Previous Occupational Exposure Research Articles

Blood pressure and renal function responses in workers exposed to lead for up to six years

Abstract Background Lead is a widespread environmental toxicant. However, there is currently no consensus whether low-level lead exposure raises blood pressure (BP) or induces kidney dysfunction. Purpose The Study for Promotion of Health in Recycling Lead (SPHERL) assessed the BP and renal function (RF) responses for up to six years in the workers without previous occupational lead exposure. Methods BP was the average of 5 consecutive readings and the estimated glomerular filtration rate was derived from serum creatinine (eGFRcrt) and cystatin C (eGFRcys). Blood lead (BL) was measured by inductively coupled plasma mass spectrometry (detection limit 0.5 mg/dL). The statistical methods included multivariable-adjusted mixed models and interval-censored Cox regression analysis. Results The 234 workers analyzed were on average 28.5 years old and included 91.9% men. The baseline BL concentration was 4.35 µg/dL and increased 3.17-fold over follow-up (median: 2.03 years; range: 0.92-6.45 years). The changes in BP and RF were not significantly correlated with the follow-up-to-baseline BL ratio (p≥0.51 and p≥0.18, respectively). The fully-adjusted changes in systolic/diastolic BP associated with a doubling of BL were -0.25/-0.12 mm Hg (CI: -0.94 to 0.44/-0.66 to 0.42 mm Hg). Accordingly, the incidence of stage-1 or -2 hypertension was not associated with the BL change (p≥0.063). Similarly, the changes in eGFRcrt and eGFRcys associated with a 3-fold BL increment were not significant, amounting to -0.70 mL/min/1.73 m2(CI: -1.70 to 0.30 mL/min/1.73 m2) and -1.06 ml/min/1.73 m2 (-2.16 to 0.03 mL/min/1.73 m2). Conclusion The BP and RF responses to an over 3-fold BL increment were small and not significant confirming the safety of modern lead-handing facilities operating under current safety rules.Figure 1Figure 2

Clinical and Sociodemographic Factors Related to Amyotrophic Lateral Sclerosis in Spain: A Pilot Study

Background: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease of unknow etiology. Male sex is a well stablished risk factor, but other factors such as early and adult life expositions show contradictory evidence. Aim: to explore the link of clinical, sociodemographic, and occupational factors with ALS patients in Spain and the impact of these factors in functionality. Methods: A cross-sectional study was conducted with ALS patients and healthy controls. Registered variables were smoking, arterial hypertension, diabetes mellitus type 2, previous cancer to reproductive organs or breast, occupational exposure, and early life exposures. Functionality in ALS patients was compared according to each exposure. Results: The ALS group consisted of 59 participants and the control group of 90 participants. ALS patients showed a significant association with previous cancer (p = 0.011), occupational exposure (p < 0.001), and older siblings (p = 0.029). ALS patients presented significant differences in BMI according to hypertension and older-sibling factors. Moreover, respiratory function was affected in patients with previous cancer (p = 0.031). Conclusions: Occupational exposure and previous cancer to reproductive organs or breast could be linked to ALS patients. In addition, hypertension and previous cancer could affect their BMI and respiratory function. Other factors such as longer smoking periods and exposition to older siblings could also characterize ALS patients.

