Oncogenic HPV genotypes.
\r\n\t
",isbn:"978-1-83968-681-8",printIsbn:"978-1-83968-680-1",pdfIsbn:"978-1-83968-682-5",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,hash:"ddc0dea7e5b98335c187688d9c0c5b42",bookSignature:"Dr. Urvashi Sharma",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/10298.jpg",keywords:"Internet of Things, Smart Biosensor and Hardware, Reliability, Patients Data, Context-Specific and Aware, Integrated and Connected, Funding Structures, Policy and Its Implications, Electronic Medical Records, Electronic Health Records, Design, Implementation and Evaluation",numberOfDownloads:60,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 3rd 2020",dateEndSecondStepPublish:"October 1st 2020",dateEndThirdStepPublish:"November 30th 2020",dateEndFourthStepPublish:"February 18th 2021",dateEndFifthStepPublish:"April 19th 2021",remainingDaysToSecondStep:"5 months",secondStepPassed:!0,currentStepOfPublishingProcess:5,editedByType:null,kuFlag:!1,biosketch:"Dr. Sharma obtained her Ph.D. from Brunel University London, U.K. Her work has contributed to understanding the role of a user and the context in relation to the successful application of e-health modalities in primary care settings in the U.K.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"105398",title:"Dr.",name:"Urvashi",middleName:null,surname:"Sharma",slug:"urvashi-sharma",fullName:"Urvashi Sharma",profilePictureURL:"https://mts.intechopen.com/storage/users/105398/images/system/105398.jpg",biography:"Dr Urvashi Sharma started her research career as a biomedical engineer exploring barriers and facilitators to remote patient monitoring and use of electronic health records. Her work has contributed to understanding the role of a user and the context in relation to successful application of e-health modalities in primary care settings in the U.K. Through her work, she also explored whether employing randomised controlled trials to ascertain the effectiveness of technological interventions is viable. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"878",title:"Phytochemicals",subtitle:"A Global Perspective of Their Role in Nutrition and Health",isOpenForSubmission:!1,hash:"ec77671f63975ef2d16192897deb6835",slug:"phytochemicals-a-global-perspective-of-their-role-in-nutrition-and-health",bookSignature:"Venketeshwer Rao",coverURL:"https://cdn.intechopen.com/books/images_new/878.jpg",editedByType:"Edited by",editors:[{id:"82663",title:"Dr.",name:"Venketeshwer",surname:"Rao",slug:"venketeshwer-rao",fullName:"Venketeshwer Rao"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4816",title:"Face Recognition",subtitle:null,isOpenForSubmission:!1,hash:"146063b5359146b7718ea86bad47c8eb",slug:"face_recognition",bookSignature:"Kresimir Delac and Mislav Grgic",coverURL:"https://cdn.intechopen.com/books/images_new/4816.jpg",editedByType:"Edited by",editors:[{id:"528",title:"Dr.",name:"Kresimir",surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"50846",title:"Diagnosis and Prevalence of High-Risk Human Papillomavirus Infection in Heterosexual Men",doi:"10.5772/62948",slug:"diagnosis-and-prevalence-of-high-risk-human-papillomavirus-infection-in-heterosexual-men",body:'\nHuman papillomavirus (HPV) infections are one of the most common sexually transmitted infections worldwide [1], representing a significant health problem due to their high prevalence and transmissibility. HPVs are a very large family of double-stranded DNA viruses (dsDNA), very resistant that can survive in the environment without a host and is able to infect humans. These viruses are not classified as serotypes, but as genotypes on the basis of DNA sequence. Currently, over 120 genotypes have been identified and about 40 genotypes (the alpha genus) can be transmitted through sexual contact and infect the anogenital region. HPV genotypes have been classified into low-risk genotypes, associated with anogenital warts, low-grade cervical lesions and recurrent respiratory papillomatosis, and high-risk genotypes (HR-HPV) [1] (\nTable 1\n), which eventually can lead to malignant transformation. HR-HPV are strongly associated with cancer and high-grade neoplasia of the anogenital tract, including the anus (AIN), penis (PeIN), uterine cervix (CIN), and vulva (VIN), and also a proportion of oropharyngeal cancer [2]. Although these infections are typically transient and asymptomatic, some of them will result in anogenital warts, and dysplastic and/or neoplastic lesions, which cause a substantial disease burden in both sexes and generate a considerable economic distress within society [3].
\nIARC classification | \nHPV genotypes | \n
---|---|
HR-HPV | \n16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 | \n
pHR-HPV | \n26, 34, 53, 66, 67, 68, 69, 70, 73, 82 | \n
Oncogenic HPV genotypes.
Classification of oncogenic HPV genotypes detected in this work.
IARC, International Agency for Research on Cancer; HR-HPV, high-risk HPV genotypes; pHR, probable/possible high-risk genotypes.
The virus may remain inactive for a long time and produce asymptomatic infection of the skin. It can be transmitted from one individual to another directly (by sexual contact) or indirectly. The dynamics of heterosexual transmission of HPV are still being investigated [4].
\nAbout one-third to one-quarter of invasive penile cancers (Alemany et al.) and nearly 99.7% of cervical cancer worldwide and in 96.8% of cervical preneoplastic and neoplastic lesions in our community (Perez et al.) may be related to HPV according to the retrospective studies. Although rare, penile cancer is associated with a high morbidity and mortality. The carcinogenesis of penile cancer is thought to involve two pathways: one related to inflammation and other dermatological conditions of the penis, and other related to HPV infection (López-Romero et al.). HPV DNA prevalence in invasive penile cancer varied geographically, with the highest prevalence in Oceania (55.6%), North America (48.7), Africa (36.8%), South America (39.7%), and Europe (45.9%), being the most common HR-HPV types: HPV16 (30.8%) and HPV18 (6.6%) [5]. So that, it is important to be cautious and not to consider overall prevalence as universal because the role of HPV in penile cancer etiology could be strongly influenced by histologic distribution and geographic region as it is also true for other HPV malignancies such as vulvar and head and neck cancers [6].
\nGenital warts (GWs) represent a significant public health problem associated with clinical symptoms (burning, bleeding, and pain) and psychosocial problems (embarrassment, anxiety, and decreased self-esteem). Several studies have suggested that the occurrence of genital warts has been increasing over time [7]. Approximately 65% of people who have sex with an infected partner will develop warts themselves [8].
\nThere has been immense progress in understanding the natural history of HPV infection in women disease. HPV is the primary cause of cervical cancers. Recently, there has been an interest in understanding the relationship between HPV infection and disease in men [9]. The male sexual partner`s role and in his partner’s genital warts or high-grade cervical intraepithelial neoplasia (CIN II, CIN III-Ca in situ) lesions is also undefined. The diagnosis of most cutaneous and external genital wart (GW) can be made on clinical examination or with AW test and biopsy. In case of genital intraepithelial neoplasia, determining the extent of diseases is essential.
\nEpidemiological studies show that the HR-HPV infection is necessarily the sexual transmitted cause of invasive cervical cancer in women and its precursor lesion, cervical intraepithelial neoplasia (CIN) [10].
