Comprehensive evaluation of long-term trends in occupational exposure: Part 1. Description of the database

Time trends in occupational exposure to chemicals in Sweden: proportion exposed, distribution across demographic and labor market strata, and exposure levels

OBJECTIVE

This study investigated time trends in occupational exposure to various chemicals in Sweden and the distribution across demographic and labor market sectors.

METHODS

Exposure to six chemicals was investigated from 1980 to 2013 by application of a job exposure matrix to national population registers. Respirable crystalline silica (RCS), diesel engine exhaust, welding fumes, wood dust, chlorinated hydrocarbon solvents, and lead were selected to represent different groups of chemicals. Trends in exposure prevalence were investigated by linear regression and compared to the occupationally active population. Confidence intervals for the rate of change over time were obtained by bootstrapping.

RESULTS

The proportion of workers born outside the Nordic countries increased over time in those exposed to RCS, diesel exhaust and wood dust. There was a shift of exposed jobs to small companies (<50 employees), especially for RCS, welding fumes, wood dust, and chlorinated hydrocarbon solvents. For RCS and welding fumes, there was a marked drop in exposure levels from 1980 to 1990 but small changes thereafter. Exposure to lead diminished, both in terms of prevalence and intensity.

CONCLUSIONS

Over time, several exposures tended to shift to small companies, the construction sector, and migrant workers, all factors being indicative of less well-controlled working conditions. Occupational exposure to chlorinated organic solvents and lead diminished, while exposure levels to RCS and welding fumes have changed little since 1990. In view of the serious and well-established negative health effects, increased efforts to reduce exposure to RCS and welding fumes are needed.

Reconstructing Historical Exposures to Respirable Dust and Respirable Silica in the Taconite Mining Industry for 1955-2010

The goal of this study was to reconstruct the historical respirable silica (RS) and respirable dust (RD) exposures of workers in the Minnesota taconite industry from 1955 to 2010 as part of several epidemiological studies for assessing the association between exposure to components of taconite dusts and the development of respiratory diseases. A job-exposure matrix (JEM) was developed that uses 9127 RS and 19 391 RD occupational hygiene historical measurements. Historical RS and RD data were extracted from several sources and were grouped into seven mines and then into eight departments [Concentrating, Crushing, Janitor, Mining, Office/control room, Pelletizing, Shop (mobile), and Shop (stationary)]. Within each department, we applied a two-level random-intercept regression model which assumes that the natural log of Y (RD or RS concentration) changes over time at a constant rate. Among all predicted RD and RS values, we found that larger RD values were located in the following departments: Crushing, Concentrating, Pelletizing, and Shop (mobile). Larger RS values were located only in either Crushing or Shop (mobile). The annual rates of change for historical RD and RS exposures were between -3.3 and 3.2%. The silica percentage in the dust varied by mine/department with the highest value of 29.3% in Mine F (Crushing) and the lowest value of 2.1% in Mine B (Pelletizing). The predicted historical RD and RS arithmetic mean exposures ranged between <0.075 and 3.14 mg m-3, and between <0.005 and 0.36 mg m-3, respectively. The result of this study is a JEM by mine, department, and year for RD and RS for epidemiological studies.

Grouping schemes of welding fume exposure in shipyard welders

Welding fume exposure can increase the risk of chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the optimal grouping schemes of welding fume exposure in shipyard welders for future accurate examination of the association between welding fume exposure and COPD. Industrial hygiene records, including welding fume measurements between 2002 and 2009 were collected from a shipyard. A total of 2,360 personal welding fume measurements was compiled with a geometric mean of 1.66 mg/m³ and a geometric standard deviation of 4.02. Welding jobs were categorized into 8 groups. There were 9 working areas. To obtain the optimal grouping scheme, various grouping schemes were created using job, area, and job^*area combination. To compare various grouping schemes, contrast and precision were calculated for each grouping scheme. For all measurement data, group mean ranking method created by ranking geometric means of the job^*area combination into 3 groups (group mean ranking method) showed the best contrast and precision values among various grouping schemes, followed by grouping based on the job. For a subset of the data excluding job^*area combinations with less than 10 measurements, grouping based on the job showed greater contrast than group mean ranking method, while for other subsets, including only repeated measurement data or further excluding job^*area combinations with less than 10 measurements from the repeated measurement subset, group mean ranking method showed greater contrast than grouping based on the job. Our results showed that group mean ranking or grouping based on the job could be a candidate for the optimal grouping schemes in this shipyard. Our efforts for optimal grouping scheme may aid future cohort study to elucidate the association between welding fume exposure and COPD.

Do regulations protect workers from occupational exposures to carcinogenic, mutagenic and reprotoxic (CMR) agents in France?

OBJECTIVE

This article explores the impact of regulations on the implementation of collective protections in France to occupational exposure to carcinogenic, mutagenic and reprotoxic (CMR) agents.

METHODS

Individual data from the French national cross-sectional survey of occupational hazards conducted in 2010 were analysed. We investigated whether stricter regulations and longer exposures were associated with higher level of collective protection using multivariate logistic regressions.

