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Alif SM, Benke GP, Kromhout H, Vermeulen R, Tran C, Ronaldson K, Walker-Bone K, Woods R, Beilin L, Tonkin A, Owen AJ, McNeil JJ. Long-term occupational exposures on disability-free survival and mortality in older adults. Occup Med (Lond) 2023; 73:492-499. [PMID: 37948123 PMCID: PMC10756660 DOI: 10.1093/occmed/kqad105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The impact of long-term occupational exposures on health in older adults is increasingly relevant as populations age. To date, no studies have reported their impact on survival free of disability in older adults. AIMS We aimed to investigate the association between long-term occupational exposure and disability-free survival (DFS), all-cause mortality and cause-specific mortality in initially healthy older adults. METHODS We analysed data from 12 215 healthy participants in the ASPirin in Reducing Events in the Elderly (ASPREE) study whose mean age was 75 years. Their work history was collated with the 'ALOHA-plus JEM' (Job Exposure Matrix) to assign occupational exposures. The primary endpoint, DFS, was a composite measure of death, dementia or persistent physical disability. The secondary endpoint, mortality, was classified according to the underlying cause. Cox proportional hazard models were used to calculate hazard ratios and 95% confidence intervals, adjusted for confounders. RESULTS A total of 1835 individuals reached the DFS endpoint during the median 4.7 years follow-up period. Both ever-high and cumulative exposure to all dusts and all pesticides during a person's working years were associated with reduced DFS. Compared to no exposure, men with high exposure to dusts and pesticides had a reduced DFS. Neither of these exposures were significantly associated with all-cause mortality. Men with high occupational exposure to solvents and women exposed to dusts experienced higher all-cause and cancer-related mortality. CONCLUSIONS Long-term occupational exposure to all dusts and pesticides was associated with a reduced DFS and increased mortality in community-dwelling healthy older adults.
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Affiliation(s)
- S M Alif
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
- School of Health Sciences, The University of Melbourne, Melbourne, Victoria 3000, Australia
- Institute of Health and Wellbeing, Federation University Australia, Berwick, Victoria 3806, Australia
| | - G P Benke
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - H Kromhout
- Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - R Vermeulen
- Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - C Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - K Ronaldson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - K Walker-Bone
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - R Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - L Beilin
- School of Medicine, The University of Western Australia, Perth, Western Australia 6009, Australia
| | - A Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - A J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - J J McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
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Castaño-Vinyals G, Sadetzki S, Vermeulen R, Momoli F, Kundi M, Merletti F, Maslanyj M, Calderon C, Wiart J, Lee AK, Taki M, Sim M, Armstrong B, Benke G, Schattner R, Hutter HP, Krewski D, Mohipp C, Ritvo P, Spinelli J, Lacour B, Remen T, Radon K, Weinmann T, Petridou ET, Moschovi M, Pourtsidis A, Oikonomou K, Kanavidis P, Bouka E, Dikshit R, Nagrani R, Chetrit A, Bruchim R, Maule M, Migliore E, Filippini G, Miligi L, Mattioli S, Kojimahara N, Yamaguchi N, Ha M, Choi K, Kromhout H, Goedhart G, 't Mannetje A, Eng A, Langer CE, Alguacil J, Aragonés N, Morales-Suárez-Varela M, Badia F, Albert A, Carretero G, Cardis E. Wireless phone use in childhood and adolescence and neuroepithelial brain tumours: Results from the international MOBI-Kids study. Environ Int 2022; 160:107069. [PMID: 34974237 DOI: 10.1016/j.envint.2021.107069] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 12/22/2021] [Accepted: 12/24/2021] [Indexed: 06/14/2023]
Abstract
In recent decades, the possibility that use of mobile communicating devices, particularly wireless (mobile and cordless) phones, may increase brain tumour risk, has been a concern, particularly given the considerable increase in their use by young people. MOBI-Kids, a 14-country (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, the Netherlands, New Zealand, Spain) case-control study, was conducted to evaluate whether wireless phone use (and particularly resulting exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF)) increases risk of brain tumours in young people. Between 2010 and 2015, the study recruited 899 people with brain tumours aged 10 to 24 years old and 1,910 controls (operated for appendicitis) matched to the cases on date of diagnosis, study region and age. Participation rates were 72% for cases and 54% for controls. The mean ages of cases and controls were 16.5 and 16.6 years, respectively; 57% were males. The vast majority of study participants were wireless phones users, even in the youngest age group, and the study included substantial numbers of long-term (over 10 years) users: 22% overall, 51% in the 20-24-year-olds. Most tumours were of the neuroepithelial type (NBT; n = 671), mainly glioma. The odds ratios (OR) of NBT appeared to decrease with increasing time since start of use of wireless phones, cumulative number of calls and cumulative call time, particularly in the 15-19 years old age group. A decreasing trend in ORs was also observed with increasing estimated cumulative RF specific energy and ELF induced current density at the location of the tumour. Further analyses suggest that the large number of ORs below 1 in this study is unlikely to represent an unknown causal preventive effect of mobile phone exposure: they can be at least partially explained by differential recall by proxies and prodromal symptoms affecting phone use before diagnosis of the cases. We cannot rule out, however, residual confounding from sources we did not measure. Overall, our study provides no evidence of a causal association between wireless phone use and brain tumours in young people. However, the sources of bias summarised above prevent us from ruling out a small increased risk.
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Affiliation(s)
- G Castaño-Vinyals
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - S Sadetzki
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Ministry of Health, Jerusalem, Israel
| | - R Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - F Momoli
- School of Epidemiology and Public Health, University of Ottawa, Canada; Risk Science International, Ottawa, Canada
| | - M Kundi
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Austria
| | - F Merletti
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | | | | | - J Wiart
- Laboratoire de Traitement et Communication de l'Information (LTCI), Telecom Paris, Institut Polytechnique de Paris, 91120 Palaiseau, France
| | - A-K Lee
- Radio Technology Research Department, Electronics and Telecommunications Research Institute (ETRI), Yuseong-gu, Daejeon, Korea
| | - M Taki
- Department of Electrical & Electronic Engineering, Graduate Schools of Science and Engineering, Tokyo Metropolitan University, Tokyo, Japan
| | - M Sim
- School of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - B Armstrong
- School of Population and Global Health, The University of Western Australia, Perth 6009, Australia
| | - G Benke
- School of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - R Schattner
- School of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - H-P Hutter
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Austria
| | - D Krewski
- Risk Science International, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada; McLaughlin Centre for Population Health Risk Assessment, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - C Mohipp
- University of Ottawa, Ottawa, Canada
| | - P Ritvo
- York University, Toronto, Ontario, Canada
| | - J Spinelli
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - B Lacour
- French National Registry of Childhood Solid Tumors, CHRU, Nancy, France; Inserm UMR 1153, Center of Research in Epidemiology and StatisticS (CRESS), Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - T Remen
- Inserm UMR 1153, Center of Research in Epidemiology and StatisticS (CRESS), Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - K Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - T Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - E Th Petridou
- Hellenic Society for Social Pediatrics & Health Promotion, Greece; Dept of Hygiene and Epidemiology, Medical School, National and Kapodistrian University of Athens, Greece
| | - M Moschovi
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - A Pourtsidis
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - K Oikonomou
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - P Kanavidis
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - E Bouka
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - R Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, India
| | - R Nagrani
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, India; Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359 Bremen, Germany
| | - A Chetrit
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
| | - R Bruchim
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
| | - M Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | - E Migliore
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | - G Filippini
- Scientific Director's Office, Carlo Besta Foundation and Neurological Institute, Milan, Italy
| | - L Miligi
- Environmental and Occupational Epidemiology Branch, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - S Mattioli
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Italy
| | - N Kojimahara
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan; Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - N Yamaguchi
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan; Saiseikai Research Institute of Care and Welfare, Tokyo, Japan
| | - M Ha
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-ro, Cheonan, Chungnam, South Korea
| | - K Choi
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-ro, Cheonan, Chungnam, South Korea
| | - H Kromhout
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - G Goedhart
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - A 't Mannetje
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - A Eng
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - C E Langer
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain
| | - J Alguacil
- CIBER Epidemiologia y Salud Pública, Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - N Aragonés
- CIBER Epidemiologia y Salud Pública, Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health of Madrid, 28035 Madrid, Spain
| | - M Morales-Suárez-Varela
- CIBER Epidemiologia y Salud Pública, Madrid, Spain; Unit of Public Health and Environmental Care, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Valencia, Spain
| | - F Badia
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain; Institut Cartogràfic i Geològic de Catalunya, Barcelona, Spain
| | - A Albert
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain
| | - G Carretero
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain
| | - E Cardis
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain.
