Neurobehavioral test performance among apprentice painters: Baseline data

In the debate on chronic effects of solvent use, it is often difficult to find information on the cerebral health status of subjects before any exposure has occurred. The objective of this study was to obtain baseline data by examination of workers at the beginning of their occupational lives. This study compares the performance of 57 apprentice painters, mean age 16.6 ± 1.2 years, with that of 62 apprentices, mean age 16.2 ± years, drawn from other manual trades involving no significant exposure to solvents. Their performances were compared twice over a period of 3 years using a series of behavioral tests chosen from a translated version of the Neurobehavioral Evaluation System (NES). There were no major differences in performance between the apprentices, except for the verbal ability test, which showed lower results for painters. This can be explained by factors such as socioeconomic background, previous schooling, or mother tongue, and raises the question of whether it is appropriate to use such a test to adjust for the influence of premorbid ability in elderly exposed workers. © 1996 Wiley-Liss, Inc.     

Solvent-related health effects among construction painters with decreasing exposure

BACKGROUND: The prevalence of solvent-related symptoms among construction painters is unclear due to their declining exposure. METHODS: A questionnaire study was conducted on 1000 male Finnish construction painters and 1000 carpenters. Symptom questions were combined with exposure parameters, medical history, and health behavior. RESULTS: Highly significant associations were found between cumulative intensity of long-term solvent exposure (CE-LT) and symptoms of memory and concentration, and mood. CE-LT was a better measure of solvent exposure than the number of years as a painter. Exposure was also associated with diagnosed psychiatric disorders, hypertension and arrhythmia. Recent exposure in the 1990s had no major effect on symptoms. CONCLUSIONS: The results strengthen the dose-response relationship of exposure and long-term neurotoxic effects. No clear association was found between recent exposure and symptoms. Cardiovascular effects in solvent-exposed construction painters is further suggested.     

Trends in inhalation exposure to hydrocarbons among commercial painters in The Netherlands

OBJECTIVES: An attempt was made to develop a database for measurements of exposure to solvents that could be used as a tool in the historical exposure assessment of commercial painters participating in a health surveillance program. METHODS: The measurement data on personal exposure from six studies still available for Dutch commercial painters were collected into a database. The database was analyzed to identify time trends for the inhalation exposure levels of hydrocarbons and the production conditions that influence exposure levels among commercial painters in The Netherlands. RESULTS: Altogether 304 measurements of solvent exposure were collected between 1980 and 1999, providing data for 137 workers. Toluene was selected as a marker for solvent exposure, since hydrocarbon exposures appeared to be strongly correlated. Exposure to toluene measured during the application of solvent-based paints has declined by 12% per year. The use of solvent-based paints, painting in small rooms, house (versus shipyard) painting, and spray-painting were associated with increased exposures. Water-based paint was also associated with increased exposure to toluene, relative to tasks in which no paint was used. The exposure model for toluene explained 86% of the between-worker variance. In a subset of the data, we observed that a single cell model did not adequately describe total solvent exposure among painters, because of the stronger-than-expected positive effect of source strength and the lack of the protective effect of general ventilation. CONCLUSIONS: An exposure model was developed that can be used to predict the intensity of inhalation exposure to aromatic solvents among commercial painters in The Netherlands.     

Development of solvent exposure index for construction painters

This article describes methodological approaches for reconstructing long-term occupational exposure to organic solvents among construction painters. A detailed exposure questionnaire was administered to 125 painters to develop a job exposure matrix (JEM). The questionnaire inquired about painting activities with solvent-based paints and use of protection equipment for the previous 25 years in 5-year intervals. Current and historical distributions of solvent air concentrations were assessed for the same time period based on the following information: industrial hygiene measurements, paint composition changes, and VOC emission rate changes from architectural and industrial maintenance coatings. Changes in protection factors of respirators were also assessed. A cumulative solvent exposure index was calculated for each painter through Monte Carlo simulations by combining appropriate input distributions of solvent air concentrations and protection factors of respirators with JEM. Sensitivity simulations revealed that the historical variations in solvent air concentrations had a higher impact on the cumulative solvent exposure index than changes in protection factors for respirators. Fifty-eight percent of painters were classified with a different exposure quartile when the solvent exposure index was used vs. an exposure based only on years using solvent-based paints, suggesting the need for more detailed exposure analysis than just years working when conducting epidemiologic studies for this worker population.     