\nDirect genital mucosa contact during sexual intercourse is the principal route of HPV transmission [11]. About 80% of newly sexual couples will develop HPV-related lesions within 3 years after commencing sexual activity, most of whom will spontaneously regress within 1–2 years or until the age of 30–35 years [12]. The biology and dynamics of HPV transmission among sexual partners is still a cause for debate and has not already been completely established. Models have shown that HPV transmissibility is substantially higher than that of other viral sexually transmitted pathogens [13], but data on the natural history of HPV transmission between heterosexual partners are limited. Many studies [14–17] analyzed the prevalence and genotypes of high-risk infections of the foreskin before first sexual intercourse found asymptomatic infection in 12–83.3% [14, 16], speculating that non-sexual routes play significant roles in HPV transmission. In this regard, HPV transmission may occur upon contact with infected towels or other objects. In contrast to these findings, Pilatz et al. [15] did not find HPV in the foreskin of boys.
\nDespite the recommendation of the guidelines on sexually transmitted diseases, investigation of the presence of HPV in men who are sexual partners of infected woman has not been agreed. Previous studies suggested that the cancer of the penis and cervix may share the same etiological factor(s), because significant numbers of invasive cervical cancer were detected in partners of patients with penile cancer [18, 19]. It was assessed the contribution of the males’ genital HPV DNA status to the risk of development of cervical neoplasia in their sexual partners, confirming that men could be vectors of HPV types typically observed in cervical cancer [20]. However, another studies did not confirm the findings of these investigators [21]. As the process of HPV infection can take more than 15 years, the current partner could not be necessarily the source of infection.
\nHPV infection causes substantial morbidity and its incidence is similar in both genders. The ongoing HPV in men study (HIM) provides the most current data on HPV infection and lesion development in men [9, 22–24]. Assessing HPV prevalence in men and investigating the sources of variation are essential for understanding the epidemiology of HPV infection.
\nThe pooled HPV in the general population is significantly higher (20.4–36.3%) [25, 26] in studies published after 2000 (8.8%) [27]. The lower pooled prevalence in earlier publications might therefore be due to the detection method used and potentially not to a change in HPV prevalence over time. Age-specific prevalence curves among men are flatter [19, 28, 29] in contrast to the pattern observed in women [30]. The prevalence of genital infection in men does not differ significantly among age groups as it does in females [30]. In general population, HPV infection has a consistently higher prevalence within the penile epithelium of asymptomatic men than within the cervix of women with normal cytological testing [29].
\nSeveral factors have been suggested to influence HPV prevalence, varying substantially between sampling sites, techniques [31, 32], and different populations [33]. HPV prevalence is higher when samples are collected from a greater number of anatomic sites [29]. Hebnes et al. [27] in meta-analysis of studies examining HPV prevalence among men found a wide heterogeneity between general and high-risk populations. HIV-positive men, men with sexually transmitted infection and male sexual partners of women with HPV, CIN, CIS, or invasive cervical cancer are considered a high-risk population [34, 35]. Number of types tested for varies between articles. In studies reporting prevalence estimates for more than one HPV type, the commonest detected types were HPV16 [20, 24, 26, 27, 36, 37] and HPV18 [27].
\nFrom a socio-epidemiological standpoint, it is important to note that HPV-infected men play a key role in the transmission of the HPV virus to their female sexual partners. The range reported in other studies for sexual partners of women with CIN was 30–68% [19, 24, 26, 36, 38]. Geographical region, anatomical sampling site, or HPV detection methods have not explained the wide heterogeneity of results [27]. In contrast, Franceschi et al. [39] showed the strongest variation by countries, with a higher prevalence of HPV infection among Brazilian sexual partners of woman with CIN compared with those detected in other countries (Colombia, Mexico, Spain).
\nThe natural course of disease in men by establishing rates of acquisition and time to clearance of HPV infection has not been investigated properly. Although fewer data of infection duration have been reported in men, findings suggest that HPV infection clear more quickly for men than for women and that men have similar duration of infection for oncogenic and non-oncogenic types [7, 28]. Mean clearance time, defined as time to elimination of 50% of all infections, was estimated to be 5.9 months (patridge JM). HPV infections in women tend to have a longer duration and are estimated to clear at average of 12.2 months [40].
\nPositive concordance is defined as both partners having the HPV outcome of interest. HPV concordance in heterosexual couples has important clinical and public health implications. In terms of HR-HPV detection, the percentage of couples harboring HR-HPV was 32–65% [28, 36, 37, 41]. In couples where both members were HPV positive, more than 60% were infected with one or more of the same HPV types. This level of concordance was observed independently of HPV prevalence and is consistent with the high transmissibility of HPV [25, 28, 36, 38, 41]. Studies over the past 20 years evaluating HPV infection concordance among heterosexual partners have shown many inconsistencies, reporting concordances of type-specific infection between 2 and 87% [20, 42–44]. Such heterogeneous findings may be due to diverse laboratory DNA detection techniques, methods for study population selection and different anatomical sites sampling, among other factors [25].
\nPositive concordance was usually higher for female partners of men with HPV infection than for male partners of women with HPV infection. Men with HPV-positive female partners had one or more of the same HPV types more often in studies that recruited men with HPV-related diseases compared with studies without this inclusion criterion for men (65.8 vs. 27.2%) [28]. These findings suggest that the epithelial cells of the penile skin are more resistant to HPV infection than the cervical epithelium and the duration of HPV infection is shorter in men than in women [28, 38].
\nInfection with one or more of the 40 HPV detected at the genitals is common among men aged 18–70 years. Only 5% of these HPV infections progressed to an external genital lesions during follow-up. There were observed substantially higher rates of progression for certain HPV types [45].
\nMost genital infections in men are asymptomatic, detectable only by viral DNA testing and become undetectable over time. Subclinical lesions, including those related with HR-HPV types, are more than 10 times common than clinical (apparent) infection and are identified on examination after application of acetic acid solution, a procedure known as acetowhite test (AW test, peniscopy). Since the American Society for Colposcopy and Cervical Pathology recommended the use of HPV DNA testing for the triage and management of women with atypical squamous cells of undetermined significance result of Pap test, an increasing number of female patients are requesting HPV DNA testing for their partners. Although the current gold standard for HPV genotyping is a genetic sequencing targeting the product of gene amplification (Heidegger), a screening test capable of detecting asymptomatic and subclinical genital HPV infection in men at a reasonable price and causing minimal discomfort to the patient would be very valuable.
\nTo date, economic data have primarily focused on the more common HPV-related cervical cancer and its precursor lesions, as well as the benign, very common condition of genital warts. Nevertheless, available data indicate that HPV-related disease is associated with a significant economic burden in males. Specifically, in men, the total direct cost of HPV infection acquired through the age of 24 years was estimated at 62 million dollars per year, the comparable figure for women being 2.8 billion [46].
\nStudies of the psychosocial effects of HPV-related disease in males are lacking. However, there is a significant psychosocial burden reported in women being screened for, or diagnosed, with HPV-related disease [47].
