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Airway irritation among indoor swimming pool personnel: trichloramine exposure, exhaled NO and protein profiling of nasal lavage fluids.

https://arctichealth.org/en/permalink/ahliterature123142
Source
Int Arch Occup Environ Health. 2013 Jul;86(5):571-80
Publication Type
Article
Date
Jul-2013
Author
Louise Fornander
Bijar Ghafouri
Mats Lindahl
Pål Graff
Author Affiliation
Occupational and Environmental Medicine, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Source
Int Arch Occup Environ Health. 2013 Jul;86(5):571-80
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Adult
Air Pollutants, Occupational - adverse effects - analysis
Biological Markers - metabolism
Chlorides - adverse effects - analysis
Cross-Sectional Studies
Electrophoresis, Gel, Two-Dimensional
Female
Humans
Immunoblotting
Male
Middle Aged
Nasal Lavage Fluid - chemistry
Nitric Oxide - metabolism
Nitrogen Compounds - adverse effects - analysis
Occupational Diseases - diagnosis - epidemiology - etiology - metabolism
Occupational Exposure - adverse effects - analysis
Prevalence
Proteome - metabolism
Respiratory Tract Diseases - diagnosis - epidemiology - etiology - metabolism
Risk factors
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
Sweden - epidemiology
Swimming Pools
Abstract
Occurrence of airway irritation among indoor swimming pool personnel was investigated. The aims of this study were to assess trichloramine exposure levels and exhaled nitric oxide in relation to the prevalence of airway symptoms in swimming pool facilities and to determine protein effects in the upper respiratory tract.
The presence of airway symptoms related to work was examined in 146 individuals working at 46 indoor swimming pool facilities. Levels of trichloramine, as well as exhaled nitric oxide, were measured in five facilities with high prevalence of airway irritation and four facilities with no airway irritation among the personnel. Nasal lavage fluid was collected, and protein profiles were determined by a proteomic approach.
17 % of the swimming pool personnel reported airway symptoms related to work. The levels of trichloramine in the swimming pool facilities ranged from 0.04 to 0.36 mg/m(3). There was no covariance between trichloramine levels, exhaled nitric oxide and prevalence of airway symptoms. Protein profiling of the nasal lavage fluid showed that the levels alpha-1-antitrypsin and lactoferrin were significantly higher, and S100-A8 was significantly lower in swimming pool personnel.
This study confirms the occurrence of airway irritation among indoor swimming pool personnel. Our results indicate altered levels of innate immunity proteins in the upper airways that may pose as potential biomarkers. However, swimming pool facilities with high prevalence of airway irritation could not be explained by higher trichloramine exposure levels. Further studies are needed to clarify the environmental factors in indoor swimming pools that cause airway problems and affect the immune system.
PubMed ID
22729567 View in PubMed
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DNA methylation of the cancer-related genes F2RL3 and AHRR is associated with occupational exposure to polycyclic aromatic hydrocarbons.

https://arctichealth.org/en/permalink/ahliterature297917
Source
Carcinogenesis. 2018 07 03; 39(7):869-878
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
07-03-2018
Author
Ayman Alhamdow
Christian Lindh
Jessika Hagberg
Pål Graff
Håkan Westberg
Annette M Krais
Maria Albin
Per Gustavsson
Håkan Tinnerberg
Karin Broberg
Author Affiliation
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Source
Carcinogenesis. 2018 07 03; 39(7):869-878
Date
07-03-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Basic Helix-Loop-Helix Transcription Factors - genetics
Biomarkers, Tumor - genetics
Carcinogens - toxicity
Creosote - adverse effects
DNA Methylation - drug effects
DNA, Mitochondrial - genetics
Humans
Lung Neoplasms - chemically induced - genetics
Male
Middle Aged
Occupational Exposure - adverse effects
Polycyclic Aromatic Hydrocarbons - adverse effects
Receptors, Thrombin - genetics
Repressor Proteins - genetics
Sweden
Young Adult
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
PubMed ID
29722794 View in PubMed
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Epistaxis in a low level hydrogen fluoride exposed industrial staff.

