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PubMed1993

Prophylaxis of HIV infection following occupational exposure.

OBJECTIVE: To review the risk of HIV infection following occupational exposure, the theoretical basis for chemoprophylaxis, investigative experience with chemoprophylaxis in animals and humans, and the economic aspects of postexposure chemoprophylaxis. DATA SOURCES: English-language articles and conference proceedings pertaining to the risk of occupational HIV infection and to postexposure chemoprophylaxis. STUDY SELECTION: Studies evaluating chemoprophylaxis of HIV infection following occupational exposure were selected for review. Abstracts reporting ongoing clinical trials were also included. DATA EXTRACTION: In vitro studies are discussed to provide the immunologic rationale for chemoprophylaxis. Animal studies examining the efficacy of chemoprophylaxis in preventing non-HIV retroviral infection are reviewed, and their applicability to human HIV infection is critically evaluated. Human studies and case reports describing attempts at chemoprophylaxis of HIV infection following occupational exposure are discussed. DATA SYNTHESIS: Chemoprophylaxis of HIV infection following occupational exposure has focused on the use of zidovudine (ZDV) because it was previously the only antiretroviral agent approved for treating HIV infection. Animal models of retroviral infection provide conflicting data regarding the efficacy of ZDV chemoprophylaxis, and there are important questions about the applicability of animal data to human HIV infection because of differences in natural histories of non-HIV retroviral infections, inoculum size, dosing of ZDV, and routes of infection. Human surveillance studies are thus far inadequate to determine the efficacy of ZDV prophylaxis because of the very low HIV seroconversion rates following occupational exposure. ZDV is well tolerated during short-term administration in people without HIV infection, but long-term safety is unknown. In addition, the true cost-benefit ratio of ZDV chemoprophylaxis is uncertain. CONCLUSIONS: Current data from in vitro, animal, and human studies are inadequate to define the appropriate role of ZDV in preventing HIV infection following occupational exposure. Limited toxicity data and the high cost of treatment must be weighed against the theoretical benefits of ZDV use in this setting. The decision to employ ZDV for postexposure prophylaxis must ultimately be based on existing institutional policies, the attitude of the responsible physician regarding such practice, and/or the desires of the exposed healthcare worker after being properly informed of potential risks and benefits.

Animals↗

PubMed2006

Occupational exposure to hexavalent chromium. Final rule.

The Occupational Safety and Health Administration (OSHA) is amending the existing standard which limits occupational exposure to hexavalent chromium (Cr(VI)). OSHA has determined based upon the best evidence currently available that at the current permissible exposure limit (PEL) for Cr(VI), workers face a significant risk to material impairment of their health. The evidence in the record for this rulemaking indicates that workers exposed to Cr(VI) are at an increased risk of developing lung cancer. The record also indicates that occupational exposure to Cr(VI) may result in asthma, and damage to the nasal epithelia and skin. The final rule establishes an 8-hour time-weighted average (TWA) exposure limit of 5 micrograms of Cr(VI) per cubic meter of air (5 [mu]g/cu m). This is a considerable reduction from the previous PEL of 1 milligram per 10 cubic meters of air (1 mg/10 cu m, or 100 [mu]g/cu m) reported as CrO3, which is equivalent to a limit of 52 [mu]g/cu m as Cr(VI). The final rule also contains ancillary provisions for worker protection such as requirements for exposure determination, preferred exposure control methods, including a compliance alternative for a small sector for which the new PEL is infeasible, respiratory protection, protective clothing and equipment, hygiene areas and practices, medical surveillance, recordkeeping, and start-up dates that include four years for the implementation of engineering controls to meet the PEL. The final standard separately regulates general industry, construction, and shipyards in order to tailor requirements to the unique circumstances found in each of these sectors. The PEL established by this rule reduces the significant risk posed to workers by occupational exposure to Cr(VI) to the maximum extent that is technologically and economically feasible.

Air Pollutants, Occupational↗

PubMed1986

Evaluation of occupational exposures: a proposed sampling method.

