bluuebunny/crossref_metadata_2025 huggingface dataset:
Cancer mortality among shoe manufacturing workers: an analysis of two cohorts.
Authors: Fu H , Demers P A , Costantini A S , Winter P , Colin D , Kogevinas M , Boffetta P
Published: December 2008

OBJECTIVES: To examine the cancer risk of shoe manufacturing workers and evaluate whether the risk was associated with exposure to leather dust and solvents. METHODS: Data from two historical cohort studies of shoe workers were expanded and analysed in parallel. A total of 4215 shoemakers from England contributing 103 726 person-years at risk and 2008 shoemakers from Florence, Italy, contributing 54,395 person-years at risk were included in the analysis. Exposure to leather dusts and solvents from glues was evaluated on the basis of job title information. Standardised mortality ratios (SMR) were calculated as ratios of observed deaths (Obs) over expected derived from national mortalities. RESULTS: Overall mortality was lower than expected in both cohorts (English cohort: Obs 3314, SMR 81, 95% confidence interval (95% CI) 78-84; Florence cohort: Obs 333, SMR 87, 95% CI 78-97). An increased risk of nasal cancer was found (English cohort: Obs 12, SMR 741; Florence cohort: Obs 1, SMR 909). 10 of the 13 cases occurred among English workers employed in the manufacture of welted boots (SMR 926, 95% CI 444-1703), a sector of the industry thought to have had the highest exposure to leather dust. Mortality from leukaemia was not increased in the English cohort (Obs 16, SMR 89), but was increased in the Florence cohort (Obs 8, SMR 214, 95% CI 92-421); and the highest risk was found among shoe workers in Florence who were first exposed between 1950 and 1959 when exposure to benzene was substantial (Obs 3, SMR 536, 95% CI 111-1566). Some evidence for an excess risk of stomach, bladder, and kidney cancer, as well as multiple myeloma and non-Hodgkin's lymphoma was also found in the Florence cohort only among workers employed in jobs with the highest exposure to solvents. CONCLUSIONS: These findings confirm the associations between exposure to leather dust and nasal cancer and between exposure to benzene and leukaemia in the shoe manufacturing industry and suggest that the risk of other cancers may be increased among workers exposed to solvents or glues.
Prevalence of dermatoses and skin sensitisation associated with use of pesticides in fruit farmers of southern Taiwan.
Authors: Guo Y L , Wang B J , Lee C C , Wang J D
Published: December 2008

OBJECTIVES: Agricultural workers are known to have occupational skin diseases. The prevalence and pattern of skin diseases are unknown in Taiwanese fruit farmers. The objective of this study is to determine the work exposure, prevalence of skin diseases, and sensitivity to common skin allergens and agricultural chemicals in fruit farmers of southern Taiwan. METHODS: 122 fruit farmers who regularly prepared and sprayed pesticides and a group of 63 printing press workers with no known exposure to pesticides were examined and patch tested with common skin allergens and agricultural chemicals. The farmers were also interviewed for their work habits, use of protective clothing, and exposure to pesticides. RESULTS: Most farmers reported regular use of hat, boots, and mask, but not gloves, raincoat, and goggles. This resulted in frequent skin contact with pesticides especially on the hands and face. About 30% of farmers had hand dermatitis, and more than two thirds had pigmentation and thickening on the hands. Fungal infection of the skin was noted in a quarter of subjects. By patch test, farmers and the printing press workers had a similar rate of sensitivity to common skin allergens. 40% of farmers were sensitive to agricultural chemical allergens, which was about twofold higher than that of the comparison group. Farmers were most frequently sensitive to Captofol, Folpet, and Captan which were associated with dermatitis on the volar aspects of the hands. CONCLUSIONS: Fruit farmers in southern Taiwan had a high prevalence of skin diseases related to use of pesticides, and appropriate protective measures and work practices should be taken to prevent such problems.
Upper aerodigestive cancer in battery manufacturers and steel workers exposed to mineral acid mists.
Authors: Coggon D , Pannett B , Wield G
Published: December 2008

OBJECTIVE--To assess the risk of cancer from inhalation of mineral acid mists. METHODS--A cohort study and nested case-control study of upper aerodigestive tumours were carried out in men employed since 1950 at two battery plants and two steel works in Britain. The cohort was identified from personnel records and included 2678 men with definite exposure to acid mists (mainly sulphuric acid), 367 with possible exposure, and 1356 who were unexposed. Mortality was compared with that in the national population by the person-years method. Cases of upper aerodigestive cancer were identified from death certificates and cancer registrations, and their exposure to acids was compared with that of age matched controls (five per case) from the same plant by conditional logistic regression. RESULTS--In follow up to 31 December 1993, 93% of men were traced, including 1277 who had died. Among the men definitely exposed to acid mists, overall mortality was less than in the national population (standardised mortality ratio (SMR) 0.92, 95% confidence interval (95% CI) 0.85-0.98) as was mortality from all cancers (SMR 0.92, 95% CI 0.79-1.05) and specifically from cancer of the larynx (SMR 0.48, 95% CI 0.01-2.70) and lung (SMR 0.98, 95% CI 0.78-1.22). A total of 15 incident or fatal cases of upper aerodigestive cancer were identified during follow up. When these men were compared with controls, risk was moderately increased in those who had worked for at least five years in jobs entailing exposures to sulphuric or hydrochloric acid in excess of 1 mg/m3 (OR 2.0, 95% CI 0.4-10). CONCLUSIONS--These findings are consistent with those from other studies which have indicated a hazard of upper aerodigestive cancer from acid mists. However, they indicate that any risk from exposures to sulphuric and hydrochloric acid below 1 mg/m3 is small.
Work related respiratory symptoms in radiographers.
Authors: Smedley J , Inskip H , Wield G , Coggon D
Published: December 2008

