Non-malignant mortality among Norwegian silicon carbide smelter workers

Real-Time Measurements and Characterization of Airborne Particulate Matter from a Primary Silicon Carbide Production Plant

Airborne particulate matter in the silicon carbide (SiC) industry is a known health hazard. The aims of this study were to elucidate whether the particulate matter generated inside the Acheson furnace during active operation is representative of the overall particulate matter in the furnace hall, and whether the Acheson furnaces are the main sources of ultrafine particles (UFP) in primary SiC production. The number concentration of ultrafine particles was evaluated using an Electrical Low Pressure Impactor (ELPI^TM, Dekati Ltd., Tampere, Finland), a Fast Mobility Particle Sizer (FMPS^TM, TSI, Shoreview, MN, USA) and a Condensation Particle Counter (CPC, TSI, Shoreview, MN, USA). The results are discussed in terms of particle number concentration, particle size distribution and are also characterized by means of electron microscopy (TEM/SEM). Two locations were investigated; the industrial Acheson process furnace hall and a pilot furnace hall; both of which represent an active operating furnace. The geometric mean of the particle number concentration in the Acheson process furnace hall was 7.7 × 10⁴ particles/cm³ for the UFP fraction and 1.0 × 10⁵ particles/cm³ for the submicrometre fraction. Particulate matter collected at the two sites was analysed by electron microscopy. The PM from the Acheson process furnace hall is dominated by carbonaceous particles while the samples collected near the pilot furnace are primarily rich in silicon.

Occupational chronic obstructive pulmonary disease: a standard of care

BACKGROUND

Consistent evidence from population studies report that 10-15% of the total burden of chronic obstructive pulmonary disease (COPD) is associated with workplace exposures. This proportion of COPD could be eliminated if harmful workplace exposures were controlled adequately.

AIMS

To produce a standard of care for clinicians, occupational health professionals, employers and employees on the identification and management of occupational COPD.

METHODS

A systematic literature review was used to identify published data on the prevention, identification and management of occupational COPD. Scottish Intercollegiate Guidance Network grading and the Royal College of General Practitioner three star grading system were used to grade the evidence.

RESULTS

There are a number of specific workplace exposures that are established causes of COPD. Taking an occupational history in patients or workers with possible or established COPD will identify these. Reduction in exposure to vapours, gases, dusts and fumes at work is likely to be the most effective method for reducing occupational COPD. Identification of workers with rapidly declining lung function, irrespective of their specific exposure, is important. Individuals can be identified at work by accurate annual measures of lung function.

CONCLUSIONS

Early identification of cases with COPD is important so that causality can be considered and action taken to reduce causative exposures thereby preventing further harm to the individual and other workers who may be similarly exposed. This can be achieved using a combination of a respiratory questionnaire, accurate lung function measurements and control of exposures in the workplace.

Respiratory hazards of metal smelting

PURPOSE OF REVIEW

The metal smelting industry is an important industry in the majority of countries in the world and employs millions of workers. In most of the production types, a variety of pollutants are emitted into the workplace atmosphere. Some of these pollutants have sensitizing properties, whereas other act as irritants in the respiratory tract. This review will explore the recent studies (2010-2012) which address the impact of exposure to pollutants in the smelting industry on nonmalignant respiratory disorders.

RECENT FINDINGS

The association between different respiratory symptoms as well as pulmonary function and the level of exposure to different agents has been investigated. Likewise, the effect of primary prevention (exposure reduction) and secondary prevention (relocation) has been studied. Finally, the association between the incidence of community-acquired pneumonia and exposure to pollutants encountered at work in the smelting industry and the results from mortality studies are reported.

SUMMARY

It appears that exposure to emissions of pollutants in the smelting industry is associated with respiratory symptoms, including asthma, lung function decline and chronic obstructive pulmonary disease, depending on the type of production. Moreover, it is possible that these exposures may enhance the risk of infectious pneumonia.

Dust exposure is associated with increased lung function loss among workers in the Norwegian silicon carbide industry

OBJECTIVES

To investigate the relationship between dust exposure and annual change in lung function among employees in Norwegian silicon carbide (SiC) plants using a quantitative job exposure matrix (JEM) regarding total dust.

METHODS

All employees, 20-55 years of age by inclusion (n=456), were examined annually for up to 5 years (1499 examinations). Spirometry was performed at each examination, and a questionnaire encompassing questions of respiratory symptoms, smoking status, job and smoking history, and present job held was completed. A JEM was constructed based on 1970 personal total dust exposure measurements collected during the study period. The association between lung function and total dust exposure was investigated using linear mixed models.

