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Jornal Brasileiro de Pneumologia :... 2010Lung cancer is a multifactorial disease. Hereditary, genetic, and environmental factors interact in its genesis. The principal risk factor for lung cancer is smoking.... (Review)
Review
Lung cancer is a multifactorial disease. Hereditary, genetic, and environmental factors interact in its genesis. The principal risk factor for lung cancer is smoking. However, the workplace provides an environment in which there is a risk of exposure to carcinogens. The International Agency for Research on Cancer currently lists 19 substances/work situations/occupations that have been proven to be associated with lung cancer (group 1). Thorough occupational history taking is not widely practiced in patients with lung cancer, which has a negative impact on the investigation of causality and, consequently, on the identification of cases of occupational cancer. The objectives of this review were to list the agents that are recognized as causes of lung cancer, to discuss the contribution of occupation to the development of the disease, to cite national studies on the subject, and to propose a list of procedures that are essential to the appropriate investigation of causality between lung cancer and occupation.
Topics: Carcinogens, Environmental; Humans; Lung Neoplasms; Occupational Diseases; Occupational Exposure
PubMed: 21225183
DOI: 10.1590/s1806-37132010000600017 -
Annals of Work Exposures and Health Jul 2020Diisocyanates are a group of chemicals that are widely used in occupational settings. They are known to induce various health effects, including skin- and respiratory...
Diisocyanates are a group of chemicals that are widely used in occupational settings. They are known to induce various health effects, including skin- and respiratory tract sensitization resulting in allergic dermatitis and asthma. Exposure to diisocyanates has been studied in the past decades by using different types of biomonitoring markers and matrices. The aim of this review as part of the HBM4EU project was to assess: (i) which biomarkers and matrices have been used for biomonitoring diisocyanates and what are their strengths and limitations; (ii) what are (current) biomonitoring levels of the major diisocyanates (and metabolites) in workers; and (iii) to characterize potential research gaps. For this purpose we conducted a systematic literature search for the time period 2000-end 2018, thereby focussing on three types of diisocyanates which account for the vast majority of the total isocyanate market volume: hexamethylene diisocyanate (HDI), toluene diisocyanate (TDI), and 4,4'-methylenediphenyl diisocyanate (MDI). A total of 28 publications were identified which fulfilled the review inclusion criteria. The majority of these studies (93%) investigated the corresponding diamines in either urine or plasma, but adducts have also been investigated by several research groups. Studies on HDI were mostly in the motor vehicle repair industry [with urinary hexamethylene diamine result ranging from 0.03 to 146.5 µmol mol-1 creatinine]. For TDI, there is mostly data on foam production [results for urinary toluene diamine ranging from ~0.01 to 97 µmol mol-1 creatinine] whereas the available MDI data are mainly from the polyurethane industry (results for methylenediphenyl diamine range from 0.01 to 32.7 µmol mol-1 creatinine). About half of the studies published were prior to 2010 hence might not reflect current workplace exposure. There is large variability within and between studies and across sectors which could be potentially explained by several factors including worker or workplace variability, short half-lives of biomarkers, and differences in sampling strategies and analytical techniques. We identified several research gaps which could further be taken into account when studying diisocyanates biomonitoring levels: (i) the development of specific biomarkers is promising (e.g. to study oligomers of HDI which have been largely neglected to date) but needs more research before they can be widely applied, (ii) since analytical methods differ between studies a more uniform approach would make comparisons between studies easier, and (iii) dermal absorption seems a possible exposure route and needs to be further investigated. The use of MDI, TDI, and HDI has been recently proposed to be restricted in the European Union unless specific conditions for workers' training and risk management measures apply. This review has highlighted the need for a harmonized approach to establishing a baseline against which the success of the restriction can be evaluated.
Topics: Biological Monitoring; Humans; Occupational Exposure; Polyurethanes; Toluene 2,4-Diisocyanate; Workplace
PubMed: 32313948
DOI: 10.1093/annweh/wxaa038 -
The Permanente Journal Apr 2022In this reflection piece, the authors describe a hypertension follow-up visit and draw attention to an often overlooked aspect of a patient's health: their occupational...