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Spinder N, Bergman JEH, van Tongeren M, Boezen HM, Kromhout H, de Walle HEK. Maternal occupational exposure to endocrine-disrupting chemicals and urogenital anomalies in the offspring. Hum Reprod 2021; 37:142-151. [PMID: 34741174 PMCID: PMC8730314 DOI: 10.1093/humrep/deab205] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/17/2021] [Indexed: 01/18/2023] Open
Abstract
STUDY QUESTION Is there an association between maternal occupational exposure to endocrine-disrupting chemicals (EDCs) early in pregnancy and subgroups of congenital anomalies of kidney and urinary tract (CAKUT), and hypospadias? SUMMARY ANSWER Exposure to specific EDCs can increase the risk of CAKUT and no association with hypospadias was observed. WHAT IS KNOWN ALREADY Previous studies showed an association between maternal occupational exposure to EDCs and hypospadias. However, little is known about the effect of these chemicals on the development of CAKUT, especially subgroups of urinary tract anomalies. STUDY DESIGN, SIZE, DURATION For this case-control study, cases with urogenital anomalies from the European Concerted Action on Congenital Anomalies and Twins Northern Netherlands (Eurocat NNL) registry and non-malformed controls from the Lifelines children cohort (living in the same catchment region as Eurocat NNL) born between 1997 and 2013 were selected. This study included 530 cases with CAKUT, 364 cases with hypospadias, 7 cases with both a urinary tract anomaly and hypospadias and 5602 non-malformed controls. Cases with a genetic or chromosomal anomaly were excluded, and to avoid genetic correlation, we also excluded cases in which a sibling with the same defect was included. PARTICIPANTS/MATERIALS, SETTING, METHODS Information on maternal occupation held early in pregnancy was collected via self-administered questionnaires. Job titles were translated into occupational exposure to EDCs using a job-exposure matrix (JEM). Adjusted odds ratios (aORs) and 95% CIs were estimated to assess the association between maternal occupational exposure to EDCs (and to specific types of EDCs) and CAKUT and hypospadias. MAIN RESULTS AND THE ROLE OF CHANCE For CAKUT and hypospadias, 23.1% and 22.9% of the cases were exposed to EDCs, respectively, whereas 19.8% of the controls were exposed. We found an association between maternal occupational exposure to organic solvents/alkylphenolic compounds and CAKUT (aOR 1.41, 95% CI 1.01-1.97) that became stronger when combinations of urinary tract anomalies co-occurred with other defects (aOR 7.51, 95% CI 2.41-23.43). An association was also observed for exposure to phthalates/benzophenones/parabens/siloxanes and CAKUT (aOR 1.56, 95% CI 1.06-2.29), specifically urinary collecting system anomalies (aOR 1.62, 95% CI 1.03-2.54) and combinations of urinary tract anomalies (aOR 2.90, 95% CI 1.09-7.71). We observed no association between EDC exposure and hypospadias. LIMITATIONS, REASONS FOR CAUTION The different study designs of Eurocat NNL and Lifelines could have introduced differential information bias. Also, exposure misclassification could be an issue: it is possible that the actual exposure differed from the exposure estimated by the JEM. In addition, women could also have been exposed to other exposures not included in the analysis, which could have resulted in residual confounding by co-exposures. WIDER IMPLICATIONS OF THE FINDINGS Women, their healthcare providers, and their employers need to be aware that occupational exposure to specific EDCs early in pregnancy may be associated with CAKUT in their offspring. An occupational hygienist should be consulted in order to take exposure to those specific EDCs into consideration when risk assessments are carried out at the workplace. STUDY FUNDING/COMPETING INTEREST(S) N.S. was paid by the Graduate School of Medical Sciences (MD/PhD programme), University Medical Center Groningen (UMCG), Groningen, the Netherlands. Eurocat Northern Netherlands is funded by the Dutch Ministry of Health, Welfare and Sports. The Lifelines Biobank initiative has been made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen (UMCG the Netherlands), University Groningen and the Northern Provinces of the Netherlands. The authors report no conflict of interest. TRIAL REGISTRATION NO N/A.
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Affiliation(s)
- N Spinder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - J E H Bergman
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M van Tongeren
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - H M Boezen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - H Kromhout
- Division of Environmental Epidemiology, Institute for Risk Assessment Science, Utrecht University, the Netherlands
| | - H E K de Walle
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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van Schaik G, Seinen P, Muskens J, van Erp T, Keurentjes J, Huss A, Kromhout H. Possible causes of aberrations in adverse grouping behavior of dairy cows: A field study. J Dairy Sci 2021; 104:7000-7007. [PMID: 33865599 DOI: 10.3168/jds.2020-19269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/14/2020] [Indexed: 11/19/2022]
Abstract
In the Dutch national surveillance system, an increasing number of reports were received in the summer of 2017 from farmers about unusual behavior of their cows. The cows were grouping during the day in summer in one part of the barn and did not move for several hours, which, according to the farmers, led to reduced food and water intake and lying time and resulted in decreased milk production and increased risk of lameness. Many farmers perceived magnetic fields from, for instance, high-voltage lines, automated milking systems, or solar panels as possible causes for the behavior of their cows. Our aim for the study was to study potential factors such as magnetic fields and other factors such as barn climate and insect burden for adverse grouping behavior of dairy cows in the barn. For each case herd, 2 control herds were selected in the same postal area code. A case was a herd in which cattle grouped at least on 7 occasions in a month for several hours. In a control herd, the cows were in the barn during the same time period as in the matching case herd but did not show adverse grouping behavior. A questionnaire was administered by telephone in 31 case herds and 62 control herds. The questionnaire gathered information on behavior of the cows and potential risk factors. In addition, data on the distance of the herd to high-voltage lines was obtained. From a total of 74 variables, all variables with a P-value ≤0.10 were included in full multivariable logistic regression model. Backward selection was carried out at P ≤ 0.10. The grouping behavior of the cows started in most herds in June, was seen only during the day, and lasted mostly 6 to 8 h, with cows often grouped in the northern part of the barn. Identified risk factors appeared to be recently constructed barns, measured stray voltage in barns, and presence of fans in barns. Given the cross-sectional design of the case-control study, causality for these risk factors leading to adverse behavior of the cows could not be proven. Dissemination of the results to farmers hopefully results in measures that can prevent the unusual grouping behavior of cows.
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Affiliation(s)
- G van Schaik
- Royal GD, Deventer 7400AA, the Netherlands; Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht 3508TD, the Netherlands.
| | - P Seinen
- Royal GD, Deventer 7400AA, the Netherlands
| | - J Muskens
- Royal GD, Deventer 7400AA, the Netherlands
| | - T van Erp
- Royal GD, Deventer 7400AA, the Netherlands
| | | | - A Huss
- Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht 3508TD, the Netherlands
| | - H Kromhout
- Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht 3508TD, the Netherlands
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Spinder N, Prins JR, Bergman JEH, Smidt N, Kromhout H, Boezen HM, de Walle HEK. Congenital anomalies in the offspring of occupationally exposed mothers: a systematic review and meta-analysis of studies using expert assessment for occupational exposures. Hum Reprod 2020; 34:903-919. [PMID: 30927411 PMCID: PMC6505450 DOI: 10.1093/humrep/dez033] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 01/28/2019] [Accepted: 02/20/2019] [Indexed: 11/23/2022] Open
Abstract
STUDY QUESTION Is there an association between maternal occupational exposure to solvents, pesticides and metals as assessed by expert-based assessment and congenital anomalies in the offspring? SUMMARY ANSWER There is an association between maternal occupational exposure to solvents and congenital anomalies in the offspring, including neural tube defects, congenital heart defects and orofacial clefts. WHAT IS KNOWN ALREADY One important environmental risk factor for development of congenital anomalies is maternal occupational exposure to chemicals in the workplace prior to and during pregnancy. A number of studies have assessed the association with often conflicting results, possibly due to different occupational exposure assessing methods. STUDY DESIGN, SIZE, DURATION For this systematic review with meta-analysis, the search terms included maternal occupation, exposure, congenital anomalies and offspring. Electronic databases MEDLINE and EMBASE were searched for English studies up to October 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS Two reviewers independently screened all citations identified by the search. Case-control studies and cohort studies were included if (I) they reported on the association between maternal occupational exposure to solvents, pesticides or metals and congenital anomalies, and (II) assessment of occupational exposure was performed by experts. Data on study characteristics, confounders and odds ratios (ORs) were extracted from the included studies for four subgroups of congenital anomalies. Methodological quality was assessed using the Newcastle-Ottawa Scale. In the meta-analysis, random effects models were used to pool estimates. MAIN RESULTS AND THE ROLE OF CHANCE In total, 2806 titles and abstracts and 176 full text papers were screened. Finally, 28 studies met the selection criteria, and 27 studies could be included in the meta-analysis. Our meta-analysis showed that maternal occupational exposure to solvents was associated with neural tube defects (OR: 1.51, 95%CI: 1.09–2.09) and congenital heart defects (OR: 1.31, 95%CI:1.06–1.63) in the offspring. Also maternal occupational exposure to glycol ethers, a subgroup of solvents, was associated with neural tube defects (OR: 1.93, 95%CI: 1.17–3.18) and orofacial clefts (OR: 1.95, 95%CI: 1.38–2.75) in the offspring. Only one study investigated the association between maternal occupational exposure to solvents and hypospadias and found an association (OR: 3.63, 95%CI: 1.94–7.17). Results of the included studies were consistent. In our meta-analysis, we found no associations between occupational exposure to pesticides or metals and congenital anomalies in the offspring. LIMITATIONS, REASONS FOR CAUTION A limited number of studies was included, which made it impossible to calculate pooled estimates for all congenital anomalies, analyse individual chemicals or calculate exposure–response relations. Bias could have been introduced because not all included studies corrected for potentially confounding factors. WIDER IMPLICATIONS OF THE FINDINGS Employers and female employees should be aware of the possible teratogenic effects of solvent exposure at the workplace. Therefore, is it important that clinicians and occupational health specialist provide women with preconception advice on occupational solvent exposure, to reduce the congenital anomaly risk. STUDY FUNDING/COMPETING INTEREST(S) NSp was paid by the Graduate School of Medical Sciences (MD/PhD program), UMCG, Groningen, the Netherlands. EUROCAT Northern Netherlands is funded by the Dutch Ministry of Health, Welfare and Sports. There are no competing interests. REGISTRATION NUMBER CRD42017053943.
