Richard Gminski

University of Freiburg, Freiburg, Baden-Württemberg, Germany

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Publications (43)100.8 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: In the present study, in vitro toxicity as well as biopersistence and photopersistence of four artificial sweeteners (acesulfame, cyclamate, saccharine, and sucralose) and five antibiotics (levofloxacin, lincomycin, linezolid, marbofloxacin, and sarafloxacin) and of their phototransformation products (PTPs) were investigated. Furthermore, antibiotic activity was evaluated after UV irradiation and after exposure to inocula of a sewage treatment plant. The study reveals that most of the tested compounds and their PTPs were neither readily nor inherently biodegradable in the Organisation for Economic Co-operation and Development (OECD)-biodegradability tests. The study further demonstrates that PTPs are formed upon irradiation with an Hg lamp (UV light) and, to a lesser extent, upon irradiation with a Xe lamp (mimics sunlight). Comparing the nonirradiated with the corresponding irradiated solutions, a higher chronic toxicity against bacteria was found for the irradiated solutions of linezolid. Neither cytotoxicity nor genotoxicity was found in human cervical (HeLa) and liver (Hep-G2) cells for any of the investigated compounds or their PTPs. Antimicrobial activity of the tested fluoroquinolones was reduced after UV treatment, but it was not reduced after a 28-day exposure to inocula of a sewage treatment plant. This comparative study shows that PTPs can be formed as a result of UV treatment. The study further demonstrated that UV irradiation can be effective in reducing the antimicrobial activity of antibiotics, and consequently may help to reduce antimicrobial resistance in wastewaters. Nevertheless, the study also highlights that some PTPs may exhibit a higher ecotoxicity than the respective parent compounds. Consequently, UV treatment does not transform all micropollutants into harmless compounds and may not be a large-scale effluent treatment option.
    Environmental Science and Pollution Research 07/2015; DOI:10.1007/s11356-015-4831-x · 2.83 Impact Factor
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    ABSTRACT: Data allowing for a complete environmental risk assessment of pharmaceuticals and their photoderatives in the environment are still scarce. In the present study, in vitro toxicity and both bio- and photopersistence of various pharmaceuticals (aciclovir, allopurinol, cetirizine, cimetidine, fluconazole, hydrochlorothiazide, lisinopril, phenytoin, primidone, ranitidine, sotalol, sulpiride, tramadol and valsartane) as well as their phototransformation products were evaluated in order to fill data gaps and to help prioritise them for further testing. Twelve out of the fourteen compounds investigated were found to be neither readily nor inherently biodegradable in the Organisation of Economic Cooperation and Development-biodegradability tests. The study further demonstrates that the photo-induced transformation of the pharmaceuticals was faster upon irradiation with a Hg lamp (UV light) than with a Xe lamp emitting a spectrum that mimics sunlight. Comparing the non-irradiated with the respective irradiated solutions, a higher acute and chronic toxicity against bacteria was found for the irradiated solutions of seven compounds (cetirizine, cimetidine, hydrochlorothiazide, ranitidine, sulpiride, tramadol and valsartane). No cyto- and genotoxic effects were found in human cervical (HeLa) and liver (Hep-G2) cells for any of the investigated compounds or their phototransformation products. This comparative study documents that phototransformation products can arise as a result of UV treatment of wastewater containing these pharmaceuticals. It further demonstrates that some phototransformation products may have a higher environmental risk potential than the respective parent compounds because some phototransformation products exhibited a higher bacterial toxicity.
    Environmental Chemistry 01/2014; 11:431-444. DOI:10.1071/EN13218 · 2.51 Impact Factor
  • Günter Speit · Richard Gminski · Rudolf Tauber
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    ABSTRACT: Conflicting results have been published regarding the induction of genotoxic effects by exposure to radiofrequency electromagnetic fields (RF-EMF). Various results indicating a genotoxic potential of RF-EMF were reported by the collaborative EU-funded REFLEX (Risk Evaluation of Potential Environmental Hazards From Low Energy Electromagnetic Field Exposure Using Sensitive in vitro Methods) project. There has been a long-lasting scientific debate about the reliability of the reported results and an attempt to reproduce parts of the results obtained with human fibroblasts failed. Another part of the REFLEX study was performed in Berlin with the human lymphoblastoid cell line HL-60; genotoxic effects of RF-EMF were measured by means of the comet assay and the micronucleus test. The plausibility and reliability of these results were also questioned. In order to contribute to a clarification of the biological significance of the reported findings, a repeat study was performed, involving scientists of the original study. Comet-assay experiments and micronucleus tests were performed under the same experimental conditions that had led to genotoxic effects in the REFLEX study. Here we report that the attempts to reproduce the induction of genotoxic effects by RF-EMF in HL-60 cells failed. No genotoxic effects of RF-EMF were measured in the repeat experiments. We could not find an explanation for the conflicting results. However, the negative repeat experiments suggest that the biological significance of genotoxic effects of RF-EMF reported by the REFLEX study should be re-assessed.
    Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis 06/2013; 755(2). DOI:10.1016/j.mrgentox.2013.06.014 · 3.68 Impact Factor
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    ABSTRACT: In a recent study, magnetite was investigated for its potential to induce toxic effects and influence signalling pathways. It was clearly demonstrated that ROS formation leads to mitochondrial damage and genotoxic effects in A549 cells. Based on these findings, we wanted to elucidate the origin of magnetite-mediated ROS formation and its influence on the cell cycle of A549 and H1299 human lung epithelial cells. A concentration and size-dependent superoxide formation, measured by electron paramagnetic resonance (EPR), was observed. Furthermore, we could show that the GSH level decreased significantly after exposure to magnetite particles while catalase (CAT) activity was increased. These effects were also depending on particle size, albeit less pronounced than those observed with EPR. We were able to show that incubation of A549 cells prior to particle treatment with diphenyleneiodonium (DPI), a NADPH-oxidase (NOX) inhibitor, leads to decreased ROS formation, but this effect was not observed for the NOX inhibitor apocynin. Soluble iron does not contribute considerably to ROS production. Analysis of cell-cycle distribution revealed a pronounced sub-G1 peak, which cannot be linked to increased cell death. Western blot analysis did not show activation of p53 but upregulation of p21 in A549. Here, we were unexpectedly able to demonstrate that exposure to magnetite leads to p21-mediated G1-like arrest. This has been reported previously only for low concentrations of microtubule stabilisation drugs. Importantly, the arrested sub-G1 cells were viable and showed no caspase 3/7 activation.
    Chemical Research in Toxicology 04/2013; 26(5). DOI:10.1021/tx300503q · 3.53 Impact Factor
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    ABSTRACT: During the 19-week finishing of a timber frame house, eight indoor air measurements were performed, comprising volatile organic compounds (VOC) and aldehydes and ketones of low molecular weight. The air change rate was 0,2 h-1 and concentrations of wood specific substances reached their maximum levels in week 2 with aliphatic aldehydes (C4-C11) and bicyclic terpenes, 862 and 823 μg/m3 respectively To determine cytotoxic effects and the relase of inflammation indicators, indoor air samples taken in parallel were examined by cellbiological tests. The same assay was performed exposing cells to the exhaust of an emission chamber loaded with oriented strand board (OSB) or thermo-hemp insulation material, which were used for the house. Neither the indoor air emissions nor the construction materials' emissions showed significant cytotoxic effects in the cellbiological tests.
    Gefahrstoffe Reinhaltung der Luft 03/2013; 73(3):81-86. · 0.33 Impact Factor
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    ABSTRACT: Reports on adverse health effects related to occupational exposure to toner powder are still inconclusive. Therefore, we have previously conducted an in vitro-study to characterize the genotoxic potential of three commercially available black printer toner powders in A549 lung cells. In these cell-based assays it was clearly demonstrated that the tested toner powders damage DNA and induce micronucleus (MN) formation. Here, we have studied the cytotoxic and proinflammatory potential of these three types of printer toner particles and the influence of ROS and NF-κB induction in order to unravel the underlying mechanisms. A549 cells were exposed to various concentrations of printer toner particle suspensions for 24 h. The toner particles were observed to exert significant cytotoxic effects in the WST-1 and neutral red (NR)-assays, although to a varying extent. Caspase 3/7 activity increased, while the mitochondrial membrane potential (MMP) was not affected. Particles of all three printer toner powders induced concentration-dependent formation of reactive oxygen species (ROS), as measured in the DCFH-DA assay. Furthermore, toner particle exposure enhanced interleukin-6 and interleukin-8 production, which is in agreement with activation of the transcription factor NF-κB in A549 cells shown by the electrophoretic mobility shift assay (EMSA). Therefore, it can be concluded that exposure of A549 lung cells to three selected printer toner powders caused oxidative stress through induction of ROS. Increased ROS formation may trigger genotoxic effects and activate proinflammatory pathways.
