2016-02-01 12:00 - Messages

Risk of Pancreatic Cancer in Female Textile Workers in Shanghai, China, Exposed to Metals, Solvents, Chemicals, and Endotoxin

Follow-Up to a Nested Case-Cohort Study
Objective: We studied associations between pancreatic cancer and occupational exposures to metals, solvents, chemicals, and endotoxin in a cohort of female textile workers in Shanghai, China. To assess the longer-term influences of these agents on pancreatic cancer we extended follow-up of this previously studied cohort.
Methods: We utilized a job exposure matrix to assess occupational exposures for 481 pancreatic cancer cases and a randomly selected sub-cohort of 3191 non-cases. We calculated hazard ratios and 95% confidence intervals using Cox proportional hazards modeling adapted for the case-cohort design.
Results: We observed a statistically significant trend of increasing hazard ratios associated with solvent exposure, but no associations with any of the remaining occupational exposures, including endotoxin and metals.
Conclusions: Our findings of increasing risk of pancreatic cancer with solvent exposures are consistent with published literature.

Source: Reul, Nicholas K.; Li, Wenjin; Gallagher, Lisa G.; Ray, Roberta M.; Romano, Megan E.; Gao, Daoli; Thomas, David B.; Vedal, Sverre; Checkoway, Harvey. Journal of Occupational & Environmental Medicine: February 2016, Volume 58, Issue 2, p. 195-199.
http://dx.doi.org/10.1097/JOM.0000000000000596

Health Effects of Electromagnetic Fields on Reproductive-Age Female Operators of Plastic Welding Machines in Fuzhou, China

Objective: The aim of this study was to investigate the health effects of electromagnetic fields (EMFs) among female operators of plastic welding machines.
Methods: We examined 180 female operators in shoe factories as the exposed group, and 349 female workers from nearby supermarkets as the unexposed group.
Results: The mean radiation levels in the vicinity of the welding machines ranged from 51.3 to 368.9?V/m. The prevalence of neurovegetative symptoms increased with higher EMFs exposures (P?<?0.05). The prevalence of menstrual disorder was 12.0% in the unexposed group, but was 26.8% and 33.8% in low and high-exposure groups, respectively (P?<?0.01). Exposure–response relationships were found between cumulate exposure and neurovegetative symptoms and menstrual disorder (P?<?0.05). Serum progesterone (P4) was significantly lower in the exposed groups (P?<?0.01).
Conclusions: EMFs exposure was associated with adverse health effects, including neurovegetative symptoms, menstrual disorder, and low level of P4.

Source: Xu, Youqiong; Zhang, Xiaoyang; Chen, Yu; Ren, Nan; Lin, Wei; Zhang, Qunwei. Journal of Occupational & Environmental Medicine: February 2016, Volume 58, Issue 2, p. 148-153.
http://dx.doi.org/10.1097/JOM.0000000000000581

Occupational Exposure Limits – State of the Science

The process of developing and using occupational exposure limits is a cornerstone of industrial hygiene practice, with a history dating back to the 1880s. Occupational exposure limits, known as OELs, have not—until recently—evolved enough to reflect the advances in related sciences of toxicology, risk assessment, and exposure assessment. Much of the pioneering effort to develop and promote OELs as a risk management strategy occurred in the 1940s, when an organization now known as the American Conference of Governmental Industrial Hygienists (ACGIH) created a list of occupational exposure limits for 132 specific chemicals. While these limits represented a significant step forward in the practice of occupational hygiene, they lacked consistent guidelines, explicit definitions, and technical documentation. Gradually, these OELs and others have evolved to consider toxicological mechanisms of action, and uncertainties associated with the data available for assessing specific chemical hazards. Yet, there has still not been a concerted effort to explore how advances in toxicology, risk assessment, and exposure and risk management might better inform consistent and transparent processes for assessing chemical hazards and establishing OELs. To begin to tackle these issues, researchers at the National Institute for Occupational Safety and Health (NIOSH) worked with outside subject matter experts. They developed a collection of 10 articles published in the Journal of Occupational and Environmental Hygiene [JOEH, December 2015] focusing on the underlying principles for developing and interpreting OELs. The articles also discuss using and interpreting OELs in the context of evolving occupational risk assessment and management practices.

