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Aflatoxins, a known carcinogen and modifiable risk factor
Benefits and Adverse Events of HPV Vaccination
TCDD, the Most Hazardous Environmental Contaminant, Accumulates in Humans
Environmental Contamination by Toxicants Released from E-waste Recycling Increases Health Risk
Radon Gas Causes Lung Cancer--Get the Message!
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Wei Cao, PhD Institute of Materia Medica, School of Pharmacy, Fourth Military Medical University, Xiaokai Zhang, Siwang Wang
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caowei{at}fmmu.edu.cn Wei Cao, et al.
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Dear Editor: Aflatoxins, derivatives of dihydrofuran coumarin, are food-borne secondary toxic metabolites produced by many strains of Aspergillus flavus and Aspergillus parasiticus which are especially abundant in areas of the world with hot, humid climates. Aflatoxin B1 (AFB1), the most abundant and potent of aflatoxins [1], is a well-known hepatocellular carcinoma (HCC) risk factor, and has been classified as a group I human carcinogen by the IARC in 1993. Aflatoxins are associated with acute toxicity, teratogenicity, mutagenicity, and carcinogenicity in human and animal populations. Acute exposure of aflatoxins can result in aflatoxicosis, which manifests as severe, acute hepatotoxicity with a case fatality rate of approximately 25% [2]. Furthermore, HCC as a result of chronic exposure of aflatoxins has been well documented, particularly in individuals already exposed to hepatitis B. In previous case-control studies involving 18,244 urine samples collected in Shanghai, China, aflatoxins exposure yielded a relative risk of 2.4 [3]. Recently, in the Taiwan cohort follow-up, aflatoxins were associated with a statistically increased risk of HCC up to 3-fold [4]. Aflatoxins, most of which occur naturally, are very stable at high temperatures, with little or no destruction occurring under ordinary cooking conditions or during pasteurization [5]. But their occurrence in food could be mitigated or prevented with the current state of agricultural knowledge and public health practice. After years of efforts, although control strategies have mostly eliminated harmful exposures in developed countries, AFT-associated health effects still pervade the developing world, such as China. Over 5 billion people in developing countries worldwide are at risk of chronic exposure to aflatoxins through contaminated food [6]. The low relative risk of HCC in developed countries proves that aflatoxin is a modifiable risk factor. Furthermore, biomonitoring of aflatoxins can be done by analyzing the aflatoxins-albumin adducts and aflatoxins metabolites in blood, milk, or urine. Therefore, an effective strategy for monitoring aflatoxins levels in food combined with biomonitoring of aflatoxins in vivo and vaccination against hepatitis B virus in developing countries is a top priority. Yours sincerely, Xiaokai Zhang, MD
Institute of Materia Medica, School of Pharmacy, Fourth Military Medical University; Xi'an, Shaanxi 710032; China. Correspondence: Wei Cao, PhD, e-mail: caowei@fmmu.edu.cn References 1. Wild CP, Gong YY. Mycotoxins and human disease: a largely ignored global health issue. Carcinogenesis. 2010;31:71-82. 2. Strosnider H, Azziz-Baumgartner E, Banziger M, et al. Workgroup report: public health strategies for reducing aflatoxin exposure in developing countries. Environ Health Perspect. 2006;114:1898-1903. 3. Ross RK, Yuan JM, Yu MC, et al. Urinary aflatoxin biomarkers and risk of hepatocellular carcinoma. Lancet. 1992;339:943-946. 4. Wu HC, Wang Q, Yang HI, et al. Aflatoxin B1 exposure, hepatitis B virus infection, and hepatocellular carcinoma in Taiwan. Cancer Epidemiol Biomarkers Prev. 2009;18:846-853. 5. McLean M, Dutton MF. Cellular interactions and metabolism of aflatoxin: an update. Pharmacol Ther. 1995;65:163-192. 6. Williams JH, Phillips TD, Jolly PE, et al. Human aflatoxicosis in developing countries: a review of toxicology, exposure, potential health consequences, and interventions. Am J Clin Nutr. 2004;80:1106-1122. |
