Adverse Effects Of Occupational Exposure Research Articles

Association of p-phenylenediamine exposure with alterations of pulmonary function, pruritus and health-related quality of life in hair dye factory workers: a cross-sectional study

P-Phenylenediamine (PPD) is a common component of hair dye, which can cause skin contact allergy and asthma with impaired pulmonary function. However, the adverse effects of occupational exposure to different dose PPD was rarely mentioned. We recruited 124 workers from a hair dye factory to explore the association of occupational PPD exposure on pulmonary function, pruritus and health related quality of life (HRQL). We categorized exposure to PPD into 3 levels: lower exposure group (< 0.00001 mg/m3); middle exposure group (0.00001–0.00033 mg/m3); higher exposure group (0.00033–0.047 mg/m3). The HRQL and subjective pruritus of the workers were assessed by the short form 36 health survey (SF-36) and Visual analogue scale (VAS) of pruritus, respectively. In the high PPD-exposed group, the percentage of FEV1 (FEV1%) was lower in higher exposure group compared with lower exposure group. The FEV1/FVC was also lower in comparison to the higher exposure and middle exposure groups (p < 0.05). PPD levels were negatively correlated with vitality and mental health (p < 0.01). The structural equation model showed the positive effects of PPD on VAS level (β = 0.213, p < 0.001), and indicated partly negtive effects of PPD on total score of SF-36 (β = − 0.465, p = 0.002), respectively. Our results indicate that occupational exposure to PPD might be associated with pulmonary function impairment, poor HRQL, and subjective pruritus of the workers.

Mortality among uranium miners in North America and Europe: the Pooled Uranium Miners Analysis (PUMA).

The Pooled Uranium Miners Analysis (PUMA) study draws together information from cohorts of uranium miners from Canada, the Czech Republic, France, Germany and the USA. Vital status and cause of death were ascertained and compared with expectations based upon national mortality rates by computing standardized mortality ratios (SMRs) overall and by categories of time since first hire, calendar period of first employment and duration of employment as a miner. There were 51 787 deaths observed among 118 329 male miners [SMR = 1.05; 95% confidence interval (CI): 1.04, 1.06]. The SMR was elevated for all cancers (n = 16633, SMR = 1.23; 95% CI: 1.21, 1.25), due primarily to excess mortality from cancers of the lung (n = 7756, SMR = 1.90; 95% CI: 1.86, 1.94), liver and gallbladder (n = 549, SMR = 1.15; 95% CI: 1.06, 1.25), larynx (n = 229, SMR = 1.10; 95% CI: 0.97, 1.26), stomach (n = 1058, SMR = 1.08; 95% CI: 1.02, 1.15) and pleura (n = 39, SMR = 1.06; 95% CI: 0.75, 1.44). Lung-cancer SMRs increased with duration of employment, decreased with calendar period and persisted with time since first hire. Among non-malignant causes, the SMR was elevated for external causes (n = 3362, SMR = 1.41; 95% CI: 1.36, 1.46) and respiratory diseases (n = 4508, SMR = 1.32; 95% CI: 1.28, 1.36), most notably silicosis (n = 814, SMR = 13.56; 95% CI: 12.64, 14.52), but not chronic obstructive pulmonary disease (n = 1729, SMR = 0.98; 95% CI: 0.93, 1.02). Whereas there are important obstacles to the ability to detect adverse effects of occupational exposures via SMR analyses, PUMA provides evidence of excess mortality among uranium miners due to a range of categories of cause of death. The persistent elevation of SMRs with time since first hire as a uranium miner underscores the importance of long-term follow-up of these workers.

Occupational radiation exposure to the head is higher for scrub nurses than cardiologists during cardiac angiography.

This study aimed to compare the head dose of a cardiologist to scrub and scout nurses during cardiac angiography. A correlational longitudinal quantitative design was used to examine the relationship between the variable of occupational dose to the medical operator when compared with the dose to the scrub and scout nurses. A quantitative analysis was performed on data collected during coronary angiograms (N=612) for one cardiologist and 22 nurses performing either the scrub or scout role between May 2015 and February 2017. Analysis was based on log-transformed dose levels and reported as geometric means and associated 95% confidence intervals. It was found that scrub nurses received on average 41% more head dose than the cardiologist during diagnostic procedures and 52% higher doses during interventional cases. Nurses working in fluoroscopic cardiovascular procedures should be provided with appropriate training and protective equipment, notably lead skull caps, to minimize their occupational radiation exposure. There is a notable lack of research evaluating the occupational head and eye exposure to nurses involved in fluoroscopic procedures. This study found that during diagnostic coronary angiograms, the scrub nurses received 41% more occupational head dose than the cardiologist and 52% higher head doses during interventional cases. Radial access resulted in higher doses to scrub nurses than femoral artery access. It is advisable that staff wear protective lead glasses and skull caps and use appropriately positioned ceiling mounted lead shields to minimize the risk of adverse effects of occupational exposure to ionizing radiation.

