1. |
- Hagenbjörk-Gustafsson, Annika, et al.
(author)
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Determinants of personal exposure to some carcinogenic substances and nitrogen dioxide among the general population in five Swedish cities
- 2014
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In: Journal of Exposure Science and Environmental Epidemiology. - : Springer Science and Business Media LLC. - 1559-0631 .- 1559-064X. ; 24:4, s. 437-443
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Journal article (peer-reviewed)abstract
- Environmental levels of airborne carcinogenic and related substances are comparatively better known than individual exposure and its determinants. We report on a personal monitoring program involving five Swedish urban populations. The aim of the program was to investigate personal exposure to benzene, 1,3-butadiene, formaldehyde, and nitrogen dioxide (NO2). The measurements were performed among 40 inhabitants during seven consecutive days, in one urban area each year, during 2000-2008. The estimated population exposure levels were 1.95 mu g/m(3) for benzene, 0.56 mu g/m(3) for 1,3-butadiene, 19.4 mu g/m(3) for formaldehyde, and 14.1,mu g/m(3) for NO2. Statistical analysis using a mixed-effects model revealed that time spent in traffic and time outdoors contributed to benzene and 1,3- butadiene exposure. For benzene, refueling a car was an additional determinant influencing the exposure level. Smoking or environmental tobacco smoke were significant determinants of exposure to NO2, benzene, and 1, 3-butadiene. Those with a gas stove had higher NO2 exposure. Living in a single-family house increased the exposure to formaldehyde significantly. In a variance component model, the between-subject variance dominated for 1,3-butadiene and formaldehyde, whereas the between-city variance dominated for NO2. For benzene, the between-subject and between-cities variances were similar.
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2. |
- Alhamdow, Ayman, et al.
(author)
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DNA-methylation of the cancer-related genes F2RL3 and AHRR is associated with occupational exposure to polycyclic aromatic hydrocarbons
- 2018
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In: Carcinogenesis. - : Oxford University Press. - 0143-3334 .- 1460-2180. ; 39:7, s. 869-878
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Journal article (peer-reviewed)abstract
- Some polycyclic aromatic hydrocarbons (PAH) are known carcinogens and workplace PAH exposure may increase the risk of cancer. Monitoring early cancer-related changes can indicate whether the exposure is carcinogenic. Here, we enrolled 151 chimney sweeps, 152 controls, and 19 creosote-exposed male workers from Sweden. We measured urinary PAH metabolites using LC/MS/MS, the cancer-related markers telomere length (TL) and mitochondrial DNA copy number (mtDNAcn) using qPCR, and DNA methylation of lung cancer-related genes F2RL3 and AHRR using pyrosequencing. The median 1-hydroxypyrene (PAH metabolite) concentrations were highest in creosote-exposed workers (8.0 μg/g creatinine) followed by chimney sweeps (0.34 μg/g creatinine) and controls (0.05 μg/g creatinine). TL and mtDNAcn did not differ between study groups. Chimney sweeps and creosote-exposed workers had significantly lower methylation of AHRR CpG site cg05575921 (88.1% and 84.9%, respectively) than controls (90%). Creosote-exposed workers (73.3%), but not chimney sweeps (76.6%) had lower methylation of F2RL3 cg03636183 than controls (76.7%). Linear regression analyses showed that chimney sweeps had lower AHRR cg05575921 methylation (B=-2.04; P<0.057, adjusted for smoking and age) and lower average AHRR methylation (B=-2.05; P<0.035), and non-smoking chimney sweeps had lower average F2RL3 methylation (B=-0.81; P<0.042, adjusted for age) compared with controls. These cancer-related markers were not associated with urinary concentrations of PAH metabolites. In conclusion, although we found no associations with PAH metabolites in urine (short-term exposure), our results suggest dose-response relationship between PAH exposure and DNA hypomethylation of lung cancer-related loci. These findings indicate that further protective measures should be taken to reduce PAH exposure.
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3. |
- Henriksson, Sara, 1975-, et al.
