Mesothelioma in Australia

Incidence (1982 to 2013) and Mortality (1997 to 2012)
Mesothelioma is a fatal cancer that typically occurs 20 to 40 years after exposure to asbestos, although exposure does not always result in the disease. Mesothelioma of the pleura (a cancer affecting the protective lining of the lungs and chest cavity) is the most common form of mesothelioma in Australia and has accounted for approximately 93% of cases since 1982. Mesothelioma of the peritoneum (a cancer affecting the abdominal lining) is less common and has accounted for approximately 6% of cases since 1982. The figures in this report include all forms of mesothelioma.


Thresholds in chemical respiratory sensitisation

There is a continuing interest in determining whether it is possible to identify thresholds for chemical allergy. Here allergic sensitisation of the respiratory tract by chemicals is considered in this context. This is an important occupational health problem, being associated with rhinitis and asthma, and in addition provides toxicologists and risk assessors with a number of challenges.
In common with all forms of allergic disease chemical respiratory allergy develops in two phases. In the first (induction) phase exposure to a chemical allergen (by an appropriate route of exposure) causes immunological priming and sensitisation of the respiratory tract. The second (elicitation) phase is triggered if a sensitised subject is exposed subsequently to the same chemical allergen via inhalation. A secondary immune response will be provoked in the respiratory tract resulting in inflammation and the signs and symptoms of a respiratory hypersensitivity reaction. In this article attention has focused on the identification of threshold values during the acquisition of sensitisation.
Current mechanistic understanding of allergy is such that it can be assumed that the development of sensitisation (and also the elicitation of an allergic reaction) is a threshold phenomenon; there will be levels of exposure below which sensitisation will not be acquired. That is, all immune responses, including allergic sensitisation, have threshold requirement for the availability of antigen/allergen, below which a response will fail to develop. The issue addressed here is whether there are methods available or clinical/epidemiological data that permit the identification of such thresholds. This document reviews briefly relevant human studies of occupational asthma, and experimental models that have been developed (or are being developed) for the identification and characterisation of chemical respiratory allergens.
The main conclusion drawn is that although there is evidence that the acquisition of sensitisation to chemical respiratory allergens is a dose-related phenomenon, and that thresholds exist, it is frequently difficult to define accurate numerical values for threshold exposure levels. Nevertheless, based on occupational exposure data it may sometimes be possible to derive levels of exposure in the workplace, which are safe.
An additional observation is the lack currently of suitable experimental methods for both routine hazard characterisation and the measurement of thresholds, and that such methods are still some way off. Given the current trajectory of toxicology, and the move towards the use of non-animal in vitro and/or in silico) methods, there is a need to consider the development of alternative approaches for the identification and characterisation of respiratory sensitisation hazards, and for risk assessment.

Source: Cochrane SA, Arts JHE, Ehnes C, Hindle S, Hollnagel HM, Poole A, Suto H, Kimber I. 2015. Toxicology, 333 : 179-194.

La qualité de l'air intérieur

Si elle ne représente pas un risque majeur, l'importance qu'elle commence à prendre mérite amplement que l'on s'attarde sur son cas : la pollution de l'air intérieur. D'autant que c'est une très grande partie des salariés de tous secteurs qui est potentiellement concernée et que ses effets, même modérés, peuvent être particulièrement gênants. Les origines de cette pollution sont très diverses, mais des solutions efficaces existent.

Source: Dossier spécial, Travail & Sécurité, n° 761, mai 2015.

Risk of cancer among firefighters in California, 1988–2007

Background: Most studies of firefighter cancer risks were conducted prior to 1990 and do not reflect risk from advances in building materials.
Methods: A case–control study using California Cancer Registry data (1988–2007) was conducted to evaluate the risk of cancer among firefighters, stratified by race.
Results: This study identified 3,996 male firefighters with cancer. Firefighters were found to have a significantly elevated risk for melanoma (odds ratio [OR] = 1.8; 95% confidence interval [CI] 1.4–2.1), multiple myeloma (OR 1.4; 95%CI 1.0–1.8), acute myeloid leukemia (OR 1.4; 95%CI 1.0–2.0), and cancers of the esophagus (OR 1.6; 95%CI 1.2–2.1), prostate (OR 1.5; 95%CI 1.3–1.7), brain (OR 1.5; 95%CI 1.2–2.0), and kidney (OR 1.3; 95%CI 1.0–1.6).
Conclusions: In addition to observing cancer findings consistent with previous research, this study generated novel findings for firefighters with race/ethnicity other than white. It provides additional evidence to support the association between firefighting and several specific cancers. © 2015 This article has been contributed to by US Government employees and their work is in the public domain in the USA.

