Detection of low level benzene exposure in supermarket wrappers by urinary muconic acid

Excess lung cancer occurrence in poultry plants. Occupational risk factors: Findings for oncogenic viruses exposure and other occupational exposures

Certain viruses naturally infect and cause cancer in chickens and turkeys. Humans are widely exposed. The viruses cause cancer in primates, and transform human cells in vitro, but it is not known if they cause cancer in humans, mainly because of the lack of epidemiologic evidence. We conducted cohort mortality studies of workers in poultry slaughtering/processing plants across the United States, because they have the highest human exposures. An excess of lung cancer and other deaths was recorded in the poultry workers. Here, we report on a case-cohort study of the lung cancer deaths nested within these cohorts, that was conducted to provide epidemiologic evidence linking these viruses with human cancer occurrence, while adjusting for possible confounders, including workplace chemical carcinogens. We obtained interviews for 339 lung cancer deaths and 457 controls, selected from our combined cohorts of 30,411 poultry plant workers and 16,405 non-poultry workers, belonging to United Food & Commercial Workers unions. Data was analyzed by both logistic regression and Cox regression, adjusting for smoking and other confounders. Lung cancer risk was independently associated with tasks or work areas indicative of exposure to both poultry oncogenic viruses and to workplace chemical carcinogens. The study provides an incremental piece of evidence (epidemiologic), indirectly linking the oncogenic viruses of poultry with the occurrence of cancer in humans, and thus may have public health implications, but the limitations highlighted must be considered. Confirmatory studies, particularly molecular studies providing definitive proof of poultry oncogenic retrovirus integration in human DNA are needed, before the findings observed in this study can be put into proper perspective.

Mortality in workers employed in pig abattoirs and processing plants

OBJECTIVE

workers in slaughterhouses and processing plants that handle pigs, and pork butchers/meatcutters have been little studied for health risks associated with employment, in spite of the fact that they are potentially exposed to oncogenic and non-oncogenic transmissible agents and chemical carcinogens at work. We report here on an update of mortality in 510 workers employed in abattoirs and processing plants that almost exclusively handled pigs and pork products.

METHODS

standardized mortality ratios (SMRs) were estimated for the cohort as a whole, and in subgroups defined by race and sex, using the corresponding US general population mortality rates for comparison. Study subjects were followed up from January 1950 to December 2006, during which time 45% of them died.

RESULTS

mortality was significantly increased overall in the cohort. A statistically significant excess of deaths was observed for colon and lung cancers in the entire cohort, SMR=2.7 (95% CI, 1.2-5.1), SMR=1.8 (95% CI, 1.1-2.7), respectively. Significant SMRs in the cohort as a whole were also observed for senile and pre-senile psychotic conditions (SMR=5.1, 95% CI, 1.4-13.1), and pneumonia (SMR=2.6, 95% CI, 1.3-4.8). An observed excess of subarachnoid hemorrhage was seen mainly in whites (SMR=10.1, 95% CI, 1.2-36.3). There was a suggestion of an excess of deaths from ischemic heart disease also, but the elevated SMR was confined to men and was not statistically significant.

CONCLUSION

this study confirms the excess occurrence of lung and colon cancers, and stroke previously reported in this occupational group. New findings are the excess of risk for senile and pre-senile psychotic conditions and pneumonia, which together with the excess of colon cancer appear specific for pig/pork workers, as they were not evident in much larger studies of workers in abattoirs and processing plants handling cattle and sheep. However, caution should be exercised in interpreting these findings, since some of them could have occurred by chance, resulting from our examination of a large number of causes of death in multiple study subgroups. For the moment, the significance of these findings remains unknown until they are confirmed in larger studies of adequate statistical power. Studies that will take into account possible occupational and non-occupational confounding factors are needed.

