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Review article

Role of Exposure Analysis in Solving the Mystery of Balkan Endemic Nephropathy

David T. Long
Thomas C. Voice


Full text: croatian pdf 58 Kb

page 300-311

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Full text: english pdf 588 Kb

page 300-311

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Abstract

Aim: Evaluate the role of exposure analysis for ochratoxin A (OTA) and aristolochic acid (AA) in the occurrence of Balkan endemic nephropathy (BEN). Method: Develop an exposure analysis model for BEN based on an accepted general model, evaluate previous findings from the literature on OTA and AA in the context of this model, discuss the strength of evidence for each, and propose approaches to address critical outstanding questions. Results: The pathway for exposure to OTA is well defined and there is evidence that humans have ingested OTA. Factors causing differential exposure to OTA and how OTA is implicated in BEN are not defined. A pathway for exposure to AA has been suggested but not demonstrated, but there is evidence of humans being exposed to AA and of its effects that are consistent with BEN. Factors causing differential exposure to AA are not known. Conclusion: Exposure analysis results suggest that neither OTA nor AA can be firmly linked to BEN. However, this analysis suggests future research approaches that could provide critical evidence on exposure, which when linked with that from the health sciences, may be able to demonstrate the cause of this disease and provide a basis for effective public health intervention strategies. One of the key unknowns for both agents is how differential exposure can occur.

Keywords

Aristolochic Acids; Balkan Endemic Nephropathy; Endemic Goiter; Environmental Exposure; Environment; Ochratoxins

Hrčak ID:

16439

URI

https://hrcak.srce.hr/16439

Publication date:

20.6.2007.

Article data in other languages: croatian

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