Occupational toxicology and the control of exposure to pharmaceutical agents at work

BACKGROUND: The pharmaceutical industry employs >350 000 people worldwide in operations including research and development (R&D), manufacturing, sales and marketing. Workers employed in R&D and manufacturing sectors are potentially exposed to drug substances in the workplace that are designed to modify physiology and also to chemical precursors that are potentially hazardous to health. Pharmaceutical workers are at risk from adverse health effects, including occupational asthma, pharmacological effects, adverse reproductive outcomes and dermatitis. AIM: This study aimed to describe the approaches taken by pharmaceutical companies for identifying and communicating potential adverse health effects that may result from workplace exposures and in setting 'in-house' exposure control limits and to highlight the challenges in controlling workplace exposures to increasingly potent compounds. METHOD: The literature was reviewed by searching the Medline and HSELine databases. RESULTS: The findings are presented in five sections, covering: test methods and approaches to occupational toxicology; hazard communication; approaches to setting health-based occupational exposure limits for pharmaceutically active agents; recent approaches to risk control; and occupational hygiene and exposure controls. CONCLUSION: Significant efforts have been directed at predicting and evaluating potential occupational health hazards in the pharmaceutical industry. The pharmaceutical industry has provided leadership in controlling exposure to hazardous substances. Much of this work has been driven by a real need to control occupational exposures to substances that can have profound adverse health effects in exposed employees and that are becoming increasingly more potent.     

A policy analysis of the problem of the reproductive health of women in the workplace

Many occupations in which women comprise the majority of the workforce involve exposure to biological, physical, and chemical hazards. Potential reproductive effects of work-related substances include impaired reproductive capacity, mutagenesis, teratogenesis, and transplacental carcinogenesis. However, female-dominated occupations tend to be only minimally regulated by the US Occupational Safety and Health Administration, and the corporate response to the issue of reproductive and fetal health has been to institute "protective discrimination policies" such as the demotion or exclusion of women of childbearing age from certain jobs. This article rates the effectiveness of alternate policy responses to increase women's occupational health and safety through use of a series of analysis criteria: equity, efficiency, preference satisfaction, right to privacy, avoidance of stigma, and unintended consequences. Policy options include the following: 1) do nothing, 2) leave current policies intact while supporting a research program to document the health consequences of specific occupational risks to women's reproductive health, 3) restrict women for who pregnancy is not ruled out from occupations or work areas known or suspected to be hazardous, 4) improve working conditions for all women, and 5) improve working conditions for all workers. Policy analysis suggests the working conditions of all workers should be improved. This alternative reduces inequity, eliminates stigma, maintains privacy, and honors preferences. Implementation of this policy would be expensive, requiring an increase in knowledge of the effects of industrial substances on female and male reproductive health, expansion of the technical capacity to control occupational hazards, and an increase in the resources of programs that monitor and regulate occupational health. However, this approach is in accord with growing concern that workers should not have to compromise their health to keep their jobs.     

Occupational Reproductive Hazards: Necessary Steps to Prevention

Although some attention has recently been given to the study of occupational reproductive hazards, little is known about Measure being taken to prevent exposure to substances having the potential to Cause such problem. In the past OSHA has prom ulgated a standard to lower the pemissible exposure level to a reprodutive toxin as the major focus only after experimental evidence was confirmed in humans. The method of selection of appropriate substitutes is also cause for concern. A chemical known to cause testicular atrophy, cancer, and gene mutatiom in subhuman test systems and to cause sterility in male workers was replaced with a substance known from experimental studies to cause testicular toxicity, canrer of multiple sites, and ge ne mutations. Exrerimental test results need to he addressed from the standpoint of determining presumptive risk to humans. A scheme for setting priorities for reduction of exposure or for consideration of regulation of occupational reprodutive hazards also needs to be developed. A policy addressing occuputional reproductive hazards may serve as a stimulus for proteting workers from these hazards and for improving scientific reseach protocols.     

职业有害因素对女工健康的影响

该文对国内外有关职业有害因素对女工健康影响的研究进行了综述,阐述了铅、苯、二氧化硫、有机磷农药、汽油、噪声、振动等职业有害因素以及不合理的劳动制度均可对女工的健康产生不良影响,如月经紊乱、早产、流产、低体重儿.另外,职业有害因素还可以影响女工的其他生理功能.     

Women's reproductive health: some recent developments in occupational epidemiology.