OBJECTIVE--To determine the prevalence of work related symptoms among radiographers compared with a control group of physiotherapists. METHOD--A postal questionnaire was used to collect information from radiographers and physiotherapists who registered in the United Kingdom during 1985-9. RESULTS--Satisfactory questionnaires were returned by 2354 (65%) of the radiographers and 3048 (69%) of the physiotherapists. There was a clear excess of work related symptoms among the radiographers. In particular, they were more likely to complain of symptoms that were worse at work, mouth soreness, sore, itchy, or runny eyes, persistent blocked nose, persistent itchy nose or sneezing, sore throat, headache, and of lower respiratory tract symptoms, which were also worse on workdays. These symptoms were associated particularly with the use of automatic processing machines. 235 radiographers gave a history of wheeze or chest tightness that had been worse at work or on days when at work. CONCLUSIONS--Work related symptoms suggesting irritation of the eyes and upper airways were more common in radiographers than controls, and may be related to exposure to x ray film processing chemicals. Men and women who reported work related wheeze or chest tightness will be followed up in more detail to assess the prevalence of occupational asthma in the cohort.
Exposure to cosmic radiation of British Airways flying crew on ultralonghaul routes.
Authors: Bagshaw M , Irvine D , Davies D M
Published: December 2008

British Airways has carried out radiation monitoring in Concorde for more than 20 years and has used a heuristic model based on data quoted by the National Aeronautics and Space Administration (NASA) to model radiation exposure in all longhaul fleets. From these data it has been calculated that no flight deck crew would exceed the control level of 6 mSv/y currently under consideration by regulatory authorities, which is three tenths of the occupational dose limit of 20 mSv/y recommended by the International Commission on Radiological Protection (ICRP). The model suggested that less than 4% of cabin crew based in Tokyo flying only between London and Japan could reach or exceed the 6 mSv/y level, based on a predicted effective dose rate of 7 microSv/h. To validate this calculation a sampling measurement programme was carried out on nine round trips flown by a Boeing 747-400 between London and Tokyo. The radiation field was measured with dosimeters used for routine personal monitoring (thermoluminescence dosimeters (TLDs) and polyallydiglycol carbonate neutron dosimeters). The limitations of the methodology are acknowledged, but the results indicate that the effective dose rate was 6 microSv/h which is consistent with the predicted effective dose rate of 7 microSv/h. This result, which is in accordance with other reported studies indicates that it is unlikely that any of the cabin crew based in Tokyo exceeded the 6 mSv/y level. In accordance with "as low as reasonably achievable" principles British Airways will continue to monitor flying crew routes and hours flown to ensure compliance.
A study of mortality among 14,730 male workers in 12 Norwegian ferroalloy plants: cohort characteristics and the main causes of death.
Authors: Hobbesland A , Kjuus H , Thelle D S
Published: December 2008

OBJECTIVES: Concern about the health hazards of exposure to workers in the ferroalloy industry has initiated this historical cohort study. The aim was to examine the mortality pattern among male employees in 12 Norwegian ferroalloy plants. METHODS: All men employed for at least six months who started their first employment during 1933-91 were eligible for the cohort. Deaths observed during 1962-90 were compared with expected figures calculated from national mortalities. Internal comparisons of rates were performed by Poisson regression analysis. The final cohort comprised 14,730 male employees who were observed for 288,886 person-years. RESULTS: Mortality from all causes of death was slightly increased (3390 deaths, standardised mortality ratio (SMR) 1.08, 95% confidence interval (95% CI) 1.04-1.11). Regression analysis of total mortality showed a significant negative trend for the rate ratios with increasing duration of employment. An increased mortality was found among employees in urban plants compared with employees in rural plants (rate ratio (RR) 1.21, 95% CI 1.13-1.29). Excess deaths from cancer (SMR 1.11) and sudden death (SMR 1.47) were found among employees with at least three years of employment. Mortality from accidents, poisonings, and violence was increased among all employees (SMR 1.28). Excess deaths from this cause were however only found for the time after the end of employment in this industry and not during employment (SMR 0.90). CONCLUSIONS: The increased mortality from cancer and sudden death could be related to work exposures, at least in subgroups, and these results warrant further studies. The excess deaths from accidents, poisonings, and violence were probably not related to work exposures. The mortality results for short term workers and other information indicate that systematic errors contribute to the increased overall mortality.
Cause specific mortality and cancer incidence among employees exposed to 2,3,7,8-TCDD after a 1953 reactor accident.
Authors: Ott M G , Zober A
Published: December 2008

