The respiratory toxicity of airborne volcanic ash from the Soufrière Hills volcano, Montserrat

2004 ◽  
Vol 68 (1) ◽  
pp. 47-60 ◽  
Author(s):  
K. A. Bérubé ◽  
T. P. Jones ◽  
D. G. Housley ◽  
R. J. Richards

AbstractThe Soufrière Hills stratovolcano on the Caribbean island of Montserrat has been erupting since 18th July 1995. An enormous amount of respirable volcanic ash has been suspended into the atmosphere by the eruptions and wind re-suspension of deposited ash. The large amount of fine, airborne particulate matter, in particular the component 10 μm equivalent aerodynamic diameter (PM10), is a cause of medical concern. Airborne levels have frequently exceeded the UK environmental standard for PM10, (50 μg/m3), although it is noted that this standard was primarily set for urban PM10. The crystalline silica in the ash is mostly cristobalite, at reported levels up to 20%. The UK government’s Chief Medical Officer, referring to Montserrat, has suggested that long-term exposure to high levels of volcanic ash could lead to silicosis. These concerns have prompted government-funded investigations into the potential toxicity of well characterized volcanic ash samples from Montserrat. Given the well established toxicity of cristobalite, particular attention was paid to the amount of this mineral in the ash samples. Three ash samples were tested: (1) a vulcanian eruption ash, (2) ash released in a domecollapse pyroclastic flow, and (3) ash from a major vulcanian explosion that was wind-transported to, and deposited on, the neighbouring island of Antigua. Comparative toxicological studies were carried out on respirable preparations of these three samples together with appropriate control mineral dusts that matched the major components of the Montserrat samples: anorthite, labradorite, cristobalite/ obsidian and cristobalite. Alpha quartz (DQ12) was the positive control. All samples, including the controls, were characterized to establish particle-size distributions, particle morphologies, and to confirm the mineralogy. Rats were challenged with 1 mg via intratracheal instillation, and groups sacrificed at three time points (1, 3 and 9 weeks). Health assessment was made by examining endpoints of increasing lung damage such as inflammation, permeability (oedema), changes in epithelium, and increase in the size of broncho-thoracic lymph nodes. The data indicate that Montserrat respirable ash, derived from dome collapse pyroclastic flows or vulcanian explosions, has minimal acute bioreactivity in the lung. The feldspar standards showed low bioreactivity, in stark contrast to the cristobalite standard that showed progressive increases in lung damage. These results suggest that either the mass of cristobalite present in the Montserrat ash was insufficient to cause an effect in the lung, or the cristobalite in the ash was, for some as yet unknown reason, markedly less bioreactive than our pure cristobalite standard.

Author(s):  
Andrew Craig Kerr

AbstractThe early Tertiary Mull-Morvern lava succession, NW Scotland, represents the thickest continuous section (1000 m from sea level to the top of Ben More) of Tertiary lavas exposed in the UK. This succession has been sampled and geochemically analysed, on a flow-by-flow basis, throughout the lava succession. Field observations during the course of this sampling suggest that the early lava flows (the Staffa Magma sub-Type) ponded in palaeovalleys along with interlava sediments. In the main part of the Mull lava succession (the Mull Plateau Group) the lava flows are on average ∼ 5 m thick. Most previous Hebridean workers have assumed that the red horizons commonly found between these later lava flows, represent weathered flow tops. However, this study has shown that in some places these red ‘boles’ appear to be a combination of both volcanic ash and weathered basalt.Chemically distinctive units of flows have been found throughout the succession. The two most abundant magma sub-types of the Mull Plateau Group, primitive (>9wt% MgO) basalts with Ba/Nb» 15 and more evolved (<9wt% MgO) basalts-hawaiites with Ba/Nb<15, form packets of flow units which can be up to 200 m thick. These chemically distinctive flow units have been correlated across the lava succession. However, the correlation of individual lava flows has proved difficult. The Mull Plateau Group lavas generally become more evolved and less contaminated with continental crust towards the top of the succession, culminating in the trachytes of the Pale Group on Ben More. Basaltic lavas above the Pale Group have markedly different trace element ratios, and seem to represent shallower, more extensive asthenospheric melting than the Mull Plateau Group.


