WHATS NEW IN HAZARDOUS NOTHING TO DISCLOSE TECHNOLOGIES AND - - PDF document

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2/27/2017 WHATS NEW IN HAZARDOUS NOTHING TO DISCLOSE TECHNOLOGIES AND EXPOSURES? GINA M. SOLOMON, M.D., M.P.H. DEPUTY SECRETARY FOR SCIENCE AND HEALTH, CALEPA CLINICAL PROFESSOR OF MEDICINE, UCSF 3-D PRINTERS OUTLINE New


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WHAT’S NEW IN HAZARDOUS TECHNOLOGIES AND EXPOSURES?

GINA M. SOLOMON, M.D., M.P.H. DEPUTY SECRETARY FOR SCIENCE AND HEALTH, CALEPA CLINICAL PROFESSOR OF MEDICINE, UCSF

NOTHING TO DISCLOSE

OUTLINE

  • New Technologies with Potential Hazards
  • 3-D printing
  • Laser cutting and engraving
  • Fluorinated telomeres
  • New Exposure Concerns
  • Preservatives: MI/MCI
  • New Tools in Toxicology and Exposure Science
  • Pathway-based toxicology
  • Sensor air monitoring technologies

3-D PRINTERS

Fused Filament Fabrication

  • Acrylonitrile butadiene styrene

(ABS)

  • Polylactic acid (PLA)
  • Polyvinyl alcohol (PVA)
  • Polycarbonate
  • High-density polyethylene

(HDPE)

  • High-impact polystyrene (HIPS)
  • Nylon, and other polymers
  • Metals
  • Ceramics
  • Other

Starting at $699

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PARTICULATE EMISSIONS: 3D PRINTERS

Kim et al. ES&T, 49:12044, 2015

VOC EMISSIONS: 3D PRINTERS

  • Caprolactam from nylon-based and imitation wood and brick filaments (∼2 to ∼180 μg/min)
  • Styrene from ABS plastics and from high-impact polystyrene (HIPS) filaments (∼10 to ∼110 μg/min)
  • Lactide from polylactic acid (PLA) filaments (∼4 to ∼5 μg/min)

Azimi et al. ES&T, 50:1260, 2016

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LASER ENGRAVING OR CUTTING

Types of Lasers

  • Fiber lasers
  • CO2 lasers
  • Nd and Nd-YAG

Laser-Generated Air Contaminants (LGACs)

  • Polycarbonate: Cresol
  • PVC: Chlorine gas, HCL, phosgene
  • PET: Tetrahydrofuran (THF)
  • Epoxy: Isocyanates, amines
  • Rubber: 1,3-Butadiene
  • Mild steel: Iron oxide, NO, NO2, CO
  • Stainless steel: nickel, chromium
  • Carbon monoxide

Medical laser contaminants reported: Carbon monoxide, hydrogen sulfide, ammonia, toluene, styrene, phenol, benzyl cyanide, and hydrocyanic acid.

FLUORINATED TELOMERS

  • Perfluoroalkyl substances (PFASs)
  • Include PFOA and PFOS (no longer used in the U.S.)
  • Used in greaseproof, waterproof, stain-repellant

coatings; aqueous fire fighting foams (AFFFs)

PERFLUOROALKYL SUBSTANCES

  • 42 families and subfamilies of PFASs and at least

268 individual PFASs – Chain length is important

  • Only PFOA and PFOS are well-studied
  • Environmentally persistent; Detectable in biota
  • Highly water soluble
  • Found in most house dust samples
  • Some PFASs present in serum of almost all people

sampled

Calafat et al. Environ Health Perspect 2007, 115:1596, 2007.

CASE REPORT

  • A 36-year-old previously healthy woman was sent to

the ER by her PMD for suspected pneumonia. She was a smoker and worked as a secretary. Her sxs included acute onset of dyspnea, dry cough, a fever of 103˚ F, generalized muscle aches, headache, nausea and vomiting.

