February 2022 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 Airtable.

More information on this database on the NERDB page

On the website, we will publish regular updates on new disease-exposure combinations we added to the database. Currently, we have 330 entries. Ordered by year in which the abstract is published

1977	1	2010	11
1988	1	2011	10
1991	1	2012	10
1995	3	2013	13
1997	1	2014	19
1999	2	2015	27
2002	1	2016	21
2005	2	2017	35
2006	1	2018	30
2007	2	2019	51
2008	5	2020	52
2009	3	2021	16
unknown year	6	2022	3

Last new entries:

Grosselin, M., Bouazzi, L., Ferreira de Moura, T., Arndt, C., Thorigny, M., Sanchez, S., & Denoyer, A. (2022). Severe Primary Open-Angle Glaucoma and Agricultural Profession: A Retrospective Cohort Study. International Journal of Environmental Research and Public Health, 19(2), 926.

While exposure to pesticides is a known risk factor for neurodegenerative brain diseases, little is known about the influence of environment on glaucoma neuropathy.

The authors aimed to determine whether farmers are at higher risk of developing severe primary open-angle glaucoma (POAG). They used a retrospective cohort study (tertiary referral center, Reims University Hospital, France) that included patients diagnosed with POAG in the last two years. Univariate analysis and adjusted multivariate logistic regression were performed to evaluate the association between agricultural profession and all recorded data. Glaucoma severity (primary outcome) and the number of patients who underwent filtering surgery (secondary outcome) were analyzed.

In total, 2065 records were screened, and 772 patients were included (66 in the farmer group and 706 in the non-farmer group). The risk of severe glaucoma was higher in the farmer group (adjusted odds ratio (aOR) 1.87, p = 0.03). More patients underwent filtering surgery in the farmer group in univariate analysis (p = 0.02) but with no statistical significance after adjustment (p = 0.08).

These results suggest pesticide exposure may be a factor accelerating the neurodegeneration in POAG, although a direct link between the agricultural profession and the disease requires further extended studies to be demonstrated.

Cooke, R. (2022). Palmaris brevis spasm syndrome in manual workers using vibratory tools. Occupational Medicine, 72(1), 51-54.

Palmaris brevis spasm syndrome (PBSS) appears to reflect benign muscle hyperactivity, with unprovoked recurrent spasm of the muscle and consequent dimpling of the hypothenar eminence. Two cases are reported, being the first known report of the condition among manual workers or those using vibratory tools. Each was diagnosed during routine health surveillance for hand–arm vibration syndrome.

With hand cramps being a frequent report among vibration-exposed workers, this condition should be considered in such cases, although the lack of reports means that the frequency of the condition is unknown. One of the employees described more frequent episodes of spasm during periods of increased manual work. Diagnosis is possible by witnessing the characteristic spasm, or by viewing photographs of it. Functional impairment is not usual, except for the brief duration of an attack. There is no consensus regarding appropriate treatment.

Wójcik-Fatla, A., Mackiewicz, B., Sawczyn-Domańska, A. et al. Timber-colonizing gram-negative bacteria as potential causative agents of respiratory diseases in woodworkers. Int Arch Occup Environ Health (2022). https://doi.org/10.1007/s00420-021-01829-1

Occurrence: Gram-negative bacteria occur commonly in the inner tissues of stored coniferous and deciduous timber, showing a marked variation in numbers. The greatest maximal numbers are found in the sapwood of coniferous timber. The common constituents of the Gram-negative biota are potentially pathogenic species of Enterobacteriaceae family of the genera Rahnella, Pantoea, Enterobacter, and Klebsiella. The air of wood-processing facilities is polluted with the wood-borne Gram-negative bacteria and produced by them endotoxin, as demonstrated worldwide by numerous studies.

Effects: There are three potential pathways of the pathogenic impact of wood-borne Gram-negative bacteria on exposed woodworkers: allergic, immunotoxic, and infectious. The allergic impact has been underestimated for a long time in relation to Gram-negative bacteria. Hopefully, the recent demonstration of the first documented case of hypersensitivity pneumonitis (HP) in woodworkers caused by Pantoea agglomerans which developed in extremely large quantities in birch sapwood, would speed up the finding of new wood-related cases of HP caused by Gram-negative bacteria.

The second pathway is associated with endotoxin, exerting strong immunotoxic (excessively immunostimulating) action. It has been demonstrated that endotoxin is released into wood dust in the form of nano-sized microvesicles, by peeling off the outer membrane of bacteria. Endotoxin microvesicles are easily inhaled by humans together with dust because of their small dimensions and aerodynamic shape. Afterward, they cause a nonspecific activation of lung macrophages, which release numerous inflammatory mediators causing an inflammatory lung reaction, chest tightness, fever, gas exchange disorders, and bronchospasm, without radiographic changes. The resulting disease is known as “Organic Dust Toxic Syndrome” or “toxic pneumonitis.”

The potential third pathway of pathogenic impact is infection. The suspected species is Klebsiella pneumoniae which may occur commonly in wood dust; however, until now this pathway has not been confirmed.

Conclusion: Summarizing, Gram-negative bacteria-inhabiting timber should be considered, besides filamentous fungi and actinobacteria, as important risk factors of occupational disease in woodworkers that could be either HP with allergenic background or toxic pneumonitis elicited by endotoxin.