Acquired dyschromatopsia among petrochemical industry workers exposed to benzene

Low-level occupational exposure to BTEX and dyschromatopsia: a systematic review and meta-analysis

Objectives. The present study aimed to assess whether occupational exposure to low concentrations of benzene, toluene, ethylbenzene and xylene (BTEX) is associated with color vision impairment. Methods. We queried PubMed, Scopus, Embase, Web of Science and ProQuest as the main databases, as well as gray literature such as Google Scholar. A random-effects model was used to assess relative risk. A funnel plot was created to assess publication bias. Meta-regression analysis was applied to identify variables that explain the between-study variation in the reported risk estimate. Results. An overall standardized mean difference of 0.529 (95% confidence interval [0.269, 0.788]; p < 0.0001) was obtained in the random-effects model, which corresponded to a medium-size effect. Duration and the levels of exposure to benzene, toluene and xylene were the significant predictors of the magnitude of the combined risk estimate. Chronic exposure to low levels of BTEX was associated with dyschromatopsia determined by the color confusion index. Conclusions. The impairments can occur even at exposures lower than the occupational exposure limits of BTEX. However, there are several flaws in the determination of workers' exposure, which did not allow to establish how low a level of these chemicals can cause color vision impairment.

Exposure to volatile hydrocarbons and neurologic function among oil spill workers up to 6 years after the Deepwater Horizon disaster

BACKGROUND

During the 2010 Deepwater Horizon (DWH) disaster, oil spill response and cleanup (OSRC) workers were exposed to toxic volatile components of crude oil. Few studies have examined exposure to individual volatile hydrocarbon chemicals below occupational exposure limits in relation to neurologic function among OSRC workers.

OBJECTIVES

To investigate the association of several spill-related chemicals (benzene, toluene, ethylbenzene, xylene, n-hexane, i.e., BTEX-H) and total petroleum hydrocarbons (THC) with neurologic function among DWH spill workers enrolled in the Gulf Long-term Follow-up Study.

METHODS

Cumulative exposure to THC and BTEX-H across the oil spill cleanup period were estimated using a job-exposure matrix that linked air measurement data to detailed self-reported DWH OSRC work histories. We ascertained quantitative neurologic function data via a comprehensive test battery at a clinical examination that occurred 4-6 years after the DWH disaster. We used multivariable linear regression and modified Poisson regression to evaluate relationships of exposures (quartiles (Q)) with 4 neurologic function measures. We examined modification of the associations by age at enrollment (<50 vs. ≥50 years).

RESULTS

We did not find evidence of adverse neurologic effects from crude oil exposures among the overall study population. However, among workers ≥50 years of age, several individual chemical exposures were associated with poorer vibrotactile acuity of the great toe, with statistically significant effects observed in Q3 or Q4 of exposures (range of log mean difference in Q4 across exposures: 0.13-0.26 μm). We also observed suggestive adverse associations among those ≥ age 50 years for tests of postural stability and single-leg stance, although most effect estimates did not reach thresholds of statistical significance (p < 0.05).

CONCLUSIONS

Higher exposures to volatile components of crude oil were associated with modest deficits in neurologic function among OSRC workers who were age 50 years or older at study enrollment.

Risk assessment of chemical mixtures by benchmark dose-principle component analysis approach in occupational exposure