RESULTS

General ventilation, for which effect is limited as collective protection for CMR products, was present in 19% of situations involving CMR agents while isolation chambers, the most effective form of protection, were only very rarely implemented. Multilevel logistic regressions show that exposure situations to products classified as category 1 or 2 by the European Union do not have a higher probability of benefiting from a collective protection measures. Exposures to products with a Binding Occupational Exposure Limit Value selectively benefited from a better level of protection. Exposures to agents entered on the International Agency for Research on Cancer (IARC) list of proven or probable carcinogens benefited more from effective collective protections than products suspected to be carcinogens but not yet classified by IARC.

CONCLUSIONS

These results suggest that the dissemination of evaluations of carcinogens by the IARC translate into improved protective measures even though the IARC classification has no mandatory impact on regulations.

Historical occupational isocyanate exposure levels in two Canadian provinces

Isocyanates such as toluene 2, 4-diisocyanate (TDI), methylene bisphenyl isocyanate (MDI), and hexamethylene diisocyanate (HDI) are known sensitizers and exposure to these chemicals can result in isocyanate-induced asthma-the leading cause of occupational asthma. A newly created exposure database was available containing occupational isocyanate measurements spanning 1981-1996 from Ontario and British Columbia (BC)-two of the largest provinces in Canada. The aim was to describe the historical measurements relative to exposure thresholds, ascertain differences in the data between provinces, and identify time trends. Descriptive statistics of the observations were summarized and stratified by isocyanate species and province. Chi-square tests and Student's t-test were performed to determine differences between provinces. To investigate time trends in the odds of a measurement exceeding the limit of detection (LOD) and time-weighted average (TWA), mixed effects logistic regression models were constructed. In total, 6,984 isocyanate measurements were analyzed, the majority of which were below the LOD (79%). Overall, 8.3% of samples were in excess of the 2014 TLV-TWA of 0.005 ppm. Comparing the two provinces, the proportion of samples exceeding the LOD and TLV-TWA was greater in BC for all isocyanate species. Differences in time trends were also observed between provinces-the odds of a sample exceeding the TLV-TWA decreased over time in the case of MDI (Ontario only), TDI (both Ontario and BC), and other isocyanates (BC only). Our finding that a majority of the exposure measurements was below the LOD is similar to that reported by others. Differences between provinces may be due the fact that isocyanates are classified as a designated substance in Ontario and must adhere to specific exposure control regulations. Limitations of the database, such as finite number of variables and measurements available until 1996 only, presents challenges for more in-depth analysis and generalization of results. An argument is made that a Canadian occupational exposure database be maintained to facilitate risk assessments as well as for occupational epidemiology research.

Evaluating temporal trends from occupational lead exposure data reported in the published literature using meta-regression

OBJECTIVES

The published literature provides useful exposure measurements that can aid retrospective exposure assessment efforts, but the analysis of this data is challenging as it is usually reported as means, ranges, and measures of variability. We used mixed-effects meta-analysis regression models, which are commonly used to summarize health risks from multiple studies, to predict temporal trends of blood and air lead concentrations in multiple US industries from the published data while accounting for within- and between-study variability in exposure.

METHODS

We extracted the geometric mean (GM), geometric standard deviation (GSD), and number of measurements from journal articles reporting blood and personal air measurements from US worksites. When not reported, we derived the GM and GSD from other summary measures. Only industries with measurements in ≥2 time points and spanning ≥10 years were included in our analyses. Meta-regression models were developed separately for each industry and sample type. Each model used the log-transformed GM as the dependent variable and calendar year as the independent variable. It also incorporated a random intercept that weighted each study by a combination of the between- and within-study variances. The within-study variances were calculated as the squared log-transformed GSD divided by the number of measurements. Maximum likelihood estimation was used to obtain the regression parameters and between-study variances.

RESULTS

The blood measurement models predicted statistically significant declining trends of 2-11% per year in 8 of the 13 industries. The air measurement models predicted a statistically significant declining trend (3% per year) in only one of the seven industries; an increasing trend (7% per year) was also observed for one industry. Of the five industries that met our inclusion criteria for both air and blood, the exposure declines per year tended to be slightly greater based on blood measurements than on air measurements.

CONCLUSIONS

Meta-analysis provides a useful tool for synthesizing occupational exposure data to examine exposure trends that can aid future retrospective exposure assessment. Data remained too sparse to account for other exposure predictors, such as job category or sampling strategy, but this limitation may be overcome by using additional data sources.