BLOOD PRESSURE AND RENAL FUNCTION RESPONSES IN WORKERS EXPOSED TO LEAD FOR UP TO SIX YEARS

Objective: As the contemporary environmental lead exposure is comparable to the pre-industry levels in developed countries, whether lead exposure still contributes to the hypertension and renal impairment is controversial. We aimed to assess the association between blood pressure, renal function and lead exposure at contemporary low level in a longitudinal occupational cohort. Design and method: The Study for Promotion of Health in Recycling Lead assessed the blood pressure (BP) including the incidence of hypertension and renal function (RF) responses for up to six years in the workers without previous occupational exposure. BP averaged by 5 consecutive readings and the estimated glomerular filtration rate (eGFR) derived from serum creatinine and cystatin C (eGFRcrt and eGFRcys). Blood lead (BL) was measured by inductively coupled plasma mass spectrometry (detection limit 0.5 mg/dL). The statistical methods included multivariable-adjusted mixed models and interval-censored Cox regression analysis. Results: The 234 workers analysed were on average 28.5 years old and included 91.9% men. The baseline BL concentration was 4.35 microgram/dL and increased 3.17-fold over follow-up (median: 2.03 years; range: 0.92-6.45 years). The changes in BP and RF were not significantly correlated with the follow-up-to-baseline BL ratio (p >= 0.51 and p >= 0.18, respectively). The fully-adjusted changes in systolic/diastolic BP associated with a doubling of BL were -0.25/-0.12 mm Hg (CI: -0.94 to 0.44/-0.66 to 0.42 mm Hg). Accordingly, the incidence of stage-1 or stage-2 hypertension was not associated with the BL change (p >= 0.063). Similarly, the changes in eGFRcrt and eGFRcys associated with a 2 fold BL increment were not significant, amounting to -0.70 mL/min/1.73 m2 (CI: -1.70 to 0.30 mL/min/1.73 m2) and 1.06 ml/min/1.73 m2 (-2.16 to 0.03 mL/min/1.73 m2). Conclusions: The BP and RF responses to an over 3-fold BL increment were small and not significant confirming the safety of modern lead-handing facilities operating under current safety rules.

Blood pressure and renal function responses in workers exposed to lead for up to six years.

The Study for Promotion of Health in Recycling Lead (SPHERL) assessed the blood pressure (BP) and renal function (RF) responses for up to 6 years in the workers without previous occupational lead exposure. BP was the average of five consecutive readings and the estimated glomerular filtration rate was derived from serum creatinine (eGFRcrt) and cystatin C (eGFRcys). Blood lead (BL) was measured by inductively coupled plasma mass spectrometry (detection limit 0.5 μg/dL). The statistical methods included multivariable-adjusted mixed models and interval-censored Cox regression analysis. The 234 workers analyzed were on average 28.5 years old and included 91.9% men. The baseline BL concentration was 4.35 μg/dL and increased 3.17-fold over follow-up (median: 2.03 years; range: 0.92-6.45 years). The changes in BP and RF were not significantly correlated with the follow-up-to-baseline BL ratio (p ≥ .51 and p ≥ .18, respectively). The fully-adjusted changes in systolic/diastolic BP associated with a doubling of BL were -0.25/-0.12mm Hg (CI: -0.94 to 0.44/-0.66 to 0.42mm Hg). Accordingly, the incidence of stage-1 or -2 hypertension was not associated with the BL change (p ≥ .063). Similarly, the changes in eGFRcrt and eGFRcys associated with a 3-fold BL increment were not significant, amounting to -0.70mL/min/1.73 m2 (CI: -1.70 to 0.30mL/min/1.73 m2 ) and -1.06mL/min/1.73 m2 (-2.16 to 0.03mL/min/1.73 m2 ). In conclusion, the BP and RF responses to an over 3-fold BL increment were small and not significant confirming the safety of modern lead-handing facilities operating under current safety rules.

Prise en charge diagnostique et thérapeutique du mésothéliome pleural en 2023: Management of pleural mesothelioma in 2023

Pleural mesothelioma (PM) is a rare tumor, usually due to previous asbestos occupational exposure. Its global prognosis is poor, without validated curative treatment to date. Diagnosis relies ideally on thoracoscopy with pleural biopsies, ± combined with talc pleurodesis. Surgery with curative intent, included with multimodal treatment, is restrained to highly selected patients. As frontline treatment, standard pemetrexed/ platinum-based chemotherapy was lightly improved by addition of bevacizumab. It is now challenged by the double-immunotherapy regiment combining Nivolumab + Ipilimumab, and perhaps soon by the combination standard chemotherapy + Pembrolizumab. No treatment is firmly validated beyond first line treatment, even if anti-PD-1/ PD-L1 ± anti-CTLA-4 antibodies also exhibited some promising results in this setting, in phase II and III trials. Thus, the search of new treatments, strategies and biomarkers is a crucial goal, and recruitment of patients in clinical trials strongly encouraged. Other immuno therapies alone or combined with standard treatments and/or targeted therapies, multimodal strategies are currently assessed. In France, the national network of expert centers for PM management, « NETMESO » (labelled by INCA), aims at proposing an optimal management to all patients systematically discussed in regional (± national) MTB dedicated to MPM, and at stimulating clinical and translational research in collaboration with its partners including patients advocating associations.1877-1203/© 2023 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Healthcare Workers (HCWs) and non-HCWs reaction to Bacillus Calmette-Guérin (BCG) in the BATTLE trial

