Showing papers in "International Archives of Occupational and Environmental Health in 1996"

Asthma and the indoor environment: the significance of emission of formaldehyde and volatile organic compounds from newly painted indoor surfaces

Abstract: As a part of the worldwide European Community Respiratory Health Survey, possible relations between asthma and emissions from newly painted indoor surfaces were studied. The participants (n = 562) answered a self-administered questionnaire, with questions on symptoms and indoor exposures, including indoor painting, during the last 12 months. The participants also underwent a structured interview, spirometry, peak flow measurements at home (PEF), methacholine provocation test for bronchial hyper-responsiveness (BHR), and skin prick tests. In addition, serum concentration of eosinophilic cationic protein (S-ECP), blood eosinophil count (B-EOS), and total immunoglobulin E (S-IgE) were measured. Current asthma was defined as a combination of BHR and at least one asthma-related symptom (wheezing and attacks of breathlessness). The information gathered on indoor painting was compared with exposure measurements of formaldehyde and volatile organic compounds (VOC) performed in a selected sample of the dwellings (n = 62). Relations between exposures, asthma and clinical signs were calculated by multiple linear or logistic regression, adjusting for possible influence of age, gender and tobacco smoking. The prevalence of asthma was increased among subjects with domestic exposure to newly painted surfaces (OR = 1.5; 95% CI 1.0-2.4), particularly newly painted wood details (OR = 2.3; 95% CI 1.2-4.5) and kitchen painting (OR = 2.2; 95% CI 1.1-4.5). Moreover, blood eosinophil concentrations were significantly elevated among subjects living in newly painted dwellings. A significantly increased prevalence of symptoms related to asthma, but not BHR, was observed in relation to workplace exposure to newly painted surfaces. The indoor concentration of aliphatic compounds (C8-C11), butanols, and 2,2,4-trimethyl 1,3-pentanediol diisobutyrate (TXIB) was significantly elevated in newly painted dwellings. The total indoor VOC was about 100 micrograms/m3 higher in dwellings painted in the last year. A significant increase in formaldehyde concentration was observed in dwellings with newly painted wood details. Our results indicate that exposure to chemical emissions from indoor paint is related to asthma, and that some VOCs may cause inflammatory reactions in the airways. To improve asthma management, and to counteract the increasing frequency of asthma, the significance of the indoor environment should not be neglected. Our study suggests that the contribution of emissions from paint to indoor concentrations of formaldehyde and VOCs should be as low as possible.

Health and immunology study following exposure to toxigenic fungi (Stachybotrys chartarum) in a water-damaged office environment.

Abstract: There is growing concern about adverse health effects of fungal bio-aerosols on occupants of water damaged buildings. Accidental, occupational exposure in a nonagricultural setting has not been investigated using modern immunological laboratory tests. The objective of this study was to evaluate the health status of office workers after exposure to fungal bio-aerosols, especially Stachybotrys chartarum (atra) (S. chartarum) and its toxigenic metabolites (satratoxins), and to study laboratory parameters or biomarkers related to allergic or toxic human health effects. Exposure characterization and quantification were performed using microscopic, culture, and chemical techniques. The study population (n = 53) consisted of 39 female and 14 male employees (mean age 34.8 years) who had worked for a mean of 3.1 years at a problem office site; a control group comprised 21 persons (mean age 37.5 years) without contact with the problem office site. Health complaints were surveyed with a 187-item standardized questionnaire. A comprehensive test battery was used to study the red and white blood cell system, serum chemistry, immunology/antibodies, lymphocyte enumeration and function. Widespread fungal contamination of water-damaged, primarily cellulose material with S. chartarum was found. S. chartarum produced a macrocyclic trichothecene, satratoxin H, and spirocyclic lactones. Strong associations with exposure indicators and significant differences between employees (n = 53) and controls (n = 21) were found for lower respiratory system symptoms, dermatological symptoms, eye symptoms, constitutional symptoms, chronic fatigue symptoms and several enumeration and function laboratory tests, mainly of the white blood cell system. The proportion of mature T-lymphocyte cells (CD3%) was lower in employees than in controls, and regression analyses showed significantly lower CD3% among those reporting a history of upper respiratory infections. Specific S. chartarum antibody tests (IgE and IgG) showed small differences (NS). It is concluded that prolonged and intense exposure to toxigenic S. chartarum and other atypical fungi was associated with reported disorders of the respiratory and central nervous systems, reported disorders of the mucous membranes and a few parameters pertaining to the cellular and humoral immune system, suggesting a possible immune competency dysfunction.

Occupational and individual factors related to musculoskeletal symptoms in five body regions among Swedish nursing personnel

Abstract: The relationship between individual factors, physical and psychosocial exposure at work, and musculoskeletal symptoms in the neck, shoulders, low back, hands, and knees was studied among female nursing personnel working at a Swedish hospital. The personnel had participated in a course in work technique (patient transfer and handling principles). Prior to the course, the subjects had filled in a questionnaire (n = 688). The aim of this cross-sectional study was to elucidate whether different individual and work factors are related to musculoskeletal symptoms in a specific body region. Due to the cross-sectional design, however, causality cannot be discussed. Univariate analyses and multiple logistic regression analyses were performed and yielded similar results. The latter analyses showed that in the present hospital setting, individual factors together with physical and psychosocial work factors were related to symptoms in the neck, low back, and hands; individual factors and psychosocial work factors were related to symptoms in the shoulders; while only individual factors were related to symptoms in the knees. The results of the present study showed that various individual factors and physical and psychosocial work factors were related to musculoskeletal symptoms in the different body regions. Thus, the identification of risk factors might have far-reaching implications for the way in which effective health programs for prevention should be designed in the hospital setting.