Epidemiological research on occupational hazards and reproductive health is an expanding and strongly developing area. This article focuses on some recent areas of occupational reproductive epidemiology that are or seem to be important for the future. Interest in the research on fertility has increased during the past decade, and time to pregnancy has proved to be a useful measure of fertility. The research on menstrual function or early fetal loss is still limited, and further research is desirable. It is important to chart the advantages and disadvantages of various methods for measuring these outcomes. Recently developed methods of exposure assessment provide new possibilities to improve the validity of exposure data. Biological exposure markers can also provide useful dosimeters for reproductive studies. Research on the reproductive effects of job stress and individual susceptibility to reproductive toxicants is also gaining in importance.     

Exposure to hazardous substances and male reproductive health: a research framework

The discovery in the mid-1970s that occupational exposures to pesticides could diminish or destroy the fertility of workers sparked concern about the effects of hazardous substances on male reproductive health. More recently, there is evidence that sperm quantity and quality may have declined worldwide, that the incidence of testicular cancer has progressively increased in many countries, and that other disorders of the male reproductive tract such as hypospadias and cryptorchidism may have also increased. There is growing concern that occupational factors and environmental chemical exposures, including in utero and childhood exposures to compounds with estrogenic activity, may be correlated with these observed changes in male reproductive health and fertility. We review the evidence and methodologies that have contributed to our current understanding of environmental effects on male reproductive health and fertility and discuss the methodologic issues which confront investigators in this area. One of the greatest challenges confronting researchers in this area is assessing and comparing results from existing studies. We elaborate recommendations for future research. Researchers in the field of male reproductive health should continue working to prioritize hazardous substances; elucidate the magnitude of male reproductive health effects, particularly in the areas of testicular cancer, hypospadias, and cryptorchidism; develop biomarkers of exposure to reproductive toxins and of reproductive health effects for research and clinical use; foster collaborative interdisciplinary research; and recognize the importance of standardized laboratory methods and sample archiving.     

Prioritizing future resources for epidemiologic research on old and newly emerging occupational hazards

BACKGROUND: Inevitably, occupational epidemiologists must decide when and how to shift research attention and resources from investigations of old, established health hazards to a focus on newly emerging potential risk factors. As yet unknown occupational health consequences of burgeoning worldwide technologies, such as the microelectronics industry, and increasing recognition of the importance of common, yet non-traditional occupationally-related health effects, such as musculoskeletal disorders in office workers, give strong impetus for embarking in new directions. However, there remains much to be learned from continued investigation of well-established occupational hazards, such as asbestos, benzene, and lead. OBJECTIVES: A rational strategy for planning future research will need to consider optimizing resources. CONCLUSIONS: The following suggestions are offered. 1) First and foremost, occupational risk factors are most directly, and arguably most validly, identified by studying workers in well-defined cohorts, ideally when exposures are adequately characterized. To this end, industry-based cohort studies should be given priority, at least for older hazards, over population-based case-control and surveillance designs. 2) Defined cohorts with extensive exposure and health outcome data should continue to be followed, as resources permit; 3) Launching cohort studies for potential new hazards should incorporate extensive exposure assessments at the outset, and should preferentially select inception cohorts of newly hired workers. Valid biomarkers of pre-clinical disease will be especially valuable in this regard. 4) Capitalizing on new technological advances in exposure assessment, clinical medicine, molecular genetics should be encouraged     