https://arctichealth.org/en/permalink/ahliterature153744
Source
Am J Ind Med. 2009 Mar;52(3):240-5
Publication Type
Article
Date
Mar-2009
Author
Pål Graff
Georgi Bozhkov
Karin Hedenlöf
Olof Johannesson
Ulf Flodin
Author Affiliation
Centre of Occupational and Environmental Medicine, University Hospital, Linköping, Sweden. pal.graff@lio.se
Source
Am J Ind Med. 2009 Mar;52(3):240-5
Date
Mar-2009
Language
English
Publication Type
Article
Keywords
Adult
Air Pollutants, Occupational - analysis
Automobiles
Cross-Sectional Studies
Environmental Monitoring - statistics & numerical data
Epidemiological Monitoring
Epistaxis - epidemiology
Female
Humans
Hydrofluoric Acid - analysis
Inhalation Exposure - analysis
Male
Maximum Allowable Concentration
Metallurgy
Middle Aged
Occupational Diseases - epidemiology
Occupational Exposure - analysis
Population Surveillance
Prevalence
Risk assessment
Sweden - epidemiology
Abstract
To assess the effect of exposure to hydrogen fluoride (HF) on the airway mucosa in an industrial setting.
A cross-sectional study encompassing 33 industrial workers in a flame soldering plant and 44 assembly workers unexposed to HF was performed by means of a questionnaire on symptoms and diagnosis regarding upper and lower airways as well as through conduct of a clinical examination of the exposed group. Air concentrations of HF that were monitored in winter amounted to 1.0 mg/m(3) and in summer time to 0.15 mg/m(3).
A threefold risk for epistaxis (RR = 3.6, 95% confidence interval 1.1-11.0) was observed in the exposed group. Time from the start of exposure to HF until debut of a nose bleeding period varied from 1 month to 6 years. Mean induction (latency) time was 42 months. Mean duration of symptoms was 26 months, range 3-72 months, indicating that the exposure level in summer time was sufficient to maintain the propensity of almost daily nose bleeding.
HF is an irritating vapor, even at relatively low air concentrations. We recommend an 8 hr TLV lower than 1.0 mg/m(3).
PubMed ID
19072856 View in PubMed
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Non-sensitising air pollution at workplaces and adult-onset asthma in the beginning of this millennium.

https://arctichealth.org/en/permalink/ahliterature101569
Source
Int Arch Occup Environ Health. 2011 Jul 1;
Publication Type
Article
Date
Jul-1-2011
Author
Pål Graff
Mats Fredrikson
Pia Jönsson
Ulf Flodin
Author Affiliation
Clinic of Occupational and Environmental Medicine, University Hospital, 58185, Linkoping, Sweden, pal.graff@lio.se.
Source
Int Arch Occup Environ Health. 2011 Jul 1;
Date
Jul-1-2011
Language
English
Publication Type
Article
Abstract
PURPOSE: This case-control study was undertaken to elucidate the controversy concerning whether low-level, long-term exposure to non-sensitising air pollution at workplaces may cause asthma. METHODS: A case-control study of 192 adult-onset asthma cases aged 20-65 years and 323 controls was conducted in the southeast of Sweden. Cases were identified from computerised registers from the region, diagnosed 2000-2004 and diagnoses were confirmed via medical files. Referents were randomised from the population register of the region. Exposure was monitored by a 16-page questionnaire. Special attention was devoted to identifying and in the final analyses excluding subjects exposed to sensitising agents. RESULTS: Three years or more of occupational exposure to air pollution from dust, smoke, fumes or vapours before the year of diagnosis by analyses adjusting for age yielded an increased risk for asthma (OR = 2.3, 95% CI 1.2-4.2) in men, while in women, no risk was seen. In a multiple logistic regression analysis in men without allergy in childhood, a significant risk was seen (OR = 2.8, 95% CI 1.07-7.4), when subjects exposed to identified allergens were excluded. In women, no excess risk was observed from occupational air pollution. CONCLUSION: The results of this study support an association between occupational exposure to low level non-sensitising air pollution and adult-onset asthma in men.
PubMed ID
21720882 View in PubMed
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Occupational Exposure to Trichloramine and Trihalomethanes in Swedish Indoor Swimming Pools: Evaluation of Personal and Stationary Monitoring.

https://arctichealth.org/en/permalink/ahliterature274123
Source
Ann Occup Hyg. 2015 Oct;59(8):1074-84
Publication Type
Article
Date
Oct-2015
Author
Jessica Westerlund
Pål Graff
Ing-Liss Bryngelsson
Håkan Westberg
Kåre Eriksson
Håkan Löfstedt
Source
Ann Occup Hyg. 2015 Oct;59(8):1074-84
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Air Pollutants - analysis
Air Pollution, Indoor - analysis - prevention & control
Chlorides - adverse effects - analysis
Environmental Monitoring - methods
Humans
Linear Models
Nitrogen Compounds - adverse effects - analysis
Occupational Exposure - analysis - prevention & control
Sweden
Swimming Pools
Trihalomethanes - adverse effects - analysis
Abstract
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.
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 ~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.
The average concentration of trichloramine for personal sampling was 71 µg m(-3), ranging from 1 to 240 µg m(-3) and for stationary samples 179 µg m(-3), ranging from 1 to 640 µg 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 (r2) of 0.693 and a significant regression coefficient ß of 0.621; (95% CI = 0.329-0.912, P = 0.001).
The trichloramine exposure levels determined in this study were well below the recommended air concentration level of 500 µg 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 µg m(-3) based on personal sampling.
Notes
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PubMed ID
26155991 View in PubMed
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Risk of sarcoidosis and seropositive rheumatoid arthritis from occupational silica exposure in Swedish iron foundries: a retrospective cohort study.

