% of respondents scoring 100%. In response to an additional question, 12.7% thought (or were unsure) that HPV causes HIV/AIDS. The mean score on the HPV Triage and TOC knowledge questions was 7.4 out of 10, with only 9.1% scoring 100%. The mean score on the HPV vaccine knowledge questions was 6.0 out of 7 and 44.3% scored 100%. Only 63.7% of respondents agreed or strongly agreed that they were adequately informed about HPV, although 73.3% agreed or strongly agreed that they could confidently answer HPV-related questions asked by patients. Multivariate analyses revealed that knowledge in each domain predicted confidence in responding to patient questions. Furthermore, the number of years since training predicted both HPV knowledge and Triage and TOC knowledge.
Although overall level of knowledge was adequate, there were significant gaps in knowledge, particularly about the role of HPV testing in the New Zealand National Cervical Screening Programme. More education is required to ensure that misinformation and stigma do not inadvertently result from interactions between health professionals and the public.
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