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Sritharan J, Arrandale VH, Kirkham TL, Dakouo M, MacLeod JS, Demers PA. Risk of chronic obstructive pulmonary disease in a large cohort of Ontario, Canada workers. Sci Rep 2024; 14:8756. [PMID: 38627517 PMCID: PMC11021393 DOI: 10.1038/s41598-024-59429-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
Although several occupational exposures have been linked to the risk of COPD; limited data exists on sex-specific differences. This study aimed to identify at-risk occupations and sex differences for COPD risk. Cases were identified in a large surveillance system established through the linkage of former compensation claimants' data (non-COPD claims) to physician visits, ambulatory care data, and hospital inpatient data (1983-2020). Cox proportional hazard models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CI) for occupation groups (occupation at time of claim), stratified by sex. HRs were indirectly adjusted for cigarette smoking using another population dataset. A total of 29,445 male and 14,693 female incident cases of COPD were identified. Increased risks were observed in both sexes for construction (HRmale 1.15, 95% CI 1.12-1.19; HRfemale 1.54, 95% CI 1.29-1.83) transport/equipment operating (HRmale 1.32, 95% CI 1.28-1.37; HRfemale 1.53, 95% CI 1.40-1.68) farming (HRmale 1.23, 95% CI 1.15-1.32; HRfemale 1.19, 95% CI 1.04-1.37) and janitors/cleaners (HRmale 1.31, 95% CI 1.24-1.37; HRfemale 1.40, 95% CI 1.31-1.49). Increased risks were observed for females employed as chefs and cooks (HR 1.44, 95% CI 1.31-1.58), bartenders (HR 1.38, 95% CI 1.05-1.81), and those working in food/beverage preparation (HR 1.34, 95% CI 1.24-1.45) among other occupations. This study demonstrates elevated risk of COPD among both male and female workers potentially exposed to vapours, gases, dusts, and fumes, highlighting the need for occupational surveillance of COPD.
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Affiliation(s)
- Jeavana Sritharan
- Occupational Cancer Research Centre, Ontario Health, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 1X3, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Victoria H Arrandale
- Occupational Cancer Research Centre, Ontario Health, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 1X3, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Tracy L Kirkham
- Occupational Cancer Research Centre, Ontario Health, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 1X3, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Mamadou Dakouo
- Occupational Cancer Research Centre, Ontario Health, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 1X3, Canada
| | - Jill S MacLeod
- Occupational Cancer Research Centre, Ontario Health, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 1X3, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Ontario Health, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 1X3, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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de Broucker V, Andujar P, Wardyn PM, Lepage N, Le Rouzic O, Edmé JL, Hulo S. Assessment of lung hyperinflation in occupational chronic obstructive pulmonary disease: a multicentric cross-sectional study. BMJ Open Respir Res 2023; 10:e001846. [PMID: 37758668 PMCID: PMC10537836 DOI: 10.1136/bmjresp-2023-001846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Occupational exposure is associated with elevated morbidity and lower quality of life in patients with chronic obstructive pulmonary disease (COPD). Static hyperinflation is an independent risk factor for all-cause mortality in COPD and for COPD exacerbation. In a multicentre, cross-sectional study (BPROFETIO), we sought to analyse the relationship between static hyperinflation and occupational exposure in patients with COPD with or without occupational exposure. MATERIAL AND METHODS An overall 'whole working life' cumulative exposure index was calculated for occupational patients with COPD. Spirometry indices and lung volumes were measured according to the 2005 American Thoracic Society/European Respiratory Society guidelines. RESULTS After adjustment for age, sex, height, body mass index, smoking and coexposure, the analysis for each occupational hazard showed a higher risk for hyperinflation and FEV1 decline or progression of COPD or GOLD stage for patients with COPD exposed to non-metallic inorganic dusts. CONCLUSION Occupational exposures should be more investigated in clinical practice and studies as they contribute to the COPD heterogeneity and are associated for some with the development of a static hyperinflation; a condition that is known to have a negative impact on quality of life and survival.