(author)
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Uptake and bioaccumulation of PCDD/Fs in earthworms after in situ and in vitro exposure to soil from a contaminated sawmill site
- 2017
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In: Science of the Total Environment. - Amsterdam, Netherlands : Elsevier. - 0048-9697 .- 1879-1026. ; 580, s. 564-571
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Journal article (peer-reviewed)abstract
- Uptake of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) was studied in earthworms collected from a sawmill site in Sweden with severe PCDD/Fs contamination (the hot spot concentration was 690,000 ng TEQWHO2005/kg d.w.) in order to investigate the transfer of PCDD/Fs from the site to the biota. PCDD/Fs concentrations in the collected earthworms were compared to PCDD/Fs concentrations in laboratory exposed earthworms (Eisenia fetida), which were exposed to contaminated soils from the sawmill site for 34 days. All analyses were performed by high resolution gas chromatography/high resolution mass spectrometry (HRGC/HRMS). PCDD/Fs concentrations in the earthworms ranged from 290 to 520,000 pg/g (f.w.). The main congeners found in both soils and earthworms were OCDF, 1234678-HpCDF, OCDD and 1234678-HpCDD. The study showed that the PCDD/Fs in the soil were biovailable to the earthworms and the PCDD/Fs concentrations in the soils correlated with the concentrations in the earthworms. Earthworm samples from soil with lower concentration had higher bioaccumulation factors than samples from soils with high concentration of contamination. Thus, a less contaminated soil could yield higher concentrations in earthworms compared to a higher contaminated soil. Assuming that when assessing risks with PCDD/F contaminated soil, a combination of chemical analysis of soil PCDD/Fs concentrations and bioavailability should be employed for a more comprehensive risk assessment.
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4. |
- Landberg, Hanna E, et al.
(author)
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A Study of the Validity of Two Exposure Assessment Tools : Stoffenmanager and the Advanced REACH Tool
- 2017
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In: Annals of Work Exposures and Health. - : Oxford University Press. - 2398-7308 .- 2398-7316. ; 61:5, s. 575-588
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Journal article (peer-reviewed)abstract
- The use of exposure modelling tools for estimating chemical airborne exposure has increased since the European Union's REACH legislation for safe use of industrial chemicals came into force. Two tools that European Chemicals Agency recommends are Stoffenmanager® and the Advanced REACH Tool (ART). The aim of this study was to investigate the validity of these two exposure modelling tools by comparing the lack of agreement between estimated and measured exposure. We examined the airborne chemical exposure at companies in seven different types of industries: wood, printing, foundry, spray painting, flour milling, chemical industry, and plastic moulding industry. The inhalable exposure of liquids or powders at two to three situations at each company was modelled with both tools and measured. To study the validity of the tools, the mean differences and precisions (lack of agreement) of exposures from both situations handling liquids and powders were calculated by using the 50th percentile outcome of the tools and the geometric mean of the measured exposure (all data were ln transformed). For Stoffenmanager, the mean difference and precision of the situations concerning liquids were 0.22 ± 1.0 and for powders -0.024 ± 0.66. It was also shown that Stoffenmanager overestimated low exposures and underestimated high exposures. Stoffenmanager showed higher agreement with the measured exposure in the wood and flour mill industries than in foundry and the plastic moulding industry. For ART, the mean difference and precision of liquids were -0.55 ± 0.88 and for powders -1.4 ± 1.6. ART showed lower agreement with the measured exposure in the wood industry.
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5. |
- Landberg, Hanna E., et al.
(author)
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Evaluation of risk assessment approaches of occupational chemical exposures based on models in comparison with measurements
- 2018
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In: Safety Science. - : Elsevier. - 0925-7535 .- 1879-1042. ; 109, s. 412-420
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Journal article (peer-reviewed)abstract
- Risk assessments of chemicals in work places are needed to protect workers' health and safety. Several different strategies can be used for conducting risk assessments. The aim of this study was to investigate approaches to risk assessment of chemicals based on exposure assessment models relative to occupational exposure limits values (OELs) and derived no-effect levels (DNELs) and in comparison with measurements relative to OELs. A second aim was to evaluate the modelled recommended outcome and compare it with measurements of exposure. In this study, 29 situations were assessed with ECETOC TRA, Stoffenmanager (R) 5.1 and ART. Personal exposure measurements were also performed. The percentage of measured exposure exceeding the recommended output was calculated to investigate the level of conservatism. All the modelled exposures were compared with OELs and DNELs where possible, and the GM of the measured exposure was compared with OELs (risk quotas). For ECETOC TRA, 31% of measured exposure exceeded modelled exposure. For Stoffenmanager (R) it was 17% and for ART and ART B it was 3% and 0% respectively. Hence, according to our data, ECETOC TRA is the least conservative. An investigation of the risk quotas showed that ECETOC TRA had 4 false safe situations, meaning the risk was low when the model was used but was high when measurements were used. This may lead to underestimating risks. All models had an elevated proportion, ECETOC TRA and ART the highest, of false unsafe situations meaning the risk was low when measurements were used but high when models were used.
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6. |
- Landberg, Hanna, et al.