\nThe currently available methods for evaluating HPV infection in male are HPV DNA test and AW test [12]. This is full description of our study procedures: The entire penis and scrotum of the patient were examined under magnification, and the presence of genital warts was recorded. After this examination, we sprayed them with 5% acetic acid solution. After 5 min, we enhanced the visualization of the skin by a colposcope under fourfold and sevenfold magnification, respectively. AW lesions were classified as typical for the presence of well-demarcated lesions with a slightly elevated border and the occurrence centrally of punctuated capillaries with or without an associated epithelial depression (Groove) and non-typical for the presence of lesions exhibiting a ragged border and lacking punctuated capillaries. Regardless of AW test result, the specimen for HPV DNA detection was obtained. Samples were taken with three cytobrushes from the preputial cavity (the inner part of the foreskin, the glans and the sulcus coronarius, scrotum, and urethral meatus) rotated 360 grades and suspended together into one single vial containing TE buffer pH 8.0 Molecular Biology grade (AppliChem GmbH, Darmstadt, Germany). Samples were maintained at 2–8°C and processed within 24–72 h after collection. The brushings were collected without spraying the genital region with saline solution. DNA was isolated using QIAamp MinElute Media Kit (Qiagen, Hilden, Germany). Extracted nucleic acids were stored at −20°C. An aliquot of the original sample was also stored at −20°C. Amplification and detection were carried out using the Linear Array HPV Genotyping Test (Linear Array. Roche Diagnostics, Mannheim, Germany) according to the manufacturer’s instructions. We described the distribution of 22 HPV genotypes classified as HR (HR-HPV, IARC Group 1 carcinogens) or probable/possible HR (pHR-HPV, IARC Group 2A/B carcinogens) by the International Agency for Research on Cancer Monograph Working Group (\nTable 1\n). This test also detects human beta-globin in order to test the adequate sample cellularity and absence of inhibitors. Linear Array does not have individual probe for HPV52 but uses a probe that simultaneously detects HPV52, HPV33, HPV35 and HPV58. Additional specific PCR was performed in case of HPV33, HPV35 and/or HPV58 infection in order to properly detect confections of these three genotypes with HPV52 [48].
\nIn our study, around 30% of positive AW results were not related with HR-HPV infection [49–51]. False-positive results may be due to low-risk HPV infection or inflammatory conditions, common in patients with sexually transmitted diseases [52]. Nevertheless, the need for detecting subclinical genital HPV infection, associated with detectable AW lesions [53], has been emphasized and these population would need follow-up or biopsy. Afonso et al. [37] found that 50% of sexual partners of women with CIN harbored HPV in lesions and these were predominantly subclinical. The diagnosis and treatment of acetowhite lesions in men do not seem to alter or improve the progress of the squamous intraepithelial lesions in their female partners [54]. Nevertheless, these acetowhite lesions on male genitalia are in fact squamous intraepithelial alterations and should not be left due to the risk of their further development [37] as Sudenga et al. [45]. have presented the first estimates of genital HPV infection progression to PeIN. They are the first authors that follow these HPV infections and their progress to lesion in men. We encourage the importance of the clinical follow-up of this men and perhaps of taking a biopsy afterwards, in case of HPV infection persistence.
\nProblems associated with screening techniques in men include inadequate collection of cells for the detection of HPV DNA by use of swabs and brushes, poor specificity, and patient discomfort during peniscopy. When lesions are not visible, sampling at multiple penile sites could increase the sensitivity of the HPV [41, 55]. In addition, the use of acetic acid and a colposcope requires specific training, clinical experience, and significant costs associated with the procedure and training. Polymerase chain reaction (PCR) has emerged as the most sensitive available method for the detection of latent HPV infection. The infectious diseases literature supports the lack of the US Food and Drug Administration (FDA) approval of HPV tests for HPV detection in men and the absence of adequate therapy for established HPV infection in this population.
\nA cross-sectional study was conducted by the Urology Department of the University Hospital of Vigo, Spain, from January 2013 to June 2015 (López Díez et al., Enf Infecc Microbiol Clin, 2016 in press). We recruited 125 asymptomatic men, aged 18 years, whose SP (sexual partner, regular sexual intercourse for more than 1 year) had presented high-grade squamous cervical lesions (CIN grade 2 or CIN grade 3-carcinoma in situ) in the previous 6 months. Prevalence of HR-HPV infection in men was 50.4% (63/125). Multiple HR-HPV infections were detected in 30.4% (38/125) of this population. Data of HPV genotype were available in 120 women. HPV16 was the most frequent genotype, detected in 47.6% (30/63) of infected men and 67.5% (81/120) women (\nTable 2\n). HR-HPV infection was detected in both partners in 50% (60/120). Among these infected couples, 62% (37/60) harbored at least one genotype in common. The HPV16-specific concordance was as follows: 41.7% (25/60) couples were concordantly HPV16 positive and 18.3% (11/60) were concordantly HPV16 negative (Kappa value: 0.21).
\nThe proportion of women with the same genotype as their male partner was 58.7% (37/63). The proportion of men sharing the same genotype as their female partner was 30.8% (37/120), p < 0.0001.
\nAW procedure was positive in 34/125 (27.2%) patients. AW procedure showed 25.4% (95% CI 13.8–36.9) sensitivity, 71.0% (95% CI 58.9–83.1) specificity, 47.1% (95% CI 28.8–65.3) positive predictive value and 48.3% (95% CI 37.5–59.2) negative predictive value for the identification of HR-HPV infection (\nTable 3\n). AW lesions and HR-HPV were detected at the same time in 16/125 (12.8%) males.
\nIARC classification | \nGenotype | \nInfected men (n) | \nGlobal prevalence (N = 125) % | \nPrevalence in HPV-positive men (N = 63) % | \n
---|---|---|---|---|
HR-HPV | \nHPV16 | \n30 | \n24.0 | \n47.6 | \n
\n | \nHPV18 | \n4 | \n3.2 | \n6.3 | \n
\n | \nHPV31 | \n9 | \n7.2 | \n14.3 | \n
\n | \nHPV33 | \n2 | \n1.6 | \n3.2 | \n
\n | \nHPV39 | \n6 | \n4.8 | \n9.5 | \n
\n | \nHPV45 | \n5 | \n4.0 | \n7.9 | \n
\n | \nHPV51 | \n11 | \n8.8 | \n17.5 | \n
\n | \nHPV52 | \n12 | \n9.6 | \n19.0 | \n
\n | \nHPV56 | \n8 | \n6.4 | \n12.7 | \n
\n | \nHPV58 | \n3 | \n2.4 | \n4.8 | \n
\n | \nHPV59 | \n6 | \n4.8 | \n9.5 | \n
pHR-HPV | \nHPV53 | \n13 | \n10.4 | \n20.6 | \n
\n | \nHPV66 | \n10 | \n8.0 | \n15.9 | \n
\n | \nHPV67 | \n1 | \n0.8 | \n1.6 | \n
\n | \nHPV68 | \n2 | \n1.6 | \n3.2 | \n
\n | \nHPV69 | \n1 | \n0.8 | \n1.6 | \n
\n | \nHPV70 | \n4 | \n3.2 | \n6.3 | \n
\n | \nHPV73 | \n3 | \n2.4 | \n4.8 | \n
Type-specific HPV prevalence in men.
