[Show abstract][Hide abstract] ABSTRACT: To quantify personal time-weighted average respirable dust and quartz exposure on a sandy, a sandy loam, and a clay soil farm in the Free State and North West provinces of South Africa and to ascertain whether soil type is a determinant of exposure to respirable quartz.
Three farms, located in the Free State and North West provinces of South Africa, had their soil type confirmed as sandy, sandy loam, and clay; and, from these, a total of 298 respirable dust and respirable quartz measurements were collected between July 2006-November 2009 during periods of major farming operations. Values below the limit of detection (LOD) (22 μg · m(-3)) were estimated using multiple 'imputation'. Non-parametric tests were used to compare quartz exposure from the three different soil types.
Exposure to respirable quartz occurred on all three farms with the highest individual concentration measured on the sandy soil farm (626 μg · m(-3)). Fifty-seven, 59, and 81% of the measurements on the sandy soil, sandy loam soil, and clay soil farm, respectively, exceeded the American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit value (TLV) of 25 μg · m(-3). Twelve and 13% of respirable quartz concentrations exceeded 100 μg · m(-3) on the sandy soil and sandy loam soil farms, respectively, but none exceeded this level on the clay soil farm. The proportions of measurements >100 μg · m(-3) were not significantly different between the sandy and sandy loam soil farms ('prop.test'; P = 0.65), but both were significantly larger than for the clay soil farm ('prop.test'; P = 0.0001). The percentage of quartz in respirable dust was determined for all three farms using measurements > the limit of detection. Percentages ranged from 0.5 to 94.4% with no significant difference in the median quartz percentages across the three farms (Kruskal-Wallis test; P = 0.91).
This study demonstrates that there is significant potential for over-exposure to respirable quartz in farming and even clay soil farming may pose a risk. Soil type may determine whether exposure is >100 μg · m(3), but the job type and the manner in which the task is performed (e.g. mechanical or manual) may be important determinants of exposure. Identifying quartz exposure determinants (e.g. type of job) and modifiers will be of value to focus implementation of controls of particular importance in developing countries.
Full-text · Article · Jun 2011 · Annals of Occupational Hygiene
[Show abstract][Hide abstract] ABSTRACT: To review the published literature on respirable quartz exposure and associated disease in agricultural related settings systematically and to describe personal respirable dust and quartz measurements collected on a sandy soil farm in the Free State province of South Africa.
The published studies on exposure to respirable silica and quartz in agriculture and related settings (to June 2009) were searched systematically through 'PubMed' and critiqued. A farm in the sandy soil region of the Free State province of South Africa producing typical crops for the region was identified and 138 respirable dust and respirable quartz measurements were collected from July 2006-August 2008 during major farming operations.
In total, 17 studies were identified: 11 investigated respirable quartz exposure on farms and 6 quartz-related diseases in agricultural settings. They provided convincing evidence of a respirable quartz risk on sandy soil farms but scant evidence of associated disease. Respirable quartz measurements from the South African farm ranged from not detectable to 626 microg m(-3) and confirmed the quartz risk as some concentrations exceeded generally accepted occupational exposure limits in all jobs evaluated, even though the majority of respirable dust concentrations were well below a commonly used occupational exposure limit of 2 mg m(-3). Twelve of 138 respirable dust measurements (9%) and 18 of 138 respirable quartz measurements (13%) exceeded commonly used occupational exposure limits of 2 mg m(-3) and 100 microg m(-3), respectively. The highest time weighted average respirable quartz concentration of 626 microg m(-3) was during wheat planting activities. Fifty-seven percent of the respirable quartz measurements exceeded the American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV) of 25 microg m(-3). Quartz percentages of the respirable dust ranged from 0.3 to 94.4% with an overall median of 13.4%.
Despite its ubiquity, little is known about quartz exposure in the agricultural industry; but this study demonstrates significant potential for overexposure in some settings. Further research is required to quantify quartz exposure and identify settings and tasks that place farmers and farmworkers at risk of quartz-associated diseases so that controls can be implemented.