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Souhail Alouini, MD, PhD, Gynecologist Surgeon Centre Hospitalier Regional d'Orléans, 45000, France
Send letter to journal:
alouini.s{at}wanadoo.fr Souhail Alouini
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Elizabeth T. H. Fontham et al. [1] cited human papillomavirus vaccination among cancer prevention means. However, the preventive action against cervical cancer is uncertain [2] and serious adverse events after immunization were reported. Indeed, the vaccination was recognized as effective only against cervical precancerous lesions caused by HPV 16 and 18 serotypes [3]. In a recent paper [4] co-authored by the FDA and the CDC, 12 424 adverse events were reported after vaccination between June 2006 and December 2008 (53.9/100 000 doses). 772 were serious adverse events after immunization. Among them there were 32 deaths. Disproportional rates of syncope and venous thromboembolic events were also reported. Consequently, girls and their parents should be well informed on known benefits and adverse effects of the human papillomavirus vaccination before consenting to be vaccinated. References 1. Fontham ET, Thun MJ, Ward E, et al; ACS Cancer and the Environment Subcommittee. American Cancer Society perspectives on environmental factors and cancer. CA Cancer J Clin. 2009:343-351. 2. Haug CJ. Human papillomavirus vaccination — reasons for caution. N Engl J Med. 2008;359:861-862. 3. The FUTURE II Study Group. Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions. N Engl J Med 2007;356:1915-1927. 4. Slade BA, Leidel L, Vellozzi C, et al. Postlicensure safety surveillance for quadrivalent human papillomavirus recombinant vaccine. JAMA. 2009 ;302:750-757. |
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Baoan Ma, Clinical Doctor Fourth Military Medical University, Bo Liao, PhD, Yong Zhang, PhD, Qingyu Fan, Prof
Send letter to journal:
baoanma{at}yahoo.com Baoan Ma, et al.
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Dear Editor, Dioxin-type chemicals contain dioxins which are based on the structure of a kind of chlorinated compounds; collectively, there are dozens of species as many as the most toxic of the carcinogenic effect which is the strongest 2,3,7,8-Tetrachlorodibenzodioxin (TCDD). TCDD has been classified as the first carcinogen by the International Cancer Research Center. The standard limit of dioxins WHO recommended in 1998 was 1-4 pico (1 pico for 10-12g) per kilogram body weight, which is even lower 1 million times than virulent poison cyanide. Ingesting or coming in contact with a small dose of TCDD can cause humans acute poisoning, headache, dizziness, vomiting, liver dysfunction, muscle pain and other symptoms, and even can cause humans severe disability or death. Intake or contact with the extremely low dose of long-term dioxin can cause chronic poisoning, which shows skin toxicity (chlorine acne), the toxicity of skin, liver, immune, reproductive and developmental and teratogenic, carcinogenic and so on. TCDD in animals has a strong carcinogenic effect and in animal tests, the results were all positive. The main sources of TCDD include the following areas: urban rubbish. We have to admit that the pace of development of the world economy has led to the rapid surge in urban rubbish [1]. However, the majority of the city's waste disposal capacity cannot keep pace with the growth rate of garbage. Simple landfills have become the main means of disposing of rubbish in many cities and residential neighborhoods, resulting in poor water quality, air and soil pollution, and so on [2]. Waste incineration is the recommended method of waste disposal, but low temperatures can also produce TCDD [3]. Industrial production of TCDD can be strongly adsorbed on the particles, through the air, water, soil, and plants into the food chain, which then transfers, directly or indirectly, to harm the human body. Therefore, strengthening propaganda and enhancing people's preventive consciousness can protect people from the scourge of dioxin contamination. For example, strengthening the harmless disposal of urban rubbish and increasing the ratio of fiber-rich and chlorophyll-rich foods (foods such as rice bran, spinach, and radish leaves) could increase the emission of TCDD and reduce accumulated hazard in the liver. Yours sincerely, Bo Liao, PhD
