Characterization of airborne dust emissions from three types of crushed multi-walled carbon nanotube-enhanced concretes

Dispersing Multi-Walled Carbon Nanotubes (MWCNTs) into concrete at low (<1 wt% in cement) concentrations may improve concrete performance and properties and provide enhanced functionalities. When MWCNT-enhanced concrete is fragmented during remodelling or demolition, the stiff, fibrous and carcinogenic MWCNTs will, however, also be part of the respirable particulate matter released in the process. Consequently, systematic aerosolizing of crushed MWCNT-enhanced concretes in a controlled environment and measuring the properties of this aerosol can give valuable insights into the characteristics of the emissions such as concentrations, size range and morphology. These properties impact to which extent the emissions can be inhaled as well as where they are expected to deposit in the lung, which is critical to assess whether these materials might constitute a future health risk for construction and demolition workers. In this work, the impact from MWCNTs on aerosol characteristics was assessed for samples of three concrete types with various amounts of MWCNT, using a novel methodology based on the continuous drop method. MWCNT-enhanced concretes were crushed, aerosolized and the emitted particles were characterized with online and offline techniques. For light-weight porous concrete, the addition of MWCNT significantly reduced the respirable mass fraction (RESP) and particle number concentrations (PNC) across all size ranges (7 nm - 20 μm), indicating that MWCNTs dampened the fragmentation process by possibly reinforcing the microstructure of brittle concrete. For normal concrete, the opposite could be seen, where MWCNTs resulted in drastic increases in RESP and PNC, suggesting that the MWCNTs may be acting as defects in the concrete matrix, thus enhancing the fragmentation process. For the high strength concrete, the fragmentation decreased at the lowest MWCNT concentration, but increased again for the highest MWCNT concentration. All tested concrete types emitted <100 nm particles, regardless of CNT content. SEM imaging displayed CNTs protruding from concrete fragments, but no free fibres were detected.

Pilot study: External surface contamination of gemcitabine and 5-fluorouracil on drug packaging

INTRODUCTION

Antineoplastic drugs (ADs) are commonly used pharmaceuticals for anticancer treatments. It has previously been shown that the external surface of drug vials frequently is contaminated with ADs. More than a decade ago methods to prevent occupational exposure were introduced by using plastic coverage of the glass vials or packing vials in a secondary plastic container. The aim of the pilot study was to determine contamination levels of ADs on different parts of AD packaging of two different commercially available drug vials on the Swedish market and to investigate the occurrence of cross contamination of ADs.

METHODS

Packagings of gemcitabine (GEM) and 5-fluorouracil (5-FU) were tested by wipe sampling. Five ADs; GEM, 5-FU, cyclophosphamide (CP), ifosfamide and etoposide were quantified using liquid chromatography mass spectrometry.

RESULTS

AD contaminations were detected in 69% and 60% of the GEM and 5-FU packaging samples. Highest levels, up to approximately 5 µg/sample, were observed on the glass vials. The protective shrink-wrap of 5-FU vials and the plastic container of GEM were contaminated with low levels of 5-FU and GEM, respectively, and furthermore the 5-FU vials with shrink-wrap were cross-contaminated with GEM. Cross-contamination of CP and GEM was detected on 5-FU vials with plastic shrink-wrap removed.

CONCLUSIONS

External contamination of ADs are still present at primary drug packagings on the Swedish market. Protection of AD vials by plastic shrink-wrap or a secondary plastic container does not remove the external contamination levels completely. The presence of cross contamination of ADs on drug packagings was also observed.

Sensitive methods for assessment of lung health in welders and controls

BACKGROUND

Welders are exposed to gas and particle emissions that can cause severe lung disease, such as chronic obstructive pulmonary disease (COPD), a leading cause of mortality and morbidity worldwide. It is hard to detect COPD early and therefore mitigating measures may be delayed. The aim of this study was to investigate lung health in welders and evaluate new sensitive methods with potential to assess early onset pulmonary changes in occupational settings.

METHODS

This study assessed the lung health and symptoms in active welders (n = 28) and controls (n = 17). Lung measurements were performed with standard spirometry and new methods: airspace dimension assessment (AiDA), oscillometry, blood serum biomarkers (club cell secretory protein 16, surfactant protein D, matrix metalloproteinases, fibroblast, hepatocyte growth factor, interleukins), and one urine biomarker (desmosine).

RESULTS

According to spirometry measurements, all participants had normal lung function. However, prevalence of cough was significantly higher among welders compared with controls and lung changes were found in welders with the novel methods. Welders had significantly higher respiratory system resistance assessed with oscillometry, serum levels of metalloproteinases 9 and hepatocyte growth factor, compared with controls. Airspace dimensions were on average higher among welders compared with controls, but the difference was not significant. The number of welding years correlated with decreased respiratory system reactance and increased serum levels of matrix metalloproteinases 9, interleukin 6, and hepatocyte growth factor. Airspace dimension assessment indices significantly correlated with increasing levels of inflammatory markers and matrix metalloproteinases.

CONCLUSIONS

This study indicated the potential to use new and more sensitive methods for identification of changes in lungs when standard spirometry failed to do so.

Size-resolved characterization of particles >10 nm emitted to air during metal recycling

BACKGROUND

In the strive towards a circular economy, metal waste recycling is a growing industry. During the recycling process, particulate matter containing toxic and allergenic metals will be emitted to the air causing unintentional exposure to humans and environment.

