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Cancer risk in asphalt workers and roofers: review and meta-analysis of epidemiologic studies.

Twenty epidemiologic studies have described cancer risk in asphalt workers and roofers in various countries. A current concern for these workers is the potential carcinogenicity posed by inhalation of bitumen fumes or dermal exposure to bitumens. Bitumens are chemically different from many carcinogenic coal-tar based materials. Both have been employed in road paving and waterproofing. We examined and combined the results of the epidemiologic studies conducted on asphalt workers and roofers. We examined the cancer risk separately in three broad job categories: 1) roofers (exposed to bitumen fumes and previously often to coal-tar fumes); 2) highway maintenance workers (HMWs) and road pavers (exposed to bitumen fumes as well as possibly coal-tar fumes previously); and 3) miscellaneous and unspecified bitumen/asphalt workers. In roofers, an increased risk was suggested for cancers of the lung (aggregated relative risk 1.8, 95% confidence interval 1.5-2.1), stomach (1.7, 1.1-2.5), nonmelanoma skin (4.0, 0.8-12), and leukemia (1.7, 0.9-2.9). Some of the excesses may be attributable to polycyclic aromatic hydrocarbons (PAH) from coal-tar products. The aggregated relative risks in road pavers and HMWs were consistently lower than in roofers for cancers of the lung (0.9, 0.8-1.0), stomach (1.1, 0.8-1.5), bladder (1.2, 0.7-1.8), skin (2.2, 1.2-3.7), and leukemias (1.3, 0.9-1.8). Their risk of skin cancer was significantly increased, based on one study. Miscellaneous and unspecified workers had a significant excess (1.5, 1.2-1.8) of lung cancer. The data were poorly focused to address the carcinogenicity of bitumen fumes, as contrasted with tar-derived exposures. For the prospect of shedding more light on the bitumen-cancer controversy, the feasibility of a powerful multicenter cohort is currently being studied by the International Agency for Research on Cancer (IARC).

Air Pollutants, Occupational↗

Upper airway symptoms and function in wood surface coating industry workers.

Respiratory and ocular effects from exposure to airborne contaminants in workers employed in the manufacture of wood products using ultraviolet radiation curing (UV) or acid curing (AC) of surface coating were investigated. Surface coating line or finishing workers exclusively employed in one or both processes were compared to a control group. Symptoms of exposure were investigated by questionnaire and medical examination. Nasal, pharyngeal, and ocular symptoms of discomfort, but not lower airway, were common among all exposed groups. These symptoms were most frequent in UV line workers and finishers of UV surface-coated wood products. Mucociliary clearance was significantly slower in UV line workers. Significantly higher olfaction thresholds were observed in UV line and AC line workers and finishers of UV/AC surface-coated wood products. Low levels of organic solvents and coating dusts (composed in part of wood dust, chemical composition unknown) were measured in the workers' breathing zones. Although remarkable improvements have been made in both AC and UV surface coating, additional control measures to eliminate airborne contaminants and improved work practices are required.

Adult↗

Diversity in context: how organizational culture shapes reactions to workers with disabilities and others who are demographically different.

Successfully integrating workers with disabilities into their organizations is both a challenge and an opportunity facing managers today. Despite laws and business practices prohibiting discrimination against those with disabilities, people with disabilities are consistently underutilized in organizations. This article applies theories of demographic diversity in organizations to assert that a richer understanding of organizational cultures and their implications for workers with disabilities may shed light on the question of how and why workers with disabilities may be excluded from mainstream work experiences and career progression. The article briefly reviews business arguments that support integration of workers with disabilities into organizations based on their contribution to the overall diversity within the organization, and reviews complications in the research on diversity to date that leave important questions of the potential gains or detriments from increasing this diversity unanswered. The article then goes on to introduce organizational culture as an underinvestigated but likely potent tool in explaining how and when workers who are demographically different, in general, and with disabilities, specifically, may be successfully integrated into an organization's work force. The article introduces three types of organizational culture: culture of differentiation, culture of unity, and culture of integration. Each is explained in terms of its content and its implications for managing diversity. A discussion of the implications of culture as a primary tool for managing the integration of workers with disabilities concludes the paper.