In this reflection piece, the authors describe a hypertension follow-up visit and draw attention to an often overlooked aspect of a patient's health: their occupational and environmental history. For years, physicians and clinicians have understood and treated disease secondary to conspicuously harmful environmental exposures; the impacts of everyday exposures on patient health are less understood and appreciated. This article specifically addresses the critical question of how primary care physicians and clinicians can think about, and address, occupational and environmental health hazards in their assessment and treatment of chronic disease in patients. We present 3 strategies that primary care physicians and clinicians can adopt to better account for environmental and occupational risks: good history taking, advising or advocacy, and education.
Topics: COVID-19; Environmental Exposure; Humans; Occupational Exposure; Personal Protective Equipment; Primary Health Care
PubMed: 35609156
DOI: 10.7812/TPP/21.129 -
Regulatory Toxicology and Pharmacology... Jun 2018The commercialization of engineered nanomaterials (ENMs) began in the early 2000's. Since then the number of commercial products and the number of workers potentially... (Review)
Review
The commercialization of engineered nanomaterials (ENMs) began in the early 2000's. Since then the number of commercial products and the number of workers potentially exposed to ENMs is growing, as is the need to evaluate and manage the potential health risks. Occupational exposure limits (OELs) have been developed for some of the first generation of ENMs. These OELs have been based on risk assessments that progressed from qualitative to quantitative as nanotoxicology data became available. In this paper, that progression is characterized. It traces OEL development through the qualitative approach of general groups of ENMs based primarily on read-across with other materials to quantitative risk assessments for nanoscale particles including titanium dioxide, carbon nanotubes and nanofibers, silver nanoparticles, and cellulose nanocrystals. These represent prototypic approaches to risk assessment and OEL development for ENMs. Such substance-by-substance efforts are not practical given the insufficient data for many ENMs that are currently being used or potentially entering commerce. Consequently, categorical approaches are emerging to group and rank ENMs by hazard and potential health risk. The strengths and limitations of these approaches are described, and future derivations and research needs are discussed. Critical needs in moving forward with understanding the health effects of the numerous EMNs include more standardized and accessible quantitative data on the toxicity and physicochemical properties of ENMs.
Topics: Animals; Humans; Maximum Allowable Concentration; Nanostructures; Occupational Exposure; Risk Assessment
PubMed: 29574195
DOI: 10.1016/j.yrtph.2018.03.018 -
International Journal of Occupational... 2015The working environment is the special case of the non-natural environment created by man in which the increased production activity brings about the concentration of... (Review)
Review
The working environment is the special case of the non-natural environment created by man in which the increased production activity brings about the concentration of stimulators particularly aggressive to the human organism, such as chemical hazards, noise, vibration, extreme temperatures, and finally, intensified psychological and emotional stress. Depending on the nature and intensity, working environment factors have been classified into dangerous, harmful and annoying. The workers are more and more frequently exposed to dangerous chemicals in the working environment. The chemicals cause many diseases including, in the 1st place, respiratory insufficiency, inflammatory skin conditions, psychoneurological disorders and neoplastic diseases. Occupational exposure limit values (OELs), the main criteria for occupational exposure assessment, constitute an important factor for the safe use of chemicals in the working environment. In Poland, to date there are 524 chemical substances and 19 dusts for which maximum admissible concentrations (MAC) have been established.
