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Airborne occupational exposures and risk of oesophageal and cardia adenocarcinoma.

https://arctichealth.org/en/permalink/ahliterature16521
Source
Occup Environ Med. 2006 Feb;63(2):107-12
Publication Type
Article
Date
Feb-2006
Author
C. Jansson
N. Plato
A L V Johansson
O. Nyrén
J. Lagergren
Author Affiliation
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Catarina.Jansson@meb.ki.se
Source
Occup Environ Med. 2006 Feb;63(2):107-12
Date
Feb-2006
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - epidemiology - etiology
Adult
Aged
Aged, 80 and over
Air Pollutants, Occupational - analysis - toxicity
Carcinoma, Squamous Cell - epidemiology - etiology
Cardia
Epidemiologic Methods
Esophageal Neoplasms - epidemiology - etiology
Female
Humans
Industry
Inhalation Exposure - adverse effects - analysis
Male
Middle Aged
Occupational Diseases - epidemiology - etiology
Occupational Exposure - adverse effects - analysis
Occupations
Research Support, Non-U.S. Gov't
Stomach Neoplasms - epidemiology - etiology
Sweden - epidemiology
Abstract
BACKGROUND: The reasons for the increasing incidence of and strong male predominance in patients with oesophageal and cardia adenocarcinoma remain unclear. The authors hypothesised that airborne occupational exposures in male dominated industries might contribute. METHODS: In a nationwide Swedish population based case control study, 189 and 262 cases of oesophageal and cardia adenocarcinoma respectively, 167 cases of oesophageal squamous cell carcinoma, and 820 frequency matched controls underwent personal interviews. Based on each study participant's lifetime occupational history the authors assessed cumulative airborne occupational exposure for 10 agents, analysed individually and combined, by a deterministic additive model including probability, frequency, and intensity. Furthermore, occupations and industries of longest duration were analysed. Relative risks were estimated by odds ratios (OR), with 95% confidence intervals (CI), using conditional logistic regression, adjusted for potential confounders. RESULTS: Tendencies of positive associations were found between high exposure to pesticides and risk of oesophageal (OR 2.3 (95% CI 0.9 to 5.7)) and cardia adenocarcinoma (OR 2.1 (95% CI 1.0 to 4.6)). Among workers highly exposed to particular agents, a tendency of an increased risk of oesophageal squamous cell carcinoma was found. There was a twofold increased risk of oesophageal squamous cell carcinoma among concrete and construction workers (OR 2.2 (95% CI 1.1 to 4.2)) and a nearly fourfold increased risk of cardia adenocarcinoma among workers within the motor vehicle industry (OR 3.9 (95% CI 1.5 to 10.4)). An increased risk of oesophageal squamous cell carcinoma (OR 3.9 (95% CI 1.2 to 12.5)), and a tendency of an increased risk of cardia adenocarcinoma (OR 2.8 (95% CI 0.9 to 8.5)), were identified among hotel and restaurant workers. CONCLUSIONS: Specific airborne occupational exposures do not seem to be of major importance in the aetiology of oesophageal or cardia adenocarcinoma and are unlikely to contribute to the increasing incidence or the male predominance.
PubMed ID
16421388 View in PubMed
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Assessment of past exposure to man-made vitreous fibers in the Swedish prefabricated house industry.

https://arctichealth.org/en/permalink/ahliterature21943
Source
Am J Ind Med. 1997 Oct;32(4):349-54
Publication Type
Article
Date
Oct-1997
Author
N. Plato
P. Gustavsson
S. Krantz
Author Affiliation
Department of Occupational Health, Karolinska Hospital, Stockholm, Sweden.