HR-HPV, high-risk HPV genotypes; pHR, probable/possible high-risk genotypes; IARC, International Agency for Research on Cancer.
Crude HPV prevalence calculated in 63 HPV-positive patients: 25 single and 38 multiple infections (López Díez et al., Enf Infecc Microbiol Clin, 2016 in press).
\n | HR-HPV DNA detection | \n\n | \n | ||
---|---|---|---|---|---|
\n | \n | Yes | \nNo | \n\n | \n\n |
n (%) | \nn (%) | \np | \nOR (95% CI) | \n||
AW lesion | \nYes | \n16 (25.4) | \n18 (29.0) | \n0.648 | \n0.83 (0.38–1.83) | \n
No | \n47 (74.6) | \n44 (71.0) | \n– | \n– | \n
Acetowhite lesions according to HR-HPV DNA detection.
Genital lesions detected by peniscopy in asymptomatic sexual partners of women with high-grade cervical lesions, according to the presence of HR-HPV.
HR-HPV DNA, high-risk HPV; AW, acetowhite test; OR, odd ratio; 95% CI, confidence interval.
Statistically significant, p < 0.05 (chi-square test).
Genital warts were present in 17/125 (13.6%) patients. AW procedure showed sensitivity 82.3 (95% CI 55.8–95.3), specificity 81.4% (95% CI 72.6–88.6), positive predictive value 41.1% (95% CI 25.1–59.1) and negative predictive value 96.7% (95% CI 89.9–99.1) for genital warts’ detection (\nTable 4\n).
\n\n | Genital warts | \n\n | \n | ||
---|---|---|---|---|---|
Yes | \nNo | \n\n | \n | \n||
n (%) | \nn (%) | \n\np\n | \nOR (95% CI) | \n||
AW lesion | \nYes | \n14 (82.3) | \n20 (18.5) | \n<0.0001 | \n20.53 (5.39–78.27) | \n
No | \n3 (17.6) | \n88 (81.5) | \n– | \n– | \n
Acetowhite lesions according to genital warts’ detection.
AW: Acetowhite test, OR: odd ratio, 95% CI: confidence interval.
Statistically significant, *p < 0.05 (chi-square test).
HR-HPV prevalence was 6/15 (40.0%) in circumcised men and 57/110 (51.8%) in not circumcised men (p > 0.05).
\nCoexistence of non-oncogenic and oncogenic HPV-types is frequent [56, 57], which may itself predispose to cancer. A Danish study of 50,000 people with GW found an elevated risk of HPV-associated cancers in people with GW compared with the general population [56]. Although test for the presence of HPV are not recommended for the diagnosis of GW [58] in our study, the AW test was sensitive and specific for genital warts’ detection, showing a high negative predictive value. This procedure could avoid missing small clinical lesions. They are generally regarded as a benign condition not associated with mortality, but they can be difficult to treat and recurrence is often observed. Visible warts represent only the tip of the iceberg, and low- and high-risk HPV infections contribute to the genital lesion burden in men [24]. Healthcare providers should have a higher suspicion for HPV-associated cancers in immunocompromised patients with GW. AW test can be helpful in the diagnosis of GW. In particular, soaking acetic acid into suspicious lesions can enhance the degree of suspicion in lesions without classic features. Taking a biopsy might also be indicated if diagnosis is uncertain, the lesions do not respond to standard therapy or the disease worsens during therapy [58].
\nLimited data exist on the association between HPV infection and smoking in men. In this study, current smoking could increase 2.3-fold the risk of HPV-prevalent infection in males, as found in the HIM study. At present, it is unclear how smoking may influence HPV infection in men, but many possible mechanisms exist. Smoking could potentially increase viral load by weakening the cellular immune response [59].
\nSexual behavior has been strongly associated with HPV infection and seropositivity in men [60]. Features previously associated with HR-HPV were as follows: young age at first sexual intercourse (FSI), a higher number of lifetime sexual partners (LSP) and a higher number of recent SP. Contradictory results about the influence of lifetime number of SP were reported [26, 41, 55, 61, 62]. This data could be attributable not only to the range of birth year of men but also to geographical characteristics [27, 33]. In Western population, the numbers of lifetime sexual partners in men and women are both relatively high, and little gender difference could be observed. Burchell et al. reported that the proportion of ≥5 lifetime sexual partners was 64.4% for men, in line with our results (55.2% in men).
\nThe risk of having one or more SP in the preceding year was has been poorly evaluated. The risk of HPV re-infection between a monogamous couple is still a matter of debate [63]. In contrast, Rombaldi et al. [64] and Parada [25] found a high association between both variables.
\nIn the National Questionnaire of Sexual Health, published by Spanish Government in 2009, it was found that the mean age of FSI was 17–18 years (29.3%) for Spanish men. In our study, younger age at FSI was not a risk factor for HPV infection as other authors have previously reported [27, 64]. There are contradictory data that could be attributable not only to the range of birth year of men but also to geographical characteristics [55, 60].
\nSimilar to other studies [55, 65], we did not find the expected protective effect of circumcision on HPV acquisition. Circumcision seems to be associated with reduced persistence in men [66] even though the mechanism of protection is unclear. Removal of the foreskin could minimize the chance of acquisition of new infections or could result in an increased clearance of preexisting infections [28, 67]. Our different results could be due to the fact that circumcision is not very common in our geographical area and that analysis could not assess specific associations in the glans penis, the area expected to be most likely protected by removal of the foreskin [68].
\nEpidemiological characteristics of the studied high-risk population are shown in \nTable 5\n. Current smoking status was associated with an increased risk of HR-HPV infection in men: 38.2% (21/55) versus 60% (42/70), OR 2.3 (95% CI 1.1–4.7), p = 0.016.
\nVariable | \nHPV detection (n = 125) | \n\np-value | \n||
---|---|---|---|---|
Positive | \nNegative | \nBivariate analysis | \nMultivariate analysis | \n|
Age at FSI | \n16.9 ± 2.7 | \n17.4 ± 2.4 | \n0.382 | \n\n | \n
Lifetime SP | \n||||
1–5 SP | \n10 (34.5%) | \n19 (65.5%) | \n0.050 | \n\n | \n
>5 SP | \n53 (55.2%) | \n43 (44.8%) | \n||
Recent SP | \n||||
1 SP | \n51 (49.0%) | \n53 (51.0%) | \n0.498 | \n\n | \n
>1 SP | \n12 (57.1%) | \n9 (42.9%) | \n||
Current smoking | \n||||
Yes | \n42 (60.0%) | \n28 (40.0%) | \n0.015* | \n0.016* (OR 2.3, 95% CI 1.1–4.7) | \n
No | \n21 (38.2%) | \n34 (61.8%) | \n||
CIN grade in partner | \n||||
CIN 2 | \n30 (54.5%) | \n25 (45.5%) | \n0.411 | \n\n | \n
CIN 3-CIS | \n33 (47.1%) | \n37 (52.9%) | \n
HPV detection in men according to epidemiological characteristics.
FSI, first sexual intercourse;, SP, sexual partners; CIN, cervical intraepithelial neoplasia; CIS: carcinoma in situ.
Age was expressed as mean ± standard deviation.
