Occupational asthma caused by acrylic compounds from SHIELD surveillance (1989-2014)

Machine learning-driven identification of air toxic combinations associated with asthma symptoms among elementary school children in Spokane, Washington, USA

Air toxics are atmospheric pollutants with hazardous effects on health and the environment. Although methodological constraints have limited the number of air toxics assessed for associations with health and disease, advances in machine learning (ML) enable the assessment of a much larger set of environmental exposures. We used ML methods to conduct a retrospective study to identify combinations of 109 air toxics associated with asthma symptoms among 269 elementary school students in Spokane, Washington. Data on the frequency of asthma symptoms for these children were obtained from Spokane Public Schools. Their exposure to air toxics was estimated by using the Environmental Protection Agency's Air Toxics Screening Assessment and National Air Toxics Assessment. We defined three exposure periods: the most recent year (2019), the last three years (2017-2019), and the last five years (2014-2019). We analyzed the data using the ML-based Data-driven ExposurE Profile (DEEP) extraction method. DEEP identified 25 air toxic combinations associated with asthma symptoms in at least one exposure period. Three combinations (1,1,1-trichloroethane, 2-nitropropane, and 2,4,6-trichlorophenol) were significantly associated with asthma symptoms in all three exposure periods. Four air toxics (1,1,1-trichloroethane, 1,1,2,2-tetrachloroethane, BIS (2-ethylhexyl) phthalate (DEHP), and 2,4-dinitrophenol) were associated only in combination with other toxics, and would not have been identified by traditional statistical methods. The application of DEEP also identified a vulnerable subpopulation of children who were exposed to 13 of the 25 significant combinations in at least one exposure period. On average, these children experienced the largest number of asthma symptoms in our sample. By providing evidence on air toxic combinations associated with childhood asthma, our findings may contribute to the regulation of these toxics to improve children's respiratory health.

Evidential requirements for the regulatory hazard and risk assessment of respiratory sensitisers: methyl methacrylate as an example

This review addresses the need for a framework to increase the consistency, objectivity and transparency in the regulatory assessment of respiratory sensitisers and associated uncertainties. Principal issues are considered and illustrated through a case study (with methyl methacrylate). In the absence of test methods validated for regulatory use, formal documentation of the weight-of-evidence for hazard classification both at the level of integration of individual studies within lines of evidence and across a broad range of data streams was agreed to be critical for such a framework. An integrated approach is proposed to include not only occupational studies and clinical evidence for the regulatory assessment of respiratory sensitisers, but also information on structure and physical and chemical factors, predictive approaches such as structure activity analysis and in vitro and in vivo mechanistic and toxicokinetic findings. A weight-of-evidence protocol, incorporating integration of these sources of data based on predefined considerations, would contribute to transparency and consistency in the outcome of the assessment. In those cases where a decision may need to be taken on the basis of occupational findings alone, conclusions should be based on transparent weighting of relevant data on the observed prevalence of occupational asthma in various studies taking into account all relevant information including the range and nature of workplace exposures to the substance of interest, co-exposure to other chemicals and study quality.

Methyl methacrylate and respiratory sensitisation: a comprehensive review

Methyl methacrylate (MMA) is classified under GHS as a weak skin sensitiser and a skin and respiratory irritant. It has recently been proposed that MMA be classified as a respiratory sensitiser (a designation that in a regulatory context embraces both true respiratory allergens, as well as chemicals that cause asthma through non-immunological mechanisms). This proposal was based primarily upon the interpretation of human data. This review, and a detailed weight of evidence analysis, has led to another interpretation of these data. The conclusion drawn is that persuasive evidence consistent with the designation of MMA as a respiratory sensitiser is lacking. It is suggested that one reason for different interpretations of these data is that occupational asthma poses several challenges with respect to establishing causation. Among these is that it is difficult to distinguish between allergic asthma, non-allergic asthma, and work-related exacerbation of pre-existing asthma. Moreover, there is a lack of methods for the identification of true chemical respiratory allergens. The characterisation and causation of occupational asthma is consequently largely dependent upon interpretation of human data of various types. Recommendations are made that are designed to improve the utility and interpretation of human data for establishing causation in occupational asthma.

Organic compound and particle emissions of additive manufacturing with photopolymer resins and chemical outgassing of manufactured resin products

Photopolymer resins are applied at an increasing rate in additive manufacturing (AM) industry as vat photopolymerization (VP) and material jetting (MJ) methods gain more popularity. The aim of this study was to measure volatile organic compound (VOC), carbonyl compound, ultrafine particle (UFP), and particulate matter (PM₁₀) air concentrations emitted in 3D printer operations. Individual chemicals were identified when multiple photopolymer resin feedstocks were used in various VP and MJ printers. The size distributions of UFPs, and indoor air parameters were also monitored. Finally, the VOC outgassing of the cured resin materials was determined over 84 days. The data demonstrated that 3D printer operators were exposed to low concentrations of airborne exposure agents as follows: average concentrations of VOCs were between 41 and 87 µg/m³, UFP number levels ranged between 0.19 and 3.62 × 10³ number/cm³; however, no impact was detected on air parameters or PM₁₀ concentrations. A majority of the UFPs existed in the 10-45 nm size range. The identified compounds included hazardous species included sensitizing acrylates and carcinogenic formaldehyde. The outgassed products included similar compounds that were encountered during the AM processes, and post-processing solvents. Products heated to 37°C emitted 1.4‒2.9-fold more VOCs than at room temperature. Total emissions were reduced by 84‒96% after 28 days roughly from 3000-14000 to 100-1000 µg/m²/hr. In conclusion, resin printer operators are exposed to low concentrations of hazardous emissions, which might result in adverse health outcomes during prolonged exposure. Manufactured resin products are suggested to be stored for 4 weeks after their production to reduce potential consumer VOC hazards.

