Occupational Respiratory Exposure to Platinum Group Metals: A Review and Recommendations

Deciphering platinum dissolution in neural stimulation electrodes: Electrochemistry or biology?

Platinum (Pt) is the metal of choice for electrodes in implantable neural prostheses like the cochlear implants, deep brain stimulating devices, and brain-computer interfacing technologies. However, it is well known since the 1970s that Pt dissolution occurs with electrical stimulation. More recent clinical and in vivo studies have shown signs of corrosion in explanted electrode arrays and the presence of Pt-containing particulates in tissue samples. The process of degradation and release of metallic ions and particles can significantly impact on device performance. Moreover, the effects of Pt dissolution products on tissue health and function are still largely unknown. This is due to the highly complex chemistry underlying the dissolution process and the difficulty in decoupling electrical and chemical effects on biological responses. Understanding the mechanisms and effects of Pt dissolution proves challenging as the dissolution process can be influenced by electrical, chemical, physical, and biological factors, all of them highly variable between experimental settings. By evaluating comprehensive findings on Pt dissolution mechanisms reported in the fuel cell field, this review presents a critical analysis of the possible mechanisms that drive Pt dissolution in neural stimulation in vitro and in vivo. Stimulation parameters, such as aggregate charge, charge density, and electrochemical potential can all impact the levels of dissolved Pt. However, chemical factors such as electrolyte types, dissolved gases, and pH can all influence dissolution, confounding the findings of in vitro studies with multiple variables. Biological factors, such as proteins, have been documented to exhibit a mitigating effect on the dissolution process. Other biological factors like cells and fibro-proliferative responses, such as fibrosis and gliosis, impact on electrode properties and are suspected to impact on Pt dissolution. However, the relationship between electrical properties of stimulating electrodes and Pt dissolution remains contentious. Host responses to Pt degradation products are also controversial due to the unknown chemistry of Pt compounds formed and the lack of understanding of Pt distribution in clinical scenarios. The cytotoxicity of Pt produced via electrical stimulation appears similar to Pt-based compounds, including hexachloroplatinates and chemotherapeutic agents like cisplatin. While the levels of Pt produced under clinical and acute stimulation regimes were typically an order of magnitude lower than toxic concentrations observed in vitro, further research is needed to accurately assess the mass balance and type of Pt produced during long-term stimulation and its impact on tissue response. Finally, approaches to mitigating the dissolution process are reviewed. A wide variety of approaches, including stimulation strategies, coating electrode materials, and surface modification techniques to avoid excess charge during stimulation and minimise tissue response, may ultimately support long-term and safe operation of neural stimulating devices.

Update on occupational allergy, including asthma, to soluble platinum salts

PURPOSE OF REVIEW

This review aims to evaluate recent literature on occupational platinum salt exposure and allergy and asthma in the context of existing evidence.

RECENT FINDINGS

A major recent development is that large quantitative platinum salt exposure datasets have become available and are finding applications in epidemiological studies. These exposure data are expected to lead to higher quality epidemiological studies focusing on exposure response relations, modifiers of exposure and sensitization risk. The exposure data might also improve medical referral advice as part of medical surveillance studies and contribute to improved evidence on the effectiveness of exposure referral.

SUMMARY

Hopefully, the availability of exposure databases form a stimulus for more exposure response studies and risk assessments leading to science based primary prevention approaches. The availability of more detailed exposure data can guide job transfer decisions in occupational clinical practice.

Exposure to soluble platinum salts in precious metal refinery workers over a 17-year period

BACKGROUND

Occupational exposure to soluble chlorinated platinum (Pt) salts, commonly called chloroplatinates, is a known cause of Pt salt sensitisation (PSS) and occupational asthma. We aimed to model inhalable soluble Pt salts exposure levels based on measurements in precious metal refineries for use in a retrospective cohort study on PSS.

METHODS

Five platinum refineries located in the United Kingdom (3 sites), United States, and South Africa provided time weighted average inhalable soluble Pt salts exposure data, measured in 2,982 personal air samples over a 17-year period (2000-2016). We used a Bayesian hierarchical model to estimate geometric mean (GM) exposure levels for each refinery and job title over time.

RESULTS

The GM of measured exposure levels over all facilities was 92 ng/m3 with a geometric standard deviation (GSD) of 9.07. Facility-specific GMs ranged from 48 ng/m3 (GSD 15.3) to 242 ng/m3 (GSD 5.99). Exposure modelling showed that soluble Pt salts exposure levels declined approximately 10% per year in two of the five facilities, but there were no clear time trends in the other facilities. A priori specified exposure groups captured most of the between-jobs differences, which helps to accurately predict exposures for jobs with no measurement data available.