Adverse reproductive outcomes among male painters with occupational exposure to organic solvents

Objectives

To assess the risks of reproductive disorders and birth defects in offspring of male painters with exposure to organic solvents, and to determine the shape of the dose‐response relationship.

Methods

Random samples of painters and carpenters were drawn from workers affiliated with the Dutch Trade Union for Construction Workers, the Netherlands, 2001. Information on reproductive outcomes, occupational exposures, and lifestyle habits was retrospectively obtained through self‐administered questionnaires filled in by 398 painters exposed to organic solvents in paints, thinners, and cleansers in the period of three months before the last pregnancy, and 302 carpenters with little or no exposure to solvents. A statistical model was used to estimate quantitative exposure measures.

Results

Workers employed as painters at three months before pregnancy had an increased risk (odds ratio 6.2, 95% CI 1.4 to 27.9) of congenital malformations in offspring compared to carpenters. There was a positive exposure‐response trend with increasing exposure to organic solvents based on quantitative model predicted exposure estimates using toluene as a marker. There was some indication of an increased risk of functional developmental disorders in offspring among painters with intermediate and high model predicted exposure. The risk of low birth weight children seemed to be slightly increased among painters as well. Results for other reproductive outcomes (time to pregnancy, spontaneous abortion, and preterm birth) did not show increased risks.

Conclusion

This study showed a positive association between paternal occupational exposure to organic solvents and congenital malformations in offspring. However, the small numbers of cases, especially when examining different exposure levels, as well as the self‐reported nature of exposure and outcome variables, may hamper interpretation of the results.     

Neurotoxicity of solvent mixtures in spray painters

A multidisciplinary cross-sectional study was carried out in 105 spray painters with long-term solvent exposure (10-44 years) and in 58 control subjects not exposed to solvents. By means of air monitoring the solvent concentrations in the ambient air during spray painting were determined using charcoal and silicagel tubes with pumps and passive samplers. In general, the air concentrations of the individual compounds did not exceed the current limit values (MAK values). Aromatic hydrocarbons like toluene, xylene, ethylbenzene, trimethylbenzene, aliphatic hydrocarbons (e.g., heptane) and acetates (ethylacetate, butylacetate) were determined to be important components of paint solvents. However, in unfavorable work conditions the "exposure index" could exceed the permissible limits two or three times. To assess the body solvent load at the time of examination, biological monitoring (BM) was performed. The main finding was that there was no evidence of neurotoxicologically relevant solvent exposure. Only in the case of methyl hippuric acid in urine spot samples did the spray painters show a higher mean value (80 mg/l) than control subjects (below 20 mg/l), indicating recent xylene exposure. Elevated urinary chromium concentrations (maximum value 29 micrograms/l) were found in 28 spray painters as a result of using zinc chromate-containing wash primers without taking protective measures. To assess the degree of past solvent exposure a special questionnaire was used. This included variables like duration and amount of solvent exposure, the presence of a technical ventilation system, health complaints during painting, etc. Additionally, three "solvent exposure indices' (SEI) were calculated and used for evaluation of "dose-effect relationships.'(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of occupational solvent exposure on reproductive hormone concentrations and fecundability in men

BACKGROUND: Little is known about the effects of organic solvents on male reproductive health. To assess fertility and reproductive endocrine function in solvent-exposed men, we investigated time-to-pregnancy using a retrospective cohort design and cross-sectionally measured reproductive hormone concentrations in painters and millwrights compared to a reference group of carpenters. METHODS: Detailed occupational, exposure, medical, and time-to-pregnancy histories were obtained by telephone interview. Plasma luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone concentrations were determined by immunoassay. Exposure indices, which summarized working life exposure to total solvents, chlorinated solvents, aromatic solvents, and thinners, degreasers, varnishes, and adhesives as a category were calculated from exposure histories. RESULTS: FSH concentrations increased significantly with increasing exposure indices for all solvents and for chlorinated solvents. There were no significant associations of solvent exposure indices with LH or testosterone levels. LH, FSH, and testosterone concentrations also did not differ by job title. Using Cox regression, time-to-pregnancy was non-significantly longer in the painters and millwrights than the carpenters. There was no significant association between time-to-pregnancy and any of the solvent exposure indices; however, it should be noted that some of the pregnancies occurred more than 20 years previously, potentially reducing the reliability of the retrospectively collected pregnancy and exposure data. CONCLUSIONS: The significant associations between FSH levels and solvent exposure indices suggest the potential for adverse effects of solvent exposures on reproductive function in men.     