ObjectivesHealthcare workers (HCWs) may have different response to Bacillus Calmette-Guérin (BCG) vaccination due to previous occupational exposure to Mycobacterium particles. We report subgroup analysis of the BATTLE trial, comparing BCG effects in HCWs vs non-HCWs. This was a secondary analysis of a trial. MethodsThe BATTLE trial was a double-blind placebo-controlled phase III clinical trial that investigated BCG revaccinating adults who were recently infected with SARS-CoV-2 virus. BCG and placebo recipients were sub-grouped based on regular occupational contact with patients into HCWs (48 BCG and 50 placebo) and non-HCWs (124 BCG and 134 placebo). Weekly COVID-19 symptom progression and injection site reactions were compared between subgroups on weeks one, two, three, and six follow-ups. ResultsHCWs were more likely to complain of itching on the injection site early after injection (OR = 2.5, p = 0.049). They developed peeling and crusting on the site of injection faster than non-HCWs (during the second week, p = 0.033 and 0.040, OR = 3.3 and 2.7, respectively). HCWs were also more likely to maintain their papule or develop a late onset pustule during later weeks (weeks four and six, p = 0.024 and 0.006, OR = 2.2 and 8.6, respectively). In terms of COVID-19 symptom progression, recovery from anosmia was more likely in the non-HCWs who received BCG (week six, pHolm’s corrected = 0.002, OR = 3.3). ConclusionHCWs’ local reaction to BCG injection was slightly more rapid and more intense, possibly due to their occupational exposure. BCG may also ameliorate COVID-19 induced inflammation and anosmia in non-HCWs but not HCWs. Therefore, HCWs might be less likely to benefit from BCG vaccination. ClinicalTrials.gov register number NCT04369794.

Changes in Infection Prevention Practices and Occurrence of Skin Symptoms among Healthcare Workers, Cleaners and Day-care Workers in Norway during the COVID-19 Pandemic

The COVID-19 pandemic has resulted in increased attention on infection prevention measures. This study aims to assess whether changes in hand hygiene procedures, use of personal protective equipment and moisturizers during the first year of the COVID-19 pandemic were associated with changes in the occurrence of skin symptoms among healthcare workers, cleaners, and day-care workers. A total of 602 participants (40%) responded to an electronic questionnaire, including questions on previous and current occupational exposure and skin problems. Increased frequency of hand washing, use of hand disinfectants, use of disposable gloves and moisturizers were all associated with an increased symptom score on the hands, wrists, forearms. Participants who increased their use of masks or respirators had a higher risk of facial skin symptoms, compared with those with non-increased occupational exposure. In conclusion, a change of behaviour among healthcare workers, cleaners and day-care workers during the first year of the COVID-19 pandemic, with an increase in occupational exposures and use of moisturizers, was associated with higher occurrence of facial skin symptoms and symptoms on the hands, wrists and forearms.

Prise en charge diagnostique et thérapeutique du mésothéliome pleural malin en 2022

Pleural mesothelioma (PM) is a rare tumor, usually due to previous asbestos occupational exposure. Its global prognosis is poor, without validated curative treatment to date. Diagnosis relies ideally on thoracoscopy with pleural biopsies, ± combined with talc pleurodesis. Surgery with curative intent, included with multimodal treatment, is restrained to highly selected patients. As frontline treatment, standard pemetrexed/platinum-based chemotherapy was lightly improved by addition of bevacizumab. It is now challenged by the double-immunotherapy regiment combining Nivolumab + Ipilimumab. No treatment is firmly validated beyond first line treatment, even if anti-PD-1/PD-L1 ± anti-CTLA-4 antibodies also exhibited some promising results in this setting, in phase II and III trials. Thus, the search of new treatments, strategies and biomarkers is a crucial goal, and recruitment of patients in clinical trials strongly encouraged. Other immunotherapies alone or combined with standard treatments and/or targeted therapies, multimodal strategies are currently assessed. In France, the national network of expert centers for PM “NETMESO” (labelled by INCa), aims at proposing an optimal management to all patients systematically discussed in regional (± national) MTB dedicated to MPM, and at stimulating clinical and translational research in collaboration with its partners: the Mesopath group, the French Thoracic Cooperative Intergroup (IFCT), and patients advocating associations.1877-1203/© 2022 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Impact of Previous Occupational Exposure on Outcomes of Chronic Obstructive Pulmonary Disease.

