Birger Heinzow

Human biomonitoring assessment values: Approaches and data requirements

Human biomonitoring (HBM) data is a very useful metric for assessing humans exposures to chemicals in commerce. To assess the potential health risks associated with the presence of chemicals in blood, urine or other biological matrix requires HBM assessment values. While HBM assessment values based on human exposure-response data remain the most highly valuable and interpretable assessment values, enough data exists for such values for very few chemicals. As a consequence, efforts have been undertaken to derive HBM assessment values in which external dose based guidance values such as tolerable daily intakes have been translated into equivalent biomonitoring levels. The development of HBM values by the German HBM Commission and Biomonitoring Equivalents by Summit Toxicology has resulted in conceptually similar assessment values. The review of the development of these values provided here demonstrates examples and approaches that can be used to broaden the range of chemicals for which such assessment values can be derived. Efforts to date have resulted in the publication of HBM assessment values for more than 80 chemicals, and now provide tools that can be used for the evaluation of HBM data across chemicals and populations.

Dietary intake of lead, cadmium, copper and zinc by children from the German North Sea island Amrum

The dietary intake of metals was studied in seven male and seven female children at the age of 1.5 to 5.3 years living in a remote area of Germany, the North Sea island Amrum. The dietary intake of lead and cadmium was measured by a seven-day-duplicate study using atomic absorption spectrometry. The dietary intake of copper and zinc were calculated from food diaries. The median lead and cadmium intakes were 2.1 micrograms/(kgbw x week) [range: 0.63-5.1 micrograms/(kgbw x week)] and 2.7 micrograms/(kgbw x week) [range: 1.7-4.4 micrograms/(kgbw x week)]. The median daily intake of copper and zinc were 1.1 mg/d (range: 0.54-2.5 mg/d) and 5.7 mg/d (range: 2.7-14 mg/d). Compared to the provisional tolerable weekly intake (PTWI) of 25 micrograms/(kgbw x week) proposed by the WHO the dietary intake of lead was low. The median amounted to 8.5% and the maximum to 20% of the PTWI. The cadmium intake was comparatively high. The median amounted to 39% and the maximum to 63% of the PTWI [7 micrograms/(kgbw x week)]. The median intake of copper was in the range of the values recommended by the German Society of Nutrition (0.7-1.0 mg/d and 1.0-1.5 mg/d for children at the age of 1-< 4 years and 4-< 7 years). Twenty-three percent of the calculated intakes were below these values. The median intake of zinc however did not reach the recommended dietary intake of 7 and 10 mg/d for children at the age of 1-< 4 years and 4-< 7 years.

Dietary intake of persistent organic pollutants (POPs) by German children using duplicate portion sampling.

The dietary intake of persistent organic pollutants (POPs) was studied in 14 German children at the age of 1.5 to 5.3 years from the North Sea island Amrum. A total of 98 duplicate samples were collected between April and May 1995. The sampling period for each participant was 7 days. Concentrations of POPs were measured by capillary gas chromatography and electron capture detection. The median daily intake [ng/(kgbw.day)] for the different compounds were as follows: 1.9 for alpha-HCH, 1.2 for beta-HCH, 9.5 for gamma-HCH, 4.6 for HCB, 3.4 for DDT, 11.2 for DDE, 1.1 for PCB 101, 5.1 for, PCB 138, 5.2 for PCB 153 and 2.2 for PCB 180. Compared to acceptable or tolerable daily intake (ADI/TDI) proposed by WHO and other organizations the dietary intake of POPs was low. The median values of the ADI/TDI for the POPs was less than 2.2%. The highest percentage of tolerable intake was found for the sum of PCB and amounted to 20.4%. However, compared with minimal risk levels (ATSDR), the percentage of dietary intake was much higher, especially for gamma-HCH (based on median intake: 95%), for HCB (23.1%) and for PCB (69%).

Indoor air guide values for glycol ethers and glycol esters-A category approach.

The German Committee on Indoor Guide Values issues indoor air guide values to protect public health. For health evaluation of glycol ethers and glycol esters in air, the entire group of substances with data for 47 chemicals was analyzed in order to gain a consistent assessment. For some glycol ethers reproductive and hematological effects are of central interest, whereas for others effects on liver and kidneys are crucial. Moreover, some glycol ethers have also been shown to cause irritation of the respiratory tract. For 14 chemicals, suitable inhalation studies were available for deriving specific guide values, or analogies to closely related substances could be drawn. For these chemicals individual indoor air guide values were derived, the respective guide value I ranging from 0.02 to 2mg/m(3). Guide values were derived according to the procedures issued by the Committee, considering the exposure duration in indoor air compared to animal studies or the situation at workplaces, the duration of the respective study, species differences, and interindividual variability including special sensitivity of children. For glycol ethers with insufficient data default guide values II and I of 0.05 and 0.005ppm, respectively, were recommended based on statistical analyses of the available data on all glycol ethers and on evaluation of single studies. For evaluation of combined effects additivity is assumed.

