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Biomedical subjects

C Edling

Publications and source records attributed to C Edling.

At least 55 records · Page 3Linked to original sources
PubMed1995

Cancer incidence among pharmaceutical workers.

OBJECTIVES: A cluster of cancers at one plant in a pharmaceutical company in Sweden was the initiator for this work, which describes the cancer incidence among the laboratory and production workers at this company. METHODS: The investigation is a retrospective cohort study. All employees with possible exposure to chemical, pharmacological, or biological agents and employment for at least six months at the company during 1960-1990 were included. Standardized incidence ratios (SIR) were calculated with the local county population as reference. RESULTS: The total cancer incidence was close to the expected. In a subcohort consisting of the highest exposed employees, an SIR of 3.5 [95% confidence interval (95% CI) 1.5-6.8] was found for urothelial tumors, while there were no urothelial tumors among the workers with the lowest exposure. An evaluation of the exposures among the subjects with urothelial tumors revealed no association with specific exposures in the workplaces. There was also a statistically significant increase in the risk for acute leukemia (SIR 4.5, 95% CI 1.2-12 ). With a 10-year induction-latency period in the calculations, the elevated risk was smaller and not significant. Although the numbers were small, there were also statistically significant overrisks for cancer of the peritoneum, the lip, and the pleura. CONCLUSIONS: A significant increase in the risk for urothelial tumors was found among pharmaceutical workers. All but one of those with urothelial tumors were smokers, but confounding from smoking could probably not explain the risk increase.

Acute Disease↗
PubMed1995

Lead intoxication caused by skeletal disease.

BACKGROUND: Inorganic lead is accumulated in the skeleton, which harbors more than 90% of the body burden of lead. If rapidly mobilized, this pool may constitute a health risk. However, clear evidence of this theory has been lacking. HISTORY: A previously healthy 36-year-old Swedish man with more than 10 years of work-related lead exposure developed headache, musculoskeletal pain, and paresthesia of both arms. Two months after the cessation of exposure, the lead level in his blood (B-Pb) was 5.5 mumol.l-1, and treatment with chelating agents was started. Shortly after the treatment period, he had an accident causing a fracture of the right collum femoris. The B-Pb was fairly stable around 1.5 mumol.l-1 for about two years after the end of exposure (95th percentile 0.6 mumol.l-1 for occupationally unexposed Swedish men). The examination showed that the patient had high skeletal turnover and clearly reduced bone density, as well as signs of tubular dysfunction. He was given the diagnosis idiopathic osteoporosis. His moderately raised bone lead concentration (about 20 micrograms.g wet weight-1; normal level in Sweden 4 micrograms.g-1) can only partly explain the raised B-Pb, remaining for years after the cessation of exposure. Instead, the main explanation is probably the increased skeletal turnover. CONCLUSIONS: A combination of a moderately increased bone lead pool and skeletal disease seems to increase the risk for lead poisoning.

Adult↗
PubMed1995

Cancer incidence and mortality of patients with suspected solvent-related disorders.

OBJECTIVE: The aim of this study was to study the incidence of cancer and deaths from cancer and other diseases among patients referred to the 11 clinics of occupational medicine in Sweden between 1967 and 1987 for examination because of exposure to organic solvents. METHODS: The cohort comprised 5791 persons, 5283 men and 508 women. Information about cancer incidence and causes of death was collected from the Cancer Register of the National Board of Health and Welfare and the National Death Register of Statistics Sweden, respectively. The expected values were calculated from the national death rates and incidence rates of cancer. RESULTS: The overall mortality rate was close to expected, but the mortality rate was decreased for diseases of the circulatory system [standardized mortality ratio (SMR) 0.7, 95% confidence limit (95% CI) 0.5-0.9] and increased for suicide (SMR 2.0, 95% CI 1.2-3.2). The total cancer incidence was slightly elevated [standardized incidence ratio (SIR) 1.2, 95% CI 0.99-1.4], and some specific cancer sites showed an increased incidence, although the lower confidence limits surpassed one. Malignancies of the lymphohematopoietic system and cancer of the uterine cervix had an increased risk (SIR 1.9, 95% CI 1.2-3.2, and SIR 3.7, 95% CI 2.2-6.2, respectively). Patients with presumerably high solvent exposure had an SIR of 1.4 for all malignancies (95% CI 0.9-2.1) and those with presumerably low exposure had an SIR of 1.1 (95% CI 0.9-1.4). CONCLUSIONS: The study showed an increased risk for malignancies of the hematopoietic system and the uterine cervix among patients originally examined with regard to solvent-induced disorders. There was also an increased risk of suicide and a decreased risk of death from diseases of the circulatory system. There was no increased risk for deaths from mental or neurological disorders.

