Asian Pacific Journal of Environment and Cancer

Tofu Liquid Waste Treatment Using Anaerob-aerobic Biofilm Aeration System to Reduce BOD COD and Ammoniac Content

Zunidra Zunidra — 2025-03-16

Background: Tofu derived from processed soybeans is popular with the public, but tofu production has an unfavourable effect. After all, it produces liquid waste that causes quite high pollution because it contains quite high organic components. The study aimed to reduce the content of Biochemical Oxygen Demand (BOD), Chemical Oxygen Demand (COD), and Ammonia in the liquid waste of a tofu factory. The scope of this research is limited to reducing the content of BOD, COD, and NH3 (Ammonia) with an anaerobic-aerobic biofilm aeration system.

Materials and Methods: This research was conducted at the Sanitation Study Program Campus, health polytechnic, Ministry of Health, Jambi from March to August 2020. Sample examination was carried out at the Regional Health Laboratory of Jambi Province. This is an experimental study with a pre-post test only design and one group post-test design. The population in this study is the tofu industry, and the sample in this study is partly water from tofu waste.

Results: The results showed a decrease in BOD, COD and Ammonia after passing through a tofu waste treatment machine using anaerobic and aerobic biofilms with BOD values of 64.6%, COD of 49.6% and Ammonia of 79.8%. The statistical test results showed that the p-value was 0.0001 for the decrease in BOD, the p-value was 0.0001 for COD, and the p-value for ammonia was 0.0001. A significant decrease in DOD, COD and Ammonia after passing through the waste treatment equipment with Anaerobic and Aerobic Biophiles.

Conclusion: This tool can be used by adding several parts and treatments such as filtering, settling basins, and adding other chemical substances. On the surface of the bio ball used, it was found that the growth of biofilm was found and to increase the ability of the equipment, initial treatment was needed, such as filtration and sedimentation of waste, reducing acidity with the help of quicklime.

Evaluation of the Association of Indoor Living Conditions and External Work Environment with Epidemiology, Baseline Demographic and Molecular Characteristics of Lung Cancer in North India

Parul Gupta — 2025-03-16

Introduction: Lung cancer has emerged as a global problem with the highest recorded mortalities amongst all types of cancer. There are multiple etiological factors associated with lung cancer such as smoking, environmental pollution, occupational exposure to carcinogens etc. Increase in lung cancer incidence among non-smokers is generally attributed to environmental pollution and occupational exposure. Also, an increase in the percentage of patients with targetable oncogenic drivers has been observed.

Methods: Here, we evaluated the effect of domestic conditions on epidemiology, baseline demographic and molecular characterization of lung cancer in India. For this data about domestic conditions such as housing type, kitchen type, fuel type, ventilation conditions and occupation was available from April 2018 to December 2019.

Results: Clinicopathological parameters of 1689 newly diagnosed lung cancer patients over the period of 3 years were recorded. Median age was 60.0years and 74.0% patients were smokers. The analysis data set for domestic conditions included 1018 patients. Working environment (indoor versus outdoor environment) had an association with lung cancer histology. 64.5% of lung cancer cases were found in people working in open outdoor environment (construction site workers, labourer, Farmers etc). People working in a closed office environment and housewives had higher frequency of adenocarcinoma and activating EGFR mutation and ALK rearrangement.

Conclusion: Domestic conditions and working environment not only selectively impact the lung cancer histology frequency but may also affect the frequency of oncogenic mutations and gene rearrangement.

First Pakistan National Eye Cancer Survey

Tayyab Afghani — 2025-03-16

Background: This is the report of first eye national eye cancer survey in Pakistan under the auspices of National Committee of Eye Health. Eye care institutions involved in eye cancer control were approached to provide the annual data on tumors of the eye.

Methods: All major stakeholders involved in prevention and control of eye cancer were requested to provide information related to situation analysis of eye cancer services in the country through a questionnaire. Overall, 1705 eye tumors were reported annually. 51% were malignant and 49% were benign eye tumors. From each province of the country, where data was available, benign and malignant tumors were separately identified.

