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Toxicology of microcystins with reference to cases of human intoxications and epidemiological investigations of exposures to cyanobacteria and cyanotoxins

Abstract

Blooms of cyanobacteria have been documented throughout history, all over the world. Mass populations of these organisms typically present hazards to human health and are known for the production of a wide range of highly toxic metabolites—cyanotoxins, of which among the most common and most investigated are the microcystins. The toxicity of the family of microcystin congeners to animal and cell models has received much attention; however, less is known about their negative effects on human health, whether via acute or chronic exposure. Useful information may be acquired through epidemiological studies since they can contribute to knowledge of the relationships between cyanotoxins and human health in environmental settings. The aim of this review is to compile and evaluate the available published reports and epidemiological investigations of human health incidents associated with exposure to mass populations of cyanobacteria from throughout the world and to identify the occurrence and likely role of microcystins in these events. After an initial screening of 134 publications, 42 publications (25 on the chronic and 17 on the acute effects of cyanotoxins) describing 33 cases of poisonings by cyanobacterial toxins in 11 countries were reviewed. The countries were Australia, China, Sri Lanka, Namibia, Serbia, Sweden, UK, Portugal, Brazil, USA, and Canada. At least 36 publications link cyanobacteria/cyanotoxins including microcystins to adverse human health effects. The studies were published between 1960 and 2016. Although the scattered epidemiological evidence does not provide a definitive conclusion, it can serve as additional information for the medical assessment of the role of microcystins in cancer development and other human health problems. This paper discusses the major cases of cyanotoxin poisonings as well as the strengths, weaknesses, and importance of the performed epidemiological research. This study also proposes some recommendations for future epidemiological work.

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Notes

  1. 1.

    All the Latin genus and species names are taken from the original papers as such without changing the nomenclature.

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Acknowledgements

The authors would like to acknowledge the funding of the Ministry of Education, Science, and Technological Development of the Serbian Government (Project Number: 176020) and also COST Action ES1105 “CYANOCOST—Cyanobacterial Blooms and Toxins in Water Resources: Occurrence, Impacts and Management” of the European Union, for adding value to this study through networking and knowledge sharing with European experts in the field. Parts of this publication were prepared within the framework of an exchange programme between the University of Novi Sad Faculty of Sciences and Åbo Akademi University. The mobility was supported from the Erasmus+ Programme, Project Code 2015-2-FI01-KA107-022151.

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Correspondence to Zorica Svirčev.

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Svirčev, Z., Drobac, D., Tokodi, N. et al. Toxicology of microcystins with reference to cases of human intoxications and epidemiological investigations of exposures to cyanobacteria and cyanotoxins. Arch Toxicol 91, 621–650 (2017). https://doi.org/10.1007/s00204-016-1921-6

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Keywords

  • Cyanobacteria
  • Microcystins
  • Epidemiology
  • Human health