  • PE respiratory rate of 22, O2 sat of 89%. Obvious

dyspnea, lungs clear to auscultation.

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“WERE YOU EXPOSED TO ANY CHEMICALS?”

  • ~1 hour prior to onset of symptoms, she sprayed her shoes

with a waterproofing spray. She used it indoors with the windows closed and without PPE. She had used it similarly in the past without any apparent adverse effects.

“HILL WALKERS LUNG”

  • Acute alveolitis or interstitial pneumonitis after acute inhalation of water

repellant sprays; distinct from polymer fume fever.

  • Contents of the sprays: Propellants (propane, butane, isooctane) and water

repellant (fluorocarbons, silicone resins)

  • Dyspnea, dry cough and an acute febrile and flu-like disease
  • Disrupts alveolar surface tension and surfactant -- alveolar collapse? In

animals causes necrosis of alveolar cells, alveolar hemorrhage and edema.

Epping et al. Int J Occup Med Environ Health. 2011, 24(4):409-13

OTHER HEALTH EFFECTS OF PFOA AND PFOS

  • In humans:
  • Immune alterations, low birth weight, decreased head circumference, reduced birth

length, and smaller abdominal circumference

  • Associations with testicular and kidney cancer.
  • In animals:
  • Developmental toxicity, changes in brain function and behavior, altered mammary gland

development, immune system effects, altered weight gain after in-utero exposure, thyroid hormone disruption, and reduced testosterone.

  • Increased incidence of tumors of the liver, testes, and pancreas.

Grandjean et al. Environmental Health 2013, 12:35. http://biomonitoring.ca.gov/chemicals/perfluorochemicals-pfcs

PRESERVATIVES: MCI AND MI

  • Methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI)
  • Introduced for industrial use in 1980
  • Approved by the FDA in 2005 (max conc. 100 ppm)
  • Now in >1000 products: baby lotions, bath products, makeup,

hair care products, deodorants, skin care products, sunscreens

  • First case reports of sensitization in 2011
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CONTACT DERMATITIS

  • Prevalence of contact allergy to MI increased from 2.5% in

2012 to 6.8% in 2014

  • Combined frequency of allergy to MI/MCI is 11.1%
  • Sources: Cosmetics, soaps & cleansers, hair care products;

water-based paints; rarely occupational

  • European Commission banned MCI-MI in leave-on body

products - July 2015

  • No restrictions in the U.S.

Yu et al. JAMA Dermatol. 2016;152(1):67

COMPETING NEEDS FOR MODERN TOXICOLOGY

Test more chemicals Use fewer lab animals Test more cheaply Test for more endpoints (endocrine, neurotox, immuno) Test more life stages Test more quickly

National Academies Press, 2007 20

Human Relevance/ Cost/Complexity Throughput/ Simplicity

HIGH-THROUGHPUT SCREENING ASSAYS

10s-100s/yr 10s-100s/day 1000s/day 10,000s- 100,000s/day LTS HTS MTS uHTS Batch testing of chemicals for pharmacological/toxicological endpoints using automated liquid handling, detectors, and data acquisition

Gene-expression

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TOXCAST IN VITRO HTS ASSAYS

  • Cell lines
  • HepG2 human hepatoblastoma
  • A549 human lung carcinoma
  • HEK 293 human embryonic kidney
  • Primary cells
  • Human endothelial cells
  • Human monocytes
  • Human keratinocytes
  • Human fibroblasts
  • Human proximal tubule kidney cells
  • Human small airway epithelial cells
  • Biotransformation competent cells
  • Primary rat hepatocytes
  • Primary human hepatocytes
  • Assay formats
  • Cytotoxicity
  • Reporter gene
  • Gene expression
  • Biomarker production
  • High-content imaging for cellular phenotype
  • Protein families
  • GPCR
  • NR
  • Kinase
  • Phosphatase
  • Protease
  • Other enzyme
  • Ion channel
  • Transporter
  • Assay formats
  • Radioligand binding
  • Enzyme activity
  • Co-activator recruitment

