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Biomedical subjects

Robert F Herrick

Publications and source records attributed to Robert F Herrick.

At least 19 recordsLinked to original sources

Personal coronary risk profiles modify autonomic nervous system responses to air pollution.

OBJECTIVE: We investigated whether PM2.5-mediated autonomic modulation depends on individual coronary risk profiles. METHODS: Five-minute average heart rate (HR) and heart rate variability (HRV, including standard deviation of normal-to-normal intervals [SDNN], square root of the mean squared differences of successive NN intervals [rMSSD], high frequency [HF]) were measured from 24-hour ambulatory electrocardiograms, and personal PM(2.5) exposures were monitored in a prospective study of 10 male boilermakers (aged 34.3 +/- 8.1 years). We used the Framingham score to classify individuals into low (score = 1-3) and high (score = 5-6) risk categories. Mixed-effect models were used for statistical analyses. RESULTS: Each 1-mg/m(3) increase in the preceding 4-hour moving average PM(2.5) was associated with HR increase (5.3 beats/min) and HRV reduction (11.7%, confidence interval [CI] = 6.2-17.1% for SDNN; 11.1%, CI = 3.1-19.1% for rMSSD; 16.6%, CI = 1.5-31.7% for HF). Greater responses (2- to 4-fold differences) were observed in high-risk subjects than in low-risk subjects. CONCLUSIONS: Our study suggests that adverse autonomic responses to metal particulate are aggravated in workers with higher coronary risk profiles.

Adult↗

Methodologic issues in follow-up studies of cancer incidence among occupational groups in the United States.

PURPOSE: Incidence studies of occupational factors and cancer in the United States are problematic because the use of population-based registries to identify cases requires development of historical data on subjects' residences and often severely restricts the time period of follow up. This article describes procedures for addressing these challenges. METHODS: We used data from studies of cancer incidence and mortality among microelectronics industry employees to assess various methods for developing residential histories and the relative informativeness of the two studies. RESULTS: We developed residential histories for 98% of 99,229 mortality study subjects. Analyses making alternative assumptions about residential histories yielded standardized incidence ratios varying by at most 6%. Use of postemployment residential histories increased person-years by up to 62% and increased the observed number of cancers by up to 28%. The proportion of mortality study person-years included in the cancer incidence study ranged from 40% to 77% among work activity subcohorts. The number of observed cancer cases in the incidence study was 60% higher than the number of observed cancer deaths in the mortality study. CONCLUSIONS: Assumptions about residential history had little impact on validity. Use of information sources with national coverage to develop residential histories increased the incidence study's precision. Despite geographic and temporal restrictions, incidence studies provide more data than mortality studies on cancers with good survival. However, the potential for selection bias in incidence studies may vary considerably among subcohorts, indicating the need for cautious interpretation of such research.

Adult↗

Temporal variability of urinary levels of nonpersistent insecticides in adult men.

Widespread application of contemporary-use insecticides results in low-level exposure for a majority of the population through a variety of pathways. Urinary insecticide biomarkers account for all exposure pathways, but failure to account for temporal within-subject variability of urinary levels can lead to exposure misclassification. To examine temporal variability in urinary markers of contemporary-use insecticides, nine repeated urine samples were collected over 3 months from 10 men participating in an ongoing study of male reproductive health. These 90 samples were analyzed for urinary metabolites of chlorpyrifos (3,5,6-trichloro-2-pyridinol (TCPY)) and carbaryl (1-naphthol (1N)). Volume- based (unadjusted), as well as creatinine (CRE)- and specific gravity (SG)-adjusted concentrations were measured. TCPY had low reliability with an intraclass correlation coefficient between 0.15 and 0.21, while 1N was moderately reliable with an intraclass correlation coefficient between 0.55 and 0.61. When the 10 men were divided into tertiles based on 3-month geometric mean TCPY and 1N levels, a single urine sample performed adequately in classifying a subject into the highest or lowest exposure tertiles. Sensitivity and specificity ranged from 0.44 to 0.84 for TCPY and from 0.56 to 0.89 for 1N. Some differences in the results between unadjusted metabolite concentrations and concentrations adjusted for CRE and SG were observed. Questionnaires were used to assess diet in the 24 h preceding the collection of each urine sample. In mixed-effects models, TCPY was significantly associated with season as well as with consuming grapes and cheese, while 1N levels were associated with consuming strawberries. In conclusion, although a single sample adequately predicted longer-term average exposure, a second sample collected at least 1 month following the first sample would reduce exposure measurement error.