MODERN PRINCIPLES AND MEANS OF PROTECTION OF WORKERS FROM ADVERSE EFFECTS OF RADIOFREQUENCY ELECTROMAGNETIC FIELDS

There is presented the analysis of criteria, methods and means of protection of workers from adverse effects of occupational exposure to radiofrequency electromagnetic fields, including protection by time (by means of hygienic standardization), as well as methods and means of the metrological control. Special attention is given to the improvement of the assessment of means for personal protection, including the application of the criterion of specific absorbed-power (absorption rate).

Abstract 19859: Reducing Radiation Exposure for Patients also Improves Staff Radiation Exposure in the Cardiac Catheterization Laboratory

Introduction: As the availability and use of medical imaging has increased, ionizing radiation has become a significant occupational exposure. Staff in the cardiac catheterization laboratory are among those with the highest exposures. Hypothesis: Changing equipment defaults to decrease patient radiation exposure would also decrease staff radiation exposure. Methods: In October 2013 we made equipment adjustments to decrease patient radiation exposure in all 3 cardiac catheterization laboratories at Eastern Maine Medical Center. We changed fluoroscopy defaults to low dose option and low frame rate (7.5 frames/sec from 15 frames/sec) while maintaining the option for operators to use higher settings as needed. We analyzed staff radiation exposure for 8 physicians and 14 nurses by comparing total collar dosimeter dose (in mRem) between the 3 months before and 3 months after the intervention controlling for procedural volume using standard statistical methods. Results: For physician operators, mean dosimeter dose decreased by 41.6% (346.8 ± 264.8 pre vs 202.5 ± 135.9 post intervention, p=0.042). For nurses whose roles are to assist during procedures or to circulate in the room, the mean dosimeter dose decreased by 25% (65.9 ± 49.4 pre vs 50.2 ± 53.5 post intervention, p=0.038). There was no significant difference between the number of cases performed by physicians (p=0.598) and nurses (p= 0.866) before and after the intervention. Procedural success did not decline post-intervention. Compliance with wearing collar dosimeter is required and reported as excellent at our institution. Conclusions: Setting fluoroscopy defaults to low dose and low frame rate to improve patient radiation exposure also significantly decreased radiation exposure for both physician and ancillary staff working in the cardiac catheterization laboratory. If widely adopted this intervention would help to mitigate the long term adverse effects of occupational exposure to ionizing radiation.

Longitudinal decline in pulmonary diffusing capacity among nitrate fertilizer workers

This study is part of a 3-year follow-up of lung function among nitrate fertilizer production workers. To study the possible adverse effects of occupational exposure to aerosols and gases on pulmonary diffusing capacity. A longitudinal study of a cohort of fertilizer workers who performed single-breath carbon monoxide diffusing capacity (DLco) tests and spirometry in 2007 and 2010. The workers completed a questionnaire on respiratory symptoms and smoking habits. Exposure to mineral dust, acid aerosols and inorganic gases was measured. The overall median inhalable and thoracic aerosol mass concentrations were 1.1mg/m(3) (min-max: <0.93-45) and 0.21mg/m(3) (min-max: <0.085-11), respectively. There were 308 participants in 2007 with 168 returning subjects in 2010. Overall, we found a statistically significant decline in the DLco of 0.068 mmol/min/kPa/year, adjusted for gender, age, height, weight, smoking status and doctor-diagnosed asthma during the 3-year follow-up (P < 0.01). The change in DLco did not vary significantly between the various job groups. Subjects with respiratory symptoms did not show a larger decline in DLco than those without symptoms. This study indicates a larger than expected decline in the DLco of fertilizer workers during a 3-year follow-up. However, the decline was not related to specific exposures at work, or to possible covariates of exposure.