Neurobehavioral changes of shipyard painters exposed to mixed organic solvents

This study was conducted to evaluate neurobehavioral changes arising from occupational exposure to organic solvents among shipyard painters and to establish whether a dose-effect relation existed where there was any observed impairment of neurobehavioral performance by running the test of Simple Reaction Time (SRT), Symbol Digit Substitution (SD), and Finger Tapping Speed (FT) with a computer-assisted neurobehavioral test battery. The study group consisted of 180 shipyard painters and 60 reference workers. The workers answered a self-administered questionnaire on occupational, medical history, and demographic characteristics including age, work duration, education level, and quantity and frequency of alcohol and smoking, and performed three psychometric tests on the Korean Computerized Neurobehavioral tests. To estimate cumulative exposure level, samples of ambient air on 61 painters were analyzed using a gas chromatograph. Shipyard painters and the reference group showed significant differences in the results of test of SD, FT of dominant hand, and FT of non-dominant hand. The test results of SD of shipyard painters also showed significant difference by duration of work. This suggests that occupational exposure of organic solvent could induce neurobehavioral changes in the shipyard painters. Therefore an objective neurobehavioral tests recommended on evaluating neurobehavioral performance of long-term solvent-exposed shipyard workers.     

Individual serum bile acids in apprentice spray painters in association with solvent exposure

The effects of exposure to solvents on serum bile acids were investigated by comparing a group of apprentice vehicle spray painters (exposed group) with one of apprentice electricians. Apprentice spray painters from the study were subdivided into high-and low-solvent-exposure groups. Concentrations of individual serum bile acids (SBA) were measured and compared with conventional liver function tests (LFTs). Total, free, glycine-and taurine-conjugated SBA were consistently found to be present at higher levels in the spray painters than in the electricians, even at the beginning of the apprenticeship. Total SBA tended to increase in spray painters with increasing years of exposure during the apprenticeship, but this was significant at only one time point. No rises were observed over the sampling period in electricians. The mean values of individual and total SBA concentrations were all found to be higher in the high-exposure group than in the low-exposure group, with some differences reaching statistical significane. None of the routine liver biochemistry parameters was different between spray painters and electricians. γ-Glutamyl transferase (GGT) was the only enzyme found to be significantly different between the high-and low-exposure groups, but all values were within the normal range. This study suggests that occupational exposure even to low levels of solvent mixtures results in increases in SBA. The increased SBA may be indicative of a subclinical liver dysfunction. Alternatively, they may reflect solvent exposure only, with the raised levels having no pathologic implication or consequence. The views expressed in this article are those of the authors and do not necessarily reflect those of the National Occupational Health and Safety Commission     

Toxicokinetics of toluene in occupationally exposed volunteers

The influence on the kinetics of toluene from long-term occupational exposure, cigarette smoking, and ethanol consumption was studied in 26 male spray painters. A group of spray painters with reported subjective symptoms such as concentration deficits, fatigue, and dizziness due to the solvent exposure did not differ in the uptake and disposition of toluene from a group of spray painters with no symptoms. In occupationally exposed workers, a tendency for an enhanced clearance of toluene from the blood was observed in relation to personal habits such as smoking and/or moderate chronic ethanol intake. Long-term occupational exposure to a mixture of organic solvents does not exert any effect on the metabolic rate of toluene as compared with that of an unexposed group.     

