A systematic review of occupational exposure to respirable coal mine dust(RCMD)in the U.S.mining industry

Cumulative inhalation of respirable coal mine dust(RCMD)can lead to severe lung diseases,including coal worker's pneu-moconiosis(CWP),silicosis,mixed dust pneumoconiosis,dust-related diffuse fibrosis(DDF),and progressive massive fibrosis(PMF).Statistics from the number of reported cases showed a significant decrease in the progression of respiratory diseases in the 1990s.However,an unexpected increase in the number of CWP cases was reported in the late 1990s.To date,there has been no comprehensive systematic review to assess all contributing factors to the resurgence of CWP cases.This study aims to investigate the effects of various mining parameters on the prevalence of CWP in coal mines.A systematic review using the preferred reporting items for systematic reviews and meta-analysis(PRISMA)method was conducted to investigate the health effects of RCMD exposure and identify the factors that may contribute to the recent resurgence of CWP cases.The systematic review yielded a total of 401 papers,which were added to the database.The total number of 148 and 208 papers were excluded from the database in the process of screening and eligibility,respectively.Then,18 papers were considered for data selection and full-text assessment.The review revealed that factors including geographic location,mine size,mining operation type,coal-seam thickness,coal rank,changes in mining practices,technology advancement,and engi-neering dust control practices are contributing to the recent resurgence of CWP among coal workers.However,the evidence for root causes is limited owing to the methodological constraints of the studies;therefore,further detailed studies are needed.

Occupational exposure to flour dust among bakery workers:prevalence,potential hazards and promising interventions

Occupational exposure to flour dust within bakery environments presents significant health hazards to bakery personnel.Flour dust,generated as a byproduct during baking,becomes airborne during the baking process,thus constituting a respiratory threat.Adverse health consequences include respiratory diseases,skin irritation,allergic reactions,and potential long-term health impacts.Data indicates that a broad segment of bakery workers encounters exposure to flour dust,with specific subgroups,such as bakers and dough mixers,being particularly susceptible.Contributing factors to this exposure encompass insufficient ventilation and a lack of awareness.It is vital to assess exposure levels through air quality monitoring and health surveillance.Efficient interventions encompass engineering solutions(e.g.,ventilation systems,dust extraction),administrative measures(including training and the use of personal protective equipment),and the implementation of occupational health and safety programs.Collaborative efforts with healthcare professionals and regulatory authorities are paramount for achieving success.Case studies underscore the effectiveness of such interventions,resulting in improved worker health,thus underscoring the advantages of protective measures.Challenges in this endeavor include industry resistance to change,financial considerations,and issues related to compliance.Future recommendations entail further research,policy enhancements,and the involvement of industry stakeholders and labor unions in advocating for worker safety.

Hepatocellular carcinoma and the risk of occupational exposure

Hepatocellular carcinoma(HCC)is the most common type of liver cancer.The main risk factors for HCC are alcoholism,hepatitis B virus,hepatitis C virus,nonalcoholic steatohepatitis,obesity,type 2 diabetes,cirrhosis,aflatoxin,hemochromatosis,Wilson’s disease and hemophilia.Occupational exposure to chemicals is another risk factor for HCC.Often the relationship between occupational risk and HCC is unclear and the reports are fragmented and inconsistent.This review aims to summarize the current knowledge regarding the association of infective and non-infective occupational risk exposure and HCC in order to encourage further research and draw attention to this global occupational public health problem.

Establishment of Occupational Exposure Limit for Warfarin in China

This study aims to establish the occupational exposure limit （OEL） in the air for workplace of warfarin based on the available toxicological studies and field investigations by using questionnaire and air monitoring. The clinical therapeutic dose was used as lowest observed effect level （LOEL）, and no observed effect level （NOEL） was achieved by using a safety factor. The highest concentration of warfarin monitored in the worksite of centrifuge washing, drying and packing were 0.029 mg/m3, 0.052 mg/m3 respectively, which did not exceed the OEL 0.2 mg/m3 recommended by NIOSH and ACGIH. Considering its feasibility for enforcement and protection for workers, we recommend OEL 0.2 mg/m3 of warfarin in China.