Occupational exposures to potentially hazardous agents may vary considerably because of worker mobility, or workplace contaminant levels that fluctuate within or between-days. In addition, individual susceptibility to adverse health effects varies among identically exposed workers. Therefore, accounting for these variables can be difficult during assessment of worker exposure for occupational health and OSHA compliance purposes. This is particularly true when there is varied and repeated exposure from day to day. A cost-effective monitoring strategy for evaluating repeated employee exposure and potential health risk that considers the foregoing exposure variables is desirable. The method this article proposes uses a well-planned sampling strategy featuring 4-hr, rather than the traditional 7 or 8-hr sampling durations. Use of 4-hr samples has been found to improve monitoring efficiency without significantly reducing sampling precision or accuracy. Statistical protocols applied during the sampling procedure and subsequent data analysis also combine to minimize the frequency and duration of samples required to reach a decision regarding the significance of a worker's exposure. The development of an Acceptable Risk Level (ARL) is another important element of the proposed method. An ARL is a variable based on risk assessment and risk management principles, which have been established by the employer for each contaminant. The ARL is dependent on the contaminant's toxicity and the time pattern and spacing of successive exposures. Ultimately, an ARL can be developed by an employer for the productive allocation of health and safety dollars to ensure worker protection.

Biometry↗

PubMed2005

The influence of occupational exposure to pesticides, polycyclic aromatic hydrocarbons, diesel exhaust, metal dust, metal fumes, and mineral oil on prostate cancer: a prospective cohort study.

AIMS: To investigate the relation between exposure to pesticides, polycyclic aromatic hydrocarbons (PAHs), diesel exhaust, metal dust, metal fumes, and mineral oil in relation to prostate cancer incidence in a large prospective study. METHODS: This cohort study was conducted among 58,279 men in the Netherlands. In September 1986, cohort members (55-69 years) completed a self-administered questionnaire on potential cancer risk factors, including job history. Follow up for prostate cancer incidence was established by linkage to cancer registries until December 1995 (9.3 years of follow up). The analyses included 1386 cases of prostate cancer and 2335 subcohort members. A blinded case-by-case expert exposure assessment was carried out to assign cases and subcohort members a cumulative probability of exposure for each potential carcinogenic exposure. RESULTS: In multivariate analyses there was a significant negative association for pesticides (RR 0.60; 95% CI 0.37 to 0.95) when comparing the highest tertile of exposure to pesticides with no exposure. No association was found for occupational exposure to PAHs (RR 0.75; 95% CI 0.42 to 1.31), diesel exhaust (RR 0.81; 95% CI 0.62 to 1.06), metal dust (RR 1.01; 95% CI 0.72 to 1.40), metal fumes (RR 1.11; 95% CI 0.80 to 1.54), or mineral oil (RR 0.99; 95% CI 0.66 to 1.48) when comparing the highest tertile of exposure with no exposure. In subgroup analysis, with respect to tumour invasiveness and morphology, null results were found for occupational exposure to pesticides, PAH, diesel exhaust, metal dust, metal fumes, and mineral oil. CONCLUSIONS: These results suggest a negative association between occupational exposure to pesticides and prostate cancer. For other carcinogenic exposures results suggest no association between occupational exposure to PAHs, diesel exhaust, metal dust, metal fumes, or mineral oil and prostate cancer.

Air Pollutants, Occupational↗

PubMed2000

Occupational exposure to inhalative irritants and methacholine responsiveness.