Mixtures of organic solvents are widely used in industrial processes. Risk assessment for chemical co-exposure has always been a challenge in past years. The present study aims to employ principle component analysis (PCA) to produce an entry for benchmark dose approximation in shoemakers based on the color vision effect. A total of 134 subjects consisting of 67 shoemakers and 67 staff workers were employed for Benchmark Dose (BMD) evaluation. Occupational exposure to benzene, toluene, xylene, and n-hexane was evaluated using NIOSH 1501 and OSHA ID-07 methods. The color vision effect was quantified using Lanthony D-15 desaturated test (D-15d). PCA was run for cumulative exposure dose (CED) of the solvents by MATLAB 2018. Finally, the lowest 95% confidence limit of the benchmark dose (BMDL) was determined using US EPA benchmark dose software (BMDS) version 3.2.1. The color confusion index (CCI) level in shoemakers increased from 1 to 1.15 by a median of 1.07. There was a significant difference in the CCI level (p value<0.0001) between exposed and control subjects. The first score of PCA was used as intake dose level (IDL) in solvents co-exposure. Using BMD analysis, the log-logistics model was fitted with a p-value> 0.1 and the lowest BMDL level. BMDL level was evaluated at 1.63, 10.25, 2.21, and 3.35 ppm for benzene, toluene, xylene, and n-hexane, respectively. The results showed a risk of color vision effect with co-exposure to solvents at different levels in the occupational exposure standards. In conclusion BMDL-PCA approach has been suggested for the risk assessment of chemical co-exposure.

Chronic Organic Solvent Exposure Changes Visual Tracking in Men and Women

Organic solvents can change CNS sensory and motor function. Eye-movement analyses can be important tools when investigating the neurotoxic changes that result from chronic organic solvent exposure. The current research measured the eye-movement patterns of men and women with and without histories of chronic organic solvent exposure. A total of 44 volunteers between 18 and 41 years old participated in this study; 22 were men (11 exposed and 11 controls), and 22 were women (11 exposed and 11 controls). Eye movement was evaluated using a 250-Hz High-Speed Video Eye Tracker Toolbox (Cambridge Research Systems) via an image of a maze. Specific body indices of exposed and non-exposed men and women were measured with an Inbody 720 to determine whether the differences in eye-movement patterns were associated with body composition. The data were analyzed using IBM SPSS Statistics version 20.0.0. The results indicated that exposed adults showed significantly more fixations (t = 3.82; p = 0.001; r = 0.51) and longer fixations (t = 4.27; p = 0.001, r = 0.54) than their non-exposed counterparts. Comparisons within men (e.g., exposed and non-exposed) showed significant differences in the number of fixations (t = 2.21; p = 0.04; r = 0.20) and duration of fixations (t = 3.29; p = 0.001; r = 0.35). The same was true for exposed vs. non-exposed women, who showed significant differences in the number of fixations (t = 3.10; p = 0.001; r = 0.32) and fixation durations (t = 2.76; p = 0.01; r = 0.28). However, the results did not show significant differences between exposed women and men in the number and duration of fixations. No correlations were found between eye-movement pattern and body composition measures (p > 0.05). These results suggest that chronic organic solvent exposure affects eye movements, regardless of sex and body composition, and that eye tracking contributes to the investigation of the visual information processing disorders acquired by workers exposed to organic solvents.

Contamination levels and potential sources of organic pollution in an Asian river

The Houjing River has long been an environmental victim of economic development. Industries that have settled along the bank of this river may have largely contributed to severe organic wastes pollution. This study collected water and sediment samples at various points along the river and measured concentrations of 61 volatile organic compounds (VOCs) and 128 semi-volatile organic compounds (SVOCs) for a period of 16 months (Feb 2014-June 2015). Our analyses show that elevated levels of VOCs were observed near two industrial areas, Dashe and Renwu industrial parks. High SVOC concentrations were found in the vicinities of the Nanzih Export Processing Zone (NEPZ) and CingPu station, possibly due to considerable effluent discharges of adjacent industrial and residential areas. Comparing this study's findings with the standard values of different governmental agencies and studies similar to this one, the ecosystem of the Houjing River was seriously contaminated. This study could be used by the government as a basis for future and urgent pollution prevention actions aimed at protecting this ecosystem and reducing the negative impacts of these contaminants on the health and well-being of the local residents and the environment.

