Linet MS, Malker HS, McLaughlin JK
… +4 more, Weiner JA, Blot WJ, Ericsson JL, Fraumeni JF
Br J Ind Med
· 1993 Jan · PMID 8431395
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Incidence of non-Hodgkin's lymphoma in different employment categories was evaluated from the Swedish Cancer-Environment Registry, which links cancer incidence during 1961 to 1979 with occupational information from the 1...Incidence of non-Hodgkin's lymphoma in different employment categories was evaluated from the Swedish Cancer-Environment Registry, which links cancer incidence during 1961 to 1979 with occupational information from the 1960 census. New associations were found for men employed in shoemaking and shoe repair, porcelain and earthenware industries, education, and other white collar occupations. Several findings supported associations found in other countries, including excesses among woodworkers, furniture makers, electric power plant workers, farmers, dairy workers, lorry drivers, and other land transport workers. Risks were not increased among chemists, chemical or rubber manufacturing workers, or petrochemical refinery workers. Caution must be used in drawing causal inferences from these linked registry data because information on exposure and duration of employment is not available. Nevertheless, this study has suggested new clues to possible occupational determinants of non-Hodgkin's lymphoma.
Veulemans H, Steeno O, Masschelein R
… +1 more, Groeseneken D
Br J Ind Med
· 1993 Jan · PMID 8431394
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A case-control study was conducted among first time patients at a clinic for reproductive disorders. The study group consisted of 1019 cases, defined as patients diagnosed infertile or subfertile on the basis of a spermi...A case-control study was conducted among first time patients at a clinic for reproductive disorders. The study group consisted of 1019 cases, defined as patients diagnosed infertile or subfertile on the basis of a spermiogram and 475 controls who were diagnosed as normally fertile by the same procedure. Possible exposure to ethylene glycol ethers was assessed by the presence of the urinary metabolites methoxyacetic acid (MAA) and ethoxyacetic acid (EAA) respectively for 2-methoxyethanol and 2-ethoxyethanol or their acetates. In total, EAA was detected in 39 cases and six controls, with a highly significant odds ratio of 3.11 (p = 0.004). On the other hand, MAA was only found in one case and two controls. The presence of EAA in urine proved to be strongly associated with exposure to preparations containing solvents, especially paint products, and with some groups of occupations, the most important of which were also directly or possibly connected with paint products. The absence of a significant correlation between the concentration of urinary EAA and the various measures of sperm quality could be explained by the expected latent period between exposure and observed effects. Other temporal aspects of the relation between exposure as judged from the presence of urinary EAA and diagnosis are also discussed.
Nilsson R, Nordlinder R, Wass U
… +2 more, Meding B, Belin L
Br J Ind Med
· 1993 Jan · PMID 8431393
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A survey was conducted at 15 textile plants with dyehouses in western Sweden. Employees with a history of work related rhinitis, asthma, or skin symptoms were offered a clinical and immunological investigation including...A survey was conducted at 15 textile plants with dyehouses in western Sweden. Employees with a history of work related rhinitis, asthma, or skin symptoms were offered a clinical and immunological investigation including skin prick tests, skin patch tests, and radioallergosorbent tests (RASTs) to detect specific allergy to reactive dyes. Among the 1142 employees, 162 were exposed to reactive dyes and 10 of these (6%) reported work related respiratory or nasal symptoms. An allergy to reactive dyes could be confirmed in five (3%, 95% confidence interval 1-7%). All but one had been exposed to reactive dyes for one year or less before the onset of symptoms. Positive RASTs could be detected in four of the five patients. All of the RAST positive patients were positive to remazol black B, but six out of eight additional remazol dyes also elicited positive results. RAST and RAST inhibition showed a cross reactivity between some of the dyes. Seven persons with work related dermatitis and three with urticaria or Quincke oedema were found. In one patient contact dermatitis to a monoazo dye was shown, but no positive patch test reactions to reactive dyes. IgE-mediated allergy to reactive dyes seems to be an important cause of respiratory and nasal symptoms among dyehouse employees exposed to dust from reactive dyes.