OBJECTIVE: To evaluate the long term health consequences of past occupational exposure to 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD). METHODS: Cancer incidence and cause specific mortality were examined up to and including 1992 in a group of 243 men with external comparisons and internal dose-response analyses. Model based estimates of TCDD dose (expressed in micrograms/kg body weight) were developed for all cohort members with an approach that incorporated detailed accounts of each employee's work activities, analyses of TCDD in blood lipid of 138 employees, and internally derived estimates of elimination rates of TCDD. RESULTS: The estimated dose of TCDD for 135 men was > or = 0.1 microgram/kg body weight and for 69 men > or = 1 microgram/kg body weight. Increased cancer risk ratios were found with higher doses of TCDD and longer interval since first exposure for all sites combined and digestive and respiratory cancers in particular. Within the high dose group (> or = 1 microgram/kg body weight), total cancer mortality was increased > or = 20 years after first exposure (13 cases, standardised mortality ratio (SMR) 1.97, 95% confidence interval (95% CI) 1.05-3.36) as was respiratory cancer (six cases, SMR 3.06; 95% CI 1.12-6.66). Among current cigarette smokers, 12 cancer deaths occurred in the high dose group (SMR 3.42, 95% CI 1.77-5.97) compared with seven deaths at lower doses of TCDD (SMR 1.29, 95% CI 0.52-2.66). Regression analyses based on the Cox's proportional hazards model provided further evidence of a relation between cumulative dose of TCDD and occurrence of both overall and digestive cancer. No evidence of an effect of TCDD on overall mortality or deaths due to circulatory disease was found and no cases of non-Hodgkin's lymphoma or soft tissue sarcoma have been found to date. CONCLUSIONS: Our findings are consistent with a carcinogenic effect induced by TCDD at doses > or = 1 microgram/kg body weight. With such a small cohort, the risk estimates are not very stable and could be affected by selection and confounding.
Reanalysis of mortality from lung cancer among diatomaceous earth industry workers, with consideration of potential confounding by asbestos exposure.
Authors: Checkoway H , Heyer N J , Demers P A , Gibbs G W
Published: December 2008

OBJECTIVE: To evaluate the potential for confounding from asbestos exposure, primarily chrysotile, on the relation between crystalline silica and mortality from lung cancer among diatomaceous earth (diatomite) workers. METHODS: A reanalysis of a cohort mortality study of diatomite workers was performed to take into account quantitative estimates of asbestos exposure. The reanalysis was limited to a subset of the original cohort, comprising 2266 white men for whom asbestos exposure could be reconstructed with greatest confidence. Comparisons between mortality from lung cancer (standardised mortality ratios (SMR)) were made between rates for 1942-87 for United States white men, and workers cross classified according to cumulative exposures to crystalline silica and asbestos. Comparisons of internal rates, involving Poisson regression modeling, were conducted for exposure to crystalline silica, with and without adjustment for asbestos exposure. Exposures were lagged by 15 years to take into account disease latency. RESULTS: There was an overall excess of lung cancer (SMR 1.41; 52 observed). The SMRs for four categories of increasing crystalline silica among the workers not exposed to asbestos were 1.13, 0.87, 2.14, 2.00. An SMR of 8.31 (three observed) was found for workers with the highest cumulative exposure to both dusts. Internal analysis, after adjustment for asbestos exposure, yielded rate ratios for categories of exposure to crystalline silica: 1.00 (reference), 1.37, 1.80, and 1.79. CONCLUSIONS: Asbestos exposure was not an important confounder of the association between crystalline silica and mortality from lung cancer in this cohort. Although based on a small number of deaths from lung cancer, the data suggest possible synergy between these exposures. An extended follow up of this cohort is in progress and should enable better assessments of independent and combined effects on risk of lung cancer.
Prevalence of occupational lung disease among Botswana men formerly employed in the South African mining industry.
Authors: Steen T W , Gyi K M , White N W , Gabosianelwe T , Ludick S , Mazonde G N , Mabongo N , Ncube M , Monare N , Ehrlich R , Schierhout G
Published: December 2008

OBJECTIVE: To determine whether previous health experiences affect the prevalence of occupational lung disease in a semirural Botswanan community where there is a long history of labour recruitment to South African mines. METHOD: A cross sectional prevalence study of 304 former miners examined according to a protocol including a questionnaire, chest radiograph, spirometry, and medical examination. RESULTS: Overall mean age was 56.7 (range 28-93) years, mean duration of service 15.5 (range 2-42) years. 26.6% had a history of tuberculosis. 23.3% had experienced a disabling occupational injury. Overall prevalence of pnemoconiosis (> 1/0 profusion, by the International Labour Organisation classification) was 26.6%-31.0%, and 6.8% had progressive massive fibrosis (PMF). Many were entitled to compensation under South African law. Both radiograph readers detected time response relations between pneumoconiosis and PMF among the 234 underground gold miners. PMF could result from < 5 years of exposure, but was not found < 15 years after first exposure. Both pulmonary tuberculosis (PTB) and pneumoconiosis were found to be associated with airflow limitation. CONCLUSIONS: Former miners in Botswana have a high prevalence of previously unrecognised pneumoconiosis, indicative of high previous exposures to fibrogenic respirable dust. Their pneumoconiosis went unrecognised because they had no access to surveillance after employment. Inadequate radiographic surveillance or failure to act on results when employed or when leaving employment at the mines could have contributed to under recognition. Community based studies of former miners are essential to fully evaluate the effects of mining exposures. Our findings indicate a failure of established measures to prevent or identify pneumoconiosis while these miners were in employment and show that few of the social costs of occupational lung diseases are borne by mining companies through the compensation system.
Dermal absorption of vaporous and liquid 2-methoxyethanol and 2-ethoxyethanol in volunteers.
Authors: Kezić S , Mahieu K , Monster A C , de Wolff F A
Published: December 2008

