Shigeki Koda

Genotoxicity and cytotoxicity of multi-wall carbon nanotubes in cultured Chinese hamster lung cells in comparison with chrysotile A fibers.

Genotoxicity and Cytotoxicity of Multi‐wall Carbon Nanotubes in Cultured Chinese Hamster Lung Cells in Comparison with Chrysotile A Fibers: Masumi Asakura, et al. Japan Bioassay Research Center, Japan Industrial Safety and Health Association

Use of a Closed System Device to Reduce Occupational Contamination and Exposure to Antineoplastic Drugs in the Hospital Work Environment

OBJECTIVES The aim of the preset study was to evaluate the applicability of a closed system device to protect against occupational contamination and exposure to antineoplastic drugs in the work environment of a hospital. METHODS We compared the contamination by and exposure to cyclophosphamide (CPA) between a conventional mixing method and a mixing method using a closed system device. Wipe samples in the preparation room, gloves samples and 24-h urine samples of pharmacists preparing antineoplastic drugs were collected. Working surfaces inside the biological safety cabinet (BSC), front side of the air grilles of the BSC, stainless steel trays, working table and floor were wiped. At first, sample collection was done on 5 days over an interval of 2 weeks using the conventional mixing method. After 2 weeks training for using the closed system device, sample collection was done 5 days over an interval of 2 weeks using the closed system device. RESULTS When pharmacists prepared antineoplastic drugs by the conventional method, CPA was detected from all wipe samples, and the mean and median concentrations of CPA were 1.0 and 0.16 ng cm(-2), respectively (range was from 0.0095 to 27 ng cm(-2)). When pharmacists prepared antineoplastic drugs with a closed system device, CPA was detected from 75% of the wipe samples at mean and median concentrations of 0.18 and 0.0013 ng cm(-2), respectively (the range was from lower than detection limit to 4.4 ng cm(-2)). Using the closed system device significantly reduced the surface contamination of CPA for all wipe sampling points in the preparation room (Mann-Whitneys U-test). The range of CPA of glove samples used in the conventional method and closed system device ranged from lower than detection limit to 3200 ng per glove-pair and from lower than detection limit to 740 ng per glove-pair, respectively. Using the closed system device significantly reduced the gloves contamination of CPA (Mann-Whitneys U-test). The range of urinary CPA of six pharmacists preparing the antineoplastic drugs with the conventional method and closed system device ranged from lower than detection limit to 170 ng day(-1) and from lower than detection limit to 15 ng day(-1), respectively. Using the closed system device significantly reduced the amount of urinary CPA in pharmacists preparing the antineoplastic drugs (Wilcoxons signed ranks test). CONCLUSIONS We concluded that a closed system device can reduce occupational contamination and exposure to antineoplastic drugs in the hospital work environment.

Polychlorinated dibenzo-p-dioxin and dibenzofuran concentrations in the serum samples of workers at continuously burning municipal waste incinerators in Japan

