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Annals of Allergy, Asthma & Immunology... Dec 2023Millions of veterans have been exposed to burn pit smoke during combat deployments throughout the last three decades. Toxic compounds present in burn pit fumes that may... (Review)
Review
Millions of veterans have been exposed to burn pit smoke during combat deployments throughout the last three decades. Toxic compounds present in burn pit fumes that may cause or exacerbate upper and lower airway diseases include dioxins, polyaromatic hydrocarbons, and particulate matter, among others. There have been several observational studies evaluating the potential role of burn pit exposure in the development of a multitude chronic health conditions, and the veterans Administration has established the Airborne Hazards and Open Burn Pit Registry in 2014. However, specific causality of airway disease from burn pits has been difficult to prove, and there are multiple barriers toward etiologic research. Preclinical models have demonstrated airway dysfunction and inflammation but modeling human exposures remains challenging. Here, we review the current literature on the potential impact of burn pit exposure on chronic airway disease.
Topics: Humans; Veterans; Incineration; Occupational Exposure; Military Personnel; Pulmonary Disease, Chronic Obstructive; Chronic Disease
PubMed: 37343826
DOI: 10.1016/j.anai.2023.06.012 -
Journal of Occupational and... Aug 2023The objective of this review was to scope the current evidence base related to three exposure assessment concepts: frequency, intensity, and duration (latency) for... (Review)
Review
The objective of this review was to scope the current evidence base related to three exposure assessment concepts: frequency, intensity, and duration (latency) for cleaning and disinfection exposures in healthcare and subsequent work-related asthma risks. A search strategy was developed addressing intersections of four main concepts: (1) work-related asthma; (2) occupation (healthcare workers/nurses); (3) cleaning and disinfection; and (4) exposure. Three databases were searched: Embase, PubMed, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) database. Data were extracted related to three main components of risk assessment: (1) exposure frequency, (2) exposure intensity, and (3) exposure duration. Latency data were analyzed using an exponential distribution fit, and extracted concentration data were compared to occupational exposure limits. The final number of included sources from which data were extracted was 133. Latency periods for occupational asthma were exponentially distributed, with a mean waiting time (1/λ) of 4.55 years. No extracted concentration data were above OELs except for some formaldehyde and glutaraldehyde concentrations. Data from included sources also indicated some evidence for a dose-response relationship regarding increased frequency yielding increased risk, but this relationship is unclear due to potential confounders (differences in role/task and associated exposure) and the healthy worker effect. Data priority needs to include linking concentration data to health outcomes, as most current literature does not include both types of measurements in a single study, leading to uncertainty in dose-response relationships.
Topics: Humans; Disinfection; Occupational Exposure; Glutaral; Asthma; Occupational Diseases; Health Personnel
PubMed: 37279493
DOI: 10.1080/15459624.2023.2221712 -
Current Opinion in Allergy and Clinical... Apr 2024This review summarizes the recent literature on the long-term outcome of sensitizer-induced and irritant-induced occupational asthma. (Review)
Review
PURPOSE OF REVIEW
This review summarizes the recent literature on the long-term outcome of sensitizer-induced and irritant-induced occupational asthma.
RECENT FINDINGS
Recent studies of sensitizer-induced occupational asthma show that after the offending exposure has ceased, most patients report at least partial relief of symptoms. However, in the long term, the diagnosis may negatively impact their careers, incomes, and quality of life. The studies also offer new insights into diisocyanate-induced occupational asthma phenotypes and asthma remission rates. One third of these cases were in remission in long-term after reduction or cessation of exposure. The long-term prognosis of irritant-induced occupational asthma was demonstrated to be poorer than sensitizer-induced occupational asthma. Older age, low fractional exhaled nitric oxide levels and uncontrolled asthma at the time of diagnosis predicted uncontrolled asthma in the long term in patients with irritant and low-molecular-weight sensitizer induced occupational asthma.
SUMMARY
Recent studies provide further evidence of the long-term outcome of different occupational asthma phenotypes and the factors that affect them. These findings help us identify patients at risk of poor asthma outcomes, who need close monitoring and support. It should also be borne in mind that occupational asthma diagnosis may have wider-ranging negative impacts on patients' lives.