Physical workload and the aging worker: a review of the literature

Abstract: In the coming decades, demographic, economic and social changes will result in an increased proportion of elderly persons in the workforce in most industrialized countries. This trend is causing growing interest in the problems of the ageing worker in current employment. The objective of this particular paper is to provide more insight into the impact of ageing on the balance between physical work capacity and physical workload. To this end, the scientific literature in the field is reviewed and ordered by means of a specific conceptual model of “ageing and physical workload”. A progressive decline in physical work capacity, characterized by diminished aerobic capacity and muscular capacity, has consistently been reported. However, inter-individual differences appear to be considerable. The question of whether there are systematic differences in physical work demands between younger and older workers within occupations has been answered vaguely. Conflicting results in this matter bring into discussion the role of the actual working method as one of the determinants of the physical workload. An agerelated imbalance between physical workload and physical work capacity is suggested to result in a chronic overload, increasing the risk of long-term health effects such as musculoskeletal complaints and disorders. For many ageing workers in physically demanding occupations, extreme physical workloads, increasing the risk of disease or disablement, are still reported. The multiconceptual study of ageing and physical workload in the present paper reveals several possibilities for preventive measures. However, as information is still lacking, additional research is needed, in particular on the onset and development of long-term effects on health in relation to age and work demands.

Physiological comparison of three interventions in light assembly work: reduced work pace, increased break allowance and shortened working days

Abstract: An industrial assembly task known to imply a high risk for shoulder-neck disorders was simulated in the laboratory. Eight females (aged 22-32 years) were trained to manage industrial work pace (120 according to the methods-time measurement system, MTM). They carried out seven work protocols at different days with different combinations of work pace (120 or 100 MTM), break allowance (20 min of active or passive breaks added every 2 h), and duration of the working day (2, 4 or 6 h). During 6 h of work at 120 MTM the electromyographic (EMG) amplitude from the upper trapezius muscle increased by about 11%, the EMG zero crossing rate decreased by about 2.5%, and perceived fatigue increased by about 4 CR10 scale units. When work pace was reduced to 100 MTM, the upper trapezius EMG amplitude decreased by 20% and became less variable. Heart rate decreased by about 10 bpm, perceived fatigue decreased by about 1 CR10 scale units, and shoulder tenderness was reduced by about 5%. However, the work task could still not be performed in a physiological steady state. Added breaks, whether active or passive, had no apparent effects on upper trapezius load during work or on physiological responses. Recovery of EMG, maximal strength, heart rate and blood pressure sensitivity, and tenderness was complete 4 h after work, independent of the preceding work conditions. These findings suggest that a limitation of the daily duration of assembly work may be more effective in limiting acute fatigue than reduced work pace or increased break allowance.

Biomonitoring of urinary aromatic amines and arylamine hemoglobin adducts in exposed workers and nonexposed control persons.

Abstract: The renal excretion of arylamines in occupationally exposed and nonexposed subjects was measured by a gas chromatography-electron capture detector method. Additionally, in the occupationally exposed persons hemoglobin adduct levels of arylamines were determined by a liquid chromatography-electrochemical detector method, together with the individual acetylator status. The aromatic amines aniline,p-toluidine, 2-naphthylamine, and 4-chloro-o-toluidine were detected in the urine of nonsmoking subjects who were not occupationally exposed to arylamines. Significantly higher concentrations of aniline,o-toluidine,m-toluidine, 2-naphthylamine, and 4-methyl-1,3-phenylenediamine could be observed in the urine of smoking control persons in comparison to nonsmokers. Comparison of smokers and nonsmokers in a group of workers primarily exposed to aniline and 4-chloroaniline revealed significant differences (P < 0.05) in the formation of 4-aminodiphenyl hemoglobin adducts and in the renal excretion of 2-naphthylamine. The slow acetylators in this group produced significantly more hemoglobin adducts of aniline and 4-chloroaniline than did the fast acetylators. In slow acetylators among the smoking workers there was a significant increase in the formation of 4-aminodiphenyl hemoglobin adducts and in the renal excretion of 4-chloroaniline andm-toluidine. The results indicate that there are influences of smoking habits and acetylator status on the levels of arylamine hemoglobin adducts as well as urinary arylamine concentrations. Hemoglobin adducts seem to be good parameters for monitoring aniline and 4-chloroaniline exposure at the workplace, especially if the acetylator polymorphism can be taken into account. 4-Aminodiphenyl hemoglobin adducts might be good parameters for monitoring individual smoking habits. The determination of urinary arylamine concentrations provides additional information concerning acute exposures to aromatic amines.

Cyto- and genotoxic effects of coordination complexes of platinum, palladium and rhodium in vitro

Abstract: The growing industrial use of platinum group elements as catalysts, especially in automobile exhaust detoxification (trimetal catalytic converters), is causing increasing occupational and environmental pollution. The cytotoxic and mutagenic properties of industrially used coordination complexes of platinum, palladium and rhodium were investigated using the neutral red cytotoxicity assay on two established cell lines and theSalmonella typhimurium/microsome test system (Ames test). Cytotoxic effects of the platinum complexes, measured as ED50, occurred at test concentrations of 0.2 mM. The analogous palladium salts tested were 3 times less toxic with ED50 being 0.6 mM, while the rhodium salts proved to be 30 times less toxic (ED50=6 mM). Levels of toxicity of the different complexes of a particular metal did not differ significantly from each other, which indicates that the metal itself is responsible for the toxic effects. In the Ames test, the spontaneous mutation rates increased by factors of 3 to 20 when the four tester strains were exposed to the platinum complexes. The analogous rhodium compounds proved to be considerably less mutagenic, and palladium demonstrated no mutagenic potential. As all of the four tester strains contain different mutations, the mutagenic potential of platinum and rhodium complexes appears to be based on a variety of mechanisms that damage DNA. From these in vitro experiments, it can be concluded that water-soluble complex salts of rhodium are less toxic and have a smaller mutagenic potential than the analogous platinum complexes. For palladium there is no evidence of any mutagenic property. From this point of view, the development of a catalytic converter containing predominantly palladium may be a possible means of minimizing potential health risks from this exhaust detoxification technique.

delta-Aminolevulinic acid in plasma or whole blood as a sensitive indicator of lead effects, and its relation to the other heme-related parameters.