Perspectives on reproductive and developmental toxicity

Human reproduction and development is a cycle of interdependent events. Virtually all of its phases have been shown to be the primary target of one or more non-mutagenic exogenous agents. Such agents interfere with certain of the countless epigenetic or ontogenic events essential for normal completion of the cycle. Mutagens disrupt this cycle at some points, but the overwhelming majority of reproductive and developmental toxins are not mutagenic. As in all aspects of toxicology, the reproductive and developmental effects of chemicals are determined by the intrinsic nature of the chemical, the quantity of the chemical exposure, the duration of exposure and the stage of the cycle at which it occurs. Signs of reproductive toxicity range from reduced fertility to spontaneous abortion. Adverse effects on the conceptus are categorized as functional deficits, developmental retardation, structural abnormality and death. One or more of these is anticipated to occur as a result of excess exposure to most chemicals. Although the degree of hazard and risk potential can be calculated in each instance, chemicals differ markedly in their ability to interfere with reproduction (Amann, 1982) and/or development (Johnson, 1984). Standardized methods for reproductive and developmental toxicity safety evaluation are available for detecting adverse effects upon any aspect of reproduction and development. Data currently available establish that these state-of-the-art tests conducted in laboratory animals are often highly predictive of the type of adverse effect a particular chemical will have in humans, as well as the exposure level at which it will occur. By adding a modest safety factor to the no-observed-effect-level of well-executed animal studies, safe human exposure levels can be established. Responsibility for determining the intrinsic hazard potential and the risk estimate of exposure rests with manufacturers and major users of occupational and other environmental chemicals. As public awareness of reproductive and developmental hazards has increased in recent years, it has come to be understood that some chemicals have a predilection for causing reproductive impairment and/or disrupting development in the absence of other toxicity. Such substances must be identified to establish safe exposure levels and to determine the types of effects to be expected, should excessive human exposure occur. The setting of safe exposure levels is necessary both from the standpoints of ensuring public safety and avoiding product liability.     

The influence of occupational exposure on male reproductive function

Recently, many studies have found a decrease in semen quality which has increased the focus on male reproductive health. Occupational hazards are by far the best documented in reproductive epidemiological research. Generally, occupational exposures have been divided into physical exposures (heat and radiation), chemical exposures (solvents and pesticides), psychological exposures (distress), exposure to metals and welding. The recent and/or most important epidemiological studies exploring the effect of occupational exposures on semen quality and fecundity, the ability to conceive, are reviewed. The evidence for an adverse effect on male reproduction of several occupational and environmental exposures and toxicants, such as heat, ionizing radiation, inorganic lead, dibromochloropropane, ethylene dibromide, some ethylene glycol ethers, carbon disulfide and welding operations, is strongly supported in well-designed epidemiological studies. For other agents, the association is only suspected or suggested and needs further evaluation before conclusions can be drawn. It is also important to bear in mind that many workers in the non-Western world still are exposed to substances that are banned in the Western world, sometimes in high concentrations.     

某碳酸饮料公司职业卫生状况调查

目的检测与分析某碳酸饮料公司职业危害因素,从源头控制或消除职业病危害,保护劳动者健康。方法本项目采用职业卫生现场调查法和职业卫生检测法等进行综合分析及定性和定量评价。对检测项目中职业病危害因素的危害特征、作业工人接触的有效时间进行综合分析,判定工人接触职业危害的实际程度。结果本项目存在的职业病危害因素化学物质有盐酸、氯、二氧化碳、乙二醇、氨、臭氧、氮氧化物和锰及其无机化合物,粉尘有硅藻土粉尘、活性炭粉尘和电焊烟尘,物理因素为噪声和紫外辐射。检测结果表明,作业人员接触职业病危害因素的职业接触限值均低于国家卫生标准,如作业人员接触高毒物品氨CTWA〈0.952 mg/m3、二氧化氮CTWA为0.12mg/m3;作业人员工作日内接触噪声强度符合国家卫生标准的要求。结论综合各方面分析,在确保各类防护设施有效运行、全面落实控制职业病危害的补救措施的前提下,本项目在职业病危害控制方面是可行的。     

Knowledge and practices related to occupational hazards among cement workers in United arab emirates

Background: In United Arab Emirates (UAE), the rate of industrialization has increased significantly over the past decades. However, few studies have been conducted to investigate the occupational hazards and the knowledge & practice of the working population relevant to these hazards. Objectives: To assess the knowledge and practice of workers in cement factory in Ras Al-Khaimah, UAE on the occupational hazards of their work. Material and Methods: A cross-sectional study involving 153 cement factory workers. A semi- structured interview questionnaire was used to assess the knowledge and practice of workers towards occupational hazards in general and dust in particular. Results: The majority 114 (74.5 %) of the workers knew that exposure to the dust was a serious hazard to their health, but only 52.9 % of the workers knew the hazards other than the dust that were associated with their work. All the workers mentioned that they had been provided with masks to protect them from dust, however, only 28.8 % of them claimed that they used the masks all the time during working hours. The variables: years of education, being informed about the hazards associated with the worker's job, and attending a training course about occupational health and safety were found to have a significant influence on the workers' knowledge about the occupational hazards and on their use of the personal protective equipment at work. Conclusion and Recommendations: Despite the relatively high knowledge of the cement factory workers about the adverse health effects of exposure to dust, the use of respiratory protective equipment was poor. A program to promote safety education and the use of personal protective equipment among cement factory workers is recommended.     