    Toxicology Letters 02/2013; 216(s 2–3):171–180. DOI:10.1016/j.toxlet.2012.11.018 · 3.26 Impact Factor
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    ABSTRACT: Ambient airborne particulate matter is known to cause various adverse health effects in humans. In a recent study on the environmental impacts of coal and tire combustion in a thermal power station fine crystals of PbSO4 (anglesite), ZnSO4•H2O (gunningite), and CaSO4 (anhydrite) were identified in the stack emissions. Here, we have studied the toxic potential of these sulfate phases as particulates and their uptake in human alveolar epithelial cells (A549). Both PbSO4 and CaSO4 yielded no loss of cell viability, as determined by the WST-1 and NR assays. In contrast, a concentration-dependent increase in cytotoxicity was observed for Zn sulfate. For all analyzed sulfates, an increase in the production of reactive oxygen species (ROS), assessed by the DCFH-DA assay and Electron Paramagnetic Resonance (EPR), was observed, although to a varying extent. Again, Zn sulfate was the most active compound. Genotoxicity assays revealed concentration-dependent DNA damage and induction of micronuclei for Zn sulfate and, to a lower extent, for CaSO4, whereas only slight effects could be found for PbSO4. Moreover, changes of cell cycle were observed for Zn sulfate and PbSO4. It could be shown further that Zn sulfate increased the nuclear factor kappa-B (NF-κB) DNA binding activity and activated c-Jun N-terminal kinases (JNK). During our TEM investigations, no effect on the appearance of the A549 cells exposed to CaSO4 compared to the non-exposed cells was observed, and in our experiments only one CaSO4 particle was detected in the cytoplasm. In the case of exposure to Zn sulfate, no particles were found in the cytoplasm of A549 cells, but we observed a concentration-dependent increase in the number and size of dark vesicles (presumably zincosomes). After exposure to PbSO4, the A549 cells contained isolated particles as well as agglomerates both in vesicles and in the cytoplasm. Since these metal-sulfate particles are emitted into the atmosphere via the flue gas of coal-fired power stations, they may be globally abundant. Therefore, our study is of direct relevance to the population living near such power plants.
    Chemical Research in Toxicology 11/2012; 25(12). DOI:10.1021/tx300333z · 3.53 Impact Factor
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    ABSTRACT: Epidemiological studies have shown that respirable exposure to emitted cement particulate matter is associated with adverse health risk for human. The underlying mechanisms, however, are poorly understood. To examine the effect of cement, nine blinded cement-related particulates (<10 μm) were assessed with regard to their induction of the proinflammatory cytokines IL-6 and IL-8 in human primary epithelial cells (pEC) from oropharyngeal mucosa as well as from nonsmall-cell lung carcinoma (non-SCLC) cells A549. It was demonstrated that the cement specimens did not act cytotoxic as assessed by the lactate dehydrogenase (LDH) assay. The basal and IL-1β-induced IL-8 expression was suppressed, in contrast to an unchanged IL-6. At the transcript level the basal and induced IL-6 and IL-8 gene expression was not influenced by cement dust. To discover the mechanism by which cement influenced the IL-8 expression the following experiments were performed. Submerse exposure experiments have shown that the release of IL-8 was suppressed by cement dust. Furthermore, the incubation of IL-8 with cement-related specimens under cell-free condition led to a loss of immunoreactive IL-8. An immunological masking of IL-8 by free soluble components of respiratory epithelial cells was excluded. Thus, the decrease of IL-8 protein content after cement exposure seems to be a result of the adsorption of IL-8 protein to cement particles and the inhibition of IL-8 release. In conclusion, due to absent cytotoxic and inflammatory effects of cement-related specimens in both human pEC and A549 cell models it remains open how cement exposure may lead to the respiratory adverse effects in humans.