Adult↗

Exposure to fuel-oil ash and welding emissions during the overhaul of an oil-fired boiler.

The health effects of exposure to vanadium in fuel-oil ash are not well described at levels ranging from 10 to 500 microg/m(3). As part of a larger occupational epidemiologic study that assessed these effects during the overhaul of a large oil-fired boiler, this study was designed to quantify boilermakers' exposures to fuel-oil ash particles, metals, and welding gases, and to identify determinants of these exposures. Personal exposure measurements were conducted on 18 boilermakers and 11 utility workers (referents) before and during a 3-week overhaul. Ash particles < 10 microm in diameter (PM(10), mg/m(3)) were sampled over full work shifts using a one-stage personal size selective sampler containing a polytetrafluoroethylene filter. Filters were digested using the Parr bomb method and analyzed for the metals vanadium (V), nickel (Ni), iron (Fe), chromium (Cr), cadmium (Cd), lead (Pb), manganese (Mn), and arsenic (As) by inductively coupled plasma mass spectrometry. Nitrogen dioxide (NO(2)) was measured with an Ogawa passive badge-type sampler and ozone (O(3)) with a personal active pump sampler.Time-weighted average (TWA) exposures were significantly higher (p < 0.05) for boilermakers than for utility workers for PM(10) (geometric mean: 0.47 vs. 0.13 mg/m(3)), V (8.9 vs. 1.4 microg/m(3)), Ni (7.4 vs. 1.8 microg/m(3)) and Fe (56.2 vs. 11.2 microg/m(3)). Exposures were affected by overhaul time periods, tasks, and work locations. No significant increases were found for O(3) or NO(2) for boilermakers or utility workers regardless of overhaul period or task group. Fuel-oil ash was a major contributor to boilermakers' exposure to PM(10) and metals. Vanadium concentrations sometimes exceeded the 2003 American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit value.

Adult↗

Estimation of personal exposures to particulate matter and metals in boiler overhaul work.

OBJECTIVE: We sought to develop an algorithm and estimate unmeasured exposures to particulate matter (PM) and metals in an epidemiologic study of boilermakers. METHODS: The algorithm was based on limited measurements and workers' task and time activity patterns. Half of the measurements were used to develop exposure estimates for unmeasured person days. The other half was used for method validation. RESULTS: The validation demonstrated good approximations of actual exposures with differences less than 5% for PM and vanadium (V). Average estimated exposures to PM (mg/m3) and V (microg/m3) were significantly higher for workers doing boiler repair than utility work (0.36 vs. 0.09 for PM and 5.99 vs. 0.38 for V). CONCLUSIONS: This algorithm provided reasonably accurate exposure indices for our epidemiologic study in this population. It also is likely applicable to similar exposure scenarios in other studies.

Air Pollutants, Occupational↗

Exposure assessment for retrospective follow-up studies of semiconductor- and storage device-manufacturing workers.

OBJECTIVE: This exposure assessment was conducted in the first large study of mortality and cancer incidence in semiconductor and storage device manufacturing. METHODS: Unique combinations of division, department and job codes and names (DDJ) from work history records were assigned to work groups and exposure categories. Agent exposure matrices assessed differences in potential exposures between groups. Changes in exposure over time were tracked by dividing the production history into manufacturing eras. RESULTS: Nineteen work groups were developed to capture 310,351 unique DDJs from 1965-1999. Agent exposure matrices contrasted exposure potential to solvents, metals, and work in cleanrooms between groups, and three manufacturing eras were identified for each site. CONCLUSIONS: The work groups, manufacturing eras and agent matrices have been used to classify workers in the study of cancer incidence and mortality.

Computer Storage Devices↗

Urinary levels of insecticide metabolites and DNA damage in human sperm.

