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Ahmadkhaniha R, Izadpanah F, Rastkari N. Hemoglobin adducts as an important marker of chronic exposure to low concentration of 1, 3-butadiene. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2021; 19:1607-1611. [PMID: 34900292 PMCID: PMC8617116 DOI: 10.1007/s40201-021-00716-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 07/26/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND 1, 3-Butadiene is a famous industrial compound which occurs in gasoline and diesel exhaust and in cigarette smoke. Based on little evidence of carcinogenicity in laboratory animals and humans, it was classified as a probable carcinogen. The potential of exposure to gasoline and diesel exhaust containing these chemical compounds is very considerable in urban areas. According to studies, in estimation of workers' chronic exposure with biological samples, analysis of the concentration of related hemoglobin adducts seems to give the most valid estimation of exposure. METHODS This study designed to determine the level of chronic exposure in gas station workers and traffic policemen during routine work shift, by an appropriate biological marker. In this regards, 25 gas station workers, 25 policemen engaged in traffic control, and 25 occupationally non-exposed persons were studied. Blood samples were obtained after the work shift from each person. The level of selected hemoglobin adduct, 1- and 2-hydroxy-3-butenyl valine (MHBVal) was determined by using GC-MS after a modified Edman degradation and a further acetylation. RESULTS There were significant differences among the mean concentrations of MHBVal in blood samples of gas station workers, policemen and occupationally non-exposed persons. The mean airborne levels of 1, 3-Butadiene over 60 days, differed significantly among different studied groups (ANOVA: p < 0.05 and Kruskal-Wallis test: p < 0.05). CONCLUSION There was a significant difference in MHBVal concentrations between job categories (p < 0.05 by ANOVA and Kruskal-Wallis test), and gas station workers and policemen were found to be probably the most exposed groups in this research.
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Affiliation(s)
- Reza Ahmadkhaniha
- Department of Human Ecology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Izadpanah
- Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Rastkari
- Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
- Center for water Quality Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
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Ahmadkhaniha R, Ghoochani M, Rastkari N. Application of biological monitoring for exposure assessment of 1.3 Butadiene. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2020; 18:1265-1269. [PMID: 33312640 PMCID: PMC7721966 DOI: 10.1007/s40201-020-00544-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND 1, 3-Butadiene is an important industrial compound. Based on sufficient evidence of carcinogenicity in laboratory animals and humans, the International Agency for Research on Cancer, in 1999, classified 1, 3-Butadiene as a probable carcinogen to humans (group 2A). The potential for exposure to vehicle exhaust containing these chemical compounds is very noticeable in urban locations. Exposure to incomplete combustion of gasoline has been a long time concern in many occupational fields, including policemen, service stations, and the petroleum industry but in Iran has rarely been studied. METHODS This study designed to determine the exposure levels for traffic policemen and gas station workers during routine work shift, by biological monitoring. With this aim, 25 policemen engaged in traffic control, 25 gas station workers and 25 occupationally non-exposed persons were investigated. Spot urine samples were obtained prior to and at the end of the work shift from each subject. The urinary levels of selected urinary metabolites (MHBMA and DHBMA) were determined by using LC-MS/MS. RESULTS There were significant differences among the mean urinary concentrations of DHBMA in pre-shift samples of policemen, gas station workers and occupationally non-exposed persons. The mean urinary concentrations of DHBMA differed significantly among post-shift samples of policemen and gas station (ANOVA: p < 0.05 and Kruskal-Wallis test: p < 0.05). CONCLUSIONS There was a significant difference in DHBMA concentrations between job categories (p < 0.05 by ANOVA and Kruskal-Wallis test), and policemen and gas station workers were found to be probably the most exposed groups in this study.
