Internal exposure to organic substances in a municipal waste incinerator

Summary Fifty-three persons occupied in a municipal waste incinerator were examined with respect to their internal exposure to organic substances which may be produced during pyrolysis of organic matter. For this purpose the levels of benzene in blood, polychlorinated biphenyls (PCBs) and hexachlorobenzene (HCB) in plasma, and mono- (MCPs), di- (DCPs), tri- (TCPs), tetra-(TECPs) and pentachlorophenol (PCP) and hydroxypyrene in urine were determined. For control purposes, 431 men and women were examined. Significantly higher values for the workers were found for the excretion of hydroxypyrene [median (m): 0.24vs 0.11 g/l; non-smokers], 2,4/2,5-DCP (m: 10.5 vs 3.9 g/l) and 2,4,5-TCP (m: 1.2 vs 0.8 g/l) and for the HCB level in plasma (m: 4.4 vs 2.8 g/l). For the concentrations of 4-MCP and 2,3,4,6/2,3,5,6-TECP, the controls had significantly higher concentrations in urine than did the workers in the incineration plant (m: 4-MCP 1.7 vs 1.2; 2,3,4,6/2,3,5,6-TECP: 1.2 vs 0.3 g/l). No significant differences between workers and controls were detected with respect to benzene in blood (m: 0.20 vs 0.28 g/l; non-smokers), 2,4,6-TCP and PCPs in urine (m: 0.85 vs 0.60 and 2.2 vs 2.2 g/l) or the levels of PCB congeners in plasma (m: 138, 153, 180: 5.6 vs 4.1 g/l). The elevated levels of hydroxypyrene, 2,4/2,5-DCP, 2,4,5-TCP and HCB in biological material may be related to the incineration of the waste. These elevations, however, are very small and are of interest more from the environmental than from the occupational point of view.     

Percutaneous absorption of N,N-dimethylformamide in humans

Summary Skin penetration fo N,N-dimethylformamide (DMF) liquid or vapour was studied in volunteers. Exposure to liquid DMF was performed in two ways: in a dipping experiment, one hand was dipped up to the wrist in DMF for 2–20 min, while in a patch experiment, 2 mmol DMF was applied to the skin and allowed to be absorbed completely. The period of exposure to DMF vapour (50 mg · m^–3) was 4 h. The DMF metabolites N-hydroxymethyl-N-methylformamide (MF), N-hydroxymethylformamide (F), and N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC) were monitored in the urine. Liquid DMF was absorbed through the skin at a rate of 9.4 mg · cm^–2 · h^–1. Percutaneous absorption of DMF vapour depended strongly on ambient temperature and humidity and accounted for 13%–36% of totally excreted MF. The results suggest that skin absorption of liquid DMF is likely to contribute to occupational exposure substantially more than penetration of DMF vapour. The yield of metabolites after transdermal DMF absorption was only half of that seen after pulmonary absorption. Elimination of MF and F but not that of AMCC was delayed, which supports the contention that AMCC should be used instead of MF as the most suitable biomarker of DMF in cases where percutaneous intake can occur.     

Kidney function in stainless steel welders

Summary Seventeen male manual metal-arc stainless steel welders (mean exposure time 20 years) had far higher levels of chromium in urine than individually matched controls (medians 23 vs 1.5 mol/mol creatinine;10.5 vs 0.7 g/g creatinine). However, there were no signs of kidney damage in tests of function of tubuli (-hexosaminidase, lysozyme, and ₂-microglobuline) or glomeruli (albumine clearance).     

N,N-dimethylbenzylamine: occupationa exposure,analysis and biological monitoring

Dimethylbenzylamine (DMBA) is used in the production of epoxy resins. The aims of this study were to assess occupational exposure to DMBA and evaluate the usefulness of monitoring the urinary excretion of DMBA and DMBA metabolites as indicators of exposure to DMBA. A sensitive gas chromatographic method for analysis of DMBA in air and in urine has been developed. The detection limit for DMBA in air for a 60-l air sample collected in 10 ml absorption solution was 2 g/m³ and in charcoal tubes, 0.3 g/m³. The detection limit for DMBA in urine was 0.02 mg/l. Ten male workers manufacturing epoxy resin were monitored during a full shift in the working environment and urine samples were collected at the end of exposure. The mean exposure and the highest DMBA concentration observed in air were 18 g/m³ (time-weighted average; range 3–48 g/m³) and 91 g/m³, respectively. The DMBA concentrations in the urine samples were below the detection limit. After reduction of the urine samples the DMBA concentrations in the urine samples were below the detection limit. After reduction of the urine samples the DMBA concentrations (U-SumDMBA) ranged from 0.02 to 0.22 mg/l. There was significant correlation between the exposure to DMBA and the U-SumDMBA. This observation suggests that the U-SumDMBA in urine samples collected at the end of a shift is a useful indicators of occupational exposure to DMBA.     