Occupational and environmental exposure correlates of adverse live-birth outcomes among 1032 US Navy women

The integration of women into non-traditional military occupations raises questions concerning the impact of such jobs on women's reproductive health. This study examines the extent to which US Navy women in their reproductive years report exposures to potential occupational and environmental hazards, and the degree to which such exposures are associated with self-reported adverse live-birth outcomes. Data from a survey of pregnant Navy women provided both maternal and paternal exposure information on more than 1000 active-duty women. Self-reported exposures to heavy metals, pesticides, petroleum products, and other chemicals were associated with adverse live-birth outcomes at the bivariate level. Only a father's exposure to pesticides at work predicted an adverse live-birth outcome (preterm delivery) in multivariate models. Maternal occupational exposures may exert their influence through maternal health and/or pregnancy complications and may act as mediators of health-reproductive outcome relationships.     

Global review of studies on traffic police with special focus on environmental health effects

Since occupation is a major determinant of health, traffic police personnel face multiple occupational hazards. They are continuously exposed to vehicular emissions and work in a noisy and polluted environment. The objective of the present review is to explore the impact of occupational health hazards on the health of traffic police personnel. Published research papers on traffic police reporting occupational health issues were accessed and reviewed. Attempts were made to access papers that reported negative associations in order to present a balanced review. The majority of the studies have reported a decrease in the lung function and increased respiratory morbidity. The research on the cytogenetic abnormalities or genotoxic effect of vehicular emissions arising due to long-term exposure to benzene and other polyaromatic hydrocarbons has provided conflicting results, since more or less equal numbers of studies have given evidence for and against the causal association. There is a vast accumulation of epidemiological evidence on the casual association between vehicular pollution and its carcinogenic effect. Multiple studies have concluded that traffic police are highly stressed. A number of occupational factors have been attributed to stress among traffic police. Occupational health studies help us to understand the effects of vehicular pollution and its adverse influence on workers. They also provide opportunity for defined exposures measurements and precise risk assessment. The findings from these studies are easily generalizable and can help us understand the impact of air pollution on the general population.     

甘肃省石油化工行业女工生殖道感染的影响因素分析及风险列线图

目的 建立石油化工企业女性职工生殖道感染风险的列线图模型,分析该行业女工生殖健康的影响因素.方法 选择某石油化工企业所有的5186名女性职工作为研究对象,进行现场和问卷调查,分析石油化工企业的职业病危害因素,以及女性职工的疲劳情况和生殖道感染发生率,并采用多因素logistic回归和列线图预测模型揭示生殖道感染的危险因...     

某玉米深加工生产企业职业危害现状调查与评价

目的了解玉米深加工生产企业作业场所职业病危害因素种类、工人接触水平及玉米深加工生产企业存在的职业卫生问题。方法对生产企业职业病危害控制效果评价报告进行分析。采取现场职业卫生学调查,根据国家现行职业卫生标准进行职业病危害因素检测。结果粉尘个体采样测试结果均未超过国家卫生限值的要求,合格率为100%,粉尘定点测试短时间接触浓度合格率为90.91%。所测有毒物质均未超标,所评价毒物作业岗位均合格,以玉米深加工企业较完善的设备维护制度以及所采取的通风防毒措施能满足控制有毒物质危害的效果。结论玉米深加工企业高噪声生产设备较多,加之因工艺要求多为集中布置,造成噪声叠加,工人多为固定岗位作业,接触时间长,对工人健康有一定影响,建议加强个人防护用品的使用。     

Occupational causes of chronic obstructive pulmonary disease

The relation between Chronic Obstructive Pulmonary Disease (COPD, including chronic bronchitis and emphysema (CBE), and exposure to coal dust is well established. This paper reviews the evidence relating to other occupational causes of COPD, including industries associated with exposure to fumes, chemical substances, and dusts. A review of key literature has been carried out with a focus on the magnitude of risks and levels of exposure causing disabling health effects. The literature suggests that elevated risks of developing COPD are clearly associated with several occupations, with risk estimates being high in some, even after taking into account the effect of confounders, such as smoking. Of particular concern are agricultural workers who can be exposed to a variety of gases and organic dusts, among whom CBE is clearly elevated, particularly for pig farmers and exposure to endotoxins, with an increased annual decline in lung function. Similarly, cotton textile workers are exposed to a mixture of substances affecting development of atopy, byssinosis, and CBE, and across-shift and long-term decline in lung function. Atopy also has an important role in the development of COPD in flour mill workers and bakers, with those sensitized to bakery allergens having a greater lung function decline than non-sensitized individuals. Welding processes involve a range of potential chemical, physical and radiation hazards. The average reduction in FEV1 associated with welding fumes is similar to that associated with smoking. Challenges in assessing the evidence include variation in diagnostic methods; concurrent exposure to cigarette smoke (direct or second-hand) and multiple work-place irritants; healthy worker selection/survivor effects; poor exposure definition. Raising awareness of occupational causes of COPD among employers, employees, and health service professionals is important.     

