December 2019 additions to NERDB

December 2019 additions to NERDB

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 Obvibase.

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 221 entries. Ordered by year in which the abstract is published

20093unknown year6

Last new entries

Photo by André François McKenzie on Unsplash

Guarnieri G, Bizzotto R, Gottardo O, et al Multiorgan accelerated silicosis misdiagnosed as sarcoidosis in two workers exposed to quartz conglomerate dust Occupational and Environmental Medicine 2019;76:178-180.

Clusters of silicosis cases have been reported in the fabrication of quartz conglomerate, a new high-silica-content artificial stone for kitchen and bathroom benchtops (countertops). The authors describe two cases of accelerated-type silicosis with hepatic granulomas arising in workers exposed to artificial quartz conglomerates. A confident diagnosis of multiorgan silicosis was based on a high level of respirable silica in the workplace, typical radiological alterations in chest high-resolution CT, histological findings in the lung and liver, and detection of silica crystals in both tissues by phase-contrast polarising light microscopy and scanning electron microscopy and energy dispersive spectroscopy. The development of the disease <10 years after the first exposure is consistent with an accelerated-type of silicosis. Compared with other studies related to quartz conglomerate exposure, we determined that the levels of airborne crystalline silica during activity in the finishing area were between 0.260 and 0.744 mg/m3, that is, much higher than the threshold limit value according to American Conference of Governmental Industrial Hygienists (0.025 mg/m3). Moreover, liver granulomas were associated with the accumulation of crystalline silica particles in the hepatic tissue. Quartz conglomerate fabrication is a potentially dangerous occupation. General practitioners and physicians should have awareness of this newly described occupational hazard. Accurate occupational history is critical in avoiding misdiagnosis, as silicosis caused by inhalation of dust from artificial quartz conglomerates may exhibit atypical presentation. These features seem to be related to the extremely high level of silica exposure and, possibly, to increased toxicity of the dust generated in this process.

Gravel S, Lavoué J, Bakhiyi B, Diamond ML, Jantunen LM, Lavoie J, Roberge B, Verner MA, Zayed J, Labrèche F. Halogenated flame retardants and organophosphate esters in the air of electronic waste recycling facilities: Evidence of high concentrations and multiple exposures Environment International Volume 128, July 2019, Pages 244-253

In response to a worldwide increase in the production of electronic waste, the e-recycling industry is rapidly growing. E-recycling workers are exposed to many potentially toxic contaminants, among which flame retardants (FRs), mainly suspected of being endocrine disruptors, are thought to be the most prevalent. The objective of this study was to conduct an exposure assessment of four chemical groups of FRs in Canadian e-recycling facilities and to identify the main cofactors of exposure.
Personal air samples were collected over a workday for 85 workers in six e-recycling facilities, grouped into three facility sizes, and for 15 workers in control commercial waste facilities. Sociodemographic data, tasks performed and materials processed by participating workers were recorded.
Thirty-nine of the 40 FRs analysed were detected in at least one air sample in e-recycling, and workers in this industry were exposed on average to 26 (range 12 to 39) different substances. The most detected FRs in e-recycling were PBDEs (polybrominated diphenyl ether) ranging from 120 to 5100 ng/m3), followed by OPEs ( organophosphate esters) with 740 to 1000 ng/m3, NBFRs (novel brominated) with 7.6 to 100 ng/m3, and finally ClFRs ( chlorinated) with 3.9 to 32 mg/m3. The most important cofactor of exposure was the size of the e-recycling facility, with the largest one presenting on average 12 times the concentrations found in the control facility. Among tasks as potential cofactors of exposure, manual dismantling and baler operation exposed workers to some of the highest concentrations of PBDEs and ClFRs. There was a reduction of up to 27% in exposure to FRs associated with a 3-year increase in seniority. Finally, particulate matter concentrations in e-recycling facilities were highly correlated with all chemical classes except OPEs and were higher in the large facility. The authors conclude that among the FRs analyzed, PBDE exposure was particularly high in e-recycling. Dust and particulate matter reduction strategies in these workplaces, together with training on proper working practices would certainly be important first steps to lower occupational exposures and prevent potential health effects.

Madsen, M. T., Skadhauge, L. R., Nielsen, A. D., Baelum, J., & Sherson, D. L. (2019). Pyromellitic dianhydride (PMDA) may cause occupational asthmaOccupational and environmental medicine76(3), 175–177. doi:10.1136/oemed-2018-105295

Anhydrides are widely used as cross-linking agents in epoxy resins and alkyd production, for example, as coatings and adhesives in plastic products. Sensitization to several anhydrides is known to cause occupational asthma. There are indications that the lesser-known pyromellitic dianhydride (PMDA) can cause irritative respiratory symptoms and possibly asthma. We report three cases of workers from a plastic foil manufacturing plant, who developed asthma when exposed to PMDA during specific inhalation challenge (SIC). All cases experienced a delayed decrease in forced expiratory flow in 1 s (FEV1) 4–12 hours after active challenge. FEV1 decreased by 19%, 15%, and 16%, respectively. After 21 hours, FEV1 decreased by 24% in one worker. Respiratory symptoms after working hours may represent delayed work-related asthma. During SIC, the three patients developed lower respiratory symptoms and a delayed decrease in FEV1 which suggests sensitization. The mechanism of anhydride-related asthma is not well understood. Anhydrides are known irritants and hence an irritative response cannot be excluded. The company improved ventilation and enforced the use of respiratory protection equipment, and finally phased out PMDA. Occupational workplace risk identification may help to identify exposures. SIC can contribute to improving working conditions, by identifying and confirming asthmogens in the environment.



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