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Organochlorine pesticides, polychlorinated biphenyls and polybrominated diphenyl ethers in Singapore's coastal marine sediments.

Persistent organic pollutants (POPs) are ubiquitous pollutants in the marine environment, particular in coastal areas affected by industry and shipping traffic. POPs are known for their recalcitrance and toxicity in the environment, and there is increasing concern over their global distribution and impact upon wildlife. Marine surface sediment samples taken within 6 km of the coastline of Singapore were analyzed to determine prevailing concentrations of organochlorine pesticides (OCPs), polychlorinated biphenyl (PCBs) and polybrominated diphenyl ethers (PBDEs). Total PCB concentrations varied widely from 1.4 to 329.6 ng/g (average 73.9 ng/g), where high concentrations were detected at sample locations closest to industrial areas with intensive shipping traffic. Total DDT concentrations ranged from 2.2 to 11.9 ng/g (average 6.7 ng/g) and were lower than the concentration range of 3.3-46.2 ng/g measured for total HCH (average 18.1 ng/g). Ratios of DDT/(DDE+DDD) in sediments do not indicate recent inputs of DDT into Singapore's marine environment, but high concentrations of alpha-HCH and gamma-HCH show evidence for the usage of HCHs in Southeast Asia. Peak concentrations of cis- and trans-Chlordane were 10 ng/g. Among the PBDE congeners BDE 47, 99, and 100 only BDE 47 could be detected at a range of 3.4-13.8 ng/g (average 6.2 ng/g). The levels of OCPs, PCBs and PBDEs were compared to available data for other countries in Asia, and indicated relatively moderate levels of contamination. Peak concentrations of PCBs, HCH isomers, Chlordane, Heptachlor, Heptachlor epoxide and Dieldrin have the potential to induce ecotoxicological impacts based on levels specified in the sediment quality standards of the USEPA and Canadian Council of Ministers of the Environment.

Environmental Monitoring↗

Persistent organic pollutants in mangrove food webs in Singapore.

In this study, persistent organic pollutants were quantified in sediments, subsurface seawater, sea-surface microlayer and twenty-four biota species collected at two separate mangrove habitats in Singapore. Data confirmed the ubiquity of POPs, including polybrominated diphenyl ethers (PBDEs), in the marine environment of Singapore. A biomagnification phenomenon was observed amongst the species collected and analysed from both mangrove sites studied. Thunder crabs and fish displayed the highest POP levels. Congener profiles of PBDEs varied amongst mangrove biota species and suggested different metabolic pathways exist for flame retardants. Similarly, crab species showed an ability to metabolize chlordane insecticide.

Animals↗

Distribution of organochlorine compounds in the sea-surface microlayer, water column and sediment of Singapore's coastal environment.

Hexachlorocyclohexanes (HCHs), dichlorodiphenylethanes (DDTs) and 38 PCB congeners were determined in the water column (sea-surface microlayer, subsurface, mid-depth and bottom water) and sediments from Singapore's coastal environment. The concentration ranges for summationHCHs, summationDDTs and summationPCBs in the seawater dissolved phase (DP) were 101-6110 (mean 1833), <5-405 (mean 76) and 60-6979 (mean 1611)pg/l, respectively. The concentration ranges for summationHCHs, summationDDTs and summationPCBs in the suspended particulate matter (SPM) were 26-2395 (mean 243), <5-124 (mean 19) and 38-3793 (mean 715) pg/l, respectively. Concentration levels in sediments ranged between 521 and 1758 (mean 1094), 50 and 290 (mean 88) and 339 and 1356 (mean 858) pg/g for summationHCHs, summationDDTs and summationPCBs, respectively. It was shown that the interfaces of the sea-surface microlayer (SML) and near bottom water are important compartments for the distribution of organochlorine compounds (OCs) in the water column. In comparison with data from China, the concentration levels in the water column and sediments of Singapore can be considered as low, but the reported levels were higher compared to available data from Europe.

