1
|
Zarnke A, Rhodes S, DeBono N, Berriault C, Dorman SC. Incidence of cardiovascular disease in a cohort of mine workers exposed to ultrafine aluminum powder in Ontario, Canada. Am J Ind Med 2024; 67:933-941. [PMID: 39180259 DOI: 10.1002/ajim.23646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 07/29/2024] [Accepted: 07/31/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND A retrospective cohort study was conducted to estimate associations between an ultrafine aluminum powder, McIntyre Powder (MP), and cardiovascular disease incidence in a cohort of mine workers from Ontario, Canada. Disease outcomes included ischemic heart disease (IHD), acute myocardial infarction (AMI), congestive heart failure (CHF), and strokes and transient ischemic attacks (STIA). METHODS Using work history records from the Ontario Mining Master File (MMF) mine workers were followed for disease incidence in administrative health records. The analysis included 25,813 mine workers who were exposed to MP between 1943 and 1979 and followed for cardiovascular disease (CVD) diagnoses between 2006 and 2018. Cardiovascular disease cases were ascertained using physician, hospital, and ambulatory care records. Poisson regression models were used to estimate age and birth-year adjusted incidence rate ratios (RR) and 95% confidence intervals (CI) for associations between MP exposure and CVD outcomes. RESULTS Ever-exposure to MP was positively associated with modest increases in the incidence rate of IHD, AMI, and CHF, but not STIA, using both assessment approaches. Duration of self-reported MP exposure was positively associated with monotonically increasing rates of IHD and AMI compared to never-exposed miners, with the greatest association observed among miners with >20 years of exposure (for IHD: RR 1.24, 95% CI: 0.91-1.68; and for AMI: RR 1.52, 95% CI 1.01-2.28). CONCLUSION Mine workers ever-exposed to MP had modestly elevated rates of CVD. The rate of CVD diagnoses appeared to increase with longer duration of exposure when assessed by both self-reported exposure and through historical records.
Collapse
Affiliation(s)
- Andrew Zarnke
- School of Kinesiology and Health Sciences, Laurentian University, Sudbury, Ontario, Canada
- The Occupational Health Clinics for Ontario Workers, Sudbury, Ontario, Canada
- The Centre for Research in Occupational Safety and Health (CROSH), Laurentian University, Sudbury, Ontario, Canada
| | - Sarah Rhodes
- The Occupational Health Clinics for Ontario Workers, Sudbury, Ontario, Canada
| | - Nathan DeBono
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Colin Berriault
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Sandra C Dorman
- School of Kinesiology and Health Sciences, Laurentian University, Sudbury, Ontario, Canada
- The Centre for Research in Occupational Safety and Health (CROSH), Laurentian University, Sudbury, Ontario, Canada
| |
Collapse
|
2
|
Hadrup N, Sørli JB, Jenssen BM, Vogel U, Sharma AK. Toxicity and biokinetics following pulmonary exposure to aluminium (aluminum): A review. Toxicology 2024; 506:153874. [PMID: 38955312 DOI: 10.1016/j.tox.2024.153874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 06/17/2024] [Accepted: 06/26/2024] [Indexed: 07/04/2024]
Abstract
During the manufacture and use of aluminium (aluminum), inhalation exposure may occur. We reviewed the pulmonary toxicity of this metal including its toxicokinetics. The normal serum/plasma level based on 17 studies was 5.7 ± 7.7 µg Al/L (mean ± SD). The normal urine level based on 15 studies was 7.7 ± 5.3 µg/L. Bodily fluid and tissue levels during occupational exposure are also provided, and the urine level was increased in aluminium welders (43 ± 33 µg/L) based on 7 studies. Some studies demonstrated that aluminium from occupational exposure can remain in the body for years. Excretion pathways include urine and faeces. Toxicity studies were mostly on aluminium flakes, aluminium oxide and aluminium chlorohydrate as well as on mixed exposure, e.g. in aluminium smelters. Endpoints affected by pulmonary aluminium exposure include body weight, lung function, lung fibrosis, pulmonary inflammation and neurotoxicity. In men exposed to aluminium oxide particles (3.2 µm) for two hours, lowest observed adverse effect concentration (LOAEC) was 4 mg Al2O3/m3 (= 2.1 mg Al/m3), based on increased neutrophils in sputum. With the note that a similar but not statistically significant increase was seen during control exposure. In animal studies LOAECs start at 0.3 mg Al/m3. In intratracheal instillation studies, all done with aluminium oxide and mainly nanomaterials, lowest observed adverse effect levels (LOAELs) started at 1.3 mg Al/kg body weight (bw) (except one study with a LOAEL of ∼0.1 mg Al/kg bw). The collected data provide information regarding hazard identification and characterisation of pulmonary exposure to aluminium.
