Biomonitoring of BTEX in primary school children exposed to hookah smoke

Hookah smoking is one of the major indoor sources of benzene, toluene, ethylbenzene, and xylenes (BTEX). This study aimed to investigate the potential exposure to BTEX among primary school children, particularly those exposed to hookah smoke. This cross-sectional study was conducted in Khesht, one of the southwestern cities in Iran, in mid-June 2020. Totally, 50 primary school children exposed to hookah smoke were chosen as the case group and 50 primary school children were selected as the control group. Urinary un-metabolized BTEX was measured by a headspace gas chromatography mass spectrometry (GC-MS). Additionally, a detailed questionnaire was used to gather data and information from the students' parents. The mean levels of urinary benzene, toluene, ethylbenzene, m,p-xylene, and o-xylene were 1.44, 5.87, 2.49, 6.93, and 7.17 μg/L, respectively in the exposed children. Urinary BTEX was 3.93-folds higher in the case group than in the controls (p<0.05). Household cleaning products, the floor on which the house was located, children's sleeping place, and playing outdoors were found to be important factors in predicting urinary BTEX levels. Overall, it was found necessary to avoid indoor smoking to prevent the emission of BTEX compounds via exhaled mainstream smoke and to protect vulnerable non-smokers, especially children, from exposure to second-hand and third-hand smoke.

Lifestyle and occupational factors affecting exposure to BTEX in municipal solid waste composting facility workers

Composting facilities workers are potentially exposed to different volatile organic compounds (VOCs). This study aims to investigate the potential exposure to benzene, toluene, ethylbenzene and xylenes (BTEX) compounds among workers of composting facilities by measuring un-metabolized BTEX in urine and to investigate the effect that several lifestyle factors (i.e. smoking and residential traffic), using personal protective equipment, and religious practices such as Ramadan fasting can have on the urinary BTEX concentrations. We assessed concentrations of BTEX in the urine of a composting facility workers. Samples were collected in May 2018. Overall, 25 workers chosen as the exposed group and 20 inhabitants living close to the composting facility as a control group. The urine samples were collected from studied subjects. Identification and quantification of un-metabolized BTEX was performed using a headspace gas chromatography-mass spectrometry (GC-MS). Detailed information of participants was gathered by a comprehensive questionnaire. The geometric mean levels of urinary benzene, toluene, ethylbenzene, m‑p xylene, and o‑xylene in the exposed subjects were 1.27, 2.12, 0.54, 1.22 and 1.51 μg/L, respectively; 1.4 to 3.7-time higher than values in control group (p < 0.05). Post-shift levels were significantly higher than pre-shift for all chemicals (p < 0.05). Smoking habits, exposure to environmental tobacco smoke, and Ramadan fasting predicted urinary BTEX levels. Personal protective equipment which included a simple N95 mask did not protected workers from BTEX emissions. Composting facilities represent a significant source BTEX emissions and exposure for staff. More effective protective strategies are required to minimize exposure and related occupational hazards.

Use of urinary biomarkers to characterize occupational exposure to BTEX in healthcare waste autoclave operators

Urinary benzene, toluene, ethylbenzene, and xylenes (BTEX) can be used as a reliable biomarker of exposure to these pollutants. This study was aimed to investigate the urinary BTEX concentration in operators of healthcare waste (HCW) autoclaves. This cross-sectional study was conducted in selected hospitals in Tehran, Iran between April and June 2017. Twenty operators (as the case group) and twenty control subjects were enrolled in the study. Personal urine samples were collected at the beginning and end of the work shift. Urinary BTEX were measured by a headspace gas chromatography-mass spectrometry (GC/MS). A detailed questionnaire was used to gather information from subjects. Results showed that the median of urinary benzene, toluene, ethylbenzene, m-p xylene, and o-xylene levels in the exposed group were 3.26, 3.36, 0.84, 3.94 and 4.48 μg/L, respectively. With the exception of ethylbenzene, subjects in the exposed group had significantly higher urinary BTEX levels than control group (p < 0.05). Urinary BTEX concentrations in the exposed case group were 2.5-fold higher than in the control group. There was a significant relationship between the amount of generated waste per day and the urinary BTEX in the exposed group. Smoking status and type of autoclave used were also identified as predictors of urinary BTEX concentrations. The healthcare waste treatment autoclaves can be considered as a significant BTEX exposure source for operators working with these treatment facilities. The appropriate personal protection equipment and control measures capable in reducing BTEX exposure should be provided to HCW workers to reduce their exposures to BTEX.