Ron Niebo

Screening tests: a review with examples

Abstract Screening tests are widely used in medicine to assess the likelihood that members of a defined population have a particular disease. This article presents an overview of such tests including the definitions of key technical (sensitivity and specificity) and population characteristics necessary to assess the benefits and limitations of such tests. Several examples are used to illustrate calculations, including the characteristics of low dose computed tomography as a lung cancer screen, choice of an optimal PSA cutoff and selection of the population to undergo mammography. The importance of careful consideration of the consequences of both false positives and negatives is highlighted. Receiver operating characteristic curves are explained as is the need to carefully select the population group to be tested.

Occupational Exposure to Carbon/Coke Fibers in Plants That Produce Green or Calcined Petroleum Coke and Potential Health Effects: 1. Fiber Characteristics

Carbon/coke fibers are found in bulk samples of calcined petroleum coke. Carbon/coke and other fibers, including calcium silicate, cellulose, gypsum, and iron silicate, have been found in exposure monitoring of workers who make or handle green or calcined petroleum coke. Carbon/coke fibers are not classified or regulated as carcinogens by any agency, and the available literature (summarized in this article) has not reported significant adverse health effects associated with exposure to these fibers or dusts containing these fibers. However, available epidemiological and toxicological studies have limitations that prevent a definitive assessment of carbon/coke fiber toxicity. Therefore, it is prudent to monitor and control workplace concentrations. Analyses by transmission electron microscopy (TEM) indicate that the carbon/coke fibers are amorphous, irregularly shaped, and generally rather short (94% less than 20 μm long). Nearly all carbon/ coke fibers satisfying NIOSH 7400 B counting criteria are detectable by phase-contrast optical microscopy (PCOM), which permits the use of a highly efficient sequential sampling strategy for analysis. Data are presented on the distribution of carbon/coke structure and fiber lengths and diameters. Bootstrap resampling results are presented to determine confidence intervals for structure/fiber length and diameter. Data on time-weighted average concentrations are given in a companion article, but nearly all time-weighted average carbon/coke fiber concentrations were beneath 0.1 fibers per milliliter.

Perspectives on refractory ceramic fiber (RCF) carcinogenicity: comparisons with other fibers

Abstract In 2011, SCOEL classified RCF as a secondary genotoxic carcinogen and supported a practical threshold. Inflammation was considered the predominant manifestation of RCF toxicity. Intrapleural and intraperitoneal implantation induced mesotheliomas and sarcomas in laboratory animals. Chronic nose-only inhalation bioassays indicated that RCF exposure in rats increased the incidence of lung cancer and similar exposures resulted in mesothelioma in hamsters, but these studies may have been compromised by overload. Epidemiological studies in the US and Europe showed an association between exposure and prevalence of respiratory symptoms and pleural plaques, but no interstitial fibrosis, mesotheliomas, or increased numbers of lung tumors were observed. As the latency of asbestos induced mesotheliomas can be up to 50 years, the relationship between RCF exposure and respiratory malignances has not been fully determined. Nonetheless, it is possible to offer useful perspectives. RCF and rock wool have similar airborne fiber dimensions and biopersistence. Therefore, it is likely that these fibers have similar toxicology. Traditional rock wool has been the subject of numerous cohort and case control studies. For rock wool, IARC () concluded that the epidemiological studies did not provide evidence of carcinogenicity. Based on analogies with rock wool (read across), it is reasonable to believe that increases in lung cancer or any mesotheliomas are unlikely to be found in the RCF-exposed cohort. RCF producers have developed a product stewardship program to measure and control fiber concentrations and to further understand the health status of their workers.

Perlite toxicology and epidemiology--a review.

Abstract Perlite is a generic name for an amorphous volcanic alumina–silicate rock that expands by a factor of 4–20 when rapidly heated to 1400–1800 °F (760–980 °C). Both the ore and the expanded product have extensive and widespread commercial applications. Limited data on the toxicology of perlite in animal studies indicate that the LD50 (oral ingestion) is more than 10 g/kg and, from a chronic inhalation study in guinea pigs and rats, that the NOAEL for the inhalation pathway is 226 mg/m3. Health surveillance studies of workers in US perlite mines and expansion plants (including some workers exposed to levels greater than prevailing occupational exposure limits (OELs) conducted over 20 years indicate that the respiratory health of workers is not adversely affected. Studies in Turkish mines and expanding plants had generally similar results, but are more difficult to interpret because of high smoking rates in these populations. A recent mortality study of permanent residents of the island of Milos (Greece) exposed to various mining dusts (including perlite) resulted in non-significant increases in standard mortality ratios for pneumonia and chronic obstructive pulmonary disease (COPD), whereas a companion morbidity study revealed elevated odds ratios for allergic rhinitis, pneumonia, and COPD when compared to another industrial area of Greece. Residents were exposed to other mining dusts and other possible causes or contributing factors and no ambient monitoring data were presented so it is not possible to use this study for risk calculations of perlite-exposed populations. Perlite is regulated as a “nuisance dust” in most countries.

Product Stewardship in Wollastonite Production

In July 2002, NYCO Minerals, Inc., discovered a heretofore unknown contaminant in its wollastonite ore. The contaminant was first believed to be tremolite asbestos. Immediate efforts were made to eliminate this material. Additional studies were initiated to fully characterize the contaminant and its distribution in the ore body. Subsequent study by NYCO and their consultants led to the identification of the contaminant as a transition material (TM) intermediate between tremolite and talc. In vitro dissolution rate measurements indicated that the TM dissolved much more rapidly than tremolite asbestos. This article provides background information on wollastonite mineralogy and NYCOs product stewardship program (PSP). At present, NYCO Minerals uses selective mining to control the trace levels of TM in the ore and finished product verified by periodic monitoring of workplace air and finished product.

