Lung cancer and occupational exposures other than cotton dust and endotoxin among women textile workers in Shanghai, China

OBJECTIVES

Numerous epidemiological studies of lung cancer among textile workers worldwide consistently indicate reduced risks related to cotton dust exposure, presumably due to endotoxin contamination. Our objective was to investigate associations with other exposures potentially related to lung cancer, including wool and synthetic fibre dusts, formaldehyde, silica, dyes and metals, that have only been studied to a limited extent in the textile industry.

METHODS

We conducted a case-cohort study nested within a cohort of 267,400 women textile workers in Shanghai, China. We compared work assignments and exposure histories of 628 incident lung cancer cases, diagnosed during 1989-1998, with those of a reference subcohort of 3188 workers. We reconstructed exposures with a job-exposure matrix developed specifically for textile factories. Cox proportional hazards modelling was applied to estimate age/smoking-adjusted relative risks (hazard ratios) and risk gradients associated with job assignments and specific agents other than cotton dust and endotoxin.

RESULTS

No associations were observed for lung cancer with wool, silk or synthetic fibre dusts, or with most other agents. However, increased risks, although statistically imprecise, were noted for ≥ 10 years' exposures to silica (adjusted HR 3.5, 95% CI 1.0 to 13) and ≥ 10 years' exposures to formaldehyde (adjusted HR 2.1, 95% CI 0.4 to 11).

CONCLUSIONS

Exposures to silica and formaldehyde, although not widespread among the cohort, may have increased lung cancer risk. Silica is an established human lung carcinogen, whereas there is only weak prior evidence supporting an association with formaldehyde. Both exposures warrant consideration as potential lung carcinogens in textile manufacturing.

Dust and chemical exposures, and miscarriage risk among women textile workers in Shanghai, China

INTRODUCTION

To investigate possible associations between miscarriage and occupational exposures in the Shanghai textile industry.

METHODS

A retrospective cohort study of miscarriages among 1752 women in the Shanghai textile industry was conducted. Reproductive history was self-reported by women and occupational work histories were collected from factory personnel records. Occupational exposures were assigned by linking work history information to an industry-specific job-exposure matrix informed by factory-specific textile process information and industrial hygiene assessments. Estimates of cotton dust and endotoxin exposure were also assigned. Odds ratios (OR) and 95% CI were estimated by multivariate logistic regression, with adjustment for age at pregnancy, educational level, smoking status of the woman and her spouse, use of alcohol, and woman's year of birth.

RESULTS

An elevation in risk of a spontaneously aborted first pregnancy was associated with exposure to synthetic fibres (OR 1.89, 95% CI 1.20 to 3.00) and mixed synthetic and natural fibres (OR 3.31, 95% CI 1.30 to 8.42). No increased risks were observed for women working with solvents, nor were significant associations observed with quantitative cotton dust or endotoxin exposures. Associations were robust and similar when all pregnancies in a woman's reproductive history were considered.

CONCLUSIONS

Occupational exposure to synthetic fibres may cause miscarriages, and this possibility should be the subject of further investigation.

Occupational risk factors for pancreatic cancer among female textile workers in Shanghai, China

OBJECTIVES

To investigate whether occupational exposures to dusts and chemicals in the Shanghai textile industry are associated with risk of pancreatic cancer.

METHODS

A case cohort study nested in a cohort of 267,400 female textile workers in Shanghai, China was conducted among 180 incident pancreatic cancer cases and an age stratified randomly selected comparison subcohort (n = 3188). A complete occupational history of work in the textile industry was obtained for each woman, and was linked to a job exposure matrix developed for the textile industry to estimate exposures to specific dusts and chemicals. Cumulative exposures to cotton dust and endotoxin were reconstructed from historical and contemporaneous measurements.