OBJECTIVES: To estimate dermal absorption of vaporous and liquid 2-methoxyethanol (ME) and 2-ethoxyethanol (EE) in volunteers. METHODS: Five volunteers (two men and three women) were dermally exposed to vaporised and liquid ME and EE. Dermal exposure on an area of about 1000 cm2 (forearm and hand) to vapours of ME and EE (4000 mg/m3 ME and 3700 mg/m3 EE) lasted for 45 minutes. Duration of exposure to liquid ME and EE on an area of 27 cm2 (forearm) was 15 minutes. Dermal uptake was assessed by measurement of the main metabolites in urinary methoxyacetic acid (MAA) and ethoxyacetic acid (EAA). For each volunteer, excretion of metabolites was compared with a reference inhalatory exposure. RESULTS: Mean (SD) absorption rates of ME and EE vapour were 36 (11) and 19 (6) cm/h respectively. The mean (SD) absorption rates of the liquid ME and EE amounted to 2.9 (2.0) and 0.7 (0.3) mg/cm2.h. CONCLUSIONS: Vaporised and liquid ME and EE are readily absorbed through the skin. In the combined inhalatory and dermal exposure when whole body surface is exposed to vapour, the uptake through the skin is estimated to be 55% of the total uptake of ME and 42% of EE. Dermal uptake resulting from skin contact of both hands and forearms (about 2000 cm2) with liquid ME and EE for 60 minutes would exceed inhalatory uptake of the eight hour occupational exposure limit by 100 times at 16 mg/m3 of ME and 20 times at 19 mg/m3 of EE. The substantial skin uptake of ME and EE indicates that in assessing the health risks biological monitoring and use of biological exposure indices are preferable to environmental monitoring.
Sex ratio in relation to fathers' occupations.
Authors: Dickinson H O , Parker L
Published: December 2008

OBJECTIVE: To investigate whether the sex ratio of children varies between fathers of different occupations. METHODS: The sex ratio (the ratio of the number of boys to the number of girls at birth) was calculated in relation to paternal occupation in the cohort of all 253,433 live births in Cumbria, north west England, from 1950-89. Exact binomial confidence intervals were used to estimate whether the sex ratio in each occupational category was significantly different from that for the rest of the cohort. RESULTS: There were fewer occupational categories with significantly different sex ratios at the 5% level than expected by chance alone, assuming the same binomial distribution of sexes at birth within each paternal occupation. CONCLUSIONS: Significant variation of the sex ratio with fathers' occupations was not found. There is some evidence that the sex ratio shows less variance than expected under a binomial model which assumes independence of the sex of each child; a possible explanation of this may be parental preference for limiting family size after children of both sexes have been born or some other factor which results in children within a family being more likely to be of both sexes rather than the same sex.
Diagnostics of hand-arm system disorders in workers who use vibrating tools.
Authors: Gemne G
Published: December 2008

A hand-arm vibration syndrome occurs in some workers who use hand held vibrating tools. It is recognised to consist of white fingers, diffusely distributed finger neuropathy, pain in the arm and hand, and a small excess risk of osteoarthrosis from percussion to the wrist and elbow. Carpal tunnel syndrome is mainly due to ergonomic factors other than vibration, but certain factors related to vibration may contribute to its development. A decrease in muscle power induced by vibration, and excessive hearing deficit have been postulated. The assessment of a disorder suspected of being induced by vibration includes deciding whether there is a disorder and, if so, whether the symptoms can be caused by vibration. To decide whether the symptoms can be caused by vibration epidemiological documentation and pathogenically reasonable theories must exist. A causal diagnosis finally requires and epidemiological decision whether or not the factual exposure has elicited the patient's symptoms. Epidemiological data on the quantitative association between vibration and excessive risks of white fingers and diffusely distributed neuropathy are incomplete. The symptomatic diagnosis of white fingers is still mainly based on anamnestic information. Available laboratory tests are incapable of grading the severity of individual cases. Recording the finger systolic blood pressure during cold provocation is a method of symptomatic diagnosis with reasonable levels of specificity, sensitivity, and predictive value. For diffusely distributed neuropathy these levels are lower than desired. Electrodiagnostic tests for carpal tunnel syndrome have sufficient validity. Proper exposure evaluation must be based on an appreciation of the character of the vibration as well as effective duration and intermittency. If this is not taken into account, the number of hours of exposure and intensity of vibration are likely to be non-commensurable variables, and the simple product of them is a questionable dose measure. Separate models for risk evaluation of vascular and neurological disorders related to work with different tools and processes will have to be established. Ongoing research to obtain further data on exposure-response relations for neurological disturbances begins to yield encouraging results.
Use of screening nerve conduction studies for predicting future carpal tunnel syndrome.
Authors: Werner R A , Franzblau A , Albers J W , Buchele H , Armstrong T J
Published: December 2008

