Health Effects Of Occupational Exposure Research Articles

Systematic Review of Biological, Chemical, Ergonomic, Physical, and Psychosocial Hazards Impacting Occupational Health of United States Forestry Workers

Abstract Forestry is one of the most hazardous occupations, due in part to the biological, chemical, ergonomic, physical, and psychosocial aspects of the job. Here, we review health risks in forestry occupations, including those in professional and technical forestry, logging, and forestry support, from the standpoint of biological (e.g., insects/arachnids, plants), chemical (e.g., diesel exhaust), ergonomic (e.g., awkward postures, forceful motions), physical (temperature, noise, vibrations, radiation), and psychosocial (e.g., workplace factors that cause stress, strain, or interpersonal problems for the worker) issues. We conducted a systematic review over a 10-year period (2011–2021) to assess health hazards identified in studies conducted on these occupations and reveal knowledge gaps for future studies to address. This study focuses on occupational health rather than occupational safety. Other forestry worker occupational health and safety studies have focused on analyzing injuries and deaths directly relating to transportation and/or contact with objects such as trees or logs and equipment; however, the areas of occupational health highlighted here have been understudied. Future work should focus on these areas, with an emphasis on intervention strategies that eliminate or mitigate the deleterious health effects of occupational exposures. Study Implications: Forestry workers are exposed to occupational health hazards in their outdoor workplace. This review analyzes published work for a 10-year period (2011–2021) with broader implications such as (1) greater understanding of gaps in the literature for key occupational health hazards facing United States forestry workers and (2) better information on the need for more in-depth studies to collect information about exposure assessments to improve worker protection. This literature review can help forestry workers, managers, and scientists mitigate exposures and protect health.

The Hematological and Biochemical Effects from Pesticide Exposure on Thai Vegetable Farmers.

Pesticide-related health concerns are a global public health issue. Few studies in Thailand have explored the hematological and biochemical effects of occupational pesticide exposure. The goal of this study was to investigate the effects of pesticides on the hematology, hepatic, and renal function of Thai vegetable farmers. A cross-sectional study was carried out in Chiang Mai, northern Thailand. A total of 124 apparently healthy vegetable farmers were interviewed about their lifetime exposure to agricultural pesticides. Blood samples were collected via venipuncture to be tested for complete blood count (CBC), liver function, and kidney function. Approximately 46% of the farmers were pesticide users who reported a history of pesticide use for their crops, while 54% were non-pesticide users. In the male farmers, the activities of aspartate aminotransferase (AST), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were significantly higher in the pesticide users compared to the non-pesticide users, while the estimated glomerular filtration rate (eGFR), hematocrit (HCT), and red blood cells (RBC) were significantly lower (p < 0.05). In the females, the pesticide users had significantly higher levels of alanine aminotransferase (ALT), alkaline phosphatase (ALP), and MCHC than the non-pesticide users (p < 0.05). Pesticide use among Thai vegetable farmers may cause hematological alterations and increase the risk of hepatic and renal dysfunction. Some hematological and biochemical parameters may be used for monitoring to protect them from the adverse health effects of occupational exposure to pesticides.

Berufsbedingte Kontakturtikaria und Verdacht auf allergische Rhinitis durch Sensibilisierung gegen Cannabis sativa

Occupational contact urticaria with suspected allergic rhinitis due to sensitization to Cannabis sativa Case Presentation: A customs employee presented with complaints of allergic rhinitis related to the workplace. Results: Allergy diagnostics (rub test, prick test, specific IgE) revealed evidence of allergies to cannabis sativa and environmental allergens. Measures: The suspected presence of occupational disease no. 4301 was reported to the insurer. The avoidance of exposure to allergens was advised. Conclusions: In the future, due to changes in the legal situation, more persons in cultivation, production, distribution, the health sector, forensic laboratories and law enforcement agencies will come into contact with cannabis sativa in the workplace. Allergies may develop, but to date there are no commercially available type I allergy diagnostics related to cannabis products. Further health effects of occupational exposure and necessary preventive measures are unclear. Keywords: occupational allergy – Cannabis sativa – occupational disease no. 4301

