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PubMed2005

Comparison of exposure assessment methods in occupational exposure to benzene in gasoline filling-station attendants.

The aim of this study was to assess gasoline filling-station attendants' exposure to benzene and to determine which biological exposure index (BEI), trans,trans-muconic acid (t,t-MA) or S-phenylmercapturic acid (S-PMA), shows better correlation with environmental exposure. Exposure to benzene was measured using passive samplers (Radiello) attached to the collar of the overalls of subjects (n=33) just before the work-shift (approximately 8h); analysis was performed by GC-FID. S-PMA and t,t-MA were determined, respectively, by an immunochemiluminescent assay based on specific monoclonal antibodies and by HPLC-UV at 264 nm. Both methods of biological monitoring were performed on beginning and end-shift urine samples, and expected t,t-MA and S-PMA values were calculated. Smoking habits and life-style were ascertained by means of a questionnaire. Both environmental and biological monitoring data showed that benzene exposure for gasoline filling-station attendants was low when compared with the respective ACGIH limit values (means-benzene: 0.044 mg/m(3); t,t-MA: 171 microg/g creatinine; S-PMA: 2.7 microg/g creatinine). No significant correlation was found between exposure to benzene and t,t-MA or S-PMA excretion data. The use of expected values was also experimented for S-PMA and t,t-MA. This consists of calculating, on the basis of the known half-life of the benzene metabolite, the concentration of that metabolite that a worker should present at the end of the work-shift, the difference between this value and the value actually found is a measure of benzene exposure during work. The use of expected values in biological monitoring did not improve correlations. At these low benzene levels, environmental monitoring seems to be the best method of evaluating individual exposure. However, biological monitoring remains useful, as a mean of assessing group exposure.

Acetylcysteine↗
PubMedDate not supplied

Awareness of post-exposure prophylaxis guidelines against occupational exposure to HIV in a Mumbai hospital.

BACKGROUND: Exposure to the human immunodeficiency virus (HIV) is a matter of concern for healthcare workers. We conducted a survey to determine the level of awareness amongst operating room personnel regarding post-exposure prophylaxis in case of needlestick injuries from confirmed or suspected cases of HIV. METHODS: A structured questionnaire was presented to 39 anaesthetists and 31 surgical residents. Questions were related to identification of high risk fluids, risk of transmission, drugs, costs and procedure to be adopted for post-exposure prophylaxis. RESULTS: Fourteen respondents (20%) were aware of the true risk of transmission. About one-third identified all high risk fluids correctly. Fifty-five respondents (78%) correctly stated that washing the site with soap and water was the initial measure, but less than a third knew whom to contact immediately after a needlestick injury. Though 45 respondents (64%) correctly stated that prophylaxis should be initiated within 1 hour of injury, none knew exactly which drugs were to be used. Thirty respondents (42%) were aware of the use of zidovudine but none were aware of the second or third drugs used for post-exposure prophylaxis. Only 4 respondents (6%) knew the correct duration of post-exposure prophylaxis. Five respondents (7%) knew that the drugs were available in medical stores and 7 knew the approximate cost of therapy. CONCLUSION: There is surprisingly poor knowledge of post-exposure prophylaxis against HIV. Ongoing awareness and training programmes are necessary to improve the same.

Anti-HIV Agents↗
PubMed1996

Controlling occupational exposure to hazardous drugs. Occupational Safety and Health Administration.

Guidelines on the safe management of hazardous drugs (HDs) in the workplace are presented. OSHA published guidelines for the safe management of cytotoxic (antineoplastic) drugs in the workplace in 1986. Those guidelines have been revised in this document to reflect the latest scientific knowledge and expanded to include other potentially hazardous drugs. The guidelines (1) provide criteria for classifying drugs as hazardous, (2) summarize the evidence supporting the management of HDs as an occupational hazard, (3) discuss the equipment and worker education recommended, as well as the legal requirements of standards for the protection of workers exposed and potentially exposed to HDs, (4) update the important aspects of medical surveillance, and (5) list some common HDs currently in use. Revised and expanded work-practice guidelines intended to limit the exposure of workers to HDs are described.