Full-text · Article · Feb 2010 · Annals of Occupational Hygiene
[Show abstract][Hide abstract] ABSTRACT: Offering a balance of theory and practice, with guides for further reading, this is a clinical guide for the practitioner in the widest sense: physicians, nurses, occupational hygienists, safety officers, environmental, health officers and personnel managers. With coverage of both medicine and hygiene, and including sections on OH law, it is a primer for appropriate courses and provides all that the interested medical student would need to know.
[Show abstract][Hide abstract] ABSTRACT: Occupational exposure to chemical agents can vary enormously within- and between-workers, even when carrying out the same jobs. When repeated measurements are available, the variance components can be estimated using random- or mixed-effects models. Pooling the variance components across the fixed effects, in mixed-effects models, reduces the complexity of the models; especially, when there are a large number of fixed effects. The analyses presented in this paper tested the assumptions of homogeneity in the variance components between factories and surveys for inhalable dust exposure in the European carbon black manufacturing industry. In total, 5296 measurements from 1771 workers were available collected during two surveys carried out between 1991 and 1995. Workers were grouped into eight job categories, and for each of these separate mixed-effects models were developed, including factory, survey and in some cases the interaction term as the fixed effects. The likelihood ratio test was used to test the assumptions of homogeneity of the variance components. Statistically significant heterogeneity of the variance components was observed for two of the eight job categories, 'Fitter/Welder' and 'Warehouseman'. The heterogeneity was due mainly to differences in variance between the factories. When estimating the probability of overexposure for all the factories combined, there was little difference between the models with and without heterogeneous variance components for 'Fitters/Welders'. For the 'Warehousemen' the probability of overexposure in the last survey changed marginally from 4% in the pooled model to 6% in the heterogeneous model. Larger differences between the models were observed when estimating the probability of overexposure for individual factories, which was due to over- or under-estimation of the variance components in the pooled models. In conclusion, for most job categories pooling of the variance components appears to be justified in this database. In addition, no large differences were found when determining the industry-wide probability of 'overexposure' when comparing the pooled with the heterogeneous models. However, when evaluating the factory-specific probability of 'overexposure' or when using the models to provide exposure estimates for epidemiological studies heterogeneity in the variance components should be investigated.
No preview · Article · Feb 2006 · Annals of Occupational Hygiene
[Show abstract][Hide abstract] ABSTRACT: High levels of exposure to carbon black have been linked with an increased prevalence of chest radiograph abnormalities. However, it is unclear to what extent current levels of exposure in the carbon black manufacturing industry are associated with new cases of and progression in small opacities. Longitudinal analyses were carried out on data from workers in the European carbon black manufacturing industry who provided three full-size chest radiographs sequentially between 1987-1995. All chest radiographs were independently read by three experienced readers according to the International Labour Organisation (ILO) classification. After exclusion of participants with previous lung diseases or injuries, females, unreadable chest radiographs and from factories with a low participation rate, data from 675 workers were available for the longitudinal analyses. An association was observed between cumulative carbon black exposure and new cases of chest radiograph abnormalities (ILO category > or = 1/0) and progression in small opacities. These associations were mainly related to changes in chest radiographs from workers at one factory. A large percentage of workers with chest radiograph abnormalities reversed to normal chest films; however, after adjusting for other factors, this was not associated with levels of exposure to carbon black dust. In conclusion, the results show that exposure to carbon black is associated with increased risk of chest radiographic abnormalities, which may be reversible after reduction or cessation of exposure.