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Affiliation(s)
- N Spinder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J R Prins
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J E H Bergman
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - N Smidt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - H Kromhout
- Division of Environmental Epidemiology, Institute for Risk Assessment Science, Utrecht University, Utrecht, The Netherlands
| | - H M Boezen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - H E K de Walle
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Schüz J, Kovalevskiy E, Moissonnier M, Olsson A, Hashim D, Kromhout H, Kashanskiy S, Chernov O, Bukhtiyarov I, Ostroumova E. Comparison of Two Information Sources for Cause-of-Death Follow-up in the Russian Federation: The Asbest Chrysotile Cohort Study. Methods Inf Med 2020; 59:9-17. [PMID: 32535878 PMCID: PMC7446113 DOI: 10.1055/s-0040-1710381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/26/2020] [Indexed: 10/28/2022]
Abstract
BACKGROUND The Asbest chrysotile cohort was set up in Asbest town, Sverdlovsk oblast, Russian Federation, among the current and former workforce of the world's largest operating chrysotile mine and its processing mills, to investigate cancer risk in relation to occupational exposure to chrysotile. OBJECTIVES The cohort of 35,837 people was followed-up for mortality using cause-of-death information from official death certificates issued by the Civil Act Registration Office (ZAGS) of Sverdlovsk oblast from 1976 to 2015. Data were also retrieved from the electronic cause-of-death registry of the Medical Information Analytical Centre (MIAC) of Sverdlovsk oblast, which was launched in 1990 and operates independently of ZAGS. The objectives were to compare the completeness of record linkage (RL) with ZAGS and with MIAC, and to compare the agreement of cause-of-death information obtained from ZAGS and from MIAC, with a focus on malignant neoplasms. METHODS RL completeness of identifying cohort members in ZAGS and in MIAC was compared for the period 1990 to 2015. In the next step, for the comparison of the retrieved cause-of-death information, 5,463 deaths (1,009 from cancer) were used that were registered in 2002 to 2015, when causes of death were coded using International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) nomenclature by MIAC. For ZAGS, original cause-of-death text from the death certificates was obtained and then coded according to ICD-10 by the International Agency for Research on Cancer/World Health Organization (IARC/WHO). Agreement was evaluated at various levels of detail, and reasons for any disagreements between the MIAC and the IARC/WHO ICD-10-coded cancer diagnosis were systematically explored. RESULTS A total of 10,886 deaths were obtained from all avenues of follow-up for the period 1990 to 2015 in the cohort; 10,816 (99.4%) of these were found in ZAGS. This percentage was 88.3% if only automated deterministic RL was used and 99.4% when deterministic RL was complemented with manual searches of cohort members. Comparison of the cause-of-death information showed agreement of 97.9% at the ICD-10 main group level between ZAGS (coded by IARC/WHO) and MIAC. Of 1,009 cancer deaths, 679 (67.3%) cases had identical coding, 258 (25.6%) cases corresponded at the three-character ICD-10 level, 36 (3.6%) had codes that were within the same anatomical or morphological cluster, and for only 36 (3.6%) cases were major discrepancies identified. Altogether, the agreement between IARC/WHO coding of cause-of-death information from ZAGS and MIAC coding of malignant neoplasms was therefore 96.4%. CONCLUSIONS RL completeness and agreement of cause-of-death information obtained from ZAGS and from MIAC were both very high. This is reassuring for the quality of cancer mortality follow-up of the Asbest chrysotile cohort. For future epidemiological studies in the Russian Federation, ZAGS appears to be a reliable information source for mortality follow-up, if the automated RL is complemented with manual searches of cohort members. MIAC is a good resource for prospective studies.
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Affiliation(s)
- J. Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - E. Kovalevskiy
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health,” Moscow, Russian Federation
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - M. Moissonnier
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - A. Olsson
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - D. Hashim
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - H. Kromhout
- Institute of Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - S. Kashanskiy
- Yekaterinburg Medical Research Center for Prophylaxis and Health Protection in Industrial Workers, Yekaterinburg, Russian Federation
| | - O. Chernov
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health,” Moscow, Russian Federation
| | - I. Bukhtiyarov
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health,” Moscow, Russian Federation
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - E. Ostroumova
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
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7
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Kromhout H. 1673d Assessing exposure to occupational chemicals in large-scale epidemiological studies on occupational cancers. Epidemiology 2018. [DOI: 10.1136/oemed-2018-icohabstracts.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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8
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Huss A, Schaap K, Kromhout H. A survey on abnormal uterine bleeding among radiographers with frequent MRI exposure using intrauterine contraceptive devices. Magn Reson Med 2017; 79:1083-1089. [DOI: 10.1002/mrm.26707] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/27/2017] [Accepted: 03/18/2017] [Indexed: 11/09/2022]
Affiliation(s)
- A. Huss
- Institute for Risk Assessment Sciences; Utrecht University; the Netherlands
| | - K. Schaap
- Institute for Risk Assessment Sciences; Utrecht University; the Netherlands
| | - H. Kromhout
- Institute for Risk Assessment Sciences; Utrecht University; the Netherlands
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9
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Martens AL, Slottje P, Timmermans DRM, Kromhout H, Vermeulen RCH, Smid T. Actual and perceived exposure to base stations and non-specific symptoms in a longitudinal study. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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Behrens T, Groß I, Siemiatycki J, Conway DI, Jöckel KH, Olsson A, Kromhout H, Straif K, Schüz J, Hovanec J, Kendzia B, Pesch B, Brüning T. Is occupational prestige an independent risk factor for lung cancer? Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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11
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Hovanec J, Siemiatycki J, Conway D, Jöckel KH, Olsson A, Schüz J, Straif K, Kromhout H, Kendzia B, Pesch B, Brüning T, Behrens T. Lungenkrebs und sozio-ökonomischer Status: die SYNERGY-Studie. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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de Jong K, Vonk JM, Kromhout H, Vermeulen R, Postma DS, Boezen HM. NOS1: a susceptibility gene for reduced level of FEV1 in the setting of pesticide exposure. Am J Respir Crit Care Med 2015; 190:1188-90. [PMID: 25398110 DOI: 10.1164/rccm.201404-0697le] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- K de Jong
- 1 University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC) Groningen, The Netherlands
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Beekhuizen J, Vermeulen R, van Eijsden M, van Strien R, Bürgi A, Loomans E, Guxens M, Kromhout H, Huss A. Modelling indoor electromagnetic fields (EMF) from mobile phone base stations for epidemiological studies. Environ Int 2014; 67:22-26. [PMID: 24632329 DOI: 10.1016/j.envint.2014.02.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 02/25/2014] [Accepted: 02/25/2014] [Indexed: 06/03/2023]
Abstract
Radio frequency electromagnetic fields (RF-EMF) from mobile phone base stations can be reliably modelled for outdoor locations, using 3D radio wave propagation models that consider antenna characteristics and building geometry. For exposure assessment in epidemiological studies, however, it is especially important to determine indoor exposure levels as people spend most of their time indoors. We assessed the accuracy of indoor RF-EMF model predictions, and whether information on building characteristics could increase model accuracy. We performed 15-minute spot measurements in 263 rooms in 101 primary schools and 30 private homes in Amsterdam, the Netherlands. At each measurement location, we collected information on building characteristics that can affect indoor exposure to RF-EMF, namely glazing and wall and window frame materials. Next, we modelled RF-EMF at the measurement locations with the 3D radio wave propagation model NISMap. We compared model predictions with measured values to evaluate model performance, and explored if building characteristics modified the association between modelled and measured RF-EMF using a mixed effect model. We found a Spearman correlation of 0.73 between modelled and measured total downlink RF-EMF from base stations. The average modelled and measured RF-EMF were 0.053 and 0.041mW/m(2), respectively, and the precision (standard deviation of the differences between predicted and measured values) was 0.184mW/m(2). Incorporating information on building characteristics did not improve model predictions. Although there is exposure misclassification, we conclude that it is feasible to reliably rank indoor RF-EMF from mobile phone base stations for epidemiological studies.
