1 Residential/ Non- occupational Exposure Assessment Jeff Evans Biologist Health Effects Division Office of Pesticide Programs.

Slides:



Advertisements
Similar presentations
1 Consumer Exposure Assessment at the U.S. Environmental Protection Agency: A ccomplishments and Opportunities for Global Collaboration Thomas Brennan.
Advertisements

SADC Course in Statistics Risks and return periods Module I3 Sessions 8 and 9.
Agency for Healthcare Research and Quality (AHRQ)
Revisiting the Formula CTL Workgroup Contaminated Media Forum 1.
Hypothesis testing 5th - 9th December 2011, Rome.
Traditionally relied on MWI Random transect aerial survey –Reinecke et al. (1990) –Pearse et al. (2005) –State agencies continuing work MDWFP (2005-present)
Brian A. Harris-Kojetin, Ph.D. Statistical and Science Policy
1 SESSION on Risk Characterization. Session 5-2 Risk Characterization David Miller Chemist (USPHS) Health Effects Division Office of Pesticide Programs.
Risk Assessment.
Sensitivity Analysis for Observational Comparative Effectiveness Research Prepared for: Agency for Healthcare Research and Quality (AHRQ)
Mitigating Risk of Out-of-Specification Results During Stability Testing of Biopharmaceutical Products Jeff Gardner Principal Consultant 36 th Annual Midwest.
1 Update on Residential Pesticide Exposure Assessment Standard Operating Procedures (SOPs) DoD Pest Management Workshop Naval Air Station, Jacksonville,
Methods for Incorporating Aquatic Plant Effects into Community Level Benchmarks EPA Development Team Regional Stakeholder Meetings January 11-22, 2010.
What is a sample? Epidemiology matters: a new introduction to methodological foundations Chapter 4.
Michael H. Dong MPH, DrPA, PhD readings Human Exposure Assessment II (8th of 10 Lectures on Toxicologic Epidemiology)
Cumulative Risk Assessment for Pesticide Regulation: A Risk Characterization Challenge Mary A. Fox, PhD, MPH Linda C. Abbott, PhD USDA Office of Risk Assessment.
Chapter 3 Producing Data 1. During most of this semester we go about statistics as if we already have data to work with. This is okay, but a little misleading.
Module 8: Risk Assessment. 2 Module Objectives  Define the purpose of Superfund risk assessment  Define the four components of the human health risk.
Exposure Assessment Thanks to Marc Rigas, PhD for an earlier version of this lecture Much of the materials is drawn from Paustenbach, DJ. (2000) The practice.
The Research Process. Purposes of Research  Exploration gaining some familiarity with a topic, discovering some of its main dimensions, and possibly.
Calibrating Homeowner Equipment
The new HBS Chisinau, 26 October Outline 1.How the HBS changed 2.Assessment of data quality 3.Data comparability 4.Conclusions.
1 1 Slide © 2011 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole.
1 Occupational Air Sampling Strategies – who, when, how…. Lecture Notes.
Determining Sample Size
Food Advisory Committee Meeting December 16 and 17, 2014 Questions to the Committee Suzanne C. Fitzpatrick, PhD, DABT Senior Advisory for Toxicology Center.
1 of 35 The EPA 7-Step DQO Process Step 4 - Specify Boundaries (30 minutes) Presenter: Sebastian Tindall Day 2 DQO Training Course Module 4.
Analyzing Reliability and Validity in Outcomes Assessment (Part 1) Robert W. Lingard and Deborah K. van Alphen California State University, Northridge.
Lecture 12 Statistical Inference (Estimation) Point and Interval estimation By Aziza Munir.
Risk Assessments for Exposure of Deployed Military Personnel to Insecticides used for Personal Protection and Disease-Vector Management Robert K. D. Peterson.
Residential Single Family and Manufactured Home Heat Pump Water Heaters Christian Douglass Regional Technical Forum 4/14/2015.
VI. Evaluate Model Fit Basic questions that modelers must address are: How well does the model fit the data? Do changes to a model, such as reparameterization,
Translating HPV Information into Plain Language Characterizing Chemicals in Commerce Austin, TX December, 12-14, 2006.
Age-specific Exposure Assessment for Children Johan Bierkens, Christa Cornelis, Mirja Van Holderbeke, Rudi Torfs INTRODUCTION Recognition.
