Andrea Sass-Kortsak

An investigation of the association between exposure to styrene and hearing loss

The importance of the association between advancing age and hearing loss is well recognized. Further, prolonged significant noise exposures are also known to result in permanent hearing loss. However, little is known of the contribution of industrial chemical exposures to hearing loss. Information available, from both animal and human studies, raises the possibility that certain aromatic hydrocarbons are ototoxic. The purpose of this study was to assess whether occupational styrene exposure causes hearing loss in a group of workers in the fiber-reinforced plastics manufacturing industry. The hearing acuity of 299 subjects was determined, using pure-tone screening audiometry, at the beginning of a single workshift and again at the end of the shift. On the same day, the personal, time-weighted average exposures of each subject to both styrene and noise were measured. In addition, information on the following factors was obtained from each participant: previous work history, including exposures to noise and chemicals; use of personal protective equipment for noise or solvents; personal and family history of hearing problems; and smoking history. Current exposures together with work histories were used to construct lifetime noise and styrene exposure indices. No conclusive evidence was found for a chronic styrene-induced effect on hearing acuity, when both noise and styrene lifetime exposures were taken into account. As expected, age and noise exposures were highly important variables, both positively associated with hearing loss. In addition, the detrimental effect of noise exposure on hearing acuity was found to be strengthened with increased age. Noise and styrene exposures were highly correlated, clearly illustrating the importance of considering all associated variables in analysis of such data. No evidence was found for a relationship between smoking, recreational noise, solvent exposures, and hearing loss.

Development of models to predict dose of pesticides in professional turf applicators.

Epidemiologic studies designed to assess the chronic effects of pesticides are limited by inadequate measurements of exposures. Although cohort studies have been initiated to evaluate the effects of 2,4-dichlorophenoxyacetic acid (2,4-D) and other pesticides in professional turf applicators, they may have limited power to detect significant health risks and may be subject to bias from exposure measurement error. In this study, the doses of 2,4-D, mecoprop [2-(4-chloro-2 methylphenoxy) propionic acid, MCPP] and dicamba (3,6-dichloro-o-anisic acid) were evaluated in a group of 98 professional turf applicators from 20 companies across southwestern Ontario. During a 1-week period (Saturday to Thursday), the volume of pesticide (active ingredient) applied was only weakly related to the total dose of 2,4-D absorbed (R2=0.21). Two additional factors explained a large proportion of variation in dose: the type of spray nozzle used and the use of gloves while spraying. Individuals who used a fan-type nozzle had significantly higher doses than those who used a gun-type nozzle. Glove use was associated with significantly lower doses. Job satisfaction and current smoking influenced the dose but were not highly predictive. In the final multiple regression models predicting total absorbed dose of 2,4-D and mecoprop, approximately 63–68% of the variation was explained. The future application of these models for epidemiologic research will depend on the availability of information and records from employers, the feasibility of contacting study subjects and cost.

An Evaluation of 24-Hour Urinary Creatinine Excretion for Use in Identification of Incomplete Urine Collections and Adjustment of Absorbed Dose of Pesticides

The accurate quantification of the absorbed dose of pesticides following occupational exposures generally requires complete 24-hour urine collections, often over extended periods of time. Difficulty in obtaining volunteer cooperation may result in incomplete urine collections. Traditionally, 24-hour urinary creatinine has been used to identify incomplete urine samples and has been used to standardize pesticide and other chemical dose estimates. More recently, the use of creatinine to standardize dose estimates has been questioned, as has its utility in the identification of incomplete urine collections. This research evaluates the use of personal observation, statistical methods, and published models to predict creatinine excretion to identify and adjust for incomplete urine collections. Based on the use of published creatinine prediction models, an evaluation of the day-to-day creatinine excretion within subjects, and personal observation, a small number of suspected urine samples were identified. Although it is likely that these samples were incomplete, correction of these urine volumes based on the published models did little to improve pesticide dose prediction. Further, results indicate that subjects who report missed urine samples may be able to estimate the missing volumes with some accuracy. In future pesticide exposure studies, the use of self-reported missed volumes may help to increase the accuracy of dose prediction when there is strong cooperation with collection procedures. A statistical model to predict creatinine excretion in professional turf applicators was developed to provide a preliminary screening for urinary completeness for future studies in which compliance with urinary collection is thought to be insufficient.

The role of high-frequency hearing in age-related speech understanding deficits.