Kurzfassung der AWMF-Leitlinie medizinisch klinische Diagnostik bei Schimmelpilzexposition in Innenräumen

ZusammenfassungDie von der Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin (GHUP) federführend erstellte Leitlinie „Medizinisch klinische Diagnostik bei Schimmelpilzexposition in Innenräumen“ ist Gegenstand des vorliegenden Abschnitts. Schimmelpilzwachstum im Innenraum ist als ein potenzielles Gesundheitsrisiko zu betrachten, auch ohne dass ein quantitativer und/oder kausaler Zusammenhang zwischen dem Vorkommen einzelner Arten und Gesundheitsbeschwerden gesichert werden kann. Abgesehen von der Allergischen Bronchopulmonalen Aspergillose (ABPA) und den durch Schimmelpilze kausal verursachten Mykosen, liegen lediglich ausreichende Evidenzen für folgende Assoziationen von Feuchte-/Schimmelpilzschäden und unterschiedlichen Gesundheitseffekten vor: allergische Atemwegserkrankungen, Asthma (Manifestation, Progression, Exazerbation), allergische Rhinitis, Exogen Allergische Alveolitis, Begünstigung von Atemwegsinfekten/Bronchitis. Dabei ist das sensibilisierende Potenzial von Schimmelpilzen im Vergleich zu anderen Umweltallergenen deutlich geringer einzuschätzen. Aktuelle Studien zeigen europaweit eine vergleichsweise geringe Sensibilisierungsprävalenz von 3–10 % gemessen an der Gesamtbevölkerung. Eingeschränkte oder vermutete Evidenz für eine Assoziation liegt vor hinsichtlich „mucous membrane irritation“ und Atopischen Ekzems (Manifestation, Progression, Exazerbation). Inadäquate oder unzureichende Evidenz für eine Assoziation liegt vor für COPD, akute idiopathische pulmonale Hämorrhagie bei Kindern, Rheuma/Arthritis, Sarkoidose und Krebserkrankungen. Das Infektionsrisiko von den in Innenräumen regelmäßig vorkommenden Schimmelpilzarten ist für gesunde Personen gering, die meisten Arten sind in die Risikogruppe 1 und wenige in 2 (Aspergillus fumigatus, A. flavus) der Biostoffverordnung eingestuft. Nur Schimmelpilze, die potenziell in der Lage sind, Toxine zu bilden, kommen als Auslöser einer Intoxikation in Betracht. Ob im Einzelfall eine Toxinbildung im Innenraum stattfindet, entscheiden die Umgebungs- und Wachstumsbedingungen und hier vor allem das Substrat. Von Geruchswirkungen und/oder Befindlichkeitsstörungen kann bei Feuchte-/Schimmelpilzschäden im Innenraum grundsätzlich jeder betroffen sein. Hierbei handelt es sich nicht um eine Gesundheitsgefährdung. Prädisponierende Faktoren für Geruchswirkungen können genetische und hormonelle Einflüsse, Prägung, Kontext und Adaptationseffekte sein. Prädisponierende Faktoren für Befindlichkeitsstörungen können Umweltbesorgnisse, -ängste, -konditionierungen und -attributionen sowie eine Vielzahl von Erkrankungen sein. Besonders zu schützende Risikogruppen bezüglich eines Infektionsrisikos sind Personen unter Immunsuppression nach der Einteilung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut (RKI) und Personen mit Mukoviszidose (Zystischer Fibrose), bezüglich eines allergischen Risikos Personen mit Mukoviszidose (Zystischer Fibrose) und Personen mit Asthma bronchiale. Die rationale Diagnostik beinhaltet die Anamnese, eine körperliche Untersuchung, eine konventionelle Allergiediagnostik einschließlich gegebenenfalls Provokationstests, vereinzelt sind auch zelluläre Testsysteme indiziert. Zum Vorgehen bei Schimmelpilzinfektionen wird auf die angemeldete AWMF-Leitlinie Diagnose und Therapie invasiver Aspergillus-Infektionen verwiesen. Hinsichtlich Mykotoxine existieren zurzeit keine brauchbaren und validierten Testverfahren, die in der klinischen Diagnostik eingesetzt werden könnten. Präventivmedizinisch ist wichtig, dass Schimmelpilzbefall in relevantem Ausmaß aus Vorsorgegründen nicht toleriert werden darf. Zur Beurteilung des Schadensausmaßes und zum Vorgehen wird auf den „Schimmelpilzleitfaden“ des Umweltbundesamtes verwiesen.

Waste incineration: estimation of the workers' internal exposure to PCB, PAH chlorophenols and other relevant agents

Fifty-four persons occupied in a municipal waste incinerator were examined with respect to their internal exposure to organic substances which are possibly produced during pyrolysis of organic matter. For this purpose the levels of benzene of blood, polychlorinated biphenyls (PCB) and hexachlorobenzene (HCB) in plasma as well as mono- (MCP), di- (DCP), tri- (TCP), tetra- (TECP) and pentachlorophenols (PCP) and hydroxypyrene in urine have been determined. Four hundred thirty-one men and women were examined for control purposes. Statistical significantly higher values for the workers were found for the excretion of hydroxypyrene 2,5/2,4-DCP, 2,4,5 TCP, and for the HCB level in plasma. For the concentrations of 4-MCP and 2,3,4,6-2,3,5,6-TECP the controls had significantly higher concentrations in urine than the workers in the incineration plant. No significant differences between workers and controls were detected with respect to benzene in blood, 2,4,6-TCP and PCP in urine, and to the levels of PCP congeners in plasma. The elevated levels of hydroxypyrene, 2,4-/2,5 DCP, 2,4,5-TCP, and HCB in biological material may be related to the incineration of the waste. These elevations, however, are very small and attract attention more from the environmental than from the occupational point of view.