Abstract: To evaluate the subclinical effect of lead exposure, we determined δ-aminolevulinic acid (ALA) levels in plasma (ALA-P), blood (ALA-B), and urine (ALA-U) and the activity of δ-aminolevulinic acid dehydratase (ALAD) in lead workers. Almost all of the ALA molecules in blood were present in plasma and not in blood cells, irrespective of the blood lead concentration (Pb-B). ALA-P or ALA-B levels increased slowly at Pb-B levels below 40 μg/dl (slow phase) and rapidly at levels above 40 μg/dl (rapid phase). In both phases, ALA-P and ALA-B were well correlated with Pb-B and ALAD activity. The threshold value (no-effect level) of Pb-B for elevation of the ALA-P or ALA-B level was coincident with that for ALAD inhibition; the value was around 5 μg/dl. In the rapid phase, ALA-P increased continuously up to 100 μg/dl of Pb-B, while ALAD activity reached a plateau. Receiver operative characteristic (ROC) plot analyses indicated that ALA-P and ALAD activity [ALAD(u)] had a similar diagnostic value at Pb-B levels between 10 and 40 μg/dl, although ALAD(%), the remaining ALAD activity as a percentage of the whole activity restored by zinc and dithiothreitol, had the most powerful diagnostic efficiency at these Pb-B levels. By contrast, ALA-U and zinc protoporphyrin were less effective for the diagnosis of lead exposure than ALAD and ALA-P. These findings indicate that ALA-P is the best discriminators of lead exposure form baseline to high levels of exposure.

Neurotoxicity in operating room personnel working with gaseous and nongaseous anesthesia.

Abstract: Occupational exposure to high concentrations of anesthetic gases (more than 500 ppm of nitrous oxide and more than 15 ppm of halothane and enflurane) can cause neurobehavioral effects in operating room personnel. Factors such as stress and work organization play an additional role in reducing performance capacities. It is still unclear whether these conditions may become the predominant factor in behavioral impairment when exposure to anesthetic gases is reduced; in addition, we wished to ascertain the extent of neurobehavioral and neuroendocrine effects at relatively low levels of exposure to such gases. Therefore the same group of 30 operating room personnel was examined with neurobehavioral tests during gaseous and nongaseous anesthesia. In this way, the neuropsychological performance was examined under the same stress conditions, but with different exposure levels to anesthetic gases. Serum cortisol was measured as an additional “biological stress indicator.” Prolactin secretion was examined to study possible interference of anesthetic gases with the dopaminergic system. The results were compared with those in a control group of 20 hospital workers from other departments, with similar characteristics in respect of age, sex, and education. During work with gaseous anesthesia, average airborne concentrations (geometric mean) of nitrous oxide were 50.9 ppm (SD 20.8) on the first day of the working week and 54.2 ppm (SD 22.1) on the last day of the working week, whereas average urinary nitrous oxide (geometric mean) were 21.54 μg/l on the first day of the working week and 25.67 μg/l on the last day of the working week. The operating room workers showed slower reaction times at the end of the week with gaseous anesthesia, compared with workers using nongaseous anesthesia and the control group. At the same time they also showed increased secretion of prolactin, whereas cortisol remained unchanged. Therefore, it can be concluded that lower levels of exposure to anesthetic gases (and not only high exposure levels) cause an impairment of neurobehavioral performance, with the action of stress being less relevant. The mechanism of anesthetics' neurotoxic action seems to be related to interference with the dopaminergic system.

Reduced cadmium and lead burden in Japan in the past 10 years

Abstract: Objective To investigate the current levels of exposure of the Japanese population to cadmium and lead, in comparison with the levels in 1980s. · Design A nation wide survey was conducted in 1991–1994 (the 1990 study) in 19 study sites in Japan as a follow-up to a study conducted in 1979–1983 (the 1980 study). Blood samples and 24-h total food duplicates were collected from women who did not smoke or drink habitually. Methods Blood and food duplicates (after homogenization) were analysed for cadmium (Cd-B and Cd-F, respectively) and lead (Pb-B and Pb-F) by graphite furnace atomic absorption after wet-ashing. · Results Altogether, 467 women volunteered for blood sampling. Of these women, 375 also gave food duplicates. Geometric mean (GM) Cd-B levels in the 1990 study were lower than the corresponding 1980 values in most study sites so that the 1990 grand GM (1.98 ng/ml) for Cd-B was significantly lower than the 1980 GM (3.58 ng/ml). This reduction in Cd-B was related to the reduction in Cd-F (GM for Cd-F was 38.0 μg/day in the 1980 study and 30.0 Etg/day in the 1990 study). Dietary intake was almost exclusively the route of Cd burden among the populations studied. Both Pb-B and Pb-F also showed a remarkable reduction, i.e. from 33.9 ng/ml (1980 GM) to 23.2 ng/ml (1990 GM) in the case of Pb-B, and from 32.2 μg/day (1980 GM) to 7.1 μg/day (1990 GM) in the case of Pb-F. Pb-B, however, did not correlate with Pb-F either in the 1980 or the 1990 study, because Pb intake via inhalation of air remained significant when compared with dietary intake. · Conclusion The Cd burden in Japan has decreased markedly in the past 10 years, although it is still higher than in other countries. The Pb burden has been quite low.

