Lens Opacifications Detected by Slitlamp Biomicroscopy Are Associated With Exposure to Organic Nitrate Explosives

Lewis-Younger, Cynthia R.; Mamalis, Nick; Egger, Marlene J.; Wallace, David O.; Lu, Chun Ching

doi:10.1001/archopht.118.12.1653

Cited by 9 publications

(9 citation statements)

References 5 publications

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“…Only one previous cross‐sectional study used a control group and controlled for confounding factors (Lewis‐Younger et al 2000). Surprisingly, they found TNT‐like cataract (peripheral flecks) in 14% of the presumed unexposed workers.…”

Section: Discussionmentioning

confidence: 99%

“…The big differences in prevalences of TNT cataract in the studied populations probably reflect differences in exposure. In general, estimation of exposure is difficult due to various routes of uptake and because information on exposure is often limited as to duration (Manoilova 1968; Zhou 1990; Lewis‐Younger et al 2000). In one study, however, a more exact dose− effect relation was established in a small group of workers (Liu et al 1995).…”

Section: Introductionmentioning

confidence: 99%

“…All the studies mentioned above were uncontrolled case series. Lewis‐Younger et al (2000) presented the first large study including a control group. They discovered that 63% of the workers ( n = 61) had anterior cortical lens opacification in a pattern of peripheral flecks.…”

Section: Introductionmentioning

confidence: 99%

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Trinitrotoluene (TNT)‐induced cataract in Danish arms factory workers

Kruse

Hertel

Hindsholm

et al. 2005

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To compare the prevalence of cataract in workers exposed to trinitrotoluene (TNT) to the prevalence in a group of unexposed workers, matched on age and sex, using Tiukina's description and grading of TNT-induced cataract. Methods: A total of 23 TNT-exposed and 44 unexposed workers underwent an eye examination performed by an ophthalmologist who did not know the exposure status of the subjects. All lens opacities matching Tiukina's description were classified as TNT cataract and graded on Tiukina's scale of stages 1-4. Results: Four cases of TNT-induced cataract were identified among the 23 TNT-exposed workers and none in the unexposed group (p < 0.01). Conclusion: Exposure to TNT may cause a unique type of cataract, which a general ophthalmologist, using Tiukina's description and grading scale, will be able to distinguish from other cataracts.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Trinitrotoluene (TNT)‐induced cataract in Danish arms factory workers

Kruse

Hertel

Hindsholm

et al. 2005

Acta Ophthalmologica Scandinavica

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“…It is due to minimal antioxidant enzyme activity for defence against reactive oxygen species exogenously produced in the lens [10,11]. Ring-shaped cataract is a rare type of cataract that has been reported by few studies [12][13][14][15]. It was rst observed in a 10 years old girl with a positive family history [16] and miners [12].…”

Section: Introductionmentioning

confidence: 99%

Ring Shaped Cataract and Urinary Metabolites Among 2,4,6-trinitrotoulene Exposed Population of Pakistan

Sarwat¹,

Akhtar²,

Dayan³

et al. 2021

Preprint

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Background: Safety protocols are usually neglected among most of the TNT exposed population, therefore, rendering the community prone to various occupational hazards. The current study highlights ring shaped cataract and urinary metabolites of TNT among TNT exposed population (n=26) against a control group (n=20).Methods: An observational case-control study was carried out in two groups: 300 subjects exposed to TNT in Dir and Bajour Agency, Pakistan and a control group from the base hospital. We determined the presence of ring shaped cataract and urine metabolites of TNT using slit lamp biomicroscope and gas chromatography mass spectrometric analysis respectively.Results: Results substantiate a high level of urine metabolites for exposed subjects compared to the control group (p<0.001). Age had no significant effect on (p>0.05) on presence of ring shaped cataract and the level of urinary metabolites of TNT, while duration of exposure showed significant effect (p<0.001). Females showed high incidence of ring shaped cataract and urinary metabolites of TNT than men ( p<0.001). The mean age of the exposed subjects was 51±14.38 (Mean+SD) years. The mean year of exposure was 49±5 (Mean+SD) years,Conclusion: This study showed TNT as a risk factor for the presence of ring-shaped cataract among TNT exposed group in Pakistan. It is important to screen exposed community for the presence of ring-shaped cataract, and pre-clinical identification of TNT adducts to prevent systemic complications.

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“…Severe health effects including arrhythmias are seen at methemoglobin levels above 50% and death occurs at levels above 70%. 6 8 Cataracts develop in TNT workers in the lens periphery and serve as a marker of TNT exposure.9, 10 Further, liver damage occurs at low-to-moderate TNT exposure levels, and evidence of hepatocellular damage may be detected in the blood. Lactate dehydrogenase (LDH) and aspartate transaminase become elevated in the blood at TNT levels below 1.0 mg/m3.…”

Section: Introductionmentioning

confidence: 99%

Investigation of an Outbreak of Anemia Cases at an Army Trinitrotoluene Munitions Production Plant From 2004 to 2005 and Subsequent Surveillance 2005–2013

et al. 2014

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TNT levels rose at a munitions plant until ventilation changes reduced exposures. Despite this, anemia cases continued to rise until the commander held workers accountable for failing to wear PPE and motivated them to wear respirators to avoid a loss in pay. The case definition of anemia was revised to be consistent with the case definition used by private physicians who practiced in the community. Better coveralls are needed, which are easy to wear, reduce static discharge, and prevent TNT skin absorption.

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Lens Opacifications Detected by Slitlamp Biomicroscopy Are Associated With Exposure to Organic Nitrate Explosives

Cited by 9 publications

References 5 publications

Trinitrotoluene (TNT)‐induced cataract in Danish arms factory workers

Trinitrotoluene (TNT)‐induced cataract in Danish arms factory workers

Ring Shaped Cataract and Urinary Metabolites Among 2,4,6-trinitrotoulene Exposed Population of Pakistan

Investigation of an Outbreak of Anemia Cases at an Army Trinitrotoluene Munitions Production Plant From 2004 to 2005 and Subsequent Surveillance 2005–2013

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