An experiment was conducted to further explore the effect of ageing on speech understanding under degraded listening conditions. Two groups of subjects, aged 20-39 years and 50-75 years were tested. Measurements were made of hearing thresholds in each ear from 0.25-10 kHz, consonant discrimination in quiet and continuous speech spectrum noise (S/N = −10 dB) and monophonic and stereophonic frequency selectivity. Neither group would have been diagnosed as hearing-impaired. Nonetheless, the older group had significantly higher hearing thresholds, which increased systematically with frequency. Poorer consonant discrimination in noise was observed for the older group. This outcome was correlated with high-frequency thresholds, not with age. There was no between-group difference in stereophonic frequency selectivity, minimizing the possibility of age-related changes in central auditory processing. Monophonic frequency selectivity, an index of cochlear processing, was correlated with speech understanding. The results support the conclusion that observed age-related effects are secondary to cochlear dysfunction.

Exposure of hospital operating room personnel to potentially harmful environmental agents.

Epidemiologic studies of risk to reproductive health arising from the operating room environment have been inconclusive and lack quantitative exposure information. This study was undertaken to quantify exposure of operating room (OR) personnel to anesthetic agents, x-radiation, methyl methacrylate, and ethylene oxide and to determine how exposure varies with different operating room factors. Exposures of anesthetists and nurses to these agents were determined in selected operating rooms over three consecutive days. Each subject was asked to wear an x-radiation dosimeter for 1 month. Exposure to anesthetic agents was found to be influenced by the age of the OR facility, type of surgical service, number of procedures carried out during the day, type of anesthetic circuitry, and method of anesthesia delivery. Anesthetists were found to have significantly greater exposures than OR nurses. Exposure of OR personnel to ethylene oxide, methyl methacrylate, and x-radiation were well within existing standards. Exposure of anesthetists and nurses to anesthetic agents, at times, was in excess of Ontario exposure guidelines, despite improvements in the control of anesthetic pollution.

Sources of Personal Exposure to Fine Particles in Toronto, Ontario, Canada

Abstract Individuals are exposed to particulate matter from both indoor and outdoor sources. The aim of this study was to compare the relative contributions of three sources of personal exposure to fine particles (PM2.5) by using chemical tracers. The study design incorporated repeated 24-hr personal exposure measurements of air pollution from 28 cardiac-compromised residents of Toronto, Ontario, Canada. Each study participant wore the Rupprecht & Patash-nick ChemPass Personal Sampling System 1 day a week for a maximum of 10 weeks. During their individual exposure measurement days the subjects reported to have spent an average of 89% of their time indoors. Particle phase elemental carbon, sulfate, and calcium personal exposure data were used in a mixed-effects model as tracers for outdoor PM2.5 from traffic-related combustion, regional, and local crustal materials, respectively. These three sources were found to contribute 13% ± 10%, 17% ± 16%, and 7% ± 6% of PM2.5 exposures. The remaining fraction of the personal PM2.5 is hypothesized to be predominantly related to indoor sources. For comparison, central site outdoor PM2.5 measurements for the same dates as personal measurements were used to construct a receptor model using the same three tracers. In this case, traffic-related combustion, regional, and local crustal materials were found to contribute 19% ± 17%, 52% ± 22%, and 10% ± 7%, respectively. Our results indicate that the three outdoor PM2.5 sources considered are statistically significant contributors to personal exposure to PM2.5. Our results also suggest that among the Toronto subjects, who spent a considerable amount of time indoors, exposure to outdoor PM2.5 includes a greater relative contribution from combustion sources compared with outdoor PM2.5 measurements where regional sources are the dominant contributor.

The development of a new method to estimate total daily dose of pesticides in professional turf applicators following multiple and varied exposures in occupational settings

Abstract The evaluation of absorbed dose of pesticides in humans requires a knowledge of the kinetics and dynamics of the compound. In some circumstances, data that allow for the estimation of dose may be available from human volunteer studies, although often, it will be based on results from animal studies. If human metabolism data are available, estimates of dose may be more accurate, but it should be recognized that pesticide exposure in an occupational setting may differ from that in a controlled laboratory study. In this study, data from previously published studies are used to evaluate the urinary excretion of 2,4-dichlorophenoxyacetic acid (2,4-D), following single dermal applications to human volunteers. These studies are evaluated with the objective of determining the best method of predicting total absorbed dose following multiple and varied exposures in occupational settings. Further, an alternative to laboratory-controlled human volunteer studies is presented. Data from a third previously published biological monitoring study on six professional pesticide applicators over a 2-week period were used to generate estimates of the urinary excretion of the pesticide 2,4-D that would result from a single dose. The method used to estimate the urinary excretion parameters is a variation of an overlay technique used in pharmacology, and may provide information on the kinetics of other pesticides when it is not possible to conduct human studies. The generated estimates of 24-h urinary excretion of 2,4-D over a 6-day period were remarkably similar to those obtained in controlled studies. Finally, a method was developed to use the generated estimates to determine total absorbed dose of pesticides for an independent group of 95 professional pesticide applicators. This method requires information on the amount of pesticide used for 6 days prior to the collection of two, 24-h urine samples.