Results: The data showed that about 877 cases of eye cancers were diagnosed in a year. 38% of these were eyelid cancers, 31% were intraocular tumors, 16 % were ocular surface tumors, while 15% were cancers of the orbit. KpK region had highest percentage of eyelid cancers (72%) followed by 14% of ocular surface tumors, 10% of intraocular tumors and 4% were cancers of the orbit. Sindh province had highest percentage of intraocular cancers (40%) followed by 31% of eyelid cancers, 19% of cancers of the orbit and 10% of ocular surface tumors. Like KpK, Punjab had highest proportion of eyelid malignancies (37%) followed by 29% intraocular cancers, 20% of ocular surface tumors and 14% of orbital malignancies.

Conclusion: In terms of population, it is estimated that there are 4 cases of eye cancer per million population of Pakistan and an almost similar number of benign eye tumors. Thus, an estimated 8 cases of eye tumors per million population are examined annually.

Optimizing Cardiac Safety: Dosimetric Analysis of Advanced Radiation Techniques in Left Breast Cancer Therapy

Naveen. T — 2025-05-20

Purpose: This study aims to assess the incidental dose distribution to critical structures such as the heart, left anterior descending artery (LAD), and lungs using various external beam radiation techniques specifically, 3DCRT, IMRT, and VMAT plans.

Methods: Following approval from the Institutional Scientific Review Board (ISRB) and ethics committee, a meticulous statistical analysis was conducted based on a prospective enrolment of 60 patients. Written consent was obtained from all participants. The process involved CT simulation and precise contouring, generating three radiation plans for each individual.

Results: The study showed PTV 95 coverage was better achieved in VMAT (PTV95=99%). When coverage of VMAT was compared with 3D-CRT, P Value was statistically significant (P=0.007). The mean Dose to LAD was 15.29Gy with VMAT. The p-value obtained by comparing VMAT vs 3D-CRT was statistically significant (P=0.001). The volume of left Lung receiving 5%,10%, and 20% of the dose is better achieved with 3D-CRT.

Interpretation and Conclusion: This comparative dosimetric analysis of 3DCRT, IMRT, and VMAT in adjuvant radiotherapy for carcinoma of the left breast highlights the distinct advantages of VMAT in terms of superior PTV coverage and dose conformity. Notably, VMAT achieved a significantly lower mean dose to the LAD compared to 3DCRT, which is clinically relevant given the established correlation between radiation dose to the LAD and long-term cardiac morbidity. The reduction in LAD dose with VMAT strongly co-relates to a lower risk of radiation-induced ischemic heart disease and other late cardiac complications, reinforcing its role as an optimized treatment approach. While careful consideration of low-dose exposure to surrounding lung tissue remains essential, the overall benefits of VMAT in enhancing target coverage while minimizing cardiac risks make it a highly favorable technique in modern breast radiotherapy especially in left sided breast cancer treatment with preexisting heart diseases.

Application of Zinc Oxide Nano Particles in the Performance of Jatropha curcas Grown in Cement Waste Contaminated Soil

Thomas Okoh — 2025-09-10

Introduction: The aim of this study was to investigate the efficacy of ZnO nanoparticles in the performances of Jatropha curcas (J.curcas) grown in cement waste contaminated soil in replicated pot trials.

Methods: There were 5 levels of nano treatments (20ppm, 40ppm, 60ppm, 80ppm and 100ppm) and one level of Zinc salt and inorganic liquid fertilizers while seeds without treatments served as control. The eight different treatments were replicated 5 times each with a total of 40 experimental units of pots. A 7-day seed germination experiment was conducted in petri dishes consisting of different concentrations of nano particles except the control dish.

Results: Result showed that 100ppm Zn nano enhanced seed germination by 50% as against 0% seed germination in petri dishes without nano treatments after 7 days. The effects of nano particles on the growth of Jatropha curcas showed that, those planted in the cement contaminated medium treated with nano particles had average height (12.13 cm) with approximately ten (10) leaves with the leaf length and width measuring optimally (8.910 cm) and (8.43 cm) respectively whereas the stem diameter and the plant vigour were measured to be (3 cm) each on average.

