March 2021 additions to NERDB

March 2021 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 288 entries. Ordered by year in which the abstract is published

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Last new entries:

Videnros, C., Selander, J., Wiebert, P. et al. Investigating the risk of breast cancer among women exposed to chemicals: a nested case–control study using improved exposure estimatesInt Arch Occup Environ Health 93, 261–269 (2020).

The aim of this study was to examine if exposures to chemicals at the workplace were associated with an increased risk of postmenopausal breast cancer, using improved exposure estimates. The design is a case–control study, nested within a cohort of women from the Malmö Diet and Cancer Study. The study comprised 2400 women, 731 cases, and 1669 matched controls, born 1923–1950 and living in Malmö, Sweden between 1991 and 1996. An occupational hygienist reclassified the probability for the exposure given by a job-exposure matrix, using individual data on work tasks. First-time diagnoses of invasive breast cancer were identified through the Swedish Cancer Registry.

Women exposed to chemicals in their occupational environment had a statistically significantly increased risk (OR 1.59, 95% CI 1.11–2.29) of breast cancer, and the risk correlated positively with duration of exposure but not with exposure intensity. Women exposed to chlorinated hydrocarbon solvents for more than 10 years had a significantly higher risk of breast cancer (OR 3.06, 95% CI 1.18–7.96) as well as women exposed to oil mist for more than 10 years (OR 3.08, 95% CI 1.12–8.49). This study gives some support to the hypothesis that exposure to organic solvents as well as oil mist is associated with an increased risk of breast cancer.

Photo by Omkar Jadhav on Unsplash

Schildroth S, Osborne G, Smith AR, et al Occupational exposure to antimony trioxide: a risk assessment Occupational and Environmental Medicine Published Online First: 26 November 2020. doi: 10.1136/oemed-2020-106980

The US National Toxicology Program (NTP) recently recommended in its Report on Carcinogens Monograph for Antimony Trioxide that antimony trioxide be listed as reasonably anticipated to be a human carcinogen based on sufficient evidence of carcinogenicity in experimental animals and supporting evidence from mechanistic studies. The researchers’ goal was to estimate the possible human cancer risk from occupational exposure to antimony trioxide.

They selected data from 2-year inhalation studies in male and female mice conducted by the NTP and performed cancer dose–response analyses using cancer models and benchmark dose methods developed by the US Environmental Protection Agency. In these analyses, we generated benchmark doses and cancer slope factors for antimony trioxide and then estimated human cancer risk under various exposure scenarios. Typical and worst-case inhalation scenarios in multiple occupational settings were used in risk estimation.

In typical case scenarios, the occupational cancer risk from antimony trioxide was estimated to be 0.025 (25 in 1000) for persons working with flame retardants in plastics and textiles for 40 years. Under worst-case scenarios, the occupational cancer risk was estimated to be 0.11 (110 in 1000) for persons working with flame retardants in plastics and textiles. At the current Occupational Safety and Health Administration Permissible Exposure Limit, the cancer risk for occupational inhalation exposure of antimony trioxide was estimated to be 0.096 (96 in 1000).

The risk estimates calculated in this study suggest that exposure to antimony trioxide at levels present in certain occupational settings results in a large increase in the risk of developing cancer.

Butnor KJ, Covington J, Taatjes DJ, DeWitt J, Von Turkovich MA. Fluorine detection in the lung tissue of a worker with interstitial pulmonary fibrosis and long-term occupational exposure to polytetrafluoroethylene and perfluorooctanoic acid. Ultrastruct Pathol. 2020 Nov 20;44(4-6):496-500. doi: 10.1080/01913123.2020.1842828. Epub 2020 Nov 17. PMID: 33200662.

Exposure to polytetrafluoroethylene (PTFE), a compound used in nonstick cookware coating and a variety of other applications, is known to cause acute lung injury and granulomatous pneumonitis. It is uncertain whether PTFE and compounds used in its manufacture, such as perfluorooctanoic acid (PFOA), cause chronic lung disease.

Here we report a case of interstitial pulmonary fibrosis in a 71-year-old man who died following a brief illness clinically suspected to be acute respiratory distress syndrome. He had a 25-year history of occupational exposure to PTFE and PFOA. At postmortem examination, the lungs demonstrated diffuse alveolar damage (DAD) superimposed on interstitial pulmonary fibrosis. The interstitial fibrosis lacked fibroblast foci and exhibited basilar and subpleural accentuation with focal microscopic honeycombing.

Within the fibrotic lung parenchyma were scattered giant cells containing birefringent translucent particles. Scanning electron microscopy and energy-dispersive x-ray spectroscopy (SEM-EDS) were performed. A majority of the birefringent particles demonstrated a prominent peak for fluorine by EDS analysis. This is the first report to document the presence of fluorine, an elemental constituent of PTFE and PFOA, in fibrotic lung tissue. Careful evaluation of other individuals with long-term exposure to PTFE and/or PFOA appears warranted to better elucidate the spectrum of pulmonary disease associated with these compounds.

Meng E, Mao Y, Yao Q, Han X, Li X, Zhang K, Jin W. Population-based study of environmental/occupational lead exposure and amyotrophic lateral sclerosis: a systematic review and meta-analysis. Neurol Sci. 2020 Jan;41(1):35-40. doi: 10.1007/s10072-019-04067-z. Epub 2019 Oct 2. PMID: 31578652.

Lead is a known risk factor for amyotrophic lateral sclerosis (ALS). However, the results of studies exploring the relationship between lead exposure and the occurrence of ALS are inconsistent. To clarify this issue, Meng et al. conducted a systematic review and meta-analysis of relevant published articles on the relationship between lead exposure and the occurrence of ALS. They searched the PubMed, MEDLINE, Embase, and Science Direct databases for relevant publications. The quality of the articles was judged according to the Newcastle-Ottawa scale, and the meta-analysis was conducted using a random effect model.

A total of 583 items were retrieved of which 11 case-control studies were selected. The ratio of maximal/minimal lead exposure yielded a pooled Odds Ratio (OR) of 1.46 (95% confidence interval (CI) 1.16-1.83) with moderate heterogeneity (I2 = 51.8%; p = 0.019). Subgroup and sensitivity analyses showed stable results. There was evidence of publication bias, but the recalculated OR after employing the “fill and trim” method was 1.28 (95% CI 1.02-1.63). These results indicated that environmental/occupational lead exposure was positively proportional to the risk of ALS.

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