Cross-Sectional Study of Respiratory Symptoms, Spirometry, and Immunologic Sensitivity in Epoxy Resin Workers

Understanding the Termination of Urologic Cancer Clinical Trials: Insights and Challenges

PURPOSE

Clinical trials are valuable evidence for managing urologic malignancies. Early termination of clinical trials is associated with a waste of resources and may substantially affect patient care. We sought to study the termination rate of urologic cancer clinical trials and identify factors associated with trial termination.

METHODS

A cross-sectional search of ClinicalTrials.gov identified completed and terminated kidney, prostate, and bladder cancer clinical trials started. Trials were assessed for reasons for termination. Multivariable analyses were conducted to determine the significant factors associated with the termination.

RESULTS

Between 2000 and 2020, 9,145 oncology clinical trials were conducted, of which 11.30% (n = 1,033) were urologic cancer clinical trials. Of the urologic cancer clinical trials, 25.38% (n = 265) were terminated, with low patient accrual being the most common reason for termination, 52.9% (n = 127). Multivariable analysis showed that only the university funding source odds ratio (OR) of 2.20 (95% CI, 1.45 to 3.32), single-center studies OR of 2.11 (95% CI, 1.59 to 2.81), and sample size of <50 were significant predictors of clinical trial termination OR of 5.26 (95% CI, 3.85 to 7.69); all P values are <.001.

CONCLUSION

The termination rate of urologic cancer clinical trials was 25%, with low accrual being the most frequently reported reason. Trials funded by a university, single-center trials, and small trials (sample size <50) were associated with early termination. A better understanding of these factors might help researchers, funding agencies, and other stakeholders prioritize resource allocations for multicenter trials that aim to recruit a sufficient number of patients.

Characterization and Quantitation of Personal Exposures to Epoxy Paints in Construction Using a Combination of Novel Personal Samplers and Analytical Techniques: CIP-10MI, Liquid Chromatography-Tandem Mass Spectrometry and Ion Chromatography

Epoxy resins are extremely versatile products that are widely used in construction for coatings, adhesives, primers, and sealers. Occupational exposures to epoxies cause allergic contact dermatitis, occupational asthma, hypersensitivity pneumonitis (epoxy-resin lung) and acute decline in lung function. Despite these health concerns, there is a striking paucity of quantitative exposure data to epoxy resins in construction. The lack of practical analytical methods and suitable personal samplers for monitoring of reactive two-component epoxide systems in real-world applications has been an unmet challenge for decades. Sampling and analysis methods for epoxies should be able to collect the paint aerosols efficiently, stop polymerization reactions at the time of sample collection, and subsequently provide detailed multispecies characterization of epoxides, as well as the total epoxide group (TEG) content of a sample, to properly document the chemical composition of exposures to epoxide paints. In this work, we present the development and application of two new complementary quantitative analytical methods-liquid chromatography-tandem mass spectrometry with online ultraviolet detection and ion chromatography (IC)-for multispecies characterization of raw products, as well as inhalation and skin exposures to epoxy formulations in real-world construction applications. A novel personal sampler, CIP-10MI, was used for personal sampling of airborne epoxies. We report for the first time the results of personal inhalation and potential skin exposures to individual monomers and oligomers of bisphenol A diglycidyl ether (BADGE), as well as TEG, during metal structure coatings in construction; compare analytical results of the two analytical methods; and provide recommendations for method selection in future field studies. High inhalation and potential skin exposures to epoxies point to the need for interventions to reduce exposures among painters in construction.

Artificial stone silicosis

PURPOSE OF REVIEW

This review details recent findings related to the health effects of occupational exposure to artificial stone dust and the rapid increase in cases of artificial stone associated silicosis around the world.

RECENT FINDINGS

High crystalline silica content artificial stone is now commonly used for the production of kitchen benchtops. Reports of artificial stone silicosis from many countries have noted that workers were typically employed at small workplaces and were often diagnosed in their 30s or 40s. Poor exposure control measures were common, including the practice of 'dry processing'. Dust generated from artificial stone has been noted to have properties that influence toxicity, including high silica content, generation of nanosized particles and presence of metals and resins. Artificial stone silicosis differs from silicosis associated with other occupational settings including shorter latency and rapid disease progression. High-resolution computed tomography (CT) chest imaging of artificial stone silicosis has often noted the presence of ground glass opacities, which may not be detected in chest x-ray screening. Increased prevalence of autoimmune disease, such as scleroderma, has also been reported in this industry.

SUMMARY

Further evaluation of the safety of work with artificial stone is required, including the effectiveness of dust control measures. Current reports of artificial stone silicosis indicate the potential for widespread undiagnosed respiratory disease in this industry. Provision of more sensitive health screening methods for all at-risk workers and the development of new treatment options particularly for this form of silicosis is urgently required.