Potential Occupational Exposure Research Articles

Safety and immunogenicity of a four-component meningococcal group B vaccine (4CMenB) and a quadrivalent meningococcal group ACWY conjugate vaccine administered concomitantly in healthy laboratory workers

Safety precautions for laboratory staff working with meningococci should primarily rely on laboratory procedures preventing exposure to aerosols containing viable meningococci. Despite this, vaccination is a key component of protection in the occupational setting. In the UK in 2009, there were no licensed vaccines for meningococcal capsular group B or conjugate vaccines for capsular groups A, C, W and Y. We therefore undertook a Phase II trial in laboratory workers to investigate the safety and immunogenicity of a four component group B vaccine (4CMenB) and a quadrivalent group A, C, W and Y conjugate vaccine (ACWY-CRM).Enrolment was open to staff aged 18–65 years at the Public Health Laboratory, Manchester who may have had a potential occupational exposure risk to meningococci. 4CMenB was administered at 0, 2 and 6 months in the non-dominant arm and ACWY-CRM concomitantly at 0 months in the dominant arm. Pre- and post-vaccination blood samples were taken and analysed by the serum bactericidal antibody (SBA) assay against A, C, W and Y strains and a panel of seven diverse group B strains. Diary cards were used to record any local and systemic reactions following each vaccination.In total, 38 staff were enrolled and received initial vaccinations with 31 completing the trial per protocol. Both vaccines were proven safe, with local reactogenicity being more commonly reported following 4CMenB than ACWY-CRM. High proportions of subjects had putative protective SBA titres pre-vaccination, with 61–84 and 61–87% protected against A, C, W and Y strains and diverse MenB strains, respectively. Post-vaccination, SBA titres increased with 95–100 and 90–100% of subjects with protective SBA titres against A, C, W and Y strains and diverse MenB strains, respectively.These data suggest that 4CMenB and ACWY-CRM are safe when administered concomitantly and have the potential to enhance protection for laboratory workers.www.clinicaltrials.gov identifier: NCT00962624.

Elevated levels of PFOS and PFHxS in firefighters exposed to aqueous film forming foam (AFFF)

Exposure to aqueous film forming foam (AFFF) was evaluated in 149 firefighters working at AFFF training facilities in Australia by analysis of PFOS and related compounds in serum. A questionnaire was designed to capture information about basic demographic factors, lifestyle factors and potential occupational exposure (such as work history and self-reported skin contact with foam). The results showed that a number of factors were associated with PFAA serum concentrations. Blood donation was found to be linked to low PFAA levels, and the concentrations of PFOS and PFHxS were found to be positively associated with years of jobs with AFFF contact. The highest levels of PFOS and PFHxS were one order of magnitude higher compared to the general population in Australia and Canada. Study participants who had worked ten years or less had levels of PFOS that were similar to or only slightly above those of the general population. This coincides with the phase out of 3M AFFF from all training facilities in 2003, and suggests that the exposures to PFOS and PFHxS in AFFF have declined in recent years. Self-reporting of skin contact and frequency of contact were used as an index of exposure. Using this index, there was no relationship between PFOS levels and skin exposure. This index of exposure is limited as it relies on self-report and it only considers skin exposure to AFFF, and does not capture other routes of potential exposure. Possible associations between serum PFAA concentrations and five biochemical outcomes were assessed. The outcomes were serum cholesterol, triglycerides, high-density lipoproteins, low density lipoproteins, and uric acid. No statistical associations between any of these endpoints and serum PFAA concentrations were observed.

Maternal occupational exposure to ionizing radiation and major structural birth defects.

