October 2019 additions to NERDB

October 2019 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 Obvibase.

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 216 entries. Ordered by year in which the abstract is published

20093unknown year6

Last new entries

Purdue MP, Bakke B, Stewart P, De Roos AJ, Schenk M, Lynch CF, Bernstein L, Morton LM, Cerhan JR, Severson RK, Cozen W, Davis S, Rothman N, Hartge P, Colt JS. A case-control study of occupational exposure to trichloroethylene and non-Hodgkin lymphoma. Environ Health Perspect. 2011 Feb;119(2):232-8

Previous epidemiologic findings suggest an association between exposure to trichloroethylene (TCE), a chlorinated solvent primarily used for vapor degreasing of metal parts, and non-Hodgkin lymphoma (NHL). The authors investigated the association between occupational TCE exposure and NHL within a population-based case-control study using detailed exposure assessment methods. They studied cases (n = 1,189; 76% participation rate) and controls (n = 982; 52% participation rate) who provided information on their occupational histories and, for selected occupations, on possible workplace exposure to TCE using job-specific interview modules. An industrial hygienist assessed potential TCE exposure based on this information and a review of the TCE industrial hygiene literature. We computed odds ratios (ORs) and 95% confidence intervals (CIs) relating NHL and different metrics of estimated TCE exposure, categorized using tertiles among exposed controls, with unexposed subjects as the reference group.

They observed associations with NHL for the highest tertiles of estimated average weekly exposure (23 exposed cases; OR = 2.5; 95% CI, 1.1–6.1) and cumulative exposure (24 exposed cases; OR = 2.3; 95% CI, 1.0-5.0) to TCE. Tests for trend with these metrics surpassed or approached statistical significance (p-value for trend = 0.02 and 0.08, respectively); however, we did not observe dose-response relationships across the exposure levels. Overall, neither duration nor intensity of exposure was associated with NHL, although we observed an association with the lowest tertile of exposure duration (OR = 2.1; 95% CI, 1.0-4.7). The authors concluded that their findings offer additional support for an association between high levels of exposure to TCE and increased risk of NHL. However, we cannot rule out the possibility of confounding from other chlorinated solvents used for vapor degreasing and note that our exposure assessment methods have not been validated.

Olivier Aerts, Evelyne Mangodt, Katrien Smets, Michelle Mertens, Lieve Constandt, An Goossens Occupational airborne allergic contact dermatitis caused by N-(4-hydroxyphenyl)benzenesulfonamide Contact Dermatitis. 2019 Jan;80(1):71-73. doi: 10.1111/cod.13135

The authors report on the practical work-up of 2 patients with severe occupational (and primarily airborne) allergic contact dermatitis caused by N-(4-hydroxyphenyl)benzenesulfonamide (HPBS) (CAS no. 5471-90-9), which is used as an intermediate in the production of heat-sensitive recording material for the healthcare sector. Two atopic males, aged 53 years and 58 years, were referred for evaluation of severe dermatitis on their faces, notably the eyelids, lips, and nose, along with eczema of the neck, and, occasionally, more widespread lesions on the trunk and in the elbow folds. Both patients were employed as laborers in a factory producing heat-sensitive recording materials, namely, polyethylene terephthalate(PET) films, for use in the healthcare sector. Their work involved the weighing and emptying of bags filled with white powders used as intermediates in the production of the PET films. Consultation with the occupational physician showed that, shortly before the skin problems started, the composition of the powders had changed; that is, 4-(p-tosyl)catechol (PTC) (CAS no. 107065-85-0) and HPBS had been added. Tests were performed and showed only reactions to HPBS 0.1% pet. in both patients, + on D2 and ++ on D4 (Figure 3). Five control patients showed negative results with HPBS 0.1% pet. In conclusion, the approach eventually led to correct diagnosis and management and identified the first two cases of (primarily) air-borne allergic contact dermatitis caused by HPBS.

Gunnarsson LG, Bodin L. Occupational Exposures and Neurodegenerative Diseases-A Systematic Literature Review and Meta-Analyses. Int J Environ Res Public Health. 2019 Jan 26;16(3). pii: E337. doi: 10.3390/ijerph16030337.

The objective was to carry out an integrated and stratified meta-analysis on occupational exposure to electromagnetic fields (EMFs), metals and pesticides and its effects on amyotrophic lateral sclerosis (ALS) and Parkinson’s and Alzheimer’s disease, and investigate the possibility of publication bias. In the current study, the authors updated their recently published meta-analyses on occupational exposures in relation to ALS, Alzheimer’s and Parkinson’s disease. Based on 66 original publications of good scientific epidemiological standards, according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) guidelines. They analyzed subgroups by carrying out stratified meta-analyses on publication year, statistical precision of the relative risk (RR) estimates, an inspection of the funnel plots and test of bias. 

  • Based on 19 studies the weighted RR for occupational exposure to EMFs was 1.26 (95% confidence interval (CI) 1.07⁻1.50) for ALS, 1.33 (95% CI 1.07⁻1.64) for Alzheimer’s disease and 1.02 (95% CI 0.83⁻1.26) for Parkinson’s disease.
  • Thirty-one studies concerned occupational exposure to pesticides and the weighted RR was 1.35 (95% CI 1.02⁻1.79) for ALS, 1.50 (95% CI 0.98⁻2.29) for Alzheimer’s disease and 1.66 (95% CI 1.42⁻1.94) for Parkinson’s disease.
  • Finally, 14 studies concerned occupational exposure to metals and only exposure to lead (five studies) involved an elevated risk for ALS or Parkinson’s disease and the weighted RR was 1.57 (95% CI 1.11⁻2.20). The weighted RR for all the non-lead exposures was 0.97 (95% CI 0.88⁻1.06). 

The authors concluded that exposure to pesticides increased the risk of getting the mentioned neurodegenerative diseases by at least 50%. Exposure to lead was only studied for ALS and Parkinson’s disease and involved 50% increased risk. Occupational exposure to EMFs seemed to involve some 10% increase in risk for ALS and Alzheimer’s disease only.



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