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Wang Y, Yu Y, Zhang X, Zhang H, Zhang Y, Wang S, Yin L. Combined association of urinary volatile organic compounds with chronic bronchitis and emphysema among adults in NHANES 2011-2014: The mediating role of inflammation. CHEMOSPHERE 2024:141485. [PMID: 38438022 DOI: 10.1016/j.chemosphere.2024.141485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 01/26/2024] [Accepted: 02/15/2024] [Indexed: 03/06/2024]
Abstract
Evidence on the association of volatile organic compounds (VOCs) with chronic bronchitis (CB) and emphysema is spare and defective. To evaluate the relationship between urinary metabolites of VOCs (mVOCs) with CB and emphysema, and to identify the potential mVOC of paramount importance, data from NHANES 2011-2014 waves were utilized. Logistic regression was conducted to estimate the independent association of mVOCs with respiratory outcomes. Least absolute shrinkage and selection operator (LASSO) regression was performed to screen a parsimonious set of CB- and emphysema-relevant mVOCs that were used for further co-exposure analyses of weight quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR). Mediation analysis was employed to detect the mediating role of inflammatory makers in such associations. In single exposure analytic model, nine mVOCs were individually and positively associated with CB, while four mVOCs were with emphysema. In WQS regression, positive association between LASSO selected mVOCs and CB was identified (OR = 1.82, 95% CI: 1.25 to 2.69), and N-acetyl-S-(4-hydroxy-2-butenyl)-l-cysteine (MHBMA3) weighted the highest. Results from BKMR further validated such combined association and the significance of MHBMA3. As for emphysema, significantly positive overall trend of mVOCs was only observed in BKMR model and N-acetyl-S-(N-methylcarbamoyl)-l-cysteine (AMCC) contributed most to the mixed effect. White blood cell count (WBC) and lymphocyte number (LYM) were mediators in the positive pattern of mVOCs mixture with CB, while association between mVOCs mixture and emphysema was significantly mediated by LYM and segmented neutrophils num (NEO). This study demonstrated that exposure to VOCs was associated with CB and emphysema independently and combinedly, which might be partly speculated that VOCs were linked to activated inflammations. Our findings shed novel light on VOCs related respiratory illness, and provide a new basis for the contribution of certain VOCs to the risk of CB and emphysema, which has potential public health implications.
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Affiliation(s)
- Yucheng Wang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Yongquan Yu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Xiaoxuan Zhang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Hu Zhang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Ying Zhang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Shizhi Wang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Lihong Yin
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China.
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Soltanzadeh A, Mahdinia M, Nikbakht N, Hosseinzadeh K, Sadeghi-Yarandi M. Evaluation of human vulnerability and toxic effects of chronic and acute occupational exposure to ammonia: A case study in an ice factory. Work 2023:WOR230106. [PMID: 38143407 DOI: 10.3233/wor-230106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND The hazardous material release has frequently occurred worldwide. As a respiratory stimulant and a toxic substance, ammonia has numerous adverse effects on human health. OBJECTIVE The purpose of this study was to evaluate the human vulnerability and toxic effects of both chronic and acute respiratory exposure to ammonia. METHODS This study was conducted in an ice factory. Ammonia reservoirs were selected as the danger center. The scenarios were evaluated from the perspective of the worst-case. The Emergency Response Planning Guidelines 1-3 was used to predict the dangerous concentrations in acute exposure. The probability of human vulnerability was estimated using the Probit model. PHAST 7.2 software was used to model consequences. As a measure of chronic exposure to ammonia, NMAM 6016 was used. A respiratory symptom questionnaire developed by the American Thoracic Society was used for collecting respiratory symptom histories. RESULTS The ERPG3 level or concentration of 750 ppm was found at a distance of 617.71 and 411.01 meters from tanks, respectively, as a result of a rupture in reservoir 1 over a period of two halves of the year. It was found that the highest probit values for tank 2 at distances of zero, 25, 50, 75, 100, 125, and 150 meters were 9.55, 5.92, 5.47, 4.82, 4.23, 3.56 and 2.96, respectively. The prevalence of pulmonary symptoms, which include coughing, dyspnea, phlegm, and wheezing, was 28%, 19%, 15%, and 26% in the chronic exposure group. CONCLUSION In the event that an ammonia reservoir ruptures catastrophically, it may cause human injury at ERPG-2 or ERPG-3 levels. Results revealed that exposure to this substance can impose many pulmonary symptoms on the respiratory system of workers in industries. In order to reduce the vulnerability of humans to potential release scenarios, control measures must be implemented. Also, preventive and mitigation measures can be designed to enhance safety and resilience against the release of hazardous materials.