Environmental Monitoring↗

Child sexual and physical abuse among college students in Singapore and the United States.

OBJECTIVES: The purpose of this study was to explore differences in rates and characteristics of child sexual and physical abuse experiences among women in Singapore and the US. METHOD: Participants (N=153) completed an anonymous questionnaire which assessed experiences of childhood sexual and physical abuse, abuse characteristics (e.g., victimization age, severity), and behavioral and subjective reactions to such experiences (e.g., labeling of experiences as abuse, psychological symptomatology). Exposure to other forms of traumatic life events was also assessed. RESULTS: In comparison to Singaporean women, US women were more likely to report a history of child sexual abuse, and to report experiencing more severe forms of sexual abuse. Women in Singapore were more likely than women in the US to report a history of child physical abuse, to report experiencing injury as a result of the abuse, and to disclose the abuse. Singaporean women with a history of child sexual abuse reported elevated psychological symptom levels relative to their nonabused peers and to US women with a history of child sexual abuse, even after controlling for exposure to other types of traumatic events. No significant differences in symptomatology with regard to child physical abuse were observed. CONCLUSIONS: Although preliminary in nature, the present findings are among the first to demonstrate differences in psychological adjustment between sexually abused and nonabused Asian women living in Asia. This study also provides some of the first support for cross-national differences in the psychological adjustment of child sexual abuse survivors.

Adolescent↗

Heterocyclic aromatic amines in domestically prepared chicken and fish from Singapore Chinese households.

Chicken and fish samples prepared by 42 Singapore Chinese in their homes were obtained. Researchers were present to collect data on raw sample weight, cooking time, maximum cooking surface temperature, and cooked sample weight. Each participant prepared one pan-fried fish sample and two pan-fried chicken samples, one marinated, one not marinated. The cooked samples were analyzed for five heterocyclic aromatic amine (HAA) mutagens, including MeIQx (2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline); 4,8-DiMeIQx (2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline); 7,8-DiMeIQx (2-amino-3,7,8-trimethylimidazo[4,5-f]quinoxaline); PhIP (2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine), and IFP (2-amino-(1,6-dimethylfuro[3,2-e]imidazo[4,5-b])pyridine). A paired Student's t-test showed that marinated chicken had lower concentrations of PhIP (p<0.05), but higher concentrations of MeIQx (p<0.05) and 4,8-DiMeIQx (p<0.001) than non-marinated chicken, and also that weight loss due to cooking was less in marinated chicken than in non-marinated chicken (p<0.001). Interestingly, the maximum cooking surface temperature was higher for fish than for either marinated or non-marinated chicken (p<0.001), yet fish was lower in 4,8-DiMeIQx per gram than marinated or non-marinated chicken (p<0.001), lower in PhIP than non-marinated chicken (p<0.05), and lost less weight due to cooking than either marinated or non-marinated chicken (p<0.001). Fish was also lower in MeIQx and 7,8-DiMeIQx than marinated chicken (p<0.05). This study provides new information on HAA content in the Singapore Chinese diet.

Amines↗

Allele frequencies of 15 STR loci of three main ethnic populations in Singapore using an in-house marker panel.

Allele frequency data for 15 Short Tandem Repeat (STR) loci was studied for the three main ethnic groups residing in Singapore, namely Chinese, Malay and Indian. An in-house STR marker panel was employed, consisting all 13 tetranucleaotide STR listed in CODIS (Combined DNA Index System, USA) and two pentanucleaotide STR, Penta D and Penta E. This represents a comprehensive report for allele distribution in the Singapore population for these 15 microsatellite markers commonly used in forensic science.

DNA Fingerprinting↗

Genetic data for the 13 CODIS STR loci in Singapore Chinese.