RESULTS

After adjusting for smoking status, a trend of decreasing risk of pancreatic cancer was observed for increasing cumulative exposures to cotton dust and endotoxin with a lag of 20 years. The hazard ratios for women cumulatively exposed to >143.4 mg/m3 x years of cotton dust and >3530.6 EU/m3 x years of endotoxin were 0.6 (95% CI 0.3 to 0.9) and 0.5 (95% CI 0.3 to 0.9), respectively, compared to unexposed women. There was little evidence that exposures to other textile dusts and chemicals were associated with risk of pancreatic cancer.

CONCLUSIONS

Occupational exposure to cotton dust and endotoxin in the textile industry may have reduced risks of pancreatic cancer in this cohort. These associations should be replicated by others before making a firm conclusion of their possible effects on pancreatic cancer.

Noise exposure and hearing loss prevention programmes after 20 years of regulations in the United States

OBJECTIVES

To evaluate noise exposures and hearing loss prevention efforts in industries with relatively high rates of workers' compensation claims for hearing loss.

METHODS

Washington State workers' compensation records were used to identify up to 10 companies in each of eight industries. Each company (n = 76) was evaluated by a management interview, employee personal noise dosimetry (n = 983), and employee interviews (n = 1557).

RESULTS

Full-shift average exposures were > or =85 dBA for 50% of monitored employees, using Occupational Safety and Health Administration (OSHA) parameters with a 5 dB exchange rate (L(ave)), but 74% were > or =85 dBA using a 3 dB exchange rate (L(eq)). Only 14% had L(ave) > or =90 dBA, but 42% had L(eq) > or =90 dBA. Most companies conducted noise measurements, but most kept no records, and consideration of noise controls was low in all industries. Hearing loss prevention programmes were commonly incomplete. Management interview scores (higher score = more complete programme) showed significant associations with percentage of employees having L(ave) > or =85 dBA and presence of a union (multiple linear regression; R2 = 0.24). Overall, 62% of interviewed employees reported always using hearing protection when exposed. Protector use showed significant associations with percentage of employees specifically required to use protection, management score, and average employee time spent > or =95 dBA (R2 = 0.65).

CONCLUSIONS

The findings raise serious concerns about the adequacy of prevention, regulation, and enforcement strategies in the United States. The percentage of workers with excessive exposure was 1.5-3 times higher using a 3 dB exchange rate instead of the OSHA specified 5 dB exchange rate. Most companies gave limited or no attention to noise controls and relied primarily on hearing protection to prevent hearing loss; yet 38% of employees did not use protectors routinely. Protector use was highest when hearing loss prevention programmes were most complete, indicating that under-use of protection was, in some substantial part, attributable to incomplete or inadequate company efforts.

Occupational risk factors for nasopharyngeal cancer among female textile workers in Shanghai, China

AIMS

To investigate whether occupational exposure to dusts and chemicals in the Chinese textile industry are associated with risk of nasopharyngeal cancer.

METHODS

Sixty seven nasopharyngeal carcinoma (NPC) cases identified during 1989-98 and a random sample (n = 3188) of women were included in a case cohort study nested in a cohort of 267,400 women textile workers in Shanghai, China. A complete occupational history of work in the textile industry was obtained for each woman. A job exposure matrix developed by experienced industrial hygienists was used to assess exposures to specific dusts and chemicals.

RESULTS

Risk of NPC is associated with cumulative exposure to cotton dust. The hazard ratio for women cumulatively exposed to >143.4 mg/m3 x years of cotton dust was 3.6 (95% CI 1.8 to 7.2) compared with unexposed women. Trends of increasing risk were also found with increasing duration of exposure to acids and caustics (p = 0.05), and with years worked in dyeing processes (p = 0.06). Women who worked at least 10 years in dyeing processes had a 3.6-fold excess risk of NPC (95% CI 1.0 to 12.1).

CONCLUSIONS

Occupational exposure to cotton dust, acids, and caustics, and work in dyeing and printing jobs in the textile industry may have increased risk of NPC in this cohort.