Attitude↗

Genotoxic risk and oxidative DNA damage in workers exposed to antimony trioxide.

The growing use of antimony (Sb) compounds in industry and the consequent increase in the number of exposed workers make it important to carry out a health risk assessment. The main goal of this study was to assess the genotoxicity of Sb(2)O(3) in occupationally exposed workers. Genotoxicity was evaluated by the sister chromatid exchange (SCE) and micronucleus tests, and the enzyme (Fpg)-modified comet assay. In addition, antimony exposure levels were established by environmental monitoring with personal air samplers. We studied 23 male workers assigned to different fire retardant treatment tasks in the car upholstery industry and a control group of 23 healthy nonexposed males. The exposed workers were divided into two groups on the basis of their tasks and the work cycle: Group A comprised finishing and intermediate inspection operators who directly handled a mixture containing Sb(2)O(3); Group B were jet operators, not directly exposed to the compound. Environmental monitoring detected low Sb exposure levels but significant differences between the two groups, with Group A having the higher exposure level. Cytogenetic analyses showed no difference between exposed workers and controls for micronuclei and SCE. The enzyme-modified comet assay showed a probable relation between moderate levels of oxidative DNA damage and exposure to antimony, with a significantly higher proportion of workers in Group A having oxidative DNA damage compared to controls. The results support the theory that oxidative DNA damage is involved in the genotoxicity of antimony and indicate the need for further research in this field.

Adult↗

Observation of frequencies of lymphocytes with micronuclei in human peripheral blood cultures from workers in a sulphuric acid factory.

Frequencies of lymphocytes with micronuclei (MNF) in human peripheral blood cultures from workers in a sulphuric acid factory (the SO2 concentrations in the workplace ranged from 0.34 mg/m3 to 11.97 mg/m3 air) were investigated. It was shown that among 40 workers, the MNF of 28 workers was more than 0.1%, and the MNF of 7 workers was greater than the upper limit of the normal range (0.2%). The mean MNF of the worker and the control group was 0.168% and 0.071%, respectively. The difference between them was statistically significant (P less than 0.001). It implies that SO2 is a clastogenic and genotoxic agent. No positive correlation between the MNF and length of service in workers has been observed. In the control population, the MNF of smokers was significantly higher than that of non-smokers (P less than 0.001).

Air Pollutants, Occupational↗

Sister chromatid exchanges and chromosome aberrations in rubber workers.

Sister chromatid exchanges and chromosomal aberrations were studied in peripheral blood lymphocytes of 55 rubber workers (from two different plants) and 35 controls mainly employed in office jobs. In both plants an increased frequency of SCEs (P less than 0.05 for plant A and P less than 0.01 for plant B) was detected in nonsmoking rubber workers as compared with nonsmoking referents. When the SCEs of worker groups belonging to the different job categories were compared with referents, the only groups showing statistically significant increases in SCEs were the smoking workers from the weighing and mixing departments of factory A and the nonsmoking weighers of factory B. A slight increase in the SCE frequencies was seen especially among smoking workers employed in the chemical mixing departments. The frequency of structural chromosome aberrations was not significantly increased in the occupational groups studied, the only exception being the small group of nonsmoking weighers in plant B. Among both the exposed workers and the controls, smokers had a higher mean SCE frequency than nonsmoking referents. This difference was significant between the exposed smokers and nonsmokers of plant A (P less than 0.01) and between smoking and nonsmoking controls for plant B (P less than 0.001). In addition, the chromosome aberration frequency of smoking controls of plant A was significantly higher (P less than 0.01 when gaps excluded and P less than 0.05 when gaps included) than that of nonsmoking referents. Also, smokers among controls for plant B had an increased frequency of aberrations in their cultured blood lymphocytes when compared with nonsmokers. This difference was significant (P less than 0.05) when gaps were excluded.

Chromosome Aberrations↗

Acute and chronic neurological symptoms among paint workers exposed to mixtures of organic solvents.