Ionizing radiation (IR) is known to be carcinogenic and mutagenic, but little is known about the association between maternal occupational exposure to IR and birth defects. We studied 38,009 mothers who participated in the National Birth Defects Prevention Study and delivered between 1997 and 2009. We assessed odds ratios [ORs] for the association between maternal occupations with potential exposure to IR and 39 birth defects. We observed significant odds ratios (ORs) for isolated hydrocephaly (adjusted OR [AOR], 2.1; 95% confidence interval [CI], 1.1-4.2), isolated anotia/microtia (AOR, 2.0; 95% CI, 1.0-4.0), isolated colonic atresia (crude OR, 7.5; 95% CI, 2.5-22.3), isolated omphalocele (AOR, 2.3; 95% CI, 1.1-4.6) and isolated anencephaly (crude OR, 0.23; 95% CI, 0.06-0.94). We also observed a nonsignificant OR for birth defects in aggregate (AOR, 2.0; 95% CI, 0.9-4.6) among mothers with potential occupational exposure to fluoroscopy. We assessed 39 birth defects, observing that maternal occupations with potential exposure to IR were associated with a significantly increased risk for 4 birth defects and a significantly protected risk for 1 birth defect. These results should be interpreted cautiously because our measurement of exposure is qualitative, some of these associations may be due to occupational exposures that are correlated with IR and some may be due to chance. However, these findings serve as the first evaluation of these relationships in a large study and may be useful for generating hypotheses for future studies.

Current data on the background burden to the persistent organochlorine pollutants HCB, p,p'-DDE as well as PCB 138, PCB 153 and PCB 180 in plasma of the general population in Germany.

Despite their long-term ban, persistent organochlorine compounds like hexachlorobenzene (HCB), p,p'-dichlorodiphenylethylene (DDE) as well as polychlorinated biphenyls (PCBs) are still of environmental concern. For the evaluation of potential occupational or environmental exposures to these substances, it is essential to know the current background burden of the general population. As representative and up-to-date information is missing for Germany, we have analysed a large dataset generated in studies on potential exposure to lower chlorinated PCBs to fill this gap for the levels of HCB, DDE as well as PCB 138, PCB 153 and PCB 180. We have investigated n=2750 plasma samples of persons of the general population living in North Rhine-Westfalia and Hesse aged 6-65 years and sampled between September 2010 and March 2014. For evaluation of the age-dependent accumulation in the general population we have generated seven age groups in the collective. Our laboratory used a validated and quality controlled procedure using GC/MS for quantification of the organochlorine compounds in plasma (LOQ: 0.01μg/L). The median (95th percentile) levels for ∑ PCB 138+PCB 153+PCB 180 were 0.14 (0.73); 0.30 (0.82); 0.38 (0.88); 0.50 (1.14); 0.92; 1.58 (3.54) and 2.41 (4.82)μg/L plasma in the age groups 6-10 years (n=102), 11-17 years (n=499), 18-25 years (n=157), 26-35 years (n=710), 36-45 years (n=400), 46-55 years (n=525) and 56-65 years (n=357), respectively. Similarly, the median (95th percentile) levels of p,p'-DDE were 0.18 (1.24); 0.18 (0.74); 0.24 (0.85); 0.30 (1.20); 0.45 (1.74); 0.64 (3.25) and 0.94 (4.7)μg/L plasma. Finally, the median (95th percentile) of HCB in plasma in these age groups was 0.05 (0.10); 0.06 (0.11); 0.08 (0.15); 0.08 (0.15); 0.11 (0.22); 0.14 (0.42) and 0.20 (0.68)μg/L plasma. Our results prove an overall substantial reduction in the body burden to organochlorine compounds in Germany compared to earlier studies. However, 15% and 3.6% of the examined collective exceeded the HBM-I- and HBM-II-values for PCBs established by the German Human Biomonitoring Commission. Due to a large sample size and a collection period from 2010 to 2014, our data might be suitable for the evaluation of additional exposures to these POPs and may serve as reference values.

Global perspectives of emerging occupational and environmental lung diseases.

New technologies continue to be introduced into the workplace and the environment. These novel technologies also bring in new hazards leading to evolving patterns of established occupational and environmental diseases, as well as novel conditions never before encountered. Many of these emerging conditions have appeared in media outlets or in the literature as case reports. These sentinel cases often serve as a warning sign for subsequent outbreaks. This review will discuss environmental and occupational lung diseases and exposures from a global perspective. These diseases and exposures include environmental exposure to asbestos and lung diseases, accelerated silicosis in sandblasting jean workers, coal worker's pneumoconiosis in surface coal miners, health effects of indoor air pollution from burning of biomass fuels and exposures to heavy metals and potential health effects from hydraulic fracturing (fracking). Other emerging conditions are also discussed, including smog in developing countries, sand storms in Asia and the Middle East and respiratory illnesses from nanoparticles and man-made fibres. Clinicians must remain vigilant for potential occupational and environmental exposures, especially when evaluating patients with unusual and unique presentation, so that occupational and environmental risk factors may be identified, and monitoring and preventive measures can be implemented early.

