Journal of Environmental Medicine

Published by Wiley
Online ISSN: 1099-1301
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Article
The concept of indicators has long been applied for describing the trends and dynamics in both the environment and in human health. In recent years, significant effort has been devoted to estimating the negative impacts of the environment on human health, as well as to developing integrated metrics for the evaluation of the adverse health outcomes attributable to environmental exposures. The health-based environmental indicators (HBEIs) are measures designed to describe the status of human health with direct reference to the environmental conditions. Important potentials and limitations of the most promising approaches for developing HBEIs are examined from both a national and New Jersey prospective. The strengths and applicability of the health-based environmental measures are discussed with respect to the complex nature of the host–environment interactions and the scientific uncertainty about the environmental causation of diseases. It is concluded that the health-based environmental indicators are only supplemental tools for understanding of the relationship between environment and public health and do not provide solutions for the problems that might be encountered. Nevertheless, they can be efficiently used for improved environmental management and policy decisions. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Time-series analyses and cohort studies provide different methods of looking at the health effects of air pollution. With respect to mortality, the relative risk associated with a defined increase in the concentration of particulate matter is numerically much higher if derived from cohort studies than if based on time-series analyses. This discrepancy is often explained by arguing that chronic effects of air pollutants can only be assessed in cohort studies. However, with respect to changes in life expectancy, the results of the two study types can be shown to be consistent. In calculations of pollution-related health costs, mortality plays a dominant role. Applying the relative risk derived from cohort studies directly as a multiplier on daily or annual mortality leads to a considerable overestimation of effects. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
The aim of this study was to determine whether occupational noise exposure is a risk factor that may favour a chronic increase of diastolic and systolic blood pressure and a higher prevalence of arterial hypertension. A cross-sectional study was performed on 1372 workers employed in 11 cement plants in central and southern Italy. In 1985 the workers were subjected to a medical examination during which blood pressure was measured and information about personal features, occupational activity, diseases, family history of hypertension, use of antihypertensive drugs, smoking habit and alcohol intake were also gathered by questionnaire. For each worker noise exposure (dBA) was estimated using a series of indicators representing both the levels of exposure at the time of study and loud energy previously absorbed during the occupational life spent in the industry considered. 41.4% of the examined workers were hypertensive, according to the World Health Organization (WHO) definition (i.e. systolic blood pressure (SBP) levels ≥140 and/or diastolic blood pressure (DBP) levels ≥90 mmHg and/or reported antihypertensive treatment). Linear regression analysis showed a positive influence of age, BMI and use of antihypertensive drugs for both systolic and diastolic blood pressure. Noise exposure, independent of the indicators, was negatively associated with diastolic blood pressure only. The logistic regression analysis of the different variables contributing to high blood pressure showed a positive influence of age, BMI and family history of hypertension, while only some indicators of noise exposure were found to be negatively associated with arterial hypertension. Noise exposure, as assessed by all the different indicators used in the study, does not seem to influence systolic arterial pressure, but does have a negative influence on diastolic pressure. The prevalence of arterial hypertension, as defined by WHO criteria, appears negatively associated with noise exposure. The results obtained could be related both to a physiological variation of blood pressure following chronic noise exposure and to an unfavourable combination of elements further accentuated by the limitations of the cross-sectional study. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Movement up the household energy ladder from smoke-producing biomass fuels to relatively clean liquid, gaseous and electric fuels is commonly part of the economic transition and thus plays a role in the accompanying health transition. Here, we analyse the relationship between type of cooking fuel and the prevalence of partial and complete blindness in India using data on 173 520 persons age 30 and over from the 1992–93 National Family Health Survey. Logistic regression is used to estimate the net effects of biomass fuel (wood or dung) use on prevalence of partial and complete blindness after controlling for availability of a separate kitchen, house type, crowding, age, gender, urban-rural residence, education, religion, caste/tribe and geographical region. Persons living in biomass fuel-using households are found to have a considerably higher prevalence of blindness (partial or complete) than those living in households using cleaner fuels (OR 1.32; 95% CI 1.16–1.50). The effects are large and statistically significant for both men (OR 1.31; 95% CI 1.12–1.52) and women (OR 1.30; 95% CI 1.12–1.50) and for urban areas (OR 1.22; 95% CI 1.01–1.49) and rural areas (OR 1.49; 95% CI 1.23–1.80). The effects are strong and significant for partial blindness (OR 1.34; 95% CI 1.17–1.53), but not for complete blindness (OR 1.09; 95% CI 0.79–1.51). The level of risk and extent of biomass fuel use in India indicate that 18% of partial and complete blindness among persons age 30 and older may be attributed to biomass fuel use. The results strongly suggest that smoke exposure from the use of biomass fuels for cooking substantially increases the risk of partial blindness. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Rapid industrialization usually brings both economic development and environmental pollution, which often produces occupational diseases in the workplace and environmental diseases in the nearby community. From experience of documenting 17 occupational diseases, we found that they resulted from a lack of a comprehensive hazard communication system. The spillage of such unknown chemical hazards also produced environmental diseases for the neighbouring factories and community. Because the general treatment of occupational and environmental diseases must include the identification of hazard and taking preventive procedures to avoid further exposure, it is essential to recognize and control the hazard at the start of an industry. Thus, implementation of the life cycle assessment in ISO (International Organization of Standardization) 14000 series will guide an industry to identify and minimize the use of hazardous chemicals. A similar practice of risk assessment and reduction for every unit operation in the production process proposed by BS (British Standard) 8800 will also help to improve occupational health. Although implementation of such systems is a voluntary compliance, actual practice demands the same systems in related or satellite factories and has a strong market implication. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