OBJECTIVE

In this study detailed characterization of particle emissions and workplace exposures were performed, covering the full size range from 10 nm to 10 µm, during recycling of three different material flows: Waste of electrical and electronic equipment (WEEE), metal scrap, and cables.

METHODS

Both direct-reading instruments (minute resolution), and time-integrated filter measurements for gravimetric and chemical analysis were used. Additionally, optical sensors were applied and evaluated for long-term online monitoring of air quality in industrial settings.

RESULTS

The highest concentrations, in all particle sizes, and with respect both to particle mass and number, were measured in the WEEE flow, followed by the metal scrap flow. The number fraction of nanoparticles was high for all material flows (0.66-0.86). The most abundant metals were Fe, Al, Zn, Pb and Cu. Other elements of toxicological interest were Mn, Ba and Co.

SIGNIFICANCE

The large fraction of nanoparticles, and the fact that their chemical composition deviate from that of the coarse particles, raises questions that needs to be further addressed including toxicological implications, both for humans and for the environment.

A quantitative LC-MS method to determine surface contamination of antineoplastic drugs by wipe sampling

The main objective was to develop a wipe sampling test to measure surface contamination of the most frequently used antineoplastic drugs (ADs) in Swedish healthcare and, furthermore, to develop an analysis method sensitive enough to assess low levels of contamination. Two wipe sampling tests with separate sample processing methods assessing (i) cyclophosphamide (CP), ifosfamide (IF), 5-fluorouracil (5-FU), etoposide (ETO), gemcitabine (GEM) and cytarabine (CYT) (Wipe Test 1); and (ii) GEM, CYT and methotrexate (MTX) (Wipe Test 2), respectively, were developed by optimization of absorption and extraction efficiencies using different wipe tissue materials, tissue wetting solution, and extraction solvents. A fast liquid chromatography tandem mass spectrometry method was developed for simultaneous detection of the studied ADs. The limit of quantification for the method was between 0.04 to 2.4 ng/wipe sample (0.10 to 6.1 pg/cm² for an area of 400 cm²) and at 50 ng/sample the within-day precision was between 1.3 and 15%, and the accuracy between 102 and 127%. Wipe Test 1 was applied in an assessment of cleaning efficiency of five different cleaning solutions (formic acid, water, sodium hydroxide, ethanol, and sodium dodecyl sulfate (SDS) for removal of ADs from surfaces made of stainless steel or plastic. For CP, IF, 5-FU, GEM, and CYT 92% of the AD were removed regardless of surface and cleaning solution. In conclusion, a user-friendly assessment method to measure low levels of seven ADs in the work environment was developed and validated. Assessment of the decontamination efficiency of cleaning solutions concerning removal of ADs from stainless steel showed that efficiencies differed depending on the AD with water being the least effective cleaning agent. The results suggests that a combination of different cleaning agents including detergent and a solution with an organic component would be optimal to efficiently remove the measured ADs from surfaces in the workplace.

Emissions and exposures of graphene nanomaterials, titanium dioxide nanofibers, and nanoparticles during down-stream industrial handling

Today, engineered nanomaterials are frequently used. Nanosized titanium dioxide (TiO2) has been extensively used for many years and graphene is one type of emerging nanomaterial. Occupational airborne exposures to engineered nanomaterials are important to ensure safe workplaces and to extend the information needed for complete risk assessments. The main aim of this study was to characterize workplace emissions and exposure of graphene nanoplatelets, graphene oxide, TiO2 nanofibers (NFs) and nanoparticles (NPs) during down-stream industrial handling. Surface contaminations were also investigated to assess the potential for secondary inhalation exposures. In addition, a range of different sampling and aerosol monitoring methods were used and evaluated. The results showed that powder handling, regardless of handling graphene nanoplatelets, graphene oxide, TiO2 NFs, or NPs, contributes to the highest particle emissions and exposures. However, the exposure levels were below suggested occupational exposure limits. It was also shown that a range of different methods can be used to selectively detect and quantify nanomaterials both in the air and as surface contaminations. However, to be able to make an accurate determination of which nanomaterial that has been emitted a combination of different methods, both offline and online, must be used.

Workplace Emissions and Exposures During Semiconductor Nanowire Production, Post-production, and Maintenance Work

Background

Nanowires are a high-aspect-ratio material of increasing interest for a wide range of applications. A new and promising method to produce nanowires is by aerotaxy, where the wires are grown in a continuous stream of gas. The aerotaxy method can grow nanowires much faster than by more conventional methods. Nanowires have important properties in common with asbestos fibers, which indicate that there can be potential health effects if exposure occurs. No conclusive exposure (or emission) data from aerotaxy-production of nanowires has so far been published.

Methods

Different work tasks during semiconductor nanowire production, post-production, and maintenance were studied. A combination of direct-reading instruments for number concentration (0.007–20 µm) and filter sampling was used to assess the emissions (a couple of centimeter from the emission sources), the exposure in the personal breathing zone (max 30 cm from nose–mouth), and the concentrations in the background zone (at least 3 m from any emission source). The filters were analyzed for metal dust composition and number concentration of nanowires. Various surfaces were sampled for nanowire contamination.

