An evaluation of cases of pneumonia that occurred secondary to hydrocarbon exposure in children

OBJECTIVE

Hydrocarbon pneumonia is distinct among the types of childhood pneumonia in that it has a different pathogenesis and treatment and is preventable. In this study, the cases of 54 children with hydrocarbon pneumonia admitted to the Dicle University Medical Faculty Pediatric Chest Diseases Unit between the years 2006 and 2010 were analyzed retrospectively.

PATIENTS AND METHODS

The medical records of 54 patients diagnosed with pneumonia after ingesting/inhaling hydrocarbons were analyzed retrospectively. Age, sex, presenting symptoms, clinical status, radiological and laboratory findings and response to treatment and prognosis were noted.

RESULTS

35 (64.8%) of the patients were male, 19 (35.2%) were female and the ages of the patients ranged from 1 to 5 with an average of 2.49 ± 0.80. The etiologies of the pneumonia were thinner (33%), naphta (3.7%) and kerosene. In 49 of the patients (90.7%), the symptoms started to occur the day the patient was exposed to hydrocarbons. The average length of hospital stay was 4.0 ± 2.3 days. Six patients were treated in the intensive care unit (ICU), and one patient with hydrocarbon pneumonia due to kerosene ingestion died. Inhaled corticosteroids were administered to 18 patients who were progressively deteriorating and inhaled salbutamol was given to 16 patients with bronchospasm. Patients with radiological findings on their chest X-rays and auscultatory findings were found to have longer hospital stays (p < 0.05).

CONCLUSIONS

To prevent chemical pneumonia, precautions must be taken to stop children under 5 years of age from using/abusing chemical substances. Although some cases of chemical pneumonia lead to death, with diligent care and treatment, the outcomes are promising. The patients in this study group responded well to treatment with inhaled corticosteroids and salbutamol.

Modulation of oxidative DNA damage by repair enzymes XRCC1 and hOGG1

The influence of DNA repair gene polymorphisms (XRCC1: Arg194Trp, Arg280His, Arg399Gln; APE1: Asp148Glu; hOGG1: Ser326Cys) on oxidative DNA damage is controversial and was investigated in 214 German workers with occupational exposure to vapors and aerosols of bitumen,compared to 87 German construction workers without exposure, who were part of the Human Bitumen Study. Genotypes were determined by real-time polymerase chain reaction (PCR), and actual smoking habits by a questionnaire and cotinine analysis. Oxidative DNA damage in white blood cells (WBC) collected pre- and postshift was measured as 8-oxodGuo adducts/10(6) dGuo by a hjigh-performance liquid chromatography electron capture detection (HPLC-ECD) method, followed by calculation of the difference between post- and preshift values (Δ8-oxodGuo/10(6) dGuo). The 214 bitumen exposed workers showed higher median Δ8-oxodGuo values than the 87 references. In the whole study group (n=301) there was a trend for increasing adduct values for XRCC1 Arg(GG)399Gln(AA) during a shift, especially in nonsmokers (n=108. Referents (n=87) displayed a similar trend for hOGG1 Ser(CC)326Cys(GG). In contrast, XRCC1 Arg(GG)280His(AA) showed a decrease of median Δ8-oxodGuo/10(6) dGuo values in workers with exposure to vapors and aerosols of bitumen (n=214), especially in smokers (n=145). XRCC1 Arg194Trp and APE1 Asp148Glu displayed no marked association with Δ8-oxodGuo levels. Data indicate that the combination of different variants in DNA damage repair enzymes may modulate the production of 8-oxoguanine adducts in WBC produced by xenobiotics during a shift.

Acute respiratory distress associated with inhaled hydrocarbon

BACKGROUND

Pneumonitis is a well-known complication following aspiration of ingested liquid hydrocarbons. There are few data about acute pulmonary toxicity from unintentional hydrocarbon inhalation; most human cases involve products containing a fluoropolymer in combination with hydrocarbons.