Chemical degradation of wastes of antineoplastic agents: cyclophosphamide, ifosfamide and melphalan

Abstract: Handling genotoxic compounds commonly used in cancer chemotherapy generates contaminated wastes that require decontamination before disposal. Chemical methods are an alternative and/or a complement to incineration for the treatment of wastes and spills. As part of a program initiated by the International Agency for Research on Cancer (IARC), three chemical methods readily available in the hospital environment, viz sodium hypochlorite (NaOCl, 5.25%), hydrogen peroxide (H2O2, < or = 30%) and Fenton reagent (FeCl2, 2H2O; 0.3 g in 10 ml H2O2, 30%), were tested for the degradation of three alkylating agents (cyclophosphamide, CP; ifosfamide, IF, and melphalan). Pharmaceutical preparations corresponding to the most highly concentrated administration solutions in either NaCl (0.9%) or dextrose (5%) were inactivated by oxidation volume/volume with each of the methods for at least 1 h. The efficiency of degradation was monitored by high-pressure liquid chromatography. The mutagenicity of the degradation residues was tested by means of the Ames test using tester strains of Salmonella typhimurium TA 97a, TA 98, TA 100 and TA 102 with and without an exogenous metabolic activation system. Complete disappearance of CP was observed after 1 h with all degradation methods. However, direct mutagens were generated by the Fenton oxidation technique in the presence of dextrose (5%). IF was completely degraded by the Fenton reagent and NaOCl methods. No mutagenic residues were detected after 1 h of treatment with the Fenton technique, and after 3 h with the NaOCl method. Direct-acting mutagens remained after the H2O2 treatment in the presence of dextrose (5%). Complete degradation of melphalan was achieved in 1 h by each of the three methods, and no mutagenic residues were produced by any of the treatments. The use of NaOCl (5.25%) proved the most efficient system for degradation of the three alkylating agents.

Carcinogenic risks of inorganic arsenic in perspective.

Abstract: Induction of cancer by inorganic arsenic occurs inconsistently between species and between routes of exposure, and it exhibits different dose-response relationships between different target organs. Inhaled or ingested arsenic causes cancer in humans but not in other species. Inhaled arsenic primarily induces lung cancer, whereas ingested arsenic induces cancer at multiple sites, including the skin and various other organs. Cancer potency appears to vary by route of exposure (ingestion or inhalation) and by organ site, and increases markedly at higher exposures in some instances. To understand what might explain these inconsistencies, we reviewed several hypotheses about the mechanism of cancer induction by arsenic. Arsenic disposition does not provide satisfactory explanations. Induction of cell proliferation by arsenic is a mechanism of carcinogenesis that is biologically plausible and compatible with differential effects for species or differential dose rates for organ sites. The presence of other carcinogens, or risk modifiers, at levels that correlate with arsenic in drinking water supplies, may be a factor in all three inconsistencies: interspecies specificity, organ sensitivity to route of administration, and organ sensitivity to dose rate.

Toluene itself as the best urinary marker of toluene exposure

Abstract: Head-space gas chromatography (GC) and high-performance liquid chromatography (HPLC) (with fluorescence detectors) methods were developed for toluene (TOL-U) and o-cresol (CR-U) in urine, respectively. In order to identify the most sensitive urinary indicator of occupational exposure to toluene vapor (TOL-A) among TOL-U, CR-U, and hippuric acid in urine (HA-U), the two methods together with an HPLC (with untraviolet detectors) method for determination of HA-U were applied in the analysis of end-of-shift urine samples from 115 solvent-exposed workers (exposed to toluene at 4 ppm as geometric mean). Regression analysis showed that TOL-U correlated with TOL-A with a significantly higher correlation coefficient than did HA-U or CR-U. With regard to the TOL-A concentrations at which the exposed subjects could be separated from the nonexposed by the analyte, TOL-U achieved separation at < 10 ppm TOL-A, whereas both HA-U and CR-U did so only when TOL-A was 30 ppm or even higher. The ratio of the analyte concentrations at 50 ppm TOL-A to those at 0 ppm TOL-A was also highest for TOL-U. Overall, the results suggest that TOL-U is a better marker of exposure to toluene vapor than HA-U or CR-U.

Occupational exposure to sevoflurane and nitrous oxide in operating room personnel

Abstract: Object: To quantify the exposure of operating room personnel to sevoflurane and nitrous oxide. Design: Prospective study at a university hospital. Methods: In 25 patients undergoing elective surgical procedures, anaesthesia was induced with thiopentone/etomidate, vecuronium and fentanyl and maintained with fentanyl, sevoflurane in 35% oxygen and 65% nitrous oxide (N2O). Occupational exposure to sevoflurane and N2O was measured in the breathing zone of one representative of each of three personnel groups (anaesthetist, surgeon, auxiliary nurse) by means of a direct reading instrument using photoacoustic infrared spectrometry. Results: The mean trace concentrations of sevoflurane for the single anaesthetic procedures exceeded the 0.5 ppm level in more than 50% of the measurements. The 2 ppm level was not exceeded in the case of the anaesthetist and the surgeon, but was exceeded in 16% of the measurements for the auxiliary nurse. The level of 25 ppm N2O were exceeded in 28% of the measurements for the anaesthetist and in 16% of these for the surgeon and for the auxiliary nurse. Conclusions: To keep exposure low, sevoflurane and N2O were used in a modern working environment: a low-leakage anaesthesia machine, high room ventilation rates, scavenging system, no intermittent mask ventilation, low to medium concentrations of sevoflurane, and strict control of the cuff pressure. Nevertheless, exposure could not be kept under NIOSH threshold values in all cases.

