International Agency for Research on
Cancer (IARC) is a part of the World Health Organization (WHO) that
coordinates and conducts research on the causes of human cancer, the mechanisms
of carcinogenesis, and develops scientific strategies for cancer control.
The IARC Monographs series (> 800 agents) is one of 4 resources that OSHA
uses to list a material as known or probable human carcinogen. IARC classifies
agents (chemicals, mixtures, occupational exposures etc.) into 4 basic
categories:
group 1 : the agent (mixture) is carcinogenic
to humans. The exposure circumstance entails exposures that are carcinogenic
to humans
group 2 : the agent (mixture) is probably
carcinogenic to humans
group 2A : the exposure circumstance
entails exposures that are probably carcinogenic to humans
group 2B : the exposure circumstance
entails exposures that are possibly carcinogenic to humans.
group 3 : the agent (mixture, or exposure
circumstance) is unclassifiable as to carcinogenicity in humans.
group 4 : the agent (mixture, exposure
circumstance) is probably not carcinogenic to humans.
genotoxic carcinogens
procarcinogens or proximate carcinogens =phase I and phase II DMEs==>
primary
or ultimate carcinogens
ethylenimine / ethyleneimine : a toxic and carcinogenic compound,
C2H5N, occurring as a colorless oily liquid with
a strong odor of ammonia, used as an intermediate in a variety of industrial
processes. Derivatives include alkylating agents used as antineoplastics
ethylene dibromide / 1,2-dibromoethane : a derivative of bromine
and ethylene used as a fumigant and gasoline additive; it is irritating
to the skin and mucous membranes and carcinogenic
ethylene dichloride / 1,2-dichloroethane : a colorless heavy liquid
with a pungent odor, used as a solvent, gasoline additive, and intermediate;
it is irritating to the eyes and respiratory tract and can cause central
nervous system disturbances and renal and hepatic damage. Excessive exposure
can be carcinogenic
ethylene oxide / oxirane : a gas used
in the manufacture of ethylene glycol, acrylonitrile, and other compounds
and as a fumigant, fungicide, and sterilizing agent. It is highly irritating
to the eyes and mucous membranes and is carcinogenic
Symptoms & signs :
acute toxicity (> 700 ppm) : nausea, sleepiness, cough, chemical acute
pulmonary edema
and neurological manifetations
chronic toxicity : polyneuritis and encephalopathy
ethylidene chloride : 1,1-dichloroethane; an oily liquid with a
chloroformlike odor, used as a solvent and fumigant; it is irritating to
the eyes and respiratory system and can cause central nervous system disturbances
and renal and hepatic damage
chloroacetaldehyde : a mutagenic
metabolite produced by biotransformation of vinyl chloride in the liver.
o-tolidine : a compound related to benzidine and formerly
used in testing for occult blood; its use is now restricted because it
is a carcinogen
azoxymethane
dimethylhydrazine
polycyclic aromatic
hydrocarbons (PAH)
benzo[a]pyrene
(0.02-0.04 mg / smoked cigarette)
Sources :
smoked tobacco
(> 20 cigarettes / day => 15% likelihood of lung
carcinoma
in entire life). Nicotine acts as a cocarcinogen. Cells on the spurs between
airways build up inhaled carcinogens to concentrations at least 100 times
higher than elsewhere in the lung : some safe limits for pollutants could
be underestimates. Some particles are washed away by mucus and coughing;
others - such as tobacco smoke - are not, hence the dry, hacking cough
of a smoker. High-tar cigarettes leave deposits high up in the lungs, lower-tar
ones stain deeper in the lungs because smokers suck on them harder.
roasted meat
coke
Metabolism : converted by CYPs to diol-epoxide,
which acts as an intercalating agent formind adducts with DNA
=> gastric
adenocarcinoma
and scrotal nonmelanoma
skin cancers
in chimney-sweeps due to gravity deposition and poor hygiene
nitrites (NO2-)
Epidemiology : in 1997, not far from Bishkek,
the capital of the Kyrgyz republic, there was a mass poisoning with sodium
nitrite involving 54 people, of which 2 died. These people were drivers
of long distance trucks who had eaten plov (a dish very common in Russia
and the former Soviet states made with lamb, rice, carrots, onions and
lots of cooking oil, occasionally with added cumin), and all were ill within
2 hours. The dish was prepared by one of the drivers, who accidentally
put sodium nitrite (a white fine-grained powder that resembles salt) instead
of salt into the food
Sources : diet
food additives (E249 (KNO2),
E250
(NaNO2),
E252
(KNO2)).
Addition of nitrite leads to an attractive colour in meat products, protects
against fat oxidation and, in particular, inhibits outgrowth of Clostridium
spp..
Nitrates and nitrites have long been used as food preservatives/additives.
