A cross sectional study of chemical industry workers with occupational exposure to persulphates.

OBJECTIVES: Hair bleaches containing persulphates have been identified as the cause of occupational asthma in hairdressers. Also employees in persulphate production with occupational asthma have been described. It was the aim of this study to give an estimate of the prevalence of asthma due to persulphates in chemical workers with exposure to ammonium and sodium persulphate. METHODS: A cross sectional study was performed in 32 of 33 employees of a persulphate producing chemical plant. Eighteen of 23 workmen from the same plant with no exposure to persulphates were taken as controls. Also, information was collected from medical records of the seven subjects who had left the persulphate production for medical reasons since 1971. Data were recalled by a questionnaire, skin prick tests were performed with five environmental allergens, and ammonium and sodium persulphate (80 mg/ml). Specific immunoglobulin E (IgE) to the same environmental allergens as in the skin test, and total IgE were measured. Lung function and bronchial responsiveness to histamine were assessed by standard procedures. Workplace concentrations of ammonium and sodium persulphate were estimated by area and personal monitoring. The amount of persulphate was analysed as sulphur by inductively coupled plasma emission spectrometry. RESULTS: Work related rhinitis was reported by one subject with exposure to persulphates, conjunctivitis and bronchitis were reportedly related to work by two controls. There were no cutaneous reactions to persulphates in either group. Four non-atopic subjects exposed to persulphates, and two controls, one atopic and one non-atopic, were considered to be hyperresponsive to histamine. Three subjects exposed to persulphates with bronchial hyperresponsiveness (provocation dose of histamine causing a 15% fall in forced expiratory volume in one second (PD15 FEV1) < or = 1 mg) did not show variability in peak expiratory flow of > or = 20%, the rest refused peak flow measurements. None of the variables showed significant differences between the groups (P > 0.05). Six of the exworkers left because of work related contact dermatitis. Mean values for workplace concentrations of ammonium and sodium persulphate within the bagging plant were below 1 mg/m3, and the maximal concentrations were 1.4 mg/m3 and 3.6 mg/m3, respectively. CONCLUSION: Exposure to workplace concentrations of ammonium and sodium persulphate of about 1 mg/m3 in this chemical plant was not associated with a risk of occupational asthma.     

广州苯系物作业工人潜在职业性健康危害现况

目的 探讨广州市苯系物作业工人潜在的职业性健康危害.方法 对6234例广州市苯系物作业工人进行健康检查,并对从事潜在职业性健康危害工作工人的性别、年龄及行业分布进行分析.结果 (1)苯系物潜在职业健康危害阳性率为4.9%,其中女性5.8%,男性4.1%,女性明显高于男性,差异有统计学意义(P<0.05);女性26～40岁组,尤其是31～35岁组潜在职业健康危害阳性率较高.(2)苯系物潜在职业健康危害排在前2位的行业在男性为印刷与文体制品业和船舶制造业,在女性则为皮革加工制品业和船舶制造业.(3)主要的危害工种集中在以手工操作为主的开胶/调漆、喷/油漆、涂装和刷胶等.结论 重点加强主要危害行业中以手工操作为主的苯系物作业岗位的监控和作业工人的健康监护,应关注女性作业人群.     

Cancer and occupational exposure to arsenic: A study of pesticide workers

Mortality and morbidity experience was studied in 1,393 persons exposed to considerably high air concentrations of inorganic arsenicals for varying lengths of time during the manufacture and packaging of various pesticides in a plant in Baltimore, Maryland. Study subjects were traced for the period 1946–1977, and vital status was determined for 86.9% of 1,050 men and 66.8% of 343 women. The observed numbers of deaths from all and selected causes were compared with the expected numbers of deaths derived from population mortality rates. Among men, 23 deaths from lung cancer and 2 deaths from anemias represented statistically significant excesses over the expected numbers (P < 0.05). Lung cancer mortality was especially high in male production workers with presumed high exposure to arsenicals for a prolonged period of time. A dose-response effect was suggested for lung cancer mortality which increased with length of arsenical exposure, but no such relationship appeared for nonarsenical exposure. Workers with high arsenical exposure also had increased frequencies of such forms of arsenism as keratoses and perforation of the nasal septum. Analysis of the 23 male lung cancer deaths and 23 matched controls suggested a relationship, though not statistically significant, between lung cancer and antecedent keratoses. These findings provide strong evidence for a causal relationship between occupational exposure to inorganic arsenicals and lung cancer.     