(author)
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Evaluating the Risk Assessment Approach of the REACH Legislation : A Case Study
- 2019
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In: Annals of Work Exposures and Health. - : Oxford University Press. - 2398-7308 .- 2398-7316. ; 63:1, s. 68-76
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Journal article (peer-reviewed)abstract
- Risk assessments based on occupational exposure to chemicals have increased since REACH (European regulation on Registration, Evaluation, Authorization, and restriction of Chemicals) came into force. The European Chemicals Agency (ECHA) recommends that chemical exposure could be calculated using exposure models and that parameters used to calculate the exposure scenario (ES) should be communicated in extended safety data sheets (e-SDS) as workplace instructions which downstream users are obligated to follow. We aimed to evaluate REACH's risk assessment approach using the Stoffenmanager((R)) 6.1, the Advanced REACH Tool 1.5 (ART), and the European Centre for Ecotoxicology and Toxicology of Chemicals' targeted risk assessment (ECETOC TRA 3.1) exposure models. We observed 239 scenarios in three companies handling chemicals using 45 e-SDS. Risk characterization ratios (RCRs) were calculated by dividing estimated exposures by derived no-effect levels (DNELs). Observed RCRs were much lower than registered RCRs, indicating lower exposures. However, about 12% of the observed ES still had RCRs > 1, after adjustment for control measures and personal protections described in the ES, when using Stoffenmanager((R)). The ES with observed RCRs > 1 were the same by Stoffenmanager((R)) and ART, but not by ECETOC TRA. Stoffenmanager and ART identified 25 adjusted scenarios with RCR > 1, while ECETOC TRA gave RCR < 1 for the same scenarios. The ES with RCR > 1 were significantly associated to chemicals with higher vapour pressure and lower DNELs than ES with RCR < 1 by Stoffenmanager((R)). The correlations between observed and registered RCRs were lower than those between RCRs calculated from the different models themselves; ECETOC TRA had the lowest correlation with the registered ES. These results put in question the generic ES recommended under the REACH legislation. Downstream users may get better estimates by assessing their own ES, especially for chemicals with low DNELs and high vapour pressure.
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7. |
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8. |
- Löfstedt, Håkan, 1963-, et al.
(author)
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Respiratory and Ocular Symptoms Among Employees at Swedish Indoor Swimming Pools
- 2016
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In: Journal of Occupational and Environmental Medicine. - : Lippincott Williams & Wilkins. - 1076-2752 .- 1536-5948. ; 58:12, s. 1190-1195
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Journal article (peer-reviewed)abstract
- Background: This study investigated trichloramine exposure and prevalence of respiratory and ocular symptoms among Swedish indoor swimming pool workers.Methods: Questionnaires were distributed to pool workers and referents. Lung function and fraction of exhaled nitric oxide (FeNO) were measured before and after work. Exposure to trichloramine and trihalomethanes was measured over work shifts.Results: The mean personal trichloramine exposure was 36g/m(3). Significantly more exposed workers reported ocular and nasal symptoms. There were significant differences between groups in FeNO change following work, with exposed showing increased FeNO, which grew when analyses included only nonsmokers.Conclusions: The findings indicate that indoor swimming pool environments may have irritating effects on mucous membranes. FeNO data also indicate an inflammatory effect on central airways, but the clinical relevance is unclear. Low trichloramine levels found in this study were not associated with health effects.
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9. |
- Nilsson, Helena, 1974-, et al.
(author)
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A time trend study of significantly elevated perfluorocarboxylate levels in humans after using fluorinated ski wax
- 2010
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In: Environmental Science and Technology. - Washington, USA : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 44:6, s. 2150-2155
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Journal article (peer-reviewed)abstract
- A time trend study focusing on ski waxing technicians' exposure to perfluorinated chemicals (PFCs) from fluorinated wax fumes was performed in 2007/2008. Levels of eight perfluorocarboxylates and three perfluorosulfonates were analyzed in monthly blood samples from eight technicians, Samples were collected before the ski season, i.e., preseason, then at four AS World Cup competitions in cross country skiing, and finally during an unexposed 5-month postseason period. The perfluorinated carboxylates perfluoroheptanoic acid (PFHpA), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluoroundecanoic acid (PFUnDA) bioaccumulate, and continued exposure may contribute to elevated levels in ski technicians compared to the general population. The wax technicians' median blood level of PFOA is 112 ng/mL compared to 2.5 ng/mL in the general Swedish population. A significant correlation was found between number of working years and levels of perfluorocarboxylates. The PFOA levels in three technicians with "low" initial levels of PFOA (< 10.0 ng/mL in preseason blood) increased by 254, 134, and 120%, whereas five technicians with "high" initial levels (> 100 ng/mL in preseason sample) were at steady state. PFHxA is suggested to have a short half-life in humans relative the other perfluorocarboxylates. The levels of perfluorosulfonates were unaffected by the wax exposure.