OBJECTIVES To find whether concentrations of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) in serum increased in workers at municipal incinerators that burn continuously. METHODS 30 Workers employed at three municipal waste incineration plants (incinerator workers) and 30 control workers were studied. The incinerator workers had worn dust masks or airline masks during the periodic repair work inside the incinerators. Previous job, dietary habit, smoking habit, distance from residence to the incineration plant, and body weight and height were obtained from a questionnaire survey. Concentrations of PCDDs/PCDFs were measured in the serum of the workers and the dust deposited in the plants. The influence of various factors on serum concentrations of PCDDs/PCDFs was examined by multiple regression analysis. RESULTS Dust analysis showed the greatest amount of octachlorodibenzo-p-dioxin (OCDD), followed by 1,2,3,4,6,7,8-heptachlorodibenzo-p-dioxin (HpCDD), 1,2,3,4,6,7,8-heptachlorodibenzofuran (HpCDF), and octachlorodibenzofuran (OCDF). The toxicity equivalents (TEQs) of PCDDs and PCDFs in the deposited dust were 4.8, 1.0, and 6.4 ng TEQs/g, respectively, for plants A, B, and C. The mean serum TEQs of PCDDs and PCDFs in the incinerator workers and control workers were 19.2 and 22.9 pg TEQs/g lipid, respectively, for area A, 28.8 and 24.5 pg TEQs/g lipid for area B, and 23.4 and 23.6 pg TEQs/g lipid for area C. No significant differences were found between the incinerator workers and the controls for TEQs of PCDDs and PCDFs separately, and TEQs of PCDDs and PCDFs together. However, the serum 1,2,3,4,6,7,8-HpCDF concentration was significantly higher in the incinerator workers than in the controls for all the three areas. When the exposure index to 1,2,3,4,6,7,8-HpCDF is defined as the product of the concentration of 1,2,3,4,6,7,8-HpCDF in the deposited dust and duration of employment, the concentration of 1,2,3,4,6,7,8-HpCDF in serum increased as the exposure index increased. Multivariate analysis suggested that the serum concentration of HpCDF increased with duration of employment at the incineration plants and OCDF increased with employment of ⩾21 years. The other significant variables (p<0.01 or p<0.001) were area for hexachlorodibenzo-p-dioxin (HxCDD) and tetrachlorodibenzofuran (TCDF), Brinkman index for HpCDD, and body mass index (BMI) for tetrachlorodibenzo-p-dioxin (TCDD), HpCDD, and TEQs of PCDDs. CONCLUSION The serum TEQs of PCDDs and PCDFs was not significantly higher among the incinerator workers, but the serum concentration of 1,2,3,4,6,7,8-HpCDF was. This suggests that the incinerator workers had inhaled dust containing PCDDs and PCDFs while working in plants equipped with incinerators that burn continuously.

Association between occupational exposure levels of antineoplastic drugs and work environment in five hospitals in Japan

Purpose. The aim of the present study was to evaluate the measurement of contamination by antineoplastic drugs for safer handling of such drugs by medical workers. We investigated the relationship between the contamination level of antineoplastic drugs and the conditions of their handling. Methods. Air samples and wipe samples were collected from equipment in the preparation rooms of five hospitals (hospitals A—E). These samples were subjected to measurement of the amounts of cyclophosphamide (CPA), fluorouracil (5FU), gemcitabine (GEM), and platinum-containing drugs (Pt). Twenty-four-hour urine samples were collected from the pharmacists who handled or audited, the antineoplastic drugs were analyzed for CPA and Pt. Results. Pt was detected from air samples inside BSC in hospital B. Antineoplastic drugs were detected from wipe samples of the BSC in hospitals A, B, D, and E and of other equipment in the preparation rooms in hospitals A, B, C, and D. Cyclophosphamide and 5FU were detected from wipe samples of the air-conditioner filter in hospital A, and CPA was detected from that in hospital D. Cyclophosphamide was detected from urine samples of workers in hospitals B, D, and E. Conclusion. The contamination level of antineoplastic drugs was suggested to be related with the amount of drugs handled, cleaning methods of the equipment, and the skill level of the technique of maintaining negative pressure inside a vial. In order to reduce the contamination and exposure to antineoplastic drugs in the hospital work environment very close to zero, comprehensive safety precautions, including adequate mixing and cleaning methods was required in addition to BSC and closed system device.

The Differential Influence of Distinct Clusters of Psychiatric Symptoms, as Assessed by the General Health Questionnaire, on Cause of Death in Older Persons Living in a Rural Community of Japan

OBJECTIVES: To examine the influence of distinct clusters of psychiatric symptoms on subsequent cause‐specific mortality in older persons living in the community.