Micronucleus, Nucleoplasmic Bridge, and Nuclear Budding in Peripheral Blood Cells of Workers Exposed to Low Level Benzene

BACKGROUND

Benzene is one of the important occupational pollutants. There are some reports about the leukemogenic effects related to low-level exposure to benzene.

OBJECTIVE

To study the frequency of micronucleus (MN), nucleoplasmic bridge (NB), and nuclear budding (NBUD) in the peripheral blood lymphocytes of petrochemical workers with low level exposure to benzene.

METHODS

We enrolled 50 workers exposed to low-level benzene and 31 unexposed workers of a petrochemical industry. After exclusion of 3 samples, peripheral blood lymphocytes of the remaining 47 exposed and 31 unexposed workers were analyzed for the frequency of MN, NB, and NBUD by cytochalasin-blocked MN technique.

RESULTS

MN was present in 28 (60%) exposed and 18 (58%) unexposed workers. NB was observed in 6 (13%), and 2 (7%) exposed and unexposed workers, respectively; the frequency for NBUD was 20 (43%), and 13 (42%), respectively. No significant difference was found in the observed frequencies of MN, NB, and NBUD in the peripheral blood lymphocytes between the exposed and unexposed group workers.

CONCLUSION

Occupational exposure to low-level benzene does not increase the frequency of MN, NB, and NBUD in the peripheral blood lymphocytes, biomarkers for DNA damage.

Impaired colour vision in workers exposed to organic solvents: A systematic review

OBJECTIVE

To evaluate recent evidence concerning the relationship between the exposure to organic solvents and the impairment of colour vision.

METHODS

A bibliographic search was conducted for scientific papers published in the last 15 years, in the LILACS, PubMed, Science Direct, EBSCO, and Cochrane databases that included observational studies assessing the relationship between impairment in colour vision and exposure to organic solvents.

RESULTS

Eleven studies were selected that were performed on an economically active population and used the Lanthony D-15 desaturated test (D-15d), measured the exposure to organic solvents, and included unexposed controls. It was found that there is a statistically significant relationship between the exposure to organic solvents and the presence of an impairment in colour vision.

CONCLUSIONS

The results support the hypothesis that exposure to organic solvents could induce acquired dyschromatopsia. The evaluation of colour vision with the D-15d test is simple and sensitive for diagnosis. More studies need to be conducted on this subject in order to better understand the relationship between impaired colour vision and more severe side effects caused by this exposure.

Toluene inhalation exposure for 13 weeks causes persistent changes in electroretinograms of Long-Evans rats

Studies of humans chronically exposed to volatile organic solvents have reported impaired visual functions, including low contrast sensitivity and reduced color discrimination. These reports, however, lacked confirmation from controlled laboratory experiments. To address this question experimentally, we examined visual function by recording visual evoked potentials (VEP) and/or electroretinograms (ERG) from four sets of rats exposed repeatedly to toluene. In addition, eyes of the rats were examined with an ophthalmoscope and some of the retinal tissues were evaluated for rod and M-cone photoreceptor immunohistochemistry. The first study examined rats following exposure to 0, 10, 100 or 1000ppm toluene by inhalation (6hr/d, 5d/wk) for 13 weeks. One week after the termination of exposure, the rats were implanted with chronically indwelling electrodes and the following week pattern-elicited VEPs were recorded. VEP amplitudes were not significantly changed by toluene exposure. Four to five weeks after completion of exposure, rats were dark-adapted overnight, anesthetized, and several sets of electroretinograms (ERG) were recorded. In dark-adapted ERGs recorded over a 5-log (cd-s/m(2)) range of flash luminance, b-wave amplitudes were significantly reduced at high stimulus luminance values in rats previously exposed to 1000ppm toluene. A second set of rats, exposed concurrently with the first set, was tested approximately one year after the termination of 13 weeks of exposure to toluene. Again, dark-adapted ERG b-wave amplitudes were reduced at high stimulus luminance values in rats previously exposed to 1000ppm toluene. A third set of rats was exposed to the same concentrations of toluene for only 4 weeks, and a fourth set of rats exposed to 0 or 1000ppm toluene for 4 weeks were tested approximately 1year after the completion of exposure. No statistically significant reductions of ERG b-wave amplitude were observed in either set of rats exposed for 4 weeks. No significant changes were observed in ERG a-wave amplitude or latency, b-wave latency, UV- or green-flicker ERGs, or in photopic flash ERGs. There were no changes in the density of rod or M-cone photoreceptors. The ERG b-wave reflects the firing patterns of on-bipolar cells. The reductions of b-wave amplitude after 13 weeks of exposure and persisting for 1year suggest that alterations may have occurred in the inner nuclear layer of the retina, where the bipolar cells reside, or the outer or inner plexiform layers where the bipolar cells make synaptic connections. These data provide experimental evidence that repeated exposure to toluene may lead to subtle persistent changes in visual function. The fact that toluene affected ERGs, but not VEPs, suggests that elements in the rat retina may be more sensitive to organic solvent exposure than the rat visual cortex.