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Affiliation(s)
- Reza Ahmadkhaniha
- Department of Human Ecology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboobeh Ghoochani
- Environmental and Occupational Health Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Noushin Rastkari
- Center for Air Pollution Research, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, 1417993359 Iran
- Center for Water Quality Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
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Salimi A, Vaghar-Moussavi M, Seydi E, Pourahmad J. Toxicity of methyl tertiary-butyl ether on human blood lymphocytes. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:8556-8564. [PMID: 26797945 DOI: 10.1007/s11356-016-6090-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 01/11/2016] [Indexed: 06/05/2023]
Abstract
Methyl tertiary-butyl ether (MTBE) is a synthetic solvent widely used as oxygenate in unleaded gasoline. Few studies have addressed the cellular toxicity of MTBE on some cell lines, and so far, no comprehensive study has been conducted to investigate the probable immunotoxicity of this compound. In this study, the toxicity of MTBE on human blood lymphocytes was evaluated. Blood lymphocytes were isolated from healthy male volunteers' blood, using Ficoll polysaccharide followed by gradient centrifugation. Cell viability, reactive oxygen species (ROS) formation, lipid peroxidation, glutathione levels, and damage to mitochondria and lysosome were determined in blood lymphocytes after 6-h incubation with different concentrations of MTBE (0.1, 0.5, 1, and 2 mM). Our results showed that MTBE, in particular, decreased cell viability, which was associated with significant increase at intracellular ROS level and toxic alterations in mitochondria and lysosomes in human blood lymphocytes. Moreover, it was shown that MTBE strongly provoked lipid peroxidation and also depleted glutathione level at higher concentrations. Interestingly, MTBE exhibited its cytotoxic effects at low concentrations that may resemble to its concentrations in human blood following occupational and environmental exposure. It is therefore concluded that MTBE was capable of inducing oxidative stress and damage to mitochondria and lysosomes in human lymphocytes at concentrations ranging from 5 to 40 μg/L, which may be present in human blood as a result of environmental exposure.
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Affiliation(s)
- Ahmad Salimi
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, P.O. Box: 14155-6153, Tehran, Iran
- Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Science, Ardabil, Iran
- Students Research Committee, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrdad Vaghar-Moussavi
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, P.O. Box: 14155-6153, Tehran, Iran
- Students Research Committee, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Enayatollah Seydi
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, P.O. Box: 14155-6153, Tehran, Iran
- Students Research Committee, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jalal Pourahmad
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, P.O. Box: 14155-6153, Tehran, Iran.
- Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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De Palma G, Poli D, Manini P, Andreoli R, Mozzoni P, Apostoli P, Mutti A. Biomarkers of exposure to aromatic hydrocarbons and methyltert-butyl ether in petrol station workers. Biomarkers 2012; 17:343-51. [DOI: 10.3109/1354750x.2012.672459] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kane EV, Newton R. Occupational exposure to gasoline and the risk of non-Hodgkin lymphoma: a review and meta-analysis of the literature. Cancer Epidemiol 2010; 34:516-22. [PMID: 20561834 DOI: 10.1016/j.canep.2010.05.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Revised: 05/24/2010] [Accepted: 05/25/2010] [Indexed: 12/31/2022]
Abstract
AIMS Gasoline comprises over 500 chemicals, including the known or suspected carcinogens benzene, 1,3-butadiene, ethylbenzene and methyl tert-butyl ether (MTBE). To assess whether work in the production, distribution and use of gasoline is associated with non-Hodgkin lymphoma (NHL), we reviewed the published literature on this topic. METHOD English-language peer-reviewed articles were identified by keyword searches of bibliographic databases. Twenty-two cohorts and thirteen case-control studies examined the risk of NHL among persons employed in the downstream petroleum industry. RESULT No positive associations were found with the exception of one study. The pooled risk estimate from a random-effects meta-analysis was 1.02 (95% confidence interval (CI) 0.94-1.12). Although there were no estimates available, exposure is likely to have varied by occupation, location and time period; there was no evidence however that risk estimates varied by any of these factors. NHL is a heterogeneous disease, yet no data were reported for NHL subtypes. CONCLUSION In summary, there is no suggestion across an extensive literature that exposure to gasoline at the levels workers' experience in an occupational setting increases the risk of NHL.
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Affiliation(s)
- Eleanor V Kane
- Epidemiology and Genetics Unit, Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK.