Biological aspects and self-evaluation of shiftwork adaptation

Summary Two male truck drivers working in a Brazilian cellulose plant and classifying themselves as well- and ill-adapted to a shiftwork schedule of 4 days-on and 1 day-off, participated in an autorhythmometric study. Psychophysiological self-ratings (calmness, stress and alertness), oral temperature measurements and urine collections (detection of K⁺,Na⁺ and 17-OH concentrations) were performed regularly during the waking period for 15 consecutive days during the shift schedule — the midday shift (11:00 to 19:00h), early-morning shift (03:00 to 11:00 h) and evening shift (18:00 to 02:00 h), including days-off. Cosine fitting of the data to a successive running one-day window revealed different individual temporal patterns, with the well-adapted subject showing a relatively stable phase relationship of the variables under study and the ill-adapted subject showing a less stable relationship. The different patterns could explain, at least partially, the fact that one subject feels adapted to shiftwork and the other not.Dedicated to the memory of Prof. Dr. Dr. Joseph Rutenfranz, former Director of the Institut für Arbeitsphysiologie, Dortmund, FRG, who contributed so much to the development of studies on occupational and environmental health     

Biological and environmental monitoring of occupational exposure of pharmaceutical plant workers to methotrexate

Summary The exposure of 11 pharmaceutical plant workers to methotrexate (MTX) was studied. Personal air samples were taken during the different manufacturing processes: drug compounding, vial filling, and tablet preparation. The uptake of MTX was established by the determination of MTX in urine. MTX was analyzed using the fluorescence polarization immunoassay (FPIA), a method that is frequently used for monitoring serum levels in patients treated with MTX. The FPIA method was modified in such a way that MTX could be measured quickly and efficiently in air and urine samples. MTX was detected in air samples of all workers except for those involved in the vial filling process (range: 0.8–182 g/m³; median: 10 g/m³). The highest concentrations were observed for workers weighing MTX (118 and 182 g/m³). MTX was detected in urine samples of all workers. The mean cumulative MTX excretion over 72–96 h was 13.4 g MTX-equivalents (range: 6.1–24 g MTX-equiva g MTX-equivalents (range: 6.1–24 g MTX-equivalents). lents). A significantly lower background level of 10.2 g A significantly lower background level of 10.2 g MTX-equivalents was measured in urine of 30 control persons (range: 4.9–21 g MTX-equivalents).     

Biochemical and physiological aspects of 2,5-hexanedione: endogenous or exogenous product?

Summary This article reports results regarding two different physiological aspects of 2,5-hexanedione (2,5-HD). The first is the relationship between free 2,5-HD (the fraction of real 2,5-HD) and total 2,5-HD (2,5-HD obtained from acid hydrolysis) in urine and blood of workers exposed ton-hexane. The second part of the study is an attempt to clarify physiological excretion of 2,5-HD in subjects not occupationally exposed ton-hexane. The concentration of free 2,5-HD in urine of workers exposed ton-hexane is about 8% of total urinary 2,5-HD. In blood, free 2,5-HD is about 50% of the total. The serum concentration range of total and free 2,5-HD in workers from whom blood was taken was 33–418 g/l and 14–283 g/l respectively. In subjects not exposed ton-hexane, urinary concentration of 2,5-HD ranged between 0.17 and 0.98 mg/1, the urinary excretion rate between 0.23 and 0.57g/min, and renal clearance between 14 and 66 ml/min. The blood concentration of 2,5-HD in nonexposed subjects was 6–30g/1. Fluctuations typical of a circadian rhythm were not observed for 2,5-HD in blood or urine. We think that 2,5-HD is mainly a product of intermediate metabolism in the human body. Only a minimal part could derive fromn-hexane as a ubiquitous micropollutant.     