Results

The particle concentrations in the emission zone (measured with direct-reading instruments) were elevated during cleaning of arc discharge, manual reactor cleaning, exchange of nanowire outflow filters, and sonication of substrates with nanowires. In the case of cleaning of the arc discharge and manual reactor cleaning, the emissions affected the concentrations in the personal breathing zone and were high enough to also affect the concentrations in the background. Filter analysis with electron microscopy could confirm the presence of nanowires in some of the air samples.

Conclusions

Our results show that a major part of the potential for exposure occurs not during the actual manufacturing, but during the cleaning and maintenance procedures. The exposures and emissions were evaluated pre- and post-upscaling the production and showed that some work tasks (e.g. exchange of nanowire outflow filters and sonication of substrates with nanowires) increased the emissions post-upscaling.

Effect of welding fumes on the cardiovascular system: a six-year longitudinal study

Objective This study investigated whether low-to-moderate exposure to welding fumes is associated with adverse effects on the cardiovascular system. Methods To test this, we performed a longitudinal analysis of 78 mild steel welders and 96 controls; these subjects were examined twice, six years apart (ie, timepoints 1 and 2). All subjects (male and non-smoking at recruitment) completed questionnaires describing their health, work history, and lifestyle. We measured their blood pressure, endothelial function (by EndoPAT), and risk markers for cardiovascular disease [low-density lioprotein (LDL), homocysteine, C-reactive protein]. Exposure to welding fumes was assessed from the responses to questionnaires and measurements of respirable dust in their breathing zones adjusted for use of respiratory protection equipment. Linear mixed-effect regression models were used for the longitudinal analysis. Results Median respirable dust concentrations, adjusted for respirable protection, of the welders were 0.7 (5-95 percentile range 0.2-4.2) and 0.5 (0.1-1.9) mg/m ³at timepoints 1 and 2, respectively. Over the six-year period, welders showed a statistically significant increase in systolic [5.11 mm Hg, 95% confidence interval (CI) 1.92-8.31] and diastolic (3.12 mm Hg, 95% CI 0.74-5.5) blood pressure compared with controls (multi-variable adjusted mixed effect models). Diastolic blood pressure increased non-significantly by 0.22 mm Hg (95% CI -0.02-0.45) with every additional year of welding work. No consistent significant associations were found between exposure and endothelial function, LDL, homocysteine, or C-reactive protein. Conclusion Exposure to welding fumes at low-to-moderate levels is associated with increased blood pressure, suggesting that reducing the occupational exposure limit (2.5 mg/m ³for inorganic respirable dust in Sweden) is needed to protect cardiovascular health of workers.

Exposure to Mild Steel Welding and Changes in Serum Proteins With Putative Neurological Function-A Longitudinal Study

Welders are exposed to high levels of metal particles, consisting mainly of iron and manganese (Mn) oxide. Metal particles, especially those containing Mn can be neurotoxic. In this exploratory study, we evaluated associations between welding and expression of 87 putative neurology-related proteins in serum in a longitudinal approach. The study cohort from southern Sweden included welders working with mild steel (n = 56) and controls (n = 67), all male and non-smoking, which were sampled at two timepoints (T1, T2) 6-year apart. Observed associations in the longitudinal analysis (linear mixed models) were further evaluated (linear regression models) in another cross-sectional sample which included welders (n = 102) and controls (n = 89) who were sampled only once (T1 or T2). The median respirable dust levels for welders after adjusting for respiratory protection was at T1 0.6 (5–95 percentile: 0.2–4.2) and at T2 0.5 (0.1–1.8) mg/m³. The adjusted median respirable Mn concentration was at T2 0.049 mg/m³ (0.003–0.314) with a Spearman correlation between adjusted respirable dust and respirable Mn of r_S = 0.88. We identified five neurology-related proteins that were differentially expressed in welders vs. controls in the longitudinal sample, of which one (nicotinamide/nicotinic acid mononucleotide adenylyltransferase 1; NMNAT1) was also differentially expressed in the cross-sectional sample. NMNAT1, an axon-protective protein linked to Alzheimers disease, was upregulated in welders compared with controls but no associations were discerned with degree of exposure (welders only: years welding, respirable dust, cumulative exposure). However, we identified five additional proteins that were associated with years welding (GCSF, EFNA4, CTSS, CLM6, VWC2; welders only) both in the longitudinal and in the cross-sectional samples. We also observed several neurology-related proteins that were associated with age and BMI. Our study indicates that low-to-moderate exposure to welding fumes is associated with changes in circulating levels of neurology-related proteins.