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Affiliation(s)
- J Beekhuizen
- Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, The Netherlands
| | - R Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, The Netherlands
| | - M van Eijsden
- Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam (GGD), 1018 WT, Amsterdam, The Netherlands
| | - R van Strien
- Department of Environmental Health, Public Health Service of Amsterdam (GGD), 1018 WT, Amsterdam, The Netherlands
| | - A Bürgi
- ARIAS umwelt.forschung.beratung, CH-3011, Bern, Switzerland
| | - E Loomans
- Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam (GGD), 1018 WT, Amsterdam, The Netherlands
| | - M Guxens
- Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, The Netherlands
| | - H Kromhout
- Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, The Netherlands
| | - A Huss
- Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, The Netherlands.
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De Matteis S, Consonni D, Lubin JH, Tucker M, Peters S, Vermeulen RC, Kromhout H, Bertazzi PA, Caporaso NE, Pesatori AC, Wacholder S, Landi MT. Impact of occupational carcinogens on lung cancer risk in a general population. Int J Epidemiol 2013. [DOI: 10.1093/ije/dyt177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Mehta AJ, Thun GA, Imboden M, Ferrarotti I, Keidel D, Künzli N, Kromhout H, Miedinger D, Phuleria H, Rochat T, Russi EW, Schindler C, Schwartz J, Vermeulen R, Luisetti M, Probst-Hensch N. Interactions betweenSERPINA1PiMZ genotype, occupational exposure and lung function decline. Occup Environ Med 2013; 71:234-40. [DOI: 10.1136/oemed-2013-101592] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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de Jong K, Boezen HM, Kromhout H, Vermeulen R, Postma DS, Vonk JM. Pesticides and other occupational exposures are associated with airway obstruction: the LifeLines cohort study. Occup Environ Med 2013; 71:88-96. [DOI: 10.1136/oemed-2013-101639] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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17
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Beekhuizen J, Vermeulen R, Kromhout H, Bürgi A, Huss A. Geospatial modelling of electromagnetic fields from mobile phone base stations. Sci Total Environ 2013; 445-446:202-209. [PMID: 23333516 DOI: 10.1016/j.scitotenv.2012.12.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 12/07/2012] [Accepted: 12/07/2012] [Indexed: 06/01/2023]
Abstract
There is concern that exposure to radio frequency electromagnetic fields (RF-EMF) from mobile phone base stations might lead to adverse health effects. In order to assess potential health risks, reliable exposure assessment is necessary. Geospatial exposure modelling is a promising approach to quantify ambient exposure to RF-EMF for epidemiological studies involving large populations. We modelled RF-EMF for Amsterdam, The Netherlands by using a 3D RF-EMF model (NISMap). We subsequently compared modelled results to RF-EMF measurements in five areas with differing built-up characteristics (e.g., low-rise residential, high-rise commercial). We performed, in each area, repeated continuous measurements along a predefined ~2 km long path. This mobile monitoring approach captures the high spatial variability in electric field strengths. The modelled values were in good agreement with the measurements. We found a Spearman correlation of 0.86 for GSM900 and 0.85 for UMTS between modelled and measured values. The average measured GSM900 field strength was 0.21 V/m, and UMTS 0.09 V/m. The model underestimated the GSM900 field strengths by 0.07 V/m, and slightly overestimated the UMTS field strengths by 0.01 V/m. NISMap provides a reliable way of assessing environmental RF-EMF exposure for epidemiological studies of RF-EMF and health in urban areas.
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Affiliation(s)
- J Beekhuizen
- Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, Jenalaan 18D, 3584 CK, Utrecht, The Netherlands.
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18
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Peters S, Kromhout H, Olsson A, Wuchmann HE, Bruske I, Consonni D, Landi MT, Caporaso N, Siemiatycki J, Richiardi L, Mirabelli D, Simonato L, Gustavsson P, Plato N, Jockel KH, Ahrens W, Pohlabeln H, Boffetta P, Brennan P, Zaridze D, Cassidy A, Lissowska J, Szeszenia-Dabrowska N, Rudnai P, Fabianova E, Forastiere F, Bencko V, Foretova L, Janout V, Stucker I, Dumitru RS, Benhamou S, Bueno-de-Mesquita B, Kendzia B, Pesch B, Straif K, Bruning T, Vermeulen R. Occupational exposure to organic dust increases lung cancer risk in the general population. Occup Environ Med 2011. [DOI: 10.1136/oemed-2011-100382.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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19
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Basinas I, Sigsgaard T, Heederik D, Takai H, Omland O, Andersen NT, Wouters IM, Bonlokke J, Kromhout H, Schlunssen V. Inhalable dust and endotoxin exposure among Danish pig, dairy, poultry and mink farmers: results from the SUS cohort study. Occup Environ Med 2011. [DOI: 10.1136/oemed-2011-100382.163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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20
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Loomis DP, Kromhout H, Peipins LA, Kleckner RC, Iriye R, Savitz DA. Sampling Design and Field Methods of a Large, Randomized, Multisite Survey of Occupational Magnetic Field Exposure. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/1047322x.1994.10388264] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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21
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Hémon D, Bouyer J, Berrino F, Brochard P, Glass DC, Goldberg M, Kromhout H, Lynge E, Pannett B, Segnan N, Smit HA. Retrospective Evaluation of Occupational Exposures in Cancer Epidemiology: A European Concerted Action of Research. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/1047322x.1991.10387925] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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22
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Dumas O, Smit LAM, Pin I, Kromhout H, Siroux V, Nadif R, Vermeulen R, Heederik D, Hery M, Choudat D, Kauffmann F, Le Moual N. Do young adults with childhood asthma avoid occupational exposures at first hire? Eur Respir J 2010; 37:1043-9. [PMID: 20884739 DOI: 10.1183/09031936.00057610] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Information on the healthy worker hire effect in relation to asthma is scant. We aimed to assess whether and how childhood asthma-related characteristics (before hire) relate to occupational exposures at first hire. Analyses were conducted in 298 children examined at the first survey of the Epidemiological Study on the Genetics and Environment of Asthma (1991-1995), who reported a training period or a job at follow-up in 2003-2007 (aged 17-29 yrs; 53% males). Exposure likelihood to dust, gases and/or fumes in their first occupation was estimated by the ALOHA job exposure matrix. Asthma before the first occupation and two asthma classifications for severity (Global Initiative for Asthma 2002 guidelines) and symptoms were defined by questionnaire. In their first job, 47% of subjects were exposed. After adjustment (age, sex and education), pre-hire onset asthmatics (59%) were nonsignificantly less likely to be exposed (OR 0.67, 95% CI 0.41-1.11). Associations were stronger when considering those with severe asthma or high symptom score in childhood (OR 0.27 (95% CI 0.11-0.63) and OR 0.49 (95% CI 0.25-0.99), respectively). The association was observed in those who completed a university degree (OR 0.55, 95% CI 0.29-1.04) but not in the others (OR 0.98, 95% CI 0.44-2.22), with consistent results for all asthma characteristics. Results suggest a healthy worker hire effect in subjects with more severe or more symptomatic asthma in childhood. Education may modulate self-selection.
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Affiliation(s)
- O Dumas
- Respiratory and Environmental Epidemiology, CESP/U 1018 Inserm,Villejuif Cedex, France.
