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Respiratory exposure of museum personnel to dichlorvos insecticide.

Dichlorvos (DDVP) is an organophosphate insecticide used to protect museum specimens from insect pests. Respiratory exposure of museum personnel to DDVP has not been studied previously. Analysis of air samples from museum rooms where DDVP was being used when the ventilation system was "on" showed a lower and significantly different (p = 0.025) amount of DDVP when compared to air samples collected from the same rooms when the ventilation system was "off". The DDVP concentrations of all samples collected were below the threshold limit value established by the American Conference of Governmental Industrial Hygienists.

Air↗

Neurobehavioural effects on workers in a video tape manufacturing factory in Singapore.

This study was carried out in a video tape manufacturing factory in Singapore where workers were exposed to mixed solvents consisting of methyl ethyl ketone (MEK), cyclohexanone (CHE), tetrahydrofuran (THF), and toluene (TOL). The objectives were to quantify workers' exposure to the various solvents and to evaluate if there were any neurobehavioural changes among the workers compared to controls. Nineteen exposed workers out of the workforce of forty-five were studied. Twenty-six workers (with no exposure) matched for ethnic group, age, and years of education served as controls. Eight-hour personal environmental samples were analyzed for the 19 workers along with symptom questionnaires, clinical examinations, and neurobehavioural tests including the Santa Ana Dexterity, Finger Tapping, Digit Span, and Visual Reproduction tests. The mean TWA concentrations for MEK, THF, CHE, and TOL were all below the current American Conference of Governmental Industrial Hygienists Threshold Limit Values (TLV). However, the total solvents concentration index exceed unity in one of the work areas. Significant differences were observed for prevalence of headache, and eyes and nose irritation among the exposed workers. There were also significant differences for the Santa Ana test for both-hands, Digit Span test and Visual Reproduction test. However, no dose-effect relation between behavioral scores and airborne solvent exposure was noted. The study suggests that solvent-exposed workers in video tape manufacturing plants may have poorer visual motor control and recent memory impairment (visual and verbal) than unexposed workers. Dermal absorption of solvents may have played a role in these results by increasing workers exposure.

Adult↗

[Health hazards due to industrial substances. A toxicologic environmental problem].

Work-site chemicals are substances which are employed in manufacturing industrial operations. Contact with such materials may present a hazard to health. Substantial hygienic significance is to be attached to the detection of such injurious potentials by experimental and theoretical toxicology. The preparation of toxicologic expertises on industrial materials presents many problems. The standard approach is to utilize scientific methods on the basis of defined experimental models and quantitative relationships. Judgment of the toxicologic relevance is guided by well-documented epidemiologic or experimental data and the study of case histories. After scientific validation the result is used in practice for setting threshold limit values (MAK's, MIK's) for occupational health purposes.

Environmental Exposure↗

[The assessment of arsenic exposure in copper smelting].

The arsenic exposure in the main departments and occupational groups of the copper smelter in Pirdop has been estimated in the present study. The contents of arsenic is measured in the air and in biological samples--urine and nails. At most of the workplaces the time-weighted average (TWA) concentrations do not exceed the threshold limit value (0.05 mg/m3). The maximum TWA level is about three times higher. The intake of arsenic is significantly increased in almost all observed occupational groups. However, the excretion of only 8% of the workers is higher than the maximum background level (100 micrograms/l). The estimated degree of exposure corresponds to a low health risk. Some of the most heavily exposed occupational groups may be expected to reach higher levels of intake and health risk.

Air Pollutants, Occupational↗

Dustiness, silicosis & tuberculosis in small scale pottery workers.

Studies were carried out in eight small scale potteries to find out the airborne dust concentrations and the prevalence of dust related diseases like silicosis and tuberculosis in 292 workers. Chest radiography revealed that 44 (15.1%) pottery workers were suffering from silicosis and an equal number showed radiological evidence of tuberculosis. The environmental study showed that the concentrations of airborne dust, containing free silica, in the work environment of all departments (except packing department) of potteries were higher than threshold limit values (TLVs). The prevalence of silicosis and tuberculosis correlated with the levels of airborne dust. The prevalence of tuberculosis increased with radiological severity of silicosis. Dust control measures combined with pre-employment and periodical medical examinations are recommended for the control of silicosis and tuberculosis in the pottery industry.

Air Pollutants, Occupational↗

The correlation of chest radiograph and pulmonary function tests in asbestos miners and millers.