Collapse
Affiliation(s)
- Niels Hadrup
- National Research Centre for the Working Environment, 105 Lersø Parkallé, Copenhagen Ø, Denmark; Research Group for Risk-Benefit, National Food Institute, Technical University of Denmark, Denmark; Department of Biology, Norwegian University of Science and Technology, Trondheim 7491, Norway.
| | - Jorid B Sørli
- National Research Centre for the Working Environment, 105 Lersø Parkallé, Copenhagen Ø, Denmark
| | - Bjørn M Jenssen
- Department of Biology, Norwegian University of Science and Technology, Trondheim 7491, Norway.
| | - Ulla Vogel
- National Research Centre for the Working Environment, 105 Lersø Parkallé, Copenhagen Ø, Denmark; National Food Institute, Technical University of Denmark, Kgs Lyngby, Denmark
| | - Anoop K Sharma
- Division for Risk Assessment and Nutrition, Group for Chemical Risk Assessment and GMO, National Food Institute, Technical University of Denmark, Kemitorvet, 201, 031, Kgs Lyngby 2800, Denmark
| |
Collapse
|
3
|
Zarnke A, Oliver C, Dorman S. McIntyre Powder and its potential contributions to cardiovascular disease risk: A literature review through the McIntyre Powder historical lens. Am J Ind Med 2022; 65:813-821. [PMID: 35863903 PMCID: PMC9541914 DOI: 10.1002/ajim.23415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022]
Abstract
McIntyre Powder (MP) is a fine aluminum powder that was developed to prevent silicosis in gold and uranium mine workers in Ontario, Canada, and was administered to miners there from 1943 to 1979. Mine workers were exposed to high concentrations (35.6 mg/m3) of MP for approximately 10 min before every work shift. Contemporary physical and chemical characterizations of this powder have revealed that 12% of the powder is in the ultrafine particle size‐range (nanoparticles); and the remaining 88%, in the fine particulate size range (below 2.5 µm in diameter). The confluence of ultrafine particulate (UFP) composition and high airborne concentration of MP would be expected to overwhelm the defense mechanisms of the lung and increase the lung dust burden of the mine worker exposed to respirable dust in the mine. Published studies revealing associations between air pollution particulates and increased risk for cardiovascular disease (CVD) shown a dose–response relationship with ambient PM2.5 and UFP and suggest that miners exposed to MP may also be at increased risk of CVD. The historical perspective of the use of MP in northern Ontario hard‐rock mines and its potential implications for CVD in exposed mine workers are discussed.