Changes in psychophysiological functions during night shift in nurses. Influence of changing from a full-day to a half-day work shift before night duty

Abstract: The effects of changing from a full-day to a half-day shift work before a night duty shift on physiological and psychological functions during the night shift were investigated in 12 healthy unmarried nurses working on the same ward of a university hospital. Three shift patterns, i.e., a day shift following a day shift, a night shift following a day shift, and a night shift following a half-day shift, were studied in terms of physical activity level, sympathetic and parasympathetic activity levels, cortisol, prolactin, NK cell activity, and changes in mood states. The change to the half-day shift increased the duration of sleep before night duty by about 86 min and brought wake-up times forward by about 1 h, resulting in increases in rest and time before work. In addition, the change was revealed to reduce the influence of reversed-phase circadian rhythms on autonomic nervous activity during the night shift. The score for sleepiness was significantly lower at 0500 hours following a half-day shift. There were some marginal but not significant differences in the scores reflecting the degree of vigor, tiredness and irritation during the night shift. Although the prolactin concentration was significantly decreased at the start of the night shift after the half-day shift, there was no difference in cortisol concentration or NK cell activity between the usual night shift after a day shift and the night shift after the half-day shift. The half-day shift was not observed to cause any marked change in the fixed biorhythms of these nurses. The cortisol and NK cell activity levels were low during the night shift, suggesting that the night shift itself is a high stress level, which is prejudicial to biodefense.

Occupational chronic exposure to organic solvents. XVI. Ambient and biological monitoring of workers exposed to toluene.

Abstract: Ambient-air and biological monitoring of occupational xylene exposure were carried out on 2 groups of workers (13 and 10 men, respectively) exposed to a mixture of xylenes during the production of paints or during spraying. Methods: Personal ambient-air monitoring was performed for one complete work shift. Blood and urine samples were collected directly at the end of the shift. Biological monitoring was based on the determination of the concentration of xylenes in blood and on the quantification of the sum of the three methylhippuric acids in urine. Results: Average xylene ambient-air concentrations were 29 ppm (production) and 8 ppm (spraying), ranging from 5 to 58 ppm and from 3 to 21 ppm, respectively. The concentrations of xylenes in blood ranged from 63 to 715 μg/l and from 49 to 308 μg/l, with average values being 380 and 130 μg/l, respectively. Accordingly, the workers engaged in paint production also excreted more methylhippuric acids in their urine (average 1221 mg/l, range 194–2333 mg/l) than did the sprayers (average 485 mg/l, range 65–1633 mg/l). Discussion: Our results as well as a literature review indicate that occupational xylene exposure on average barely exceeds the threshold limit value of 100 ppm as proposed by both American and German institutions. Biological monitoring based on the determination of xylenes in blood and of methylhippuric acids in urine provides sufficient sensitivity and specificity for occupational health surveillance. The results also confirm the current limit values (BAT values) proposed by the Deutsche Forschungsgemeinschaft for xylenes in blood (1500 μg/l) and methylhippuric acids in urine (2000 mg/l).

Exposure to urban and rural air pollution: DNA and protein adducts and effect of glutathione-S-transferase genotype on adduct levels

Abstract: Ambient air in urban areas is polluted by agents suspected of causing cancer in humans. A number of epidemiological studies have revealed an increased cancer risk in urban communities, especially in lung cancer. The relative risk have been estimated to be in the order of 1.5. The objective of this study was to evaluate differences in genotoxic exposure through air pollution in urban and rural areas using DNA and protein adducts as biomarkers. Another objective was to investigate whether the GSTM1 genotype has any effect on adduct level. The analyses included 32P postlabelling of DNA adducts in lymphocytes, enzyme-linked immunosorbent assay for measuring benzo[a]pyrene protein adducts and polymerase chain reaction amplification of the GSTM1 genotype. The study was a cross-sectional study of non-smoking, healthy males from rural and urban Danish areas and from Athens, Greece. All individuals in the study were healthy, non-smoking males. The Danish urban group included 74 university students, the rural group 29 students from agricultural colleges and the Greek group 17 individuals. Adduct levels differed significantly in the three groups with median levels of 0.152 fmol/μg DNA (rural), 0.205 fmol/μg (urban) and 0.285 fmol/μg (Athens). The adduct patterns showed some identical spots, but also specific adducts. Here we report increasing DNA adduct levels comparing residents in rural, small urban and large urban residential areas; we found no influence of GSTM1 genotype on DNA or protein adduct levels in non-smokers exposed to low levels of air pollution.

Urinary malondialdehyde and 8-hydroxydeoxyguanosine as potential markers of oxidative stress in industrial art glass workers.

Abstract: Previous epidemiological studies have indicated that industrial art glass workers have increased mortality risks for certain types of cancer and for cardio-and cerebrovascular disease. To test the hypothesis that increased oxidative stress might contribute to these increased mortality risks, the urinary levels of the lipid peroxidation product, malondialdehyde (MDA), and the oxidative DNA adduct, 8-hydroxydeoxyguanosine (8OHdG) were determined in 343 workers (230 men and 113 women) from the art glass industry in the southeast of Sweden. Of the study subjects, 199 (181 men and 18 women) were engaged in the process of glass production and were regarded as exposed, whereas the remainders performed clerical, warehouse and other service work and were regarded as unexposed. One hundred and sixteen were smokers (75 men and 41 women) and 215 were non-smokers (142 men and 73 women). The findings indicate that (a) exposure to industrial art glass work per se does not cause any major oxidative stress as measured by urinary levels of MDA and 8OHdG, (b) the effects from smoking per se are limited to increased lipid peroxidation among men, and (c) joint exposure to industrial art glass work and smoking may cause increased lipid peroxidation among men and increased DNA hydroxylation among both men and women. While these findings provide no evidence for increased oxidative stress due to industrial art glass work per se, the increased 8OHdG excretion in workers who smoke may be associated with a higher risk of developing free radical-dependent degenerative disease including cancer