Cancer mortality in workers employed in cattle, pigs, and sheep slaughtering and processing plants

OBJECTIVES

We studied mortality in two separate cohorts of workers in abattoirs (N=4996) and meat processing plants (N=3642) belonging to a meatcutters' union, because they were exposed to viruses that cause cancer in food animals, and also to chemical carcinogens at work.

METHODS

Standardized mortality ratios (SMRs) and proportional mortality ratios (PMRs) were estimated for each cohort as a whole and in subgroups defined by race and sex, using the US general population mortality rates for comparison. Study subjects were followed up from January 1950 to December 2006, during which time over 60% of them died.

RESULTS

An excess of deaths from cancers of the base of the tongue, esophagus, lung, skin, bone and bladder, lymphoid leukemia, and benign tumors of the thyroid and other endocrine glands, and possibly Hodgkin's disease, was observed in abattoir and meat processing workers. Significantly lower SMRs were recorded for cancer of the thymus, mediastinum, pleura, etc., breast cancer, and non-Hodgkin's lymphoma.

CONCLUSION

This study confirms the excess occurrence of cancer in workers in abattoirs and meat processing plants, butchers, and meatcutters, previously reported in this cohort and other similar cohorts worldwide. Large nested case-control studies are now needed to examine which specific occupational and non-occupational exposures are responsible for the excess. There is now sufficient evidence for steps to be taken to protect workers from carcinogenic exposures at the workplace. There are also serious implications for the general population which may also be exposed to some of these viruses.

Mortality in the Baltimore union poultry cohort: non-malignant diseases

BACKGROUND

Workers in poultry plants have high exposure to a variety of transmissible agents present in poultry and their products. Subjects in the general population are also exposed. It is not known whether many of these agents cause disease in humans. If they do, we reason this would be readily evident in a highly exposed group such as poultry workers. We report here on mortality from non-malignant diseases in a cohort of poultry workers.

METHODS

Mortality was compared with that of the US general population, and with that of a comparison group from the same union. Risk was estimated by standardized mortality ratio, proportional mortality ratio, and directly standardized risk ratio.

RESULTS

Poultry workers as a group had an overall excess of deaths from diabetes, anterior horn disease, and hypertensive disease, and a deficit of deaths from intracerebral hemorrhage. Deaths from zoonotic bacterial diseases, helminthiasis, myasthenia gravis, schizophrenia, other diseases of the spinal cord, diseases of the esophagus and peritonitis were non-significantly elevated overall by all analyses, and significantly so in particular race/sex subgroups.

CONCLUSIONS

Poultry workers may have excess occurrence of disease affecting several organs and systems, probably originating from widespread infection with a variety of microorganisms. The results for neurologic diseases could well represent important clues to the etiology of these diseases in humans. The small numbers of deaths involved in some cases limit interpretation.

Non-cancer mortality in supermarket meat workers

OBJECTIVE

To report a non-cancer mortality update in supermarket meat workers.

METHODS

Mortality of 10,383 supermarket meat workers was compared with that of a control group of non-meat workers and the US population from 1949 to 1989.

RESULTS

Compared with both controls, male supermarket meat workers had an elevated relative risk for diabetes. There is also a suggestion of an increase in deaths from ischemic heart disease, other diseases of the kidney and ureter, alcoholism, and subarachnoid hemorrhage. Women had elevated relative risks for chronic bronchitis and ischemic heart disease, and possibly alcoholism. Numbers were too small to interpret the apparent increase in deaths from intracranial and intraspinal abcesses and acute nephritis in men and peritonitis in women.

CONCLUSIONS

The role of occupational exposure to transmissible agents and exposure to fumes from the wrapping machine warrants further investigation.