Micronucleus Test in Exfoliated Buccal Cells from Chromium Exposed Tannery Workers

Our aim wa s to investigate the adverse effects of occupational exposure to trivalent chromium in tannery workers and unexposed persons. Trivalent chromium used in tanning industry is an environmental contaminant that acts as a carcinogen towards humans and animals. The carcinogenic potential of metals is a major issue in defining human health risk from exposure. In the present investigation, 84 tannery workers and 52 control subjects with similar mean ages, smoking prevalences and alcohol consumption were enrolled for DNA damage analysis in buccal cells by Micronucleus assay (MN). Workers showed a significant increase in micronucleated cells when compared to controls with respect to their smoking habits, alcohol consumption, age and years of exposure. The current study suggests that chronic occupational exposure to Chromium during tanning could lead to increased levels of DNA damage. The res ults of the present investigation are in agreement with those obtained with the same Cr (III) compounds in mutagenicity assays in bacteria and carcinogenicity tests in rodents. A re-evaluation of the mechanisms of chromium carcinogenisis is proposed.

Effects of occupational exposure on the reproductive system: core evidence and practical implications

With the increasing labour force participation among women in Western countries, many women will work during their reproductive years. This will increase the likelihood that women during pregnancy will be exposed to a variety of chemical, physical and psychosocial factors at work. The presence of hazardous conditions in workplaces has raised concerns about their potential effects on pregnancy outcomes and birth defects in offspring. Occupational exposure may directly affect the outcome of pregnancy, such as spontaneous abortion, stillbirth, pre-term birth, small-for-gestational age and birth weight. Occupational exposure may also interact with foetal development, resulting in health effects in the offspring that range from congenital birth defects, neurobehavioral disorders at young age and even cancer in older age. To complicate matters further, occupational exposure among men may result in direct effects on the male reproductive system as well as contribute to negative pregnancy outcomes and birth defects. Thus, the reproductive system of both women and men can be affected by occupational exposure and for most health effects both maternal and paternal exposure may be a relevant route. A timely recognition of the impact of hazardous agents on this broad array of reproductive effects will provide insight into the necessary precautions to be taken for the protection of reproductive health of both women and men. In the scientific literature, there are many publications on adverse reproductive outcomes. Since the reproductive system is a complex, interconnected set of organs, tissues and hormones, there is a large variety of reported adverse effects of environmental agents on the reproductive system. However, the interpretation of an association between an occupational exposure and a reproductive health effect is almost always hampered by the fact that many adverse outcomes may be caused by multiple (work-related) factors, making it extremely difficult to attribute a particular outcome to a specific occupational exposure. In addition, negative outcomes may be due to adverse effects of occupational exposure on both the female and male reproductive system. A third critical issue is that occupational exposure may only be relevant during specific time windows, for example shortly before conception or during early pregnancy. This issue of Occupational Medicine contains three extensive reviews on the epidemiological evidence of occupational hazards to human reproduction. The first comprehensive review focuses on the female reproductive system by addressing the influence of maternal exposure on fertility and pregnancy outcomes [1]. In the second review, the focus is the impact of maternal exposure on the adverse effects in the offspring, as characterized by a variety of birth defects [2]. The third review shifts emphasis towards the contribution of occupational exposure among men to male reproductive dysfunction, primarily measured by semen quality and fecundity [3]. Together these reviews present a comprehensive picture of the role of occupational risk factors in reproductive health. The main aims of this accompanying article are to present a summary of the core findings in the three reviews, to discuss important constraints in the interpretation of these results and then derive practical implications for research and practice in occupational health.

Biologic Markers of Oxidative Stress and Nephrotoxicity as Studied in Biomonitoring of Adverse Effects of Occupational Exposure to Lead and Cadmium

In this work, we studied impregnation levels of workers occupationally exposed to lead (Pb) and cadmium (Cd), usefulness of early urinary markers of nephrotoxicity, and occurrence of oxidative stress as the underlying mechanism involved in Pb- or Cd-induced adverse effects. Thirty-five men were recruited from a nonferrous metal smelter. Pb and Cd in blood (B-Pb, B-Cd) and urine (U-Pb, U-Cd) were measured. Relations between oxidative stress markers (malondialdehyde, superoxide dismutase, glutathione peroxidase, selenium, glutathione reductase, glutathione status, 8-hydroxy-2'-deoxyguanosine) and exposure levels, on the one hand, and early urinary markers (alpha-1-microprotein, beta-2-microglobulin, retinol binding protein, alpha and pi-glutathione S-transferases) and exposure levels, on the other hand, were evaluated. Mean exposure levels were moderate (B-Pb = 395.71 microg Pb/L; U-Pb = 95.19 microg Pb/g creatinine; B-Cd = 5.83 microg Cd/L; U-Cd = 4.67 microg Cd/g creatinine). Changes in malondialdehyde, glutathione status, 8-hydroxy-2'-deoxyguanosine, and alpha-glutathione S-transferases were closely correlated with exposure levels and did not depend on tobacco consumption. We showed that these workers showed moderate Pb and Cd exposure levels. Taken together, the data suggests the use of alpha-glutathione S-transferases excretion in urine as a hallmark of early changes in the proximal tubular integrity that could later lead to clinical disease if exposure is not reduced.