BACKGROUND: Members of the general population are exposed to non-persistent insecticides at low levels. The present study explored whether environmental exposures to carbaryl and chlorpyrifos are associated with DNA damage in human sperm. METHODS: Subjects (n=260) were recruited through a Massachusetts infertility clinic. Individual exposures were measured as spot urinary metabolite concentrations of chlorpyrifos [3,5,6-trichloro-2-pyridinol (TCPY)] and carbaryl [1-naphthol (1N)], adjusted using specific gravity. Sperm DNA integrity was assessed by neutral comet assay and reported as comet extent, percentage DNA in comet tail (Tail%) and tail distributed moment (TDM). RESULTS: A statistically significant increase in Tail% was found for an interquartile range (IQR) increase in both 1N [coefficient=4.1; 95% confidence interval (CI) 1.9-6.3] and TCPY (2.8; 0.9-4.6), while a decrease in TDM was associated with IQR changes in 1N (-2.2; -4.9 to 0.5) and TCPY (-2.5; -4.7 to -0.2). A negative correlation between Tail% and TDM was present only when stratified by comet extent, suggesting that Tail% and TDM may measure different types of DNA damage within comet extent strata. CONCLUSIONS: Environmental exposure to carbaryl and chlorpyrifos may be associated with increased DNA damage in human sperm, as indicated by a change in comet assay parameters.

Adult↗

Glove use and the relative risk of acute hand injury: a case-crossover study.

The purpose of this study was to investigate the relationship between glove use and acute traumatic occupational hand injury. We used a case-crossover, within-subject study design to control for differences between individuals such as occupation, injury history, age, gender, risk-taking behavior, manual dexterity, and muscle strength. A total of 1166 hand-injured workers were interviewed regarding the use of gloves at the time of the injury. The self-reported average duration of glove use in the previous work month was the measure of expected exposure to wearing gloves. Nineteen percent of subjects reported wearing gloves at the time of the injury. The expected exposure to glove use in the past work month was 27.9%. Glove use was associated with a lower risk of lacerations and punctures but not crush, fractures, avulsions, amputations, dislocations; the risk of the former two injury types was estimated to be 60-70% lower while wearing gloves. Glove use is only one component of a comprehensive hand injury prevention approach that might include the identification and elimination of sharp hazards, engineering controls, safety warnings, training in high-risk situation awareness, and proper selection and timing of glove use.

Acute Disease↗

Laboratory evaluation of a potential diesel fuel interference in the determination of polycyclic aromatic compounds on dermal samplers.

Road pavers are exposed to asphalt fumes through dermal contact, inhalation, or ingestion. These fumes contain polycyclic aromatic compounds (PACs), a class of compounds including polycyclic aromatic hydrocarbons (PAHs). The PAHs include compounds such as pyrene and benzo(a)pyrene and a large number of other compounds of known or suspected carcinogenicity. To estimate dermal deposition of asphalt fume particulate matter, polypropylene sampling patches can be worn on a worker's inside wrist. Diesel fuel used for cleaning can splash onto the dermal sampler. Exposed dermal patches were solvent extracted and PACs estimated in the extract using a modification of NIOSH Method 5800. The final solution was analyzed by high pressure liquid chromatography (HPLC) with a fluorescence detector using an excitation wavelength of 270 nanometers and an emission wavelength of 415 nanometers. The PACs were concentrated on a C-18 reverse phase guard column but not separated so that they could be measured expediently as a group. In this study we examined whether deposited diesel fuel interferes with the HPLC determination of PACs. We characterized the effect of diesel fuel contamination over broad ranges of both analyte and interferent. Two drops, or approximately 100 microL, of diesel fuel on the dermal samplers caused an overestimation of the concentration of polycyclic aromatic compounds (PACs). In the range of PACs determined in our field study (0 to 54 microg per sample), these errors could have exceeded 100%. Because 100 microL of deposited diesel fuel produced a clear visual "wetness," this observation can serve as one of the criteria for sample rejection. Sampling media must be examined carefully for visible contamination to prevent bias in the measurement of PACs deposited from asphalt fume.

Air Pollutants, Occupational↗

Comparison of fine particle measurements from a direct-reading instrument and a gravimetric sampling method.