Reactivity of mono-meso-substituted iron(II) octaethylporphyrin complexes with hydrogen peroxide in the absence of dioxygen. Evidence for nucleophilic attack on the heme

Treatment of the mono-meso-substituted iron(II) octaethylporphyrin complexes, (py)2Fe(II)(meso-NO2-OEP), (py)2Fe(II)(meso-CN-OEP), (py)2Fe(II)(meso-HC(O)-OEP), (py)2Fe(II)(meso-Cl-OEP), (py)2Fe(II)(meso-OMe-OEP), (py)2Fe(II)(meso-Ph-OEP), and (py)2Fe(II)(meso-n-Bu-OEP), with hydrogen peroxide in pyridine-d5 at -30 degrees C in the strict absence of dioxygen has been monitored by 1H NMR spectroscopy. The product oxophlorin complexes are stable as long as the samples are protected from exposure to dioxygen. Hydrogen peroxide reacts cleanly with mono-meso-substituted iron(II) porphyrins in pyridine solution under an inert atmosphere to form mixtures of three possible oxygenation products, (py)2Fe(cis-meso-R-OEPO), (py)2Fe(trans-meso-R-OEPO), and (py)2Fe(OEPO). The yields of (py)2Fe(OEPO), which results from replacement of the unique meso substituent, as a function of the identity of the meso substituent decrease in the order NO2 > HC(O) approximately equal to CN approximately equal to Cl > OMe > Ph, Bu, which suggests that the species responsible for attack on the porphyrin periphery is nucleophilic in nature. A mechanism involving isoporphyrin formation through attack of hydroxide ion on a cationic iron porphyrin with an oxidized porphyrin ring is suggested. The identity of the unique meso functionality also affects the regiospecificity of substitution when the unique meso group is retained. Although random attack at the two different meso sites is expected to yield a cis/trans product ratio of 2, the observed ratios vary in the following order: cyano, 5.0; n-butyl, 4.9; chloro, 3.2; formyl, 2.6; methoxy, 1.9; phenyl 1.4.

Comparison of three methods for assessment of hand exposure to azinphos-methyl (Guthion) during apple thinning

Hand exposures of apple thinners to the pesticide azinphos-methyl (Guthion) were measured using three methods (glove, handwash, and wipe). Hand exposure sampling for each method was conducted following apple thinning work for a period of two hours for six to eight workers. Foliar residue samples were collected on each day of hand exposure sampling in the same orchard blocks that were thinned; foliar residues are considered to have been constant during the four-day study, which took place, on average, six days after pesticide application. Hand exposure estimates derived from each of the three methods differed significantly (ANOVA: p < 0.001). Mean measured exposure rates for the glove, handwash, and wipe methods were 6.48, 1.83, and 0.28 mg/hr, respectively. A corrected estimate of hand exposure, 2.7 mg/hr, was calculated from the handwash measurements and the handwash removal efficiency factor from a laboratory study. Comparison with this hand exposure estimate suggests that the glove method produced a 2.4-fold overestimate of exposure, whereas the wipe method produced a 10-fold underestimate. Studies that measure hand exposure to pesticides should include a careful description of sampling methods and should recognize the potential for measurement bias. Furthermore, the standardization and validation of dermal exposure assessment methods are critical to developing more comparable and more accurate pesticide exposure estimates.

Upper respiratory irritation from controlled exposure to vapor from carbonless copy forms

Exposure to carbonless copy forms has been associated with subjective reports of respiratory and skin irritation, but objective measurements of human reactions to exposure are lacking. Thirty workers with complaints of prior sensitivity to the forms were given brief, controlled exposure to vapors from carbonless forms and from bond paper in random, single-blind fashion. Nasal impedance increased 34% after exposure to carbonless forms (P less than .025) and rose 8% after exposure to plain paper (P greater than .10). However, frequency of symptoms did not differ between the two exposure modes, and was not correlated with the nasal measurements. Quantitation of nasal congestion by this technique may be a sensitive measure of short-term reaction to inhalation of irritants.