Silica exposure during construction activities: statistical modeling of task-based measurements from the literature

Many construction activities can put workers at risk of breathing silica containing dusts, and there is an important body of literature documenting exposure levels using a task-based strategy. In this study, statistical modeling was used to analyze a data set containing 1466 task-based, personal respirable crystalline silica (RCS) measurements gathered from 46 sources to estimate exposure levels during construction tasks and the effects of determinants of exposure. Monte-Carlo simulation was used to recreate individual exposures from summary parameters, and the statistical modeling involved multimodel inference with Tobit models containing combinations of the following exposure variables: sampling year, sampling duration, construction sector, project type, workspace, ventilation, and controls. Exposure levels by task were predicted based on the median reported duration by activity, the year 1998, absence of source control methods, and an equal distribution of the other determinants of exposure. The model containing all the variables explained 60% of the variability and was identified as the best approximating model. Of the 27 tasks contained in the data set, abrasive blasting, masonry chipping, scabbling concrete, tuck pointing, and tunnel boring had estimated geometric means above 0.1mg m(-3) based on the exposure scenario developed. Water-fed tools and local exhaust ventilation were associated with a reduction of 71 and 69% in exposure levels compared with no controls, respectively. The predictive model developed can be used to estimate RCS concentrations for many construction activities in a wide range of circumstances.

Workplace measurements by the US Occupational Safety and Health Administration since 1979: descriptive analysis and potential uses for exposure assessment

BACKGROUND

Inspectors from the US Occupational Safety and Health Administration (OSHA) have been collecting industrial hygiene samples since 1972 to verify compliance with Permissible Exposure Limits. Starting in 1979, these measurements were computerized into the Integrated Management Information System (IMIS). In 2010, a dataset of over 1 million personal sample results analysed at OSHA's central laboratory in Salt Lake City [Chemical Exposure Health Data (CEHD)], only partially overlapping the IMIS database, was placed into public domain via the internet. We undertook this study to inform potential users about the relationship between this newly available OSHA data and IMIS and to offer insight about the opportunities and challenges associated with the use of OSHA measurement data for occupational exposure assessment.

METHODS

We conducted a literature review of previous uses of IMIS in occupational health research and performed a descriptive analysis of the data recently made available and compared them to the IMIS database for lead, the most frequently sampled agent.

RESULTS

The literature review yielded 29 studies reporting use of IMIS data, but none using the CEHD data. Most studies focused on a single contaminant, with silica and lead being most frequently analysed. Sixteen studies addressed potential bias in IMIS, mostly by examining the association between exposure levels and ancillary information. Although no biases of appreciable magnitude were consistently reported across studies and agents, these assessments may have been obscured by selective under-reporting of non-detectable measurements. The CEHD data comprised 1 450 836 records from 1984 to 2009, not counting analytical blanks and erroneous records. Seventy eight agents with >1000 personal samples yielded 1 037 367 records. Unlike IMIS, which contain administrative information (company size, job description), ancillary information in the CEHD data is mostly analytical. When the IMIS and CEHD measurements of lead were merged, 23 033 (39.2%) records were in common to both IMIS and CEHD datasets, 10 681 (18.2%) records were only in IMIS, and 25 012 (42.6%) records were only in the CEHD database. While IMIS-only records represent data analysed in other laboratories, CEHD-only records suggest partial reporting of sampling results by OSHA inspectors into IMIS. For lead, the percentage of non-detects in the CEHD-only data was 71% compared to 42% and 46% in the both-IMIS-CEHD and IMIS-only datasets, respectively, suggesting differential under-reporting of non-detects in IMIS.

CONCLUSIONS

IMIS and the CEHD datasets represent the biggest source of multi-industry exposure data in the USA and should be considered as a valuable source of information for occupational exposure assessment. The lack of empirical data on biases, adequate interpretation of non-detects in OSHA data, complicated by suspected differential under-reporting, remain the principal challenges to the valid estimation of average exposure conditions. We advocate additional comparisons between IMIS and CEHD data and discuss analytical strategies that may play a key role in meeting these challenges.

Combining a job-exposure matrix with exposure measurements to assess occupational exposure to benzene in a population cohort in shanghai, china

BACKGROUND

Generic job-exposure matrices (JEMs) are often used in population-based epidemiologic studies to assess occupational risk factors when only the job and industry information of each subject is available. JEM ratings are often based on professional judgment, are usually ordinal or semi-quantitative, and often do not account for changes in exposure over time. We present an empirical Bayesian framework that combines ordinal subjective JEM ratings with benzene measurements. Our aim was to better discriminate between job, industry, and time differences in exposure levels compared to using a JEM alone.

METHODS

We combined 63 221 short-term area air measurements of benzene exposure (1954-2000) collected during routine health and safety inspections in Shanghai, China, with independently developed JEM intensity ratings for each job and industry using a mixed-effects model. The fixed-effects terms included the JEM intensity ratings for job and industry (both ordinal, 0-3) and a time trend that we incorporated as a b-spline. The random-effects terms included job (n = 33) and industry nested within job (n = 399). We predicted the benzene concentration in two ways: (i) a calibrated JEM estimate was calculated using the fixed-effects model parameters for calendar year and JEM intensity ratings; (ii) a job-/industry-specific estimate was calculated using the fixed-effects model parameters and the best linear unbiased predictors from the random effects for job and industry using an empirical Bayes estimation procedure. Finally, we applied the predicted benzene exposures to a prospective population-based cohort of women in Shanghai, China (n = 74 942).