: BackgroundOccupational exposures have been regarded as a risk factor for the development of chronic obstructive pulmonary disease (COPD). However, there is little knowledge regarding the effect of occupational exposure on the treatment outcomes of COPD. Therefore, the aim of this study was to evaluate the question of whether occupational exposure can have a potential impact on COPD outcomes. Methods: Information regarding self-reported occupational exposure for 312 patients with COPD from the Korean Obstructive Lung Disease (KOLD) Cohort were included. A comparison of the rate of acute exacerbation, annual lung function change, and quality of life according to the presence or absence of occupational exposure was performed. Results: Seventy-six patients (24.4%) had experienced occupational exposure; chemical materials were most common. At enrollment, a higher COPD-specific version of the St. George Respiratory Questionnaire total score (39.7 ± 18.8 vs. 33.1 ± 17.6, p = 0.005) and a higher exacerbation history in the past year (30.3% vs. 17.5%, p = 0.017) were observed for patients with occupational exposure compared to those without occupational exposure. Furthermore, in the follow-up period, after adjusting for potential confounders, a higher frequency of acute exacerbation (odd ratio, 1.418; 95% confidence interval, 1.027–1.956; p = 0.033) and a more rapid decline in forced expiratory volume in 1 s (p = 0.009) was observed for COPD patients with occupational exposure compared to those without occupational exposure. Conclusions: In the KOLD cohort, worse outcomes in terms of exacerbation rate and change in lung function were observed for COPD patients with occupational exposure compared to those without occupational exposure. These findings suggest that occupational exposure not only is a risk factor for COPD but also might have a prognostic impact on COPD.

Smoking and socioeconomic factors linked to acute exacerbations of COPD: analysis from an Asthma + Lung UK survey

BackgroundUnderstanding the factors driving acute exacerbations of chronic obstructive pulmonary disease (COPD) is key to reducing their impact on human health and well-being.Methods5997 people with COPD, mean 66 years, 64%...

Occupational blood exposure beyond needle stick injuries: hospital-based cross-sectional study among healthcare workers in governmental hospitals of Northern Ethiopia

BackgroundOccupational blood exposure is one of the major public health problems that healthcare workers (HCWs) are encountering. Most previous occupational blood exposure studies are delimited to needle stick injury, which could underestimate the real level of blood exposure. On the other hand, others deal with crude blood and body-fluids exposure, which possibly overestimate the magnitude of blood exposure. Therefore, this study aimed at determining the prevalence of occupational blood exposure and identifying associated factors among HCWs in the Southern Tigrai zone governmental hospitals of Northern Ethiopia considering all the potential means of blood exposure (needle stick injury, sharp medical equipment injury, and blood splash) while excluding blood-free body-fluids.MethodsA hospital based cross-sectional study design was employed to gather data from randomly selected HCWs in three governmental hospitals from February to March, 2020. A multivariable logistic regression model was used to identify the independent factors associated with the outcome variable.ResultsFrom the total of 318 HCWs, 148 (46.5 %) were exposed to blood at least once in their lifetime. Working for more than 40 h per week (AOR= 9.4; 95 % CI: 7.61, 11.41), lack of adequate personal protective equipment (PPE) (AOR=3.88; 95 % CI: 1.64, 5.42), Hepatitis B virus vaccination (AOR=0.54; 95 % CI: 0.12,0.78), recapping used needle sticks (AOR=3.18; 95 % CI: 1.28, 8.83), and lack of infection prevention and patient safety (IPPS) training (AOR=13.5; 95 % CI: 8.12,19.11) were detected to significantly increase the likelihood of occupational blood exposure.ConclusionsAs nearly half of the HCWs were exposed to blood, reducing work load below 40 h per week by employing additional staff members, supplying adequate PPE, avoiding recapping of used needle sticks, and providing IPPS training for the HCWs should be practiced.