Löf A, Wigaeus Hjelm E, Colmsjö A
… +3 more, Lundmark BO, Norström A, Sato A
Br J Ind Med
· 1993 Jan · PMID 8431392
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Nine male volunteers were exposed to 2H8-toluene (200 mg/m3 for two hours during a workload of 50 W) via inspiratory air with the aid of a breathing valve and mouthpiece. Labelled toluene was used to differentiate betwee...Nine male volunteers were exposed to 2H8-toluene (200 mg/m3 for two hours during a workload of 50 W) via inspiratory air with the aid of a breathing valve and mouthpiece. Labelled toluene was used to differentiate between hippuric acid originating from exposure to toluene and hippuric acid normally excreted in urine. The total uptake of toluene was 2.2 (standard deviation (SD) 0.2) mmol, or 50% of the amount inhaled. Four hours after the end of exposure 1.4 (SD 0.3) mmol or 65% of the total uptake had been excreted in urine as 2H-hippuric acid and 20 hours after the end of exposure the cumulative excretion of 2H-hippuric acid was 1.8 (SD 0.3) mmol, or 78% of the total uptake. By contrast the cumulative excretion of labelled plus unlabelled hippuric acid exceeded the total uptake of toluene already after four hours. The excretion rate of 2H-hippuric acid was highest, about 5 mumol/min, during exposure and the SD between the subjects was low. The background concentrations of unlabelled hippuric acid in urine were high, however, and there were large differences between subjects. These findings confirm earlier indications that for low exposure, urinary hippuric acid concentration cannot be used for biological monitoring of exposure to toluene.
Takebayashi T, Omae K, Hosoda K
… +3 more, Satoh T, Hamaguchi T, Sakurai H
Br J Ind Med
· 1993 Jan · PMID 8431390
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Exposure-effect and exposure-response relation between exposure to lead and delta-aminolaevulinic acid concentration in blood (ALA-B) were examined in 238 male workers exposed to lead. Concentrations of ALA-B ranged from...Exposure-effect and exposure-response relation between exposure to lead and delta-aminolaevulinic acid concentration in blood (ALA-B) were examined in 238 male workers exposed to lead. Concentrations of ALA-B ranged from 26 to 352 micrograms/l and lead concentrations in blood (Pb-B) from 7.1 to 86.0 micrograms/dl. Concentrations of ALA-B correlated closely with concentrations of Pb-B (r = 0.74), and increased ALA-B concentration occurred at Pb-B concentrations of around 30 micrograms/dl. Exposure-response curves indicated that the 50 percentile response doses were roughly 30, 40, and 50 micrograms/dl Pb-B when cut off points of ALA-B were set at 50, 60, and 70 micrograms/l respectively. The sensitivity and specificity of measurements of ALA-B concentrations for health screening were sufficiently high when the health based exposure limits of lead were set at 30-50 micrograms/dl. Moreover, a pronounced increase in ALA-B concentrations occurred when the inhibition rate of erythrocyte ALA dehydratase exceeded 85%. These findings suggest that ALA-B is a useful indicator for assessing the early effects of exposure to lead on haem biosynthesis.
Roels H, Bernard AM, Cárdenas A
… +7 more, Buchet JP, Lauwerys RR, Hotter G, Ramis I, Mutti A, Franchini I, Bundschuh I
Br J Ind Med
· 1993 Jan · PMID 8431389
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Cadmium (Cd) was the third heavy metal investigated in the European collaborative research project on the development and validation of new markers of nephrotoxicity. Fifty workers exposed to Cd and 50 control workers we...Cadmium (Cd) was the third heavy metal investigated in the European collaborative research project on the development and validation of new markers of nephrotoxicity. Fifty workers exposed to Cd and 50 control workers were examined. After application of selection criteria 37 workers (mean age 43) exposed to Cd for an average of 11.3 years; and 43 age matched referents were retained for final analysis. The average concentrations of Cd in blood (Cd-B) and urine (Cd-U) of exposed workers were 5.5 micrograms Cd/l and 5.4 micrograms Cd/g creatinine respectively. By contrast with lead and mercury, Cd had a broad spectrum of effects on the kidney, producing significant alterations in amounts of almost all potential indicators of nephrotoxicity that were measured in urine--namely, low and high molecular weight proteins, kidney derived antigens or enzymes, prostanoids, and various other biochemical indices such as glycosaminoglycans and sialic acid. An increase in beta 2-microglobulin and a decrease of sialic acid concentration were found in serum. Dose-effect/response relations could be established between most of these markers and Cd-U or Cd-B. The thresholds of Cd-U associated with a significantly higher probability of change in these indicators were estimated by logistic regression analysis. Three main groups of thresholds could be identified: one around 2 micrograms Cd/g creatinine mainly associated with biochemical alterations, a second around 4 micrograms Cd/g creatinine for high molecular weight proteins and some tubular antigens or enzymes, and a third one around 10 micrograms Cd/g creatinine for low molecular weight proteins and other indicators. The recent recommendation by the American Conference of Governmental Industrial Hygienists (ACGIH) of 5 micrograms Cd/g creatinine in urine as the biological exposure limit for occupational exposure to Cd appears thus justified, although for most of the effects occurring around this threshold the link with the subsequent development of overt Cd nephropathy is not established. In that respect, the very early interference with production of some prostanoids (threshold 2 micrograms Cd/g creatinine) deserves further investigation; although this effect might contribute to protect the filtration capacity of the kidneys, it might also play a part in the toxicity of Cd on bone.