2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Claudio Ortolani ◽  
Elide A. Pastorello

Abstract Background On June 30, 2020, the WHO reported over 10 millions of COVID-19 cases worldwide with over half a million deaths. In severe cases the disease progresses into an Acute Respiratory Distress Syndrome (ARDS), which in turn depends on an overproduction of cytokines (IL-6, TNFα, IL-12, IL-8, CCL-2 and IL1) that causes alveolar and vascular lung damage. Clearly, it is essential to find an immunological treatment that controls the “cytokine storm”. In the meantime, however, it is essential to have effective antiviral and anti-inflammatory drugs available immediately. Pharmacologic therapy for COVID-19 Hydroxychloroquine or chloroquine have been widely adopted worldwide for the treatment of SARS-CoV-2 pneumonia. However, the choice of this treatment was based on low quality of evidence, i.e. retrospective, non-randomized controlled studies. Recently, four large Randomized Controlled Trials (RCTs) have been performed in record time delivering reliable data: (1) the National Institutes of Health (NIH) RCT included 60 hospitals participating all over the world and showed the efficacy of remdesivir in reducing the recovery time in hospitalized adults with COVID-19 pneumonia; (2) three large RCTs already completed, for hydroxychloroquine, dexamethasone and Lopinavir and Ritonavir respectively. These trials were done under the umbrella of the 'Recovery' project, headed by the University of Oxford. The project includes 176 participating hospitals in the UK and was set up to verify the efficacy of some of the treatments used for COVID-19. These three ‘Recovery’ RCTs concluded definitely: (a) that treatment with hydroxychloroquine provides no benefits in patients hospitalized with COVID-19; (b) that treatment with dexamethasone reduced deaths by one-third in COVID-19 patients that were mechanically ventilated, and by one-fifth in patients receiving oxygen only; (c) that the combination of Lopinavir and Ritonavir is not effective in reducing mortality in COVID-19 hospitalized patients. Conclusions The results of these four large RCTs have provided sound indications to doctors for the treatment of patients with COVID-19 and prompted the correction of many institutional provisions and guidelines on COVID-19 treatments (i.e. FDA, NIH, UK Health Service, etc.). Even though a definitive treatment for COVID-19 has not yet been found, large RCTs stand as the Gold Standards for COVID-19 therapy and offer a solid scientific base on which to base treatment decisions.


Author(s):  
K. J. Beven ◽  
S. Almeida ◽  
W. P. Aspinall ◽  
P. D. Bates ◽  
S. Blazkova ◽  
...  

Abstract. This paper discusses how epistemic uncertainties are considered in a number of different natural hazard areas including floods, landslides and debris flows, dam safety, droughts, earthquakes, tsunamis, volcanic ash clouds and pyroclastic flows, and wind storms. In each case it is common practice to treat most uncertainties in the form of aleatory probability distributions but this may lead to an underestimation of the resulting uncertainties in assessing the hazard, consequences and risk. It is suggested that such analyses might be usefully extended by looking at different scenarios of assumptions about sources of epistemic uncertainty, with a view to reducing the element of surprise in future hazard occurrences. Since every analysis is necessarily conditional on the assumptions made about the nature of sources of epistemic uncertainty it is also important to follow the guidelines for good practice suggested in the companion Part 1 by setting out those assumptions in a condition tree.


2020 ◽  
Vol 105 (9) ◽  
pp. e35.1-e35
Author(s):  
Adam Sutherland ◽  
Denham Phipps ◽  
Steve Tomlin ◽  
Darren Ashcroft

AimsProblems with medication account for 10–20% of all adverse healthcare events in the NHS, costing between £200–400 million per year.1 Children are more likely to experience medication related harm.2 International reviews of the prevalence of drug-related problems are over ten years old.3 There is a need for a focussed and critical review of the prevalence and nature of drug-related problems in hospitalised children in the UK to support the development and targeting of interventions to improve medication safety.4MethodsNine electronic databases (Medline, Embase, CINAHL, PsychInfo, IPA, Scopus, HMIC, BNI, The Cochrane library and clinical trial databases) were searched from January 1999 to September 2018. Studies were included if they were based in the UK, reported on the frequency of adverse drug reactions (ADRs), adverse drug events (ADEs) or medication errors (MEs) affecting hospitalised children, and quality appraisal of the studies was conducted.Results26 studies were included; none of which specifically reported on the prevalence of ADEs. Three ADR studies reported a median prevalence of 28.3% of patients (IQR 13); >70% of reactions warranted withdrawal of medication. Sixteen studies reported on prescribing errors and the median prescribing error rate in all paediatric contexts was 10.7% of prescriptions (IQR 6) Seven studies explored prescribing errors in PICU and the prevalence was twice that in non-ICU areas (11.1% prescriptions; IQR 2.9 versus 6.5% prescriptions; IQR 4.3). The median rate of dose prescribing errors was 11.1% doses prescribed (IQR 10.6). Four studies reported administration errors of which three used consistent methods. Across these three studies, a median prevalence of 12.4% of administrations (IQR 7.3) was found. Administration technique errors represented 53% of these errors (IQR 14.7). Errors detected during medicines reconciliation at hospital admission affected 43% of patients, 33% (IQR 13) of prescribed medication with 70.3% (IQR 14) classified as potentially harmful. Medication errors detected during reconciliation on discharge from hospital affected 33% of patients and 19.7% of medicines, with 22% considered potentially harmful. No studies examined the prevalence of monitoring or dispensing errors.ConclusionsChildren are commonly affected by drug-related problems throughout their hospital journey. Given the high prevalence and risk of patient harm, there is an urgent need for outcome-focussed research on preventable ADEs in paediatric hospital settings in the UK. A deeper understanding of medication processes for children in hospital from a systems and theoretical perspective will also support the development and tragetting of effective interventions to improve patient safety.ReferencesChief Medical Officer. An Organisation With a Memory. London; 2000.Kaushal R, Bates DW, Landrigan C, et al. Medication errors and adverse drug events in pediatric inpatients. JAMA 2001;285:2114–2120.Ghaleb MA, Barber N, Franklin BD, Yeung VWS, Khaki ZF, Wong ICK. Systematic review of medication errors in pediatric patients. Ann Pharmacother 2006;40:1766–1776.


