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PubMed2003

[Effect of occupational exposure and smoking on spirometric tests and symptoms of chronic bronchitis].

The importance of occupational exposure to airborne agents in the development of obstructive lung disease is uncertain. The aim of the study was to evaluate the effects of smoking and of occupational exposure on the lung function and chronic respiratory symptoms. I studied a group of 1239 adults (766 men and 473 women; mean age 44.9 +/- 8.6 yrs; current smokers 42.1%, lifetime nonsmokers 41.6%) working in 5 factories in the Bielsko-Biala area. Simple spirometric test (FEV1, FVC, FEV1%FVC) and a questionnaire on chronic respiratory symptoms, smoking habits and occupational exposures were applied. Respiratory symptoms and lung function were studied in relation to years of occupational exposure and adjusted for smoking habit. Occupational exposure was reported by 35.7% (n = 442) participants (dust 20.6%; gases or fumes 27.6%; mixed exposure 51.8%), with a mean duration of 20.9 +/- 9.2 years. In all cases concentrations of noxious agents did not exceed allowed levels. The symptoms of chronic bronchitis (cough and phlegm) were present in 12.3% and airflow limitation (FEV1% FVC < 0.7) in 6.9% of subjects. The significant relation of respiratory symptoms and bronchial obstruction to smoking was confirmed. No significant association between occupational exposure and ventilatory function or respiratory symptoms was found in a whole group. Smoking--specific analysis showed that current smokers appeared to be more susceptible to the effects of professional exposure. It was expressed in lower lung function indices and significantly higher odds ratios for airflow limitation or chronic respiratory symptoms for smokers exposed compared to nonexposed. Sufficient evidence of health selection processes known as a "healthy smoker" and a "healthy worker" effects were revealed.

Adult↗
PubMed1994

Widia tool grinding: the importance of primary prevention measures in reducing occupational exposure to cobalt.

An occupational health and industrial hygiene survey was carried out in Widia tool grinding industries in the area covered by Local Health Unit No. 60--Vimercate (Northern Italy). The principal objectives of the study were to assess occupational cobalt exposure, identify the measures required to improve the 'risk' situations, and implement specific health protocols. The results identified a variable level of occupational hazard in the tool grinding sector. An important factor in the containment of occupational exposure was, along with correct practical procedures, the existence of adequate primary prevention measures (aspiration systems over the machines). In the plants where good industrial hygiene conditions prevailed, environmental cobalt concentrations were below the TLV, whereas the levels recorded in plants with inadequate equipment were as much as 10 times the TLV. Similarly, urinary cobalt for the workers in these same plants was as much as 13 times higher than the reference population value. However, this was recorded in plants with good industrial hygiene conditions. After technical improvements, the results of biological monitoring showed an overall reduction in exposure indicator values.

Air Pollutants, Occupational↗
PubMed1999

Occupational exposure to tetrachloroethene and its effects on the kidneys.

Occupational exposure to tetrachloroethene (TCE) has been reported to cause early adverse effects on the kidneys. We investigated the effects of TCE exposure on the kidneys in 82 exposed and 19 nonexposed workers from four dry-cleaning shops in The Netherlands. The mean inhaled amount of TCE in the exposed group, which was assessed by determination of its concentration in alveolar air samples, was 8.4 mg/m3 (range, 2.2-44.6 mg/m3). This value corresponds to a mean 8-hour time-weighted average exposure of 7.9 mg/m3 (range, 1-221 mg/m3). A chronic dose index (CDI) was estimated from data on the current TCE dose and the occupational history of the individual subjects. The mean CDI in the exposed group was 400 months X mg/m3 (range, 12-4882 months X mg/m3). Effects on the tubules were assessed with the parameters N-acetyl-beta-D-glucosaminidase, beta-galactosidase, alanine aminopeptidase, and retinol-binding protein (RBP) in urine. Early effects on the glomeruli were monitored with the parameter albumin in urine. Total protein in urine was determined for the general assessment of effects on the glomeruli and tubules. The tubular parameter RBP was increased in the exposed group, compared with the nonexposed group. None of the other parameters differed between the study groups, and none of the renal-effect parameters correlated with the TCE dose or the CDI. In conclusion, occupational exposure to TCE may cause a minor effect on the tubular RBP at exposure levels below the Dutch occupational exposure limit (240 mg/m3).