Source
Am J Ind Med. 1997 Oct;32(4):349-54
Date
Oct-1997
Language
English
Publication Type
Article
Keywords
Air Pollutants, Occupational - adverse effects
Cohort Studies
Housing
Humans
Lung Neoplasms - epidemiology
Mineral Fibers - adverse effects
Models, Statistical
Occupational Exposure - statistics & numerical data
Research Support, Non-U.S. Gov't
Retrospective Studies
Sweden - epidemiology
Abstract
Large quantities of man-made vitreous fibers (MMVF) are handled in the Swedish prefabricated wooden house industry. The present study is part of a program to investigate mortality, cancer incidence, and current as well as previous exposure to MMVF among workers in the Swedish prefabricated wooden house industry. Since measurements of historical fiber exposure levels are lacking, these were calculated by the application of a matrix of multipliers to recently measured MMVF levels. The multipliers represented changes over time in production rate, technical properties of the fibers, manual handling vs. automation, and ventilation control. The multipliers were based on a similar matrix, developed for the MMVF-manufacturing industry, which was modified to reflect the conditions in the wooden house industry. The model was developed for the highest-exposed job title in the study, insulators. One hundred and twenty samples of airborne fiber were taken in 11 plants to reflect current exposure levels. The highest mean fiber exposure level for insulators was assessed as 0.18 f/ml (geometric mean), which occurred during the mid-1970s, compared to 0.10 f/ml at the end of the 1980s and the early 1960s. Changes in production rate, improved ventilation control, and the surface area of the total amount of MMVF sheets handled per insulator were the most important variables of the model. No increased risk of lung cancer was found in the present industry.
PubMed ID
9258388 View in PubMed
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Blood markers of inflammation and coagulation and exposure to airborne particles in employees in the Stockholm underground.

https://arctichealth.org/en/permalink/ahliterature159463
Source
Occup Environ Med. 2008 Oct;65(10):655-8
Publication Type
Article
Date
Oct-2008
Author
C. Bigert
M. Alderling
M. Svartengren
N. Plato
U. de Faire
P. Gustavsson
Author Affiliation
Department of Occupational and Environmental Health, Karolinska Institutet, Norrbacka 4th Floor, SE-171 76 Stockholm, Sweden. carolina.bigert@sll.se
Source
Occup Environ Med. 2008 Oct;65(10):655-8
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Adult
Biological Markers - metabolism
Blood Coagulation Factors - metabolism
C-Reactive Protein - metabolism
Cardiovascular Diseases - blood - etiology
Female
Humans
Interleukin-6 - blood
Male
Middle Aged
Occupational Exposure - adverse effects - statistics & numerical data
Particulate Matter - toxicity
Railroads
Sweden
Workplace
Abstract
Although associations have been found between levels of ambient airborne particles and cardiovascular disease (CVD) in the general population, little is known about possible cardiovascular effects from high exposure to particles in underground railway systems. This study investigates risk markers for CVD in employees exposed to particles in the Stockholm underground system.
79 workers (54 men and 25 women) in the Stockholm underground were investigated between November 2004 and March 2005. All were non-smokers aged 25-50 years. Three exposure groups were delineated: 29 platform workers with high exposure to particles, 29 train drivers with medium exposure and 21 ticket sellers with low exposure (control group). A baseline blood sample was taken after 2 non-working days, and a second sample after 2 working days, for analysis of levels of plasminogen activator inhibitor-1 (PAI-1), high-sensitivity C-reactive protein (hs-CRP), interleukin-6, fibrinogen, von Willebrand factor and factor VII. The study investigated changes in plasma concentrations between sample 1 and sample 2, and differences in average concentrations between the groups.
No changes between sample 1 and 2 were found that could be attributed to particle exposure. However, the highly exposed platform workers were found to have higher plasma concentrations of PAI-1 and hs-CRP than the ticket sellers and train drivers. This suggests that particle exposure could have a long-term inflammatory effect. These differences remained for PAI-1 in the comparison between platform workers and ticket sellers after adjusting for body mass index.
Employees who were highly exposed to airborne particles in the Stockholm underground tended to have elevated levels of risk markers for CVD relative to employees with low exposure. However, the differences observed cannot definitely be linked to particle exposure as such.
PubMed ID
18178587 View in PubMed
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Cancer incidence among European man-made vitreous fiber production workers.