Assessment of Pulmonary Function Test among Employees of Petrol Filling Stations

In the current scenario, the health-related issues at the workplace are steadily increasing. Amongst various factors,one of the reasons for the atmospheric pollution to be raised, is an increase in the number of vehicles, as there isa marked trend towards urbanization. Health effects of occupational exposure to gasoline and air pollution fromvehicular sources are relatively unexplored among petrol filling station workers. The objectives of the presentstudy were to (1) assess the vital parameters among employees of petrol filling stations. (2) assess the pulmonaryfunction test among employees of petrol filling stations. A total of 40 employees from selected petrol filling stationsat New Delhi have participated in the study. Highest 40% of employees had more than 2 years of exposure.Regarding type of work, majority (74%) were service station attendants and least (8%) were managers. Highestpercentage of employees (88%) worked for more than 5 days in a week. Similarly, highest percentage employees(80%) worked 8hours in a day and 48 hours per week. The results revealed normal vital organ function and longerthe occupational exposure, the higher the incidence of respiratory morbidity among the employees. The reasonsbehind this increase are not using personal protective equipment and occupational exposure.

Organ dose reconstruction for the radiation epidemiological study of Korean radiation workers: The first dose evaluation for the Korean Radiation Worker Study (KRWS)

The Korea Institute of Radiological and Medical Sciences has started a radiation epidemiological study, titled "Korean Radiation Worker Study," to evaluate the health effects of occupational exposure to radiation. As a part of this study, we investigated the methodologies and results of reconstructing organ-specific absorbed doses based on personal dose equivalent, Hp(10), reported from 1984 to 2019 for 20,605 Korean radiation workers. For the organ dose reconstruction, representative exposure scenarios (i.e., radiation energy and exposure geometry) were first determined according to occupational groups, and dose coefficients for converting Hp(10) to organ absorbed doses were then appropriately taken based on the exposure scenarios. Individual annual doses and individual cumulative doses were reconstructed for 27 organs, and the highest values were observed in the thyroid doses (on average 0.77 mGy/y and 10.47 mGy, respectively). Mean values of individual cumulative absorbed doses for the red bone marrow, colon, and lungs were 7.83, 8.78, and 8.43 mSv, respectively. Most of the organ doses were maximum for industrial radiographers, followed by nuclear power plant workers, medical workers, and other facility workers. The organ dose database established in this study will be utilized for organ-specific risk estimation in the Korean Radiation Worker Study.

Bias-corrected Hp(10)-to-Organ-Absorbed Dose Conversion Coefficients for the Epidemiological Study of Korean Radiation Workers.

The effects of radiation on the health of radiation workers who are constantly susceptible to occupational exposure must be assessed based on an accurate and reliable reconstruction of organ-absorbed doses that can be calculated using personal dosimeter readings measured as and dose conversion coefficients. However, the data used in dose reconstruction contain significant biases arising from a lack of reality and could result in an inaccurate measure of organ-absorbed doses. Therefore, this study quantified the biases involved in organ dose reconstruction and calculated the bias-corrected -to-organ-absorbed dose coefficients for the use in epidemiological studies of Korean radiation workers. Two major biases were considered: (1) the bias in arising from the difference between the dosimeter calibration geometry and the actual exposure geometry and (2) the bias in air kerma-to- conversion coefficients resulting from geometric differences between the human body and slab phantom. The biases were quantified by implementing personal dosimeters on the slab and human phantoms coupled with Monte Carlo method and considered to calculate the bias-corrected -to-organ-absorbed dose conversion coefficients. The bias in was significant for large incident angles and low energies (e.g., 0.32 for right lateral at 218 keV), whereas the bias in dose coefficients was significant for the posterior-anterior (PA) geometry only (e.g., 0.79 at 218 keV). The bias-corrected -to-organ-absorbed dose conversion coefficients derived in this study were up to 3.09-fold greater than those from ICRP publications without considering the biases. The obtained results will aid future studies in assessing the health effects of occupational exposure of Korean radiation workers. The bias-corrected dose coefficients of this study can be used to calculate organ doses for Korean radiation workers based personal dose records.