Source: Rebecca J. Tsai, Sara E. Luckhaupt, Pam Schumacher, Rosemary D. Cress, Dennis M. Deapen, Geoffrey M. Calvert. American Journal of Industrial Médicine, 2015.

Carbon Nanotube and Nanofiber Exposure Assessments

An Analysis of 14 Site Visits
Recent evidence has suggested the potential for wide-ranging health effects that could result from exposure to carbon nanotubes (CNT) and carbon nanofibers (CNF). In response, the National Institute for Occupational Safety and Health (NIOSH) set a recommended exposure limit (REL) for CNT and CNF: 1 µg m-3 as an 8-h time weighted average (TWA) of elemental carbon (EC) for the respirable size fraction. The purpose of this study was to conduct an industrywide exposure assessment among US CNT and CNF manufacturers and users. Fourteen total sites were visited to assess exposures to CNT (13 sites) and CNF (1 site). Personal breathing zone (PBZ) and area samples were collected for both the inhalable and respirable mass concentration of EC, using NIOSH Method 5040. Inhalable PBZ samples were collected at nine sites while at the remaining five sites both respirable and inhalable PBZ samples were collected side-by-side. Transmission electron microscopy (TEM) PBZ and area samples were also collected at the inhalable size fraction and analyzed to quantify and size CNT and CNF agglomerate and fibrous exposures. Respirable EC PBZ concentrations ranged from 0.02 to 2.94 µg m-3 with a geometric mean (GM) of 0.34 µg m-3 and an 8-h TWA of 0.16 µg m-3. PBZ samples at the inhalable size fraction for EC ranged from 0.01 to 79.57 µg m-3 with a GM of 1.21 µg m-3. PBZ samples analyzed by TEM showed concentrations ranging from 0.0001 to 1.613 CNT or CNF-structures per cm3 with a GM of 0.008 and an 8-h TWA concentration of 0.003. The most common CNT structure sizes were found to be larger agglomerates in the 2-5 µm range as well as agglomerates >5 µm. A statistically significant correlation was observed between the inhalable samples for the mass of EC and structure counts by TEM (Spearman ρ = 0.39, P < 0.0001). Overall, EC PBZ and area TWA samples were below the NIOSH REL (96% were <1 μg m-3 at the respirable size fraction), while 30% of the inhalable PBZ EC samples were found to be >1 μg m-3. Until more information is known about health effects associated with larger agglomerates, it seems prudent to assess worker exposure to airborne CNT and CNF materials by monitoring EC at both the respirable and inhalable size fractions. Concurrent TEM samples should be collected to confirm the presence of CNT and CNF.

Source: Dahm MM, Schubauer-Berigan MK, Evans DE, Birch ME, Fernback JE, Deddens JA. Ann Occup Hyg, 2015 Apr 7.

Biomarkers for Lung Epithelium Injury in Occupational Hexavalent Chromium-Exposed Workers

Objective: To evaluate whether Club (Clara) cell protein (CC16) and surfactant-associated protein D (SP-D) can be used as biomarkers for lung injury caused by chromium exposure.
Methods: The concentrations of chromium in the air (CrA), chromium in the blood (CrB), lung function, CC16, SP-D, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were detected in 91 chromium-exposed workers and 38 controls.
Results: In chromium-exposed group, the levels of CrA, CrB, SP-D, TNF-α, and IL-6 were significantly higher, whereas forced expiratory volume in one second (FEV1), FEV1/FVC, maximal expiratory flow (MEF), maximum ventilation volume (MVV), CC16, and CC16/SP-D were lower. Negative correlations were shown between CC16, SP-D or CC16/SP-D, and CrB or inflammatory cytokines (TNF-α and IL-6). Positive relationships were shown between CC16 or CC16/SP-D with indicators of lung function. Tobacco smoking and chromium exposure had synergic effects on lung injury.
Conclusions: CC16, as an immunosuppressive protein, and CC16/SP-D can be used as sensitive and noninvasive biomarkers for lung injury. Smoking should be banned in chromium workplaces.