The purpose of this study was to determine the prevalence rates of acute and chronic neurologic symptoms among paint workers and the association of such symptoms with the severity of exposure to mixtures of solvents. Two paint manufacturing factories and 25 various kinds of spray painting factories were selected for study. Air concentrations of organic solvents were measured by personal samplers and were analyzed by gas chromatography. A total of 196 workers were given a screening neurological examination and a questionnaire on acute and chronic neurologic symptoms. A detailed personal medical history and a profile on alcohol consumption and medication were also included. The results showed that xylenes and toluene were the major solvents found in almost all the air samples with average contents of 50 and 24% on a weight basis of 73 air samples. We classified workers according to different exposure patterns and different air concentrations of breathing zones: high (8-hr hygienic effect, 0.25-9.86; median, 1.66), short-term high (hygienic effect, 0-3.38; median, 0.12), and low (hygienic effect, 0-0.38; median, 0.12). All workers showed no overt neurological signs such as ataxic gait, poor coordination, or muscle weakness. After excluding those workers who consumed more than 280 g of alcohol per week (n = 8), took antihypertensive medications (n = 4), or were treated with antipsychotic agents (n = 1), we found that the severity of exposure was associated with acute symptoms of headache and chest tightness and chronic symptoms of dizziness, easy fatigability, depressed mood, and palpitation. There was no association between peripheral neurological symptoms and the severity of exposure. Workers in the high exposure group were 2.7 times more likely to develop two or more acute symptoms and 3.3 times more likely to develop three or more chronic symptoms of the central nervous system than the low exposure group. After modeling by multiple logistic regression, we concluded that exposure to a medium level of mixtures of solvents (hygienic effect exceeding 1.66) may produce acute and chronic central neurological symptoms.

Acute Disease↗

Assessment of central, peripheral, and autonomic nervous system functions in lead workers: neuroelectrophysiological studies.

To assess the effects of lead on central, peripheral, and autonomic nervous systems, the visual-, short-latency somatosensory-, and brainstem auditory-evoked potentials (VEP, SSEP, and BAEP), event-related potential (P300), distribution of nerve conduction velocities (DCV), and electrocardiographic R-R interval variability (CVRR), together with conventional median and radial nerve conduction velocities (NCV), were measured in the lead workers. The lead workers consisted of 22 gun metal foundry workers occupationally exposed to lead, zinc, and copper. In the lead workers with blood lead concentrations below 65 micrograms/dl, the latencies of the VEP (from the retina to the visual cortex), SSEP (from the brachial plexus to the brainstem), and P300 (which reflects cognitive function) were significantly prolonged when compared with the sex- and age-matched controls. All these latencies and the BAEP latencies (from the cochlear nerve to the brainstem) were significantly correlated with the indicators of lead absorption among these workers. The CVRR (especially, a component of parasympathetic activity) was significantly depressed in the lead workers. The slower (V10) velocity of the DCV, the motor, and sensory NCVs were also significantly slowed. These findings suggest that lead affects not only peripheral nerve but also the central and autonomic nervous functions at a subclinical level; zinc may antagonize the neurotoxic effects of lead.

Adult↗

Nonlinearity in the lung cancer dose-response for airborne arsenic: apparent confounding by year of hire in evaluating lung cancer risks from arsenic exposure in Tacoma smelter workers.

Most analytic studies of human epidemiologic data have affirmed the linear association between excess lung cancer risk and airborne arsenic exposure. Recent Canadian analyses, however, based on the mortality follow-up of Tacoma smelter workers from 1940-1976, provided strong evidence of a nonlinear dose-response when lung cancer risk was expressed in terms of the standardized mortality ratio. Using recently updated data covering ten additional years of mortality experience among Tacoma workers (1940-1986), new analyses were undertaken to further explore nonlinearity in the lung cancer dose-response in this worker cohort. Lung cancer risk was expressed in terms of both the standardized mortality ratio (SMR) and the excess mortality rate (EMR). As in Canadian analyses, nonlinearity was assessed through a three parameter model containing both linear and negative exponential terms for dose. Dropping the negative-exponential dose-term lead to the standard suite of linear dose-response models, with and without intercept, used for comparative purposes. Analyses were undertaken by subcohort as there was strong evidence of confounding by year of initial hire, which largely explained the nonlinearity in the dose-response observed in Canadian analyses. Subcohort analyses based on initial employment, prior to 1940 or thereafter, showed that the nonlinearity in the dose-response was strongly influenced by date of initial hire. whether the cohort risk was measured by either the SMR or EMR, a nonlinear dose-response was evident only among workers hired prior to 1940. This, however, was strongly related to the artifactually low lung cancer mortality seen among workers hired between 1930 and 1939. Among workers hired after 1940, analyses showed that a linear dose-response provided a clearly superior fit. While analyses showed comparable goodness of fit when models were fitted to the SMR and EMR. Only those based on the EMR provided strong evidence of a dose-response. Overall, nonlinearity as observed in Canadian analyses was likely the result of several sources of bias not taken into account by Canadian investigators.