High-frequency hearing loss,occupational noise exposure and hypertension: a cross-sectional study in male workers

Background  

The association between occupational noise exposure and hypertension is inconsistent because of an exposure bias caused by outer-ear measurements of noise levels among workers. This study used hearing loss values (HLVs) measured at 4 kHz and 6 kHz in both ears as a biomarker to investigate the chronic effects of noise exposure on hypertension in 790 aircraft-manufacturing workers.     

A cross-sectional study of pulmonary function among workers exposed to multimetals in the glass bangle industry

Spirometric lung functions were evaluated in 220 asymptomatic glass bangle workers exposed to the salts of various heavy metals, such as arsenic, lead, zinc, copper, manganese, cobalt, cadmium, and selenium, which are used as coloring agents in the manufacture of glass bangles. The mean values of various spirometric variables (viz. FVC, FEV1, IMBC, and PEFR) were within normal range (more than 80% of the predicted values) in both smoking and nonsmoking glass bangle workers and did not reveal any significant differences in comparison with those observed in the unexposed controls. However, variables such as FEV1/FVC% ratio, FEF25-75 and FEF75-85 were reduced significantly (p less than 0.001) in the exposed group. The reduction was more marked in the smoking glass bangle workers indicating additive effect of cigarette smoking on the small airways. The exposed group showed a significantly higher prevalence (16.3%) of respiratory impairment in comparison to that observed in the controls (7.9%) as a result of exposure to various metals in the work environment (p less than 0.01). The respiratory impairment observed in the exposed group indicated primarily restrictive pattern of pulmonary abnormality (10.4%), while the controls revealed only 1.1% prevalence of this disease (p less than 0.001). The effect of the duration of exposure on the prevalence of respiratory impairment in the glass bangle industry revealed significantly higher prevalence (p less than 0.05) in those who worked for more than 10 years (23.0%) than in those who worked for less than 10 years (10.8%) thereby indicating that the duration of exposure is directly related to the prevalence of respiratory impairment.     

Neuropsychiatric effects in workers with occupational exposure to carbon disulfide

In a cross-sectional study, prevalence of dysfunctions of the central nervous system was assessed in 134 male workers exposed to different levels of carbon disulfide (CS2) in a rayon viscose plant and compared to 38 non-exposed workers. In three groups of workers from the same plant with different levels of CS2 (heavy, intermediate, none) estimated by personal samplers, disorders in the central nervous system were examined by means of psychiatric examination and questionnaire 16 (Q16). Unconditional logistic regression was calculated adjusted for age, alcohol consumption and education. Psychoorganic syndrome was diagnosed significantly more often in workers with heavy CS2 exposure, with adjusted OR of 17.9 (95% CI 2.18-146.73), and insignificantly in workers with intermediate exposure. Prevalence of workers with more than 6 positive answers on the Q16 was higher in the heavily exposed workers (OR=4.76; 95% CI 1.80-12.60). A similar result was found for almost all the questions in the Q16, and the most pronounced psychological symptom was of less interest in sex (adjusted OR=8.14; 95% CI 2.19-30.22). High correlation was found between symptoms recorded on neuropsychiatric examination and on Q16. Both neuropsychiatric exams and Q16 indicated disturbances in the central nervous system due to the long-term heavy exposure to CS2. Disorders of the central nervous system were found more often in workers with heavy exposure to CS2. Questionnaire Q16 is a valuable means for selecting workers for further neuropsychiatric testing.     

Survey of occupational exposure of waste industry workers to infectious waste in Washington State.

