Ramazzini; Blog on work and health by Annet Lenderink

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Legislation helps prevention

One of the most difficult things in Occupational Health is show that preventive measures really have impact on the incidence of work-related disease. In an interesting study by Jill Stocks et al. data of the registries for occupational diseases in the UK are used to study the influence of European legislation on reducing chromate exposure in cement. They found a steeper decline in allergic contact dermatitis attributed to chromate than for other types of allergic contact dermatitis after introduction of the legislation.

S J Stocks, R McNamee, S Turner, M Carder, R M Agius Has European Union legislation to reduce exposure to chromate in cement been effective in reducing the incidence of allergic contact dermatitis attributed to chromate in the UK? Occup Environ Med2012;69:150-152 Read the rest of this entry »

Filed under: Allergies, Chemical agents, Skin, , , ,

Suggestive relation between multiple myeloma and chlorinated solvent exposure

The relationship between multiple myeloma and occupational exposure to six chlorinated solvents
Laura S Gold et al. 2011

Evidence from a relatively large case-control study (181 cases (71% response) vs. 481 controls (52% response)) suggests that exposures to certain chlorinated solvents may be associated with increased incidence of multiple myeloma; however, the study is limited by relatively low participation (52%) among controls

What this paper adds:

  • The aetiology of multiple myeloma is poorly understood.

  • The purpose of this research was to examine relationships between occupational exposures to chlorinated solvents and multiple myeloma.
  • This research provides evidence that certain chlorinated solvents, most notably trichloroethylene, are associated with increased incidence of multiple myeloma.

  • While results were less clear, exposure to 1,1,1-trichloroethane, methylene chloride, perchloroethylene, carbon tetrachloride and chloroform also conferred increased risk of multiple myeloma in our population. Read the rest of this entry »

Filed under: Chemical agents, Occupational cancer, ,

Exposure to neurotoxic solvents may influence blue-yellow color vision in aircraft maintenance workers

Australian researchers studied the possible persisting effects to color vision of exposure to formulations containing neurotoxins during F-111 fuel tank maintenance. They studied 3 groups: 512 exposed personnel, 458 technical-trade comparisons, and 330 non-technical comparisons. Forty five percent of all participants had blue-yellow color deficient vision (CDV) in at least one eye. Deficiencies of this nature are caused by environmental exposures. There were statistically significant differences in CCI a blue-yellow confusion in the exposed group versus technical group (odds ratio 1.4: 95% CI 1.1–1.7). No differences were observed between the exposed group and the non-technical group. The researchers concluded that the results indicate reduced color discrimination among the exposed subjects compared to one of two control groups. The findings may be due to previous exposure to solvents among the air force personnel

Maya Guest et al. 2010, Impairment of color vision in aircraft maintenance workers
International Archives of Occupational and Environmental Health (13 November 2010), pp. 1-11 Read the rest of this entry »

Filed under: Chemical agents, , ,

Bakery employees at risk for work-related allergies

NIOSH study confirms that despite all the knowledge on the risks of exposure to flour, employees of large commercial bakeries are still at risk of sensitization and respiratory symptoms from exposure to high levels of bakery associatied antiges (BAA). Higher exposure comes with more work-related symptoms. Read the rest of this entry »

Filed under: Allergies, Asthma, Chemical agents, , ,

Gas from freight containers risk to harbour employees

Residues of pesticide fumigants and toxic industrial chemicals in freight containers represent a health hazard to employees and consumers, especially since freight containers are sealed for transport and distributed widely throughout the importing countries before being opened for unloading.

We investigated 2113 freight containers arriving at the second largest container terminal in Europe, Hamburg, Germany, over a 10-week period in 2006. The countries of origin, type of contents and the pesticide fumigation history declared on labels attached to the container were recorded.

We determined that 1478 (70%) containers were contaminated with toxic chemicals above chronic reference exposure levels; 761 (36%) even exceeded the higher acute reference exposure level thresholds. Benzene and/or formaldehyde contamination was 4-times greater than for fumigants.

Our findings indicate a health risk for dockworkers, container unloaders and even end-consumers, especially as many of the cancerogenic or toxic gases elude subjective detection.

High frequency of fumigants and other toxic gases in imported freight containers—an underestimated occupational and community health risk
Xaver Baur, Bernd Poschadel, Lygia Therese Budnik
Occup Environ Med 2010;67:207-212

Filed under: Accidents, Chemical agents, Occupational exposure, ,

Which low molecular weight chemicals potentially cause allergy?

Until now there is no agreed protocol for the prediction of low molecular weight (LMW) respiratory sensitizers. To assess the validaty of a previously published quantitative structure–activity relationship (QSAR) model for the prediction of novel chemical respiratory sensitizers research was done on already known asthmagenic (28) and control chemicals (129). 

The area under the receiver operating characteristic (ROC) curve for the model’s ability to distinguish asthmagens from controls was 0.87 (95% CI 0.76–0.97). With a cut-off hazard index of 0.5 resulting in sensitivity of 79% and specificity of 93%.  The ROC curve for this QSAR demonstrates good global predictive power for distinguishing asthmagenic from non-asthmagenic LMW organic compounds. This makes QSAT potentially useful for occupational and respiratory physicians.

Further validation of computer-based prediction of chemical asthma hazard
 Seed, M., Agius, R. Occupational Medicine 2010 60(2):115-120 Read the rest of this entry »

Filed under: Asthma, Chemical agents, New occupational risks, , ,

Combined exposure to Noise and Ototoxic Substances

Review by the European Agency for Safety and Health at Work

Noise-induced hearing loss remains one of the most prominent occupational diseases in Europe. However, noise is no longer perceived as the only source of work-related hearing damage and increasing attention is being paid to the risks of combined exposure to high-level noise and ototoxic substances.