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10. |
- Nilsson, Helena, 1974-, et al.
(author)
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Biotransformation of fluorotelomer compound to perfluorocarboxylates in humans
- 2013
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In: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 51, s. 8-12
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Journal article (peer-reviewed)abstract
- Levels of perfluorocarboxylates (PFCAs) in biological compartments have been known for some time but their transport routes and distribution patterns are not properly elucidated. The opinions diverge whether the exposure of the general population occurs indirect through precursors or direct via PFCAs. Previous results showed that ski wax technicians are exposed to levels up to 92 000 ng/m(3) of 8:2 fluorotelomer alcohol (FTOH) via air and have elevated blood levels of PFCAs. Blood samples were collected in 2007-2011 and analyzed for C(4)-C(18) PFCAs, 6:2, 8:2 and 10:2 unsaturated fluorotelomer acids (FTUCAs) and 3:3, 5:3 and 7:3 fluorotelomer acids (FTCAs) using UPLC-MS/MS. Perfluorooctanoic acid (PFOA) was detected in levels ranging from 1.90 to 628 ng/mL whole blood (wb). Metabolic intermediates 5:3 and 7:3 FTCA were detected in all samples at levels up to 6.1 and 3.9 ng/mL wb. 6:2, 8:2 and 10:2 FTUCAs showed maximum levels of 0.07, 0.64 and 0.11 ng/mL wb. Also, for the first time levels of PFHxDA and PFOcDA were detected in the human blood at mean concentrations up to 4.22 ng/mL wb and 4.25 ng/mL wb respectively. The aim of this study was to determine concentrations of PFCAs and FTOH metabolites in blood from ski wax technicians.
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11. |
- Nilsson, Helena, 1974-, et al.
(author)
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Inhalation exposure to fluorotelomer alcohols yield perfluorocarboxylates in human blood?
- 2010
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In: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 44:19, s. 7717-7722
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Journal article (peer-reviewed)abstract
- Levels of perfluorinated carboxylates (PFCAs) in different environmental and biological compartments have been known for some time, but the routes of exposure still remain unclear. The opinions are divergent whether the exposure to general populations occurs mainly indirect through precursor compounds or direct via PFCAs. Previous results showed elevated blood levels of PFCAs in ski wax technicians compared to a general population. The objective of this follow-up study was to determine concentrations of PFCAs, perfluorosulfonates (PFSAs), and fluorotelomer alcohols (FTOHs), precursor compounds that are known to degrade to PFCAs, in air collected in the breathing zone of ski wax technicians during work. We collected air samples by using ISOLUTE ENV+ cartridges connected to portable air pumps with an air flow of 2.0 L min(-1). PFCAs C5-C11 and PFSAs C4, C6, C8, and C10 were analyzed using LC-MS/MS and FTOHs 6:2, 8:2, and 10:2 with GC-MS/MS. The results show daily inhalation exposure of 8:2 FTOH in mu g/m(3) air which is up to 800 times higher than levels of PFOA with individual levels ranging between 830-255000 ng/m(3) air. This suggests internal exposure of PFOA through biotransformation of 8:2 FTOH to PFOA and PFNA in humans.
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12. |
- Nilsson, Helena, 1974-, et al.
(author)
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Professional ski waxers' exposure to PFAS and aerosol concentrations in gas phase and different particle size fractions
- 2013
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In: Environmental science. Processes & impacts. - : Royal Society of Chemistry. - 2050-7887 .- 2050-7895. ; 15:4, s. 814-822
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Journal article (peer-reviewed)abstract
- Previous reports show that professional ski waxers have elevated blood levels of perfluorinated substances (PFAS) such as perfluorooctanoate (PFOA) and are exposed to very high concentrations of PFAS in air during ski waxing. Aerosol exposure increases the risk of cardiovascular disease, and PFOA is a potential hormonal disruptor and carcinogen, and can affect the fatty acid metabolism. Animal studies have shown that 8: 2 FTOH can undergo biotransformation to PFOA. For the first time, this study presents an occupational scenario of professional ski waxers who are exposed to extremely high dust levels as well as per-and polyfluorinated compounds. Personal and fixed measurements of total aerosol, inhalable and respirable fractions were performed during World Cup events 2007-2010. The occupational exposure limit (OEL) is exceeded in 37% of the personal measurements with concentrations up to 15 mu g m(-3) in air. There are differences between personal and area total aerosol concentrations with levels from personal measurements twice as high as those from the area measurements. The personal levels for FTOH ranged up to 996 mg m(-3) (mean = 114 mu g m(-3)) and for PFOA up to 4.89 mu g m(-3) (mean = 0.53 mu g m(-3)) in ENV+ sorbent samples as compared to the general exposure levels from air reaching only low ng m(-3) (<30 ng m(-3)) levels. FTOHs were not detected in aerosols but PFOA showed an average level of 12 mu g m(-3) (range = 1.2-47 mu g m(-3)). The ski waxers' exposure to paraffin fumes and PFAS is not in compliance with the occupational exposure standards and by far exceed the general populations' exposure. Preventive measures must be taken to minimize the exposure in this occupational group.
