Volume 34, Issue 2

The use of electronic cigarettes (e-cigarettes or “vaping”) has seen an unprecedented increase worldwide. Vaping has been promoted as a beneficial smoking cessation tool and an alternative nicotine delivery device that contains no combustion by-products. However, nicotine is highly addictive, and the increased use of nicotine-containing e-cigarettes among teens and individuals who are not in need of smoking cessation may lead to overall greater nicotine dependence in the population. Furthermore, available research indicates that vaping solutions and their emissions may contain much more than just nicotine, including aerosolized flavorings, propylene glycol (PG), and other intentional and unintentional contaminants. These materials could present undefined potential health hazards to both e-cigarette users and bystanders, the full extent of which is not well understood at this time. Whereas e-cigarette usage and exposures may lower some or most of the risks associated with conventional cigarette use, the health effects of nicotine and aerosol exposures from e-cigarettes are not well understood. Research indicates that vaping aerosols are not benign, especially for nearby people in areas with limited ventilation and people with compromised health conditions. In addition, e-juice liquids have already been responsible for an increase in accidental poisonings in children. Because the magnitude of health and safety hazards that vaping may present to nonusers remains unclear, it is prudent to manage and control vaping in indoor locations where smoking is currently restricted. Based on a review of current scientific information, the American Industrial Hygiene Association (AIHA) recommends that e-cigarettes should be considered a source of aerosols, volatile organic compounds (VOCs), and particulates in the indoor environment that have not been thoroughly characterized or evaluated for health risk or safety.

Several systematic reviews have been conducted so far to examine the effect of air pollution on respiratory diseases, but there has not been a corresponding meta-analysis to estimate the effect sizes for wheeze-associated diseases/disorders, which is one of the leading causes of emergency department visits and hospitalizations for children worldwide. The aim of this review is to systematically evaluate the relationship between air pollution and risk of wheeze-associated disorders in children in Southeast Asia. We searched the relevant computerized databases (PubMed, EMBASE, Web of Science, Scopus and Cochrane library) for indexed publications up to July 2018. Finally, eight studies were qualified for performing a random-effect meta-analysis to compute the pooled effect sizes. The results show that each increase of 10 μg/m 3 in concentrations of PM 2.5 , PM 1 was associated with 1–2% increase in risk of wheeze-associated disorders. Positive associations were found for PM 10 , SO 2 , NO 2 , NO x but no association was found for CO and O 3 . We confirmed the strong effect of fine particulate matters on respiratory health and recommend an updated meta-analysis should be done when more studies are available.

In our environment, various naturally occurring radionuclides are present (both underground and overground) in several places, which results in lifelong human exposure. The radiation dose received by human beings from the radiation emitted by these naturally occurring radionuclides is approximately 87%. Exposure to radiation poses radiological health hazards. To assess the human health hazards from radiation, the concentration of these naturally occurring radionuclides are measured in soil (used for cultivation), building materials (soil, bricks, sand, marble, etc.), water and dietary items, worldwide. The available literature revealed that numerous studies related to the subject have been carried out in Pakistan. Most of these studies measured the radioactivity concentrations of primordial [uranium ( 238 U), thorium ( 232 Th), radium ( 226 Ra) and potassium ( 40 K)] and anthropogenic [cesium ( 137 Cs)] radionuclide in soil samples (used for cultivation), fertilizers, building materials (i.e. bricks, rocks, sand, soil, marble, etc.), as well as water and dietary items, using a sodium iodide detector or high purity germanium. An effort was made in 2008 to compile these studies as a review article. However, since then, considerable studies have been undertaken and reported in the literature. Therefore, the main objective of the present article is to provide a countrywide baseline data on radionuclide levels, by overviewing and compiling the relevant studies carried out in Pakistan.

Introduction Obstructive sleep apnea (OSA) is a widely prevalent sleep-related breathing disorder, which leads to several life-threatening diseases. OSA has systemic effects on various organ systems. Untreated OSA is associated with long-term health consequences including hypertension, heart disease, diabetes, depression, metabolic disorders, and stroke. In addition, untreated OSA is reported to be associated with cognitive dysfunction, impaired productivity at the workplace and in an increased risk of motor vehicle accidents (MVAs) resulting in injury and fatality. Other consequences of OSA include, but are not limited to, impaired vigilance, daytime somnolence, performance deficits, morning headaches, mood disturbances, neurobehavioral impairments, and general malaise. Additionally, OSA has become an economic burden on most health systems all over the world. Many driving license regulations have been developed to reduce MVAs among OSA patients. Methods Studies of the personal, societal, public health, and legal aspects of OSA are reviewed. Data were collected through the following databases: MEDLINE, Google Scholar, Scopus, SAGE Research Methods, and ScienceDirect. Conclusion OSA leads to worsening of patients’ personal relationships, decreasing work productivity, and increasing occupational accidents as well as MVAs. The costs of undiagnosed and untreated OSA to healthcare organizations are excessive. Thus, proper management of OSA will benefit not only the patient but will also provide widespread benefits to the society as a whole.