Inorganic Fiber Lung Burden in Subjects with Occupational and/or Anthropogenic Environmental Asbestos Exposure in Broni (Pavia, Northern Italy): An SEM-EDS Study on Autoptic Samples.

Increased mortality due to malignant mesothelioma has been demonstrated by several epidemiologic studies in the area around Broni (a small town in Lombardy, northern Italy), where a factory producing asbestos cement was active between 1932 and 1993. Until now, the inorganic fiber burden in lungs has not been investigated in this population. The aim of this study is to assess the lung fiber burden in 72 individuals with previous occupational and/or anthropogenic environmental exposure to asbestos during the activity of an important asbestos cement factory. Inorganic fiber lung burden was assessed in autoptic samples taken from individuals deceased from asbestos-related diseases using a scanning electron microscope equipped with an energy-dispersive spectrometer. Significant differences in the detected amount of asbestos were pointed out among the three types of exposure. In most lung samples taken from patients who died of mesothelioma, very little asbestos (or, in some cases, no fibers) was found. Such subjects showed a significantly lower median amount of asbestos as compared to asbestosis. Almost no chrysotile was detected in the examined samples. Overall, crocidolite was the most represented asbestos, followed by amosite, tremolite/actinolite asbestos, and anthophyllite asbestos. There were significant differences in the amount of crocidolite and amosite fibers according to the kind of exposure. Overall, these findings provide novel insights into the link between asbestos exposure and mesothelioma, as well as the different impacts of the various types of asbestos on human health in relation to their different biopersistences in the lung microenvironment.

Two-year neurocognitive responses to first occupational lead exposure.

Objectives:Lead exposure causes neurocognitive dysfunction in children, but its association with neurocognition in adults at current occupational exposure levels is uncertain mainly due to the lack of longitudinal studies. In the Study for Promotion of Health in Recycling Lead (NCT02243904), we assessed the two-year responses of neurocognitive function among workers without previous known occupational exposure newly hired at lead recycling plants.Methods:Workers completed the digit-symbol test (DST) and Stroop test (ST) at baseline and annual follow-up visits. Blood lead (BL) was measured by inductively coupled plasma mass spectrometry (detection limit 0.5 µg/dL). Statistical methods included multivariable-adjusted mixed models with participants modelled as random effect.Results:DST was administered to 260 participants (11.9% women; 46.9%/45.0% whites/Hispanics; mean age 29.4 years) and ST to 168 participants. Geometric means were 3.97 and 4.13 µg/dL for baseline BL, and 3.30 and 3.44 for the last-follow-up-to-baseline BL ratio in DST and ST cohorts, respectively. In partially adjusted models, a doubling of the BL ratio was associated with a 0.66% [95% confidence interval (CI) 0.03–1.30%; P=0.040] increase in latency time (DST) and a 0.35% (95% CI -1.63–1.63%; P=0.59) decrease in the inference effect (ST). In fully adjusted models, none of the associations of the changes in the DST and ST test results with the blood lead changes reached statistical significance (P≥0.12).Conclusions:An over 3-fold increase in blood lead over two years of occupational exposure was not associated with a relevant decline in cognitive performance.

Audiometric findings of printing press workers exposed to noise and organic solvents

Objective To determine if exposure to organic solvents and noise is associated with audiometric results among workers from a printing press in Mexico City. Design Cross-sectional study. Study sample One hundred and seventy-six male workers at a printing press in Mexico City exposed to noise and organic solvents, including xylene, and 103 non-exposed male workers as reference group. Hearing thresholds were assessed with pure-tone audiometry. Results Poorer hearing thresholds were observed among printing workers than non-exposed controls, particularly among groups with over 5 years of exposure. Hearing thresholds differences were observed in the frequencies above 500 Hz, especially in 4000 Hz in all exposure groups compared to the reference. Adjusted models for age and previous exposure to noise and organic solvents showed worse hearing thresholds as years of seniority increased –β coefficients (95% CI): ≤5 years: 3.06 dB (0.01, 6.10); >5–10 years: 4.51 dB (1.13, 7.89); >10 years: 4.58 dB (1.20, 7.96). Further analyses showed no interaction between noise and organic solvents on hearing thresholds, considering both current and previous occupational exposures. Conclusion Exposure to noise levels that were below recommended exposure limits and organic solvents were associated with poorer hearing thresholds than those observed among non-exposed study participants. This suggests that workers exposed to solvents should be included in hearing conservation programmes, even when noise exposures are below 85 dB. If only noise levels were taken into consideration in the risk assessment of this worker population, the risk of hearing effects could have been overlooked.