Adult↗
PubMed1994

Occupational exposure to water-based paints and self-reported asthma, lower airway symptoms, bronchial hyperresponsiveness, and lung function.

The associations between occupational exposure to water-based paints and the prevalence of self-reported asthma, other lower airway symptoms, bronchial hyperresponsiveness (BHR), and lung function were studied in house painters. Symptom prevalences were obtained from a self-administered questionnaire sent to 415 male painters during 1989-1992. Clinical investigations were carried out in three selected groups: 23 painters with asthmatic symptoms, nine painters with other lower airway symptoms, and 12 painters without airway symptoms. The clinical studies included lung function test, methacholine provocation test, and occurrence of atopy, confirmed by skin prick test to common allergens. In addition, a group of 18 young male painters with no occupational exposure to solvent-based paints were followed with dynamic spirometry before and after a workshift, when only water-based paints were used. The prevalence of self-reported asthma (7%) was somewhat, but not statistically, increased compared to an industrial population without exposure to water-based paints or other airway irritants. A decrease in FEV1 and FVC during the workday was observed in the young painters. In the clinical studies the painters exhibited increased BHR compared to the referents and a decreased FEV1. The number of years working as a painter was related to a decrease in FEV1, which was most pronounced in subjects with atopy who also reported lower airway symptoms in relation to the degree of work with water-based paints, but not to the degree of use of solvent-based paints. Our results indicate that house painters have an increased risk of airway problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Occupational exposure to water based paint and symptoms from the skin and eyes.

Water based paints contain organic solvents and many additives, such as biocides, surfactants, pigments, binders, amines, and monomers. The chemical complexity may introduce new potential health hazards to house painters, in particular irritative and allergic disorders. This study was performed to compare how house painters experience work with water based paints or solvent based paints, and to evaluate whether exposure to water based paints increases mucous membrane and dermal symptoms among house painters. 255 male house painters aged 20 to 65 were invited to participate in the study. Controls were two industrial populations, in total 302 men, without exposure to water based paints. Self administered questionnaires were used to assess the painter's experiences of working with different types of paints and the occurrence of symptoms in the exposed and unexposed groups. Hygiene measurements were performed during normal working days when only water based paints and no solvent based paints were used. The painters were exposed to low concentrations of dust, metals, ammonia, formaldehyde, and volatile organic compounds. The work environment was considered better when working with water based paints than with solvent based paints. There were more complaints of frequent urination when working with water based paint. Taste or olfactory disturbances were less common. General as well as work related eye and skin irritation was more common among the exposed workers. For other symptoms no significant differences were found. The study indicates that the introduction of water based paints has improved the work environment for house painters. Water based paints cause less discomfort and airway irritation than the earlier solvent based paints. Adverse general health effects seem low. Some of the painters may have dermal symptoms caused by the components in water based paints.

Adult↗
PubMed1993

High exposures to organic solvents among graffiti removers.

The exposure to organic solvents among 12 graffiti removers was studied. Health effects were also assessed by structured interview and a symptom questionnaire. Blood and urine samples were collected at the end of the day of air sampling. The concentrations of dichloromethane, glycol ethers, trimethylbenzenes and N-methyl-2-pyrrolidinone in the breathing zone of each worker were measured during one working day. The 8-h time-weighted average exposure to dichloromethane ranged from 18 to 1200 mg/m3. The Swedish Permissible Exposure Limit value for dichloromethane is 120 mg/m3. The air concentrations of glycol ethers, trimethylbenzenes and N-methyl-2-pyrrolidinone were low or not detectable. No exposure-related deviations in the serum concentrations of creatinine, aspartate transaminase, alanine transaminase, gamma-glutamyl transpeptidase or hyaluronan or the urine concentrations of alpha 1-microglobulin, beta 2-microglobulin or N-acetyl-beta-glucosaminidase were found. Irritative symptoms of the eyes and upper respiratory tract were more prevalent than in the general population. This study demonstrates that old knowledge about work hazards is not automatically transferred to new professions. Another aspect is that the public is also exposed as the job is performed during daytime in underground stations. At least for short periods, bystanders may be exposed to high concentrations of organic solvent vapours. People with predisposing conditions, e.g. asthmatics, may risk adverse reactions.