Machine learning-driven identification of early-life air toxic combinations associated with childhood asthma outcomes

Air pollution is a well-known contributor to asthma. Air toxics are hazardous air pollutants that cause or may cause serious health effects. Although individual air toxics have been associated with asthma, only a limited number of studies have specifically examined combinations of air toxics associated with the disease. We geocoded air toxic levels from the US National Air Toxics Assessment (NATA) to residential locations for participants of our AiRway in Asthma (ARIA) study. We then applied Data-driven ExposurE Profile extraction (DEEP), a machine learning-based method, to discover combinations of early-life air toxics associated with current use of daily asthma controller medication, lifetime emergency department visit for asthma, and lifetime overnight hospitalization for asthma. We discovered 20 multi-air toxic combinations and 18 single air toxics associated with at least 1 outcome. The multi-air toxic combinations included those containing acrylic acid, ethylidene dichloride, and hydroquinone, and they were significantly associated with asthma outcomes. Several air toxic members of the combinations would not have been identified by single air toxic analyses, supporting the use of machine learning-based methods designed to detect combinatorial effects. Our findings provide knowledge about air toxic combinations associated with childhood asthma.

Occupational Methacrylate Allergy in Dental Personnel

Purpose of the article: Acrylate and methacrylate (MA) use in the dental industry is widespread, being utilized in dental prostheses and composite resins, dentin bonding materials, and glass ionomers. However, occupational methacrylate allergy in dental personnel is a growing phenomenon. The aims of this retrospective observational study are to evaluate the risk of occupational contact dermatitis following exposure to methacrylates in dental personnel and to identify possible preventive measures. Materials and Methods: A total of 126 subjects exposed to acrylic and methacrylic resins in their professional context and who reported clinical manifestations were included from our outpatient department database. These were subdivided into two groups: 81 dental technicians and 45 dental hygienists. All the subjects had undergone patch testing with a “methacrylate series” (FIRMA) and readings were taken after 2 days (D2), 4 days (D4), and 7 days (D7). Results: A significantly higher incidence of methacrylate allergy was found in the dental technician group compared to the dental hygienists. Among the dental technicians, 40.7% of the subjects presented skin manifestations. The hands were the most frequently affected sites. Conclusion: Our results confirm the high sensitizing potential of MA in the workplace for dental personnel and in particular an increased professional risk in work where the hands are directly involved (dental technicians). Patch testing as an integrated part of a screening tray is needed for a complete evaluation of occupational skin allergy due to MA in dental personnel. The adoption of proper primary preventive measures, including gloves, protective eyewear, face shields, and disposable gowns, can be useful in preventing new cases of contact dermatitis, which may lead to a change of occupation in dental personnel.

Phenotyping Occupational Asthma Caused by Acrylates in a Multicenter Cohort Study

BACKGROUND

While acrylates are well-known skin sensitizers, they are not classified as respiratory sensitizers although several cases of acrylate-induced occupational asthma (OA) have been reported.

OBJECTIVE

To evaluate the characteristics of acrylate-induced OA in a large series of cases and compare those with OA induced by other low-molecular-weight (LMW) agents.

METHODS

Jobs and exposures, clinical and functional characteristics, and markers of airway inflammation were analyzed in an international, multicenter, retrospective cohort of subjects with OA ascertained by a positive inhalation challenge to acrylates (n = 55) or other LMW agents (n = 418) including isocyanates (n = 125).

RESULTS

Acrylate-containing glues were the most prevalent products, and industrial manufacturing, dental work, and beauty care were typical occupations causing OA. Work-related rhinitis was more common in acrylate-than in isocyanate-induced asthma (P < .001). The increase in postchallenge fractional exhaled nitric oxide was significantly greater in acrylate-induced OA (26.0; 8.2 to 38.0 parts per billion [ppb]) than in OA induced by other LMW agents (3.0; -1.0 to 10.0 ppb; P < .001) or isocyanates (5.0; 2.0 to 16.0 ppb; P = .010). Multivariable models confirmed that OA induced by acrylates was significantly and independently associated with a postchallenge increase in fractional exhaled nitric oxide (≥17.5 ppb).

CONCLUSIONS

Acrylate-induced OA shows specific characteristics, concomitant work-related rhinitis, and exposure-related increases in fractional exhaled nitric oxide, suggesting that acrylates may induce asthma through different immunologic mechanisms compared with mechanisms through which other LMW agents may induce asthma. Our findings reinforce the need for a reevaluation of the hazard classification of acrylates, and further investigation of the pathophysiological mechanisms underlying their respiratory sensitizing potential.