Occupational health in the pharmaceutical industry: an overview.

The pharmaceutical industry is an important contributor to the health of the UK economy, with 65 000 people directly employed and many more in support industries [1]. It delivered a net trade surplus of £2.6 billion to the UK economy in 2002 and was rated as the highest value-adding industry, with £78 000 of value added to the economy per industry employee in the same period. It is a highly competitive global industry with significant high-risk, long-term investment in increasingly costly drug discovery and development activity. It takes ~10–12 years to bring a new medicine to market and the average development cost is £350 million, with high attrition rates. The rewards are high for successful transnational players, with pre-tax profits of 30% on sales [2]. The industry presents particular challenges to occupational health practitioners engaged in the delivery of effective occupational health services. The demands of a highly technical work environment must be blended with the need to maintain effective health management in a fast-paced, changing and pressured global business climate. This, combined with a high level of focus on innovation and productivity through human capital development strategies, provides a rich mix of factors to take into account when selecting and implementing health interventions that are appropriate, risk-targeted, cost-effective and acceptable to employees and management. An overview of health hazards in the industry published in 1947 provides a familiar list of headings and exposure issues to today’s pharmaceutical occupational health practitioner. The contemporary collection of reviews in this issue of Occupational Medicine provides an update: so, has anything changed beyond the product names that populate the lists of recognized causes of exposure-related health effects? [3] Providing rational, risk-based advice on the prediction, prevention and management of exposure-related health effects from a diverse and novel range of workplace health hazards requires increasingly specialized technical competences and industry knowledge. Binks reviews occupational toxicology and the control of exposure to pharmaceutical agents at work [4]. He provides insight into the high level of resource investment and multidisciplinary expertise applied to predicting the potential adverse effects of occupational exposure. The industry has pioneered occupational hazard categorization systems and led the way in developing novel approaches to the containment of highly potent biologically active substances. Heron and Pickering review the published evidence for health effects related to exposure to active pharmaceutical ingredients [5]. The literature continues to be dominated by well-known historical clusters of occupational illness burden associated with particular classes of drug compounds and there is a paucity of recently published data. Is this a cause for optimism that the battle has been won? Laboratory animal allergy (LAA) remains an important and potentially life-threatening cause of occupational sensitization, often with significant career implications for those affected. Gordon and Preece [6] present a summary of the state of the art in preventing this condition. They offer encouragement that investment in a policy-driven integrated approach to allergen exposure control can result in a reduction in incidence. The lower level of importance of occupational health interventions, such as health surveillance, compared to other components of LAA risk management systems is noted. However, occupational health practitioners remain well placed to play a key role in facilitating and co-ordinating the Director, Southern Client Services, Aon Health Solutions, 2 Circus Place, London EC2M 5RS, UK. Tel: +44 20 7638 3422; e-mail: alister.scott@aers.aon.co.uk Occupational Medicine 2003;53:354–356 DOI: 10.1093/occmed/kqg114

Follow-up study of respiratory health of newly-hired female cotton textile workers.

Numerous studies have investigated adverse effects of exposure to cotton dust on respiratory health, but very limited longitudinal data are available with regard to the early pulmonary response to cotton dust. Moreover, the adverse effects of occupational exposure to cotton dust have been difficult to separate from the confounding effects of smoking. This setting provided a unique opportunity to evaluate early respiratory effects in newly hired and non-smoking female textile workers. To identify early pulmonary responses to cotton dust exposure and associated gram-negative bacterial endotoxin, respiratory symptoms and pulmonary function in 225 newly-hired textile workers were assessed at work initiation, and at three and twelve months later. All the workers were females and nonsmokers, with an average age of 18 years. Symptom incidence at three months was 3.6% for usual cough with phlegm, and 6.7% for usual dry cough. Lung function changes were detectable at one year: FEV1 declined by 70 ml and FVC by 124 ml over the year, and workers reporting respiratory symptoms at three months showed a significantly greater cross-shift drop in FEV1 (- 2.3%) than those without the symptoms (- 0.7%). These results suggest that the occurrence of respiratory symptoms represents the earliest response to cotton dust exposure, followed by lung function changes. Early respiratory symptoms may be a risk factor for subsequent loss of pulmonary function in cotton textile workers.