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13. |
- Westberg, G, et al.
(author)
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Prediction of prognosis by echocardiography in patients with midgut carcinoid syndrome.
- 2001
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In: The British journal of surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 88:6, s. 865-72
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Journal article (peer-reviewed)abstract
- The association between malignant midgut carcinoid tumours and right-sided cardiac lesions is well known, but the pathogenetic link between tumour secretion and valvular disease is still obscure. The purpose of this investigation was to describe the morphological and functional changes of valvular heart disease in a large patient series and to correlate these findings with hormonal secretion and prognosis.
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14. |
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15. |
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16. |
- Westerlund, Jessica, 1983-, et al.
(author)
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Occupational exposure to trichloramine and trihalomethanes : adverse health effects among personnel in habilitation and rehabilitation swimming pools
- 2019
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In: Journal of Occupational and Environmental Hygiene. - : Taylor & Francis. - 1545-9624 .- 1545-9632. ; 16:1, s. 78-88
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Journal article (peer-reviewed)abstract
- Personnel in swimming pool facilities typically experience ocular, nasal, and respiratory symptoms due to water chlorination and consequent exposure to disinfection by-products in the air. The aim of the study was to investigate exposure to trichloramine and trihalomethanes (chloroform, bromodichloromethane, dibromochloromethane, and bromoform) from the perspective of adverse health effects on the personnel at Swedish habilitation and rehabilitation swimming pools. The study included ten habilitation and rehabilitation swimming pool facilities in nine Swedish cities. The study population comprised 24 exposed swimming pool workers and 50 unexposed office workers. Personal and stationary measurements of trichloramine and trihalomethanes in air were performed at all the facilities. Questionnaires were distributed to exposed workers and referents. Spirometry, fraction of exhaled nitric oxide (FENO) and peak expiratory flow (PEF) were measured. Personal and stationary measurements yielded trichloramine levels of 1-76 µg/m3 (average: 19 µg/m3) and 1-140 µg/m3 (average: 23 µg/m3), respectively. A slightly higher, but not significant, prevalence of reported eye- and throat-related symptoms occurred among the exposed workers than among the referents. A significantly increased risk of at least one ocular symptom was attributed to trichloramine exposure above the median (20 µg/m3). Lung function (FVC and FEV1) was in the normal range according to the Swedish reference materials, and no significant change in lung function before and after shift could be established between the groups. Average FENO values were in the normal range in both groups, but the difference in the values between the exposed workers and referents showed a significant increase after shift. Hourly registered PEF values during the day of the investigation did not show any unusual individual variability. In conclusion, the increased risk of developing at least one ocular symptom at personal trichloramine concentrations over 20 µg/m3 combined with an increase in the difference in FENO during the work shift of the exposed workers should not be neglected as an increased risk of respiratory inflammation in the habilitation and rehabilitation swimming pool environment.
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17. |
- Westerlund, Jessica, 1983-, et al.
(author)
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Occupational Exposure to Trichloramine and Trihalomethanes in Swedish Indoor Swimming Pools : Evaluation of Personal and Stationary Monitoring
- 2015
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In: Annals of Occupational Hygiene. - : Oxford University Press. - 0003-4878 .- 1475-3162. ; 59:8, s. 1074-1084
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Journal article (peer-reviewed)abstract
- Introduction: Chlorination is a method commonly used to keep indoor swimming pool water free from pathogens. However, chlorination of swimming pools produces several potentially hazardous by-products as the chlorine reacts with nitrogen containing organic matter. Up till now, exposure assessments in indoor swimming pools have relied on stationary measurements at the poolside, used as a proxy for personal exposure. However, measurements at fixed locations are known to differ from personal exposure.Methods: Eight public swimming pool facilities in four Swedish cities were included in this survey. Personal and stationary sampling was performed during day or evening shift. Samplers were placed at different fixed positions around the pool facilities, at similar to 1.5 m above the floor level and 0-1 m from the poolside. In total, 52 personal and 110 stationary samples of trichloramine and 51 personal and 109 stationary samples of trihalomethanes, were collected.Results: The average concentration of trichloramine for personal sampling was 71 mu g m(-3), ranging from 1 to 240 mu g m(-3) and for stationary samples 179 mu g m(-3), ranging from 1 to 640 mu g m(-3). The air concentrations of chloroform were well below the occupational exposure limit (OEL). For the linear regression analysis and prediction of personal exposure to trichloramine from stationary sampling, only data from personal that spent > 50% of their workday in the pool area were included. The linear regression analysis showed a correlation coefficient (r (2)) of 0.693 and a significant regression coefficient beta of 0.621; (95% CI = 0.329-0.912, P = 0.001).Conclusion: The trichloramine exposure levels determined in this study were well below the recommended air concentration level of 500 mu g m(-3); a WHO reference value based on stationary sampling. Our regression data suggest a relation between personal exposure and area sampling of 1:2, implying an OEL of 250 mu g m(-3) based on personal sampling.