Allele frequencies for the 13 CODIS STR loci included in the AmpFISTR Profiler Plus and AmpFISTR Cofiler kits (Applied Biosystems, Foster City, USA) were determined in a sample of 209 unrelated Chinese in Singapore. The combined random match probability for the 13 loci is about 6.6 x10(-15) and the overall probability of excluding paternity is 0.9999899. The results demonstrate that the loci are useful for forensic human identification and parentage testing for the Chinese population in Singapore.

China↗

A survey of buprenorphine related deaths in Singapore.

Buprenorphine is available in Singapore as substitution treatment for opioid dependence since 2002. This study surveys buprenorphine related deaths in Singapore between September 2003 and December 2004. The aims are to establish the autopsy prevalence of buprenorphine related deaths and the demographical and toxicological profile of the cases. Toxicological screening was performed for all unnatural deaths, deaths involving known drug addicts, as well as when autopsy revealed no obvious cause of death. Twenty-one cases had buprenorphine detected in post-mortem blood and/or urine samples. Eighteen were sudden deaths. There were two fatal falls from height and one death by hanging. All subjects were male. The age range was 24-48 years. Fourteen subjects were between 30 and 39 years of age. The mean age was 35 years. The majority (62%) were Chinese. Eleven (52%) were known drug abusers. For sudden deaths, two groups were identified. Six cases died from natural causes. Blood buprenorphine levels ranged from undetected (detected in urine) to 3.2 ng/mL (mean 1.4 ng/mL). Twelve cases were attributed directly and indirectly to mixed drug poisoning. Blood buprenorphine levels ranged from undetected (detected in urine) to 17 ng/mL (mean 3.2 ng/mL). Nineteen cases showed concurrent abuse of buprenorphine and benzodiazepine, diazepam being the most frequently detected, followed by nitrazepam and midazolam. The availability of buprenorphine as substitution therapy is associated with an increase in buprenorphine related deaths. The danger of co-abuse of buprenorphine and benzodiazepines is highlighted.

Adult↗

Shifting the burden of health care finance: a case study of public-private partnership in Singapore.

Since becoming independent in 1965, Singapore has attained high standards in health care provision while successfully transferring a substantial portion of the health care burden to the private sector. The government's share of total health care expenditure contracted from 50% in 1965 to 25% in 2000. At first glance, the efficiency-driven health care financing reforms which emphasize individual over state responsibility appear to have been implemented at the expense of equity. On closer examination, however, Singaporeans themselves seem unconcerned about any perceived inequity of the system. Indeed, they appear content to pay part of their medical expenses, plus additional monies if they demand a higher level of services. In fact, access to needed care for the poor is explicitly guaranteed. Mechanisms also exist to protect against financial impoverishment resulting from catastrophic illness. Singapore's experience provides an interesting case study in public-private partnership, illustrating how a hard-headed approach to health policy can achieve national health goals while balancing efficiency and equity concerns.

Attitude to Health↗

A retrospective review of 287 consecutive children in singapore presenting with intermittent exotropia.

BACKGROUND: Intermittent exotropia, X(T), is a relatively common form of strabismus among children in Singapore. The purpose of this study is to see how children presenting with this condition fared during a period of 5 years. METHODS: The medical records of all children younger than 16 years who presented to the eye clinic at the Singapore National Eye Centre with X(T) between January 1992 and December 1995 were reviewed retrospectively. RESULTS: A total of 287 patients satisfied the entry requirements of this study. Estimated age of onset of exotropia was documented in 161 subjects. The mean age of estimated onset was 3.0 +/- 2.5 years. The mean age of presentation was 6.1 +/- 3.1 years. The mean amount of distant exotropia was 36.4 +/- 12.5 prism diopters (PD). Seventy-two percent of children had poor/no distant control. During a 3-year period, the size of exotropia appears to remain constant (within 5 PD of original) in 48% and improved >5 PD in 32%. Control of distant exotropia remained the same in 63%, improved in 17% and worsened in 20%. Near exotropia was initially present in only 35.5%. The mean amount of near exotropia, when present, was 25.9 +/- 13.7PD. Near control remained the same in 65% and worsened in 22%. More variation was observed in subjects presenting before 5 years of age. One hundred sixty-two (56.4%) subjects underwent surgery. The mean age of surgery was 8.0 +/- 2.6 years. Surgery resulted in a final strabismus size between 10 PD exotropia and 5PD esotropia in 65.2% at 1 year postoperation. CONCLUSION: Half the subjects presenting with an intermittent exotropia eventually had surgery. In the remaining nonsurgical subjects, intermittent exotropia, once present, appeared to be a relatively stable condition.