Wollastonite toxicity: an update

Abstract This review updates earlier work addressing the epidemiology and toxicity of wollastonite. Earlier chronic animal bioassay and human mortality data were inadequate (IARC term) or negative and no new studies of these types have been published. Wollastonite has been determined to have low biopersistence in both in vivo and in vitro studies, which probably accounts for its relative lack of toxicity. Earlier morbidity studies of mining/mineral processing facilities in Finland and New York State indicated that exposure to wollastonite might result in pleural plaques (Finland) or decrements in certain measures of lung function (New York). More recent analysis of data from an ongoing health surveillance program at one facility (New York) indicates that there are no pleural plaques or interstitial lung disease or decrements in lung function among never smokers or former smokers occupationally exposed to wollastonite. This result probably reflects continued reduction in exposures as part of an ongoing product stewardship program at this facility and suggests that wollastonite has relatively low toxicity as currently managed.

Effect of oxidation and extent of oxidation on biologically active PACs in asphalt products

Recent studies have reported divergent results in rodent cancer assays using fume condensates from a variety of asphalt products. This paper presents results of a study investigating the role of oxidation, or extent of oxidation, on these findings. Five straight run asphalts, made from widely used crude oils, were used as inputs to both production scale and laboratory oxidation units and processed to a range of softening points used in common roofing products. For each of the five asphalts studied, the oxidation reaction significantly decreased measures of polycyclic aromatic compounds (PACs) that have been linked, previously and in analyses included in this study, to tumor induction in rodent bioassays. Mutagenicity index determined by the modified Ames assay was reduced between 41% and 50% from the input asphalt to the final oxidized product. A fluorescence method tuned to a subset of PAC compounds that have been associated with carcinogenic behavior in mouse bioassays was reduced between 39% and 71%. The decrease was largest in the first quarter of the oxidation reaction. These findings indicate that oxidation, by itself, was not a likely factor in the tumor induction seen in the previous studies. Rather, other factors such as the conditions of fume generation and crude source (coupled with possible differences in distillation endpoints) were more likely to have determined the outcomes. Analyses of previously published data, presented in this paper, suggest that the modified Ames and fluorescence assays are valuable screening tools for use in future health-related asphalt research.

Fiber glass and rock/slag wool exposure of professional and do-it-yourself installers.

The fiber glass (FG) and rock/slag wool (RSW) manufacturers have developed a Health and Safety Partnership Program (HSPP) with the participation and oversight of the Occupational Safety and Health Administration (OSHA). Among its many provisions the HSPP includes the continuing study of FG and RSW workplace concentrations in manufacturing facilities operated by FG/RSW producers and among their customers and end users. This analysis estimates the probable cumulative lifetime exposure (fiber-months/cubic centimeter [f-months/cc]) to those who install FG and RSW insulation in residential, commercial, and industrial buildings in Canada and the United States. Both professional and do-it-yourself (DIY) cohorts are studied and the estimated working lifetime exposures are compared with benchmark values derived from an analysis of the epidemiological studies of FG and RSW manufacturing cohorts. The key finding of this analysis is that both of these end-user cohorts are likely to have substantially lower cumulative lifetime exposures than the manufacturing cohorts. As the most recent updates of the epidemiological studies concluded that there was no significant increase in respiratory system cancer among the manufacturing cohorts, there is likely to be even less risk for the installer cohorts. This analysis also underscores the wisdom of stewardship activities in the HSPP, particularly those directed at measuring and controlling exposure.

Horizontal diffusion elutriation: a new size-separation technique for preparation of rodent-respirable fibers for animal testing.

Short-and long-term animal experiments are used to examine the toxicology and biopersistence of various types of fibers. In order to ensure an adequate exposure dose for testing, modern experimental protocols specify that the exposure aerosol (in an inhalation test) or the fibers (in an intratracheal instillation [IT] test) must contain at least a minimum concentration of long (> 20 μm) rodent-respirable fibers. As produced and handled, most fibers contain a distribution of diameters and lengths, only some of which are both long and rodent-respirable. Therefore, it is necessary to size-separate the fibers to enrich the proportion of long, rodent-respirable fibers in the material to be tested. This article presents a new and relatively simple method for size separation that avoids some of the difficulties associated with other methods. The method, termed horizontal diffusion elutriation (HDE), is illustrated by size-separating refractory ceramic fiber (RCF) and four polycrystalline alumina (PCA) fibers.

Bentonite toxicology and epidemiology – a review

Abstract Bentonite, a clay with numerous industrial and consumer applications, is mined and processed in many countries of the world. Its many beneficial uses also create the potential for widespread occupational and consumer exposure. The available studies on toxicity and epidemiology indicate that the principal exposure pathway of concern is inhalation of respirable dust by occupationally exposed cohorts. Bentonite itself is probably not more toxic than any other particulate not otherwise regulated and is not classified as a carcinogen by any regulatory or advisory body, but some bentonite may contain variable amounts of respirable crystalline silica, a recognized human carcinogen. Therefore, prudent management and adherence to occupational exposure limits is appropriate. This review summarizes the literature available on production, applications, exposure, toxicity, and epidemiology of bentonite and identifies data gaps and limitations.