February 2024 additions to NERDB

February 2024 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 is on the NERDB page

We will publish regular updates on new disease-exposure combinations we added to the database on the website. Currently, we have 408 entries. Ordered by the year in which the abstract is published

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New entries:

Pesticides spraying – picture by Pixabay

Galli G, De Pous-Gerardin C, Hanguehard R, Berthy F, Le Moal C, Lourde C, Barnetche T, Skopinski S, Contin-Bordes C, Delva F, Carles C, Truchetet ME. Occupational quantitative exposure to crystalline silica, solvents, pesticides, and risk of clinical forms of systemic sclerosis. Rheumatology (Oxford). 2023 Nov 14:kead602. doi: 10.1093/rheumatology/kead602. Epub ahead of print. PMID: 37963059.

Objectives: To estimate the association between SSc clinical phenotypes and quantitative occupational exposure to crystalline silica, chlorinated solvents, trichloroethylene, and pesticides using job-exposure matrices.

Methods: In the VISS-EXPOSITION transversal study, data on declarative occupational exposure to crystalline silica, solvents, and pesticides were retrieved. In parallel, the Lifetime Occupational History was evaluated using a questionnaire and cursus laboris for SSc patients followed at Bordeaux University Hospital (France). Using job-exposure matrices, we assessed patients’ occupational exposure in relation to relevant clinical phenotypic forms of the disease.

Results: Toxic exposure to crystalline silica and pesticides is underestimated by patients. Non-biased job-exposure matrices retrieved more exposed patients than the declarative assessment (10.1% of patients by job-exposure matrices versus 6.3% by declaration for crystalline silica and 25.9% versus 12.2% for pesticides). Patients overestimate their solvent exposure (7.9% for chlorinated solvents and 4.8% for trichlorethylene assessed by job-exposure matrices and 24.4% declarative exposure to solvents at large). Clinical form evaluation revealed a nonsignificant trend toward an increased risk of crystalline silica occupational exposure in the pulmonary fibrotic group of SSc patients (OR 3.12 CI 95% [0.80-12.15]). We also observed a nonsignificant trend toward elevated OR (OR 2.89 CI 95% [0.93-8.95]) for chlorinated solvent occupational exposure and the vascular phenotype of SSc. Of note, pesticide occupational exposure evaluation represents one of the largest to date in SSc patients.

Conclusion: This study emphasizes that many exposed SSc patients are unaware of their occupational exposure. Job-exposure matrices allow better exposure screening for SSc secondary prevention and occupational exposure compensation.

Peñalver-Piñol, A., Benavente, Y., Frias-Gomez, J. et al. Occupational exposure to pesticides and endometrial cancer in the Screenwide case-control studyEnviron Health 22, 77 (2023). https://doi.org/10.1186/s12940-023-01028-0


Endometrial cancer is the most common gynaecological tumour in developed countries, and disease burden is expected to increase over the years. Identifying modifiable risk factors may help developing strategies to reduce the expected increasing incidence of these neoplasms.


This study evaluates the association between occupational exposure to pesticides and endometrial cancer using data from a recent case-control study in Spain.


The analyses included data from 174 consecutive incident endometrial cancer cases and 216 hospital controls frequency-matched by age. Data were collected through structured epidemiological questionnaires and exposure to pesticides was assessed using a Spanish job-exposure matrix (MatEmESp).


Overall, 12% of controls and 18% of cases were occupationally exposed to pesticides. We observed a positive association between occupational exposure to pesticides and endometrial cancer (OR = 2.08; 95% CI = 1.13–3.88 compared to non-exposed). In general, exposures that occurred farther in the past were significantly associated with endometrial cancer. Exposure to insecticides, fungicides and herbicides were positively associated with endometrial cancer (OR = 2.08; 95% CI = 1.13–3.88, OR = 4.40; 95% CI = 1.65–13.33, and OR = 5.25; 95% CI = 1.84–17.67, respectively). The agricultural, poultry and livestock activities scenario was associated with endometrial cancer (OR = 4.16; 95% CI = 1.59–12.32), while the cleaning exposure scenario was not (OR = 1.22; 95% CI = 0.55–2.67).


Assessment of occupational exposure to pesticides assessed using a Spanish job-exposure matrix revealed a positive association with endometrial cancer. The elucidation of the role of pesticide compounds on endometrial cancer should shed a light on the aetiology of this tumour.

