ASSOC. PROF. DR. MOHD. HASNI JAAFAR ...

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Leptospiral spp? Brucella spp? Others? Page 16. TOXICOGENOMICS. Toxicant. Gene. Disease agent. Page 17. DISEASE AGENT MUTATION. Virulence.
ASSOC. PROF. DR. MOHD. HASNI JAAFAR ENVIRONMENTAL HEALTH SPECIALIST AND TOXICOLOGIST (ACT, SOT, TSS, MySOT) UKM Medical Centre The National University of Malaysia

CONTENT  Introduction.  Common toxic agents.  Related diseases.

 Protecting communities and workers.  Next forward.

TOXICOLOGY IN PUBLIC HEALTH  Study on adverse health effects of toxic

substances on human (direct) and environment (indirect).  Spectrum of effects  Harmful – minimal damage or reversible function.  Toxic – irreversible effects or fatal.

Sensitive sub-population  Communities - extreme age groups  Fetus and infant.  Elderly.

 Immunocompromise patient  AIDS  Chronic diseases (DM, CCF, LF, ESRF).

 Industrial and mining workers  Higher risk (unhealthy, cancer, death).

MALAYSIA  Chemical  Heavy metals (arsenic, cadmium,

lead, mercury, chromium hexavalent).  Solvents (benzene, formaldehyde).  Dioxins and furans.  Pesticides (OP, carbamate).

MALAYSIA  Physical  PM10 (dust).  Radiation and radioactive materials (housekeeping).

 Biological  Plant and animal toxins.

ENDOCRINE DISRUPTOR CHEMICALS  Heavy metals  Lead and cadmium.

 Pesticides  Solvents

MODERN DISEASE  Pollutants as external stressor to cell, tissue or

organ.  Possible pathological pathway  Exposure – Oxidation of cells – Lipid peroxidation - Apoptosis  PM10 = premature death  Lead = hypertension

LATEST STUDIES (MALAYSIA)  Blood lead (Pb) related with ECG changes (prolonged P wave) at 2.9 µg/L (standard of 10 µg/dL – neurobehavioral).  Risk factors for myocardial infarction (case control studies at UKMMC)  Arsenic.  Nickel.

 Cadmium.

 Protective minerals = selenium and zinc.

TOXICANTS AND DISEASE VIRULENCY  Group A Streptococcus (GAS) by Mn  Complemented mutant MntE GAS (Turner et al.

2015).  Zinc exposure  Candida spp. (Böttcher et al. 2015).

 Phytophthora alni subspecies Alni (forest pathogen in

southern Sweden)  Spread limited by cold (winter) conditions (Redondo et

al. 2015).

 Outbreak of food poisoning caused by Salmonella

enterica subspecies enterica serovar Berta (Salmonella Berta) reported in Italy  Poor hygiene conditions in the facility concerned and

high summer temperatures (Giannatale et al. 2012).

 Multidrug resistance of E. coli  To sulfamethoxazole or ciprofloxacin after exposure to high zinc and copper (Castro et al. 2015).  High Pb, Cd and Cu in Uganda wetlands  High concentration of E. coli (Fuhrimann et al. 2015).  How about  Leptospiral spp?  Brucella spp?  Others?

TOXICOGENOMICS Disease agent

Gene Toxicant

DISEASE AGENT MUTATION Virulence

Emerging (New) Re emerging

EMERGING AND RE EMERGING OF DISEASES  Due  High virulence (disease agent).  Multidrug resistance (disease agent).  Compromised immune system (human).

 Leptospirosis (most common).  Leprosy, MDR tuberculosis, AGE (E. coli).

 Latest  Typhoid outbreak (?mutated salmonella spp.)

NEW DISEASE – TOXICOLOGY INTERACTIONS TOXICITY

TOXICANT TRADITIONAL DISEASES

HUMAN

DISEASE AGENT

VIRULENCY

EMERGING AND RE EMERGING DISEASES

PROTECTING COMMUNITIES  More clinical toxicological studies.  More toxicological studies on various

chronic diseases and cancer.  Training for medical doctors, engineers, and others.  Active input in mass media (society).

PROTECTING WORKERS  More clinical toxicological studies

among risk occupations.  More toxicological studies on various chronic occupational diseases.  Training for occupational health doctors, and engineers.  Use updated MSDS and guidelines.

NEXT FORWARD  Monitoring surveillance  Biological

Disease agent (routine).  Body burden of toxicant (seldom done). 

 Environmental

Disease agent (routine).  Toxicants (seldom done). 

TERIMA KASIH JUMPA LAGI