CONCLUSIONS

We applied exposure modelling to estimate time, refinery, and job-specific soluble Pt salts exposures. A significant annual decline in exposure levels was observed in two of the five participating facilities. Modelled exposure levels can be linked to individual workers' job history for exposure-response analysis of PSS in an epidemiological study.

Skin and respiratory exposure to soluble lead, cobalt, nickel, copper, arsenic and silver at two South African precious metals refineries

OBJECTIVES

Precious metals refinery workers are exposed to soluble platinum group metals (PGMs) during PGM-refining but may also be exposed to hazardous non-PGMs (Pb, Co, Ni, Cu, As and Ag) still present in the matte following base metals refining. The aim of this article was to report the skin and respiratory exposure of workers to soluble non-PGMs during PGM-refining.

METHODS

Skin and respiratory exposure (of 40 workers at two precious metals refineries) were measured simultaneously over two consecutive shifts. Skin exposure was measured on the palm, wrist, neck and forehead using Ghostwipes™ and respiratory exposure was measured using the MDHS method 46/2 during which soluble metals were extracted using 0.07 M HCl and mechanical agitation, followed by ICP-MS analysis.

RESULTS

The geometric means (GM) of average skin exposure to individual soluble metals on all anatomical areas was found in the order Cu (0.018 µg/cm²) > Ni (0.016 µg/cm²) > Pb (0.008 µg/cm²) > Ag (0.006 µg/cm²) > As (0.004 µg/cm²) > Co (0.0008 µg/cm²) with the palm being the highest exposed anatomical area. The order of the GM respiratory exposure was Pb (0.224 µg/m³) > Ag (0.201 µg/m³) > Cu (0.159 µg/m³) > As (0.079 µg/m³) > Ni (0.034 µg/m³) > Co (0.016 µg/m³) with exposure to As exceeding the South African occupational exposure limit (20 µg/m³) during concentrate handling (max 66.174 µg/m³).

CONCLUSIONS

Workers were exposed to a mixture of toxic PGM and non-PGMs via the skin and inhalation. Exposure to these metals could lead to the development of diseases, such as contact dermatitis, occupational allergy, or occupational cancer. Non-PGMs must be included in hazardous chemical risk assessments and control strategies implemented at precious metals refineries.

An improved method for sampling and analytical measurement of aerosol platinum in ambient air and workplace environments

In this study we critically examined with both field and laboratory experiments key components of extant methods for measurement of aerosol soluble platinum in ambient air and workplace environments. Our goal was to develop an improved method for soluble platinum measurement that could be readily implemented in the field and laboratory using readily available modern analytical tools, and in parallel provide insight into factors influencing the robustness of specific aspects of measurement methods for soluble platinum. Experiments addressed sampler type, filter media and pre-cleaning, extraction solvent and volume, extraction time & energy and materials composition, with the objective of optimizing each specific component and promulgating strategies for improving signal/noise and precision. We used basic clean-room protocols and applied ICPMS tools to address these objectives. We document a method that provides for measurement of soluble platinum at the 0.02 ng/m³ level (8-h sample at 2 L/min). Of the four samplers evaluated (IOM, closed-face cassette, and two parallel particle impactors), the IOM exhibited the best precision. The three filter substrates evaluated (Teflon, MCE, PVC) performed similarly in most challenges, however, overall, we conclude that MCE media is the most robust collection substrate for soluble platinum measurements. To achieve the lowest detection levels, it is critical to pre-clean the filter substrates. The use of a 0.07 M HCl extractant (in preference to a water extractant) is recommended - platinum recoveries, particularly from real-world samples, are higher and more consistent with the HCl extractant. The outcomes of the extraction kinetics experiments suggest that an extraction time of 60 min may improve the method performance with 0.07 M HCl but degrade the performance with water, in comparison with a 30-min extraction period. The use of sonication in preference to a table-top shaker is recommended for energy input during extraction.

Skin and respiratory exposure to platinum group metals at two South African precious metals refineries

OBJECTIVE

Platinum Group Metals (PGMs) are mined and refined together and have the potential to elicit adverse respiratory and skin health effects. The aim of this study was to investigate the simultaneous skin and respiratory exposure of precious metals refinery workers to all six soluble PGMs.