OBJECTIVE: To determine if an abnormal sensory nerve conduction study consistent with median mononeuropathy in asymptomatic workers was predictive of future complaints of the hand or finger suggestive of carpal tunnel syndrome. METHODS: This was a case-control study of over 700 active workers at five different work sites: four sites involved manufacturing workers and one site represented clerical workers. Patients' reports of symptoms of pain, numbness, tingling, or burning in the hand or finger that lasted more than one week or occurred three or more times after the initial screening were investigated. 77 cases were defined as asymptomatic workers with electrodiagnostic findings of median mononeuropathy in either hand based on a comparison of median and ulnar sensory evoked peak latencies. A difference > or = 0.5 ms was defined as abnormal; a normal difference was < or = 0.2 ms. Controls were asymptomatic age, and sex matched workers with normal nerve conduction studies in both hands. Follow up questionnaires were completed 17 (SD 6) months later. RESULTS: The follow up participation rate was 72%. Cases had a 12% risk of developing symptoms during the follow up period compared with 10% in the control group, chi 2 = 0.12, P = 0.73. CONCLUSIONS: Abnormal median sensory nerve conduction studies in asymptomatic workers were not predictive of future hand or fingers complaints and if used for preplacement screening among active workers this should be done with caution.
Retrospective estimation of exposure to benzene in a leukaemia case-control study of petroleum marketing and distribution workers in the United Kingdom.
Authors: Lewis S J , Bell G M , Cordingley N , Pearlman E D , Rushton L
Published: December 2008

OBJECTIVE: To provide quantitative estimates of exposure to benzene for cases and controls in an epidemiology study to investigate the risk of leukaemia in petroleum distribution workers. METHODS: Work histories were obtained for cases and controls together with detailed information on the distribution sites. For each job in the work history, an estimate of exposure (parts per million (ppm)) was obtained by multiplying a measure derived from exposure data by modifying factors to reflect the differences between the conditions that existed at the time of measurement and those at the time of interest. The modifying factors used related to job activity, the number of road tankers loaded, the benzene content of the gasoline, the mixture of products handled, temperature, and loading technology. Cumulative exposures for each case and control were obtained by multiplying the exposure estimates for each job by the duration of time in the respective jobs, and summing these over all jobs in the work history. Peak exposure and exposure through dermal contact were quantitatively classified for each job. RESULTS: Measured exposures were obtained for 30 job categories, and ranged from 0.003 to 8.20 ppm. 40% of work histories were assigned background exposures, with a further 34% assigned the exposure estimate for a driver carrying out top submerged loading of motor fuel into road tankers. Cumulative exposures ranged from < 1 to > 200 ppm-years, although 81% were < 5 ppm-years. Comparison of the exposure estimates for selected jobs with data from sources not used in the study showed similar results. CONCLUSION: The estimates of exposure to benzene in this study provide a sound basis for the epidemiological analyses.
DNA single strand breakage, DNA adducts, and sister chromatid exchange in lymphocytes and phenanthrene and pyrene metabolites in urine of coke oven workers.
Authors: Popp W , Vahrenholz C , Schell C , Grimmer G , Dettbarn G , Kraus R , Brauksiepe A , Schmeling B , Gutzeit T , von Bülow J , Norpoth K
Published: December 2008

OBJECTIVES: To investigate the specificity of biological monitoring variables (excretion of phenanthrene and pyrene metabolites in urine) and the usefulness of some biomarkers of effect (alkaline filter elution, 32P postlabelling assay, measurement of sister chromatid exchange) in workers exposed to polycyclic aromatic hydrocarbons (PAHs). METHODS: 29 coke oven workers and a standardised control group were investigated for frequencies of DNA single strand breakage, DNA protein cross links (alkaline filter elution assay), sister chromatid exchange, and DNA adducts (32P postlabelling assay) in lymphocytes. Phenanthrene and pyrene metabolites were measured in 24 hour urine samples. 19 different PAHs (including benzo(a)pyrene, pyrene, and phenanthrene) were measured at the workplace by personal air monitoring. The GSTT1 activity in erythrocytes and lymphocyte subpopulations in blood was also measured. RESULTS: Concentrations of phenanthrene, pyrene, and benzo(a)pyrene in air correlated well with the concentration of total PAHs in air; they could be used for comparisons of different workplaces if the emission compositions were known. The measurement of phenanthrene metabolites in urine proved to be a better biological monitoring variable than the measurement of 1-hydroxypyrene. Significantly more DNA strand breaks in lymphocytes of coke oven workers were found (alkaline filter elution assay); the DNA adduct rate was not significantly increased in workers, but correlated with exposure to PAHs in a semiquantitative manner. The number of sister chromatid exchanges was lower in coke oven workers but this was not significant; thus counting sister chromatid exchanges was not a good variable for biomonitoring of coke oven workers. Also, indications for immunotoxic influences (changes in lymphocyte subpopulations) were found. CONCLUSIONS: The measurement of phenanthrene metabolites in urine seems to be a better biological monitoring variable for exposure to PAHs than measurement of hydroxypyrene. The alkaline filter elution assay proved to be the most sensitive biomarker for genotoxic damage, whereas the postlabelling assay was the only one with some specificity for DNA alterations caused by known compounds.
Experimental exposure of male volunteers to N-methyl-2-pyrrolidone (NMP): acute effects and pharmacokinetics of NMP in plasma and urine.
Authors: Akesson B , Paulsson K
Published: December 2008