Reregistration of Consumer Pesticides: US Environmental Protection Agency December 13, 2005 US Environmental Protection Agency December 13, 2005 Mosquito.
Hypothesis testing Intermediate Food Security Analysis Training Rome, July 2010.
Session 9 & 10. Definition of risk assessment and pre condition for risk assessment Establishment of clear, consistent agency objectives. Risk assessment.
Pesticide Spray Drift Conference September 5 and 6, 2001 AgDRIFT® Dave Esterly Environmental Focus, Inc
5-4-1 Unit 4: Sampling approaches After completing this unit you should be able to: Outline the purpose of sampling Understand key theoretical.
Case Control Study Dr. Ashry Gad Mohamed MB, ChB, MPH, Dr.P.H. Prof. Of Epidemiology.
Lead NAAQS Review: 2 nd Draft Risk Assessment NTAA/EPA Tribal Air Call August 8, 2007 Deirdre Murphy and Zachary Pekar OAQPS.
Risk Assessment.
United Nations Workshop on Revision 3 of Principles and Recommendations for Population and Housing Censuses and Evaluation of Census Data, Amman 19 – 23.
National Physical Activity Guidelines
Technical Support for the Impact Assessment of the Review of Priority Substances under Directive 2000/60/EC Updated Project Method for WG/E Brussels 22/10/10.
Who’s Minding the Kids in the Summer? Child Care Arrangements for Summer 2006 Lynda Laughlin - U.S. Census Bureau Joseph Rukus - Cornell University Annual.
1 Module One: Measurements and Uncertainties No measurement can perfectly determine the value of the quantity being measured. The uncertainty of a measurement.
An Overview of the Objectives, Approach, and Components of ComET™ Mr. Paul Price The LifeLine Group All slides and material Copyright protected.
Exposure Assessment for Health Effect Studies: Insights from Air Pollution Epidemiology Lianne Sheppard University of Washington Special thanks to Sun-Young.
Statistics Canada Citizenship and Immigration Canada Methodological issues.
EHS 507 Food Exposures: Fruits and Vegetables  Fruits and vegetables may become contaminated by multiple pathways –Purposeful spraying or soil treatment.
Agronomic Spatial Variability and Resolution What is it? How do we describe it? What does it imply for precision management?
RISK DUE TO AIR POLLUTANTS
United States Department of Agriculture Food Safety and Inspection Service Overview of Trim Sampling Compliance Guidelines and Discussion Daniel Engeljohn,
Matrix Models for Population Management & Conservation March 2014 Lecture 10 Uncertainty, Process Variance, and Retrospective Perturbation Analysis.
1 Collecting and Interpreting Quantitative Data Deborah K. van Alphen and Robert W. Lingard California State University, Northridge.
이 장 우. 1. Introduction  Bisphenol A is a high production volume chemical -Annual production of over six billion pounds -polycarbonate plastics.
1. Consumers, Health, Agriculture and Food Executive Agency Risk assessment with regard to food and feed safety Risk analysis Why risk assessment in the.
Copyright 2010, The World Bank Group. All Rights Reserved. Producer prices, part 2 Measurement issues Business Statistics and Registers 1.
Worker re-entry exposure within the framework of the BROWSE project Kim Doan Ngoc  Pieter Spanoghe 
Single Season Study Design. 2 Points for consideration Don’t forget; why, what and how. A well designed study will:  highlight gaps in current knowledge.
 Occupancy Model Extensions. Number of Patches or Sample Units Unknown, Single Season So far have assumed the number of sampling units in the population.
Risk CHARACTERIZATION
Uncertainty Analysis in Emission Inventories
Uncertainty Analysis in Emission Inventories
Analyzing Reliability and Validity in Outcomes Assessment Part 1
Institute for Risk Assessment Sciences
Inferential Statistics
GUIDELINES FOR THE COLLECTION OF PESTICIDE USAGE STATISTICS A summary
Analyzing Reliability and Validity in Outcomes Assessment
Presentation transcript:

1 Residential/ Non- occupational Exposure Assessment Jeff Evans Biologist Health Effects Division Office of Pesticide Programs

