April 2020 additions to NERDB part 1

NERDB is the New and emerging risks database. This bibliographic database is an initiative of Nicole Palmen and Annet Lenderink with the support of Modernet and is currently powered by Airtable.

More information on this database on the NERDB page

On the website we will publish from this month on regular updates on new disease – exposure combinations we added to the database. Currently, we have 227 entries. Ordered by year in which the abstract is published

1977	1	2010	11
1988	1	2011	10
1995	3	2012	10
1997	1	2013	13
1999	2	2014	19
2002	1	2015	27
2005	2	2016	21
2006	1	2017	35
2007	2	2018	30
2008	5	2019	27
2009	3	2020	1
unknown year	6

Last new entries

Arslan, S, Uzunhasan, I, Kocas, BB, et al. Effect of chronic toluene exposure on heart rhythm parameters. Pacing Clin Electrophysiol. 2018; 41: 783– 787. https://doi.org/10.1111/pace.13381

Toluene is used extensively in various industrial processes, and an increasing number of workers are getting exposed to its vapor. Cardiac abnormalities that have been reported in association with toluene exposure (in toxic doses) are atrioventricular conduction abnormalities, sinus bradycardia, ventricular tachycardia, recurrent myocardial infarction, dilated cardiomyopathy, and coronary vasospasm. This study aimed to investigate the effects of chronic toluene exposure on cardiac rhythm.

In this study, 40 workers in the polishing industry with more than 3 months of exposure to a mixture of organic solvents including toluene and 38 control subjects working in other fields who were matched by age, sex, smoking, habits, and living accommodation were investigated.

The maximum heart rate was significantly lower in the toluene-exposed group compared to the control group (130.5 ± 15.1 vs 138.6 ± 16.0, P = 0.02). Corrected low frequency (cLF) and cLF/corrected high frequency (cHF) were also significantly lower in the toluene-exposed group. Mean cHF, root-mean-square successive difference, and standard deviation of all five-minute NN interval means values were significantly higher in the toluene-exposed group.

This study implies that chronic toluene exposure disturbs cardiac autonomy, particularly by suppressing sympathetic activity, and parasympathetic suppression also occurs with increased exposure duration. We also demonstrated that chronic toluene exposure was not associated with major cardiac arrhythmias and rhythm conduction system disorders.

Clofent, D., de Homdedeu, M., Muñoz-Esquerre, M., Cruz, M. J., & Muñoz, X. (2020). Sudan red dye: a new agent causing type-2 occupational asthma. Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 16, 7. https://doi.org/10.1186/s13223-020-0404-8

Sudan red or 1-[(2-methoxyphenyl)azo]-2-naphthol is a low molecular weight azoic agent widely used in industry, particularly in the production of hair dyes. The use of this product in the food industry is prohibited due to its potential carcinogenic effect, but no respiratory involvement has been reported to date. We present the case of a 46-year-old female patient who had been working in a cosmetics packaging company for 20 years. The patient developed occupational asthma to a red azo dye known as Sudan red. The diagnosis was confirmed by a specific bronchial provocation test. Induced sputum samples were obtained previously and in the 24 h following the procedure, with a rise in the percentage of eosinophils from 10 to 65%. This report describes the case of a patient who developed OA caused by exposure to an azoic dye called Sudan red. The clinical and analytical features suggest a type 2-related asthma; however, we are not yet able to confirm the specific pathophysiological mechanism. The extensive use of azo dyes in the industry means that it is particularly important to describe their implications for health, which are probably underestimated at present.

Yeo, C. D., Han, D., Lee, J., Chung, W. B., Jung, J. I., Lee, K. Y., Kim, T. J., Jang, W., Kim, M., & Kang, J. Y. (2019). A case of early diagnosis of pulmonary capillary hemangiomatosis in a worker with exposure to silica. BMC pulmonary medicine, 19(1), 133. https://doi.org/10.1186/s12890-019-0896-5

Pulmonary capillary hemangiomatosis (PCH) is a progressive and refractory vascular disease in the lung. A 29-year-old female who had worked at a bathtub factory presented with progressive exertional dyspnea for the past 2 years. Computed tomography revealed centrilobular, diffusely spreading ground-glass opacities sparing subpleural parenchyma with some cystic lesions and air-trapping in both lungs, suggesting a peculiar pattern of interstitial lung disease with airway involvement. There was not any evidence of right heart failure or pulmonary hypertension on echocardiogram, as well as radiography. Microscopic examination of the lung by thoracoscopic resection showed atypical proliferation of capillary channels within alveolar walls and interlobar septa, without invasion of large vessels. We diagnosed PCH in a young female complaining progressive dyspnea with prior exposure to occupational silica or organic solvent without elevated right ventricular systolic pressure (RVSP) who showed an atypical pattern of radiologic findings.