September 2022 additions to NERDB

September 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

On the website, we will publish regular updates on new disease-exposure combinations we added to the database. Currently, we have 354 entries. Ordered by year in which the abstract is published

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New entries:

Photo by Jon Kline via Pixabay

Grahn, K., Broberg, K., Gustavsson, P. et al. Occupational exposure to particles and biomarkers of cardiovascular disease—during work and after vacationInt Arch Occup Environ Health 95, 1537–1548 (2022).


Ambient particle matter is a risk factor for cardiovascular disease (CVD). However, little is known about associations between particles in occupational settings and risk of CVD. We investigated associations between occupational dust exposure and biomarkers of CVD, and potential recovery effects after vacation.


Personal dust exposure measurements (respirable silica, respirable dust < 4 µm, and particles of 0.1–10 µm (PM 0.1–10)) were conducted once, and biological sampling was performed twice on non-smoking, male construction workers in Stockholm county, Sweden; during work and immediately after summer vacation. Linear regressions with adjustments for confounders and covariates were performed, evaluating associations between occupational dust exposure and biomarkers. Paired t-tests were performed, evaluating changes before and after vacation.


Sixty-five workers participated. Homocysteine concentrations were significantly higher with increasing concentrations (mg/m3) of respirable silica, respirable dust, and PM 0.1–10, and pulse rate with higher levels of respirable dust and dust of PM 0.1–10. Homocysteine levels were also positively correlated to the number of years of dust exposure, as were low-density lipoprotein (LDL) levels. A clear recovery effect was present for LDL after vacation, but not for homocysteine.


Occupational dust exposure was associated with some CVD risk markers, even at mean exposure concentrations below the Swedish occupational exposure limits for respirable silica and respirable dust, respectively. Vacation resulted in recovery for some risk markers. However, the change in the homocysteine and LDL levels suggests a long-term effect. Reduction of occupational exposure to dust may decrease the risk of CVD among exposed workers.

de Perio MA, Hendricks KA, Dowell CH, Bower WA, Burton NC, Dawson P, Schrodt CA, Salzer JS, Marston CK, Feldmann K, Hoffmaster AR, Antonini JM. Welder’s Anthrax: A Review of an Occupational Disease. Pathogens. 2022 Mar 26;11(4):402. doi: 10.3390/pathogens11040402. PMID: 35456077; PMCID: PMC9029013.

Since 1997, nine cases of severe pneumonia, caused by species within the B. cereus group and with a presentation similar to that of inhalation anthrax, were reported in seemingly immuno-competent metalworkers, with most being welders. In seven of the cases, isolates were found to harbor a plasmid similar to the B. anthracis pXO1 that encodes anthrax toxins.

In this paper, we review the literature on the B. cereus group spp. pneumonia among welders and other metalworkers, which we term welder’s anthrax. We describe the epidemiology, including more information on two cases of welder’s anthrax in 2020. We also describe the health risks associated with welding, potential mechanisms of infection and pathological damage, prevention measures according to the hierarchy of controls, and clinical and public health considerations.

Considering occupational risk factors and controlling exposure to welding fumes and gases among workers, according to the hierarchy of controls, should help prevent disease transmission in the workplace.

Morotti A, Sollaku I, Franceschini F, Cavazzana I, Fredi M, Sala E, De Palma G. Systematic Review and Meta-analysis on the Association of Occupational Exposure to Free Crystalline Silica and Rheumatoid Arthritis. Clin Rev Allergy Immunol. 2022 Apr;62(2):333-345. doi: 10.1007/s12016-021-08846-5. Epub 2021 Mar 2. PMID: 33651342; PMCID: PMC8994741.

Occupational exposure to free crystalline silica and tobacco smoking is associated with an increased risk of rheumatoid arthritis, with evidence of interaction in seropositive subjects.

Further studies in the field are needed to support such an association. We carried out a systematic search for all published epidemiological studies concerning the association between occupational exposure to free crystalline silica (FCS) and subsequent development of rheumatoid arthritis (RA). A meta-analysis was conducted on relevant studies.

We searched PubMed and Embase, search engines, for original articles published (from 1960 to November 2019) in any language. In addition, we also searched reference lists of included studies manually for additional relevant articles. Finally, twelve studies were included in the meta-analysis (seven case-control cases and five cohort studies). The odds risks and 95% confidence interval (CI) were calculated using a random effect meta-analysis.

A primary meta-analysis (using a random effect model)-regarding RA risk in subjects exposed to FCS-yelled to an overall OR of 1.94 (95% CI 1.46-2.58). We also conducted three further meta-analyses, taking into account the presence of autoantibodies (anti-RF or anti-ACPA) and smoking habits, and found a significant association between FCS and RA in both seropositive and seronegative subjects (OR 1.74, 95% CI 1.35-2.25 and OR 1.23, 95% CI 1.06-1.4, respectively) and in seropositive subjects which were smokers (OR 3.30, 95% CI 2.40-4.54).

The studies that have investigated the association between RA and occupational exposure to FCS are still scarce, and the heterogeneity between the studies remains high. Some critical limitations have been identified within studies, among which, the methods for assessing exposure stand out. Although with due caution, our results confirm the hypothesis of an association between occupational exposure to FCS and RA development. There was an interaction between FCS and tobacco smoking in RA seropositive workers.

Ish, J., Gimeno Ruiz de Porras, D., Symanski, E., Ballester, F., Casas, M., Delclos, G. L., … & Whitworth, K. W. (2022). Maternal occupational exposures and fetal growth in a Spanish birth cohortPloS one17(4), e0264530.

While the epidemiologic literature suggests certain maternal occupational exposures may be associated with reduced measures of size at birth, the occupational literature employing fetal biometry data to assess fetal growth is sparse. The present study examines associations between maternal occupational exposures and ultrasound-measured fetal growth.

We included 1,739 singleton pregnancies from the INfancia y Medio Ambiente (INMA) project (2003-2008). At 32 weeks of pregnancy, interviewers ascertained mothers’ employment status and assessed job-related physical loads, work schedules, and job strain during pregnancy. Job titles were linked to a job-exposure matrix to estimate exposure to 10 endocrine-disrupting chemical-groups (EDC).

We calculated z-scores from longitudinal growth curves representing trajectories from 0-12, 12-20 and 20-34 gestational weeks for abdominal circumference (AC), biparietal diameter (BPD), femur length (FL), and estimated fetal weight (EFW). Linear mixed models clustered by IMNA region (i.e., Gipuzkoa, Sabadell, Valencia) were used to examine associations between occupational exposures and fetal growth. Effect estimates are presented as percentage change in fetal growth.

There was limited evidence of associations between work-related non-chemical stressors and fetal growth. We observed associations of similar magnitude between multiple EDC groups and decreased EFW trajectories during 20-34 gestational weeks (phthalates: -1.4% [-3.5, 0.6%]; alkyl phenolic compounds (APCs): -1.1% [-2.3, 0.1%]; miscellaneous chemicals: -1.5% [-3.7, 0.8%]), while miscellaneous chemicals were associated with increased BPD from 12-20 weeks (2.1% [0.8, 3.5%]).

Notably, 67% of women exposed to phthalates were hairdressers; 68% of women exposed to APC’s worked as domestic cleaners. In conclusion, we found limited evidence that maternal occupational exposures impact fetal growth. Further research should consider the combined impact of multiple workplace exposures.

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