2 Purpose To present our use of a calendar based model (Calendex™), to address the temporal aspects of OP pesticide use  Approach is similar to the OP case study presented to SAP (12/7-8/00) To discuss the data used in our cumulative residential exposure assessment To discuss with the Panel:  Use of distributions of the available data  Additional ways to incorporate survey data and other pesticide use in future assessments

3 Residential OP Assessment: Uses Indoor use: DDVP (crack and crevice, pest strips) Pet use: DDVP and Tetrachlorvinphos (spray/dip, collars) – currently only qualitatively assessed Home Lawns: Bensulide, Malathion, Trichlorfon Golf Course: Acephate, Bensulide, Fenamiphos, Malathion, Trichlorfon Home Garden: Acephate and Disulfoton (ornamental), Malathion (ornamental and edible food) Public Health: Fenthion, Malathion, Naled

4 Expression of Residential Risk MOE = POD (mg/kg/day) Exposure (mg/kg/day) Routes considered, as appropriate  Oral, Dermal, Inhalation

5 Age Groups Assessment performed for the following age groups:  Children 1-2 years old  Children 3-5 years old  Adults 20+

6 Scope Assessments conducted for 12 distinct geographical regions, reflecting climate & pest pressure differences  One region split into two residential assessments Includes remaining residential OPs that have significant exposure and appropriate exposure data Pet products not quantified  Only screening level SOPs available at this time

Regional Framework Source: USDA ERS

8 Region 5 – Eastern Uplands Lawn: DDVP, Malathion, Trichlorfon Golf Course: Acephate, Bensulide, Fenamiphos, Malathion, Trichlorfon Ornamental Gardens: Acephate, Disulfoton, Malathion Home Garden: Malathion Indoor: DDVP (pest strips and crack and crevice treatments)

9

10

11 Road Map Key Data Used (distributions selected)  Lawn  Golf Courses  Public Health  Home Garden Characterization Future Consideration of Survey Data

12 Lawns – Use Information National Home & Garden Pesticide Use Survey (NHGPUS 1991)  percent of households using a given pesticide – regional distinctions Treated lawns based on regions using the National Garden Survey  Percent of population hiring lawn care services Lawn Size (Vinlove and Torla 1995 and ORETF Survey)

13 Lawn Size Uniform Distribution 500 – 15,000 ft 2 Difficult to quantify  Only considers lot size minus footprint  Does not consider other structures/green space

14 Lawns: Use Information Label  site/pest relationships  application rates State Cooperative Extension services  Timing of applications to control common pests Comparative Insecticide Effectiveness for Major Pest Insects of Turf in the United States

15 Lawn: Applicator Exposure Data Data source: ORETF Application Type:  Granular push-type rotary spreaders  Hose-end sprayer – ready to use and one requiring the user to add the concentrate Clothing types:  Range of clothing  Short-sleeved shirt, short pants and long-sleeved shirt, long pants

16 Lawn: Applicator Exposure Unit Exposure (UE)  mg of exposure/amount of active ingredient (a.i.) used UE x ai/sq ft x area treated Divided by body weight

17 Lawn: Applicator Exposure Data Hose-end Sprayer  Uniform Distribution: – 49 mg/lb ai Granular Applicator  Uniform Distribution: 0.02 – 7.6 mg/lb ai

18 Lawn: Applicator Exposure Data Well understood activity pattern  Easy to measure and develop distributions However, selected a uniform distribution that: Reflects range of clothing that can be worn Survey data suggest that clothing worn while applying pesticides changes as growing season progresses –seasonal changes are only based on formulation type not equipment used –Hose-end includes both “mix you own” and “ready to use”

19 Lawn: Post- Application Exposure Data Difficult activity pattern to determine what is representative Residue transfer to skin (transfer coefficient)  Choreographed Activities of Adults Measured Using Biological Monitoring, (Vacarro 1996) Crawling, football, Frisbee  Non-Scripted Activities of Children Measured Using Fluorescent Tracers, (Black 1993) Mostly solitary play with toys and books. Also activities such as cartwheels

20 Lawn: Post- Application Exposure Data Duration: up to 2 and 3.5 hrs for adults and children respectively (Cumulative, EFH) Adult TC: 1,930 – 13,200 cm 2 /hr  Uniform distribution (n – 16 Vacarro) Child TC: 700 – 16,000 cm 2 /hr  Uniform distribution Vacarro (n – 16) and Black (n – 14)

