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.
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.
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).
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).