Identification of cis- and trans-verbenol in human urine after occupational exposure to terpenes

Summary Urine from sawmill workers exposed to -pinene, -pinene and -3-carene was collected and hydrolyzed with -glucuronidase at pH 5.0 for 24h at 37°C. After hydrolysis the urine was cleaned on a SEP-PAK C₁₈ cartridge. The cartridge was eluted with n-heptane. The eluate was injected onto a gas chromatograph equipped with a 25-m (0.32-mm ID) SP-1000 capillary column. The major peak in the chromatogram was identified by GC-MS as trans-verbenol by electron impact at 70 eV. cis-Verbenol was also identified. These metabolites could not be detected in non-hydrolyzed urine from the exposed workers or in hydrolyzed urine from an unexposed individual. The recoveries of the verbenols from hydrolyzed urine were in the range of 85 to 94% and the metabolites were stable both in urine and in n-heptane after sample cleaning at –20°C for at least 12 weeks. We suggest that these metabolites are formed from -pinene by hydroxylation.     

Air-borne B. subtilis enzymes in the detergent industry

Summary Air-borne dust was collected on stationary and portable filters in two factories producing biological detergents. In one factory (Factory A) the detergent base was mixed with enzyme (subtilisin) powder, and the handling of the enzyme was done without effective protection. In the other factory (Factory B) the enzyme was encapsulated in granules before mixing the with detergent base, and the production line was shielded to prevent the spread of dust.Both the amount of air-borne dust and the relative enzyme activity of the dust were greater in Factory A than in Factory B in spite of the considerably larger production of enzyme detergents in the latter factory. The workers studied in Factory A were, on the average, exposed to 5.4 GU (glycine units) per cubic millimetre in their breathing zones, and those studied in Factory B were exposed to enzyme activities about and below 1 GU/m³.Based on exposure measurements and medical examination of the exposed workers, a time-weighted hygienic limit value for subtilisins of 1 GU/m³ is proposed.     

Muscle Learning Therapy—Efficacy of a Biofeedback Based Protocol in Treating Work-Related Upper Extremity Disorders

Work-related upper extremity disorders (WRUEDs) continue to present significant treatment and financial challenges to providers, employers, and insurers. This retrospective study reviews outcomes for 309 subjects who, between 1995 and 1999, were referred through the workers' compensation system for treatment of computer keyboard- and mouse-related WRUED injuries. The mean length of time from the recorded date of injury to the date of intake was 12.9 months. Subjects were offered a 12-visit course in muscle learning therapy (MLT). MLT is an operant conditioning program which uses surface electromyography (sEMG) to train injured workers to control their muscles during work activities. Patient response to therapy was obtained by a therapist-administered questionnaire during Visit 8 of 12. A group of 309 subjects, who had failed to respond to a previous course of therapy (typically physical therapy), reported significant improvements of pain in the neck, thorax, and upper extremities. Ninety six percent reported that they felt more in control, 86% reported feeling better overall, and 81% reported either working the same and feeling better or working and accomplishing more. This study provides preliminary support for this approach and provides justification for controlled clinical trials in the future.     

“Fostering Moratorium” in residential child and youth care education

This paper highlights the professional socialization process of child and youth care workers from a new point of view, namely, focusing on the existential needs of beginning practitioners for a period of moratorium. The data gathered during an ethnographic study of newly recruited group workers in Israeli residential institutions led the authors to the conceptualization of a new model, the Fostering Moratorium.     

Investigations on neurotoxicity of chemical substances at the workplace

Summary A cross-sectional study was performed in order to investigate the influence of chronic lead-exposure on the peripheral nervous system. We examined 148 male workers of a storage battery manufacturing plant, who had been exposed to lead metal and inorganic lead compounds for 1 to 28 years (mean 11 years). Fifteen workers with non-occupational risks of peripheral neuropathy (former diseases, alcohol abuse, medication) were excluded from the study. The investigation program comprised: case history, physical examination, analyses of blood- and urine-samples and determination of maximal motor, mixed and sensory conduction velocity (NCV) of the ulnar and median nerve of the right forearm. Objectively no worker showed any signs of health effects related to lead exposure. The Biological Monitoring included the determination of (1) Blood-lead level (Pb-B), (2) Free erythrocyte porphyrins (FEP), (3) -Aminolevulinic acid dehydratase (ALA-D) and (4) -Aminolevulinic acid in urine (ALA-U). Further time-weighted-average (TWA)-values of Pb-B were calculated on the basis of several determinations over the period 1975–1981. The following actual (TWA) median values resulted: Pb-B 53 g/dl (54 g/dl), ALA-U 5.6 mg/l (8.4 mg/l), FEP 2.0 mg/l (2.0 mg/l). The Biologischer Arbeitsstoff Toleranz Wert (BAT) of 70 g//dl for Pb-B was exceeded in 15 workers (11%), and of 15 mg/l for ALA-U in 30 cases (23%). In comparison with age-matched controls, the lead workers showed a mild slowing of NCV with mean values between 0.8 and 2.0 m/s. Multiple stepwise regression analyses revealed statistically significant correlations between the four NCV and age as well as Pb-B. There were better correlations by using TWA than actual data of Pb-B. Consideration of the results of the regression analyses, together with an evaluation of the individual neurophysiological status as a function of internal lead exposure, a dose-effect-relationship was found only in the case of Pb-B exceeding 70 g/dl. From our study it is concluded that chronic lead exposure resulting in blood-lead levels of below 70 g/dl is no occupational risk causing a functionally significant slowing of nerve conduction velocities.With Grants from the Deutsche Forschungsgemeinschaft, Bonn (Project no. Va 23/19-1)     

