bluuebunny/crossref_metadata_2025 huggingface dataset:
Haematopoietic cancer mortality among vehicle mechanics.
Authors: Hunting K L , Longbottom H , Kalavar S S , Stern F , Schwartz E , Welch L S
Published: December 2008

OBJECTIVE AND METHODS--This historical cohort study investigated causes of death among car and mobile equipment mechanics in the District of Columbia's Department of Public Works. Men who were employed for at least one year between 1977 and 1989 were eligible for inclusion in the cohort; follow up was up to the end of 1991. Three cases of leukaemia (index cases) had been reported among these workers before the inception of this study. This research was undertaken to estimate the relative risk of haematological cancer among mechanics working for the District of Columbia. RESULTS--Among the 335 male fleet maintenance workers, the all cause standardised mortality ratio (SMR) was 0.50 (33 observed deaths, 95% confidence interval (95% CI) 0.35-0.70), and the all cancer SMR was 0.55 (nine deaths, 95% CI 0.25-1.05). Three deaths from lymphatic and haematopoietic cancer were observed; the SMR was 3.63 (95% CI 0.75-10.63). In the subgroup with highest potential for exposure to fuels and solvents, the SMR for leukaemia and aleukaemia was 9.26 (two deaths, 95% CI 1.12-33.43), and the SMR for other lymphatic and haematopoietic neoplasms was 2.57 (one death from malignant lymphoma, 95% CI 0.06-14.27). All three lymphatic and haematopoietic cancer deaths were among car and mobile equipment mechanics (one was an index case). The two additional index cases were a fourth mechanic who died of leukaemia in 1992, after mortality follow up ended, and a fifth mechanic who was diagnosed with leukaemia in 1988 and is still alive. CONCLUSION--Many garage mechanics in this cohort regularly used petrol to clean parts and to wash their hands; some workers would occasionally siphon petrol by mouth. Benzene, a recognised cause of haematological cancer, is a component of petrol. Previous research indicates that garage mechanics may be at risk of leukaemia and other haematological cancers, presumably due to exposure to petrol; this study supports those findings.
Thetford plastics fire, October 1991: the role of a preventive medical team in chemical incidents.
Authors: Baxter P J , Heap B J , Rowland M G , Murray V S
Published: December 2008

OBJECTIVES--To review the role of a medical team in the emergency management of a major polyvinyl chloride (PVC) fire in an urban area. METHODS--The district health authority's consultant in communicable disease control (CCDC) was requested to advise on the health impacts of a fire that consumed some 1000 tonnes of plastic, mainly PVC, over 72 hours and which emitted a large smoke plume that threatened the health of local residents and emergency workers alike, constituting one of the largest incidents the local emergency services had dealt with in recent years. A medical team was formed comprising the CCDC, a regional epidemiologist, an occupational physician, and a medical toxicologist. This paper is an account of this team's experience of advising on the medical management of the emergency without having any formally established role or previous training for the task. RESULTS--The main issues requiring the input of the medical team included: the possible products of combustion and their effects on health; the clinical management of those exposed; the alerting of local hospitals to the type of casualties to expect; the special health risks posed to emergency workers, especially the firemen; the need for evacuation of local residents; the risks of contamination of soil, water, and crops; the potential health impact of the plume; and the provision of expert and authoritative advice on the short and long term health implications to the public. Active surveillance systems, which included the local general practitioners and hospitals, were established and air monitoring instigated. The 46 casualties were restricted to emergency personnel who had inadvertently received exposure to the fire smoke: all recovered within 48 hours. Local residents were unharmed. CONCLUSION--The incident showed the need for preventive medical teams trained to fill a formal advisory and investigative role for chemical releases and fires, and which can play an integral part in emergency management.
Seasonal changes in ambulatory blood pressure in employees under different indoor temperatures.
Authors: Kristal-Boneh E , Harari G , Green M S , Ribak J
Published: December 2008

OBJECTIVE--The effect of indoor temperature control on summer and winter ambulatory blood pressure levels at work was studied. METHOD--Ambulatory systolic blood pressure (SBP) and diastolic blood pressure (DBP) were monitored once in summer and once in winter in 101 healthy normotensive subjects aged 28-63 years, engaged in similar physical work, from two plants with and three without air conditioning. Subjects were interviewed about health related habits, and measurements of environmental and occupational conditions were obtained. RESULTS--After controlling for possible confounders, mean SBP and DBP during work were significantly higher in winter than in summer (delta SBP = 3.4 mm Hg, P = 0.035; delta DBP = 3.3 mm Hg, P < 0.003). The seasonal change in SBP and DBP showed an independent association with the presence or absence of air conditioning of the industrial plants (SBP: beta = 0.194, P < 0.0001; DBP: beta = 0.054, P = 0.038). The percentage of subjects with increases of more than 10 mm Hg from summer to winter was higher in plants without than with air conditioning. CONCLUSIONS--(1) In normotensive subjects ambulatory working BP varies by season, with higher values in winter. If validated for hypertensive subjects, it may be necessary to tailor drug treatment to these variations. (2) The findings make it clear that drawing valid conclusions from comparisons of BPs between groups requires controlling for several factors, particularly season of the year. (3) Climatic conditions in the industrial plant influence the magnitude of seasonal variations in BP. Work in plants without air conditioning places a considerable added load on the employee's cardiovascular system.
Acute effects of vibration from a chipping hammer and a grinder on the hand-arm system.
Authors: Kihlberg S , Attebrant M , Gemne G , Kjellberg A
Published: December 2008