In developing countries, one of the most severe modern-day dilemmas is the management of industrial wastewater. In these countries, industrial wastewater effluents are directly discharged into the natural drain, a sewer system, an internal septic tank or a nearby field. Some of these industrial wastewater effluents are inadequately treated or untreated before being discharged. In recent years, in developing countries, urbanization and industrial activities have led to environmental deterioration. This paper was designed to review the health and environmental impacts of inadequately treated or untreated industrial wastewater effluents in Pakistan. The quality of industrial wastewater effluents is responsible for the degradation of the receiving water bodies. This is due to the reason that inadequately treated or untreated industrial wastewater effluents may cause eutrophication in the receiving water bodies and also form a favorable condition for toxin-producing waterborne pathogens. In order to comply with the wastewater guidelines and legislations, there is a need for proper treatment before discharge. In order to minimize the risk to the environment and public health, there is a need for proper treatment processes for industrial wastewater effluents. To achieve unpolluted discharge of industrial wastewater into the receiving water bodies, regular monitoring, proper and suitable treatment, careful planning and appropriate legislation are recommended.

Recent advances in neuroepigenetics have revealed its essential role in governing body function and disease. Epigenetics regulates an array of mechanisms that are susceptible to undergoing alteration by intracellular or extracellular factors. DNA methylation, one of the most extensively studied epigenetic markers is involved in the regulation of gene expression and also plays a vital role in neuronal development. The epigenome is most vulnerable during early the embryonic stage and perturbation in DNA methylation during this period can result in a latent outcome which can persist during the entire lifespan. Accumulating evidence suggests that environmental insults during the developmental phase can impart changes in the DNA methylation landscape. Based on reports on human subjects and animal models this review will explore the evidence on how developmental exposure of the known environmental pollutant, lead (Pb), can induce changes in the DNA methylation of genes which later can induce development of neurodegenerative disorders like Alzheimer’s disease (AD).

Pyrethroid insecticides are commonly used worldwide. The chronic effects of these compounds are of concern given that epidemiological studies have suggested an association with hematological cancer, particularly in children. However, the biological evidence at molecular and cellular levels is limited. A review on the molecular and cellular effects of pyrethroids is helpful to guide the study of the biological plausibility of the association of pyrethroids with hematological cancer. We reviewed studies suggesting that pyrethroids are genotoxic, induce genetic rearrangements, alter gene expression and modify DNA. All of these biological modifications could potentially contribute to the carcinogenic process in hematopoietic cells.

Background There is an increasing range of adverse health effects associated with air pollution at very low concentrations. Few studies have assessed respiratory parameters among filling station attendants. Objectives This study assessed air pollutants; particulate matter (PM 10 ) and total volatile organic compounds (TVOC) concentrations at filling stations as well as determined forced expiratory volume in one second (FEV 1 ) and peak expiratory flow rate (PEFR) levels among filling station attendants. Methods A cross-sectional study was conducted to assess PM 10 and TVOC concentrations at 20 systematically selected filling stations in Ibadan North Local Government Area, Ibadan for 2 months using a Thermo Scientific pDR 1500 PM 10 monitor and SF2000-TVOC meter. FEV 1 and PEFR levels were measured in order to assess the effect of exposure to PM 10 and TVOC on lung function of 100 filling station attendants using a PIKO-1 Electronic peakflow/FEV 1 meter. Results Total mean PM 10 concentrations (μg/m 3 ) in the morning (43.7±16.5) and afternoon (27.8±7.9) were significantly lower (p<0.01) than the World Health Organization (WHO) guideline limit (50 μg/m 3 ). Total mean TVOC concentrations (ppm) in the morning (12.0±3.4) and afternoon (5.6±2.4) were however significantly higher (p<0.01) than the Occupational Safety and Health Administration (OSHA) guideline limit (3 ppm). Mean FEV 1 for filling station attendants was 1.63±0.39 and PEFR was 171.7±45.9. Conclusion Filling stations are hotspots for the emission of VOCs and PM 10 . However, filling station attendants in this study are at risk of exposure to high concentrations of VOCs but not PM 10 . FEV 1 and PEFR values among filling station attendants were very low which could possibly be attributed to extended exposure to air pollutants. Regular medical examinations should also be conducted on filling station attendants in order to aid early detection of deviations in their health status.

Parents had already taken information about galactosemia from web medical pages because they were asked for a second blood sample from their infant suspected for the disease. All enzyme types of this disorder are diagnosed by neonatal screening perinatally and treated with a galactose (GAL) free diet. The most frequent information about the disease was mental retardation (100%), eye cataracts (100%) liver dysfunction (90.5%), speech delay (76.1%), hypoglycemia (69.0%), seizures (31.0), etc. Most clinical and laboratory information about galactosemia taken from the Internet was correct for the classical type of the disorder. A differentiation of the galactosemia enzyme types is needed.