21 Lawn: Post- Application Exposure Data Turf Transferable Residues (TTR)  Chemical specific dissipation data (mg/cm 2 ) Uniform distribution selected for each day’s residues –Each day includes a range of values instead of mean –First day values include “as soon as dry” up to 8 hours after application –Watering in and not watering in –Other days include potential for rainfall

22 Lawn: Post- Application Exposure Data Non-Dietary Ingestion (Hand-to-Mouth) Most challenging activity pattern to assess  Hand-to-mouth frequency of events, (Reed 1999)  Adjust lawn residue data (TTR) to account for saliva wetted hands, (Clothier 2000)  Saliva extraction e.g., (Camann 1995)

23 Lawn: Post- Application Exposure Data Hand-to-mouth frequency of events (Reed 1999)  Children in day-care (n-20) at home (n-10)  Uniform distribution: 0.4 to 26 events/hr  Mean 9.5, median 8.5, 90 th percentile 20 Issue: indoors vs. outdoors, active vs. quiet play Freeman et al., 2001: outdoors (~2-3x less than indoors) –Small subset (4 out of 19)

24 Lawn: Post- Application Exposure Data  Lawn residue data to account for saliva wetted hands (Clothier 2000) Compared wet hand efficiency vs. dry hand efficiency (cyfluthrin, chlorthalonil and chlorpyrifos) Dry hand transfer efficiency is similar to TTR measurements (0.9 to 3%) for 2 chemicals –Chlorpyrifos much lower overall ( %) Wet palms: uniform distribution 1.4-3x higher than TTRs

25 Lawn: Post- Application Exposure Data  Saliva extraction (uniform: 10 to 50%) 50% removal by saliva wetted sponges – vigorous (Camann et al., 1995) 20 – 40% hands rinsed with water/Ethanol and water/Isopropanol (Fenske and Lu, 1994) ~10 – 22% soil removal from hands to account for possible residue/soil matrix (Kissel et al., 1998)

26 Golf Courses: Post- Application Exposure Data Percent of individuals participating in golf, 1992 Golf Course Operations by the Center for Golf Course Management Number of hours playing golf Percent of Golf Courses Applying Selected Pesticides (Doane GolfTrak, ) An activity pattern that is easy to understand and measure

27 Golf Courses: Post- Application Exposure Data Residue transfer to skin (transfer coefficient)  Uniform distribution: 200 to 760 cm 2 /hr  Small data set (less than 10) includes walking and using a cart. Chemical-specific turf residue data

28 Public Health: Post- Application Range of residues that deposit onto lawns is based on a percent of public health use application rate (3.8 to ~30%) using values presented in Tietze et al., 1994 and the Spray drift model, AgDrift Once an estimate of deposition is made the post application is assessed in the same way that lawn chemicals are Estimates of % population based on percent of homes having lawns Timing and pesticide used based on personal communication and publications prepared by organizations such as the Florida Coordinating Council of Mosquito Control

29 Garden : Applicator Exposure Data An activity pattern that is easy to understand and measure  Shaker Can (n-20): uniform, mg/lb ai  Garden Duster (n-20) uniform, mg/lb ai  Small Tank Sprayer (n-20), uniform, mg/lb ai Similar issues regarding clothing as in lawn applications

30 Garden: Applicator Exposure Data  Area Treated  Ornamental Gardens: uniform, 500 to 2,000 ft 2 No data. Defined in the assessment as the area consisting of the perimeter around a median home area 2,250 sq ft 2., with a 2.5 to 8 ft border  Vegetable gardens: log-normal, 135 to 8,000 ft 2 May be easier for people to estimate than lawns

31 Garden: Post- Application Exposure Post-application dermal exposure  An easily defined activity in agriculture  Home gardens are more difficult due to wide variety of crops grown (fruits and vegetables) and a wide variety of activities Uniform distribution of 100 to 5,000 cm 2 /hr  Duration of garden activities: uniform, 5 to 60 min.  Chemical/regional specific residue data

32 Indoor: Inhalation Exposure Data Applicator – uniform range of inhalation exposure values for pressurized aerosol can (PHED) 0.72 – mg/lb ai Post application inhalation exposure (adults and children)  Pest Strips: – 0.11 mg/m 3 (Collins et al., 1973)  Crack and Crevice – – mg/m 3 (Gold et al., 1983) Duration of time spent indoors, and breathing rates  Up to 24 hours, at rest to moderate