OBJECTIVES--The purpose of this study was to compare various effects on the hand-arm system of vibration exposure from a chipping hammer and a grinder with the same frequency weighted acceleration. Grip and push forces were measured and monitored during the exposure. The various effects were: muscle activity (measured with surface electrodes), discomfort ratings for different parts of the hand-arm system (made during and after exposure), and vibration perception threshold (for 10 minutes before and 10 minutes after the exposure). RESULTS--No increase in muscle activity due to exposure to vibration was found in the hand muscle studied. In the forearm, conversely, there was an increase in both muscle studied. For the upper arm the muscle activity only increased when exposed to impact vibration. Subjective ratings in the hand and shift in vibration perception threshold were effected more by the grinder than the hammer exposure. CONCLUSION--These results show that the reaction of the hand-arm system to vibration varies with frequency quantitatively as well as qualitatively. They do not support the notion that one single frequency weighted curve would be valid for the different health effects of hand-arm vibration (vascular, musculoskeletal, neurological, and psychophysiological).
Airway responsiveness and job selection: a study in coal miners and non-mining controls.
Authors: Petsonk E L , Daniloff E M , Mannino D M , Wang M L , Short S R , Wagner G R
Published: December 2008

BACKGROUND--It has been suggested that health related job selection is a major cause of the healthy worker effect, and may result in inaccurate estimates of health risks of exposures in the working environment. Improved understanding of self selection, including the role of airway hyperresponsiveness, should improve accuracy in estimating occupational risks. METHODS--We evaluated symptoms of the respiratory tract, lung function, occupational and smoking histories, and airway responsiveness from a cross sectional survey of 478 underground bituminous coal miners and non-mining controls. Workers with abnormal spirometry were excluded from methacholine testing. RESULTS--Methacholine responsiveness (> or = 15% decline in forced expiratory volume in one second) was associated in both miners and controls with reduced ventilatory lung function and an increased risk of respiratory symptoms. Miners with the longest duration of work at the coal face had a low prevalence of methacholine responsiveness, compared with miners who had never worked at the coal face (12% v 39%, P < 0.01). Throughout their mining careers, miners who responded to methacholine were consistently less likely to have worked in dusty jobs than miners who did not respond to methacholine. CONCLUSIONS--These results provide evidence that workers who are employed in dusty jobs are less likely than their unexposed coworkers to show increased non-specific airway responsiveness, presumably as a result of health related job selection. Surveys of workers in which responsiveness data are unavailable may underestimate the effects of dust exposure on respiratory health.
Enzymuria in a population living near a cadmium battery plant.
Authors: Järup L , Carlsson M D , Elinder C G , Hellström L , Persson B , Schütz A
Published: December 2008

OBJECTIVES--To study the body burden of cadmium and signs of tubular dysfunction in a rural population living near a closed nickel cadmium battery plant. METHODS--Cadmium and N-acetyl-beta-glucosaminidase (NAG) in urine were measured in 72 subjects who lived close to the plant. RESULTS--Residents living close to the plant had higher median urinary cadmium concentrations than those living farther away (1.01 v 0.46 nmol/mmol creatinine) and than a control group (0.2 nmol/mmol creatinine). There was a significant correlation between urinary cadmium and the excretion of NAG in urine as well as signs of tubular dysfunction in residents who excreted urinary cadmium above 0.5 nmol/mmol creatinine. CONCLUSION--Tubular dysfunction may appear in environmentally exposed subjects at lower cadmium body burdens than previously anticipated.
Differences in occupational mortality from pleural cancer, peritoneal cancer, and asbestosis.
Authors: Coggon D , Inskip H , Winter P , Pannett B
Published: December 2008

OBJECTIVE--To assess whether the increased risk of disease related to asbestos in occupations from the construction and engineering industries applies equally to pleural cancer, peritoneal cancer, and asbestosis. METHODS--Analysis was based on deaths among men aged 20-74 in England and Wales during 1979-80 and 1982-90. (n = 1,656,096). Information about cause of death and the last full time occupation of decedents was derived from death certificates. Proportional mortality ratios (PMRs) by occupation were calculated for each of pleural cancer, peritoneal cancer, and asbestosis. RESULTS--Altogether, 2848 deaths were attributed to cancer of the pleura, 362 to cancer of the peritoneum, and 281 to asbestosis. When occupations were ranked according to PMRs from these diseases, striking differences were found. The category of construction workers which included laggers had the highest mortality from peritoneal cancer (PMR 990, 64 deaths), but a PMR of only 160 (77 deaths) for pleural cancer. In contrast, several occupations with much higher mortality from pleural tumours had no excess of peritoneal cancer. PMRs for asbestosis related more closely to those for peritoneal than pleural cancer. CONCLUSIONS--These findings suggest that the exposure-response relations for diseases related to asbestos are not all linear, and that risks of pleural mesothelioma may be underestimated by simple extrapolation from observations in cohorts with heavy exposure.
Further information on aluminium inhalation in silicosis.
Authors: Bégin R , Massé S , Dufresne A
Published: December 2008