Topics: Humans; Asthma, Occupational; Occupational Diseases; Irritants; Quality of Life; Occupational Exposure
PubMed: 38126800
DOI: 10.1097/ACI.0000000000000962 -
American Journal of Industrial Medicine Mar 2024Worldwide, lung cancer is the second leading cause of cancer death in women. The present study explored associations between occupational exposures that are prevalent... (Meta-Analysis)
Meta-Analysis
Prevalent occupational exposures and risk of lung cancer among women: Results from the application of the Canadian Job-Exposure Matrix (CANJEM) to a combined set of ten case-control studies.
BACKGROUND
Worldwide, lung cancer is the second leading cause of cancer death in women. The present study explored associations between occupational exposures that are prevalent among women, and lung cancer.
METHODS
Data from 10 case-control studies of lung cancer from Europe, Canada, and New Zealand conducted between 1988 and 2008 were combined. Lifetime occupational history and information on nonoccupational factors including smoking were available for 3040 incident lung cancer cases and 4187 controls. We linked each reported job to the Canadian Job-Exposure Matrix (CANJEM), which provided estimates of probability, intensity, and frequency of exposure to each selected agent in each job. For this analysis, we selected 15 agents (cleaning agents, biocides, cotton dust, synthetic fibers, formaldehyde, cooking fumes, organic solvents, cellulose, polycyclic aromatic hydrocarbons from petroleum, ammonia, metallic dust, alkanes C18+, iron compounds, isopropanol, and calcium carbonate) that had lifetime exposure prevalence of at least 5% in the combined study population. For each agent, we estimated lung cancer risk in each study center for ever-exposure, by duration of exposure, and by cumulative exposure, using separate logistic regression models adjusted for smoking and other covariates. We then estimated the meta-odds ratios using random-effects meta-analysis.
RESULTS AND CONCLUSIONS
None of the agents assessed showed consistent and compelling associations with lung cancer among women. The following agents showed elevated odds ratio in some analyses: metallic dust, iron compounds, isopropanol, and organic solvents. Future research into occupational lung cancer risk factors among women should prioritize these agents.
Topics: Humans; Female; Lung Neoplasms; 2-Propanol; Canada; Occupational Exposure; Dust; Risk Factors; Solvents; Iron Compounds; Case-Control Studies; Occupational Diseases
PubMed: 38192156
DOI: 10.1002/ajim.23562 -
International Archives of Occupational... Mar 2024Diesel exhaust (DE) is an established lung carcinogen. The association with leukemia is not well established. We conducted a systematic review and meta-analysis of... (Meta-Analysis)
Meta-Analysis
PURPOSE
Diesel exhaust (DE) is an established lung carcinogen. The association with leukemia is not well established. We conducted a systematic review and meta-analysis of cohort studies to determine the association between occupational DE exposure and risk of leukemia.
METHODS
A systematic literature review was performed to identify all cohort studies on occupational exposure to DE and associated risk of leukemia. STROBE guidelines and PECOS criteria were followed. Meta-analyses with fixed effects (and random-effects model in cases of high heterogeneity) were performed to calculate summary relative risks (RR) and 95% confidence intervals (CI), including subgroup analyses by outcome (mortality or incidence), sex, geographic region, industry type, and study quality. Study quality was assessed using the the Joanna Briggs Institute (JBI) critical appraisal checklist for cohort studies.
RESULTS
Of the 30 studies retained, 20 (8 from North America, 12 from Europe) reported a total of 33 estimates of the risk of leukemia. Overall, the relative risk (RR) of leukemia was 1.01 (95% CI = 0.97-1.05, I = 21.2%, n = 33); corresponding results for leukemia incidence and mortality were RR = 1.02 (95% CI = 0.98-1.06, I = 27.9%, n = 19) and RR = 0.91 (95% CI = 0.81-1.02, I = 0.0%, n = 15), respectively. The main results were confirmed in analyses by sex and geographic area. A statistically significant association was detected for miners (RR = 1.58, 95% CI = 1.15-2.15, I = 77.0%, n = 2) but not for other occupational groups. Publication bias was not detected (p = 0.7).
CONCLUSION
Our results did not indicate an association between occupational DE exposure and leukemia, with the possible exception of miners. Residual confounding cannot be excluded.