Source: Li, Ping; Li, Yang; Zhang, Ji; Yu, Shan Fa; Tong, Wei; Hu, Xiao; Jia, Guang. Journal of Occupational & Environmental Medicine: April 2015, Volume 57, Issue 4, p. e45-e50.

IARC evaluation of five organophosphate pesticides

A Working Group of 17 experts from 11 countries met at the International Agency for Research on Cancer (IARC), the specialized cancer agency of the World Health Organization on 3-10 March 2015 to review the available published scientific evidence and evaluate the carcinogenicity of five organophosphate insecticides and herbicides: diazinon, glyphosate, malathion, parathion, and tetrachlorvinphos.  A summary of the final evaluations together with a short rationale have now been published online in The Lancet Oncology, and the detailed assessments will be published as Volume 112 of the IARC Monographs.


Is There an Association of Circulatory Hospitalizations Independent of Mining Employment in Coal-Mining and Non–Coal-Mining Counties in West Virginia?

Objective: Exposures associated with coal mining activities, including diesel fuel exhaust, products used in coal processing, and heavy metals and other forms of particulate matter, may impact the health of nearby residents. We investigated the relationships between county-level circulatory hospitalization rates (CHRs) in coal and non–coal-mining communities of West Virginia, coal production, coal employment, and sociodemographic factors.
Methods: Direct age-adjusted CHRs were calculated using West Virginia hospitalizations from 2005 to 2009. Spatial regressions were conducted to explore associations between CHR and total, underground, and surface coal production.
Results: After adjustment, neither total, nor surface, nor underground coal production was significantly related to rate of hospitalization for circulatory disease.
Conclusions: Our findings underscore the significant role sociodemographic and behavioral factors play in the health and well-being of coal mining communities.

Source: Talbott, Evelyn O.; Sharma, Ravi K.; Buchanich, Jeanine; Stacy, Shaina L. Journal of Occupational & Environmental Medicine: April 2015, Volume 57, Issue 4, p. e30-e36.

Bladder Cancer Screening in Aluminum Smelter Workers

Objective: To present results of a bladder cancer screening program conducted in 18 aluminum smelters in the United States from January 2000 to December 2010.
Methods: Data were collected on a cohort of workers with a history of working in coal tar pitch volatile exposed areas including urine analysis for conventional cytology and ImmunoCyt/uCyt+ assay.
Results: ImmunoCyt/uCyt+ and cytology in combination showed a sensitivity of 62.30%, a specificity of 92.60%, a negative predictive value of 99.90%, and a positive predictive value of 2.96%. Fourteen cases of bladder cancer were detected, and the standardized incidence ratio of bladder cancer was 1.18 (95% confidence interval, 0.65 to 1.99). Individuals who tested positive on either test who were later determined to be cancer free had undergone expensive and invasive tests.
Conclusions: Evidence to support continued surveillance of this cohort has not been demonstrated.

Source: Taiwo, Oyebode A.; Slade, Martin D.; Cantley, Linda F.; Tessier-Sherman, Baylah; Galusha, Deron; Kirsche, Sharon R.; Donoghue, A. Michael; Cullen, Mark R. Journal of Occupational & Environmental Medicine: April 2015, Volume 57, Issue 4, p. 421-427.