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23
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Naidoo S, London L, Rother HA, Burdorf A, Naidoo RN, Kromhout H. Pesticide safety training and practices in women working in small-scale agriculture in South Africa. Occup Environ Med 2010; 67:823-8. [PMID: 20576924 DOI: 10.1136/oem.2010.055863] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Unregulated use of pesticides continues in developing countries in the presence of illiteracy and limited safety training and practices. This paper describes training and safety practices when mixing and spraying pesticides, and acetylcholinesterase levels among women farmers in KwaZulu-Natal, South Africa. METHODS A cross-sectional study conducted in women working in small-scale agriculture in rural KwaZulu-Natal, South Africa in 2006 assessed pesticide training and safety practices using a questionnaire survey and measured acetylcholinesterase levels in 803 women. Three components of safety behaviour were identified through principle component analysis and described. RESULTS The mean age of participants was 41.8 years (range 18-82 years) with a mean of 6.9 years (range 1-12 years) of education among school attendees. Among the 803 women included, 366 (45.6%) were the primary sprayers on their farm. Only 16.4% of the sprayers had ever attended a pesticide training course and only 18.0% reported ever reading pesticide labels. Of the women using some form of protective equipment, 56.7% and 54.9% reported doing so when mixing and spraying pesticides, respectively. The mean acetylcholinesterase level corrected for haemoglobin among study participants was 28.9 U/g Hb (95% CI 28.4 to 29.4). CONCLUSION Women working in small-scale agriculture in rural KwaZulu-Natal with limited access to pesticide training observe few safety practices when mixing and spraying pesticides.
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Affiliation(s)
- S Naidoo
- Department of Occupational and Environmental Health, School of Family and Public Health Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
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24
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Henneberger PK, Mirabelli MC, Kogevinas M, Antó JM, Plana E, Dahlman-Höglund A, Jarvis DL, Kromhout H, Lillienberg L, Norbäck D, Olivieri M, Radon K, Torén K, Urrutia I, Villani S, Zock JP. The occupational contribution to severe exacerbation of asthma. Eur Respir J 2010; 36:743-50. [PMID: 20351033 DOI: 10.1183/09031936.00135109] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The goal of this study was to identify occupational risk factors for severe exacerbation of asthma and estimate the extent to which occupation contributes to these events. The 966 participants were working adults with current asthma who participated in the follow-up phase of the European Community Respiratory Health Survey. Severe exacerbation of asthma was defined as self-reported unplanned care for asthma in the past 12 months. Occupations held in the same period were combined with a general population job-exposure matrix to assess occupational exposures. 74 participants reported having had at least one severe exacerbation event, for a 1-yr cumulative incidence of 7.7%. From regression models that controlled for confounders, the relative risk (RR) was statistically significant for low (RR 1.7, 95% CI 1.1-2.6) and high (RR 3.6, 95% CI 2.2-5.8) biological dust exposure, high mineral dust exposure (RR 1.8, 95% CI 1.02-3.2), and high gas and fumes exposure (RR 2.5, 95% CI 1.2-5.5). The summary category of high dust, gas, or fumes exposure had RR 3.1 (95% CI 1.9-5.1). Based on this RR, the population attributable risk was 14.7% among workers with current asthma. These results suggest occupation contributes to approximately one in seven cases of severe exacerbation of asthma in a working population, and various agents play a role.
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Affiliation(s)
- P K Henneberger
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, MS H2800, 1095 Willowdale Road, Morgantown, WV 26505, USA.
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Olivieri M, Mirabelli MC, Plana E, Radon K, Antó JM, Bakke P, Benke G, D'Errico A, Henneberger P, Kromhout H, Norbäck D, Torén K, van Sprundel M, Villani S, Wieslander G, Zock JP, Kogevinas M. Healthy hire effect, job selection and inhalation exposure among young adults with asthma. Eur Respir J 2010; 36:517-23. [PMID: 20185427 DOI: 10.1183/09031936.00125709] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of the present study was to assess whether asthma onset prior to entering the workforce influences whether a person holds a subsequent job with asthma-related inhalation exposures. The data of 19,784 adults from the European Community Respiratory Health Survey were analysed. For each respondent, a current or previously held job was linked to a job exposure matrix assigning high, low or no exposure to dust, gases or fumes. Jobs were also categorised according to the risk of exposures related to occupational asthma. Associations between asthma and subsequent occupational exposures were assessed using logistic regression models, with a random intercept for study centre and fixed adjustment for age, sex, type of study sample and smoking status. Of the respondents, 8% (n = 1,619) reported asthma with onset before completion of full-time education. This population was at decreased risk of having a job with high (odds ratio 0.79; 95% confidence interval 0.68-0.92) or low (0.91; 0.80-1.03) exposure to dust, gases or fumes. The associations were consistent across exposure types (dusts, gases or fumes) and for jobs with a high risk of occupational asthma. Adults with asthma onset prior to entering the workforce may be less likely to hold jobs involving inhalation exposures.
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Affiliation(s)
- M Olivieri
- Dept of Medicine and Public Health, Unit of Occupational Medicine, University Hospital of Verona, University of Verona, 37129 Verona, Italy.
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Schinkel J, Fransman W, Heussen H, Kromhout H, Marquart H, Tielemans E. Cross-validation and refinement of the Stoffenmanager as a first tier exposure assessment tool for REACH. Occup Environ Med 2009; 67:125-32. [DOI: 10.1136/oem.2008.045500] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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27
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Miller BG, Fransman W, Heederik D, Hurley JF, Kromhout H, Fitzsimons E. A review of the data quality and comparability of case-control studies of low-level exposure to benzene in the petroleum industry. Int Arch Occup Environ Health 2009; 83:69-76. [PMID: 19756697 DOI: 10.1007/s00420-009-0463-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 08/24/2009] [Indexed: 11/26/2022]
Abstract
PURPOSE Published case-control studies of risks of leukaemia following low exposures to benzene in the distribution of petroleum (gasoline) have not all identified the same level of risk, but the studies have had differences in cohort inclusion, case determination and availability of occupational and lifestyle data. We reviewed the quality and comparability of the data from three (of four) studies. METHODS Through site visits, discussions with the investigators and reading study reports, we reviewed and audited the methods used for selecting cases and controls, for estimating individual exposures and for analysing and interpreting the data. Case-control comparisons of exposures were examined using customized graphs. RESULTS We found that there were no issues of subject selection, methods or general data quality that were likely to have distorted their internal comparisons; we could not check in detail whether the metric for exposure assessments was the same across the studies; the exposure assessments for the Australian study required the least backward estimation, and the Canadian, which also had fewest cases, the most; evidence of an increased risk at higher exposures in Australia was convincing. CONCLUSIONS The findings are consistent with some effect of benzene at higher lifetime exposures. A proposed pooled analysis should improve quantification of any exposure-response relationship.
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Affiliation(s)
- B G Miller
- Institute of Occupational Medicine, Research Avenue North, Riccarton, Edinburgh, EH14 4AP, UK.
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Abstract
BACKGROUND Musculoskeletal pain is associated with demographic, occupational and physical factors. METHODS Our study investigated the prevalence and factors associated with musculoskeletal pain in 911 women working in small-scale agriculture in rural northern KwaZulu-Natal, South Africa in 2006 using a questionnaire survey. RESULTS In total, 67% (n = 574) of women reported any chronic musculoskeletal pain. The 12-month prevalence of pain ranged from 63.9% to 73.3% and the prevalence of specific chronic pain lasting more than 3 months ranged from 42.8% to 48.3%. Older age, carrying heavy loads, working with hands above shoulder height, and frequently squatting and kneeling were associated with chronic musculoskeletal pain. CONCLUSION The prevalence of pain reported in our study, was similar to other developing countries, but considerably higher than in developed countries. Ergonomic interventions including improved and adapted work techniques and tools should be considered to reduce the prevalence of pain in our study population.
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Affiliation(s)
- S Naidoo
- Department of Occupational and Environmental Health, Faculty of Medicine, University of KwaZulu-Natal, KwaZulu-Natal, South Africa.