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Affiliation(s)
- Virginie de Broucker
- ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, University of Lille, Lille, France
- Service des Explorations Fonctionnelles Respiratoires, CHU Lille, Lille, France
| | - Pascal Andujar
- Faculté de médecine, Occupational Diseases; IMRB, GEIC2O, Université Paris-Est Créteil Val de Marne, Creteil, France
- Service de Pneumologie et Pathologie professionnelle, Centre Hospitalier Intercommunal de Creteil, Creteil, France
| | - Pierre-Marie Wardyn
- ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, University of Lille, Lille, France
- Médecine du Travail du Personnel Hospitalier, CHU Lille, Lille, France
| | - Nadège Lepage
- ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, University of Lille, Lille, France
- Service des Pathologies Professionnelles et Environnementales, CHU Lille, Lille, France
| | - Olivier Le Rouzic
- Inserm U1019, University of Lille, Lille, France
- Service de Pneumologie, CHU Lille, Lille, France
| | - Jean-Louis Edmé
- ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, University of Lille, Lille, France
| | - Sébastien Hulo
- ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, University of Lille, Lille, France
- Service des Explorations Fonctionnelles Respiratoires, CHU Lille, Lille, France
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Moitra S, Tabrizi AF, Khadour F, Henderson L, Melenka L, Lacy P. Exposure to insulating materials and risk of coronary artery diseases: a cross-sectional study. Front Public Health 2023; 11:1235189. [PMID: 37608979 PMCID: PMC10441239 DOI: 10.3389/fpubh.2023.1235189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/18/2023] [Indexed: 08/24/2023] Open
Abstract
Background Although previous reports link exposure to insulating materials with an increased risk of mesothelioma and chronic respiratory diseases, studies evaluating their associations with the risk of coronary artery diseases (CAD) are lacking. Aims We aimed at evaluating the associations between exposure to insulating materials and the 10-year risk of CAD among insulators. Methods In this cross-sectional study, we recruited 643 adults (≥18 years), full-time insulators from the Local 110 Heat and Frost Insulators and Allied Workers Union in Edmonton, Alberta. We obtained demographic information, personal and family history, and job-exposure history, including experience (years) and types of exposure to insulating materials. Clinical profiling including Framingham risk scores (FRS) was assessed. Results Of all insulators, 89% were men (mean ± SD age: 47 ± 12 years), 27% had a parental history of cardiac diseases, and 22% had a comorbid chronic respiratory disease. In total, 53% reported exposure to asbestos, while 61, 82, and 94% reported exposure to ceramic fibers, fiberglass, and mineral fibers, respectively. In single-exposure multivariable regression models adjusted for experience, marital status, and body mass index (BMI), asbestos was found to be associated with higher FRS (β: 1.004; 95%CI: 0.003-2.00). The association remained consistent in multi-exposure models and a higher association was found between asbestos exposure and FRS among insulators with comorbid chronic respiratory disease. Conclusion Our study demonstrates that apart from cancer and chronic respiratory diseases, asbestos exposure may also have a cardiac effect, thus warranting the need for systematic surveillance to protect workers from the adverse effects of these materials.