https://arctichealth.org/en/permalink/ahliterature20877
Source
Scand J Work Environ Health. 1999 Jun;25(3):222-6
Publication Type
Article
Date
Jun-1999
Author
P. Boffetta
A. Andersen
J. Hansen
J H Olsen
N. Plato
L. Teppo
P. Westerholm
R. Saracci
Author Affiliation
International Agency for Research on Cancer, Lyon, France. boffetta@iarc.fr
Source
Scand J Work Environ Health. 1999 Jun;25(3):222-6
Date
Jun-1999
Language
English
Publication Type
Article
Keywords
Humans
Incidence
Mineral Fibers
Mouth Neoplasms - epidemiology
Neoplasms - epidemiology
Occupational Diseases - epidemiology
Research Support, Non-U.S. Gov't
Scandinavia - epidemiology
Abstract
OBJECTIVES: This study analyzed cancer incidence among man-made vitreous fiber workers. METHODS: A cancer incidence follow-up was conducted among 3685 rock-slag wool (RSW) and 2611 glass wool (GW) production workers employed for > or =1 year in Denmark, Finland, Norway, or Sweden, and the standardized incidence ratios (SIR) were calculated on the basis of national incidence rates. RESULTS: Overall cancer incidence was close to expectation. Lung cancer incidence was increased among the RSW [SIR 1.08, 95% confidence interval (95% CI) 0.85-1.36] and GW (SIR 1.28, 95% CI 0.91-1.74) workers. For both subcohorts, a trend was suggested for time since first employment (P-value for linear trend 0.1 and 0.2, respectively). Neither subcohort showed an association with employment during the early technological phase, when fiber exposure was high. The incidence of oral, pharyngeal, and laryngeal cancer was increased among the RSW (SIR 1.46, 95% CI 0.99-2.07) and the GW (SIR 1.41, 95% CI 0.80-2.28) subcohorts. Despite a trend in risk for these neoplasms among the GW workers with time since first employment, the lack of a positive relation with other indirect indicators of fiber exposure points against a causal interpretation. No association between RSW or GW exposure and the risk of other neoplasms was suggested. CONCLUSIONS: These lung cancer results are similar to those of a mortality study that included a larger number of factories. For other cancers there was no suggestion of an association with RSW or GW exposure.
PubMed ID
10450772 View in PubMed
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Cancer incidence, mortality and exposure-response among Swedish man-made vitreous fiber production workers.

https://arctichealth.org/en/permalink/ahliterature23051
Source
Scand J Work Environ Health. 1995 Oct;21(5):353-61
Publication Type
Article
Date
Oct-1995
Author
N. Plato
P. Westerholm
P. Gustavsson
T. Hemmingsson
C. Hogstedt
S. Krantz
Author Affiliation
Department of Occupational Health, Karolinska Hospital, Stockholm, Sweden.
Source
Scand J Work Environ Health. 1995 Oct;21(5):353-61
Date
Oct-1995
Language
English
Publication Type
Article
Keywords
Adult
Aged
Air Pollutants, Occupational - adverse effects
Cause of Death
Cohort Studies
Female
Follow-Up Studies
Humans
Lung Neoplasms - etiology - mortality
Male
Middle Aged
Mineral Fibers - adverse effects
Neoplasms - etiology - mortality
Occupational Diseases - etiology - mortality
Occupational Exposure - adverse effects
Research Support, Non-U.S. Gov't
Risk factors
Stomach Neoplasms - etiology - mortality
Survival Analysis
Sweden - epidemiology
Abstract
OBJECTIVE--The objective of this study was to provide an extended follow-up of workers in three Swedish plants producing man-made vitreous fibers (MMVF). METHOD--Mortality and cancer incidence was investigated among 3539 male and female workers, employed for at least one year before 1978. Mortality was followed from 1952 to 1990 and cancer incidence from 1958 to 1989. National and regional mortality and cancer incidence rates were used to calculate the expected numbers. RESULTS--Twenty-seven lung cancer deaths were observed compared with 23 expected (standardized mortality ratio 117, 95% confidence interval 81-176), based on regional mortality. With a latency time of 30 years, the lung cancer risk was significantly elevated, but not trend was found for the standardized mortality ratio with increasing duration of exposure to MMVF. The lung cancer and stomach cancer mortality was higher in the rock wool industry than in the fiber glass industry. Fiber exposure from 1938 to 1990 was estimated in the two rock wool plants by applying a model for historical fiber exposure estimation, specific for different job titles in the rock wool production industry. No relationship was found between individually cumulated rock wool fiber exposure and lung cancer or stomach cancer risk. CONCLUSIONS--The numbers of lung cancers and stomach cancer cases were low and did not therefore allow more general conclusions regarding the cancer hazard for exposed workers. A large European study in progress will probably allow more precise conclusions.