33 Methods Summary All available data considered  e.g.,Lawn residue data available for all compounds and made regional adjustments where feasible Addressed a variety of activity patterns  Some more straight forward : Application  Some more difficult : Hand-to-Mouth Tended to use uniform distributions when presented with scenarios that had confounding variables

Characterization Input Parameter BiasAssumptions and Uncertainty Lawn Applicator: hose-end ~60 replicates, high confidence – issues re: clothing and percent of users for “mix your own” and ‘ready-to-use” Lawn Applicator: rotary ~30 reps, high confidence, clothing issues Lawn Size~Reasonable considering equipment used, may be a slight underestimate in areas that have larger lawns (Midwest) Dermal Contact Transfer - to + Adults: activities appear to be representative, but distributions may be reflective of study design rather than actual activities Children: Includes above scripted activities and a range of non scripted activities. Study is based on a non-toxic substance (not a pesticide), high transfer efficiency (6%) + over estimate; - under estimate; ~ neutral

Characterization Input Parameter BiasAssumptions and Uncertainty Turf Residues: dermal ~Reflects a range of high values (e.g., immediately after sprays dry to values influenced by rainfall) Turf Residues: hand-to-mouth ~ to + Based on surrogate data Frequency~ to + Based on video-observations of children, indoor scenarios Duration on Lawn ~For children the value is time spent outdoors in addition to time on lawns – Does not account for survey responses of individuals that did not play on lawns or go outside Public Health: Drift ~Distribution of aerial and ground equipment values Population Exposed ~ to + Assumed large % of population based on those having lawns. Minimal exposure + over estimate; - under estimate; ~ neutral

Characterization Input ParameterBiasAssumptions and Uncertainty Home Garden Applicator: spray ~20 reps, high confidence, clothing issues Home Garden Applicator: dust ~20 reps, high confidence, clothing issues Home Garden Applicator: granular ~chemical specific, high confidence, clothing issues Garden Area Treated: ornamentals ~ to +assumes all plants are treated Vegetable~well studied variable for individual crops, but not for multiple crops and activities. Recognize it’s a highly variable exposure scenario + over estimate; - under estimate; ~ neutral

Characterization Input ParameterBiasAssumptions and Uncertainty Frequency of Applications ~ to +based on generic insecticides, not chemical specific Post Application garden ~ to +assumes all plants are treated Residues~regional and chemical specific Indoor Air~chemical specific data Duration~rest to light activity - established values duration hours Population Exposed~ to +values based on use of all pest strips, not just those containing DDVP Use patterns for all scenarios ~based on percent of households using that particular pesticide. + over estimate; - under estimate; ~ neutral

38 Survey Data Overview of our use of survey data to address use and co-occurrence Future considerations:  Use of existing macro activity pattern data SHEDS example  Upcoming pesticide use survey

39 Survey Data: Macro Activity Patterns Human Activity Patterns  Calendar based models present an opportunity to consider an individual’s macro activity patterns that can lead to exposure to one or more chemicals  Macro Activity Patterns are broadly defined as where individuals spend their time In the garden Driving to work

40 Survey Data: Macro Activity Patterns Our Basic Approach (Independence/Dependence)  Identify households based on reported use of an OP for a given scenario (e.g., NHGPUS) 6% of households in Region 5 use lawn chemical A  Identify the time individuals spend on lawns or other locations In the Exposure Factors Handbook, there are recommended values taken from surveys such as the National Human Activity Pattern Survey (NHAPS)

41 Survey Data: Macro Activity Patterns STEP 1: Calculate Exposure from Food for Individual #1 on a given day (Food Exposure(from DEEM™)) STEP 2: Select Residential Treatments for Individual #1 on a given day  Specific to region, time and demographics of individual Were pesticides applied in/around home? If so, which treatments? –And how much, how often, during what time frame, with what frequency, and by whom? Repeat Step 2 until all relevant residential uses are addressed

42 Survey Data: Macro Activity Patterns Co-occurrence is driven by random probabilities (% households being treated)  (6% lawn use) x (10% crack and crevice) = 0.6% However, once a household is selected, the probability of being on the lawn is 1 because:  We used a distribution of time spent on the lawn based only on individuals who were actually on lawns  Does not account for individual responses indicating they did not spend time on lawns

