Per- and polyfluoroalkyl substances (PFAS) have recently been shown to affect human health at low levels in the blood, according to epidemiological evidence. Consequently, human exposure to these chemicals should be strictly controlled to prevent health risks. This review reports on the potential sources of PFAS using Japan as an example. Tap water has attracted attention as a source of exposure to PFAS. PFAS have also been detected in the air, in household dust, and in consumer products. Furthermore, in the general population, diet is the most common source of exposure, and there is particular concern about human exposure to PFAS accumulated in seafood. Continuous monitoring is important for appropriate management of exposure for both humans and the environment.
Seafood/toxicity* ; Fluorocarbons/toxicity* ; Japan ; Drinking Water/standards* ; Air Pollutants/toxicity* ; Humans ; Dust/analysis* ; Environmental Exposure/standards* ; Food Contamination/analysis* ; Environmental Pollutants/toxicity* ; Water Pollutants, Chemical/toxicity*

Mercury exists naturally and as a man-made contaminant. The release of processed mercury can lead to a progressive increase in the amount of atmospheric mercury, which enters the atmospheric-soil-water distribution cycles where it can remain in circulation for years. Mercury poisoning is the result of exposure to mercury or mercury compounds resulting in various toxic effects depend on its chemical form and route of exposure. The major route of human exposure to methylmercury (MeHg) is largely through eating contaminated fish, seafood, and wildlife which have been exposed to mercury through ingestion of contaminated lower organisms. MeHg toxicity is associated with nervous system damage in adults and impaired neurological development in infants and children. Ingested mercury may undergo bioaccumulation leading to progressive increases in body burdens. This review addresses the systemic pathophysiology of individual organ systems associated with mercury poisoning. Mercury has profound cellular, cardiovascular, hematological, pulmonary, renal, immunological, neurological, endocrine, reproductive, and embryonic toxicological effects.
Body Burden ; *Environmental Exposure ; Environmental Pollutants/*toxicity ; Humans ; Methylmercury Compounds/*toxicity ; Nervous System/*drug effects ; Seafood/analysis

INTRODUCTIONFood-dependent exercise-induced anaphylaxis (FDEIA) is an uncommon and under-recognised syndrome that clinicians may not consider in a patient presenting with anaphylaxis.

CLINICAL PICTUREWe describe here 5 patients aged 9 to 20 years old who presented at a local tertiary hospital over a 2-year period from August 2006 to July 2008. All presented with urticaria, 4 were hypotensive, 2 had angioedema and another 2 had dyspnoea. The symptoms occurred between 15 and 150 minutes (mean, 81) after exercising and consuming various food. All had consumed shellfish. All patients were admitted with the diagnosis of anaphylaxis of undefined aetiology. Diagnosis of FDEIA was only reached upon referral to an allergist.

TREATMENT AND OUTCOMEPatients were treated with standard medicines for anaphylaxis including adrenaline, antihistamines, steroids and fluid flushes. Symptoms resolved in 2 to 3 days with no further episodes. At discharge, patients were prescribed epinephrine auto-injectors and given written anaphylaxis management plans.

CONCLUSIONSMore public awareness and strategies to ensure accurate diagnosis and management of this condition are necessary.

Adolescent ; Anaphylaxis ; drug therapy ; etiology ; Angioedema ; etiology ; Animals ; Bronchodilator Agents ; therapeutic use ; Child ; Dyspnea ; etiology ; Epinephrine ; therapeutic use ; Exercise ; Female ; Food Hypersensitivity ; diagnosis ; drug therapy ; etiology ; Humans ; Male ; Retrospective Studies ; Seafood ; adverse effects ; toxicity ; Syndrome ; Urticaria ; etiology ; Vasoconstrictor Agents ; therapeutic use ; Young Adult