OBJECTIVES--In previous studies, a significant reduction in biological activity of quartz by the surface chemistry of aluminium was noted. Aluminium lactate inhalation one month after quartz exposure significantly suppressed silicosis. In a recent study, it was noted that aluminium inhalation failed to alter the silicosis process after disease was recognised by standard chest radiography in the first year after monthly treatment. METHODS--That study was extended with the same groups of sheep, the aluminium treated group received weekly aerosol of 100 mg of aluminium lactate for an additional two years. All sheep were evaluated at three-month intervals by chest radiography, lung function, and lung lavage. RESULTS--The sheep with silicosis had significantly reduced lung functions, increased cellularity, phospholipids, and hyaluronan. These changes persisted for several years without significant differences between the silicotic sheep with or without the aluminium aerosol treatment. CONCLUSION--Aluminium aerosol treatment of silicosis after radiographic recognition of disease and the end of exposure did not alter the disease process.
Individual exposure to particulate air pollution and its relevance to thresholds for health effects: a study of traffic wardens.
Authors: Watt M , Godden D , Cherrie J , Seaton A
Published: December 2008

OBJECTIVE--To investigate the differences between measurements of personal exposure to particulate air pollution and static area measurements in a group of people working close to traffic and to determine whether such differences might obscure any threshold for health effects in epidemiological studies. METHODS--Personal air sampling was carried out on two groups of eight traffic wardens for four days on two consecutive weeks in November 1994. These measurements were compared with standard environmental static sampling data that were obtained for the same period. A simulation with log normal distributions of personal exposures was produced, and an arbitrary risk calculated for each exposure, assuming a threshold of 50 micrograms/m3, and an exposure-response curve was calculated. RESULTS--The median concentration for personal samplers in week 1 was 123 micrograms/m3 and 41 micrograms/m3 in week 2. Corresponding area concentrations were 10 micrograms/m3 and 7.5 micrograms/m3. The differences between the personal and area results were significant, as were the differences for personal sampling between weeks 1 and 2. The simulation showed that the variation in individual exposures around an area sampler obscured the threshold. CONCLUSIONS--Area sampling data may be of limited value in the investigation of the biological effects of exposure to pollution and their use may result in real thresholds being obscured. Personal exposure assessment may be crucial in determination of the health effects attributable to different concentrations of air pollutants.
Decreased glomerular filtration rate in solderers exposed to cadmium.
Authors: Järup L , Persson B , Elinder C G
Published: December 2008

OBJECTIVES--to evaluate the degree of cadmium induced glomerular impairment and to assess the dose-response relation between cadmium dose and the prevalence of glomerular dysfunction. METHODS--A comparison of glomerular filtration rates (GFR) assessed by Cr-EDTA clearance was made in 42 solderers previously exposed to cadmium for at least five years. Blood and urine data were collected at health examinations in 1984, 1989, and 1993. Individual doses of cadmium were estimated by analysing cadmium in blood. RESULTS--Glomerular lesions induced by cadmium are irreversible and the GFR decreases with the degree of tubular damage. The GFR also decreases with cadmium dose and there is a dose-response relation between blood cadmium and prevalence of glomerular damage with 3.4% prevalence at blood cadmium concentrations below 50 nmol/l, 33% at blood cadmium concentrations between 50 and 75 nmol/l and 100% prevalence of glomerular damage when cadmium in blood exceeds 75 nmol/l. CONCLUSIONS--The kidney lesions induced by cadmium are irreversible and the prevalence of those lesions are dose dependent. There is also evidence of a dose related decrease in GFR even a long time after the end of exposure. Exposure to cadmium should therefore be minimised and workers exposed to cadmium should be examined regularly for many years after the end of exposure.
Geltape method for measurement of work related surface contamination with cobalt containing dust: correlation between surface contamination and airborne exposure.
Authors: Poulsen O M , Olsen E , Christensen J M , Vinzent P , Petersen O H
Published: December 2008

OBJECTIVES--The geltape method is a new method for optical measurement of total amount of dust on surfaces. The objectives were to study the potential applicability of this method to measurements of work related cobalt exposure during painting of plates with cobalt dye. METHODS--Consecutive series of work related geltape prints were taken from surfaces inside and outside the ventilation cabins of two plate painters during two full working days. The amount of dust picked up by the geltapes was measured optically with a field monitor. Also, personal air samples were collected on filters at the different work processes. In the laboratory the contents of cobalt on the geltape prints and the filters were measured with inductive coupled plasma atomic emission spectroscopy. RESULTS--The key results were: (a) when the geltape prints were taken from surfaces inside the cabins the optically measured area of the geltapes covered with total dust (area (%)) correlated well with the chemically measured amount of cobalt present on the geltapes. Linear correlation coefficient (R2) was 0.91 for geltape prints taken on the floor and 0.94 for prints taken on the ceiling; (b) the cumulative airborne cobalt exposure, calculated from data on work related exposure by personal sampling, correlated with the area (%) of geltape prints taken from the ceiling of the cabin (R2 = 0.98); (c) the geltape method could be used to distinguish both between work processes with different levels of cobalt exposure, and between plate painters subjected to significant differences in airborne cobalt exposure. CONCLUSION--The geltape method could produce measures of the work related exposures as well as whole day exposure for cobalt. The geltape results correlated with measurements of personal airborne cobalt exposure. In this industry the profile of exposure is well-defined in time, and it seems reasonable to apply this fast and low cost method in routine exposure surveillance to obtain a more detailed description of the exposure than can be obtained by the use of airborne measurements only.
Prognosis of vibration induced white finger: a follow up study.
Authors: Petersen R , Andersen M , Mikkelsen S , Nielsen S L
Published: December 2008