Drug-Related Side Effects and Adverse Reactions↗
PubMed1988

[Assessment of occupational exposures to industrial hazardous substances. I. A proposed method based on interday fluctuation of contaminant concentrations for evaluating employee's exposure averages (TWAs)].

Occupational exposures to potentially hazardous substances may vary considerably because of factors such as sampling and analytical errors, and intraday and interday environmental fluctuations in contaminant concentration. Of these factors, day-to-day environmental fluctuations most likely affect daily exposure averages over days, weeks, months or years. A new method based on day-to-day fluctuations of daily exposure averages (geometric standard deviation) was developed for making reliable assessment of the employee's exposure situation. It is assumed that daily exposure averages of a worker are lognormally and independently distributed statistically. Finally, a classification scheme on the basis of n days measurements is presented. 95% upper limit or arithmetic mean of individual exposure averages (8-h TWAs) can be evaluated in comparison with an established standard. The method may provide an approximate estimate because of statistical premise, but it can be utilized for practical purposes, particularly, in case where only one or two days are being monitored. An action level concept based on random sampling and analytical errors and interday variations developed by OSHA/NIOSH, and a sampling and decision scheme based on one-sided tolerance limits proposed by Tuggle (1982) are also discussed.

Data Interpretation, Statistical↗
PubMed2001

The development of a prototype database for the voluntary reporting of occupational exposure data on chemicals.

A prototype occupational exposure database was developed as part of a study to retrospectively collect chemical exposure data from U.K. industry. The data dictionary for the database was constructed using existing recommendations on core data elements developed by working groups from the ACGIH and the European Union. The study also made use of existing job and workplace coding schemes. The practicalities of gathering the data by voluntary donation, its storage in a database, and the transfer of suitably anonymised data to the U.K. Health and Safety Executive's National Exposure Database system were investigated and assessed. Prior to the development, several existing exposure database systems were evaluated for their suitability to store the data from the study. Though of high quality, these were found to be insufficiently flexible for the diversity of datasets encountered and so the prototype exposure database was constructed using a leading database development package. The database was successfully used to gather data and forward it in a suitable format to the U.K. Health and Safety Executive. The published recommendations on occupational exposure databases and the associated coding schemes provided a very useful foundation for designing and implementing the prototype database. However, as data collection proceeded it became clear that the existing recommendations often were poorly understood and misinterpreted, or at least interpreted differently, by different database designers, data collectors, and other users of occupational exposure data. It is suggested that several items in the ACGIH and European Union core recommendations are ambiguous and need to be clarified. Once agreed, the improved database design criteria need to be widely promoted to foster a common understanding and to encourage their use by all those involved in collecting occupational exposure data. Beyond this, recommendations for exposure databases should be augmented to facilitate easy exchange of data between organizations.

Databases, Factual↗
PubMed2005

Awareness of post-exposure prophylaxis guidelines against occupational exposure to HIV in Hospital Sungai Petani.

Occupational risk of Human Immunodeficiency Virus (HIV) infection is a matter of concern for health care workers. We conducted a study to gauge the level of awareness amongst HCW (doctors and nurses) working in Hospital Sungai Petani regarding the post-exposure prophylaxis in case of needle stick injuries from confirmed or suspected cases of HIV. Nineteen Doctors (56%) and 13 nurses (25%) were aware of correct risk of transmission. None identified all the four risk fluids correctly. 94% of doctors and 98% of nurses correctly stated that washing the site with soap and water is the initial procedure, but only few (1/10 of doctors and 1/3 of nurses) knew whom to contact immediately after injury. Twenty three doctors (67%) and 41(78%) nurses were aware of the use of Zidovudine but only 10 participants were aware of the use of second drug. Only 6 doctors (17%) and 8 nurses (15%) knew the correct duration of post-exposure prophylaxis. Twenty-three doctors (67%) and 35 nurses (67%) knew that the drugs were available in Hospital Pharmacy and 11 doctors and 12 nurses knew the approximate cost of therapy. On the average about 50% of doctors and nurses have fair knowledge of post exposure prophylaxis against HIV. Ongoing awareness and training are necessary to improve the same.