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Affiliation(s)
- Subhabrata Moitra
- Alberta Respiratory Centre and Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Ali Farshchi Tabrizi
- Alberta Respiratory Centre and Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Fadi Khadour
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | - Linda Henderson
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | - Lyle Melenka
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | - Paige Lacy
- Alberta Respiratory Centre and Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Suder Egnot N, Allen H, Hazan R, Vater MF, Denic-Roberts H, LeClaire R, Marsh GM. Systematic review of epidemiological studies evaluating the association between exposure to man-made vitreous fibers and non-malignant respiratory diseases. Regul Toxicol Pharmacol 2023; 139:105361. [PMID: 36806369 DOI: 10.1016/j.yrtph.2023.105361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/23/2023] [Accepted: 02/15/2023] [Indexed: 02/20/2023]
Abstract
This study aimed to systematically review and synthesize epidemiological evidence evaluating the association between occupational man-made vitreous fiber (MMVF) exposure and non-malignant respiratory disease (NMRD). We searched PubMed and Scopus databases to identify epidemiological studies evaluating the association between occupational MMVF exposure (limited to insulation wools) and at least 1 NMRD outcome published prior to January 2023. A total of 23 studies met our inclusion criteria. Studies of NMRD mortality among workers with MMVF exposure (n = 9) predominately reported null findings. Qualitative and quantitative synthesis of evidence from these studies suggests that MMVF exposure is not associated with elevated risk of NMRD mortality. The remaining 14 studies evaluated NMRD morbidity, specifically self-reported respiratory symptoms and/or subclinical measures of respiratory disease. Our review did not identify any consistent or compelling evidence of an association between MMVF exposure and any NMRD morbidity outcome; however, this body of evidence was largely limited by cross-sectional design, self-reported exposure and/or outcome ascertainment, incomplete statistical analysis and reporting, and questionable generalizability given that 13/14 studies were published over 20 years ago. We recommend that future studies aim to overcome the limitations of this literature to more accurately characterize the association between occupational MMVF exposure and NMRD morbidity.
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Siegel J, Gill N, Ramanathan M, Patadia M. Unified Airway Disease. Otolaryngol Clin North Am 2023; 56:39-53. [DOI: 10.1016/j.otc.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Nasirzadeh N, Soltanpour Z, Mohammadian Y, Pourhasan B. Lung Cancer and Pleural Mesothelioma Risk Assessment for the General Population Exposed to Asbestos in Different Regions of Tehran, Iran. J Res Health Sci 2022; 22:e00563. [PMID: 37571934 PMCID: PMC10422159 DOI: 10.34172/jrhs.2022.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/06/2022] [Accepted: 12/28/2022] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Asbestos is a natural fiber leading to health risks like chronic lung diseases. The current study aimed to estimate pleural mesothelioma and lung cancer risk for population exposure to asbestos in Tehran, Iran. STUDY DESIGN A cross-sectional study. METHODS According to the annual report of Air Quality Control Company (AQCC), from 2011-2020, carcinogenic risk and mesothelioma were assessed based on the Environmental Protection Agency (EPA) method using the Monte Carlo simulation (MCS). The relative risk (RR) of mortality cancer was calculated based on Camus and colleagues' model. Moreover, mesothelioma risk was estimated by Bourgault and colleagues' model. RESULTS The mean concentration and health risk of asbestos in ambient air generally reduced from 2011 to 2020. The highest mortality risk for lung cancer was 8.4 per 100000 persons in 2011 and reduced to 1.8 in 2017. For mesothelioma, the corresponding values were 8.96 per 100000 persons in 2011 and reduced to 1.92 in 2017. CONCLUSION The findings of this study could be helpful to health policymakers in the management of asbestos risk.