Handling chemotherapy drugs-Do medical gloves really protect?

Due to their potential mutagenic, carcinogenic and teratogenic effects occupational exposure to chemotherapy drugs should be kept to a minimum. Utilization of personnel protective devices, especially the use of protective medical gloves, is a mainstay to avoid skin contact. The choice of appropriate gloves is of outstanding importance. For optimal protection in the oncology setting it is essential to establish general guidelines evaluating appropriate materials and defining quality standards. Establishing these guidelines can facilitate better handling and avoid potential hazards and late sequelae. In Europe there are no specific requirements or test methodologies for medical gloves used in the oncology environment. The implementation of uniform standards for gloves used while handling chemotherapy drugs would be desirable. In contrast, in the US medical gloves used to handle chemotherapy drugs have to fulfill requirements according to the ASTM International (American Society of Testing and Materials) standard D 6978-05. Nitrile or natural rubber latex is a preferred basic glove material, while vinyl is considered inappropriate because of its generally increased permeability. For extended exposure to chemotherapy drugs, double gloving, the use of thicker gloves and the frequent change of gloves increases their protective power.

0080 Retrospective Exposure Assessment on the Photolithography Process in Semiconductor Manufacturing Facility

ObjectivesThe purpose of this study was to assess potential occupational exposure to chemicals among workers using both qualitative and quantitative information during specific job tasks on the photolithography process of...

Transient receptor potential channels and occupational exposure

The discovery that a number of transient receptor potential (TRP) channels are expressed in a subpopulation of primary sensory neurons innervating the upper and lower airways as well as in nonneuronal cells in the airways and lungs has initiated a quest for the understanding of their role in the physiology and pathophysiology of the respiratory tract. Various members of the TRP vanilloid subfamily (TRPV1, TRPV4) and the TRP ankyrin 1 (TRPA1), because of their localization in peptidergic sensory neurons, promote airway neurogenic inflammation. In particular, TRPA1, which is gated by oxidative and nitrative stress byproducts, has been found to mediate inflammatory responses produced by an unprecedented series of toxic and irritant agents produced by air pollution, contained in cigarette smoke, and produced by accidental events at the workplace. The observation that reactive molecules endogenously produced in the airways/lungs of asthma, work-related asthma, and chronic obstructive pulmonary disease target TRPA1 underscores the primary role of the TRPA1 channel in these conditions. Identification of TRP channels, and especially TRPA1, as major targets of oxidative/nitrative stress and a variety of irritant environmental agents supports the hypothesis that neurogenic inflammation plays an important role in work-related inflammatory diseases and that antagonists for such channels may be novel therapeutic options for the treatment of these diseases.

Carbon Monoxide Toxicity after Lighting Coals at a Hookah Bar

Unintentional non-fire-related (UNFR) carbon monoxide (CO) poisonings continue to account for a significant health and economic burden in the United States. While most of these poisonings are related to faulty central heating or water heaters in private dwellings, less common sources should also be considered when a patient presents with any signs or symptoms suggestive of CO toxicity. The authors present a case where a patient was found to have severe CO poisoning, a COHgb level of 33.8%, after lighting coals for a water pipe called a hookah. The patient was initially unconscious and was found to have electrocardiogram (ECG) changes consistent with cardiac ischemia that resolved following treatment with hyperbaric oxygen therapy. In recent years, hookah bars have gained in popularity, especially in urban areas and around college campuses. This was the first case to identify the potential occupational exposure of employees working at hookah bars to CO. Furthermore, the patient's COHb level of 33.8% was higher than any previously reported in the literature with exposure via hookah pipe. The practitioner should consider CO poisoning in patients who smoke tobacco via a hookah and consider early hyperbaric oxygen therapy in those experiencing significant symptoms.