An environmental-cum-medical survey was carried out in asbestos mines and milling units at Pullivendalla, Cuddaph (A.P.) India. This was done in two mines and six milling units with 95% of the total work force being surveyed. Out of a total of 633 registered workers, 329 (52%, all males) were employed in mines while 135 (21.4%) workers of whom 114 (84%, all females) were employed in the milling units. All subjects underwent limited medical examination, spirometry and chest radiographs. The levels of asbestos fiber concentration was much below threshold limit value (TLV) in underground mines but several times higher than TLV in milling units. The percentage of workers with abnormal pulmonary function tests (PFT) and chest radiographs increased with duration of exposure in smokers as well as non-smokers. Restrictive pattern of lung functions (159 workers-16.27%) was more common than obstructive (33 workers-5.21%) and combined type (22 workers-3.4%). Similarly, the parenchymal changes (156 workers-24.6%) were more common than pleural (27 workers-4.3%). As most of the males were employed in mines, where the fiber levels were much below TLV, the number of male workers with normal PFT and chest radiographs were ten times (61.3%) more than male workers with both the parameters abnormal (6.3%). As most of the females (114 our of 120--95%) were employed in milling units, where the levels of fibers were several times higher than TLV, the number of females having both the parameters normal 29 (24.1%) or abnormal 35 (29.2%) were similar.

Air Pollutants, Occupational↗

[The maximum permissible concentrations, the approximate safe exposure levels and diagnostic tests for poisoning by inhibitors of metal corrosion].

Submitted in the paper are data on maximum permissible concentrations and tentative threshold limit values for those inhibitors of atmospheric metal corrosion and inhibitors of corrosion under acid conditions that have come into widespread use. Experimental animal studies together with observations over those occupationally exposed to the inhibitors permitted recommending tests of early diagnosis of intoxication such as measurement of blood and urine content of inhibitors, accumulation of methemoglobin in blood for methemoglobin-producers, alterations in peripheral blood, changes in biochemical reactions (activities of transferases, alkaline phosphatase, lactatdehydrogenase in blood serum), parameters characterizing the functional status of cardiovascular system.

Air Pollutants, Occupational↗

Silicosis and pulmonary tuberculosis in stone-grinding factories in Saraburi, Thailand.

The stone-grinding industry is well known to place its workforce at higher risk for silicosis. In addition, workers who are exposed to silica fibers are at a higher risk for pulmonary tuberculosis. This study was conducted to determine the prevalence levels of silicosis and pulmonary tuberculosis among workers in 33 factories in 3 subdistricts of Saraburi, Thailand and the associated risk factors. Thirty-one of the factories (93.9%) had amounts of either total dust or respirable dust exceeding threshold limit values with the average levels of total dust and respirable dust of 24.3 +/- 34.6 and 2.4 +/- 1.6 mg/m3 respectively. Radiologic patterns indicated that 61 workers (9.0%) had silicosis and 13 workers (1.9%) had pulmonary tuberculosis. The prevalence of silicosis and pulmonary tuberculosis was significantly associated with years of work. This study demonstrated the need for developing and supporting potential primary preventive intervention, periodic medical screening as a part of a medical surveillance system and a national occupational medical services program.

Adolescent↗

Glycophorin A somatic cell mutation frequencies in Finnish reinforced plastics workers exposed to styrene.

We have used the glycophorin A (GPA) in vivo somatic cell mutation assay to assess the genotoxic potential of styrene exposure in 47 reinforced plastics workers occupationally exposed to styrene and 47 unexposed controls matched for age, gender, and active smoking status. GPA variant erythrocyte frequencies (Vf), reflecting GPA allele loss (phi/N) and allele loss and duplication (N/N) somatic mutations arising in vivo in the erythroid progenitor cells of individuals of GPA M/N heterozygous genotype, were flow cytometrically determined in peripheral blood samples from these subjects. Measurements of styrene exposure of the workers at the time of blood sampling showed a mean 8-h time-weighted average (TWA8-h) styrene concentration of 155 mg/m3 (37 ppm) in the breathing zone. Mean urinary concentrations of the styrene metabolites mandelic acid (MA) and mandelic acid plus phenyl glyoxylic acid (MA+PGA) were 4.4 mmol/liter (after workshift) and 2.1 mmol/liter (next morning), respectively. Multivariate analysis of covariance on log-transformed GPA Vf data with models allowing adjustment for age, gender, smoking status, and styrene exposure showed that N/N Vf were nearly significantly increased among all of the exposed workers (adjusted geometric mean, 6.3 per million versus 5.0 in the controls; P = 0.058) and were statistically significantly elevated (adjusted geometric mean, 6.8 versus 5.0 in the controls; P = 0.036) among workers classified into a high-exposure group according to personal TWA8-h concentration of styrene in the breathing zone of > or = 85 mg/m3 (20 ppm; Finnish threshold limit value). Women in this high exposure group showed especially elevated N/N Vf (adjusted geometric mean 8.5 versus 5.3 in control women; P = 0.020); this elevation was also significant if urinary MA+PGA of > or = 1.2 mmol/liter was used as the basis of classification (adjusted geometric mean, 8.3; P = 0.030). The occupational exposure could not be shown to influence phi/N Vf. Cigarette smoking was associated with significantly elevated GPA Vf among active smokers (P = 0.042 for phi/N and P = 0.020 for N/N) and among active and ex-smokers combined (P = 0.014 for N/N). Its influence on phi/N Vf was especially clear among active smokers in the control group (P = 0.005). An effect of smoking, nearly statistically significant, was also observed for the phi/N Vf of control ex-smokers (P = 0.055) and of all active and ex-smokers combined (P = 0.050). Thus, the two characterized chemical exposures experienced by this group of workers and controls appear to produce differential effects on the two independent classes of GPA variants enumerated in the assay. This result suggests that the genotoxicity of these agents is mediated, at least in part, by different genetic mechanisms. Styrene exposure is associated with a specific increase in GPA N/N Vf; these allele loss and duplication variants reflect predominantly somatic recombination mechanisms in erythroid progenitor cells. Tobacco smoke exposure in active and ex-smokers is also associated not only with an increase in N/N Vf but also with an increase in phi/N Vf, reflecting the induction of GPA gene-inactivating mutations, including point mutations and deletions. This finding is consistent with a broad mechanistic spectrum of tobacco smoke genotoxicity associated with this complex mixture of chemical mutagens. Finally, there was no detectable effect of age on phi/N Vf; however, a highly significant (P = 0.0002) increase in N/N Vf with age, even after adjustment for other variables, was observed.

Adult↗

Carbon disulphide. IV. Cardiovascular function in workers in the viscose industry.

OBJECTIVE: The aim of the study was to examine whether an increase can be detected in the prevalence of coronary heart disease or a higher prevalence of unusual cardiological findings in workers with occupational exposure to carbon disulphide (CS2) at the level of the threshold limit value of 10 ppm currently valid in occupational medicine. METHODS: In a cross-sectional study we investigated 247 men occupationally exposed to CS2 and a comparable control group (n = 222). The current exposure to CS2 was measured using personal air monitoring and biological monitoring of all test persons. A cumulative exposure index (median of CS2 exposure in the past multiplied by the duration of employment) was calculated. In addition to collecting comprehensive anamnestic data on all persons, we carried out a physical examination, an ultrasound examination of the large arteries, a resting and exercise ECG and an echocardiographic examination. RESULTS: No increase could be found in the prevalence of coronary heart disease or of arteriosclerotic findings in the exposed subjects. There was no difference in the distribution of the performance of the two groups in the ergometric tests. The echocardiogram showed a median increase in the diameter of the left atrium and left ventricle of 1-2 mm in the exposed subjects. These differences could also be confirmed statistically after multiple linear regression analysis. The left ventricular, telesystolic diameter was positively associated (P < 0.05) with internal exposure (CS2 metabolite in urine), and fractional shortening revealed a plausible negative trend (P = 0.0755). Current external exposure (CS2 in air) and cumulative exposure did not influence any of the parameters investigated. CONCLUSION: The findings may indicate a negatively inotropic effect of CS2 so far unknown in man. However, no clinical relevance for this effect was apparent.

Carbon Disulfide↗

The role of confounding variables in the assessment of neurobehavioural effects of chronic solvent exposure.