Clinical Competence↗
PubMed1985

Occupational exposure to polychlorinated biphenyls (PCBs).

Human occupational exposure to polychlorinated biphenyls (PCBs) with varying chlorine content has been reported by several investigators, using analyses of blood or adipose samples or skin wipes to evaluate levels in the body. The intensity of occupational exposure is related to both duration and intensity of exposure. The qualitative nature of occupational exposure, as well as casual environmental exposure, has been shown to consist of less readily metabolized PCB congeners. The pattern of PCB congeners in human tissues, determined by gas chromatography, may or may not be readily ascribed to specific PCB standard mixtures. The average occupational exposure, as depicted in several studies of blood, plasma or serum concentrations, is approximately 10 to 1000 times that observed in nonoccupationally exposed persons. Currently used methods of PCB quantitation and pattern identification vary widely, with no uniformly administered criteria being applied to characterize human PCB exposure.

Adipose Tissue↗
PubMed2003

Occupational exposure and urological cancer.

Occupational exposure is definitely a major cause of cancer. In the field of urology, the urinary bladder is the most important target. A classical cause of bladder cancer is exposure to carcinogenic aromatic amines, especially benzidine and beta-naphthylamine. Such exposures were related to work places in the chemical industry, implying production and processing of classical aromatic amines, and in the rubber industry. Occupational bladder cancer has also been observed in dyers, painters and hairdressers. Even some occupations with much lower exposures to carcinogenic aromatic amines, like coke oven workers or workers in the rubber industry after the ban on beta-naphthylamine, are at risk. In these occupations, exposure to complex mixtures of substances containing combustion products (e.g. polycyclic aromatic hydrocarbons) or nitrosamines is common. Renal cell cancer has been observed as an occupational disease in cases of very high exposure to trichloroethylene having led to narcotic or prenarcotic symptoms. Occupationally related cancers of the prostate or the testes appear currently not relevant.

Amines↗
PubMed1991

Biological monitoring of environmental and occupational exposure to mercury.

Biological monitoring was used to assess mercury exposure from occupational and environmental sources in a group of chloralkali workers (n = 89) and in a control group (n = 75). In the control group, the median value for blood mercury (B-Hg) was 15 nmol/l, that for serum mercury (S-Hg) was 4 nmol/l and that for urinary mercury (U-Hg) was 1.1 nmol/mmol creatinine. Corresponding levels in the chloralkali group were 55 nmol/l, 45 nmol/l and 14.3 nmol/mmol creatinine, respectively. In the control group, there were statistically significant relationships between fish consumption and both B-Hg and S-Hg values (P less than 0.001), whereas U-Hg correlated best with the individual amalgam burden (P less than 0.01). In the chloralkali group, the mercury levels in blood and urine were significantly related to the type of work (P less than 0.001) but not to the length of employment, to fish consumption or to the quantity of dental amalgam fillings. In both groups there were poor correlations between smoking or alcohol intake and the mercury levels in blood and urine. The results strongly suggest that fish is an important source of methylmercury exposure and that amalgam fillings are probably the most important source of inorganic mercury exposure among occupationally unexposed individuals. In the chloralkali group, mercury exposure from fish and amalgam was overshadowed by occupational exposure to inorganic mercury.

Adult↗
PubMed1978

Monitoring of occupational exposure to nitrous oxide.

The occupational exposure of operating room personnel to nitrous oxide was investigated by using multiple spot sampling, integrated personal sampling and end-tidal sampling in an operating room which had no ventilation system. The effect of passive scavenging on occupational exposure was determined. The study showed that all three methods to determine occupational exposure can yield representative time-weighted exposure patterns. However, the integrated personal sampling was considered the preferable method as it involved considerable saving of time and labour compared with taking and analyzing multiple end-tidal and spot samples. Passive scavenging of waste anaesthetic gases led to a three-fold to six-fold reduction of exposure of operating room personnel to nitrous oxide.