Cellular Assays Biochemical Assays

Assays (n = 467) Chemicals (n = 320)

http://www.epa.gov/ncct/toxcast/

Judson et al EHP (2010)

11

EXAMPLE: SIGNATURE DERIVATION FOR LIVER CARCINOGENS

12 24

Using the Data: Overall Biological Activity

Perfluorooctane sulfonic acid Symclosene

AR .assay .hit.percentage ER .assay .hit.percentage TR .assay .hit.percentage Other.assay .hit.percentage Lipinski_LS.norm alized Ingenuity .pathway .hit.percentage KEGG.pathway .hit.percentage endpoint.hit.count.percentage

Linuron Fenitrothion Bisphenol A

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Contains: Chemical structures, experimental and predicted physicochemical and toxicity data, and additional links

https://comptox.epa.gov/dashboard >9,000 chemicals; >1,000 assays https://actor.epa.gov/dashboard/

DATABASE RESOURCES ON CHEMICALS

  • ToxCast and Tox21 - High-throughput chemical screening data
  • ExpoCast - Chemical exposure data and prediction models
  • DSSTox - High quality chemical structures and annotations
  • PhysChemDB - Physical Chemical Properties Database
  • CPCat - Chemicals listed by associated categories of chemical and product use

https://www.epa.gov/chemical-research

AIR SENSORS, A RAPIDLY GROWING TECHNOLOGY

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US EPA VILLAGE GREEN AND AIRMAPPER

Neighborhood Monitor with Real-Time Data and Web Dashboards AirMapper, a real-time particle instrument for measuring personal exposure

U.S. EPA “MY AIR, MY HEALTH” CHALLENGE

  • Sensor system that detects air pollutants and physiological markers with a

known or plausible link to air pollution

  • Winner “Conscious Clothing”
  • Measures:
  • Particulate matter
  • Tidal volume
  • Breathing rate

https://www.innocentive.com/ar/challenge/9932947

TZOA – ENVIRONMENTAL TRACKER

CAIRCLIP: REAL-TIME, HAND-HELD OZONE AND NO2

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  • Folding@Home
  • Stanford project to

understand protein folding by crowd sourcing computation

  • Habitatmap/Aircasting
  • Platform for mapping and

sharing environmental data using your smartphone

Crowd Sourcing

REAL-TIME IAQ MONITORING

Aclima 2016: https://aclima.io/blog/posts/how-ventilation-indoor-temperature-and-carbon-dioxide-are-linked/

  • 1. Was he exposed to a 3-D printer, laser cutter, or engraver?
  • 2. Did he recently use a waterproofing spray?
  • 3. Is he using a new shampoo or soap?
  • 4. Is anyone else at work or at home having similar symptoms?

A 23 yo male presents with new onset of cough and

  • dyspnea. His exam is notable for scattered wheezes but

he appears otherwise healthy. Relevant considerations include all of the following except: A 37 yo woman presents with recent onset of a rash on her face and hands. The rash is shown below. Which of the following is most likely associated with the rash?

  • 1. Styrene from an ABS cartridge on a 3-D printer
  • 2. Caprolactam from a nylon filament on a 3-D printer
  • 3. Laser cutting on PVC plastic releasing phosgene
  • 4. A preservative in her soap
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  • 1. Indoor CO2 monitoring is not recommended because it is not associated with

any of the symptoms that are being reported.

  • 2. There are sensors that continuously monitor for temperature, humidity, PM,

and CO2, and this information could help address the concerns.

  • 3. He should hire a professional to test for benzene and formaldehyde, which

could be causing these symptoms.

  • 4. The employees are likely just malingering.

An employer comes to you asking for help because his employees are complaining of headaches, fatigue, and “brain fog” in the

  • ffice. Absenteeism is high. Workers have asked about air
  • monitoring. You can tell him: