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1.
Firefighting Induces Acute Inflammatory Responses that are not Relieved by Aspirin in Older Firefighters.
Smith, DL, Friedman, NMG, Bloom, SI, Armero, WL, Pence, BD, Cook, MD, Fernhall, B, Horn, GP, Woods, J
Journal of occupational and environmental medicine. 2019;(7):617-622
Abstract
OBJECTIVE Sudden cardiac events account for 40% to 50% of firefighter line-of-duty deaths. Inflammatory proteins are strong biomarkers of cardiovascular inflammation. The present study investigated the effects of aspirin supplementation on inflammatory biomarkers following firefighting. METHODS Using a randomized, placebo-controlled, double-blind crossover design, 24 male firefighters (48.2 ± 5.9 years) were allocated into four conditions: acute (81 mg; single-dose) aspirin and placebo supplementation, and chronic (81 mg; 14 days) aspirin and placebo supplementation. Inflammatory proteins [interleukin (IL)-6, C-reactive protein (CRP), intracellular adhesion molecule (ICAM)-1, P-selectin, matrix metalloproteinase-9 (MMP-9)] and antioxidant potential [total antioxidant capacity (TAC)] were measured pre- and post-structural firefighting drills. RESULTS Firefighting activities significantly increased IL-6, MMP-9, and P-Selectin; however, no changes in TAC and ICAM-1 were detected. Neither acute nor chronic aspirin supplementation attenuated this inflammatory response. CONCLUSION Firefighting significantly increases inflammatory biomarkers and neither acute nor chronic low-dose aspirin mitigates this response.
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2.
Glyphosate's Synergistic Toxicity in Combination with Other Factors as a Cause of Chronic Kidney Disease of Unknown Origin.
Gunatilake, S, Seneff, S, Orlando, L
International journal of environmental research and public health. 2019;(15)
Abstract
Chronic kidney disease of unknown etiology (CKDu) is a global epidemic. Sri Lanka has experienced a doubling of the disease every 4 or 5 years since it was first identified in the North Central province in the mid-1990s. The disease primarily affects people in agricultural regions who are missing the commonly known risk factors for CKD. Sri Lanka is not alone: health workers have reported prevalence of CKDu in Mexico, Nicaragua, El Salvador, and the state of Andhra Pradesh in India. A global search for the cause of CKDu has not identified a single factor, but rather many factors that may contribute to the etiology of the disease. Some of these factors include heat stroke leading to dehydration, toxic metals such as cadmium and arsenic, fluoride, low selenium, toxigenic cyanobacteria, nutritionally deficient diet and mycotoxins from mold exposure. Furthermore, exposure to agrichemicals, particularly glyphosate and paraquat, are likely compounding factors, and may be the primary factors. Here, we argue that glyphosate in particular is working synergistically with most of the other factors to increase toxic effects. We propose, further, that glyphosate causes insidious harm through its action as an amino acid analogue of glycine, and that this interferes with natural protective mechanisms against other exposures. Glyphosate's synergistic health effects in combination with exposure to other pollutants, in particular paraquat, and physical labor in the ubiquitous high temperatures of lowland tropical regions, could result in renal damage consistent with CKDu in Sri Lanka.
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3.
Neurotoxic effects of mercury exposure in dental personnel.
Bjørklund, G, Hilt, B, Dadar, M, Lindh, U, Aaseth, J
Basic & clinical pharmacology & toxicology. 2019;(5):568-574
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Abstract
Numerous studies have reported neurobehavioural effects in dental personnel occupationally exposed to chronic low levels of mercury (Hg). Hg exposure from dental work may also induce various chronic conditions such as elevation of amyloid protein expression, deterioration of microtubules and increase or inhibition of transmitter release at motor nerve terminal endings. Therefore, clinical studies of Hg toxicity in dentistry may provide new knowledge about disturbed metal homeostasis in neurodegenerative diseases such as Alzheimer's disease, multiple sclerosis and mood disorders. The purpose of this MiniReview is to evaluate the evidence of possible relevance between Hg exposure in dentistry and idiopathic disturbances in motor functions, cognitive skills and affective reactions, as well as dose-response relationships.
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4.
Low-dose computed tomography screening for lung cancer in people with workplace exposure to asbestos.
Maisonneuve, P, Rampinelli, C, Bertolotti, R, Misotti, A, Lococo, F, Casiraghi, M, Spaggiari, L, Bellomi, M, Novellis, P, Solinas, M, et al
Lung cancer (Amsterdam, Netherlands). 2019;:23-30
Abstract
OBJECTIVES Smoking is the main risk factor for lung cancer, but environmental and occupational exposure to carcinogens also increase lung cancer risk. We assessed whether extending low-dose computed tomography (LDCT) screening to persons with occupational exposure to asbestos may be an effective way reducing lung cancer mortality. MATERIALS AND METHODS We conducted a nested case-control study within the COSMOS screening program, assessing past asbestos exposure with a questionnaire. LDCT scans of asbestos-exposed participants were reviewed to assess the presence of pulmonary, interstitial and pleural alterations in comparison to matched unexposed controls. We also performed an exhaustive review, with meta-analysis, of the literature on LDCT screening in asbestos-exposed persons. RESULTS Exposure to asbestos, initially self-reported by 9.8% of COSMOS participants, was confirmed in 216 of 544 assessable cases, corresponding to 2.6% of the screened population. LDCT of asbestos-exposed persons had significantly more pleural plaques, diaphragmatic pleural thickening and pleural calcifications, but similar frequency of parenchymal and interstitial alterations to unexposed persons. From 16 papers, including this study, overall lung cancer detection rates at baseline were 0.81% (95% CI 0.50-1.19) in asbestos-exposed persons, 0.94% (95% CI 0.47-1.53) in asbestos-exposed smokers (12 studies), and 0.11% (95% CI 0.00-0.43) in asbestos-exposed non-smokers (9 studies). CONCLUSION Persons occupationally exposed to asbestos should be monitored to gather more information about risks. Although LDCT screening is effective in the early detection lung cancer in asbestos-exposed smokers, our data suggest that screening of asbestos-exposed persons with no additional risk factors for cancer does is not viable due to the low detection rate.
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5.
Oxidative Stress Indices as Markers of Lead and Cadmium Exposure Toxicity in Auto Technicians in Ibadan, Nigeria.
Omotosho, IO
Oxidative medicine and cellular longevity. 2019;:3030614
Abstract
Auto technicians (auto mechanics, panel beaters, battery chargers, and auto painters) are among the most valuable work force in the society. Reports on oxidative stress in persons occupationally exposed to mixed chemicals abound; however, few have narrowed down specifically on auto technicians, while even fewer have stratified the exposure in the different subgroups of auto technicians. This study evaluated the antioxidant status in auto technicians routinely exposed to lead and cadmium and stratified the results of exposure by different subgroups of auto technicians in Ibadan, Nigeria. Sixty-five apparently healthy males (aged 18 to 65years) were selected based on specific inclusion criteria using a structured questionnaire. Thirty-four were cases consisting of participants routinely working as auto technicians or apprentices(≥2years) while controls were thirty-one nonoccupationally exposed male members of staff/students of the University College Hospital, Ibadan, Nigeria. Blood was collected from all participants and analyzed for the presence of lead, total antioxidant capacity (TAC), and total plasma peroxides (TPP); oxidative stress index (OSI) was calculated. Urine samples collected from all participants were analyzed for the presence of urinary lead and cadmium using standard laboratory methods. Although values of TAC in cases (22538 ± 8726.54) were not statistically different from what was obtained in controls (26741.87 ± 8696.68), TPP and OSI were statistically higher in cases than in controls (183.88 ± 53.39 and 120.16 ± 70.54, respectively, and 0.93 ± 0.45 and 0.49 ± 0.33, respectively). The blood lead level in cases (10.11 ± 4.47) was significantly higher than in controls (7.72 ± 1.22) while elevated urinary lead and cadmium levels were observed in cases (0.65 ± 0.21 and 0.34 ± 0.11, respectively) compared to controls (0.52 ± 0.19 and 0.27 ± 0.10, respectively). Raised TPP and OSI levels-hallmark of active lipid peroxidation-found to be highest among panel beaters compared to others may be prognostic of membrane-damaging diseases in this subgroup of auto technicians.
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6.
Spacecraft Maximum Allowable Concentrations for Manganese Compounds in Mars Dust.
Romoser, AA, Ryder, VE, McCoy, JT
Aerospace medicine and human performance. 2019;(8):709-719
Abstract
INTRODUCTION Exposure to excess manganese (Mn) can cause multiple toxicological outcomes in humans, most notably neurotoxicity. Ample epidemiological evidence suggests that chronic, low-level exposure causes subclinical cognitive effects. Because NASA astronauts will be exposed to Mars regolith, Spacecraft Maximum Allowable Concentrations (SMACs) were developed following an extensive literature review.METHODS Multiple databases were searched for information relevant to derivation of Mn SMAC values. An additional search for Mars dust data was performed. Risk assessment approaches were applied, including adjustments for space-relevant susceptibility to Mn effects, to develop limits for 1-h to 1000-d exposures. Rover data informed the assessment and enabled calculation of allowable total dust exposure based on Mn content.RESULTS Over 400 relevant sources were identified. Applicability of exposure characteristics and data collection methods influenced key study choice. SMACs ranging from 3 mg · m-3 (1 h) - 0.0079 mg · m-3 (1000 d) were set to protect primarily against neurocognitive and respiratory effects. Considering 0.38 wt% total Mn presence in the dust, maximum recommended total dust exposure should not exceed 790 mg · m-3 (1 h) - 2 mg · m-3 (1000 d).DISCUSSION This literature review allowed for identification of relevant studies to inform SMAC development. Manganese is one of several components to consider when developing an appropriate total dust limit for Martian dust; other dust elements may alter Mn bioavailability. Mission-specific activities may require alteration of assumptions regarding Mn dust concentration and exposure duration. However, based on expected toxicity of particulate matter itself, the acute SMACs are protective, even with transient exposure during activities that could produce higher concentrations.Romoser AA, Ryder VE, McCoy JT. Spacecraft maximum allowable concentrations for manganese compounds in Mars dust. Aerosp Med Hum Perform. 2019; 90(8):709-719.
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Risk of obstructive pulmonary diseases and occupational exposure to pesticides: a systematic review and meta-analysis.
Pourhassan, B, Meysamie, A, Alizadeh, S, Habibian, A, Beigzadeh, Z
Public health. 2019;:31-41
Abstract
OBJECTIVE This meta-analysis study was performed to examine the relationship between occupational exposure to pesticides and the risk of obstructive pulmonary diseases such as chronic obstructive pulmonary disease (COPD) and chronic bronchitis. STUDY DESIGN This is a systematic review and meta-analysis study. METHODS PubMed and Scopus databases were searched for English-language publications. Eight cohort studies and one case-control study were included in the pooled analysis. RESULTS These studies had a total of 101,353 participants from eleven different countries and were published between 2006 and 2018. The heterogeneity among the studies was high (P < 0.001, I2 = 68.7%). In a random-effects model meta-analysis, a pooled odds ratio (OR) analysis showed that there was a direct relationship between occupational exposure to the pesticides and obstructive pulmonary diseases (OR = 1.33, 95% confidence interval [CI]: 1.21-1.47). A positive significant relationship was also observed between exposure to the pesticides and risk of chronic bronchitis (OR = 1.27, 95% CI: 1.23-1.31). Also, there was a significant relationship between occupational exposure to the pesticides and an increased risk of COPD (OR = 1.44, 95% CI: 1.14-1.81). No evidence of publication bias was found among the studies according to the results of the Egger's test (P of bias = 0.157). CONCLUSIONS Findings of this study show that occupational exposure to pesticides can be associated with an increased risk of obstructive lung diseases including chronic bronchitis and COPD.
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Exposure to fine particles increases blood pressure of hypertensive outdoor workers: A panel study.