Air Pollutants↗
PubMed2001

The role of environmental and occupational exposures in Turkish immigrants with fibre-related disease.

Environmental exposure to tremolite and erionite causes endemic diseases of the lung and pleura in Turkey. This study aimed to evaluate the impact of these exposures and further occupational exposures on fibre-related diseases in Turkish immigrants living in Belgium. The study included 51 males and 17 females that emigrated < 1-38 yrs ago. Most of them (n=46) had nonmalignant pleural lesions, one had asbestosis and one had mesothelioma. Environmental asbestos exposure was likely for the majority of patients (60%), but there were also reports of possible occupational asbestos (n = 14) and erionite (n = 2) exposure. Tremolite was the main fibre type in bronchoalveolar lavage fluid (BALF). Elevated concentrations of amosite or crocidolite were detected in only two patients. The delay elapsed since the end of the environmental exposure had no influence on the asbestos body or the tremolite fibre concentrations in the BALF of Turkish immigrants. Most fibre-related diseases in Turkish immigrants are probably due to environmental rather than occupational exposure. Precise information about geographical origin and occupation should be obtained when investigating these patients. Mineralogical analysis of bronchoalveolar lavage fluid gives valuable information on the type and intensity of exposure, especially in patients with both environmental and occupational exposure.

Adult↗
PubMed1994

Occupational exposure to glycol ethers: implications for occupational health nurses.

1. Evaluation of workplace exposure to reproductive hazards is difficult and is often confounded by occupational exposure to multiple agents and exposure to non-occupational factors. 2. A growing body of evidence from animal and human study data supports a causal association between occupational exposure to certain glycol ethers and adverse reproductive outcomes. 3. Occupational health nurses providing services to employees exposed to glycol ethers should remain knowledgeable about the results of epidemiologic studies and current trends in the regulation of glycol ethers in industry. 4. Occupational health nurses are in a key position to reduce exposure to reproductive hazards by monitoring trends in group data and by implementing training and education programs to employees exposed to reproductive hazards.

Animals↗
PubMed1995

A screen for RAS mutations in individuals at risk of secondary leukaemia due to occupational exposure to petrochemicals.

Occupational exposure to petrochemicals, in particular benzene, has been identified as a risk factor in the development of acute leukaemia. A cohort of exposed (n = 44) and non-exposed individuals (n = 19) from the same petrochemical installation were screened by polymerase chain reaction (PCR) followed by oligonucleotide hybridization (ONH) for the presence of mutations in the H, K, and NRAS cellular proto-oncogenes. A KRAS mutation was detected in one individual from the exposed group who was haematologically normal at the time of sampling. The presence of this mutation was confirmed by nude mouse tumorigenicity assay and positively identified as a K13 Gly-Asp substitution by cloning and sequencing.

Adult↗
PubMed1980

Methanol monitoring. Comparison of urinary methanol concentration with formic acid excretion rate as a measure of occupational exposure.

Methods of monitoring occupational exposure to methanol were investigated in volunteer subjects who had ingested small amounts of methanol. It was confirmed that urinary methanol concentrations accurately reflected those in the blood. This relationship was maintained over a considerable range of concentrations in spite of large variations of urine flow. Concomitant ingestion of ethanolic beverages increased the urinary methanol concentration slightly. Urinary formic acid concentration was too variable to be of value but rate of urinary excretion of formic acid did reflect methanol uptake. The ratio of urinary formic acid to creatinine concentrations (F/C ratio) is a practical monitoring method. However, formic acid elimination rate is reduced by ingestion of ethanolic beverages. Urinary methanol concentration is favoured as a method of monitoring and a concentration of 10 microgram/ml measured at the end of the work shift is suggested as the level above which occupational exposure should be suspected and the appropriate action taken.

Ethanol↗
PubMed2000

Validity of self reported occupational exposures to hand transmitted and whole body vibration.