Exposure–response relationships for select cancer and non-cancer health outcomes in a cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950–2009)

Objectives: To examine exposure–response relationships between surrogates of firefighting exposure and select outcomes among previously studied US career firefighters.
Methods: Eight cancer and four non-cancer outcomes were examined using conditional logistic regression. Incidence density sampling was used to match each case to 200 controls on attained age. Days accrued in firefighting assignments (exposed-days), run totals (fire-runs) and run times (fire-hours) were used as exposure surrogates. HRs comparing 75th and 25th centiles of lagged cumulative exposures were calculated using loglinear, linear, log-quadratic, power and restricted cubic spline general relative risk models. Piecewise constant models were used to examine risk differences by time since exposure, age at exposure and calendar period.
Results: Among 19 309 male firefighters eligible for the study, there were 1333 cancer deaths and 2609 cancer incidence cases. Significant positive associations between fire-hours and lung cancer mortality and incidence were evident. A similar relation between leukaemia mortality and fire-runs was also found. The lung cancer associations were nearly linear in cumulative exposure, while the association with leukaemia mortality was attenuated at higher exposure levels and greater for recent exposures. Significant negative associations were evident for the exposure surrogates and colorectal and prostate cancers, suggesting a healthy worker survivor effect possibly enhanced by medical screening.
Conclusions: Lung cancer and leukaemia mortality risks were modestly increasing with firefighter exposures. These findings add to evidence of a causal association between firefighting and cancer. Nevertheless, small effects merit cautious interpretation. We plan to continue to follow the occurrence of disease and injury in this cohort.

Source: Robert D Daniels, Stephen Bertke, Matthew M Dahm, James H Yiin, Travis L Kubale, Thomas R Hales, Dalsu Baris, Shelia H Zahm, James J Beaumont, Kathleen M Waters, Lynne E Pinkerton. Occup Environ Med, 2015.

The Relationship Between Occupational Metal Exposure and Arterial Compliance

Background: The objective of this study was to evaluate the relationship between cumulative occupational exposure to various metals and arterial compliance in welders.
Methods: The observational follow-up study consisted of 25 subjects. Levels of nickel (Ni), lead, cadmium, manganese, and arsenic from toenails were assessed using mass spectrometry. Arterial compliance as reflected by augmentation index (AIx) was measured using SphygmoCor Px Pulse Wave Analysis System. Linear regression models were used to assess the associations.
Results: For every 1 unit increase in log-transformed toenail Ni, there was a statistically significant 5.68 (95% confidence interval, 1.38 to 9.98; P = 0.01) unit increase in AIx. No significant associations were found between AIx and lead, cadmium, manganese, and arsenic.
Conclusions: Cumulative Ni exposure is associated with increased arterial stiffness in welders and may increase risk of adverse cardiovascular outcomes.

Source: Wong, Jason Y.Y.; Fang, Shona C.; Grashow, Rachel; Fan, Tianteng; Christiani, David C. Journal of Occupational & Environmental Médicine, April 2015, Volume 57, Issue 4, p. 355–360. 

Worker exposure and high time-resolution analyses of process-related submicrometre particle concentrations at mixing stations in two paint factories

The paint and coatings industry is known to have significant particulate matter (PM) emissions to the atmosphere. However, exposure levels are not studied in detail especially when considering submicrometre (PM1) and ultrafine particles (particle diameter below 100nm). The evidence is increasing that pulmonary exposures to these size fractions are potentially very harmful. This study investigates particle emissions during powder handling and paint mixing in two paint factories at two mixing stations in each factory. In each case measurements were made simultaneously at the mixing station (near-field; NF), as well as at 5–15 m distance into the workroom far-field (FF), and in the workers breathing zone. Particle concentrations (5nm to 30 µm) were measured using high time-resolution particle instruments and gravimetrically using PM1 cyclone filter samplers. The PM1 filters were also characterized by scanning electron microscopy (SEM). The NF particle and dust concentration levels were linked to pouring powder and were used to characterize the emissions and efficiencies of localized controls. NF particle number concentrations were 1000–40000cm−3 above FF concentrations. NF particles were mainly between 100 and 500nm and emissions appeared to occur in short bursts. Personal PM1 exposure levels varied between 0.156 and 0.839mg m−3 and were 1.6–15 times higher than stationary NF PM1 concentrations. SEM results verified that the personal exposure and NF particles were strongly dominated by the pigments and fillers used. Better understanding of the entire temporal personal exposure could be improved by using real-time particle monitors for personal exposure measurements. This study provides better insight into PM exposure characteristics and concentration levels in the paint industry.