RESULTS

Exposure levels were 13 times higher in 1965 than in 2000 and declined at a rate that varied from 4 to 15% per year from 1965 to 1985, followed by a small peak in the mid-1990s. The job-/industry-specific estimates had greater differences between exposure levels than the calibrated JEM estimates (97.5th percentile/2.5th percentile exposure level, (B)(G)R(95)(B): 20.4 versus 3.0, respectively). The calibrated JEM and job-/industry-specific estimates were moderately correlated in any given year (Pearson correlation, r(p) = 0.58). We classified only those jobs and industries with a job or industry JEM exposure probability rating of 3 (>50% of workers exposed) as exposed. As a result, 14.8% of the subjects and 8.7% of the employed person-years in the study population were classified as benzene exposed. The cumulative exposure metrics based on the calibrated JEM and job-/industry-specific estimates were highly correlated (r(p) = 0.88).

CONCLUSIONS

We provide a useful framework for combining quantitative exposure data with expert-based exposure ratings in population-based studies that maximized the information from both sources. Our framework calibrated the ratings to a concentration scale between ratings and across time and provided a mechanism to estimate exposure when a job/industry group reported by a subject was not represented in the exposure database. It also allowed the job/industry groups' exposure levels to deviate from the pooled average for their respective JEM intensity ratings.

Statistical modeling to determine sources of variability in exposures to welding fumes

BACKGROUND/AIMS

Exposures to total particulate matter (TP) and manganese (Mn) received by workers during welding and allied hot processes were analyzed to assess the sources and magnitudes of variability.

METHODS

Compilation of data from several countries identified 2065 TP and 697 Mn measurements for analysis. Linear mixed models were used to determine fixed effects due to different countries, industries and trades, process characteristics, and the sampling regimen, and to estimate components of variance within workers (both intraday and interday), between workers (within worksites), and across worksites.

RESULTS

The fixed effects explained 55 and 49% of variation in TP and Mn exposures, respectively. The country, industry/trade, type of ventilation, and type of work/welding process were the major factors affecting exposures to both agents. Measurements in the USA were generally higher than those in other countries. Exposure to TP was 67% higher in enclosed spaces and 43% lower with local exhaust ventilation (LEV), was higher among boilermakers and was higher when either a mild-steel base metal or a flux cored consumable was used. Exposure to Mn was 750% higher in enclosed spaces and 67% lower when LEV was present. Air concentrations of Mn were significantly affected by the welding consumables but not by the base metal. Resistance welding produced significantly lower TP and Mn exposures compared to other welding processes. Interestingly, exposures to TP had not changed over the 40 years of observation, while those of Mn showed (non-significant) reductions of 3.6% year(-1). After controlling for fixed effects, variance components between worksites and between-individual workers within a worksite were reduced by 89 and 57% for TP and 75 and 63% for Mn, respectively. The within-worker variation (sum of intraday and interday variance components) of Mn exposure was three times higher than that of TP exposure. The estimated probabilities of exceeding occupational exposure limits were very high (generally much >10%) for both agents.

CONCLUSIONS

Welding exposures to TP and Mn vary considerably across the world and across occupational groups. Exposures to both contaminants have been and continue to be unacceptably high in most sectors of industry. Because exposures to the two agents have different sources and characteristics, separate control strategies should be considered to reduce welders' exposures to TP and Mn.

Occupation and cancer in Britain

Background:

Prioritising control measures for occupationally related cancers should be evidence based. We estimated the current burden of cancer in Britain attributable to past occupational exposures for International Agency for Research on Cancer (IARC) group 1 (established) and 2A (probable) carcinogens.

Methods:

We calculated attributable fractions and numbers for cancer mortality and incidence using risk estimates from the literature and national data sources to estimate proportions exposed.

Results:

5.3% (8019) cancer deaths were attributable to occupation in 2005 (men, 8.2% (6362); women, 2.3% (1657)). Attributable incidence estimates are 13 679 (4.0%) cancer registrations (men, 10 063 (5.7%); women, 3616 (2.2%)). Occupational attributable fractions are over 2% for mesothelioma, sinonasal, lung, nasopharynx, breast, non-melanoma skin cancer, bladder, oesophagus, soft tissue sarcoma, larynx and stomach cancers. Asbestos, shift work, mineral oils, solar radiation, silica, diesel engine exhaust, coal tars and pitches, occupation as a painter or welder, dioxins, environmental tobacco smoke, radon, tetrachloroethylene, arsenic and strong inorganic mists each contribute 100 or more registrations. Industries and occupations with high cancer registrations include construction, metal working, personal and household services, mining, land transport, printing/publishing, retail/hotels/restaurants, public administration/defence, farming and several manufacturing sectors. 56% of cancer registrations in men are attributable to work in the construction industry (mainly mesotheliomas, lung, stomach, bladder and non-melanoma skin cancers) and 54% of cancer registrations in women are attributable to shift work (breast cancer).

Conclusion:

This project is the first to quantify in detail the burden of cancer and mortality due to occupation specifically for Britain. It highlights the impact of occupational exposures, together with the occupational circumstances and industrial areas where exposures to carcinogenic agents occurred in the past, on population cancer morbidity and mortality; this can be compared with the impact of other causes of cancer. Risk reduction strategies should focus on those workplaces where such exposures are still occurring.