OBJECTIVES: To study the acute effects of exposure to the increasingly used solvent, N-methyl-2-pyrrolidone (NMP) in male volunteers. Further, to determine the NMP concentration in plasma and urine during and after the exposure. METHODS: Six male volunteers were exposed for eight hours on four different days to 0, 10, 25, and 50 mg/m3 NMP. Plasma was collected and urine was sampled during and after the exposure. Changes in nasal volume were measured by acoustic rhinometry and in airway resistance by spirometry. RESULTS: The eight-hour experimental exposure to 10, 25, and 50 mg/m3 did not induce discomfort to eyes or upper airways. Acute changes in nasal volume were not found, and no changes in the spirometric data could be registered. The elimination curves suggested a non-linear pattern and at the end of exposure showed mean (range) half lifes of NMP in plasma of about 4.0 (2.9-5.8) hours and in urine 4.5 (3.5-6.6) hours. The unmetabolised NMP found in urine samples collected during exposure and at the subsequent 44 hours corresponded to about 2% of the calculated absorbed dose. At the end of the exposure there was a close correlation between exposures and the plasma concentration and urinary excretion of NMP. CONCLUSIONS: NMP was absorbed through the respiratory tract and readily eliminated from the body, mainly by biotransformation to other compounds. Exposure to 10, 25, or 50 mg/m3 NMP did not cause nose, eye, or airway irritation. Thus, NMP is a mild irritant.
Physician based surveillance system for occupational respiratory diseases: the experience of PROPULSE, Québec, Canada.
Authors: Provencher S , Labrèche F P , De Guire L
Published: December 2008

OBJECTIVE: To evaluate the feasibility of implementing a physician based surveillance system of occupational respiratory diseases (PROPULSE) in Québec with regard to physician participation rate, characteristics of reported cases, and comparison with official statistics from the Workers' Compensation Board (WCB). METHODS: All chest physicians and allergists in Québec were asked to report suspected new cases of occupational respiratory diseases, on a monthly basis, between October 1992 and September 1993. For each case, personal information was collected and the physician's opinion on whether the condition was related to work was categorised as highly likely, likely, and unlikely. RESULTS: Of the 161 physicians initially approached, 68% participated. Physicians rated 48% of suspected cases as highly likely, 29% as likely, and 20% as unlikely. The most often reported diagnosis was asthma (63%), followed by diseases related to asbestos (16%). Silicosis was less frequent (5%) but it was reported for six workers under 40 of whom five were involved in sandblasting activities. The high proportion of cases of asthma probably reflects the increasing importance of this disease but may also reflect the different patterns of reporting among physicians with different expertise. The distribution of cases by diagnostic category is quite different between the PROPULSE system and that of the WCB (annual mean number of compensated cases during a four year period). Asthma and allergic alveolitis are more frequent in PROPULSE, reactive airways dysfunction syndrome are about the same in both systems, and other diseases are more frequent among compensated cases. The most frequent sensitising agents reported for asthma were the same in both systems (isocyanates, flour, and wood dust). 15% of the PROPULSE cases were not covered by the WCB, and therefore would not be found in the board's official statistics. CONCLUSIONS: A physician based reporting procedure can be implemented as part of a surveillance system to supplement data from other sources and thus provide a better understanding of the occurrence of occupational respiratory diseases.
Changes in respiratory function after one and three hours of exposure to formaldehyde in non-smoking subjects.
Authors: Akbar-Khanzadeh F , Mlynek J S
Published: December 2008

OBJECTIVE: To determine the changes in respiratory function within one hour and three hours of exposure to formaldehyde and investigate the relation between exposure to formaldehyde and acute changes in respiratory function. METHOD: Respiratory function of 50 non-smoking medical students exposed to formaldehyde in a gross anatomy laboratory were compared with respiratory function of 36 non-exposed, non-smoking physiotherapy students. Formaldehyde concentrations were measured in the breathing zone of each exposed subject and in the general work environment. RESULTS: Formaldehyde concentrations in the breathing zone of exposed subjects generally exceeded recommended standards. On average, the variables of respiratory function of both the exposed and the control subjects increased significantly within one hour and from one to three hours after exposure. The increase in respiratory function of the exposed subjects was significantly less than that of the control subjects. There was no meaningful correlation between concentration of formaldehyde in the breathing zone and changes in the respiratory function of exposed subjects. CONCLUSION: As the increase in the respiratory function of the subjects can be attributable to normal diurnal variation, the significantly lower increase in respiratory function of the exposed group than in the control group is probably due to exposure to formaldehyde. The results of this study do not, however, support a dose-response relation.
Humidification and perceived indoor air quality in the office environment.
Authors: Reinikainen L M , Aunela-Tapola L , Jaakkola J J
Published: December 2008