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Affiliation(s)
- Nafiseh Nasirzadeh
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Soltanpour
- Department of Occupational Health Engineering, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yousef Mohammadian
- Department of Occupational Health Engineering, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahman Pourhasan
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Moitra S, Tabrizi AF, Henderson L, Khadour F, Osman M, Melenka L, Lacy P. Chronic effects of occupational exposure to mineral fibers and recurrent chest infections in insulators. ERJ Open Res 2022; 8:00095-2022. [PMID: 35651365 PMCID: PMC9149384 DOI: 10.1183/23120541.00095-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/14/2022] [Indexed: 11/18/2022] Open
Abstract
Mineral fibres, which are types of commercially produced man-made vitreous fibres (MMVFs) with a woolly consistency, are industrially manufactured by passing air through molten glass, rock or slag, and are commonly known as glass, slag or rock wool. Although all these materials are grouped together as mineral fibres, there are differences in their composition and physical properties. Glass wool/fibreglass is made from borosilicate glass, which is composed of sand, soda ash dolomite, limestone, ulexite and anhydrite, while rock and slag wools are produced from naturally occurring igneous rock (basalt or dolomite rocks) and molten furnace slag, respectively [1]. These disorganised, interlocking fibres were reported to deliver potentially deleterious health effects, particularly on the skin and upper respiratory tract, to workers occupationally exposed to these materials, such as during installation or removal of insulation [2, 3]. While a few studies reported no evidence of pneumoconiosis in the industrial workers exposed to glass, rock or slag wool [4], several case reports appeared in recent years describing a long biopersistence of MMVFs leading to the development of pulmonary fibrosis at a later stage [5–8]. However, evidence of mineral fibre-associated respiratory tract infections has been limited. In this study, we aimed to investigate whether occupational exposure to mineral fibres was associated with recurrent chest infections. Exposure to mineral fibres (man-made forms of vitreous fibres often used as insulating material) is a risk factor for recurrent chest infections among workers, underscoring the necessity of workplace surveillance for protection from hazardous substanceshttps://bit.ly/38cUpmA
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Wagner J, Fowles J, Barreau T. Fiberglass and Other Flame-Resistant Fibers in Mattress Covers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031695. [PMID: 35162717 PMCID: PMC8835476 DOI: 10.3390/ijerph19031695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 11/16/2022]
Abstract
Public complaints have raised concerns that some mattresses in the current marketplace may be potential sources of airborne fiberglass. Although mattress foam is often marketed as chemical-free, their cover compositions are not as well understood by the general public. To fill these basic information gaps, the covers of four newly purchased mattresses were sampled and analyzed using polarized light microscopy, SEM-EDS, and FTIR microspectroscopy. Two of the mattress covers contained over 50% fiberglass in their inner sock layers. Up to 1% of the fiberglass had migrated to adjacent fabric layers, representing a potential risk of consumer exposure if the zipper on the outer cover is opened. The observed fiberglass fragments had calculated aerodynamic diameters ranging between 30 and 50 µm, suggesting they are potentially inhalable into the nose, mouth, and throat, but are likely too large to penetrate deeper into the lungs. No fiberglass was observed on the brand new mattresses’ outer surfaces. Synthetic fibers also present in the sock layers were consistent with flame resistant modacrylic containing vinyl chloride and antimony. The use of fiberglass and other chemicals in mattress covers poses a potential health risk if these materials are not adequately contained. The apparent non-inclusion of mattress covers in chemical-free certifications suggests that further improvements are needed in mattress labeling and education of consumers.
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Affiliation(s)
- Jeff Wagner
- Environmental Health Laboratory Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA 94804, USA
- Correspondence:
| | - Jefferson Fowles
- Environmental Health Investigations Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA 94804, USA; (J.F.); (T.B.)
| | - Tracy Barreau
- Environmental Health Investigations Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA 94804, USA; (J.F.); (T.B.)