Determinants of wood dust exposure in the Danish furniture industry--results from two cross-sectional studies 6 years apart

Objectives: This paper investigates determinants of wood dust exposure and trends in dust level in the furniture industry of Viborg County, Denmark, using data from two cross-sectional studies 6 years apart.

Methods: During the winter 1997/1998, 54 factories were visited (hereafter study 1). In the winter 2003/2004, 27 factories were revisited, and personal dust measurements were repeated. In addition, 14 new factories were included (hereafter study 2). A total of 2303 woodworkers participated in study 1, and 2358 measurements from 1702 workers were available. From study 2, 1581 woodworkers participated and 1355 measurements from 1044 workers were available. Information on occupational variables describing potential determinants of exposures like work task, exhaust ventilation, enclosure and cleaning procedures were collected. A total of 2627 measurements and 1907 persons were included in the final mixed model in order to explore determinants of exposure and trends in dust level.

Results: The overall inhalable wood dust concentration (geometric means (geometric standard deviation)) has decreased from 0.95 mg/m³ (2.05) in study 1 to 0.60 mg/m³ (1.63) in study 2, representing a 7% annual decrease in dust concentration, which was confirmed in the mixed model. From study 1 to study 2 there has been a change towards less manual work and more efficient cleaning methods, but on the contrary also more inadequate exhaust ventilation systems. The following determinants were found to ‘increase’ dust concentration: sanding; use of compressed air; use of full-automatic machines; manual work; cleaning of work pieces with compressed air; kitchen producing factories and small factories (<20 employees). The following determinants of exposure were found to ‘decrease’ dust concentration: manual assembling/packing; sanding with adequate exhaust ventilation; adequate exhaust ventilation; vacuum cleaning of machines and special cleaning staff.

Conclusions: Despite a substantial drop in the dust concentration during the last 6 years in the furniture industry in Viborg County, further improvements are possible. There should be more focus on improved exhaust ventilation, professional cleaning methods and avoiding use of compressed air.

Usage of air monitoring and biomarkers of isocyanate exposure to assess the effect of a control intervention

Exposure to isocyanates is known to have respiratory effects in workers and therefore it is essential to monitor the occupational exposure. An earlier study of a continuous foaming plant using toluene diisocyanate (TDI) showed that the exposure to isocyanates can be high. Since then several preventive actions were implemented at the plant. The aim of this study was to observe the effect of these actions measured by air and biological monitoring. Four workers were monitored in the year 2000 and six in 2005, with air measurements during the continuous foaming process, and with measurements of biomarkers in one plasma sample each year and with two urinary samples being collected in the year 2000 and one in 2005. The median TDI air concentrations in 2005 were approximately 20% of the 2000 levels and the median levels of biomarkers in 2005 were approximately 10% of the 2000 levels. According to our measurements the preventive action had a real effect to decrease the exposure to TDI. As the workers both before and after the preventive actions used personal protective equipment, the use of biomarkers was necessary to assess the real gain in the preventive actions.

Retrospective exposure assessment of airborne asbestos related to skilled craftsmen at a petroleum refinery in Beaumont, Texas (1940-2006)

Despite efforts over the past 50 or more years to estimate airborne dust or fiber concentrations for specific job tasks within different industries, there have been no known attempts to reconstruct historical asbestos exposures for the many types of trades employed in various nonmanufacturing settings. In this paper, 8-h time-weighted average (TWA) asbestos exposures were estimated for 12 different crafts from the 1940s to the present day at a large petroleum refinery in Beaumont, TX. The crafts evaluated were insulators, pipefitters, boilermakers, masons, welders, sheet-metal workers, millwrights, electricians, carpenters, painters, laborers, and maintenance workers. This analysis quantitatively accounts for (1) the historical use of asbestos-containing materials at the refinery, (2) the typical workday of the different crafts and specific opportunities for exposure to asbestos, (3) industrial hygiene asbestos air monitoring data collected at this refinery and similar facilities since the early 1970s, (4) published and unpublished data sets on task-specific dust or fiber concentrations encountered in various industrial settings since the late 1930s, and (5) the evolution of respirator use and other workplace practices that occurred as the hazards of asbestos became better understood over time. Due to limited air monitoring data for most crafts, 8-h TWA fiber concentrations were calculated only for insulators, while all other crafts were estimated to have experienced 8-h TWA fiber concentrations at some fraction of that experienced by insulators. A probabilistic (Monte Carlo) model was used to account for potential variability in the various data sets and the uncertainty in our knowledge of selected input parameters used to estimate exposure. Significant reliance was also placed on our collective professional experiences working in the fields of industrial hygiene, exposure assessment, and process engineering over the last 40 yr. Insulators at this refinery were estimated to have experienced 50th (and 95th) percentile 8-h TWA asbestos exposures (which incorporated 8-h TWA fiber concentrations, respirator use and effectiveness, and time spent working with asbestos-containing materials) of 9 (16) fibers/cc (cubic centimeter) from 1940 to 1950, 8 (13) fibers/cc from 1951 to 1965, 2 (5) fibers/cc from 1966 to 1971, 0.3 (0.5) fibers/cc from 1972 to 1975, and 0.005 (0.02) fibers/cc from 1976 to 1985 (estimated exposures were <0.001 fibers/cc after 1985). Estimated 8-h TWA exposures for all other crafts were at least 50- to 100-fold less than that of insulators, with the exception of laborers, whose estimated 8-h TWA exposures were approximately one-fifth to one-tenth of those of insulators. In spite of the data gaps, the available evidence indicates that our estimates of 8-h TWA asbestos exposures reasonably characterize the typical range of values for these categories of workers over time.