Preserved meats such as ham, lunch meats, bacon, and hot dogs are high
in nitrates and nitrites and should never be pureed and added to baby food
for young infants. Further, foods containing these products should not
be saved in the refrigerator for older infants. Processed meats, with the
exception of dry sausage (salami, pepperoni, etc.) and dry-cured hams,
use only sodium nitrite and not nitrates. The usage level of sodium nitrite
is limited in the USA in all meat products to 156 parts per million (ppm)
sodium nitrite based on meat weight. It has occasionally been mistaken
for salt or sugar
undiluted, it may be used as an insecticide or as a corrosion inhibitor
for metal tanks
dietary nitrate (NO3-) : the daily dietary exposure
of the general population is estimated from the UK 1997 Total Diet study
to be 52 mg/day
vegetables contribute approximately 70% to this total dietary exposure.
Dietary exposure estimates for adult consumers of vegetables commonly eaten
in the UK are 93 mg/day and 140 mg/day for mean and 97.5th percentile consumers,
respectively. No significant variance in nitrate levels is found for most
vegetables cultivated during the summer and winter harvests. The mean nitrates
level are higher in A. tuberosum Roth (5150 mg/kg) and spinach (4259
mg/kg), intermediate in radish (1878 mg/kg) and Chinese cabbage (1740 mg/kg),
and lower in onion (23 mg/kg), soybean sprouts (56 mg/kg) and green pepper
(76 mg/kg) compared with those in other vegetables. The average nitrite
contents in various vegetables are about 0.6 mg/kg, and the values are
not significantly different among most vegetables. Anyway it is not necessary
to establish limits of nitrates contents of vegetables due to the co-presence
of beneficial elements such as vitamin
C
and vitamin Ewhich
are known to inhibit the formation of N-nitrosamine. the risk of
GC decreased with high consumption of fresh vegetables and fruits, whereas
high consumption of foods rich in nitrate and carcinogenic substances produced
during the cooking process increased the risk of GC
contaminant of drinking water in many rural areas
When in saliva is reduced by anaerobic bacteria (gastric colonization by
Veillonella
parvula
and Haemophilus
parainfluenzae
is increased in hypochlorydria due to atrophic gastritis, e.g during Helicobacter
pylori
infection). Until recently nitrate was perceived as a purely harmful dietary
component which causes infantile methaemoglobinaemia, carcinogenesis
and possibly even teratogenesis. Epidemiological studies have failed
to substantiate this. It has been shown that dietary nitrate undergoes
enterosalivary
circulation. It is recirculated in the blood, concentrated by the salivary
glands, secreted in the saliva and reduced to nitrite by
nitrate reductase+
Gram-positive facultative anaerobic nitrite-producing bacteria (NPB)
(Staphylococcus sciuri
and Staphylococcus
intermedius
>> Pasteurella spp.
> Streptococcus spp.,
Peptostreptococcus
spp.,
Veillonella
spp.,
Staphylococcus
aureus,
Staphylococcus
epidermidis,
Nocardia
spp.,
Corynebacterium
pseudodiphteriticum,
Fusobacterium
nucleatumref)
on the tongue. The proportion of culturable NPB in the total culturable
microbial population increases from 6% (105 CFUs/cm2)
on the anterior tongue to 65% (107 CFUs/cm2) on the
posterior tongue. Different species compositions of NPB are found on different
tongue sections with S. intermedius populations decreasing and S.
sciuri and Pasteurella populations increasing towards the posterior
tongue. Nitrite production is sensitive to oxygen, and significant nitrite
production is only detected on the posterior tongue where the majority
of bacteria are situated in deep clefts in the tongue surfaceref.
Pathogenesis : salivary nitrite is swallowed
into the acidic stomach where it is reduced to large quantities of NO
and other oxides of N and, conceivably, also contributes to the
formation of systemic S-nitrosothiols. NO and solutions of
acidified nitrite, mimicking gastric conditions, have been shown to have
antimicrobial activity against a wide range of organisms. In particular,
acidified nitrite is bactericidal for a variety of gastrointestinal pathogens
such as Yersinia spp.
and Salmonella spp..
NO is known to have vasodilator properties and to modulate platelet function,
as are S-nitrosothiols. Thus, nitrate in the diet, which determines
reactive nitrogen oxide species production in the stomach (McKnight et
al. 1997), is emerging as an effective host defence against gastrointestinal
pathogens, as a modulator of platelet activity and possibly even of gastrointestinal
motility and microcirculation. Therefore dietary nitrate may have an important
therapeutic role to play, not least in the immunocompromised and in refugees
who are at particular risk of contracting gastroenteritides. A large amount
of N2O
produced in the intestine and normal nitrate intake do not influence the
breath NO concentration, probably due to its relatively small production.