Adult↗
PubMed2006

Occupational exposures and head and neck cancers among Swedish construction workers.

OBJECTIVES: Occupational exposures in the construction industry may increase the risk of head and neck cancers, although the epidemiologic evidence is limited by problems of low study power and inadequate adjustment for tobacco use. In an attempt to address this issue, the relationship between selected occupational exposures and head and neck cancer risk was investigated using data from a large cohort of Swedish construction workers. METHODS: Altogether 510 squamous cell carcinomas of the head and neck (171 in the oral cavity, 112 in the pharynx, 227 in the larynx) were identified during 1971-2001 among 307 799 male workers in the Swedish construction industry. Exposure to diesel exhaust, asbestos, organic solvents, metal dust, asphalt, wood dust, stone dust, mineral wool, and cement dust was assessed using a semi-quantitative job-exposure matrix. Rate ratios (RR) and 95% confidence intervals (95% CI) were calculated for head and neck cancers in relation to occupational exposure, using Poisson regression with adjustment for age and smoking status. RESULTS: Asbestos exposure was related to an increased laryngeal cancer incidence (RR 1.9, 95% CI 1.2-3.1). Excesses of pharyngeal cancer were observed among workers exposed to cement dust (RR 1.9, 95% CI 1.2-3.1). No occupational exposures were associated with oral cavity cancer. These findings did not materially change upon additional adjustment for cigarette pack-years. CONCLUSIONS: These findings offer further evidence that asbestos increases the risk of laryngeal cancer. The observation of a positive association between cement dust exposure and pharyngeal cancer warrants further investigation.

Adult↗
PubMed2006

Assessing occupational exposure to perchloroethylene in dry cleaning.

Occupational exposure to perchloroethylene (PERC) in dry cleaning is analyzed by calculating airborne concentrations for a large set of possible exposure scenarios. Different generations of dry-cleaning machines ranging from vented machines used until the 1980s to nonvented closed-loop machines used since the 1990s are investigated; the geographical scope of the study is Germany. Concentrations are calculated for diffuse emissions, release of contaminated air during loading and unloading, and residual solvent releases from cleaned garments with a dynamic two-box model for near field and far field. The concentration estimates for near field and far field agree well with measured concentrations. The airborne concentrations are compared with maximum workplace concentrations (MAK values). The full set of scenarios shows for which historical situations the workplace concentrations were near the MAK value and that the transition to newer dry-cleaning machines reduced the occupational exposure by more than one order of magnitude. In addition, numbers of exposed workers are estimated for different years. Whereas more than 25,700 workers in the near field were exposed to PERC in 1975, the number has been below 5900 since 2001, which is due mainly to a reduced amount of garments being dry cleaned and, to a lesser extent, to replacement of PERC by nonchlorinated solvents. The results from the scenario-based analysis are consistent with exposure ranges obtained from a Monte Carlo calculation using frequency distributions of key input parameters, such as emission factors, batch times, and room volumes.

Air Pollutants, Occupational↗
PubMedDate not supplied

Immunomodulatory effects of occupational exposure to mancozeb.

The effects of occupational exposure to ethylene-bis-dithiocarbamate of manganese and zinc on the immune system were evaluated in a group of mancozeb-exposed manufacturers and controls. The immune system tests revealed the following: (a) lymphocyte proliferative responses triggered by different activators and mitogen-induced IL-2 production were higher in exposed subjects than in controls; (b) production of monocyte/macrophage-derived IL-1 and polyclonal IgG and IgM, by beta-lymphocytes, did not differ between exposed subjects and controls; (c) percentages and absolute numbers of total T-cells, T-helper cells, T-suppressor/cytotoxic cells, activated T-cells, total beta-cells, and natural killer cells were similar in exposed subjects and controls; (d) serum immunoglobulin classes and complement fractions were within the range of normality; and (e) rheumatoid factor and non-organ-specific serum autoantibodies were absent in exposed and control subjects. An increase in T-cell functional response was found in the exposed group, suggesting a slight immunomodulator effect of mancozeb in conditions of low-level, prolonged occupational exposure.

