Contact allergy to gold with pharyngeal and laryngeal disorders.
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Biomedical subjects
Publications and source records attributed to I Kilpikari.
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Decreased erythrocyte glutathione s-transferase activity was found in workers exposed to hot rubber fumes in two-roll mill and calender departments (6.6 +/- 0.9 and 6.8 +/- 0.8 mumol/min X mg haemoglobin, respectively vs 8.4 +/- 0.5 in controls). This trend was also noted in the general category of all rubber exposed workers without stratification according to their task (7.6 +/- 0.5, n = 30). This result was contrary to that expected, as the cases with the lowest values had the greatest urinary thioether excretion. The thioethers are the end-products of the enzyme-catalyzed glutathione conjugation reaction aimed at the inactivation of potentially toxic chemicals. Thus, it appears that the assay of erythrocyte glutathione s-transferase activity is not very informative about exposure, although the enzyme assay might disclose other, so far unknown, biological effects of reactive rubber chemicals.
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Spontaneous abortions of hospitalized women and congenital malformations were analyzed among rubber workers to investigate the possibility of an association between reproductive problems and chemical exposures in the rubber industry. Information on workers was obtained from the membership register of the Union of Rubber and Leather Workers and from the personnel register of a rubber factory. The frequencies of spontaneous abortions did not appreciably differ when the pregnancies occurred during Union membership or during employment in the factory as compared with the pregnancies occurring before or after that time. A case-referent study concerning the association between different exposures and spontaneous abortions showed that the odds ratio for factory workers exposed to rubber chemicals was increased in the footwear department. A corresponding risk was not observed in the tire department. The contradictory observations may be explained by concomitant exposure to solvents in the footwear department or by other nonoccupational factors. The possible association between congenital malformations and exposures in the rubber and leather industries was studied by the case-referent technique. No significant increase in the risk of malformations was observed in any branch of employment. However, the numbers of malformations were rather small.
A follow-up study was carried out among workers in the processing and tire and tube fabrication departments of a Finnish rubber plant. A total of 1.331 workers were followed up for cancer through the files of the Finnish Cancer Registry from 1953 to 1976 (11,709 person years). The expected number of cancer cases was calculated on the basis of the age and sex-specific incidence rates for the urban population of the surrounding province. Twenty-one cancer cases were found against 18.9 expected (RR 1.1, 95% confidence interval 0.7-1.7). The risk of cancer of the digestive organs, respiratory organs, and urinary bladder was higher than expected, and the risk increased with the length of the follow-up time. However, the differences were not statistically significant.
The occurrence of occupational contact dermatitis among workers in a rubber factory from 1976 to 1980 was studied. Insurance compensation was paid to 50 workers with dermatitis. 21 of the cases were allergic and 27 toxic contact dermatitis, giving a contact dermatitis frequency of 5.6/1000 workers. Paraphenylenediamine compounds were the main cause of allergic contact dermatitis and solvents the main cause of toxic contact dermatitis.
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Exposure to potentially alkylating in a rubber factory was measured by determining thioether concentrations in urine samples collected at the end of work on a Friday. The study population consisted of the total work force (113) in the production departments of a factory, and office clerks (111) in two factories of the same company. The highest excretion of thioethers was detected in female workers in the belt department who were exposed through the palmar skin. High excretion was also found in workers exposed to air-borne contaminants in the calender department and in workers in the raw material stores and chemical mixing sections. Lower values were found in this dispatching station and in the contaminant-free offices. Urinary thioether determination appears to be a reliable and easy method of assessing the exposure to certain rubber chemicals.
Epidemiological studies have shown that those who work in rubber industry have an increased risk of cancer. In the working environment they are exposed, probably, to several hundred different chemicals some of them being known or suspected carcinogens and mutagens. The bacterial fluctuation test was used to detect the mutagenicity in the urines of exposed workers. A group of unexposed office clerks served as controls. Both groups consisted of smokers and non-smokers, and that was taken into consideration in the results. Rubber workers, either smokers or non-smokers, exhibited significantly higher mutagenic activity in their urine than the occupationally unexposed controls when the base-pair substitution strain E. coli WP2 uvrA was used as indicator organism. Use of the frameshift strain S. typhimurium TA98 revealed increased mutagenicity in the urine of occupationally exposed smokers, nonsmokers and unexposed smokers. The extent of mutagenicity in the urine of workers who smoked suggested a synergistic effect of smoking and occupational exposure. The bacterial fluctuation test with urine samples as sources of mutagenicity is able to detect chemical exposure if the excreted compounds are still in active form or can be activated. The method can be used to identify hazardous working conditions long before the manifestation of possible pathological changes in exposed individuals.
The thiols in the morning urine of 224 employees of a chemical plant were determined after alkaline hydrolysis of all urinary thioethers. The highest thioether excretion was found in rubber workers and radial tyre builders in comparison with clerks, plastic monomer mixers and footwear preparers. Smoking and medication tended to increase thioether excretion. Urinary thioether determination may prove to be a valuable tool in assessing exposure to mixtures of chemicals regardless of the route of absorption.
The deaths of male rubber workers in two processing departments and a tire and tube manufacturing department of a Finnish rubber plant were studied. The number of person-years at risk was 7,049. Follow-up continued for 24 yr, from January 1, 1953 to December 31, 1976. The total number of deaths was 29 compared with 43 expected (relative risk = 0.7). Only 5 deaths from cardiovascular diseases were found vs. 17.9 expected. The relative risk of death from cancer was 1.0 (7/6.8) and 1.7 (5/2.9) for workers who were exposed for more than 10 yr. For other causes of death the relative risk was not dependent on the length of exposure.
Studies of the cancer risk among rubber workers published since 1968 are reviewed. The total material examined comprised 80,000 workers and 4000 cancer deaths. An increased risk of stomach cancer, lung cancer, bladder cancer, and leukemia was found. The increased risk of cancer at a specific anatomic site was correlated with the mode of exposure specific for the working area or division. On the other hand, no clear exposure-risk relationship could be demonstrated. It is likely that there has been an increased risk of cancer since the elimination of alpha- and beta-naphthylamine by 1950. However, the etiologic fraction is less than that due to prevalent exposures increasing the risk of common cancers at specific anatomic sites.