OBJECTIVES: Occupational exposures to inhalative irritants have been associated with an increased reporting of respiratory symptoms in previous studies. Methacholine responsiveness represents a continuous measure of airway responsiveness. As such, it may be less subject to recall bias and more sensitive to detecting effects of occupational exposure on airways. Such effects may be stronger among atopic persons. The objective of the study was to examine the relationship between self-reports of occupational exposure to dusts, gases, vapors, aerosols, and fumes and methacholine responsiveness. METHODS: A sample was studied of never smokers (N=3044) chosen randomly from 8 areas in Switzerland. Atopy was defined as any positive skin test to 8 inhalative allergens. Nonspecific bronchial reactivity was tested using methacholine chloride and quantified by calculating the slope of the dose-response. RESULTS: The methacholine slopes were 19% [95% confidence interval (95% CI) 6-32] higher for never smokers with exposure to dusts, fumes, vapors, gases, or aerosols than for the unexposed group. When only atopic never smokers were examined. the increase was larger (37%, 95% CI 7-75), and for persons with >2 positive skin prick tests the effect was still higher (42%, 95% CI -1.5-104). Exposure to vapors and aerosols was strongly associated with increased methacholine slopes among the atopic subjects. CONCLUSIONS: Occupational exposure, particularly to dusts and fumes, was associated with increased bronchial reactivity in never smokers in this study. The magnitude of the effect was larger among atopic subjects.

Adolescent↗

PubMed1999

Adult-onset asthma and occupational exposures.

OBJECTIVES: This study examined certain occupational exposures and the risk for adult-onset asthma. METHODS: A nested case-referent study of adult-onset asthma was performed on a random population sample (N=15813), aged 21 to 51 years. Cases for the study included 2 groups: subjects reporting "physician-diagnosed" asthma (N=251) and a broader "asthma" group (N=362). The "asthma" group consisted of subjects with "physician-diagnosed" asthma (N=251) and subjects reporting asthma-like symptoms without having "physician-diagnosed" asthma (N=111). The referents (N=2044) were randomly selected from the whole population sample. The case-referent sample was investigated with a comprehensive questionnaire about occupational exposures, asthma, respiratory symptoms, smoking, and atopy. Odds ratios were calculated with stratification for gender, year of diagnosis, and birth year. RESULTS: The highest odds ratio for "physician-diagnosed" asthma was associated with exposure to flour dust [odds ratio (OR) 2.8, 95% confidence interval (95% CI) 1.5-5.2] and the occupational handling of resin-based paints (isocyanates) (OR 3.0, 95% CI 1.6-5.9). Exposure to welding fumes, textile dust, and work with glues containing acrylates was also associated with an increased odds ratio for "physician-diagnosed" asthma. Including persons with asthma-like symptoms (ie, the asthma group) showed similar results. CONCLUSION: This population-based case-referent study from Sweden indicates that occupational exposure to acrylate-based compounds and welding fumes is associated with increased risk for adult-onset asthma.

Adult↗

PubMed2003

Multiple myeloma and diesel and other occupational exposures in swedish construction workers.

We examined the relationships between occupational exposures and the risk of multiple myeloma among male construction workers in Sweden. A total of 446 myeloma subjects were identified among 365,424 male workers followed from 1971 to 1999. Occupational exposure was assessed using a semiquantitative job-exposure matrix, based on a survey carried out by the Construction Industry's Organization for Working Environment, Occupational Safety and Health in Sweden. Rate ratios (RRs) in the exposed groups relative to the unexposed groups were estimated by Poisson regression. We found an increased risk (RR = 1.3, 95% CI 1.04-1.71) among construction workers exposed to diesel exhaust. Adjustment for other occupational exposures did not change this estimate (RR = 1.3, 95% CI 1.00-1.77). However, there was no monotonic increase in risk with estimated level of exposure (RR for low = 1.4, moderate = 1.1, high = 1.4). There was no evidence of increased risk associated with the other occupational exposures among these construction workers, including asbestos, asphalt, cement dust, metal dust, mineral wool, organic solvents, stone dust and wood dust. Occupational exposure to diesel exhaust in the Swedish construction industry may present a small risk of multiple myeloma, but lack of an exposure-response trend tempers our ability to draw clear conclusions.

Aged↗

PubMed1997

[Silicon carbide, occupational exposure, proposed MAC values].