Simultaneous Nasal Carriage by Methicillin-Resistant and Methicillin Susceptible Staphylococcus aureus of Lineage ST398 in a Live Pig Transporter.

Methicillin-resistant Staphylococcus aureus (MRSA) sequence type (ST)398 is a livestock associated (LA) lineage with zoonotic potential, especially in humans with live pig contact. The objective of this study was to characterize two S. aureus strains of lineage ST398 (one methicillin-resistant (MRSA), one methicillin-susceptible (MSSA)) isolated from the same nasal sample of a patient admitted in the Intensive-Care Unit of a Spanish Hospital, and with previous occupational exposure to live pigs, by whole-genome-sequencing (WGS). The sample was obtained during routine surveillance for MRSA colonization. Purified genomic DNA was sequenced using Illumina HiSeq 2000 and processed using conventional bioinformatics software. The two isolates recovered were both S. aureus t011/ST398 and showed similar resistance-phenotypes, other than methicillin susceptibility. The possession of antibiotic resistance genes was the same, except for the mecA-gene located in SCCmecV in the MRSA isolate. The MSSA isolate harbored remnants of a SCCmec following the deletion of 17342bp from a recombination between two putative primases. Both isolates belonged to the livestock-associated clade as defined by three canonical single-nucleotide-polymorphisms, and neither possessed the human immune evasion cluster genes, chp, scn, or sak. The core genome alignment showed a similarity of 99.6%, and both isolates harbored the same mobile genetic elements. The two nasal ST398 isolates recovered from the patient with previous occupational exposure to pigs appeared to have a livestock origin and could represent different evolutionary steps of animal-human interface lineage. The MSSA strain was formed as a result of the loss of the mecA gene from the livestock-associated-MRSA lineage.

Occupational Exposure to Noise and Age-related Hearing Loss in an Elderly Population of Southern Italy

Background: Age-Related Hearing Loss (ARHL) is a gradual and irreversible age-dependent decline in auditory function. There is still no consensus on the long-term functional effects of noise exposure on ARHL. Objective: This study aimed to compare the prevalence of ARHL in an elderly population occupationally exposed to noise in a non-exposed population. Methods: The population was divided into two groups: a group of 482 subjects professionally exposed to noise for over 10 years and a group of 1129 non-exposed subjects. Among the exposed subjects, a subgroup of 298 who worked for over 10 years in the glassware industry was selected. All the participants underwent a thorough otorhinolaryngological examination. Results: The presence of ARHL was found in 81% of exposed subjects and in 4% of non-exposed subjects. In the sub-group of glassware workers, the prevalence was 88%. The statistical analysis showed a significant association between previous occupational exposure to noise and ARHL (OR = 1.09; 95% CI = 1.067-1.124; p = 0.0012) and between exposure to the glassware industry and ARHL (OR = 1.89; 95% CI = 1.78-1.96; p = 0.006). Conclusion: Consistent with recent studies, we found a significantly higher prevalence of ARHL among workers exposed to noise; however, further studies are needed to support these findings.

