Multi-Media Exposure to Polycyclic Aromatic Hydrocarbons at Lake Chaohu, the Fifth Largest Fresh Water Lake in China: Residual Levels, Sources and Carcinogenic Risk

The residual levels of 16 priority polycyclic aromatic hydrocarbons (PAHs) in environment media and freshwater fish were collected and measured from Lake Chaohu by using Gas chromatography-mass spectrometry. Potential atmospheric sources were identified by molecular diagnostic ratios and the positive matrix factorization (PMF) method. PAH exposure doses through inhalation, intake of water and freshwater fish ingestion were estimated by the assessment model recommended by US EPA. The carcinogenic risks of PAH exposure were evaluated by probabilistic risk assessment and Monte Carlo simulation. The following results were obtained: (1) The PAH16 levels in gaseous, particulate phase, water and fish muscles were 59.4 ng·m−3, 14.2 ng·m−3, 170 ng·L−1 and 114 ng·g−1, respectively. No significant urban-rural difference was found between two sampling sites except gaseous BaPeq. The relationship between gaseous PAHs and PAH in water was detected by the application of Spearman correlation analysis. (2) Three potential sources were identified by the PMF model. The sources from biomass combustions, coal combustion and vehicle emission accounted for 43.6%, 30.6% and 25.8% of the total PAHs, respectively. (3) Fish intake has the highest lifetime average daily dose (LADD) of 3.01 × 10−6 mg·kg−1·d−1, followed by the particle inhalation with LADD of 2.94 × 10−6 mg·kg−1·d−1. (4) As a result of probabilistic cancer risk assessment, the median ILCRs were 3.1 × 10−5 to 3.3 × 10−5 in urban and rural residents, which were lower than the suggested serious level but higher than the acceptable level. In summary, the result suggests that potential carcinogenic risk exists among residents around Lake Chaohu. Fish ingestion and inhalation are two major PAH exposure pathways.

302 Migratory Foreign Body in The Neck- How A Fishbone Morphed into A Piece of Glass In 18 Months

Background Foreign body (FB) ingestion is a common presentation to ear, nose, and throat (ENT) surgeons. Usual culprits include fish or chicken bones, steak, or non-organic items. FBs can be categorised into batteries, hard objects, and soft boluses. Hard objects that have not passed beyond the post-cricoid region require removal to minimise perforation risk. In rare cases FBs are reported to migrate extra-luminally into surrounding tissues of the neck necessitating cross-sectional imaging ahead of neck exploration. Case Report A 70-year-old lady presented to A&E with a sensation of FBs in her throat. She was aphagic without dyspnoea. Home-cooked fish ingestion was the precursor. Panendoscopy was clear. The patient was discharged once tolerating fluids and soft diet. She presented 14 months later to the ENT clinic with a persistent FB sensation in her throat. A computed-tomography scan of neck showed a right sided, radio-opaque, 3 cm foreign body sitting just anterior to the carotid sheath, behind the right superior thyroid lobe. An elective external neck exploration revealed a 3 cm shard of glass which was successfully removed without complications. Conclusions Extra-luminal migration of FBs is extremely rare. They may present with life-threatening suppurative or vascular complications. A literature review revealed that migratory FBs tend to be sharp and long such as needles, wires, or fishbones. To allow prompt diagnosis and management, we propose a low threshold for CT imaging in instances with a clear history and persistent symptoms even when panendoscopy is negative.

Severe scombroid poisoning and life-threatening hypotension

Scombroid fish poisoning (SFP), the most common fish-related illness worldwide, is a histamine response caused by the heat stable toxin histamine. A healthy 48-year-old woman and co-author of this paper developed palpitations, tachycardia and hypotension 10 min after a tuna steak dinner. She subsequently developed numbness of her face, flushing, conjunctival erythema, abdominal pain, nausea, vomiting, diarrhoea, headache and chest pain. Her ECG revealed tachycardia with ST depression. Her hypotension did not respond to fluid resuscitation, and she required phenylephrine. Based on exposure history, clinical syndrome, exclusion of other diseases and consultation with poison control, a diagnosis of scombroid poisoning was established. The state health department was notified. The patient was weaned off vasopressors, dosed famotidine and discharged 43 hours after fish ingestion with no symptoms and normal ECG. SFP is an often misdiagnosed and underreported illness with the potential to cause life-threatening hypotension.

