Occupational exposure to textile dust and lung cancer risk: Results from the ICARE Study

Occupational exposure to endotoxins and small cell lung cancer: a systematic review with meta-analysis

The relationship of occupational exposure to endotoxins with different histologic subtypes of lung cancer has not been established. Our objective was to conduct a systematic review with meta-analysis to assess the effect of exposure to endotoxins on the development of small cell lung cancer (SCLC). A bibliographic search was conducted using MEDLINE, Embase, CENTRAL, and Web of Science databases until December 2022, including all cohort and/or case-control studies that examined occupational exposure to endotoxins and SCLC. Risk of bias was assessed using the U.S. Office of Health Assessment and Translation tool. A random effects model was applied, publication bias were assessed, and a sensitivity analysis was conducted. Four papers were selected for meta-analysis purposes. A total of 144 incident cases of SCLC and 897 population or hospital controls were included. Occupational exposure to endotoxins was considered for textile/leather industry and agricultural sector workers exposed to endotoxins originating from wool, cotton, or leather dust. Except for one study, all investigations were classified as having a low probability of risk of biases. The results of the meta-analysis were not statistically significant (pooled OR: 0.86; 95% CI:0.69-1.08). In addition, neither between-study heterogeneity (I2=0%;p=0.92) nor publication bias was observed (p=0.49). The results of the sensitivity analysis, after including five studies that assessed the risk of SCLC among textile industry and crop/livestock farm workers (not specifically exposed to endotoxins), showed a negative statistically non-significant association and low between-study heterogeneity (pooled OR: 0.90; 95% CI:0.79-1.02; I2=22%;p=0.23). Subjects exposed to occupational exposure to endotoxins seem to exhibit a negative association with the development of SCLC, although the results are not conclusive.

Effects of dose and human N-acetyltransferase 1 genetic polymorphism in benzidine metabolism and genotoxicity

Benzidine undergoes N-acetylation and following CYP1A2-catalyzed N-hydroxylation undergoes O-acetylation catalyzed by N-acetyltransferase 1 (NAT1). Benzidine exposure is associated with urinary bladder cancer but the effect of NAT1 genetic polymorphism on individual risk remains unclear. We used Chinese hamster ovary (CHO) cells transfected with human CYP1A2 and NAT1*4 allele (reference) or NAT1*14B (variant) to investigate the effects of dose and NAT1 polymorphism on benzidine metabolism and genotoxicity. Rates of benzidine N-acetylation in vitro were higher in CHO cells transfected with NAT1*4 compared to NAT1*14B. CHO cells transfected with NAT1*14B exhibited greater N-acetylation rates in situ than cells transfected with NAT1*4 at low doses of benzidine expected with environmental exposures but not at higher doses. NAT1*14B exhibited over tenfold lower apparent KM which resulted in higher intrinsic clearance for benzidine N-acetylation compared to CHO cells transfected with NAT1*4. Benzidine-induced hypoxanthine phosphoribosyl transferase (HPRT) mutations were higher in CHO cells transfected with NAT1*14B than with NAT1*4 (p < 0.001). Benzidine caused concentration-dependent increase in γ-H2AX signal (indicative of DNA double-strand breaks) in CHO cells transfected with NAT1*4 or NAT1*14B. CHO cells transfected with NAT1*14B exhibited significantly higher level of DNA damage than with NAT1*4 (p < 0.0001). Benzidine-induced ROS did not differ significantly (p > 0.05) between CHO cells transfected with NAT1*4 or NAT1*14B except at 50 μM. Levels of benzidine-induced DNA damage and reactive oxygen species (ROS) showed strong dose-dependent correlation. Our findings support human studies associating NAT1*14B with increased incidence or severity of urinary bladder cancer in workers exposed to benzidine.

Occupational Exposures and Smoking in Eosinophilic Granulomatosis With Polyangiitis: A Case-Control Study

OBJECTIVE

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Environmental agents and occupational exposures may confer susceptibility to EGPA, but data are scarce. This study was undertaken to investigate the association between occupational exposures (e.g., silica, farming, asbestos, and organic solvents) and other environmental agents (e.g., smoking) and the risk of EGPA.

METHODS

Patients with newly diagnosed EGPA (n = 111) and general population controls (n = 333) who were matched for age, sex, and geographic area of origin were recruited at a national referral center for EGPA. Exposures were assessed using a dedicated questionnaire administered by a specialist in occupational medicine, under blinded conditions. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated.

RESULTS

Exposures to silica (OR 2.79 [95% CI 1.55-5.01], P = 0.001), organic solvents (OR 3.19 [95% CI 1.91-5.34], P < 0.001), and farming (OR 2.71 [95% CI 1.71-4.29], P < 0.001) were associated with an increased risk of EGPA. Co-exposure to silica and farming yielded an OR of 9.12 (95% CI 3.06-27.19, P < 0.001), suggesting a multiplicative effect between these 2 exposures. Smoking (current and former smokers combined) was significantly less frequent among patients with EGPA compared to controls (OR 0.49 [95% CI 0.29-0.70], P < 0.001). The pack-year index was also lower among patients with EGPA (OR 0.96 [95% CI 0.94-0.98], P < 0.001). The association of silica and farming was primarily aligned with ANCA-positive EGPA, while the association of smoking status and organic solvents was primarily aligned with ANCA-negative EGPA.

CONCLUSION

The environment can influence susceptibility to EGPA. Exposure to silica, farming, or organic solvents is associated with an increased risk of EGPA, while smoking is associated with a lower risk. These exposures seem to have distinct effects on different EGPA subsets.

Cotton dust exposure and risk of lung cancer: A meta-analysis of observational studies

Findings on the association between cotton dust exposure and lung cancer risk in epidemiologic studies have been inconsistent. Therefore, we conducted a meta-analysis of data from observational studies to quantify this association.PubMed, EMBASE, and the Cochrane library databases were searched for observational studies with data on cotton dust exposure and lung cancer risk. Studies that reported adjusted relative risks (RRs) with 95% confidence intervals (CIs) of lung cancer associated with cotton dust exposure were included. Subgroup analyses were conducted according to key characteristics.Fifteen studies involving a total of 73,812 individuals were included in the meta-analysis. Combining estimates from all the 15 observational studies, cotton dust exposure was associated with a decreased risk of lung cancer (combined RR, 0.78; 95% CI, 0.66-0.91; P = .002). Pooled estimates of multivariate RRs by gender were 0.71 (95% CI, 0.58-0.88; P = .001) among males, based on 7 studies, and 0.77 (95% CI, 0.67-0.89; P < .001) among females, based on 9 studies. Further analyses examining the influence of a single study on the results by omitting a study at each turn yielded a range of RR from 0.74 to 0.82.Our meta-analysis indicates that cotton dust exposure is associated with a decreased risk of lung cancer.

Occupational exposure to respirable dust from the coal-fired power generation process: sources, concentration, and health risk assessment

To investigate the contamination levels of respirable dust released in the work environment and the induced workers' health risk at a coal-fired power plant, we collected 405 dust samples from different dusty workstations by personal sampling during the coal-fired power generation process. Then, an inhalation risk assessment model from the USEPA was combined with the Monte Carlo simulation method to quantitatively evaluate the health risk caused by dust inhalation. Of 10 workstations researched, the dust concentration in the most workstations exceeded the prescribed occupational exposure limit. Workers engaged in ash removal suffered the highest health risk at 4.08 × 10^-6 ± 2.85 × 10^-6 (95% CI), closely followed by those involved in other job categories. The results can contribute to the formulation of targeted dust prevention measures and implementation of risk management for the coal-fired power sector.