Cárdenas A, Roels H, Bernard AM
… +7 more, Barbon R, Buchet JP, Lauwerys RR, Roselló J, Ramis I, Mutti A, Franchini I
Br J Ind Med
· 1993 Jan · PMID 8431388
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The present study has been carried out in the framework of a collaborative research project on the development of new markers of nephrotoxicity. A battery of more than 20 potential indicators of renal changes has been ap...The present study has been carried out in the framework of a collaborative research project on the development of new markers of nephrotoxicity. A battery of more than 20 potential indicators of renal changes has been applied to 50 workers exposed to lead (Pb) and 50 control subjects. After application of selection criteria 41 exposed and 41 control workers were eventually retained for the final statistical analysis. The average blood Pb concentration of exposed workers was 480 micrograms/l and their mean duration of exposure was 14 years. The battery of tests included parameters capable of detecting functional deficits (for example, urinary proteins of low or high molecular weight), biochemical alterations (for example, urinary eicosanoids, glycosaminoglycans, sialic acid) or cell damage (for example, urinary tubular antigens or enzymes) at different sites of the nephron or the kidney. The most outstanding effect found in workers exposed to Pb was an interference with the renal synthesis of eicosanoids, resulting in lower urinary excretion of 6-keto-PGF1 alpha and an enhanced excretion of thromboxane (TXB2). The health significance of these biochemical alterations, detectable at low exposure to Pb is unknown. As they were not associated with any sign of renal dysfunction, they may represent reversible biochemical effects or only contribute to the degradation of the renal function from the onset of clinical Pb nephropathy. The urinary excretion of some tubular antigens was also positively associated with duration of exposure to Pb. Another effect of Pb that might deserve further study is a significant increase in urinary sialic acid concentration.
Cárdenas A, Roels H, Bernard AM
… +7 more, Barbon R, Buchet JP, Lauwerys RR, Roselló J, Hotter G, Mutti A, Franchini I
Br J Ind Med
· 1993 Jan · PMID 8431387
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Several markers of renal changes have been measured in a cohort of 50 workers exposed to elemental mercury (Hg) and in 50 control workers. After application of selection criteria 44 exposed and 49 control workers were re...Several markers of renal changes have been measured in a cohort of 50 workers exposed to elemental mercury (Hg) and in 50 control workers. After application of selection criteria 44 exposed and 49 control workers were retained for the final statistical analysis. Exposed workers excreted on average 22 micrograms Hg/g creatinine and their mean duration of exposure was 11 years. Three types of renal markers were studied--namely, functional markers (creatinine and beta 2-microglobulin in serum, urinary proteins of low or high molecular weight); cytotoxicity markers (tubular antigens and enzymes in urine), and biochemical markers (eicosanoids, thromboxane, fibronectin, kallikrein, sialic acid, glycosaminoglycans in urine, red blood cell membrane negative charges). Several bloodborne indicators of polyclonal activation were also measured to test the hypothesis that an immune mechanism might be involved in the renal toxicity of elemental Hg. The main renal changes associated with exposure to Hg were indicative of tubular cytotoxicity (increased leakage of tubular antigens and enzymes in urine) and biochemical alterations (decreased urinary excretion of some eicosanoids and glycosaminoglycans and lowering of urinary pH). The concentrations of anti-DNA antibodies and total immunoglobulin E in serum were also positively associated with the concentration of Hg in urine and in blood respectively. The renal effects were mainly found in workers excreting more than 50 micrograms Hg/g creatinine, which corroborates our previous estimate of the biological threshold of Hg in urine. As these effects, however, were unrelated to the duration of exposure and not accompanied by functional changes (for example, microproteinuria), they may not necessarily represent clinically significant alterations of renal function.