Source: http://blogs.cdc.gov/niosh-science-blog/2016/02/22/oels/

Occupational exposure levels of bioaerosol components are associated with serum levels of the acute phase protein Serum Amyloid A in greenhouse workers

BACKGROUND: Occupational exposure to particles may be associated with increased inflammation of the airways. Animal experiments suggest that inhaled particles also induce a pulmonary acute phase response, leading to systemic circulation of acute phase proteins. Greenhouse workers are exposed to elevated levels of bioaerosols. The objective of this study is to assess whether greenhouse workers personal exposure to bioaerosol components was associated with serum levels of the acute phase proteins Serum Amyloid A (SAA) and C-reactive protein (CRP). METHODS: SAA and CRP levels were determined in serum sampled repeatedly from 33 greenhouse workers. Blood was drawn repeatedly on Mondays and Thursdays during work weeks. Acute phase protein levels were compared to levels in a comparison group of 42 people and related to individual exposure levels to endotoxin, dust, bacteria, fungi and beta-glucan. RESULTS: Serum levels of SAA and CRP were not significantly different in greenhouse workers and a reference group, or on the two work days. In a mixed model, SAA levels were positively associated with endotoxin exposure levels (p = 0.0007). Results for fungi were not clear. CRP levels were positively associated with endotoxin exposures (p = 0.022). Furthermore, when workers were categorized into three groups based on SAA and CRP serum levels endotoxin exposure was highest in the group with the highest SAA levels and in the group with middle and highest CRP levels. SAA and CRP levels were elevated in workers with asthma. CONCLUSION: Greenhouse workers did not have elevated serum levels of SAA and CRP compared to a reference group. However, occupational exposure to endotoxin was positively associated with serum levels of the acute phase proteins SAA and CRP. Preventive measures to reduce endotoxin exposure may be beneficial.

Source: Anne Mette Madsen, Trine Thilsing, Jesper Bælum, Anne Helene Garde and Ulla Vogel. Environmental Health, 2016, 15: 9.
http://dx.doi.org/10.1186/s12940-016-0090-7

Single and Combined Exposure to Zinc- and Copper-Containing Welding Fumes Lead to Asymptomatic Systemic Inflammation

Objective: Recently, it has been shown that exposure to welding fumes containing both zinc and copper leads to asymptomatic systemic inflammation in humans as shown by an increase of blood C-reactive protein. In the present study, it was investigated which metal is responsible for this effect.
Methods: Fifteen healthy male subjects were exposed under controlled conditions to welding fumes containing either zinc, or copper, or copper and zinc.
Results: For each exposure blood C-reactive protein increased.
Conclusions: Copper- and zinc-containing welding fumes are able to induce systemic inflammation.

Source: Markert, Agnieszka; Baumann, Ralf; Gerhards, Benjamin M.; Gube, Monika; Kossack, Veronika; Kraus, Thomas; Brand, Peter. Journal of Occupational & Environmental Medicine: February 2016, Volume 58, Issue 2, p. 127-132.
http://dx.doi.org/10.1097/JOM.0000000000000652

Criteria for a Recommended Standard: Occupational Exposure to Heat and Hot Environments

Occupational exposure to heat can result in injuries, disease, reduced productivity, and death. To address this hazard, the National Institute for Occupational Safety and Health (NIOSH) has evaluated the scientific data on heat stress and hot environments and has updated the Criteria for a Recommended Standard: Occupational Exposure to Hot Environments. This document was last updated in 1986, and in recent years, including during the Deepwater Horizon oil spill response of 2010, questions were raised regarding the need for revision to reflect recent research and findings. This revision includes additional information about the physiological changes that result from heat stress; updated information from relevant studies, such as those on caffeine use; evidence to redefine heat stroke and associated symptoms; and updated information on physiological monitoring and personal protective equipment and clothing that can be used to control heat stress.

Source: http://www.cdc.gov/niosh/docs/2016-106/

Health and Safety Risks for Workers Involved in Manual Tank Gauging and Sampling at Oil and Gas Extraction Sites

The National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) have identified health and safety risks to workers who manually gauge or sample fluids on production and flowback tanks from exposure to hydrocarbon gases and vapors, exposure to oxygen-deficient atmospheres, and the potential for fires and explosions.