Association between Occupational Exposure and Control Measures for Antineoplastic Drugs in a Pharmacy of a Hospital

OBJECTIVES To investigate the association between occupational contamination and exposure levels to antineoplastic drugs and the application of control measures in a hospital work environment. METHODS Wipe samples of equipments were collected at a hospital in Osaka Prefecture, Japan, from 2007 to 2011. These samples were subjected to measurements of cyclophosphamide (CP), gemcitabine (GEM), platinum-containing drugs (Pt), and fluorouracil (5FU). Additionally, 24-h urine samples were collected from pharmacists who handled antineoplastic drugs, which were analyzed for CP and alpha-fluoro-beta-alanine (AFBA). The application of control measures was scored according to a checklist, which consisted of the following five items: safety equipment and maintenance, training and documentation, devices for safe handling, personal protective equipment, and emergency care. The aim was to obtain a score of 80%. RESULTS The median CP, GEM, and 5FU concentrations of all wipe samples were significantly lower during the period when the mean score was >80% (attainment period) versus when the mean score was ≤80% (nonattainment period; all P < 0.001, Mann-Whitneys U-test). Additionally, the median urinary CP and AFBA concentrations of pharmacists during the attainment period tended to be lower than that of those during the nonattainment period (P = 0.061 and 0.061, respectively, using Mann-Whitneys U-test). CONCLUSIONS Contamination and levels of exposure to antineoplastic drugs decreased with a score higher than 80%. The scores of the items on the checklist appeared to adequately reflect the condition of the control measures, as increases in all five items were associated with reductions in the contamination by and levels of exposure to all drugs.

Relationship of job stress with nicotine dependence of smokers--a cross-sectional study of female nurses in a general hospital.

The degree of nicotine dependence is an important predictor of successful cessation of smoking among smokers. Some investigators reported a possible relationship between reducing job stress and successful smoking cessation . This may be attributable to the effect of job stress on nicotine dependence. That is, high levels of job stress could produce and/or maintain high levels of nicotine dependence among smokers, and could result in difficulty in smoking cessation. If this hypothesis were true, workplace smoking cessation programs should take account of the influence of job stress on nicotine dependence, and measures to curb nicotine dependence resulting from coping with job stress should be introduced into the programs. There are, however, few reports that deal with the influence of job stress on the nicotine dependence of smokers in the workplace. Tobacco dependence is a multi-dimensional addiction that includes psychological and behavioral aspects of dependence on smoking or nicotine as well as physiological dependence 7, . It is important to measure various aspects of nicotine dependence separately. Two short and easyto-apply self-reporting questionnaires are frequently used to screen for nicotine dependence. They are the Fagerstrom Test of Nicotine Dependence (FTND) 2) and the Tobacco Dependence Screener (TDS). They evaluate different aspects of nicotine dependence. The FTND assesses the physiological aspects of nicotine dependence and is positively associated with the number of cigarettes smoked per day and the plasma level of nicotine and cotinine 2, . On the other hand, the TDS is closely correlated with the psychological aspects of nicotine dependence; a TDS score of 6 or greater indicates nicotine dependence diagnosed according to the International Classification of Diseases, 10 revision (ICD-10), and the Diagnostic and Statistical Manual of Mental Disorders, third edition revised (DSM-III-R), with sensitivity values of 95% and 79%, and specificity values of 81% and 66%, respectively. In addition, previous studies reported a poor concordance between the FTND score and the DSM-III-R diagnosis; Moolchan et al. showed that the highest kappa (at a cutoff of the FTND=7 or greater) was .205. The objective of this cross-sectional study was to examine the relationship between perceived job stress and nicotine dependence assessed with two self-reporting questionnaires (i.e., the FTND and TDS) completed by workers who smoked tobacco. Nurses were chosen as subjects in this study. They are health professionals with a reportedly high prevalence of smoking ; in addition, they are expected to act as role models for patients with a desire to quit smoking. Elkind has reported that certain peculiar characteristics associated with the hospital environment and the nursing process may contribute to the smoking habits of nurses. Nurses deserve special attention in developing a smoking cessation program which considers the influence of job stress on the smoking habit.

