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British Journal Of Industrial Medicine[JOURNAL]

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A case-control study of occupational risk factors for laryngeal cancer.

Wortley P, Vaughan TL, Davis S … +2 more , Morgan MS, Thomas DB

Br J Ind Med · 1992 Dec · PMID 1472441 · Full text

To determine whether specific jobs and occupational exposures are associated with laryngeal cancer lifetime occupational histories from a population-based case-control study in western Washington were examined. The study... To determine whether specific jobs and occupational exposures are associated with laryngeal cancer lifetime occupational histories from a population-based case-control study in western Washington were examined. The study included 235 cases diagnosed between September 1983 and February 1987, and 547 controls identified by random digit dialing. After controlling for alcohol use, cigarette smoking, age and education, significantly increased risks were found for painters in construction (odds ratio (OR)) = 2.8, (95% confidence interval (95% CI) 1.1-6.9), supervisors and miscellaneous mechanics (OR = 2.3, 95% CI 1.1-4.8), construction workers (OR = 3.4, 95% CI 1.4-8.1), metalworking and plastic working machine operators (OR = 2.6, 95% CI 1.3-4.9) and handlers, and equipment cleaners and labourers (OR = 1.5, 95% CI 1.0-2.2). Allowing for a 10 year induction and latent period did not have a consistent effect on the associations. Potential exposures to asbestos, chromium, nickel, formaldehyde, diesel fumes, and cutting oils were assessed by using a job exposure matrix developed for this study. Three measures of exposure were examined--namely, peak, duration, and an intensity weighted exposure score. No significantly raised risks were seen, although increased risk was suggested among those exposed long term to formaldehyde in jobs with the highest exposures.

Health hazard of poorly regulated exposure during manufacture of cemented tungsten carbides and cobalt.

Auchincloss JH, Abraham JL, Gilbert R … +4 more , Lax M, Henneberger PK, Heitzman ER, Peppi DJ

Br J Ind Med · 1992 Dec · PMID 1472440 · Full text

Forty two of 125 former workers in a factory in Syracuse, New York, which manufactured hard metal parts from tungsten carbide and cobalt, were studied by chest radiographs, spirometry, and plethysmographically determined... Forty two of 125 former workers in a factory in Syracuse, New York, which manufactured hard metal parts from tungsten carbide and cobalt, were studied by chest radiographs, spirometry, and plethysmographically determined lung volumes. The plant was closed in 1982 and the studies were performed in 1983-5. Recorded measurements of carbide dust concentrations were only mildly excessive by modern standards, but deceitful efforts to reduce the apparent concentration of dust were known to have occurred during an inspection by the Occupational Safety and Health Administration. Lung biopsies in four cases in the study and necropsy in one of the 83 cases not studied during life showed giant cell interstitial pneumonia and appreciable concentrations of tungsten carbide. This information indicates that exposure was substantial. Four workers had evidence of pulmonary fibrosis by chest radiographs; two of these workers had normal pulmonary function. Fourteen had abnormal pulmonary function, five of whom had a restrictive pattern, eight a pattern of air trapping, and one a combined pattern. Thus radiographic, or functional abnormalities, or both occurred in 16 of the 42 cases studied. No correlation with duration of exposure was established. Progressive clinically important disease (one fatal) has been found in four ex-workers, two in each of the restrictive and air trapping groups. These findings suggest that poorly regulated dust concentrations in a hard metals factory possibly cause pulmonary abnormalities and sometimes severe illness.

The histocompatibility antigen in asbestos related disease.