Preview · Article · Sep 2002 · European Respiratory Journal
[Show abstract][Hide abstract] ABSTRACT: A study to assess the association between the prevalence of hypospadias and maternal occupational exposure to potential endocrine-disrupting chemicals was carried out using data from the congenital anomaly register of the Office for National Statistics. The occupation of the mother is recorded in this register and to facilitate the assessment of maternal occupational exposure, a specific job-exposure matrix for potential endocrine-disrupting chemicals was developed. Seven categories of contaminants were evaluated (pesticides, polychlorinated organic compounds, phthalates, alkylphenolic compounds, bi-phenolic compounds, heavy metals and other substances). Maternal occupations were all coded using the 1980 version of Categories of Occupations. Three occupational hygienists assessed the likelihood of exposure (unlikely, possible, probable) to these seven substance groups for all 348 possible job titles independently. Almost 30% of the job titles were classified as exposed to at least one substance category (possible or probable), with approximately 16% of the job titles being probably exposed to at least one substance category. Some examples of occupations with probable exposure to potential endocrine-disrupting chemicals include: farm workers, electricians, workers in the plastics industry, painters, printers, hairdressers, dental practitioners, laboratory workers, textile workers and cleaners. It is recognized that there are a lot of limitations to the use of job-exposure matrices in general and with the matrix presented in this paper in particular. However, the matrix forms the basis on which further developments on occupational exposure assessment of potential endocrine-disrupting chemicals could be founded. In addition, the job-exposure matrix has identified areas where more exposure information is required. For example, exposure to potential endocrine-disrupting chemicals can occur in occupations such as hairdressing and workers in beauty salons, where the working population is more likely to be female and for which little data exist on levels of exposure.
Full-text · Article · Aug 2002 · Annals of Occupational Hygiene
[Show abstract][Hide abstract] ABSTRACT: To assess respiratory morbidity over several cross sectional phases in the European carbon black manufacturing industry.
Participants completed an amended (and translated) MRC respiratory morbidity questionnaire with additional questions on previous exposures, job history, etc, and spirometry traces in each phase. Concurrent with the health outcome measures, personal exposure to inhalable dust was measured.
Percentage participation rose from 90% in phase 2 (19 factories) to 95% in phase 3 (16 factories). Exposure dropped slightly between the 2 and 3 phases; as did the prevalence of reporting symptoms. Percentage of predicted lung function volumes exceeded 100% for forced expired volume in 1 second (FEV(1)) and forced vital capacity (FVC), whereas forced mid-expiratory flow (FEF(25%-75%)) and FEV(1)/FVC ratio were below 100% in both phases. The multiple linear and logistic regressions showed that carbon black had a significant effect on lung function and on most respiratory symptoms, respectively.
Both current and cumulative exposure to carbon black have a deleterious effect on respiratory morbidity. Due to the drop in exposure between phases 2 and 3, recent exposures seem to have less of an impact on the respiratory morbidity in the workers in phase 3 than those in phase 2.
Full-text · Article · Sep 2001 · Occupational and Environmental Medicine
[Show abstract][Hide abstract] ABSTRACT: A large study to investigate the respiratory health effects of occupational exposure to carbon black in the European carbon black manufacturing industry commenced in 1987. During the study, a large amount of personal occupational exposure data was collected. This article describes the empirical models used to study the determinants of inhalable dust exposure, using data from 16 factories collected in the third and last cross-sectional phase of this study. Information on activities during the measurements was collected using short job category-specific questionnaires. In addition, questionnaires were completed by factory representatives on the implementation of control measures and changes in production process since the first cross-sectional phase. Mixed effects analyses of variance models were used to identify determinants of exposure, while taking into account the within- and between-worker (random) variance components. The results of these models show that, for any job category, factory is a strong predictor of exposure in this industry. These differences could not be explained entirely by factors such as age of the factory or the control measures implemented since the first phase of the study. Surprisingly, implementation of local exhaust ventilation systems had an effect that was counterintuitive; for example, in warehouses where local exhaust ventilation systems had been implemented, higher dust exposure levels were found compared to those where such control measures had not been installed since the first cross-sectional survey. Season appeared to have some effect on exposure for some job titles, with generally relatively low exposures being found in the summer. Finally, a number of activities were identified that caused higher levels of dust exposure, most notably "changing of filters" and "clean-up of carbon black spills."
No preview · Article · Mar 2001 · Applied Occupational and Enviromental Hygiene
[Show abstract][Hide abstract] ABSTRACT: Carbon black, a powdered form of elemental carbon is used in the manufacture of rubber products, paints, plastics, and inks. In 1974, the Health and Safety Executive initiated a cohort mortality study on possible carcinogenic effects on carbon black workers.
