Respiratory cancer risks among workers with glutaraldehyde exposure

OBJECTIVE: Glutaraldehyde is a substance that represents a substantial portion of the human exposure to aldehydes in medicine and industry. Other aldehydes such as formaldehyde have been associated with increased cancer rates of the upper respiratory tract and leukemia. Our study is the only one, to our knowledge, to examine cancer rates among exposed glutaraldehyde workers. METHODS: In an extended follow up using death certificates, we calculated standardized mortality ratios (SMRs) and 95% confidence intervals (CIs) for three cumulative exposure categories of glutaraldehyde. There were 99,730 person-years of observation among unexposed workers, 2934 person-years in the lower exposure category, < 0-100.0 parts per billion (ppb)-years, and 2805 person-years in the higher exposure category of 100.0+ ppb-years. RESULTS: For all respiratory cancers for these exposure categories, the SMRs were 0.9 (95% CI = 0.7-1.1), 1.0 (95% CI = 0.2-3.0), and 0.3 (95% CI = 0.0-1.5). No increasing trend of SMR with increasing exposure is observed for any cause of death examined. We observed no cancers of the nasal cavity and sinus (0.03 expected), nasopharynx (0.02 expected), or leukemia (0.6 expected) among all glutaraldehyde-exposed workers. CONCLUSIONS: Although our study findings should be tempered by the small size and the potentially low prevalence of smoking among glutaraldehyde workers, we found no increased rates of respiratory tract cancer or leukemia related to glutaraldehyde exposure.     

Work-related symptoms and Salmonella antibodies among wastewater treatment plant workers

Wastewater treatment plant workers are exposed to microbes, including Salmonella, but the prevalence of antibodies against Salmonella species or serovars in their serum samples has not been studied. Antibodies against Salmonella Infantis and lipopolysaccharide antigen common to S. Enteritidis and S. Typhimurium in immunoglobulin classes IgA, IgM and IgG were measured from 79 serum samples of wastewater treatment plant workers and from 79 blood donor samples. Faecal samples for Salmonella and Campylobacter were studied. Gastrointestinal, dermal and other symptoms were compared between 81 wastewater treatment plant workers and 89 food-processing workers. The blood donors had more antibodies against all of the tested antigens expect for S. Infantis in IgM and IgA classes, even though the wastewater treatment plant workers had more gastrointestinal symptoms than the controls. No Salmonella or Campylobacter were found in any faecal samples. Salmonella is not a probable cause of symptoms among wastewater treatment plant workers.     

Endotoxin exposure and symptoms in wastewater treatment workers

BACKGROUND: Wastewater treatment workers can be exposed to biological and chemical agents resulting in work-related health effects. The aim of this study was to investigate work-related symptoms in these workers. METHODS: Questionnaire data of 468 employees from 67 sewage treatment plants is evaluated. Personal endotoxin exposure (8 hr measurements; n = 460) was measured in a sample of workers in three different periods over 1 year. RESULTS: Endotoxin exposure ranged from 0.6 to 2093 endotoxin units (EU)/m(3), the geometric mean exposure was low (27 EU/m(3)). Factor analysis yielded three clusters of correlated symptoms: "lower respiratory and skin symptoms," "flu-like and systemic symptoms," and "upper respiratory symptoms." Symptoms appeared to be more prevalent in workers exposed to endotoxin levels higher than 50 EU/m(3). A significant dose-response relationship was found for "lower respiratory and skin symptoms" and "flu-like and systemic symptoms" (P < 0.05). CONCLUSIONS: Wastewater treatment workers reported a wide range of symptoms that may be work-related. Microbial exposures such as endotoxin seem to play a causal role.     

医务人员职业暴露监测分析

目的探讨医务人员职业暴露人群分布、高危环节以及暴露源等,为制定职业防护措施、预防职业暴露后感染提供依据。方法利用湘雅感染监测管理系统开展监测,分析2011年8月-2013年8月上报的医务人员发生职业暴露数据。结果两年上报254人次职业暴露事件,职业暴露人群以临床护士最高,200人次占78.74%,工龄≤6年人员发生职业暴露达208人次占81.90%,针刺伤是职业暴露最主要方式,达213人次占83.86%,暴露源确定感染乙型肝炎病毒、丙型肝炎病毒、戊型肝炎病毒、苍白密螺旋体、人类免疫缺陷病毒等血源性病原体达121人次占47.64%,确认职业暴露后发生丙型肺炎病毒感染两人,感染率为8.70%,坚持完成1年聚乙二醇干扰素联合利巴韦林抗病毒治疗获得痊愈。结论落实标准预防、推广无针注射和无针输液,是降低医务人员职业暴露有效措施;暴露后遵医嘱及时预防性用药,追踪监测、尽早诊断急性感染、积极抗病毒治疗,是预防暴露后感染以及感染后发展为慢性病的有力保障。     