Results of Studying Genotoxic Effects of Dioxins Depending on Polymorphisms of Xenobiotic Detoxification Genes and the Length of Service of Firefighters

Introduction: The work of firefighters is associated with a high risk to health and life. During firefighting, firemen are exposed to a combination of various factors, among which chemical agents rank first. Of all the toxic products of combustion, the most dangerous are genotoxic substances having a high cumulative effect and a very long clearance time, including dioxins and dioxin-like polychlorinated biphenyls generated during low-temperature combustion of organic chlorine compounds. Objective: To study karyopathological manifestations of the genotoxic effects of dioxins in firefighters, de¬pending on the length of service and various polymorphic variants of the xenobiotic detoxification genes. Materials and methods: The cytogenetic status of firefighters was assessed using an extended micronucleus test of buccal epithelium. The study was conducted in 2019–2022 involving 252 firefighters, 86 rescuers and other professionals. The risk of cytogenetic abnormalities in epitheliocytes was assessed using calculation methods and expressed as an index of accumulation of cytogenetic disorders. For each subject, two smears of buccal epithelium were prepared followed by the analysis of two thousand intact cells. Results: We noted an increase in the frequency of karyotype aberrations in buccal epithelial cells of firefighters compared to controls correlating with the length of service and dioxin concentrations in blood lipids. The analysis of the relationship between various polymorphic variants of xenobiotic detoxification genes, dioxins in blood lipids of firefighters, and the index of accumulation of cytogenetic damage showed that individuals with a combination of six genotypes (EPHX1 Tyr/Tyr, CYP1A1 A/A, GSTT1 I/I, GSTM1 I/I, GSTP1 A /A, and GSTP1 C/C) possessed xenobiotic detoxification enzymes with high activity and better resistance to karyotypic changes induced by genotoxicants. Conclusion: The levels of cytogenetic disorders established in the present study give evidence of adverse health effects of occupational exposure to toxic combustion products in firefighters of the State Fire Service of the Russian Ministry of Emergency Situations.

Impact of occupational pesticide exposure assessment method on risk estimates for prostate cancer, non-Hodgkin’s lymphoma and Parkinson’s disease: results of three meta-analyses

Assessment of occupational pesticide exposure in epidemiological studies of chronic diseases is challenging. Biomonitoring of current pesticide levels might not correlate with past exposure relevant to disease aetiology, and indirect...

Dose-Response Effects of Low-Dose Ionizing Radiation on Blood Parameters in Industrial Irradiation Workers.

While previous studies have focused on the health effects of occupational exposure of radiations on medical radiation workers, few have analyzed the dose-response relationship between low radiation doses and changes in blood parameters. Even fewer studies have been conducted on industrial worker populations. Using a prospective cohort study design, this study collected health examination reports and personal dose monitoring data from 705 industrial irradiation workers who underwent regular physical examinations at Dongguan Sixth People’s Hospital. The dose-response effects of low-dose ionizing radiation on blood parameters were assessed using a generalized linear model and restricted cubic spline model. Red blood cell counts decreased then increased, before decreasing again with increasing ionizing radiation. This was in contrast to the curve of the total platelet count after irradiation. Additionally, a radiation dose of 2.904 mSv was the turning point for the nonlinear curve of hemoglobin count changes. In conclusion, long-term, low-dose ionizing radiation affects blood cell levels in industrial irradiation workers. There is a nonlinear dose-response relationship between red blood cell, platelet, and hemoglobin counts and the cumulative radiation dose. These findings should alert radiation workers to seek preventive medical treatment before the occurrence of any serious hematopoietic disease.