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Unmetabolized VOCs in urine as biomarkers of low level occupational exposure. Int J Occup Med Environ Health 2010; 23:21-6. [DOI: 10.2478/v10001-010-0003-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Rastkari N, Ahmadkhaniha R, Yunesian M. Single-walled carbon nanotubes as an effective adsorbent in solid-phase microextraction of low level methyl tert-butyl ether, ethyl tert-butyl ether and methyl tert-amyl ether from human urine. J Chromatogr B Analyt Technol Biomed Life Sci 2009; 877:1568-74. [DOI: 10.1016/j.jchromb.2009.04.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2008] [Revised: 03/31/2009] [Accepted: 04/01/2009] [Indexed: 11/15/2022]
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Keretetse GS, Laubscher PJ, Du Plessis JL, Pretorius PJ, Van Der Westhuizen FH, Van Deventer E, Van Dyk E, Eloff FC, Van Aarde MN, Du Plessis LH. DNA damage and repair detected by the comet assay in lymphocytes of african petrol attendants: a pilot study. ACTA ACUST UNITED AC 2008; 52:653-62. [PMID: 18664513 DOI: 10.1093/annhyg/men047] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Petrol attendants are exposed to petrol volatile organic compounds (VOCs) which may have genotoxic and carcinogenic effects. The single-cell gel electrophoresis assay (comet assay) is a method highly sensitive to DNA damage induced by environmental and occupational exposure to carcinogenic and mutagenic agents. The aim of this study was to evaluate the level of exposure of petrol attendants to petrol VOCs and also to determine their effect on DNA damage and repair in lymphocytes of African petrol attendants. The exposed group consisted of 20 subjects, randomly selected from three petrol stations. A control group of 20 unexposed subjects was also chosen and matched for age and smoking habits with the exposed group. Sorbent tubes were used to assess personal exposure of petrol attendants. The comet assay was used to investigate the basal DNA damage and repair capacity in isolated lymphocytes of petrol attendants and unexposed subjects. Blood samples were taken from the petrol attendants at the end of their 8-h working shift and also from the unexposed subjects. The petrol attendants were found to be exposed to levels of petrol VOCs lower than the South African occupational exposure limit for constituent chemicals. A significant relationship was found between the volume of petrol sold during the shift and the average concentrations of benzene, toluene and the total VOCs measured. However, relative humidity had a negative correlation with the average concentrations of benzene, toluene, xylene and the total VOCs. Significantly higher basal DNA damage was observed with the exposed group compared to the unexposed group. The period of exposure influenced the level of DNA damage and the calculated repair capacity. Smoking and age had a significant influence on the level of DNA damage. DNA repair capacity was delayed in smokers of both exposed and unexposed group.
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Affiliation(s)
- G S Keretetse
- Subject-Group Physiology, Faculty of Health Sciences, North-West University, Potchefstroom Campus, Private Bag X6001, Potchefstroom 2520, South Africa
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Janasik B, Jakubowski M, Jałowiecki P. Excretion of unchanged volatile organic compounds (toluene, ethylbenzene, xylene and mesitylene) in urine as result of experimental human volunteer exposure. Int Arch Occup Environ Health 2007; 81:443-9. [PMID: 17680265 DOI: 10.1007/s00420-007-0233-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2007] [Accepted: 07/11/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate elimination of unchanged volatile organic compounds (VOC's) through urine and the use of respective data for occupational exposure assessment, six volunteers were exposed under controlled conditions to toluene (TOL), ethylbenzene (EB), xylene (XYL) and mesitylene (MES) at concentrations ranging from 20 to 200 mg/m(3). The study was to elicit the toxicokinetic data and compare the precision of VOC's exposure assessment based on determining unchanged compounds in blood, urine and their metabolites in urine. METHODS During and after exposure blood and urine samples were analysed by gas chromatography using the headspace and SPME headspace technique RESULTS The kinetics of VOC's elimination in urine complied with an open two-compartment model. The (half-time) T (1/2 )values varied from 0.45 to 0.88 h for phase I and from 6.7 to 19.2 h for phase II. The precision of the method for unchanged VOC's was similar to that based on unchanged compounds in blood and better than their main metabolites in urine. CONCLUSION The obtained result indicate that determining unchanged VOC's in urine can be used as an exposure test even in the ranges of VOC's in the air that are much lower than the current TWA for occupational exposure.