The mortality of a cohort of 1,147 male manual workers from five U.K. factories manufacturing carbon black was investigated for the period 1951-1996. All subjects were employed in the carbon black industry for 12 months or more, and all were first employed before 1975. Limited work histories were used to calculate estimates of individual cumulative exposure to carbon black, using a job-exposure matrix derived by the study team.
Based on serial rates for the general population of England and Wales, significantly elevated mortality was observed in the main study cohort for all causes (Obs 372, Exp 328.7, SMR 113, P < 0.05) and for lung cancer (Obs 61, Exp 35.3, SMR 173, P < 0.001). There were highly elevated lung cancer SMRs at two of the factories, and unexceptional SMRs at the remaining three factories. There was no indication of lung cancer SMRs increasing with period from first employment. Poisson regression analyses failed to find significant trends of lung cancer risks increasing either with cumulative exposure to carbon black (4 levels) or with duration of employment at the participating factories (4 levels).
Confident interpretation of the elevated SMRs found for lung cancer in two of the factory subcohorts is not possible but the study has been unable to link cumulative exposure to carbon black with elevated risks of lung cancer.
No preview · Article · Feb 2001 · American Journal of Industrial Medicine
[Show abstract][Hide abstract] ABSTRACT: In an attempt to investigate the relationship between exposure to carbon black and respiratory morbidity, a study of the complete carbon black manufacturing industry in Western Europe was commissioned. As part of this study, a large number of personal inhalable (n=8015) dust exposure measurements was taken during three phases of data collection between 1987 and 1995. Repeated measurements on the same worker were taken in the last two phases, which enabled the estimation of the within- and between-worker components of variance. Simultaneously, the fixed effects of phase and factory were estimated using mixed-effects analysis of variance. The results show that the personal inhalable dust exposure has reduced significantly since the first phase of the study. In addition, the interaction term between phase and factory was significant in most job categories, confirming that the reduction of exposure was not equal across all factories. When all factories were considered together, the probability that the mean exposure of a randomly selected worker (overexposure) or the probability that the exposure on a randomly selected day for a randomly selected worker (exceedance) was higher than 3.5mg m(-3), was 10% or less for all job categories in the last phase. However, when the factories were considered separately, it appeared that the probability of overexposure or exceedance was in excess of 10% for the job categories 'Fitter/Welder', 'Warehouseman' and 'Site crew' for a number of factories. Therefore, even though exposure levels of inhalable dust have dropped considerably across the whole carbon black manufacturing industry in Western Europe, further reductions in exposure levels are required in these areas to make sure that the probability of overexposure and exceedance falls below a level of 10%.
[Show abstract][Hide abstract] ABSTRACT: Risk factors for bronchial hyperresponsiveness have previously been established in the general community. In settings where occupational asthma is a risk, it has not been established whether occupational sensitization or measures of exposure are important. Bronchial responsiveness to histamine was measured in a cohort of 506 workers exposed to acid anhydrides. Skin-prick tests were performed with conjugates of phthalic, maleic and trimellitic anhydride with human serum albumin and with common inhalant allergens. Employment and smoking histories were recorded. Occupational exposure was measured using personal air samplers and estimates of past exposure made by retrospective exposure assessment. Three hundred and seventy workers (73%) had bronchial responsiveness measured (median age 39 yrs, range 18-77) and 46 (12%) of these were hyperresponsive (provocative dose causing a 20% fall in forced expiratory volume in one second (FEV1; PD20) < or = 8 micromol). Twelve (3%) of these responsive workers had a skin-prick test reaction to an acid anhydride conjugate, 124 (34%) to a common inhalant allergen, and 148 (40%) were current smokers. Multivariate analysis showed that occupational sensitization, sensitization to a common inhalant allergen, age, and pack-years of smoking were independent risk factors for bronchial hyperresponsiveness. Of these only occupational sensitization was completely independent of baseline FEV1. It is concluded that sensitization to acid anhydrides is a significant risk factor for bronchial hyperresponsiveness. However, measures of personal acid anhydride exposure were not associated with bronchial hyperresponsiveness.