OBJECTIVES--To follow up 102 patients with vibration induced white finger (VWF). METHODS--102 subjects with VWF were reexamined one to 13 years after the condition had first been diagnosed. Information about symptoms, occupation, vibration exposure, smoking habits, age, and the prevalence of other diseases was present in the medical records from the first examination and was collected by a questionnaire and an interview at the second examination. The decrease in systolic blood pressure in a finger during cold provocation (FSP%) was measured in the same finger at both examinations. RESULTS--At the second examination, 22% stated that the frequency of attacks had decreased. The improvement was most frequent in subjects with little or no exposure to vibration during the previous two years, in non-smokers, and in subjects without other circulatory diseases than VWF. 32% stated that the frequency of attacks had increased. The aggravation was most notable in smokers and subjects who also had circulatory diseases other than VWF. The number of finger phalanges that blanched on cooling averaged 15.8 at the first examination and 14.4 at the second examination. Working with high vibration hand held tools during the previous two years was related to an aggravation, with more finger phalanges affected at the second examination. Presence of other circulatory diseases had the same effect. In non-smokers the number of affected finger phalanges had decreased at the second examination. The FSP% had increased (improvement) in 43%, decreased (aggravation) in 12%, and was unchanged in 45%. The increase in FSP% was more pronounced in the older than in the younger subjects. The decrease of FSP% was more frequent among the younger subjects and subjects with a short follow up. CONCLUSION--As the FSP% in nearly half of the subjects had improved, it is concluded that VWF has a good prognosis in patients with mainly moderate to severe VWF after one to 13 years of observation. The improvement in FSP%, however, was not reflected in the subjective experience of the development of attacks of VWF. Continued work with high vibration hand held tools, smoking, other circulatory diseases, and low age at the time of diagnosis had an unfavourable influence on the prognosis.
People with high mercury uptake from their own dental amalgam fillings.
Authors: Barregård L , Sällsten G , Järvholm B
Published: December 2008

OBJECTIVES--To describe people with high mercury (Hg) uptake from their amalgam fillings, and to estimate the possible fraction of the occupationally unexposed Swedish population with high excretion of urinary Hg. METHODS--Three case reports are presented. The distribution of excretion of urinary Hg in the general population was examined in pooled data from several sources. RESULTS--The three cases excreted 23-60 micrograms of Hg/day (25-54 micrograms/g creatinine), indicating daily uptake of Hg as high as 100 micrograms. Blood Hg was 12-23 micrograms/l, which is five to 10 times the average in the general population. No other sources of exposure were found, and removal of the amalgam fillings resulted in normal Hg concentrations. Chewing gum and bruxism were the probable reasons for the increased Hg uptake. Extrapolations from data on urinary Hg in the general population indicate that the number of people with urinary excretion of > or = 50 micrograms/g creatinine could in fact be larger than the number of workers with equivalent exposure from occupational sources. CONCLUSION--Although the average daily Hg uptake from dental amalgam fillings is low, there is a considerable variation between people; certain people have a high mercury uptake from their amalgam fillings.
Work characteristics and lifestyle as predictors in the development of chronic non-specific lung disease among elderly municipal employees.
Authors: Tammilehto L , Tuomi K
Published: December 2008

OBJECTIVES--This study prospectively evaluated factors of working conditions and lifestyle in the development of chronic non-specific lung disease (CNSLD). METHODS--Baseline data were collected in 1981 from 5386 municipal employees born in 1923-35 who had no diagnosed CNSLD. The subjects were studied again in 1985 with a postal questionnaire. The predictors of CNSLD were selected by multivariate logistic regression analysis. RESULTS--159 (3%) reported the development of CNSLD confirmed by a physician. During the 4.6 year follow up period the average annual incidence was 6.5/1000 subjects. In men the logit model followed was: smoking (odds ratio (OR) 1.17, 95% confidence interval (95% CI) 1.06-1.29), tight work schedule (OR 1.31, 95% CI 1.03-1.65), loss of a close friend (OR 2.21, 95% CI 1.13-4.31), and retirement of a spouse (OR 3.31, 95% CI 1.35-8.11). In women the selected risk factors were: smoking (OR 1.22, 95% CI 1.01-1.38), atopy (OR 1.99, 95% CI 1.12-3.53), physically heavy work (OR 1.65, 95% CI 1.09-2.29), poor physical working conditions such as heat, cold, changing temperature (OR 1.41, 95% CI 1.13-1.75), and infrequent communication with other people at work (OR 1.25, 95% CI 1.05-1.49). CONCLUSION--The differences in the predictors of the incidence of CNSLD between men and women were partly explained by different smoking habits, frequency of atopy, and working conditions. In men the significance of life events (loss of close friend and retirement of wife) need further investigation.
Bronchial dysplasia induced by radiation in miners exposed to 222Rn progeny.
Authors: Michaylov M A , Pressyanov D S , Kalinov K B
Published: December 2008