Al Jarad N, Uthayakumar S, Buckland EJ … +4 more , Green TS, Ord J, Newland AC, Rudd RM

Br J Ind Med · 1992 Dec · PMID 1472439 · Full text

Thirty nine phenotypes of human leucocyte antigens (HLA)-A-B-DR and DQ were obtained from 99 asbestos workers (one woman and 98 men). Presence or absence of antinuclear antibodies and rheumatoid factor was determined in... Thirty nine phenotypes of human leucocyte antigens (HLA)-A-B-DR and DQ were obtained from 99 asbestos workers (one woman and 98 men). Presence or absence of antinuclear antibodies and rheumatoid factor was determined in 91 of them. Workers were divided into five groups: asbestos workers with no apparent disease (AW; n = 17), diffuse benign pleural disease (PD; n = 31), asbestosis (AS; n = 24), asbestosis with lung cancer (AS-CA; n = 14), and mesothelioma (M; n = 13). Compared with AW, several trends of differences of HLA antigen prevalence were found in patients with asbestos related disease, but these did not achieve statistical significance when p was corrected (pcorr) by number of analyses undertaken. Analysis of the results obtained in previous studies together with the results of this study showed that compared with AW, AS patients had decreased prevalence of HLA-DR5 (pcorr < 0.02). Reasons for the differences in results of previous studies and statistical methods commonly used to compare prevalences of HLA antigen are discussed.

Psychiatric disorders and occupational exposure to solvents.

Labrèche FP, Cherry NM, McDonald JC

Br J Ind Med · 1992 Dec · PMID 1472438 · Full text

Three hundred and eighty one men admitted to hospital for the first time with any psychiatric diagnosis were individually matched for age and year to patients admitted to general hospitals. An occupational history was ob... Three hundred and eighty one men admitted to hospital for the first time with any psychiatric diagnosis were individually matched for age and year to patients admitted to general hospitals. An occupational history was obtained from 90% of this study group by telephone interview or mail. Exposure to solvents was assessed by three methods, individual rating of each job recorded, application of an exposure matrix based on job title, and assessment of lifetime job histories of selected case-referent pairs. A sample of individual ratings used in the analysis was compared with ratings made by five experts. The panel values tended to be lower but all six sets of ratings correlated well. There was no increased risk of psychiatric illness among subjects exposed to moderate or greater solvent concentrations for at least 10 years (odds ratio (OR) 1.0, 90% confidence interval (90% CI) 0.7-1.4, individual rating; OR 1.1, 90% CI 0.6-2.0, job title matrix; OR 0.9, 90% CI 0.5-1.7, lifetime assessments). At higher exposures the risk was increased--although not to a statistically significant degree--especially for cases with non-psychotic diagnoses (ICD-9 codes 300-316). This negative result, by all three methods of assessment of exposure, contrasted with that from a parallel investigation of cases of organic psychoses and cerebral degeneration.

Preventing occupational asthma.

Venables KM

Br J Ind Med · 1992 Dec · PMID 1472437 · Full text

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Renal and immunological effects of occupational exposure to inorganic mercury.

Nuyts GD, De Broe ME

Br J Ind Med · 1992 Dec · PMID 1298271 · Full text

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Agglutination of lung surfactant with glucan.

De Lucca AJ, Brogden KA, French AD

Br J Ind Med · 1992 Nov · PMID 1463675 · Full text

Respirable cotton dust, implicated in the pathogenesis of byssinosis, contains a number of bioactive compounds. These include lipopolysaccharide (LPS), tannins, bacterial peptides, byssinosin, iacinilene C, and 1,3-beta-... Respirable cotton dust, implicated in the pathogenesis of byssinosis, contains a number of bioactive compounds. These include lipopolysaccharide (LPS), tannins, bacterial peptides, byssinosin, iacinilene C, and 1,3-beta-D-glucan. The exact aetiological agent of byssinosis in such dust has not been definitively identified nor has its mechanism of action on lower lung surfaces been determined. In the present study 1,3-beta-D-glucan, Enterobacter agglomerans LPS, and ovine pulmonary surfactant were mixed in varying combinations. After incubation, their characteristics were determined by sucrose density centrifugation, TLC, and carbohydrate analysis. Precipitates were found in mixtures containing surfactant-glucan and surfactant-glucan-LPS, but not in surfactant-LPS. Precipitates were not seen in the surfactant, LPS, and glucan controls. The formation of a precipitate did not increase the density of the surfactant glucan mixture when compared by density gradient centrifugation with the surfactant control. The interaction between surfactant and glucan was analysed by molecular modelling. The energy of a surfactant-glucan complex (60.07 kcal/mol) was calculated to be much lower than the sum of glucan (47.09 kcal/mol) and surfactant (30.98 kcal/mol) when added separately. The results indicate that 1,3-beta-D-glucan does interact with surfactant and this complex may play a part in the pathogenesis of byssinosis by altering lung physiology maintained by pulmonary surfactant.