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Affiliation(s)
- Ahmad Soltanzadeh
- Department of Occupational Health and Safety Engineering, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - Mohsen Mahdinia
- Department of Occupational Health and Safety Engineering, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - Neda Nikbakht
- Department of Mechanical, Industrial and Aerospace Engineering, Gina Cody School of Engineering and Computer Science, Concordia University, Montreal, Canada
| | - Kiana Hosseinzadeh
- Department of Occupational Health and Safety Engineering, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohsen Sadeghi-Yarandi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Khodadadi-Mousiri A, Yaghoot-Nezhada A, Sadeghi-Yarandi M, Soltanzadeh A. Consequence modeling and root cause analysis (RCA) of the real explosion of a methane pressure vessel in a gas refinery. Heliyon 2023; 9:e14628. [PMID: 37035385 PMCID: PMC10073755 DOI: 10.1016/j.heliyon.2023.e14628] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
Background The present study aimed to consequence modeling and root cause analysis of the real explosion of a methane pressure vessel in separation unit of a gas refinery in Iran. Method ology: This study was performed in a gas refinery in the south of Iran. The studied scenario was the actual scenario that occurred in the studied pressure vessel. Modeling of possible consequences was performed using PHAST 7.2 software. Also, the root causes analysis of the accident was performed using experts' brainstorming. Results At radii of 15 and 45 m, the radiation level reaches 12.5 and 4 kW/m2, respectively. In the late explosion worst-case, the vapor cloud explodes after reaching a distance of 20 m from the pressure vessel. At radii of 20 m, 25 m, and 150 m from the center of the explosion, the pressure reaches 0.2068, 0.1379, and 0.02068 bar, respectively. In the Early Explosion Overpressure, the acceptable pressure is obtained at a distance of 193 m. Moreover, in the Early Explosion Overpressure radiation, at radii of 28 m, 38 m, and 193 m, the pressure reaches 0.2068, 0.1379, and 0.02068 bar, respectively. Conclusion The findings revealed that creating an appropriate risk management algorithm with a focus on consequence modeling can be an effective step towards reducing losses in the process industry. This results can create a novel insight in comparing the two reactive and proactive approaches and also reveal the effectiveness of consequence modeling in reducing the severity of risks.
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Soltanzadeh A, Mahdinia M, Golmohammadpour H, Pourbabaki R, Mohammad-Ghasemi M, Sadeghi-Yarandi M. Evaluating the potential severity of biogas toxic release, fire and explosion: consequence modeling of biogas dispersion in a large urban treatment plant. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:335-346. [PMID: 35152844 DOI: 10.1080/10803548.2022.2041846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objectives. Biogas production in treatment plants for energy generation has increased in recent years. This study aimed to model the consequence of biogas release in a large urban treatment plant. Methods. The study modeled biogas storage tank consequences in a large urban treatment plant in Iran. Due to potential for biogas harmfulness, three consequences of toxic release, fire and explosion were evaluated. Scenarios were evaluated in the worst-case situation. All modeling steps were performed using PHAST version 7.2. Results. In the case of catastrophic reservoir rupture in summer, distances of 3788.94, 128.86 and 91.72 m from the reservoir in the wind direction will be in the range of 100, 500 and 1000 ppm biogas, respectively. Study of pressure values due to explosion in the catastrophic rupture scenario revealed that distances of 57.19, 14.70 and 115.84 m from the biogas reservoir were in the range of 0.02, 0.13 and 0.2 bar pressure increase, respectively. Conclusion. Due to the treatment plant's location in a dense urban area, biogas dispersion could lead to exposure of many people to high-risk areas. Therefore, taking control measures comparable with the consequence modeling output can be a practical step toward reducing vulnerability against such incidents.