Inhalation exposure to volatile organic compounds in the printing industry

ABSTRACTThis study reports on the occupational inhalation exposure to VOCs of workers in the Kuwaiti printing industry. Using the evacuated canister methodology, we targeted 72 VOCs in three printeries and compared the concentrations to previous reports and relevant occupational exposure levels (OELs). We found that recent efforts in the printing industry to reduce VOC usage had been successful, as concentrations of key hazardous VOCs were substantially lower than anticipated. On the other hand, nearly all target VOCs were found. Non-production areas were sampled along with the offset printing areas, another strength of this study, and revealed exposures to hazardous VOCs among administers and digital printer and CTP operators. Exposure to ototoxic VOCs amounted to 1–3% of the OEL, consisting mostly of ethylbenzene, which was likely in use in two of the study printeries. Exposure to carcinogenic or probably carcinogenic VOCs was 15–20% of the OEL at four locations across the three printeries, consisting mostly of vinyl chloride and benzyl chloride. Vinyl chloride VOC was partially sourced from outdoors, but was also likely used inside the study printeries. Interestingly, concentrations of vinyl chloride were similar in most sampling locations to that of CFC-114, a CFC banned by the Montreal Protocol and not commonly used as a refrigerant. This unexpected finding suggests further study is warranted to identify the use of these VOCs in printeries. Exposure to hazardous VOCs up to nearly 50% of the OEL, consisting largely of bromoform and vinyl chloride. Bromoform was found in all the study printeries, sourced partially from outdoor air. The higher concentrations found inside the study printeries likely resulted from the use of the desalinated water for washing. This finding raises of emissions from sources other than blanket washes, and inks, etc. adding to the total VOC load in printery indoor air.Implications: Results from this study indicate that efforts to reduce worker exposure to VOCs particularly dangerous to human health in recent years have been successful, but there is still much to be done to protect workers. Exposures to ototoxic and carcinogenic VOCs were identified, among both production and non-production workers. Unexpected findings included the apparent use in printing activities of the carcinogen vinyl chloride and CFC-114, banned under the Montreal Protocol. Observed lapses in safety procedures included failure to utilize ventilation systems and closing doors between work areas, indicating management and worker education should remain a priority.

Validity of retrospective occupational exposure estimates of lead and manganese in a case–control study

ObjectivesThe validity of surrogate measures of retrospective occupational exposure in population-based epidemiological studies has rarely been evaluated. Using toenail samples as bioindicators of exposure, we assessed whether work tasks and...

Volatile Organic Compound Exposure in Colorado Nail Salons

A pilot study of Volatile Organic Compound (VOC) exposure was conducted in 6 nail salons along Colorado’s front range. Measurements included area concentrations of Total VOCs (TVOCs), Formaldehyde (HCHO), Benzene, Toluene, Ethylbenzene, and Xylenes (BTEX), as well as personal exposure sampling of four additional VOCs and worker health surveys. Preliminary data includes average TVOC levels between 3ppm and 22ppm, average HCHO levels between 12ppb and 405ppb, and BTEX concentrations between 23ppb and 300ppb. All participating salons exceeded the NIOSH standard for 8hr time-weighted HCHO concentration on at least one measurement day, and several salons exceeded other HCHO standards including the ACGIH 8hr Threshold Limit Value (TLV). BTEX concentrations observed were similar to those measured in previous occupational exposure studies of gasoline and diesel station attendants and oil refinery workers. Most (65%) survey respondents reported experiencing at least one health symptom as a result of their employment in the nail salon industry, with the most common symptoms including headaches, skin irritation, eye irritation, and nose irritation. Cancer risk estimates for Benzene and Formaldehyde exposure were calculated using cancer slope factors published by the United States Environmental Protection Agency (US EPA) in their Integrated Risk Information System (IRIS). These estimates are based on a 30-year occupational exposure duration, and incorporate average body weights provided by the Center for Disease Control (CDC), as well as inhalation rates provided by US EPA. The elevated lifetime risk for Squamous Cell Carcinoma (SCC) from formaldehyde exposure ranged from approximately 1 in 100,000 (1.18x10^-5) to over 6 in 10,000 (6.5x10^-4). The elevated lifetime risk for Leukemia from benzene exposure ranged from 5.15x10^-7 to 5.05x10^-5.

Cancer of the esophagus and asbestos exposure.

Our study aimed at analyzing incidence and mortality from esophageal cancer within a cohort of workers with previous occupational asbestos exposure (ARDCo Program). A 10-year follow-up study was conducted in the 14 515 male subjects included in this program between October 2003 and December 2005. Follow-up began when exposure stopped. Asbestos exposure was analyzed by industrial hygienists using data from a standardized questionnaire. The Cox model was used, with age as the time axis variable adjusted for smoking, time since first exposure (TSFE) and cumulative exposure index (CEI) of exposure to asbestos. We reported a significant dose-response relationship between CEI of exposure to asbestos and esophageal cancer, in both incidence (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.00-1.58), and mortality (HR 1.40, [95%CI 1.12-1.75]). This large-scale study suggests the existence of a relationship between asbestos exposure and cancer of the esophagus.