March 2023 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 376 entries. Ordered by the 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	52
2008	5	2020	52
2009	3	2021	28
		2022	34
unknown year	6	2023	2

New entries:

Uter W, Strahwald J, Hallmann S, Johansen JD, Havmose MS, Kezic S, van der Molen HF, Macan J, Babić Ž, Franić Z, Macan M, Turk R, Symanzik C, Weinert P, John SM. Systematic review on skin adverse effects of important hazardous hair cosmetic ingredients with a focus on hairdressers. Contact Dermatitis. 2023 Feb;88(2):93-108. doi: 10.1111/cod.14236. Epub 2022 Oct 28. PMID: 36254351.

Background: The burden of occupational hand eczema in hairdressers is high, and (partly strong) allergens abound in the hair cosmetic products they use.

Objectives: To systematically review published evidence concerning contact allergy to an indicative list of active ingredients of hair cosmetics, namely, p-phenylenediamine (PPD), toluene-2,5-diamine (PTD), persulfates, mostly ammonium persulfate (APS), glyceryl thioglycolate (GMTG), and ammonium thioglycolate (ATG), concerning the prevalence of sensitization, particularly in terms of a comparison (relative risk; RR) between hairdressers and non-hairdressers.

Methods: Following a PROSPERO-registered and published protocol, eligible literature published from 2000 to February 2021 was identified, yielding 322 publications, and extracted in standardized publication record forms, also considering the risk of bias.

Results: Based on 141 publications, the contact allergy prevalence to PPD was 4.3% (95% CI: 3.8-4.9%) in consecutively patch-tested patients. Other ingredients were mostly tested in an aimed fashion, yielding variable, and partly high contact allergy prevalences. Where possible, the RR was calculated, yielding an average increased sensitization risk in hairdressers of between 5.4 (PPD) and 3.4 (ATG). Additional evidence related to immediate-type hypersensitivity, experimental results, exposures, and information from case reports was qualitatively synthesized.

Conclusions: An excess risk of contact allergy is clearly evident from the pooled published evidence from the last 20 years. This should prompt an improvement in working conditions and product safety.

Cavalier H, Trasande L, Porta M. Exposures to pesticides and risk of cancer: Evaluation of recent epidemiological evidence in humans and paths forward. Int J Cancer. 2023 Mar 1;152(5):879-912. doi: 10.1002/ijc.34300. Epub 2022 Oct 25. PMID: 36134639; PMCID: PMC9880902.

Knowledge of the role in cancer etiology of environmental exposures such as pesticides is a prerequisite for primary prevention. We review 63 epidemiological studies on exposure to pesticides and cancer risk in humans published from 2017 to 2021, with emphasis on new findings, methodological approaches, and gaps in the existing literature.

While much of the recent evidence suggests causal relationships between pesticide exposure and cancer, the strongest evidence exists for acute myeloid leukemia (AML) and colorectal cancer (CRC), diseases in which the observed associations were consistent across several studies, including high-quality prospective studies and those using biomarkers for exposure assessment, with some observing dose-response relationships.

Though high-quality studies have been published since the IARC monograph on organophosphate insecticides in 2017, there are still gaps in the literature on carcinogenic evidence in humans for a large number of pesticides.

To further knowledge, we suggest leveraging new techniques and methods to increase sensitivity and precision of exposure assessment, incorporate multi-omics data, and investigate more thoroughly exposure to chemical mixtures. There is also a strong need for better and larger population-based cohort studies that include younger and non-occupationally exposed individuals, particularly during developmental periods of susceptibility.

Though the existing evidence has limitations, as always in science, there is sufficient evidence to implement policies and regulatory action that limit pesticide exposure in humans and, hence, further prevent a significant burden of cancers.

Aoki A, Saito A, Shima K, Kimura Y, Asakawa K, Ohashi R, Umezu H, Sakagami T, Moriyama H, Kikuchi T. Occupational Lung Disease Caused by Exposure to Polytetrafluoroethylene. Intern Med. 2022 Dec 15;61(24):3713-3717. doi: 10.2169/internalmedicine.9008-21. Epub 2022 May 21. PMID: 35598992; PMCID: PMC9841090.

We herein report a 45-year-old man with multiple foreign body granulomas in the lungs caused by polytetrafluoroethylene (PTFE). A mass in the right lower lobe of the lung and bilateral centrilobular lung nodules were found unexpectedly during the patient’s visit to a hospital for a respiratory infection. The patient’s occupation for 26 years involved spraying PTFE.

A lung biopsy using bronchoscopy revealed granulomatous lesions and giant cells. The presence of fluorine in the granulomatous lesions was confirmed using an electron probe microanalyzer with a wavelength-dispersive spectrometer. Fluorine is a component of PTFE and is not found in normal lung tissue.

Zhou S, Wang Y, Yu C, Ding C, He J, Liu Y, Wang H, Ni C. Metal Exposure-Related Welder’s Pneumoconiosis and Lung Function: A Cross-Sectional Study in a Container Factory of China. Int J Environ Res Public Health. 2022 Dec 14;19(24):16809. doi: 10.3390/ijerph192416809. PMID: 36554689; PMCID: PMC9779211.

Long-term inhalation of welding fume at high exposure can cause welder pneumoconiosis, and metals in welding dust are associated with respiratory dysfunction.

This cross-sectional study, which contains 384 Chinese male workers who were or had been working in a container factory, aimed to assess the potential risk of haemal (concentration in blood) and urinary metal content in welder’s pneumoconiosis. Further, we investigated their effects on lung function parameters.

Metal content and lung function were measured using inductively coupled plasma-mass spectrometry (ICP-MS) and spirometer, respectively. The concentration and metal content of respirable dust as well as total dust were collected at this container factory.

Lung function of cases with welder’s pneumoconiosis was significantly worse, as indicated by lower values of FVC, FVC% predicted, FEV1, FEV1% predicted, MEF25% predicted, and MMEF% predicted (p < 0.05).

Results of logistic regression models showed that haemal Cr and Zn were risk factors for welder’s pneumoconiosis (OR = 4.98, 95%CI: 1.73-21.20, p = 0.009 for Cr; OR = 5.23, 95%CI: 1.56-41.08, p = 0.033 for Zn) after adjusted with age, BMI, working years, welding dust exposure years, and smoking status.

Multiple linear regression models showed that several metals (haemal Cd and Pb; urinary Cd and Fe) were significantly associated with different lung function indices in the welder’s pneumoconiosis group.

Compared to non-welders, welders were exposed to considerably higher levels of respirable dust, total dust, and six kinds of metals (p < 0.05).

In conclusion, haemal Cr and Zn are positively related to welder pneumoconiosis. Meanwhile, Cd and Pb might worsen lung function in welder pneumoconiosis.