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Torén K, Zock JP, Kogevinas M, Plana E, Sunyer J, Radon K, Jarvis D, Kromhout H, d'Errico A, Payo F, Antó JM, Blanc PD. An international prospective general population-based study of respiratory work disability. Thorax 2009; 64:339-44. [PMID: 19158120 DOI: 10.1136/thx.2008.105007] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Previous cross-sectional studies have shown that job change due to breathing problems at the workplace (respiratory work disability) is common among adults of working age. That research indicated that occupational exposure to gases, dust and fumes was associated with job change due to breathing problems, although causal inferences have been tempered by the cross-sectional nature of previously available data. There is a need for general population-based prospective studies to assess the incidence of respiratory work disability and to delineate better the roles of potential predictors of respiratory work disability. METHODS A prospective general population cohort study was performed in 25 centres in 11 European countries and one centre in the USA. A longitudinal analysis was undertaken of the European Community Respiratory Health Survey including all participants employed at any point since the baseline survey, 6659 subjects randomly sampled and 779 subjects comprising all subjects reporting physician-diagnosed asthma. The main outcome measure was new-onset respiratory work disability, defined as a reported job change during follow-up attributed to breathing problems. Exposure to dusts (biological or mineral), gases or fumes during follow-up was recorded using a job-exposure matrix. Cox proportional hazard regression modelling was used to analyse such exposure as a predictor of time until job change due to breathing problems. RESULTS The incidence rate of respiratory work disability was 1.2/1000 person-years of observation in the random sample (95% CI 1.0 to 1.5) and 5.7/1000 person-years in the asthma cohort (95% CI 4.1 to 7.8). In the random population sample, as well as in the asthma cohort, high occupational exposure to biological dust, mineral dust or gases or fumes predicted increased risk of respiratory work disability. In the random sample, sex was not associated with increased risk of work disability while, in the asthma cohort, female sex was associated with an increased disability risk (hazard ratio 2.8, 95% CI 1.3 to 5.9). CONCLUSIONS Respiratory work disability is common overall. It is associated with workplace exposures that could be controlled through preventive measures.
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Affiliation(s)
- K Torén
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy at University of Gothenburg, Box 414, S-405 30 Göteborg, Sweden.
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de Vocht F, Kromhout H, Ferro G, Boffetta P, Burstyn I. Bayesian modelling of lung cancer risk and bitumen fume exposure adjusted for unmeasured confounding by smoking. Occup Environ Med 2008; 66:502-8. [PMID: 19060029 DOI: 10.1136/oem.2008.042606] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Residual confounding can be present in epidemiological studies because information on confounding factors was not collected. A Bayesian framework, which has the advantage over frequentist methods that the uncertainty in the association between the confounding factor and exposure and disease can be reflected in the credible intervals of the risk parameter, is proposed to assess the magnitude and direction of this bias. METHODS To illustrate this method, bias from smoking as an unmeasured confounder in a cohort study of lung cancer risk in the European asphalt industry was assessed. A Poisson disease model was specified to assess lung cancer risk associated with career average, cumulative and lagged bitumen fume exposure. Prior distributions for the exposure strata, as well as for other covariates, were specified as uninformative normal distributions. The priors on smoking habits were specified as Dirichlet distributions based on smoking prevalence estimates available for a sub-cohort and assumptions about precision of these estimates. RESULTS Median bias in this example was estimated at 13%, and suggested an attenuating effect on the original exposure-disease associations. Nonetheless, the results still implied an increased lung cancer risk, especially for average exposure. CONCLUSIONS This Bayesian framework provides a method to assess the bias from an unmeasured confounding factor taking into account the uncertainty surrounding the estimate and from random sampling error. Specifically for this example, the bias arising from unmeasured smoking history in this asphalt workers' cohort is unlikely to explain the increased lung cancer risk associated with average bitumen fume exposure found in the original study.
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Affiliation(s)
- F de Vocht
- Occupational and Environmental Health Research Group, School of Translational Medicine, Faculty of Medical and Human Sciences, The University of Manchester, Manchester M13 8GE, UK.
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de Vocht F, Sobala W, Peplonska B, Wilczynska U, Gromiec J, Szeszenia-Dabrowska N, Kromhout H. Elaboration of a quantitative job-exposure matrix for historical exposure to airborne exposures in the Polish rubber industry. Am J Ind Med 2008; 51:852-60. [PMID: 18651573 DOI: 10.1002/ajim.20615] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND A job-exposure matrix (JEM) for inhalable aerosols, aromatic amines, and cyclohexane soluble matter (CSM) was elaborated based on measurements collected routinely between 1981 and 1996. METHODS The data were grouped based on similarities in exposure levels and time trends in different departments, and were analyzed using smoothing splines and mixed effects models. RESULTS Although higher than in western European countries, inhalable aerosol exposure decreased after changes in production volume and implementation of exposure reduction measures in mid-1980s. Aromatic amines concentrations first increased following the factory's production volume, but subsequently decreased in more recent years. CSM concentrations were uniformly distributed between departments. CONCLUSIONS This JEM provides an overview of historical exposure levels in a large Polish rubber factory and will enable estimation of lifetime exposure for individual workers in a Polish rubber workers cohort and further investigation of the associations between specific exposures and cancer risk.
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Affiliation(s)
- F de Vocht
- Occupational & Environmental Health Research Group, School of Translational Medicine, Faculty of Medical and Human Sciences, The University of Manchester, Manchester, UK.
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Burstyn I, Kromhout H. Still no evidence that coal tar exposure confounded the association between bitumen/asphalt fume and lung cancer in the cohort of European asphalt workers. J Occup Environ Hyg 2008; 5:D73-D76. [PMID: 18464093 DOI: 10.1080/15459620802111525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Bongers S, Janssen NAH, Reiss B, Grievink L, Lebret E, Kromhout H. Challenges of exposure assessment for health studies in the aftermath of chemical incidents and disasters. J Expo Sci Environ Epidemiol 2008; 18:341-359. [PMID: 18461091 DOI: 10.1038/jes.2008.23] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Accepted: 03/07/2008] [Indexed: 05/26/2023]
Abstract
Exposure assessment during and after acute chemical incidents and disasters is essential for health studies that may follow. During chemical incidents, the focus usually lies on risk assessment and afterward attention shifts toward possible (long-term) health effects. This may lead to insufficient available data on exposure to study the association between exposure and health outcome, and collection of additional exposure data is often required. Literature on health studies conducted after several chemical incidents was reviewed to obtain better insight on the needs of health studies. Four different types of scenarios were distinguished based on when exposure data were collected and the exposure data used for health studies. These four scenarios gave insight on exposure data needed for conclusive health studies and when different methods of exposure data collection should be used. Literature indicated that adequate and rapid exposure assessment during chemical incidents is vital for health studies, because data that are not collected during or directly after an incident may be irretrievably lost. Poor exposure assessment is not always the only problem in health studies. Problems in health studies including poor exposure assessment may be prevented when the general design and needs of health studies are taken into account when designing contingency plans. Together with measures that will help facilitate funding, design, and coordination of health studies, disaster management programs should, among others, prepare for methods that lead to a swift identification of released substances, determination of concentrations and dispersion of released substances, designing basic questionnaire outlines, and rapid evaluation of the usefulness and necessity of employing biological sampling.
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Affiliation(s)
- Sim Bongers
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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Peters S, Talaska G, Jonsson BA, Kromhout H, Vermeulen R. Polycyclic Aromatic Hydrocarbon Exposure, Urinary Mutagenicity, and DNA Adducts in Rubber Manufacturing Workers. Cancer Epidemiol Biomarkers Prev 2008; 17:1452-9. [DOI: 10.1158/1055-9965.epi-07-2777] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Van Rooij JGM, Kasper A, Triebig G, Werner P, Jongeneelen FJ, Kromhout H. Trends in occupational exposure to styrene in the European glass fibre-reinforced plastics industry. Ann Occup Hyg 2008; 52:337-49. [PMID: 18550625 PMCID: PMC2488378 DOI: 10.1093/annhyg/men020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Aim: This study presents temporal trends of styrene exposure for workers in the European glass fibre-reinforced plastics (GRP) industry during the period 1966–2002. Methods: Data of personal styrene exposure measurements were retrieved from reports, databases and peer-reviewed papers. Only sources with descriptive statistics of personal measurements were accepted. The styrene exposure data cover personal air samples and biological monitoring data, that is, urinary styrene metabolites (mandelic acid and/or phenylglyoxylic acid) and styrene in blood. Means of series of measurements were categorized by year, country, production process, job and sampling strategy. Linear mixed models were used to identify temporal trends and factors affecting exposure levels. Results: Personal exposure measurements were available from 60 reports providing data on 24145 1–8-h time-weighted average shift personal air samples. Available data of biological exposure indicators included measurements of mandelic acid in post-shift urine (6361 urine samples being analysed). Trend analyses of the available styrene exposure data showed that the average styrene concentration in the breathing zone of open-mould workers in the European GRP industry has decreased on average by 5.3% per year during the period 1966–1990 and by only 0.4% annually in the period after 1990. The highest exposures were measured in Southern Europe and the lowest exposures in Northern Europe with Central Europe in between. Biological indicators of styrene (mandelic acid in post-shift urine) showed a somewhat steeper decline (8.9%), most likely because urine samples were collected in companies that showed a stronger decrease of styrene exposure in air than GRP companies where no biological measurements were carried out.
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Affiliation(s)
- J G M Van Rooij
- IndusTox Consult, P.O. Box 31070, Nijmegen 6503 CB, the Netherlands.