METHODS

Case report of a 45-year-old male who presented with respiratory distress after a 15-min inhalational exposure to a canvas waterproofing spray containing liquefied petroleum gas, ethylene glycol monobutyl ether, and isopropanol.

RESULTS

Patients had symptoms, exam findings, and chest X-ray that were consistent with an acute pneumonitis.

CONCLUSION

Acute pulmonary injury can occur after a short exposure to an inhaled hydrocarbon and associated symptoms appear to respond to supportive measures, including oxygen, corticosteroids, and bronchodilators.

Aliphatic and polycyclic aromatic hydrocarbons in the Xihe River, an urban river in China's Shenyang City: distribution and risk assessment

The characteristics of petroleum hydrocarbons and the risks they pose to the ecosystem were studied in the Xihe River, which is an urban river located in Shenyang, China. High levels of aliphatic hydrocarbons (AHc) and polycyclic aromatic hydrocarbons (PAHs) were observed in the river due to the discharge of wastewater from industrial and municipal facilities for a long period of time. High-molecular-weight hydrocarbons, including unresolved complex mixtures (UCM) of n-alkanes between n-C16 and n-C32 and of PAHs with four to six rings, were the dominant hydrocarbons in the river, particularly in suspended particulate matter (SPM) and sediments. The AHc was mainly from petrogenic sources, whereas PAHs was from both pyrolytic and petrogenic source inputs. Our results suggest that there is a high risk of toxicity for the soils and groundwater of the study area. The overall toxicity in the sediments can be described using the toxic equivalent (TEQ) of dibenzo[a,h]anthracene (DBA) based on benzo(a)pyrene (TEQ(BaP)) and dioxins (TEQ(TCDD)) toxic equivalent concentrations. The TEQ values for benzo(a)pyrene (TEQ(BaP)) and dioxins (TEQ(TCDD)) presented a consistent assessment of sediment PAHs.

Development of the concept of spatial-temporal mask for testing effects of discharge from well-drilling activities on biological communities

This paper describes the use of Bayesian spatial models to develop the concept of a spatial-temporal mask for the purpose of identifying regions in which before and after drilling effects are most clearly defined and from which the consequences of exposure of macrofauna and meiofauna to the release of drilling discharges can be evaluated over time. To determine the effects of drilling fluids and drill-cuttings on the marine benthic community, it is essential to know not only where discharged materials ended up within the possible impact area, but also the chemical concentrations to which biota were exposed during and after drilling. Barium and light hydrocarbons were used as chemical tracers for water-based and non-aqueous-based fluids in a shallow water site in the Campos Basin, off the coast of Brazil. Since the site showed evidence of exposure to waste material from earlier drilling, the analysis needed to take into account the background concentrations of these compounds. Using the Bayesian models, concentrations at unsampled sites were predicted and regions altered and previously contaminated were identified.

A novel total petroleum hydrocarbon fractionation strategy for human health risk assessment for petroleum hydrocarbon-contaminated site management

Human health risk assessments for petroleum, oil, and lubricant (POL)-contaminated sites are more complicated than for sites contaminated by single compounds due to the complex composition and various analytical methods associated with total petroleum hydrocarbons (TPH). Although several TPH fractionation methods are commonly used, including that of the TPH Criteria Working Group (TPHCWG), an efficient and economical human health risk assessment method is not yet available. To address this concern, a new modified fractionation strategy is recommended in this study, which resolves the problems of the current TPH fractionation methods while retaining reliability in the results. For the purpose of this study, the distribution characteristics of the 13 TPHCWG fractions were examined, and human health risk assessments for the POL-contaminated sites were performed. The results show that aliphatic EC8-16 and aromatic EC10-21 among the 13 TPH fractions are major contributors to human health risks along all exposure routes, making up approximately 96% of the hazard index (HI) of the TPH fractions, on average. Therefore, it is reasonable to concentrate on aliphatic EC8-16 and aromatic EC10-21 fractions, rather than to study all of the TPH fractions, in evaluating human health risk for TPH-contaminated sites.