A critique of benzene exposure in the general population

Benzene risk assessment indicates that exposure to a time-weighted average (TWA) of 1-5 parts per million (ppm) benzene in ambient air for 40 years is associated with an increased risk of acute myeloid leukemia. Decreased white blood cell count, platelet count and other hematological indices have also been observed in persons exposed to as low as 1 ppm airborne benzene. Evidence from studies worldwide consistently shows elevated levels of benzene biomarkers that are equivalent to 0.1-2 ppm benzene in ambient air, or even higher in the general population without occupational exposure to benzene (including children). The public health significance of these observations depends on to what extent these levels reflect actual benzene exposure, and whether such exposures are life-long or at least occur frequently enough to pose a possible health threat. We reviewed the evidence and discussed possible explanations for these observations. It was concluded that while there is reason to suspect that benzene contributes significantly to elevated levels of biomarkers in the general population, there is growing concern that this cannot be definitively ascertained without concomitant consideration of the role of other factors such as metabolic polymorphisms and sources of biomarkers other than benzene, which have been insufficiently studied to date. Such studies are urgently needed for valid assessment of this potential public health problem.

An overview of occupational benzene exposures and occupational exposure limits in Europe and North America

Benzene has become one of the most intensely regulated substances in the world. Its ubiquitous use as a solvent has led to many working populations being exposed; in the early days often in uncontrolled conditions, leading to high exposures. Current occupational exposures are tightly controlled and are largely confined to workers in the petrochemical industry, vehicle mechanics, firefighters, workers exposed to automobile emissions, and some other occupational groups. Typically, occupational exposure levels are currently at or below 3.25 mg/m3 (1 ppm), and environmental exposures are typically below 50 microg/m3 (15 ppb). Smoking remains a significant source of exposure in both occupationally and non-occupationally exposed individuals. The early experiences of high occupational exposures led to the identification of haematopoietic effects of benzene and the need for improved control and regulation. As with most occupational standards, there has been a reduction in exposure limits as effects have been identified at ever-lower levels, accompanied by a societal concern for improved standards of occupational health. In 1946, the United States occupational exposure limit for benzene, promulgated by the American Conference of Governmental Industrial Hygienists, was 325 mg/m3 (100 ppm), but nowadays most European and North American countries have harmonised at 1.63-3.25mg/m3 (0.5-1 ppm). This latter figure was agreed within the European Union in 1997 and was adopted within national legislation by all Member States. The data on which this limit is set are essentially the same as those used by other standard-setting committees; this is an excellent example of how standards are set using science, pragmatism and societal values in the absence of complete information.

Metabolic interactions between acetylsalicylic acid and benzene

The aim of the study was to evaluate cytochrome P-450 dependent hepatic monooxygenases system and urinary excretions of phenol and muconic acid in animals subjected to acetylsalicylic acid (ASA) orally and benzene by inhalations. ASA increased urinary excretion of muconic acid although it did not affect the urinary level of phenol. Benzene decreased concentrations of P-450 and b(5) cytochromes and the activities of NADPH-cytochrome P-450 and NADH-cytochrome b(5) reductases. In rats exposed to ASA and benzene simultaneously the concentration of both cytochromes and the activity of the cytochrome dependent reductases was higher than in the rats exposed only to benzene and sometimes exceeded the control group values.

Winter indoor air pollution in Alaska: identifying a myth

The benzene and toluene levels inside three homes with attached garages were measured for 12 consecutive weeks during the winter months in Fairbanks, Alaska (Latitude 64.5 degrees N). Results for air samples collected over 12 h for the homes showed indoor benzene mixing ratios ranging from 1.6 to 20.4 parts per billion of mixing ratio volume (ppbv), and toluene air mixing ratios ranging from 7.3 to 41.6 ppbv. A correlation between benzene and toluene levels in each home and similar regression lines suggested the same major emission source, car and small equipment gasoline, present in attached garages. In one home, there was a correlation between indoor benzene mixing ratios and the urinary biomarker, trans,trans-muconic acid. Inside, air mixing ratios of benzene and toluene decreased with decreasing outside temperature in all homes studied, even though homes were relatively tight to prevent heat loss during this period of low winter outdoor temperatures. It is suggested that buildup of these pollutants indoors is prevented by the influence of an increased indoor/outdoor temperature differential and an ensuing increase in home ventilation.