Air Pollutants, Occupational↗
PubMed2002

Smoking, occupational exposure and mortality in workers in Guangzhou, China.

PURPOSE: To compare the mortality risk of smoking and overall occupational exposure in Guangzhou, China. METHODS: Baseline data on smoking and occupational exposure of 82159 workers aged 30+ were retrieved from medical records established in 1988-92. Vital status and causes of death were followed through 1998. RESULTS: During follow-up 1584 workers had died. Adjusted relative risks (RR) with 95% confidence intervals (95%CI) for ever-smoking in men was 1.23 (1.07-1.41) for total deaths, 1.43 (1.17-1.74) for all cancer, 3.77 (2.31-6.14) for lung cancer and 2.54 (1.09-5.92) for stomach cancer (all showing significant linear trends with amount and duration of smoking). The RR in women of 1.10 (0.59-2.06) for total deaths and 1.60 (0.65-3.92) for all cancer were positive but not significant. No significant excess mortality risk was observed for occupational exposure in each gender. In both genders combined, the RR for total deaths was 1.23 (1.08-1.40) for smoking and 1.07 (0.96-1.19) for occupational exposure. If the relationships were causal, 12% of all deaths could be attributed to smoking but only 3% to occupational exposure. CONCLUSION: Smoking was more predictive of premature deaths than overall occupational exposures in middle aged workers. Smoking cessation should be a top priority in occupational health practice.

Adult↗
PubMed2000

Tobacco smoking, occupational exposure and chronic respiratory disease in an Italian industrial area.

Tobacco smoking and occupational exposure are the major factors responsible for chronic obstructive pulmonary disease (COPD) worldwide. The prevalence of this disease and its main risk factors were investigated in an area characterized by a high density of iron- and steelworking factories in North Italy. A total of 1,497 subjects (50% male) aged 40-59 yrs underwent an interview and a physical assessment, and 1,244 of them also underwent spirometry. The prevalences of COPD and asthma were 16.1 and 5.2% among males and 4.4 and 4.0% among females. COPD and respiratory symptoms were associated with both smoking and occupational exposure in males: the odds ratios for having been occupationally exposed among males were 2.3 (95% confidence interval 1.4-3.7) for COPD and 1.7 (1.2-2.6) for respiratory symptoms. No association was found between asthma and tobacco smoking or occupational exposure. The forced expiratory volume in one second and forced vital capacity were associated negatively with smoking and not associated with occupational exposure. In females, lesser effects of cigarette smoking on both self-reported respiratory diseases and lung function tests were found. The attributable risks of chronic obstructive pulmonary disease for smoking and occupational exposure among males were 52.9 and 8.8%, respectively, and 60.3% when considered together, whereas 18.8% of chronic obstructive pulmonary disease cases among females were attributable to smoking.

Adult↗
PubMed1994

Are the apparent effects of cigarette smoking on lung and bladder cancers due to uncontrolled confounding by occupational exposures?

It has been suggested that the well known associations between smoking and cancer may in part reflect inadequately controlled confounding due to occupational exposures. The purpose of the present analysis is to describe the association between cigarette smoking and both lung and bladder cancers, taking into account the potential confounding effects of over 300 covariates, most of which represent occupational exposures. A population-based case-control study was undertaken in Montreal to investigate the associations between a large variety of environmental and occupational exposures, on the one hand, and several types of cancer, on the other. Interviews were carried out with male incident cases of several sites of cancer, including 857 lung cancers and 484 bladder cancers. A group of non-smoking-related cancers, comprising 1,707 interviewed subjects, was used as one control group. Additionally, 533 population controls were interviewed and constituted a second control group. Interview information included detailed lifetime smoking histories, job histories, and other potential confounders. Each job history was reviewed by a team of experts who translated it into a history of occupational exposures. These occupational exposures, as well as nonoccupational covariates, were treated as potential confounders in the analysis of cigarette smoking effects. Regardless of whether population controls or cancer controls were used, the odds ratio (OR) between smoking and lung cancer (ranging from 12 to 16 for ever vs never smokers) was not materially affected by adjustment for occupational exposures. The odds ratios for bladder cancer (ranging from 2 to 3) were also unaffected by confounding due to occupational exposures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Urinary porphyrin profiles as a biomarker of mercury exposure: studies on dentists with occupational exposure to mercury vapor.