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Affiliation(s)
- Beata Janasik
- Department of Chemical Hazard, Institute of Occupational Medicine, Lodz, Poland.
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Vainiotalo S, Kuusimäki L, Pekari K. Exposure to MTBE, TAME and aromatic hydrocarbons during gasoline pump maintenance, repair and inspection. J Occup Health 2007; 48:347-57. [PMID: 17053301 DOI: 10.1539/joh.48.347] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The exposure of gasoline pump repairers and inspectors to gasoline was studied at service stations and repair shops in Finland in April-June 2004. The average air temperature ranged from 7 degrees C to 16 degrees C and wind speed from 2.5 to 7 m/s. The gasoline blends contained mixtures of methyl tert-butyl ether (MTBE) and tert-amyl methyl ether (TAME), the total content of oxygenates being 11-12%. The content of benzene was <1%. Breathing zone air was collected during the work task using passive monitors. The mean sampling period was 4.5 h. The mean TWA-8 h concentrations for MTBE, TAME, hexane, benzene, toluene, ethylbenzene and xylene were 4.5, 1.3, 0.55, 0.23, 2.2, 0.26 and 1.1 mg/m3, respectively. None of the individual benzene concentrations exceeded the binding limit value for benzene (3.25 mg/m3). The sum concentration of MTBE and TAME in urine was between 8.9 and 530 nmol/l in individual post-shift samples. The individual sum concentrations of the metabolites tert-butyl alcohol and tert-amyl alcohol collected the following morning after the exposure ranged from 81 to 916 nmol/l. All individual results were below corresponding biological action levels. Exposure to aromatic hydrocarbons was estimated from post-shift urine samples, with benzene showing the highest concentration (range 4.4 and 35 nmol/l in non-smokers). The exposure levels were similar to those measured in previous studies during unloading of tanker lorries and railway wagons. The results indicated a slightly higher exposure for inspectors, who calibrated fuel pump gauges at the service stations, than for pump repairers. No significant skin exposure occurred during the study.
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Affiliation(s)
- Sinikka Vainiotalo
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, Helsinki, Finland.
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Scibetta L, Campo L, Mercadante R, Foà V, Fustinoni S. Determination of low level methyl tert-butyl ether, ethyl tert-butyl ether and methyl tert-amyl ether in human urine by HS-SPME gas chromatography/mass spectrometry. Anal Chim Acta 2007; 581:53-62. [PMID: 17386425 DOI: 10.1016/j.aca.2006.07.083] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Revised: 07/29/2006] [Accepted: 07/31/2006] [Indexed: 11/22/2022]
Abstract
Methyl tert-butyl ether (MTBE), ethyl tert-butyl ether (ETBE) and tert-amyl methyl ether (TAME) are oxygenated compounds added to gasoline to enhance octane rating and to improve combustion. They may be found as pollutants of living and working environments. In this work a robotized method for the quantification of low level MTBE, ETBE and TAME in human urine was developed and validated. The analytes were sampled in the headspace of urine by SPME in the presence of MTBE-d12 as internal standard. Different fibers were compared for their linearity and extraction efficiency: carboxen/polydimethylsiloxane, polydimethylsiloxane/divinylbenzene, and polydimethylsiloxane. The first, although highly efficient, was discarded due to deviation of linearity for competitive displacement, and the polydimethylsiloxane/divinylbenzene fiber was chosen instead. The analysis was performed by GC/MS operating in the electron impact mode. The method is very specific, with range of linearity 30-4600 ng L(-1), within- and between-run precision, as coefficient of variation, <22 and <16%, accuracy within 20% the theoretical level, and limit of detection of 6 ng L(-1) for all the analytes. The influence of the matrix on the quantification of these ethers was evaluated analysing the specimens of seven traffic policemen exposed to autovehicular emissions: using the calibration curve and the method of standard additions comparable levels of MTBE (68-528 ng L(-1)), ETBE (<6 ng L(-1)), and TAME (<6 ng L(-1)) were obtained.