Metal Exposure and Risk of Diabetes and Prediabetes among Chinese Occupational Workers

Objective To study the association between metal exposure and risk of diabetes and prediabetes among Chinese workers exposed to metals.Methods We used data obtained from the baseline survey of the Jinchang Cohort Study of workers in Jinchang Industry,the largest nickel production company in China.A total of 42,122 workers ≥20 years of age were included in the study.A standardized,structured questionnaire was used to collect epidemiological information.Physical examinations and laboratory tests were conducted to evaluate the health status of the participants and to measure various biomarkers including blood sugar,lipids,and urinary metal concentrations.Logistic regression was used to study the association between occupational groups categorized according to the measured metal levels(office workers,low-level;mining/production workers,mid-level;and smelting/refining workers,high-level)and risk of diabetes and prediabetes.Results The overall prevalence of diabetes and prediabetes was 7.5% and 16.8%,respectively.The adjusted odds ratios for diabetes among mining/production workers and smelting/refining workers compared to office workers were 1.5(95% CI:1.3,1.7)and 3.8(95% CI:3.4,4.3),respectively.No association was observed between these occupational groups and prediabetes in this study.Conclusion Occupations associated with higher levels of metal exposure were associated with an increased risk of diabetes in this cohort.More studies are needed to confirm this observed association.

Occupational exposures and colorectal cancers:A quantitative overview of epidemiological evidence

A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer.In more recent times,however,a growing evidence has shown that other determinants can be very important in increasing(or reducing) incidence of this malignancy.The hypothesis that environmental and occupational risk factors are associated with colorectal cancer is gaining ground,and high risks of colorectal cancer have been reported among workers in some industrial branches.The aim of this study was to investigate the epidemiologic relationship between colorectal cancer and occupational exposures to several industrial activities,by means of a scientific literature review and meta-analysis.This work pointed out increased risks of colorectal cancer for labourers occupied in industries with a wide use of chemical compounds,such as leather(RR = 1.70,95%CI:1.24-2.34),basic metals(RR = 1.32,95%CI:1.07-1.65),plastic and rubber manufacturing(RR = 1.30,95%CI:0.98-1.71 and RR = 1.27,95%CI:0.92-1.76,respectively),besides workers in the sector of repair and installation of machinery exposed to asbestos(RR = 1.40,95%CI:1.07-1.84).Based on our results,the estimated crude excess risk fraction attributable to occupational exposure ranged from about 11% to about 15%.However,homogeneous pattern of association between colorectal cancer and industrial branches did not emerge from this review.

Occupational Exposure to Indium of Indium Smelter Workers

Case reports of indium-related lung disease in workers have raised public concern to the human toxicity of indium （In） and its compounds. However, studies evaluating the exposure or health of workers in In smelting plants are rare. Therefore, in this study, we focused on four In smelting plants, with the main objective of characterizing In in smelter plants in China and discussing the potential exposure biomarkers of In exposure.

Transition from minimal change disease to focal segmental glomerulosclerosis related to occupational exposure:A case report

BACKGROUND Although minimal change disease(MCD)and focal segmental glomerulosclerosis(FSGS)have been described as two separate forms of nephrotic syndrome(NS),they are not completely independent.We report a case of a patient transitioning from MCD to FSGS,review the literature,and explore the relationship between the two diseases.CASE SUMMARY A 42-year-old male welder,presenting with lower extremity edema and elevated serum creatinine,was diagnosed with NS and end-stage kidney disease(ESKD)based on laboratory test results.The patient had undergone a kidney biopsy for NS 20 years previously,which indicated MCD,and a second recent kidney biopsy suggested FSGS.The patient was an electric welder with excessive levels of cadmium and lead in his blood.Consequently,we suspect that his aggravated pathology and occurrence of ESKD were related to metal nephrotoxicity.The patient eventually received kidney replacement therapy and quit his job which involved long-term exposure to metals.During the 1-year follow-up period,the patient was negative for metal elements in the blood and urine and recovered partial kidney function.CONCLUSION MCD and FSGS may be different stages of the same disease.The transition from MCD to FSGS in this case indicates disease progression,which may be related to excessive metal contaminants caused by the patient’s occupation.

Effect of Occupational Manganese Exposure on Uric Acid Levels in Human Urine

Objective To investigate the effect of long-term and low-level occupational Mn exposure on the level of uric acid （UA） in human urine. Methods In this study, 65 volunteers were recruited, who were working on welding and foundry work in an plant in Gansu province, China. Additionally, 29 control samples were collected from individuals who did not have any history of excessive Mn exposure. An improved high performance liquid chromatography system equipped with a diode-array detector （HPLC-DAD） method was developed to determine the UA level in human urine. A Spectra AA 220 Atomic Absorption Spectrophotometer （AAS） was used to measure the Mn level in the urine. Results The analytical method was validated acceptable accuracy, precision, and recovery significantly lower than that of control samples for concentrations ranging from 3.82-45.84 pg/mL with Overall, the UA levels of Mn exposure samples were （P〈O.O5）. Conclusion The practical method developed here is suitable for both routine monitoring of UA level in human urine and metabolism research. Long-term and low-level occupational Mn exposure may lead to a lower UA level in urine, and UA might be an indicator of the early stage of manganism.