Topics: Humans; Vehicle Emissions; Occupational Exposure; Cohort Studies; Europe; Incidence
PubMed: 38142415
DOI: 10.1007/s00420-023-02034-y -
Toxicology and Industrial Health Oct 2023The widespread and increasing use of engineered nanomaterials (i.e., particulate materials measuring 1-100 nanometers (nm) in at least one dimension) poses a potential... (Review)
Review
The widespread and increasing use of engineered nanomaterials (i.e., particulate materials measuring 1-100 nanometers (nm) in at least one dimension) poses a potential health and safety risk to exposed workers. The unique properties of nanomaterials have made nanomaterials useful in multiple industries. However, their production and use may compromise worker health, presenting an emerging occupational health hazard, the acute and chronic effects of which have not been fully assessed. In this scoping review, we critically assess the literature on biomarkers of effect from nanoparticles and discuss the utility of biomonitoring as a means of assessing the physiological effects of nanoparticle exposure among nanotechnology workers. Multiple databases were queried based on select inclusion and exclusion criteria according to PRISMA guidelines, and articles were independently screened by two topic experts. Of 286 articles initially retrieved, 28 were included after screening and eligibility. The reviewed articles indicated that sensitive effect biomarkers could reflect early health effects of exposure to nanoparticles in the workplace and may be useful for monitoring toxicological effects and associated risks.
Topics: Humans; Biomarkers; Nanoparticles; Nanostructures; Occupational Exposure; Occupational Health
PubMed: 37490405
DOI: 10.1177/07482337231185994 -
Annals of Work Exposures and Health Jun 2024Little is known about occupational co-exposure. The objective was to assess the prevalence of exposure and co-exposure to biomechanical factors and neurotoxic chemicals...
OBJECTIVES
Little is known about occupational co-exposure. The objective was to assess the prevalence of exposure and co-exposure to biomechanical factors and neurotoxic chemicals in French workers in 2017.
METHODS
Data from the French representative survey SUMER 2017 (SUrveillance Médicale des Expositions aux Risques professionnels) were analyzed. A total of 25 118 workers were included. Exposure to 4 biomechanical factors (manual handling of loads, forceful joint exertion, repetitive movements, and hand-arm transmitted vibrations) and 18 neurotoxic chemicals (n-hexane, perchloroethylene, trichloroethylene, etc.) were assessed using a questionnaire during face-to-face interviews with occupational physicians.
RESULTS
Among men, 22.9% were exposed to at least one biomechanical factor and 10.2% were exposed to at least one neurotoxic chemical, mainly single exposures. Among women, 10.8% were exposed to at least one biomechanical factor and 3.1% were exposed to at least one neurotoxic chemical, also mainly single exposures. Occupational co-exposure to biomechanical factors and neurotoxic chemicals was observed among 4.8% of men and 0.7% of women. Workers under 30 yr old, blue-collar workers and those working in small companies were more co-exposed than other workers. In men, the prevalence of co-exposure was higher in the construction sector compared to other economic activities.
DISCUSSION
This study stresses the importance of considering multiple occupational exposures while the current prevention measures are designed to focus on preventing occupational factors individually.
Topics: Humans; Occupational Exposure; Male; Female; France; Adult; Prevalence; Middle Aged; Biomechanical Phenomena; Surveys and Questionnaires; Neurotoxins; Occupational Diseases
PubMed: 38513688
DOI: 10.1093/annweh/wxae019 -
Journal of Occupational and... Nov 2023Occupational exposure to ototoxicants, substances that can cause hearing loss alone or exacerbate hearing loss when exposure occurs in combination with noise, is a... (Review)
Review
Occupational exposure to ototoxicants, substances that can cause hearing loss alone or exacerbate hearing loss when exposure occurs in combination with noise, is a workplace hazard that is poorly understood. A review of existing research indicates that some solvents and heavy metals may be ototoxic, but few studies have attempted to estimate the impact of ototoxicant exposure on the United States worker population. Researchers examined trends in workplace exposure to ototoxicants among workers in the United States by comparing exposure data collected by the Occupational Safety and Health Administration against worker hearing loss data provided by the Bureau of Labor Statistics (BLS) for 2012-2019. The study found that the noise exposure data was strongly correlated to the hearing loss data using Pearson's correlation ( < .001), confirming that the exposure data collected by OSHA is predictive of the risk of occupational illness as reported by BLS. Chi-square analysis indicates that reported hearing loss was more common among industry subsectors with exposure to ototoxicants than those without exposure to ototoxicants. These findings suggest that workers with coexposure to ototoxicants and noise may be at a higher risk of experiencing hearing loss than those exposed to noise alone, and action should be taken to minimize this risk.