Reconsideration of the WHO NCTB strategy and test selection

The World Health Organization-recommended neurobehavioral core test battery (NCTB) became the international standard for identifying adverse human behavioral effects due to neurotoxic chemical exposure when it was first proposed in 1983. Since then the WHO NCTB has been repeatedly cited as the basis for test selection in human neurotoxicology research. A discussion group was held before the International Symposium on Neurobehavioral Methods and Effects in Occupational and Environmental Health to review the NCTB and reconsider its tests. The workshop made three consensus recommendations to the International Congress on Occupational Health (ICOH) Scientific Committee on Neurotoxicology and Psychophysiology (SCNP):. 1. A 'screening' battery of broadly sensitive tests is needed as guidance to the field of human neurotoxicology 2. The SCNP should convene a panel to reconsider the functions measured and the tests in the WHO NCTB 3. Three disciplines should be represented in the panel recommending a revised NCTB: neuropsychology; experimental psychology; neurology. This recommendation will be pursued at the next meeting of the International Congress on Occupational Health (ICOH) Scientific Committee on Neurotoxicology and Psychophysiology (SCNP).

Color vision impairments among shipyard workers exposed to mixed organic solvents, especially xylene

OBJECTIVES

We evaluated color vision impairment in workers exposed to organic solvents, especially xylene.

METHODS

Three groups of subjects, comprising 63 workers occupationally exposed to organic solvents, 122 non-exposed workers in the same industry, and 185 subjects from the general population as controls, were evaluated for color vision. Exposure to solvents was indirectly evaluated by measuring the concentration of a urinary metabolite. Color vision was assessed using the Lanthony Desaturated 15-hue (Lanthony D-15) panel.

RESULTS

Color confusion index (CCI) values in the exposed group were significantly higher than in the non-exposed workers or the general population, after adjustment for age and education, and significantly correlated with the concentration of methylhippuric acid. Color vision impairments were detected more frequently among the exposed group, and the most common types were type III and complex impairments. The rate of type III impairments was 9.52% in the exposed group, 1.64% in the non-exposed group, and 1.62% in the general population.

CONCLUSION

Our results support the hypothesis that acquired color vision impairments could be induced by exposure to xylene. Testing for color vision impairment is a relatively simple, non-invasive and sensitive diagnostic method for relatively low-level exposures to xylene.