Particulate air pollution, specifically the fine particle fraction (PM2.5), has been associated with increased cardiopulmonary morbidity and mortality in general population studies. Occupational exposure to fine particulate matter can exceed ambient levels by a large factor. Due to increased interest in the health effects of particulate matter, many particle sampling methods have been developed In this study, two such measurement methods were used simultaneously and compared. PM2.5 was sampled using a filter-based gravimetric sampling method and a direct-reading instrument, the TSI Inc. model 8520 DUSTTRAK aerosol monitor. Both sampling methods were used to determine the PM2.5 exposure in a group of boilermakers exposed to welding fumes and residual fuel oil ash. The geometric mean PM2.5 concentration was 0.30 mg/m3 (GSD 3.25) and 0.31 mg/m3 (GSD 2.90)from the DUSTTRAK and gravimetric method, respectively. The Spearman rank correlation coefficient for the gravimetric and DUSTTRAK PM2.5 concentrations was 0.68. Linear regression models indicated that log, DUSTTRAK PM2.5 concentrations significantly predicted loge gravimetric PM2.5 concentrations (p < 0.01). The association between log(e) DUSTTRAK and log, gravimetric PM2.5 concentrations was found to be modified by surrogate measures for seasonal variation and type of aerosol. PM2.5 measurements from the DUSTTRAK are well correlated and highly predictive of measurements from the gravimetric sampling method for the aerosols in these work environments. However, results from this study suggest that aerosol particle characteristics may affect the relationship between the gravimetric and DUSTTRAK PM2.5 measurements. Recalibration of the DUSTTRAK for the specific aerosol, as recommended by the manufacturer, may be necessary to produce valid measures of airborne particulate matter.

Aerosols↗

An unrecognized source of PCB contamination in schools and other buildings.

An investigation of 24 buildings in the Greater Boston Area revealed that one-third (8 of 24) contained caulking materials with polychlorinated biphenyl (PCB) content exceeding 50 ppm by weight, which is the U.S. Environmental Protection Agency (U.S. EPA) specified limit above which this material is considered to be PCB bulk product waste. These buildings included schools and other public buildings. In a university building where similar levels of PCB were found in caulking material, PCB levels in indoor air ranged from 111 to 393 ng/m3; and in dust taken from the building ventilation system, < 1 ppm to 81 ppm. In this building, the U.S. EPA mandated requirements for the removal and disposal of the PCB bulk product waste as well as for confirmatory sampling to ensure that the interior and exterior of the building were decontaminated. Although U.S. EPA regulations under the Toxic Substances Control Act stipulate procedures by which PCB-contaminated materials must be handled and disposed, the regulations apparently do not require that materials such as caulking be tested to determine its PCB content. This limited investigation strongly suggests that were this testing done, many buildings would be found to contain high levels of PCBs in the building materials and potentially in the building environment. The presence of PCBs in schools is of particular concern given evidence suggesting that PCBs are developmental toxins.

Boston↗

The relationship of urinary metabolites of carbaryl/naphthalene and chlorpyrifos with human semen quality.

Most of the general population is exposed to carbaryl and other contemporary-use insecticides at low levels. Studies of laboratory animals, in addition to limited human data, show an association between carbaryl exposure and decreased semen quality. In the present study we explored whether environmental exposures to 1-naphthol (1N), a metabolite of carbaryl and naphthalene, and 3,5,6-trichloro-2-pyridinol (TCPY), a metabolite of chlorpyrifos and chlorpyrifos-methyl, are associated with decreased semen quality in humans. Subjects (n=272) were recruited through a Massachusetts infertility clinic. Individual exposures were measured as spot urinary concentrations of 1N and TCPY adjusted using specific gravity. Semen quality was assessed as sperm concentration, percent motile sperm, and percent sperm with normal morphology, along with sperm motion parameters (straight-line velocity, curvilinear velocity, and linearity). Median TCPY and 1N concentrations were 3.22 and 3.19microg/L, respectively. For increasing 1N tertiles, adjusted odds ratios (ORs) were significantly elevated for below-reference sperm concentration (OR for low, medium, and high tertiles = 1.0, 4.2, 4.2, respectively; p-value for trend =0.01) and percent motile sperm (1.0, 2.5, 2.4; p-value for trend = 0.01). The sperm motion parameter most strongly associated with 1N was straight-line velocity. There were suggestive, borderline-significant associations for TCPY with sperm concentration and motility, whereas sperm morphology was weakly and nonsignificantly associated with both TCPY and 1N. The observed associations between altered semen quality and 1N are consistent with previous studies of carbaryl exposure, although suggestive associations with TCPY are difficult to interpret because human and animal data are currently limited.

Adult↗

Association of expired nitric oxide with urinary metal concentrations in boilermakers exposed to residual oil fly ash.