OBJECTIVES--To investigate whether sputum cytology can be used to monitor epithelial cell changes in groups at high risk of lung cancer from exposure to radiation. METHODS--Dysplasia of bronchial cells was investigated by means of sputum cytology in a group of 434 underground miners. 100 of them were not exposed, and 334 were exposed to 222Rn progeny at cumulative exposures < 450 working level months. RESULTS--The frequency of dysplasia in the exposed group was significantly higher than that in the not exposed group (P < 0.0001), and an exposure-response relation was found. This relation was different for smokers and non-smokers. CONCLUSIONS--Possibly the frequencies of dysplasia could be used to assess past exposures of groups of miners. This approach could be applied to cases where data on radiation monitoring are not available or are very scarce.
Induction of P-450 in workers exposed to dioxin.
Authors: Halperin W , Kalow W , Sweeney M H , Tang B K , Fingerhut M , Timpkins B , Wille K
Published: December 2008

OBJECTIVES--To examine the effects of occupational exposure to substances contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on cytochrome P-4501A2 activity in a cross sectional medical survey. METHODS--The exposed workers had been employed at two chemical plants > 15 years earlier in the manufacture of 2,4, 5-trichlorophenol and its derivatives. The control group consisted of people with no occupational exposure to phenoxy herbicides and who lived within the communities of the exposed workers. A total of 58 workers and 125 unexposed controls participated in the analysis. Cytochrome P-450 activity was assessed with test that measures caffeine metabolites in the urine. A ratio of metabolites of caffeine (CMR) constituted a measure of P-4501A2 activity. RESULTS--Compared with the control group in multivariate logistic regression, raised non-significant associations were found for three of four categories of TCDD in exposed workers (TCDD < 20 pg/g, odds ratio (OR) 1.7, 95% confidence interval (95% CI) 0.6 to 5.0, TCDD 20-66, OR 0.3, 95% CI 0.0 to 1.7; TCDD 67-147, OR 2.3, 95% CI 0.6 to 8.8; TCDD > or = 148, OR 3.1, 95% CI 0.8 to 12.5). We found a strongly significant association of CMR and urinary cotinine, a measure of smoking, and urinary free ethanol. We found weak non-significant associations between P-4501A2 activity and increased serum TCDD among workers. CONCLUSIONS--The absence of an association between serum TCDD and cytochrome P-4501A2 may be due to the size of the study, insensitivity of the CMR to assess cytochrome P-4501A2 activity, or inadequate levels of exposure, although these were among the highest in human groups tested.
Mortality from lung cancer and other diseases related to smoking among fishermen in north east Italy.
Authors: Mastrangelo G , Malusa E , Veronese C , Zucchero A , Marzia V , Boscolo Bariga A
Published: December 2008

OBJECTIVES--To study the mortality of fishermen. This was suggested by a cluster of cases of lung cancer in Chioggia, a large fishing harbour in the Veneto. The aim was to weight occupation against smoking with respect to risk of lung cancer. METHODS--7530 fishermen registered in the 1971-86 port authority registers of Chioggia and Venice were followed up for mortality from 1971 to 1989. Of 475 causes of death, 460 were traced. Standardised mortality ratio (SMR) was calculated with the regional population as a reference. A nested case-control study was carried out in Chioggia decedents only by interviewing next of kin. Complete data were obtained in 172 (70% response). Cases (lung cancer deaths) and controls (other causes of death) were compared for smoking and occupation, as a group of non-fishermen was available in the cohort. Logistic regression analysis was used to adjust for confounding factors. RESULTS--SMRs were high for lung cancer but low for other diseases related to smoking: circulatory and respiratory disease, tumours of the mouth, pharynx, oesophagus, and bladder. Likewise, SMRs were high for liver cancer but low for other diseases related to alcohol: digestive and circulatory disease, buccal, pharyngeal, and oesophageal tumours. In the case-control study, the risk of lung cancer was found to be related to smoking, and there was no interaction between occupation and smoking. When adjusted for age and smoking, the occupational indicators had no influence on the risk of mortality from lung cancer. CONCLUSIONS--Among fishermen in north east Italy the greatest health hazard is lung cancer, and the factor involved in this risk is smoking, not occupation. Smoking, however, was linked with long hours at sea in another study.
Maintenance of stellite and tungsten carbide saw tips: respiratory health and exposure-response evaluations.
Authors: Kennedy S M , Chan-Yeung M , Marion S , Lea J , Teschke K
Published: December 2008

