Pierre Goutet

Symptoms, airway responsiveness, and exposure to dust in beech and oak wood workers

OBJECTIVES To investigate the relation between levels of cumulative exposure to wood dust and respiratory symptoms and the occurrence of bronchial hyperresponsiveness among beech and oak workers. METHODS 114 Male woodworkers from five furniture factories and 13 male unexposed controls were examined. The unexposed control group was supplemented by 200 male historical controls. Statistical analyses were performed excluding and including the historical controls. Dust concentration was measured by personal sampling methods. Cumulative exposure to dust was calculated for each woodworker by multiplying the duration of the work by the intensity of exposure (years.mg/m3). Bronchial hyperresponsiveness was assessed by the methacholine bronchial challenge test. Subjects were labelled methacholine bronchial challenge positive if forced expiratory volume in 1 second (FEV1) fell by ⩾20%. The linear dose-response slope was calculated as the last dose divided by the total dose given. RESULTS 443 Dust samples were collected. The median cumulative exposure to dust was 110 years.mg/m3 with lower and upper quartiles at 70 and 160 years.mg/m3 Overall, no declines in FEV1 and forced vital capacity (FVC) were found with increasing exposures. A dose-response relation was found between intensity of exposure on the one hand, and sore throat, increased prevalence of positive methacholine bronchial challenge tests, and steeper dose-response slope, on the other. CONCLUSION Exposure to oak and beech dust may lead to the development of sore throat and bronchial hyperresponsiveness.

Airway responsiveness, respiratory symptoms, and exposures to soluble oil mist in mechanical workers.

OBJECTIVES: To assess the relation between measured levels of exposure to soluble oil mists in a plant manufacturing ball bearings, and both respiratory symptoms and airway responsiveness in the workforce. METHODS: 114 male workers exposed to oil mist and 55 unexposed male controls from nearby factories were studied. Soluble oil mist concentrations were measured with area samplers. Respiratory symptoms were assessed by questionnaire and measurement of airway responsiveness to methacholine with an abbreviated method. Subjects were labelled positive to methacholine airway challenge (MAC+) if forced expiratory volume in one second (FEV1) fell by > or = 20%. The linear dose-response slope was calculated as the percentage fall in FEV1 at the last dose divided by the total dose given. RESULTS: Geometric mean concentrations of oil mists ranged from 0.65 mg/m3 (GSD 1.29) to 2.20 mg/m3 (GSD 1.55) based on 92 measurements obtained from 1979-93. The prevalence of chronic cough or phlegm, bouts of bronchitis, and dyspnoea was greater among exposed workers than among controls (odds ratio (OR) 4.64, P = 0.002 for chronic cough and phlegm). After adjustment for smoking and age, dyspnoea was significantly related to an index of cumulative exposure to oil mist (OR 1.44, P = 0.006/10 y.mg/m3). The proportion of MAC+ subjects was similar in the two groups. However, after adjustment for baseline FEV1 and age, the dose-response slope was significantly steeper among exposed workers than among controls (P = 0.01), a finding indicating airway hyperresponsiveness in the exposed workers. Furthermore, the dose-response slope was significantly related to baseline FEV1, age, and, after adjustment for FEV1, the index of cumulative exposure to oil (P = 0.004). CONCLUSION: Subjects with exposure to soluble oil mist in the metal industry are at risk of developing both respiratory symptoms and airway hyperresponsiveness.

Lung cancer mortality and iron oxide exposure in a French steel-producing factory

Objective: To study the possible association between iron oxide exposures and lung cancer risk among workers in a French carbon steel-producing factory. Methods: 16 742 males and 959 females ever employed for at least 1 year between 1959 and 1997 were followed up for mortality from January 1968 to December 1998. Causes of death were ascertained from death certificates. Job histories and smoking habits were available for 99.7% and 72.3% of subjects, respectively. Occupational exposures were assessed by a factory-specific job-exposure matrix (JEM) validated with atmospheric measurements. Standardised mortality ratios (SMRs) were computed using local death rates (external references). Poisson regressions were used to estimate the relative risks (RRs) for occupational exposures (internal references), adjusted on potential confounding factors. Results: Among males, observed mortality was lower than expected for lung cancer compared to the local population (233 deaths, SMR 0.89, 95% CI 0.78 to 1.01) and higher than expected compared to the French population (SMR 1.30, 95% CI 1.15 to 1.48) No lung cancer excess was observed for exposure to iron oxides (RR 0.80, 95% CI 0.55 to 1.17) and no dose–response relationship with intensity, duration of exposure or cumulative index was found. A significant bladder cancer excess was observed among workers exposed to oil mist (RR 2.44, 95% CI 1.06 to 5.60), increasing significantly with intensity, duration of exposure and cumulative index. Conclusion: This study did not detect any relationship between exposure to iron oxides and lung cancer mortality. An excess of mortality from bladder cancer was found among workers exposed to oil mist.

