No abstract

Bismuth (Bi) and silver (Ag) are used in increasing amounts and are consequently being emitted from various sources and showing high accumulation rates in soils when sewage sludge is applied on arable land. This study aimed to analyze the amounts of Bi and Ag in three cosmetic products (foundation, powder, and eye shadow) in order to study the flows in urban wastewater in Stockholm, Sweden. Analyses showed that Bi was present in very high concentrations (7,000 to 360,000 milligrams per kilogram) in one third of the analyzed foundation and powder samples, whereas Ag concentrations all were below the detection limit. These cosmetic products explained approximately 24% of the measured total Bi amounts per year reaching the WWTP (wastewater treatment plant), making cosmetics a major Bi source, whereas for Ag the corresponding contribution was <0.1% of the measured annual Ag amounts. The results were roughly adapted for Europe and the United States, estimating the Bi flows from cosmetics to WWTPs. On a global scale, these flows correspond to a non-negligible part of the world Bi production that, every year, ends up in sewage sludge, limiting the reuse of a valuable metal resource. From an environmental and resource perspective, foundations and powder products should be considered as significant sources of measured Bi amounts in sludge. This large Bi flow must be considered as unsustainable. For Ag, however, the three analyzed cosmetic products are not a significant source of the total Ag load to WWTPs. Keywords:bismuth cosmetics industrial ecology sewage sludge silver substance flow analysis Supporting information is available on the JIE Web site

Background: General practitioners (GPs) are often the first point of contact for Swedish patients seeking medical advice for skin lesions of concern, but many lack training in dermoscopy. Objective: To examine the effects of a 1-day training course in dermoscopy among Swedish GPs. Methods: The intervention group consisted of GPs who underwent a 1-day training course in dermoscopy and a control group that did not undergo any education. Before the training course, the intervention group performed a test consisting of 30 dermoscopy cases including 9 different benign and malignant melanocytic and nonmelanocytic diagnoses. The participants then took the same test directly after the course and again after 6 months. The control group took the same test twice with a 6-month interval in between tests in order to avoid recall bias. Results: Twenty-seven GPs in the intervention group took the test before and immediately after the course with an improvement of their median test scores by 8 points (13 vs 20 correct answers, P < 0.01). Eighteen participants also took the test a third time after 6 months with similar results compared with the second test (median scores of 20.5 vs 20.0, P = 0.3). In the control group, 16 persons preformed both tests with an improvement of their median score by 2 points (13.5 vs 15.5 correct answers, P = 0.06). Conclusions: The results of this study show positive effects on diagnostic accuracy in a test situation among GPs receiving a 1-day training course in dermoscopy.

No abstract

A great deal of research has been devoted to the characterization of metal exposure due to the consumption of vegetables from urban or industrialized areas. It may seem comforting that concentrations in crops, as well as estimated exposure levels, are often found to be below permissible limits. However, we show that even a moderate increase in metal accumulation in crops may result in a significant increase in exposure. We also highlight the importance of assessing exposure levels in relation to a regional baseline. We have analyzed metal (Pb, Cd, As) concentrations in nearly 700 samples from 23 different vegetables, fruits, berries and mushrooms, collected near 21 highly contaminated industrial sites and from reference sites. Metal concentrations generally complied with permissible levels in commercial food and only Pb showed overall higher concentrations around the contaminated sites. Nevertheless, probabilistic exposure assessments revealed that the exposure to all three metals was significantly higher in the population residing around the contaminated sites, for both low-, median- and high consumers. The exposure was about twice as high for Pb and Cd, and four to six times as high for As. Since vegetable consumption alone did not result in exposure above tolerable intakes, it would have been easy to conclude that there is no risk associated with consuming vegetables grown near the contaminated sites. However, when the increase in exposure is quantified, its potential significance is harder to dismiss - especially when considering that exposure via other routes may be elevated in a similar way.