Relationship between job stress and plasma fibrinolytic activity in male Japanese workers

Abstract: Psychosocial job stress has been shown to be associated with the development of cardiovascular disease. However, the pathophysiological mechanisms underlying this relationship remain unclear. The aim of the present study was to elucidate whether marked job stress affects the parameters of blood coagulation and fibrinolysis, such as plasma fibrinogen concentration, tissue plasminogen activator (t-PA), and plasminogen activator inhibitor 1 (PAI-1) activities, in 213 middleaged male workers in a computer-producing factory. Job stress was measured using a Japanese version of the Job Content Questionnaire (JCQ) developed by Karasek. The mean t-PA activity in workers with lower and higher job demands was 0.23 and 0.18 IU/ml respectively, and this difference was significant (P < 0.05). The mean plasma fibrinogen in workers with lower and higher job decision latitude was 224.8 and 236.3 mg/dl respectively, and the mean PAI-1 activity in workers with lower and higher job strain was 14.9 and 17.7 U/ml respectively, though these differences remained at a borderline level of significance (0.05 < P < 0.10). Multiple regression analyses showed that the parameters of blood coagulation and fibrinolysis were closely associated with the cardiovascular risk factors of age, obesity, blood pressure, elevated serum lipids, and smoking, but that high job demands were significantly related to decreases in t-PA activity, independently of the traditional risk factors. These results suggest that psychosocial job stress may be related, at least partly, to the development of cardiovascular disease via changes in plasma fibrinolytic activity.

Otoneurological study in workers exposed to styrene in the fiberglass industry

Abstract: Twenty workers exposed to styrene and acetone in small fiberglass factories were monitored for 8 h using passive dosimeters Urine samples were collected at the end of the workshift and before the start of work on the next morning The 8-h time-weighted average exposure values for styrene and acetone ranged from 14 to 416 mg/m3 and from 70 to 277 mg/m3, respectively The sum of styrene metabolites, mandelic acid and phenylglyoxylic acid (MA + PGA), in the next-morning urine samples ranged from 81 to 943 mg/g creatinine Different test sensitivity was identified in the otoneurological battery: it was low for audiometric tests and ABR, and relatively high for vestibular tests The vestibular system seems partially sensitive to the toxic effects of styrene in the absence of clinical signs and symptoms The actual exposure levels for styrene cannot be considered devoid of functional subclinical consequences

Correlation between lead in plasma and other indicators of lead exposure among lead-exposed workers.

Abstract: In order to clarify the bioavailability of lead in plasma (PbP), we performed a study on five workers in a Japanese factory manufacturing lead glass-based paints. Blood and urine samples were obtained over a period of 15 months, during which time the workers took it in turns to perform sifting work (with the highest level of lead exposure) for 1-month periods. A total of 75 sets of blood and urine samples were thus obtained. We determined whole blood lead (PbB), PbP, Urinary coproporphyrin (CPU), urinary δ-aminolevulinic acid (ALAU), urinary lead (PbU) and ALA in plasma (ALAP). In the 15 sets of samples obtained at the end of the period with a high level of lead exposure, PbP correlated significantly with ALAU, CPU, PbU and ALAP, but PbB correlated significantly only with PbU. In the 60 sets of samples obtained following a low level of lead exposure, correlation coefficients between the concentrations of PbP and of ALAU, CPU and PbU exceeded those between the concentrations of PbB and of ALAU, CPU and PbU. These findings indicate that PbP is a better dose indicator of lead biochemically available for heme synthesis and that PbU has a closer correlation with PbP than with PbB.

Internal exposure of waste incineration workers to organic and inorganic substances.

Abstract: One hundred and twenty-two persons employed in an industrial waste incineration plant were examined with respect to organic and inorganic substances which may be produced during the combustion of different waste. The employees were divided into three groups: persons with contact with the incinerator (WI workers,n = 45), periphery workers (n = 54) and management (n = 23). For the evaluation of internal exposure, the levels of lead, cadmium, mercury, benzene, toluene, ethylbenzene andm-xylene in blood, chromium in the erythrocytes, polychlorinated biphenyls, hexachlorobenzene and pentachlorophenol in plasma, and arsenic, chromium, nickel, vanadium, chlorophenols and hydroxypyrene in urine were determined. The internal exposures of the three groups were tested against each other and were compared with the reference values of the general population. Differences between the groups investigated were tested using theU test according to Wilcoxon, Mann and Whitney (P < 0.05). The biological exposure limits valid in Germany (BAT values) were not exceeded in any cases. Compared with the background levels of the German population, certain parameters were exceeded in several employees. Significantly higher levels of the WI workers in comparison to both periphery workers and management were found for toluene in blood (median: 1.1 vs 0.9 vs 0.6 μg/l). For the lead and cadmium levels in blood and for the urinary excretion of arsenic, 2,4-dichlorophenol and tetrachlorophenols, statistical differences were found only between WI workers and one of the other groups. However, in all cases the elevations were very small and of interest more from the environmental than from the occupational point of view. It must be stressed that this waste incineration plant is very modern in terms of worker health and safety. At older plants without corresponding health and safety measures, higher internal exposure of the employees to hazardous substances may exist.