    Environmental Toxicology 05/2012; 27(5):297-306. DOI:10.1002/tox.20643 · 3.20 Impact Factor
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    ABSTRACT: Exposure to emissions from laser printers during the printing process is commonplace worldwide, both in the home and workplace environment. In the present study, cytotoxic and genotoxic effects of the emission from five low to medium-throughput laser printers were investigated with respect to the release of ozone (O(3) ), volatile organic compounds (VOC), particulate matter (PM), and submicrometer particles (SMP) during standby and operation. Experiments were conducted in a 1 m(3) emission chamber connected to a Vitrocell® exposure system. Cytotoxicity was determined by the WST-1 assay and genotoxicity by the micronucleus test in human A549 lung cells. The five laser printers emitted varying but generally small amounts of O(3) , VOC, and PM. VOC emissions included 13 compounds with total VOC concentrations ranging from 95 to 280 μg/m(3) (e.g., 2-butanone, hexanal, m,p-xylene, and o-xylene). Mean PM concentrations were below 2.4 μg/m(3). SMP number concentration levels during standby ranged from 9 to 26 particles/cm(3). However, three of the printers generated a 90 to 16 × 10(3) -fold increase of SMP during the printing process (maximum 294,460 particles/cm(3)). Whereas none of the printer emissions were found to cause cytotoxicity, emissions from two printers induced formation of micronuclei (P < 0.001), thus providing evidence for genotoxicity. As yet, differences in biological activity cannot be explained on the basis of the specific emission characteristics of the different printers. Because laser printing technology is widely used, studies with additional cytogenetic endpoints are necessary to confirm the DNA-damaging potency and to identify emission components responsible for genotoxicity.
    Environmental and Molecular Mutagenesis 03/2012; 53(2):125-35. DOI:10.1002/em.20695 · 2.63 Impact Factor
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    ABSTRACT: Ciprofloxacin (CIP), a broad-spectrum, second-generation fluoroquinolone, has frequently been found in hospital wastewaters and effluents of sewage treatment plants. CIP is scarcely biodegradable, has toxic effects on microorganisms and is photosensitive. The aim of this study was to assess the genotoxic potential of CIP in human HepG2 liver cells during photolysis. Photolysis of CIP was performed in aqueous solution by irradiation with an Hg lamp, and transformation products were monitored by HPLC-MS/MS and by the determination of dissolved organic carbon (DOC). The cytotoxicity and genotoxicity of CIP and of the irradiated samples were determined after 24 h of exposure using the WST-1 assay and the in vitro micronucleus (MN) test in HepG2 cells. The concentration of CIP decreased during photolysis, whereas the content of DOC remained unchanged. CIP and its transformation products were not cytotoxic towards HepG2 cells. A concentration-dependent increase of MN frequencies was observed for the parent compound CIP (lowest observed effect level, 1.2 μmol L(-1)). Furthermore, CIP and the irradiated samples were found to be genotoxic with a significant increase relative to the parent compound after 32 min (P < 0.05). A significant reduction of genotoxicity was found after 2 h of irradiation (P < 0.05). Photolytic decomposition of aqueous CIP leads to genotoxic transformation products. This proves that irradiated samples of CIP are able to exert heritable genotoxic effects on human liver cells in vitro. Therefore, photolysis as a technique for wastewater treatment needs to be evaluated in detail in further studies, not only for CIP but in general.
    Environmental Science and Pollution Research 12/2011; 19(5):1719-27. DOI:10.1007/s11356-011-0686-y · 2.83 Impact Factor
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    ABSTRACT: Various publications indicate that the operation of laser printers and photocopiers may be associated with health effects due to the release of gaseous components and fine and ultrafine particles (UFP). However, only sparse studies are available that evaluate the possible exposure of office workers to printer emissions under real conditions. Therefore, the aim of our study was to assess the exposure of office workers to particulate matter released from laser printers and photocopiers. Concentrations of fine particles and UFP were measured before, during, and after the operation of laser printing devices in 63 office rooms throughout Germany. Additionally, the particles were characterized by electron microscopy and energy-dispersive X-ray spectroscopy. A significant increase of fine particles and UFP was identified in ambient workplace air during and after the printing processes. Particle fractions between 0.23 and 20 μm emitted by the office machines significantly affect particle mass concentrations while printing 500 pages, i.e., during the printing process, PM(0.23-20), PM(2.5), and PM(10) concentrations increased in 43 out of the evaluated 62 office rooms investigated. Additionally, a significant increase was observed in submicrometer particles, with median particle number concentrations of 6,503 particles/cm(3) before and 18,060 particles/cm(3) during the printing process. Our data indicate that laser printers and photocopiers could be a relevant source of fine particles and particularly UFP in office rooms.