Br J Ind Med
· 1993 Jan · PMID 8381659
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This study was undertaken to investigate the production of interleukin 1 (IL-1) by pleural leucocytes in culture and to evaluate the influence of intratracheal instillation of crocidolite asbestos on this production. Nor...This study was undertaken to investigate the production of interleukin 1 (IL-1) by pleural leucocytes in culture and to evaluate the influence of intratracheal instillation of crocidolite asbestos on this production. Normal pleural leucocytes spontaneously released IL-1 in culture and stimulation with lipopolysaccharide (LPS) dramatically increased production. Intratracheal instillation with crocidolite asbestos induced recruitment of pleural leucocytes in the longer term and changed IL-1 production by the leucocytes. Reduced production of IL-1 was found by one day after instillation of asbestos and this was correlated with the dose of asbestos. With increasing time after instillation, however, release of IL-1 by pleural leucocytes gradually recovered to normal until, one month after asbestos injection, the leucocytes produced augmented IL-1 in culture compared with control pleural leucocytes. Our data show that pleural leucocytes possess the potential to produce IL-1 in vitro and this capability is altered by intratracheal instillation of crocidolite asbestos. This may be relevant to development of pleural diseases associated with inhalation of asbestos.
Br J Ind Med
· 1993 Jan · PMID 8381658
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Sixty patients with occupational asthma due to exposure to toluene diisocyanate (TDI) were re-evaluated, five years after the initial diagnosis had been confirmed by a specific bronchial provocation challenge. During bot...Sixty patients with occupational asthma due to exposure to toluene diisocyanate (TDI) were re-evaluated, five years after the initial diagnosis had been confirmed by a specific bronchial provocation challenge. During both examinations the severity of asthmatic symptoms and the need for antiasthma treatment were graded and lung function tests, measurement of airway responsiveness to methacholine (PD15), and skin tests with common inhalant allergens were carried out. The evolution of the disease was established on the basis of the increase or decrease in asthmatic symptoms, requirements for medication, and FEV1 and PD15 methacholine between the two examinations. At follow up 17 patients (group A, 28.3%) had carried on working in the same environment after relocation to jobs with only occasional exposure to TDI; 15 of them used protective respiratory devices. The remaining 43 (group B, 71.7%) avoided further inhalation of TDI by moving to another sector. Group A showed a significant decrease in FEV1 and PD15 methacholine and significant increases in the severity of symptom score and requirement for medication; 13 subjects (76.5%) were worse, four (23.5%) were stable, and no one had recovered or improved. Group B showed significantly less severe symptoms and a threefold increase in PD15 methacholine; 12 subjects (28.2%) totally recovered, 10 (23.2%) improved, 16 (37.2%) were stable, and five (11.6%) were worse. In group B the duration of exposure to TDI and of symptoms before the initial diagnosis delineated the patients who recovered from those who did not improve; intermediate values in these features characterised the subjects who improved but did not recover. It is inferred that complete removal from exposure is the only effective way of preventing deterioration in patients with occupational asthma due to TDI. Early diagnosis and early removal from exposure after the onset of asthma are important factors for a favourable outcome of the disease.
Albin M, Engholm G, Fröström K
… +3 more, Kheddache S, Larsson S, Swantesson L
Br J Ind Med
· 1992 Dec · PMID 1472445
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The extent of agreement between International Labour Office (ILO) and clinical readings of chest x ray films from construction workers was studied. From a survey of 5898 workers 258 subjects with a profusion of small opa...The extent of agreement between International Labour Office (ILO) and clinical readings of chest x ray films from construction workers was studied. From a survey of 5898 workers 258 subjects with a profusion of small opacities of > or = 1/1 and a stratified sample of subjects with profusion < 1/1 were selected. Only 41% of the films classified as ILO profusion category > or = 1/1 were clinically recorded as non-normal for the parenchyma. The proportion of films recorded as pneumoconiotic (or possibly so) was especially low for irregular opacities (22%), but increased with the profusion category (both rounded and irregular) as well as with the size of rounded opacities (p 3/11, q 12/25, r 3/4). Only with the profusion category > or = 2/1 were most of the films recorded as pneumoconiotic. The specificity and sensitivity were highest in the geographical areas where a few clinical readers had assessed many films each. The proportion of false negative clinical reports was low for circumscribed pleural thickening of the chest wall (9%) and diaphragmatic pleural thickening (6%). For calcified pleural changes and for the combination of diffuse pleural thickening and obliteration of the costophrenic angle, false negative reports were absent. The present study shows an unsatisfactory sensitivity for clinical compared with ILO readings as a means for screening the parenchyma of workers with a risk of pneumoconiosis.