Source: Koponen IK, Koivisto AJ, Jensen KA. Annals of Occupational Hygiene, 2015.

Exposure to airborne particles and volatile organic compounds from polyurethane molding, spray painting, lacquering, and gluing in a workshop

Due to the health risk related to occupational air pollution exposure, we assessed concentrations and identified sources of particles and volatile organic compounds (VOCs) in a handcraft workshop producing fishing lures. The work processes in the site included polyurethane molding, spray painting, lacquering, and gluing. We measured total VOC (TVOC) concentrations and particle size distributions at three locations representing the various phases of the manufacturing and assembly process. The mean working-hour TVOC concentrations in three locations studied were 41, 37, and 24 ppm according to photo-ionization detector measurements. The mean working-hour particle number concentration varied between locations from 3000 to 36,000 cm−3. Analysis of temporal and spatial variations of TVOC concentrations revealed that there were at least four substantial VOC sources: spray gluing, mold-release agent spraying, continuous evaporation from various lacquer and paint containers, and either spray painting or lacquering (probably both). The mold-release agent spray was indirectly also a major source of ultrafine particles. The workers' exposure can be reduced by improving the local exhaust ventilation at the known sources and by increasing the ventilation rate in the area with the continuous source.

Source: Mølgaard B, Viitanen AK, Kangas A, et al. International Journal of Environmental Research and Public Health, 2015;12 (4), p. 3756-73.

Optimisation de SATURISK, l’outil de calcul du temps de service des cartouches de protection respiratoire contre les vapeurs organiques

L'exposition des travailleurs aux solvants, ou plus largement aux vapeurs organiques, doit être maîtrisée sinon maintenue en deçà des valeurs limites réglementaires. Lorsque l'ensemble des mesures administratives, d'ingénierie et de protection collective ne permet pas d'atteindre des niveaux d'exposition sans danger pour la santé, les travailleurs concernés doivent être équipés d'appareils de protection respiratoire (APR). En l'absence de situations de danger immédiat pour la vie et la santé (DIVS), les APR équipés de cartouches de filtration à base de charbon activé sont utilisés contre les vapeurs organiques. Se pose alors la question du temps de service de ces cartouches. Parmi les options disponibles pour y répondre, celle visant à mettre en œuvre des modèles prédictifs des temps de claquage est la plus utilisée.
Ainsi, l'objectif de ce projet consistait en la mise à jour de Saturisk, l'outil en ligne offert par l'Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST) pour calculer le temps de service des cartouches pour les vapeurs organiques. Cette mise à jour visait notamment à intégrer un éventail plus large de cartouches  et de solvants à Saturisk. En parallèle, le développement d'un système expérimental basé sur la miniaturisation des cartouches a été réalisé pour vérifier, dans des conditions contrôlées, les temps de service prédits par le modèle.


Température estivale, concentrations d’ozone et lésions professionnelles acceptées au Québec

Les changements climatiques sont indéniables et leurs impacts sur la santé de la population  préoccupent de plus en plus les scientifiques et les décideurs publics. Les spécialistes prévoient des hausses de température au Québec et que les durées et l’intensité des périodes de chaleur accablante et de canicules augmenteront. D’autres paramètres environnementaux seront possiblement modifiés à la suite de l’augmentation de la température extérieure, comme la hausse des concentrations ambiantes de certains polluants atmosphériques tel l’ozone au sol.
Ces changements pourraient avoir un impact sur la santé et la sécurité des travailleurs. Dans la littérature, il est rapporté que l’exposition à la chaleur extérieure entraîne de la mortalité, de la morbidité et possiblement une augmentation de l’incidence des lésions professionnelles. Toutefois, les relations statistiques entre la température extérieure et la survenue de maladies ou d’accidents chez les travailleurs n’ont été que très peu documentées et ne l’ont jamais été dans des conditions similaires à celles du Québec. Le même constat s’impose quant à la relation entre l’ozone et les problèmes respiratoires chez les travailleurs, alors que les effets d’une exposition simultanée ozone-chaleur n’ont jamais été étudiés pour cette population.


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