Task- and time-dependent weighting factors in a retrospective exposure assessment of chemical laboratory workers

A chemical exposure assessment was conducted for a cohort mortality study of 6157 chemical laboratory workers employed between 1943 and 1998 at four Department of Energy sites in Oak Ridge, Tennessee, and Aiken, South Carolina. Previous studies of chemical laboratory workers have included members within professional societies where exposure assessment was either limited or not feasible, or chemical processing employees where laboratory and production workers were combined. Because sufficient industrial hygiene records were unavailable for all four sites, weighted duration of employment was used as a surrogate for the magnitude of exposure. Potential exposure indices were calculated for each worker using number of days employed and weighting factors for frequency of contact and year of employment. A total of 591 unique laboratory job titles indicative of a chemical laboratory worker were collapsed into 18 general job title categories. Through discussions with current and retired workers, along with examination of historical organizational charts and job descriptions, the percentage of time with activities involving the direct handling of chemicals in the laboratory was estimated for each job title category. Scaled weighting factors of 1, 0.6, 0.3, and 0.05 were assigned to the job title categories representing 100%, 60%, 30%, and 5% of daily activities handling chemicals, respectively. Based on limited industrial hygiene monitoring data, personal radiation monitoring records, and professional judgment, weighting factors that declined 4% annually were applied to each year to account for improvements in laboratory technique, advancements in instrumentation, improvement in engineering controls, and increased safety awareness through time. The study cohort was separated into three categories of chemical exposures based on department level information: (1) inorganic, (2) mixed inorganic and organic, and (3) unknown. Potential exposure indices ranged from 0.15 to 6824.5 with a median value of 377.5 and a mean equal to 884.2. This exposure assessment method is useful for epidemiologic analyses when quantitative exposure data are absent or insufficient.

Occupational exposure to NDMA and NMor in the European rubber industry

Many nitrosamines are suspected of being human carcinogens, with the highest concentrations in the environment being measured in the rubber industry. Time trends of personal exposure to N-nitrosodimethylamine (NDMA) and to N-nitrosomorpholine (NMor) during the past two decades in the German rubber industry were analysed and compared with cross-sectional studies in the same period in the Netherlands, Poland, the UK and Sweden. In the majority of the surveyed departments exposures reduced over time, but considerable heterogeneity was present between departments and sectors. Significant reductions were primarily found in curing and post-treating departments and ranged from -3% year(-1) to -19% year(-1). In contrast, NDMA levels increased (+13% year(-1)) in maintenance and engineering in the tyres industry. Average NDMA-levels in general rubber goods (GRG) and NMor-levels in tyre production in Germany did not decrease significantly in the past two decades, whereas NDMA-levels in tyre production (-10% year(-1)) and NMor-levels in GRG (-7% year(-1)) declined significantly after the introduction of an exposure limit for total nitrosamines in Germany in 1988. Confidence intervals of average exposures in other studied countries largely overlap trends observed in Germany. Exposure to N-nitrosamines decreased on average two-to-five fold in the German rubber industry with comparable concentration levels in other European countries. Although average levels are well below the current limits exposure has not been eliminated, and incidental high exposures do still occur.

A probabilistic assessment of the impact of interventions on oncology nurses' exposure to antineoplastic agents

OBJECTIVE

The main goal was to investigate the potential of a probabilistic approach for exposure assessment and use this information to evaluate the impact of a complex of policy actions/interventions on dermal exposure to antineoplastic agents among oncology nurses. The central theme of this study was to make optimal use of existing data, supplemented only with limited additional information from a questionnaire survey.

METHODS

A task based exposure model was used to estimate dermal exposure of the hands among oncology nurses in non-academic hospitals in the Netherlands. Monte Carlo simulation was used to integrate information from available (exposure) studies and generate exposure distributions for the total population of oncology nurses in both pre- and post-intervention situation. Graphs and descriptive statistics of the simulated exposure distributions were used to evaluate trends in population exposure.

RESULTS

The inventory showed that important intervention occurred in the preparation and administering of antineoplastic agents and in the handling of urine. Hardly any changes were identified in de nursing tasks. The use of gloves seemed to have decreased for a number of tasks. The results of the analysis show that the interventions did not affect the median exposure. However frequencies of occurrence of individuals with very high and very low total dermal exposures decreased substantially in the post-intervention situation. Analysis of the effect of pregnancy showed that pregnancy is very unlikely to influence exposure or any of the key input variables.

