Headspace measurements of irradiated in vitro cultured cells using PTR-MS

A pilot study was performed to evaluate a new concept for a radiation biodosimetry method. Proton transfer reaction-mass spectrometry (PTR-MS) was used to find out whether radiation induces changes in the composition of volatile organic compounds (VOCs) in the headspace of in vitro cultured cells. Two different cell lines, retinal pigment epithelium cells hTERT-RPE1 and lung epithelium cells A-549, were irradiated with gamma radiation at doses of 4 Gy and 8 Gy. For measuring the cell-specific effects, the VOC concentrations in the headspace of flasks containing cells plus medium, as well as of flasks containing pure medium were analyzed for changes before and after irradiation. No significant radiation-induced alterations in VOC concentrations in the headspace could be observed after irradiation.

Discrimination of cancerous and non-cancerous cell lines by headspace-analysis with PTR-MS

Proton transfer reaction mass spectrometry (PTR-MS) has been used to analyze the volatile organic compounds (VOCs) emitted by in-vitro cultured human cells. For this purpose, two pairs of cancerous and non-cancerous human cell lines were selected:1. lung epithelium cells A-549 and retinal pigment epithelium cells hTERT-RPE1, cultured in different growth media; and 2. squamous lung carcinoma cells EPLC and immortalized human bronchial epithelial cells BEAS2B, cultured in identical growth medium. The VOCs in the headspace of the cell cultures were sampled: 1. online by drawing off the gas directly from the culture flask; and 2. by accumulation of the VOCs in PTFE bags connected to the flask for at least 12 h. The pure media were analyzed in the same way as the corresponding cells in order to provide a reference. Direct comparison of headspace VOCs from flasks with cells plus medium and from flasks with pure medium enabled the characterization of cell-line-specific production or consumption of VOCs. Among all identified VOCs in this respect, the most outstanding compound was m/z = 45 (acetaldehyde) revealing significant consumption by the cancerous cell lines but not by the non-cancerous cells. By applying multivariate statistical analysis using 42 selected marker VOCs, it was possible to clearly separate the cancerous and non-cancerous cell lines from each other.

The effects of low environmental cadmium exposure on bone density

Recent epidemiological data indicate that low environmental exposure to cadmium, as shown by cadmium body burden (Cd-U), is associated with renal dysfunction as well as an increased risk of cadmium-induced bone disorders. The present study was designed to assess the effects of low environmental cadmium exposure, at the level sufficient to induce kidney damage, on bone metabolism and mineral density (BMD). The project was conducted in the area contaminated with cadmium, nearby a zinc smelter located in the region of Poland where heavy industry prevails. The study population comprised 170 women (mean age=39.7; 18-70 years) and 100 men (mean age=31.9; 18-76 years). Urinary and blood cadmium and the markers of renal tubular dysfunction (beta(2)M-U RBP, NAG), glomerular dysfunction (Alb-U and beta(2)M-S) and bone metabolism markers (BAP-S, CTX-S) as well as forearm BMD, were measured. The results of this study based on simple dose-effect analysis showed the relationship between increasing cadmium concentrations and an increased excretion of renal dysfunction markers and decreasing bone density. However, the results of the multivariate analysis did not indicate the association between exposure to cadmium and decrease in bone density. They showed that the most important factors that have impact on bone density are body weight and age in the female subjects and body weight and calcium excretion in males. Our investigation revealed that the excretion of low molecular weight proteins occurred at a lower level of cadmium exposure than the possible loss of bone mass. It seems that renal tubular markers are the most sensitive and significant indicators of early health effects of cadmium intoxication in the general population. The correlation of urinary cadmium concentration with markers of kidney dysfunction was observed in the absence of significant correlations with bone effects. Our findings did not indicate any effects of environmental cadmium exposure on bone density.

Hydrophilic olive cake extracts: characterization by physicochemical properties and Cu(II) complexation

Disposed olive cake generates hydrophilic components that can be mobilized in the aquatic environment. This paper deals with the characterization of such components, isolated by alkaline extraction. It is shown that these substances possess properties very much resembling humic acid, including a substantial inventory of proton exchanging groups. Extraction and purification of the hydrophilic components from the disposed olive cake was performed by the standard approach for isolation of humic acids from solid sources, i.e. alternating alkaline dissolution and acid flocculation, leaving the purified extract in the protonated form. The purified sample was characterized by Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES), Fourier Transform Infra Red Spectroscopy (FTIR), UV-vis, Time-of-Flight Secondary Ion Mass Spectrometry (TOF-SIMS) and Asymmetrical Flow Field-Flow Fractionation (AFFFF). The complex formation properties were investigated by potentiometry using Cu(II) ion selective electrode under atmospheric conditions at I=0.1M NaClO(4) (aqueous solution) and pH 6. The formation constant for the CuHA complex is found to be logbeta=5.3+/-0.4 which is close to the corresponding value (logbeta=5.2+/-0.4) obtained from similar investigations with the commercially available Aldrich humic acid (this study) and corresponding published values for various humic acids. Both, structural properties and complex formation data show that the olive cake extract has considerable similarities with humic acids from different sources, pointing towards potential similarities in environmental behavior and impact.

Expression of tumour necrosis factor-related apoptosis-inducing ligand and caspase-3 in relation to grade of inflammation and stage of fibrosis in chronic hepatitis C

AIM

To assess whether the distribution of the recently described proapoptotic ligand, tumour necrosis factor-related apoptosis-inducing ligand (TRAIL), and the apoptosis effector, caspase-3 alters with the degree of inflammation and fibrosis present in liver biopsy specimens from patients with chronic hepatitis C virus infection.

METHODS AND RESULTS

Expression of TRAIL and caspase-3 was assessed immunohistochemically in liver biopsy specimens obtained from 89 adults with chronic hepatitis C. Expression of TRAIL in hepatocytes correlated inversely with stage of fibrosis (P = 0.001), classified according to the Scheuer score; expression of caspase-3 in hepatocytes correlated with grade of inflammation (P = 0.012). Expression of TRAIL in hepatocytes was not correlated with grade of inflammation (P > 0.05); expression of caspase-3 was not correlated with stage of fibrosis (P > 0.05). Maximum expression of proapoptotic TRAIL protein was observed in cases with low grade inflammation (G0) and low stage fibrosis (S1). Maximum expression of caspase-3 in hepatocytes was observed in cases with high grade inflammation (G3-4) and high stage fibrosis (S3), but not with liver cirrhosis (S4).

CONCLUSIONS

There is a significant decrease in TRAIL expression with increasing grade of inflammation, whereas caspase-3 expression is significantly increased with advanced fibrosis, short of cirrhosis.

