December 2022 additions to NERDB

December 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 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 364 entries. Ordered by the year in which the abstract is published

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New entries:

Afbeelding van Alexander Fox | PlaNet Fox via Pixabay

Monti, Carlo PhD; Giammichele, Grazia MD; Antuono, Vittorio MD; Loreti, Beatrice MD; Tomei, Francesco MD; De Marco, Federica MD; Massimi, Roberto BS; Marchione, Stefania MD; Suppi, Anastasia MD; Tomei, Gianfranco BS; Ricci, Serafino MD. Low-Dose Occupational Exposure to Nickel and Thyroid Hormones. Journal of Occupational and Environmental Medicine: November 2022 – Volume 64 – Issue 11 – p e667-e671 doi: 10.1097/JOM.0000000000002660


The aim of this study was to evaluate the effects of a low-dose exposure to nickel, as it is present in urban air, on thyroid hormones and on thyrotropin in outdoor workers exposed to urban pollutants.

Materials and Methods 

A total of 164 outdoor workers were studied and divided by sex and smoking habit. Each worker underwent measurement of urinary nickel and of blood triiodothyronine, L-thyroxine, and thyrotropin levels. A statistical analysis was performed.


Statistical analysis shows a significant and positive correlation between urinary nickel and L-thyroxine, both in total sample and in males.

Discussion and Conclusion 

The study suggests that occupational exposure to a low dose of nickel may affect thyroid function in municipal police workers. These data may provide information on other categories of outdoor workers with similar exposure.

Patel A, Hasany A, Tarlo SM. Occupational hypersensitivity pneumonitis after polyurethane adhesive exposure. CMAJ. 2022 Aug 2;194(29):E1027-E1030. doi: 10.1503/cmaj.220052. PMID: 35918092; PMCID: PMC9481262.

This case description highlights the importance of obtaining an occupational history when assessing patients with respiratory symptoms. In particular, it is important to ask about specific exposures to agents
such as birds, moulds and polyurethanes, given their known associations with lung disease. Hypersensitivity pneumonitis is a type of interstitial lung disease that is often caused by occupational exposures. Early detection is crucial since it can progress to lung fibrosis, which is associated with substantial morbidity and death.

Cloeren, M, Dement, J, Gaitens, J, et al. Beryllium disease among construction trade workers at Department of Energy nuclear sites: A follow-up
Am J Ind Med. 2022; 65: 708- 720. doi:10.1002/ajim.23411


Construction workers at U.S. Department of Energy (DOE) nuclear weapons facilities are screened to identify DOE-related occupational illnesses, including beryllium sensitization (BeS) and chronic beryllium disease (CBD). The study objectives were to estimate beryllium disease risks and the CBD claims acceptance rate in the energy workers’ benefits program.


Workers diagnosed with BeS via beryllium lymphocyte proliferation test (BeLPT) included in screening examinations were interviewed about subsequent diagnosis of CBD. We estimated the proportion who developed CBD based on the ratio of CBD cases, based on self-reported compensation claim status, to all workers with BeS interviewed. We used stratified analyses to explore trends in disease frequency by age, race, sex, DOE employment duration, site, trade group, and cigarette smoking history.


Between 1998 and 2020, 21,854 workers received a BeLPT; 262 (1.20%) had BeS (two abnormals or one abnormal plus one borderline test); 212 (0.97%) had a single abnormal BeLPT. Of 177 BeS workers interviewed, 35 (19.8%) reported an accepted CBD compensation claim. The claims acceptance rate among BeS workers increased with years of DOE employment, from 8.4% with <5 years to 33.3% for >25 or more years. Five of 68 interviewed workers with a single positive BeLPT reported CBD claim acceptance; an additional CBD case was confirmed by chart review (8.8%).


Years of DOE work predict the risk of developing CBD among those sensitized and getting a claim for CBD accepted. Ongoing surveillance and increased awareness of the risk of beryllium exposure and CBD as an occupational disease among construction workers are needed.

Gargano EM, Blömeke B, Gaspari AA, Goebel C. The 2-Methoxymethyl Modification of p -Phenylenediamine Reduces the Sensitization Risk for Hairdressers to Hair Dyes-An Occupational Hand Exposure-Based Risk Assessment. Dermatitis. 2022 Jul-Aug 01;33(4):293-301. doi: 10.1097/DER.0000000000000915. Epub 2022 Jun 29. PMID: 35777963; PMCID: PMC9301993.

Background: Allergic contact dermatitis involving the hands is a common occupational skin disease for hairdressers and the potent sensitizers p-phenylenediamine (PPD) and toluene-2,5-diamine (PTD) are associated with the development of occupational allergic contact dermatitis.

Objective: The aim of the study was to analyze whether the use of the moderate sensitizer 2-methoxymethyl-PPD (ME-PPD) in professional hair dyes is a suitable tool to reduce the occupational contact allergy risk for hairdressers.

Methods: Hand exposure of hairdressers (N = 11) to ME-PPD was analyzed under routine hair coloring conditions in commercial salons. By accounting for wet work and uneven hand exposure, the daily hand exposure was derived and compared with the occupational acceptable exposure level (AEL), that is, the sensitization induction threshold of ME-PPD adjusted for interindividual variability among workers.

Results: The daily hand exposure to ME-PPD was 1.6 μg/cm2, and the occupational AEL was 215 μg/cm2. The ratio of hand exposure to AEL was calculated as the margin of safety (MOS) against occupational sensitization. For ME-PPD, the MOS of 134 indicates a low likelihood of sensitization versus PPD and PTD with MOS values of 2.7 and 5.9, respectively.

Conclusions: Our data predict that the use of ME-PPD in professional hair color products improves the protection of hairdressers against hair dye–related contact allergy versus the use of PPD and PTD.



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