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An overview of brominated flame retardants in the environment.

The presence of brominated flame retardant (BFR) chemicals, and particularly polybrominated diphenyl ethers (PBDEs), tetrabromobisphenol A (TBBPA) and hexabromocyclododecane (HBCD), has become of increasing concern to scientists over the past decade. Environmental studies conducted primarily in Europe, Japan and North America indicate that these chemicals are ubiquitous in sediment and biota. The levels of PBDEs seem to be increasing, and several trends, including in humans, indicate that this increase may be rapid. The occurrence of high concentrations of certain PBDE isomers may be sufficient to elicit adverse effects in some wildlife. There is also concern that levels could cause adverse effects in sensitive human populations such as young children, indigenous peoples, and fish consumers. However, our knowledge about these chemicals, their sources, environmental behavior, and toxicity is limited, making risk assessment difficult. In this paper, the current state of knowledge is reviewed and areas for further research recommended to improve future monitoring and risk assessment efforts.

Animals↗

Headache, stomachache, backache, and morning fatigue among adolescent girls in the United States: associations with behavioral, sociodemographic, and environmental factors.

BACKGROUND: Data on the prevalence and co-occurrence of multiple somatic symptoms among US adolescent females as they are influenced by sociodemographic, behavioral, and environmental factors is limited. OBJECTIVES: To describe the health status of adolescent US females measured by the prevalence, frequency, and co-occurrence of headache, stomachache, backache, and morning fatigue and to investigate associations between selected risk and protective factors. DESIGN, SETTING, AND PARTICIPANTS: School-based, cross-sectional, nationally representative survey of adolescents in the 6th through 10th grades in the US. Data collected between 1997 and 1998. MAIN OUTCOME MEASURES: Prevalence of headache, stomachache, backache, and morning fatigue. RESULTS: Among US adolescent girls, 29.1% experience headaches, 20.7% report stomachaches, 23.6% experience back pain, and 30.6% report morning fatigue at the rate of more than once a week. Co-occurrence of somatic complaints is common. Among girls who experienced headaches more than once a week, 3.2 million (53.3%) also reported stomach pain more than once a week and 4.1 million (74.3%) reported morning fatigue more than once a week. Heavy alcohol use, high caffeine intake, and smoking cigarettes every day were strongly associated with all symptoms, while parent and teacher support served as protective factors. CONCLUSIONS: Somatic complaints of headache, stomachache, backache, and morning fatigue are common among US adolescent girls and co-occur often. Effective clinical treatment of this population requires comprehensive assessment of all female adolescents presenting with seemingly isolated somatic complaints.

Abdominal Pain↗

Neurotransmitter modulation of steroid action in target cells that mediate reproduction and reproductive behavior.

Two major functional interactions between steroid hormones and neurotransmitters are generally recognized. First, steroids affect neurotransmission, and second, through effects on hypothalamic peptides that regulate anterior pituitary function neurotransmitters affect steroid secretion. In recent years, evidence has accumulated which indicates that neurotransmitters can also affect steroid action within postsynaptic steroid target cells. We review evidence for this relationship in pineal, uterus and hypothalamus and propose that the modulation of target cell responsiveness to steroids is an important mechanism by which neurotransmitters affect steroid-dependent processes. The operation of such a mechanism provides a means for environmental, behavioral and emotional events to rapidly and selectively alter steroid effects on behavior and physiology.

Animals↗

A comparison of blacks and whites seeking treatment for chronic pain.

OBJECTIVE: Most conceptualizations of chronic pain acknowledge the importance of culture and social circumstances. Cultural and social influences may differ for persons of different racial or ethnic groups, and this circumstance may lead them to experience and adjust differently to pain. The current study compared adjustment to chronic pain by blacks and whites seeking treatment for chronic pain. SUBJECTS AND MEASURES: Fifty-seven black and 207 white patients completed measures of anxiety, depression, disability, pain, and physical symptoms during their initial visit to a university pain clinic. RESULTS: Comparisons showed that the groups did not differ with regard to age, sex, education, chronicity of pain, pain location, work status, previous surgeries, medical diagnosis, medication, wage replacement, or involvement in litigation. However, the black group reported higher pain severity, more avoidance of activity, more fearful thinking, more physical symptoms, and greater physical and psychosocial disability. The groups remained significantly different with regard to avoidance, fearful thinking, and physical symptoms after pain severity was statistically controlled for; however, they did not remain different on disability. CONCLUSIONS: These results show that blacks and whites with chronic pain experience pain differently. Several factors may underlie these differences, including family situation, health care experiences, or other unmeasured behavioral, environmental, or social influences. Other investigators should attempt to replicate these findings and more closely examine variables that may explain them.