Expression of Bax, Bcl-xL and Bcl-2 proteins in relation to grade of inflammation and stage of fibrosis in chronic hepatitis C

AIMS

To determine the expression of regulators of apoptosis in chronic hepatitis C.

METHODS AND RESULTS

Expression of Bax, Bcl-xL and Bcl-2 proteins was assessed immunohistochemically in liver biopsy specimens obtained from 89 adults with chronic hepatitis C. Expression of Bax in hepatocytes correlated inversely with grade of inflammation (P < 0.001) and stage of fibrosis (P = 0.011), classified according to the Scheuer score; expression of Bcl-xL in hepatocytes did not correlate with grade of inflammation (P = 0.106) or stage of fibrosis (P = 0.078); maximum Bcl-xL expression was observed in grade 3 inflammation and stage 4 fibrosis. Expression of Bcl-2 protein in hepatocytes was present in only two cases (both with advanced disease); the expression of Bcl-2 protein in interlobular bile duct epithelial cells correlated with the grade of inflammation (P = 0.018), but not with stage of fibrosis (P = 0.154). The expression of Bcl-2 protein in lymphoid cells infiltrating portal zones and lobules did not correlate with grade of inflammation (P = 0.113) or stage of fibrosis (P = 0.815).

CONCLUSION

Major differences in expression of studied proteins were observed in relation to grade of inflammation and stage of fibrosis in chronic hepatitis C.

Does fecal diversion offer any chance for spontaneous closure of the radiation-induced rectovaginal fistula?

Analysis of the clinical course of patients with postirradiation rectovaginal fistula after fecal diversion. The studied group included 17 women with postirradiation rectovaginal fistula who underwent fecal diversion as a sole mode of treatment, between January 1987 and December 2002, in our department. All patients were subjected to radiotherapy due to cancer of the uterine cervix, administered 5-107 months before the fistula appearance (mean, 22.9 months). In 3 of 17 patients (18%), spontaneous closure of fistula was observed after 5, 6, and 9 months, respectively, from fecal diversion. Closure was confirmed by endoscopy. Length of follow-up after fecal diversion ranged from 0.5 to 122 months. The actuarial probability of spontaneous closure of postradiotherapy rectovaginal fistula was 0.24 at 9 months of follow-up and then remained stable thereafter. In conclusion, colostomy alone gives hardly a chance for closure of the postradiotherapy rectovaginal fistula. Additional surgical measures are necessary.

Patients with Paget disease of nipple and with palpable mass in breast have unfavorable prognosis

Recent data indicate that in breast cancer patients the presence of Paget disease of the nipple may be related to poor prognosis. Therefore, we decided to assess long-term results of the treatment of such patients, and to assess the relationship between the physical and pathological findings and prognosis. The files of 60 patients with Paget disease of the nipple who were treated between 1977 and 2000 were analyzed retrospectively with respect to the results of physical and pathologic examinations, disease recurrence and survival. In 38/60 patients, the cancer was invasive. In 26/60 patients, palpable masses in the breast were diagnosed. The 5-year overall survival probability was 0.68; the probability was 0.82 for patients without palpable masses, 0.51 for those with palpable masses, 0.91 for patients without invasive cancer and 0.58 for patients with associated invasive cancer. In conclusions, patients with Paget disease of the nipple and with palpable mass in the breast had unfavorable diagnosis. The nature of all nipple changes should be explained as early as possible in order to diagnose the disease when no mass is palpable in the breast.

Immunohistochemical evaluation of P21ras and P53 proteins expression in human non-small-cell lung cancers

Human non-small-cell lung cancers (NSCLCs) of 48 patients were analyzed immunohistochemically to detect P21 ras and P53 proteins expression. The relationship between P21 ras and P53 proteins expression and clinicopathologic findings was also assessed. DAKO EnVision TM detection system was employed in the study. The P21 ras and P53 proteins expression was shown in 75% (36/48) and 33.3% (16/48) studied NSCLCs, respectively. In both cases the difference was significant when compared with adequate negative control. Simultaneous expression of both studied proteins was observed in all cases in which P53 expression was noticed. No significant association of P21 ras and P53 expression was found with age, histologic type, histologic grade, tumor size or lymph node metastasis of the studied NSCLCs. Therefore, our study suggests that P21 ras and P53 protein play a role in the pathogenesis of NSCLCs but they have no value as a prognostic markers in the case of lung cancers.

Glutathione S-transferase M1 and P1 metabolic polymorphism and lung cancer predisposition

Individual susceptibility to different environmental agents is expected to be associated with alterations in metabolism of xenobiotics. Thus, genetic polymorphism of glutathione S-transferase (GST) can be recognized as a potential risk modifier in lung cancer development. The distribution of GSTM1 and GSTP1 genotypes was studied in a group of 138 diagnosed lung cancer patients and in 165 controls living in central Poland and RFLP-PCR technique was applied. The frequency of GSTM1 null genotype and GSTP1 Val single and duplicated alleles was similar among patients and controls. GSTM1 homozygous deletion was most prevalent in small-cell carcinoma groups (adjusted odds ratio (OR): 2.32, 95% confidence interval (CI): 0.98-5.52). In patients and controls, GSTM1A genotype was most frequent (34.1% vs. 37.0%). The estimated lung cancer risk for GSTM1 null, GSTP1 Ile/Val and GSTP1 Val/Val combined genotype was 1.44 (95% CI: 0.73-2.83), suggesting the absence of modifying effect of defective GSTM1 and GSTP1 alleles on lung cancer predisposition.

Hearing loss among workers exposed to moderate concentrations of solvents

OBJECTIVES

It is known that some industrial organic solvents are ototoxic. This study was aimed at evaluating the hearing effects of a mixture of organic solvents alone or in combination with noise on employees in paint and lacquer enterprises. The concentration of solvents was below the occupational exposure limits (OEL) for most of the subjects.

METHODS

Altogether 517 subjects were divided into the following three groups: persons with no risk due to noise or organic solvent exposure at the workplace, workers exposed to organic solvents only, and workers exposed to both organic solvents and noise.

RESULTS

The relative risk (RR) of hearing loss in the solvent-only exposure group was significantly increased (RR 4.4 and RR 2.8 for noise exposure of < 80 dB-A and < 85 dB-A, respectively) in a wide range of frequencies (2-8 kHz). No additional risk in the solvent + noise exposure group was found (RR 2.8). Hearing thresholds were significantly poorer in a wide range of frequencies (1-8 kHz) for both groups exposed to solvents, when compared with the reference group. The mean hearing thresholds at frequencies of 2-4 kHz were poorer for workers exposed to solvents + noise than for the solvent-only group; this finding suggests an additional effect for noise. However, there was no correlation between hearing loss and the extent of solvent exposure.