We surveyed 940 Washington state waste industry workers to evaluate occupational exposure to potentially infectious materials (response rate 47 percent). Only 26 percent were trained specifically to deal with safety hazards associated with medical waste. For the year preceding the survey, 50 percent of respondents reported having received cuts and scratches on the job, 22 percent reported direct contact with waste blood on their clothing or shoes, 8 percent had blood exposure on their skin, 3 percent blood exposure on their face or eyes, and 6 percent occupational hypodermic needlestick injuries (10 percent among waste collectors.     

Occupational risk factors for work-related disorders in greenhouse workers

Aim This study reviews the evidence on the association between working in greenhouses and the occurrence of muscelosckeletal, reproductive and respiratory disorders, dermal effects, cancer and neurobehavioral effects. Subjects and methods PUBMED, MEDLINE and EBSCO literature bases were searched to identify epidemiological studies conducted over 1996–2006 that focused on the health outcomes of greenhouse workers. Three exclusion criteria were used to limit the selection to studies with quantitative assessment of the association between work-related risk factors and health disorders: lack of data on work-related risk factors, lack of a suitable risk estimate for work-related risk factors or of sufficient information that allowed calculation of a risk estimate and serious methodological concerns in relation to the purpose of this review (strong selection bias, very low response rate, recall bias). Results The analysis indicates that greenhouse exposure is associated with an increased risk of respiratory disorders, sensitization to allergens and skin reactions. Exposure to dust, bacteria, allergens, fungi and gases may cause or exacerbate asthma, asthma-like syndrome, mucous membrane irritation, chronic bronchitis and dermatitis. The results of the review showed that male workers employed in greenhouse horticulture for more than 10 years had a decreased median sperm concentration. The data on the effect of working in greenhouses on the time to pregnancy are unequivocal, but most of them indicate a relationship between a decreased fecundability ratio and greenhouse work, this referring mostly to pesticide exposure. There are also some indications that greenhouse work may contribute to musculoskeletal and neurobehavioral disorders, but only a few epidemiological studies have corroborated these findings. Some studies present evidence for the carcinogenicity of the pesticides used in greenhouses. Conclusion The results of this literature review imply a necessity to increase an awareness of the possible adverse health effects among greenhouse workers occupationally exposed to pesticides, biological agents or other factors of their specific work environment. On behalf of the DIRERAF partners: 1. Department of Hygiene and Epidemiology, Medical School University of Athens a. Associate Professor Athena Linos M.D., M.P.H., F.A.C.E b. Mr. Christos Chatzis M.D. c. Mr. Dimitrios Zikos RN d. Dimitrios Kouimintzis M.D. e. Euagelia Hronopoulou M.D. 2. Institute of Preventive Medicine, Environmental and Occupational Health a. Ioanna Kotsioni BA, MSc b. Eirini Papageorgiou BA, MSc 3. Nofer Institute of Occupational Medicine, Lodz 4. International Centre for Pesticides and Health Risk Prevention 5. Institut Municipal d’Investigacio Medical 6. Erasmus University, Rotterdam 7. Dresden University of Technology 8. Charles University of Prague 9. Finnish Institute of Occupational Health 10. Medical University of Sofia 11. Institute of Rural Health, Bratislava Review J. Jurewicz, D. Kouimintzis, A. Burdorf, W. Hanke, C. Chatzis, A. Linos     