The study assessed peripheral sensory function and its relation to self-reported wartime exposures to potentially neurotoxic substances in Gulf War veterans with chronic fatigue syndrome (CFS). Male Gulf veterans fulfilling the 1994 CDC diagnostic criteria for CFS were compared with matched controls. Quantitative sensory testing was performed to establish thresholds of perception for the sense of light touch and radiant heat. The Devens survey was used to collect data on self-reported exposures to by-products of combustion and organophosphate compounds. Gulf veterans with CFS had elevated tactile but normal thermal thresholds compared with their controls. Sick veterans had greater rates of self-reported exposures and/or noxious side effects for all assessed toxicants. Interestingly, both Gulf veteran groups, including those reporting no symptoms, had impaired perception of light touch when compared with age-matched samples of non-Gulf war veteran men. The results of this study are consistent with a hypothesis that Gulf veterans with CFS have a subtle neurological deficit that might reflect underlying peripheral neuropathy. The association between this deficit and self-report of multiple potentially neurotoxic exposures suggests that war zone pollutants may be possible contributing factors. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Dental laboratory technicians use a wide range of materials and techniques. They are thus subject to occupational exposures of many different kinds. The aim of this review is to present the circumstances of exposure, the related risks, and the epidemiological data available in the literature. Exposures to metals, waxes, resins and silica can cause irritation or allergic reactions, affecting either the skin or the respiratory tract. The risks of benign pneumoconiosis induced by hard metals are well documented. A prevalence of 15.4% after 20 or more years of exposure has been reported, whereas the prevalence in the general population is less than 1%. Malignant pneumoconiosis is caused by dust from crystalline silica, asbestos or beryllium. Silicosis is the most common occupational disease among dental technicians, while for berylliosis the risk is not well documented. Isolated cases of systemic autoimmune diseases have been observed. No study has yet demonstrated a link between these diseases and occupational exposure of dental technicians. Silica is known to provoke systemic scleroderma, but its role in prosthetists remains to be established. The first steps in prevention are the identification, classification and evaluation of exposure and the effects of that exposure on the health of exposed workers. Reduction or elimination of exposure by collective or individual protective measures are the best modalities of prevention.Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
A systematic search of the peer-reviewed biomedical literature was performed for original studies linking environmental hazards with health effects in wild animal populations. Some 104 original studies were identified in the BIOSIS and Medline databases since 1966 and classified in terms of study design. A marked increase in published studies has occurred over the past decade, examining a wide range of hazards and outcomes. Most analytic studies were ecologic or cross-sectional in nature. All cross-sectional studies sampled subjects on the basis of exposure, using a reference population for the selection of controls. Studies of wild animal populations may hold unique advantages for toxicant hazard identification, yet the current range of study designs appears restricted. Increased use of study approaches such as sampling based on outcome, intra-population comparisons, as well as cohort and case-control designs may improve hazard identification and priority setting for confirmatory toxicologic and human studies of effects seen in wildlife. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
This review addresses the evidence on the health effects of exposure to emissions of NO² from gas stoves, covering findings of 45 epidemiological studies. These studies had addressed diverse outcome measures, including the risks of acute respiratory illness, decreased pulmonary function, respiratory symptoms and asthma exacerbation. Although most studies have focused on schoolchildren, studies of adults and more recently, prospective studies of infants have also been carried out. The findings have not been consistent across all studies in showing adverse effects. We conclude that the evidence does not support a causal relationship between exposure NO² or use of a gas stove and increased risk for respiratory morbidity at the levels of NO2 typically associated with gas stoves. Some studies do show increased risk for respiratory health effects, however, and the evidence does not support the conclusion that NO2 emitted by gas stoves is risk-free. Further research would be indicated if populations receiving exposures in a range of interest can be identified. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
The health impact of environmental odor pollution varies with both the source and the exposed population. Some environmental odors herald toxicologically important exposures. On the other hand, some potent odorants, in particular organic amines and reduced sulfur gases, have odor thresholds several orders of magnitude lower than their thresholds for irritant (or other toxic) effects. Notwithstanding this apparent margin of safety, community members impacted by such emissions often report, not only odor-related annoyance, but also such somatic symptoms as headache, nausea and shortness of breath. This paper reviews potential pathophysiologic mechanisms whereby ordors, per se, may trigger symptoms among exposed individuals. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