Adolescent↗
PubMed1993

Occupational exposure to organic solvents as a cause of sleep apnoea.

A high prevalence of sleep apnoea was found in a group of men occupationally exposed to organic solvents. Workers with long term exposure to organic solvents often report symptoms such as fatigue, forgetfulness, and concentration difficulties. These symptoms are strikingly similar to those reported by patients with obstructive sleep apnoea syndrome (OSAS). This is a frequently diagnosed disorder characterised by disturbed sleep causing psychic or somatic complications and daytime sleepiness. A study was undertaken to evaluate whether people with long term occupational exposure to organic solvents have a higher prevalence of sleep apnoea than the general population. Patients exposed to solvents (66 men) were invited to participate in a screening for sleep apnoea. A static charge sensitive bed was used for the monitoring of respiration movements and pulse oximetry during one night. A classical sleep apnoea was diagnosed if periodic respiration movement exceeded 45% of estimated sleep time and the oxygen desaturation index exceeded 6. The prevalence of sleep apnoea among the men exposed to solvents was compared with the prevalence in the general population (1.4%). The prevalence among the participating exposed men was 19.7% which gave a conservative relative risk estimate of 14.1 (95% confidence interval (95% CI) 7.5-24.2). The results indicate that exposure to organic solvents causes sleep apnoea. An alternative possibility is that people with sleep apnoea are misdiagnosed as cases of solvent induced toxic encephalopathy. The interpretation has importance for the caring of the patient.

Age Factors↗
PubMed1993

Exposure dependent increase in DNA single strand breaks in leucocytes from workers exposed to low concentrations of styrene.

Single strand breaks in DNA were monitored in leucocytes from 17 men occupationally exposed to styrene. Personal air monitoring was carried out during one workday with two diffusion samplers and a portable photoionisation detector placed in the breathing zone. Exposure to styrene was also monitored by analysing styrene in blood and urine and mandelic acid in urine. Single strand breaks were measured in leucocytes by the alkaline elution technique. The biological samples were collected before a shift, at the end of a shift, and the next morning, before the next shift. An exposure dependent increase in single strand breaks was seen at the end of a shift but not before a shift or the next morning. Linear regression analysis indicated that the amount of DNA damage was roughly doubled after eight hours of exposure to 18 ppm styrene or at a urine concentration of 240 mg mandelic acid/g creatinine compared with the damage in non-exposed men. This study indicates that monitoring of single strand breaks with the alkaline elution technique may be a sensitive marker of genotoxic effects. To our knowledge, this is the first time that such a marker has been shown to correlate with exposure to less than 20 ppm styrene.

Adult↗
PubMed1993

Mortality and incidence of cancer among sewage workers: a retrospective cohort study.

To study the incidence of and mortality from cancer among sewage workers a retrospective analysis was performed on a cohort of 656 men employed for at least one year at any one of 17 Swedish sewage plants during the years 1965-86. Assessment of exposure was done by classification of work tasks. Lower than expected total mortality (standardised mortality ratio (SMR) = 0.75, 95% confidence interval (95% CI) 0.58-0.97) and cardiovascular mortality (SMR = 0.61, 95% CI 0.39-0.91) was found. This was interpreted as a result of the healthy worker effect. For all cancers combined the mortality (SMR = 1.08, 95% CI 0.68-1.67) and morbidity (SMR = 1.02, 95% CI 0.72-1.38) were comparable with those of the general population. There were increased incidences for brain tumours (SMR = 2.19, 95% CI 0.45-6.39), gastric cancers (SMR = 2.73, 95% CI, 1.00-5.94), and renal cancers (SMR = 1.68, 95% CI = 0.35-4.90). For lung cancer the risk was reduced (SMR = 0.70, 95% CI 0.15-2.05). Allowance for a latency period of 10 years from the start of exposure did not change the pattern. Logistic modelling was used to search for exposure-response relations. In a logistic model with the confounder age forced in, renal cancer had a significant positive relation with a weighted sum of employment times, where the weights describe the classification of exposure. No exposure-response relations were found for brain tumors or gastric cancers. The increased risks are based on small numbers of cases. A future follow up will add more conclusive power to the study. Specific exposures need to be identified to allow for a better dose-response analysis.