RESULTS

The annual change in forced expiratory volume (FEV) in one second per squared height, FEV1/height(2), per mg/m(3) increase in dust exposure was -2.3 (95% CI -3.8 to -0.79) (mL/m(2))×year(-1). In an employee of average height (1.79 m) and exposure (1.4 mg/m(3)) the estimated contribution to the annual change in FEV1 associated with dust was 10.4 mL/year. The annual change in FEV1/height(2) in current, compared with non-smokers was -1.9 (-7.2 to 3.4) (mL/m(2))×year(-1). The estimated overall annual decline in FEV1 among current and non-smokers in the highest exposed group was -91.2 (-124.3 to -58.1) (mL/m(2))×year(-1) and -49.0 (-80.2 to -17.8) (mL/m(2))×year(-1), respectively.

CONCLUSIONS

Dust exposure, expressed by a quantitative JEM, was found to be associated with an increased yearly decline in FEV1 in employees of Norwegian SiC plants.

A novel strategy for retrospective exposure assessment in the Norwegian silicon carbide industry

The objective was to construct a retrospective job-exposure matrix (JEM) for the Norwegian silicon carbide industry. More than 3300 historical total dust measurements were available (1967-2005); however, there were few measurements of other agents. Total dust measurements were therefore used as the basis for the JEM, and a novel method was developed to estimate exposure to other agents. Multiple linear regression models were developed to describe historical exposure to total dust. Exposure estimates were extrapolated backward to periods without exposure data by adjustments for process and work-hour related changes. An exposure assessment study was performed where total dust was sampled in parallel with fibers or respirable dust. The respirable dust was analyzed for the content of quartz, cristobalite, and silicon carbide. Mixed-effect models were developed to estimate the exposure to these agents from total dust exposure, plant, and job group. Exposure to asbestos and polycyclic aromatic hydrocarbons was assigned qualitatively. Multiple linear regression models of total dust described historical exposure best in the furnace department (R(2) (adj) = 0.49-0.74). Models in the other departments explained less variance (R(2) (adj) = 0.12-0.32). Exposure determinants and total dust explained a substantial proportion of the between- (70-100%) and within-worker (8.0-54%) variance in the mixed-effect models. The relative bias between available historical measurements and the estimated exposure to dust components varied between -39% (fiber) and 40% (quartz). However, corrections were not considered necessary due to limitations in the historical data. The component-specific metrices were sufficiently different from each other (r(Pearson) < 0.7), with the exception of total and respirable dust (r(Pearson) = 0.84) and total dust and cristobalite (r(Pearson) = 0.72), and will enable component-specific epidemiologic analyses in the future. Improved and less correlated estimates of exposure levels for the different components in the dust were obtained with the updated exposure assessment. Due to limitations in the measurement data, assumptions had to be made, especially in the period before 1967. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resource: a file containing tables outlining multiple linear regression models for prediction of total dust exposure in the processing departments of Norwegian SiC producing plants, evaluation of the predictive abilities of the reduced total dust models, and mixed models for pedicting exposure to fibers and respirable quartz, cristobalite, non-fibrous silicon carbide and respirable dust from total dust exposure.].

Mortality from non-malignant respiratory diseases among workers in the Norwegian silicon carbide industry: associations with dust exposure

Objectives

Increased mortality from asthma, chronic bronchitis and emphysema has previously been reported among workers in the silicon carbide (SiC) industry. The objective of the present study was to evaluate the influence of specific exposure factors on mortality from obstructive lung diseases (OLD), using a newly revised job-exposure matrix.

Materials and methods

1687 long-term workers employed in 1913–2003 in the Norwegian SiC industry were characterised with respect to cumulative exposure to quartz, cristobalite, SiC particles and SiC fibres. Standardised mortality ratios (SMRs) for underlying causes of death, 1951–2007, were calculated stratified by category of cumulative exposure, and Poisson regression analyses of OLD were performed using cumulative exposure variables.

Results

An increased total mortality (SMR 1.1, 95% CI 1.0 to 1.2) and increased mortality from cancer, non-malignant respiratory diseases and external factors, were observed. The SMR of OLD was increased at the highest level of cumulative exposure to all investigated exposure factors. In the internal analyses, a twofold increased risk of OLD was observed with increasing levels of cumulative exposure to SiC particles. In a multivariate model, SiC particles showed the most stable increased risk estimate when controlled for other exposure factors, among workers with less than 15 years of employment. Among workers with more than 15 years of employment, crystalline silica, primarily cristobalite, seemed to be the most important exposure factor.

Conclusion

Exposure to SiC and crystalline silica may contribute to OLD development among SiC industry workers in different time windows, and possibly through different mechanisms.