Source: http://www.cdc.gov/niosh/docs/2016-108/default.html

Prostate cancer risk among French farmers in the AGRICAN cohort

Objectives: Prostate cancer is one of the most frequent cancers among men worldwide. Its etiology is largely unknown, but an increased risk has been repeatedly observed among farmers. Our aim was to identify occupational risk factors for prostate cancer among farmers in the prospective cohort study AGRICAN.
Methods: Data on lifetime agricultural exposures (type of crops, livestock and tasks including pesticide use, re-entry and harvesting) were collected from the enrolment questionnaire. During the period from enrolment (2005–2007) to 31 December 2009, 1672 incident prostate cancers were identified. Hazard ratios (HR) were estimated using Cox regression analysis.
Results: We found an increased risk for cattle breeders using insecticides [HR 1.20, 95% confidence interval (95% CI) 1.01–1.42] with a significant dose–response relationship with number of cattle treated (P for trend 0.01). A dose–response relationship was also observed with the number of hogs (P for trend 0.06). We found an excess of prostate cancer risk among people involved in grassland activities, mainly in haymaking (HR 1.18, 95% CI 1.02–1.36). Pesticide use and harvesting among fruit growers were associated with an elevated prostate cancer risk, with a two-fold increased risk for the largest area. For potato and tobacco producers, an elevated prostate cancer risk was observed for almost all tasks, suggesting a link with pesticide exposure since all of them potentially involved pesticide exposure.
Conclusions: Our analysis suggests that the risk of prostate cancer is increased in several farming activities (cattle and hog breeding, grassland and fruit-growing) and for some tasks including pesticide use.

Source: Lemarchand C, Tual S, Boulanger M, Levêque-Morlais N, Perrier S, Clin B, Guizard A-V, Velten M, Rigaud E, Baldi I, Lebailly P. Scand J Work Environ Health, 2016. 
http://dx.doi.org/10.5271/sjweh.3552

Size-resolved characterization of particles and fibers released during abrasion of fiber-reinforced composite in a workplace influenced by ambient background sources

We demonstrate the use of high- to low-resolution microscopy and particle chemical analysis during normal vacuum and cryo-conditions to identify the nature and relative abundances of process-generated particles and fibers from sanding of a glass and carbon fiber epoxy layer-composite in a workplace influenced by both indoor and ambient background sources. The study suggests that a proper exposure characterization requires multiple techniques covering wide size ranges to reach a conclusion. Besides a rise in number concentration due to release of particles during the sanding, a significant contribution of ambient particles to the background in the production facility was observed in the sub-micron size range. Fibers are posing a dominant exposure risk in the micron size range, with carbon fibers dominating in count.

Source: Kirsten I. Kling, Marcus Levin, Alexander C.Ø. Jensen, Keld A. Jensen, Ismo K. Koponen. Aerosol and Air Quality Research, January 2016, Volume 16, No. 1, p. 11-24. 
http://dx.doi.org/10.4209/aaqr.2015.05.0295 

Magnitude and characteristics of acute paraquat- and diquat-related illnesses in the US: 1998–2013

Background: Paraquat and diquat are among the most commonly used herbicides in the world.
Objectives: Determine the magnitude, characteristics, and root causes for acute paraquat- and diquat-related illnesses in the US
Methods: Illnesses associated with paraquat or diquat exposure occurring from 1998 through 2011 were identified from the Sentinel Event Notification System for Occupational Risks (SENSOR)-Pesticides Program, the California Department of Pesticide Regulation (CDPR) Pesticide Illness Surveillance Program (PISP), and the Incident Data System (IDS). Cases identified by the National Poison Data System (NPDS) were reviewed for the years 1998–2003 and 2006–2013.
Results: A total of 300 paraquat- and 144 diquat-related acute illnesses were identified by SENSOR, PISP, and IDS. NPDS identified 693 paraquat- and 2128 diquat-related acute illnesses. In SENSOR/PISP/IDS, illnesses were commonly low severity (paraquat=41%; diquat=81%); however, SENSOR/PISP/IDS identified 24 deaths caused by paraquat and 5 deaths associated with diquat. Nineteen paraquat-related deaths were due to ingestion, seven of which were unintentional, often due to improper storage in beverage bottles. In SENSOR/PISP/IDS, paraquat and diquat-related acute illnesses were work-related in 68% (n=203) and 29% (n=42) of cases, respectively. When herbicide application site was known, the vast majority of acute paraquat-related illnesses (81%) arose from agricultural applications. Common root causes of illness were failure to use adequate personal protective equipment (PPE), application equipment failure, and spill/splash of herbicide.
Conclusions: Although the magnitude of acute paraquat/diquat-related illnesses was relatively low, several fatalities were identified. Many illnesses could be prevented through stricter compliance with label requirements (e.g. ensuring proper herbicide storage and PPE use), and through enhanced training of certified applicators.