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18. |
- Andersson, Lena, et al.
(author)
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Estimating trends in quartz exposure in Swedish iron foundries : predicting past and present exposures
- 2012
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In: Annals of Occupational Hygiene. - Oxford, United Kingdom : Oxford University Press. - 0003-4878 .- 1475-3162. ; 56:3, s. 362-372
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Journal article (peer-reviewed)abstract
- Background: Swedish foundries have a long tradition of legally required surveys in the work place that, from the late 1960s onwards, included measurements of quartz. The availability of exposure data spanning almost 40 years presents a unique opportunity to study trends over that time and to evaluate the validity of exposure models based on data from shorter time spans. The aims of this study were (i) to investigate long term trends in quartz exposure over time, (ii) using routinely collected quartz exposure measurements to develop a mathematical model that could predict both historical and current exposure patterns, and (iii) to validate this exposure model with up-to-date measurements from a targeted survey of the industry.Methods: Eleven foundries, representative of the Swedish iron foundry industry, were divided into three groups based on the size of the companies, i.e. the number of employees. A database containing 2333 quartz exposure measurements for 11 different job descriptionswas used to create three models that covered time periods which reflected different work conditions and production processes: a historical model (1968– 1989), a development model (1990–2004), and a validation model (2005–2006). A linear mixed model for repeated measurements was used to investigate trends over time. In all mixed models, time period, company size, and job title were included as fixed (categorical) determinants of exposure. The within- and between-worker variances were considered to be random effects. A linear regression analysis was erformed to investigate agreement between the models. The average exposure was estimated for each combination of job title and company size.Results: A large reduction in exposure (51%) was seen between 1968 and 1974 and between 1975 and 1979 (28%). In later periods, quartz exposure was reduced by 8% per 5 years at best. In the first period, employees at smaller companies experienced ~50%higher exposure levels than those at large companies, but these differences became much smaller in later years. The furnace and ladle repair job were associated with the highest exposure, with 3.9–8.0 times the average exposure compared to the lowest exposed group. Without adjusting for this autonomous trend over time, predicting early historical exposures using our development model resulted in a statistically significant regression coefficient of 2.42 (R2 5 0.81), indicating an underestimation of historical exposure levels. Similar patterns were seen for other historical time periods. Comparing our development model with our validation model resulted in a statistically significant regression coefficient of 0.31, indicating an overestimation of current exposure levels.Conclusion: To investigate long-term trends in quartz exposure over time, overall linear trends can be determined by using mixed model analysis. To create individual exposure measures to predict historical exposures, it is necessary to consider factors such as the time period, type of job, type of company, and company size. The mixed model analysis showed systematic changes in concentration levels, implying that extrapolation of exposure estimates outside the range of years covered by measurements may result in underestimation or overestimation of exposure.
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19. |
- Andersson, Lena, et al.