A multidisciplinary cross-sectional study on solvent-related health effects in painters compared with construction workers

Objectives: The main aim of the study was to examine possible solvent-associated effects on the nervous system in currently employed painters. Special attention was paid to evaluate subtle health effects. Materials and methods: A total of 401 painters and 209 construction workers without solvent exposure with at least 10 years of professional experience were subjected to a clinical, neurological, psychiatric, neuropsychological and neurophysiological examination. For personal medical and occupational history, standardized questionnaires were used. A quantitative rating of exposure was obtained by expert rating of the respective occupational history without knowledge of the individual test results. Results: There was no excess of somatic disorders or solvent-associated adverse effects on the nervous system. No distinct effects of solvent exposure on nerve conduction velocities (NCV) or cognition were found. Discrete NCV deficits in painters were not considered a sign of subclinical polyneuropathy. Painters, however, reported an excess of specific symptoms that could be assigned to “mood and behaviour”. The differences between specific and non-specific questionnaire outcomes on the one hand and the positive correlation between chronic exposure index and symptom scores on the other hand support the hypothesis of solvent-induced effects. Because data is lacking on past solvent exposure, it is not possible to relate these effects to current exposure limits. Conclusions: Currently employed painters differ from controls not exposed to solvents with respect to the frequency of certain symptoms in mood and behaviour. These symptoms are related to life-long solvent exposure rather than to current exposure. At present, the issue of time course and reversibility or irreversibility of these symptoms cannot be answered. The predictive value for subsequent neuropsychiatric morbidity remains to be elucidated in follow-up studies. Received: 5 August 1998 / Accepted: 7 February 1999     

Airway symptoms among house painters in relation to exposure to volatile organic compounds (VOCS)—a longitudinal study

The increased use of water-based paint (WBP) for indoor application during the last decade has drastically changed the exposure conditions for Swedish house painters. WBP has a lower emission of volatile organic compounds (VOCs) than solvent-based paint (SBP), but contains more reactive compounds, such as biocides, glycol ethers, and other high molecular solvents. The aim of this study was to compare the incidence of airway symptoms and self-reported asthma in house painters with a different degree of use of WBP and SBP. The incidence of seven general airway symptoms, and three work-related symptoms, was analysed by means of a self-administered questionnaire, in a cohort of 207 house painters followed from 1989 to 1992. Different airway symptoms were compared with clinical information obtained by a methacholine challenge test and dynamic spirometry in a selected subgroup of 44 painters. Information on the degree of use of SBP and WBP was used to estimate the total exposure to volatile organic compounds (TVOC) for each individual. In total, 175 men in the cohort worked as painters during the study period. No increase of asthma or respiratory symptoms was observed among those 50 painters with a pure exposure to WBP (estimated TVOC 1–3mgm⁻³). Most painters (N = 125) had a mixed exposure to SBP and WBP, the main source of the TVOC being the limited use of SBP. WBP was perceived as less irritative than SBP, but complaints on airway irritation from WBP increased during the study period. The most pronounced increase of airway irritation in relation to both SBP and WBP, was observed among those 35 painters with the highest solvent exposure (estimated TVOC 100–380 mgm⁻³). An increase of respiratory symptom index and shortness of breath, in relation to estimated TVOC exposure was also observed. Selection effects were detected. Painters leaving their job during the study period had more non-specific hyper-reactivity symptoms, and more airway irritation from WBP-as compared to painters remaining at their occupation. Our study indicates that VOC emissions from SBPs may contribute to the development of respiratory symptoms and airway irritation. We found no increase of respiratory symptoms among painters exposed only to WBPs. There were, however, indications that VOC exposure from WBPs may cause airway irritation in some subjects. Because of selection effects, cross-sectional studies on respiratory symptoms in relation to occupational exposure to paint emissions may be inconclusive.     

Estimation of long term exposure to mixed solvents from questionnaire data: a tool for epidemiological investigations.