This paper discusses some common statistical problems that are often encountered in the specification and interpretation of regression models used in environmental epidemiology; such models have been used to establish new or modified ambient standards intended to protect public health. These statistical problems include: collinearity (identifying the ‘correct’ pollutant), confounding (omission of other variables that may be correlated with both response and putative dose), the ‘ecological fallacy’ (aggregating individual doses and responses over space or time), measurement error (uncertainties in data, applicability and measurement per se) and linearity (identifying curvature or thresholds in dose-response function). These problems occur in both time-series and cross-sectional studies. Although none of these potential problem areas is new, they have rarely been considered together or comprehensively. This paper considers them as specific instances of the general problem of surrogate variables, for which an analytical framework is presented together with some examples of their practical consequences and some guidelines for interpreting environmental epidemiology studies. Findings of the analysis include: single-pollutant regression models are likely to overstate effects; although aggregation results in loss of information, it biases the estimates only when confounding is present; the traditional approaches to correcting for measurement errors implied by the difference between personal exposures and ambient air quality do not apply, but estimates may be based on consideration of the ‘error’ term as an additional source of exposure; it may not be possible to deduce the correct shape of a dose-response function in the presence of measurement error and correlated covariates. These findings are intended to be descriptive rather than definitive; the main purpose is to stimulate the detailed research required to develop practical remedies that would allow epidemiology to be used appropriately in setting environmental standards.Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
The purpose of the present paper is to examine the complex set of questions about the PM-mortality exposure–response (E-R) relationship by looking at the practical and demonstrable consequences of time series model building and by considering alternate modelling methods. Two questions are posed. The first is how to demonstrate goodness-of-fit for an exposure–response model and the effectiveness of a particular term in the model. The second is how to detect poor model fit associated with unusual relationships in the data, such as thresholds or other non-linear patterns. Suggested solutions are demonstrated using the Philadelphia data set used by Kelsall. These solutions are potentially applicable to other time series data analyses. Examination of the example data indicate several findings. First, the addition of the pollution terms to a model which contains temporal and weather variables has a negligible change on the predictive ability of the model. While the statistical criteria are slightly improved the practical improvement in mortality prediction is minimal. Second, for these data, there is demonstrable evidence that there is a threshold effect for total suspended particulate (TSP) on predicted mortality. The threshold is also seen in the gaseous pollutants. Lastly, the inclusion of terms representing the day of the week statistically improves model fit to a greater extent than the pollution terms. The results from this exercise suggest that several steps should be added to the traditional analysis and presentation of time-series data. These include visual and tabular presentation of results from each major model and analysis for a threshold at least for the criteria pollutant terms. The presentation elements allow the reader to independently assess model fit and the predictive capabilities of the model. Determination of a threshold allows objective determination of a no adverse effect level. Overall, application of these methods to time-series analyses provides more specificity for testing the predictive power of the model and for protecting health.Copyright
 
Article
Keywords:air pollution;particulate matter;health effects
 
Article
We investigated effects of summer air pollution exposure on outdoor workers in the Fraser Valley, Canada. Fifty farm workers performed spirometry daily before and after each 12–16 h workday from 1 July to 18 August 1994. The mean daily maximum (1 h) ambient ozone concentration was 39 ppb (range 10–89 ppb) and the mean daily maximum 8 h average ozone concentration was 31 ppb (range 5–66 ppb). PM10 concentrations were low (mean 24 h average 16 μg m−3, range 6–30 μg m−3) and highly correlated with ozone. Due to the high level of correlation between ozone, temperature and PM10 it was not possible to separately analyse the effect of each of these variables on lung function. In regression models including daily maximum ozone (an indicator of photochemical smog), an individual's mean lung function level and the Julian date, decreased afternoon FEV1 and FVC, and the daily change (afternoon–morning) corrected for the morning measurement, were associated with ozone. These associations were still apparent the following morning, suggesting a persistent air pollution effect. These results reproduce our earlier finding of persistent lung function decrements in farm workers in the Fraser Valley associated with relatively low concentrations of ambient air pollution. In the subset of 12 individuals who participated in both studies, there was no correlation in individual responses to ozone between the two study periods. During both summer studies we observed a marked seasonal decline in lung function, although lung function levels improved to initial values between the two studies, suggesting a reversible seasonal effect of ozone on lung function. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Pustular eruptions are often overlooked complications of mercury exposure. A 35-year-old woman with a history of contact dermatitis to Mercurochrome® in childhood presented with generalized erythema with a symmetrical reinforcement in the flexures 2 days after exposure to a broken mercury thermometer. She was febrile with no other clinical or biological signs. Blood and urinary mercury levels were within normal range. Histology of a pustular lesion of the thigh showed eczematiform and pustular changes. Patch tests evidenced sensitization to several mercury derivatives, but not to other allergens from the ICDRG standard battery, except for nickel. This case report further illustrates that inhalation of mercury vapour can result in systemic contact dermatitis, sometimes called baboon syndrome or acute generalized exanthematous pustulosis. Copyright © 1999 by John Wiley & Sons, Ltd.
