Per Søstrand

Exposure to hydrogen fluoride: an experimental study in humans of concentrations of fluoride in plasma, symptoms, and lung function.

OBJECTIVES: To study the absorption of inhaled hydrogen fluoride (HF) by measuring plasma fluorides and HF concentrations in the breathing zone during exposure to HF. A possible dose-effect relation was investigated by following airway symptoms and lung function-that is, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC)-during and after exposure to HF. METHODS: 20 healthy, male volunteers were exposed for one hour to constant HF concentrations that ranged from 0.2 to 5.2 mg/m3; these concentrations are known to occur among potroom workers in the primary aluminium industry. Plasma fluorides were analysed before, during, and after exposure. Symptoms from the eyes and the upper and lower airways were registered and graded from 1 to 5 with a standardised questionnaire. RESULTS: The total symptom score was significantly increased at the end of exposure for all the subjects as a group (P < 0.01) and for the group exposed to HF below the present Norwegian standard for total fluorides 0.6 mg/m3 (P = 0.05). No change was detected in FEV15 although a significant decrease was found in FVC in the group exposed to fluorides below the hygienic standard (n = 9) and for the entire group (n = 23). Almost all the symptoms had disappeared four hours after the end of exposure. Symptom scores from the upper airways were significantly correlated with the HF concentration (r = 0.62, P = 0.002), the change in plasma fluoride concentration (delta C) (r = 0.51, P = 0.01), and the maximum plasma fluoride concentration (Cmax) (r = 0.42, P = 0.05). A significant correlation was also found between the total symptom score for airways and the HF concentration. CONCLUSIONS: The present study showed a strong relation between inhaled HF and concentrations of fluoride in plasma. Upper airway and eye symptoms occurred after one hour of exposure to HF even when below the Norwegian hygienic standard for fluorides.

Hazardous peak concentrations of hydrogen sulfide gas related to the sewage purification process.

The concentration of hydrogen sulfide in the atmosphere of a sewage purification plant in Norway was studied. Continuous measurements over several 3-week periods showed that the concentrations generally were lower than 2 ppm, but peak concentrations over 100 ppm were discovered. Rapid onset and decline characterized these peak concentrations, which occurred at regular intervals. Through evaluation of the time pattern of these peaks compared with plant operations, a specific process was identified as the likely causative factor of the spikes. Through simple remedial actions the hydrogen sulfide concentration associated with this activity was reduced from above 100 ppm to less than 2 ppm. Olfactory fatigue to hydrogen sulfide and strong offensive odors from other compounds in the sewage makes smell ineffective for signaling high concentrations. Peak concentrations may therefore pass unnoticed unless detected with continuous measuring equipment. The risk for exposure may be reduced by enclosing processes and through the use of spot extraction ventilation in areas with compacted anaerobic waste material.

Airway inflammation in paper mill workers.

Paper mill workers are exposed to culturable microorganisms (MOs). We hypothesized that inflammatory airway response could be detected in sputum of nonsymptomatic workers. From four paper mills, we included 29 healthy nonsmoking men. Workers exposed to high levels of MOs (HMOE, n = 17) were compared with workers exposed to low levels of MO (LMOE, n = 12). A reference group of 22 healthy, nonsmoking, nonexposed (NE) men were also included. We performed differential cell counts of induced sputum, studied gene expressions of isolated sputum macrophages and analyzed inflammatory parameters, including matrix metalloproteinases. Sputum from HMOE workers had a significantly higher percentage of neutrophils than that from LMOE workers (P < 0.05) and NE controls (P < 0.001). There was also an increased gene expression of different pro-inflammatory cytokines, interleukin-6, tumor necrosis factor-&agr;, and macrophage inflammatory protein-1&bgr; in isolated airway macrophages and increased levels of total matrix metalloprotease-9 activity in induced sputum from the HMOE group. Our findings indicate that paper industry workers exposed to MOs develop subclinical airway inflammation.