Adaptation, Psychological↗

The proximate determinants of fertility in populations exposed to chronic hypoxia.

It has been hypothesized that hypoxia reduces fertility, but comparative studies of high and low altitude populations have been unable to verify or refute this proposal because it is difficult to control for the behavioral and sociocultural factors that may also either underlie fertility differentials or compensate for physiological changes caused by varying partial pressure of oxygen. Taken collectively, estimates of fertility in populations exposed to chronic hypoxia range widely and do not suggest any reproductive patterns specific to high altitude. Here we review the available data from the Andes and the Himalaya on the proximate determinants of fertility, that set of factors through which any and all environmental, behavioral, and sociocultural factors must act to influence fertility levels. Although hypoxia could potentially affect some of these factors, there is no unequivocal evidence that this occurs in human populations indigenous to high altitude. At this time, it appears that local variations in infant feeding beliefs and practices, often coupled with prolonged breast-feeding, play a major role in determining fertility variation in Andean populations. In the Himalaya, large numbers of adults are not in sanctioned sexual unions as a consequence of polyandrous marriage practices and religious celibacy. The absence of a clear negative effect of hypoxia on fertility in populations indigenous to high altitude, even though migrants report reproductive difficulties, argues that these populations have adapted to the conditions at high altitude. The experimental and clinical evidence presented in this issue suggests proximate mechanisms by which such adaptation, shaped by natural selection and developmental processes, is possible.

Abortion, Spontaneous↗

Behavioral self-management in treating sleep-maintenance insomnia.

Three controlled case studies are presented to demonstrate the application of behavioral self-management to two subtypes of sleep-maintenance insomnia. Patient 1 suffered from brief but frequent arousals to wakefulness and to NREM Stage 1 sleep. Patient 2 suffered from brief but frequent arousals and extended minutes awake after sleep onset. Patient 3 suffered from an extended latency to sleep onset and also extended minutes awake after sleep onset. The self-management treatment program was designed to teach these patients skills for identifying and modifying environmental, behavioral, physiological, and cognitive conditions related to poor sleep. Results are documented using home and laboratory all-night sleep recordings during treatment and at 3 and 12 months following the end of treatment.

Adult↗

Reciprocal influences among adrenocortical activation, psychosocial processes, and the behavioral adjustment of clinic-referred children.

The reciprocal effects among cognitive-behavioral, environmental, and biological influences on clinic-referred children's (N = 64; 34 boys; M age 12.71 years) short-term psychological and psychiatric adjustment were studied. At clinic intake and 6 months later, standardized measures of adjustment and control-related beliefs were assessed. Before and after conflict-oriented parent-child interaction tasks the children's saliva was sampled. Adrenocortical responses (i.e., increases in salivary cortisol) to the social conflict task predicted children's internalizing problem behaviors and anxiety disorders at follow-up. Consistently high adrenocortical reactivity at intake and follow-up was associated with deflated social competence over the 6-month period. Also, specific patterns of discontinuity in children's internalizing behavior problems predicted individual differences in their subsequent adrenocortical responsiveness. Specifically, rising behavior problem levels across time predicted higher and declining behavior problem levels predicted lower adrenocortical reactivity at follow-up. Findings are among the first to suggest links among internalizing behavior problems, adrenocortical responsiveness to social challenge, and clinic-referred children's short-term cognitive-behavioral and emotional adjustment.

Adolescent↗

Environmental factors and aggressive behavior.

This paper briefly reviews some of the research areas which indicate a correlation between environmental factors and initiation of aggressive behavior. Environmental factors including lunar influences, month of birth, climate and the effects of crowding and certain chemicals are discussed.

Aggression↗

Different behavior of tetracyclines and sulfonamides in sandy soils after repeated fertilization with liquid manure.