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Affiliation(s)
- Ahmad Soltanzadeh
- Department of Occupational Health and Safety Engineering, Research Center for Environmental Pollutants, Faculty of Health, Qom University of Medical Science, Qom, Iran
| | - Mohsen Mahdinia
- Department of Occupational Health and Safety Engineering, Research Center for Environmental Pollutants, Faculty of Health, Qom University of Medical Science, Qom, Iran
| | - Hamedeh Golmohammadpour
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Pourbabaki
- Research committee, Department of Occupational Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Mohammad-Ghasemi
- Department of Environmental Engineering, West Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mohsen Sadeghi-Yarandi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Ahmadi-Moshiran V, Sajedian AA, Soltanzadeh A, Seifi F, Koobasi R, Nikbakht N, Sadeghi-Yarandi M. Carcinogenic and health risk assessment of respiratory exposure to Acrylonitrile, 1,3-Butadiene and Styrene (ABS) in a Petrochemical Industry Using the United States Environmental Protection Agency (EPA) Method. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2022; 28:i-ix. [PMID: 35363589 DOI: 10.1080/10803548.2022.2059171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed to carcinogenic and health risk assessment of respiratory exposure to acrylonitrile, 1,3-butadiene, and styrene in the petrochemical industry. MATERIALS AND METHODS This cross-sectional study was conducted in a petrochemical plant producing acrylonitrile, butadiene, and styrene (ABS) copolymers. Respiratory exposure with acrylonitrile, 1,3-butadiene and styrene was measured using methods No. 1604, 1024, and 1501 of the National Institute of Occupational Safety and Health, respectively. The US Environmental Protection Agency method was used to assess carcinogenic and health risks. RESULTS The average occupational exposure to acrylonitrile, 1,3-butadiene, and styrene was 560.82 μg. m-3 for 1,3-butadiene, 122.8 μg. m-3 for acrylonitrile and 1.92 μg. m-3 for styrene. The average lifetime cancer risk (LCR) in the present study was 2.71 ×10-3 for 1,3-butadiene, 2.1 ×10-3 for acrylonitrile, and 6.6 for styrene. Also, the mean non-cancer risk (HQ) among all participants for 1,3-butadiene, acrylonitrile, and styrene was 4.04 ± 6.93, 10.82 ± 14.76, and 0.19 ± 0.11, respectively. CONCLUSION The values of carcinogenic and health risks in the majority of the subjects were within the unacceptable risk levels due to exposure to 1,3-butadiene, acrylonitrile, and styrene vapors. Hence, corrective actions are required to protect the workers from non-cancer and cancer risks.
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Affiliation(s)
- Vahid Ahmadi-Moshiran
- Department of Occupational Health Engineering, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran. Email address: , Tel
| | - Ali Asghar Sajedian
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Email address: , Tel
| | - Ahmad Soltanzadeh
- Department of Occupational Health and Safety Engineering, Research Center for Environmental Pollutants, Faculty of Health, Qom University of Medical Sciences, Qom, Iran. , Tel
| | - Fatemeh Seifi
- Department of HSE, Faculty of Environment and Energy, Islamic Azad University, Science and Research Branch, Tehran, Iran. Email address: , Tel
| | - Rozhin Koobasi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Email address: , Tel
| | - Neda Nikbakht
- Department of Chemical Engineering Health, Safety and Environment and Human and Sustainable Development Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran. Email address: , Tel
| | - Mohsen Sadeghi-Yarandi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Email address: , Tel
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Chen WQ, Zhang XY. 1,3-Butadiene: a ubiquitous environmental mutagen and its associations with diseases. Genes Environ 2022; 44:3. [PMID: 35012685 PMCID: PMC8744311 DOI: 10.1186/s41021-021-00233-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/27/2021] [Indexed: 01/09/2023] Open
Abstract
1,3-Butadiene (BD) is a petrochemical manufactured in high volumes. It is a human carcinogen and can induce lymphohematopoietic cancers, particularly leukemia, in occupationally-exposed workers. BD is an air pollutant with the major environmental sources being automobile exhaust and tobacco smoke. It is one of the major constituents and is considered the most carcinogenic compound in cigarette smoke. The BD concentrations in urban areas usually vary between 0.01 and 3.3 μg/m3 but can be significantly higher in some microenvironments. For BD exposure of the general population, microenvironments, particularly indoor microenvironments, are the primary determinant and environmental tobacco smoke is the main contributor. BD has high cancer risk and has been ranked the second or the third in the environmental pollutants monitored in most urban areas, with the cancer risks exceeding 10-5. Mutagenicity/carcinogenicity of BD is mediated by its genotoxic metabolites but the specific metabolite(s) responsible for the effects in humans have not been determined. BD can be bioactivated to yield three mutagenic epoxide metabolites by cytochrome P450 enzymes, or potentially be biotransformed into a mutagenic chlorohydrin by myeloperoxidase, a peroxidase almost specifically present in neutrophils and monocytes. Several urinary BD biomarkers have been developed, among which N-acetyl-S-(4-hydroxy-2-buten-1-yl)-L-cysteine is the most sensitive and is suitable for biomonitoring BD exposure in the general population. Exposure to BD has been associated with leukemia, cardiovascular disease, and possibly reproductive effects, and may be associated with several cancers, autism, and asthma in children. Collectively, BD is a ubiquitous pollutant that has been associated with a range of adverse health effects and diseases with children being a subpopulation with potentially greater susceptibility. Its adverse effects on human health may have been underestimated and more studies are needed.