https://arctichealth.org/en/permalink/ahliterature291590
Source
BMJ Open. 2017 Jul 20; 7(7):e016839
Publication Type
Journal Article
Date
Jul-20-2017
Author
Per Vihlborg
Ing-Liss Bryngelsson
Lena Andersson
Pål Graff
Author Affiliation
Faculty of Medicine and Health, Department of Occupational and Environmental Medicine, Örebro University, Örebro, Sweden.
Source
BMJ Open. 2017 Jul 20; 7(7):e016839
Date
Jul-20-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Arthritis, Rheumatoid - chemically induced - epidemiology
Extraction and Processing Industry
Follow-Up Studies
Humans
Iron
Male
Middle Aged
Occupational Exposure - adverse effects
Retrospective Studies
Risk assessment
Sarcoidosis - chemically induced - epidemiology
Silicon Dioxide - adverse effects
Sweden - epidemiology
Young Adult
Abstract
To study the impact of occupational silica exposure on the incidence rates of sarcoidosis and rheumatoid arthritis (RA) in a cohort of exposed workers in Swedish iron foundries.
The prevalence of sarcoidosis and RA in a cohort of silica exposed workers was compared with the prevalence in the general Swedish population in this register study. A mixed model was used to calculate silica exposure, and individual silica exposures were used to compute dose responses.
Personnel records from 10 iron foundries were used to identify workers whose employment began before 2005 which was then linked to the national non-primary outpatient visits register.
The final cohort consisted of 2187 silica-exposed male workers who had been employed for at least 1?year and were still alive without having emigrated when the follow-up study began. The cohort's employment period covers 23 807 person-years at risk.
The presented results indicate that moderate to high levels of silica exposure increase risks for sarcoidosis and seropositive RA.
Mean levels of airborne silica dust in the foundries decreased significantly between the 1970s and 2000s. Incidence rates of sarcoidosis (3.94; 95%?CI 1.07 to 10.08) and seropositive RA (2.59; 95%?CI 1.24 to 4.76) were significantly higher among highly exposed individuals.
Our results reveal increased risks for sarcoidosis and seropositive RA among individuals with high exposure to silica dust (>0.048?mg/m3) compared with non-exposed and less-exposed groups.
Notes
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PubMed ID
28729325 View in PubMed
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Silica exposure increases the risk of stroke but not myocardial infarction-A retrospective cohort study.

https://arctichealth.org/en/permalink/ahliterature291281
Source
PLoS One. 2018; 13(2):e0192840
Publication Type
Journal Article
Date
2018
Author
Chenjing Fan
Pål Graff
Per Vihlborg
Ing-Liss Bryngelsson
Lena Andersson
Author Affiliation
Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Source
PLoS One. 2018; 13(2):e0192840
Date
2018
Language
English
Publication Type
Journal Article
Keywords
Age Factors
Female
Humans
Male
Middle Aged
Myocardial Infarction - epidemiology
Occupational Exposure
Registries
Retrospective Studies
Risk factors
Silicon Dioxide - toxicity
Stroke - epidemiology
Sweden
Abstract
Work-related exposure to silica is a global health hazard that causes diseases such as silicosis. Some studies have also reported that silica exposure is linked to elevated cardiovascular disease mortality. However, these diagnoses have not been investigated in detail and there have been few studies on morbidity. The aim of this study is to examine morbidity and mortality from different cardiovascular diseases among silica-exposed Swedish foundry workers.
Historical and contemporary measurements (1968-2006) of respiratory silica exposure were matched to job categories, individual foundries, and 4 time periods (1968-1979, 1980-1989, 1990-1999, 2000-2006) using a mixed model. Morbidity and mortality data for the studied cohorts were matched against the General Population Registry. Statistical analyses were performed with SPSS and STATA, and the data were stratified by age, gender, and year.
Mortality from cardiovascular disease (SMR 1.3; 95% CI 1.2-1.4) and stroke (SMR 1.6, 95% CI 1.2-2.1) was significantly elevated among the studied population. The cohort also exhibited significantly elevated morbidity from stroke (SIR 1.34; 95% CI 1.2-1.5) but not myocardial infarction. The mean age at the time of first morbidity from stroke was 64 years, with 36% of the cases occurring before the age of 60.
Swedish foundry workers exposed to respirable silica exhibit elevated morbidity and mortality from stroke, but not from myocardial infarction. Our results also suggest a relationship between silica exposure and morbidity from stroke at a younger age than the general population.
Notes
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PubMed ID
29481578 View in PubMed
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7 records – page 1 of 1.