Recently we showed that tetracyclines tend to persist and may accumulate in sandy soils after repeated fertilizations with liquid manure. We continued these field investigations from 2001 to 2003 and observed no further accumulation of tetracyclines in soil, but found that the average tetracycline concentration remained higher than 150 microg/kg soil. From 2000 to 2002, approximately 330 g tetracycline, 7 g chlortetracycline, 28 g sulfamethazine, and 57 g sulfadiazine per hectare were transferred via liquid manure to the topsoil (0-30 cm). Nevertheless, no leaching of tetracyclines into deeper soil segments or groundwater was observed. Furthermore, we developed new analytical methods for the detection of various sulfonamides in liquid manure, soil, and groundwater. Investigation of the same fields used in the tetracycline study showed that sulfamethazine occurred in concentrations approximately two orders of magnitude lower than that of tetracycline in the plow layer. Although there apparently were very low concentrations of sulfamethazine in soil, we detected it in groundwater sampled by suction probes at 1.4 m below soil surface in the spring of 2002. Further investigations confirmed these findings. To our knowledge, this is the first direct evidence of continuous leaching of a veterinary drug from soil into groundwater under field conditions. We conclude that tetracyclines and sulfonamides show distinctly different environmental behaviors. One explanation may be their different sorption coefficients in soil, indicating (in part) their different mobilities in this ecosystem.

Adsorption↗

[Sorption characteristics of phenanthrene on sediments from Chinese southern rivers and lakes].

The sorption/desorption behavior of phenanthrene in five aquatic sediments from Chinese southern rivers and lakes were studied using multiple cycles of sorption/desorption experiments. The results showed that the sorption of phenanthrene on sediments was proportional to the content of organic carbon and that there were irreversible sorption processes. When the total sorption was separated into reversible and irreversible fractions, reversible sorption of phenanthrene on sediments could be better predicted by its partitioning between water and organic carbon phase. It was concluded that the sediment organic carbon could be the essential factor that controlling the environmental behavior of polycyclic aromatic hydrocarbon in aquatic sediment under study and the ecological risk should associated also with the irreversibility of the sorption processes.

Adsorption↗

Use of sleep hygiene in the treatment of insomnia.

Sleep hygiene (SH) refers to a list of behaviors, environmental conditions, and other sleep-related factors that can be adjusted as a stand-alone treatment or component of multimodal treatment for patients with insomnia. This paper presents a review of SH, how this concept has been applied and often modified over the past 24 years, and how it relates to the modern sleep disorder nosology, particularly Inadequate Sleep Hygiene. Although a recognized and commonly utilized treatment option, there is no absolute consensus about which steps must be included to constitute SH treatment, and there is much overlap between SH and other cognitive-behavioral treatments for insomnia such as Stimulus Control Procedures and Sleep Restriction Therapy. The literature on the effects of manipulations of individual components of SH under experimental conditions (e.g. effects of presleep alcohol or caffeine intake) in normal sleepers show mixed results. Empirical data demonstrating the role of poor SH as a contributor to insomnia, or showing that good SH improves sleep in patients with insomnia, is not available. Instead of evaluating the impact of a comprehensive list of SH recommendations, a focus on guidelines for use of individual rules is needed.

Body Temperature↗

Risk characterization, assessment, and management of organic pollutants in beneficially used residual products.

A wide array of organic chemicals occur in biosolids and other residuals recycled to land. The extent of our knowledge about the chemicals and the impact on recycling programs varies from high to very low. Two significant challenges in regulating these materials are to accurately determine the concentrations of the organic compounds in residuals and to appropriately estimate the risk that the chemicals present from land application or public distribution. This paper examines both challenges and offers strategies for assessing the risks related to the occurrence of organic compounds in residuals used as soil amendments. Important attributes that must be understood to appropriately characterize and manage the potential risks for organic chemicals in biosolids include toxicity and dose response, transport potential, chemical structure and environmental stability, analytical capability in the matrix of interest, concentrations and persistence in waste streams, plant uptake, availability from surface application versus incorporation, solubility factors, and environmental fate. This information is complete for only a few chemicals. Questions persist about the far greater number of chemicals for which toxicity and environmental behavior are less well understood. This paper provides a synopsis of analytical issues, risk assessment methodologies, and risk management screening alternatives for organic constituents in biosolids. Examples from experience in Wisconsin are emphasized but can be extrapolated for broader application.

Agriculture↗

Source and behavior analyses of dioxins based on congener-specific information and their application to Tokyo Bay basin.