 
Article
Methomyl, a potent anticholinesterase carbamate insecticide, is markedly toxic in man following suicidal ingestion. Thirteen cases of acute field-poisonings in rural workers after spraying methomyl reported to the Lyon Poison Centre demonstrate that poisoning can occur following occupational exposure. In this setting, the cutaneous route is critical. Although recovery was obtained uneventfully within 48 h in all cases, preventive measures are essential to avoid accidental poisonings. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
In order to investigate the relation between air pollution and child morbidity in São Paulo, a time-series study was carried out. Daily records of hospital admissions for children under 13 years old were obtained at the Health State Secretary, covering 112 hospitals in the period from October 1992 to October 1993. Daily levels of PM10, ozone, SO2, CO and NO2 were obtained from the environmental state agency (CETESB), while both CETESB and the Institute of Astronomy and Geophysics (IAG) of the University of São Paulo provided daily measures of temperature and relative humidity. Daily counts of child respiratory admissions (RESP) were considered as the dependent variable of pollutants in regression models, controlled for months of the year, days of the week, weather factors, and the daily number of non respiratory admissions (NORESP). PM10 and ozone were the pollutants that exhibited the most robust association with RESP. The mean levels of PM10observed during the period of study (70 μg m−3) were associated with an increase of 12% in RESP. The association between air pollution and RESP was significant within a time lag between 1 to 7 days and was dose-dependent. This result indicates that air pollution represents a significant pediatric health problem in São Paulo. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
The aim of this study was to assess the effects of PM10 daily concentrations in urban ambient air on bronchial reactivity and on two indices of respiratory function (FEV1 and PEF) of healthy control (n = 20) and of mild asthmatic adults (n = 20). The study took place over two periods of a month and a half, during summer 1996 and winter 1997. Each volunteer underwent two methacholine challenge tests, one during a weekday, the other early on the next Monday morning, after a weekend of lower exposure. They also monitored their FEV1 and PEF twice daily with an electronic peak flow meter. The respiratory function decreased among asthmatic subjects a few days after daily PM10 levels had increased (−1.25% for FEV1, 95% CI = [−0.58, −1.92]; and −0.87% for PEF [−0.1, −1.63], for a daily 10 μg m−3 variation of PM10 in summer; −0.25% [−0.51, 0.02] for FEV1 only in winter). No association between daily variations of respiratory function and PM10 was observed among control subjects. Bronchial reactivity was not significantly different between the two days of methacholine tests among asthmatic and control subjects, either in summer or in winter. This study confirms the greater sensitivity of asthmatic adults, compared with healthy subjects, to short-term variations of ambient air concentrations of particles. However, bronchial reactivity is not modified by small short-term variations of particulate pollution among mild asthmatics or healthy subjects. Copyright
 
Article
The effects of low-level lead on hearing were investigated in newborn chicks. Hearing was measured using an unconditioned response—a delay in subjects’ ongoing peeping when they detect a new sound. Lead acetate was introduced into the air space of the egg at either 12 or 14 days of incubation in doses that varied between 36 and 88 mg kg−1. Subjects were then tested at 0 and 4 days after hatching. A test of absolute thresholds showed no effect of the lead. A test of backward masking, however, showed a significant deficit in temporal processing. In backward masking a short tone pip is followed by a brief silent period and then by a longer and louder noise. Ability to hear the brief signal despite the subsequent masker is a test of rapid hearing. Lead-exposed chicks were deficient in this task, especially at 4 days of age and with a brief silent period between signal and masker. Human children with reading disabilities show a similar deficit. It is thus possible that variations of this test can elucidate basic developmental deficits that are also involved in human perceptual disorders and dyslexia. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Epidemiological studies of PM pollution and health have attempted to exploit observable sources of exposure variability to evaluate potential health consequences. These studies have become increasingly ingenious and rigorous in their ability to use natural exposure variability. Although a large majority of studies have evaluated only changes in short-term exposures, long-term, chronic exposure may be more important in terms of overall public health. This paper outlines the various dimensions of natural PM exposure variability that have been exploited in the epidemiology of PM literature, discuss how this exposure variablilty has or has not been utilized in recent epidemiology studies of PM exposure and human health, outline the inferences being drawn from the studies, and present the major limitations of these studies.Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Recent epidemiological data have indicated that the ambient concentration of the inhalable fraction of atmospheric particles (PM10) is associated with respiratory and cardiovascular morbidity and mortality. These effects may be related to particle induced inflammatory reactions in the airways, but little actual information is available about the deposition and retention of ambient particles in human airways, particularly in the very small airways. To examine this question, we isolated portions of large airways, large airway carinas, and small airways between the mainstem bronchus and the respiratory bronchioles (RB) from the autopsy lungs of seven never-smokers from the general population, and determined mineral content by analytical electron microscopy. Overall, RB at generations 11,12, and 13 showed consistently high particle concentrations, averaging 25 to 100 times the particle concentration in the mainstem bronchus, but roughly similar elevated concentrations were also seen in the carinas of airway generations 4 and 5. Mean aerodynamic particle sizes by site ranged between 0.30 and 0.60μoxm, with slightly larger particles in the RB. Crystalline silica was the predominant mineral species in all sites. Ultrafine particles were present in all sites but constituted less than 15% of the total number of particles in any location. Ultrafine particles were largely individual particles of metals and crystalline silica, and no aggregated carbonaceous or noncarbonaceous ultrafine particles were identified. More than 90% of the particles in every site had aerodynamic diameters less than 2.5μoxm. We conclude that the RB and the carinas of generations 4 and 5 in the normal human lung show very high and roughly equal concentrations of inhaled ambient particles, suggesting that these two anatomic compartments are potential sites of particle toxicity. All portions of the airways effectively retain PM2.5. Ultrafine particles are retained throughout the airways and also show concentration peaks in the large airway carinas and RB. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Allyl isothiocyanate (AITC) has been used as a food additive for paste-type wasabi (Japanese horseradish) and karashi (Japanese mustard) almost only in Japan, even though it has been reported to be carcinogenic and mutagenic. In the present paper, the capacities for DNA damage and the intracellular generation of reactive oxygen species (ROS) by AITC were examined by a ‘rec-lac assay’ and a ‘kat-sod assay’ by using E. coli mutants lacking DNA repair capacities and ROS scavenging enzymes, respectively. Both assays were developed by Nishioka et al. and consist of a streak test, a survival test and a β-galactosidase test. The results show strong DNA damaging capacity, and intracellular generation of ROS by AITC. These results indicate the possibility that intracellular ROS performs some role in DNA damage in bacterial cells treated with AITC. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
