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Inhalation of ciclesonide via HFA-MDI results in high pulmonary deposition, especially in the peripheral regions of the lung. High pulmonary deposition contributes to ciclesonide's ability to maintain lung function and control symptoms in patients with asthma. Deposition and activation of ciclesonide in the oropharynx is low, consistent with previous reports of low oropharyngeal deposition and a reduced incidence of local side effects in patients receiving ciclesonide therapy.

Background:The prevalence of obesity is increasing in all countries, becoming a substantial public health concern worldwide. Increasing evidence has associated obesity with persistent pollutants such as the pesticide DDT and its metabolite p,p′-DDE.Objectives:Our objective was to systematically review the literature on the association between exposure to the pesticide DDT and its metabolites and obesity to develop hazard identification conclusions.Methods:We applied a systematic review-based strategy to identify and integrate evidence from epidemiological, in vivo, and in vitro studies. The evidence from prospective epidemiological studies was quantitatively synthesized by meta-analysis. We rated the body of evidence and integrated the streams of evidence to systematically develop hazard identification conclusions.Results:We identified seven epidemiological studies reporting prospective associations between exposure to p,p′-DDE and adiposity assessed by body mass index (BMI) z-score. The results from the meta-analysis revealed positive associations between exposure to p,p′-DDE and BMI z-score (normalβ=0.13 BMI z-score (95% CI: 0.01, 0.25) per log increase of p,p′-DDE). Two studies constituted the primary in vivo evidence. Both studies reported positive associations between exposure to p,p′-DDT and increased adiposity in rodents. We identified 19 in vivo studies and 7 in vitro studies that supported the biological plausibility of the obesogenic effects of p,p′-DDT and p,p′-DDE.Conclusions:We classified p,p′-DDT and p,p′-DDE as “presumed” to be obesogenic for humans, based on a moderate level of primary human evidence, a moderate level of primary in vivo evidence, and a moderate level of supporting evidence from in vivo and in vitro studies. https://doi.org/10.1289/EHP527

BackgroundThe RD50 (exposure concentration producing a 50% respiratory rate decrease) test evaluates airborne chemicals for sensory irritation and has become an American Society for Testing and Materials (ASTM) standard method. Past studies reported good correlations (R2) between RD50s and the occupational exposure limits, particularly threshold limit values (TLVs).ObjectiveThe main purpose of this study was to examine the relationship between RD50s and human sensory irritation responses in a quantitative manner, particularly for chemicals that produce burning sensation of the eyes, nose, or throat, based on lowest observed adverse effect levels (LOAELs) reported for human subjects.MethodsWe compared RD50s with LOAELs and acute reference exposure levels (RELs). RELs, developed by the California Environmental Protection Agency’s Office of Environmental Health Hazard Assessment, represent a level at which no adverse effects are anticipated after exposure. We collected RD50s from the published literature and evaluated them for consistency with ASTM procedures. We identified LOAELs for human irritation and found 25 chemicals with a corresponding RD50 in mice.DiscussionWe found the relationship between RD50s and LOAELs as log RD50 = 1.16 (log LOAEL) + 0.77 with an R2 value of 0.80. This strong correlation supports the use of the RD50 in establishing exposure limits for the public. We further identified 16 chemical irritants with both RD50s and corresponding acute RELs, and calculated the relationship as log RD50 = 0.71 (log REL) + 2.55 with an R2 value of 0.71. This relationship could be used to identify health protective values for the public to prevent respiratory or sensory irritation.ConclusionConsequently, we believe that the RD50 has benefits for use in setting protective levels for the health of both workers and the general population.