BACKGROUND: Exposure to metal-containing particulate matter has been associated with adverse pulmonary responses. Metals in particulate matter are soluble, hence are readily recovered in urine of exposed individuals. This study investigated the association between urinary metal concentrations and the fractional concentration of expired nitric oxide (F(E)NO) in boilermakers (N = 32) exposed to residual oil fly ash (ROFA). METHODS: Subjects were monitored at a boiler overhaul site located in the New England area, USA. F(E)NO and urine samples were collected pre- and post-workshift for 5 consecutive workdays. Metals investigated included vanadium (V), chromium (Cr), manganese (Mn), nickel (Ni), copper (Cu), and lead (Pb). RESULTS: The median F(E)NO was 7.5 ppb (95% CI: 7.4-8.0), and the median creatinine-adjusted urinary metal concentrations (mug/g creatinine) were: vanadium, 1.37; chromium, 0.48; manganese, 0.30; nickel, 1.52; copper, 3.70; and lead, 2.32. Linear mixed-effects models indicated significant inverse exposure-response relationships between log F(E)NO and the log-transformed urinary concentrations of vanadium, manganese, nickel, copper, and lead at several lag times, after adjusting for smoking status. CONCLUSIONS: Urine samples may be utilized as a biomarker of occupational metal exposure. The inverse association between F(E)NO and urinary metal concentrations suggests that exposure to metals in particulate matter may have an adverse effect on respiratory health.

Adolescent↗

The association of expired nitric oxide with occupational particulate metal exposure.

Toxicologic studies have shown that soluble transition metals in residual oil fly ash (ROFA) can induce pulmonary injury. In this study, we investigated the association between the fractional concentration of expired nitric oxide (FENO) and exposure to metal constituents of particulate matter with an aerodynamic mass median diameter < or =2.5 microm (PM2.5) in boilermakers exposed to ROFA and metal fume. Metals investigated included vanadium, chromium, manganese, nickel, copper, and lead. Subjects were monitored for 5 consecutive days during boiler repair overhauls in 1999 (n=20) and 2000 (n=14). In 1999, we found a significant inverse association between log-transformed FENO and PM2.5 metal concentrations. LogFENO changed by -0.03 (95% CI: -0.04, -0.01), -0.56 (95% CI: -0.88, -0.24), -0.09 (95% CI: -0.16, -0.02), and -0.04 (95% CI: -0.07, -0.02) per microg/m3 of PM2.5 vanadium, chromium, manganese, and nickel, respectively. In 2000, no significant associations were observed, most likely due to exposure misclassification resulting from the use of respirators. The inverse association between PM2.5 metal exposure and FENO in subjects with limited respirator usage suggests that soluble transition metals might be partially responsible for the adverse pulmonary responses seen in workers exposed to ROFA.

Adolescent↗

Excessive exposure to silica in the US construction industry.

Exposures to respirable dust and silica were investigated among 36 construction sites in the USA. Personal measurements (n = 151) were analyzed from 80 workers in four trades, namely bricklayers, painters (while abrasive blasting), operating engineers and laborers. Painters had the highest exposures (median values for respirable dust and silica: 13.5 and 1.28 mg/m(3), respectively), followed by laborers (2.46 and 0.350 mg/m(3)), bricklayers (2.13 and 3.20 mg/m(3)) and operating engineers (0.720 and 0.075 mg/m(3)). Mixed models were fitted to the log-transformed air levels to estimate the means and within- and between-worker variance components of the distributions in each trade. We refer to the likelihood that a typical worker from a given trade would be exposed, on average, above the occupational exposure limit (OEL) as the probability of overexposure. Given US OELs of 0.05 mg/m(3) for respirable silica and 3 mg/m(3) for respirable dust, we estimated probabilities of overexposure as between 64.5 and 100% for silica and between 8.2 and 89.2% for dust; in no instance could it be inferred with certainty that this probability was <10%. This indicates that silica exposures are grossly unacceptable in the US construction industry. While engineering and administrative interventions are needed to reduce overall air levels, the heterogeneous exposures among members of each trade suggest that controls should focus, in part, upon the individual sites, activities and equipment involved. The effects of current controls and workplace characteristics upon silica exposures were investigated among operating engineers and laborers. Silica exposures were significantly reduced by wet dust suppression (approximately 3-fold for laborers) and use of ventilated cabs (approximately 6-fold for operating engineers) and were significantly increased indoors (about 4-fold for laborers). It is concluded that urgent action is required to reduce silica exposures in the US construction industry.