Adult↗

Mortality from lung cancer and cardiovascular diseases among stainless-steel producing workers.

The mortality pattern of workers involved in the production of stainless steel (SS) was studied from 1968 to 1984 in order to investigate a possible risk of lung cancer in relation to exposure to chromium compounds, polycyclic aromatic hydrocarbons, and silica. The role of heat exposure in mortality from cardiovascular diseases also was examined. The cohort was comprised of 4,227 workers. Complete individual job histories were provided by the company (UGINE SA). The smoking habits of 24 percent of the cohort members were known from the interview of workers still active during the data collection. The observed numbers of deaths were compared with the expected ones based on national rates with adjustment for age, sex, and calendar time (standardized mortality ratio, SMR). No significant excesses of lung cancer were observed among workers employed in the manufacture of ferroalloys (SMR = 0.68) and in the melting and casting of SS (SMR = 1.04), whereas a significant excess appeared among SS foundry workers (SMR = 2.29). This excess was higher and remained significant among workers with more than 30 years since first employment in the foundry area (SMR = 3.34). Among subjects exposed to heat, no excess was observed for all cardiovascular diseases or for ischemic heart diseases.

Cardiovascular Diseases↗

Seroprevalence of hepatitis A virus infection among sewage workers in the Parisian area, France.

Sewers are an ideal environment to be occupationally exposed to viral hepatitis A (HAV) infection, because of high frequency and ability of the virus to remain viable for prolonged periods in sewage. However, data on the occupational risk of HAV infection among sewage workers is not well documented. In a cross sectional study comparing sewage workers (n = 155) to those not occupationally exposed to it (n = 70), we found a non significant increase in HAV seropositivity among sewage workers of 12.9% (p = 0.07). The prevalence of HAV antibody was significantly associated with duration of occupational exposure to sewage (p < 0.015), stay in HAV endemic areas (p < 0.03), age (p < 0.001), and number of siblings (p < 0.03). A stepwise logistic regression analysis gave an adjusted odds ratio for HAV seropositivity 2.15 fold greater in sewage workers compared to those not occupationally exposed to it. So, although there was no significant difference in the prevalence of HAV antibody between sewage workers and others, exposure to sewage was an independent risk factor for HAV seropositivity, and this raises the question of whether it is necessary to vaccinate sewage workers against viral hepatitis A.

Adult↗

Two-year observation of pulmonary function in workers exposed to low concentrations of toluene diisocyanate.

Pulmonary effects were investigated in 106 toluene diisocyanate (TDI)-exposed workers and 39 referents in 64 exposed workers and 21 referents on the 2-year follow-up study in 1982. Means of individual, time-weighted average (TWA) exposure concentrations measured by personal monitors were approximately 0.001 ppm in each year. Short-term exposure at 0.02 ppm or over was observed in 9.3% of the collected samples in 1980 and 1.9% in 1982. Pulmonary function was assessed by measurements of maximum expiratory flow-volume curve and respiratory impedance. No differences were observed in the means of the pulmonary functions and their individual daily changes between the TDI workers and the referents. Significant intra-individual, two-year decreases were observed in some pulmonary function parameters in both groups, but when the effect of aging was adjusted, the decreases disappeared. Prevalences of respiratory symptoms in the TDI workers were not significantly higher than those in the referents, except for irritating complaints of the eyes and throat probably due to peak exposure to TDI and/or co-existing irritants. Eight of the TDI workers had episodes of acute asthmatic reactions shortly after having begun their TDI jobs and most parameters in their maximum expiratory flow were significantly less than the predicted values, though exposure concentrations when the episodes occurred could not be defined. From these results, it was suggested that TDI exposure at the levels of 0.001 ppm may not induce adverse pulmonary effects when the workers are not hypersusceptive to TDI.