Correspondence: Baoan Ma, Professor, e-mail: baoanma@yahoo.com Institute of Orthopedic Oncology, Tangdu Hospital; Fourth Military Medical University; Xi'an 710038; P. R. China References 1. Nouwen J, Cornelis C, De Fre R, et al. Health risk assessment of dioxin emissions from municipal waste incinerators: the Neerlandquarter (Wilrijk, Belgium). Chemosphere. 2001;43(4-7):909-923. 2. Schuhmacher M, Domingo JL. Long-term study of environmental levels of dioxins and furans in the vicinity of a municipal solid waste incinerator. Environment International. 2006;32(3):397-404. 3. Nadal M, Perello G, Schuhmacher M, Cid J, Domingo JL. Concentrations of PCDD/PCDFs in plasma of subjects living in the vicinity of a hazardous waste incinerator: Follow-up and modeling validation. Chemosphere. 2008;73(6): 901-906. |
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Xia Huo, Professor Shantou University Medical College, Shantou, PR. China, Xijin Xu
Send letter to journal:
xhuo{at}stu.edu.cn Xia Huo, et al.
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Dear Editor: Electronic waste (e-waste) trade and recycle put Guiyu, a small town of China into a toxic area [1]. The world produces 20 to 50 million tons of e-waste a year, according to the UN, enough to load a train that would stretch around the world. Ironically, these e-wastes produced by advanced electronic technology contain significant amount of environmental toxicants including metals (lead [Pb], cadmium [Cd], mercury [Hg], chromium [Cr], arsenic [As], nickel [Ni], manganese [Mn], copper [Cu], zinc [Zn] and cobalt [Co]), and Persistent Organic Pollutants (POPs, e.g., polybrominated diphenyl ethers [PBDEs], polychlorinated biphenyls [PCBs], polyvinyl chloride [PVC], and polycyclic aromatic hydrocarbons [PAHs]). Many of these chemicals are harmful to the environment and human health if there is inadequate disposal and poor recycling of e-waste. The lack of appropriate recycling technology for e-waste makes it extremely difficult to solve this environmental health problem completely. With extremely primitive and uncontrolled methods since 1990s, nearly 6,000 family workshops in Guiyu process approximately 1.6 million tons of e-waste per year, producing extensive environmental pollutants including heavy metals (e.g., Cd, Co, Cr, Cu, Ni, Pb, Zn) and POPs (e.g., dioxins, furans, PBDEs, PAHs). These contaminants were found in unusually high levels, sometimes reaching the highest documented levels measured in environmental and human samples [2-4]. Our study found that people employed in e-waste recycling in Guiyu had a high incidence of skin damage, headaches, vertigo, nausea, chronic gastritis, and gastroduodenal ulcers. Guiyu children had significantly elevated blood Pb, Cd, Cr, Ni and Mn with lower forced volume vital capacity (FVC), temperament alterations, damage of lymphocyte DNA, and changes of antioxidant enzymes activities. Guiyu neonates also showed elevated Pb, Cd, Cr and PBDEs in cord blood with impairment of neurobehavioral development, and much higher rates of adverse birth outcomes such as fetal death, low birth weight, and preterm delivery [5-10]. Many studies, including our studies, clearly indicate that environmental pollution due to informal e-waste process are the main cause for occupational and secondary exposure at e-waste recycling areas. This kind of exposure to high levels of dangerous chemicals has caused serious detrimental effects on humans, especially on recycling workers, local children, and infants, and may cause long-term adverse outcomes such as cancer, which still need to be evaluated in larger epidemiological studies. Xijin Xu, MD, PhD (1, 2) Xia Huo, MD, PhD (1) 1. Analytic Cytology Laboratory, 2. Department of Cell Biology, Shantou University Medical College, Shantou, PR. China. Correspondence should be addressed to Xia Huo, Analytic Cytology Laboratory, Shantou University Medical College, 22 Xinling Rd., Shantou 515041, PR. China, Tel: 086-754-88900307, E-mail: xhuo@stu.edu.cn References 1. Stone R. Confronting a toxic blowback from the electronics trade. Science. 