Human exposure to volatile halogenated hydrocarbons from the general environment

Summary The objective of this study was to assess individual human exposure to volatile halogenated hydrocarbons (VHH) under normal environmental conditions by means of biological monitoring, i.e. by the measurement of these compounds or their metabolites in body fluids, such as blood, serum, and urine. Blood samples of 39 normal subjects without known occupational exposure to these agents were examined for the occurrence of VHH. The following compounds were present in quantifiable concentrations in 60 to 95% of the blood samples examined: chloroform (median 0.2 g/l; range < 0.1–1.7 g/l), 1,1,1-trichloroethane (median 0.2 g/l; range < 0.1–3.4 g/l), tetrachloroethylene (median 0.4 g/l; range < 0.1–3.7 g/l). Trichloroethylene could be detected in 31% of all blood samples (median < 0.1 g/l; range < 0.1–1.3 g/l). In addition, the levels of trichloroacetic acid (TCA) were determined in serum and 24-h urine samples of 43 and 94, respectively, normal subjects. TCA was present in measurable concentrations in all serum and urine samples examined. The median of the TCA levels in serum was 21.4 g/l (range 4.8–221.2 g/l) and in urine 6.0 g/24 h (range 0.6–261.4 g/24 h). The results are discussed in relation to data from the literature on human exposure to VHH from the general environment, i.e. via air, food, and water. The upper normal limits calculated from the results of this investigation can be used to detect even minor excessive exposures to VHH.     

Biological monitoring of cobalt exposure,based on cobalt concentrations in blood and urine

Summary Cobalt exposure level and its concentrations in blood and urine were determined for 175 hard metal workers. For control data, the cobalt concentrations in blood and urine were measured for 20 office workers. The exposed workers had significantly higher cobalt concentrations in both blood and urine. The relationships between exposure level and cobalt concentrations in blood and urine were linear and positive. The results clearly showed that the cobalt concentration in the blood or urine can be used as an exposure indicator. With cobalt exposure of 100 g/m³, the cobalt concentration was 0.57 to 0.79 g/dl in blood and 59 to 78 g/l in urine with 95% confidence limits. In workers using respirators, the cobalt concentrations in the blood and urine decreased to 2/5 and 1/8, respectively, of those not using respirators.     

An evaluation of psychometric properties of the client's questionnaire of the Wisconsin Quality of Life Index-Canadian version (CaW-QLI)

Psychometric properties of Client's questionnaire from the Canadian version of the Wisconsin Quality of Life-Index (CaW-QLI) were assessed with two groups, 89 English (E) and 94 French (F) individuals with schizophrenia or schizoaffective disorder. Sub-samples of 40E and 36F were re-interviewed within a 2-week period. Spearman correlations-SC between each domain and CaW-QLI global Score ranged from 0.39 to 0.76, while inter-domain correlations were low, confirming the multidimensional properties of the scale. Cronbach's (internal consistency) were 0.78(E) and 0.70(F) for the CaW-QLI global scores and, from 0.45 to 0.88 among seven of eight domains. Test–retest (Concordance Correlation Coefficient-CCC) ranged from 0.36 to 0.80 among the domains, and from 0.80(E) and 0.85(F) between CaW-QLI global scores. Regarding convergent validity, SC between CaW-QLI global score and Spitzer's QOL-Index were 0.72(E) and 0.58(F). As hypothesized, there were higher correlations between CaW-QLI global scores (E and F) and SF-36 scales related to mental health than those related to physical health. Minor changes in the scoring are proposed to enhance face and content validity.     