Causal relationship between exposure to chemicals and malignant melanoma? A review and study proposal

Malignant melanoma (MM) is a significant cause of morbidity and mortality worldwide. The MM-related incidence and mortality have been increasing at an alarming rate over at least the past four decades. Malignant melanoma has been thought to be related mainly to exposure to the sun or UV radiation. A review of the scientific literature reveals many significant correlations between chemical exposure in the workplace and the occurrence of malignant melanoma, particularly in cutaneous areas that have never been exposed to sunlight. Discrepant findings are reported by independent studies concluding that MM is causally related to employment-related chemical exposures and to investigators with industry affiliations. More studies are needed to define a correlation of chemical exposure as a co-factor on the pathogenesis in some melanoma patients. We propose further investigation by dermatologists working in Melanoma Centers, using a simple questionnaire on chemical exposure among patients, that have previously been diagnosed and are followed up for melanoma comparing with appropriate matched controls. Collecting the data and results from the questionnaire will help us understand the initiation events in melanoma and prevention health issues.

Environmental liability and life-cycle management of used lubricating oils

Used oil handling, as a business, requires an extensive understanding by management that environmental liabilities exist through its supply chain. Findings from a review of the legal requirements of operating a used oil handling business were: understanding the transfer of ownership of used petroleum hydrocarbons is critical to any such business and how this is documented; used oil handlers are responsible for providing training to their staff, including site personnel and any third party waste contractors, and for communicating best practice procedures relating to the management of used petroleum hydrocarbons to all those individuals and organisations involved in business relationships that the used oil handling companies have; used oil handlers should audit the performance of any third party contractors that it engages to conduct work on behalf of its customers. Hypothetical situations of a company planning to enter the used oil handling market are described in relation to petroleum hydrocarbon wastes it handles to illustrate the range of potential liabilities. Companies proposing to establish a used oil handling business should ensure that they provide accurate advice to its employees, its customer's employees and to its third party contractors, all of which may be responsible for handling used petroleum hydrocarbons as part of the service it intends to provide, and that it has a well documented system addressing how environmental issues are managed.

Occupational exposure to solvents and gasoline and risk of cancers in the urinary tract among Finnish workers

BACKGROUND

Bladder cancer (BC) is generally considered as an occupational disease, and some chemical exposures may also be associated with renal cell cancer (RCC). The aim of this study was to estimate the risk of cancers of the urinary tract in relation to occupational exposure to solvents and gasoline.

METHODS

A cross-sectional cohort of all economically active Finns from the 1970 population census was followed up for BC (10,277 cases) and RCC (9,954 cases). Census occupations were assigned estimates of exposure to hydrocarbon (HC) solvents and gasoline with a job exposure matrix. Relative risk (RR) estimates were defined using Poisson regression models, adjusted for smoking and obesity.

RESULTS

Exposure to solvents was positively associated with the incidence of BC in women but not in men. The RR estimates were above 1.2 in nearly all exposure categories of all exposures studied but a statistically significant excess was only seen for middle levels of chlorinated HC solvents (1.7; 95% CI = 1.2-2.5) and a low level of aromatic HC solvents (1.6; 95% CI = 1.3-2.1). The RR estimates for RCC were close to unity in all categories of exposure.

CONCLUSIONS

Our findings suggest that occupational exposure to certain solvents may have an impact on BC risk. The risk of RCC does not appear to be altered by exposure to HC solvents or gasoline.

Cancer incidence and mortality in aircraft maintenance workers

BACKGROUND

A cancer incidence and mortality study was conducted in response to health concerns raised by workers from F-111 aircraft deseal/reseal fuel tank maintenance programs, to determine whether personnel exposed to deseal/reseal had an excess of cancers and mortality.

METHODS

Number of deaths and cancers for individuals involved in F-111 DSRS activities were matched against two Air Force comparison groups. Analyses were weighted to adjust for differences in age, exposure period and rank.