MCPA Permeation Through Protective Gloves

Permeation of 4-chloro-2-methylphenoxyacetic acid (MCPA) in commercial herbicide formulations through common protective glove types was evaluated to aid in the selection of appropriate skin protection. The ASTM test method F739-91 was used to measure the permeation of two undiluted formulations, one containing a salt, and the other an ester form of MCPA. The four glove types tested were natural rubber, neoprene 73, nitrile 37-145, and Viton-coated chloroprene. Triplicate tests of each combination of formulation and glove material were conducted. Permeation cells with a 0.01 M sodium hydroxide collection medium were used for the experiments. Aliquots of the collection medium were withdrawn at regular intervals and acidified, and quantification of the free acid was achieved using HPLC-UV (230 nm). There was no appreciable permeation of the salt formulation over a 24-hour test period. For the ester formulation, the following mean steady-state permeation rate (microg x cm(-2) min(-1)) and mean lag time (hours), respectively, were measured: Viton (0.06, 17.8), natural rubber (0.08, 15.4), neoprene 73 (0.21, 15.1), and nitrile (0.04, 24.2). Permeation was associated with significant swelling, averaging a nearly 30 percent increase from the pre-immersion thickness. All four glove types provide adequate protection against permeation by the salt formulation and at least eight-hour protection against the ester formulation. Given the greater permeation of the ester formulation, the salt formulation of MCPA herbicide should be used whenever possible.

Prostate cancer and driving occupations: could whole body vibration play a role?

PurposeTo summarize the literature on the risk of prostate cancer in whole body vibration (WBV) related occupations and estimate a combined meta-rate ratio.MethodsA systematic review and meta-analysis of five case–control and three cohort studies published between 1996 and 2004 was conducted. A pooled relative risk (RR) estimate was calculated and the studies were evaluated for homogeneity and publication bias.ResultsThe overall pooled RR estimate was 1.14 (95% CI 0.99–1.30) for the random effects model, based on 17 estimates of relative risk from the eight studies. Significant heterogeneity was found. There was no indication of publication bias.ConclusionsThe increased, though not statistically significant pooled RR for prostate cancer obtained in this meta-analysis indicates that occupational exposure to WBV cannot be ruled out as a possible risk factor for the disease. However, all included studies involved driving occupations with exposure to other risk factors for prostate cancer. Therefore, further epidemiologic studies are needed to better understand this association.

Prostate Cancer and Occupational Whole-Body Vibration Exposure

Prostate cancer is common and its etiology largely unknown; therefore, it is important to explore all potential risk factors that are biologically plausible. Recent literature suggests a relationship between whole-body vibration (WBV) and prostate cancer risk. The aim of this study was to determine whether occupational WBV was a risk factor for prostate cancer. Existing data, collected on 447 incident cases and 532 population controls (or their proxies), in Montreal, Canada, were used to evaluate this question. Personal interviews collected detailed job descriptions for every job held, the tasks involved, and type of equipment used. For each job, experts assessed the intensity and daily duration of WBV exposure. Inter-rater agreement for WBV ratings was examined using the kappa statistic, with values that ranged from 0.83 to 0.94. Logistic regression models explored the relationship between WBV exposure and prostate cancer, using various combinations of intensity, daily duration, and years of exposure. Potential confounders were also examined. Occupations with WBV exposure demonstrated an increased statistically non-significant risk [odds ratio (OR) = 1.44, 95% confidence interval (CI): 0.99-2.09]. The risk for transport equipment operation, a job with WBV exposure, was significantly elevated (OR = 1.90, 95% CI: 1.07-3.39). These results, together with those of an earlier study, suggest that workers in heavy equipment and transport equipment operation may have increased risk of prostate cancer. Further investigation is warranted.