Roshini Peiris-John

Impact of low-level exposure to organophosphates on human reproduction and survival

Despite their widespread and longstanding use for the public good, organophosphate (OP) pesticides have led to many adverse effects on human health. Environmental exposure to OPs and adverse reproductive outcomes in men and women working on or living near farms are increasingly reported worldwide. The aim of the current review is to determine whether exposure to OPs, at levels lower than that which results in clinical manifestations of acute OP poisoning, leads to an adverse impact on fertility, growth and development, and to highlight possible effects for further investigation. There is evidence of impaired fertility due to a reduction in semen quality and possibly lower testosterone levels in exposed males. There is also evidence of impairment of fetal growth and development brought about by prenatal exposure to OPs. Paraoxonase gene (PON1) activity in the fetus and during early childhood makes the fetus and child more vulnerable to OP poisoning, suggesting that OP exposure has a greater impact on fetal and infant growth and development than on adults when exposed to the same concentrations of pesticides. This review raises concerns that exposure to OP pesticides at levels currently regarded as safe adversely affect human reproductive function and survival.

Could ochratoxin A in food commodities be the cause of chronic kidney disease in Sri Lanka

Ochratoxin A (OA) is a naturally occurring mycotoxin with nephrotoxic properties that can contaminate plant food products. OA concentrations were assessed in commonly consumed food items in the North Central Province of Sri Lanka, where chronic kidney disease is diagnosed at epidemic proportions. Ninety-eight randomly selected food samples were analysed. Mycotoxin was detected in the extract by using a MycoMonitor Ochratoxin A ELISA assay kit (Helica Biosystems Inc., USA). The levels of OA found in these food commodities were below the recommended statutory maximum limit and are unlikely to be a potential risk factor for nephropathy in the North Central Province of Sri Lanka.

Fetal effects of environmental exposure of pregnant women to organophosphorus compounds in a rural farming community in Sri Lanka

Background. The possible deleterious effects of low-grade, chronic environmental and occupational exposure to organophosphorus compounds (OPCs) are not well documented. Objective. To investigate the possible effects of low-level, chronic exposure of pregnant mothers to OPCs on the fetus by measuring OPC levels, and using markers of OPC exposure, oxidative stress and oxidative tissue damage. Methods. Toxicity was assessed by measuring (i) OPC levels in breast milk and plasma from maternal and cord blood using gas chromatography, (ii) maternal and fetal butyrylcholinesterase (BChE) activity using inhibition assays, (iii) antioxidant status of the fetus using superoxide dismutase activity assays, (iv) oxidative stress in the fetus by determining malondialdehyde (MDA) concentrations, and (v) examining for fetal DNA fragmentation using electrophoresis. Samples were obtained from consenting mothers living in a farming community in southern Sri Lanka at the end of the pesticide spray season (study group) and just before the commencement of the spray season (in-between spray season; control group). Results. Organophosphate residues were detected in only two subjects (chlorpyrifos in maternal and cord blood of one during the spray season and dimethoate in breast milk of another during the in between spray season), but the test employed was capable of only detecting concentrations above 0.05mg/l. However, cord blood obtained during the spray season showed significant inhibition of BChE activity, increased oxidative stress and more DNA fragmentation when compared with cord blood obtained during the in-between spray season. Conclusions. Inhibition of cord blood BChE activity indicates fetal exposure to organophosphorus compounds during times when there is a high probability of environmental drift. This provides a plausible explanation for the increased oxidative stress and high DNA fragmentation in the fetus. Long-term outcomes of such exposures are unknown.

PW 0474 Crash characteristics and patterns of injry among hospitalised road traffic crash victims in urban sri lanka

Road traffic crashes (RTC) and consequent injuries constitute a global threat to public health disproportionately borne by low-and-middle-income countries. With rapid urbanisation and increased motorisation, RTC is identified as one of the leading causes of death and injury in Sri Lanka. This study aimed to describe crash characteristics and patterns of injury among victims of RTCs admitted to a tertiary-care state hospital in Colombo, the capital of Sri Lanka. Recorded data on all victims of RTCs admitted to the Colombo South Teaching Hospital from 01.01.2017 to 31.03.2017 were systematically extracted and analysed. Of the 573 victims, 468 (82%) were males and 47% were aged 21–40 years (overall range: five months to 90 years). Almost half the victims (49%) were motorcyclists or pillion riders, and pedestrians and three-wheeled vehicle occupants contributed a further 21% each. Higher proportions of crashes occurred between 12 noon to 3 pm (19%) and 6 pm to 9 pm (19%). The lower and upper limbs (55%) and head/face/neck (34%) were the commonest body regions injured. Abrasions/contusions/lacerations (74%) and fractures (32%) were the commonest types of injuries sustained. Eight percent of abdomino-pelvic injuries presented with internal bleeding and 7% of head injuries presented with intra-cranial bleeding. The in-hospital case-fatality was 3% (n=17). The mean and median lengths of hospital stay were 2.6 and 1 days, respectively (range: one to 37 days). At discharge, 38% of patients had significant disabilities or restrictions in function with recommended on-going care through rehabilitation/physiotherapy or outpatient services. The majority of RTC victims admitted to hospital were males, young adults, and people sustaining head and limb injuries and almost 40% required post-discharge health care. Victims were largely riders/occupants of 2–3 wheeled motor vehicles or pedestrians, indicating the critical need for national road safety initiatives that particularly focus on risks to these vulnerable road users.

PW 0473 Travel behaviours and barriers for transport safety of older adults in sri lanka

Mobility and social participation greatly enhance the well-being and quality of life of older adults. A rapid increase in older populations together with comorbidities in the process of ageing have important implications for transport policies globally, and especially in low-and-middle-income countries. This study aimed to explore older adults’ travel behaviours and challenges for transport safety in Sri Lanka, where the demographic transition and non-communicable disease burden make older people and those living with disability particularly vulnerable to road traffic injury. Utilising registers of Social Services Departments of three Divisional Secretariats in the Colombo district, a random household travel survey recruited 90 older people aged 60 years and above. An interviewer-administered questionnaire explored participants’ travel patterns and barriers to safe transportation. Nearly 50% of participants had primary education or less. Almost 80% earned less than Rs. 20 000 (US

Chronic renal failure in North Central Province of Sri Lanka: an environmentally induced disease

130) per month. A total of 80% of participants reported disabilities such as visual impairments (33.3%) and arthritis (33.3%). A 48 hour travel record showed that 73% of participants travelled mainly to community meetings (26% of trips), the majority doing so by foot (37%) or using public buses (36%). Pedestrians reported risks of injury, poor road conditions, and reckless driving as important concerns influencing travel. Public transport users reported unfavourable vehicular designs and services, unavailability of seats, and negative attitudes of service providers as important barriers. Poor public transport systems have resulted in perceived injury risks and related missed opportunities for mobility, delays in getting services, and financial burdens on older adults. The travel patterns, constraints and perceptions reported by older Sri Lankans emphasize the need to implement age and disability friendly road designs and transportation systems alongside increased public awareness of needs of older people. Policy implications based on this knowledge will promote safe transportation and well-being of these communities.