CONCLUSIONS

The present study shows that the probabilistic approach adds valuable information to deterministic exposure assessment, especially when extrapolating data on a subpopulation to populations of individuals at large. The results show that the identified changes in the past decade in Dutch non-academic hospitals resulted in changes in the exposure distribution of antineoplastic agents among oncology nurses.

From expert-based to quantitative retrospective exposure assessment at a Soderberg aluminum smelter

OBJECTIVES

Expert judgement of exposure levels is often only poorly or moderately correlated with directly measured levels. For a follow-up of a historical cohort study at a Söderberg aluminum smelter we updated an expert-based semiquantitative job exposure matrix of coal tar pitch volatiles (CTPV) to quantitative estimates of CTPV and benzo(a)pyrene (BaP).

METHODS

Mixed effects models to predict exposure for potroom operation and maintenance jobs were constructed from personal CTPV and BaP measurements. Mean exposures of jobs in non-potroom locations were directly calculated when measurements were available. Exposure estimates for jobs/time periods with no measurements were based on proportion of time spent in exposed areas compared to jobs where exposure was modeled or measured. For pre-1977, the original expert exposure assignments were calibrated using the updated 1977 estimates.

RESULTS

The rate of change in exposure levels varied by time period and was accounted for in mixed models with a linear spline time trend. Other variables significant in the models were job, potroom group and season as fixed effects, and worker as a random effect. The models for potroom operations explained 45 and 27% of the variability in the CTPV and BaP measurements, respectively. The models for maintenance jobs explained 40 and 19% of the variability in the CTPV and BaP measurements, respectively. For 1977-2000 model estimates, direct calculation of means and extrapolation from modeled/measured exposures accounted for 57, 6 and 37% of the exposed person-years, respectively.

CONCLUSIONS

The above methodology maximized the use of exposure measurements and largely replaced the original expert-based estimates. Finer discrimination between exposure levels was possible with the updated exposure assessment. The new estimates are expected to reduce exposure misclassification and help better assess the exposure-response relationships.

Use of history science methods in exposure assessment for occupational health studies

AIMS

To show the power of history science methods for exposure assessment in occupational health studies, using the dry cleaning industry in Denmark around 1970 as the example.

METHODS

Exposure data and other information on exposure status were searched for in unconventional data sources such as the Danish National Archives, the Danish Royal Library, archives of Statistics Denmark, the National Institute of Occupational Health, Denmark, and the Danish Labor Inspection Agency. Individual census forms were retrieved from the Danish National Archives.

RESULTS

It was estimated that in total 3267 persons worked in the dry cleaning industry in Denmark in 1970. They typically worked in small shops with an average size of 3.5 persons. Of these, 2645 persons were considered exposed to solvents as they were dry cleaners or worked very close to the dry cleaning process, while 622 persons were office workers, drivers, etc in shops with 10 or more persons. It was estimated that tetrachloroethylene constituted 85% of the dry cleaning solvent used, and that a shop would normally have two machines using 4.6 tons of tetrachloroethylene annually.

CONCLUSION

The history science methods, including retrieval of material from the Danish National Archives and a thorough search in the Royal Library for publications on dry cleaning, turned out to be a very fruitful approach for collection of exposure data on dry cleaning work in Denmark. The history science methods proved to be a useful supplement to the exposure assessment methods normally applied in epidemiological studies.

Asthma symptoms in women employed in domestic cleaning: a community based study

BACKGROUND

Epidemiological studies have shown an association between cleaning work and asthma, but the risk factors are uncertain. The aim of this study was to assess the risk of asthma in women employed in domestic cleaning.

METHODS

A cross sectional study was conducted in 4521 women aged 30 to 65 years. Information on respiratory symptoms and cleaning work history was obtained using a postal questionnaire with telephone follow up. Asthma was defined as reported symptoms in the last year or current use of drugs to treat asthma. Odds ratios (OR) with 95% confidence intervals (CI) for asthma in different cleaning groups were estimated using adjusted unconditional logistic regression models.

RESULTS

593 women (13%) were currently employed in domestic cleaning work. Asthma was more prevalent in this group than in women who had never worked in cleaning (OR 1.46 (95% CI, 1.10 to 1.92)). Former domestic cleaning work was reported by 1170 women (26%), and was strongly associated with asthma (OR 2.09 (1.70 to 2.57)). Current and former non-domestic cleaning work was not significantly associated with asthma. Consistent results were obtained for other respiratory symptoms. Twenty five per cent of the asthma cases in the study population were attributable to domestic cleaning work.

CONCLUSIONS

Employment in domestic cleaning may induce or aggravate asthma. This study suggests that domestic cleaning work has an important public health impact, probably involving not only professional cleaners but also people undertaking cleaning tasks at home.

Occupational exposure to n-hexane in Italy--analysis of a registry of biological monitoring

OBJECTIVE

This study assesses 2,5-hexanedione (2,5-HD) in the urine of subjects exposed to n-hexane solvent between 1991 and 1998, from details obtained from the Registry of Biological Monitoring (BM) at the Florence Local Health Unit, and its development over time.