RESULTS

Eight hundred seventy-three exposed, 7,577 comparison group one, and 9,408 comparison group two individuals were matched against death and cancer data, with 431 cancers and 431 deaths. Cancer incidence was higher in the exposed group, with marginally significant increases of 40-50% (cancer incidence rate ratio range 1.45-1.62). Exposed group mortality was significantly lower than both comparison groups, likely due to survivor bias in the exposed group (mortality rate ratio range 0.33-0.44).

CONCLUSIONS

On the balance of probabilities, there is an increased risk of cancer associated with participation in F-111 deseal/reseal activities.

[Hygienic evaluation of the effects of petroleum hydrocarbons on crops]

Experience in standardizing the soil levels of chemicals suggests that the translocation hazard index is limiting for most standardized substances. The current unavailability of scientifically grounded maximum allowable concentration of soil petroleum generates a need for studies using this hazard index. The studies were made to examine different soil petroleum levels, by employing various test crops.

Bitumen products alter bax, bcl-2 and cytokeratin expression: an in vivo study of chronically exposed road pavers

BACKGROUND

The skin of road pavers is chronically exposed to bitumen fumes, a mixture of volatile compounds and particles, containing several carcinogenic and non-carcinogenic polycyclic aromatic hydrocarbons. Bitumen fumes can alter cutaneous barrier integrity in various ways and induce skin diseases. The present study was devised to investigate the expression of apoptosis proteins (bax and bcl-2) and the cytokeratin pattern in skin specimens from road paving workers exposed to bitumen fumes using immunohistochemical techniques.

METHODS

Skin forearm punch biopsies from 16 occupationally exposed workers and an unexposed control group were processed for immunohistochemistry using a broad-spectrum anti-cytokeratin antibody and monoclonal antibodies for bax and bcl-2 immunostaining. Urinary 1-hydroxypyrene (1-OHP) was also determined.

RESULTS

Morphological specimen evaluation showed epidermal thinning of exposed skin and flattened dermal papillae. In sections from exposed subjects, grade 3 bax overexpression and cytokeratin immunoreaction was detected in all layers, while bcl-2 expression was downregulated (grade 1) and confined to the basal layer. There was a significant difference in 1-OHP values between road pavers and the control group (p < 0.05).

CONCLUSION

Overexpression of the cytokeratin pattern and bax and underexpression of bcl-2 in chronically bitumen-exposed skin suggest that bitumen fumes induce activation of apoptosis as a defense mechanism.

[Theory and practice of primary cancer prevention]

The primary aim of cancer prevention is to stop carcinogens from entering the body. Since the low doses involved in carcinogenesis do not cause true toxicological effects, usual toxicological analytic methods do not allow the detection of the early effects of carcinogens. Exposure to chemical carcinogens causes damage to nuclear chromatin, the most vulnerable part of the cell, by inducing DNA damage, chromosomal abnormalities and mutations, which foreshadow the danger of cancer development. In such cases intervention is possible in two ways. On the one hand, we attempt to remove the causative agent from the environment, while on the other we aid the elimination of somatic mutations. The latter is called active prevention; the introduction of substances into the body that can help the elimination of defective cells (apoptosis induction) or stop processes responsible for elongation errors (i.e. with antioxidants). Concerning our own studies, we present the results of 25 years of research on the genotoxicological characteristics of workers exposed to various chemicals, which show that active prevention can in fact be effective in conjunction with information on specific biomarkers. We present in detail the genotoxic changes found in hospital nurses who routinely administer intravenous cytostatic therapy, and the relationship of these changes to their immunotoxic and clinical laboratory parameters. Genotoxic substances decrease the oxidative burst and natural killer (NK) cell activity, which may explain the immunosuppressive effects of occupational exposures. We also present the detailed results of a follow-up study involving two groups of industrial workers. We monitored the status of workers involved in benzene production for 15 years and of asphalt industry workers for 8 years. In both studies we concluded that genotoxic effects can be decreased by ensuring appropriate working conditions, while a temporary lapse in these conditions or accidental changes lead to increases in genotoxic parameters. Since genotoxic effects develop over an extended period (4-5 months), they are independent of hygienic conditions at any single inspection and, thus, their detection also offers a way to ascertain true exposure levels. Our studies also show a connection between genotoxic effects and immune function, which is adversely affected not only by occupational exposures, but also by medications and smoking. From our results with workers in the oil and asphalt industries, we concluded that the levels of chromosomal aberrations (CAs) and sister chromatid exchange (SCE) increase in proportion to exposure levels and decrease with a certain delay following the attenuation of the exposure. We could not detect an increased frequency of any chronic disease in industrial workers. The increased numbers of iron deficiency anemia and thyroid disease in nurses providing cytostatic therapy was, however, related to their occupational exposure.