An issue in the assessment of toxic effects on neurobehavioural function in occupational or environmental settings is the presence and relative contribution of confounding variables. Factors such as education level and alcohol use are well-known to exert effects on the performance of neurobehavioural tests. In a prospective study of a cohort of vehicle spray painters, measures of neurobehavioural function, demographic characteristics, daily habits including alcohol-use and general health status were taken from the onset of their exposure on four occasions for three full years. This study provided the opportunity to assess the relative contribution of confounding variables and the study factor, solvent exposure, on neurobehavioural function in a study design which limits the heterogeneity of the study sample. In such a design the effects of confounding would expected to be reduced. Multiple linear regression analysis was used with three confounding variables, education level, alcohol use and occupational experience as well as solvent exposure as predictor variables of neurobehavioural test performance. Although the level of solvent exposure was considerably less than the composite threshold limit value for the solvent mixtures encountered, the results indicated that psychomotor performance deteriorated with increasing solvent exposure, but only on the hand steadiness test. The confounding variables showed even greater influences on performance. Education level affected performance on both psychomotor and cognitive tests in the expected direction. Occupational experience also influenced test performance but only for psychomotor tests. With increasing time in the trade, spray painters showed significantly superior performance on reaction time, hand steadiness and visual pursuit tests. Since training in spray painting focuses on psychomotor coordination, this result would be expected. Alcohol use was associated with mixed effects on neurobehavioural function. Painters who reported using greater amounts of alcohol showed significantly poorer performance on the visual test, critical flicker fusion, but better performance on the short term memory and learning measures of the paired associates test so supporting the findings of previous studies of facilitating effects of lower levels of alcohol on memory. These findings reinforce the importance of separating effects due to confounders from effects due to toxic exposures in studies of neurobehavioural function. They emphasise the dilemma of test selection, choosing tests that are sensitive enough to detect effects due to toxic exposure but which are not affected by confounding variables.

Australia↗

Glassblowers' ocular health and safety: optical radiation hazards and eye protection assessment.

The aims of this study were to investigate the levels of optical radiation exposure in glassblowing and to determine type(s) of protective eyewear commonly used. Radiometric measurements of radiant emissions from different molten glass materials and heating systems were carried out in six installations. Spectral transmittance curves of available protective lenses used at the locations were obtained. Significant variation (P = 0.0001) in ocular irradiation was obtained. All operations produced irradiances higher than the threshold limit values (TLVs) for the visible spectrum (400 to 700 nm). In craft glassblowing which employs furnace systems, irradiance levels exceeding the TLVs for near infrared (760 1o 1100 nm) were obtained. Molten soda-lime and quartz glasses emitted substantial subthreshold near UV radiation. This study shows that variation exists in glassblowing ocular radiation exposure due to different glass materials and heating systems, therefore selection of appropriate eye protector should be on an individual basis.

Adolescent↗

Pharmacokinetics of methanol and formate in female cynomolgus monkeys exposed to methanol vapors.

The 1990 Clean Air Act Amendments contain mandates for reduced automotive emissions and add new requirements for the use of alternative fuels such as methanol to reduce certain automotive pollutants. Methanol is acutely toxic in humans at relatively low doses, and the potential for exposure to methanol will be increased if it is used in automotive fuel. Formate is the metabolite responsible for neurotoxic effects of acute methanol exposure. Since formate metabolism is dependent on folate, potentially sensitive folate-deficient subpopulations, such as pregnant women, may accumulate formate and be at higher risk from low-level methanol exposure. Our objective was to determine the pharmacokinetics of 14C-methanol and 14C-formate in normal and folate-deficient monkeys after exposure to 14C-methanol vapors at environmentally relevant concentrations: below the threshold limit value (TLV), at the TLV of 200 parts per million (ppm), and above the TLV. Four normal adult female cynomolgus monkeys were individually anesthetized with isoflurane, and each was exposed by endotracheal intubation to 10, 45, 200, or 900 ppm 14C-methanol for 2 hours. Concentrations of the inhaled and exhaled 14C-methanol, blood concentrations of 14C-methanol and 14C-formate, exhaled 14C-carbon dioxide (14CO2), and respiratory parameters were measured during exposure. After exposure, 14C-methanol and 14CO2 exhaled, 14C-methanol and 14C-formate excreted in urine, and 14C-methanol and 14C-formate in blood were quantified. The amounts of exhaled 14C-methanol and 14CO2, blood concentrations of 14C-methanol and 14C-formate, and 14C-methanol and 14C-formate excreted in urine were linearly related to methanol exposure concentration. For all exposures, blood concentrations of 14C-methanol-derived formate were 10 to 1000 times lower than endogenous blood formate concentrations (100 to 200 mM) reported for monkeys and were several orders of magnitude lower than levels of formate known to be toxic. Since the metabolism of formate in primates depends on the availability of tetrahydrofolate, the same four monkeys were next placed on a folate-deficient diet until folate concentrations in red blood cells consistent with moderate folate deficiency (29 to 107 ng/mL) were achieved. Monkeys were then reexposed to the highest exposure concentration, 900 ppm 14C-methanol, for a similar 2-hour period, and again the pharmacokinetic data described above were obtained. Even with a reduced folate status, monkeys exposed to 900 ppm methanol for 2 hours had peak concentrations of methanol-derived formate that were well below the endogenous levels of formate. Although these results represent only a single exposure and therefore preclude broad generalizations, they do suggest the body contains sufficient folate stores to effectively detoxify small doses of methanol-derived formate from exogenous sources, such as those that might occur during normal use of automotive fuel.