Preventive Effects on Low Back Pain and Occupational Injuries by Providing the Participatory Occupational Safety and Health Program

Preventive Effects on Low Back Pain and Occupational Injuries by Providing the Participatory Occupational Safety and Health Program: Shigeki Koda, et al. Department of Public Health, Kochi Medical School—The goal of the study was to estimate the effects of a participatory occupational safety and health (OSH) program on the incidence of low back pain (LBP) and occupational injuries (Ols). This participatory OSH program was introduced in the Tokyo Metropolitan Bureau of Waste Management in 1986. The authors examined the incidence rates of LBP and Ols with lost working time and/or medical care cost. The incidence rate per 100 full‐time employees was calculated from 2,297 claimed cases of LBP and 9,272 claimed ones of Ols from 1984 to 1994. The strategy of a participatory OSH program, which developed original rule‐based OSH activities, included two factors: OSH activities that involved employees and employers from 1986 to 1990, and have been promoted by employee participation since 1991. The incidence rates for LBP and Ols have decreased from 2.73 and 8.30 per 100 full‐time employees in 1986 to 0.87 and 5.02 in 1994, respectively. The participatory OSH program, which has promoted employee‐employer involvement and employee participation, is effective in preventing LBP and Ols in the workplaces.

Polychlorinated dibenzo-p-dioxin and dibenzofuran concentrations in serum samples of workers at an infectious waste incineration plant in Japan.

In 1998–2000, concentrations of summed polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) in the exhaust gas of an infectious waste incineration plant were 17–510 ng toxic equivalents (TEQ)/m3, which reached levels above the Japanese legal limit value of 80 ng TEQ/m3. The incinerator ceased operation in November 2000. This study was aimed at determining whether the incinerator workers were exposed to high levels of PCDDs and PCDFs. Blood samples of five workers were collected at 1 month and 16 months after the end of the occupational dioxin exposure. For comparison, blood samples were also collected from control subjects. Ash remaining in the incinerator and dust deposited around the conveyer and incinerator areas were collected; TEQ values were 44 and 10 ng TEQ/g, respectively. A month after the end of occupational dioxin exposure, mean TEQ for the workers was 49.1 pg TEQ/g lipid, which was 2.7 times as high as that for the controls. At 16 months, the mean TEQ for the workers decreased to 29.4 pg TEQ/g lipid, which was 1.6 times that for the controls. Ratios of serum level of each congener of PCDDs and PCDFs between 1 and 16 months after exposure were 0.44 to 0.69. This study showed that the serum dioxin levels for the infectious waste incinerator workers were higher than the controls, and the serum dioxin level decreased after the end of the occupational dioxin exposure.

Secular Trends and Geographical Variations in the Dietary Intake of Polybrominated Diphenyl Ethers (PBDEs) Using Archived Samples from the Early 1980s and Mid 1990s in Japan

Secular Trends and Geographical Variations in the Dietary Intake of Polybrominated Diphenyl Ethers (PBDEs) Using Archived Samples from the Early 1980s and Mid 1990s in Japan: Yasuhiko Wada, et al. Hyogo College of Medicine—A retrospective exposure assessment among the general population for polybrominated diphenyl ethers (PBDEs) was conducted using dietary surveys. We analyzed samples of food duplicate portions collected in the early 1980s (1980 survey: N=40) and the mid 1990s (1995 survey: N=39) from female subjects (5 participants from each of 8 sites per survey except for one site) living throughout Japan, from the north (Hokkaido) to the south (Okinawa). The study populations in the 1980 and 1995 surveys were different, but lived in the same communities. We measured four PBDE congeners [2,2’,4,4’‐tetrabrominated diphenyl ether (tetraBDE): #47; 2,2’,4,4’,5‐pentaBDE: #99; 2,2’,4,4’,6‐pentaBDE: #100; and 2,2’,4,4’,5,5’‐hexaBDE: #153] in the diet. #99 was the most abundant congener in the diet (49% of the total PBDEs), followed by #47 (33%), #100 (12%) and #153 (6%). Regional variations found in the 1980 survey decreased in the 1995 survey. The total daily intake of PBDEs (ng/d) [GM (GSD)] in the 1980 survey [91.4 (4.1)] was not significantly different from that in the 1995 survey [93.8 (3.4)] for the total population, nor did it differ among the sites including Shimane, in which a 20‐fold increase in serum concentrations was observed in the same population1). In consideration of the significant increases in the serum concentration, inhalation may be more important than food ingestion as the route of human exposure to PBDEs.