CONCLUSIONS

The results indicate that occupational organic solvent exposure at moderate concentrations increases the risk of hearing loss, and the ototoxic effects should be considered when the health effects of exposed workers are monitored.

Nested case-control study of lung cancer among pulp and paper workers in relation to exposure to dusts

BACKGROUND

Numerous studies have indicated an increased risk of lung cancer in pulp and paper industry workers. In a 1990 survey, standardized mortality ratio (SMR) was found to be 122 (95% CI:96-153) for lung cancer in Polish male workers in the pulp and paper industry, and 166 (95% CI:95-270) among workers engaged in paper production.

METHODS

A nested case-control design within a cohort of pulp and paper workers was applied. Seventy-nine lung cancer cases and 237 "healthy" controls were selected from the cohort of 10,460 workers employed during the years 1968-1990, and observed until the end of 1995. Based on personnel files, occupational exposure was reconstructed by experts. Using a questionnaire, data on smoking habits were collected. ORs unadjusted and adjusted for smoking were calculated applying the model of conditional logistic regression.

RESULTS

Occupational exposure to inorganic dusts (kaolin, lime, cement, brick, grindstone) adjusted for smoking was a significant lung cancer risk factor, with a 4.0-fold risk (95% CI:1.3-12.6), and a dose-response by cumulative dose index. Among organic dusts only wood dust increased albeit insignificantly the risk for those exposed (adjusted for smoking OR = 2.1, 95% CI:0.9-4.9), but without dose-response relationship.

CONCLUSIONS

Exposure to occupational dust with relatively low content of silica, but at high concentrations may be considered as a factor increasing lung cancer risk. However, the observation made in this study should be viewed with caution as it was based on a small number of cases, and further evidence is needed to confirm or refute the authors' hypothesis.

[Quantitative evaluation for risk assessment of neoplasms caused by exposure to chemical substances]

This work is based on the assumption that work safety and hygiene inspectors or a work hygiene inspectors in sanitary and epidemiological station will not develop their own dose-response models on the basis of background data. They should be equipment with a tool allowing them to assess a given risk in the most simple way. Dose-response models for assessing cancer risk induced by carcinogenic chemicals are presented in the "Guidelines on health risk assessment of carcinogenic agents" published since 1995 by The Nofer Institute of Occupational Medicine in Łódź. Nevertheless, it seemed advisable to gather in one publication all models published thus far, and by adding relevant comments and necessary formulas for calculations, produce a simple set of practical rules of risk assessment. All models already published in Guidelines may be divided into two groups: linear and non-linear models. In addition, among linear models one may differentiate those for asbestos dust exposure because of different nature of the relationship between the extent of exposure and likelihood of cancer occurrence. The models are given in three tables under the following headings: linear models for 21 chemicals, non-linear models for 12 chemicals and linear models for asbestos. There are also included formulas that allow to convert dose into concentration and concentration into dose, and occupational exposure into equivalent exposure over the course of a lifetime, as well as conversion coefficients enabling the use of animal experiment results in the assessment of human risk.

Cardiovascular disturbances in workers exposed to carbon disulfide

According to literature data myocardial infarction was often the first noticeable effect of CS2 on the cardiovascular system. Therefore, a question arises whether earlier circulatory lesions are absent in CS2-exposed people, or they are present but are not detectable by the diagnostic methods used. The aim of our study has been to determine whether electrocardiological disturbances do occur in exposed people, and their association, if any, with the level of CS2 exposure. Modern diagnostic methods (resting and 24-h ECG, heart rate variability, late ventricular potential analysis, and long-term blood pressure monitoring) were used to answer this question. The examination comprised 177 male workers aged 24-66 years (44+/-12), employed under conditions of the exposure for 5-38 years (14+/-9), and 93 male workers non-exposed to CS2 aged 23-65 years (41+/-12). Results of our studies show that abnormalities in resting and/or 24-h ECG recordings occur significantly more frequently in people exposed to CS2 than in the controls. ECG abnormalities were found primarily among the workers with a long, over 20-year, period of exposure. The considerable coincidence between the questionnaire and ECG results was found (87% reported complaints were confirmed by ECG data). Therefore it seems that all CS2-exposed people reporting heart symptoms should be subjected to a detailed examination. The frequency of late ventricular potentials in CS2-exposed people was not higher than in the controls. It may indicate that the ECG disturbances observed in those people were associated with functional rather than organic changes. Results of long-term ABP monitoring did not show increased incidence of elevated blood pressure in the exposed group. As the levels of the risk factors of ischemic heart disease in the exposed and control groups were similar, it seems that exposure to CS2 was responsible for the significant changes in the circulatory system.

Mortality of workers at two asbestos-cement plants in Poland

To assess mortality rate among workers occupationally exposed to asbestos, cohort studies were carried out in two asbestos cement plants operating since the 1960s. Asbestos cement sheets for roofing and siding have been manufactured there, using mostly chrisotile, and since 1985 also crocidolite for pressure pipes. In all, the cohort comprised 3,220 workers, including 2,616 male workers. Subject to consideration were the workers employed for at least three months in the period between the onset of the production and 1980. The vital status of the subjects was traced up to 31 December 1991. The availability of the cohort was 96.8%. Workers' mortality was analysed using standardized mortality ratio (SMR). The reference group was the general population of Poland. In the male cohort, 385 cases of death were recorded. Statistically significant excess of mortality from large intestine cancer (7 cases, SMR = 264) and pleural mesothelioma (5 cases, SMR = 2846) was found. In male workers who died from pleural mesothelioma the work history ranged from 12 to 26 years. An excess mortality from pleural mesothelioma was also noted among the female workers (2 cases, SMR = 11,275). No malignant neoplasms of other locations produced significant excess mortality either in the male or female workers.

Time-of-flight secondary ion mass spectrometry of matrix-diluted oligo- and polypeptides bombarded with slow and fast projectiles: positive and negative matrix and analyte ion yields, background signals, and sample aging

Human angiotensin II, chain B of bovine insulin, and porcine insulin were determined by time-of-flight secondary ion mass spectrometry under impact of approximately 25 keV Xe+ and SF5+ ion beams and approximately 100 MeV 252Cf fission fragments. Matrix-embedded samples, dissolved in a large surplus of alpha-cyano-4-hydroxycinnamic acid, were prepared by nebulizer spray deposition, neat samples by the droplet technique. It is shown that the status of the sample can be assessed by evaluating the matrix-specific features of the mass spectra. The beneficial effect of matrix isolation was small for angiotensin but large for the insulin samples, which did not show parent peaks from neat material. Negative ion yields under SF5+ impact were up to a factor of 50 higher than with Xe+. For positive secondary ions, the enhancement was much smaller. The mass spectra produced by slow ion beams or fast fission fragments were qualitatively similar. Quantitative differences include the following: with fast projectiles the yields were about 10-30 times higher than with slow ions, but similar for negative ion emission under SF5+ bombardment; the analyte-to-matrix yield ratios were higher with slow ions and up to 250 times higher than the molar analyte concentration; for analyte ions the peak-to-background ratios were higher using slow projectiles; the fraction of carbon-rich collisionally formed molecular ions was much higher with fast projectiles. Sample aging in vacuum for up to five weeks strongly reduced the yield of protonated analyte molecules ejected by slow ion impact, but not of deprotonated species. Hence protonation seems to correlate with sample "wetness" or the presence of volatile proton-donating additives.