OBJECTIVE: To evaluate the effect of humidification on the odour, acceptability, and stuffiness of indoor air. METHODS: In a six period cross over trial at the Pasila Office Center, Helsinki, the air of two wings of the building in turn were ventilated with air of 30%-40% humidity. A third wing served as a non-humidified control area. The quality of indoor air was assessed weekly by a panel containing 18 to 23 members. The intraindividual differences in the ratings for odour, stuffiness, and acceptability between humidified and non-humidified wings were used to assess the effect of humidification. The roles of sex, current smoking, and age as potential effect modifiers were assessed by comparing the mean intraindividual differences in ratings between the groups. RESULTS: Humidified air was found to be more odorous and stuffy (paired t test P = 0.0001) and less acceptable than the non-humidified air (McNemar's test P < 0.001). The differences in odour and stuffiness between humidified and non-humidified air were greater for women and for non-smokers, and greatest differences were in the youngest age group, and least in the oldest age group. The differences were not significant. CONCLUSIONS: An untrained panel of 20 members is able to differentiate a slight malodour and stuffiness in indoor air. The results suggest that steam air humidification decreases the perceived air quality. This effect is strongest in women and young subjects.
Latex allergy: epidemiological study of 1351 hospital workers.
Authors: Liss G M , Sussman G L , Deal K , Brown S , Cividino M , Siu S , Beezhold D H , Smith G , Swanson M C , Yunginger J , Douglas A , Holness D L , Lebert P , Keith P , Wasserman S , Turjanmaa K
Published: December 2008

OBJECTIVE: To determine the prevalence of latex sensitisation among a large group of healthcare workers, study the occupational and non-occupational factors associated with latex allergy, and characterise latex exposure in air and by gloves. METHODS: All 2062 employees of a general hospital in Hamilton, Ontario, Canada who regularly used latex gloves were invited to participate in a cross sectional survey, representing the baseline phase of a prospective cohort morbidity study. Attempts were made to recruit employees who were diagnosed with latex allergy before the survey. Glove extracts were assayed for antigenic protein, and area and personal air samples were obtained on two occasions (summer and winter) to estimate exposure to airborne latex protein. A questionnaire on medical and occupational information was administered by an interviewer. Skin prick tests were performed with latex reagents, three common inhalants, and six foods. RESULTS: The mean (SD) latex protein concentrations were 324 (227) micrograms/g in powdered surgical gloves and 198 (104) micrograms/g in powdered examination gloves. Personal latex aeroallergen concentrations ranged from 5 to 616 ng/m3. There was a total of 1351 (66%) participants. The prevalence of positive latex skin tests was 12.1% (95% confidence interval (95% CI) 10.3% to 13.9%). This prevalence did not vary by sex, age, hospital, or smoking status but subjects who were latex positive were significantly more likely to be atopic (P < 0.01). Participants who were latex positive were also significantly more likely to have positive skin tests to one or more foods (Mantel-Haenszel odds ratio (OR) adjusted for atopy 12.1, 95% CI 7.6 to 19.6, P < 10(-9)). Work related symptoms were more often reported among latex positive people, and included hives (OR 6.3, 95% CI 3.2 to 12.5), eye symptoms (OR 1.9, 95% CI 1.2 to 2.8), and wheezy or whistling chest (OR 4.7, 95% CI 2.8 to 7.9). The prevalence of latex sensitivity was highest among laboratory workers (16.9%), and nurses and physicians (13.3%). When the glove consumption per healthcare worker for each department was grouped into tertiles, the prevalence of latex skin test positivity was greater in the higher tertiles of glove use for sterile (surgical) gloves (P < 0.005) but not for examination gloves. CONCLUSIONS: In this large, cross sectional study of healthcare workers, the prevalence of latex sensitisation was 12.1% (9.5% among all those eligible), and there were significant associations with atopy, positive skin tests to certain foods, work related symptoms, and departmental use of gloves per healthcare worker. This cohort is being followed up prospectively and will be retested to determine the incidence of development of latex sensitivity.
Study of business ethics in occupational medicine.
Authors: Philipp R , Goodman G , Harling K , Beattie B
Published: December 2008

OBJECTIVE: To investigate the views of specialists in occupational medicine about business ethics in occupational medicine. METHOD: A qualitative study with face to face focus groups and successive reviews of the draft consensus was undertaken of all accredited specialists in occupational medicine who were members of the south Wales and west of England group of the Society of Occupational Medicine, and of all regional specialty advisers and deputies from the Faculty of Occupational Medicine. RESULTS: There was widespread agreement for the need of a code of business ethics. In all, during the four draft stages of preparing a consensus, 72% (28/39) of members of the south Wales and west of England group of the Society of Occupational Medicine, and 31% (20/64) of regional specialty advisers and deputies provided detailed comment for inclusion in it. CONCLUSIONS: Consensus of their views was reached among study participants for issues of business ethics involving advertising, competence, qualifications, fees, commitment, changes in provider contracts, regulation, and supervision of trainees. It provides a basis for further debate.
Health and safety problems associated with long working hours: a review of the current position.
Authors: Spurgeon A , Harrington J M , Cooper C L
Published: December 2008