OBJECTIVE--To study exposure to cobalt and chromium in saw maintenance rooms and test respiratory health among saw filers at lumber mills. Hard-metal lung disease is associated with cobalt in the manufacture of tungsten carbide tools; recently it has also been reported among tool maintenance workers. Lumber mills often use saws tipped with tungsten carbide or with a newer alloy, stellite (containing more cobalt, as well as chromium). METHODS--A cross sectional study of 118 saw filers at eight lumber mills was carried out that included a standardised questionnaire, spirometry, personal air sampling, and examination of tasks every 10 minutes (by observation). Comparison data were from a study of bus mechanics tested with similar methods. RESULTS AND CONCLUSION--Cobalt exposure was associated with tungsten carbide grinding but not with stellite grinding. Chromium exposure was associated mainly with stellite welding. Saw filers had a twofold increase in phlegm and wheeze (P < 0.01) and a threefold increase in cough, phlegm, and wheeze related to work (P < 0.001), but no increase in breathlessness. Stellite welding was associated with a significant increase in nasal symptoms and cough related to work and a small decrease in airflow (forced expiratory volume in one second/forced vital capacity (FEV1/FVC%), P < 0.05). Saw filers wet grinding with tungsten carbide had significant reductions in forced expiratory lung volumes (FEV1 and FVC, P < 0.05) and were significantly more likely to have FEV1 and FVC values in the abnormal range. Cobalt exposure (in wet grinding) and duration of work that involved tungsten carbide grinding were both associated with significant reductions in FEV1 and FVC. Average cobalt exposures in this study were about 5 micrograms/m3, well below the currently accepted permissible concentration, which suggests that the current workplace limit for cobalt may be too high.
Effects within the week on forced vital capacity are correlated with long term changes in pulmonary function: reanalysis of studies on car painters exposed to isocyanate.
Authors: Dahlqvist M , Tornling G , Plato N , Ulfvarson U
Published: December 2008

OBJECTIVES--To examine if car painters who work with polyurethane paints that contain hexamethylenediisocyanate (HDI) and hexamethylenediisocyanate biuret trimer (HDI-BT) develop acute as well as chronic impairment of lung function. METHODS--In this study data were reanalysed from two earlier studies on a group of car painters to see if a decrease in lung function within the week is a marker of vulnerability in those workers. Data on changes in forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) within the week were available for 20 car painters who were also examined six years later. RESULTS--10 men showed a decline in FVC within the week. There were no significant differences in age, duration of employment, exposures during the follow up period, or smoking between car painters who had decline in lung function within the week and car painters who had not. A significant correlation was found between the change in FVC within the week and the long term (six year) change in FVC, standardised for the effects of aging and smoking, and adjusted for the number of peak exposures. CONCLUSIONS--The results suggest that the decrease in FVC within the week might serve as a guide to identify car painters at risk of a further decrement in lung function above the effects of aging, smoking, and exposure.
Lead and cadmium in human placentas and maternal and neonatal blood (in a heavily polluted area) measured by graphite furnace atomic absorption spectrometry.
Authors: Baranowska I
Published: December 2008

OBJECTIVE--To measure the concentrations of the trace elements lead and cadmium in human placenta and in maternal and neonatal (cord) blood. To assess the influence of the strongly polluted environment on the content of metals in tissues and on the permeability of placenta to cadmium and lead. Various methods of mineralisation were tested before analysis. METHODS--Graphite furnace atomic absorption spectrometry was used for the determination of lead and cadmium. The samples for analysis were prepared by mineralisation under pressure in a Teflon bomb (HNO3, 110 degrees C), by wet ashing under normal pressure (HNO3 + H2O2 for 12 hours), and by microwave digestion in concentrated nitric acid. RESULTS--In analysed samples the following mean concentrations of cadmium and lead were found: in venous blood Pb = 72.50 ng/ml, Cd = 4.90 ng/ml; in placenta Pb = 0.50 microgram/g, Cd = 0.11 microgram/g; in cord blood Pb = 38.31 ng/ml, Cd = 1.13 ng/ml. CONCLUSION--High concentrations of lead and cadmium were found in placentas and in maternal blood whereas in neonatal blood there was an increased concentration of lead and only traces of cadmium. It is concluded that the placenta is a better barrier for cadmium than for lead. Among the examined methods of mineralisation, microwave digestion was the best.
Study of morbidity of personnel with potential exposure to vinclozolin.
Authors: Zober A , Hoffmann G , Ott M G , Will W , Germann C , van Ravenzwaay B
Published: December 2008

OBJECTIVES--To examine internal exposure and targeted health outcomes of employees exposed to 3-(3,5-dichlorophenyl)-5-methyl-5-vinyl-1,3-oxazolidine-2,4-dione; chemical abstracts service (CAS) number: 50471-44-8 (vinclozolin). METHODS--A cross sectional study of 67 men exposed to vinclozolin for one to 13 years during synthesis and formulation operations and 52 controls. Biomonitoring was based on determination of urinary metabolites that contained a 3,5-dichloroaniline (3,5-DCA) moiety. Targeted health endpoints were the same as in previous subchronic and chronic animal studies--namely, reversible changes in the concentrations of hormones of the adrenocorticotrophic and gonadotrophic feedback systems, signs of liver injury, haemolytic anaemia, cataract formation (uniquely in rats), and hormonally induced hyperplasia and tumours at high doses. The clinical investigation consisted of a medical and occupational history questionnaire, physical examination, laboratory determinations (including testosterone, LH, and FSH measurements), ultrasonography of the liver and prostate, a detailed eye examination, and routine spirometry. RESULTS--The mean 3,5-DCA concentration for two thirds of the study group exceeded an equivalent of the vinclozolin acceptable daily intake (ADI) used for consumer regulatory purposes. Even the highest concentrations were, however, at least 10 times below the no observable adverse effect level (NOAEL) based on animal studies. Analysis of physical examination and laboratory data provided no evidence of hormonal responses induced by vinclozolin. Furthermore, no evidence of liver injury, prostate changes, cataract formation, or haemolytic anaemia was found. CONCLUSION--There was no evidence of any health effects induced by vinclozolin among employees with potential long term exposure. In particular, no antiandrogenic effects were found.
Mortality and cancer morbidity in workers from an aluminium smelter with prebaked carbon anodes--Part II: Cancer morbidity.
Authors: Rønneberg A , Andersen A
Published: December 2008