Chemical exposure in occupational settings and related health risks: a neglected area of research in Pakistan

In Pakistan a huge number of workers is routinely exposed to various types of chemical contaminants but there is a dearth of information as to the impact of these agents, due to a lack of a routine surveillance system and proper reporting. Prolonged and sometimes acute occupational exposures to varied organic chemicals may result in numerous health related problems. Studies from all over the world have shown adverse health outcomes of chemicals that are commonly used in various occupations. Such chemical exposures are not just confined to the workplace, but the residents surrounding industrial sites also face significant health risks due to indirect chemical exposure. Occupational exposure is a multidimensional risk factor that varies from one occupation to another, and is associated with health decline in workers. Common determinants of workplace hazards include improper, or lack of use of self-protective equipment, active and passive exposure to cigarette smoke as well as the socio-demographic and economic background of workers. There may be more than one cause of occupational stress and psychophysical disturbance among workers such as workload, lower salaries, and lack of social and medical facilities; indeed, their general health is poor. Therefore, in Pakistan, it is particularly important to focus on these issues and set rules and regulations to create occupational hazard awareness among workers, which will promote health safety at work places. If priorities are given to the correct use of self-protective equipment, adopting proper hygiene at the workplace and to avoid smoking, occupational exposures and consequent health risks may be minimized significantly.

Psychophysical evaluation of achromatic and chromatic vision of workers chronically exposed to organic solvents

The purpose of this paper was to evaluate achromatic and chromatic vision of workers chronically exposed to organic solvents through psychophysical methods. Thirty-one gas station workers (31.5 ± 8.4 years old) were evaluated. Psychophysical tests were achromatic tests (Snellen chart, spatial and temporal contrast sensitivity, and visual perimetry) and chromatic tests (Ishihara's test, color discrimination ellipses, and Farnsworth-Munsell 100 hue test—FM100). Spatial contrast sensitivities of exposed workers were lower than the control at spatial frequencies of 20 and 30 cpd whilst the temporal contrast sensitivity was preserved. Visual field losses were found in 10–30 degrees of eccentricity in the solvent exposed workers. The exposed workers group had higher error values of FM100 and wider color discrimination ellipses area compared to the controls. Workers occupationally exposed to organic solvents had abnormal visual functions, mainly color vision losses and visual field constriction.

Avaliação visual de sujeitos expostos de forma ocupacional a solventes orgânicos através de métodos psicofísicos

Os solventes orgânicos são substâncias neurotóxicas que podem causar efeitos danosos sobre as funções visuais. É comum a exposição ocupacional a esses tipos de substâncias, pois elas apresentam grande aplicabilidade em inúmeras atividades. Os efeitos podem ser quantificados por testes psicofísicos. Os testes mais usados nesse tipo de avaliação são de ordenamento de matizes, como o Teste D15 Dessaturado de Lanthony e o Teste dos 100 Matizes de Farnsworth-Munsell, e avaliação de sensibilidade ao contraste espacial de luminância, como MCT 8000 Vistech, VCTS 6500 Vistech e FACT 101. Em geral esses testes descrevem perda de discriminação de cores, afetando tanto o eixo azul-amarelo quanto o eixo verde-vermelho, e diminuição da sensibilidade ao contraste de luminância principalmente para as frequências espaciais mais baixas. Existe correlação positiva entre os resultados da avaliação psicofísica e vários marcadores biológicos e ambientais, mas essa correlação depende do marcador e do tipo de solvente ao qual os indivíduos são expostos. Fatores como alcoolismo crônico e tabagismo inveterado podem interferir no processo de correlacionar esses resultados.

The challenges of controlling organic solvents in a paint factory due to solvent impurity

In this study, several exhaust ventilation systems were designed and implemented in a paint manufacturing factory, using ACGIH recommendations. The personal exposure of workers to solvents used in the factory was evaluated to examine the role of implemented standard ventilation system. For this purpose, Toluene and Xylene concentration were monitored before and after the application of ventilation systems. Personal samples and subsequent analysis were conducted according to OSHA's method No: 12. Samples were analyzed, using Gas Chromatography. The results showed that the ventilation standards recommended by ACGIH were able to control Toluene and Xylene vapors successfully below the recommended TLVs (e.g. 44.49 ppm and 97.73 ppm respectively). It was also discovered that although Benzene was not reported as a component of the paint, its concentration in breathing zone of workers were much higher than the respective TLV (e.g. 4.5 ppm). This could be from the impurity of solvents used in paint factories which raises new questions. According to IRIS epidemiologic information, it was found that implementation of industrial ventilation systems decrease the relative risk (RR) of leukemia due to exposure to benzene, from 66.4 to 3.2 cases per work life, in this factory. Finally it was deduced that solvents impurities such as Benzene should be seriously considered as a major problem that may not be controlled using ventilation standards recommended by ACGIH for paint mixing and storing process.