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Affiliation(s)
- Wan-Qi Chen
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xin-Yu Zhang
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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Nellis M, Caperton CO, Liu K, Tran V, Go YM, Hallberg LM, Ameredes BT, Jones DP, Boysen G. Lung metabolome of 1,3-butadiene exposed Collaborative Cross mice reflects metabolic phenotype of human lung cancer. Toxicology 2021; 463:152987. [PMID: 34648870 PMCID: PMC9062885 DOI: 10.1016/j.tox.2021.152987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/30/2021] [Accepted: 10/07/2021] [Indexed: 11/24/2022]
Abstract
1,3-Butadiene (BD) exposure is known to cause numerous adverse health effects, including cancer, in animals and humans. BD is metabolized to reactive epoxide intermediates, which are genotoxic, but it is not well know what other effects BD has on cellular metabolism. We examined the effects of exposure to BD on the mouse lung metabolome in the genetically heterogeneous collaborative cross outbred mouse model. Mice were exposed to 3 concentra-tions of BD for 10 days (2, 20, and 200 ppm), and lung tissues were analyzed using high-resolution mass spectrometry-based metabolomics. As compared to controls (0 ppm BD), BD had extensive effects on lung metabolism at all concentrations of exposure, including the lowest concentration of 2 ppm, as reflected by reprogramming of multiple metabolic pathways. Metabolites participating in glycolysis and the tricarboxylic acid cycle were elevated, with 8 out of 10 metabolites demonstrating a 2 to 8-fold increase, including the oncometabolite fumarate. Fatty acid levels, sphingosine, and sphinganine were decreased (2 to 8-fold), and fatty acyl-CoAs were significantly increased (16 to 31-fold), suggesting adjustments in lipid metabolism. Furthermore, metabolites involved in basic amino acid metabolism, steroid hormone metabolism, and nucleic acid metabolism were significantly altered. Overall, these changes mirror the metabolic alterations found in lung cancer cells, suggesting that very low doses of BD induce metabolic adaptations that may prevent or promote adverse health effects such as tumor formation.
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Affiliation(s)
- Mary Nellis
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA, 30322, United States
| | - Caitlin O Caperton
- Department of Environment and Occupational Health, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, United States; The Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, United States
| | - Ken Liu
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA, 30322, United States
| | - ViLinh Tran
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA, 30322, United States
| | - Young-Mi Go
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA, 30322, United States
| | - Lance M Hallberg
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, United States; Sealy Center for Environmental Health and Medicine, University of Texas Medical Branch, Galveston, TX, 77555, United States; Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX, 77555, United States
| | - Bill T Ameredes
- Sealy Center for Environmental Health and Medicine, University of Texas Medical Branch, Galveston, TX, 77555, United States; Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX, 77555, United States; Division of Pulmonary, Critical Care, and Sleep Medicine, University of Texas Medical Branch, Galveston, TX, 77555, United States
| | - Dean P Jones
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA, 30322, United States
| | - Gunnar Boysen
- Department of Environment and Occupational Health, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, United States; The Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, United States.
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Sadeghi-Yarandi M, Karimi A, Ahmadi V, Sajedian AA, Soltanzadeh A, Golbabaei F. Cancer and non-cancer health risk assessment of occupational exposure to 1,3-butadiene in a petrochemical plant in Iran. Toxicol Ind Health 2020; 36:960-970. [PMID: 33108261 DOI: 10.1177/0748233720962238] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
1,3-Butadiene is classified as carcinogenic to humans by inhalation. This study aimed to assess cancer and non-cancer risk following occupational exposure to 1,3-butadiene. This cross-sectional study was conducted in a petrochemical plant producing acrylonitrile butadiene styrene copolymer in Iran. Occupational exposure to 1,3-butadiene was measured according to the National Institute for Occupational Safety and Health 1024 method. Cancer and non-cancer risk assessment were performed according to the United States Environmental Protection Agency method. The average occupational exposure to 1,3-butadiene during work shifts among all participants was 560.82 ± 811.36 µg m-3. The average lifetime cancer risk (LCR) in the present study was 2.71 × 10-3; 82.2% of all exposed workers were within the definite carcinogenic risk level. Also, the mean non-cancer risk (hazard quotient (HQ)) among all participants was 10.82 ± 14.76. The highest LCR and HQ were observed in the safety and fire-fighting station workers with values of 7.75 × 10-3 and 36.57, respectively. The findings revealed that values of carcinogenic and noncarcinogenic risk in the majority of participants were within the definitive and unacceptable risk levels. Therefore, corrective measures are necessary to protect these workers from non-cancer and cancer risks from 1,3-butadiene exposure.
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Affiliation(s)
- Mohsen Sadeghi-Yarandi
- Department of Occupational Health Engineering, School of Public Health, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Karimi
- Department of Occupational Health Engineering, School of Public Health, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Ahmadi
- Department of Occupational Health Engineering, School of Public Health, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Asghar Sajedian
- Department of Occupational Health Engineering, School of Public Health, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Soltanzadeh
- Department of Occupational Safety and Health Engineering, Health Faculty, 154202Qom University of Medical Sciences, Qom, Iran
| | - Farideh Golbabaei
- Department of Occupational Health Engineering, School of Public Health, 48439Tehran University of Medical Sciences, Tehran, Iran
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