(author)
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Exposure assessment and modeling of quartz in Swedish iron foundries for a nested case-control study on lung cancer
- 2012
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In: Journal of Occupational and Environmental Hygiene. - Philadelphia : Taylor & Francis. - 1545-9624 .- 1545-9632. ; 9:2, s. 110-119
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Journal article (peer-reviewed)abstract
- Exposure assessment of quartz in Swedish iron foundries was performed based on historical and present measurement data. To evaluate the exposure response relationship between quartz exposure and lung cancer, we modeled quartz exposure from our database of measurements using determinants job title, time period and company. Based on these modeled exposure data, we conducted a nested case– control evaluation.In our database, the overall individual daily time-weighted average (TWA) quartz concentrations of current and historical data varied between 0.0018 and 4.9 mg/m3, averaging 0.083 mg/m3. The job titles with mean TWAs for the whole study period exceeding the European Union recommended occupational exposure limit of 0.05 mg/m3 were fettlers (0.087 mg/m3), furnace and ladle repair (0.42 mg/m3) and maintenance (0.054 mg/m3) workers.The mixed model analysis demonstrated significant determinants on the job level for furnace and ladle repair (β=4.06; 95% CI 2.78-5.93). For all jobs significantly higher exposure levels occurred only during the first time period, 1968-1979 (β=2.08; 95% CI 1.75-2.47), and a decreasing but not significant trend was noted for the three following 10 year time periods up to 2006 (β=1.0, 0.96 and 1, respectively). Two iron foundries had significantly higher quartz concentration levels than the others (β=1.31; 95% CI 1.00-1.71 and β=1.63; 95% CI 1.00-2.65, respectively). The individual cumulative quartz exposure measures were categorized in low, medium and high exposure (0.5-<1, 1-1.9 and ≥2 mg/m3 *years, respectively).In the nested case-control analysis, we found the highest odds ratios of lung cancer (OR 1.17; 95% CI 0.53-2.55) for the medium exposure group. No dose– response trend or significantly increased risk was determined for our high exposed group (≥2 mg/m3), representing 40 years of exposure at >0.05 mg/m3 of quartz. To conclude, certain foundry workers are still exposed to high levels of quartz, but an increased risk of lung cancer caused by quartz exposure in these Swedish iron foundries could not be confirmed at our exposure levels.
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20. |
- Andersson, Lena, 1965-, et al.
(author)
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Inflammatory and coagulatory markers and exposure to different size fractions of particle mass, number and surface area air concentrations in the Swedish hard metal industry, in particular to cobalt
- 2021
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In: Biomarkers. - : Taylor & Francis. - 1354-750X .- 1366-5804. ; 26:6, s. 557-569
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Journal article (peer-reviewed)abstract
- Purpose: To study the relationship between inhalation of airborne particles and cobalt in the Swedish hard metal industry and markers of inflammation and coagulation in blood.Methods: Personal sampling of inhalable cobalt and dust were performed for subjects in two Swedish hard metal plants. Stationary measurements were used to study concentrations of inhalable, respirable, and total dust and cobalt, PM10 and PM2.5, the particle surface area and the particle number concentrations. The inflammatory markers CC16, TNF, IL-6, IL-8, IL-10, SAA and CRP, and the coagulatory markers FVIII, vWF, fibrinogen, PAI-1 and D-dimer were measured. A complete sampling was performed on the second or third day of a working week following a work-free weekend, and additional sampling was taken on the fourth or fifth day. The mixed model analysis was used, including covariates.Results: The average air concentration of inhalable dust and cobalt were 0.11 mg/m3 and 0.003 mg/m3, respectively. For some mass-based exposure measures of cobalt and total dust, statistically significant increased levels of FVIII, vWF and CC16 were found.Conclusions: The observed relationships between particle exposure and coagulatory biomarkers may indicate an increased risk of cardiovascular disease.
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21. |
- Andersson, Lena, 1965-, et al.
(author)
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Respiratory health and inflammatory markers : Exposure to respirable dust and quartz and chemical binders in Swedish iron foundries
- 2019
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In: PLOS ONE. - : PLOS. - 1932-6203. ; 14:11
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Journal article (peer-reviewed)abstract
- PURPOSE: To study the relationship between respirable dust, quartz and chemical binders in Swedish iron foundries and respiratory symptoms, lung function (as forced expiratory volume FEV1 and vital capacity FVC), fraction of exhaled nitric oxide (FENO) and levels of club cell secretory protein 16 (CC16) and CRP.METHODS: Personal sampling of respirable dust and quartz was performed for 85 subjects in three Swedish iron foundries. Full shift sampling and examination were performed on the second or third day of a working week after a work free weekend, with additional sampling on the fourth or fifth day. Logistic, linear and mixed model analyses were performed including, gender, age, smoking, infections, sampling day, body mass index (BMI) and chemical binders as covariates.RESULTS: The adjusted average respirable quartz and dust concentrations were 0.038 and 0.66 mg/m3, respectively. Statistically significant increases in levels of CC16 were associated with exposure to chemical binders (p = 0.05; p = 0.01) in the regression analysis of quartz and respirable dust, respectively. Non-significant exposure-responses were identified for cumulative quartz and the symptoms asthma and breathlessness. For cumulative chemical years, non-significant exposure-response were observed for all but two symptoms. FENO also exhibited a non significant exposure-response for both quartz and respirable dust. No exposure-response was determined for FEV1 or FVC, CRP and respirable dust and quartz.CONCLUSIONS: Our findings suggest that early markers of pulmonary effect, such as increased levels of CC16 and FENO, are more strongly associated with chemical binder exposure than respirable quartz and dust in foundry environments.