Algorithms↗

Temporal factors and the prevalence of transient exposures at the time of an occupational traumatic hand injury.

Temporal factors and the prevalence of exposure to transient risk factors for occupational traumatic hand injury were analyzed among 1166 subjects participating in a case-crossover study. Temporal factors included time of injury and elapsed time to injury since the start of the work shift. Transient exposures included work equipment, work practice, and worker-related factors. The highest frequency of injury was observed from 08:00 am to 12:00 pm (54.6%), with a peak from 10:00 to 11:00 am (14.9%). The median time into the work shift for injury was 3.5 hours. Subjects injured 2 to 3 hours into their work shift most often reported using a machine, tool, or work material that performed differently than usual (23.9%). These results suggest that acute hand injuries occur earlier in the workday and safety programs should place increased vigilance on these times.

Accidents, Occupational↗

The relationship between environmental exposures to phthalates and DNA damage in human sperm using the neutral comet assay.

Phthalates are industrial chemicals widely used in many commercial applications. The general population is exposed to phthalates through consumer products as well as through diet and medical treatments. To determine whether environmental levels of phthalates are associated with altered DNA integrity in human sperm, we selected a population without identified sources of exposure to phthalates. One hundred sixty-eight subjects recruited from the Massachusetts General Hospital Andrology Laboratory provided a semen and a urine sample. Eight phthalate metabolites were measured in urine by using high-performance liquid chromatography and tandem mass spectrometry; data were corrected for urine dilution by adjusting for specific gravity. The neutral single-cell microgel electrophoresis assay (comet assay) was used to measure DNA integrity in sperm. VisComet image analysis software was used to measure comet extent, a measure of total comet length (micrometers); percent DNA in tail (tail%), a measure of the proportion of total DNA present in the comet tail; and tail distributed moment (TDM), an integrated measure of length and intensity (micrometers). For an interquartile range increase in specific gravity-adjusted monoethyl phthalate (MEP) level, the comet extent increased significantly by 3.6 micro m [95% confidence interval (95% CI), 0.74-6.47]; the TDM also increased 1.2 micro m (95% CI, -0.05 to 2.38) but was of borderline significance. Monobutyl, monobenzyl, monomethyl, and mono-2-ethylhexyl phthalates were not significantly associated with comet assay parameters. In conclusion, this study represents the first human data to demonstrate that urinary MEP, at environmental levels, is associated with increased DNA damage in sperm.

Adult↗

Association of expired nitric oxide with occupational particulate exposure.

Particulate air pollution has been associated with adverse respiratory health effects. This study assessed the utility of expired nitric oxide to detect acute airway responses to metal-containing fine particulates. Using a repeated-measures study design, we investigated the association between the fractional concentration of expired nitric oxide (F(E)NO) and exposure to particulate matter with an aerodynamic mass median diameter of less than or equal to 2.5 micro m (PM(2.5)) in boilermakers exposed to residual oil fly ash and metal fumes. Subjects were monitored for 5 days during boiler repair overhauls in 1999 (n = 20) or 2000 (n = 14). The Wilcoxon median baseline F(E)NO was 10.6 ppb [95% confidence interval (CI): 9.1, 12.7] in 1999 and 7.4 ppb (95% CI: 6.7, 8.0) in 2000. The Wilcoxon median PM(2.5) 8-hr time-weighted average was 0.56 mg/m(3) (95% CI: 0.37, 0.93) in 1999 and 0.86 mg/m(3) (95% CI: 0.65, 1.07) in 2000. F(E)NO levels during the work week were significantly lower than baseline F(E)NO in 1999 (p < 0.001). A significant inverse exposure-response relationship between log-transformed F(E)NO and the previous workday's PM(2.5) concentration was found in 1999, after adjusting for smoking status, age, and sampling year. With each 1 mg/m(3) incremental increase in PM(2.5) exposure, log F(E)NO decreased by 0.24 (95% CI: -0.38, -0.10) in 1999. The lack of an exposure-response relationship between PM(2.5) exposure and F(E)NO in 2000 could be attributable to exposure misclassification resulting from the use of respirators. In conclusion, occupational exposure to metal-containing fine particulates was associated with significant decreases in F(E)NO in a survey of workers with limited respirator usage.

Adolescent↗