\n* p < 0.05, statistically significant.
Prevalence of HR-HPV infection was 14/17 (82.4%) in patients with genital warts versus 49/108 (45.4%) in patients without genital warts (OR 5.6, 95% CI 1.5–20.7, p = 0.008) (\nFigure 1\n).
\nStatistically significant, *p< 0.05 (chi-square test).
Until recently, no highly effective primary prevention strategy to reduce the risk of HPV acquisition existed. However, research has demonstrated that nonavalent, quadrivalent and bivalent HPV vaccines stimulate immunogenicity in males and females [69]. On October 16, 2009, the FDA approved the use of quadrivalent vaccine in males aged 9–26 years for the prevention of genital warts. Subsequently, the Advisory Committee on immunization Practices (ACID) declined to recommend the quadrivalent vaccine for routine immunization in men [70], providing a permissive recommendation in this age range for HPV vaccination. Most European countries offer HPV vaccination for girls, but vaccine recommendations for boys are warranted. HPV vaccination of girls will in theory also benefit the male population through herd immunity.
\nUninfected sexual partners may be an important target population for HPV vaccination [71]. Potential interventions such as a therapeutic HPV vaccine may avert new HPV infections. Moreover, vaccinating boys would reduce HPV-related diseases in both sexes to a greater extent than herd immunity, which depends on high vaccination rates among females.
\nThe benefits of vaccination to individuals seronegative to HPV types included in the vaccine are clear, and emerging studies suggest that HPV vaccine may also help people who previously had and cleared an infection [72] although additional researches in this population are needed. While prophylactic HPV vaccine does not have substantial impact on established infection, it may have cross-protection against non-vaccine genotypes [73]. However, if these vaccines could also be successful in lowering the HPV load, they may also assist in lowering transmission [13].
\nThere is no direct evidence for protection by HPV vaccines against penile cancer because penile cancer is so rare that there could never be a clinical trial large enough to measure the effect [74]. HPV vaccines have not been around long enough to measure the population impact on penile cancer. However, the observed HPV type distribution reinforces the potential benefit of current and new vaccines in reduction in HPV-related penile neoplasia lesions [6].
\nFuture trials of HPV vaccines in men should take into account not only the presence of penile HPV infection but also the presence of penile subclinical lesions as an outcome measure for the efficacy of a vaccine. More complex study designs would also allow researchers to better understand first transmission, reinfection and back and forth passage within couples, concordance in couples in which one partner has received HPV vaccine and concordance after treatment for HPV-related lesions is an essential component of prevention programs aimed to reduce cervical cancer and other HPV-related diseases in men and women.
\nHPV causes cancer in both men and women. The HPV-related cancer burden remains higher in women than men, even in countries that have effective cervical cancer screening programs. It is clear that males have poor knowledge of HPV infection, morbidity, transmission, and prevention. Moreover, several issues are controversial and should be addressed by adopting a multidisciplinary and multiprofessional approach. Regardless of vaccination strategies adopted, efforts should be made to educate males about HPV and its health implications.
\nCurrently, there is no licensed test for HPV detection in men and there are no recommendations for male screening. Although routine HPV testing is not necessary for men in general population, findings from emerging research in high-risk population suggest that HPV infection is pervasive and persistent in these groups, warranting the adoption of additional screening and prevention policies. Our findings suggest the need for greater attention to sexual partners of HPV-infected individuals. Male sexual partners of female with high-grade lesions should be referred for evaluation and combined peniscopy, and HPV DNA test will ensure accurate detection of HPV status among males. Female partners of men with HPV-related diseases should be encouraged to get screened for HPV-related disease given that they have a high likelihood of concomitant infection and that most infection in couples are of the same viral type. Screening may also benefit male partners of HPV-infected women. Interventions that study the true prevalence of HPV infection in asymptomatic men and try to reduce HPV-associated penile lesions could be important to both men and women.
\nFurther prospective and controlled studies in different populations are needed to provide adequate counseling to men that demand to know whether they are infected by HR-HPV. Long-term follow-up will contribute to the knowledge about the influence of persistent HPV infection in male and the potential recurrence of his sexual partner after treatment. We assume that the faster way to achieve greatest protection for cervical cancer and its precursors is to vaccinate males as well as female because both genders contribute to the transmission of HPV infection.
\nThe prevention, diagnosis, and treatment of HPV-associated diseases in men will reduce the disease burden not only in males, but also in females, and help destigmatize the focus of the HPV-related disease on women.
\nWe thank nursery team, especially Carmen Garcia from the Urology Department of the University Hospital of Vigo, for their excellent help in this research, collecting patients. We thank M. Consuelo Reboredo from the Gynecology Department and the laboratory technicians of the Microbiology Department of the University Hospital of Vigo, for their support of the study. We are also grateful to Angel de la Orden for the revision of the manuscript.
\n0.12% of earth crust is made up of phosphorus mineral. P is a nonrenewable natural resource present in all types of rock and soils, in all living cells, and however can form complex compounds. Mineral deposits are the major supply of phosphorus. All phosphate mineral was derived from apatite by weathering. Mostly phosphate is found in different forms like quartz, calcite, dolomite, apatite, Fe-oxide minerals and clay minerals. Apatite mineral is used for manufacturing fertilizers. Extraction of phosphorus depends on the physical properties of the rocks and its geological setting.
Since ancient times man used natural resources such as manures, vegetables material, and bones as fertilizers. In 1840 Liebig, the German chemist, suggested the formation of superphosphate by dissolving bones in sulfuric acid that made the P more available to plants. This practice becomes so popular that bone supply is restricted in a very short time. To overcome this problem, some workers started extraction of phosphorus from rocks; in 1847 the first commercial production of P rocks from the mining of coprolites began in Suffolk in Great Britain and peaked in 1876 when about 25,000 metric tons were mined.
Presently all the Phosphate reserves that are found all over the world are not “mineable” deposits, as mining of them are not economically feasible. The United States is the highest phosphate-producing country in the world, while Morocco and China are the second and third countries with respect to phosphate production. Australia and Canada are recently known sites of phosphorus mining. There are rich deposits of phosphate found in Mongolia and Peru that will fulfill the need in the future. Florida phosphate industry becomes one of the major producer and exporter of phosphate fertilizer due to good transportation and industrial infrastructure facility in America and also because a substantial layer of phosphate is only 15 to 50 feet below a soft overburden. The phosphate mining in Central Florida overshadowed other sources because of low cost of mining, large deposits and the good quality of phosphate content of Florida rock. Florida is presently providing approximately 75% of the nation’s supply of phosphate fertilizer and about 25% of the world supply. In 2000, mining operations began in Ontario, Canada, of North America. Florida’s phosphate is part of a deposit that stretches across the state and up the coast to the Chesapeake Bay. The phosphate mining is expanded from Central Florida to Polk and Hillsborough counties, south, to Hardee, DeSoto, Manatee and Sarasota counties. In Northern Florida phosphate deposits are present in Hamilton, Columbia and Suwannee counties.