Health status and cancer related mortality among nuclear plant workers exposed to ionizing radiation

Background: The investigation of potential adverse health effects of occupational exposures to ionizing radiation, on nuclear plant workers, is an important area of research. In this study, we aimed to calculate the incidence and risk of cancer development and mortality during last five years (2015-2019). Material and methods: 456 nuclear industry workers were included into this study (39 cancer patients and 417 healthy. For this cohort, the cancer mortality has been assessed by data obtained from national health registry excluded for the probability of known causes of death. The associations between cumulative occupational radiation exposures (radon, gamma radiation and long-lived radionuclides) and cancer mortality were calculated. Results: Radon and Gamma exposure was significantly higher among workers who developed cancer [8.4 (0; 3,224.5) vs 19.7 (0; 128.4), p=0.03] and [12.0 (2.1; 110.0) vs 24.5 (0; 470.1), p=0.02]. However, no significant association was found between long-lived radionuclides and risk of cancer (p=0.07). Conclusion: In conclusion, significant association has been observed between the risk of cancer development and radon and gamma exposure among nuclear industry workers, but no association was found between cancer and long-live nucleoids exposure. Keywords: ionizing radiation; nuclear industry; cancer; mortality.

Health Status and Cancer Related Mortality among Nuclear Plant Workers Exposed to Ionizing Radiation

The investigation of potential adverse health effects of occupational exposures to ionizing radiation, on nuclear plant workers, is an important area of research. In this study, we aimed to calculate the incidence and risk of cancer development and mortality during last five years (2015-2019). 456 nuclear industry workers were included into this study (39 cancer patients and 417 healthy). For this cohort, the cancer mortality has been assessed by data obtained from national health registry excluded for the probability of known causes of death. The associations between cumulative occupational radiation exposures (radon, gamma radiation and long-lived radionuclides) and cancer mortality were calculated. Radon and Gamma exposure was significantly higher among workers who developed cancer [8.4 (0; 3,224.5) vs. 19.7 (0; 128.4), p=0.03] and [12.0 (2.1; 110.0) vs. 24.5 (0; 470.1), p=0.02]. However, no significant association was found between long-lived radionuclides and risk of cancer (p=0.07).

Health effects of occupational exposure to printer emissions on workers in China: Cardiopulmonary function change

Printers emitted nanoparticles (NPs), ozone (O3) and volatile organic chemicals (VOCs) during operation that elicited adverse effects on indoor air quality of the printing room, which may affect the health of exposed workers. The aim of this work was to explore the health effects of occupational exposure to printer emissions on workers, especially cardiovascular and lung function. We sampled particles in the print shop for characterization, including particle size distribution and elemental composition, and measured PM1 number concentrations in print shops and other workplaces. We assessed blood pressure, heart rate and pulmonary function in 53 printing room workers and 54 controls in Beijing, China. Multiple linear regression analysis were used to examine health effects of exposure to printer emissions. The PM1 number concentration in the print shop was more than 2 times that of the control group. Compared with controls, the exposed workers with lower education and income had heavier workload with a median of 7 days per week and 12 h per day on working days, and presented cardiopulmonary function injury with increased the diastolic blood pressure (DBP), systolic blood pressure (SBP), and mean arterial pressure (MAP). The most significant changes of cardiopulmonary function were found in exposed workers with more than 10 years of working age. Multiple linear regression also showed printer emissions exposure was associated with increased SBP and MAP, while decreased lung function indices. This study found changes in the cardiopulmonary function of staff members exposed to printer emissions, which prompted the necessity and urgency of improving the environment of printing rooms and protecting the health of exposed workers.

Artificial stone silicosis.

