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 from this month on regular updates on new disease – exposure combinations we added to the database. Currently, we have 273 entries. Ordered by year in which the abstract is published

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Last new entries

Manangama, G., Gramond, C., Audignon-Durand, S., Baldi, I., Fabro-Peray, P., Ilg, A. G. S., … & Brochard, P. (2020). Occupational exposure to unintentionally emitted nanoscale particles and risk of cancer: From lung to central nervous system-Results from three French case-control studiesEnvironmental Research191, 110024.

Nanoscale particles (1–100 nm) can be of natural origin, and either intentionally or unintentionally produced by human activities. Toxicological data have suggested a possible carcinogenic effect of such particles. The aim of this study was to estimate the association between occupational exposure to nanoscale particles and the risk of lung cancer, pleural mesothelioma, and brain tumors in adults.

Three French population-based case-control studies were analyzed:

  • the ICARE study including 2029 lung cancer cases and 2591 controls;
  • the PNSM study including 371 pleural mesothelioma cases and 730 controls
  • the CERENAT study including 257 brain tumor cases and 511 controls.

Occupational exposure to unintentionally emitted nanoscale particles (UNPs) was retrospectively assessed by a job-exposure matrix providing a probability and a frequency of exposure.

In adjusted analyses among men, significant associations between occupational exposure to UNPs and lung cancer (OR = 1.51; 95% CI: 1.22–1.86 and brain tumors (OR = 1.69; 95% CI: 1.17–2.44) were observed. No increased OR was observed for pleural mesothelioma (OR = 0.78; 95% CI: 0.46–1.33). This is the first study showing positive associations between occupational exposure to UNPs and increased risk of lung cancer and brain tumors. These preliminary results should encourage further epidemiological research.

  • Nanoscale particles may have a carcinogenic effect on humans.
  • Positive association between lung cancer, brain tumors, and nanoscale particles.
  • Retrospective exposure assessment of nanoscale particles by a job-exposure matrix
Spraying agriculture
Picture by Erich Westendarp via Pixabay

Gamache PL, Haj Salem I, Roux-Dubois N, et al. Exposure to Pesticides and Welding Hastens the Age-at-Onset of Parkinson’s Disease. The Canadian Journal of Neurological sciences. Le Journal Canadien des Sciences Neurologiques. 2019 Nov;46(6):711-716. DOI: 10.1017/cjn.2019.248.

The age-at-onset (AAO) of Parkinson’s disease (PD) is thought to be influenced by environmental factors and polygenic predispositions. Professional exposures to pesticides and toxic metals were shown to be associated with earlier onset in small sample studies. The aim of this study was to confirm the association between professional exposures to pesticides and toxic metals and the AAO of PD, on a larger cohort of patients, defined with a clinic-based ascertainment scheme.

The authors used an incident cohort of 290 patients recruited through three designated movement disorder clinics in the province of Quebec, Canada. Patients completed a detailed questionnaire regarding professional exposures to pesticides and toxic metals. They compared the AAO in patients without prior professional exposure (N = 170) and those with exposure to pesticides (N = 53) or toxic metals through welding (N = 30). They subdivided patients exposed to pesticides according to the frequency and proximity of their contacts.

Patients with prior exposure to pesticides (AAO = 54.74 years) or toxic metals (54.27 years) had a significantly earlier AAO compared to the control group (59.26 years) (p = 0.003). In those exposed to pesticides, closer (p = 0.03) and more frequent (p = 0.02) contacts were negatively correlated with AAO.

Exposure to pesticides and toxic metals were both associated with an earlier onset of PD, an effect that was greater with higher levels of exposure, both in terms of frequency and proximity.

Verma, N. (2020). Risk assessment studies of the impact of occupational exposure of pharmaceutical workers on the development of antimicrobial drug resistanceJournal of Occupational and Environmental Hygiene, 1-10.

