Psilocybine services in Oregon: a call for awareness among clinical toxicologists.

Background: In 2023, Oregon enacted laws regulating the manufacture and use of psilocybine products in licensed facilities for supervised sessions with trained facilitators.

Commentary: This commentary summarizes the final rules for psilocybine services in Oregon, and provides perspectives from a clinical toxicologist on some of the issues that may arise. These include the scope of practice for non-clinical facilitators, prevention and management of adverse drug reactions, and toxicological uncertainties with regards to dose considerations for people with mental health and other medical conditions.

Naltrexone: Not Just for Opioids Anymore.

Naltrexone is a semi-synthetic opioid with competitive antagonist activity at mu opioid receptors. Its efficacy has been demonstrated in the treatment of alcohol and opioid dependence, but adherence to daily dosing has been recognized as a factor limiting long-term effectiveness. Recently, a long-acting injectable formulation of naltrexone has received FDA-approval for treating alcohol and opioid dependence.

A Community-Based Approach to Developing a Mobile Device for Measuring Ambient Air Exposure, Location, and Respiratory Health.

In west Eugene (Oregon), community research indicates residents are disproportionately exposed to industrial air pollution and exhibit increased asthma incidence. In Carroll County (Ohio), recent increases in unconventional natural gas drilling sparked air quality concerns. These community concerns led to the development of a prototype mobile device to measure personal chemical exposure, location, and respiratory function.

Determination of parent and hydroxy PAHs in personal PM₂.₅ and urine samples collected during Native American fish smoking activities.

A method was developed for the measurement of 19 parent PAHs (PAHs) and 34 hydroxylated PAHs (OH-PAHs) in urine and personal air samples of particulate matter less than 2.5 μm in diameter (PM₂.₅) using GC-MS and validated using NIST SRM 3672 (Organic Contaminants in Smoker's Urine) and SRM 3673 (Organic Contaminants in Nonsmoker's Urine).

A cross-sectional study of the association between ventilation of gas stoves and chronic respiratory illness in U.S. children enrolled in NHANESIII.

Background: Gas stoves emit pollutants that are respiratory irritants. U.S.

Naphthalene biomarkers and relationship with hemoglobin and hematocrit in White, Black, and Hispanic adults: results from the 2003-2004 National Health and Nutrition Examination Survey.

Naphthalene is an important contaminant in indoor and outdoor air. Acute overexposure can have toxic effects, resulting in hemolysis. There have been no studies evaluating the impact of environmental exposure on red blood cell indices.

Age and gender dependent bioavailability of R- and R,S-α-lipoic acid: a pilot study.

Lipoic acid (LA) shows promise as a beneficial micronutrient toward improving elder health. Studies using old rats show that (R)-α-LA (R-LA) significantly increases low molecular weight antioxidants that otherwise decline with age. Despite this rationale for benefiting human health, little is known about age-associated alterations in absorption characteristics of LA, or whether the commercially available racemic mixture of LA (R,S-LA) is equally as bioavailable as the naturally occurring R-enantiomer.

Dialkyl phosphates as biomarkers of organophosphates: the current divide between epidemiology and clinical toxicology.

Context: Organophosphate insecticides are widely utilized throughout the world. The cholinergic toxidrome, resulting from cholinesterase inhibition, is the clinically relevant endpoint in organophosphate poisoning. In recent years, urinary dialkyl phosphates (DAPs) have emerged as a common method of assessing exposure to organophosphates in epidemiological investigations.

Naphthalene Mothballs: Emerging and Recurring Issues and their Relevance to Environmental Health.

Naphthalene is a polycyclic aromatic hydrocarbon that is commonly encountered in indoor and outdoor environments. There is growing awareness of the environmental health risks associated with inhalation exposure to naphthalene in the indoor environment. While there are numerous potential sources of naphthalene indoors, the use of mothballs can be a significant contributor to ambient concentrations.

The spatial epidemiology of cocaine, methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) use: a demonstration using a population measure of community drug load derived from municipal wastewater.

Aims: To determine the utility of community-wide drug testing with wastewater samples as a population measure of community drug use and to test the hypothesis that the association with urbanicity would vary for three different stimulant drugs of abuse.

Design And Participants: Single-day samples were obtained from a convenience sample of 96 municipalities representing 65% of the population of the State of Oregon.

Measurements: Chemical analysis of 24-hour composite influent samples for benzoylecgonine (BZE, a cocaine metabolite), methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA).

Longitudinal trends in organophosphate incidents reported to the National Pesticide Information Center, 1995-2007.

Background: Regulatory decisions to phase-out the availability and use of common organophosphate pesticides among the general public were announced in 2000 and continued through 2004. Based on revised risk assessments, chlorpyrifos and diazinon were determined to pose unacceptable risks. To determine the impact of these decisions, organophosphate (OP) exposure incidents reported to the National Pesticide Information Center (NPIC) were analyzed for longitudinal trends.

Regional variation in the severity of pesticide exposure outcomes: applications of geographic information systems and spatial scan statistics.

Introduction: Geographic information systems and spatial scan statistics have been utilized to assess regional clustering of symptomatic pesticide exposures reported to a state Poison Control Center (PCC) during a single year. In the present study, we analyzed five subsequent years of PCC data to test whether there are significant geographic differences in pesticide exposure incidents resulting in serious (moderate, major, and fatal) medical outcomes.