Adolescent↗

DYT1 mutations amongst adult primary dystonia patients in Singapore with review of literature comparing East and West.

BACKGROUND: Dystonia is a heterogenous group of movement disorders whose clinical spectrum is very wide. At least 13 different genes and gene loci have been reported. While a 3-bp deletion in the DYT1 gene is the most frequent cause of early limb-onset, generalized dystonia, it has also been found in non-generalized forms of sporadic dystonia. An 18-bp deletion in the DYT1 gene has also been reported. OBJECTIVES: We screened for the 3-bp and 18-bp deletions in the DYT1 gene among our sporadic, adult-onset primary dystonia patients in Singapore. We reviewed the literature to compare the frequency of DYT1 mutation between the East and the West. METHODS: We screened 54 patients with primary dystonia (focal: n=41; segmental: n=11; multifocal: n=1; generalized: n=1) for the deletions in the DYT1 gene. A careful review of all published literature on DYT1 screening among sporadic, non-familial, non-Ashkenazi Jewish patients was done. RESULTS: We did not detect any mutations in the exon 5 of the DYT1 gene in any of our patients. The frequency of DYT1 mutation amongst Asians (1.0%) was comparable to the West (1.56%) (p=NS). CONCLUSIONS: DYT1 mutations are uncommon amongst adult primary dystonia patients in Singapore.

Adult↗

Chlorinated pesticides and PCBs in the sea-surface microlayer and seawater samples of Singapore.

Sea-surface microlayer (SML) and seawater samples collected from Singapore's coastal marine environment were analyzed for selected chlorinated pesticides and polychlorinated biphenyls (PCBs). The SML is a potential site of enrichment of persistent organic pollutants (POPs) compared to the underlying water column. The concentration ranges of SigmaHCH, SigmaDDT and SigmaPCB in subsurface (1 m depth) seawater were 0.4-27.2 ng/l (mean 4.0 ng/l), 0.01-0.6 ng/l (mean 0.1 ng/l) and 0.05-1.8 ng/l (mean 0.5 ng/l) respectively. In the SML, the concentration ranges of SigmaHCH, SigmaDDT and SigmaPCB were 0.6-64.6 ng/l (mean 9.9 ng/l), 0.01-0.7 ng/l (mean 0.2 ng/l) and 0.07-12.4 ng/l (mean 1.3 ng/l) respectively. High spatial and temporal distribution was observed for all POPs measured. However, overall levels measured in the SML were lower than levels reported in the literature for SML samples from temperate coastal regions-possibly due to loss of semi-volatile compounds in the tropical climate of Singapore. Atmospheric wet deposition during the monsoon season may be an important source of POPs to the SML. This study provides the first scientific data on POP concentrations and enrichment factors in the SML for Southeast Asia.

Environmental Monitoring↗

Survival under chronic stress from sediment load: spatial patterns of hard coral communities in the southern islands of Singapore.