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de Vocht F, Vermeulen R, Burstyn I, Sobala W, Dost A, Taeger D, Bergendorf U, Straif K, Swuste P, Kromhout H. Exposure to inhalable dust and its cyclohexane soluble fraction since the 1970s in the rubber manufacturing industry in the European Union. Occup Environ Med 2008; 65:384-91. [DOI: 10.1136/oem.2007.034470] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mannetje AT, Dryson E, Walls C, McLean D, McKenzie F, Maule M, Cheng S, Cunningham C, Kromhout H, Boffetta P, Blair A, Pearce N. High risk occupations for non-Hodgkin's lymphoma in New Zealand: case-control study. Occup Environ Med 2008; 65:354-63. [DOI: 10.1136/oem.2007.035014] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lillienberg L, Zock JP, Kromhout H, Plana E, Jarvis D, Torén K, Kogevinas M. A population-based study on welding exposures at work and respiratory symptoms. ACTA ACUST UNITED AC 2008; 52:107-15. [PMID: 18216372 DOI: 10.1093/annhyg/mem063] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In the first European Community Respiratory Health Survey (ECRHS I), an excess asthma risk was associated with high exposure to gases and fumes, mineral and biological dusts. In a 9-year follow-up study (ECRHS II), the aim was to study if welding at work increases the risk of asthma symptoms, wheeze and chronic bronchitis symptoms. The study also aimed to identify specific welding risk factors. In a random population sample of individuals from 22 European centres in 10 countries, 316 males reported welding at work during the follow-up period. These individuals responded to a supplemental questionnaire about frequency of welding, use of different methods and materials, welding environment and respiratory protection. Cumulative exposure to welding fumes for the follow-up period was estimated by using a database on welding fume exposures. Log-binomial regression models were used to estimate prevalence ratios (PR) with 95% confidence intervals (CIs) for prevalence of asthma symptoms or asthma medication, wheeze and chronic bronchitis symptoms in relation to welding methods and welded materials as well as estimated cumulative welding fume exposure compared to an external reference group. In the study population of 316 males, 62% performed welding <1 h day(-1), 23% 1-3 h day(-1) and 15% >4 h day(-1). Welding was a common task in many occupations and only 7% of the individuals actually called themselves welders and flame cutters, while the largest groups doing welding worked in construction or were motor, agricultural and industrial mechanics and fitters. Welding at work was not associated with an increased prevalence of asthma symptoms or wheeze but there was an association with chronic bronchitis symptoms (PR = 1.33, 1.00-1.76). Using assigned cumulative exposure in tertiles showed that the lowest exposed tertile had the highest PR of bronchitis symptoms. Chronic bronchitis symptoms was significantly higher in those frequently welding in galvanized steel or iron (PR = 2.14, 1.24-3.68) and in those frequently manual welding stainless steel (PR = 1.92, 1.00-3.66). There was also an increase in the prevalence of wheeze in individuals welding painted metal (PR = 1.66, 0.99-2.78; PR = 1.83, 0.90-3.71). Welding with manual metal arc technique <1 day week(-1) showed a prevalence risk of 1.69 for wheeze (CI = 1.16-2.46). In conclusion, the present study shows an association between welding in galvanized material and stainless steel and chronic bronchitis symptoms. There was also an increased prevalence of wheeze and welding in painted metal. The results support that welding in coated material is a respiratory hazard underscoring the importance of preventive actions.
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Affiliation(s)
- L Lillienberg
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
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Jin Y, Deddens JA, Saejiw N, Chaiear N, Ngoencharee J, Sadhra S, Coble JB, Vermeulen RCH, Ji BT, Xue S, Dosemeci M, Lu W, Zheng W, Gao YT, Blair A, Chow WH, Rothman N, Kromhout H, Fransman W, de Vocht F, van Wendel de Joode B, Neitzel RL, Daniell WE, Davies HW, Sheppard L, Seixas NS, Teschke K, Johnson P, Trask C, Chow Y, Village J, Koehoorn M. Exposure assessment 2. Occup Environ Med 2007. [DOI: 10.1136/oem.64.12.e18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Koskela RS, Sorsa JA, Koski A, Mutanen P, Gibbs GW, Yu ITS, Tse LA, de Vocht F, Burstyn I, Ferro G, Olsson A, Hashibe M, Kromhout H, Boffetta P, Olsson AC, Fevotte J, Mannetje AT, Fletcher T, Zaridze D, Szeszenia-Dabrowska N, Rudnai P, Lissowska J, Fabianova E, Cassidy A, Mates D, Bencko V, Foretova L, Janout V, Brennan P, Boffetta P, Schubauer-Berigan MK, Deddens JA, Steenland K, Sanderson WT, Petersen MR. Cancer 2. Occup Environ Med 2007. [DOI: 10.1136/oem.64.12.e19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sutedja NA, Veldink JH, Fischer K, Kromhout H, Wokke J, Huisman MH, Heederik DJ, Van den Berg LH. Lifetime occupation, education, smoking, and risk of ALS. Neurology 2007; 69:1508-14. [DOI: 10.1212/01.wnl.0000277463.87361.8c] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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de Vocht F, Liket L, De Vocht A, Mistry T, Glover P, Gowland P, Kromhout H. Exposure to alternating electromagnetic fields and effects on the visual and visuomotor systems. Br J Radiol 2007; 80:822-8. [PMID: 17875601 DOI: 10.1259/bjr/22263979] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Acute effects on the visual and visuo-motor systems by exposure to electromagnetic fields (EMFs) at a frequency and amplitude similar to those produced by MR imaging gradient coils were assessed. 40 volunteers were exposed in random order to three, time varying, magnetic field gradients (0, 20 and 10 mT m(-1)r.m.s.). The waveform was 50 cycles of a 490 Hz sinusoidal waveform repeated every second with a total duration of 10 min for each trial. The EMFs were generated using an in-house designed and built magnetic gradient coil and waveform generator. During each trial, a test battery assessing the visual sensory (FACT) and visuo-motor (Pursuit Aiming II and visual tracking) neurobehavioral domains was completed by all volunteers. The sequence of these tests was assigned at random for each volunteer. Performance in these tests was analysed using linear mixed effects models adjusted for confounding factors collected in a pre-trial questionnaire. Variability of the estimates was assessed using a delete-1 jack-knife procedure. There was a trend for visuo-motor accuracy to be reduced (p = 0.06) by 1% during high exposure, but not at medium exposure. There was a weaker trend for visual contrast sensitivity to be improved by 12% and 21% during medium and high exposure, respectively, compared with the non-exposed sessions (p = 0.08). These effects did not reach 5% statistical significance within a population of 40 volunteers, but also the magnitude of these effects did not depend on single "extreme" observations.
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Affiliation(s)
- F de Vocht
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, The Netherlands.
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de Vocht F, Burstyn I, Straif K, Vermeulen R, Jakobsson K, Nichols L, Peplonska B, Taeger D, Kromhout H. Occupational exposure to NDMA and NMor in the European rubber industry. ACTA ACUST UNITED AC 2007; 9:253-9. [PMID: 17344951 DOI: 10.1039/b615472g] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Many nitrosamines are suspected of being human carcinogens, with the highest concentrations in the environment being measured in the rubber industry. Time trends of personal exposure to N-nitrosodimethylamine (NDMA) and to N-nitrosomorpholine (NMor) during the past two decades in the German rubber industry were analysed and compared with cross-sectional studies in the same period in the Netherlands, Poland, the UK and Sweden. In the majority of the surveyed departments exposures reduced over time, but considerable heterogeneity was present between departments and sectors. Significant reductions were primarily found in curing and post-treating departments and ranged from -3% year(-1) to -19% year(-1). In contrast, NDMA levels increased (+13% year(-1)) in maintenance and engineering in the tyres industry. Average NDMA-levels in general rubber goods (GRG) and NMor-levels in tyre production in Germany did not decrease significantly in the past two decades, whereas NDMA-levels in tyre production (-10% year(-1)) and NMor-levels in GRG (-7% year(-1)) declined significantly after the introduction of an exposure limit for total nitrosamines in Germany in 1988. Confidence intervals of average exposures in other studied countries largely overlap trends observed in Germany. Exposure to N-nitrosamines decreased on average two-to-five fold in the German rubber industry with comparable concentration levels in other European countries. Although average levels are well below the current limits exposure has not been eliminated, and incidental high exposures do still occur.