2009;325(5944):1055. 2. Wong MH, Wu SC, Deng WJ, et al. Export of toxic chemicals - a review of the case of uncontrolled electronic-waste recycling. Environ Pollut. 2007;149(2):131-40. 3. Leung AO, Luksemburg WJ, Wong AS, et al. Spatial distribution of polybrominated diphenyl ethers and polychlorinated dibenzo-p-dioxins and dibenzofurans in soil and combusted residue at Guiyu, an electronic waste recycling site in southeast China. Environ Sci Technol. 2007; 41(8):2730-2737. 4. Bi X, Thomas GO, Jones KC, et al. Exposure of electronics dismantling workers to polybrominated diphenyl ethers, polychlorinated biphenyls, and organochlorine pesticides in South China. Environ Sci Technol. 2007;41(16):5647-5653. 5. Huo X, Peng L, Xu X, et al. Elevated blood lead levels of children in Guiyu, an electronic waste recycling town in China. Environ Health Perspect. 2007;115(7):1113-1117. 6. Zheng L, Wu K, Li Y, et al. Blood lead and cadmium levels and relevant factors among children from the e-waste recycling town in China. Environ Res. 2008;108(1):15-20. 7. Li Y, Xu X, Liu J, et al. The hazard of chromium exposure to neonates in Guiyu of China. Sci Total Environ. 2008;403(1-3):99-104. 8. Li Y, Xu X, Wu K, et al. Monitoring of lead load and its effect on neonatal behavioral neurological assessment scores in Guiyu, an electronic waste recycle town in China. J Environ Monit. 2008;10:1233-1238. 9. Huo X, Li Y, Xu X, et al. Toxic heavy metal waste exposure and abnormal birth outcomes in an electronic waste recycling town of China. Toxicology Letters. 2008;180:S185. 10. Wu K, Xu X, Liu J, et al. Polybrominated diphenyl ethers in umbilical cord blood and relevant factors in neonates from Guiyu, China. Environ Sci Technol. In Press. |
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Gloria J Linnertz, radon activist CanSAR (Cancer Survivors Against Radon)
Send letter to journal:
seascape{at}htc.net Gloria J Linnertz
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I would scream from the rooftops for the whole world to hear if I could. Radon gas causes lung cancer and this can be prevented if people know about it and the physicians, legislators, homebuilders, and--yes--the American Cancer Society will just open their ears and listen to the facts. Do these agencies, organizations, and government bodies not care that people are dying by the thousands each year in our country from something that can easily be prevented! Two very well-known scientists, Dr. Bill Field and Dr. Jay Lubin, have presented facts to the president concerning radon gas. Was anyone listening? Was any action taken? Was the public informed? Was the American Cancer Society even aware of this? The World Health Organization knows of the deadly powers of radon gas and the surgeon general has released warnings urging everyone to test their homes for radon gas. Does this information fall on deaf ears of those people in a position to take action against radon and save lives? Will someone listen to the following facts: · Radon exposure is the seventh leading cause of cancer mortality in
the United States.
Here are some of the things that can be done by those groups mentioned earlier: · American Cancer Society can put out brochures and ad campaigns
urging people to test for radon and fix if the level is 2.7 of higher.
Please listen to the cries of those who have been touched and robbed by this silent killer. Family members, widows, and widowers who would gather with me and shout from the rooftops, "Take action against radon and save lives." Gloria Linnertz
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