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Plastic products leach chemicals that induce in vitro toxicity under realistic use conditions
(2021)
Plastic products contain complex mixtures of extractable chemicals that can be toxic. However, humans and wildlife will only be exposed to plastic chemicals that are released under realistic conditions. Thus, we investigated the toxicological and chemical profiles leaching into water from 24 everyday plastic products covering eight polymer types. We performed migration experiments over 10 days at 40 °C and analyzed the migrates using four in vitro bioassays and nontarget high-resolution mass spectrometry (UPLC-QTOF-MSE). All migrates induced baseline toxicity, 22 an oxidative stress response, 13 antiandrogenicity, and one estrogenicity. Overall, between 17 and 8681 relevant chemical features were present in the migrates. In other words, between 1 and 88% of the plastic chemicals associated with one product were migrating. Further, we tentatively identified ∼8% of all detected features implying that most plastic chemicals remain unknown. While low-density polyethylene, polyvinyl chloride, and polyurethane induced most toxicological endpoints, a generalization for other materials is not possible. Our results demonstrate that plastic products readily leach many more chemicals than previously known, some of which are toxic in vitro. This highlights that humans are exposed to many more plastic chemicals than currently considered in public health science and policies.
Objective: To explore and describe exposure to suicidality in healthcare providers (HCP) working with oncological patients. Special emphasis was put on five central aspects from the HCPs perspective: Exposure, Confidence, Expertise, Distress, and Education.
Methods: A 48‐item online questionnaire was developed and distributed to HCPs working with cancer patients. Three hundred fifty‐four answered questionnaires were analyzed.
Results: Overall 83.3% of HCPs reported to have encountered at least one suicidal patient in the last year. Feeling confident in talking about suicidality was reported by 72.1% of HCPs, with 71.2% of nurses reporting feeling insecure compared with only 5.1% of psychotherapists. Similarly, 22.3% of HCPs felt overwhelmed when confronted with a patient who substantiated his suicidality during consultation. A lack of personal knowledge concerning suicidality in general and in oncological patients in particular, was reported by 39.6% and 49.8%, respectively. In total, 88.1% of HCPs reported feeling distressed when confronted with suicidality, while 81.1% of participants wanted further education regarding suicidality in cancer patients despite that 73.2% had already received some sort of psycho‐oncology education.
Conclusions: Despite the well‐documented fact of elevated suicide rates in cancer patients, there remain deficits in knowledge, which induce feelings of insecurity and helplessness in HCPs. There is a demand for further education concerning the treatment of suicidal cancer patients. Therefore, special curricula addressing this topic should be devised. A general debate about suicidality in cancer patients could help raise awareness of this problem and generate means of prevention.