OBJECTIVE--To investigate associations between cancer incidence and exposure to coal tar pitch volatiles, asbestos, pot emissions (fluorides, sulphur dioxide), heat stress, and magnetic fields in workers from a Norwegian aluminium smelter that operated from 1914 to 1975. METHODS--Cancer incidence between 1953 and 1991 was recorded in a cohort of 1137 men hired between 1922 and 1975. The expected number of cancer cases was calculated from incidence rates in Norwegian men. A job exposure matrix with semiquantitative exposure estimates was used to investigate associations between cumulative exposure estimates was used to investigate associations between cumulative exposure and cancer incidence through exploring temporal relations by considering exposures only within specific time windows. RESULTS--A significant excess of cancer cases, 90 observed v 59.0 expected, was found in workers who had been employed for less than three years. No such excess was found in men with at least three years' employment, with 120 cases observed v 129.7 expected. In this subcohort an association was found between the incidence of bladder cancer and exposure to coal tar pitch volatiles 40 years or more before each person-year under observation, and between incidence of lung cancer and tar exposure 35-50 years before observation. An association was also found between incidence of kidney cancer and exposure to heat stress 20-35 years before observation. CONCLUSIONS--The results support previous findings that exposure to coal tar pitch volatiles in the aluminium industry has been associated with increased risk of bladder and lung cancer. They also add information about temporal relations, suggesting that exposure to tar in this smelter has acted on an early stage in the development of these cancers, followed by a latency period of 30-40 years.
Evaluation of the respiratory health of dock workers who load grain cargoes in British Columbia.
Authors: Dimich-Ward H D , Kennedy S M , Dittrick M A , DyBuncio A , Chan-Yeung M
Published: December 2008

OBJECTIVES--To investigate the respiratory health of dock workers who load grain cargoes. METHODS--The respiratory health of 118 dock workers who load grain cargoes in the ports of Vancouver and Prince Rupert was compared with that of 555 grain elevator workers from the same regions. 128 civic workers were used as an unexposed control group. RESULTS--The prevalences of chronic cough and phlegm were at least as high in dock workers as those found in the elevator workers, and when adjusted for differences in duration of employment and smoking, dock workers had an eightfold higher risk of developing chronic phlegm than did civic workers. Symptoms of eye and skin irritation that were experienced at least monthly were highest for dock workers. Average percentage of the predicted FEV1 and FVC for dock workers (mean 100.6% and 105.3% respectively) were similar to the civic workers but significantly higher than those found for elevator workers. Higher subjective estimates of duration of exposure to grain dust (hours/day) were associated with lower values of FEV1. CONCLUSIONS--The more intermittent grain dust exposure patterns of dock workers may have allowed for some recovery of lung function, but chronic respiratory symptoms were less labile.
Pre-employment screening among trainee bakers.
Authors: De Zotti R , Molinari S , Larese F , Bovenzi M
Published: December 2008

OBJECTIVES--To assess the prevalence of atopy in a vocational school so as to evaluate the feasibility of pre-employment screening. METHODS--The prevalence of atopy by family diathesis, prick tests, immunoglobulin E (IgE) concentrations, and personal history of allergic respiratory diseases was investigated in 144 trainee bakers and 81 students on a graphic artists course (mean age 15.4 years). Skin sensitisation to wheat, rye, and barley flours, to alpha amylase, and to storage mites was also evaluated. RESULTS--Personal allergic symptoms were reported by 13.2% of the bakers and 14.7% of the graphic artists and there was a significant association between symptoms and atopy by prick tests (odds ratio (OR) 17.2; 95% confidence interval (95% CI) 5.27-56.4) and by family history (OR 3.11; 95% CI 1.02-9.53). When bakers were grouped according to the presence of allergic symptoms and results of immunological tests, 6.9% had asthma, 6.3% had rhinoconjunctivitis, and a high percentage (28.5%) were without symptoms but scored positive on prick tests or family symptoms. Skin sensitisation to storage mites had similar prevalences (16%) in the two groups of trainees and occurred nearly always in atopic people. Positive skin tests to wheat flour (3.5%), rye (0.7%), and alpha amylase (0.7%) were specific to bakers. CONCLUSIONS--Pre-employment screening is a useful source of medical information and allows for counseling. The presence of asthma, or of another allergic disease in a severe form, is suggested as a criterion for excluding students of a vocational school from training as bakers. Student bakers without allergic symptoms but atopic by other criteria should be informed about their risks of developing occupational asthma, and periodic check ups must be recommended. Screening studies in vocational school provide a better understanding of specificity of skin sensitisation to occupational allergens.
Developments in reproductive risk management.
Authors: Stijkel A , van Dijk F J
Published: December 2008