Twenty-four-hour light exposure and melatonin levels among shift workers

OBJECTIVES: We sought to measure melatonin levels and 24-hour light intensity exposure in health care workers over a 7-day period in natural occupational and residential settings. METHODS: Five office workers and 17 nurses working either days or rotating night and day shifts wore a device to record light intensity exposure for one or two 7-day periods, completed a questionnaire, and provided three saliva samples for melatonin. RESULTS: Rotating shift workers had irregular light exposure patterns and abnormal melatonin levels compared with those working days. In addition to lower-than-normal melatonin levels during sleep periods, rotating shift workers exhibited higher-than-normal melatonin levels on arising and during work. Self-reported years of shift work were correlated with measured melatonin and light. CONCLUSIONS: Rotating shift work is supported as a surrogate for exposure to light-at-night and circadian disruption.     

职业多环芳烃暴露人群尿中生物标志物浓度水平

多环芳烃类化学物质因为其被熟知的致癌性而一直备受关注, 近来越来越多的学者意识到单一的接触生物标志物并不能完全代表暴露者体内的暴露水平。本研究就1999年以后15年间报道的职业环境中接触多环芳烃类物质的工人尿中接触生物标志物进行综述, 重点对其浓度水平进行描述, 为职业环境中多环芳烃类化学物质暴露的生物学检测提供理论依据。     

高温噪声作业人员血脂水平的调查分析

目的探讨高温+噪声和单纯噪声的职业病危害因素对劳动者血脂水平的影响,为预防和减轻高温及噪声对作业人员健康的影响提供依据,同时探讨血脂是否可作为噪声、高温作业人员职业健康检查的必检项目。方法选择某工厂的冶炼工、浇铸工、热处理工60名为高温、噪声接触对象;选取该厂的原料工、打磨工、制模工60名为单纯噪声接触对象;选取该厂不接触噪声、常温作业的财务人员、销售人员、采购人员72名为对照组。用方差分析、秩和检验的方法进行统计分析。结果高温+噪声组、单纯噪声组和对照组工人的血脂成分中总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平(x珋±s)和甘油三酯(TG)中位数水平的差异无统计学意义,高密度脂蛋白胆固醇(HDL-C)中位数水平,3组间差异有统计学意义(P0.05)。3组工人HDL-C水平多重比较显示,高温+噪声组与噪声组之间差异有统计学意义(P0.05);高温+噪声组与对照组、噪声组与对照组之间差异有统计学意义(P0.01);3组工人血脂增高率比较,TC、LDL、TG,均P0.05,HDL-C增高率P0.05。TC、TG、LDL水平不高于对照组,差异无统计学意义,高温+噪声组、单纯噪声组的血脂异常检出率(除HDL-C外)均比对照组高,但差异无统计学意义。结论血脂检查不应做为噪声、高温作业人员职业健康检查的必检项目。     

Health effects of long-term mercury exposure among chloralkali plant workers

BACKGROUND: Inorganic mercury is toxic to the nervous system, kidneys, and reproductive system. We studied the health effects of mercury exposure among former employees of a chloralkali plant that operated from 1955 to 1994 in Georgia. METHODS: Former plant workers and unexposed workers from nearby employers were studied. Exposure was assessed with a job-exposure matrix based on historical measurements and personnel records. Health outcomes were assessed with interviews, physical examinations, neurological and neurobehavioral testing, renal function testing, and urinary porphyrin measurements. Exposure-disease associations were assessed with multivariate modeling. RESULTS: Exposed workers reported more symptoms, and tended toward more physical examination abnormalities, than unexposed workers. Exposed workers performed worse than unexposed subjects on some quantitative tests of vibration sense, motor speed and coordination, and tremor, and on one test of cognitive function. Few findings remained significant when exposure was modeled as a continuous variable. Neither renal function nor porphyrin excretion was associated with mercury exposure. CONCLUSIONS: Mercury-exposed chloralkali plant workers reported more symptoms than unexposed controls, but no strong associations were demonstrated with neurological or renal function or with porphyrin excretion.     

Hazardous chemical exposure at a municipal wastewater treatment plant

The use of municipal wastewater treatment plants for the disposal of industrial wastes creates the potential for the exposure of treatment plant workers to hazardous chemical compounds that may be present in these wastes. Urine from workers and air and wastewater samples from a municipal wastewater treatment plant receiving wastes from a pesticide manufacturer were analyzed on several occasions by electron-capture gas chromatography for the presence of the compounds hexachlorocyclopentadiene (HEX) and hexachlorobicycloheptadiene (HEX-BCH) which are present in the waste stream from this industry. HEX-BCH was detected more frequently in urine from these workers than in urine from workers at another municipal wastewater treatment plant in the same city. Urine concentrations of HEX-BCH were found to be higher in specimens collected late in the work shift than in those collected earlier. The primary rate of exposure is thought to be by inhalation. This is the first known report of these compounds being detected in human urine and it demonstrates the potential for wastewater treatment plant worker exposure to industrial wastes.     