Occupational exposure to dust silicon carbide production and exploitation of its products was evaluated. Individual dosimetry was used to measure concentrations of total and respirable dusts; concentration of respirable mineral fibres was measured by means of light microscopy; the distribution of fiber length was analysed by employing a laser FM-7400; morphology of dust molecules was analysed in light and electron microscopes; x-ray diffraction and infrared spectrometry was used to identify dust mineral composition. Concentrations of total dust at workposts involved in silicon carbide production ranged between 5.0 and 14.0 mg/m3 (mean = 10.3 mg/m3); concentration of respirable fraction between 0.1 and 1.9 mg/m3 (mean = 1.1 mg/m3); and concentration of respirable mineral fibres between 0.42 and 1.04 f/cm3 (mean = 0.64 f/cm3). In the plants where SiC products were used the mean concentrations of total dust and respirable mineral fibres were about two times lower, and the concentrations of respirable fraction about five times lower. In the workpost air the presence of carborundum, mullite and cristobalite was revealed. A proposed MAC value for SiC dust (nonfibrous) containing less than 2% of free crystalline silica accounts for 10 mg/m3 for total dust.

Air Pollutants, Occupational↗

PubMed1999

Occupational exposure to styrene in Norway, 1972-1996.

Occupational exposure to styrene has been of special concern in Norway since the beginning of the 1970s, especially the exposure in the reinforced plastic industry. Campaigns have been carried out by the Norwegian Directorate of Labour Inspection and various measures have been set forth to reduce the workers' exposure to styrene. Alongside the campaigns, extensive monitoring programs were carried out. The measurement results are compiled in the database EXPO at the National Institute of Occupational Health (Norway). This article presents a statistical analysis of the measurement data to assess the occupational exposure to styrene in Norway since the 1970s. Results from 7,011 measurements carried out in 234 enterprises covering the period 1972-1996 are included in the database. The analyses show occupational exposure to styrene of 33.0 ppm (median) (mean: 49.4 ppm) for this period. The analyses show a decrease from a median of 62 ppm in the 1970s to 7.1 ppm in the 1990s. The analyses do not disclose any crucial impact from any single preventive measure implemented by the authorities to reduce exposure level. The reduction in the level is probably due to a contribution from different measures. The decline in the styrene exposure coincides with a similar reduction in other countries, and it may be that international concern and technical improvements in the manufacturing process have been an important factor in the exposure level reduction in the Norwegian plastic reinforced industry as well.

Air Pollutants↗

PubMed2006

Occupational exposure to pfiesteria species in estuarine waters is not a risk factor for illness.

BACKGROUND: Exposure to the dinoflagellate Pfiesteria has, under certain circumstances, been associated with deficits in human learning and memory. However, uncertainties remain about the health risk of chronic, low-level exposures (as seen among occupationally exposed commercial fishermen), particularly in light of studies suggesting that Pfiesteria strains are widespread in the estuarine environment in the U.S. mid-Atlantic region. METHODS: We selected an initial cohort of 152 persons, including 123 persons with regular, occupational exposure to the Chesapeake Bay ; 107 of the cohort members were followed for the full four summer "seasons" of the study. Cohort members were questioned biweekly about symptoms, and data were collected about the areas of the bay in which they worked. These latter data were matched with data on the presence or absence of Pfiesteria in each area, based on polymerase chain reaction analysis of > 3,500 water samples. Cohort members underwent neuropsychological testing at the beginning and end of each summer season. RESULTS: No correlation was found between work in an area where Pfiesteria was identified and specific symptomatology or changes on neuropsychological tests. CONCLUSIONS: Although high-level or outbreak-associated exposure to Pfiesteria species (or specific strains within a species) may have an effect on health, routine occupational exposure to estuarine environments in which these organisms are present does not appear to pose a significant health risk.

Adult↗

PubMed1997

Amyotrophic lateral sclerosis and occupational exposure to electromagnetic fields.