Some three decades ago in 1880, Dr. C. A. Simmonsin of England, who owned a rock quarry for building stone in Hawthorne, sends some of his rocks to Washington, DC, for analysis. The analysis determined the presence of phosphate in the rock samples, and in 1883 he made the first attempt for mining phosphate in Florida. But it was in 1889 by Albertus Vogt and others in Marion County who began the production of the first hard rock by the Marion Phosphate Company. This was later in 1890 followed by the Dunnellon Phosphate Company, in which Vogt had ownership interest, and in this way the area was flooded by thousands of prospectors, and the great Florida phosphate boom had begun. By 1894 more than 215 phosphate mining companies were operating statewide. The boom brought wealth. But in 1900 due to consolidation and capitalization, this number had dwindled to about 50. In 1881, Captain J. Francis LeBaron, chief engineer of the US Army Corps, during his survey of Peace River of Polk County, analyzed river pebbles and confirmed the presence of phosphate, but at that time this discovery did not catch much attention. In 1886 John C. Jones and Captain W. R. McKee, of Orlando, discovered high grade phosphate along the Peace River which led to the formation of an association known as the Peace River Phosphate. Mining activity along the Peace River proceeded both in the river itself and on the adjacent land. The so-called river pebble mining was the first to be exploited. In 1888, the first shipment of Peace River phosphate pebble was launched by Arcadia Phosphate Company about a year ahead of the Peace River Phosphate Company. This phosphate discovery was kept relatively quiet. Rumors of no phosphate in Central Florida spread as a result; Polk County’s phosphate deposit took a back seat the first 15 years to the hard rock region to the north. The Florida Phosphate Company and the Pharr Phosphate Company were the two phosphate mining plants found in pebble district till 1890. In 1891 Pharr started shipment of land pebble for the first time; due to this there occurred a boom in the rate of river pebble production in 1893. Phosphate mining came to North Florida in the 1960s when Occidental Petroleum Company was looking for a way to get into the fertilizer business to get profit. Occidental went north and opened a mine in White Springs where it mined phosphate until 1995, when the Potash Corporation of Saskatchewan (PCS) purchased the operation. Nowadays Mosaic and PCS Phosphate, White Springs, are the two phosphate mining companies in Florida, and the third one are US Agri-Chemicals which produce phosphate fertilizers in Central Florida.
A blanket of phosphate deposits covers much of the Peninsular Florida has a large phosphate deposits which consists of approximately equal parts phosphate rock, clay and sand, averages 12 to 15 feet in thickness. The matrix is buried beneath a soil that is 15–30 feet deep. By the end of 1999, approximately 300,000 acres of land, or more than 460 square miles, had been mined in Florida. Polk County is the heart of the Bone Valley mining region, and the mineable deposit in this area stretches to Hillsborough, Hardee, Manatee, and DeSoto counties. The large depositions were also found in mining in North Florida’s Hamilton County from a mineable area that extends into Columbia and Suwanee counties. Similar deposition is found in both the areas. Mining in Central Florida has been moving south. As sites mine out, the draglines move to where the contiguous deposit of phosphate pebble is found. Toward the south the quality of rock decreases which brings technological challenges for the mining industries. During the past years, mining is slowed down in Polk County’s southern fringe. In 2000 closing of IMC Clear Springs and Noralyn mines conveyed a close to active. Currently phosphate mining companies has opened new mining sites in Manatee, DeSoto and Hardee counties.
The fertilizer that quickly became the item of commerce as most widely used by the growers today, and it had the highest concentration of phosphate and nitrogen at 18 N–46P2O5–0K2O.
This fertilizer is essentially the same as DAP, but it has a lower concentration of nitrogen at 11 N–52P2O5–0K2O. It is completely water soluble and has granular material; it mixes well and frequently serves as an ingredient in bulk-blended fertilizers.
It is very similar to the superphosphate fertilizer that provides 46% P2O5, some calcium and sulfur to plants. GTSP is formed by reaction of phosphate rock with phosphoric acid.
It’s an acid used to make a concentrated or fluid fertilizer. PCS is the acid produced only by Florida Company in North Florida.
Phosphoric acid is used in granulation plants where ammonia is added to phosphoric acid to produce the ammoniated phosphate fertilizer. Purified food-grade phosphoric acid is used in making soft drinks.
Defluorinated phosphate rock or phosphoric acid is used to make animal feed supplements by combining phosphate rock with phosphoric acid, sodium carbonate and then calcine or react it with lime to get dicalcium phosphate.
Sulfuric acid
This acid is used to produce phosphoric acid after reacting with phosphate rocks at phosphate plants.
Sedimentary marine phosphorites are the principle resources of phosphate rock. The world’s largest sedimentary reservoirs are found in North Africa, China, the Middle East, and the United States. Valuable igneous sedimentary reservoirs are also found in Brazil, Canada, Finland, Russia, and South Africa. Substantially large phosphate deposits have been spotted near the Atlantic Ocean and the Pacific Ocean shown in Table 1 and Figure 1. World resources of phosphate rock are more than 300 billion tons. There are no imminent shortages of phosphate rock.
Phosphate rock production worldwide in 2017, by country (in 1000 metric tons).
It was observed that applications of H3PO3 and phosphite (Phi) were less effective as compared to phosphoric acid (H3PO4) and its derivatives on the first crop. With increasing rates of phosphite (Phi), phytotoxic effects were detected on the crop yield. However, nutritive role of Phi in growth response was evident when compared to the zero-P control. Whereas researchers found Phi and H3PO3 treatments beneficial to the second crop, this was due to probable conversion of Phi to phosphate in the soil. In general, better yield was obtained when Phi materials were used on soils with limestone. Further scientific studies related with the significance of H3PO3 and its salts in agriculture did not occur for nearly 30 years, but rather their performance against plant diseases was mentioned [1]. During the disease control analysis, many incidents related to the plant’s physical and chemical mobility were observed when the plants were treated with H3PO3 or its salts in the absence of plant pathogens, some of which are described below. Ouimette and Coffey [2] reported that the Phi were more readily absorbed into plant tissues than phosphates—very important in crops with leaf surfaces that resist foliar spray uptake. In a comprehensive review given by Guest and Grant [3] related with the complex action of phosphonates, several unique features of this chemical group were recounted. For example, Phi is a rapidly absorbing nutrient, which translocates from xylem to phloem according to normal source-sink relationships for nutrient element materials. Guest and Grant [3] reported that the Phi is more persistent as it metabolized slowly in plant tissue as compared with phosphate and does not participate in all the same biochemical pathways as phosphate. Adam and Conrad and Casida [4, 5] confirmed their results through experiments where bacterium Pseudomonas fluorescens 195 showed the ability to oxidize Phi and also discharge it in the growth medium as phosphate. Malacinski and Konetzka [6] repeated the same work and reported that a short adaptive period was required before oxidation of Phi by organisms, and this whole process took 14–15 weeks. Bezuidenhout et al. [7] during their study reported first time that the Phi can also be converted microbially to phosphate within plant tissues and identified three genera of bacteria (Alcaligenes, Pseudomonas and Serratia). These findings complemented the previous observations given by Rothbaum [8] that elemental P in soil was oxidized non-enzymatically under particular temperature and water. Busman et al. [9] reported that the phosphate fertilizer applied to the soil will not be utilized by the crop in the first season. Rothbaum and Baillie [8, 10] observed that Phi was less adsorbed than phosphate by the same soil. This lower ‘phosphate fixation’ improved growth of Phi-treated soil, with a period gap, as compared to phosphate-treated soil. Rhone-Poulenc Ag Company of the United States expressed concern to the US Environmental Protection Agency (EPA) about classifying a fungicide based on H3PO3 salts as a biochemical pesticide and affirmed the non-enzymatic oxidation of Phi to phosphate occur naturally over time. Lovatt [11] discovered that foliar application of K3PO3 to P-deficient citrus seedlings restored plant growth. This demonstrated that through metabolic processes, Phi was readily taken up by plant leaves and replaced phosphate as a source of Frazier and Waerstad [12] tested the composition and solubility of Phi to analyze the potential of this class of materials for increasing the plant nutrient element content of liquid fertilizers. Albrigo [13] reported the positive response of Phi on winter pre-bloom foliar of Valencia oranges which were increased flower number, fruit set and yield, plus increased total soluble solids. Additional studies by Lovatt [14] on foliar fertilization of citrus showed that application of K3PO3 in May and July to navel orange significantly increased the number of large-size fruit, total soluble solids and the ratio of soluble solids to acid, compared to control fruit. Biagro Western Sales, Inc., Visalia, CA, took the lead in commercialization of Phi-supplying fertilizer products patented by the University of California Anon and Lovatt [15, 16]. Today farmers are well educated and formed community of producers; they analyze themselves the effect of new Phi products on both soil and crop. In a practical sense, acceptance by discriminating growers is strong evidence that the benefits of H3PO3-derived fertilizers are standing up to their ultimate test—the real world of agricultural crop production.