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Affiliation(s)
- Licia Scibetta
- Department of Occupational and Environmental Medicine, University of Milano and Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via S. Barnaba, 8-20122 Milano, Italy
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Kirkeleit J, Riise T, Bråtveit M, Pekari K, Mikkola J, Moen BE. Biological monitoring of benzene exposure during maintenance work in crude oil cargo tanks. Chem Biol Interact 2006; 164:60-7. [PMID: 17049507 DOI: 10.1016/j.cbi.2006.08.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2006] [Revised: 08/17/2006] [Accepted: 08/18/2006] [Indexed: 10/24/2022]
Abstract
We investigated the association between the individual concentrations of benzene in the breathing zone and the concentrations of benzene in the blood and urine among workers maintaining crude oil cargo tanks. Benzene exposure was measured during three consecutive 12h work days among 13 tank workers and 9 unexposed referents (catering section). Blood and urine samples were collected pre-shift on the first day, post-shift on the third day, and pre-next shift on the following morning. The workers used half-mask air-purifying respirators, but not all workers used these systematically. The individual geometric mean benzene exposure in the breathing zone of tank workers over 3 days was 0.15 ppm (range 0.01-0.62 ppm). The tank workers' post-shift geometric mean benzene concentrations were 12.3 nmol/l in blood and 27.0 nmol/l in urine versus 0.7 nmol/l for both blood and urine among the referents. Benzene in the work atmosphere was highly correlated with the internal concentration of benzene both in post-shift blood (r=0.87, P<0.001) and post-shift urine (r=0.90, P<0.001), indicating that the varying use of respirators did not explain much of the variability in absorbed benzene. The results showed that, despite low benzene exposure in this work atmosphere and the use of personal protective equipment to a varying degree, the tank workers had a significant uptake of benzene that correlated highly with benzene exposure. The internal concentration of benzene was higher than expected considering the measured individual benzene exposure, probably due to an extended work schedule of 12h and physical strain during tank work. Control measures should be improved for processes, which impose a potential for increased absorption of benzene upon the workers.
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Affiliation(s)
- Jorunn Kirkeleit
- Section for Occupational Medicine, Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, N-5018 Bergen, Norway.
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Jakubowski M, Trzcinka-Ochocka M. Biological monitoring of exposure: trends and key developments. J Occup Health 2005; 47:22-48. [PMID: 15703450 DOI: 10.1539/joh.47.22] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The concept of biological monitoring (BM) has gained the special interest of individual scientists and international organizations. Today, when analytical problems have almost ceased due to new laboratory techniques and quality assurance systems, the methods for interpretation of results have become the most important issue. There are important discrepancies regarding the role of biological monitoring of occupational exposure between Europe and the United States. BM has been an important tool of medical health surveillance in the European countries. In the United States it belongs rather to the field of occupational hygiene. It seems that both the approaches can be accepted. More attention should be paid to the development of the truly health-based biomarkers of exposure based on the dose-effect and dose-response relationships. New areas of application of BM of occupational exposure include determination of DNA and protein adducts, unchanged volatile organic compounds in urine, monitoring of exposure to pesticides, antineoplastic drugs, hard metals, and polycyclic aromatic hydrocarbons. In the general environment BM is the most valuable tool for acquiring knowledge of current levels of internal exposure to xenobiotics, identifying the hot spots and developments in trends of exposure. BM can provide policy makers with more accurate information on the control measures undertaken. At present, the main areas include heavy metals, persistent organic pollutants and pesticides. BM of chemical exposure has become increasingly important in the assessment of the health risk in occupational and environmental medicine. Therefore it would be worthwhile to include BM in the curricula for the training of occupational hygienists.
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