Porphyrins are formed as intermediates in the biosynthesis of heme. In humans and other mammals, porphyrins with eight, seven, six, five, and four carboxyl groups are excreted in the urine in a well-established pattern. Mercury selectively alters porphyrin metabolism in kidney proximal tubule cells, leading to an altered urinary porphyrin excretion pattern. Previous studies in rats have shown that changes in the urinary porphyrin profile during exposure to mercury as methylmercury hydroxide are uniquely characterized by highly elevated (20- to 30-fold) levels of four- and five-carboxyl porphyrins and by the excretion of an atypical porphyrin ("precoproporphyrin"), which elutes on high performance liquid chromatography (HPLC) approximately midway between penta- and coproporphyrins. Changes in the urinary porphyrin profile are highly correlated with the dose and duration of mercury exposure and persist for up to 20 wk following cessation of mercury treatment. In the present studies, the utility of urinary porphyrin profile changes as a biomarker of mercury exposure in human subjects was evaluated. Urinary porphyrin concentrations were measured in dentists participating in the Health Screening Programs conducted during the 1991 and 1992 annual meetings of the American Dental Association and compared with urinary mercury levels measured in the same subjects. Among dentists with no detectable urinary mercury, mean concentrations of urinary porphyrins were within the established normal ranges for male human subjects. In contrast, among dentists with urinary mercury in excess of 20 micrograms/L, mean urinary concentrations of four- and five-carboxyl porphyrins as well as of precoproporphyrin were elevated three to four times those of unexposed subjects. Significant differences in urinary porphyrin concentrations remained when porphyrin concentrations in spot urine samples were adjusted for creatinine levels. These findings suggest that urinary porphyrin profiles may serve as a useful biomarker of mercury exposure in clinical or epidemiologic studies of mercury-related human health risks.

Animals↗
PubMed2001

Occupational exposure to volatile anaesthetics: epidemiology and approaches to reducing the problem.

Long term occupational exposure to trace concentrations of volatile anaesthetics is thought to have adverse effects on the health of exposed personnel. In contrast with halothane--an agent likely to cause mutagenic effects and proven to be teratogenic--isoflurane and enflurane have not so far been proved to have adverse effects on the health of personnel exposed long term. Data on the newer agents sevoflurane and desflurane are limited. Since possible health hazards from long term exposure to inhalational anaesthetics cannot yet be definitively excluded, many Western countries have established limits for exposure. These usually range from 2 to 10 ppm as a time-weighted average over the time of exposure. A number of investigations have demonstrated that, in operating theatres with modern climate control and waste anaesthetic gas scavenging systems, occupational exposure is unlikely to exceed threshold limits. However, occupational exposure from the use of volatile agents in operating theatres with poor air control--especially during bronchoscopy procedures in paediatric patients--remains a source of concern. This also holds true for both postanaesthesia care units (PACU) and intensive care units (ICU) lacking proper air conditioning and waste gas scavengers. To minimise occupational exposure to volatile anaesthetics, all measures must be taken to provide climate control and properly working scavenging devices, and ensure sufficient personal skill of the anaesthetist, e.g. during inhalational mask induction. Furthermore, low-flow anaesthesia should be used whenever possible. The sole use of intravenous drugs such as propofol instead of volatile agents, were this possible, would eliminate occupational exposure, but may result in environmental pollution by toxic metabolites (e.g. phenol).