Collapse
Affiliation(s)
- Andrew Zarnke
- Laurentian University, Sudbury, Ontario, Canada.,The Occupational Health Clinics for Ontario Workers, Sudbury, Ontario, Canada.,The Centre for Research in Occupational Safety and Health (CROSH), Laurentian University, Sudbury, Ontario, Canada
| | - Christine Oliver
- The Occupational Health Clinics for Ontario Workers, Sudbury, Ontario, Canada.,Dalla Lana School of Public Health, Division of Occupational and Environmental Health, University of Toronto, Toronto, Ontario, Canada
| | - Sandra Dorman
- Laurentian University, Sudbury, Ontario, Canada.,The Centre for Research in Occupational Safety and Health (CROSH), Laurentian University, Sudbury, Ontario, Canada
| |
Collapse
|
4
|
Bickley LM, Martell J, Cowan D, Wilken D, Yan W, McNeill FE, Zarnke A, Hedges K, Chettle DR. Bone aluminum measured in miners exposed to McIntyre powder. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2022; 19:335-342. [PMID: 35452589 DOI: 10.1080/15459624.2022.2063876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A small pilot study was conducted to test whether the technique of in vivo neutron activation analysis could measure bone aluminum levels in 15 miners who had been exposed to McIntyre Powder over 40 years prior. All miners were over 60 years of age, had worked in mines that used McIntyre Powder, and were sufficiently healthy to travel from northern to southern Ontario for the measurements. Individual aluminum levels were found to be significantly greater than zero with 95% confidence (p < 0.05) in 7 out of the 15 miners. The inverse variance weighted mean of the 15 participants was 21.77 ± 2.27µgAl/gCa. This was significantly higher (p < 0.001) than in a group of 15 non-occupationally exposed subjects of a comparable age from Southern Ontario who had been measured in a previous study. The inverse variance weighted mean bone aluminum content in the non-occupationally exposed group was 3.51 ± 0.85µgAl/gCa. Since the use of McIntyre Powder ceased in 1979, these subjects had not been exposed for more than 40 years. Calculations of potential levels at the cessation of exposure in the 1970s, using a biological half-life of aluminum in bone of 10 to 20 years predicted levels of bone aluminum comparable with studies performed in dialysis patients in the 1970s and 1980s. This pilot study has shown that the neutron activation analysis technique can determine differences in bone aluminum between McIntyre Powder exposed and non-exposed populations even though 40 years have passed since exposure ceased. The technique has potential application as a biomarker of exposure in cross-sectional studies of the health consequences of exposure to McIntyre Powder.
Collapse
Affiliation(s)
- L M Bickley
- Department of Physics & Astronomy, McMaster University, Hamilton, Ontario, Canada
| | - J Martell
- Occupational Health Clinics for Ontario Workers, Sudbury, Ontario, Canada
| | - D Cowan
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - D Wilken
- Occupational Health Clinics for Ontario Workers, Sudbury, Ontario, Canada
| | - W Yan
- Occupational Health Clinics for Ontario Workers, Sudbury, Ontario, Canada
| | - F E McNeill
- Department of Physics & Astronomy, McMaster University, Hamilton, Ontario, Canada
| | - A Zarnke
- Occupational Health Clinics for Ontario Workers, Sudbury, Ontario, Canada
- Laurentian University, School of Kinesiology and Health Sciences, Sudbury, ON, Canada
- Center for Research for Occupational Safety and Health, Sudbury, ON, Canada
| | - K Hedges
- Occupational Health Clinics for Ontario Workers, Sudbury, Ontario, Canada
| | - D R Chettle
- Department of Physics & Astronomy, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
5
|
Oliver LC, Sampara P, Pearson D, Martell J, Zarnke AM. Sarcoidosis in Northern Ontario hard-rock miners: A case series. Am J Ind Med 2022; 65:268-280. [PMID: 35156713 PMCID: PMC10138725 DOI: 10.1002/ajim.23333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/07/2022] [Accepted: 01/27/2022] [Indexed: 12/19/2022]
Abstract
Sarcoidosis is a rare multisystem granulomatous disease traditionally considered to be of unknown etiology. The notion that sarcoidosis has no known cause is called into question with the increasing number of case reports and epidemiologic studies showing associations between occupational exposures and disease published in the past 10-20 years. Occupational exposures for which associations are strongest and most consistent are silica and other inorganic dusts, World Trade Center (WTC) dust, and metals. Occupations identified as at-risk for sarcoidosis include construction workers; iron-foundry and diatomaceous earth workers; WTC emergency responders; and metal workers. We report here 12 cases of sarcoidosis in a cohort of hard-rock miners in Northern Ontario, Canada. To our knowledge sarcoidosis has not been reported previously in hard-rock miners. The cases are all male and Caucasian, with average age 74 years. At the time of diagnosis, two were never smokers; six, former smokers; and four, current smokers. Five have extrapulmonary sarcoidosis: two cardiac and three endocrine (hypercalciuria). Using occupational histories and air sampling data from the gold, uranium, and base-metal mines in which they worked, we examined exposure of each case to respirable crystalline silica (RCS). The annual mean RCS exposure for the 12 cases was 0.14 mg/m3 (range: 0.06-1.3 mg/m3 ); and the mean cumulative RCS exposure was 1.93 mg/m3 years (range: 0.64-4.03 mg/m3 years). We also considered their exposure to McIntyre Powder, an aluminum powder used for silicosis prophylaxis.