Source: Gamola Z. Fortenberrya, John Beckmanb, Abby Schwartzd, Joanne Bonnar Pradoe, Lucia S. Grahamf, Sheila Higginsg, Michelle Lackovich, Prakash Mulayi, Heidi Bojesj, Justin Waltzk, Yvette Mitchelll, Kathy Leinenkugelm, Michel S. Orielf, Elizabeth Evansn, Geoffrey M. Calvert. Environmental Research, Volume 146, April 2016, p. 191-199.
http://dx.doi.org/10.1016/j.envres.2016.01.003

A review of the evidence for occupational exposure risks to novel anticancer agents

Introduction: Evidence of occupational exposure risks to novel anticancer agents is limited and yet to be formally evaluated from the Australian healthcare perspective.
Methods: From March to September 2013 medical databases, organizational policies, drug monographs, and the World Wide Web were searched for evidence relating to occupational exposure to monoclonal antibodies, fusion proteins, gene therapies, and other unclassified novel anticancer agents.
Results: Australian legislation, national and international guidelines, and drug company information excluded novel agents or provided inconsistent risk assessments and safe handling recommendations. Monoclonal antibody guidelines reported conflicting information and were often divergent with available evidence and pharmacologic rationale demonstrating minimal internalisation ability and occupational exposure risk. Despite similar physiochemical, pharmacologic, and internalisation properties to monoclonal antibodies, fusion proteins were included in only a minority of guidelines. Clinical directives for the safe handling of gene therapies and live vaccines were limited, where available focusing on prevention against exposure and cross-contamination. Although mechanistically different, novel small molecule agents (proteasome inhibitors), possess similar physiochemical and internalisation properties to traditional cytotoxic agents warranting cytotoxic classification and handling.
Conclusion: Novel agents are rapidly emerging into clinical practice, and healthcare personnel have few resources to evaluate risk and provide safety recommendations. Novel agents possess differing physical, molecular and pharmacological profiles compared to traditional cytotoxic anticancer agents. Evaluation of occupational exposure risk should consider both toxicity and internalisation. Evidence-based guidance able to direct safe handling practices for novel anticancer agents across a variety of clinical settings is urgently required.

Source: King, Julie, Alexander, Marliese, Byrne, Jenny, MacMillan, Kent, Mollo, Adele, Kirsa, Sue, & Green, Michael. (2016). Journal of Oncology Pharmacy Practice, 22(1), 121-134.
http://dx.doi.org/10.1177/1078155214550729

Statistics Western Australia: Lead levels in blood 1994-2015

The WA Occupational Safety and Health Regulations (1996) require that health surveillance, including blood lead level tests, is provided to workers undertaking lead risk work. This report summarises these results by calendar year for the period 1 January 1994 – 15 May 2015 (date of test).

Source: http://www.commerce.wa.gov.au/publications/statistics-western-australia-lead-levels-blood-1994-2015

DEMETER : 14 nouvelles fiches publiées

14 nouvelles fiches ont été publiées dans le guide DEMETER (Documents pour l'évaluation médicale des produits toxiques vis-à-vis de la reproduction), qui en contient désormais près de 150. Destiné en particulier aux médecins du travail, ce guide a pour but de fournir une aide à l'évaluation du risque pour la reproduction lors d'exposition d'hommes ou de femmes en milieu professionnel à des produits chimiques. Chaque fiche contient des informations sur les dangers vis-à-vis de la reproduction, pour permettre au médecin d'évaluer le risque dû à l'exposition en fonction de sa période de survenue (avant la conception, pendant la grossesse ou l'allaitement). Des propositions de conduite à tenir sont fournies.

Source: http://www.rst-sante-travail.fr/rst/header/actualites/demeter.html

Mise à jour de la norme servant à mesurer l’exposition aux rayonnements

La récente mise à jour de la norme ISO 15382:2015 "Radioprotection - Procédures pour la surveillance des doses au cristallin, à la peau et aux extrémités" se concentre sur la réalisation d'une mesure juste de l'exposition aux rayonnements ionisants pour une situation donnée. Elle prend en considération les enseignements tirés des plus récentes études et permet d'améliorer les mesurages de routine en matière de dosimétrie.
Les rayonnements ionisants sont utilisés dans nombre d'applications et de secteurs, notamment pour les diagnostics médicaux et la radiothérapie, l'énergie nucléaire, les systèmes de détection à rayons X dans les aéroports, voire la prospection géologique. Les limites de sécurité en matière d'exposition aux rayonnements demeurent une question complexe, car chaque organe du corps réagit différemment. Par exemple, la peau doit être protégée contre les réactions tissulaires, telles que l'ulcération, alors que la surexposition du cristallin peut donner lieu à des cataractes.

Source: http://eurogip.fr/fr/eurogip-infos-actu?id=4166

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