Identification of pollution sources and estimation of their contribution to dioxin pollution are important for taking better countermeasures against such sources. The information based on seventeen 2,3,7,8-chlorine-substituted congeners and 10 homologues is usually not sufficient for source identification. The usefulness of detailed congener-specific information of tetra- to octachlorinated polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans was examined by principal component analysis and compared with conventional dioxin information. It was revealed that congener-specific information was far more effective for source identification than conventional information. For source apportioning, it was shown that multiple regression analysis with detailed source congener profiles could be carried out successfully when calculations were performed for individual homologues. This was because of the large variation in homologue composition in source dioxin profiles in addition to the difference in environmental behavior among the homologues. The newly proposed methods for statistical analysis were applied to the estimation of dioxin mass balance in Tokyo Bay basin. It was found that Tokyo Bay sediment core contained dioxins from three major sources: combustion, pentachlorophenol (PCP), and chloronitrophen (CNP). PCP and CNP contained large amounts of dioxin as impurity and were used extensively as paddy field herbicides in Japan in the past. The total dioxin load from the two herbicides to the basin during the past 45 years (1951-1995) was estimated to be five times larger than that from combustion source in terms of toxic equivalents (WHO-TEQ). However, in the surface sediment of the bay, the contribution from the herbicides was nearly equal to that from combustion. The herbicide contribution peaked during the 1960s and 1970s and gradually decreased thereafter.

Agriculture↗

Risk factors for late relapse in male and female ex-smokers.

Three hundred twenty-nine ex-smokers (149 males and 180 females) who had maintained abstinence for at least 3 months prior to intake were followed for a period of 1 year to ascertain individual characteristics from cognitive, behavioral, environmental, and health domains that were predictive of later relapse. Multiple logistic regression analysis revealed significant associations between relapse, family history, and stress variables in males and between relapse, family history, stress, pre- and postcessation smoking characteristics, work-related variables, and physical activity in females. Within the predictor sets, both risk and protective factors were identified. The male and female models are discussed separately, compared, and related to previous research. Implications for further model development are specified; most notably, the utility of conceptualizing relapse independent of gender is questioned. Future research efforts could focus on the role played by family smoking history in adult relapse behavior. Smoking cessation interventions may need to tailor their efforts specifically to men and to women. Along with techniques to manage stress both during and after cessation, women may benefit especially from interventions that provide nicotine replacement and counseling for work-related difficulties.

Adult↗

Environmental biochemistry of chromium.

Chromium is a d-block transitional element with many industrial uses. It occurs naturally in various crustal materials and is discharged to the environment as industrial waste. Although it can occur in a number of oxidation states, only 3+ and 6+ are found in environmental systems. The environmental behavior of Cr is largely a function of its oxidation state. Hexavalent Cr compounds (mainly chromates and dichromates) are considered toxic to a variety of terrestrial and aquatic organisms and are mobile in soil/water systems, much more so than trivalent Cr compounds. This is largely because of differing chemical properties: Hexavalent Cr compounds are strong oxidizers and highly soluble, while trivalent Cr compounds tend to form relatively inert precipitates at near-neutral pH. The trivalent state is generally considered to be the stable form in equilibrium with most soil/water systems. A diagram of the Cr cycle in soils and water is given in Fig. 6 (Bartlett 1991). This illustration provides a summary of environmentally relevant reactions. Beginning with hexavalent Cr that is released into the environment as industrial waste, there are a number of possible fates, including pollution of soil and surface water and leaching into groundwater, where it may remain stable and, in turn, can be taken up by plants or animals, and adsorption/precipitation, involving soil colloids and/or organic matter. Herein lies much of the environmental concern associated with the hexavalent form. A portion of the Cr(VI) will be reduced to the trivalent form by inorganic electron donors, such as Fe2+ and S2-, or by bioprocesses involving organic matter. Following this conversion, Cr3+ can be expected to precipitate as oxides and hydroxides or to form complexes with numerous ligands. This fraction includes a vast majority of global Cr reserves. Soluble Cr3+ complexes, such as those formed with citrate, can undergo oxidation when they come in contact with manganese dioxide, thus reforming hexavalent Cr. In trace amounts, Cr is an essential component of animal nutrition, functioning mainly in glucose metabolism, and possibly in fat metabolism. While shown to be nonessential for plants, it is required by some microbes, possibly as a cofactor for specific enzyme systems. Bacteria with plasmid-conferred resistance to Cr(VI) have been isolated from water, soil, and sediments, and the resistance mechanisms have been somewhat characterized. One of the chief mechanisms is bioreduction of toxic Cr(VI) to the relatively nontoxic Cr(III). This has been shown to occur directly, by enzymatic processes at the cell membrane, and indirectly, with microbially produced H2S acting as the reductant.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Environmental risk assessment of pharmaceutical drug substances--conceptual considerations.