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Short-Term Acute Exposure to Wildfire Smoke and Lung Function among Royal Canadian Mounted Police (RCMP) Officers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211787. [PMID: 34831540 PMCID: PMC8618710 DOI: 10.3390/ijerph182211787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/04/2021] [Accepted: 11/08/2021] [Indexed: 11/17/2022]
Abstract
The increasing incidence of extreme wildfire is becoming a concern for public health. Although long-term exposure to wildfire smoke is associated with respiratory illnesses, reports on the association between short-term occupational exposure to wildfire smoke and lung function remain scarce. In this cross-sectional study, we analyzed data from 218 Royal Canadian Mounted Police officers (mean age: 38 ± 9 years) deployed at the Fort McMurray wildfires in 2016. Individual exposure to air pollutants was calculated by integrating the duration of exposure with the air quality parameters obtained from the nearest air quality monitoring station during the phase of deployment. Lung function was measured using spirometry and body plethysmography. Association between exposure and lung function was examined using principal component linear regression analysis, adjusting for potential confounders. In our findings, the participants were predominantly male (71%). Mean forced expiratory volume in 1 s (FEV1), and residual volume (RV) were 76.5 ± 5.9 and 80.1 ± 19.5 (% predicted). A marginal association was observed between air pollution and higher RV [β: 1.55; 95% CI: -0.28 to 3.37 per interquartile change of air pollution index], but not with other lung function indices. The association between air pollution index and RV was significantly higher in participants who were screened within the first three months of deployment (2.80; 0.91 to 4.70) than those screened later (-0.28; -2.58 to 2.03), indicating a stronger effect of air pollution on peripheral airways. Acute short-term exposure to wildfire-associated air pollutants may impose subtle but clinically important deleterious respiratory effects, particularly in the peripheral airways.
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Keller JG, Wiemann M, Gröters S, Werle K, Vennemann A, Landsiedel R, Wohlleben W. Aerogels are not regulated as nanomaterials, but can be assessed by tiered testing and grouping strategies for nanomaterials. NANOSCALE ADVANCES 2021; 3:3881-3893. [PMID: 36133012 PMCID: PMC9419173 DOI: 10.1039/d1na00044f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/16/2021] [Indexed: 06/16/2023]
Abstract
Aerogels contribute to an increasing number of novel applications due to many unique properties, such as high porosity and low density. They outperform most other insulation materials, and some are also useful as carriers in food or pharma applications. Aerogels are not nanomaterials by the REACH definition but retain properties of nanoscale structures. Here we applied a testing strategy in three tiers. In Tier 1, we examined a panel of 19 aerogels (functionalized chitosan, alginate, pyrolyzed carbon, silicate, cellulose, polyurethane) for their biosolubility, and oxidative potential. Biosolubility was very limited except for some alginate and silicate aerogels. Oxidative potential, as by the ferric reduction ability of human serum (FRAS), was very low except for one chitosan and pyrolyzed carbon, both of which were <10% of the positive control Mn2O3. Five aerogels were further subjected to the Tier 2 alveolar macrophage assay, which revealed no in vitro cytotoxicity, except for silicate and polyurethane that induced increases in tumor necrosis factor α. Insufficiently similar aerogels were excluded from a candidate group, and a worst case identified. In the Tier 3 in vivo instillation, polyurethane (0.3 to 2.4 mg) elicited dose-dependent but reversible enzyme changes in lung lavage fluid on day 3, but no significant inflammatory effects. Overall, the results show a very low inherent toxicity of aerogels and support a categorization based on similarities in Tier 1 and Tier 2. This exemplifies how nanosafety concepts and methods developed on particles can be applied to specific concerns on advanced materials that contain or release nanostructures.
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Affiliation(s)
- Johannes G Keller
- BASF SE, Dept. Experimental Toxicology and Ecology, Dept. Material Physics 67056 Ludwigshafen Germany
| | - Martin Wiemann
- IBE R&D Institute for Lung Health, gGmbH Münster Germany
| | - Sibylle Gröters
- BASF SE, Dept. Experimental Toxicology and Ecology, Dept. Material Physics 67056 Ludwigshafen Germany
| | - Kai Werle
- BASF SE, Dept. Experimental Toxicology and Ecology, Dept. Material Physics 67056 Ludwigshafen Germany
| | | | - Robert Landsiedel
- BASF SE, Dept. Experimental Toxicology and Ecology, Dept. Material Physics 67056 Ludwigshafen Germany
| | - Wendel Wohlleben
- BASF SE, Dept. Experimental Toxicology and Ecology, Dept. Material Physics 67056 Ludwigshafen Germany
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