METHODS

The simultaneous skin and respiratory exposure to soluble PGMs of forty workers at two precious metals refineries were measured over two consecutive work shifts using Ghostwipes™ and Methods for the Determination of Hazardous Substances method 46/2. Skin exposure was measured on the palm, wrist, neck, and forehead of workers.

RESULTS

The highest geometric mean (GM) skin exposure (average of palm, wrist, neck and forehead) was found for soluble Pt (0.008 µg/cm²) [95% confidence interval (CI) 0.005-0.013], followed, in order, by Rh, Ir, Pd, Ru, and Os. Significantly higher concentrations of soluble PGMs were found on the palm and wrist compared to the neck and forehead (p < 0.0001). The highest GM respiratory exposure was found for soluble Pd (0.342 µg/m³ [95% CI 0.163-0.718]) followed, in order, by Pt, Rh, Ru, Ir, and Os. Skin exposure to all soluble PGMs was positively correlated with respiratory exposure (r = 0.466-0.702).

CONCLUSION

This is the first study to report skin exposure to all six soluble PGMs. Precious metals refinery workers were exposed to quantifiable concentrations of soluble PGMs via both the skin and inhalation. Exposure via both routes occurred together and control measures should be aimed at reducing both skin and respiratory exposure.

Platinum Accumulation and Cancer-Related Fatigue, Correlation With IL-8, TNF-α and Hemocytes

Platinum-based chemotherapy drugs cause platinum accumulation and result in cancer-related fatigue (CRF), which is related to immune response through still ambiguous mechanisms. We aimed to explore the correlation between platinum and CRF from the perspective of platinum accumulation. After allowing for complete metabolism of the administered platinum drugs, we collected blood samples from 135 patients who had at least two platinum chemotherapy rounds, correlated the platinum concentration (C-Pt), pro-inflammatory cytokines IL-8 and TNF-α, hematological index with therapeutic effect, adverse reactions and fatigue. The median platinum concentration was higher in patients treated with cisplatin than oxaliplatin (424.0 vs 211.3 μg/L), and the occurrence of fatigue was 64.4% in all subjects. Separately, the incidence and degree of fatigue were 74.1% and 9.5 in the patients with higher platinum concentration compared to 57.1% and 2.0 in the lower group. C-Pt, IL-8 and TNF-α were positively correlated with the degree of CRF, while erythrocyte count and hemoglobin were negatively correlated with the degree of CRF. Mediating effect analysis showed that increased IL-8 concentration mediated 57.4%, while decreased erythrocyte count mediated 24.1% of the C-Pt effect on CRF. Platinum accumulation may involve increasing IL-8, cause inflammation or aggravate anemia, which in combination lead to CRF.

Occupational Exposure to Metals and Solvents: Allergy and Airway Diseases

PURPOSE OF REVIEW

Occupational allergic diseases (OAD) such as occupational contact dermatitis (OCD), occupational asthma (OA), and occupational rhinitis (OR) are the most prevalent occupational diseases in industrialized countries. The purpose of this review is to provide an update about the main occupational metal and solvent exposures related to allergy and airway diseases and to discuss newly defined causative agents and industries in this field.

RECENT FINDINGS

Currently for over 400 causative agents for OA and OCD, several hundreds of agents for OR have been identified. Although many studies have reported an overall decline in OAD related to known agents after implementation of efficient and effective workplace preventive measures, the constant development of new products continuously introduces to the market potential unknown respiratory hazards. Workplace allergens are often high molecular weight (HMW) agents that are > 10 kDa molecular weight and capable of eliciting IgE sensitization. Sensitizing low molecular weight (LMW) agents are often reactive chemicals. Metals and solvents are two large causative agent groups related to OADs that mainly behave as LMW (< 10 kDa) sensitizers and/or irritants. Avoidance of causative exposures through control strategies is the primary prevention approach for OADs. These strategies must be applied and covered for all known and newly defined causative agents. This review aims to summarize current status of known occupational metal and solvent exposures related to allergy and airway diseases and to discuss newly defined causative agents and industries in this field.