OBJECTIVES: To assess the accuracy with which workers report their exposure to occupational sources of hand transmitted (HTV) and whole body vibration (WBV). METHODS: 179 Workers from various jobs involving exposure to HTV or WBV completed a self administered questionnaire about sources of occupational exposure to vibration in the past week. They were then observed at work over 1 hour, after which they completed a second questionnaire concerning their exposures during this observation period. The feasibility of reported sources of exposure during the past week was examined by questioning managers and by inspection of tools and machines in the workplace. The accuracy of reported sources and durations of exposure in the 1 hour period were assessed relative to what had been observed. RESULTS: The feasibility of exposure in the previous week was confirmed for 97% of subjects who reported exposure to HTV, and for 93% of subjects who reported exposure to WBV. The individual sources of exposure reported were generally plausible, but occupational use of cars was substantially overreported, possibly because of confusion with their use in travel to and from work. The accuracy of exposures reported during the observation period was generally high, but some sources of HTV were confused-for example, nailing and stapling guns reported as riveting hammers, and hammer drills not distinguished from other sorts of drill. Workers overestimated their duration of exposure to HTV by a median factor of 2.5 (interquartile range (IQR) 1.6-5.9), but estimated durations of exposure were more accurate when the exposure was relatively continuous rather than for intermittent short periods. Reported durations of exposure to WBV were generally accurate (median ratio of reported to observed time 1.1, IQR 1.0-1.2). CONCLUSIONS: Sources of recent occupational exposure to vibration seem to be reported with reasonable accuracy, but durations of exposure to HTV are systematically overestimated, particularly when the exposure is intermittent and for short periods. This raises the possibility that dose-response relations may have been biased in some of the studies on which exposure standards might be based, and that the levels in currently proposed standards may be too high. Future studies should pay attention to this source of error during data collection.

Adolescent↗
PubMed2006

Occupational exposure to acidic chemicals and occupational dental erosion.

OBJECTIVE: This study investigated the association between occupational acidic chemicals (ACs) exposure and occupational dental erosion. METHODS: A cross-sectional study was conducted in which three dentists surveyed 951 subjects from 42 factories using five types of ACs below Korean Threshold Limit Values (K-TLVs). Subjects agreed to participate by a written consent; 519 were acid exposed workers and 431 were non-exposed. The modified ten Bruggen Cate's criteria was used to classify erosion. Length and type of exposure to ACs were assessed using questionnaires. Logistic regression analysis including interaction terms was applied. RESULTS: ACs exposure was associated with erosion severity. Multiple exposures to ACs were found to be strongly associated with severe erosion. Interaction between wearing masks and AC exposure was significant. CONCLUSIONS: This study showed a clear association between AC exposure below K-TLVs and erosion. Hence, the authors propose to lower K-TLVs of five types of ACs.

Acids↗
PubMed1996

[Clinical state, bronchial reactivity and atopic symptoms in patients with occupational bronchial asthma 3-4 years after cessation of occupational exposure].

The results of numerous studies of occupational bronchial asthma proved that bronchial spasticity and nonspecific bronchial hyperreactivity persists after cessation of occupational exposure. The aim of the study was to evaluate the condition of patients with bronchial asthma after cessation of occupational exposure. A group of 23 patients with bronchial asthma had been observed twice: 1-6 months after cessation of occupational exposure and then 36 or 48 months later. An analysis of the clinical progress, both during the diagnostic process and the control examination, was based on a questionnaire including questions on cough intensity, dysponca, mean daily use of aerosol beta-mimetics and daily oral and inhalatory doses of corticosteroids. The analysis covered the month during the year proceeding the examination in which patients found themselves in the best psychosomatic condition. During both periods considered by patients themselves as the best ones from the clinical point of view, respiratory function tests and allergological tests were performed. The majority of patients with occupational bronchial asthma had reported, 2-3 years after cessation of occupational exposure, subjective complaints which indicated the improvement of their clinical condition. In those patients, the decrease in the intensity of specific allergic reactions was not observed. In the majority of patients with occupational bronchial asthma nonspecific bronchial hyperreactivity has not diminished despite a two-year break in occupational exposure.

Adult↗