Rock phosphate is one of the basic raw materials needed in the manufacture of phosphatic fertilizers like single superphosphate, diammonium phosphate, nitrophosphates, etc. Commercial rock phosphate occurs in nature as deposits of apatites (bearing minerals) along with other accessory minerals such as quartz, silicates, carbonates, sulfates, sesquioxides, etc. Four types of rock phosphate minerals are carbonate apatite [3Ca3(PO4)2.CaCO3], fluorapatite [3Ca3 (PO4)2.CaF2], hydroxyapatite [3Ca3(PO4)2.Ca(OH)2], and sulpho apatite [3Ca3 (PO4)2.CaSO4]. Because of their well-developed crystalline formation property, the apatites of igneous and metamorphic origin are generally regarded as less reactive. However, the apatites of sedimentary rock deposits are soft minerals possessing microcrystalline structure and are of major commercial importance for direct application in the soil [17].
The classification of reserves of indigenous rock phosphate as done by the Indian Bureau of Mines, and the purpose for which each grade can be used is given in Table 2.
Countries | Mine production | |
---|---|---|
2015 | 2016 | |
United States | 27,400 | 27,800 |
Algeria | 1400 | 1500 |
Australia | 2500 | 2500 |
Brazil | 6100 | 6500 |
China | 120,000 | 138,000 |
Egypt | 5500 | 5500 |
India | 1500 | 1500 |
Israel | 3540 | 3500 |
Jordan | 8340 | 8300 |
Kazakhstan | 1840 | 1800 |
Mexico | 1680 | 1700 |
Morocco and Western Sahara | 29,000 | 30,000 |
Peru | 3880 | 4000 |
Russia | 11,600 | 11,600 |
Saudi Arabia | 4000 | 4000 |
Senegal | 1240 | 1250 |
South Africa | 1980 | 1700 |
Syria | 750 | — |
Togo | 1100 | 900 |
Tunisia | 2800 | 3500 |
Vietnam | 2500 | 2800 |
Other countries | 2470 | 2410 |
World total (rounded) | 241,000 | 261,000 |
Showing world production of phosphate in 2015 and 2016.
Grade | P2O5 (%) | Reserve (mt) | Remarks |
---|---|---|---|
High | +30 | 15.27 | Considered for wet production of fertilizers |
Medium | 25–30 | 18.95 | Considered mainly for partially acid rock phosphate and for processed phosphates after less beneficiation |
Low | 11–25 | 55.22 | Approx. 20% P2O5 grade and relatively more reactive material may be considered for partially acidulated rock phosphate production and others for direct application |
Unclassified | 170.04 | ||
Total | 259.48 |
Classification of known reserves of indigenous rock phosphate in India.
Including all grades and types of rock phosphate, the known global resources are in the order of 163,000 million tons. Though globally adequate, rock phosphate is inequitably geographically distributed. Africa holds about 41%, the United States has 21%, former USSR 13%, the Middle East 10%, Asia 8%, and South America 3%, while Australia, New Zealand and Oceania together reported for only 2% and Europe >1%. Phosphate rock resources in India is, however, not very comfortable as it possesses a resource of only 260 million tons (0.19% of the world) of rock phosphate of all types and grades, catering the agricultural needs of 1/6 of the population of the world. Out of the total rock phosphate resource, the country has a predominance of low grade rock phosphate having only 15.27 million tons reserve of high grade rock phosphate (Table 1), and the remaining low grade rock phosphate is unacceptable to P fertilizer industry due to its very low P2O5 and high CaCO3 content [18]. The current annual domestic demand of high grade rock phosphate is of the order of 4 million tons. Out of which 95% is consumed in agriculture sector as a source of P fertilizer. The domestic production of about 1.4 million tons/year of rock phosphate could hardly meet 35% of the total demand, and the remaining (65%) demand is met through imports. P fertilizer industry largely depends on sulfur, phosphoric acid, and ammonia besides rock phosphate. India imports around 1.7 million tons of sulfur, 2–4 million tons of phosphoric acid, 1.5 million tons of NH3 and 4.9 million tons of rock phosphate for phosphate industry which constitutes a substantial part of our international trade in fertilizer raw material. Thus, the rapidly increasing price of soluble phosphatic fertilizer has raised interest in cheaper alternatives. Under such conditions, we must explore new methodologies for the utilization of indigenous low grade rock phosphate by converting it into a potential resource of P for direct application to the soil. The direct utilization of indigenous rock phosphate deposits could only alleviate the dependence of the country on foreign suppliers.
Soils has an eminent reserve of total P, but very little amount of P is actually available to the plants to support their growth to fulfill the requirement; continuous application of phosphate fertilizers is essential for increasing crop yield. Water solubility of phosphate fertilizers depends on both acidic and neutral to alkaline conditions. Several factors that influence the application of rock phosphate as P fertilizer are rate of dissolution, soil characteristics, plant species and fertilizer.
Factors which determine rock phosphate dissolution rate are its lattice composition, accessory mineral type and particle size. Solubility of apatites increased by substituting CO32− for PO43− in the lattice structure due to decrease a-dimension of the unit cell, and crystal instability [19]. Silverman et al. [20] reported Calcium carbonate as the soluble apatite as compared to other apatites. Rate of its dissolution increases with the concentration of Ca2+ and pH at the surface of apatite, and therefore it reduces the rate of rock phosphate dissolution in soil. The rate of dissolution reduced under field conditions due to leaching or plant uptake of calcium ions. The rate of dissolution increases as the particle size decreases; this might be because fine particle size has greater degree of contact between rock phosphate and soil.