This review details recent findings related to the health effects of occupational exposure to artificial stone dust and the rapid increase in cases of artificial stone associated silicosis around the world. High crystalline silica content artificial stone is now commonly used for the production of kitchen benchtops. Reports of artificial stone silicosis from many countries have noted that workers were typically employed at small workplaces and were often diagnosed in their 30s or 40s. Poor exposure control measures were common, including the practice of 'dry processing'. Dust generated from artificial stone has been noted to have properties that influence toxicity, including high silica content, generation of nanosized particles and presence of metals and resins. Artificial stone silicosis differs from silicosis associated with other occupational settings including shorter latency and rapid disease progression. High-resolution computed tomography (CT) chest imaging of artificial stone silicosis has often noted the presence of ground glass opacities, which may not be detected in chest x-ray screening. Increased prevalence of autoimmune disease, such as scleroderma, has also been reported in this industry. Further evaluation of the safety of work with artificial stone is required, including the effectiveness of dust control measures. Current reports of artificial stone silicosis indicate the potential for widespread undiagnosed respiratory disease in this industry. Provision of more sensitive health screening methods for all at-risk workers and the development of new treatment options particularly for this form of silicosis is urgently required.

Evaluation of Blood Lipid Concentrations of Dioxins in Firefighters Depending on Polymorphic Variants of Xenobiotic Detoxification Genes

Summary. Background: The specifics of occupational activities of firefighters is determined by exposures to both fire hazards and a combination of occupational risk factors of various nature significantly exceeding their standard values. Adverse chemical exposures rank first due to unpredictable toxic effects of combustion products from burning synthetic polymers. Yet, the most dangerous are low-temperature fires emitting a wide range of air contaminants including highly lipophilic, bioaccumulative and persistent dioxins. The purpose of the research was to study the relationship between various polymorphic variants of xenobiotic detoxification genes and blood lipid concentrations of dioxins in firefighters. Materials and methods: We measured average dioxin concentrations in ambient air at different stages of firefighting and in blood lipids of firefighters with different length of service using the analytical method of gas chromatography–mass spectrometry (GC-MS). The cumulative effect of dioxins was estimated in relation to polymorphic variants of xenobiotic detoxification genes of the first and second phases of biotransformation by determining polymorphisms, the main research method being polymerase chain reaction (PCR). Results: High concentrations of dioxins measured in ambient air at all stages of firefighting and in blood lipids of firefighters with a significant correlation with work experience indicate that inhalation is one of the main routes of exposure to dioxins and that these chemicals are occupational risk factors for this professional group. The analysis of the relationship between various polymorphic variants of xenobiotic detoxification genes and blood lipid concentrations of dioxins in the firefighters showed a higher blood level of dioxins in carriers of minor alleles. Conclusions: Genotyping of firefighters and identification of carriers of minor alleles of xenobiotic detoxification genes may contribute to timely preventive and rehabilitation measures aimed at elimination of adverse health effects of occupational exposure to dioxins.

Assessment of exposure to cobalt and its compounds in Italian industrial settings.

Background:Adverse health effects of occupational exposure to cobalt and its compounds are well-documented.Objectives:The aim of the study is to evaluate exposures to cobalt in Italian industrial settings.Methods:Data on cobalt and its compounds were collected from an occupational exposure registry. Statistical analysis was carried out for some exposure-related variables (i.e., cobalt compound, activity sector, occupational group, firm size). The number of workers potentially exposed was estimated for selected industrial sectors.Results:Overall 1,701 measurements were analyzed in the period 1996-2016. The geometric mean of cobalt airborne concentration was 0.33 µg/m3. Most exposures occurred in the manufacture of fabricated metal products (50%) and among metal finishing-, plating- and coating-machine operators (42%). A total of 30,401 workers potentially exposed to cobalt was estimated, over 72% were male.Conclusions:Identifying professional groups at high-risk of exposure can help to control the most dangerous situations for workers’ health. Surveillance systems based on occupational exposure registries contribute to support systematic improvement of working conditions.

Mass Spectrometry-Based Metabolomics Reveals Occupational Exposure to Per- and Polyfluoroalkyl Substances Relates to Oxidative Stress, Fatty Acid β-Oxidation Disorder, and Kidney Injury in a Manufactory in China.