In order to clarify the neurobehavioural effects of aluminium and age-dependent differences among occupationally aluminium (Al) exposed workers, 103 Al-exposed and 64 non-exposed workers aged 25–60 years were selected to be involved in the study using the WHO recommended Neurobehavioral Core Test Battery (NCTB). The air concentration of aluminium at work sites and the level of urinary aluminium were measured. The results obtained from this study showed that the mean concentration of air aluminium was up to 5.31 mg m−3, and the level of urinary aluminium among Al-exposed workers appeared significantly higher than that of controls. The scores of digit span in the younger age group, digit symbol in the middle age, and pursuit aiming in the older age of Al-exposed workers were markedly lower than in the non-exposed workers at the corresponding age ranges. Obvious changes of mood were observed in elderly Al-exposed workers, but no significant differences between younger Al-exposed and non-exposed workers was found. The results indicate that occupational aluminium exposure might interfere with normal behavioural function. The effects seemed to be age-dependent. Younger workers showed memory disturbances and the elderly appeared to be affected for mood and motor activities. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Latex-specific IgE antibody immunoassays are heavily relied upon in the diagnosis of latex allergy in the United States. The goal of this study is to compare anti-latex IgE levels measured by two U.S. Food and Drug Administration (FDA)-cleared kits (CAP® System and AlaSTAT® Microplate) in sera obtained from employees in non-healthcare industries. Sera were obtained from 381 workers employed in several, non-healthcare industries over the past 10 years, and stored frozen. All 381 coded sera were analysed for latex-specific IgE using the Diagnostic Products Corporation microplate AlaSTAT® and the Pharmacia-UpJohn CAP® System. Concordance between methods and intra- and inter-assay reproducibility were evaluated. Twenty-six sera gave positive results using the AlaSTAT® assay (26/381, 6.82%), while 24 yielded CAP® positive results (6.30%). There were no significant differences (p = NS) between the assays' measurements of latex-specific IgE antibody levels for all 381 sera, yielding 0.28 ± 0.19 kU L−1 and 0.34 ± 0.59 kUA L−1, respectively. AlaSTAT® and CAP® assays agreed on the positive status of 9 (9/381, 2.4%) sera, and the negative status of 340 sera (340/381, 89.2%). The assays yielded discordant results on some individual sera. CAP® discordant results occurred in 17/26 sera (65.4%) of AlaSTAT® positive sera, while AlaSTAT® discordant results were found in 15/24 (57.7%) of the CAP® positive sera. The CAP® System, for instance, detected 0.39–2.3 kUA l−1 (1.03 ± 0.59, [mean ± SD]) of latex-specific IgE in the serum from 15 individuals that were all AlaSTAT® negative. In contrast, the AlaSTAT® detected 0.36–1.6 kU l−1 (0.62 ± 0.31, [mean ± SD]) of IgE anti-latex in the serum from 17 subjects that were all CAP® negative. These data indicate that the a priori seroprevalence of latex-specific sera IgE is about 6%–7% in non-healthcare workers and that the CAP® and AlaSTAT® assays agree on the positive or negative status of the majority of sera (91.6%). However, caution should be exercised when applying FDA-cleared in vitro assays for latex-specific sera IgE in populations known to have potentially low concentrations of latex-specific IgE antibodies, as there appears to be a finite possibility for these assays to misclassify sera as being positive or negative for latex-specific IgE antibodies. Published in 1999 by John Wiley & Sons, Ltd.
 
Article
The present study afforded the opportunity to study the effect of lead on haematological parameters of 538 Saudi female pupils aged 6 to 12 years living in Riyadh City. Blood lead levels ranged from 2.300 to 27.362 μg dl−1. Based on Mentzer's formula, 42 pupils were excluded due to thalassaemia. Multiple regression analyses were conducted to study the effect of lead on haematological parameters such as HGB, HCT, MCV and MCH after adjusting for serum Fe and a number of other variables. The results showed that MCV was significantly associated with blood lead levels. Microcytic anaemia in 108 pupils with blood lead levels ≥10 μ dl−1 was also investigated. Of the 108 pupils, 24 had microcytic anaemia as defined by MCV <80 fl and HCT <0.36. The results of this study indicate that haematological abnormalities can be seen at blood lead levels less than the current CDC acceptable limit for lead. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Corrosive compounds and burns destroy the skin barrier function. Little is known about the dynamics of repair of this function during the healing process. The passive sustainable hydration test was performed as a non-invasive approach to measure water loss through the skin using electrometric evaluations under continuous occlusion by the sensor probe. Evaluations were made in 10 patients suffering from recent second- and third-degree contact burns. Skin sites corresponding to burned and unburned areas, and to healing sites following grafts or not were compared. The data show that the skin barrier function improves progressively and often irregularly after contact burn, and may remain altered for more than 2 months after epithelialisation. Therefore, maturation of the stratum corneum appears to be a slow process. The consequences of this during the healing phase following contact burns are twofold: the resistance of the water barrier remains impaired and the risk of transcutaneous penetration of various xenobiotics including toxic products is increased. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Nephropathy has been reported in children with overt lead intoxication. Only recently low-level lead exposure has been associated with renal effects, especially with regard to tubular function. The objective of the present study was to investigate the relation between lead exposure and renal function in children in the Katowice region, an industrial area in Poland. This cross-sectional study involved 157 children, aged 4–14 years. Blood lead concentration was used as an index of lead exposure. Glomerular filtration rate was estimated using the height adjusted serum creatinine calculation (crea-GFR) and measurement of cystatin C in serum. The renal tubular function was evaluated by measuring the urinary concentration of protein HC. The median blood lead concentration was 0.35 μmol/L (72 μg/L) with a range of 0.09–1.36 μmol/L. Crea-GFR (n = 143) decreased significantly (p = 0.002) with increasing concentrations of lead in the blood. Serum cystatin C (n = 84) increased with blood lead (p = 0.004). There was an association (p = 0.002) between blood lead and urinary concentration of protein HC (n = 49). In summary, the present findings indicate that the association between blood lead and the markers of renal function on both a glomerular and a tubular level may be caused by environmental lead exposure. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