Sex differences in the risk of multiple myeloma associated with agriculture.

Zahm SH, Blair A, Weisenburger DD

Br J Ind Med · 1992 Nov · PMID 1463686 · Full text

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Cigarette smoking and small irregular opacities.

Lee WR

Br J Ind Med · 1992 Nov · PMID 1463685 · Full text

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Lymphocyte subsets in subjects exposed to asbestos: changes in circulating natural killer cells.

al Jarad N, Macey M, Uthayakumar S … +2 more , Newland AC, Rudd RM

Br J Ind Med · 1992 Nov · PMID 1463684 · Full text

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Fatal injury due to unrestrained vehicle load.

Teanby D

Br J Ind Med · 1992 Nov · PMID 1463683 · Full text

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Risk of spontaneous abortion in workers exposed to toluene.

Ng TP, Foo SC, Yoong T

Br J Ind Med · 1992 Nov · PMID 1463682 · Full text

Rates of spontaneous abortions were determined using a reproductive questionnaire administered by personal interview to 55 married women with 105 pregnancies. They were employed in an audio speaker factory and were expos... Rates of spontaneous abortions were determined using a reproductive questionnaire administered by personal interview to 55 married women with 105 pregnancies. They were employed in an audio speaker factory and were exposed to high concentrations of toluene (mean 88, range 50-150 ppm). These rates of spontaneous abortion were compared with those among 31 women (68 pregnancies) who worked in other departments in the same factory and had little or no exposure to toluene (0-25 ppm), as well as with a community control group of women who underwent routine antenatal and postnatal care at public maternal health clinics (190 women with 444 pregnancies). Significantly higher rates for spontaneous abortions were noted in the group with high exposure to toluene (12.4 per 100 pregnancies) compared with those in the internal control group (2.9 per 100 pregnancies) and in the external control group (4.5 per 100 pregnancies). Among the exposed women, significant differences were also noted in the rates of spontaneous abortion before employment (2.9 per 100 pregnancies) and after employment in the factory (12.6 per 100 pregnancies). Almost all the women were nonsmokers and did not drink; other known risk factors such as maternal age at pregnancy, order of gravidity, and race were not likely to explain the results. Thus, specific exposure to toluene seems to be associated with a risk of foetal loss.

Menstrual function in workers exposed to toluene.

Ng TP, Foo SC, Yoong T

Br J Ind Med · 1992 Nov · PMID 1463681 · Full text

Rates of menstrual disorders were studied in 231 female production workers with high exposure to toluene (mean 88 (range 50-150 ppm) in a factory manufacturing audio speakers and compared with a control group of 58 femal... Rates of menstrual disorders were studied in 231 female production workers with high exposure to toluene (mean 88 (range 50-150 ppm) in a factory manufacturing audio speakers and compared with a control group of 58 female production workers in other departments in the same factory who had little or no exposure to toluene (0-25 ppm). An external community control group of 187 working class women under routine care at public maternal and child health centres were also studied. Detailed menstrual and reproductive histories were obtained by personal interview using a structured questionnaire. The rates for dysfunctional uterine bleeding (cycle irregularity and prolonged or heavy menstrual bleeding) were similar in all groups. Dysmenorrhoea seemed to occur more often in the women highly exposed to toluene compared with women at maternal and child health centres, but not compared with factory controls with low exposure to toluene. There was no evidence that dysfunctional uterine bleeding was likely to result from exposure to toluene. It is uncertain whether dysmenorrhoea was associated specifically with exposure to toluene, as other behavioural and work related factors may also result in dysmenorrhoea.

A case-control study of motor neurone disease: its relation to heritability, and occupational exposures, particularly to solvents.