[Incidence of occupational diseases in Poland]

The paper is aimed at presenting the incidence of occupational diseases in Poland. The analysis was performed on the basis of the information included in 'occupational disease certificates'. All sanitary and epidemiological stations throughout the country are committed to send these certificates to the Central Register of Occupational Medicine in The Nofer Institute of Occupational Medicine in Lódź. The incidence of occupational diseases during the three recent years (1996-97-98) was the subject of a thorough analysis. In all, 11,318, 11,685 and 12,017 cases of occupational diseases, respectively were registered over those three years. The corresponding rates were 116.0, 116.9 and 117.3, respectively per 100,000 people employed. In 1998, diseases of the voice organ predominated (30.4%) of all occupational diseases) and they were followed by hearing impairment (28.2%), infectious and parasitic diseases (9.9%), pneumoconioses (8.2%), dermatoses (6.4%), vibratory syndrome (2.9%) and poisoning (2.5%). These disease categories constituted over 88% of all occupational diseases registered in that year. Diseases of the voice organ which showed the greatest growth dynamic were mainly diagnosed among teachers. Neither in the United States nor in the member states of the European Union, this pathology is included into the list of occupational diseases. In view of high rates of its incidence in our country it has become one of essential problems of occupational medicine. In Poland, particular attention is paid to infectious and parasitic diseases among which hepatitis occupies the first place (65%), mostly among health service workers. The decrease in hepatitis incidence observed in the 1990s has been due to an intensive vaccination programme in this group of workers. The incidence of occupational hepatitis became rather stable and accounted for 940 cases per year, however the incidence of hepatitic C increased at the same time. Lower rates of incidence of 'classic' occupational diseases, such as poisoning, pneumoconioses or vibratory syndrome are a positive observation. It is also interesting to note that the rate of occupational diseases diagnosed in advanced stage has also diminished. When analyzing occupational diseases one should bear in mind that the majority of pathologies already diagnosed result from long-term effect of exposure to harmful factors. In all, 93% of cases of occupational diseases emerged after a ten-year exposure. The highest rates, taking account of sections of activity, were found in mining and quarrying, health service, agriculture, hunting and forestry.

[Quantitative assessment of cancer risk following epidemiological studies]

The role of data derived from epidemiological studies in the quantitative assessment of cancer risk has been constantly growing. That results from the fact that epidemiological studies are performed directly on humans so that it is possible to avoid bias very often associated with methods of extrapolation between animals and humans. Moreover, a slow but continuous increase in the number of well designed epidemiological studies with results which can be used to estimate dose-response relationship is being observed. In this paper, the methodological foundations of cancer risk modelling on the basis of epidemiological studies are discussed, and the dose-response relationship based on epidemiological study carried out in an occupational cohort of workers employed in a pulp and paper plant was estimated. The epidemiological study was performed by the team of the Department of Epidemiology, The Nofer Institute of Occupational Medicine, Lódź. Lung cancer was adopted as the effect of occupational exposure. In oder to estimate the increase in cancer risk induced by occupational exposure, the risk for the whole occupational life was calculated by employing the methods of competitive risks, essential relative risks were modelled using Poisson means for data divided into groups, and a Cox proportional-hazards model was used for single data. The analysis indicated, that the data from epidemiological studies render it possible to carry out a more thorough investigation as compared to data obtained from animal experiments. As to the cohort under study, a certain effect of age at which workers enter into exposure on lung cancer risk was observed. A risk 'outfit' the workers bring in at the beginning of their employment is clearly visible in older age groups. A general conclusion drawn from the study may be formulated as follows: epidemiological studies play a major role in assessing the effect of working conditions on the increase in the morbidity risk, however, they are not a panacea for all the problems emerging in the cancer risk assessment in exposed persons. Therefore, information obtained from epidemiological and toxicological studies should supplement and reinforce one another, and data from both sources should be used to obtain the best possible characteristics of risk cancer in humans.

Hyposensitivity to amphetamine following exposure to chlorphenvinphos--protection by amphetamine preexposure

We investigated the effect of an acute exposure to chlorphenvinphos (CVP), an organophosphate anticholinesterase, on amphetamine-induced open-field locomotion in rats. CVP was administered in a single i.p. dose of 1.0 mg/kg (1/10 of the LD50). All animals were challenged with 1.0 mg/kg amphetamine (AMPH) three weeks after the CVP exposure, i.e. after a time sufficient for acetylcholinesterase recovery. Some rats were also given AMPH three weeks before the CVP exposure. In rats challenged with AMPH only once after the CVP exposure, AMPH-induced open-field locomotion was significantly reduced. Such an effect was not observed in rats given AMPH three weeks before the CVP exposure. The results suggest that a single CVP exposure may result in persistent dopaminergic hyposensitivity, and that an amphetamine pretreatment may protect the rat against this effect.

[The causes of increased risk for lung cancer in the pulp and paper industry workers. The effect of smoking and exposure to chemicals]

An analysis of mortality in a cohort of workers employed in the pulp and paper industry, carried out by the authors of this presentation several years ago, indicated an increase of 22% in the risk of mortality from lung cancer. This risk decreased by only 4% after taking account of smoking. The results obtained then were considered as sufficient to undertake further studies aimed at identifying specific occupational factors responsible for an increased risk for mortality from lung cancer in the population under study. The nested case-control study, in which cases (of lung cancer) and controls were selected from the same cohort observed earlier, was approved as the most suitable method for achieving the aforesaid aim. The study covered 79 cases of deaths from lung cancer confirmed by histological and cytological or radiological examinations, and 237 'healthy' controls matched in the ratio of one to three, taking into account gender, date of birth and date of employment. A group of experts carried out in-depth analysis of exposure to harmful factors in each case of death and in each control. Using a questionnaire, specially developed for this purpose, detailed data on smoking habits among persons under study were collected. Odds ratio was used as a measure of a relative risk for death from lung cancer. A crude relative risk and risk adjusted by eliminating the effect of smoking, applying the model of conditional logistic regression, were calculated for individual exposure factors. Smoking proved to be a significant causal factor responsible for the development of lung cancer in the cohort studied. That was evidenced by relative risk accounting for 12.9 for smokers in relation to non-smokers and an enhanced risk with the increasing number of cigarettes smoked daily, the number of smoking years and an accumulated dose. The study does not confirm a hypothesis that chemical factors specific of the pulp and paper industry exert a significant effect on the risk of death from lung cancer. Odds ratios, crude and adjusted for smoking, were lower than one in all distinguished categories of exposure.