Quantitative determination of airborne respirable non-fibrous alpha-silicon carbide by x-ray powder diffractometry

OBJECTIVES

The purpose of the present investigation was to establish a method for the determination of airborne respirable non-fibrous silicon carbide (SiC). The main application is within the industrial production of SiC.

METHODS

Due to the complex airborne aerosol mixture of crystalline compounds in the SiC industry, X-ray powder diffractometry was selected as the most appropriate method. Without any international standard material for the respirable fraction of non-fibrous SiC, pure and suitable products from three SiC plants in Norway were selected. These products have a median particle diameter in the range 4.4-5.1 mum. The method is based on thin sample technique, with the dust deposited on a polycarbonate filter. Absorption correction is done by standard procedures with the use of a silver filter, situated below the polycarbonate filter.

RESULTS

The diffraction line used for quantitative determination was selected carefully. This was done to avoid interferences from quartz, cristobalite, and graphite, which all are airborne components present in the atmosphere during the industrial process. The instrumental limit of detection for the method is 12 microg.

CONCLUSIONS

This method has been used to determine airborne non-fibrous SiC in a comprehensive ongoing project in the Norwegian SiC industry for further epidemiological studies. The method is fully applicable for compliance work.

Exposure to fibres, crystalline silica, silicon carbide and sulphur dioxide in the norwegian silicon carbide industry

OBJECTIVES

The aim of this study was to assess personal exposure to fibres, crystalline silica, silicon carbide (SiC) and sulphur dioxide in the Norwegian SiC industry.

METHODS

Approximately 720 fibre samples, 720 respirable dust samples and 1400 total dust samples were collected from randomly chosen workers from the furnace, processing and maintenance departments in all three Norwegian SiC plants. The respirable dust samples were analysed for quartz, cristobalite and non-fibrous SiC content. Approximately 240 sulphur dioxide samples were collected from workers in the furnace department.

RESULTS

The sorting operators from all plants, control room and cleaning operators in Plant A and charger, charger/mix and payloader operators in Plant C had a geometric mean (GM) of fibre exposure above the Norwegian occupational exposure limit (OEL) (0.1 fibre cm(-3)). The cleaner operators in Plant A had the highest GM exposure to respirable quartz (20 mug m(-3)). The charger/mix operators in Plant C had the highest GM exposure to respirable cristobalite (38 mug m(-3)) and the refinery crusher operators in Plant A had the highest GM exposure to non-fibrous SiC (0.65 mg m(-3)). Exposure to the crystalline silica and non-fibrous SiC was generally low and between 0.4 and 2.1% of the measurements exceeded the OELs. The cleaner operators in Plant A had the highest GM exposure to respirable dust (1.3 mg m(-3)) and total dust (21 mg m(-3)). GM exposures for respirable dust above the Norwegian SiC industry-specific OEL of 0.5 mg m(-3) were also found for refinery crusher operators in all plants and mix, charger, charger/mix and sorting operators in Plant C. Only 4% of the total dust measurements exceeded the OEL for nuisance dust of (10 mg m(-3)). Exposure to sulphur dioxide was generally low. However, peaks in the range of 10-100 p.p.m. were observed for control room and crane operators in Plants A and B and for charger and charger/mix operators in Plant C.

CONCLUSION

Workers in the SiC industry are exposed to a mixture of several agents including SiC fibres, quartz, cristobalite, non-fibrous SiC and sulphur dioxide. Exposure levels were generally below the current Norwegian OELs; however, high exposure to fibres and respirable dust still occurs in the furnace department.

Production of silicon metal and alloys is associated with accelerated decline in lung function: a 5-year prospective study among 3924 employees in norwegian smelters

OBJECTIVES

To investigate the association between decline in lung function and production of alloys in the Norwegian smelting industry.

METHODS

All employees (N = 3924) were examined annually for 5 years (16,570 examinations). The employees were classified into three categories: 1) line operators (employed full time in the production line), 2) nonexposed (no exposure last year), and 3) non-line operators (remaining subjects). The outcome variable was expressed as forced expiratory volume in 1 second per squared height (FEV1/height(2)).

RESULTS

In the subcohorts of the ferrosilicon/silicon metal and silicon carbide industries, the differences between line operators and nonexposed workers were -2.3 (-4.3 to -0.3) (CI = 95%) and -5.6 (-10.4 to -0.7) mL/(m(2) x year), respectively.

CONCLUSION

Line operators in the ferrosilicon/silicon metal and silicon carbide industries had a steeper annual decline in FEV1/height compared with nonexposed workers.