PubMed ID
8571091 View in PubMed
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Cancer mortality among man-made vitreous fiber production workers.

https://arctichealth.org/en/permalink/ahliterature22108
Source
Epidemiology. 1997 May;8(3):259-68
Publication Type
Article
Date
May-1997
Author
P. Boffetta
R. Saracci
A. Andersen
P A Bertazzi
J. Chang-Claude
J. Cherrie
G. Ferro
R. Frentzel-Beyme
J. Hansen
J. Olsen
N. Plato
L. Teppo
P. Westerholm
P D Winter
C. Zocchetti
Author Affiliation
International Agency for Research on Cancer, Lyon, France.
Source
Epidemiology. 1997 May;8(3):259-68
Date
May-1997
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cohort Studies
Confidence Intervals
Europe - epidemiology
Female
Humans
Lung Neoplasms - etiology - mortality
Male
Middle Aged
Mineral Fibers - adverse effects
Neoplasms - etiology - mortality
Occupational Diseases - etiology - mortality
Research Support, Non-U.S. Gov't
Risk
Risk factors
Time Factors
Abstract
We have updated the follow-up of cancer mortality for a cohort study of man-made vitreous fiber production workers from Denmark, Finland, Norway, Sweden, United Kingdom, Germany, and Italy, from 1982 to 1990. In the mortality analysis, 22,002 production workers contributed 489,551 person-years, during which there were 4,521 deaths. Workers with less than 1 year of employment had an increased mortality [standardized mortality ratio (SMR) = 1.45; 95% confidence interval (CI) = 1.37-1.53]. Workers with 1 year or more of employment, contributing 65% of person-years, had an SMR of 1.05 (95% CI = 1.02-1.09). The SMR for lung cancer was 1.34 (95% CI = 1.08-1.63, 97 deaths) among rock/slag wool workers and 1.27 (95% CI = 1.07-1.50, 140 deaths) among glass wool workers. In the latter group, no increase was present when local mortality rates were used. Among rock/slag wool workers, the risk of lung cancer increased with time-since-first-employment and duration of employment. The trend in lung cancer mortality according to technologic phase at first employment was less marked than in the previous follow-up. We obtained similar results from a Poisson regression analysis limited to rock/slag wool workers. Five deaths from pleural mesothelioma were reported, which may not represent an excess. There was no apparent excess for other categories of neoplasm. Tobacco smoking and other factors linked to social class, as well as exposures in other industries, appear unlikely to explain the whole increase in lung cancer mortality among rock/slag wool workers. Limited data on other agents do not indicate an important role of asbestos, slag, or bitumen. These results are not sufficient to conclude that the increased lung cancer risk is the result of exposure to rock/slag wool; however, insofar as respirable fibers were an important component of the ambient pollution of the working environment, they may have contributed to the increased risk.
Notes
Comment In: Epidemiology. 1998 Mar;9(2):218-9; author reply 219-209504299
Comment In: Epidemiology. 1998 Mar;9(2):218; author reply 214-209504298
PubMed ID
9115020 View in PubMed
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Characterization of current exposure to man-made vitreous fibres (MMVF) in the prefabricated house industry in Sweden.

https://arctichealth.org/en/permalink/ahliterature215442
Source
Ann Occup Hyg. 1995 Apr;39(2):167-79
Publication Type
Article
Date
Apr-1995
Author
N. Plato
S. Krantz
L. Andersson
P. Gustavsson
L. Lundgren
Author Affiliation
Department of Occupational Health, Karolinska Hospital, Stockholm, Sweden.