Ethical and scientific issues of nanotechnology in the workplace

In the absence of scientific clarity about the potential health effects of occupational exposure to nanoparticles, a need exists for guidance in decision making about hazards, risks, and controls. An identification of the ethical issues involved may be useful to decision makers, particularly employers, workers, investors, and health authorities. Because the goal of occupational safety and health is the prevention of disease in workers, the situations that have ethical implications that most affect workers have been identified. These situations include the a) identification and communication of hazards and risks by scientists, authorities, and employers; b) workers' acceptance of risk; c) selection and implementation of controls; d) establishment of medical screening programs; and e) investment in toxicologic and control research. The ethical issues involve the unbiased determination of hazards and risks, nonmaleficence (doing no harm), autonomy, justice, privacy, and promoting respect for persons. As the ethical issues are identified and explored, options for decision makers can be developed. Additionally, societal deliberations about workplace risks of nanotechnologies may be enhanced by special emphasis on small businesses and adoption of a global perspective.     

Workgroup report: Implementing a national occupational reproductive research agenda--decade one and beyond

The initial goal of occupational reproductive health research is to effectively study the many toxicants, physical agents, and biomechanical and psychosocial stressors that may constitute reproductive hazards in the workplace. Although the main objective of occupational reproductive researchers and clinicians is to prevent recognized adverse reproductive outcomes, research has expanded to include a broader spectrum of chronic health outcomes potentially affected by reproductive toxicants. To aid in achieving these goals, the National Institute for Occupational Safety and Health, along with its university, federal, industry, and labor colleagues, formed the National Occupational Research Agenda (NORA) in 1996. NORA resulted in 21 research teams, including the Reproductive Health Research Team (RHRT). In this report, we describe progress made in the last decade by the RHRT and by others in this field, including prioritizing reproductive toxicants for further study; facilitating collaboration among epidemiologists, biologists, and toxicologists; promoting quality exposure assessment in field studies and surveillance; and encouraging the design and conduct of priority occupational reproductive studies. We also describe new tools for screening reproductive toxicants and for analyzing mode of action. We recommend considering outcomes such as menopause and latent adverse effects for further study, as well as including exposures such as shift work and nanomaterials. We describe a broad domain of scholarship activities where a cohesive system of organized and aligned work activities integrates 10 years of team efforts and provides guidance for future research.     

Ethical and scientific issues of nanotechnology in the workplace

In the absence of scientific clarity about the potential health effects of occupational exposure to nanoparticles, a need exists for guidance in decisionmaking about hazards, risks, and controls. An identification of the ethical issues involved may be useful to decision makers, particularly employers, workers, investors, and health authorities. Because the goal of occupational safety and health is the prevention of disease in workers, the situations that have ethical implications that most affect workers have been identified. These situations include the a) identification and communication of hazards and risks by scientists, authorities, and employers; b) workers' acceptance of risk; c) selection and implementation of controls; d) establishment of medical screening programs; and e) investment in toxicologic and control research. The ethical issues involve the unbiased determination of hazards and risks, nonmaleficence (doing no harm), autonomy, justice, privacy, and promoting respect for persons. As the ethical issues are identified and explored, options for decision makers can be developed. Additionally, societal deliberations about workplace risks of nanotechnologies may be enhanced by special emphasis on small businesses and adoption of a global perspective.     

女工职业健康现况概述

该文对传统行业、新兴行业中存在的职业有害因素对女工健康的影响进行了概述,阐述了职业有害因素对女工生殖系统、女工子代及其他系统功能的影响。同时对外来女工的职业健康状况进行了概述,提出女工职业健康现况亟待解决的问题很多,以期引起进一步的关注和研究。