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22. |
- Andersson, Lena, 1965-, et al.
(author)
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Respiratory Health and Inflammatory Markers : Exposure to Cobalt in the Swedish Hard Metal Industry
- 2020
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In: Journal of Occupational and Environmental Medicine. - : Lippincott Williams & Wilkins. - 1076-2752 .- 1536-5948. ; 62:10, s. 820-829
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To study the relationship between inhalable dust and cobalt and respiratory symptoms, lung function, exhaled nitric oxide in expired air and CC16 in the Swedish hard metal industry.METHODS: Personal sampling of inhalable dust and cobalt, medical examination including blood sampling was performed for 72 workers. Exposure-response relationships was determined using logistic, linear and mixed model analysis.RESULTS: The average inhalable dust and cobalt concentrations were 0.079 and 0.0017 mg/m, respectively. Statistically significant increased serum levels of CC16 were determined when the high and low cumulative exposures for cobalt were compared. Non-significant exposure-response relationships was observed between cross-shift inhalable dust or cobalt exposures and asthma, nose dripping and bronchitis.CONCLUSIONS: Our findings suggest an exposure-response relationship between inhalable cumulative cobalt exposure and CC16 levels in blood, which may reflect an injury or a reparation process in the lungs.
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23. |
- Andersson, Lena, 1965-, et al.
(author)
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Silica Exposure and Cardiovascular, Cerebrovascular, and Respiratory Morbidity in a Cohort of Male Swedish Iron Foundry Workers
- 2023
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In: Journal of Occupational and Environmental Medicine. - : Lippincott Williams & Wilkins. - 1076-2752 .- 1536-5948. ; 65:9, s. 731-739
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Journal article (peer-reviewed)abstract
- In this study, we present quantitative exposure-response data on silica exposure in male Swedish iron foundry workers receiving inpatient care for cardiovascular, cerebrovascular, and respiratory morbidity. The study show a significantly increased COPD risk at cumulative silica exposures that correspond to TWA silica below the Swedish OEL of 0.1 mg/m3. ObjectiveWe present quantitative exposure-response data on silica exposure in male Swedish iron foundry workers for cardiovascular, cerebrovascular, and respiratory morbidity.MethodsThis research is a cohort study of 2063 male Swedish iron foundry workers. From the Swedish National Patient Registers, data on morbidity incidence were retrieved. A historical measurement database of 1667 respirable silica exposure measurements from 10 Swedish iron foundries was used to calculate the cumulative exposure dose for each worker.ResultsIncreased morbidity risk for the whole group of foundry workers was determined for ischemic heart disease, cerebrovascular disease, chronic obstructive pulmonary disease (COPD), bronchitis, and pneumonia. In addition, an increased risk for COPD at cumulative silica exposures ranging from 0.11 to 0.84 mg/m3 year is presented.ConclusionsThe study presents a significantly increased COPD risk at cumulative silica exposures below the Swedish occupational exposure limit.
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25. |
- Hedbrant, Alexander, 1987-, et al.
(author)
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Effects on white blood cell counts and the NLRP3 inflammasome due to dust and cobalt exposure in the hard metal industry
- 2022
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In: Biomarkers. - : Taylor & Francis. - 1354-750X .- 1366-5804. ; , s. 60-70
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Journal article (peer-reviewed)abstract
- INTRODUCTION: In light of potential negative health effects of cobalt exposure, a characterization of inflammatory mechanisms in exposed individuals is warranted. The current study investigated cobalt exposure in the Swedish hard metal industry and its relationship to inflammatory markers, including NLRP3 inflammasome activation and white blood cell (WBC) counts.MATERIAL AND METHODS: Inhalable cobalt and dust exposures, and systemic cobalt levels, were determined for 72 workers in the hard metal industry and linear regression models were applied to correlate exposure to markers of inflammasome activation and WBC counts.RESULTS: Mean exposures to inhalable dust (0.11 mg/m3) and cobalt (0.0034 mg/m3) were below the Swedish occupational exposure limits, and these low exposures did not correlate with any investigated outcomes. Instead, cobalt blood levels significantly correlated with a ca 10% decrease in IL-18 plasma levels per 10 nM cobalt increase. Furthermore, pre-shift cobalt blood and/or urine levels significantly correlated with some WBC measures, including decreased neutrophil-to-lymphocyte ratio, increased lymphocyte-to-monocyte ratio, and lymphocyte counts.CONCLUSION: The low inhalable particle exposures had no impact on WBC counts and inflammasome activation. Instead, systemic cobalt levels, which also include skin exposure, demonstrated possible suppressive effects on inflammatory responses in cobalt-exposed individuals in the hard metal industry.
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