Occupational workers are usually exposed to high levels of per- and polyfluoroalkyl substances (PFASs), placing them under greater health risks compared to the general population. Herein, 40 occupational workers from a factory in China and 52 control subjects from the general population were involved in an investigation on the potential health concerns of occupational exposure to PFASs by mass spectrometry-based metabolomics analysis. The PFAS levels in plasma from both groups were analyzed. Six PFAS congeners (∑6PFASs) were found to be the main components of the 13 detected PFASs, with a geometric mean of 1770 and 22.2 ng mL-1 in occupational workers and the general population, respectively. Metabolic profiles of the plasma samples were acquired using liquid chromatography coupled with orbitrap high-resolution mass spectrometry and gas chromatography-mass spectrometry. The partial least-squares-discriminant analysis model indicated that the plasma metabolic profiles of the two groups could be clearly separated. Differential and correlation analyses were applied to discover potential biomarkers. A total of 14 potential biomarkers were identified, and they were found to be associated with oxidative stress, fatty acid β-oxidation disorder, and kidney injury. The obtained results indicated that the health effects of occupational exposure to PFASs on workers should not be ignored.

Airport emission particles: exposure characterization and toxicity following intratracheal instillation in mice

BackgroundLittle is known about the exposure levels and adverse health effects of occupational exposure to airplane emissions. Diesel exhaust particles are classified as carcinogenic to humans and jet engines produce potentially similar soot particles. Here, we evaluated the potential occupational exposure risk by analyzing particles from a non-commercial airfield and from the apron of a commercial airport. Toxicity of the collected particles was evaluated alongside NIST standard reference diesel exhaust particles (NIST2975) in terms of acute phase response, pulmonary inflammation, and genotoxicity after single intratracheal instillation in mice.ResultsParticle exposure levels were up to 1 mg/m3 at the non-commercial airfield. Particulate matter from the non-commercial airfield air consisted of primary and aggregated soot particles, whereas commercial airport sampling resulted in a more heterogeneous mixture of organic compounds including salt, pollen and soot, reflecting the complex occupational exposure at an apron. The particle contents of polycyclic aromatic hydrocarbons and metals were similar to the content in NIST2975. Mice were exposed to doses 6, 18 and 54 μg alongside carbon black (Printex 90) and NIST2975 and euthanized after 1, 28 or 90 days. Dose-dependent increases in total number of cells, neutrophils, and eosinophils in bronchoalveolar lavage fluid were observed on day 1 post-exposure for all particles. Lymphocytes were increased for all four particle types on 28 days post-exposure as well as for neutrophil influx for jet engine particles and carbon black nanoparticles. Increased Saa3 mRNA levels in lung tissue and increased SAA3 protein levels in plasma were observed on day 1 post-exposure. Increased levels of DNA strand breaks in bronchoalveolar lavage cells and liver tissue were observed for both particles, at single dose levels across doses and time points.ConclusionsPulmonary exposure of mice to particles collected at two airports induced acute phase response, inflammation, and genotoxicity similar to standard diesel exhaust particles and carbon black nanoparticles, suggesting similar physicochemical properties and toxicity of jet engine particles and diesel exhaust particles. Given this resemblance as well as the dose-response relationship between diesel exhaust exposure and lung cancer, occupational exposure to jet engine emissions at the two airports should be minimized.