Primary DNA damage in peripheral mononuclear blood cells of workers exposed to bitumen-based products

Abstract: The genotoxic effect of occupational exposure to bitumen-based products was determined by the extent of DNA strand breaks and alkali-labile sites of the DNA of peripheral mononuclear blood cells from seven roofers, 18 road paving workers, and nine bitumen painters. In order to evaluate short-term genotoxic effect the workers were investigated on Fridays and on Mondays after a weekend free of occupational exposure. The roofers (all cigarette smokers) showed a significantly (P < 0.002) 43% higher mean level of alkaline DNA strand breaks on Friday than did the ten smoking controls included in this study. Also, comparison of the individual levels of alkaline strand breaks on Mondays and on Fridays revealed a significant increase (P < 0.05, Wilcoxon test) during the work week. In the road paving workers and the bitumen painters no statistically significant difference in the mean levels of alkaline strand breaks could be found compared to controls either for the measurement on Mondays or for that on Fridays. However, interesting tendencies were observed. As in the group of roofers, the mean level of alkaline DNA strand breaks as well as the majority of the individual levels of alkaline strand breaks of road paving workers was higher on Fridays than on Mondays. In contrast, bitumen painters exhibited a relatively high level of alkaline DNA strand breaks on Mondays and a decreased mean level of strand breaks on Fridays. DNA adducts could be detected at a low level (up to 2.9 adducts per 10(9) bases) in 10 of 14 road paving workers and bitumen painters using the 32P-postlabelling assay. The number of DNA adducts correlated with the years spend in the present job. Road paving workers and bitumen painters showed only suggestive evidence for a possible genotoxic effect due to their occupational exposure. Because we cannot exclude the formation of DNA cross-links in these workers, a more detailed investigation of the hazard is urgently needed. For roofers, substantial genotoxic damage in peripheral mononuclear blood cells was observed in this study.

Urinary hexane diamine as an indicator of occupational exposure to hexamethylene diisocyanate

Abstract: The occupational exposure of 19 men to hexamethylene diisocyanate (HDI) vapour was monitored during one 8-h shift. It ranged from 0.30 to 97.7 μg/m3. This was compared with the urinary output of hexane diamine (HDA) liberated by acid hydrolysis from its conjugates in post-shift samples. The excretion varied from 1.36 to 27.7 μg/g creatinine, and there was a linear association of HDI air concentration with urinary HDA excretion. The validity of the urinary analysis was confirmed by simultaneous blind analysis in another laboratory. The results had an excellent linear concordance. Thus, it seems that while the gas chromatographic-mass spectrometric detection method requires sophisticated apparatus, the results are very useful to occupational health practices. A biological exposure index limit of 19 μg HDA/g creatinine in a post-shift urine specimen is proposed as an occupational limit level of HDI monomer (time-weighted average=75 μg/m3). Most importantly, biological monitoring of HDA is sensitive enough to be used at and below the current allowable exposure limit levels.

N-alkylvaline levels in globin as a new type of biomarker in risk assessment of alkylating agents.

Abstract: Adducts with the N-terminal valine of erythrocyte globin can serve as individual biomarkers of systemic and cellular exposure to endogenous and exogenous alkylating agents In contrast to “detoxification markers” of this kind of mecapturic acids derived from alkylation of glutathione, individual N-alkylations of valine in globin reflect the formally “toxifying” part of the stress due to alkylating agents transformed into the ultimate toxicant Thus, in contrast to the traditional methods of biological monitoring this approach enables a better evaluation of systemic exposure to reactive agents, adapted more sensibly to the exposure situation over the whole life span of erythrocytes, and it can serve as a specific biomarker of exposure for the purpose of health surveillance in occupational medicine An individual evaluation of exposures in comparison with the range of corresponding background levels is discussed from the point of view of supplementary risk assessment in medical surveillance of occupationally exposed persons

Evaluation and classification of high-resolution computed tomographic findings in patients with pneumoconiosis

Abstract: The standard ILO classification for pneumoconiotic changes using conventional X-ray films has become well established. In recent years computed tomography has played an increasing role in occupational medicine and above all in the assessment of pneumoconiosis. Therefore a standardised method of classification for CT also seems necessary. A system of classification developed by occupational hygienists and radiologists allows a detailed description of parenchymal and pleural changes and the use of 28 additional symbols. Furthermore, special diagnoses relevant to occupational medicine and additional comments can be made. The classification system was tested in practice in the research project “Early diagnosis of asbestos-related diseases” (Fruhdiagnostik asbestverursachter Erkrankungen). It was shown to be both practicable and easily reproducible, intra-individually and interindividually.

Three-year survey of blood lead levels in 8828 Taiwanese adults.

Abstract: The purpose of this study was to investigate environmental lead exposure in the general Taiwanese population. A total of 8828 Taiwanese adults selected by a multistage sampling method were investigated. Characteristics of the participants were ascertained by questionnaire and 10 ml venous blood was drawn by public health nurses. The blood specimens were distributed to six laboratories for blood lead level (BLL) measurement. A quality control program was applied during the analysis of the BLLs in order to improve precision and accuracy. The arithmetic mean BLL of the 8828 Taiwanese adults was 7.70 ± 5.23 μg/dl, with a maximal level of 69.1 μ/dl. The median was 6.5 μ/dl and the 90th percentile was 14.0 μg/dl. After logarithmic transformation, the geometric mean was 1.84 ± 0.67 μg/dl. This study also found that elevated BLLs were associated with certain personal characteristics, i.e., gender, ethnic group, and education level; life-style factors, such as smoking, alcohol consumption, Chinese herbal drug consumption, milk consumption, and sources of drinking water; residential location, i.e., level of urbanization; and occupational history of lead exposure. However, age, floor level of residence, distance from house to road, and betel nut consumption were not associated with elevated BLLs. These results showed that BLLs in the Taiwanese population were not higher than those in developed and developing countries. Most of the influencing factors were also found in other studies; however, local factors such as ethnic group, Chinese herbal drug consumption, and sources of drinking water are important considerations in Taiwan when examining ways to prevent overexposure to lead in the general population.

In vivo measurements of lead in fingerbone in active and retired lead smelters.