Adult↗

[Environmental and biological monitoring of occupational exposure to perchloroethylene in dry cleaning shops].

Occupational exposure to perchloroethylene (PCE) was studied in a total of 106 workers in 78 dry cleaning shops in the province of Pavia, Northern, Italy. Environmental monitoring was performed by personal passive sampling. The median time weighted average (TWA) level of PCE was 57 mg/m3, i.e., about 30% of the current Threshold Limit Value (TLV) proposed by the American Conference of Governmental Industrial Hygienists (ACGIH). However, in 12 workers exposure exceeded this limit. Biological monitoring was performed via measurement of urinary trichloroacetic acid (TCA), i.e. the exposure index currently used in Italy, and urinary excretion of unmodified perchloroethylene (PCE-U) in samples collected at the end of the half-shift. Median levels of TCA and PCE were 1.03 mg/l and 17.7 micrograms/l respectively. The correlation coefficient between environmental TWA concentrations of perchloroethylene and PCE-U was 0.755 (0.809 after logarithmic transformation), compared to 0.660 for TCA values. The subjects were then classified as "low exposed" and "heavily exposed" according to whether personal exposure was lower or higher than 57 mg/m3, the median TWA value of the whole group. PCE-U levels were significantly correlated to exposure in both subgroups whereas TCA was correlated only in the "heavily exposed subjects", but not in those with lower exposure. The results of the study show that in the majority of dry cleaning shops exposure to PCE was well below the current occupational limits. Nevertheless surveillance of dry cleaners is recommended as nearly 10% of the workers exceeded the environmental and biological limits. Urinary excretion of unmodified PCE appears to be a very reliable indicator for biological monitoring of PCE exposure in dry cleaning and is also significantly correlated to exposure at low levels. The estimated biological equivalent exposure level (BEEL) for PCE-U, corresponding to the current TLV-TWA proposed by the ACGIH, is 55 micrograms/l. Urinary TCA seems to be less suitable for assessment of individual exposure to perchloroethylene in dry cleaners as it is poorly representative of exposure to low levels of the solvent, which is a very common occurrence in this occupational group nowadays.

Adult↗

Occupational neurotoxic diseases in Taiwan: a review of the outbreaks and clinical features.

In the past 20 years, several outbreaks of neurotoxic disease due to occupational exposure have occurred in Taiwan. The most notorious outbreaks were 'Yu-cheng' due to contamination of polychlorinated biphenyls in cooking oil, lead poisoning in battery manufacturers and workers in a ship-scrapping yard, tile factory and battery recycling plants, and n-Hexane intoxication in press-proffers and ball-manufacturers. In addition, there were manganese intoxication in ferromanganese smelters, mercury intoxication in lamp-socket workers, carbon disulfide intoxication in viscose rayon workers and hydrogen sulfide intoxication in chemical synthetic plants. Although the incidence of occupational neurotoxic diseases has increased, the real incidence is probably still underestimated. The reasons for the underestimation include: 1) the education for workers in industrial hygiene is inadequate; 2) high risk workers are not screened well; 3) physicians are not well trained in early diagnosis of occupational diseases; 4) material safety data information is not readily available in the factories; and 5) the threshold limit values for toxic substances are relatively high in Taiwan, compared with other developed countries.

Carbon Disulfide↗

[Dust and microorganism count at delivery, sorting and composting of home refuse and home refuse-like industrial waste].