Adult↗

DNA-protein cross-links and sister chromatid exchange frequencies in lymphocytes and hydroxyethyl mercapturic acid in urine of ethylene oxide-exposed hospital workers.

The lymphocytes of 25 hospital workers exposed to ethylene oxide and of a standardized control group were investigated for DNA damage (measured by alkaline filter elution) and sister chromatid exchange (SCE) frequencies. Additionally, the excretion of hydroxyethyl mercapturic acid (HEMA) in the 24-h urine of ten workers and ten control persons was determined. The peak levels of ethylene oxide in air during the first 8 min after opening of the sterilization unit were measured. Peak levels of ethylene oxide in the air of up to 417 ppm after opening of the sterilization unit were detected. In the alkaline filter elution assay we found significantly reduced elution rates in the exposed workers, indicating DNA-protein cross-links. The reduction of the elution rates through HVLP filters correlated significantly with the exposure classification (low, medium, high) (r = -0.45, P < 0.05) and the ethylene oxide peak level after opening of the sterilization unit (r = -0.42, P < 0.05). The SCE frequencies in the standardized control group were significantly elevated. With respect to (n = 78) historic control SCE values of our institute, the SCE values of the disinfectors were not significantly elevated (6.54 vs 6.27). The ethylene oxide-exposed workers did not have a greater percentage of high-frequency SCE cells. The mean HEMA concentration in the urine of the exposed workers was significantly elevated, but there were wide variations in HEMA concentrations and no correlation to ethylene oxide exposure. We conclude that the alkaline filter elution assay may be a sensitive parameter for ethylene oxide-exposed workers.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcysteine↗

Platelet monoamine oxidase B activity in workers exposed to styrene.

A cross-sectional study was conducted to evaluate monoamine oxidase type B (MAO-B) activity in platelets as a biomarker of effect of styrene and perchloroethylene exposures. MAO-B is an enzyme system involved in dopamine catabolism, the impairment of which has been postulated as a mechanism of styrene-induced neurotoxicity. We previously observed an inverse association between blood styrene and MAO-B among reinforced plastics manufacturing workers. The present study included 59 male boat plant workers exposed to styrene (exposure range < 1-144 ppm, 8-h TWA). Two comparison groups comprised six male dry cleaning workers exposed to perchloroethylene (PCE; exposure range < 2-37 ppm) and 14 male laundry workers not exposed to either agent. Respiratory protection was not used by any of the styrene- or PCE-exposed workers; thus, air concentrations were regarded as valid exposure indicators. MAO-B activity (pmol/10(8) cells/h) was measured in peripheral blood platelets, using phenylethylamine as substrate. Only small overall mean differences in MAO-B were observed among the three groups; mean values were 4.21, 4.51, and 4.12 for the styrene-exposed, PCE-exposed, and laundry workers, respectively. Despite the absence of gross differences among the groups, styrene exposure was inversely related to MAO-B. Mean values for four increasing exposure group quartiles were: 5.60, 4.13, 3.69, and 3.44. The Spearman rank correlation coefficient for styrene with MAO-B was -0.41. Adjustment for age, medication use, smoking, and alcohol consumption had only a minimal effect on this trend.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Vibration perception threshold of forest worker's finger during temporary obstructed blood circulation.

Vibration detection threshold (VPT) of 149 professional forest workers was measured during a compulsory annual health examination. The authors' earlier developed measuring method for VPT of finger was modified. The blood circulation of the hand was obstructed for 6 min and VPT was measured 4 min after releasing the obstruction. VPTs of all forest workers increased during obstruction. In forest workers suffering from decreased hand grip force (decreased HGF) the increase of VPT differed significantly from forest workers without symptoms, and VPT in the former group still increased after releasing the obstruction. VPT remained also at the raised level after releasing the obstruction with forest workers suffering from vibration-induced white finger (VWF). Nevertheless, on an individual basis even the modified measuring method failed to discriminate subjects without symptoms from those with symptoms of hand-arm vibration syndrome. The raised VPT and sensitivity for obstruction of blood circulation suggest that the reason for decreased HGF in forest workers may be a consequence of an injury in the peripheral nerves.