Absorption,metabolism and elimination of N,N-dimethylformamide in humans

Summary Excretion of N,N-dimethylformamide (DMF) and DMF metabolites N-hydroxymethyl-N-methylformamide (MF), N-hydroxymethyl-formamide (F) and N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC) has been monitored in the urine of volunteers during and after their 8-h exposure to DMF vapour at a concentration of 10, 30 and 60 mg · m^–3. The pulmonary ventilation in these experiments was typically about 101 · min^–1 and the retention in the respiratory tract was 90%. After exposure to 30 mg DMF · m^–3, the yield of compound determined in the urine represented 0.3% (DMF), 22.3% (MF), 13.2% (F) and 13.4% (AMCC) of the dose absorbed via the respiratory tract. The excretion curves of the particular compounds attained their maximum 6–8h (DMF), 6–8h (MF), 8–14h (F) and 24–34h (AMCC) after the start of the exposure. The half-times of excretion were approximately 2, 4, 7 and 23 h respectively. In contrast to slow elimination of AMCC after exposure to DMF, AMCC was eliminated rapidly after AMCC intake. This discrepancy could be explained by rate-limiting reversible protein binding of a reactive metabolic intermediate of DMF, possibly methylisocyanate.     

“Mom” as a Protective Strategy Used by Children in Foster Care

How children use language impacts on their adjustment in foster care. It is important to understand the strategies children use with caregivers to protect themselves. The shortage of literature on how children cope in foster care is concerning because it limits placement workers in their ability to help children in care. This paper examines some of the reasons children take it upon themselves to call their foster caregiver Mom even when they have been discouraged from doing so. The phenomenon of children referring to foster caregivers as Mom is examined in this paper for how this strategy provides protection for children, theoretical explanations for how the use of Mom works, and for the opportunities its use brings.     

A study of neurophysiological measurements and various function tests on workers occupationally exposed to vibration

Summary Seventy male air grinder operators and 72 age-matched control workers were examined. Both groups of workers worked in the warm climate (20°–33°C) of southern Taiwan. None of the workers had symptoms of white fingers. The investigation program comprised: (1) case history, (2) physical examination, (3) determination of maximal motor conduction velocity, proximal and distal sensory conduction velocity (NCV) of the median and ulnar nerves of the right upper extremity, (4) measurement of skin temperature, nail press test, pain threshold and vibratory sense threshold of the upper extremities, and (5) testing of the motor function. The dose-effect correlation between the NCV, various function tests and total operating time (TOT) was performed by multiple stepwise regression analyses. The regression analyses revealed a statistically significant correlation (dose/effect) between the six NCV, vibratory sense threshold, pain threshold and age, as well as TOT.     

Blood toluene as a biological index of environmental toluene exposure in the “normal” population and in occupationally exposed workers immediately after exposure and 16 hours later

Blood toluene was measured in a group of 100 workers occupationally exposed to a mean 8-h environmental toluene concentration of 128 g/l (34 ppm), and in a group of 269 normal subjects without occupational exposure to toluene. The mean blood toluene of the workers at the end of the shift and the following morning, after 16 h, was 457 and 38 g/l, respectively. The normal subjects had a blood toluene level of 1.1 g/l. On the basis of the highly significant correlation between blood toluene and occupational exposure, it can be calculated that environmental toluene exposure of 188 and 377 g/l (50 and 100 ppm) gives end-of-shift blood toluene levels of 690 and 1390 g/l, respectively. The corresponding blood toluene levels on the following morning are 50 and 100 /l, respectively.     

Incidence of leukaemia and brain tumours in Finnish workers exposed to ELF magnetic fields

Summary The relative incidence of leukaemia, acute myeloid leukaemia (AML) and central nervous system (CNS) tumours among workers presumably exposed to extremely low frequency (ELF) magnetic fields (MFs) was studied. The study population consisted of all male industrial workers in Finland aged 25 to 64 years during 1971–1980 according to the Population Census in 1970. The occupations were grouped into three exposure categories according to the probability of exposure. The category of probable exposure included electrical occupations and the category of possible exposure included occupations where electric motors or welding are common. All other occupations were included to the category of no exposure. Cancer incidence rates in different occupational groups during 1971–1980 were obtained after linking the census records with the national death certificates and the files of the Finnish Cancer Registry. The adjusted relative risks (with 95% confidence limits) in the categories of probable and possible exposure were for all leukaemia 1.9 (1.0–3.5) and 1.4 (1.1–1.8), for AML 1.5 (0.5–4.7) and 1.4 (0.9–2.1), and for CNS tumours 1.3 (0.7–2.3) and 1.3 (1.0–1.6), respectively. The results are concordant with earlier studies suggesting elevated risk among workers exposed to ELF magnetic fields.