Quantifying the exposure of construction painters to mixed organic solvents is difficult in the face of a lack of industrial hygiene data, the heterogeneity of the solvents used, and the variability in work practices which influences the amount of solvents to which a worker is actually exposed. This report describes an attempt to derive an estimate of airborne solvent exposure using questionnaire responses in a population of construction and maintenance painters. This exposure index (EI) is a weighted average of the total number of gallons used a year minus the fraction which would be absorbed by a respirator, where the weights are based on the method of application (spraying, rolling, brushing) and the presence of ventilation (per cent time inside v outside). An analysis performed to determine the sensitivity of the EI to variations in the values chosen for several parameters showed that the index is relatively insensitive to the underlying assumptions that we have used. One component of the EI (self report of hours worked) correlated well with union payroll records. The EI appears to provide a useful relative (not absolute) estimate of airborne exposure to organic solvent mixtures which may be used as a dose surrogate in epidemiological investigations.     

Study of the electrical impedance of blood from house painters

Summary Using a four-electrode technique the electrical impedance was measured at 150 kHz (100 A) on whole blood samples from 13 male house painters (age 19–49 years; median 35 years) exposed occupationally to vapors from alkyd paints containing organic solvents and from a control group of 7 healthy unexposed men (age 27–53 years; median 37 years). The blood impedance of the two groups was monitored prior to and 9 days after an initial administration of acetylsalicylic (600 mg). The resistivity calculated from the impedance of whole blood from the painters remained significantly higher than the corresponding values for the controls. The hematological values for the two groups were within normal ranges, although the painters had significantly higher platelet counts than the controls. Effects of long-term exposure of the painters to volatile solvents are discussed.     

Estimation of long term exposure to mixed solvents from questionnaire data: a tool for epidemiological investigations

Quantifying the exposure of construction painters to mixed organic solvents is difficult in the face of a lack of industrial hygiene data, the heterogeneity of the solvents used, and the variability in work practices which influences the amount of solvents to which a worker is actually exposed. This report describes an attempt to derive an estimate of airborne solvent exposure using questionnaire responses in a population of construction and maintenance painters. This exposure index (EI) is a weighted average of the total number of gallons used a year minus the fraction which would be absorbed by a respirator, where the weights are based on the method of application (spraying, rolling, brushing) and the presence of ventilation (per cent time inside v outside). An analysis performed to determine the sensitivity of the EI to variations in the values chosen for several parameters showed that the index is relatively insensitive to the underlying assumptions that we have used. One component of the EI (self report of hours worked) correlated well with union payroll records. The EI appears to provide a useful relative (not absolute) estimate of airborne exposure to organic solvent mixtures which may be used as a dose surrogate in epidemiological investigations.     

Neurotoxicity of solvent mixtures in spray painters

A multidisciplinary cross-sectional study was performed to examine the chronic neurotoxicity of organic solvents. Participating in the study were 105 persons employed as spray painters and having long-term solvent exposure (10-44 years) and a control group consisting of 58 construction workers, electricians, and plumbers without occupational contact to solvents. Samples were matched for age, preexposure intelligence level, occupation, and socioeconomic status. After controlling for potentially non occupational confounding factors (neuropsychiatric diseases, metabolic disorders, high blood pressure, alcohol intake) 83 spray painters and 42 controls were entered finally into the study. The evaluation included work history, self-rating questionnaire, neurologic investigation, psychiatric analysis using the Present State Examination (PSE), psychological testing, and computerized axial tomography (CAT) of the brain. Physical and neurologic examinations demonstrated no case of overt disorders of the central or peripheral nervous system. An important result of the psychiatric analysis was that the syndromes "special features of depression" and "loss of interest and concentration" occurred significantly more frequently among spray painters than among controls. Further analyses demonstrated an association with chronic exposure over 30 years and repeated acute neurotoxic effects during solvent exposures. Neither psychological nor performance tests demonstrated any statistically significant differences in the performance sets after adjustment according to premorbid intelligence level; this finding supports the presumption of only a low grade of mental dysfunction. Correlation analyses indicated a relationship between subjective health complaints and long-term solvent exposure; however, the effect of age cannot be completely ruled out.(ABSTRACT TRUNCATED AT 250 WORDS)     

Chronic toxic encephalopathy among house painters with disability pension

Among a group of 14 painters accorded a disability pension, 11 showed signs and symptoms of slight encephalopathy. Five of these 11 painters previously had been pensioned with a diagnosis of musculoskeletal disease, while the encephalopathy was unrecorded in the disability pension records. The combined effect of the two diseases may have caused the disability. We considered occupational solvent exposure the most probable cause of the encephalopathy in four of these five painters. This study indicates that case-referent studies based on diagnoses from disability pension registers may lead to underestimation of the risk of toxic encephalopathy.     