Six reef sites were chosen along the west coasts of Singapore's southern islands, to: (1) quantitatively assess and compare coral community composition and structure, and recruitment rates, (2) assess the relationship between the aforementioned patterns and the environmental conditions, and (3) provide insights on potential processes that incorporate history at these study sites. Chronic exposure to high sediment load was the most obvious form of anthropogenic stress. Recruitment rates on ceramic tiles were low (1.4+/-1.0-20+/-14.7 recruits m(-2)year(-1)) but decreased towards the main island of Singapore as did hard coral cover and coral density. Coral fauna consisted of genera generally found in deeper waters (e.g., fungiids, foliose Oxypora, Leptoseris, and Echinopora) or those well adapted to turbid waters (e.g., Porites, Pectinia, Leptastrea, Montipora). Light extinction coefficient (K) and % live coral cover (%LCC) showed a strong and inverse curvilinear relationship (%LCC=13.60 *K(-3.40)). Similarly, the rate of sediment deposition (DFSPM) (Recruitment rate, RR=1.51-0.17 *DFSPM) and water clarity (RR=3.56-2.92 *K) exhibited strong and inverse relationships with recruitment rates. Although measured levels of the down-ward flux of suspended particulate matter and suspended solids were well within "normal" levels recorded in the literature, it was the proportion of benthic space, generic coral composition, and site history that offered compelling evidence of chronic exposure to increased sediment load. Clearly a reduction in both water clarity and live-coral cover has taken place since monitoring efforts began in the early 1970s, in fact coral cover has more than halved at all sites examined since the 1980s and benthic space was predominantly occupied by dead corals covered with sediment and filamentous algae.

Analysis of Variance↗

Prevalence of microplastics in Singapore's coastal marine environment.

Microplastics have been recently identified as marine pollutants of significant concern due to their persistence, ubiquity and potential to act as vectors for the transfer and exposure of persistent organic pollutants to marine organisms. This study documents, for the first time, the presence and abundance of microplastics (>1.6 microm) in Singapore's coastal environment. An optimized sampling protocol for the collection and analysis of microplastics was developed, and beach sediments and seawater (surface microlayer and subsurface layer) samples were collected from nine different locations around the coastline. Low density microplastics were separated from sediments by flotation and polymer types were identified using Fourier transform infrared (FTIR) spectrometry. Synthetic polymer microplastics identified in beach sediments included polyethylene, polypropylene, polystyrene, nylon, polyvinyl alcohol and acrylonitrile butadiene styrene. Microplastics were detected in samples from four out of seven beach environments, with the greatest quantity found in sediments from two popular beaches in the eastern part of Singapore. Polyethylene, polypropylene and polystyrene microplastics were also found in the surface microlayer (50-60 microm) and subsurface layer (1m) of coastal waters. The presence of microplastics in sediments and seawater is likely due to on-going waste disposal practices from industries and recreational activities, and discharge from shipping.

Bathing Beaches↗

Survival under chronic stress from sediment load: spatial patterns of hard coral communities in the southern islands of Singapore.

Six reef sites were chosen along the west coast of the southern islands of Singapore, at an increasing distance from the densely populated metropolitan area, to study the spatial patterns of coral reef communities on the upper reef slope ( approximately 4m) and the associated environmental conditions. Chronic exposure to high sediment load was the most obvious form of anthropogenic stress. Recruitment rates on ceramic tiles were low (1.4+/-1.0-20+/-14.7 recruits m(-2) yr(-1)) but decreased towards the main island of Singapore as did hard coral cover and coral density. Coral fauna consisted of genera generally found in deeper waters (e.g., fungiids, foliose Oxypora, Leptoseris, and Echinopora) or those well-adapted to turbid waters (e.g., Porites, Pectinia, Leptastrea, Montipora). Light extinction coefficient (K) and % live coral cover (%LCC) showed a strong and inverse curvilinear relationship (%LCC=13.60 *K(-3.40)). Similarly, the rate of sediment deposition (DFSPM) (RR=1.51-0.17 *DFSPM) and water clarity (RR=3.56-2.92 *K) exhibited strong and inverse relationships with recruitment rates (RR). Although measured levels of the downward flux of suspended particulate matter and suspended solids were well within "normal" levels recorded in the literature, it was the proportion of benthic space, generic coral composition, and site history that offered compelling evidence of chronic exposure to increased sediment load. Clearly a reduction in both water clarity and live-coral cover has taken place since monitoring efforts began in the early 1970s, in fact coral cover has more than halved at all sites examined since the 1980s and benthic space was predominantly occupied by dead corals covered with sediment and filamentous algae.