[Application of BMD models in quantitative evaluation of carcinogenic risk]

The characteristics of the relationship between the exposure level and the incidence of harmful health effects is a general objective of assessing health risk related to chemical exposure. A real dose-response relationship, particularly for low doses, is usually unknown thus it can only be deduced on the basis of biological and statistical considerations. Low dose risk estimation requires extrapolation beyond the range of data observed. Nowadays, quantitative risk assessment encounters certain duality as linear models are mostly used in evaluation of environmental exposure, and nonlinear models are most frequently applied in occupational exposure. Bearing in mind that the assumption on the dose-response linear relationship is an apparent simplification built on our lack of knowledge of carcinogenic mechanisms, it seems that the proposal of the US Environmental Protection Agency (US EPA) to use benchmark dose methods (BMD) for exposure effects manifested by neoplasms, is the compromise between a conservative approach of the EPA towards risk modelling resulting from the limited knowledge of these mechanisms and lack of criteria for selection of nonlinear models. In the case of carcinogenic risk assessment, this solution involves the identification of so called 'cut off point' by applying relevant statistical models. The cut off point indicates the exposure level that contributes to the increase in risk by 10%, 5% or 1%. Another possibility is to use interspecies extrapolation methods for the cut of point modification, and then draw a line between the cut off point and the beginning of the system of co-ordinates. Since it is not feasible to apply a complete BMD methods for certain chemicals (e.g. bezo(a)pirene), not because of chemical properties, but due to insufficient experimental experience, it is proposed to use the method of sticking together a straight line and a curve in relation to a two-grade curve and not to its confidence limitation.

Cancer risk in workers of the pulp and paper industry in Poland. A continued follow-up

A mortality cohort study was undertaken among Polish pulp and paper workers. This paper concentrates on neoplasms mortality among men and women employed continuously for at least one year in the factory producing sulphate pulp, paper board and paper products. A retrospective observation carried out till 31 December 1995 covered 10,460 workers employed during the years 1968-1990. The cohort accessibility was 99%. Cancer risk was evaluated on the basis of standardized mortality ratio (SMR) calculated according to the person-years method. The general population of Poland was the reference population. The results of a 23-year cohort observation, published earlier, showed a lowered overall mortality from all causes and from all malignant neoplasms, and a significant excess of death from peritoneum and prostate cancer among pulp mill male subcohort. The conclusion was drawn that a 'young' cohort and relatively short follow-up period might have affected the results. The results presented in this paper, obtained after further five years of observation showed in the male cohort an excess of deaths from cancer of respiratory tract and peritoneum (lung SMR = 122, nasal cavities SMR = 587, peritoneum SMR = 562). An approximate correction for smoking habits resulted in only 4 decreased risk estimates for lung cancer, indicating a small positive confounding effect of smoking in this material. In female cohort an excess of brain cancer was found (SMR = 355). Only the excess mortality from cancers of nose, lung and peritoneum was coherent with the exposure to higher concentrations of wood dust, pulp, paper and board dust. It may support a hypothesis that these factors as well as dust pollutants, not yet identified in this study, may be considered as one of the risk factors contributing to the incidence of neoplasms of these sites.

Environmental exposure to asbestos in asbestos cement workers: a case of additional exposure from indiscriminate use of industrial wastes

The paper presents data on cancer risk, especially pleural mesothelioma and lung cancer, among the workers of asbestos cement plant who living in the vicinity of the plant, were also environmentally exposed to asbestos. In 1959 an asbestos cement factory was founded in the rural area of south-eastern Poland. Apart from chrysotile asbestos, crocidolite was used till 1985 chiefly for the manufacture of pressure pipes. The blue asbestos made up 15% of the mean annual tonnage of the processed asbestos. It was found that soon after asbestos production had started the process wastes were made available to local community, particularly to the workers of that factory. For over twenty years asbestos wastes of all kinds, both wet (process sludge) and dry (from pipe and sheet grinding) were exploited for the hardening of roads, paths, farmyards and sports fields and as construction material components. For the evaluation of cancer risk due to occupational exposure to asbestos a cohort of 1,526 workers employed in this factory was observed till the end of 1996. The cohort availability was 95.6%. Standardized mortality ratio (SMR) was calculated using the man-years method. The reference population was the general population of Poland. The results of the study demonstrated a statistically significant increase in the risk of a) pleural mesothelioma--over an 80-fold excess among males and over a 200-fold one among females; b) lung cancer in females--over a 6-fold excess; c) colon cancer in males--over a 3-fold excess. In the 1990 ten new cases of pleural mesothelioma in the cohort were reported. As compared to other asbestos-cement cohorts in Poland, observed at the same time, this cohort presented a very high risk of pleural mesothelioma. The analysis of 16 cases of pleural mesothelioma found in the cohort from 1987 to 1997 revealed 4 cases with very short employment period (3.5 months-5 years) including two cases with relatively short latency period (11-12 years). In order to find explanation of these findings, additional investigations were made. The epidemiological study indicated that all these persons were at the same time subject to non-occupational exposure associated with massive utilization of commonly available asbestos-cement wastes as road surface material.

[Evaluation of reproductive disorders in men occupational exposed to lead]

The objective of the study was to define the prevalence of reproductive disorders in men occupationally exposed to lead in concentrations occurring usually in the work environment. The period of time preceding the conception in couples in which men were occupationally exposed to lead was adopted as the measure of the disorder. A cross-section survey was performed. Men of selected plants of Upper Silesia and Głogów responded to questions included in the questionnaire regarding age, education, occupation, occupational exposure, health condition, addictions, the situation in the family as well as questions concerning the respondent's spouse (age, education, occupation, addictions, health condition). The blood lead concentrations in persons exposed to this metal in the period preceding the conception were defined on the basis of medical data stored by the plant occupational outpatient clinics. The control group consisted of workers of the metallurgic industry, living in Lódź or its vicinity, and non-occupationally exposed men living in Silesia. In total 341 exposed men and 510 non-exposed controls participated in the study. The investigated groups were rather homogeneous as to the age of those under study and their spouses, education, addictions and the number of children. The analysis of the survey results indicated that in 5% of couples in the control group the time before conception exceeded one year. A similar occurrence of reproductive disorders was found in couples in which man was occupationally exposed to lead. The proportion of couples with reproductive disorders in this group (regardless of the size of Pb exposure) was 6%. The stratification of the Pb-exposed groups, taking into account the exposure size in accordance with the WHO criteria (group 1-220 micrograms/l, that is below the accepted value above which the ZnPP level increases; group II-PbB 200-400 micrograms/l that is up to the level recommended as the highest level for the population occupationally exposed to lead; and group III-PbB above 400 micrograms/l) allowed the analysis of the frequency of reproductive disorders depending on the size of the exposure. The percentage of couples with delayed conception accounted for 4.5% in group I; 8.7% in group II, and in group III did not differ significantly from that in the control group. These results show that men's occupational exposure to lead below allowable concentration in the biological material (500 micrograms/Pb/l blood in Poland or 400 micrograms/Pbl recommended by WHO) does not pose the risk for prolonged period preceding the conception in their partners.