Anesthetics, Inhalation↗
PubMed1984

Exposure-effect and exposure-response relationships between occupational exposure to styrene and neuropsychological functions.

A neuropsychological test battery was administered to 50 workers exposed to styrene and to 50 sex-, intelligence-, and age-matched controls. The main styrene metabolites, ie, mandelic acid (MA) and phenylglyoxylic acid (PGA), were measured as exposure indices in the urine collected on Saturday mornings, just before neuropsychological testing. Exposure-response and exposure-effect relationships were found between the intensity of the exposure (as reflected by the sum of MA and PGA) and the scores of the neuropsychological tests. Verbal learning skills were significantly impaired in workers with a sum of MA and PGA higher than 150 mmole/mole creatinine, corresponding to styrene airborne concentrations higher than 25 ppm (mean daily exposure). Logical memory and visuo-constructive abilities were shown to be significantly affected in workers with MA and PGA higher than 300 mmole/mole creatinine, corresponding to exposure levels of more than 50 ppm of styrene in air.

Adult↗
PubMed1999

[The toxic effect of mercury in occupational exposure].

The paper addresses the problems of environmental and occupational exposures to mercury compounds. Mercury and its compounds are very toxic. Occupational exposure and environmental pollution are the major sources of hazard to human health. Metallic mercury evaporates at room temperature producing inorganic and organic compounds, and forms amalgams with many metals. In more than 50 professions, workers may be exposed to mercury, particularly in the mining and chemical industries and in agriculture. Occupational poisoning is rarely acute but it is usually chronic. The symptoms result from the damage to the central nervous system, and the kidney, as well as from the impairment of erythrocyte metabolism, coagulation and immune response. Mercury may also induce allergic reactions. Chronic mercury poisoning is diagnosed on the basis of the clinical picture in the presence of the occupational exposure. Inorganic mercury poisoning is treated specifically with chelating agents.

Adolescent↗
PubMed1995

Occupational exposure to environmental tobacco smoke.

OBJECTIVES: To measure occupational exposures to environmental tobacco smoke in diverse settings, including offices and production areas, and to evaluate the effectiveness of policies that restrict or ban smoking in the workplace. DESIGN: Survey. The average weekly concentration of environmental tobacco smoke was measured with passive monitors that sample nicotine. Approximately 25 samples were placed in each worksite for 1 week. SETTING: Twenty-five Massachusetts worksites, including fire stations, newspaper publishers, textile dyeing plants, and manufacturers of valves, fiberoptics, flight instruments, batteries, adhesives, semiconductor equipment, filters, and tools and dies. Samples were collected in offices and production areas. MAIN OUTCOME MEASURES: The distribution of nicotine concentrations in various work settings as a function of company smoking policy. These data were interpreted with three approaches: comparing measured concentrations with a published risk assessment; comparing occupational exposures with home exposures; and evaluating the "cigarette equivalents" to which workers were exposed. RESULTS: Worksite smoking policy had a major effect on the nicotine concentrations, which fell from a median of 8.6 micrograms/m3 in the open offices at worksites that allowed smoking to 1.3 micrograms/m3 in sites that restricted smoking, and to 0.3 microgram/m3 in worksites that banned smoking. The nonoffice workspaces were affected similarly, with median concentrations of 2.3, 0.7, and 0.2 microgram/m3 at worksites that allowed, restricted, and banned smoking, respectively. CONCLUSION: All three evaluation methods indicated that occupational exposure to environmental tobacco smoke presents a substantial risk to workers in the absence of a policy restricting or banning smoking.

Housing↗
PubMed2003

Occupational exposure to inhalational anesthetics during cardiac surgery on cardiopulmonary bypass.