Drugs, i.e. active ingredients of human medicinal products, may be introduced into the environment after use in patients by sewage effluent pathways and consequently are detected at low concentrations in sewage effluents and in surface waters. Legal requirements in a number of geographical regions (Europe, US, and intended in Canada) demand environmental risk assessments (ERA) for new drug substances. Existing regulatory concepts of ERA are based initially on a set of short-term ecotoxicological studies in three to four different species, environmental behavior and the application of assessment factors to correct for the ERA inherent uncertainty. Based on theoretical considerations and the experience with a very limited, but well investigated, number of examples while considering that drugs are highly biologically active compounds, the appropriateness of this risk assessment procedure for all drug substances might be questioned. Indeed, e.g. long-term effects may occur at much lower concentrations and follow different toxicodynamic mechanism than extrapolated from short-term studies., In such cases, the application of assessment factors for deriving chronic no-observed effect concentration (NOECs) appears to be problematic. Although long-term tests with a variety of organisms would provide a complete database for the evaluation of the environmental risks, this is unachievable for all drugs due to time, money and animal welfare constraints. In order to avoid unnecessary testing, a concept is presented, which makes use of pharmacological and toxicological, as well as pharmaco- and toxicokinetic information derived from mammals during drug substance development. Useful data for adoption in a case-by-case testing strategy can be obtained by evaluating (a) the pharmacological activity, which indicates specific targets in mammalian species and may allow for an analysis, whether a similar target is available in aquatic species; (b) the mammalian toxicity, which may indicate, which targets are most susceptible to adverse effects; (c) the difference between acute and chronic effects in mammals, since the magnitude of this difference may indicate, whether long-term effects are expected at significantly lower levels than acute effects; (d) the (pharmacologically and toxicologically) effective plasma levels in mammalian test organisms, which may be compared with the relevant exposure scenario for the environment. Additionally, activity classes of compounds may be established based on experience with specific substances, in order to develop an appropriate test strategy. The above preliminary considerations should support decisions on the selection of candidate substances for chronic effects studies and for the appropriate selection of test species and endpoints to monitor. Generally, ecologically relevant endpoints such as impairment of growth, development and reproduction should be used to assess the ecotoxicologic effects.

Animals↗

The chemical industry: challenges and opportunities through the year 2000.

Three major areas are discussed regarding future challenges and opportunities for the chemical industry: (1) product qualities, (2) the waste situation, and (3) monitoring needs in industry and the environment. It is stressed that there remains much to be done with respect to improving safety testing and assessment of chemicals and that our knowledge of the environmental behavior of existing chemicals is dismal. The currently rather unsatisfactory information transfer situation is highlighted. Regarding waste production, in principle, the chemical industry must develop and operate closed systems to the extent that is technically feasible. In the area of monitoring, a new generation of "key indicators" must be developed. These indicators will be symptom oriented and capable of reacting to and indicating the presence of biologically active agents of unknown nature or variety. They can thus detect unexpected changes in the environment and allow assessment of the biological relevance of emissions and effluents of unknown chemical compositions. Regarding exposure changes, a new analytical approach is suggested in the form of "Exposure-Trend-Analysis Systems" (ETAS), which optimize the detection of unexpected concentration trends in environmental matrices without focusing on preselected chemicals. It is suggested that the chemical industry can meet all reasonable demands for improving its performance in protecting the environment, provided that governments and the industry itself cooperate on an international level--beyond the European Common Market.

Air Pollutants↗

Healthcare needs of HIV-infected persons in hospital, outpatient, home, and long-term care settings.

In this descriptive study, healthcare needs reported by 386 HIV-infected persons from all risk categories and their primary nurses from four care settings (hospital, outpatient, long-term care, and home) are identified. Healthcare needs were classified into four domains of nursing practice using a conceptual framework from community health nursing--physiologic, psychosocial, health behaviors, environmental--and were assessed using the Healthcare Needs Scale for Patients with HIV/AIDS. Nurses' perceptions of major healthcare needs across all settings centered around decreased physical endurance, limited physical mobility, and sensory deficits. Patients' needs focused on financial issues. The results reflect the multidimensional nature of this infection and provide direction for clinical practice.

Activities of Daily Living↗