[Data processing computer system for evaluation of health effects due to occupational diseases diagnosed in Poland]

General consequences of occupational diseases for both employees and the country's economy have been known for many decades. Nevertheless there were no legal instruments and financial means to carry out studies leading to a comprehensive evaluation of health effects induced by occupational diseases diagnosed in Poland. Only recently, the legal basis has been provided by the revision of the regulations on occupational diseases (Official Journal of the Ministry of Health and Social Welfare no 9, heading 51, 1989), and the financial means allocated according to the Governmental Strategic Programme (SPR-1) for the years 1995-1998. The objectives of the study and the results obtained have been presented in another publication. Here the authors concentrated on some aspects of data collection and their analysis. An essential element in the establishment of data base on health effects of occupational diseases was its integration, namely the number of diagnosed occupational disease had to correspond with the entity in the Register of Occupational Diseases. Such an approach helped to avoid including in the base all metrical data, as information on effects of occupational diseases was collected exclusively for persons with detected and diagnosed occupational disease, which had to be previously placed in the Register of Occupational Diseases. The correctness of data input and the data analysis were carried out outside the Paradox system. The analysis of histograms of characteristics under study and the explanation of departing values were employed to evaluate the freedom from bias, and the statistical package for social sciences (SPSS) was used to analyse the data.

[Health effects of occupational diseases diagnosed in Poland during the years 1990 and 1994]

The study was carried out on the material of 15,136 occupational diseases that accounted for 71.9% and 65.6% of all cases detected in 1990 and 1994, respectively. The analysis focused on the selected health effects of occupational diseases, such as sickness absenteeism, the transfer to other workposts, the percentage of health impairment and related single recompensation as well as disability pension. The study helped to draw many conclusions of great value, and disclosed major pathologies and their causes responsible for the range of related health effects. Long-term sickness absenteeism, high percentage of health impairment and related consequences for the country's economy (single recompensations and growing number of disability pensions paid due to occupational diseases), and low proportion of transfers to safe workposts were most striking among the effects in question. The study also contributed to initiating the establishment of the data base and the development of the system for data collection and analysis of information on health effects of occupational diseases in Poland.

[A quantitative assessment of health risk induced by occupational exposure to inorganic arsenic]

The risk of neoplastic disease, primarily lung cancer, induced by occupational, inhalation exposure to nonorganic arsenic was assessed. In order to identify individual risk in the linear dose-response relationship which would serve as a basis for the risk assessment among persons exposed occupationally, the author also analysed the latest epidemiological studies performed in Sweden, as well as repeated analyses of American studies. This allowed to diminish individual risk by several times. It is thought that a diminished value of individual risk is, in the light of the most up-to-date epidemiological studies, closer to the reality than the value proposed by the Environmental Protection Agency (EPA). Having the value of individual risk related to occupational exposure, equal 1.79 x 10(-4), lung cancer risk after forty years of employment under the exposure level within the range of currently binding MAC values for arsenic (0.05 mg/m3) accounts for 8.95 x 10(-3), thus slightly exceeding the adopted value of 1 x 10(3). Whereas a new value, proposed by the Expert Group for Chemical Factors of the International Commission for Updating the list of MAC and MAI values in 1996, equals 0.01, so the risk for a forty-year employment accounts for 1.79 x 10(-3), in fact the value corresponding to that already approved. In addition, the assessment indicated that smoking increases by 4-6 times the risk of lung cancer induced by exposure to arsenic.

[Cancer risk in asbestos-cement industry workers in Poland]

A cohort study was carried out in order to evaluate the cancer risk in the asbestos-cement industry workers. The cohort consisted of workers employed in four asbestos-cement plants. One of those plants was established in 1924, the other three in the 1960s and 1970s. Currently only two of these plants continue their production. The plants used mainly chrysotile asbestos as well as crocidolite and amosite. Amphibolite asbestos was used before the mid-nineteen eighties in production of pressure pipes utilising about 15% of the total quantity of asbestos used. The measurements of the asbestos fibre concentration at work-sites have been taken occasionally since the mid 1980s, thus, the determination of a cumulative dose for individual persons in the cohort and the evaluation of the dose-effect relationship were not feasible. It could only be supposed that the concentrations at the preparatory work-site during first years of the plants' operation accounted for several tens fibres/cm3 in the production that employed the dry method. The cohort consisted of workers employed in the plant for at least three months between beginning of the plant during the post-war period, and 1980, that is during the period when amphibolite asbestos was in use. The retrospective observation was completed on 31 December 1991. The analysis of the death risk by causes was based on a standardized mortality ratios (SMRs) calculated using the person-years method. Statistical significance of SMRs was assessed by means of Poisson distribution one-sided test. The general population of Poland was used as the reference population to estimate the death risk. The cohort comprised 4,712 persons (3,563 males and 1,149 females). Of this number 4,500 persons (3,405 males and 1,095 females) were followed. The cohort availability were 95.5%. Male mortality, both total (473 deaths; SMR = 83) and due to malignant neoplasms (108 deaths; SMR = 86) was lower than in the general population. An excess of deaths from neoplasm of the pleura was by about 23 times higher (5 deaths; SMR = 2,288) and from neoplasm of the large intestine by two times higher (7 deaths; SMR = 214). Among females (41 deaths; SMR = 50) death risk was lower than in the reference population. At a low level of total mortality from neoplasms (13 deaths; SMR = 52) a statistically significant excess of deaths from neoplasm of the pleura (2 deaths; SMR = 2,112) was observed. In the plants investigated the analysis revealed a considerably diversified mortality from asbestos-related neoplasms. The incidence of pleura mesothelioma should be attributed to the use of considerable quantities of crocidolite asbestos and high concentrations of fibres in the air in plants II and IV, particularly during the first years after their establishment. In view of a long period of latency the excess of this neoplasm can be expected till 2020.