Cause of Death↗
PubMed1993

Increase in neuropsychiatric symptoms after occupational exposure to low levels of styrene.

The results of this study suggest that exposure to styrene below the current Swedish permissible exposure limit of 20 ppm induces neurotoxic effects expressed as an increased number of neuropsychiatric symptoms. Twenty men exposed to styrene at a plastics factory participated. The reference group included 20 non-exposed men matched for age, working schedule, and physical work load. Exposure to styrene during one workday was assessed by personal air monitoring and biological monitoring. To evaluate the physical work load the pulse(heart) rate was measured. One week before the study each man completed a neuropsychiatric symptom questionnaire containing 16 items. Also 17 questions regarding acute symptoms of local irritation and symptoms of the central nervous system were presented after the psychometric tests were performed. The tests were simple reaction time, colour word vigilance, and symbol digit. A follow up with regard to the symptoms among the exposed men was done after their summer vacation, about two to five weeks after their last exposure. The mean eight hour time weighted average (TWA) concentration of styrene in air, measured by passive dosimetry was 8.6 ppm (range 0.04-50.4 ppm). The exposed men had significantly more symptoms than the referents although there were no significant differences for the psychometric tests. At the follow up the exposed men reported fewer symptoms. This study indicates that symptoms are earlier indicators of adverse effects than complex tests and underlines the importance of regular follow up of people exposed to styrene (and probably organic solvents in general).

Acute Disease↗
PubMed1993

Renal function impairment in workers previously exposed to cadmium.

Cadmium-induced renal effects were followed (1989) in 16 workers previously exposed to cadmium, who had been shown 5 years earlier to have had tubular damage; all but 1 worker had persistent tubular damage (beta 2-microglobulin > 60 micrograms/mmol creatinine). The mean glomerular filtration rate (GFR) decreased from 77.3 to 71.7 ml/min/1.73 m2, which is 2.0 ml/min more than would have been expected from aging only. There was a negative correlation between loss of tubular function (relative clearance of beta 2-microglobulin) and the ratio of observed versus reference GFRs in accordance with a 1984 study. The results confirm that cadmium-induced tubular damage is irreversible. They also suggest that the glomerular dysfunction after cadmium exposure is irreversible and progressive also after exposure stops. A nonsignificant correlation was found between cumulative cadmium exposure and decreased GFR.

Adult↗
PubMed1991

Environmental, occupational, and personal factors related to the prevalence of sick building syndrome in the general population.

Possible relations between prevalence of sick building syndrome (SBS) and environmental, occupational, and personal factors were studied in a random sample (0.1%) of the general population aged 20-65 in a three county region in middle Sweden. Childhood exposure to environmental tobacco smoke from smoking mothers and a childhood in urban areas was related to SBS symptoms. Current urban residency, fresh paint, and preschool children in the dwelling were also related to symptoms. Other residential factors such as age of building, type of building, degree of crowding, mechanical ventilation, or signs of moisture or mould growth were not related to symptoms. Other factors related to symptoms were history of atopy, allergy to nickel, proneness to infection, hyperreactivity, static electricity, work with video display units (VDU), work satisfaction, and climate of cooperation at work. Age, sex, marital state, education level, work stress, obesity, current or earlier smoking, regular physical exercise, or occupational exposure to chemicals did not correlate with symptoms. Women had a higher proportion of symptoms than men but these differences were not significant when adjusting for differences in allergy to nickel, hyperreactivity, and proneness to infection. Maternal smoking was related to a twofold increase of both atopy and allergy to nickel in the adult offspring. Eye symptoms were most common in administrative, managerial, and service work. Airway symptoms were most common in transport and communication work. Dermal symptoms were most common in professional and technical and related work. General symptoms were most common in service, health, hospital, and social work. The lowest prevalence of symptoms was found in agricultural, forestry, and sales work. Women and subjects allergic to nickel worked more often in occupations without exposure to chemicals, but no evidence was found for selection mechanisms causing sensitive persons to move from exposed to unexposed occupations. It was concluded that symptoms included in SBS are common in the general population, and of multifactorial origin related to both personal, occupational, and residential factors, and certain environmental exposures such as maternal smoking, the urban environment, VDU work, and volatile organic hydrocarbons from newly painted dwellings.