The effects of long-term occupational exposure to dust from herbs

Introduction: Herbs are a heterogeneous group of many species with several thousand plants, which are used in large quantities in the pharmaceutical and food industries. The aim of the study was to analyse the health effects of long-term occupational exposure to dust from herbs. Methods: A group of 150 people occupationally exposed to dust from herbs, consisting of farmers and workers from herbs processing industry, was examined. As a reference group, 50 urban dwellers not exposed to any kind of organic dust were examined. Examined people were interviewed with the help of the ATS questionnaire compiled by Ferris and by the questionnaire developed in the Institute of Agricultural Medicine in Lublin, Poland for examination of work-related symptoms caused by organic dust. The lung function examination (vital capacity (VC), forced expiratory volume in the first second (FEV₁), and FEV₁/VC (%) of normal ranges) and allergological tests (skin prick test, precipitin test and inhibition of leukocyte migration (MIF) test) with microbial antigens were conducted. Results: 71.3% (95% CI 64.1–78.6%) of the exposed people reported occurrence of work-related symptoms. A post-shift decrease of spirometric values (VC, VC%) was observed in the exposed group (mean decrease 2.6%, P<0.01). A significant relationship was found between the number of work-related symptoms and decrease of FEV₁ values, both before (Spearman correlation coefficient r=−0.21, P<0.05) and after work (r=−0.31, P<0.01). In allergological tests, the frequencies of positive reactions in the exposed group were significantly higher than in the reference group. Precipitins specific to Pantoea agglomerans were found in 30.6% (95% CI 23.2–38.1%) of exposed, compared to 12.0% among unexposed (P=0.01). The frequency of positive results in the migration inhibition test was significantly higher among exposed workers for all antigens tested. Conclusion: Long-term exposure to dust from herbs causes work-related symptoms and decrease of lung function parameters, which, finally, may lead to occupational disease.     

安徽地区儿童暴露于农村生活环境对过敏性哮喘的影响

目的 研究暴露于农村生活环境对预防儿童哮喘及致敏的保护作用.方法 向2986名在校儿童父母发放哮喘标准调查表,采用放射性变应原荧光酶免疫吸附实验(RAST-FEIA)检测儿童血清中特异性IgE(sIgE)含量.结果 与在城镇生活的儿童相比,暴露于农村生活环境儿童的过敏性哮喘与非过敏性哮喘、过敏性哮鸣及特应性哮呜危险度显著性降低(OR=0.45,95%CI:0.13～0.96:OR=0.41,95%CI:0.15～0.95;OR=0.32,95% CI:0.11～0.62;OR=0.44,95% CI:0.13～0.91).1周岁内暴露与农村生活环境的儿童过敏性哮喘及特应性致敏危险度较低(OR=0.23,95% CI:0.04～0.91;OR=0.32,95%CI:0.17～0.78);若暴露持续至6周岁,过敏性哮喘及特应性致敏危险度更低(OR=0.21,95%CI:0.03～0.87;OR=0.31,95%CI:0.15～0.78).结论 暴露于农村环境对预防儿童过敏性哮喘及致敏的发生可能有保护作用,持续的暴露能加强此作用.     

某化纤企业作业工人二硫化碳接触水平

目的 了解某化纤企业二硫化碳(CS2)的污染水平.方法 选择该企业有代表性的车间和工种,对作业工人接触CS2的浓度进行检测,同时,收集该企业历年来CS2浓度检测资料进行综合分析.结果 79.6％的工种接触CS2的短时间接触浓度≤10 mg/m3,92％的工种接触CS2的短时间接触浓度≤20 mg/m3;约70％的工种接触CS2的时间加权平均浓度≤5 mg/m3,约90％的工种接触CS2的时间加权平均浓度≤10 mg/m3,仅有个别工种作业工人接触CS2的时间加权平均浓度＞15 mg/m3或短时间接触浓度＞30 mg/m3.结论 该化纤企业大部分工种作业工人接触CS2的浓度相对稳定在较低水平,但仍有相当一部分工种作业工人接触CS2浓度超过国家职业接触限值,今后仍需加强对CS2污染的治理.     