Topics: Humans; Industry; Occupational Exposure; Solvents; Workplace; Hearing Loss
PubMed: 37540204
DOI: 10.1080/15459624.2023.2240874 -
Reviews on Environmental Health Sep 2023Hazardous organic compounds such as benzene, toluene, ethylbenzene, o-xylene, m-xylene, and p-xylene (known as BTEX) found at work and at home can cause adverse health... (Meta-Analysis)
Meta-Analysis Review
Hazardous organic compounds such as benzene, toluene, ethylbenzene, o-xylene, m-xylene, and p-xylene (known as BTEX) found at work and at home can cause adverse health effects of human beings throughout their lives. Biological monitoring, an exposure assessment method, considers all exposed organic and non-organic compounds. Our goal was to perform a systematic review and a statistical analysis (meta-analysis) of peer-reviewed publications to assess urinary concentrations of BTEX biomarkers in both occupationally-exposed population and the general population. Several major electronic databases, including Scopus, Embase, Medline, Web of Science, and Google scholar (grey literature), were searched for biomonitoring studies of BTEX. Overall, 33 studies met the eligible criteria for the systematic review and six met the full inclusion criteria for meta-analysis. For meta-analysis, we included studies in which unmetabolized BTEX compounds were measured in urine samples. Due to insufficient data, studies that measured BTEX metabolites in urine samples and unmetabolized BTEX compounds in blood samples were excluded from the meta-analysis but were analyzed in the qualitative synthesis. Most studies showed increased urinary concentrations of BTEX in exposed individuals (mainly workers) compared to unexposed individuals. The results showed that the highest total BTEX concentrations were recorded in painters and policemen. This study showed that the undoubted associations between lifestyle and environmental factors and urinary levels of BTEX or its metabolites have not yet been confirmed in current biomonitoring studies. This is attributed to the few studies reported in this research area, the lack of homogeneous information, and the disagreement in the published results of the studies.
Topics: Humans; Biological Monitoring; Environmental Monitoring; Benzene; Toluene; Biomarkers; Air Pollutants; Occupational Exposure
PubMed: 35751850
DOI: 10.1515/reveh-2022-0042 -
Arhiv Za Higijenu Rada I Toksikologiju 2022Salivary cortisone strongly correlates with serum cortisol, and since it is less invasive to measure salivary cortisone than serum cortisol and easier than to measure...
Salivary cortisone strongly correlates with serum cortisol, and since it is less invasive to measure salivary cortisone than serum cortisol and easier than to measure cortisol in saliva, as its concentrations are much lower, we wanted to compare salivary cortisone and cortisol levels as markers of noise-induced stress reaction. The study included 104 participants aged 19-30 years, 50 of whom were exposed to occupational noise ≥85 dB(A) and 54 non-exposed, control students. All participants took samples of their saliva with Salivette Cortisol synthetic swabs on three consecutive working days first thing in the morning. Salivary cortisone and cortisol levels were determined with high-performance liquid chromatography. In addition, they completed a 10-item Perceived Stress Scale (PSS-10) questionnaire, and occupationally noise-exposed participants also completed the Health and Safety Executive (HSE) questionnaire on occupational psychosocial risks. The exposed participants had significantly higher cortisone (P<0.001) and cortisol (P<0.001) levels than controls, and the correlation between cortisone and cortisol levels in the exposed participants was strong (ϱ =0.692, P<0.001), which suggests that salivary cortisone can replace cortisol measurements in saliva as a more reliable method than salivary cortisol and less invasive than serum cortisol. However, the level of perceived stress scored on PSS-10 in the exposed participants did not differ significantly from stress reported by controls, but correlated negatively with cortisone levels, which is contrary to our expectations and raises questions as to why.
Topics: Humans; Cortisone; Hydrocortisone; Chromatography, High Pressure Liquid; Occupational Exposure
PubMed: 38146755
DOI: 10.2478/aiht-2023-74-3785