Higher maximum N2O concentration after ingesting lettuce in
old subject is probably because more bacteria, which rapidly reduce dietary
nitrate in the upper intestinal tract, inhabit the gut in old age.
acute overdose : nitrite causes the oxidation of the iron in hemoglobin
from the ferrous to the ferric state, converting normal hemoglobin to methemoglobin
(methemoglobinemia),
which is unable to transport oxygen from lungs to tissues and imparts a
brown hue to the blood. This etiology should be suspected when a
blood sample is brown and does not redden on exposure to air. Bacteria
in the gastrointestinal system mediate the conversion of nitrate to nitrite.
Consequently the risk of methemoglobinemia from ingestion of nitrate depends
not only on the dose of nitrate by also on the number and type of enteric
bacteria. In meat, the nitrite is bound to the myoglobin in the meat and
would therefore not be an issue in methemoglobinemia
chronic overdose : => peroxynitrite => mutagenic N-nitrosoamines
(e.g. 3-nitro-L-tyrosine residues, especially at the
gastric cardia : that a multitude of reactive nitrogen species other than
peroxynitrite are capable of producing nitrotyrosine) and N-nitrosoamides
=> gastric
adenocarcinoma
and esophageal
squamous cell carcinoma (ESCC)
; long-term exposure to elevated nitrate levels in drinking water may contribute
to the risk of non-Hodgkin's
lymphoma (NHL)ref
Laboratory examinations Therapy : intravenous methylene blue;
hemodialysis
is not of any benefit
Experimental animal models : administration
of sarcosine ethyl ester hydrochloride (SEEH) and sodium nitrite (NaNO2),
precursors of N-nitrososarcosine ethyl ester (NSEE)
feeding laboratory animals
the chemical at high dosages for their entire life span => autopsies and
histochemical examinations : this approach can detect both genotoxic and
nongenotoxic carcinogens.
nematodes offer advantages especially during the expensive initial stages
that typically involve large-scale screening. For example, it takes just
3½ days for the roundworm to develop from egg to adult. Since each
adult worm is only 1 mm in length, large numbers can be maintained and
tested in small spaces. Because the roundworms are transparent, researchers
can also directly monitor chemicals effects on the worms’ developing internal
organs. Toxicity screening during development evaluates how pre-selected
amounts of chemicals affect groups of animals as they grow. Even if the
animals do not sicken or die as they mature in the presence of toxicants,
the chemicals may affect their organs in ways that can be investigated
- normally through surgery or necropsy. As with laboratory rats and mice,
"knockout" varieties of C. elegans can be produced to evaluate how
the animal’s physiology changes if specific genes are excluded from its
genome through biochemical manipulation. Unlike genetically engineered
rodents, the roundworms themselves are not engineered. Instead, their bacterial
food is simply spiked with "antisense" DNA designed to block the function
of the gene. To knock out one mouse gene can cost $100,000 to do a genetics
study that takes 1 year, whereas in C. elegans you just feed the
roundworms a strain of bacterium and the gene is knocked out. In addition,
strains of the roundworms have been genetically engineered to make various
cells change color or emit a fluorescent glow in the presence of a toxic
chemical. Much of the work is being done by computer-controlled robotic
machines. Robots automatically dispense hot agar gel to support the bacterial
colonies the worms use as food. After the agar cools and solidifies in
the sunken wells where the animals will live, machines add drops of bacteria.
Robots also measure out chemicals at various levels of dilution and place
those in the wells. Meanwhile, another machine, called a "biosorter," sends
worms through a centrifuge before sucking them into tiny passages. There
they are counted and sorted one by one while a laser beam senses each animal’s
length, as well as its diameter, age, color and general health. Then the
biosorter dispenses the right worms into the correct wells for a specific
experiment. There are 96 wells arrayed on each plate, the basic testing
unit of this highly automated operation. Between 10 and 50 nematodes are
placed in each well depending on the test. You may put worms that have
just hatched into a well and watch them grow or you do another experiment
where we put an adult animal in and see how many offspring it makes and
count the offspring and see how fast they grow. Another variation is to
create varieties of transgenic worm lines, each bearing a different gene
that fluoresces green under stress. That way in a 96-well plate each well
would have a different strain of transgenic worm that could respond to
a chemical. So you just put the same chemical in all the wells to find
out which gene is turning on. Alternatively you can look for changes in
the expression of every gene in the animal caused by a given chemical with
microarray fingerprints. Whole flasks of worms can be grown and dosed with
chemicals before having the mRNA extracted from their cells. The amount
of each mRNA molecule can then be measured on custom microarrays and compared
with the genomes of nematodes that have not been exposed to chemicals.
Prevention : replace carcinogenic chemicals
with noncarcinogenic ones