Gunnarsson LG, Bodin L, Söderfeldt B … +1 more , Axelson O

Br J Ind Med · 1992 Nov · PMID 1463680 · Full text

Motor neurone disease (MND) was studied in relation to various determinants in a case-control study covering nine counties in southern Sweden. A questionnaire about occupational exposures, medical history, lifestyle fact... Motor neurone disease (MND) was studied in relation to various determinants in a case-control study covering nine counties in southern Sweden. A questionnaire about occupational exposures, medical history, lifestyle factors etc was given to all cases in the age range 45-79 and to a random sample of 500 population controls in the same age range. The questionnaires were answered by 92 cases and 372 controls, a response rate of 85% and 75% respectively. Among men high Mantel-Haenszel odds ratios (MHORs) were obtained for electricity work (MHOR = 6.7, 95% confidence interval (95% CI) 1.0-32.1), welding (MHOR = 3.7, 95% CI 1.1-13.0), and impregnating agents (MHOR = 3.5, 95% CI 0.9-13.1). Heritability with regard to a neurodegenerative disease or thyroid disease seemed to predispose to a risk of developing MND (OR = 2.1, 95% CI 1.0-4.3). The highest OR was found for the combination of such heritability, exposure to solvents, and male sex (OR = 15.6, 95% CI 2.8-87.0), a combination that occurred for seven cases and three controls. Hereditary factors and external exposures had a different distribution among cases with the spinal type of MND than among cases with involvement of the pyramidal tract or bulbar paresis also.

Chronic neurobehavioural effects of elemental mercury in dentists.

Ngim CH, Foo SC, Boey KW … +1 more , Jeyaratnam J

Br J Ind Med · 1992 Nov · PMID 1463679 · Full text

Neurobehavioural tests were performed by 98 dentists (mean age 32, range 24-49) exposed to elemental mercury vapour and 54 controls (mean age 34, range 23-50) with no history of occupational exposure to mercury. The dent... Neurobehavioural tests were performed by 98 dentists (mean age 32, range 24-49) exposed to elemental mercury vapour and 54 controls (mean age 34, range 23-50) with no history of occupational exposure to mercury. The dentists were exposed to an average personal air concentration time weighted average (TWA) of 0.014 (range 0.0007-0.042) mg/m3 for a mean period of 5.5 (range 0.7-24) years and had a mean blood mercury concentration of 9.8 (range 0.6-57) micrograms/l. In neurobehavioural tests measuring motor speed (finger tapping), visual scanning (trail making), visuomotor coordination and concentration (digit symbol), verbal memory (digit span, logical memory delayed recall), visual memory (visual reproduction, immediate and delayed recall), and visuomotor coordination speed (bender-gestalt time), the performance of the dentists was significantly worse than that of the controls. The dentists scored 3.9 to 38.9% (mean 13.9%) worse in these tests. In trail making, digit span, logical memory delayed recall, visual reproduction delayed recall, and bender-gestalt time test scores were more than 10% poorer. In each of the tests in which significant differences were found and in the block design time, the performance decreased as the exposed dose (product of the TWA of air mercury concentrations and the years of exposure) increased. These results raise the question as to whether the current threshold limit value of 0.050 mg/m3 (TWA) provides adequate protection against adverse effects of mercury.

Organic brain damage and occupational solvent exposure.

Cherry NM, Labrèche FP, McDonald JC

Br J Ind Med · 1992 Nov · PMID 1463678 · Full text

Three hundred and nine men with organic dementia, cerebral atrophy, or psycho-organic syndrome admitted for five nights or more to one of 18 Quebec hospitals were individually matched with patients admitted (1) with some... Three hundred and nine men with organic dementia, cerebral atrophy, or psycho-organic syndrome admitted for five nights or more to one of 18 Quebec hospitals were individually matched with patients admitted (1) with some other psychiatric diagnosis and (2) to a general hospital. Lifetime occupational histories were obtained by telephone. Occupational exposure to solvents was assessed blind to type of case by (1) individual ratings and (2) a job exposure matrix; men who worked in moderate or high solvent concentrations for at least 10 years were considered exposed. With the psychiatric referent series, an odds ratio of 1.4 (90% CI 1.0-2.0) was calculated by individual exposure ratings and 1.4 (90% CI 0.9-2.2) by job matrix. Increased risk was mainly in those with organic dementia or cerebral atrophy and an alcohol related diagnosis. The same pattern of risk was found against the general hospital referents. Adjustment for possible confounders did not alter the risk estimates appreciably. Also, lifetime job histories, compared in selected case-referent pairs, gave similar evidence of increased risk (odds ratio 2.3; 90% CI 1.0-5.5). It is concluded that the combined effect of occupational solvent exposure and alcohol intake is probably an important cause of organic brain damage.