Lead and other Heavy Metals in Dust Fall from Single-Family Housing Demolition

We measured lead and other heavy metals in dust during older housing demolition and effectiveness of dust suppression. We used American Public Housing Association Method 502 and U.S. Environmental Protection Agency Methods SW3050B and SW6020 at 97 single-family housing demolition events with intermittent (or no) use of water to suppress dust at perimeter, non-perimeter, and locations without demolition, with nested mixed modeling and tobit modeling with left censoring. The geometric mean (GM) lead dust fall during demolition was 6.01 micrograms of lead per square foot per hour (μg Pb/ft(2)/hour). GM lead dust fall was 14.18 μg Pb/ft(2)/hour without dust suppression, but declined to 5.48 μg Pb/ft(2)/hour (p=0.057) when buildings and debris were wetted. Significant predictors included distance, wind direction, and main street location. At 400 feet, lead dust fall was not significantly different from background. GM lead concentration at demolition (2,406 parts per million [ppm]) was significantly greater than background (GM=579 ppm, p=0.05). Arsenic, chromium, copper, iron, and manganese demolition dust fall was significantly higher than background (p<0.001). Demolition of approximately 400 old housing units elsewhere with more dust suppression was only 0.25 μg Pb/ft(2)/hour. Lead dust suppression is feasible and important in single-family housing demolition where distances between houses are smaller and community exposures are higher. Neighbor notification should be expanded to at least 400 feet away from single-family housing demolition, not just adjacent properties. Further research is needed on effects of distance, potential water contamination, occupational exposures, and water application.

Biomonitoring Study of Dry Cleaning Workers Using Cytogenetic Tests and the Comet Assay

Perchloroethylene (PCE) is the main solvent used in the dry cleaning industry worldwide. The aim of the present work was to evaluate the genotoxic potential of occupational exposure to PCE in dry cleaning workers. The study was carried out in 59 volunteers (30 workers, 29 controls). The genotoxic effect was evaluated by analyzing chromosome aberrations (CAs), and micronuclei (MN) and DNA damage (assessed by the comet assay) in peripheral blood lymphocytes. Environmental monitoring of exposure was carried out on personal breathing zone air samples collected during two consecutive working days by measuring the concentration of PCE air levels. The mean PCE concentration in workplace air of dry cleaning workers was 31.40 mg/m3. There were no significant differences in CA frequency between dry cleaning workers and the controls, but analysis showed a significant association of CA frequency with employment duration and frequency of exposure to PCE. The MN frequency and DNA damage detected by alkaline comet assay were significantly increased in dry cleaning workers compared to the controls. The results suggest that (a) chronic occupational exposure to dry cleaning solvents below permissible occupational exposure limit of 70 mg/m3 (i.e., ∼10.3 ppm) may lead to an increased risk of genetic damage among dry cleaning workers, and (b) CA, MN tests, and comet assay are useful to monitor populations exposed to low doses of PCE.

Airway dysfunction in elite athletes - an occupational lung disease?

Airway dysfunction is prevalent in elite endurance athletes and when left untreated may impact upon both health and performance. There is now concern that the intensity of hyperpnoea necessitated by exercise at an elite level may be detrimental for an athlete's respiratory health. This article addresses the evidence of causality in this context with the aim of specifically addressing whether airway dysfunction in elite athletes should be classified as an occupational lung disease. The approach used highlights a number of concerns and facilitates recommendations to ensure airway health is maintained and optimized in this population. We conclude that elite athletes should receive the same considerations for their airway health as others with potential and relevant occupational exposures.

275 Occupation and mesothelioma in pleura and peritoneum in Sweden - Updated incidence for males and females 1961–2009

ObjectivesMesothelioma incidence increased in Sweden between years 1970 and 2000, and seems to have reached a plateau in the last decade. We used data from the Swedish component of the...

Reliability of Family Proxy Data for Studies of Malignant Mesothelioma: Results from the ATSDR Pilot Surveillance

Objective. To evaluate the validity of proxy interviews in obtaining information on persons with rapidly fatal diseases such as malignant mesothelioma (MM). Methods. Persons with MM diagnosed in 2002 through 2005 in New York and New Jersey and 1997–2004 in Wisconsin were eligible for inclusion in the project. Persons with MM and their family member proxy were interviewed using the same questionnaire designed by ATSDR to collect information on potential direct or indirect occupational and environmental exposure to asbestos, genetic, and health related malignancy predisposition, and exposure to tobacco products. Descriptive statistics and the McNemar/Durkalski test were used to analyze 33 matched pairs. Results. The overall study confirmed a generally high ability of proxies to give interviews of comparable quality and completeness when asked dichotomous questions. The reliability of information collected from proxies varied by topic and family relationship. Conclusions. Family proxy interviews, using dichotomous responses, can serve as an acceptable source of information about health and exposure-related risk factors for MM.

