The toxicity of rubber additives. Findings from a survey of 140 plants in Ohio

Peripheral eosinophilia and respiratory symptoms in rubber injection press operators: a case-control study

To evaluate a suspected association between an outbreak of acute respiratory illness and eosinophilia and employment as a rubber worker, we performed a retrospective review of medical records of rubber workers employed from September 1983 to July 1984 in a plant housing a thermoinjection process. Twenty-five workers met the case definition of a respiratory illness requiring a physician visit. The predominant respiratory illness was acute in onset with cough, chest tightness, and dyspnea. Peripheral eosinophilia, up to 40% of white blood cells in a peripheral smear, was seen in 10 of 18 (56%) cases. Twenty-one of 25 white males with respiratory symptoms were employed in the thermoinjection process (odds ratio = 22, p less than .001). Smoking and employment in this process contributed independently to an increased risk of being a case as determined by a logistic regression analysis. Return to the plant building caused recurrence of symptoms in most cases, and these workers have been transferred or left the company. We conclude that a strong previously unrecognized association exists between employment in this neoprene rubber thermoinjection process and the development of an acute respiratory illness.

Decreased erythrocyte glutathione s-transferase activity in rubber workers

Decreased erythrocyte glutathione s-transferase activity was found in workers exposed to hot rubber fumes in two-roll mill and calender departments (6.6 +/- 0.9 and 6.8 +/- 0.8 mumol/min X mg haemoglobin, respectively vs 8.4 +/- 0.5 in controls). This trend was also noted in the general category of all rubber exposed workers without stratification according to their task (7.6 +/- 0.5, n = 30). This result was contrary to that expected, as the cases with the lowest values had the greatest urinary thioether excretion. The thioethers are the end-products of the enzyme-catalyzed glutathione conjugation reaction aimed at the inactivation of potentially toxic chemicals. Thus, it appears that the assay of erythrocyte glutathione s-transferase activity is not very informative about exposure, although the enzyme assay might disclose other, so far unknown, biological effects of reactive rubber chemicals.

Nationwide epidemic of septicemia caused by contaminated intravenous products: mechanisms of intrinsic contamination

Between 1 July 1970 and April 1971, in many hospitals in this country, there were outbreaks of nosocomial septicemia caused by Enterobacter cloacae of E. agglomerans (formerly Erwinia, herbicola-lathyri). All of these hospitals used infusion products manufactured by one company, Abbott Laboratories, and all affected patients had onset of septicemia while receiving the company's infusion products. Septicemia was epidemiologically and microbiologically traced to intrinsic contamination of the company's screw-cap closure for infusion bottles which was sealed with a newly introduced elastomer liner. Epidemic organisms were isolated from these closures. Investigations both in the laboratory and in the manufacturing plant into the mechanism of contamination of these products revealed the following. (i) Epidemic strains were present in numerous areas throughout the manufacturing plants. (ii) Viable microorganisms gained access to the interior of screw-cap closures after the autoclave step of production. (iii) Cooling closures actively drew moisture through the thread interstices into the inner-most depths of the closure. (iv) Transfer of contaminants from closures to fluid was easily effected by simple manipulations duplicating normal in-hospital use. (v) The red-rubber liner used in the company's screw-cap closures before the introduction of elastomer contained a broad-spectrum antimicrobial inhibitor. The findings from this epidemic and the associated studies show that the screw-cap closure as it is now designed cannot be considered secure for products that must remain sterile.