43 Survey Data: Macro Activity Patterns Consolidated Human Activity Database (CHAD) hhtp://  Compilation of pre-existing human activity surveys collected at the national, state and city level Review questionnaires and individual responses Develop daily activity patterns for an individual based on responses to the questionnaires Most surveys are cross-sectional rather than longitudinal

44 Survey Data: Macro Activity Patterns Stochastic Human Exposure and Dose Simulation model - SHEDS  Developed by: Valerie Zartarian Jianping Xue Haluk Ozkaynak

45 bedroom sleeping living room playing lawn playing car In-transit daycare learning Exposure Rate [ug/min] Time (min) etc... Macro-activities

46 8 CHAD diaries simulate a person’s year in specified age-gender cohort  1 person from each of 4 seasons  1 person from each of 2 day categories (weekend and weekday) Fix 5 weekday diaries and 2 weekend diaries Repeat 7 day activity patterns within each season Day of Year Winter Weekday Winter Weekend Spring Weekday Spring Weekend Summer Weekday Summer Weekend Fall Weekday Fall Weekend

47 Survey Data: Macro Activity Patterns Residential Exposure Joint Venture (REJV)  Longitudinal survey data addressing the application pesticides in and around households When and where applications are made Multiple applications made in one day What they wore while making those applications Demographic information (children)

48 EXTRA SLIDES From other presentations FOLLOW

49

50

51 Region 11 had an applicator residue where a residue for a child should be

52

53 Questions for the SAP on Residential Exposure

54 Question 1 Historically, the Agency has relied on means (primarily arithmetic or geometric) from residue and exposure studies for key input variables in exposure assessments. The recent development of calendar based models and others having features to incorporate distributions of exposure values has presented the Agency an opportunity to consider using all available data points from existing exposure and residue studies. In the Cumulative Risk Assessment Case study presented to the FIFRA Scientific Advisory Panel in September, 2000, most of the exposure variables were presented as uniform distributions. The exceptions were for variables that are reasonably well established, such as exposure durations taken from the Agency’s Exposure Factors Handbook. The data used in the Case Study and in the preliminary CRA, are believed to be from well conducted studies of generally high quality. However, these data sets tend to be small (e.g., n = ) and are being used to address wide variety of exposure situations. The uniform distribution appears to be most appropriate for these relatively small data sets because it relies on easily established values such as the minimum and maximum and provides the most conservative estimate of the standard deviation

55 Question 1 (continued) Does the Panel have any additional comments or thoughts on OPP’s use of the uniform distribution in general or on OPP’s selection of the uniform distribution for the specific parameters chosen? What criteria, if any, would the SAP recommend for developing parametric input distributions from available data? Under what circumstances, if any, would it be appropriate to use available data empirically? Does the Panel have any recommendations on how sensitivity analyses could be performed to determine if the assumption of a uniform distribution is responsible for a majority of the risk at the tails of the exposure distribution.

56 Question 2 The use of calendar based models also allows exposure assessors to consider exposure from a variety of sources from the same or from different chemicals. Longitudinal survey data such as the National Human Activity Pattern Survey (NHAPS) are available for consideration by HED for use in future assessments. In addition, from a practical standpoint, the use of such survey data ensures combinations of exposure do not come from unrealistic random combinations that current models may produce (e.g., activities adding up more than 24 hours in a day).

57 Question 2 (continued) The use of calendar based models provides an opportunity to explore the potential for the co-occurrence of multiple sources of exposures from residential pathways. In the cumulative assessment, OPP used summary statistics from sources such as the Exposure Factors Handbook (EFH) regarding the time spent indoors, time spent on lawns and time spent at other outdoor locations. In the preliminary assessment, we assumed these activities were stochastically independent. OPP is currently evaluating data in the EFH such as data from the National Human Activity Pattern Survey (NHAPS) to determine if it can directly incorporate (i.e., empirically) information on an individual’s activity patterns over a full day from this database to account for the likelihood and duration that an individual might be exposed to a pesticide through various activities over the course of a day. Please comment on whether and how OPP might directly incorporate NHAPS (or similar time use data) into the software to better account for variation in activities across individuals?

58