Allergy to methyltetrahydrophthalic anhydride in epoxy resin workers.

Nielsen J, Welinder H, Horstmann V … +1 more , Skerfving S

Br J Ind Med · 1992 Nov · PMID 1463677 · Full text

One hundred and forty four current and 26 former workers in a plant producing barrels for rocket guns from an epoxy resin containing methyltetrahydrophthalic anhydride (MTHPA; time weighted average air concentration up t... One hundred and forty four current and 26 former workers in a plant producing barrels for rocket guns from an epoxy resin containing methyltetrahydrophthalic anhydride (MTHPA; time weighted average air concentration up to 150 micrograms/m3) were studied. They showed higher frequencies of work related symptoms from the eyes (31 v 0%; p < 0.001), nose (53 v 9%; p < 0.001), pharynx (26 v 6%; p < 0.01), and asthma (11 v 0%; p < 0.05) than 33 controls. Also they had higher rates of positive skin prick test to a conjugate of MTHPA and human serum albumin (16 v 0%; p < 0.01), and more had specific IgE and IgG serum antibodies (18 v 0%; p < 0.01 and 12 v 0%; p < 0.05 respectively). There were statistically significant exposure-response relations between exposure and symptoms from eyes and upper airways, dry cough, positive skin prick test, and specific IgE and IgG antibodies. There was a non-significant difference in reaction to metacholine between exposed workers and non-smoking controls. In workers with and without specific IgE antibodies, differences existed in frequency of nasal secretion (54 v 23%; p < 0.05) and dry cough (38 v 12%; p < 0.05). Workers with specific IgG had more dry cough (38 v 12%; p < 0.05), but less symptoms of non-specific bronchial hyperreactivity (0 v 26%; p < 0.05). Atopic workers sneezed more than non-atopic workers (65 v 30%; p < 0.01). In a prospective study five sensitised workers who left the factory became less reactive to metacholine, and became symptom free. In 41 workers who stayed, there was no improvement, despite a 10-fold reduction in exposure. The results show the extreme sensitising properties of MTHPA.

Evaluation of exposure to polycyclic aromatic hydrocarbons in a coke production and a graphite electrode manufacturing plant: assessment of urinary excretion of 1-hydroxypyrene as a biological indicator of exposure.

Buchet JP, Gennart JP, Mercado-Calderon F … +3 more , Delavignette JP, Cupers L, Lauwerys R

Br J Ind Med · 1992 Nov · PMID 1463676 · Full text

OBJECTIVES: Characterisation of the airborne concentration of 13 polycyclic aromatic hydrocarbons (PAHs) at various workplaces in a graphite electrode and a coke production plant. Validation of the urinary excretion of 1... OBJECTIVES: Characterisation of the airborne concentration of 13 polycyclic aromatic hydrocarbons (PAHs) at various workplaces in a graphite electrode and a coke production plant. Validation of the urinary excretion of 1-hydroxypyrene (hydroxypyrene) as a biological marker of exposure to PAH. DESIGN: Cross sectional study of workers exposed to PAHs (106 in the graphite electrode producing plant and 16 in the coke works). METHODS: Personal air sampling during at least six hours per workshift using a glass fibre filter and a Chromosorb 102 solid sorbent tube and analysis of PAHs by high performance liquid chromatography (HPLC) and spectrofluorometric detection (SFD). Collection of spot urine samples before and after the shift and analysis of 1-hydroxypyrene by HPLC and SFD. RESULTS: The workers most exposed to PAHs were those occupied at the topside area of the coke oven plant and those working in the blending and impregnation areas of the graphite electrode producing plant (mean airborne concentration of total PAHs: 199 and 223 micrograms/m3 respectively). Except for naphthalene and perylene, the relative proportion of the different PAHs did not differ between the plants. Pyrene concentration in air was highly correlated with the total airborne PAH concentration (r = 0.83, p < 0.0001) and the correlation coefficients between hydroxypyrene concentration in postshift urine samples and pyrene or total PAHs in air were 0.67 (p < 0.0001) and 0.72 (p < 0.0001) respectively. Excretion of hydroxypyrene doubled when the exposure to pyrene in air increased 10-fold. The half life for the urinary excretion of hydroxypyrene was around 18 hours (95% confidence interval 16.1-19.8). Smoking habits only explained 2.3% of the variance in hydroxypyrene excretion compared with 45% for the pyrene concentration in air. CONCLUSION: The determination of the urinary excretion of hydroxypyrene in postshift urine samples can be used as a suitable biomarker to assess individual exposure to PAHs in coke ovens and in graphite electrode manufacturing plants.