Direct analysis of urinary trans,trans-muconic acid by coupled column liquid chromatography and spectrophotometric ultraviolet detection: method applicability to human urine

A coupled column liquid chromatographic (LC-LC) method for the direct analysis in human urine of the ring opened benzene metabolite, trans,trans-muconic acid (t,t-MA) is described. The method was tested using urine samples collected from five refinery workers exposed to concentrations of airborne benzene (0.2-0.5 ppm), and from non-exposed volunteers. The analytical columns used were of 50 x 4.6 mm I.D. packed with 3 microm p.s. Microspher C18 material as the first column (C-1), and a 100 x 4.6 mm I.D. column packed with 3 microm p.s. Hypersil ODS material as the second one (C-2). The mobile phases applied consisted, respectively, of methanol-0.074% trifluoroacetic acid (TFA) in water (4:96, v/v) on C-1, and of methanol-0.074% TFA in water (10:90, v/v) on C-2. Under these conditions t,t-MA eluted 15 min after injection. The present method, coupling the LC-LC technique with UV detection at 264 nm, permits the quantitation of t,t-MA directly in urine at levels as low as 0.05 mg/l. The determination is performed with a sample throughput of 2 h(-1) requiring only pH adjustment and centrifugation of the sample. Calibration plots of standard additions of t,t-MA to pooled urine taken from five non-exposed subjects were linear (r>0.999) over a wide concentration range (0.05, 0.1, 0.5, 1.0, 2.0 mg/l). The precision of the method (RSD) was in the range of 0.5 to 3.8%, and the within-session repeatability on workers urine samples (levels 0.06, 0.1, 0.2, 1.0 mg/l) was in the range of 3 to 8%. The present method improves the applicability of routine t,t-MA analysis, where it is most desirable that a large number of biological samples can be processed automatically or with minimal human labour, at low cost, and with a convenient turn-around time.

Improved coupled column liquid chromatographic method for high-speed direct analysis of urinary trans,trans-muconic acid, as a biomarker of exposure to benzene

A coupled column liquid chromatographic (LC-LC) method for high-speed analysis of the urinary ring-opened benzene metabolite, trans,trans-muconic acid (t,t-MA) is described. Efficient on-line clean-up and concentration of t,t-MA from urine samples was obtained using a 3 microm C18 column (50x4.6 mm I.D.) as the first column (C-1) and a 5 microm C18 semi-permeable surface (SPS) column (150x4.6 mm I.D.) as the second column (C-2). The mobile phases applied consisted, respectively, of methanol-0.05% trifluoroacetic acid (TFA) in water (7:93, v/v) on C-1, and of methanol-0.05% TFA in water (8:92, v/v) on C-2. A rinsing mobile phase of methanol-0.05% TFA in water (25:75, v/v) was used for cleaning C-1 in between analysis. Under these conditions t,t-MA eluted 11 min after injection. Using relatively non-specific UV detection at 264 nm, the selectivity of the assay was enhanced remarkably by the use of LC-LC allowing detection of t,t-MA at urinary levels as low as 50 ng/ml (S/N>9). The study indicated that t,t-MA analysis can be performed by this procedure in less than 20 min requiring only pH adjustment and filtration of the sample as pretreatment. Calibration plots of standard additions of t,t-MA to blank urine over a wide concentration range (50-4000 ng/ml) showed excellent linearity (r>0.999). The method was validated using urine samples collected from rats exposed to low concentrations of benzene vapors (0.1 ppm for 6 h) and by repeating most of the analyses of real samples in the course of measurement sequences. Both the repeatability (n=6, levels 64 and 266 ng/ml) and intra-laboratory reproducibility (n=6, levels 679 and 1486 ng/ml) were below 5%.