Source
Ann Occup Hyg. 1995 Apr;39(2):167-79
Date
Apr-1995
Language
English
Publication Type
Article
Keywords
Calcium Compounds - analysis
Glass
Humans
Occupational Exposure - analysis
Silicates - analysis
Sweden
Abstract
The exposure to man-made vitreous fibres (MMVF) was investigated at 11 Swedish plants manufacturing prefabricated wooden houses. Current fibre levels were studied by monitoring personal exposure using the membrane filter technique. All samples were analysed by phase contrast optical microscopy (PCOM) according to Swedish standard rules; they were also analysed using a set of modified criteria for fibre counting, developed for this study, which in addition also required straight, parallel and/or convergent edges of the fibres. The objective of this alternating counting method, the modified fibre method, was to exclude fibres with appearance other than MMVF, that might be present in the wood industries. The method was validated by scanning electron microscopy (SEM). In all, 120 samples were taken and 273 analyses were performed. The mean exposure (GM), analysed by the standard method, was for insulators 0.10 f ml-1 (range 0.03-0.30 f ml-1) and for woodcutters 0.09 f ml-1) (range 0.05-0.19 f ml-1). Analysed by the modified fibre method the insulators were exposed to 0.029 f ml-1 (range 0.013-0.077 f ml-1 and the cutters to 0.021 f ml-1 (range 0.014-0.033 f ml-1). A significant difference was observed between the exposure for near-field workers/job titles and far-field workers/job titles. Analysis of fibre levels by the modified fibre method indicated that only a minor proportion, around 25%, of the total airborne fibres were MMVFs. The reliability of the alternative modified counting method was high, and a high correlation (r = 0.94) with the SEM results was also achieved.
PubMed ID
7741414 View in PubMed
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Comparison of information on occupation and lifestyle habits obtained from European man-made vitreous fibre production workers and their relatives.

https://arctichealth.org/en/permalink/ahliterature10978
Source
Int J Epidemiol. 1997 Oct;26(5):1009-16
Publication Type
Article
Date
Oct-1997
Author
J. Hansen
P. Boffetta
A. Andersen
J W Cherrie
J. Chang-Claude
U. Eilber
R. Frentzel-Beyme
T. Hemmingsson
J H Olsen
N. Plato
R. Saracci
G B Skare
P. Westerholm
Author Affiliation
International Agency for Research on Cancer, Lyon, France.
Source
Int J Epidemiol. 1997 Oct;26(5):1009-16
Date
Oct-1997
Language
English
Publication Type
Article
Keywords
Adolescent
Aged
Case-Control Studies
Chemical Industry - statistics & numerical data
Comparative Study
Denmark - epidemiology
Feasibility Studies
Female
Humans
Incidence
Interpersonal Relations
Life Style
Male
Middle Aged
Mineral Fibers - adverse effects
Occupational Diseases - epidemiology - etiology
Occupations - statistics & numerical data
Questionnaires
Random Allocation
Regression Analysis
Reproducibility of Results
Research Support, Non-U.S. Gov't
Risk factors
Survival Rate
Abstract
BACKGROUND: Studies of the aetiology of fatal diseases often rely on data obtained from relatives, which can cause loss of precision and introduce bias. We assessed the quality of such information on demographics, occupation, smoking and alcohol habits. METHODS: We compared contemporary interviews, based on a structured questionnaire, with male workers from the man-made vitreous fibre production industry in four European countries and their relatives. The participation rate was 63% (74 pairs of workers and relatives). RESULTS: Only minor differences in the ability to answer the questions appeared among workers and relatives, except for specific occupational questions. There was moderate to excellent agreement for demographics, residential and work history (kappa or intraclass correlation range: 0.44-0.98). For smoking habits, beer and wine consumption the agreement was good to excellent (range: 0.59-0.99). In particular, number of different residential areas, jobs, industries, and duration of wine drinking were significantly underreported by the relatives. No general determinant for reduced agreement appeared. CONCLUSIONS: In general, the quality of information obtained from relatives appeared good. However, information on specific occupational exposures may be improved by supplementing the information from relatives with details obtained from colleagues, occupational hygiene experts or occupation-exposure matrices.
PubMed ID
9363522 View in PubMed
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Cutaneous melanoma: hints from occupational risks by anatomic site in Swedish men.