Assessment of Arsenic Surface Contamination in a Museum Anthropology Department

To assess potential arsenic (As) contamination of work surfaces to improve upon the control strategy at an anthropology department in a large natural history museum. Work practices were observed and control strategy reviewed to inform an occupational hygiene assessment strategy utilizing surface wipe sampling. A total of 35 sampling targets were identified, focusing on surfaces that receive high touch traffic, including workstations, artifact transport carts, and elevator buttons. Arsenic sampling and analysis were performed using reference method Occupational Safety and Health Administration ID-125G. Four of the sampling areas returned detectable levels of As, ranging from 0.052 to 0.350 μg/100 cm. Workplace observations and wipe sampling data enabled the development of recommendations to help to further reduce potential occupational exposure to As. Continuous reduction of surface contamination is prudent for known human carcinogens.

Use of Birth Certificates to Examine Maternal Occupational Exposures and Autism Spectrum Disorders in Offspring

The continuing rise in the prevalence of autism spectrum disorders has led to heightened interest in the role of nongenetic factors, including exogenous exposures, but little research has been conducted. To explore a possible role in autism etiology, we used data available from our prior studies to examine potential occupational exposures, as these may occur at higher levels than environmental exposures. Parental occupation was obtained from birth certificates for 284 children with autism and 659 controls, born in 1994 in the San Francisco Bay Area. Self-reported occupation and industry were coded into eight exposure/chemical groups based on potential neurotoxicity or reprotoxicity by a board-certified physician in occupational medicine and an industrial hygienist blinded to case-control status. Mothers of autistic children were twice as likely to work in occupations considered exposed (14.4%) as mothers of controls (7.2%) (adjusted odds ratio [AOR] 2.3 [95% confidence interval {CI} 1.3-4.2]). The exposure categories of the greatest frequency among case mothers were exhaust and combustion products (AOR = 12.0 [95% CI 1.4-104.6]) and disinfectants (AOR = 4.0 [95% CI 1.4-12.0]). Paternal occupational exposure was not associated with autism, potentially consistent with a direct in-utero exposure effect. There are several limitations of this hypothesis-generating study, including lack of detail on workplace and job duties, leading to possible misclassification and low proportion exposed. However, this misclassification would not be biased by case-control status and is unlikely to explain the associations we did find, suggesting that further research on exogenous exposures may yield useful etiologic clues.

Professional Aircrews’ Attitudes Toward Infectious Diseases and Aviation Medical Issues

Air carrier and professional corporate aircrews provide a unique and highly distinct population in which to examine potential transport and transmission of infectious diseases (ID). This study sought to assess frequency of flying while acutely ill, identify clinical triggers in self-grounding, determine employer support for self-grounding, examine rates of influenza vaccination, and identify unmet needs for current information on ID issues related to extensive travel required of professional aircrews. Anonymous questionnaires were completed by select European mainline, U.S. regional airline, and professional corporate aircrews on ID topics such as flying while ill, flying with ill crewmembers, receipt of influenza vaccination, disinfection, and other aviation medical issues. Data were analyzed and reported as composite and stratified by airline vs. corporate aviation respondents. Aircrews often flew while ill (or with ill crewmembers); 52% flew until fever reached 38 degrees C (100.4 degrees F) and an additional 37% flew up to 38.89 degrees C (102 degrees F). Rate of annual influenza vaccination was quite low for all groups, but especially so for airline crews (21-27%), even given potential occupational exposure risk. Crews also had strongly differing perceptions of employer views on self-grounding, depending upon employment setting. There were sizable disparities between aircrew flying for U.S. regional, European mainline, and large corporate aviation departments with respect to self-grounding when ill and routinely receiving a seasonal influenza vaccination. All study groups reported a pressing need for enhanced anonymous access to current ID and medical information.