Analysis of Variance↗

Low birth weight in relation to parental occupations-a population-based registry in Singapore (1994-1998).

OBJECTIVES: To study the association between parental occupation and low birth weight (LBW) in infants born in Singapore between 1994 and 1998. Other factors that may be related to LBW were also investigated. METHODS: A retrospective study. Information was obtained from the Singapore National Registry of Births and Deaths on parental occupations for live births between 1 January 1994 to 31 December 1998. Parental date of birth, ethnic group, and highest educational qualification were also obtained. The associations between these factors and the occurrence of LBW was assessed using descriptive statistics and logistic regression analysis. RESULTS: A total 208,360 live births were studied. Analyses were restricted to singleton births > or =37th week gestation (total of 189,064). No significant differences in LBW risk were found for the different maternal occupational groups, compared with a referent group ("legislators, senior officers, and managers"). However, fathers who were "not working" (OR=2.04; 1.57-2.65), "not classifiable by occupation" (OR=1.34; 1.09-1.65), and "cleaners, laborers, and related workers" (OR=1.32; 1.12-1.55) had the highest risk of LBW infants when compared with "legislators, senior officers, and managers," after adjustment for maternal occupation, ethnic group, educational level and age, paternal educational level, infant gestational age, sex, and birth order. CONCLUSION: Certain paternal occupational groups appear to be associated with a higher risk of having LBW infants. This may be linked to socioeconomic status and possible work-related factors. Future studies of pregnancy outcomes should not ignore the potential contributions of fathers.

Cross-Sectional Studies↗

Pediatric tracheotomies in an Asian population: the Singapore experience.

OBJECTIVE: Over the past 2 decades, tracheotomy in children and infants has evolved from a primarily emergent procedure for upper airway obstruction into a semielective procedure for airway access in assisted ventilation. We present a 12-year retrospective review of tracheotomies performed in the pediatric population in Singapore. STUDY DESIGN AND SETTING: We reviewed all tracheotomies performed in children below the age of 16 years in 2 tertiary pediatric medical centers in Singapore from January 1991 to December 2003. Indications for surgery are reviewed, and outcomes in terms of morbidity rate, mortality rate, postoperative rehabilitation, and duration of decannulation process were analyzed. RESULTS: Tracheotomies were performed in 48 children during the study period. The mean age of patients was 3.24 years, with ages ranging from 16 days to 14 years. Sixty-three percent of tracheotomies were done within the 1st year of life. The chief indication was airway access for assisted ventilation. The overall complication rate was 31%. There were 13 attempts at decannulation, with 9 successes. No tracheotomy-related deaths occurred. CONCLUSION: Tracheotomy is a relatively safe procedure in children and infants. Lower decannulation rates and the evolving role of tracheotomy for early access in assisted ventilation permits earlier discharge with tracheotomy in situ.

Adolescent↗

Incidence of Parkinson's disease in Singapore.

To investigate the incidence of Parkinson's disease (PD) in Singapore, a parkinsonism-free cohort of 14,835 participants was followed-up and incident cases of PD identified through phone interviews, medical record reviews and a hospital's database. A movement disorders specialist subsequently verified the diagnosis through a medical records review. The age and sex-adjusted (US 1990 population) incidence rate was 32 per 100,000 person years for individuals aged 50 years and above. The rates differed between Chinese, Malays and Indians (p=0.03). The difference in inter-racial rates needs to be interpreted with caution in view of the small numbers. The incidence of PD in Singapore is comparable with that in Western countries.

Age Distribution↗