Respiratory disease in non-smoking Western Australian goldminers.

Musk AW, Rouse IL, Rivera B … +2 more , de Klerk NH, McNulty JC

Br J Ind Med · 1992 Nov · PMID 1463674 · Full text

Respiratory symptoms, spirometry, and transfer factor were measured in 208 non-smoking Western Australian underground goldminers (mean age 32) to identify the presence of respiratory abnormalities resulting from undergro... Respiratory symptoms, spirometry, and transfer factor were measured in 208 non-smoking Western Australian underground goldminers (mean age 32) to identify the presence of respiratory abnormalities resulting from underground work. These subjects were part of a larger group of 771 subjects attending for statutory periodic chest x ray examinations in the industry. They had worked underground for a median of three years. The prevalence odds ratios of bronchitis, dyspnoea, wheeze, and asthma all tended to be related to duration of underground employment, even after adjusting for age, those for wheeze and asthma reaching statistical significance. After adjusting for age and height the duration of employment also had a significant effect on TL/VA but not on FEV1, FVC, or TL. These changes are consistent with the presence of airway narrowing and non-specific lung fibrosis or emphysema in non-smoking underground goldminers.

Hydrogen peroxide release and hydroxyl radical formation in mixtures containing mineral fibres and human neutrophils.

Leanderson P, Tagesson C

Br J Ind Med · 1992 Nov · PMID 1334424 · Full text

The ability of different mineral fibres (rock wool, glass wool, ceramic fibres, chrysotile A, chrysotile B, amosite, crocidolite, antophyllite, erionite, and wollastonite) to stimulate hydrogen peroxide (H2O2) and hydrox... The ability of different mineral fibres (rock wool, glass wool, ceramic fibres, chrysotile A, chrysotile B, amosite, crocidolite, antophyllite, erionite, and wollastonite) to stimulate hydrogen peroxide (H2O2) and hydroxyl radical (OH.) formation in mixtures containing human polymorphonuclear leucocytes (PMNLs) was investigated. In the presence of azide, all the fibres caused considerable H2O2 formation, and about twice as much H2O2 was found in mixtures with the natural fibres (asbestos, erionite, and wollastonite) than in mixtures with the manmade fibres (rock wool, glass wool, and ceramic fibres). In the presence of externally added iron, all the fibres were found to generate OH. and the natural fibres caused about three times more OH. formation than the manmade fibres. In the absence of external iron, there was less OH. formation; however, amosite, crocidolite, antophyllite, erionite, and wollastonite still generated considerable amounts of OH., also under circumstances in which only small amounts of OH. were produced in mixtures with the manmade fibres. These findings indicate that natural fibres generate more H2O2 and OH. than manmade fibres when incubated with PMNLs in the presence of external iron. They also suggest that the natural fibres, amosite, crocidolite, antophyllite, erionite, and wollastonite may act catalytically in the dissociation of H2O2 to OH. in the absence of external iron, whereas manmade fibres such as rock wool, glass wool, and ceramic fibres, do not seem to be able to generate OH. in the absence of external iron.
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