The European Community Directive on Working Time, which should have been implemented in member states of the European Community by November 1996, contains several requirements related to working hours, including the right of employees to refuse to work more than 48 hours a week. The United Kingdom government attempted to oppose the Directive, arguing that there is no convincing evidence that hours of work should be limited on health and safety grounds. Much of the research in this area has focused on the problems of shiftworking and previous reviews have therefore tended to emphasise this aspect of working hours. However, there is much less information about the effects of overtime work, which is a central element of the terms of the Directive. This paper reviews the current evidence relating to the potential effects on health and performance of extensions to the normal working day. Several gaps in the literature are identified. Research to date has been restricted to a limited range of health outcomes--namely, mental health and cardiovascular disorders. Other potential effects which are normally associated with stress--for example, gastrointestinal disorders, musculoskeletal disorders, and problems associated with depression of the immune system, have received little attention. Also, there have been few systematic investigations of performance effects, and little consideration of the implications for occupational exposure limits of extensions to the working day. Existing data relate largely to situations where working hours exceed 50 a week and there is a lack of information on hours below this level, which is of direct relevance to the European Community proposal. Finally, it is clear from investigations relating to shiftwork that a range of modifying factors are likely to influence the level and nature of health and performance outcomes. These include the attitudes and motivation of the people concerned, the job requirements, and other aspects of the organisational and cultural climate. It is concluded that there is currently sufficient evidence to raise concerns about the risks to health and safety of long working hours. However, much more work is required to define the level and nature of those risks.
Mortality of workers exposed to methylene chloride employed at a plant producing cellulose triacetate film base.
Authors: Tomenson J A , Bonner S M , Heijne C G , Farrar D G , Cummings T F
Published: December 2008

OBJECTIVE: To study mortality among 1785 employees of a factory that produced cellulose triacetate film base at Brantham in the United Kingdom. Also, to investigate patterns of mortality after exposure to methylene chloride; in particular, mortality from liver and biliary tract cancer, lung cancer, pancreatic cancer, and cardiovascular disease. SUBJECTS AND METHODS: All male employees with a record of employment at the film factory in 1946-88. A total of 1473 subjects worked in jobs that entailed exposure to methylene chloride. The mean duration of exposure was nine years at 19 ppm (eight hour time weighted average). RESULTS: In the cohort, 334 deaths were identified up to 31 December 1994. Mortalities for the cohort were compared with national and local rates and expressed as standardised mortality ratios (SMR). In the subcohort of workers exposed to methylene chloride, substantially reduced mortalities compared with national and local rates were found for all causes, all cancers, and the principal cancer sites of interest. The significantly reduced lung cancer mortalities in exposed workers (SMR 48) seemed to reflect the restrictions on smoking at the workplace. In contrast, mortality from ischaemic heart disease in exposed workers, although lower than national rates (SMR 92), was slightly increased compared with local rates. However, mortality from ischaemic heart disease was lower in active employees (SMR 83) where a direct effect of exposure to methylene chloride should be concentrated. No in service mortality due to ischaemic heart disease was found in workers with the highest cumulative exposure (> or = 800 ppm-years). CONCLUSIONS: The study provided no indication that employment at the plant, or exposure to methylene chloride, had adversely affected the mortalities of workers.
Risk of stillbirth from occupational and residential exposures.
Authors: Pastore L M , Hertz-Picciotto I , Beaumont J J
Published: December 2008

OBJECTIVES: To analyse the risk of stillbirth from 12 residential and occupational maternal exposures during pregnancy. METHODS: Stillbirths and neonatal deaths in 1984 within 24 hours of birth from 10 California counties were identified from death certificates. Controls were randomly selected from live births born in 1984 and frequency matched to cases by maternal age and county. Data sources included vital statistics and a self-administered postal questionnaire. Logistic regression and proportional hazards modelling were performed; the proportional hazards considered the truncated opportunity for exposure among cases. Special focus was given to two cause of deaths groups: congenital anomalies (12% of deaths) and complications of the placenta, cord, and membranes (37% of deaths). RESULTS: Occupational exposure to pesticides during the first two months of gestation was positively associated with stillbirths due to congenital anomalies (odds ratio (OR) 2.4, 95% confidence interval (95% CI) 1.0 to 5.9), and during the first and second trimesters with stillbirths due to all causes of death (risk ratios (RR) 1.3-1.4, 95% CI 1.0 to 1.7) and stillbirths due to complications of the placenta, cord, and membranes (RR 1.6-1.7, 95% CI 1.1 to 2.3). Occupational exposure to video display terminals in the third trimester was found to have a modest inverse association with stillbirths (RR 0.7, 95% CI 0.6, 0.9). Home pesticide exposure was positively associated with stillbirths due to congenital anomalies (OR 1.7, 95% CI 1.0 to 2.9). CONCLUSIONS: Occupational exposure to pesticides, especially during early pregnancy, had a clear positive association with stillbirths regardless of cause of death. Methodologically, this study of stillbirths is unique in its analysis of specific causes of death and use of time specific exposure windows.