In an hypothesis-generating case-control study of amyotrophic lateral sclerosis, lifetime occupational histories were obtained. The patients (n = 28) were clinic based. The occupational exposure of interest in this report is electromagnetic fields (EMFs). This is the first and so far the only exposure analyzed in this study. Occupational exposure up to 2 years prior to estimated disease symptom onset was used for construction of exposure indices for cases. Controls (n = 32) were blood and nonblood relatives of cases. Occupational exposure for controls was through the same age as exposure for the corresponding cases. Twenty (71%) cases and 28 (88%) controls had at least 20 years of work experience covering the exposure period. The occupational history and task data were used to classify blindly each occupation for each subject as having high, medium/high, medium, medium/low, or low EMF exposure, based primarily on data from an earlier and unrelated study designed to obtain occupational EMF exposure information on workers in "electrical" and "nonelectrical" jobs. By using the length of time each subject spent in each occupation through the exposure period, two indices of exposure were constructed: total occupational exposure (E1) and average occupational exposure (E2). For cases and controls with at least 20 years of work experience, the odds ratio (OR) for exposure at the 75th percentile of the E1 case exposure data relative to minimum exposure was 7.5 (P < 0.02; 95% CI, 1.4-38.1) and the corresponding OR for E2 was 5.5 (P < 0.02; 95% CI, 1.3-22.5). For all cases and controls, the ORs were 2.5 (P < 0.1; 95% CI, 0.9-8.1) for E1 and 2.3 (P = 0.12; 95% CI, 0.8-6.6) for E2. This study should be considered an hypothesis-generating study. Larger studies, using incident cases and improved exposure assessment, should be undertaken.

Adult↗

PubMed1992

Risk of needlesticks and occupational exposures among residents and medical students.

PROBLEM: Occupational exposure to human immunodeficiency virus (HIV) disease is a problem of concern to all health care workers, especially those in large urban teaching hospitals with large numbers of HIV-positive patients. METHOD: The self-reported incidence of needlesticks and other exposures to patients' blood and body fluids in 550 medical students and residents at the Los Angeles County-University of Southern California Medical Center during the 1989 through 1990 training year was studied by means of an anonymous survey. RESULTS: Seventy-one percent of respondents reported one or more needlesticks or other exposures during the training year. Surgical residents had a sixfold greater rate of occupational exposure compared with medicine residents and were significantly more likely to experience suture needlesticks, cuts, open wound contamination, and mucous membrane exposure. Medical students generally were at somewhat lower risk compared with residents, but had greater rates of hollow-needle puncture accidents. No trend was found for accidental exposure by level of residency training. The known HIV-positive exposure rate for students and residents was 9.5% per person per year. Only 9% of exposures were actually reported to the health center. CONCLUSIONS: Based on the rate of exposures reported, numbers of known and estimated HIV-positive patients, and previously published HIV seroconversion rates, we would expect an annual rate of HIV seroconversion rates, we would expect an annual rate of HIV seroconversion as a result of occupational exposures of between 27 and 46 per 100,000. This rate is similar to the leading cause of death in this age group--motor vehicle accidents--and is equivalent to one student or resident in this medical center seroconverting every 2 to 3 years. Although only a portion of accidental exposures are regarded as preventable, these data emphasize the importance of increased efforts toward improved education, prevention, and accessibility of protective equipment.

Accidents, Occupational↗

PubMedDate not supplied

Effects from environmental Mn exposures: a review of the evidence from non-occupational exposure studies.