Topics: Carcinogens, Environmental; Dust; Environmental Monitoring; Hazardous Substances; Humans; Maximum Allowable Concentration; Occupational Exposure; Occupational Health; Poland
PubMed: 26182920
DOI: 10.13075/ijomeh.1896.00243 -
Scandinavian Journal of Work,... 1994Recent progress in assessing exposure in occupational epidemiology studies is reviewed. Traditional methods based on surrogate and qualitative measures of exposure are... (Review)
Review
Recent progress in assessing exposure in occupational epidemiology studies is reviewed. Traditional methods based on surrogate and qualitative measures of exposure are no longer sufficient for searching for new risks, quantifying risks, and learning about their mechanisms. More sophisticated methods and exposure indices are needed that are aimed at estimating the exposure-response relation. Prospective studies, case-referent studies within cohorts, and community-based case-referent studies applying interviews of the subjects or confirming exposures from work-places are designs favoring exposure assessment. Exposure modeling is expected to improve the quality of estimates in industry-based studies. Job-exposure matrices have proved useful, especially in analyses of large studies, provided that they are applied so that misclassification does not significantly bias the results. Misclassification of exposure should be regularly assessed and controlled in epidemiologic studies. Good documentation of the information used and studies on methodological validity and reliability are needed to develop exposure assessment.
Topics: Case-Control Studies; Cohort Studies; Humans; Occupational Diseases; Occupational Exposure; Retrospective Studies; Risk Assessment
PubMed: 7846489
DOI: No ID Found -
Scandinavian Journal of Work,... Oct 2023Crystalline silica is found in many construction materials. Although it is one of the oldest known occupational exposures, new exposure contexts have emerged in recent...
OBJECTIVES
Crystalline silica is found in many construction materials. Although it is one of the oldest known occupational exposures, new exposure contexts have emerged in recent years. In 2021, France classified work involving exposure to respirable crystalline silica (ie, silica dust) generated by a work process as carcinogenic. In order to assess exposure in the French workforce between 1947 and 2020, we developed a silica job-exposure matrix (JEM) for the Matgéné program.
METHOD
The JEM was linked with occupational data from different population censuses (1982, 1990, 1999, 2007 and 2017). The proportions and numbers of workers exposed to silica dust in France at these various census time points were estimated and described by sex and industry for 2017.
RESULTS
After decreasing between 1982 and 1999, the proportion of workers exposed to silica dust remained stable at 4%, representing 975 000 workers in 2017. Exposed workers were mostly men (93%), and most worked in the construction industry (64%). This was also the industry where the majority of workers were exposed to a level above the French 8-hour time weighted average occupational exposure limit (TWA-OEL).
CONCLUSION
A large number of workers in France were still exposed (some highly) to silica dust in 2017 so this agent still poses an occupational health concern. The results of this study provide key information about the continued surveillance of the evolution of exposure to silica dust. In a few years, it will be possible to quantify the impact of the 2021 regulation in terms of proportions and number of workers exposed to silica dust.
Topics: Male; Humans; Female; Occupational Exposure; Silicon Dioxide; Dust; Occupational Health; Construction Industry; Air Pollutants, Occupational; Inhalation Exposure
PubMed: 37539747
DOI: 10.5271/sjweh.4105 -
Biomolecules Feb 2022Carcinogenic polycyclic aromatic hydrocarbons (cPAHs) are considered the most serious cancer risk. This study was conducted to assess the effect of acute exposure to...
Carcinogenic polycyclic aromatic hydrocarbons (cPAHs) are considered the most serious cancer risk. This study was conducted to assess the effect of acute exposure to cPAHs on cancer biomarker proteins p53 and p21 in occupational workers during the hajj season in Makkah. One hundred five participants were recruited, including occupational workers and apparently healthy individuals; air samples were collected using personal sample monitors to identify the subjects' exposure to cPAHs. Quantitative analyses of benzo(a)anthracene (BaA), benzo(b)fluoranthene (BbF), benzo(a)pyrene (BaP), dibenzo(a,h)fluronathene (DBA), indeno(1,2,3-c,d)pyrene (IND) and chyresene (CRY) were carried out using the GC/Mass technique. Serum p53 and p21 proteins were analyzed using ELISA. The ambient air samples collected by the occupationally exposed group were more highly polluted by cPAHs, (90.25 ± 14.1) ng/m, than those of the unexposed control groups, (30.12 ± 5.56) ng/m. The concentration of distributive cPAHs was markedly more elevated in the air samples of the exposed group than in those taken from the non-exposed group. The study results demonstrated significant links between short-term exposure to cPAHs and serum p53 and p21 levels. Serum p53 and p21 proteins potentially influence biomarkers when exposed to ambient air cPAHs.