Paternal occupation and neural tube defects: a case-control study based on the Oxford Record Linkage Study register

Certain paternal occupations and related exposures have been suggested as possible risk factors for neural tube defects (NTD). We analysed data collected as part of a case-control study to investigate the relationship between paternal occupational exposures and NTD. Cases were 694 NTD-affected pregnancies diagnosed between 1970 and 1987 in Oxfordshire or West Berkshire, England. Controls were randomly selected from a computerised maternity database individually matched to cases on maternal year of birth and year of index pregnancy. Data on paternal occupation were abstracted from hospital antenatal records. Associations between paternal occupational exposures and NTD were assessed using odds ratios adjusted for maternal year of birth, year of index pregnancy, gender of baby, multiplicity of birth and number of previous obstetric events. Statistically significant positive associations were observed for paternal occupational exposure to agrochemicals and animals. Analysis by occupational title revealed that more case than control fathers were farmers, gardeners and butchers. Statistically significant negative associations were seen for paternal occupational exposure to inhaled hydrocarbons and metal-working oil mists. The findings from this population-based study for paternal agricultural and animal-related occupations overlap and have been previously observed. The apparent protective effects of fathers working with inhaled hydrocarbons and metal-working oil mists have not been previously described. No underlying biological mechanisms have been identified, therefore other explanations cannot be excluded.

Expression of JP-8–Induced Inflammatory Genes in AEII Cells Is Mediated by NF-κB and PARP-1

Lung epithelial cells are critical in the regulation of airway inflammation in response to environmental pollutants. Altered activation of NF-kappaB is associated with expression of several proinflammatory factors in respiratory epithelial cells in response to an insult. Here we show that a low threshold dose (8 microg/ml) of the jet fuel JP-8 induces in a rat alveolar epithelial cell line (RLE-6TN) a prolonged activation of NF-kappaB as well as the increased expression of the proinflammatory cytokines TNF-alpha and IL-8, which are regulated by NF-kappaB. The up-regulation of IL-6 mRNA in cells exposed to JP-8 appears to be a reaction of RLE-6TN cells to reduce the enhancement of proinflammatory mediators in response to the fuel. Moreover, lung tissues from rats exposed to occupational levels of JP-8 by nasal aerosol also showed dysregulated expression of TNF-alpha, IL-8, and IL-6, confirming the in vitro data. The poly(ADP-ribosyl)ation of PARP-1, a coactivator of NF-kappaB, was coincident with the prolonged activation of NF-kappaB during JP-8 treatment. These results evidenced that a persistent exposure of the airway epithelium to aromatic hydrocarbons may have deleterious effects on pulmonary function.

A case of fire-eater's pneumonia in an active-duty soldier

Fire-eater's pneumonia is an acute, intense hydrocarbon pneumonitis resulting from aspiration of volatile hydrocarbons such as kerosene, gasoline, or turpentine. The vast majority of patients have resolution of their acute lung injury with supportive care only, avoiding the need for surgical lung reduction procedures. We describe a case of severe hydrocarbon pneumonitis secondary to aspiration of JP-8 jet fuel. The presentation, management, and prognosis of fire-eater's pneumonia are reviewed.