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Affiliation(s)
- F de Vocht
- Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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de Vocht F, Stevens T, Glover P, Sunderland A, Gowland P, Kromhout H. Cognitive effects of head-movements in stray fields generated by a 7 Tesla whole-body MRI magnet. Bioelectromagnetics 2007; 28:247-55. [PMID: 17290435 DOI: 10.1002/bem.20311] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The study investigates the impact of exposure to the stray magnetic field of a whole-body 7 T MRI scanner on neurobehavioral performance and cognition. Twenty seven volunteers completed four sessions, which exposed them to approximately 1600 mT (twice), 800 mT and negligible static field exposure. The order of exposure was assigned at random and was masked by placing volunteers in a tent to hide their position relative to the magnet bore. Volunteers completed a test battery assessing auditory working memory, eye-hand co-ordination, and visual perception. During three sessions the volunteers were instructed to complete a series of standardized head movements to generate additional time-varying fields ( approximately 300 and approximately 150 mT.s(-1) r.m.s.). In one session, volunteers were instructed to keep their heads as stable as possible. Performance on a visual tracking task was negatively influenced (P<.01) by 1.3% per 100 mT exposure. Furthermore, there was a trend for performance on two cognitive-motor tests to be decreased (P<.10). No effects were observed on working memory. Taken together with results of earlier studies, these results suggest that there are effects on visual perception and hand-eye co-ordination, but these are weak and variable between studies. The magnitude of these effects may depend on the magnitude of time-varying fields and not so much on the static field. While this study did not include exposure above 1.6 T, it suggests that use of strong magnetic fields is not a significant confounder in fMRI studies of cognitive function. Future work should further assess whether ultra-high field may impair performance of employees working in the vicinity of these magnets.
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Affiliation(s)
- F de Vocht
- Environmental and Occupational Health Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
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Affiliation(s)
- H Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands.
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Curwin B, Misty H, Sanderson W, Striley C, Heederik D, Kromhout H, Reynolds S, Alavanja M. Pesticide Dose Estimates for Children of Iowa Farmers and Non-Farmers. Epidemiology 2006. [DOI: 10.1097/00001648-200611001-00220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
OBJECTIVES The objectives were (i) to identify occupational populations outside hospitals working with antineoplastic drugs, (ii) to determine the size of the populations 'at risk', (iii) to identify major determinants and routes of exposure outside hospitals and (iv) to estimate exposure levels and frequencies relative to levels found in hospitals. METHODS The survey consisted of two phases; (i) identification of activities with potential exposure to antineoplastic drugs by literature review, interviews, questionnaires and workplace visits, (ii) exploratory measurements of exposure and surface contamination in selected sectors. RESULTS Eight sectors were identified with potential exposure to antineoplastic drugs: pharmaceutical industry, pharmacies, universities, veterinary medicine, nursing homes, home care, laundry facilities, and waste treatment. Four sectors were of primary concern: veterinary medicine, home care, nursing homes and industrial laundries. The populations potentially exposed in these sectors vary considerably (from several tens to thousands of workers), as do their levels of exposure. Exposure measurements collected in the veterinary medicine sector showed that workers are indeed exposed to antineoplastic drugs and, in some cases (on gloves after administration), levels were 15 times higher than levels measured during administration in hospitals. Workers sorting contaminated hospital laundry in industrial laundry facilities were exposed to antineoplastic drugs through inhalation. For the home care and nursing homes sectors the highest exposure levels were found when cleaning toilets and washing treated patients. These two sectors are expected to have the largest exposed population (5,000-10,000 individuals). CONCLUSIONS This study has resulted in a comprehensive overview of populations with potential exposure to antineoplastic drugs. Exposure levels can potentially be high compared with the hospital environment, because exposure routes are complex and awareness of the hazard (and therefore use of protective measures) is low. The number of individuals outside hospitals in The Netherlands exposed to antineoplastic drugs is estimated to be between 5,000 and 15,000.
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Affiliation(s)
- T Meijster
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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48
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Meijster T, Fransman W, van Hemmen J, Kromhout H, Heederik D, Tielemans E. A probabilistic assessment of the impact of interventions on oncology nurses' exposure to antineoplastic agents. Occup Environ Med 2006; 63:530-7. [PMID: 16551759 PMCID: PMC2078132 DOI: 10.1136/oem.2005.022723] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE The main goal was to investigate the potential of a probabilistic approach for exposure assessment and use this information to evaluate the impact of a complex of policy actions/interventions on dermal exposure to antineoplastic agents among oncology nurses. The central theme of this study was to make optimal use of existing data, supplemented only with limited additional information from a questionnaire survey. METHODS A task based exposure model was used to estimate dermal exposure of the hands among oncology nurses in non-academic hospitals in the Netherlands. Monte Carlo simulation was used to integrate information from available (exposure) studies and generate exposure distributions for the total population of oncology nurses in both pre- and post-intervention situation. Graphs and descriptive statistics of the simulated exposure distributions were used to evaluate trends in population exposure. RESULTS The inventory showed that important intervention occurred in the preparation and administering of antineoplastic agents and in the handling of urine. Hardly any changes were identified in de nursing tasks. The use of gloves seemed to have decreased for a number of tasks. The results of the analysis show that the interventions did not affect the median exposure. However frequencies of occurrence of individuals with very high and very low total dermal exposures decreased substantially in the post-intervention situation. Analysis of the effect of pregnancy showed that pregnancy is very unlikely to influence exposure or any of the key input variables. CONCLUSIONS The present study shows that the probabilistic approach adds valuable information to deterministic exposure assessment, especially when extrapolating data on a subpopulation to populations of individuals at large. The results show that the identified changes in the past decade in Dutch non-academic hospitals resulted in changes in the exposure distribution of antineoplastic agents among oncology nurses.
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Affiliation(s)
- T Meijster
- Risk Assessment in the Work Environment, a collaborative centre between IRAS and TNO Quality of Life, Utrecht, The Netherlands.
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49
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Abstract
AIMS To study the validity of using a cross-sectional industry-wide exposure survey to develop exposure groupings for epidemiological purposes that extend beyond the time period in which the exposure data were collected. METHODS Exposure determinants were used to group workers into high, medium, and low exposure groups. The contrast of this grouping and other commonly used grouping schemes based on plant and department within this exposure survey and a previously conducted survey within the same industry (and factories) were estimated and compared. RESULTS Grouping of inhalable and dermal exposure based on exposure determinants resulted in the highest, but still modest, contrast (epsilon approximately 0.3). Classifying subjects based on a combination of plant and department resulted in a slightly lower contrast (epsilon approximately 0.2). If the determinant based grouping derived from the 1997 exposure survey was used to classify workers in the 1988 survey the average contrast decreased significantly for both exposures (epsilon approximately 0.1). On the contrary, the exposure classification based on plant and department increased in contrast (from epsilon approximately 0.2 to epsilon approximately 0.3) and retained its relative ranking overtime. CONCLUSIONS Although determinant based groupings seem to result in more efficient groupings within a cross-sectional survey, they have to be used with caution as they might result in significant less contrast beyond the studied population or time period. It is concluded that a classification based on plant and department might be more desirable for retrospective studies in the rubber manufacturing industry, as they seem to have more historical relevance and are most likely more accurately recorded historically than information on exposure determinants in a particular industry.
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Affiliation(s)
- R Vermeulen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD 20892, USA.
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50
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van Wendel de Joode B, Bierman EPB, Brouwer DH, Spithoven J, Kromhout H. An assessment of dermal exposure to semi-synthetic metal working fluids by different methods to group workers for an epidemiological study on dermatitis. Occup Environ Med 2005; 62:633-41. [PMID: 16109820 PMCID: PMC1741081 DOI: 10.1136/oem.2004.015396] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Assessment of exposure assessment to metal working fluids (MWF) has almost exclusively focused on inhalation exposure. AIMS To assess levels of, and factors affecting, dermal and inhalation exposure to semi-synthetic MWF, and to identify suitable dermal exposure grouping schemes among metal workers for an epidemiological survey on dermatitis of hands, forearms, and head. METHODS A cross-sectional survey was conducted in four metal working machining departments of a truck manufacturing plant, estimating dermal and inhalation exposure levels to semi-synthetic metal working fluids (SMWF) in machine operators. Dermal exposure levels to SMWF were estimated by three different methods for dermal exposure assessment (VITAE, surrogate skin pad method, and a semi-quantitative dermal exposure assessment method (DREAM)). RESULTS The identified factors affecting dermal exposure were similar for the three methods, although differences were found for estimated variability in dermal exposure levels between groups, within groups (among workers), and from day to day. With the VITAE method differences in exposure levels were detected between workers that were not detected with the surrogate skin pad method, and only partly with the DREAM method. CONCLUSIONS Considering the additional effort and costs that use of the VITAE method entailed, the observational semi-quantitative DREAM method appeared to be more efficient for grouping of dermal exposure levels for the epidemiological study on dermatitis.
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Affiliation(s)
- B van Wendel de Joode
- Risk Assessment in the Work Environment, TNO Quality of Life and IRAS, Utrecht, Netherlands
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