Conclusion: The effects of nano particles on the emergence of plant and height showed that the emergence of the J. curcas was more rapid (2.750 ± 0.957 cm) following the treatment with fertilizer while the treatment with nano particles at 60 ppm had the highest mean plant height (21.250 ± 4.193 cm). The effect of nano particles on the number of leaves and length of J. curcas revealed that plants in the control experiment had the lowest number and length of leaves (8.500 ± 1.291) and (8.500 ± 0.707cm) respectively while the treatment with nano particles at 60 ppm had the highest mean number of leaves (16.750 ± 4.113) and leaf length (9.250 ± 0.500 cm). Inferences drawn from the study suggest that addition of zinc oxide (ZnO) nano particles to cement waste contaminated soil increased growth, some biochemical aspects, and yield attributes of J. curcas.

Genotoxicity Effects of Heavy Metal Pollution on Mangifera indica L. (Mango) Exposed to Roadside Traffic in Makurdi, Nigeria

Jose V. Addy — 2025-09-10

Objective: The study aimed to assess the genotoxicity effects of heavy metals pollution on Mangifera indica L. (Mango) exposed to roadside traffic from NNPC Petroleum Depot, Makurdi-Nigeria.

Methods: Thirty (30) samples of Mangifera indica (Mango) parts comprising of fruits, bark and roots were washed with distilled water, dried at 40 °C and digested with trioxonitrate (v) acid HNO₃ at 120 °C. Six heavy metals nickel, lead, zinc, copper, cadmium, and chromium were analyzed using Shimadzu AAS 6300 Atomic Absorption Spectrophotometer (AAS).

Results: The mean concentration of Nickel, Zinc, Lead, Copper, Cadmium and chromium in fruits, barks, and roots of Mangifera indica L (Mango) were above the permissible limit of 0.03, 3.00, 0.1, 0.08, 0.03 and 0.05 mg/kg (WHO, 2022) for Nickel, Zinc, Lead (Pb2+), Copper, Cadmium and Chromium respectively except the mean concentration of Zinc in fruit, bark, and root that was within the permissible limit of 3mg/kg (WHO, 2022). The DNA amounts in fruits and roots at the NNPC Petrol Depot were 555 and 422 respectively, while from the control site were 208 and 180, respectively. The DNA content (ng/μl) in fruits and roots at the NNPC Depot were 940 and 840, respectively, while the DNA amounts in fruits and roots from the control site were 202 and
210, respectively. The DNA content in fruits and roots after the NNPC Depot, Apir-Makurdi were 748 and 540, respectively, while the DNA amounts in fruits and roots from the control site were 211 and 201 respectively.

Discussion: One-way ANOVA showed that the concentration of heavy metals in parts of Mangifera indica L (Mango) is statistically significant at (P<0.05). Genotoxic effects of heavy metals pollution from roadside traffic on mango plants cause oxidative stress, which plays a major role in DNA-damage induction with more DNA content, fragmentation as well as more smearing of DNA. The DNA fragmentation index from all the polluted sites was above forty percent (40 %), indicating the level of severity. From these findings, people that consume these Mango fruits are prone to metal pollution capable of causing cancer.

Conclusion: Policies on reducing air pollution should be enforced while creating awareness that food crops cultivated near roadside should not be consumed.

Hemostatic Radiotherapy – A Retrospective Audit from a Tertiary Cancer Centre in South India

Gautam Vydia Vedagiri — 2025-09-10

Background: Tumor-related bleeding is a life-threatening complication of cancer, necessitating immediate intervention. Radiotherapy (RT) serves as an effective non-invasive method to achieve hemostasis. This study evaluates the outcomes of hemostatic RT at our institution, highlighting its success in resource-limited settings.

Methods: A retrospective analysis was conducted on 38 patients who received hemostatic RT for tumor-related bleeding between 2013 and 2023. The primary endpoint was hemostasis, defined as the cessation or stabilization of bleeding. Secondary endpoints included overall survival (OS) and treatment-related toxicity. The most common RT regimen was 500 cGy per fraction over two fractions (total dose: 10 Gy), using cobalt-based therapy or 6 MV X-rays.