Evaluating the Risk Assessment Approach of the REACH Legislation: A Case Study

Risk assessments based on occupational exposure to chemicals have increased since REACH (European regulation on Registration, Evaluation, Authorization, and restriction of Chemicals) came into force. The European Chemicals Agency (ECHA) recommends that chemical exposure could be calculated using exposure models and that parameters used to calculate the exposure scenario (ES) should be communicated in extended safety data sheets (e-SDS) as workplace instructions which downstream users are obligated to follow. We aimed to evaluate REACH's risk assessment approach using the Stoffenmanager® 6.1, the Advanced REACH Tool 1.5 (ART), and the European Centre for Ecotoxicology and Toxicology of Chemicals' targeted risk assessment (ECETOC TRA 3.1) exposure models. We observed 239 scenarios in three companies handling chemicals using 45 e-SDS. Risk characterization ratios (RCRs) were calculated by dividing estimated exposures by derived no-effect levels (DNELs). Observed RCRs were much lower than registered RCRs, indicating lower exposures. However, about 12% of the observed ES still had RCRs > 1, after adjustment for control measures and personal protections described in the ES, when using Stoffenmanager®. The ES with observed RCRs > 1 were the same by Stoffenmanager® and ART, but not by ECETOC TRA. Stoffenmanager and ART identified 25 adjusted scenarios with RCR > 1, while ECETOC TRA gave RCR < 1 for the same scenarios. The ES with RCR > 1 were significantly associated to chemicals with higher vapour pressure and lower DNELs than ES with RCR < 1 by Stoffenmanager®. The correlations between observed and registered RCRs were lower than those between RCRs calculated from the different models themselves; ECETOC TRA had the lowest correlation with the registered ES. These results put in question the generic ES recommended under the REACH legislation. Downstream users may get better estimates by assessing their own ES, especially for chemicals with low DNELs and high vapour pressure.

Mild steel welding is associated with alterations in circulating levels of cancer-related proteins

Welding fumes were recently classified as carcinogenic to humans and worldwide millions work as welders or perform welding operations. The purpose of this study was to identify new biomarkers of welding-induced carcinogenesis. We evaluated a panel of 91 putative cancer-related proteins in serum in a cohort of welders working with mild steel (n = 77) and controls (n = 94) from southern Sweden sampled on two occasions 6-year apart using a longitudinal analysis (linear mixed models). The significant results from the longitudinal analysis were tested for reproducibility in welders (n = 88) and controls (n = 69) sampled once during the same sampling period as timepoint 1 or timepoint 2 (linear regression models), i.e., in a cross-sectional setting. The models were adjusted for age, body-mass index, and use of snus. All study participants were non-smokers at recruitment. Exposure to welding fumes was assessed using questionnaires and respirable dust measurement in the breathing zone that was adjusted for personal respiratory protection equipment. The median respirable dust in welders was 0.7 (0.2-4.2) and 0.5 (0.1-1.9) mg/m³ at the first and second timepoints, respectively. We identified 14 cancer-related proteins that were differentially expressed in welders versus controls in the longitudinal analysis, out of which three were also differentially expressed in the cross-sectional analysis (cross-sectional group). Namely, syndecan 1 (SDC1), folate receptor 1 (FOLR1), and secreted protein acidic and cysteine rich (SPARC) were downregulated, in welders compared with controls. In addition, FOLR1 was negatively associated with years welding. Disease and function analysis indicated that the top proteins are related to lung cancer as well as cell invasion and migration. Our study indicates that moderate exposure to welding fumes is associated with changes in circulating levels of putative cancer-related proteins, out of which FOLR1 showed a clear dose-response relationship. It is, however, unclear to which extent these changes are adaptive or potential early biomarkers of cancer.

Diesel Exhaust Exposure Assessment Among Tunnel Construction Workers-Correlations Between Nitrogen Dioxide, Respirable Elemental Carbon, and Particle Number

Objectives

Occupational exposure to diesel exhaust is common due the widespread use of diesel-powered combustion engines. Diesel exhaust is chemically complex and consists of thousands of compounds present as gases and particulate matter. Both nitrogen dioxide (NO2) and elemental carbon (EC) have been used as markers for diesel exhaust exposure. Currently EC is regarded as the best surrogate of diesel exhaust. The objective was to quantify the occupational exposure to diesel exhaust in underground tunnel construction work using a multi-metric approach, and to investigate the correlations between NO2, respirable EC, respirable organic carbon (OC), respirable total carbon (TC), respirable dust (RD), and particle number. Also, the use of NO2 as a proxy for diesel exhaust was evaluated, how much of the variability in the diesel exhaust exposure was attributed to within and between individual factors and if there was a difference between expert and self-administered measurements of NO2.

Methods

The personal exposure to diesel exhaust was assessed by expert supervised measurements of NO2, EC, OC, TC, RD and particle number in the breathing zones of underground tunnel workers. Stationary sampling of NO2, EC, OC, TC, RD, size-fractioned mass concentration, and particle number were conducted. The personal and stationary measurements were conducted on three occasions simultaneously. The workers measured their exposure by repeated self-administered measurements of NO2. The self-administered measurements were performed twice for each worker with at least one month lag between the samplings.

Results

In the simultaneous sampling of diesel exhaust, the geometric mean (GM) concentration of NO2 and respirable EC were 72 µg m-3 (10th-90th percentile 34-140 µg m-3) and 2.6 µg m-3 (10th-90th percentile 1.6-7.3 µg m-3), respectively. The GM for OC and TC was 28 µg m-3 (10th-90th percentile 20-42 µg m-3) and 31 µg m-3 (10th-90th percentile 20-50 µg m-3), respectively. The GM for RD and particle number was 180 µg m-3 (10th-90th percentile 20-530 µg m-3) and 47 900 cm-3 (10th-90th percentile 27500-94100 cm-3), respectively. A significant correlation was found between NO2 and respirable EC [Spearman's correlation r = 0.53 (P = 0.05)]. The within-worker variability of NO2 was 45.5% and the between-worker variability was 54.5%. The self-administered measured concentrations of NO2 (GM 70 µg m-3) did not statistically differ from the NO2 concentrations measured by an expert (P > 0.35).