Effect of occupational exposures on decline of lung function in early chronic obstructive pulmonary disease

RATIONALE

Several occupational exposures adversely affect lung function.

OBJECTIVES

This study reports the influence of continued occupational dust and fume exposures on the rate of decline of lung function in participants with early chronic obstructive pulmonary disease (COPD) studied in a population-based study.

METHODS

Subjects consisted of 5,724 participants in the Lung Health Study, a multicenter study of smoking cessation and anticholinergic bronchodilator administration in smokers with early COPD (3,592 men; 2,132 women). Average post-bronchodilator FEV1 at entry was 78.4% predicted for men and 78.2% predicted for women; all participants had an FEV1/FVC ratio less than 0.70.

MEASUREMENTS AND MAIN RESULTS

Participants underwent a baseline evaluation and five annual follow-up assessments, including questionnaires and spirometry. The effect of ongoing dust or fume exposure on FEV1 in each follow-up year was statistically evaluated with a mixed-effects regression model, which was adjusted for FEV1 at entry, age, airway responsiveness to methacholine, baseline smoking intensity, and time-varying (yearly) smoking status during each follow-up year. In men with early COPD, each year of continued fume exposure was associated with a 0.25% predicted reduction in post-bronchodilator FEV1% predicted. Continued smoking and airway hyperresponsiveness were also associated with reduction in FEV1 during each year of follow-up in both men and women. Statistically significant effects of dust exposure on the rate of decline were not found, nor were effects of fume exposure noted in women.

CONCLUSIONS

These results suggest a need for secondary prevention by controlling occupational fume exposures.

Production of silicon alloys is associated with respiratory symptoms among employees in Norwegian smelters

OBJECTIVES

To develop a qualitative exposure classification of employees in Norwegian smelters and to investigate the relationship between respiratory symptoms and occupational exposure using this classification.

METHODS

The 3,924 participants completed a standardised questionnaire including questions of respiratory symptoms, familial asthma, allergy, doctor-diagnosed asthma, smoking habits, previous exposure and occupation. The employees were classified according to their current job function: (1) line operators were employed full time on the production line, (2) non-exposed employees did not work in production, (3) the remaining employees were classified as non-line operators. The association between the prevalence of respiratory symptoms and job category was examined using multivariate logistic regression.

RESULTS

The mean age of the participants was 38.6 years (standard deviation 9.2 years), 88.5% were males. The odds ratios (OR) (95% confidence intervals in parenthesis) for dyspnoea, cough and phlegm regarding previous exposure compared with no previous exposure were 1.4 (1.1-1.7), 1.4 (1.2-1.8) and 1.3 (1.0-1.7), respectively. The OR in line operators compared with non-exposed employees was 1.2 (0.9-1.7) for dyspnoea, 1.3 (1.0-1.8) for cough and 1.9 (1.4-2.7) for phlegm. The OR for respiratory symptoms was higher in relation to previous exposure than current job function except for phlegm.

CONCLUSION

In Norwegian smelters respiratory symptoms appear to be positively related to both current job function and previous exposure. Previous exposure appears to be more important than current job function.

Occupational causes of chronic obstructive pulmonary disease

The relation between Chronic Obstructive Pulmonary Disease (COPD, including chronic bronchitis and emphysema (CBE), and exposure to coal dust is well established. This paper reviews the evidence relating to other occupational causes of COPD, including industries associated with exposure to fumes, chemical substances, and dusts. A review of key literature has been carried out with a focus on the magnitude of risks and levels of exposure causing disabling health effects. The literature suggests that elevated risks of developing COPD are clearly associated with several occupations, with risk estimates being high in some, even after taking into account the effect of confounders, such as smoking. Of particular concern are agricultural workers who can be exposed to a variety of gases and organic dusts, among whom CBE is clearly elevated, particularly for pig farmers and exposure to endotoxins, with an increased annual decline in lung function. Similarly, cotton textile workers are exposed to a mixture of substances affecting development of atopy, byssinosis, and CBE, and across-shift and long-term decline in lung function. Atopy also has an important role in the development of COPD in flour mill workers and bakers, with those sensitized to bakery allergens having a greater lung function decline than non-sensitized individuals. Welding processes involve a range of potential chemical, physical and radiation hazards. The average reduction in FEV1 associated with welding fumes is similar to that associated with smoking. Challenges in assessing the evidence include variation in diagnostic methods; concurrent exposure to cigarette smoke (direct or second-hand) and multiple work-place irritants; healthy worker selection/survivor effects; poor exposure definition. Raising awareness of occupational causes of COPD among employers, employees, and health service professionals is important.