Feng MX, Zou H, Lu YQ. Severe liver injury and clinical characteristics of occupational exposure to 2-amino-5-chloro-N,3-dimethylbenzamide: A case series. Hepatobiliary Pancreat Dis Int. 2023 Oct 22:S1499-3872(23)00202-3. doi: 10.1016/j.hbpd.2023.10.008. Epub ahead of print. PMID: 37903709.

Background: The 2-amino-5-chloro-N,3-dimethylbenzamide is a key intermediate in the synthesis of pesticides and pharmaceuticals. However, no literature currently exists on 2-amino-5-chloro-N,3-dimethylbenzamide poisoning in humans. This study aimed to reveal the health hazard of this chemical for humans and summarize the clinical characteristics of patients with occupational 2-amino-5-chloro-N,3-dimethylbenzamide poisoning.

Methods: This observational study included four patients with 2-amino-5-chloro-N,3-dimethylbenzamide poisoning from June 2022 to July 2022. The entire course of the incidents was described in detail. Blood 2-amino-5-chloro-N,3-dimethylbenzamide concentrations were detected by a mass spectrometer. Hematoxylin and eosin staining was performed to assess liver injury, and immunofluorescence was used to evaluate hepatic mitophagy.

Results: The 2-amino-5-chloro-N,3-dimethylbenzamide powder (99% purity) entered the human body mainly via the skin and respiratory tract due to poor personal protective measures. The typical course of 2-amino-5-chloro-N,3-dimethylbenzamide poisoning was divided into latency, rash, fever, organic damage, and recovery phases in accordance with the clinical evolution. Rash and fever may be the important premonitory symptoms for further organ injuries. The chemical was detected in the blood of all patients and caused multiple organ injuries, predominantly liver injury, including kidney, myocardium, and microcirculation. Three patients recovered smoothly after comprehensive treatments, including artificial liver therapy, continuous renal replacement therapy, glucocorticoids, and other symptomatic and supportive treatments. One patient survived by liver transplantation. The postoperative pathological findings of the removed liver showed acute liver failure, and immunofluorescence staining confirmed the abundance of mitophagy in residual hepatocytes.

Conclusions: This study is the first to elaborate the clinical characteristics of patients with 2-amino-5-chloro-N,3-dimethylbenzamide poisoning. The chemical enters the body through the respiratory tract and skin during industrial production. The 2-amino-5-chloro-N,3-dimethylbenzamide poisoning causes multiple-organ dysfunction with a predominance of liver injury. Liver transplantation may be an effective option for patients with severe liver failure. The mechanisms of liver injury induced by 2-amino-5-chloro-N,3-dimethylbenzamide might involve abnormal mitochondrial function and mitophagy.

Fishwick D, Carder M, Iskandar I, Fishwick BC, van Tongeren M. Irritant asthma and work: cases from the UK SWORD reporting scheme from 1999 to 2018. Occup Environ Med. 2023 Oct;80(10):553-557. doi: 10.1136/oemed-2023-108884. Epub 2023 Sep 28. PMID: 37770178; PMCID: PMC10579497.

Background: Acute irritant asthma is a preventable health consequence of a workplace exposure and has a number of adverse outcomes. While cases and case series are reported, little is known about the causes and incidence of this condition over prolonged periods of time.

Aims: We aimed to estimate the reported incidence of irritant asthma referred to a national reporting scheme, and how this has changed over time.

Methods: Cases of irritant asthma reported to SWORD, the UK-based Surveillance of Work-related Occupational Respiratory Diseases scheme, were grouped into four 5-year time periods from 1999 onwards. Likely causative exposures, job, work sector and incidence rates were analysed over time.

Results: 307 actual cases equated to 1066 estimated cases; actual cases had a mean age of 46 years (SD 17.8); 70.7% were male. The annual incidence fell from 1.98 per million employed in the first 5-year period, to 0.56 in the most recent. Eleven occupational codes were associated with six or more attributed cases, and between them accounted for 38% of all cases. Thirteen exposure categories were associated with five or more cases. These were formaldehyde (n=5), cutting oils and coolants (n=6), isocyanates (n=6), pesticides and herbicides (n=6), welding fumes (n=7), paints (n=7), solder and colophony (n=7), solvents (n=9), fuel oil, diesel and ill-defined fumes (n=10), chlorine and hypochlorites (n=15), acids (n=23), smoke (n=25) and cleaning products and sterilising agents (n=39).

Conclusions: While the incidence of irritant asthma may have fallen, cases are persistently attributed to well-described causes. A persistence of cases attributed to cleaning agents was seen.



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