Collapse
Affiliation(s)
- L. Christine Oliver
- Dalla Lana School of Public Health, Division of Occupational and Environmental Health University of Toronto Toronto Ontario Canada
- The Occupational Health Clinics for Ontario Workers Sudbury Ontario Canada
| | - Paul Sampara
- The Occupational Health Clinics for Ontario Workers Sudbury Ontario Canada
| | - Donna Pearson
- The Occupational Health Clinics for Ontario Workers Sudbury Ontario Canada
| | - Janice Martell
- The Occupational Health Clinics for Ontario Workers Sudbury Ontario Canada
| | - Andrew M. Zarnke
- The Occupational Health Clinics for Ontario Workers Sudbury Ontario Canada
- Department of Kinesiology and Health Sciences, School of Kinesiology and Health Sciences Laurentian University Sudbury Ontario Canada
- Center for Research in Occupational Safety and Health Laurentian University Sudbury Ontario Canada
| |
Collapse
|
6
|
León-Jiménez A, Mánuel JM, García-Rojo M, Pintado-Herrera MG, López-López JA, Hidalgo-Molina A, García R, Muriel-Cueto P, Maira-González N, Del Castillo-Otero D, Morales FM. Compositional and structural analysis of engineered stones and inorganic particles in silicotic nodules of exposed workers. Part Fibre Toxicol 2021; 18:41. [PMID: 34809667 PMCID: PMC8607701 DOI: 10.1186/s12989-021-00434-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 10/31/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Engineered stone silicosis is an emerging disease in many countries worldwide produced by the inhalation of respirable dust of engineered stone. This silicosis has a high incidence among young workers, with a short latency period and greater aggressiveness than silicosis caused by natural materials. Although the silica content is very high and this is the key factor, it has been postulated that other constituents in engineered stones can influence the aggressiveness of the disease. Different samples of engineered stone countertops (fabricated by workers during the years prior to their diagnoses), as well as seven lung samples from exposed patients, were analyzed by multiple techniques. RESULTS The different countertops were composed of SiO2 in percentages between 87.9 and 99.6%, with variable relationships of quartz and cristobalite depending on the sample. The most abundant metals were Al, Na, Fe, Ca and Ti. The most frequent volatile organic compounds were styrene, toluene and m-xylene, and among the polycyclic aromatic hydrocarbons, phenanthrene and naphthalene were detected in all samples. Patients were all males, between 26 and 46 years-old (average age: 36) at the moment of the diagnosis. They were exposed to the engineered stone an average time of 14 years. At diagnosis, only one patient had progressive massive fibrosis. After a follow-up period of 8 ± 3 years, four patients presented progressive massive fibrosis. Samples obtained from lung biopsies most frequently showed well or ill-defined nodules, composed of histiocytic cells and fibroblasts without central hyalinization. All tissue samples showed high proportion of Si and Al at the center of the nodules, becoming sparser at the periphery. Al to Si content ratios turned out to be higher than 1 in two of the studied cases. Correlation between Si and Al was very high (r = 0.93). CONCLUSION Some of the volatile organic compounds, polycyclic aromatic hydrocarbons and metals detected in the studied countertop samples have been described as causative of lung inflammation and respiratory disease. Among inorganic constituents, aluminum has been a relevant component within the silicotic nodule, reaching atomic concentrations even higher than silicon in some cases. Such concentrations, both for silicon and aluminum showed a decreasing tendency from the center of the nodule towards its frontier.