The concept of biomonitoring comprises the one-off or repeated systemic measurement of concentrations of hazardous substances and their metabolites in biological materials. If the materials are from a human biological source, the concept of human-biomonitoring is usual. In contrast to determining exposure to the human environment (e.g. air quality, food contamination), biomonitoring has the advantage of reflecting the actual, individual exposure of a human organism (e.g. in the form of biomarker). This enables an individual health risk concerning systemic effects to be better described than by solely measuring exposure. Benzene and toluene are volatile organic compounds (VOC). Their ubiquity means they are found in all indoor air. Due to their toxic potential (benzene—carcinogenic, toluene—neurotoxic) and the quantities in which toluene is found, sometimes actual exposure to toluene must be measured. One way is to test urine for specific metabolites to monitor the internal burden and dosage. S-phenyl- and S-benzylmercapturic acid (SPMA and SBMA) were selected and their concentrations determined in urine samples from Leipzig children. The results were correlated with the benzene and toluene concentrations of indoor air. Whereas a correlation was found between benzene and SPMA, no connection was established between toluene and SBMA. One of the next targets is to find a correlation between the measuring results and information concerning ailments given in response to questionnaires on the children’s health.<<< WCODE [203] >>>Copyright
 
Article
Building dampness in the floor construction is known to cause chemical degradation of polyvinyl chloride floor coatings, but few epidemiological studies on this topic have been published. Another topic of interest is the different symptoms in different buildings constructed with different building materials and with different architectural designs. The term Sick Building Syndrome (SBS) is sometimes used to describe irritation to the eyes, skin, and upper airways, headache and fatigue in relation to the indoor environment. The aim of our investigation was to study symptoms in relation to building dampness and type of building in geriatric hospitals. Four hospitals for geriatrics were selected to represent buildings with different ages and design, irrespectively of symptom prevalence. All staff (n = 95) were requested to answer a medical questionnaire, 88 (93%) participated. Measurements of room temperature, relative air humidity, air flow rate, illumination, moulds, bacteria, formaldehyde and other volatile compounds, respirable dust, carbon monoxide, carbon dioxide, nitrogen dioxide and ozone were carried out in all buildings. Statistical analyses were performed by bivariate analysis, and multiple logistic regression, adjusting for possible influence of building age, age of the subjects, gender, tobacco smoke, atopy and the perceived psychosocial work environment. Dampness in the upper concrete floor surface (75–84%), ammonia under the floor [3 parts per million (3 ppm)], and 2-ethyl-1-hexanol in the air were detected in two buildings built in 1985 and 1993. Increased occurrence of ocular, nasal and throat symptoms, and dry facial skin were found in the damp buildings. Those in the specially designed building had fewer of these symptoms. In conclusion, the study provides new evidence on possible health effects of dampness-related alkaline degradation of di(2-ethyl-hexyl) phthalate (DEPH) in PVC-building material. Emissions related to degradation of DEPH due to dampness in the floor construction, detected by an increase of 2-ethyl-1-hexanol in the air, seems to increase the occurrence of ocular, nasal, throat and facial skin symptoms. The indoor environment of one specially designed building with a high ceiling and avoidance of fluorescent lighting and interior plastic materials, seemed to have a positive influence on well-being. Our results support the view that building dampness should be avoided, and shows that it is possible to construct a new building where the inhabitants have few symptoms. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Although much research has been done on the effects of lead exposure on cognitive development, the magnitude, persistence and public health implications of such effects remain controversial. A literature search, in conjunction with our own work, was conducted to review these issues. Currently available evidence suggests that early exposure to environmental lead may cause a discernible effect on cognitive development, and this effect seems to persist into later childhood. No threshold is evident down to a blood lead concentration of 5 μg dl−1, although there is a paucity of epidemiological data at these lower levels. An economic loss could be serious for children exposed to an excess of lead in their environment. The environmental lead problem is preventable, or, where it is already established, is remediable. It should therefore be addressed, especially in developing countries where rapid industrialisation and increased use of motor vehicles are occurring. There is clear evidence that excessive lead exposure is still a significant public health issue in most countries, particularly developing countries. The formulation of a public health strategy should seek a balance between consideration of the nature and extent of the risk to human population health, knowledge of any dose-effect threshold, estimation of socio-environmental benefits, and commitment to making the best use of existing resources. The development of such a strategy should take into account the views and priorities of all interested parties, and—most certainly—those of communities directly at risk from lead exposure. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
We conducted an epidemiological study on exposure to a toxic waste incineration plant that focused on heavy metals and organochlorines and their potential health effect. In this paper we concentrate on whether chromium urine concentration (CrU) in 24 h urine samples was associated with changes in the number of lymphocytes in blood samples. The potential confounding effects of age, gender, environmental tobacco smoke (ETS), blood lead, blood mercury and polychlorinated biphenyls (PCBs) in blood, as well as the concentration of mercury, cadmium and arsenic in 24 h urine samples were controlled for. The numbers of total lymphocytes, T lymphocytes, B lymphocytes, natural killer cells, CD4 helper and CD8 cytotoxic T cells were determined with fluorescence-activated cell sorter (FACS). CrU was categorized into four groups: below detection limit (0.08 μg l⁻¹); detection limit to 0.13 μg l⁻¹; 0.14–0.22 μg l⁻¹; 0.24 μg l⁻¹ and above. The groups were analysed as predictors of different lymphocyte subpopulations in separate multiple linear regression models adjusted for potential confounders (age, gender, passive smoking, PCB, lead and mercury in whole blood, arsenic, cadmium, mercury in 24 h urine).