Results: Hemostasis was achieved in 89% of patients (n = 34). The median OS was 6 months (range: 1.5–9 months), with survival varying by tumor type. No grade 3 or higher acute toxicities were observed. Parotid carcinoma patients had the longest survival (9 months), whereas plasma cell leukemia had the shortest (1.5 months). The study underscores the effectiveness of hypofractionated RT in achieving hemostasis, especially in LMICs where cobalt therapy remains a critical resource.

Conclusion: Our findings reaffirm the efficacy of hypofractionated RT in controlling tumor-related bleeding with minimal toxicity. This study emphasizes the importance of RT as a cost-effective and accessible treatment option in LMICs, advocating for further research into optimizing fractionation schedules and integrating systemic therapies.

Strategic Management and Reduction of Treatment Delays in Radiotherapy (Smart – Rad) – A Prospective Quality Improvement Study from a Tertiary Cancer Centre in South India

Arun Kumar M N — 2025-09-10

Background: Prolonged waiting times for daily radiation treatment negatively impact patient satisfaction, adherence, and workflow efficiency in radiotherapy centers. Our centre is a tertiary care centre with a high workload, treating around 300 patients a day. The average waiting time was recorded as 54 minutes, which led to patient dissatisfaction. To overcome this, this study was conducted to implement targeted quality improvement interventions to reduce waiting times and optimize treatment workflows.

Methods: A baseline analysis identified key inefficiencies through fishbone and 2x2 matrix analyses. Contributing factors included inefficient scheduling, non-compliance with appointment timings, manpower shortages, and a lack of imaging protocols. Interventions included spaced scheduling, priority slots for special cases, patient and staff education, dedicated coordination personnel, and weekly process reviews. Statistical analysis of pre- and post-intervention waiting times was conducted to evaluate outcomes.

Results: The implementation of interventions reduced the average waiting time from 54 minutes to 36 minutes exceeding our expectation of 40 minutes. Improved patient adherence, enhanced workflow efficiency, and better utilization of the treatment unit were observed. A comparative analysis with global literature highlighted the effectiveness of the multi-faceted approach, achieving results comparable to advanced centers using more resource-intensive strategies.

Conclusion: This quality improvement initiative demonstrates that systematic interventions tailored to institutional needs can significantly reduce waiting times in radiotherapy.

Review Article: Chlorothalonil and Cancer: A Comprehensive Overview

Yaser Soleimani — 2025-03-16

Chlorothalonil, a broad-spectrum fungicide, has been extensively used in agriculture for over five decades. It plays a vital role in preventing fungal diseases in various crops, contributing significantly to increased agricultural productivity. However, concerns about the safety of chlorothalonil have arisen, particularly regarding its potential to cause cancer. The International Agency for Research on Cancer (IARC) classified chlorothalonil as a possible human carcinogen (Group 2B), which has led to intensified scrutiny of its long-term effects on human health. This review aims to critically evaluate the existing body of evidence on chlorothalonil’s potential carcinogenicity, examining toxicological data, mechanisms of action, and epidemiological studies, while also discussing regulatory actions and future research directions.

Prognostic Significance of Tumor-Stroma Ratio in Hepatocellular and Gall Bladder Carcinoma: Protocol for a Systematic Review and Meta-analysis

Sana Ahuja — 2025-05-04

Background: The tumor-stroma ratio (TSR) has emerged as a crucial prognostic marker in various cancers, including breast, colorectal, and lung cancers. However, evidence for its prognostic value in hepatocellular carcinoma (HCC) and gallbladder carcinoma (GBC) remains limited and inconsistent. This systematic review and meta-analysis will assess the prognostic significance of TSR in patients with HCC and GBC, determining its potential to guide clinical decision-making and improve patient outcomes.