Conclusion

The diesel exhaust exposure in tunnel construction work was low. A significant correlation between NO2 and EC was observed. This indicates that NO2 could be used as a proxy for diesel exhaust in tunnel work if diesel exhaust is the only source of NO2 and if the ratio between EC and NO2 is known and constant. Passive sampling of NO2 is much easier and cheaper to perform compared with active sampling of EC. It is possible to utilize self-administered NO2 measurements in extreme and inaccessible work environments. This study adds support to continued use of NO2 as an exposure marker in combination with EC for diesel exhaust exposure. In tunnel construction work, the variability in the diesel exhaust exposure was high both between- and within-workers.

Occupational exposure to particles and mitochondrial DNA - relevance for blood pressure

BACKGROUND

Particle exposure is a risk factor for cardiovascular diseases. Mitochondrial DNA (mtDNA) is a primary target for oxidative stress generated by particle exposure. We aimed to elucidate the effects of occupational exposure to particle-containing welding fumes on different biomarkers of mtDNA function, and in turn, explore if they modify the association between particle exposure and cardiovascular response, measured as blood pressure.

METHODS

We investigated 101 welders and 127 controls (all non-smoking males) from southern Sweden. Personal sampling of the welders' exposure to respirable dust was performed during work hours (average sampling time: 6.8 h; range: 2.4-8.6 h) and blood pressure was measured once for each subject. We measured relative mtDNA copy number by quantitative PCR and methylation of the mitochondrial regulatory region D-loop and the tRNA encoding gene MT-TF by bisulfite-pyrosequencing. We calculated the relative number of unmethylated D-loop and MT-TF as markers of mtDNA function to explore the modification of mtDNA on the association between particle exposure and blood pressure. General linear models were used for statistical analyses.

RESULTS

Welders had higher mtDNA copy number (β = 0.11, p = 0.003) and lower DNA methylation of D-loop (β = -1.4, p = 0.002) and MT-TF (β = -1.5, p = 0.004) than controls. Higher mtDNA copy number was weakly associated with higher personal respirable dust exposure among welders with exposure level above 0.7 mg/m3 (β = 0.037, p = 0.054). MtDNA function modified the effect of welding fumes on blood pressure: welders with low mtDNA function had higher blood pressure than controls, while no such difference was found in the group with high mtDNA function.

CONCLUSION

Increased mtDNA copy number and decreased D-loop and MT-TF methylation were associated with particle-containing welding fumes exposure, indicating exposure-related oxidative stress. The modification of mtDNA function on exposure-associated increase in blood pressure may represent a mitochondria-environment interaction.

Carbon Nanotube Emissions from Arc Discharge Production: Classification of Particle Types with Electron Microscopy and Comparison with Direct Reading Techniques

Introduction:

An increased production and use of carbon nanotubes (CNTs) is occurring worldwide. In parallel, a growing concern is emerging on the adverse effects the unintentional inhalation of CNTs can have on humans. There is currently a debate regarding which exposure metrics and measurement strategies are the most relevant to investigate workplace exposures to CNTs. This study investigated workplace CNT emissions using a combination of time-integrated filter sampling for scanning electron microscopy (SEM) and direct reading aerosol instruments (DRIs).

Material and Methods:

Field measurements were performed during small-scale manufacturing of multiwalled carbon nanotubes using the arc discharge technique. Measurements with highly time- and size-resolved DRI techniques were carried out both in the emission and background (far-field) zones. Novel classifications and counting criteria were set up for the SEM method. Three classes of CNT-containing particles were defined: type 1: particles with aspect ratio length:width >3:1 (fibrous particles); type 2: particles without fibre characteristics but with high CNT content; and type 3: particles with visible embedded CNTs.

Results:

Offline sampling using SEM showed emissions of CNT-containing particles in 5 out of 11 work tasks. The particles were classified into the three classes, of which type 1, fibrous CNT particles contributed 37%. The concentration of all CNT-containing particles and the occurrence of the particle classes varied strongly between work tasks. Based on the emission measurements, it was assessed that more than 85% of the exposure originated from open handling of CNT powder during the Sieving, mechanical work-up, and packaging work task. The DRI measurements provided complementary information, which combined with SEM provided information on: (i) the background adjusted emission concentration from each work task in different particle size ranges, (ii) identification of the key procedures in each work task that lead to emission peaks, (iii) identification of emission events that affect the background, thereby leading to far-field exposure risks for workers other than the operator of the work task, and (iv) the fraction of particles emitted from each source that contains CNTs.

Conclusions:

There is an urgent need for a standardized/harmonized method for electron microscopy (EM) analysis of CNTs. The SEM method developed in this study can form the basis for such a harmonized protocol for the counting of CNTs. The size-resolved DRI techniques are commonly not specific enough to selective analysis of CNT-containing particles and thus cannot yet replace offline time-integrated filter sampling followed by SEM. A combination of EM and DRI techniques offers the most complete characterization of workplace emissions of CNTs today.