Full-text · Article · May 2000 · European Respiratory Journal
[Show abstract][Hide abstract] ABSTRACT: Equations using variance components in exposure data to predict attenuation and standard error of exposure--response slopes have been published recently. However, to date, no comparisons have been made between results of applying these equations to a real data set with the exposure-response relations estimated directly.
Data on lung function parameters and personal inhalable and respirable dust exposure levels from the European carbon black respiratory health study were used. The predicted attenuation and standard error of the relation between current inhalable and respirable dust levels and lung function parameters (FVC and FEV(1)) were calculated for various exposure grouping schemes. These results were compared with the observed exposure-response relations. Workers were grouped by Job Category, the combination of factory and Job Category and five a posteriori created Exposure Groups. In addition, the individual approach was also used, as exposure data were available for each worker.
The rank orders of the coefficients from the regression analyses using the different grouping schemes were similar to those predicted by the equations, although the differences were larger than predicted. When using inhalable dust exposure, the predicted standard errors of the exposure-response slopes were slightly lower than those estimated directly; for respirable dust the predicted standard errors were about a factor two to three smaller than those from the regression analyses. When considering FVC, the predicted exposure-response relations were all statistically significant, whilst the observed relation was only significant when using the five a posteriori Exposure Groups. When reviewing the relations between dust exposure and level of FEV(1), all relations were statistically significant, with the exception of the (observed) relation between respirable dust and FEV(1), when the individual approach was used.
Using different grouping schemes for estimating exposure can have large effects on the slope and standard error of the exposure-response relation. It is, therefore, important that the effect of the different grouping schemes on the level and precision of the exposure-response slope be estimated. Despite violation of most of the assumptions when applying the equations to predict attenuation and the standard error of the exposure-response slope, the similarities in predicted and observed exposure-response relations and standard errors are indicative of the robustness of these equations. Therefore, the equations appear to be a useful tool in establishing the most efficient way of utilizing exposure measurements.
No preview · Article · Nov 1999 · American Journal of Industrial Medicine
[Show abstract][Hide abstract] ABSTRACT: The concern that maternal exposure to electromagnetic fields (EMF) might be related to childhood cancer risks, particularly leukemia risks.
Maternal occupational data already collected as part of the Oxford Survey of Childhood Cancers have been reviewed. Information on occupations held before, during, and after the pregnancy was sought for 15,041 children dying of cancer in Great Britain in the period 1953-1981, and for an equal number of matched controls. Each period of working was classified under one of five headings: (1) sewing machinist; (2) textile industry workers (other than sewing machinists) with likely exposures to EMF; (3) other machinists and other jobs with likely "higher" EMF exposure; (4) other jobs with likely exposure to some EMF, and (5) jobs with little potential for EMF exposure.
Relative to risks in the children of mothers who held occupations with little potential for EMF exposure during pregnancy (a category that included housewives), risks of all childhood cancers were close to unity both for the children of sewing machinists (22 case and 31 control mothers, RR 0.72, 95% CI 0.42 to 1.25) and for the children of other machinists with likely "higher" EMF exposures (44 case and 47 control mothers, RR 0.93, 95% CI 0.61 to 1.41). Corresponding risks for all childhood leukemias and for all childhood brain cancers were similarly unexceptional. Simultaneous adjustment for social class, maternal age at birth of child, and sibship position had little effect.
The study findings did not indicate that maternal occupational exposure to EMF during pregnancy is a risk factor for childhood leukemias, childhood brain cancers, or the generality of all childhood cancers.
No preview · Article · May 1999 · American Journal of Industrial Medicine
[Show abstract][Hide abstract] ABSTRACT: To estimate past exposure to phthalic (PA), trimellitic (TMA) and maleic anhydride (MA) in three alkyd resin and one cushioned flooring factory to estimate exposure-response relations in a retrospective cohort study.
Personal exposure measurements were carried out in 1992 and quantitative and qualitative information on past exposure and production processes were collected. Job titles were ranked by decreasing exposure and amalgamated into job categories and exposure groups. Multiplication factors for back calculating past exposure levels were estimated with past exposure data, or if no such data were available these factors were estimated by a panel of occupational hygienists. Exposure levels were back calculated starting with the exposure levels in 1992.
