Objective: The authors examined the long-term health effects of occupational exposure to acrylamide among production and polymerisation workers. Methods: An earlier study of 371 acrylamide workers was expanded to include employees hired since 1979. In this updated study, 696 acrylamide workers were followed from 1955 through 2001 to ascertain vital status and cause of death. Exposure to acrylamide was retrospectively assessed based on personal samples from the 1970s onwards and area samples over the whole study period. Results: Fewer of the acrylamide workers died (n = 141) compared to an expected number of 172.1 (SMR 81.9, 95% CI 69.0 to 96.6). No cause-specific SMR for any of the investigated types of cancer was exposure related. The authors did, however, find more pancreatic cancer deaths than expected (SMR 222.2, 95% CI 72.1 to 518.5). With respect to non-malignant disease, more diabetes deaths were observed than expected (SMR 288.7, 95% CI 138.4 to 531.0). To assess the influence of regional factors, the analysis was repeated with an internal reference population. The elevated SMR for diabetes persisted. Conclusion: This study provides little evidence for a cancer risk from occupational exposure to acrylamide at production facilities. However, the increased rates of pancreatic cancer in this study and another larger study of acrylamide production workers indicate that caution is needed to rule out a cancer risk. The authors believe that the excess of diabetes mortality in this study is most likely not related to acrylamide exposure, because a larger study of acrylamide workers reported a deficit in this cause of death. The authors conclude that the increased SMR for diabetes mortality is probably not related to regional influences.
This study examines serum levels of 2,3,7,8-substituted chlorinated dioxins and furans, and PCBs for 375 Michigan workers with potential chlorophenol exposure, 37 Worker Referents, and 71 Community Referents. The chlorophenol workers were last exposed to trichlorophenol and/or pentachlorophenol 26-62 years ago. Employees working only in the trichlorophenol units had mean lipid-adjusted 2378-tetrachlorodibenzo-p-dioxin (TCDD) levels of 15.9 ppt compared with 6.5 ppt in the Worker Referents. Employees working only in the pentachlorophenol units had mean lipid-adjusted levels for 123478-H6CDD of 16.1 ppt, 123678-H6CDD of 150.6 ppt, 123789-H6CDD of 20.2 ppt, 1234678-H7CDD of 192.6 ppt, and OCDD of 2,594.0 ppt compared with the Worker Referent levels for the same congeners of 7.5, 74.7, 8.6, 68.7, and 509.1 ppt, respectively. All furan and PCB levels among workers in the trichlorophenol and/or pentachlorophenol departments were similar to the Worker Referents. The Tradesmen who worked throughout the plant had dioxin congener profiles consistent with both trichlorophenol and pentachlorophenol exposures. PCB levels and levels of 23478-P5CDF, 123478-H6CDF, and 123678-H6CDF were also greater in these Tradesmen than in the Worker Referents. The Worker Referent group had higher levels of dioxins and furans than the Community Referents indicating the potential for exposure outside the chlorophenol departments at the site. Distinct patterns of dioxin congeners were found many years after exposure among workers with different chlorophenol exposures. Furthermore, past trichlorophenol exposures were readily distinguishable from past pentachlorophenol exposures based on serum dioxin evaluations among workers. These data can be used to better assess dioxin exposures in future health studies.
Aim: To use biological monitoring data to evaluate the soundness of job based exposure classifications. Methods: The authors studied 52 chlorpyrifos manufacturing workers and 60 referent workers to compare chlorpyrifos exposure estimations from job titles and work areas to urinary excretion of 3,5,6 trichloro-2-pyridinol (TCP), a metabolite of chlorpyrifos. Work history records and industrial hygiene monitoring data were used to establish cumulative interim exposure. Chlorpyrifos exposure during the study year was assessed biologically by urinary excretion of TCP. Results: Exposure as measured by three urinary TCP samples was significantly higher among the chlorpyrifos workers (188 mg/l) than it was for the referent subjects (7 mg/l). Urinary TCP also correlated well with specific exposure categories of negligible (0.73-1.98 mg/m 3 days), low (1.99-4.91 mg/m 3 days), and moderate (4.92-15.36 mg/ m 3 days). The weighted Kappa coefficient was 0.80 (95% CI 0.72 to 0.87) for the mean TCP over the study period. Conclusions: The estimates of chlorpyrifos exposure based on job classifications and industrial hygiene measurements were significantly related to urinary TCP excretion, indicating that the ambient estimates are useful for providing exposure estimates among chlorpyrifos manufacturing workers. J ob titles, tasks, and work areas have been used in epidemiology studies as surrogate indicators of exposure to organophosphorus insecticides. However, biological exposure markers of specific organophosphorus compounds have not been used to confirm or quantify these estimates of workers' exposure. Monthly measurements of butyrylcholinesterase (BuChE, plasma cholinesterase) activity are often collected among chlorpyrifos applicators and manufacturing workers. Whereas the degree of inhibition of BuChE has been demonstrated to correlate with job based exposure categories, 1 BuChE is characterised by a high degree of intraindividual variability.2 3 Quantifying the excretion in urine of the principal metabolite of chlorpyrifos, 3,5,6-trichloro-2-pyridinol (TCP) as opposed to enzyme activity is a more specific marker of exposure. The purpose of the current analyses was to use urinary TCP data among chlorpyrifos manufacturing workers to validate the use of job based exposure classifications used in health studies. The present study was conducted as part of a prospective investigation of neurological and neurobehavioural function in chlorpyrifos manufacturing workers. 4 METHODSAll chlorpyrifos manufacturing workers employed at a Michigan facility on 1 September 1999 were asked to participate. Saran manufacturing workers were chosen as a referent population. Fifty two of the 66 eligible chlorpyrifos workers (80%) participated and 60 of the 74 (81%) randomly selected Saran workers participated. The referent workers were similar to the chlorpyrifos workers with respect to age (mean 41 years for both), weight (88 kg for both), and education (14 years for both).Measurements of urinary TCP excretion were collected from each subject o...
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