Oxidative stress, telomere shortening, and DNA methylation in relation to low-to-moderate occupational exposure to welding fumes

Evidence suggests that exposure to welding fumes is a risk factor for lung cancer. We examined relationships between low-to-moderate occupational exposure to particles from welding fumes and cancer-related biomarkers for oxidative stress, changes in telomere length, and alterations in DNA methylation. We enrolled 101 welders and 127 controls (all currently nonsmoking men) from southern Sweden. We performed personal sampling of respirable dust and measured 8-oxodG concentrations in urine using a simplified liquid chromatography tandem mass spectrometry method. Telomere length in peripheral blood was measured by quantitative polymerase chain reaction. Methylation status of 10 tumor suppressor genes was determined by methylation-sensitive high-resolution melting analysis. All analyses were adjusted for age, body mass index, previous smoking, passive smoking, current residence, and wood burning stove/boiler at home. Welders were exposed to respirable dust at 1.2 mg/m(3) (standard deviation, 3.3 mg/m(3); range, 0.1-19.3), whereas control exposures did not exceed 0.1 mg/m(3) (P < 0.001). Welders and controls did not differ in 8-oxodG levels (β = 1.2, P = 0.17) or relative telomere length (β = -0.053, P = 0.083) in adjusted models. Welders showed higher probability of adenomatous polyposis coli (APC) methylation in the unadjusted model (odds ratio = 14, P = 0.014), but this was not significant in the fully adjusted model (P = 0.052). Every working year as a welder was associated with 0.0066 units shorter telomeres (95% confidence interval -0.013 to -0.00053, P = 0.033). Although there were no clear associations between concentrations of respirable dust and the biomarkers, there were modest signs of associations between oxidative stress, telomere alterations, DNA methylation, and occupational exposure to low-to-moderate levels of particles.

Exposure to welding fumes is associated with hypomethylation of the F2RL3 gene: a cardiovascular disease marker

Background

Welders are at risk for cardiovascular disease. Recent studies linked tobacco smoke exposure to hypomethylation of the F2RL3 (coagulation factor II (thrombin) receptor-like 3) gene, a marker for cardiovascular disease prognosis and mortality. However, whether welding fumes cause hypomethylation of F2RL3 remains unknown.

Methods

We investigated 101 welders (median span of working as a welder: 7 years) and 127 unexposed controls (non-welders with no obvious exposure to respirable dust at work), age range 23–60 years, all currently non-smoking, in Sweden. The participants were interviewed about their work history, lifestyle factors and diseases. Personal sampling of respirable dust was performed for the welders. DNA methylation of F2RL3 in blood was assessed by pyrosequencing of four CpG sites, CpG_2 (corresponds to cg03636183) to CpG_5, in F2RL3. Multivariable linear regression analysis was used to assess the association between exposure to welding fumes and F2RL3 methylation.

Results

Welders had 2.6% lower methylation of CpG_5 than controls (p<0.001). Higher concentrations of measured respirable dust among the welders were associated with hypomethylation of CpG_2, CpG_4 and CpG_5 (β=−0.49 to −1.4, p<0.012); p<0.029 adjusted for age, previous smoking, passive smoking, education, current residence and respirator use. Increasing the number of years working as a welder was associated with hypomethylation of CpG_4 (linear regression analysis, β=−0.11, p=0.039, adjusted for previous smoking). Previous tobacco smokers had 1.5–4.7% (p<0.014) lower methylation of 3 of the 4 CpG sites in F2RL3 (CpG_2, CpG_4 and CpG_5) compared to never-smokers. A non-significant lower risk of cardiovascular disease with more methylation was observed for all CpG sites.

Conclusions

Welding fumes exposure and previous smoking were associated with F2RL3 hypomethylation. This finding links low-to-moderate exposure to welding fumes to adverse effects on the cardiovascular system, and suggests a potential mechanistic pathway for this link, via epigenetic effects on F2RL3 expression.

A Cross-Sectional Study of the Cardiovascular Effects of Welding Fumes

Objectives

Occupational exposure to particulate air pollution has been associated with an increased risk of cardiovascular disease. However, the risk to welders working today remains unclear. We aimed to elucidate the cardiovascular effects of exposure to welding fumes.

Methods

In a cross-sectional study, structured interviews and biological sampling were conducted for 101 welders and 127 controls (all non-smoking males) from southern Sweden. Personal breathing zone sampling of respirable dust was performed. Blood pressure (BP) and endothelial function (using peripheral arterial tonometry) were measured. Plasma and serum samples were collected from peripheral blood for measurement of C-reactive protein, low-density lipoprotein, homocysteine, serum amyloid A, and cytokines.

Results

Welders were exposed to 10-fold higher levels of particles than controls. Welders had significantly higher BP compared to controls, an average of 5 mm Hg higher systolic and diastolic BP (P≤0.001). IL-8 was 3.4 ng/L higher in welders (P=0.010). Years working as a welder were significantly associated with increased BP (β=0.35, 95%CI 0.13 – 0.58, P=0.0024 for systolic BP; β=0.32, 95%CI 0.16 – 0.48, P<0.001 for diastolic BP, adjusted for BMI) but exposure to respirable dust was not associated with BP. No clear associations occurred between welding and endothelial function, or other effect markers.

Conclusions

A modest increase in BP was found among welders compared to controls suggesting that low-to-moderate exposure to welding fumes remains a risk factor for cardiovascular disease.