Study on the health effects of occupational exposure to lead exceeded

Objective: The main purpose of this study was to explore the health effects of occupational exposure to lead exceeded. Methods: We collected 114 inpatients who exposure to lead, and diagnosed lead toxicity by No. 5 Suzhou People's Hospital from January 2011 to May 2018. Samples were selected according to 1:4 of the lead exceeded group and the control group. The age and gender of the lead exce eded group were matchied, and balanced between the two groups. Lead exceeded group: 84 inpatients occupational exposure to lead, whose blood or urinary lead exceeded. Control group: 336 healthy checkup persons who did not contact with any toxic or hazardous substances. Results: The diastolic blood pressure of lead exceeded group was significantly higher than control group (P<0.05) . The red blood cell count, hemoglobin, mean red blood cell volume, mean hemoglobin content, mean hemoglobin concentration, the platelet count, and the lymphocyte count levels of lead exceeded group were significantly lower than control group (P<0.05) , while the average platelet volume level of lead exceeded group was significantly higher than control group (P<0.05) . The aspartate aminotransferase, glucose and the urea nitrogen levels of lead exceeded group were significantly higher than control group, while the creatinine of lead exceeded group was significantly lower than control group (P<0.05) . The total protein, albumin, cholesterol and low density lipoprotein levels of lead exceeded group were significantly lower than control group (P<0.05) . The abnormal rate of electrocardiogram and spleen B (24.4%, 8.33%) in lead exceeded group were significantly higher than control group (11.04%, 0.6%) (P<0.05) . The abnormal rate of liver B ultrasound, and gallbladder B ultrasound (23.81%、8.32%) in lead exceeded group were significantly lower than control group (41.32%、21.06%) (P<0.05) . Conclusion: Occupational exposure to lead exceeded not only has a significant impact on red blood cell related indicators, but also has a certain impact on cardiac function and liver and kidney functions. It is suggested that lead exprsure may have some effect on health of occupational population.

Electromagnetic fields exposure assessment among workers at broadcast centers in Poland.

In the studies investigating the potential health effects of occupational exposure to electromagnetic fields (EMF), the key problem is the assessment of workers' exposure. Electromagnetic fields exposure assessment requires determining maximum EMF levels, for the acute effect, and the dose absorbed, for the cumulative effect. A study was undertaken to determine EMF exposure in workers at broadcasting centers (BCs) in Poland. It was the first part of a comprehensive project on health effects of occupational exposure to EMF. The study was conducted in 4 selected BCs. Spot measurements of electric field strength (E), and the results of E measurements that were made in the past for occupational hygiene assessments, were used for determining workers' exposure to electric field. The parameters considered were the maximum E value (Emax), the weighted average E value (Eavg) and the E lifetime dose (Elifetime dose). In the group of workers examined, the E values did not exceed 16.7 V/m for Emax (the occupational exposure limit (OEL) for work shift in Poland is 20 V/m), 2.9 V/m for Eavg and 1 500 000 (V/m)2×h for Elifetime dose. In view of the lack of dosimetry data, a retrospective assessment of BC workers' exposure to very high frequency and ultra-high frequency EMF was conducted, which made it possible to estimate EMF lifetime dose for the workers. Since the EMF exposure levels at BCs did not exceed the admissible values, they can be considered safe to the workers' health, according to the approach used for developing OELs for EMF exposure. Med Pr 2018;69(5):477-482.

Introducing Greek Guidelines for the Diagnosis and Treatment of Adverse Health Effects of Occupational Exposure to Metals.

Background Aim:Implementing guidelines in the practice of occupational health is a high-priority need, since their use can reduce the variability in practice and increase professional efficiency, resulting in higher quality of health care services. The aim of this report is to provide information regarding the development process of the first series of national guidelines for the diagnosis and treatment of adverse health effects occurring after occupational exposure to hazardous metals in Greece. This task was recently initiated in Greece as part of the health care reform system in the context of the ongoing financial crisis.Methods:The following metals: arsenic (As), cadmium (Cd), chromium (Cr), lead (Pb), mercury (Hg), and nickel (Ni), which are the most commonly encountered in Greece, were selected to be studied. A systematic review of medical literature resulted in 94 review papers of the initial 3,932 eligible according to the inclusion criteria.Results:For each metal, an extensive report was produced, including physical and chemical properties, routes of exposure, health hazards, medical surveillance, occupational exposure limits, protection and control measures, first aid and rescue, and waste management. Special attention was paid to environmental exposure data, effects on children health, and necessary laboratory examinations.Conclusions:The first series of guidelines, regarding diagnosis and treatment of individuals who have been occupationally exposed to metals is available; it was recently published in Greece by the National School of Public Health, aiming at helping occupational health practitioners enhance the quality of their provided services.