 
Article
Comparisons of red blood cell cholinesterase values (AChE, EC 3.1.1.7) from different laboratories can be difficult. This study evaluated different methods of interlaboratory comparison. Eleven subjects gave triplicate samples for analysis by three commercial laboratories. Comparisons were made relative to the mid-point of each laboratory’s reference range (mid-range), and by transformation to Ellman assay activity in U/mL using published/derived conversion factors. To observe each laboratory’s reliability, four subjects submitted two additional duplicate samples to each laboratory. The mean intraspecimen variabilities were 3%, range 1%–8%; 4%, range 0–9%; and 13%, range 2%–24% for laboratories 1–3, respectively. The mean mid-range percent for laboratory 3 was substantially lower than the means for laboratories 1 and 2. Therefore, laboratory 3 values were adjusted based on the means for laboratories 1 and 2 and the mid-point suggested by laboratory 3’s assay kit. The mean AChE relative to these mid-points were 109%, 107%, and 107% for laboratories 1–3, respectively. Ellman activities were 19.0, 19.9 and 20.8 U/mL for laboratories 1–3, respectively. Intrasubject differences for both comparison methods showed agreement that approximated intraspecimen variabilities for each laboratory. Comparisons involving laboratory 3 showed the poorest agreement consistent with laboratory 3’s greater intraspecimen variation. AChE from different laboratories can be compared by both methods evaluated in this study. All comparisons are limited by the precision and reliability of the laboratories involved. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Occupational dermatoses caused by plastic composites based on polyester resins, epoxy resins and vinyl ester resins (epoxy diacrylates) were reviewed. Common causes of irritant contact dermatitis are glass-fibre reinforcement and dust from product-finishing processes. Irritant contact dermatoses are also caused by resins, styrene, acetone, benzoyl peroxide, etc. Diglycidyl ether of bisphenol A (DGEBA) epoxy resin, amine hardeners, dicarboxylic (phthalic) anhydride hardeners and reactive epoxy diluents are common causes of allergic contact dermatitis. Non-DGEBA epoxy resins, tetraglycidyl-4,4′-methylenedianiline (TGMDA) and triglycidyl-p-aminophenol (TGPAP) used in carbon fibre reinforced composites may cause sensitization from prepregs. Diethylene glycol maleate is a new allergen in polyester resin cement. Natural rubber latex in protective gloves, and low molecular weight chemicals such as the epoxy resin hardener methyl tetrahydrophthalic anhydride (MTHPA) are causes of immunologic contact urticaria. Patch-testing with materials used by the patients at work, together with chemical analysis, is often needed to find the causative allergen, in addition to patch testing with standard test trays. Avoidance of skin contact with resin compounds, use of protective gloves, local ventilation, proper working methods, and informing the workers, are needed to lower the prevalence of occupational dermatoses in the manufacture of plastic composites. Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
The aim of the study was to determine the prevalence of sensitization and contact dermatitis in a population of Italian farmers and the importance of pesticides as skin sensitizers. Sixty-four female worker (mean age 35) employed in the harvesting of cherries, peaches, olives and grapes were studied. Skin diseases were assessed with a questionnaire and physical examination. The farm workers were patch tested with the GIRDCA standard series containing 30 allergens and six pesticides currently used on the farm. 18 workers (28%) were sensitized to one or more allergens. 36 subjects (52%) were found to be atopic and three (4.7%) had dermatitis of the hands with positive reactions to the GIRDCA standard series. Differences in contact sensitization betweeen atopic and non atopic patients were not statistically significant (χ2 test). One worker had contact urticaria to peaches and 36 farmers (52%) referred to itching and skin rashes in summer, during the harvesting of peaches. Only 18 workers reported that they almost always wore protective clothing. Despite the high frequency of positive patch tests, contact sensitization to pesticides was unusual in our group. No cases of allergic contact dermatitis to pesticides were found and only one patient who was symptomless (1.5%) had an allergic reaction to pesticides (azinphos-methyl). Copyright © 1999 John Wiley & Sons, Ltd.