OBJECTIVE: The risk posed to human health by environmental manganese exposure is unknown. Occupational-exposure outcomes may not extrapolate to environmental exposures due to the healthy worker effect and differences in dosage parameters which may affect the biological response. This paper attempts to combine the existing literature on non-occupational Mn exposures with results from our current study in SW Quebec on environmental Mn exposure (Mergler et al., this issue) within the framework of a biologically-based, dose-response (BBDR) model. BBDR MODEL: The basic BBDR model consists of seven stages relating exposure to health effects. The stages are: 1) sources, 2) applied dose, 3) absorbed dose, 4) target-site dose, 5) toxic event, 6) measurable change, and 7) health outcome. RESULTS: Several air monitoring programs, such as the PTEAM study (Riverside, CA, 1990, mean PM10 Mn outdoor-airborne 24 h average = 0.045 microgram/m3), provided data relevant to the estimation of Mn applied dose, but did not include measures of body burden. Data from the SW Quebec study showed a mean total-particulate airborne Mn concentration of 0.022 microgram/m3 with a range of 0.009 to 0.035 microgram/m3 across four sampling sites, whereas the EPA reference concentration (RfC) is 0.05 microgram/m3. EPA has considered tap water levels to be safe below 200 micrograms/l Mn, and mean Mn tap-water (MnW) level in the participants' homes was 6.38 +/- 11.95 micrograms/l with a range from 0.1 to 158.9 micrograms/l Mn. A previous study of MnW exposure in Greece reported Mn levels in areas with low, medium and high MnW ranging from 4 to 2,300 micrograms/l and a significant association with Mn in hair but not Mn in blood (MnB). The mean absorbed dose of the SW Quebec study participants, as indicated by MnB, was 7.5 +/- 2.3 micrograms/l with a range of 2.5 to 15.9 micrograms/l. Our study and others on environmental Mn exposure did not provide an estimate of target-site dose. However, a significant correlation (r = 0.65) between MnB and signal intensity in T1-weighted MRI images has been reported in liver-disease patients with Parkinson-like signs who had MnB levels as low as 6.6 micrograms/l. Only animal and in vitro studies have provided evidence on the mechanisms of toxicity caused by Mn in the CNS. Several studies reported measurable changes in endpoints suggestive of a Parkinson-like syndrome in subjects with MnB levels ranging from 7.5 to 25.0 micrograms/l. Among other effects on neurobehavioral function observed in the current study was a significant relationship between MnB and the direction and speed of body-sway in men. The effects observed in these participants are sub-clinical and no health outcomes have been diagnosed. However, the Parkinson's disease incidence in the study area was previously reported to be 2-5 times higher than in the rest of Quebec, and several studies indicate that 25-35% of idiopathic Parkinson disease diagnoses are incorrect. Our study, the Greek study, and some clinical studies suggest that the risk of a Parkinson-like syndrome diagnosis may increase with continued Mn exposure and aging. CONCLUSION: The limited data available for the BBDR model point to the need for evidence, particularly on relationships between Mn species, exposure route, MnB with chronic environmental exposure, ageing, and susceptibility factors, to improve human-health risk assessments for chronic, environmental Mn exposure.

Dose-Response Relationship, Drug↗

PubMed1998

Identification of Ergonomic-Related Hazards in an Industrial Sample Using the National Occupational Exposure Survey.

The National Occupational Exposure Survey (NOES) was used to determine probabilities for 4 potential physical-agent and 10 potential ergonomic-related exposure hazards among a representative sample of U.S. industries. Potential physical-agent hazard exposures, principally whole-body and segmental vibration, were highest among railroad and heavy construction industries. Several construction industries had high probabilities of potential ergonomic-related exposure hazards, especially to the back and upper extremities. Establishments with 100 to 249 employees had the highest probability of potential exposures to the 2 types of hazards. Measures of safety and health climate did not differ consistently between high-hazard and low-hazard establishments. The approach taken in this paper may be used to help identify highrisk industries, evaluate interventions, and develop inspection strategies.

exposures↗

PubMed2006

The development and regulation of occupational exposure limits in Taiwan.

The occupational exposure limits (OELs) in Taiwan was promulgated in 1974 and has been revised five times since then. Many of the OELs were adopted from the most recent ACGIH TLVs and US OSHA PELs. A total of 483 chemicals were listed in the current Taiwan OELs Standard. The procedures of OELs development in Taiwan include the IOSH organized a recommended exposure limits (RELs) Committee to select the target chemicals and to recommend the RELs through literature review based on the health effects in the first stage, then, the CLA put policy needs, economical and technical feasibility into consideration and set up the final OELs at the second stage. A standard operation manual of RELs Committee has been developed. Based on our experience, several issues including the participation of representatives from a comprehensive spectrum, communication/education and training/enforcement, continuous collection of the local exposure data and health hazard information, use of health risk assessment, consideration of economic, and technical feasibility, as well as the globalization and information and experience sharing are critical in developing the appropriate OELs. Three examples including benzene, crystalline silica, and 2-methoxy ethanol are given to demonstrate the operation of system.