BACKGROUND: Eventual hazards from occupational exposure of operating room personnel to inhalational anesthetic agents cannot yet be definitively excluded. We determined if occupational exposure of operating room personnel to waste anesthetic gases during cardiopulmonary bypass (CPB) complies with the established governmental limits. METHODS: Ten adults underwent inhalational anesthesia for coronary artery bypass grafting with nitrous oxide and either sevoflurane (n = 5) or desflurane (n = 5). The administration of inhalational anesthetic agents was stopped before initiation of CPB. Gas samples were obtained before and during CPB every 90 seconds from the breathing zones of anesthesiologist (A), surgeon (S), and perfusionist (P). Time-weighted averages (TWA) over the time of exposure were calculated. RESULTS: The surgeon's exposure to nitrous oxide was 9.3 +/- 1.9 parts per million (ppm) before and 3.0 +/- 1.4 ppm during CPB (A: 6.7 +/- 1.1 ppm and 0.5 +/- 0.1 ppm; P: 3.7 +/- 1.4 ppm during CPB). Occupational exposure to desflurane was 0.21 +/- 0.10 ppm before and 0.62 +/- 0.28 ppm during CPB for the surgeon (A: 0.02 +/- 0.01 ppm and 0.02 +/- 0.003 ppm; P: 0.82 +/- 0.26 ppm during CPB), thereby exceeding the given limit of 0.5 ppm. Exposure levels of sevoflurane were below the 0.5 ppm limit at all times, as were nitrous oxide levels (threshold limit: 25 ppm). CONCLUSIONS: Although occupational exposure to inhalational anesthetic agents was low at most times during the study and none of the operating room staff complained about subjective or objective impairment or discomfort, all measures must be taken to further minimize occupational exposure, including sufficient air conditioning and routine use of waste gas scavenging systems on CPB equipment.

Adult↗
PubMed2002

Population-based study of non-infectious rhinitis in relation to occupational exposure, age, sex, and smoking.

BACKGROUND: Many types of occupational exposure are associated with the risk of non-infectious rhinitis. We investigate the risk factors for this association. METHODS: A random population of 2,044 subjects (aged 21-51) answered a questionnaire that was comprised of detailed questions on occupational exposure, nasal complaints, and smoking. NIR was defined as the sensation of nasal blockage and/or attacks of sneezing without having a cold. The incidence rates for NIR among exposed and unexposed were calculated. In the different exposed groups, only NIR with onset after the start of exposure was regarded as exposed. If a subject reported NIR before the relevant exposure started, he/she was excluded from that analysis. Relative risks (RR) were calculated as incidence rate ratios. Odds ratios controlling for smoking, age, and atopy were also calculated. RESULTS: The incidence rate for NIR was 13.5/1,000 person-years. Males exposed to fire fumes (RR 2.5, 95% confidence interval (CI) 1.5-4.1), women exposed to paper dust (RR 2.0, 95% CI 1.5-2.9), and male cleaners (RR 3.1, 95% CI 1.9-5.1) displayed an increased risk of developing NIR. Smoking was associated with an increased risk of NIR for both sexes. CONCLUSIONS: Exposure to several occupational irritants is associated with a higher risk of developing NIR.

Adolescent↗
PubMed2001

Recording of data of individual measurements of occupational exposure: guideline of the Dutch Society of Occupational Hygiene (October 1999).

Following the recommendations of the European Working Group on Exposure Databases, a Working Group (on Storage of Data of Measurements of Occupational Exposure) of the Dutch Occupational Hygiene Society has developed a Guideline which was presented at the International Symposium on Occupational Exposure Databases and Their Application for the Next Millennium, November 1-3, 1999, London. To establish the present situation, a small-scale telephone survey of monitoring practices and storage of data was done within the Society. The results of the telephone survey and the draft guidance document were discussed with the occupational hygienists and other stakeholders (e.g., authorities, industry, labor unions, and occupational physicians) in a society meeting. This meeting was used to gather ideas on the need and support for a guidance document and to get input for improving the draft guidance document and for implementation of the Guideline. After this meeting, the Guideline was further developed and published by the Dutch Occupational Hygiene Society. The Guideline concentrates on the data elements required when storing exposure data. The data elements presented are the minimum and should be stored minimally to ensure proper interpretation of results at present and in the future and definitions of the items used are given. The Guideline does not prescribe how the data should be stored, or which procedures need to be used to guarantee the quality of the recorded data elements.

Data Collection↗