Occupational Exposure of Healthcare Workers during COVID-19 Field Surveillance Activities in South India: A Cross-Sectional Qualitative Study

Context: Health Care Workers (HCWs) involved in field-level activities are exposed to COVID-19 which puts them under physical and psychological stress. Aim: The objective of this study was to understand the perception of the health care workers regarding their occupational exposure to COVID-19, including the safety measures used during field surveillance activities. Settings and Design: This cross-sectional study was conducted from June 2020 to July 2020 among the health care workers involved in COVID-19 field containment activities in two south Indian states—Telangana and Tamil Nadu. Methods and Material: Respondents were purposively sampled based on their involvement in the COVID-19 field level activities. Sixteen In-Depth Interviewees (IDIs) were conducted telephonically with medical officers, district epidemiologists, community health workers, sanitary workers, emergency medical technicians, and ambulance coordinators. Statistical Analysis Used: IDIs were analyzed using manual thematic analysis. Results: Seven themes and sub-themes emerged: awareness and training, occupational exposure to COVID-19 and duration, safety measures, occupational burnout, social stigma, psychological violence, and facilitating factors. Respondents felt a high level of occupational exposure to COVID-19 in addition to increased workload and stress due to fear of infection, shortage of workforce, denial of week off, psychological violence, and social stigma which affected them deeply. Support from supervisors and family, and measures ensuring the safety of women were facilitating factors to cope with the situation. Conclusions: It is important to safeguard the general and mental health of field-level health workers involved in COVID-19 activities, to keep their morale high during the continuing pandemic.

Respiratory Morbidity Associated with Long-Term Occupational Inhalation Exposure to High Concentrations of Hydrated Calcium Sulfate Dust

Despite wide application of hydrated calcium sulfate, possible respiratory effects of long-term occupational exposure to high concentrations of this chemical have only been investigated in a limited number of epidemiological studies. This study is undertaken to examine this issue, more thoroughly. This cross-sectional study is carried out at a local gypsum plant in Shiraz, capital of Fars province situated in south western Iran. All exposed subjects (20 male workers) and 20 healthy non-exposed male individuals as the referent group are investigated. Prevalence of respiratory symptoms among the studied subjects is evaluated and they undergo spirometry test (twice for the exposed group and once for the unexposed employees). Moreover, to assess the extent to which workers are exposed to gypsum dust and using standard methods, inhalable and respirable fractions of this compound are measured in different dusty worksites. Average airborne concentration of inhalable dust fraction is estimated to be 24 ± 14.76 mg/m3 which is higher than the recommended threshold limit value (TLV) for this chemical. Respiratory symptoms such as phlegm, wheezing and dyspnea are significantly more prevalent in exposed subjects than in non-exposed employees (p < 0.05). The results of ventilatory function tests (pre- shift) don’t show any significant differences between both groups. However, some post-shift parameters of ventilatory function such as FVC, FEV1 and FEV1/FVC ratio are significantly lower than those of preshift and referent group. Exposure to high atmospheric concentrations of gypsum dust is associated with a significant increase in the prevalence of respiratory symptoms along with acute reversible significant decreases in some parameters of ventilatory function.

Influence of Occupational Noise Exposure on Cognitive Ability of Grinders

Purpose: To investigate whether long-term noise exposure affects the cognitive ability of grinders. Methods: Cumulative noise exposure (CNE) and LAeq.8h determination were used to characterize the level of individual noise exposure;the Montreal Cognitive Assessment (MoCA) test (Beijing version) was used to evaluate cognitive function. Results: We compared the basic situation of workers in different groups and individual noise exposure intensity of grinders was monitored. Multiple linear-regression analysis was made and score of MoCA in different group was finally drawn. Conclusion: CNE and total score of MoCA have the relationship of negative correlation (r = -0.303, p < 0.05) which means long-term occupational noise exposure can affect the cognitive ability of grinders.