[The effect of occupational exposure to metallic mercury on selected parameters of hemostasis]

The group investigated comprised 60 workers under conditions of chronic exposure to metallic mercury vapours (mean exposure duration--9.3 yrs; mean age of subjects--38.5 yrs). The control group was composed of 24 non-exposed persons (mean age--39.9 yrs). The workers exposed were divided into three groups according to the air concentration of metallic mercury vapours at the workpost, group A--0.15-0.17 mg/m3, group B--0.03-0.08 mg/m3 and group C--0.02-0.03 mg/m3. The workers qualified for the study did not receive any medication containing acetylsalicylic acid derivatives, and did not consume alcoholic drinks for few days prior to the study. Persons with the diagnosis or the history of blood disorders, venous or arterial thrombosis as well as those with diabetes and hyperlipidaemia were excluded from the study. The haemostasis assessment was based on the results of laboratory tests, PLT, TBT, ACT, APTT, HTCT, INR and Fg, AT III, alpha 2 M, FDP, and FM concentrations. The comparison of the exposed and control groups revealed a statistically significant decrease in ACT and AT III concentrations. When particular groups under exposure were compared with one another and the controls, the increased INR and Fg concentrations were found in group A. Moreover, this group showed an increased platelet count, as well as decreased TBT and alpha 2 M concentrations. However, the differences between the groups were statistically insignificant. The results of the study indicated that chronic exposure to mercury may impair haemostasis and lead to hypercoagulability. The latter may result from the deficiency of natural coagulation inhibitors.

[Mortality among workers in the pulp-paper industry. A successive follow up of the cohort]

After five successive years of observation the authors present a verified evaluation of the delayed health effects in the pulp and paper industry workers (with particular regard to mortality from malignant neoplasms). The cohort studied consisted of 10,460 workers employed for at least 12 months between 1967 and 1990 in the plants manufacturing sulfate pulp, paper, board and paper products. Subjects were assigned to three subcohorts according to the work areas: 1. pulp mill workers; 2. paper mill workers (paper and board as well as their products); 3. other workers. The workers were enrolled in the subcohort if they were employed for at least one year in one of these departments. One subject could be included in more than one subcohort. The vital status of the cohort was determined through a variety of sources over an observation period of 28 yrs (1967-95). Mortality data were analysed in terms of cause-specific standardized mortality ratios (SMRs) with expected deaths count based on the national mortality rates in Poland. The results of a twenty three-year cohort observation, published earlier, showed the lowered overall mortality (explained by a "healthy worker effect") and the excess of deaths from malignant neoplasms for some sites (peritoneum, prostate, brain). Due to a small number of deaths recorded, kind of exposure and its duration, were left out of the analysis. The results presented in this paper, obtained after five successive years of the male cohort observation, showed an excess of deaths from cancers of the respiratory tract and peritoneum. In the female cohort an excess of brain cancers was found. Only an excessive mortality from malignant neoplasms of the respiratory system was coherent with the exposure to higher concentrations of wood, paper and board dust. An excess mortality from diseases of the circulatory system was found in both males and females employed in paper production.

[Morbidity of occupational diseases in Poland in the years 1994-1996]

The authors analysed all cases of occupational diseases diagnosed in Poland over the last three years. The following variables were considered: age, gender of patients, duration of exposure to factors inducing occupational disease, nosologic units, and the types of work places by the European Activity Classification and their localization by voivodships. The obtained results helped to formulate the following conclusions: 1. The number of occupational diseases in the period under study ranged annually between 11,156 and 11,320 cases. The incidence rates (number of cases/100,000 employed) fell within 116-131. 2. The general incidence of occupational diseases was shaped by: hearing impairment, chronic diseases of voice organs, communicable and invasive diseases, pneumoconioses, skin diseases, vibratory syndrome and poisoning. 3. The majority of diagnosed diseases occurred at least after 10 years of occupational exposure to causal factor. 4. The highest incidence of occupational diseases by the European Activity Classification was observed in mining and quarrying, manufacture, education and health services. 5. The analysis of the occupational disease incidence in individual work places indicated a number, however small, of enterprises which are a major source of these diseases.

Heart rate variability in workers exposed to carbon disulfide

It is assumed that the cardiovascular impairments resulting from CS2 exposure may be associated with some functional disturbances within the autonomic nervous system. We adopted the heart rate variability (HRV) analysis to investigate the sympathetic and parasympathetic functions of the autonomic nervous system in workers exposed to carbon disulfide. The studies were performed on 152 workers, aged 24-66, with the period of exposure ranging from 5-38 years and 93 age-matched, non-exposed, healthy individuals as the control group. The HRV analysis concerned time-domain (AVG R-R, SD R-R, modal, median, minimum and maximum values) and frequency-domain indices (power spectrum in the very low-VLF, low-LF and high-HF frequency bands) calculated using the fast Fourier transformation. In the exposed group, neurovegetative regulation impairments could be observed. They were expressed as increased heart rate at rest, reduced power spectrum: total (TPS) and within HF, LF and VLF frequency bands as well as the absence of the physiological dependence of HRV parameters on age. These abnormalities could be found even in the group of workers exposed to the lowest CS2 levels (0-10 mg/m3) and they concerned the VLF band. In workers under conditions of exposure to 10-18 mg/m3 the dysfunction of the autonomic control referred both to its sympathetic and parasympathetic part and was found to be more intense in workers exposed to the highest CS2 concentrations (over 18 mg/m3). In view of our findings we concluded that occupational exposure to carbon disulfide may bring about an impaired neurovegetative regulation of the cardiovascular function.

[Quantitative evaluation of health risk associated with occupational inhalation exposure to vinyl chloride at production plants in Poland]

Vinyl chloride is classified by the IARC in group 1-human carcinogens. In Poland occupational exposure to vinyl chloride is found among workers employed in many branches of industry, among others in the industry of vinyl chloride synthesis and polymerization as well as in the plastics, footwear, rubber, pharmaceutical and metallurgical industries. Concentrations observed range from the noon-determinable level to 90 mg/m3, at the MAC value equal to 5 mg/m3. Neoplasm of liver is a major carcinogenic effect of vinyl chloride. Hence, the health assessment focused on this critical risk. Four different linear dose-response models, developed by several authors and based on results of different epidemiological studies, were used to characterise the extent of cancer risk depending on the level of vinyl chloride concentrations. The estimated risk related to a forty-year employment under exposure equal to MAC values (5 mg/m3) fell within the range from 2.9.10(-4) to 2.6.10(-3). As the figures depict it did not exceed the acceptable level (10(-3)).