Government Regulation↗

PubMedDate not supplied

[Occupational exposure to asbestos and recognition of pleural mesothelioma as occupational disease in the province of Genoa].

The present study compares the data of pleural mesothelioma (PM) patients resident in the province of Genoa (Italy) who, in the period 1994-1996, applied to the Italian National Insurance Institute for Work Accident (INAIL), for workers' compensation for asbestos-related diseases due to occupational exposure, with the dataset of PM patients collected by the Mesothelioma Registry of Liguria (REM) in the same period and in the same area. As PM is a malignant tumor of a prevalently occupational origin, it is recognized and acknowledged as such by INAIL when clinical and etiological characteristics are matched. Objectives of this study were to describe observed PM cases, to evaluate completeness of collected data and differences between those who requested compensation and those who did not. The REM describes the incidence of PM among Ligurian residents, proposing patients with a specific questionnaire to assess occupational, environmental and indoor asbestos exposures. The REM collected 199 new cases of PM among the residents of both the city of Genoa (1994-96) and the province of Genoa (1995-96). In the same period, INAIL received 48 (24%) applications for compensation. Among these, 43 subjects were included in a subgroup of 98 patients registered in the REM as cases with definite diagnosis and ascertained asbestos exposure; 32 were awarded compensation, while 11 are under evaluation. The data collected by REM do not show proven asbestos exposure and/or PM diagnosis for five other subjects (two compensated and three under judgment). This study reveals that: a) only a 24% of the patients with a diagnosis of PM and asbestos exposure apply for compensation; b) an exchange of information among institutions involved in primary prevention, in the evaluation of occupational exposures to carcinogens and in insurance compensation is useful.

Aged↗

PubMed1988

Estimates of the proportion of lung cancer attributable to occupational exposure.

The proportion of lung cancer due to occupational exposure has been estimated by computing the attributable risk in the population (ARp) from various case-control studies. Different criteria have been used in including occupational exposures from published studies: (i) exposure to lung carcinogens according to a job-exposure matrix approach; (ii) occupations in which an increased risk of lung cancer has been established; (iii) occupations in which an increased risk of lung cancer has been suggested; and (iv) occupations associated with a statistically significant increase of lung cancer. Only studies in which the confounding effect of smoking was controlled for have been included. We found a wide variability of ARp estimates, mainly due to the different geographical locations of the studies, while they seem to be only moderately affected by the different criteria of inclusion of the relevant occupational exposures. Studies using job-exposure matrices gave ARps ranging from 0.6% to 35%. When a list of recognized carcinogenic exposures was used for the selection of the relevant occupations, the estimates varied between 2.4% and 40%. From the studies reviewed it also appears that tobacco smoking has a very limited confounding effect. Various limitations of the exercise are discussed.

Age Factors↗

PubMed1996

[Squamous epithelial carcinoma of the tongue after occupational exposure to chromium VI compounds].

BACKGROUND: The major key risk factors of head and neck cancer are chronic alcohol and tobacco consumption. There ist further increasing evidence that exposure to hazardous occupational agents increases the cancer risk substantially. CASE REPORT: By means of a case report and an overview of the literature, the role of occupational exposure to hexavalent chromium compounds as a risk factor of head and neck cancer is analysed. RESULTS AND CONCLUSIONS: The mechanisms of chromium carcinogenesis are outlined. Possible interactions of life-style factors and occupational factors which may influence the cancer risk in a synergistic manner are also discussed. Critical analysis of the literature provides evidence of a possible role of occupational exposition to hexavalent chromium compounds as a risk factor for oral squamous cell cancer.

Carcinogens, Environmental↗