High exposures to PA were estimated to have occurred among workers operating the PA melting pots in factory 1 (estimated exposure in 1960-9 was 2480 micrograms.m-3). Highest concentrations of TMA were estimated to have occurred among the ink mixers in factory 2 from 1979 to 1986 (554 micrograms.m-3). Exposure in most other job titles was thought to be fairly constant over time for PA, TMA, and MA.
Exposure to acid anhydride at these factories has fallen during the period covered by the study. However, it is estimated that in only one job in factory 2 did past exposure to acid anhydride exceed the current occupational exposure standard. Accuracy of the estimated exposure is limited by a paucity of reliable past exposure data.
Full-text · Article · Nov 1998 · Occupational and Environmental Medicine
[Show abstract][Hide abstract] ABSTRACT: To examine the relation between exposure to acid anhydrides and the risk of developing immediate skin prick test responses to acid anhydride human serum albumin (AA-HSA) conjugates or work related respiratory symptoms; to assess whether these relations are modified by atopy or smoking.
A cohort of 506 workers exposed to phthalic (PA), maleic (MA), and trimellitic anhydride (TMA) was defined. Workers completed questionnaires relating to employment history, respiratory symptoms, and smoking habits. Skin prick tests were done with AA-HSA conjugates and common inhalant allergens. Exposure to acid anhydrides was measured at the time of the survey and a retrospective exposure assessment was done.
Information was obtained from 401 (79%) workers. Thirty four (8.8%) had new work related respiratory symptoms that occurred for the first time while working with acid anhydrides and 12 (3.2%) were sensitised, with an immediate skin prick test reaction to AA-HSA conjugates. Sensitisation to acid anhydrides was associated with work related respiratory symptoms and with smoking at the time of exposure to acid anhydride. When all subjects were included and all three acid anhydrides were taken into account there was no consistent evidence for an exposure-response relation, but with the analysis restricted to a factory where only TMA was in use there was an increased prevalence of sensitisation to acid anhydrides and work related respiratory symptoms with increasing full shift exposure. This relation was apparent within the current occupational exposure standard of 40 micrograms.m-3 and was not modified significantly by smoking or atopy.
Intensity of exposure and cigarette smoking may be risk factors for sensitisation to acid anhydrides. Exposure is also a risk factor for respiratory symptoms. As there was evidence for sensitisation to TMA at full shift exposures within the occupational exposure standard this standard should be reviewed.
Full-text · Article · Nov 1998 · Occupational and Environmental Medicine
[Show abstract][Hide abstract] ABSTRACT: To investigate the role of occupational exposures in the risk of developing urothelial cancer.
Occupational histories, obtained using a self-administered questionnaire, for 803 patients with urothelial cancer (first diagnosed 1991-93) were compared with similar information for 2135 matched controls. Relative risks (RRs) were estimated using conditional logistic regression. Comparisons were also made with historical regional employment information available from the 1971 census.
There were many statistically significant positive associations for urothelial cancer risks and ever being employed in specified occupations (with or without statistical adjustment for smoking status in 1991). Smoking-adjusted RRs of > 2.0 were obtained for seven occupations; manufacture of fire lighters/ patent fuels (RR 4.30, 95% confidence interval 0.78-23.79), rodent extermination (3.71, 1.20-11.48), manufacture of dyestuffs (2.61, 0.98-7.00), leather work (2.51, 1.44-4.35), cable manufacturing industry (2.46, 1.20-5.04), textile printing and dyeing (2.32, 0.98-5.45), and sewage works (2.19, 1.16-4.11). Analyses of the occupations followed in 1971 (thus allowing for 20-year latency) indicated an elevated RR for workers in the plastics industry (5.22, 1.57-17.36).
The historical legacy of exposure to aromatic amines in the rubber, cable-making, dyestuffs and other industries remains. An important proportion of patients presenting with urothelial tumours are likely to have had occupational exposure to urothelial carcinogens. A review of occupational exposures in the contemporaneous plastic, textile and leather industries is warranted.
Full-text · Article · Jul 1998 · British Journal of Urology