    Environmental Science and Pollution Research 11/2011; 19(9):3840-9. DOI:10.1007/s11356-011-0647-5 · 2.83 Impact Factor
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    ABSTRACT: Pinewood (Pinus ssp.) is widely used for furniture and building purposes. However, despite its widespread use, information on possible human sensory irritations and pulmonary effects caused by exposure to volatile organic compounds (VOC) emitted from pinewood is sparse. For this purpose, (1) sensory irritation of eyes, nose and throat, (2) lung function parameters (FVC, FEV1), (3) exhaled nitrogen oxide (NO) concentration, (4) eye blink frequency, and (5) sensory evaluation (using the SD method) were investigated before, after, and partly during exposure of human volunteers to emissions from pinewood panels. Fifteen healthy nonsmokers were exposed for 2 h under controlled conditions to VOCs emitted from pinewood panels in a 48 m3 test chamber. VOC concentrations were about 5 mg/ m3 (loading rate, 1 m2/m3), 8 mg/m3 (loading rate, 2 m2/m3), and 13 mg/m3 (loading rate, 3 m2/m3), respectively. Terpene and aldehyde exposure concentrations ranged from about 3.50 ± 0.51 mg/m3 and 0.07 ± 0.008 mg/m3, 5.00 ± 0.95 mg/ m3, and 0.20 ± 0.02 mg/m3 or 9.51 ± 1.10 mg/m3 and 0.21 ± 0.04 mg/m3 for loading rates of 1, 2, and 3 m2/m3, respectively. The emissions consisted predominantly of α-pinene and δ3-carene. No concentration-dependent effects before or after exposure to the emissions were measured with respect to sensory irritation, pulmonary function, exhaled NO, and eye blink frequency. Only the odor of the emissions was perceived by the study subjects, rated as being closer to “pleasant” than to “unpleasant.” In conclusion, the results of our study suggest that short-term exposure to high VOC concentrations, even up to 13 mg/m3, released from pine wood does not elicit sensory irritation or pulmonary effects in healthy humans under controlled conditions.
    Journal of Wood Science 10/2011; 57(5). DOI:10.1007/s10086-011-1182-1 · 0.94 Impact Factor
  • Fuel and Energy Abstracts 08/2011; 205. DOI:10.1016/j.toxlet.2011.05.765
  • Fuel and Energy Abstracts 08/2011; 205. DOI:10.1016/j.toxlet.2011.05.585
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    ABSTRACT: Airborne particulate matter (PM) of varying size and composition is known to cause health problems in humans. The iron oxide Fe(3)O(4) (magnetite) may be a major anthropogenic component in ambient PM and is derived mainly from industrial sources. In the present study, we have investigated the effects of four different size fractions of magnetite on signaling pathways, free radical generation, cytotoxicity, and genotoxicity in human alveolar epithelial-like type-II cells (A549). The magnetite particles used in the exposure experiments were characterized by mineralogical and chemical techniques. Four size fractions were investigated: bulk magnetite (0.2-10 μm), respirable fraction (2-3 μm), alveolar fraction (0.5-1.0 μm), and nanoparticles (20-60 nm). After 24 h of exposure, the A549 cells were investigated by transmission electron microscopy (TEM) to study particle uptake. TEM images showed an incorporation of magnetite particles in A549 cells by endocytosis. Particles were found as agglomerates in cytoplasm-bound vesicles, and few particles were detected in the cytoplasm but none in the nucleus. Increased production of reactive oxygen species (ROS), as determined by the 2',7'-dichlorfluorescein-diacetate assay (DCFH-DA), as well as genotoxic effects, as measured by the cytokinesis block-micronucleus test and the Comet assay, were observed for all of the studied fractions after 24 h of exposure. Moreover, activation of c-Jun N-terminal kinases (JNK) without increased nuclear factor kappa-B (NF-κB)-binding activity but delayed IκB-degradation was observed. Interestingly, pretreatment of cells with magnetite and subsequent stimulation with the pro-inflammatory cytokine tumor necrosis factor-alpha (TNFα) led to a reduction of NF-κB DNA binding compared to that in stimulation with TNFα alone. Altogether, these experiments suggest that ROS formation may play an important role in the genotoxicity of magnetite in A549 cells but that activation of JNK seems to be ROS-independent.
