November 2023 additions to NERDB

November 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 396 entries. Ordered by the year in which the abstract is published

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New entries:

Picture through Pixabay

Engelsman, M.; Banks, A.P.W.; He, C.; Nilsson, S.; Blake, D.; Jayarthne, A.; Ishaq, Z.; Toms, L.-M.L.; Wang, X. An Exploratory Analysis of Firefighter Reproduction through Survey Data and Biomonitoring. Int. J. Environ. Res. Public Health 202320, 5472.

Firefighters are occupationally exposed to chemicals that may affect fertility. To investigate this effect, firefighters were recruited to contribute blood, urine, breast milk or semen samples to (1) evaluate chemical concentrations and semen parameters against fertility standards and the general population; (2) assess correlations between chemical concentrations and demographics, fire exposure and reproductive history; and (3) consider how occupational exposures may affect reproduction.

A total of 774 firefighters completed the online survey, and 97 firefighters produced 125 urine samples, 113 plasma samples, 46 breast milk samples and 23 semen samples. Blood, urine and breast milk samples were analysed for chemical concentrations (semivolatile organic compounds, volatile organic compounds, metals). Semen samples were analysed for quality (volume, count, motility, morphology).

Firefighter semen parameters were below WHO reference values across multiple parameters. Self-reported rates of miscarriage were higher than the general population (22% vs. 12–15%) and in line with prior firefighter studies. Estimated daily intake for infants was above reference values for multiple chemicals in breast milk.

More frequent fire incident exposure (more than once per fortnight), longer duration of employment (≥15 years) or not always using a breathing apparatus demonstrated significantly higher concentrations across a range of investigated chemicals. The findings of this study warrant further research surrounding the risk occupational exposure has on reproduction.

Drent, M., Bomans, P. H. H., Van Suylen, R. J., Lamers, R. J. S., Bast, A., & Wouters, E. F. M. (2000). Association of man-made mineral fibre exposure and sarcoidlike granulomasRespiratory medicine94(8), 815-820.

It is assumed that sarcoidosis is caused by inhalation of air-borne agents in susceptible persons triggering the inflammatory reaction. The association between metallic dust exposure, such as beryllium and aluminum, and sarcoid-like pulmonary disorders is well known.

The ability of man-made mineral fibres (MMMF) to cause granulomatous lung disease has not been appreciated until now. Recently, we observed the association between sarcoid-like granulomatous reaction and occupational history of glass fibre exposure. We hypothesized that there might be a relationship between MMMF exposure and the development of sarcoid-like granulomas.

Therefore, the records of 50 sarcoidosis patients—who visited our outpatient clinic between 1996 and 1999—were reviewed. This revealed that 14 cases recalled a history of exposure to either glass fibres or rock wool, both MMMF fibres.

The available obtained tissue specimens (n=12) were reviewed. In six cases electron microscopy qualitative analysis of small fragments of the tissue revealed among others silica, aluminium and sometimes titanium. A distinct relation between fibre deposits fibre deposits and granulomas was found. These findings indicate that in susceptible people MMMF exposure might be related to a chronic granulomatous disease similar to chronic beryllium disease.

Francisco LFV, da Silva RN, Oliveira MA, Dos Santos Neto MF, Gonçalves IZ, Marques MMC, Silveira HCS. Occupational Exposures and Risks of Non-Hodgkin Lymphoma: A Meta-Analysis. Cancers (Basel). 2023 May 4;15(9):2600. doi: 10.3390/cancers15092600. PMID: 37174074; PMCID: PMC10177442.

Non-Hodgkin lymphoma (NHL) is a heterogeneous group with different types of diseases. It remains unclear as to what has led to an increase in incidences of NHL, however, chemical substance exposure is known to be one of the risk factors for the disease.

Therefore, we performed a systematic review and meta-analysis including case-control, cohort, and cross-sectional observational epidemiological studies to verify the association between occupational exposure to carcinogens and NHL risk. Articles between the years 2000 and 2020 were collected. Two different reviewers performed a blind selection of the studies using the Rayyan QCRI web app. Post-completion, the selected articles were extracted and analyzed via the RedCap platform.

Our review resulted in 2719 articles, of which 51 were included in the meta-analysis, resulting in an overall OR of 1.27 (95% CI 1.04-1.55). Furthermore, it was observed that the main occupation associated with the increased risk of NHL was that in which workers are exposed to pesticides. We therefore conclude that the evidence synthesis of the epidemiological literature supports an increased risk for NHL, regardless of subtype, considering occupational exposure to certain chemical compounds, mainly pesticides, benzene, and trichloroethylene, and certain classes of work, primarily in the field of agriculture.

Becam J, Martin E, Pouradier G, Doudka N, Solas C, Guilhaumou R, Fabresse N. Transdermal Nicotine Poisoning: A Rare Case Report of Occupational Exposure. Toxics. 2023 May 17;11(5):464. doi: 10.3390/toxics11050464. PMID: 37235278; PMCID: PMC10222450.

We report a case of accidental nicotine intoxication following transdermal exposure in a 22-year-old man with no medical history, who worked in a company manufacturing e-liquids for electronic cigarettes.

He accidentally spilled 300 mL of pure nicotine solution (>99%) on his right leg without wearing protective clothing or a mask. Less than a minute later, he experienced dizziness, nausea, and headaches, followed by painful burning sensations in the affected area. He immediately removed his pants and washed his leg thoroughly with water.

He presented to the emergency department two hours later, where he exhibited a respiratory rate of 25 cpm, a heart rate of 70 bpm, headaches, abdominal pain, pallor, and vomiting. He recovered without specific treatment five hours post-intoxication.

Plasma levels of nicotine, cotinine, and hydroxycotinine were measured five hours after exposure using liquid chromatography-mass spectrometry. The concentrations found were 447 ng/mL for nicotine, 1254 ng/mL for cotinine, and 197 ng/mL for hydroxycotinine.

Nicotine is an alkaloid that can be highly toxic, with doses of 30-60 mg being potentially fatal. Transdermal intoxication is rare, with very few cases reported in the literature. This case highlights the risk of acute intoxication through cutaneous exposure to nicotine-containing liquid products and the need for protective clothing when handling such products in a professional context.



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