Methods: A PCC provided the data on unintentional pesticide exposures for the time period 2001-2005.

Regional and temporal variation in methamphetamine-related incidents: applications of spatial and temporal scan statistics.

Introduction: This investigation utilized spatial scan statistics, geographic information systems, and multiple data sources to assess spatial clustering of statewide methamphetamine-related incidents. Temporal and spatial associations with regulatory interventions to reduce access to precursor chemicals (pseudoephedrine) were also explored.

Methods: Four statewide data sources were utilized including regional poison control center statistics, fatality incidents, methamphetamine laboratory seizures, and hazardous substance releases involving methamphetamine laboratories.

Toxigenic fungi and mycotoxins in outdoor, recreational environments.

Introduction: Some epidemiological studies of damp buildings have focused on health risks from indoor exposure to toxigenic fungi and mycotoxins. Most of these studies have not considered assessment of these hazards in outdoor environments. The purpose of this investigation was to assess for toxigenic fungal species in outdoor recreational environments through the microbial analysis of locations representing opportunities for human exposure.

Fatality after a single dermal application of lindane lotion.

Lindane lotion, approved by the US Food and Drug Administration (FDA) for treatment of scabies and lice, poses risks of serious adverse effects on the nervous system. In 2003, the FDA issued a public health advisory for lindane products, emphasizing the importance of compliance with labeling instructions. The author presents a case in which a fatal outcome followed a single dermal application of lindane.

Pyrethrin and pyrethroid exposures in the United States: a longitudinal analysis of incidents reported to poison centers.

Introduction: Citing the Food Quality Protection Act, the US Environmental Protection Agency (EPA) decided to phase out and eliminate organophosphate insecticide use in residential environments. The phase out process spanned from 2000 to 2005, and it may have resulted in increased consumer use of insecticides containing other active ingredients. This study utilized data from the national Poison Control Center to assess possible changes in exposure incidents involving pyrethrin and pyrethroid insecticides during the phase out of organophosphates from residential uses.

Organophosphate exposures in the United States: a longitudinal analysis of incidents reported to poison centers.

The implementation of the Food Quality Protection Act of 1996 resulted in a decision by the U.S. Environmental Protection Agency to phase out and eliminate the use of organophosphate insecticides in residential environments.

Pyrethroid insecticides: advances and challenges in biomonitoring.

Pyrethroid insecticides have a wide variety of applications throughout the world. They are structurally diverse chemicals that are synthetically derived from naturally occurring pyrethrin insecticides. Significant advances in analytical chemistry have led to the development of biomarkers of exposure to pyrethroids, and these methods are currently being applied to study exposure in the general population.

Pesticides and electronic resources for health care providers.

Agricultural workers are at higher risk of occupational injuries, including pesticide exposures. There is general agreement that the training of health care providers to recognize and manage such exposures is limited and in need of improvement. While the Internet presents opportunities for health care providers to access information and continue their medical education, it can be difficult to identify relevant resources in a timely manner.

Biopesticides.

The term 'biopesticide' encompasses a broad array of microbial pesticides, biochemicals derived from micro-organisms and other natural sources, and processes involving the genetic incorporation of DNA into agricultural commodities that confer protection against pest damage (plant-incorporated protectants). Some microbial pesticides, such as Bacillus thuringiensis, have a long history of safe and effective use as a biological insecticide. More recent developments in microbial pest control include the utilisation of other bacterial and fungal species that may competitively inhibit the growth of pathogenic and toxigenic micro-organisms on important agricultural commodities.

DEET: a review and update of safety and risk in the general population.

The emergence of West Nile Virus (WNV) in North America has resulted in increased public awareness and utilization of insect repellents containing N,N-diethyl-m-toluamide (DEET) in the prevention of mosquito-borne disease. Regulatory reassessments in North American countries have recently been completed for insect repellents containing DEET as active ingredient, resulting in labeling changes intended to minimize unnecessary exposure to special populations, including children. This article describes those changes, and summarizes more recent data relating to the pharmacokinetics, toxicology, and epidemiology of adverse effects associated with DEET in humans.

Trichothecenes in the environment: relevance to human health.

Trichothecenes are agriculturally important mycotoxins of relevance to human health. Fungi capable of producing trichothecenes can be found throughout the world, and include certain species of Fusarium, Myrothecium, and Stachybotrys. The production of mycotoxins by these toxigenic species is determined by genetic factors and the environmental conditions of their growth.

Dietary aflatoxin exposure and chemoprevention of cancer: a clinical review.

Exposure to dietary aflatoxins is considered to be an important risk factor for the development of hepatocellular carcinoma in certain regions of the world. Significant advances have recently been made in understanding the clinical toxicology of aflatoxins. These include the development and validation of biomarkers of exposure and genotoxic effect.

Regional variation in the incidence of symptomatic pesticide exposures: applications of geographic information systems.

Objective: To evaluate the epidemiology of symptomatic human pesticide exposures using poison control center data and geographic information systems.

Methods: All symptomatic human pesticide exposures reported to the poison center during the period from January 1 to December 31, 2000 were included for analysis using geographic information systems. A space-time scan statistic was utilized to evaluate for clustering of symptomatic human exposures.