Exposure and emission measurements during production, purification, and functionalization of arc-discharge-produced multi-walled carbon nanotubes

BACKGROUND

The production and use of carbon nanotubes (CNTs) is rapidly growing. With increased production, there is potential that the number of occupational exposed workers will rapidly increase. Toxicological studies on rats have shown effects in the lungs, e.g., inflammation, granuloma formation, and fibrosis after repeated inhalation exposure to some forms of multi-walled CNTs (MWCNTs). Still, when it comes to health effects, it is unknown which dose metric is most relevant. Limited exposure data for CNTs exist today and no legally enforced occupational exposure limits are yet established. The aim of this work was to quantify the occupational exposures and emissions during arc discharge production, purification, and functionalization of MWCNTs. The CNT material handled typically had a mean length <5 μm. Since most of the collected airborne CNTs did not fulfil the World Health Organization fibre dimensions (79% of the counted CNT-containing particles) and since no microscopy-based method for counting of CNTs exists, we decided to count all particle that contained CNTs. To investigate correlations between the used exposure metrics, Pearson correlation coefficient was used.

METHODS

Exposure measurements were performed at a small-scale producer of MWCNTs and respirable fractions of dust concentrations, elemental carbon (EC) concentrations, and number concentrations of CNT-containing particles were measured in the workers' breathing zones with filter-based methods during work. Additionally, emission measurements near the source were carried out during different work tasks. Respirable dust was gravimetrically determined; EC was analysed with thermal-optical analysis and the number of CNT-containing particles was analysed with scanning electron microscopy.

RESULTS

For the personal exposure measurements, respirable dust ranged between <73 and 93 μg m(-3), EC ranged between <0.08 and 7.4 μg C m(-3), and number concentration of CNT-containing particles ranged between 0.04 and 2.0 cm(-3). For the emission measurements, respirable dust ranged between <2800 and 6800 μg m(-3), EC ranged between 0.05 and 550 μg C m(-3), and number concentration of CNT-containing particles ranged between <0.20 and 11cm(-3).

CONCLUSIONS

The highest exposure to CNTs occurred during production of CNTs. The highest emitted number concentration of CNT-containing particles occurred in the sieving, mechanical work-up, pouring, weighing, and packaging of CNT powder during the production stage. To be able to quantify exposures and emissions of CNTs, a selective and sensitive method is needed. Limitations with measuring EC and respirable dust are that these exposure metrics do not measure CNTs specifically. Only filter-based methods with electron microscopy analysis are, to date, selective and sensitive enough. This study showed that counting of CNT-containing particles is the method that fulfils those criteria and is therefore the method recommended for future quantification of CNT exposures. However, CNTs could be highly toxic not only because of their length but also because they could contain, for example transition metals and polycyclic aromatic hydrocarbons, or have surface defects. Lack of standardized counting criteria for CNTs to be applied at the electron microscopy analysis is a limiting factor, which makes it difficult to compare exposure data from different studies.

Investigation of lead concentrations in whole blood, plasma and urine as biomarkers for biological monitoring of lead exposure

Lead in blood is a major concept in biomonitoring of exposure but investigations of its alternatives are scarce. The aim of the study was to describe different lead biomarkers' variances, day-to-day and between individuals, estimating their fraction of the total variance. Repeated sampling of whole blood, plasma and urine were conducted for 48 lead-exposed men and 20 individuals under normal environmental lead exposure, in total 603 measurements. For lead workers, the fraction of the total variance attributed to differences between individuals was 91% for whole-blood lead (geometric mean 227 μg/l; geometric standard deviation (GSD): 1.55 μg/l); plasma 78% (0.57 μg/l; GSD: 1.84 μg/l); density-adjusted urine 82%; and unadjusted urine 75% (23.7 μg/l; GSD: 2.48 μg/l). For the individuals under normal lead exposure, the corresponding fractions were 95% of the total variance for whole blood (20.7 μg/l; GSD: 8.6 μg/l), 15% for plasma (0.09 μg/l; GSD: 0.04 μg/l), 87% for creatinine-adjusted urine and 34% for unadjusted (10.8 μg/l; GSD: 6.7 μg/l). Lead concentration in whole blood is the biomarker with the best ability to discriminate between individuals with different mean concentration. Urinary and plasma lead also performed acceptably in lead workers, but at low exposures plasma lead was too imprecise. Urinary adjustments appear not to increase the between-individual fraction of the total variance among lead workers but among those with normal lead exposure.

Hygienic guidance values for wipe sampling of antineoplastic drugs in Swedish hospitals

The use of antineoplastic drugs in health care steadily increases. Health care workers can be occupationally exposed to antineoplastic drugs classified as carcinogenic or teratogenic. Monitoring of surface contamination is a common way to assess occupational exposure to antineoplastic drugs, since wipe sampling is used as a surrogate measure of dermal exposure. Since no occupational limits for antineoplastic drugs in work environments exist, 'hygienic guidance values' (HGVs) should be used instead. HGVs are practicable, achievable levels, not health based, and can be calculated from exposure data from representative workplaces with good occupational hygiene practices. So far, guidance values for surface monitoring of antineoplastic drugs only exist for pharmacies where antineoplastic drugs are prepared. The objective was to propose HGVs for surface monitoring of cyclophosphamide (CP) and ifosfamide (IF) in Swedish hospitals where antineoplastic drugs are administered to patients. In total, 17 workplaces located at six hospitals in Sweden were surveyed by wipe sampling. Wipe samples were collected, worked up and then analyzed with liquid chromatography tandem mass spectrometry. Surface contamination of CP and IF was found on 80% and 73% of the sampled surfaces, thus indicating that there is potential for health care workers to be exposed to CP and IF via the skin. The median surface load of CP was 3.3 pg cm(-2) (range <0.05-10,800 pg cm(-2)). The corresponding value for IF was 4.2 pg cm(-2) (range <0.13-95,000 pg cm(-2)). The highest surface loads were found on the floors. The proposed HGVs were set at 90th percentile values, and can be applicable to hospital workplaces where patients are treated with CP or IF. Surface monitoring combined with HGVs is a useful tool for health care workers to regularly benchmark their own surface loads which could control and reduce the occupational exposure to CP and IF in hospital workplaces. Thus, the occupational safety of the health care workers will be increased.