Santos, UP, Ferreira Braga, AL, Bueno Garcia, ML, Amador Pereira, LA, Lin, CA, Chiarelli, PS, Saldiva de André, CD, Afonso de André, P, Singer, JM, Nascimento Saldiva, PH
Environmental research. 2019;:88-94
Abstract
BACKGROUND Hypertension and air pollution are two important risk factors for cardiovascular morbidity and mortality. Although several studies suggest that air pollution has a significant impact on blood pressure, studies on long-term effects are sparse and still controversial. OBJECTIVE To evaluate the effects of exposure of outdoor workers to different levels of traffic-generated PM2.5 on blood pressure. DESIGN This is an observational panel study. PARTICIPANTS 88 non-smoking workers exposed to different concentrations of air pollution were evaluated weekly along four successive weeks. MEASUREMENTS In each week, personal monitoring of 24-h PM2.5 concentration and 24-h ambulatory blood pressure were measured. The association between blood pressure variables and PM2.5, adjusted for age, body mass index, time in job, daily work hours, diabetes, hypertension and cholesterol was assessed by means of multiple linear regression models fitted by least squares. RESULTS Exposure to PM2.5 (ranging from 8.5 to 89.7 μg/m3) is significantly and consistently associated with an increase in average blood pressure. An elevation of 10 μg/m3 in the concentration of PM2.5 is associated with increments of 3.9 mm Hg (CI 95% = [1.5; 6.3]) in average systolic 24-h blood pressure for hypertensive and/or diabetic workers. CONCLUSION Exposure to fine particles, predominantly from vehicular traffic, is associated with elevated blood pressure in hypertensive and/or diabetic workers.
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9.
Acute Respiratory Failure from Cement Exposure: A Case Report and Review of the Literature.
Ali, S, Wightman, R, Hack, J
Rhode Island medical journal (2013). 2019;(1):55-57
Abstract
Cement is widely used in construction. Acute exposures with immediate sequelae have been infrequently described. This case report describes a man who developed multifocal pneumonitis with acute respiratory distress syndrome (ARDs) and respiratory failure one day after cement dust exposure. Chromium, cobalt, and nickel components in cement may cause pulmonary tissue irritation. Sand and gravel in cement may cause direct abrasive injury. Inhalation may cause direct thermal injury through an exothermic reaction. The silicon dioxide component has been shown to cause pulmonary injury through cytokine-mediated inflammation. Cement batches for smaller-scale construction jobs are often mixed onsite increasing exposure risk. Implementation of personal protective equipment has been shown to reduce respiratory symptoms among cement workers, underscoring the need for occupational health standards and further research. [Full article available at http://rimed.org/rimedicaljournal-2019-02.asp].
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WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to occupational ergonomic risk factors and of the effect of exposure to occupational ergonomic risk factors on osteoarthritis of hip or knee and selected other musculoskeletal diseases.
Hulshof, CTJ, Colosio, C, Daams, JG, Ivanov, ID, Prakash, KC, Kuijer, PPFM, Leppink, N, Mandic-Rajcevic, S, Masci, F, van der Molen, HF, et al
Environment international. 2019;:554-566
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of disability-adjusted life years from osteoarthritis of hip or knee, and selected other musculoskeletal diseases respectively, attributable to exposure to occupational ergonomic risk factors to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on exposure to occupational ergonomic risk factors (Systematic Review 1) and systematically review and meta-analyze estimates of the effect of exposure to occupational ergonomic risk factors on osteoarthritis of the hip or knee, and selected other musculoskeletal diseases respectively (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science and CISDOC. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference lists of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. The included occupational ergonomic risk factors will be any exposure to one or more of: force exertion; demanding posture; repetitiveness; hand-arm vibration; lifting; kneeling and/or squatting; and climbing. Included outcomes will be (i) osteoarthritis and (ii) other musculoskeletal diseases (i.e., one or more of: rotator cuff syndrome; bicipital tendinitis; calcific tendinitis; shoulder impingement; bursitis shoulder; epicondylitis medialis; epicondylitis lateralis; bursitis elbow; bursitis hip; chondromalacia patellae; meniscus disorders; and/or bursitis knee). For Systematic Review 1, we will include quantitative prevalence studies of any exposure to occupational ergonomic risk factors stratified by country, gender, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control-studies and other non-randomized intervention studies with an estimate of the relative effect of any exposure with occupational ergonomic risk factors on the prevalence or incidence of osteoarthritis and/or selected musculoskeletal diseases, compared with the theoretical minimum risk exposure level (i.e., no exposure). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42018102631.