Skov T, Maarup B, Olsen J
… +3 more, Rørth M, Winthereik H, Lynge E
Br J Ind Med
· 1992 Dec · PMID 1472444
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During the past decades conclusive evidence has accumulated that alkylating antineoplastic drugs (ADs) can cause cancer, most notably acute non-lymphocytic leukaemia, and that most ADs are reprotoxic. Studies on health w...During the past decades conclusive evidence has accumulated that alkylating antineoplastic drugs (ADs) can cause cancer, most notably acute non-lymphocytic leukaemia, and that most ADs are reprotoxic. Studies on health workers handling ADs have shown significantly increased risks for miscarriages (two studies) and malformations (two studies). The present study monitored the risk for cancer and adverse reproductive outcome among Danish nurses handling ADs. No increased risks were found for miscarriages, malformations, low birth weight, or preterm birth among the offspring of nurses handling ADs during pregnancy. The sex ratio was normal. The relative risk (RR) for leukaemia was significantly increased (10.65) but based on only two cases, one of acute myeloblastic and one of chronic myeloid leukaemia. From the available exposure data occupational exposures to ADs were apparently higher in the studies that have reported increased risks for miscarriages and malformations than in the present one. Regarding reproductive outcome the study gives some confidence that the safety measures which were implemented in the oncology departments around 1980 can protect the health personnel against adverse effects of ADs on reproduction. As the study is as yet the only negative one in a well protected setting, it should be followed up by other studies of well protected health personnel handling ADs. The findings concerning the leukaemia risk, although based on small numbers, encourage larger studies.
Sandström T, Ledin MC, Thomasson L
… +2 more, Helleday R, Stjernberg N
Br J Ind Med
· 1992 Dec · PMID 1472443
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In this investigation the effects of repeated exposure to 1.5 ppm NO2 on immune competent cells in bronchoalveolar lavage (BAL) fluid was studied. Special attention was focused on effects on lymphocyte subpopulations. Ei...In this investigation the effects of repeated exposure to 1.5 ppm NO2 on immune competent cells in bronchoalveolar lavage (BAL) fluid was studied. Special attention was focused on effects on lymphocyte subpopulations. Eight healthy subjects were exposed to 1.5 ppm NO2 every second day on six occasions. Bronchoalveolar lavage fluid was collected at least three weeks before the exposure series as reference and 24 hours after the last exposure. The results obtained were analysed using a non-parametric test for paired observations, with each subject as his own control. Significant reductions were found in the total number and percentage of T cytotoxic-suppressor cells in BAL fluid; this caused an increase in the ratio of T helper-inducer: cytotoxic-suppressor cells. The total number of natural killer cells in the BAL fluid was also reduced. The numbers of all other cell types were unchanged after exposure. No reduction of phagocytosis of opsonised yeast particles by alveolar macrophages in vitro was detected. It is concluded that repeated short term exposures to 1.5 ppm NO2, a moderate occupational concentration, induces significant effects on immune competent bronchoalveolar lymphocytes. This indicates that previous findings of changes in the lymphoid immune system induced by NO2 in animals may well be applicable to humans.
Br J Ind Med
· 1992 Dec · PMID 1472442
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Antibodies to Toxoplasma were measured by enzyme linked immunosorbent assay (ELISA) in sera from 159 abattoir workers, 142 pig farmers, and 106 grain or berry farmers. Farmers occupationally exposed to pigs had antibodie...Antibodies to Toxoplasma were measured by enzyme linked immunosorbent assay (ELISA) in sera from 159 abattoir workers, 142 pig farmers, and 106 grain or berry farmers. Farmers occupationally exposed to pigs had antibodies in 53 (37%) cases, abattoir workers in 40 (25%) cases, and farmers not exposed to pigs in 24 (23%) cases. In each group antibodies were more prevalent among those who had a cat or cats in the household. Controlling for age and cat contacts changed the prevalences less than one percent. The results indicate that pig farmers might have an occupational risk of toxoplasmosis. As the prevalence of antibodies among abattoir workers was about the same as among the referent farmers, it seems unlikely that infection from Toxoplasma could be acquired by mere handling of raw meat.