Validation of urinary excretion of cyclophosphamide as a biomarker of exposure by studying its renal clearance at high and low plasma concentrations in cancer patients

OBJECTIVES

Cyclophosphamide (CP) is an alkylating agent classified as a human carcinogen. Health care workers handling this drug may be exposed during, e.g., preparation or administration. Cyclophosphamide is readily absorbed by inhalation and by dermal uptake. A biomarker, CP in urine, has frequently been used to assess the occupational exposure to CP, but has not been fully validated. The aim of this study was to investigate if the proportion of the CP dose that is excreted in urine (renal clearance) is constant over different plasma drug concentrations and other pharmacokinetic parameters, e.g., urine flow.

METHODS

Pharmacokinetics of CP were studied in 16 breast cancer patients that were treated with postoperative adjuvant chemotherapy including CP. Plasma and urine from the patients were collected at different occasions up to 12 days after the dose. Urine was collected during 4-h periods and blood was sampled at the end of each period. Analysis of CP was performed by liquid chromatography tandem mass spectrometry. The limit of detection for CP in urine and plasma was 0.01 and 0.02 ng/ml, respectively. The precisions of the developed methods were determined to < or =8%.

RESULTS

The administered doses of CP in absolute amounts ranged between 800 and 2,240 mg. Mean renal clearance of CP was 8.6 (confidence interval 6.5-10.7) ml/min and was not significantly dependent of the plasma drug concentration. However, a significant correlation between renal clearance and urine flow was observed. There was a large inter-individual variation in the plasma and urine concentrations even when the same doses were given.

CONCLUSIONS

Cyclophosphamide in urine can be continued to be used as a biomarker to monitor occupational exposure to CP, however the inter-individual variability of excretion of CP in urine, and its dependency on urine flow must be taken into consideration in future applications.

Surface Contamination of Cyclophosphamide Packaging and Surface Contamination with Antineoplastic Drugs in a Hospital Pharmacy in Sweden

Workplaces, e.g. hospital pharmacies and hospital departments, where antineoplastic drugs are handled might be contaminated with these drugs, and pharmacy personnel and health care workers may be exposed. In this study potential sources for exposure of antineoplastic drugs were investigated. Unbroken drug vials and tablet blister packages, both containing cyclophosphamide (CP) and their outer packaging were wipe sampled. Analysis was performed by liquid chromatography combined with tandem mass spectrometry (LC-MS/MS). The result showed that almost every part of the primary packaging was contaminated with CP and ifosfamide (IF). However, the amounts of CP and IF were low, and most likely not harmful for the personnel handling these packaging in association with drug preparation. The contamination must originate from the pharmaceutical manufacturer. Different surfaces in the preparation unit of a Swedish hospital pharmacy were also investigated at two different occasions by wipe sampling. In the preparation unit CP and IF were found as contaminants on the majority of the investigated surfaces. After the first measurement the hospital pharmacy improved its routines. Lower amounts of CP and IF were detected at the second measurement. A low degree of contamination with CP and IF was also detected on the floor outside the preparation unit and this indicated a small distribution of antineoplastic drugs to the surroundings.

Development and validation of methods for environmental monitoring of cyclophosphamide in workplaces

Methods to monitor contamination of workplaces with antineoplastic drugs have been developed and validated. Cyclophosphamide (CP) was used as a model compound as it is one of the most commonly used antineoplastic drugs. A wipe sampling method to detect contamination with CP at surfaces was developed. A personal air sampling method to sample gas and vapour on solid sorbent tubes and particles with filters was also developed. Wipe and filter samples were extracted and sorbent samples were eluted, all with ethyl acetate. The samples were analysed with liquid chromatography tandem mass spectrometry. (2)H(6)-labelled cyclophosphamide was used as an internal standard. The between-day precision was 2-5% for wipe samples, 4-6% for sorbent samples and 3-8% for filter samples. The limit of detection was 0.02 ng CP per sample for the wipe and filter methods and 0.03 ng CP per sample for the solid sorbent method. Wipe sampling on surfaces made of different materials resulted in mean recoveries between 78-106%. The desorption recovery was between 97-102% for the wipe samples, 97% for the sorbent samples and 101% for the filter samples. Samples were stable for up to 2 months at 5 degrees C and -20 degrees C and for about 2 d at room temperature. The developed methods were applied to the measurement of contamination with CP in a hospital pharmacy. Trace amounts of CP, 1.3 and 1.4 ng, were detected on surfaces in the pharmacy.