Ototoxic substances are chemicals which can affect the structures and/or the function of the inner ear and the associated signal transmission pathways in the nervous system. This publication aims to provide an up-to-date picture of our knowledge in this field.

It includes: a description of the basic features of the physiological mechanisms leading to hearing impairment, current diagnostic tools, and an overview of the chemicals that may be deleterious to the inner ear, ranking the certainty of their ototoxic properties in a defined weight-of-evidence approach.

The review also identifies the health effects resulting from exposure to multiple ototoxic substances and also from the interaction of ototoxic substances and noise, pointing out the work areas where exposure to ototoxic substances is likely. Finally, the report highlights gaps in our current knowledge for proposed future action and research.

Filed under: Chemical agents, Hearing loss, Noise, , ,

Increasing prevalence of pneumoconiosis in US coal miners

Retrospective assessment of chest x-rays from 90,973 underground coal miners from Kentucky, Virginia, and West Virginia showed an increasing prevalence of pneumoconiosis over the past decade.

R-type opacities increased in the 1990s (PR=2.5; 95% CI=1.7–3.7) and after 1999 (PR=4.1; 95% CI=3.0–5.6) compared to the 1980s (adjusted for profusion category and miner age).

The prevalence of progressive massive fibrosis in 2000-2008 was also elevated compared to the 1980’s (PR=4.4; 95% CI=3.1–6.3) and 1990’s (PR=3.8; 95% CI=2.1–6.8).

The change in the epidemiology and disease profile documented in this and other recent studies imply that U.S. coal miners are being exposed to excessive amounts of respirable crystalline silica.

Pneumoconiosis among underground bituminous coal miners in the United States: is silicosis becoming more frequent?
A Scott Laney (aol4@cdc.gov)
Occup Environ Med doi:10.1136/oem.2009.047126 Read the rest of this entry »

Filed under: Chemical agents, lung, ,

Silica exposure occupational cause of systemic sclerosis?

Systemic sclerosis is a rare chronic disease of unknown cause characterized by diffuse fibrosis, degenerative changes, and vascular abnormalities in the skin, joints, and internal organs (especially the esophagus, lower GI tract, lung, heart, and kidney). Common symptoms include Raynaud’s syndrome, polyarthralgia, dysphagia, heartburn, and swelling and eventually skin tightening and contractures of the fingers. Lung, heart, and kidney involvement accounts for most deaths.

Researchers from the University of Toledo (USA) examined the association between systemic sclerosis (SSc) and occupational exposure to silica. They included 16 studies in the analysis and calculated the combined estimator of relative risk (CERR) and 95% confidence interval (CI) using fixed or random effect models. The findings suggest that silica exposure may be a significant risk factor for developing SSc and specifically in males: the overall CERR was 3.20 (95% CI, 1.89–5.43), in females 1.03 (95% CI, 0.74–1.44), in males 3.02 (95% CI, 1.24–7.35).

Occupational silica exposure as a risk factor for scleroderma: a meta-analysis
Zachary D. McCormic, Sura S. Khuder, Bishwa K. Arya1, April L. Ames and Sadik A. Khuder International Archives of Occupational and Environmental Health Online: 3 January 2010 Read the rest of this entry »

Filed under: Chemical agents, Occupational diseases, Occupational exposure, Skin, ,

Dangerous oxygen depletion risk in transportation of wood

There are several articles on the risks that can occur during the transportation of timber. My colleague Gert van der Laan published a article in Dutch on our website, from which I quote here:

Oxygen Deficit fatal in bulk transportation of timber

“In two years time occurred in Swedish ports five fatal cases and several incidents during the unloading of bulk carriers to blocks and wood chips / wood logs. In all cases, the victims descended into stairwells in the vessels directly connected to the bulk space stood. On 10 ships there were more than forty different measurements taken at different times. The average oxygen level was 10%, but in 17% of the measurements showed the oxygen level decreased to 0%! Although during the winter the oxygen reduction was less pronounced, even then there was an incident with fatalities for. there were on average 46 hours between loading and unloading and although there were different woods, the microbiological activity was highest in samples of fresh wood chips and bark. The conclusion is that transport of timber in confined spaces can cause severe hypoxia and CO2 formation can occur.”

Relevant articles:
Oxygen depletion and formation of toxic gases following sea tranportation of logs and wood chips
Svedberg U, Petrini C, Johanson G.
Ann. Occup. Hyg. 53; 799-787, 2009

Rate and Peak Concentrations of Off-Gas Emissions in Stored Wood Pellets—Sensitivities to Temperature, Relative Humidity, and Headspace Volume
Xingya Kuang, Tumuluru Jaya Shankar1, Xiaotao T. Bi1, C. Jim Lim1, Shahab Sokhansanj and Staffan Melin
Annals of Occupational Hygiene 2009 53(8):789-796; doi:10.1093/annhyg/mep049

Emission of Volatile Aldehydes and Ketones from Wood Pellets under Controlled Conditions
Mehrdad Arshadi, Paul Geladi, Rolf Gref and Pär Fjällström
Annals of Occupational Hygiene 2009 53(8):797-805; doi:10.1093/annhyg/mep058

Filed under: Accidents, Chemical agents, Occupational exposure, ,

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Annet Lenderink

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