2019 ◽  
Vol 50 (14) ◽  
pp. 2435-2443 ◽  
Author(s):  
Robyn E. Wootton ◽  
Rebecca C. Richmond ◽  
Bobby G. Stuijfzand ◽  
Rebecca B. Lawn ◽  
Hannah M. Sallis ◽  
...  

AbstractBackgroundSmoking prevalence is higher amongst individuals with schizophrenia and depression compared with the general population. Mendelian randomisation (MR) can examine whether this association is causal using genetic variants identified in genome-wide association studies (GWAS).MethodsWe conducted two-sample MR to explore the bi-directional effects of smoking on schizophrenia and depression. For smoking behaviour, we used (1) smoking initiation GWAS from the GSCAN consortium and (2) we conducted our own GWAS of lifetime smoking behaviour (which captures smoking duration, heaviness and cessation) in a sample of 462690 individuals from the UK Biobank. We validated this instrument using positive control outcomes (e.g. lung cancer). For schizophrenia and depression we used GWAS from the PGC consortium.ResultsThere was strong evidence to suggest smoking is a risk factor for both schizophrenia (odds ratio (OR) 2.27, 95% confidence interval (CI) 1.67–3.08, p < 0.001) and depression (OR 1.99, 95% CI 1.71–2.32, p < 0.001). Results were consistent across both lifetime smoking and smoking initiation. We found some evidence that genetic liability to depression increases smoking (β = 0.091, 95% CI 0.027–0.155, p = 0.005) but evidence was mixed for schizophrenia (β = 0.022, 95% CI 0.005–0.038, p = 0.009) with very weak evidence for an effect on smoking initiation.ConclusionsThese findings suggest that the association between smoking, schizophrenia and depression is due, at least in part, to a causal effect of smoking, providing further evidence for the detrimental consequences of smoking on mental health.


2020 ◽  
Author(s):  
Geraint Vaughan ◽  
David Wareing ◽  
Hugo Ricketts

&lt;p&gt;On 22 June 2019, the Raikoke volcano in the Kuril Islands erupted, sending a plume of ask and sulphur dioxide into the stratosphere. A Raman lidar system at Capel Dewi, UK (52.4&amp;#176;N, 4.1&amp;#176;W) has been used to measure the extent and optical depth of the stratospheric aerosol layer following the eruption. The lidar was modified to give it much enhanced sensitivity in the elastic channel, allowing measurements up to 25 km, but the Raman channel is only sensitive to the troposphere. Therefore, backscatter ratio profiles were derived by comparison with aerosol-free profiles derived from nearby radiosondes, corrected for aerosol extinction. Small amounts of stratospheric aerosol were measured prior to the arrival of the volcanic cloud, probably from pyroconvection over Canada. Volcanic ash began to arrive as a thin layer at 14 km late on 3 July, extending over the following month to fill the stratosphere below around 19 km. Aerosol optical depths reached around 0.03 by mid-August and continued at this level for the remainder of the year. The location of peak backscatter varied considerably but was generally around 15 km. However, on one notable occasion on August 25, a layer around 300 m thick with peak lidar backscatter ratio around 1.5 was observed as high as 21 km.&lt;/p&gt;


1989 ◽  
Vol 17 (5) ◽  
pp. 407-416 ◽  
Author(s):  
S. I. Ankier ◽  
S. J. Warrington

In order that a new chemical entity may be marketed as a drug its pharmacological effects must first be evaluated using animals. Its bioavailability must also be determined and toxicological studies are performed to assess its acute and chronic toxicity, mutagenicity, effects on fertility, perinatal effects, teratogenicity and carcinogenicity. If the results of efficacy and toxicity studies in animals are favourable, the drug is then tested in a few human volunteers, followed by pilot studies and large-scale clinical trials. Regulations that control how these trials are performed are considered. The licensing of drugs in the UK, USA and Europe is compared.


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