Collapse
Affiliation(s)
- Antonio León-Jiménez
- Pulmonology, Allergy and Thoracic Surgery Department, Puerta del Mar University Hospital, Cádiz, Spain.
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain.
| | - José M Mánuel
- IMEYMAT: University Institute of Research in Electron Microscopy and Materials of the University of Cadiz, Puerto Real, Cádiz, Spain
- Department of Condensed Matter Physics, School of Sciences, University of Cádiz, Puerto Real, Cádiz, Spain
| | - Marcial García-Rojo
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
- Department of Anatomic Pathology, Puerta del Mar University Hospital, Cádiz, Spain
| | - Marina G Pintado-Herrera
- INMAR: University Research Institute of Marine Research, University of Cádiz, Puerto Real, Cádiz, Spain
- Department of Physical Chemistry, CASEM, University of Cádiz, Puerto Real, Cádiz, Spain
| | - José Antonio López-López
- INMAR: University Research Institute of Marine Research, University of Cádiz, Puerto Real, Cádiz, Spain
- Department of Analytical Chemistry, CASEM, University of Cádiz, Puerto Real, Cádiz, Spain
| | - Antonio Hidalgo-Molina
- Pulmonology, Allergy and Thoracic Surgery Department, Puerta del Mar University Hospital, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - Rafael García
- IMEYMAT: University Institute of Research in Electron Microscopy and Materials of the University of Cadiz, Puerto Real, Cádiz, Spain
- Department of Materials Science, Metallurgical Engineering and Inorganic Chemistry, School of Sciences, University of Cádiz, Puerto Real, Cádiz, Spain
| | - Pedro Muriel-Cueto
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
- Department of Anatomic Pathology, Puerta del Mar University Hospital, Cádiz, Spain
| | | | | | - Francisco M Morales
- IMEYMAT: University Institute of Research in Electron Microscopy and Materials of the University of Cadiz, Puerto Real, Cádiz, Spain
- Department of Materials Science, Metallurgical Engineering and Inorganic Chemistry, School of Sciences, University of Cádiz, Puerto Real, Cádiz, Spain
| |
Collapse
|
7
|
Susihono W, Gede Adiatmika IP. Assessment of inhaled dust by workers and suspended dust for pollution control change and ergonomic intervention in metal casting industry: A cross-sectional study. Heliyon 2020; 6:e04067. [PMID: 32509992 PMCID: PMC7264714 DOI: 10.1016/j.heliyon.2020.e04067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/20/2020] [Accepted: 05/22/2020] [Indexed: 01/15/2023] Open
Abstract
Metal casting industry including is an industry which produce high dust pollution (fly ash). Improvements in the form of ergonomic interventions have been carried out by many companies, but do not guarantee all parameters run well. The total indoor suspended dust (TSP) measurement results are not enough to guarantee healthy working conditions. Additional assessment of workers' inhaled dust is needed to change pollution control and work improvement to ergonomics. The design of this study is Cross Sectional Study. Research subjects numbered 84 people. All samples met the inclusion criteria. Measurement results of Characteristic of research subject, Working Environment Conditions, Exposition of dust inhaled by workers, Total Indoor Suspended Dust of the Company (p > 0.05). Found critical hours of workers exposed to dust (fly ash), starting from 4 h after working (Department of Process Cement, Department of Black Sand) and 2 h after working for the Department of Loam. Critical hours exposed to dust (fly ash) used as the basis for company management and regulators to take new policies in controlling fly ash pollution and ergonomic interventions. Ergonomic interventions can be carried out by activating the dust collector at critical hours, applying active resting hours at critical hours and conditioning workers to breathe fresh air. The impact of this ergonomic intervention is a decrease in musculoskeletal complaints by 25.27%, reduction in boredom 25.01%, and an increase in job satisfaction 38.46%.
Collapse
Affiliation(s)
- Wahyu Susihono
- Industrial Engineering Department, Faculty of Engineering, University of Sultan Ageng Tirtayasa, Banten, Indonesia
| | | |
Collapse
|