Internationally, the debate on aims for occupational health policy is expanding its horizons. Included among the issues are not only concerns about safety for workers, but also for their progeny. Equality among the sexes is also assuming a prominent position. In several countries, existing and proposed legislation already considers these matters. In the course of this article it is argued that this legislation and its implementation are inadequate. There are several reasons for this. Firstly, what constitutes health risks for workers exposed to chemical substances is subject to different interpretations. This is further complicated when one includes risks to reproductive function and to the progeny: the reproductive risks of toxicity. The different interpretations of the concepts of safety and equality are also discussed. There are differences in regulations and in standards about whether or not safety factors should be used when knowledge is uncertain. The operation of reasonable measures with a generic or sex specific policy also differs. Secondly, the current occupational exposure limits are set too high. These aspects are considered and it is probable that the policy aims should be made more specific. An elaborated approach that includes the "precautionary principle" in safety standards is proposed. To advise employers in their role as managers of reproductive risks of toxicity, a recently developed system for occupational health and safety services is described. This system is based on two criteria: effectiveness and reasonableness of proposed measures. The effectiveness criterion includes the precautionary principle; the reasonableness criterion includes equal rights and opportunities for men and women. Finally, a supportive governmental policy that is consistent with the most recent international development is recommended.
Tumour necrosis factor-alpha (TNF-alpha) in patients who have asbestosis and develop cancer.
Authors: Partanen R , Koskinen H , Hemminki K
Published: December 2008

OBJECTIVES--Concentrations of tumour necrosis factor-alpha (TNF-alpha) were assayed by radioimmunoassay in serum samples collected between 1981 and 1987 from 111 patients with asbestosis who were at a high risk of cancer. Follow up of these patients until 1993 showed that 38 had developed cancer (27 lung, three mesotheliomas, and eight diverse malignancies). RESULTS--The mean serum concentrations of TNF-alpha given in fmol/100 microliters serum in all the cases with cancer (14.1) and the cases with lung cancer (13.6) were significantly higher (P < 0.05) than the mean concentrations in the exposed controls (10.5). A positive increase was considered to be any value that was > 2 SDs above the mean of the exposed controls. 22% (six of 27) of the cases with lung cancer were positive compared with 4% (three of 73) of the exposed controls, a significant difference (P < 0.001). The serum concentrations of TNF-alpha correlated moderately with cancer (r = 0.3), lung cancer (r = 0.3), and Neu oncoproteins and epidermal growth factor receptor (EGFR) (r = 0.3, 0.5 respectively). Also, there was a significant correlation between development of cancer and severity or progression of asbestosis. There was no correlation between the concentrations of TNF-alpha and severity or progression of asbestosis. CONCLUSIONS--These results showed high concentrations of TNF-alpha in the patients who had cancer. TNF-alpha may offer an auxiliary method in early diagnosis of cancers related to asbestosis.
Upper airway response in workers exposed to fuel oil ash: nasal lavage analysis.
Authors: Hauser R , Elreedy S , Hoppin J A , Christiani D C
Published: December 2008

OBJECTIVES--Among other constituents, fuel oil ash contains vanadium pentoxide, a known respiratory irritant. Exposure to ambient vanadium pentoxide dust has been shown to produce irritation of the eyes, nose, and throat. The usefulness of nasal lavage in detecting an inflammatory response to exposure to fuel oil ash among 37 boilermakers and utility workers was investigated. METHODS--A baseline lavage was performed on the morning of the first day back to work after an average of 114 days away from work (range 36 hours to 1737 days). A lavage was performed after exposure on the morning three days after the baseline lavage. Exposure to respirable particulate matter of diameter < or = 10 microns (PM10) and respirable vanadium dust were estimated with daily work diaries and a personal sampling device for respirable particulates. These estimates were made for each subject on each workday during the three days between lavages. For each subject, the adjusted change in polymorphonuclear cells was calculated by dividing the change in polymorphonuclear cell counts by the average of the counts before and after exposure. The association between the adjusted polymorphonuclear cell counts and exposure was assessed with multiple linear regression, adjusted for age and current smoking. RESULTS--Personal sampling (one to 10 hour time weighted average) showed a range of PM10 concentrations of 50 to 4510 micrograms/m3, and respirable vanadium dust concentration of 0.10 to 139 micrograms/m3. In smokers the adjusted polymorphonuclear cell count was not significantly different from zero (-0.1%, P > 0.5), but in nonsmokers it was significantly greater than zero (+50%, P < 0.05). In both non-smokers and smokers, there was considerable variability in adjusted polymorphonuclear cell counts and a dose-response relation between these adjusted cell counts and either PM10 or respirable vanadium dust exposure could not be found. CONCLUSION--A significant increase in polymorphonuclear cells in non-smokers but not smokers was found. This suggests that in non-smokers, exposure to fuel oil ash is associated with upper airway inflammation manifested as increased polymorphonuclear cell counts. The lack of an increase in polymorphonuclear cells in smokers may reflect either a diminished inflammatory response or may indicate that smoking masks the effect of exposure to fuel oil ash.