Hazardous chemical exposure at a municipal wastewater treatment plant

The use of municipal wastewater treatment plants for the disposal of industrial wastes creates the potential for the exposure of treatment plant workers to hazardous chemical compounds that may be present in these wastes. Urine from workers and air and wastewater samples from a municipal wastewater treatment plant receiving wastes from a pesticide manufacturer were analyzed on several occasions by electron-capture gas chromatography for the presence of the compounds hexachlorocyclopentadiene (HEX) and hexachlorobicycloheptadiene (HEX-BCH) which are present in the waste stream from this industry. HEX-BCH was detected more frequently in urine from these workers than in urine from workers at another municipal wastewater treatment plant in the same city. Urine concentrations of HEX-BCH were found to be higher in specimens collected late in the work shift than in those collected earlier. The primary rate of exposure is thought to be by inhalation. This is the first known report of these compounds being detected in human urine and it demonstrates the potential for wastewater treatment plant worker exposure to industrial wastes.     

医务人员血源性职业暴露的监测分析

目的探讨医务人员血源性职业暴露状况,为制定科学有效的管理、预防控制和监测处理办法提供依据。方法对某医院2015年1月-2017年1月发生职业暴露的87名医务人员的监测数据进行统计分析。结果发生血源性职业暴露的科室:手术系列科室最多,占62.07%,职业暴露人员中护士发生率最高为67.82%,医师为32.18%;职业暴露源前三位分别为乙型肝炎、梅毒、不明暴露源,分别占33.33%、28.74%和21.84%;发生职业暴露的方式主要是锐器伤;损伤锐器类型中针刺伤为主;锐器伤操作环节以操作完成后处理锐器发生率最高为31.03%,其次是输液拔针和回套针帽,分别占25.29%和16.09%;经过规范的处理和预防用药,随访6月(HIV随访1年)无医务人员因职业暴露发生血源性病原体感染。结论加强防护知识的培训是减少职业暴露最根本的途径,规范操作是避免失误发生的基本要求,标准预防是防止职业暴露的最佳方法,必要的防护用品配备是减少职业暴露发生的物质保证,采用安全注射系统切断了职业暴露发生的必要环节,完善报告流程是职业暴露后及时处理的重要保证,保护暴露者隐私和必要的心理疏导是帮助暴露者减轻精神压力和提高处置依从性的关键。     

Chronic psychological effects of exposure to mercury vapour among chlorine-alkali plant workers

BACKGROUND: Quantitative assessment of nervous system function is essential in characterising the nature and extent of impairment in individuals experiencing symptoms following work-place mercury vapour exposure. OBJECTIVES: The purpose of this study was the application of standardised tests of behavioural, psychomotor and memory function to understand the neuropsychological effects of mercury in occupationally exposed chlorine-alkali plant workers. SUBJECTS AND METHODS: The study comprised 45 workers at a chlorine-alkali plant with the mean age of 39.36 +/- 5.94 years, who had been exposed to daily inhalation of mercury vapour over long-term employment of 16.06 +/- 4.29 years. The cumulative mercury index was 155.32 +/- 95.02 micrograms/g creatinine, the mean of urinary mercury concentrations on the first day of the study was 119.50 +/- 157.24 micrograms/g creatinine, and the mean of urinary mercury concentrations 120 days after cessation of exposure was 21.70 +/- 26.07 micrograms/g creatinine. The analysis included tests of behavioural, psychomotor and memory function. The behavioural test battery consisted of: Environmental Worry Scale (EWS), Minnesota Modified Personal Inventory (MMPI-2), Purdue standard 25 minute test, and adapted, 10 minutes test, Bender's Visual-Motor Gestalt test (BGT), and Eysenck Personality Inventory (EPQ). The data were compared to a control group of 32 not directly exposed workers. RESULTS: In the mercury vapour exposed workers with relatively high level exposure to inorganic mercury vapour (TWA/TLV = 0.12 mg/m3/0.025 mg/m3) we identified somatic depression-hypochondria symptoms with higher scores for scales: hysteria (P < 0.001), schizoid and psycho-asthenia (MMPI-2). The mercury-exposed workers had introvert behaviour (EPQ, MMPI-2). The cognitive disturbances in mercury-exposed workers were identified as: concentration difficulty, psychomotor, perceptual and motor coordination disturbances, and brain effects. We identified fine tremor of the hands in 34 out of 45 mercury-exposed workers (BGT). CONCLUSIONS: The results point to a relationship between the duration of mercury exposure and the long-term, probably irreversible, psychological disturbances.     