Downregulation of Serum PTEN Expression in Mercury-Exposed Population and PI3K/AKT Pathway-Induced Inflammation

Objective This study investigated the impact of occupational mercury(Hg) exposure on human gene transcription and expression, and its potential biological mechanisms.Methods Differentially expressed genes related to Hg exposure were identified and validated using gene expression microarray analysis and extended validation. Hg-exposed cell models and PTEN lowexpression models were established in vitro using 293T cells. PTEN gene expression was assessed using qRT-PCR, and Western blotting was used to measure PTEN, AKT, and PI3K protein levels. IL-6 expression was determined by ELISA.Results Combined findings from gene expression microarray analysis, bioinformatics, and population expansion validation indicated significant downregulation of the PTEN gene in the high-concentration Hg exposure group. In the Hg-exposed cell model(25 and 10 μmol/L), a significant decrease in PTEN expression was observed, accompanied by a significant increase in PI3K, AKT, and IL-6 expression.Similarly, a low-expression cell model demonstrated that PTEN gene knockdown led to a significant decrease in PTEN protein expression and a substantial increase in PI3K, AKT, and IL-6 levels.Conclusion This is the first study to report that Hg exposure downregulates the PTEN gene, activates the PI3K/AKT regulatory pathway, and increases the expression of inflammatory factors, ultimately resulting in kidney inflammation.

A Bayesian network for estimating hypertension risk due to occupational aluminum exposure

Background The correlation between metals and hypertension,such as sodium,zinc,potassium,and magnesium,has been confirmed,while the relationship between aluminum and hypertension is not very clear.This study aimed to evaluate the correlation between plasma aluminum and hypertension in electrolytic aluminum workers by the Bayesian networks(BN).Methods In 2019,476 male workers in an aluminum factory were investigated.The plasma aluminum concentration of workers was measured by inductively coupled plasma mass spectrometry.The influencing factors on the prevalence of hypertension were analyzed by the BN.Results The prevalence of hypertension was 23.9%in 476 male workers.The risk of hypertension from plasma aluminum in the Q2,Q3,and Q4 groups was 5.20(1.90–14.25),6.92(2.51–19.08),and 7.33(2.69–20.01),respectively,compared with that in the Q1 group.The risk of hypertension from the duration of exposure to aluminum of>10 years was 2.23(1.09–4.57),compared without aluminum exposure.Area under the curve was 0.80 of plasma aluminum and the duration of exposure to aluminum was based on covariates,indicating that aluminum exposure had important predictive value in the prevalence of hypertension in the occupational population.The results of the study using the BN model showed that if the plasma aluminum of all participants was higher than Q4(≥47.86µg/L)and the participants were drinking,smoking,diabetes,central obesity,dyslipidemia,and aged>50 years,the proportion of hypertension was 71.2%.Conclusions The prevalence of hypertension increased significantly with the increase of plasma aluminum level.

Health Risk Assessment of Employees Exposed to Chlorination By-products of Recreational Water in Large Amusement Parks in Shanghai

Objective Chlorination is often used to disinfect recreational water in large amusement parks;however,the health hazards of chlorination disinfection by-products(DBPs)to occupational populations are unknown.This study aimed to assess the exposure status of chlorinated DBPs in recreational water and the health risks to employees of large amusement parks.Methods Exposure parameters of employees of three large amusement parks in Shanghai were investigated using a questionnaire.Seven typical chlorinated DBPs in recreational water and spray samples were quantified by gas chromatography,and the health risks to amusement park employees exposed to chlorinated DBPs were evaluated according to the WHO's risk assessment framework.Results Trichloroacetic acid,dibromochloromethane,bromodichloromethane,and dichloroacetic acid were detected predominantly in recreational water.The carcinogenic and non-carcinogenic risks of the five DBPs did not exceed the risk thresholds.In addition,the carcinogenic and non-carcinogenic risks of mixed exposure to DBPs were within the acceptable risk limits.Conclusion Typical DBPs were widely detected in recreational water collected from three large amusement parks in Shanghai;however,the health risks of DBPs and their mixtures were within acceptable limits.

A summary of UNSCEAR evaluation on occupational exposure to ionizing radiation and call for more representative data in broader range of occupational sectors

The annex D of the United Nations Scientific Committee on the Effects of Atomic Radiation(UNSCEAR)2020/2021 Report presented a comprehensive global estimate of occupational exposure to ionizing radiation.The worldwide annual number of workers exposed to natural and human-made sources of ionizing radiation was estimated to be approximately 24 million in the period 2010-2014.About 52% of those were employed in the sectors that involve exposure to natural sources of radiation.The worldwide average annual effective dose for all workers during the period 2010-2014 was estimated to be around 1.2 mSv-about two thirds of the value estimated for the period 1995-1999.The annual effective dose was estimated to be around 2.0 mSv for workers exposed to natural sources and 0.5 mSv for workers exposed to human-made sources.The overriding limitation of current evaluation was the low rate of participation by United Nations Member States in providing occupational exposure monitoring data,especially data from non-nuclear sectors and occupational sectors involving naturally occurring radioactive materials.As the assessment of the worldwide occupational exposure is a complex task,the Committee relies on the collection of up-to-date data on occupational exposure from United Nations Member States in a broad range of occupational sectors,and continues collaboration with international organizations.