 
Article
Experience of using two stable-isotope-based effect biomarkers is briefly reviewed. New in vivo methods were developed, adopted, validated and used in an effort to meet the desired standards for early effect monitoring methods in environmental medicine and epidemiology, i.e. they should be noninvasive, non-distressing, simple and readily accepted by voluntary test persons, as well as very sensitive and reliable. Certain tests based on stable isotopes may fulfill these requirements. The specific advantages of using stable isotopes are the minimization of the diagnostic drug dose, and the unequivocal recovery of the labelled diagnostic compound and its metabolites from among their unlabelled endogenous forms in the body. Particular interest is focused on: (1) The measurement of liver detoxification capacity using the [13C]methacetin breath test and the [15N]methacetin urine test; (2) The estimation of antral Helicobacter pylori colonization using the [13C]urea breath test and the [15N]urea urine test. The methods were used in a number of environmental–epidemiological studies with defined groups of children, including: Preschool children (n = 130) living near disused industrial plants and waste dumps (methacetin tests); School beginners (n = 3347) suspected of H. pylori colonization (urea tests). Although both tests provided accurate results in the studies and individual environmental–medical diagnosis, it was found that 13C breath test results were less reliable than the corresponding 15N urine test results if the test person was physically active during the test period. Therefore, 15N urine tests should be preferred whenever monitoring investigations based on stable isotopes are undertaken among young children. Copyright
 
Article
This study evaluated the 1970–1993 mortality experience of 2550 of white and black men employed at a Texas plastics plant that made polyethylene, polypropylene, K-resin (a copolymer of 1,3-butadiene and styrene) and other materials. Of particular interest was the relationship between work in plastics manufacturing and colorectal cancer, as certain epidemiological investigations have reported an increase in this form of cancer among workers with potential exposure to polypropylene. Overall, subjects had fewer than expected deaths from all causes combined (269 observed/364.3 expected), from all cancer (79/89.3) and from colorectal cancer (5/9.5). Polypropylene workers had one observed compared with 0.4 expected death from colorectal cancer. A two-fold increase in deaths from accidents among hourly men was attributable to an explosion in the polyethylene area. Certain subgroups of workers had a slight increase in lung cancer deaths. These results were not statistically significant, did not display marked patterns with duration of employment or time since hire and were not clearly attributable to occupational exposure. Some subgroups of employees had more than expected deaths from oesophagus cancer, pancreas cancer and prostate cancer. These findings were based on small numbers, and there is no persuasive evidence that the excesses were due to chemicals at the plant. However, longer follow-up will be necessary to obtain more precise results for subjects with long-term employment and with long potential induction time. Copyright
 
Article
J Occup Environ Med. 1996 Jun;38(6):571-6. Serum concentrations of methanol after inhalation at 200 ppm. Osterloh JD, D'Alessandro A, Chuwers P, Mogadeddi H, Kelly TJ. SourceDepartment of Laboratory Medicine, University of California, USA. Abstract Methanol has been proposed as an alternative automotive fuel to reduce pollution in the urban environment. Utilization of methanol will increase exposure to low levels of methanol vapors for the general public and in occupational settings. Information on absorption by inhalation and serum concentrations after low-level exposure would be important in evaluating the health impact of generalized methanol exposure. During a randomized double-blind study of the potential neurobehavioral effects of inhaled methanol at 200 ppm for 4 hours, 15 timed specimens from 22 subjects were obtained for methanol analysis by head-space gas chromatography. Methanol was rapidly absorbed by inhalation (absorption rate constant = 0.87 +/- 0.60 hours-1). Serum methanol concentrations were increased by more than fourfold at the end of the exposure period (6.5 +/- 2.7 vs 0.9 +/- 0.6 mg/L), as were urinary methanol excretion rates, although formate concentrations were not increased over background concentrations. The overall (n = 22) elimination half-life was 3.2 +/- 2.3 hours. Elimination from plasma fit a monoexponential model for only half of the subjects during the 4-hour postexposure follow-up period (mean half-life = 2.2 hours). Subjects with poor fits either showed greater variability or apparent slow (nonsignificant) declines in serum methanol concentrations, possibly because of the offsetting contributions of dietary intake or endogenous production, but more likely as a result of the limited number of sampling times and limited follow-up period. PMID:8794955[PubMed - indexed for MEDLINE] The following toggler user interface control may not be accessible. Tab to the next button to revert the control to an accessible version. Destroy user interface controlPublication Types, MeSH Terms, SubstancesPublication TypesClinical TrialRandomized Controlled TrialMeSH TermsAdultAir Pollutants/bloodAir Pollutants/pharmacokinetics*Air Pollutants/urineArea Under CurveDouble-Blind MethodEnvironmental Exposure*FemaleFormates/bloodFormates/pharmacokineticsFormates/urineHalf-LifeHumansLeast-Squares AnalysisMaleMethanol/bloodMethanol/pharmacokinetics*Methanol/urineMiddle AgedSubstancesAir PollutantsFormatesformic acidMethanol The following toggler user interface control may not be accessible. Tab to the next button to revert the control to an accessible version. Destroy user interface controlLinkOut - more resourcesFull Text SourcesLippincott Williams & WilkinsOvid Technologies, Inc.Molecular Biology DatabasesMETHANOL - HSDBFORMIC ACID - HSDBSODIUM METHOXIDE - HSDB
 
Article
There is increasing recognition in comparative risk assessment of the intrinsic subjectivity of fundamental framing assumptions and the consequent necessity for active participation in analysis by all interested and affected parties. Despite this, there remains considerable inertia in the implementation of these insights in formal policy making and regulatory procedures on risk. Here, the issue seems as often to be seen as a need for better ‘communication’ and ‘management’ as for better analysis, with attention devoted as much to the classification of divergent public perspectives as to techniques for direct stakeholder participation. Pointing to the fundamental methodological problems posed in risk assessment by the conditions of ignorance and Arrow’s impossibility, the present paper contends that public participation is as much a matter of analytical rigour as it is of political legitimacy. It is argued that straightforward techniques such as multi-criteria and sensitivity analysis, along with a formal approach to diversification across portfolios of ‘less risky’ options, may go some way toward addressing these apparently intractable problems.
 
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