The exposure of employees to airborne dust and microorganisms was assessed in a waste processing plant established to recover reusable materials from unsorted domestic and industrial waste. Exposure criteria considered relevant were the quantity of the individual size-selected particle fractions, the morphological properties of the particles, their heavy metal content, and the degree of their contamination with various microorganisms and mold. In addition, separate microbiological analyses to determine potential pathogen concentrations in the air were made. The highest concentrations of total and fine dust were measured in the waste delivery area. A close correlation between the frequency of deliveries and the level of dust exposure was observed. In this area, fine dust concentrations exceeded the threshold limit value of 6 mg/m3 repeatedly for shorter periods. The average fine dust concentration during an entire work-shift, however, was considerably lower than this value. Particles with an aerodynamic diameter of 2 to 7 microns predominated both in the waste delivery and the processing areas. Fibrous dust particles were present in smaller numbers than spherical particles and consisted mainly of organic materials. Natural and artificial inorganic fibers were found only occasionally. The concentrations of lead, cadmium, nickel and mercury were considerably lower than the corresponding MAK and TRK values, and were--with the exception of lead--in the range of the respective metal concentrations in the atmosphere of urban areas. Microscopical examinations of used protective masks (protection category P2) revealed that dust particles were deposited even on the inner side of the masks. Most of the particles on this side were very small and carried nickel or titanium. Microorganism concentrations measured in air from the highly dust-exposed areas of the plant showed values up to 6.9 x 10(5) cfu/m3, with a mold content of 6.6 x 10(4) cfu/m3. Approximately 90% of the microorganisms were deposited on particles of the fine dust fraction (particle size < 7 microns), and more than 50% contaminated particles with an aerodynamic diameter of 2 to 4.7 microns. In the compost facility, mold concentrations of up to 8.4 x 10(5) cfu/m3 were measured. In contrast, the level of microbial contamination in the filtered air from the compost facility did not exceed the concentration measured in air outside the plant. The data which were obtained during the winter months are probably at the lower end of the average exposure range over the entire year. In regard to exposure assessment, it should be mentioned that particles with a size of 4 to 7 microns are not really "inert" particles, since they are preferential carriers for heavy metals and microorganisms. More studies in the future should be performed to establish, whether the level of exposure to microorganisms can be estimated indirectly by the determination of dust exposure.

Air Microbiology↗

Respiratory irritative effects of trimethylbenzenes: an experimental animal study.

Sensory respiratory irritation effects of trimethylbenzene isomers (TMBs) (hemimellitene, mesitylene and pseudocumene) in male Balb/C mice were investigated in conditions of acute exposure and in male Wistar rats in conditions of repeated 90-day inhalation exposure to pseudocumene. The pseudocumene, mesitylene and hemimellitene concentrations depressing the respiratory rate to 50% (RD50) were 578, 519, 541 ppm, respectively. Inhalation exposure to pseudocumene for 90 days increased the total number of cell macrophages, polymorphonuclear leukocytes and lymphocytes number at all three test concentrations compared with the controls. Total protein lactate dehydrogenase (LDH) and acid phosphatase activity in bronchoalveolar lavage (BAL) were significantly increased in all exposed groups. Based on the effects observed in the respiratory tract, the threshold limit value of at least 10 ppm should be considered for the occupational exposure to trimethylbenzene isomers.

Animals↗

Bronchial asthma in two chemical fertilizer producing factories in eastern Saudi Arabia.

SETTING: Two urea fertilizer producing factories in Saudi Arabia. OBJECTIVE: To determine the prevalence of respiratory symptoms and diseases in employees exposed to ammonia gas. DESIGN: A cross-sectional study involving 161 exposed subjects and 355 controls. All completed a respiratory symptoms questionnaire, with additional questions on present and past occupations. Ammonia concentrations were measured in the different sections of the factories. RESULTS: The ammonia levels in factory B were well below the threshold limit value (TLV) (range 0.02-7.0 mg/m3 of air). In factory A the range was 2.0-130.4 mg/m3. The control and exposed groups were comparable with respect to their smoking habits. The exposed subjects in factory A had significantly higher relative risks (RR) for all respiratory symptoms; the same was true for haemoptysis (RR: 4.1, 95% confidence interval: 1.63-10.28). Bronchial asthma, chronic bronchitis, and a combined diagnosis were significantly higher among those exposed to high cumulative ammonia levels. However, in the logistic regression analysis ammonia concentration was significantly related to cough, phlegm, shortness of breath with wheezing and bronchial asthma. CONCLUSION: Exposure to ammonia gas in the workplace is significantly associated with increase in respiratory symptoms and bronchial asthma. Re-engineering measures to lower the levels of ammonia in factory A are strongly recommended. The affected employees should be removed from further exposure and followed up.

Adult↗