三氯乙烯接触工人及职业性三氯乙烯药疹样皮炎患者补体相关免疫指标的变化

目的 观察三氯乙烯(TCE)接触工人及职业性TCE药疹样皮炎(OMDT)患者体内补体相关免疫指标的变化情况,为其发病机制研究提供线索.方法 收集8例确诊为OMDT患者入院时、入院第1、2、3、4、5周和出院时共7次血液样本,进行肝功能、免疫球蛋白和补体相关指标检测,同时以39名未发病的TCE接触工人为接触组,检测车间空气中TCE浓度以及工人8h TCE时间加权平均浓度;收集工人尿液和血液样本,检测尿液中三氯乙酸(TCA)含量;分析接触工人血液中补体相关免疫指标与病例组的差异.结果 与入院时[C3d-CIC:(92.86±44.80)mg/L,C3:(0.91±0.19)mg/L]相比,OMDT患者出院时C3d-CIC水平[(52.41±17.75)mg/L]降低,C3含量[(1.14±0.22) mgL]升高,差异均有统计学意义(P＜0.05).其中C3含量随着病情好转逐渐上升.4家调查工厂空气中TCE浓度为(351.96±36.72)mg/m3,均超过国家规定的职业接触限值,接触工人8hTCE时间加权平均浓度与尿中TCA含量超过国家规定职业接触限值的人数分别占调查总人数的28.21％和56.41％.与OMDT患者出院时[IgG:(10.03±l.21)mg/L;CIC:(103.50±29.17 )mg/L]相比,TCE接触组IgG[( 17.21±1.85 )mg/L]和CIC[(227.46±111.67) mU/L]含量增高,差异均有统计学意义(P＜0.01).其他指标比较,差异无统计学意义(P＞0.05).结论 OMDT发病机制中可能涉及Ⅱ型和Ⅲ型变态反应,从而引起脏器损伤.     

Mortality study of beryllium industry workers occupational lung cancer

A cohort of 3685 white males employed during 1937–1948 in two major industries manufacturing beryllium was followed to the end of 1976 to evaluate lung cancer mortality experience. Lung cancer mortality among beryllium-exposed workers was contrasted with that of workers employed in the viscose rayon industry. Study results demonstrated that lung cancer mortality among beryllium-exposed workers was significantly greater than that expected on the basis of lung cancer mortality experience of workers in the viscose rayon industry having similar employment patterns. The results of the present study are consistent with earlier animal bioassay studies and recent epidemiologic studies indicating that beryllium is carcinogenic. The results of the present study are not consistent with speculation attributing the excessive lung cancer mortality among beryllium-exposed workers to personal characteristics of individuals having unstable employment patterns.     

Reducing occupational exposure to chemical carcinogens

Strategies for controlling occupational exposure to chemicalcarcinogens are set out in the European Union Carcinogens Directiveand in national legislation such as the British Control of SubstancesHazardous to Health Regulations. While such legislative requirementsmust apply to all occupational chemical carcinogens, it is arguedthat priority should be given to controlling those agents thatcontribute most to the cancer burden. Examples of possible strategiesto reduce exposure to two agents (diesel exhaust particulateand paint emissions) are discussed. It is concluded that thereare no real technical difficulties in controlling exposuresto chemical carcinogens; however, for many of the key agents,we need to change attitudes to the potential risks and clearlydemonstrate to employers and employees how to reduce the exposures.     

Occurrence of occupational asthma in aluminum potroom workers in relation to preventive measures

The purpose of this study was to investigate whether preventive measures such as reduction of exposure and the introduction of the histamine provocation test (HPT) as a selection instrument resulted in a lower incidence of potroom asthma (PA) and a longer time lag between the commencement of employment and the occurrence of PA. Between 1970 and 1990, 179 cases of PA were diagnosed. This period was divided into three periods. During period 1 (1970–1975), no exposure data were available. Period 2 (1976–1981) is characterized by known exposure data obtained by means of fluoride determinations in urine. At the beginning of period 3 (1982–1990) the HPT was incorporated into the preemployment medical examination. We computed the incidence density (ID) in the three periods and analyzed the timelag in relation to the year of employment and confounding factors such as age, atopic history, blood eosinophil counts, lung function, smoking habits at preemployment, and exposure level. After introduction of the preemployment HPT the ID decreased, but cases continued to occur (ID 11.6 in period 2 versus 2.5 in period 3). The time lag was did not differ when subjects with bronchial hyperresponsiveness were screened out. The exposure level and an atopic history were factors associated with the period of employment and, therefore, confounded the results. The results of this study support the role of an atopic history as a risk factor for development of PA at lower exposure levels and suggest that potroom exposure not only incites asthmatic symptoms but also acts as an inducer of respiratory disease. Received: 15 January 1997 / Accepted: 19 June 1997