[A qualitative evaluation of health risk associated with occupational inhalation exposure to cadmium in production plants in Poland]

In Poland several thousand people work under exposure to cadmium with different concentrations. The concentrations observed range between the level which is not determinable and the level above 0.3 mg/m3, at the MAC value equal to 0.04 mg/m3. In 1993 the cadmium classification was modified by the International Agency for Research on Cancer (IARC). Previously cadmium had been proved to be carcinogenic to animals (group 2B). At present it is classified in group 1, namely in the group of substances proved to be carcinogenic to humans. The cadmium MAC value, mandatory in Poland, has been set on the basis of the data on its chronic, toxic renal effects, but its critical effect in the form of cancer has not been taken into consideration. The author, using the results of epidemiological studies carried out by Thun et al., presented three dose-response functions which describe the relationship between the size of exposure and the probable incidence of lung cancer. The author used a linear multistage model, a Poisson model and a Cox proportional-hazards model; the magnitude of the risk from occupational exposure to concentrations equal to MAC values (0.04 mg/m3) was different for each model and it accounted for 9.02 x 10(-3), 2.04 x 10(-2) and 4.68 x 10(-2), respectively. Each of these values exceeded the acceptable level of the risk from occupational exposure which usually falls within 10(-3).

Cancer mortality among pulp and paper workers in Poland. A cohort study

Mortality among workers in the Polish pulp and paper industry was evaluated in a cohort study of 10,460 workers who had been employed continuously for at least one year, between 1968 and 1990 in the factory producing sulphate pulp, paper, board and paper products. Three subcohorts were formed according to the work areas. A standardized mortality ratio (SMR) analysis was used to compare death rates for each group exposed with Polish national rates. Mortality from all causes and from all malignant neoplasms, both in the female and in male cohorts was lower than that observed in the general population. In the pulp male subcohort a significantly elevated risk of death from peritoneum cancer (2 obs, SMR = 2,530) and prostate cancer (4 obs, SMR = 854) was recorded, although overall mortality from all causes and from all malignant neoplasms was lower than expected. The excess of deaths from neoplasms in other sites was statistically nonsignificant in all subcohorts. This study did not confirm the excess mortality from lung, stomach and lymphatic cancers found by other authors. The "young" cohort and a relatively short follow-up period (23 years) might have affected the results.

[Occupational neoplasms in Poland in the years 1971-1994]

The analysis of the incidence of malignant neoplasms, recognised as occupational disease, in Poland during the years 1971-94 was based on occupational disease certificates sent obligatory to the Nofer institute of Occupational Medicine (Lódz) by all sanitary and epidemiological stations under the Ministry of Health and Social Welfare and the Polish State Railways. During the period study 1118 occupational neoplasms were diagnosed, including 1042 cases (93.2%) of neoplasms in males. Among males malignant Ineoplasms of lung (36.1%), larynx (25.5%), bladder (14.7), skin (6%), lymphatic and haematopoietic tissue (3.4%) and pleura (2.9%) were most common. The rate occupational neoplasms in the total number of neoplasms registered accounted for 0.11% in males and 0.01% in females. PAH (29.1%), asbestos dust (18.8%), ionizing radiation (13.8%), chromium and its compounds (13.5%) and benzidine (9.8%) belong to the most frequent causes of malignant neoplasms in males, and ionizing radiation (31.5%) and asbestos dust (30.3%) in females. The number of neoplasms recognised as occupational disease is very low. Underestimation of occupational neoplasms is very common throughout the world, but it is particularly high in Poland if we take the incidence of pleura mesothelioma as an example. This is mainly due to: (1) the lack of clinical and morphological specificity of occupationally induced neoplasms; (2) a long latency; (3) the influence of other factors confounding the effect of occupational exposure; (4) a relatively small number of occupational carcinogens identified thus far; (5) limited knowledge of occupational carcinogens and criteria for occupational disease certification, and unsatisfactory interviewing skills among doctors who diagnose cancer disease. The identification of a harmful factor and the size of exposure to it, belongs to the weakest point in certifying the occupational background of the disease. The essential conclusions presented stress the urgent need for establishing the system facilitating the diagnosis and certification of occupational neoplasms.

[Eosinophil cationic protein in persons with contact allergy to disinfectants]

The concentration of eosinophil cationic protein (ECP) in blood serum was determined in 53 health service workers (women) with contact allergy to disinfectants and in 16 healthy women using a radioimmunological method. The mean ECP concentration in the study group accounted for 7.518 micrograms/l, and in the control group 4.893 micrograms/l. The concentration of 8.403 micrograms/l (the mean concentration in the control group + 2 SD) was taken as a cut off concentration value. In 17 (32.1%) persons with contact dermatitis, pathological ECP values were found. An increased ECP was observed in persons with positive results of prick test, especially in the case of Dermatophagoides, pollens and latex as well as in those with increased total IgE concentration. Our results indicate the involvement of immediate allergy in the incidence of contact allergy to disinfectants.

Mortality among different occupational groups of workers with pneumoconiosis: results from a register-based cohort study

A mortality cohort study was carried out on 11,224 men with pneumoconiosis diagnosed during the period 1970-1985. The cohort was selected from among subjects entered into the National Register of Occupational Diseases and included 7,065 coal miners, 924 employees of underground work enterprises, 1,796 workers of the metallurgical industry and iron and nonferrous foundries, as well as 1,439 refractory materials, china, ceramics, and quarry workers. The cohort was traced up to the end of 1991. The mortality of all groups enrolled in the study, as compared with that of general male population of Poland, showed a statistically significant excess of overall mortality (SMRs ranging from 105; 95% confidence interval [CI]: 100-110 to 136; CI: 121-153) as well as a great excess of deaths from diseases of the respiratory system (SMRs from 383; 95% CI: 345-424 to 588; 95% CI: 457-744). In workers of the metallurgical industry, foundries, and those from refractory materials, china, and ceramics manufacturing plants as well as quarries, a statistically significant excess of deaths from infectious diseases (mostly tuberculosis) was found (SMRs: 503; 95% CI: 364-677 and 286; 95% CI: 177-437, respectively). Mortality from lung cancer was significantly elevated only in the group of metallurgical industry and iron and nonferrous foundry workers (SMR: 159; 95% CI: 124-201). In the remaining subcohorts, no significant excess of deaths from lung cancer was noted. The study does not support the hypothesis on the role of exposure to crystalline silica in the induction of lung cancer. Significantly lower mortality was seen for diseases of the circulatory system (SMR: 89; 95% CI: 82-96), hypertensive disease (SMR: 63; 95% CI: 38-98), cerebrovascular disease (SMR: 79; 95% CI: 62-99), atherosclerosis (SMR: 79; 95% CI: 66-93), and injuries and poisonings (SMR: 50; 95% CI: 38-64) in coal miners. In addition, lower mortality was noted for cerebrovascular disease (SMR: 56; 95% CI: 32-91) and injuries and poisonings (SMR: 34; 95% CI: 17-61) in metallurgical industry and iron and nonferrous foundry workers.