Possible adverse effect of chromium in occupational exposure of tannery workers.

Our aim was to investigate the adverse effects of occupational exposure to trivalent chromium. We measured chromium and iron levels in serum and urine and hemoglobin levels in tannery workers and unexposed persons. We studied three groups of subjects. Group 1 included 15 non-smoking male tannery workers highly exposed to chromium from tanning and retanning departments. Group 2 included 14 non-smoking male tannery workers with moderate chromium exposure from dying, drying and finishing departments. Group 3 included 11 healthy, non-smoking male subjects without direct chromium exposure. Higher serum chromium levels were observed in groups 1 and 2 with respect to group 3 (mean values respectively: 0.43; 0.25 and 0.13 microg x l(-1)). Urine chromium levels in group 1 were higher than those in controls (mean values: 1.78 and 1.35 microg x l(-1)). In group 1 an inverse association was found between serum chromium and urine iron (-0.524), urine chromium and hemoglobin (-0.594) and between the urine chromium to iron ratio and hemoglobin (-0.693, p<0.05). The results suggest a chromium adverse effect on iron metabolism, possibly associated with excessive body chromium accumulation. In conclusion, chromium urine test could be recommended for diagnosis of chromium adverse effect on iron metabolism. Further studies are needed to quantify the relationship between urine chromium and hemoglobin metabolism.

Evaluation of adverse effects of occupational exposure to halothane in medical staff

Evaluation of adverse effects of occupational exposure to halothane in medical staff

Urinary total protein and β-2-microglobulin in workers exposed to trichloroethylene

Chlorinated solvents are thought to be more nephrotoxic than nonchlorinated solvents in humans. Many workers have been exposed to trichloroethylene (TCE) because TCE is one of the most useful chlorinated solvents in some industries. Thus, to detect adverse effects of human exposure to TCE on kidneys, urinary total protein (U-TP) and beta-2-microglobulin (U-B2M) were determined in 104 male workers occupationally exposed to TCE and 102 male nonexposed controls. The workers have been probably exposed to 15 ppm TCE in air. The U-TP level of the workers, rather than the U-B2M level, was slightly higher than those of the controls. The differences of the U-TP level or the U-B2M level between the two groups, however, were not significant excluding an exception. (The mean U-TP level for 35- to 44-year-old workers was significantly higher than that for corresponding controls.) These results suggest that adverse effects of occupational exposure to TCE on kidney is very mild and glomerular rather than tubular.

Evaluation of mutagenicity and other adverse effects of occupational exposure to sodium azide

The ubiquitous use of sodium azide has resulted in widespread occupational exposure to it in both laboratory and industrial settings, despite a lack of knowledge of the risks which may be involved. Explosive, toxic, and mutagenic hazards have been shown at even low-dose exposures. These effects occur in many species, from cellular damage through pathology of whole systems, and human fatalities have been reported. The advantages to its availability for applicable uses precludes reaching a “no exposure” level, but efforts to decrease unnecessary exposure can reduce its risk; therefore a quantitative procedure for determining human exposure is necessary. However, for various reasons present methods for this type of evaluation of azide are unsatisfactory, and minimizing hazard is dependent upon good laboratory hygiene and motivated personnel. The increasing use of azide and proportionally increasing occupational and accidental exposure in the future warrants the undertaking of chronic exposure studies, which hopefully will result in more explicit guidelines for human protection.

Gas mantle lighting conditions in ten large cities in the United States

Allyl formate (CAS # 1838-59-1) is a highly flammable, clear, colorless liquid. It is used as a solvent in spray lacquers, enamels, varnishes, and latex paints and as an ingredient in paint thinners and strippers, varnish removers, and herbicides. It is also used in liquid soaps, cosmetics, industrial and household cleaners, and dry-cleaning compounds. Acute exposure to allyl formate causes liver and kidney damage. Allyl formate is classified as a periportal hepatotoxicant since it selectively damages the periportal region of the liver in rodents. The most important adverse effects of occupational exposures to allyl formate are upper respiratory tract irritation. This compound may be fatal if inhaled, ingested, or absorbed through skin.