Neglected, Drug-Induced Platinum Accumulation Causes Immune Toxicity

Previous studies only focused on different adverse reactions caused by various platinum drugs, but not on common immunotoxicity caused by the accumulation of elemental platinum. Here, we determined the serum platinum concentrations of cancer patients after a metabolism period of platinum drug chemotherapy, in addition to hematological indices and subsequent immune-related adverse reactions, then analyzed the correlations between platinum accumulation, immune cell levels, and immune-toxicity. We chose the day before the next round of chemotherapy as the specified time point for blood sampling. Samples were collected at five time points, separately in oxaliplatin and cisplatin groups. The median serum platinum concentrations in all patients was 294.8 (205.6, 440.3) μg/L, and was approximately two-fold greater in the cisplatin group than in the oxaliplatin group (429.3 vs. 211.7 μg/L). The platinum level of both groups peaked at the third time point, with the average of females being higher than males (383.9 vs. 266.5 μg/L), and was positively correlated with leukocyte and platelet counts, but negatively correlated with erythrocyte counts and concentration of hemoglobin. The risks of anemia and adverse reactions were individually increased by 0.002- and 0.007-fold for every μg/L increase of platinum concentration. To our knowledge, this is the first study on the relationship between platinum accumulation, immune cell levels and toxicity, showing that drug-induced platinum accumulation may interfere with immune cells and thus increase the risk of toxicity.

Metal nanomaterials: Immune effects and implications of physicochemical properties on sensitization, elicitation, and exacerbation of allergic disease

The recent surge in incorporation of metallic and metal oxide nanomaterials into consumer products and their corresponding use in occupational settings have raised concerns over the potential for metals to induce size-specific adverse toxicological effects. Although nano-metals have been shown to induce greater lung injury and inflammation than their larger metal counterparts, their size-related effects on the immune system and allergic disease remain largely unknown. This knowledge gap is particularly concerning since metals are historically recognized as common inducers of allergic contact dermatitis, occupational asthma, and allergic adjuvancy. The investigation into the potential for adverse immune effects following exposure to metal nanomaterials is becoming an area of scientific interest since these characteristically lightweight materials are easily aerosolized and inhaled, and their small size may allow for penetration of the skin, which may promote unique size-specific immune effects with implications for allergic disease. Additionally, alterations in physicochemical properties of metals in the nano-scale greatly influence their interactions with components of biological systems, potentially leading to implications for inducing or exacerbating allergic disease. Although some research has been directed toward addressing these concerns, many aspects of metal nanomaterial-induced immune effects remain unclear. Overall, more scientific knowledge exists in regards to the potential for metal nanomaterials to exacerbate allergic disease than to their potential to induce allergic disease. Furthermore, effects of metal nanomaterial exposure on respiratory allergy have been more thoroughly-characterized than their potential influence on dermal allergy. Current knowledge regarding metal nanomaterials and their potential to induce/exacerbate dermal and respiratory allergy are summarized in this review. In addition, an examination of several remaining knowledge gaps and considerations for future studies is provided.

Application of the direct peptide reactivity assay (DPRA) to inorganic compounds: a case study of platinum species

The in chemico Direct Peptide Reactivity Assay (DPRA) was developed as a non-animal, relatively high throughput, screening tool for skin sensitization potential. Although the Adverse Outcome Pathway (AOP) for respiratory sensitization remains to be fully elucidated, it is recognized that the molecular initiation event for both skin and respiratory sensitization to low molecular weight chemicals involves haptenation with proteins. The DPRA examines the reactivity of a test compound to two model peptides (containing either cysteine or lysine) and consequently is able to screen for both skin and respiratory sensitization potential. The DPRA was primarily developed for and validated with organic compounds and assessment of the applicability of the assay to metal compounds has received only limited attention. This paper reports the successful application of the DPRA to a series of platinum compounds, including hexachloroplatinate and tetrachloroplatinate salts, which are some of the most potent chemical respiratory sensitizers known. Eleven platinum compounds were evaluated using the DPRA protocol as detailed by Lalko et al., with only minor modification. Two palladium compounds with structures similar to that of the platinum species studied and cobalt chloride were additionally tested for comparison. The hexachloroplatinate and tetrachloroplatinate salts showed exceptionally high reactivity with the cysteine peptide (EC₁₅ values of 1.4 and 14 μM, respectively). However, for platinum compounds (e.g. hydrogen hexahydroxyplatinate and tetraammineplatinum) where clinical and epidemiological evidence indicates limited sensitization potential, the cysteine DPRA showed only minor or no reactivity (EC₁₅ values of 24 600 and >30 000 μM, respectively). The outcomes of the lysine peptide assays were less robust and where EC₁₅ was measurable, values were substantially higher than the corresponding results from the cysteine assay. This work supports the value of in chemico peptide reactivity as a metric for assessment of platinum sensitization potential and therefore in screening of new platinum compounds for low or absent sensitization potential. Additional studies are required to determine whether the DPRA may be successfully applied to other metals. We provide details on method modifications and precautions important to the success of the DPRA in the assessment of metal reactivity.