Pharmaceutical and Antibiotic Environmental Impacts, Advanced biosensing and bioanalysis techniques, Biosensors and Analytical DetectionJohn L. Wilkinson, Alistair B.A. Boxall, Dana W. Kolpin, Kmy Leung, Racliffe Weng Seng Lai, Cristóbal Galbán‐Malagón, Aiko D. Adell, Julie Mondon, Marc Métian, Rob Marchant, Alejandra Bouzas‐Monroy, Aida Cuní‐Sanchez, Anja Coors, Pedro Carriquiriborde, Macarena Rojo, Christopher Gordon, Magdalena Cara, Monique Moermond, Thais Luarte, Vahagn Petrosyan, Yekaterina Perikhanyan, Clare S. Mahon, Christopher J. McGurk, Thilo Hofmann, Tapos Kormoker, Volga Iñiguez, Jessica Guzman-Otazo, Jean Leite Tavares, Francisco Gildasio De Figueiredo, María Tereza Pepe Razzolini, Victorien Dougnon, Gildas Gbaguidi, Oumar Traoré, Jules M. Blais, Linda E. Kimpe, Michelle Wong, Donald Wong, Romaric Ntchantcho, Jaime Pizarro, Guang‐Guo Ying, Chang-Er Chen, Martha Isabel Páez-Melo, Jina Martínez-Lara, Jean‐Paul Otamonga, John Poté, Suspense A. Ifo, Penelope Wilson, Silvia Echeverría-Sáenz, Nikolina Udiković‐Kolić, Milena Milaković, Despo Fatta‐Kassinos, Lida Ioannou‐Ttofa, Vladimíra Belušová, Jan VEnvironmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in rivers, these employ different analytical methods, measure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world's rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.
Proceedings of the National Academy of Sciences · 2022Global Cancer Incidence and Screening, COVID-19 and healthcare impacts, Hematological disorders and diagnosticsChristina Fitzmaurice, Degu Abate, Naghmeh Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Omar Abdel‐Rahman, Ahmed Abdelalim, Amir Abdoli, Ibrahim Abdollahpour, Abdishakur S. M. Abdulle, Nebiyu Dereje Abebe, Haftom Niguse Abraha, Laith J. Abu‐Raddad, Ahmed Abualhasan, Isaac Akinkunmi Adedeji, Shailesh M Advani, Mohsen Afarideh, Mahdi Afshari, Mohammad Aghaali, Dominic Agius, Sutapa Agrawal, Ayat Ahmadi, Elham Ahmadian, Ehsan Ahmadpour, Muktar Beshir Ahmed, Mohammad Esmaeil Akbari, Tomi Akinyemiju, Ziyad Al‐Aly, Assim M. AlAbdulKader, Fares Alahdab, Shazia Alam, Genet Melak Alamene, Birhan Alemnew, Kefyalew Addis Alene, Cyrus Alinia, Vahid Alipour, Syed Mohamed Aljunid, Fatemeh Allah Bakeshei, Majid A. Almadi, Amir Almasi‐Hashiani, Ubai Alsharif, Shirina Alsowaidi, Nelson Alvis‐Guzmán, Erfan Amini, Saeed Amini, Yaw Ampem Amoako, Zohreh Anbari, Nahla Anber, Cătălina Liliana Andrei, Mina Anjomshoa, Fereshteh Ansari, Ansariadi Ansariadi, Seth Christopher Yaw Appiah, Morteza Arab‐Zozani, Jalal Arabloo,Importance Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs). Conclusions and Relevance The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.
JAMA Oncology · 2019