https://arctichealth.org/en/permalink/ahliterature17965
Source
Occup Environ Med. 2004 Feb;61(2):117-26
Publication Type
Article
Date
Feb-2004
Author
B. Perez-Gomez
M. Pollán
P. Gustavsson
N. Plato
N. Aragonés
G. López-Abente
Author Affiliation
Cancer and Environmental Epidemiology Area, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain. bperez@isciii.es
Source
Occup Environ Med. 2004 Feb;61(2):117-26
Date
Feb-2004
Language
English
Publication Type
Article
Keywords
Adult
Humans
Linear Models
Male
Melanoma - epidemiology - etiology - pathology
Middle Aged
Neoplasms, Radiation-Induced - epidemiology - etiology
Occupational Diseases - epidemiology - etiology - pathology
Risk Assessment - methods
Risk factors
Skin Neoplasms - epidemiology - etiology
Sweden - epidemiology
Ultraviolet Rays - adverse effects
Abstract
AIMS: To improve knowledge of the epidemiology of melanoma by comparing occupational risks of cutaneous melanoma (CM) by anatomic site in Swedish workers. METHODS: Male workers employed in 1970 and living in the country in 1960 were followed up from 1971 to 1989 using the Swedish Registers of Death and Cancer. A more specifically exposed subcohort included men reporting the same occupation in 1960 and 1970. For each location, occupational risk ratios (RRs) were extracted from Poisson regression models adjusted by age, period, town size, and geographical area. To diminish the influence of socioeconomic factors, intrasector analyses, comparing only jobs belonging to the same occupational sector, were performed. Risk patterns for different locations were compared. RESULTS: High RRs for different sites were found among workers exposed to UV sources (dentists, physiotherapists, and lithographers), and sun exposed workers (harbour masters, and lighthouse/related work). Risk excesses were seen in fur tailors, tanners/fur dressers, patternmakers/cutters, electrical fitters/wiremen, telephone/telegraph installers/repairmen, and some glass/pottery/tile workers. Results for lower and upper limbs were significantly correlated but somewhat independent of those found in thorax, the most frequent location. Correlation between head/neck and thorax was moderate. Specific risk excesses were found for rolling mill workers in head/neck, for chimney sweeps in upper limbs, and for aircraft pilots/navigators/flight engineers in lower limbs. CONCLUSIONS: High RRs in the trunk among occupations with UV exposure from artificial sources suggest an effect not restricted to exposed sites. An unusual distribution of cases and RRs in chimney sweeps, rolling-mill, or glass/pottery/tile workers suggests local effects of exposures. The not previously reported risk excess in this job and in fur related processes, and the RR in electrical fitters and telephone/telegraph installers deserve further investigation. Disparities between locations, as RRs in thorax and limbs, may reflect differences in aetiological mechanisms.
PubMed ID
14739377 View in PubMed
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Decreased lung function and exposure to diisocyanates (HDI and HDI-BT) in car repair painters: observations on re-examination 6 years after initial study.

https://arctichealth.org/en/permalink/ahliterature67935
Source
Am J Ind Med. 1990;17(3):299-310
Publication Type
Article
Date
1990
Author
G. Tornling
R. Alexandersson
G. Hedenstierna
N. Plato
Author Affiliation
Department of Thoracic Medicine, Karolinska Hospital, Stockholm, Sweden.
Source
Am J Ind Med. 1990;17(3):299-310
Date
1990
Language
English
Publication Type
Article
Keywords
Adult
Air Pollutants, Occupational - toxicity
Automobiles
Cyanates - toxicity
Environmental Exposure
Humans
Longitudinal Studies
Lung - drug effects - physiopathology
Male
Occupational Diseases - chemically induced - etiology - physiopathology
Paint - toxicity
Research Support, Non-U.S. Gov't
Respiratory Function Tests
Smoking - adverse effects
Sweden
Abstract
Thirty-six car painters and 115 control persons participated in a follow-up investigation 6 years after the initial study, including measurement of lung function (dynamic spirometry and nitrogen washout test) and estimation of exposure to diisocyanates based on individual working routines, use of respiratory protection equipment, and measurements. The mean exposure for the car painters was 0.0015 mg/m3 hexamethylenediisocyanate (HDI) and 0.09 mg/m3 hexamethylenediisocyanate-biurettrimer (HDI-BT), but frequently there were peak exposures exceeding 2.0 mg/m3 HDI-BT for at least 30 sec. Compared with smoking controls, the smoking car painters had greater yearly reduction in FVC (95 versus 38 ml), FEV1 (61 versus 28 ml), and VC (77 versus 30 ml). The nonsmoking car painters showed no differences in lung volumes compared with their nonsmoking controls. The impairment correlated well with the frequency of high peak exposures to HDI-BT, but not with the mean exposure to diisocyanates.
PubMed ID
2305810 View in PubMed
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20 records – page 1 of 2.