Cancer risks among New Zealand meat workers

The study reports a series of case-referent studies based on the New Zealand Cancer Register and involving 19,904 male cancer patients aged 20 years or more at the time of registration during the period 1980-1984. For each cancer site, the registrations for the remaining sites formed the reference group. An increased risk for lung (OR 1.30, 95% CI 1.06-1.58) and laryngeal (OR 2.01, 95% CI 1.19-3.39) cancer was found among meatworkers. It was confined to men aged less than 65 years at registration. The risk for soft-tissue sarcoma was elevated (OR 1.90, 95% CI 0.90-4.02). The risk estimate for all types of leukemia was elevated moderately (OR 1.45, 95% CI 0.90-2.31), but cell type-specific analyses revealed a greater effect for acute myeloid leukemia (OR 2.12, 95% CI 1.09-4.12). This study adds to the evidence that employment as a meatworker is associated with increased risk for several forms of cancer.     

Lymphohaematopoeitic cancer mortality among workers with benzene exposure

Lymphohaematopoeitic cancer mortality was examined among 4417 workers at a chemical plant by cumulative and peak benzene exposure. There was little evidence of increasing risk with increasing cumulative exposure for all leukaemias or acute non-lymphocytic leukaemias (ANL), or the other lymphohaematopoeitic cancers with the exception of multiple myeloma. For multiple myeloma, the SMRs were 1.1 (95% CI 0.3 to 2.5) in the non-exposed group, 1.4 (95% CI 0.2 to 5.1) in the <1 ppm-years, 1.5 (95% CI 0.2 to 5.4) in the 1–6 ppm-years, and 2.6 (95% CI 0.7 to 6.7) in the >6 ppm-years group. We found no trends by peak exposures for any of the cancers. However, when peak exposures over 100 ppm for 40 or more days were considered, the observed number of all leukaemias (SMR = 2.7, 95% CI 0.8 to 6.4), ANL (SMR = 4.1, 95% CI 0.5 to 14.9), and multiple myeloma (SMR = 4.0, 95% CI 0.8 to 11.7) were greater than expected. While the observed number of deaths is small in this study, the number of peak exposures greater than 100 ppm to benzene is a better predictor of risk than cumulative exposure. The dose rate of benzene and a threshold for exposure response may be important factors for evaluating lymphohaematopoietic risk.     

Assessment of exposure to chloramphenicol and azathioprine among workers in a South African pharmaceutical plant

There have been very few published studies that have evaluated exposure to myelotoxic drugs among production workers in pharmaceutical plants. Previous studies have focussed mainly on nurses and evaluated exposure to cytotoxic drugs using urine mutagenicity as a marker of exposure. The aim of this study was to evaluate the exposure of workers involved in the production of chloramphenicol and azathioprine. Exposure was evaluated utilising biological monitoring, biological effect monitoring and environmental monitoring. Biological monitoring included plasma chloramphenicol levels, plasma 6-mercaptopurine and urine 6-thiouric acid levels. These were analysed using high performance liquid chromatography. Myelotoxic effect was assessed by measuring the haematological indices of bone. marrow function. The exposed 17 workers were compared to matched controls of equal numbers. Neither substance could be detected in serum nor urine by the analytical methods employed. However, haematological indices demonstrated a significantly decreased mean reticulocyte and neutrophil count in the azathioprine exposed group. Industrial hygiene measurements demonstrated contamination of the air inside the airhood of exposed workers. In conclusion, it is evident that workers involved in the production of both these drugs are at risk of developing adverse health effects. Furthermore, more sensitive analytical methods need to be developed to evaluate absorption of myelotoxic chemicals among occupationally exposed workers.     

Blood lead and erythrocyte protoporphyrin levels in association with smoking and personal hygienic behaviour among lead exposed workers

Aims: To investigate the effects of smoking and personal hygienic behaviour on blood lead (BPb) and free erythrocyte protoporphyrin levels (FEP) in lead exposed workers. Methods: Subjects were 105 lead exposed male workers in a battery recycling plant during the years 2000–03. BPb and FEP were measured as part of the ongoing occupational surveillance. Each worker completed a questionnaire for assessment of smoking and four measures of personal hygienic behaviour (glove and mask use, hand and face washing before meals during working hours). Results: Statistically significant decreases in mean BPb and FEP occurred during the three years. The proportion of BPb reduction in the non-smoking workers was significantly higher (mean 24.3%) than in the smoking workers (15.3%). When the workers were classified into three groups (excellent, good, and poor) based on the four personal hygienic behavioural indicators, the greatest decreases of BPb and FEP were observed in the non-smoking workers of the excellent group. Conclusions: The consistent use of protection devices and cleanliness at work appeared to contribute to the lowering of BPb and FEP. Cessation of smoking in the workplace was also of importance.