    Chemical Research in Toxicology 07/2011; 24(9):1460-75. DOI:10.1021/tx200051s · 3.53 Impact Factor
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    ABSTRACT: Until now, the adverse effects of toner powders on humans have been considered to be minimal. However, several recent reports have suggested possible significant adverse health effects from toner dust inhalation. The aim of this study was to evaluate the genotoxic potential of black toner powders in vitro. For the study of DNA damage, A549 cells were exposed to toner-powder suspensions and to their DMSO extracts, and then subjected to the comet assay and to the in-vitro cytokinesis block micronucleus test (CB-MNvit). Cytotoxic effects of the toner samples were assessed by the erythrosin B assay. Furthermore, size, shape, and composition of the toner powders were investigated. None of the three toner powders or their DMSO extracts reduced cell viability; however, they did induce DNA damage and formed micronuclei at concentrations from 80 to 400 μg cm(-2) , although to a varying extent. All toner powders contain considerable amounts of the pigments carbon black and magnetite (Fe(3) O(4) ) as well as small amounts of polycyclic aromatic hydrocarbons (PAHs). The overall results of our in-vitro study suggest that the investigated toner-powder samples are not cytotoxic but genotoxic. From the results of the physical and chemical characterization, we conclude that metals and metalloids as components of magnetite, or PAHs as components of the carbon-bearing material, are responsible for the genotoxic effects. Further research is necessary to determine the relevance of these in-vitro observations for private and occupational toner powder exposure.
    Environmental and Molecular Mutagenesis 05/2011; 52(4):296-309. DOI:10.1002/em.20621 · 2.63 Impact Factor
  • Das Gesundheitswesen 03/2011; 73(03). DOI:10.1055/s-0031-1274472 · 0.62 Impact Factor
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    ABSTRACT: Due to the reduction of air change rates in low-energy houses, the contribution to indoor air quality of volatile organic compounds (VOCs) emitting from oriented strand boards (OSB) has become increasingly important. The aim of this study was to evaluate sensory irritations, pulmonary effects and odor annoyance of emissions from OSB in healthy human volunteers compared to clean air. Twenty-four healthy non-smokers were exposed to clean air and OSB emissions for 2 h under controlled conditions in a 48 m(3) test chamber at three different time points: to fresh OSB panels and to the same panels after open storage for 2 and 8 weeks. Chemosensory irritation, exhaled nitric oxide (NO) concentration, eye blink frequency, lung function and subjective perception of irritation of eyes, nose and throat were examined before, during and after exposure. Additionally, olfactory perception was investigated. Total VOC exposure concentrations reached 8.9 ± 0.8 mg/m(3) for the fresh OSB panels. Emissions consisted predominantly of α-pinene, Δ(3)-carene and hexanal. Two-hour exposure to high VOC concentrations revealed no irritating or pulmonary effects. All the subjective ratings of discomfort were at a low level and the medians did not exceed the expression 'hardly at all.' Only the ratings for smell of emissions increased significantly during exposure in comparison to clean air. In conclusion, exposure of healthy volunteers to OSB emissions did not elicit sensory irritations or pulmonary effects up to a VOC concentration of about 9 mg/m(3). Sensory intensity of OSB emissions in the chamber air was rated as 'neutral to pleasant.'
    Human & Experimental Toxicology 11/2010; 30(9):1204-21. DOI:10.1177/0960327110388537 · 1.75 Impact Factor
  • Toxicology Letters 07/2010; 196. DOI:10.1016/j.toxlet.2010.03.562 · 3.26 Impact Factor
  • Toxicology Letters 07/2010; 196. DOI:10.1016/j.toxlet.2010.03.564 · 3.26 Impact Factor

Publication Stats

393 Citations
100.80 Total Impact Points


  • 2012–2013
    • University of Freiburg
      Freiburg, Baden-Württemberg, Germany
  • 2008–2013
    • Universitätsklinikum Freiburg
      • Department of Environmental Health Sciences
      Freiburg an der Elbe, Lower Saxony, Germany
  • 2006–2008
    • Justus-Liebig-Universität Gießen
      Gieben, Hesse, Germany
    • Charité Universitätsmedizin Berlin
      Berlín, Berlin, Germany
  • 2002–2003
    • Universität Trier
      Trier, Rheinland-Pfalz, Germany
  • 2001
    • Universität Heidelberg
      • Institute of Medical Microbiology and Hygiene
      Heidelburg, Baden-Württemberg, Germany