Methods: The PubMed, Scopus, and Web of Science databases will be comprehensively searched, with no language or publication date restrictions. Studies eligible for inclusion are cohort studies, and case-control studies, that evaluate the prognostic value of TSR in patients diagnosed with HCC or GBC. The TSR is defined as the proportion of stromal tissue relative to tumor cells, with a cut-off value of 50% used to categorize patients as TSR-high or TSR-low. Data extraction and quality assessment will be independently performed by three researchers, with extracted data including study details, patient demographics, and outcomes (overall survival). The quality of each study will be assessed using the Newcastle Ottawa Scale.

Results: The results will be pooled in a meta-analysis, calculating hazard ratios (HR) for survival outcomes. Statistical heterogeneity will be assessed using the I², Q test, tau², and prediction intervals. Subgroup analyses and meta-regression will explore potential sources of heterogeneity, and sensitivity analyses will be conducted to test the robustness of the findings. Publication bias will be evaluated using Begg’s funnel plot and Egger’s test.

Conclusion: This study will evaluate the prognostic significance of TSR in hepatocellular carcinoma and gallbladder carcinoma.

Indoor Radon Exposure and Risk of Childhood Leukemia: A Systematic Review and Meta-analysis

Amirhosein Nazari — 2025-08-16

Background: Radon, a naturally occurring radioactive gas, is a known carcinogen for lung cancer, but its role in leukemia remains less understood. This systematic review and meta-analysis aimed to evaluate the association between radon exposure and the risk of leukemia.

Methods: We conducted a systematic review of case-control and cross-sectional studies to investigate the link between radon exposure and leukemia risk. Studies were selected based on specific criteria, including validated radon exposure assessments and quantitative risk estimates. A comprehensive search across PubMed, Scopus, and Web of Science identified 743 articles, with 11 studies meeting the inclusion criteria. Data were extracted using a standardized form, and the Joanna Briggs Institute (JBI) critical appraisal tool assessed study quality. Meta-analysis was performed using a random-effects model to account for study heterogeneity.

Results: The meta-analysis of 11 studies yielded a pooled odds ratio (OR) of 1.57 (95% CI: 0.77–2.38), suggesting a potential positive association between radon exposure and leukemia risk. However, this association was not statistically significant, as the confidence interval included the null value of 1. Substantial heterogeneity was observed across studies (I² = 99.54%, p < 0.001). Sensitivity analyses indicated that no single study disproportionately influenced the pooled estimate. Funnel plot inspection and statistical tests (Egger’s and Begg’s) revealed no evidence of publication bias.

Conclusion: This meta-analysis suggests a potential association between radon exposure and leukemia risk, though the evidence is not statistically significant. The observed heterogeneity underscores the need for further research with standardized methods and larger sample sizes to clarify the relationship between radon exposure and leukemia. Future studies should focus on improving exposure assessment and exploring underlying biological mechanisms.

Occupational Exposure to Asbestos and Mesothelioma Risk: A Protocol of Meta-Analysis and Systematic Literature Review in Germany

Mahdi Daraei — 2025-02-19

Background: Occupational exposure to asbestos is a known risk factor for mesothelioma, a rare but deadly cancer with a prolonged latency period. This study focuses on the association between occupational asbestos exposure and mesothelioma risk within the German context, reflecting the country’s unique industrial legacy and regulatory framework.

Methods: This protocol outlines a systematic meta-analysis and literature review targeting studies related to occupational asbestos exposure and mesothelioma risk in Germany. The review incorporates comprehensive searches of major databases, focusing on studies published in peer-reviewed journals. Data extraction will emphasize study characteristics, exposure assessment, and confounder adjustments. Quality assessment tools will evaluate study reliability and biases.

Results: The meta-analysis aims to quantify mesothelioma risk linked to occupational asbestos exposure in Germany. The analysis will include pooled risk estimates adjusted for exposure levels, fiber types, and industry-specific contexts. Subgroup and sensitivity analyses will enhance the robustness of findings.

Conclusion: The findings are expected to offer evidence-based insights into the risks of occupational asbestos exposure in Germany, informing health policies and strategies to mitigate the burden of asbestos-related diseases.