Occupational Exposure to Beryllium in French Enterprises: A Survey of Airborne Exposure and Surface Levels

An assessment survey of occupational exposure to beryllium (Be) was conducted in France between late 2004 and the end of 2006. Exposure estimates were based on the analytical results of samples collected from workplace air and from work surfaces in 95 facilities belonging to 37 sectors of activity. The results of this study indicated airborne Be concentrations in excess of the occupational exposure limit value of 2 microg m(-3) recommended in France. Metallurgy and electronic component manufacturing represented the activities and occupations where workers had the highest arithmetic mean exposures to Be. Surface contamination levels were also high and frequently exceeded thresholds recommended by different bodies. These results should prompt the development of prevention programmes that include Be substitution, process control and surface decontamination, in conjunction with suitable medical surveillance.

Occupational exposure to chrome VI compounds in French companies: results of a national campaign to measure exposure (2010-2013).

A campaign to measure exposure to hexavalent chromium compounds was carried out in France by the seven CARSAT chemistry laboratories, CRAMIF laboratory, and INRS over the 2010-2013 period. The survey included 99 companies involved in various activity sectors. The inhalable fraction of airborne particles was sampled, and exposure levels were determined using ion chromatography analysis combined with post-column derivatization and UV detection. The quality of the measurement results was guaranteed by an inter-laboratory comparison system involving all the laboratories participating in this study. Exposure levels frequently exceeded the French occupational exposure limit value (OELV) of 1 µg m(-3), in activities such as thermal metallization and manufacturing and application of paint in the aeronautics sector. The results also reveal a general trend for a greater proportion of soluble Chromium VI (Cr VI) compounds compared with insoluble compounds. Qualitative and quantitative information relating to the presence of other metallic compounds in the air of workplaces is also provided, for example for Cr III, Ni, Fe, etc. The sampling strategy used and the measurement method are easy to implement, making it possible to check occupational exposure with a view to comparing it to an 8 h-OELV of 1 µg m(-3).

O22-1 Bladder cancer and occupational exposure to metalworking fluid mist: a nested case-control study in french steel-producing factories

Objective To assess possible relationships between occupational exposure to metalworking fluid (MWF) mist and bladder cancer risk. Methods A nested case-control study was conducted within a cohort of workers from 6 steel-producing factories. Cases were diagnosed with bladder cancer in 2006–2012. Three controls per case were randomly selected from the cohort, matched to cases by age at diagnostic and counter-matched according to 4 strata of surrogate measure of exposure to MWF mists, assessed using a job-exposure matrix. Cases (n = 84) and controls (n = 251) provided information during personal interviews on occupational history, including the type of MWF used (straight oils, soluble oils, synthetic fluids), and smoking habits. Experts estimated intensity, frequency and probability of exposure to each MWF mist. Conditional logistic regression, adapted to counter-matching, was used to calculate Odds-Ratios (OR) and 95% confidence intervals (95% CI), taking into account the 3 types of MWF mist, and adjusting for smoking and other occupational factors. Results A statistically significant OR for bladder cancer was observed for workers exposed to MWF mist, for over 20 years during occupational history (OR 3.32, 95% CI: 1.48–7.46). ORs were statistically significant for workers ever exposed to straight oils (OR 2.14, 95% CI: 1.05–4.36), for over 20 years during occupational history (OR 5.49, 95% CI: 1.75–17.2). ORs statistically not greater than 1 were observed for workers ever exposed to soluble oils (OR 1.46, 95% CI: 0.71–3.02), for over 20 years during occupational history (OR 2.43, 95% CI: 0.88–6.70). OR was not statistically significant for workers ever exposed to synthetic fluids (OR 1.2, 95% CI: 0.31–3.30). Dose-response relationships were observed with cumulative exposure to MWF mist and straight oils in the last 20 years before diagnosis. Conclusion This study highlighted association between recent exposure to straight oils and bladder cancer risk, but did not detect any relationship concerning soluble oils or synthetic fluids.