Adult↗

Measuring method for vibration perception threshold of fingers and its application to vibration exposed workers.

A measuring method for the vibration perception threshold (VPT) of fingers has been developed. The VPTs of 118 and 149 professional forest workers were measured during a compulsory annual health examination in 1979 and 1983, respectively. Also the VPTs of eight pedestal grinders, who were suffering vibration-induced white finger (VWF), were measured in 1979 and 1983. The control group consisted of 20 research workers who had no vibration exposure in the past and no symptoms in their hands. The measuring system for VPT gave repeatable results. The frequency of the most sensitive VPT of vibration exposed workers alternated between 63 and 125 Hz instead of 125 Hz of subjects without vibration exposure. The VPT of the pedestal grinders and forest workers with decreased hand grip force and with vibration-induced white finger were significantly higher than those of the controls. The VPTs of the forest workers decreased slightly and that of the grinders increased from 1979 to 1983. In spite of long vibration exposure in the past and continuing lower level vibration exposure, the increased VPT of forest workers does not seem to be permanent.

Adult↗

Respiratory function in greenhouse workers.

Respiratory findings were studied in a group of 135 female and 32 male workers employed in greenhouses. In addition 51 women and 30 men were studied as a control group. Exposed women had significantly higher prevalences of chronic cough, dyspnea, chest tightness, and rhinitis (P < 0.01) than the controls. Among the men, only rhinitis was more prevalent in greenhouse workers (P < 0.01) than in controls. Smokers had higher prevalences of all chronic respiratory symptoms than nonsmokers, but the differences were statistically significant only for chronic cough and rhinitis in women and for chronic phlegm in men. There was a high prevalence of acute symptoms during work. A large number of greenhouse workers complained of skin reactions to plants and pesticides (women: 37.8%; men: 34.4%). Workers had significantly lower mean ventilatory capacity measurements (except in the case of forced vital capacity) when compared to standard predicted values. Smokers and nonsmokers had similar values of lung function expressed as percentages of the predicted values. Greenhouse workers exposed for more than 10 years had a significantly lower FEF25, measured as a percentage of the predicted value, than workers exposed for less than 10 years. Our data indicate that occupational exposure to greenhouses may be associated with the development of acute and chronic respiratory symptoms and impairment of ventilatory capacity.

Adult↗

A study of the prevalence of acute respiratory disorders among workers in the textile industry.

An epidemiological study of 774 workers in seven eastern France cotton textile factories was conducted to determine the prevalence of acute respiratory disorders. From nine non-textile companies, 464 workers, stratified as to sex, age and tobacco consumption participated in the study as a control population. A questionnaire designed to elicit the respiratory symptoms (in particular the Monday tightness characterizing byssinosis) was administered to the 1238 workers. Peak-expiratory-flow (PEF) measurement was made for each subject, exposed and non-exposed, before the start of the shift on the day of the worker's return to work and repeated at the end of the shift. The PEF's variations during the workshift were studied. Present Monday tightness was mentioned by 48 cotton exposed workers (6.2%) and by 9 non-exposed (1.9%) (P less than 0.001). A 10% decrease in PEF during the shift was present in 63 cotton exposed workers (8.1%) and in 10 non-exposed (2.1%) (P less than 0.001). For the exposed population, Monday tightness was analysed using multiple logistic regression, showing an absence of a link with smoking, an increased occurrence after 20 years of exposure (OR = 7.3) and a link with current job (more frequent among those with the dustiest jobs) (OR = 4.9). The multiple logistic analysis of a 10% decrease in PEF showed effects of smoking habits (OR = 1.86). It also showed a link with "highly polluted job" history (OR = 2.7), but especially with present job (OR = 3.4). The absence of a constant link between Monday tightness and drop of the PEF was found.

Adult↗