The rate of dissolution of rock phosphate also depends on the chemical properties and type of soil to which it is applied. As compared to other parameters, pH buffering capacity was very important in soil. Earlier studies indicated that the amount of rock phosphate-P decreased with the increase in soil pH. The rate of dissolution of rock phosphate was highly sensitive to Ca2+ activity in the soil solution. A linear relationship between the log of Ca2+ activity and log of P in soil solution has been reported by Robinson and Syers [21]. Phosphate retention capacity and soil moisture also affect rock phosphate dissolution of the soil to retain P. Wet soil enhances the rate of phosphate dissolution by allowing the dissolution products. The product transported away from the surface of the rock phosphate particles and recognized the positive effect of organic matter on rock phosphate dissolution.
Ability of plants to extract P from rock phosphates was recognized by Merril, quoted in Flach et al. [22]. Plants affect the dissolution by the secreting acid or alkali, through Ca uptake, production of chelating organic acids such as citric, malic and 2-ketogluconic acids which complex Ca and deplete P in the soil. Roots of the plants induced change in rhizosphere pH which causes imbalance in the proportion of anionic (usually NO3−, H2PO4−, SO42− and Cl−) and cationic nutrient (K+, Ca2+, Mg2+ and Na+) uptake by the plants. The imbalance in the rhizosphere is maintained by the release of either H+ or OH−/HCO3−, thus balancing the pH of the rhizosphere. Acidic soil enhances the rate of rock phosphate dissolution. Effective rock phosphate utilization by plant species such as e.g., buckwheat and rapeseed has been responsible for their high Ca uptake. Flach et al. [22] assessed the ability of maize, pearl millet and finger millet to utilize P from rock phosphates by a pot experiment and concluded that plant species influence P dissolution; therefore, choice of crop is very important to maximize the solubility of rock phosphate.
Today growing extraction and consumption of phosphate is exhausting existing deposits, and therefore the rate of P reserves depleting. This means that at a certain point time comes when all the phosphorus reached to the alarming peak and that condition is called ‘peak phosphorus’ according to literatures. This condition will be calculated on the basis of phosphate rock reserves. Since no consensus was there on the size of these reserves, so nobody knows when will be the peak phosphorus stage will occur. Peak phosphorus has been calculated by the Global Phosphorus Research Initiative (GPRI). In 2009 the GPRI estimated that phosphorus production would peak around the year 2033 and that afterward production will continuously decrease until reserves are depleted within the next 50-100 years. The US Geological Survey (USGS) re-estimated reserves at 60,000 mmt up from previous estimates of 16,000 mmt; the IFDC stated that ‘there is no indication of “peak phosphorus” event within the next 20–25 years. The concept of peak phosphorus itself is contested; the main fault in the calculations of peak phosphorus is based on phosphate rock reserves not resources which provide the basis for estimation of static ranges. Phosphate rock reserve data explained by national geological surveys do not point out the absolute quantity of an element which is available for extraction, as the static paradigm would suggest. According to the ‘dynamic adaptive paradigm’, due to changes in economic feasibility, scarcity in the production of phosphate rock occurs. This paradigm led to scarcity which is a permanent feature of human existence: minerals become scarce as long as they are immensely valued in the society, and how much time and effort it takes to extract them, and they are related to all other goods and services in the society. Shortage of phosphate rock is an important issue when observed from a different angle that is other than relative availability. One of the reasons of fall in phosphate rock exports is the geopolitical turmoil in supplier regions. Scarcity may also result by lack of water available to the mining industry. Price inelasticity of supply, time and investments are the limiting factors which can lead to scarcity of phosphorous rock.
Nowadays the good news is that crisis can be averted. Almost 4/5 of the phosphorus mined for food production never actually reaches the food on our forks. We can therefore invest in renewable phosphate fertilizers or innovations in on-farm efficiency to safeguard our farmers, our agriculture and food consumers. In every sector recycling of phosphorous is efficiently taking place from agriculture and mining to sanitation sector to changing diet (Figure 2) [23]. To meet long-term phosphorous demand of society, we have to face the technical and institutional challenges for implementing practical solutions. An integrated, context-specific approach should be developed over partial measures. Technologies and practices with effective policy instruments (regulatory, economic, facilitation) are required to encourage and bear such measures.
Sustainable phosphorus measures: Efficiency, recycling and changing diets.
Food demand is rising globally with no slowing down in sight. Especially in China and other rapidly growing economies, more demand for meat and dairy means more demand for fertilizers, while human body only needs around 0.4 kg of P each year. 22.5 kg of phosphate rocks are mined to meet the requirement of phosphate for each person’s diet. For growing population water and energy are considered as critical for meeting future demands of food for increasing population. However, there is no approximated value of phosphorus scarcity in future as a limiting factor. Thus far we can say that without phosphorus, there would be no food and life on earth. There is no single international body responsible for managing global P resources currently in the long term, unlike oil, water and nitrogen.
Phosphorus can be recovered and used over and over again if present in sufficient concentrations dissimilar to oil, which is lost once it is used. Between the phosphate reserves and the food which we eat, up to 80% of P is lost in the process from production of fertilizers, application of phosphate on fields, in food processing and final consumption. With the increasing efficiency of phosphorous, we have to carry on recovery process of P from residues of crops, waste food items in dumpsters, manure, human excreta, struvite and other sources such as bone meal, ash and algae. A key opportunity to meeting the goal of global food security lies in the often overlooked link between addressing hunger and sanitation. In agriculture P plays a critical role as a nutrient, and but on the other hand, it is also considered as an environmental pollutant due to sewage emerging from human settlements. Human activities produce 3 million tons of P each year. If this P is recirculated back in agriculture fields from where they first came, we can maintain balance in sustaining food production in the decoupled communities which are dependent on globalized P fertilizer markets.
It may be concluded that evolution of phosphorous acid (H3PO3) and its salts as fertilizers owes much to both the early investigators searching for phosphate replacements and to the many scientists who later sorted out the relevant facts about plant response to Phi through phytopathological research. In recent years, scientific aroused their interest in the nutrient properties of H3PO3-derived products which stimulate their commercialization of H3PO3 as fertilizers. Trails of these fertilizers on crops have given fruitful results. The nutritive properties of Phi products proved to be a useful addition to producers’ resources. Phi fertilizers elicit positive responses to crop like it enhances flowering and fruit set in cirrus and are converted to phosphate through oxidation process. H3PO3 derivatives give similar responses as that of orthophosphate in fertilization of crops, despite sometimes delayed. Phosphorus acid-derived fertilizers provide a more readily available source of P than that which occurs in soil. Phi products provide more phosphorus to plants as compared to phosphate fertilizers due to their high efficacy of phosphorus uptake through plant foliage. Earlier concept of not using phi as P fertilizers is now changed due to positive results recorded by the scientist about the use of these products as fertilizers. Thus we can reduce a lot of financial burden from our economy by reducing the import of rock phosphate and other by-products required in the manufacture of commercial P fertilizer.
The authors are grateful to section of Ecology and Environmental Botany, Department of Botany, A.M.U, Aligarh.
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