Pharmaceutical workers involved with the production of antimicrobial drugs are exposed to various antimicrobial chemicals in different steps of manufacturing such as grinding, sieving, compression, granulation, mixing, and filling. These exposures may lead to the development of multidrug resistance (MDR) in bacteria. Scientific reports on the occupational health hazard of pharmaceutical workers involved in manufacturing antibiotics are scarce. The present study aimed to compare the degree of bacterial resistance in pharmaceutical workers in India to that of individuals not involved in the pharmaceutical field.

Twenty male workers from 5 local pharmaceutical companies and 20 male subjects not involved in the pharmaceutical field (non-pharmaceutical subjects) were randomly selected. Nasal fluid and mucus/cough specimens were collected from each subject and were cultured separately at 37 °C for 24 hr to obtain bacterial growth. The cultured species were then identified, isolated, and subjected to microbial sensitivity testing against 18 different antibiotics from 8 different groups by the disk diffusion method. 

Staphylococcus spp., Pseudomonas spp., and Escherichia coli were identified and isolated from the culture of nasal fluids and mucuses, respectively. All the isolated species of bacteria exhibited significant enhancement of the degree of MDR in pharmaceutical workers compared with non-pharmaceutical subjects. Workers with a longer working history had a greater degree of antibiotic resistance and vice versa.

It can be certainly considered that the exposure of pharmaceutical workers to antibiotic agents resulted in a high incidence of multidrug resistance. Effective steps should be taken to minimize the inherent exposure of pharmaceutical workers to antibiotics during work to prevent antimicrobial drug resistance.

Cummings KJ, Stanton ML, Kreiss K, Boylstein RJ, Park JH, Cox-Ganser JM, Virji MA, Edwards NT, Segal LN, Blaser MJ, Weissman DN, Nett RJ. Work-related adverse respiratory health outcomes at a machine manufacturing facility with a cluster of bronchiolitis, alveolar ductitis and emphysema (BADE). Occup Environ Med. 2020 Jun;77(6):386-392.

The authors describe a group of four machine manufacturing facility workers with novel occupational lung disease of uncertain etiology characterized by lymphocytic bronchiolitis, alveolar ductitis, and emphysema (BADE). They wanted to evaluate current workers’ respiratory health in relation to job category and relative exposure to endotoxin, which is aerosolized from in-use metalworking fluid.

They offered a questionnaire and spirometry at baseline and at a 3.5-year follow-up. Endotoxin exposures were quantified for 16 production and non-production job groups. Forced expiratory volume in one second (FEV1) decline of ≥10% was considered excessive. We examined SMRs compared with US adults, adjusted prevalence ratios (aPRs) for health outcomes by endotoxin exposure tertiles, and predictors of excessive FEV1 decline.

Among 388 (89%) baseline participants, SMRs were elevated for wheeze (2.5 (95% CI 2.1 to 3.0)), but not obstruction (0.5 (95% CI 0.3 to 1.1)). Mean endotoxin exposures (range: 0.09-28.4 EU/m3) were highest for machine shop jobs. Higher endotoxin exposure was associated with exertional dyspnea (aPR=2.8 (95% CI 1.4 to 5.7)), but not lung function.

Of 250 (64%) follow-up participants, 11 (4%) had excessive FEV1 decline (range: 403-2074 mL); 10 worked in production. Wheeze (aPR=3.6 (95% CI 1.1 to 12.1)) and medium (1.3-7.5 EU/m3) endotoxin exposure (aPR=10.5 (95% CI 1.3 to 83.1)) at baseline were associated with excessive decline. One production worker with excessive decline had BADE on subsequent lung biopsy.

The authors concluded that lung function loss and BADE were associated with production work. Relationships with relative endotoxin exposure indicate work-related adverse respiratory health outcomes beyond the sentinel disease cluster, including an incident BADE case. Until causative factors and effective preventive strategies for BADE are determined, exposure minimization and medical surveillance of affected workforces are recommended.