Occupational exposure to water based paint and symptoms from the skin and eyes.

Water based paints contain organic solvents and many additives, such as biocides, surfactants, pigments, binders, amines, and monomers. The chemical complexity may introduce new potential health hazards to house painters, in particular irritative and allergic disorders. This study was performed to compare how house painters experience work with water based paints or solvent based paints, and to evaluate whether exposure to water based paints increases mucous membrane and dermal symptoms among house painters. 255 male house painters aged 20 to 65 were invited to participate in the study. Controls were two industrial populations, in total 302 men, without exposure to water based paints. Self administered questionnaires were used to assess the painter's experiences of working with different types of paints and the occurrence of symptoms in the exposed and unexposed groups. Hygiene measurements were performed during normal working days when only water based paints and no solvent based paints were used. The painters were exposed to low concentrations of dust, metals, ammonia, formaldehyde, and volatile organic compounds. The work environment was considered better when working with water based paints than with solvent based paints. There were more complaints of frequent urination when working with water based paint. Taste or olfactory disturbances were less common. General as well as work related eye and skin irritation was more common among the exposed workers. For other symptoms no significant differences were found. The study indicates that the introduction of water based paints has improved the work environment for house painters. Water based paints cause less discomfort and airway irritation than the earlier solvent based paints. Adverse general health effects seem low. Some of the painters may have dermal symptoms caused by the components in water based paints.     

Neuropsychological symptoms in Chinese male and female painters: an epidemiological study in dockyard workers

OBJECTIVES: To study the prevalences of neuropsychological symptoms in male and female dockyard painters in China and to compare them with those in British dockyard painters. METHODS: All 116 painters were identified, active and retired, who had been employed in two Chinese dockyards for at least 1 year together with a matched random sample of 263 dockyard non-painters. Neuropsychological and personality questionnaires that we had used previously in a study of United Kingdom dockyard painters were used, translated into Chinese. Neuropsychological symptoms in painters and controls were compared, adjusting for age, educational level, smoking, alcohol intake, and personality. RESULTS: The response rate was 94% for painters and 97% for controls. Highly significant excesses of symptoms were found in painters, suggestive of neuropsychological dysfunction. Both male and female painters showed higher relative risks than were found in similar tradespeople in the United Kingdom. The relative risk increased with increasing score of both neurological and psychological symptoms. Relative risk of having a high symptom score, compared with controls and adjusted for confounders, was 6.61 (95% confidence interval (95% CI) 2.36 to 18.50) for 2-15 years exposure, 14.88 (5.74 to 38.56) for 16-22 years and 9.42 (3.97 to 22.36) for > or = 22 years. CONCLUSION: These results indicate that neuropsychological symptoms are associated with heavy exposure to painting work in China, and that the phenomenon is likely to be found worldwide wherever there is such exposure to solvent based paints. The high response rate in this study answers a possible criticism of the earlier United Kingdom study.

 

     

Pilot study on prevalence of color vision dysfunction in long-term solvent-exposed painters

Main purpose of our study was to examine whether painters with long-term exposure to mixtures of organic solvents show slight dysfunctions in color vision ability. The study population consisted of 140 men with chronic exposure to organic solvents from paint and thinners (mean duration of exposure: 26 years). We used the Lanthony Desaturated Panel-D-15 (LDP-D15) to test color vision and calculated the color confusion index (CCI). The results were compared with reference values taken from the literature. Additionally the questionnaire Q18 for solvent related neurotoxic symptoms was applied and its results compared with the CCI. Painters between 25 to 55 years old had higher median CCI values than the respective age group of the references. No statistical significant association between CCI and the actual or chronic solvent exposure was found. The results of the Q18 did also not correlate significantly with the exposure indices. We recommend further studies to explore if the color confusion index is an appropriate indicator of early neurotoxic effects in painters.