Adult↗
PubMed1990

Volatile organic compounds, respirable dust, and personal factors related to prevalence and incidence of sick building syndrome in primary schools.

Possible relations between incidence and prevalence of sick building syndrome (SBS), indoor exposures, and personal factors were studied in a four year longitudinal study among personnel (n = 129) in six primary schools. The mean concentration of carbon dioxide was above the recommended value of 0.08 microliter/l (800 ppm) in all schools, indicating a poor outdoor air supply. Indoor concentration of volatile hydrocarbon (VOC) was enhanced at high room temperatures. Respirable dust, but not concentration of VOC was enhanced at lower ventilation rates and high air humidity. Chronic SBS was related to VOC, previous wall to wall carpeting in the schools, hyper-reactivity, and psychosocial factors. Incidence of new SBS was related to concentration of respirable dust, current smoking, and the psychosocial climate. Remission of hyperreactivity, decrease in sick leave owing to airway illness, removal of carpeting in the schools, and moving from new to old dwellings resulted in a decrease in SBS score. It is concluded that SBS is of multifactorial origin, related to a variety of factors and exposures. The total concentration of hydrocarbons is a simple and convenient measure of exposure, which also seems to be a predictor of chronic symptoms. Further investigations on the effect of temperature, ventilation, and air humidity on SBS should consider how these factors may influence the chemical composition of the air. Because poor air quality in schools could also affect the children, it may have implications for the state of health of a large proportion of the population.

Carbon Dioxide↗
PubMed1990

Long-term follow up of workers exposed to solvents.

Long term occupational exposure to organic solvents may cause adverse effects to the central nervous system. This collaborative study between six Swedish departments of occupational medicine examines the overall prognosis in terms of working capacity, symptoms, and psychometric test performance for individuals occupationally exposed to organic solvents. After re-analyses of the data from an initial clinical investigation of 111 men, the subjects were divided into two subgroups: one group of 65 with symptoms but no impairment on the tests and one group of 46 with toxic encephalopathy (symptoms and test impairment). At least five years after the initial examination the subjects were asked to attend a re-examination that included a structured medical interview and a psychometric investigation. The results indicate that effects on the central nervous system persist even when exposure has ceased. In the group of 46 more men had stopped working and were receiving sickness or early retirement pensions. This group also had reduced activity levels with regard to everyday life, leisure activities, and education or training and more neuropsychiatric symptoms. There was no support for the view that a solvent induced toxic encephalopathy is a progressive disease comparable with presenile dementia such as Alzheimer's disease or Pick's disease. If a worker was removed from exposure when he presented symptoms without signs of impairment in intellectual function recovery was seen in most cases.

Aged↗
PubMed1990

Cardiac arrhythmia in refrigerator repairmen exposed to fluorocarbons.

A field study of 89 refrigerator repairmen was carried out to ascertain whether occupational exposure to fluorocarbons induces cardiac arrhythmia. The concentrations of fluorocarbons in the breathing zones and the heart activity were recorded simultaneously. Most cooling systems contained FC 12 or FC 22. The highest level recorded in one minute was 14,000 ppm and the highest time weighted level during eight hours was 280 ppm. Two types of arrhythmia were recorded, ectopic beats and sudden bradycardia. A within subject comparison design was applied and the main parameter was the difference in arrhythmia frequencies between exposed and unexposed periods. No appreciable differences between exposed and unexposed periods and no consistent dose effect relations were observed, although subjects in the medium exposure category showed a difference of borderline significance (Wilcoxon's test: p = 0.05, one tailed). The frequencies of arrhythmia when unexposed were somewhat higher than previously reported. Misclassification of the exposure and the possible confounding effect of physical workload and psychological strain may have obscured a causal relation and therefore a minor effect cannot be ruled out. The results do not support the notion that fluorocarbons induce cardiac arrhythmia in occupationally exposed refrigerator repairmen.

Adult↗