Topics: Benzo(a)pyrene; Biomarkers, Tumor; Humans; Occupational Exposure; Polycyclic Aromatic Hydrocarbons; Tumor Suppressor Protein p53
PubMed: 35204761
DOI: 10.3390/biom12020260 -
Journal of Occupational and... 2015The fundamental goal of this article is to describe, define, and analyze the components of the risk characterization process for occupational exposures. Current methods...
The fundamental goal of this article is to describe, define, and analyze the components of the risk characterization process for occupational exposures. Current methods are described for the probabilistic characterization of exposure, including newer techniques that have increasing applications for assessing data from occupational exposure scenarios. In addition, since the probability of health effects reflects variability in the exposure estimate as well as the dose-response curve-the integrated considerations of variability surrounding both components of the risk characterization provide greater information to the occupational hygienist. Probabilistic tools provide a more informed view of exposure as compared to use of discrete point estimates for these inputs to the risk characterization process. Active use of such tools for exposure and risk assessment will lead to a scientifically supported worker health protection program. Understanding the bases for an occupational risk assessment, focusing on important sources of variability and uncertainty enables characterizing occupational risk in terms of a probability, rather than a binary decision of acceptable risk or unacceptable risk. A critical review of existing methods highlights several conclusions: (1) exposure estimates and the dose-response are impacted by both variability and uncertainty and a well-developed risk characterization reflects and communicates this consideration; (2) occupational risk is probabilistic in nature and most accurately considered as a distribution, not a point estimate; and (3) occupational hygienists have a variety of tools available to incorporate concepts of risk characterization into occupational health and practice.
Topics: Dose-Response Relationship, Drug; Humans; Models, Statistical; Occupational Exposure; Occupational Health; Risk Assessment; Risk Management; Uncertainty
PubMed: 26302336
DOI: 10.1080/15459624.2015.1084421 -
European Journal of Epidemiology Jan 2024Numerous epidemiologic studies and a few systematic reviews have investigated the association between occupational solar exposure and basal cell carcinoma (BCC).... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Numerous epidemiologic studies and a few systematic reviews have investigated the association between occupational solar exposure and basal cell carcinoma (BCC). However, previous reviews have several deficits with regard to included and excluded studies/risk estimates and the assessment of risk of selection bias (RoSB). Our aim was to review epidemiologic studies with a focus on these deficits and to use meta-(regression) analyses to summarize risk estimates.
METHODS
We systematically searched PubMed (including MEDLINE) and Embase for epidemiologic studies. Study evaluation considered four main aspects of risk of bias assessments, i.e. Selection of subjects (selection bias); Exposure variables; Outcome variables; Data analysis.
RESULTS
Of 56 identified references, 32 were used for meta-(regression) analyses. The overall pooled risk estimate for BCC comparing high/present vs. low/absent occupational solar exposure was 1.20 (95% CI 1.02-1.43); among studies without major deficits regarding data analysis, it was 1.10 (95% CI 0.91-1.33). Studies with low and high RoSB had pooled risk estimates of 0.83 (95% CI 0.73-0.93) and 1.95 (95% CI 1.42-2.67), respectively. The definitions of exposure and outcome variables were not correlated with study risk estimates. Studies with low RoSB in populations with the same latitude or lower than Germany had a pooled risk estimate of 1.01 (95% CI 0.88-1.15).
CONCLUSION
Due to the different associations between occupational solar exposure and BCC among studies with low and high RoSB, we reason that the current epidemiologic evidence base does not permit the conclusion that regular outdoor workers have an increased risk of BCC.
Topics: Humans; Carcinoma, Basal Cell; Germany; Occupational Exposure; Selection Bias; Skin Neoplasms
PubMed: 38170370
DOI: 10.1007/s10654-023-01061-w