Changes in Eating Habits among Displaced and Non-Displaced University Students

Nowadays the younger generations are moving their food habits from the traditional diet to a Western diet, which is low in fruits and vegetables and high in fat and sugary drinks. University students are a particularly vulnerable population once, with the entrance to university, they are subjected to new influences and responsibilities; in particular, those who live far from their parents’ houses are more predisposed to unhealthy eating habits. To assess the influence that admission to university has had on the frequency of intake of certain foods and meals as well as their adherence to the Mediterranean diet (MedDiet), self-administered questionnaires were applied. The sample included 97 Portuguese students, with an average age of 21 years, a normal weight, according to body mass index, and an average MedDiet adherence. Most of the individuals did not smoke and the majority did not drink coffee. It was also observed that displaced students consume fast food more frequently compared to the period before they start university. Fish ingestion decreased and coffee consumption increased, in the same group, after starting their university studies.

A rare case of Shewanella septicemia: risk factors, environmental associations and management

Shewanella species are Gram-negative, saprophytic, motile bacilli. Exposure to aquatic environment and raw fish ingestion have been defined as significant associated risk factors. The two species most commonly associated with human infections are Shewanella algae and Shewanella putrefaciens and major portion of infections (80%) caused by the former. Herein, we report a case of Shewanella septicaemia in a 70-year-old man in Omaha, NE who had no exposure to aquatic environment. To date, no defined treatment guidelines are present due to rarity of Shewanella infections, which is contributing to emerging antibiotic resistance.

PS01.103: THE UNUSUAL CAUSES OF ODYNOPHAGIA

Background Odynophagia can be caused by infective and non-infective inflammatory processes, benign and malignant esophageal disorders such as achalasia, gastro-esophageal reflux disease and carcinoma. Methods We described two unusual cases of odynophagia and their individual management. Results Case 1 is a 21 year-old Indian man presented with 2 days history of odynophagia after taking doxycycline capsules indicated for acne. An esophagogastroduodenoscopy (OGD) was performed and showed multiple mid esophageal ulcers. Esophageal biopsy taken showed inflammatory ulcer slough with no fungal infection, dysplasia or malignancy. Doxycycline was stopped and patient recovered with complete resolution of odynophagia. Case 2 is a 55 year-old Chinese man presented with 1 day history of odynophagia and severe chest pain after eating a bowl of hot fish soup. A CT Thorax was performed which showed a localised perforation of the right wall of the esophagus with extraluminal gas posterior to the trachea. An urgent OGD was performed and an L-shaped fish bone was removed successfully and an endoclip was applied to close the puncture hole of esophagus. Patient made a full recovery without any mediastinal infection. Conclusion Odynophagia from mid esophageal ulcers secondary to doxycycline intake should be recognized and can be easily managed by stopping the antibiotics with complete resolution of the symptom. Fish ingestion leading to sharp bone induced penetrating esophageal injury can be safely managed by endoscopic removal and endoclip application. Disclosure All authors have declared no conflicts of interest.

A zero percent plastic ingestion rate by silver hake (Merluccius bilinearis) from the south coast of Newfoundland, Canada

Silver hake, (Merluccius bilinearis), contributes significant biomass to Northwest Atlantic ecosystems. The incidence of plastic ingestion for 134 individuals collected from Newfoundland, Canada was examined through visual examination of gastrointestinal contents and Raman spectrometry. We found a frequency of occurrence of ingestion of 0%. Through a comprehensive literature review of globally published fish ingestion studies, we found our value to be consistent with 41% (n=100) of all reported fish ingestion rates. We could not statistically compare silver hake results to other species due to low sample sizes in other studies (less than n=20) and a lack of standardized sampling methods. We recommend that further studies should 1) continue to report 0% plastic ingestion rates and 2) should describe location and species-specific traits that may contribute to 0% ingestion rates, particularly in locations where fish consumption has cultural and economic significance.