METHODS

The Registry contains 15,925 samples from 6,650 subjects occupationally exposed to n-hexane, especially in leather (9,099 samples; 3,607 subjects) and shoe (3,865 samples; 1,938 subjects) production.

RESULTS

Over the time span studied there was a total reduction of 31.9% in urinary 2,5-HD level. The yearly decrease over the entire period was 5.4%. Dividing the 8 years into three periods: before the introduction of the new legislation for health protection in the workplace (1991-1993), during its transition (1994-1996) and after its complete enforcement (1997-1998), respectively, we observed a marked decrease in the last period. Women and young people (under 30 years) experienced significantly higher absorption levels (respectively, 7.1% and 24.4%).

CONCLUSION

The data suggest that monitoring was more frequent in subjects with higher starting values, and the greatest decrease was reported in this group. Reduction may be due to less n-hexane in the products used, better structural conditions in the factories, and the effectiveness of inspections carried out by the authority for hygiene and safety in the workplace. The results confirm the usefulness of the reporting of risk levels of exposure to industrial toxicants by routine biological monitoring.

Exposure of Danish workers to trichloroethylene, 1947-1989

The aim of this study was to investigate the exposure of Danish workers to trichloroethylene (TCE) and the factors that affected such exposure. Data from Danish health authorities were evaluated for use in an epidemiological study of possible adverse health effects of TCE. The paper files relating to 1,075 air measurements taken between 1947 and 1989 at 150 companies were examined to extract information about calendar year, company, industry, type of measurement, and worker. Multiple regression models were used to analyze the effects of various factors on the concentration of TCE. TCE concentrations decreased over the four decades studied. The geometric mean was 329 mg/m3 for measurements taken 1947-1959, and 260 mg/m3, 53 mg/m3, and 23 mg/m3, respectively, for the three subsequent decades. Regression analyses showed that 1) TCE concentrations decreased on average 4 percent per year before 1964 and 15 percent per year afterward; 2) area and personal measurements gave similar concentrations (for the same calendar period, industry, and duration of measurement); 3) longer-duration measurements were associated with lower TCE concentrations; 4) high TCE concentrations occurred in the iron and metal industry; and, 5) in this industry men were exposed to concentrations two times those of women. Moreover, this study indicated that both the exposure level and the proportion of exposed workers in Danish companies increased with decreasing number of employees. Epidemiological studies of health effects of TCE may benefit from evaluating potential risk within different strata of calendar time, number of company employees, sex, and type of industry.

Occupational exposure to butadiene, isoprene and chloroprene

Workers are exposed to butadiene, isoprene and chloroprene in the manufacture of these monomers and in their use in the production of various elastomers. These include styrene butadiene rubber, polybutadiene, polyisoprene, butyl rubber and neoprene. Monomer production and extraction are done in typical closed chemical process units where low background levels of the monomers are the result of minor leaks in valves and pumps. Occasionally, higher levels occur as a result of planned or unplanned events that cause releases. Polymer production is also a closed process, but the occasional clogging of pipes and equipment with polymer requiring maintenance operations where some release is likely occurs much more often than for monomer production. For this reason, exposure levels are generally higher on polymer production units. Polymer finishing is essentially an open process, but almost all monomer should have been stripped from the polymer before finishing. Where small amounts of solvents or monomers remain in the polymer and are volatilized in finishing, they are captured by vapor control systems. As a result, exposures in finishing are typically low. Measured levels of exposure in recent years are presented. In general, modern levels of exposure are well below OSHA, ACGIH and other applicable limits. Few measurements were made prior to the 1970s, but epidemiological estimates made by modeling suggest that levels could have been quite high in the 1940s and 1950s. In these years, manual reactor cleaning was common, and pumps often leaked.

Comprehensive evaluation of long-term trends in occupational exposure: Part 2. Predictive models for declining exposures

OBJECTIVES

To explore the effects of various factors related to the industry, the contaminant, and the period and type of sampling on long term declining trends in occupational exposure.

METHODS

Linear regression analyses were used to assess the relation between reductions in exposure and geographical location, industrial sector, type of contaminant, type of monitoring, carcinogenic classification, calendar period, duration of sampling, and number of reductions in the threshold limit value during the sampling period. Both univariable and multivariable models were applied.

RESULTS

Based on univariable analyses, the findings suggest that exposures declined more rapidly in manufacturing than in mining, more rapidly for aerosol contaminants than for vapours, and more rapidly when biological, rather than airborne, monitoring was conducted. Exposures collected more recently (first year of sampling in 1972 or later) fell more rapidly than exposures first evaluated during earlier periods. Irrespective of when the data were collected, the results also suggest that the longer the duration of sampling the slower the rate of decline. Taken together, we found that characteristics related to the contaminant, the industry, the sampling period, and the type of sampling explained a substantial proportion of the variability for exposures evaluated before 1972 (R2 = 0.78) and for sites evaluated both before and after 1972 (R2 = 0.91), but explained essentially no variation for data gathered exclusively after 1972 (R2 = 0.04).

CONCLUSIONS

By identifying factors that have affected the rates of reduction in a consistent fashion, the results should guide investigators in estimating historical levels when studies assessing exposure-response relations are carried out.