Hypersensitivity pneumonitis in a cluster of sawmill workers: a 10-year follow-up of exposure, symptoms, and lung function

Abstract Background: The long-term prognosis of repeated acute episodes of hypersensitivity pneumonitis (HP) is not well described. We report on a 10-year follow-up of a 10-person cluster from a Norwegian sawmill who had all experienced relapsing episodes of HP. Objectives: To evaluate the health symptoms, work-related sick-leave, and lung function of 10 workers exposed to mold in a Norwegian sawmill. Methods: Participants were evaluated at baseline and 10 years later at follow-up. A structured interview, measurement of serum IgG antibodies to Rhizopus microsporus (R. microsporus) antigens, lung function tests, high resolution computed tomography (HRCT) of the chest, and personal measurements of exposure to mold spores and dust were completed for each participant. Results: At baseline, nearly all workers reported acute episodes of HP more than twice a month. At follow-up, both the frequency and intensity of symptoms had declined. Sick-leave was reduced and gas diffusing capacity improved – paralleling the gradually reduced air levels of mold spores. Conclusions: In spite of an initially high occurrence of symptoms, long-term clinical and physiological outcome was good. With reduced exposure to mold spores, symptoms declined and lung function was restored.

Inflammation in induced sputum after aluminium oxide exposure: an experimental chamber study

Introduction Workers in aluminium production are exposed to a complex mixture of particles and gases potentially harmful to the airways, among them aluminium oxide (Al2O3). With the use of an exposure chamber, we aimed to examine the effects of short-term controlled exposure to Al2O3 on lung function and inflammatory markers in healthy volunteers. Methods 15 men (age 19–31) were exposed in random order to clean air or Al2O3 particles (3.8–4.0 mg/m3) for 2 h including 30 min exercise (stationary bike, 75 W). The permissible exposure level (PEL) for Al2O3 by Occupational Safety and Health Administration, USA, is 5 mg/m3 time weighted average (TWA). Sham and particle exposures were separated by at least 2 weeks. Spirometry was carried out, and induced sputum and blood samples were collected 48 h before and 4 and 24 h after exposure. Results Levels of sputum neutrophils (mean (±SEM)) was increased 24 h post-Al2O3 vs pre-Al2O3 exposure (43% (4) vs 31% (4), p=0.01) and the protein level of interleukin (IL)-8 had a 4.8 (0.9)-fold change increase 24 h after exposure (p<0.01). Following Al2O3 exposure, gene signatures in sputum were significantly increased related to several pathways. Conclusions The present study suggests that controlled exposure to Al2O3 particles at levels below PEL (TWA) induces airway inflammation in healthy humans marked by elevated neutrophils and elevated IL-8. In addition, increased expression of genes associated with several biological processes was observed in sputum. Interestingly, inhaled Al2O3-induced effects were localised to the airways and not systemic.

736 Acute irritant-induced asthma caused by ozone

Introduction Ozone-generating UV-lamps are used to remove unwanted grease from ventilation systems. Irritant asthma after exposure to artificially produced ozone has been described at a Norwegian fish hatchery and a sewage plant, as well as in the Swedish paper industry. We present cases that developed asthma after an accident with ozone-producing UV-systems in a restaurant kitchen. Methods Case series Seven subjects that developed asthma were studied in relation to exposure, symptoms, medical history and clinical findings including lung function measurements, reversibility of airflow limitation and bronchial hyper responsiveness (BHR) to methacholine, both shortly after the accidental exposure and two years after the incident. Result Out of a total number of 127 possibly ozone-exposed employees, 55 employees reported symptoms, and seven employees were diagnosed with occupational asthma after the incident. Six of these seven subjects had either positive reversibility and/or positive BHR tests. Two years after cessation of exposure all seven subjects still needed treatment for asthma. Three of the subjects had BHR despite the use of inhaled corticosteroids, all graded as ‘very mild BHR’. FVC, FEV1, FEV1/FVC ratio and FeNO values were within normal range in all cases. None had long absence from work or needed emergency treatment in hospital for their asthma. Discussion The adverse impact of ozone exposure on the airways is well known from epidemiological studies, where the focus has been on the negative health effects of ozone (O3) in ambient air, especially in large cities. Commercial use of the ozone gas’ odour absorbing and germ-killing properties has become more common in the last decade. Accidents involving ozone gas from air purifiers with UV-lamps may cause acute irritant asthma. There is a need for greater awareness in the use of ozone-generating devices.

100 kBq m-3 Radon Activity Concentration in the Atmosphere of a Bathroom Supplied with Groundwater From A Gneissic Rock Area with Consanguineous Intrusions.

AbstractInhalation of escaping radon from groundwater comprises the largest part of radiological hazard from groundwater radionuclides in the uranium and thorium series. Groundwater containing 1.5 mg dm−3 uranium and 3 kBq dm−3 radon activity concentration supplied an ordinary bathroom of 15 m3 in a home. Using the showerhead, atmospheric levels of radon activity in the bathroom exceeded 100 kBq m−3 within a period of about 1 h.