Abstract: Object. The aim of this study was to determine the bone lead concentration in lead smelters and reference subjects, relate them to the lead concentration in blood (B-Pb) and urine (U-Pb), and to use the measured bone lead to calculate a biological half-life for lead in bone. Method and design. The lead concentration in the second phalanx of the left index finger (bone-Pb) was determined in vivo using an X-ray fluorescence technique. The study population comprised 89 smelters with a history of long-term exposure to lead (71 active and 18 retired) and 35 reference subjects (27 active and 8 retired) with no known occupational exposure to lead. Bone-Pb was related to the previous lead exposure, estimated as a time-integrated B-Pb (CBLI). Results. The retired smelters had the highest bone-Pb (median value 55 μg/g wet weight, as against 23 μg/g in active smelters) and 3 μg/g in the reference subjects. A strong positive correlation was observed between the bone-Pb and the CBLI among both active (r s =0.73; P<0.001) and retired (r s =0.71; P=0.001) smelters. The corresponding correlations between the bone-Pb and the period of employment were of the same magnitude. For retired workers, there were positive correlations between the bone-Pb and the B-Pb (r s =0.58; P=0.011) and U-Pb (r s =0.56; P=0.02). Multiple regression analyses showed that bone-Pb was best described by the CBLI, which explained 29% of the observed variance (multiple r 2) in bone-Pb in active workers and about 39% in retired workers. The estimated biological half-life of bone-Pb among active lead workers was 5.2 years (95% confidence interval 3.3–13.0 years). Conclusions. The high bone-Pb seen in retired workers can be explained by the long exposure periods, the higher exposure levels in earlier decades, and the slow excretion of lead accumulated in bone. The importance of the skeletal lead pool as an endogenous source of lead exposure in retired smelters was indicated by the associations between the B-Pb or U-Pb, on the one hand, and the bone-Pb, on the other. In active workers, the ongoing occupational exposure was dominant. The in vivo X-ray fluorescence technique is still mainly a research tool, and more work has to be done before it can be used more widely in clinical practice. However, over the next decade we can anticipate retrospective, prospective and cross-sectional epidemiological studies in which bone lead determinations reflecting the previous lead exposure in both occupationally and nonoccupationally lead exposed populations are related to various types of adverse health outcomes. Such studies will improve our knowledge of dose–response patterns and provide data that will have an impact on hygienic threshold limit values and prevention of lead-induced diseases.

An updated cohort mortality study of workers at a northeastern United States petroleum refinery

Abstract: An update of a cohort study of 4855 employees at a Paulsboro, New Jersey refinery was conducted to further examine mortality patterns. The earlier study investigated refinery workers employed for a minimum of 1 year between 1 January 1946 and 1 January 1979. The vital status of these workers was ascertained through 1979. The update extended enrollment in the study and vital status follow-up for an additional 8 years (1980–1987). As in the previous study, mortality from all causes [standardized mortality ratio (SMR) = 87; 95% confidence interval (95% CI): 83–91] was significantly lower than expected compared with the general population. Total cancer mortality was also lower than expected (SMR = 96; 95% CI: 86–106). A borderline significant mortality increase in prostatic cancer was found (SMR = 144; 95% CI: 106–190). This increase was similar to the nonsignificant increase reported in the original study (SMR = 135; 95% CI: 90–196). The excess was of comparable magnitude among white males and nonwhite males, although it was not significant for the latter. Detailed analysis indicated that the prostatic cancer was not likely to be related to employment at the refinery. Mortality from lymphatic and hematopoietic cancers was similar to the expected mortality. Mortality from overall leukemia was as expected and detailed analyses by specific cell type showed no increase. An increase in mortality occurred from non-Hodgkin's lymphoma among male workers (SMR = 132; 95% CI: 74–217). The increase was not statistically significant and unlikely to be associated with refinery employment. Mortality from multiple myeloma among male employees was lower than expected (SMR = 74; 95% CI: 20–190). Mortality from asbestos-related diseases (pulmonary fibrosis, lung cancer, malignant mesothelioma) was also lower than expected among male workers. No cause-specific mortality was found to be associated with duration of employment at the refinery, including several causes which have been reported to be elevated in previous studies. The findings of this updated study indicate, as in the previous report, the generally favorable mortality experience of Paulsboro refinery workers.

Occupational exposure to Cr(VI): comparison between chromium levels in lymphocytes, erythrocytes, and urine

Abstract: The relationships between chromium (Cr) levels in lymphocytes, erythrocytes, urine, and ambient air were compared among 14 chrome-platers from a metallurgic plant in Bulgaria and two groups of local controls, one from the same heavily polluted industrial town as the chrome-platers (n=11) and one from a seaside resort town 100 km away (n=6). Among the chrome-platers, the Cr concentration in peripheral lymphocytes was positively correlated with total Cr and Cr(VI) levels in ambient air and with Cr excretion in urine. As compared to the controls, the chromeplaters had mean Cr levels in lymphocytes twice as high, in erythrocytes ninefold higher, and in urine fourfold to eightfold higher. Although Cr levels in urine and lymphocytes were similar between the two control groups, levels in erythrocytes were 3 times higher among subjects from the industrial area than among those from the seaside town. The study suggests that lymphocyte Cr could be a good indicator of the Cr body burden caused by high exposures to Cr(VI), such as in electroplating operations. In these conditions, erythrocyte Cr may be less useful, possibly owing to increased toxicity due to the high affinity of erythrocytes for Cr. However, when exposure is lower, such as in most environmental situations, erythrocyte Cr should provide a better and more sensitive index than lymphocyte Cr. By contrast, urinary Cr, which provides information on total Cr exposure, including Cr(III) from dietary and environmental sources, does not seem to be of value for studying occupational exposure to Cr(VI).