Maternal occupational exposure to polycyclic aromatic hydrocarbons and congenital heart defects among offspring in the national birth defects prevention study

There is evidence in experimental model systems that exposure to polycyclic aromatic hydrocarbons (PAHs) results in congenital heart defects (CHDs); however, to our knowledge, this relationship has not been examined in humans. Therefore, we conducted a case-control study assessing the association between estimated maternal occupational exposure to PAHs and CHDs in offspring. Data on CHD cases and control infants were obtained from the National Birth Defects Prevention Study for the period of 1997 to 2002. Exposure to PAHs was assigned by industrial hygienist consensus, based on self-reported maternal occupational histories from 1 month before conception through the third month of pregnancy. Logistic regression was used to evaluate the association between maternal occupational PAH exposure and specific CHD phenotypic subtypes among offspring. The prevalence of occupational PAH exposure was 4.0% in CHD case mothers (76/1907) and 3.6% in control mothers (104/2853). After adjusting for maternal age, race or ethnicity, education, smoking, folic acid supplementation, and study center, exposure was not associated with conotruncal defects (adjusted odds ratio [AOR], 0.98; 95% confidence interval [CI], 0.58-1.67), septal defects (AOR, 1.28; 95% CI, 0.86-1.90), or with any isolated CHD subtype. Our findings do not support an association between potential maternal occupational exposure to PAHs and various CHDs in a large, population-based study. For CHD phenotypic subtypes in which modest nonsignificant associations were observed, future investigations could be improved by studying populations with a higher prevalence of PAH exposure and by incorporating information on maternal and fetal genotypes related to PAH metabolism. Birth Defects Research (Part A), 2012.

Methylation capacity of arsenic and skin lesions in smelter plant workers

Potential occupational arsenic exposure is a significant problem in smelting plants. The metabolites containing arsenic with an oxidation of +3 have been considered more cytotoxic and genotoxic than their parent inorganic species. The current study examined the capacity of arsenic methylation and its risk on skin lesions. The primary aim of this study is to determine if methylation capacity, as measured by urinary arsenic metabolites, differed in workers with skin lesions compared to workers without skin lesions. Hydride generation-atomic absorption spectrometry was used to determine three arsenic species in urine of workers who had been working in arsenic plants, and primary and secondary methylation indexes were calculated. Skin lesions were examined at the same time. Many workers had obvious skin lesions (36/91). The mean concentrations of inorganic arsenic (iAs), monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA) in urine of workers are obviously higher than those of the control group. There are more iAs, MMA, and DMA in urine, higher MMA%, lower iAs% for workers with skin lesions compared with those without skin lesions. Workers with skin lesions have the lowest SMI (3.50±1.21), and they may be in danger. Our results support the viewpoint that individuals who metabolize inorganic arsenic to MMA easily, but metabolize MMA to DMA difficulty have more risk of skin lesions.

Evaluation of cytotoxic, oxidative stress, proinflammatory and genotoxic responses of micro- and nano-particles of dolomite on human lung epithelial cells A549

Dolomite is a natural mineral of great industrial importance and used worldwide, thus millions of workers are at risk of occupational exposure. Its toxicity is however, meagerly documented. In the present investigation, a dolomite powder obtained from its milling unit was analyzed by some standard methods namely, optical microscopy, transmission electron microscopy and dynamic light scattering. Results showed that dolomite powder contained particles of different shapes and size both microparticles (MPs) and nanoparticles (NPs), suggesting potential occupational exposure of these particles. An attempt was therefore, made to investigate dolomite toxicity in a particle size-dependent manner in human lung epithelial cells A549. The comparative toxicity evaluation of MPs and NPs was carried out by assessing their effects on cell viability, membrane damage, glutathione, reactive oxygen species (ROS), lipid peroxidation (LPO), micronucleus (MN) and proinflammatory cytokines, namely tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6). These markers of cytotoxicity, genotoxicity and inflammation were assayed in cells exposed to MPs and NPs in a dose-and time-dependent manner. Invariably, their toxic effects were dose-and time-dependent while NPs in general were significantly more toxic. Notably, NPs caused oxidative stress, genotoxicity and inflammatory responses, as seen by significant induction of ROS, LPO, MN, TNF-α, IL-1β and IL-6. Thus, the study tends to suggest that separate health safety standards would be required for micrometer and nanometer scale particles of dolomite.