[Usefulness of color vision test for early detection of neurological damages by neurotoxic substances]

This paper reviews the published literature that is concerned with color vision impairment from industrial and environmental exposure to neurotoxic substances, and we evaluated whether testing for color vision impairment could be an affordable procedure for assessing these neurotoxic effects. In general, most cases of congenital color vision impairment are red-green, and blue-yellow impairment is extremely rare. However, most of the acquired color vision impairment that is related to age, alcohol or environmental factors is blue-yellow impairment. Therefore, many studies have been performed to identify this relationship between exposure to neurotoxic substances, such as organic solvents and heavy metals, and the prevalence of blue-yellow color vision impairment. The test for color vision impairment is known to be very sensitive to the early signs of nervous system dysfunction and this can be useful for making the early diagnosis of neurotoxic effects from exposure to very low concentrations of toxic substances.

Paternal work stress and prolonged time to pregnancy

OBJECTIVE

The aim of this study was to explore an association between psychosocial stress at work in married men and their spouses' prolonged time to pregnancy (TTP).

METHODS

All married male workers of a large Korean petrochemical enterprise and their wives fulfilling the selection criteria were included. Main selection criteria were lack of use of contraceptives and experienced pregnancy in recent past. Data were available from 322 couples. Psychosocial stress at work was measured by the effort-reward imbalance questionnaire. Prolonged TTP was measured by the "TTP questionnaire".

RESULTS

After adjustment for confounding effects of demographic and life-style characteristics and benzene exposure, delayed TTP, defined by frequency of first-cycle pregnancy, was associated with one standard deviation (SD) increase of the effort-reward ratio in the chronically stressed group of married men (OR = 0.47; 95% CI = 0.22-0.99) in logistic regression analysis. A similar, but somewhat weaker effect, was found for the overall group (OR = 0.67; 95% CI = 0.47-0.94).

CONCLUSIONS

Paternal stress at work, as measured by effort-reward imbalance, seemed to be associated with a decreased number of conceptions in the first menstrual cycle.

Association of the NQO1, MPO, and XRCC1 polymorphisms and chromosome damage among workers at a petroleum refinery

Benzene is a leukemogen, and exposure to benzene is an occupational hazard in the petroleum refining industries. The effects of genetic polymorphisms in the NQO1 (rs1800566), MPO (rs2333227), and XRCC1 (rs25487) genes on benzene-induced chromosome abnormalities were assessed in 108 benzene-exposed workers and 33 office workers. The mean benzene exposure for exposed workers was 0.51 ppm for full-shift workers, and the time-weighted average ranged from 0.004 to 4.25 ppm. The frequencies of micronuclei (MN) and chromosome aberrations (CA) were significantly higher in workers exposed to benzene than unexposed controls. Exposed workers with the T/T genotype for NQO1 showed significant 1.9-fold (95% CI = 1.5-2.3) and 2.6-fold (95% CI = 1.7-3.9) increases in MN and CA frequencies, respectively, compared to controls with C/C and C/T genotypes, after adjusting for age, smoking status, and alcohol intake. Among exposed workers, subjects with the combination of MPO G/G and XRCC1 Arg/Gln or Gln/Gln showed a significantly higher CA frequency compared to those with the combination of MPO G/A or A/A and XRCC1 Arg/Arg genotypes. These results indicated that the genotoxicity induced by a chronic benzene exposure is modulated by genes involved in both DNA repair and benzene metabolic pathways.