Evaluation of the Living Conditions and Health Perceptions of Waste Electrical and Electronic Equipment Handlers in the Informal Sector in Dakar

Electrical and electronic devices are becoming an increasingly important part of our society. In Africa, and in Senegal in particular, the handling and management of electronic and electrical equipment (EEE) that has reached the end of its life is mainly informal. This professional environment is characterized by the disintegration of the sector and the social heterogeneity that can be found there. The objective of this study is to assess the standard of living of electrical and electronic equipment waste handlers in the Dakar region, as well as their perception of their health. A survey was used to obtain information on sociodemographic background, living arrangements, perception of health status, and good practices to be implemented in case of work-related health problems. Life style, perception of general health and health problems were ranged as excellent, very good, good, average and poor. Informal recyclers in the Dakar region lived mainly in rooms and buildings as tenants (49.1%), or in family homes (48.4%) before starting this activity, and 51.2% continue to live in rooms and buildings as tenants compared to 41.4% who still live in a family home. The perception of health status ranged from poor to excellent, and 4.9% believe that they are limited in work due to a disability or health problem. Informal work is a heterogeneous phenomenon that makes research and policymaking particularly complex. There are several external factors within informal WEEE re-cyclers that can cause health problems or functional disability. However, the living conditions and the perception they have of their state of health are contradictory to the working conditions and the social environment to which they belong. A biomedical approach would consolidate these achievements by confirming or invalidating them.

A Comparison of Airborne Formaldehyde Field Measurements Collected in an Anatomic Pathology Laboratory

Environmental monitoring of airborne formaldehyde (FA) using sensitive methodologies is fundamental to prevent health risks. The objective of this study was to compare three different FA monitoring methods during the daily activities of an anatomic pathology laboratory. Daily eight-hour measurements deriving from Radiello® passive diffusive samplers (PDS), NEMo XT continuous optical sensor (COS), and multi-gas 1512 photoacoustic monitor (MPM) were simultaneously compared over a period of 14 working days. Given the different daily distributions of the measurements performed by the three devices, all measurements were time-aligned for comparison purposes. The 95% limit of agreement (LOA) method was applied to estimate the degree of concordance of each device with respect to the others. Formaldehyde arithmetic mean measured using PDS was 32.6 ± 10.4 ppb (range: 19.8 - 62.7). The simultaneous measures performed by COS and MPM were respectively 42.4 ± 44.8 ppb (range: 7.0 - 175.0) and 189.0 ± 163.7 ppb (range: 40.0 - 2895.4). The MPM geometric mean (171.3 ppb) was approximately five times higher than those derived from COS (32.3 ppb) and PDS (31.4 ppb). The results of the LOA method applied to log-transformed FA data showed the same systematic discrepancies between MPM and the other two devices. A good agreement between PDS and COS could lead to a tailored approach according to the individual specificity of these techniques. This tool may be useful for accurately assessing the risk of FA exposure among healthcare workers. However, the limited specificity of the MPM does not support its use as a monitoring method for FA in the workplace.

Prevalence of Latent Tuberculosis Infection [LTBI] in Prison Officers: A Systematic Review and Meta-Analysis

This study aimed to perform a systematic review and meta-analysis to determine the LTBI prevalence in prison officers worldwide. A systematic search was performed in PubMed, WoS, Embase, and BVS, including all articles related to LTBI prevalence and risk factors. After critical evaluation and qualitative synthesis of the identified articles, a meta-analysis was used. Five studies carried out between 2012 and 2022 were included, with a total sample size of 1718 prison officers. The overall LTBI prevalence was 50% [95% confidence interval [CI]: 48% - 52%;n = 816], with high heterogeneity between studies. Smoking [OR = 1.76;CI 95% = 1.26 - 2.46] and males [OR = 2.08;CI 95% = 1.31 - 3.31] were positively related to a higher LTBI prevalence among prison officers. Thus, preventive measures and the rapid and accurate diagnosis of new cases should be emphasized to ensure tuberculosis control, especially among risk groups such as prison officers.