Combined Exposures to Dangerous Substances in the Workplace; An - - PowerPoint PPT Presentation
Combined Exposures to Dangerous Substances in the Workplace; An epidemiological perspective Roel Vermeulen, PhD Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Institute for Risk Assessment Sciences
Roel Vermeulen, PhD Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Institute for Risk Assessment Sciences University of Utrecht
An interfacultary research institute within the faculties Veterinary Medicine, Medicine, Pharmaceutical Sciences and Biology of Utrecht University The mission of IRAS is to provide education and research
exposure to potentially harmful agents in the environment, at the workplace and through the food chain
– Benzene – Dioxin – Electromagnetic fields – Formaldehyde – Trichloroethylene – Selected pesticides
– Asbestos – Diesel exhaust – Indoor air pollution – Metals – Polycyclic Hydrocarbons
H o d g s o n ( 1 9 9 0 ) K u z m i c k i e n e ( 2 0 0 7 ) S z e s z e n i a - D a b r o w s k a ( 1 9 9 9 ) A s t r a k i a n a k i s ( 2 0 0 7 ) F r i t s c h i ( 2 0 0 4 ) W u - W i l l i a m s ( 1 9 9 3 ) L e v i n ( 1 9 8 7 ) M a s t r a n g e l o ( 2 0 0 8 ) M e r c h a n t ( 1 9 8 1 ) H e n d e r s o n ( 1 9 7 3 ) K o s k e l a ( 1 9 9 0 ) 1 . 1 6 8 1 5 . 9 7 R R
O v e r a ll ( I- s q u a r e d = 9 7 .8 % , p = 0 .0 0 0 ) A lb e r g h in i ( 1 9 9 1 ) L e v in ( 1 9 8 8 ) L a a k k o n e n ( 2 0 0 8 ) P u k k a la ( 1 9 9 7 ) W a n g ( 2 0 0 2 ) S ta r k ( 1 9 9 0 ) S p e r a ti ( 1 9 9 9 ) F a u s tin i ( 1 9 9 3 ) J a h n ( 1 9 9 9 ) G u n n a r d o ttir ( 1 9 9 1 ) M a s tr a n g e lo ( 2 0 0 5 ) W ik lu n d ( 1 9 9 4 ) B u r m e is te r ( 1 9 8 1 ) A la v a n ja ( 2 0 0 5 ) R o n c o ( 1 9 9 2 ) L e e ( 2 0 0 6 ) M a s tr a n g e lo ( 1 9 9 6 ) W ilk u n d ( 1 9 8 8 ) 1 .2 0 7 1 4 .8 4 R R
Lenters et al., submitted
– Cross-sectional survey on genotoxic exposures in the rubber industry
– to characterize the physical, chemical and oxidant properties
characteristics are critical determinates of adverse systemic and respiratory effects
– Synergistic effects of multiple exposures to lung carcinogens
increased cancer risks: lung, bladder, larynx and leukemia1
Current genotoxic risks largely unknown
Geometric mean particulate exposure (mg/m3) for each production function in each plant
mix pre mod cur fin ship es lab 1 2 3 4 5 6 7
1 2 3 4 5 6
mg/m3 Production function Company
Geometric mean mutagenicity TSM exposure (rev/m3) for each production function in each plant
mix pre mod cur fin ship lab 1 2 3 4 5 6 7
200 400 600 800 1000 1200
Rev/m3 Production function Company
Holmes et al., 2008
Included case-control studies: HDA Germany AUT Germany LUCAS Sweden TURI N-ROME I taly EAGLE I taly I NCO-Copernicus Czech Republic, Hungary, Poland, Romania, Russia, Slovakia, UK LUCA France PARI S France I CARE France EPI C The Netherlands Montreal Canada Overall alm ost 3 0 ,0 0 0 cases and controls
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Targeted Exposures – Lung Carcinogens
Asbestos
chrysotile (white asbestos); amphibole;
Chrom ium
chromium VI; total chromium
Nickel
soluble nickel compounds; insoluble nickel compounds; total nickel
PAHs
benzo(a)pyrene; naphthalene
Respirable Crystalline Silica
respirable quartz; respirable cristobalite; respirable tridymite; respirable crystalline silica
The power to detect interactions in epidemiological studies is low:
pah cr ni as mmmf rcs dme asb
4722 (33%) 3008 (21%) 1467 (10%) 396 (3%) 1714 (12%) 933 (7%) 1748 (12%)
pah
3502 (24%) 2196 (15%) 2873( 20%) 1641 (12%) 3744 (26%) 4656 (32%)
cr
2217 (16%) 296 (2%) 1607 (11%) 912 (6%) 81 (1%)
ni
281 (2%) 248 (2%) 80 (1%) 62
as
81 (1%) 2389 (17%) 2346 (16%)
mmmf
723 (5%) 17
rcs
2902 (20%)
pah cr ni as mmmf rcs dme asb
567 (4%) 7 6 10
pah
7 7 18 686 (5%) 525 (4%)
Cr
7
Ni As mmmf rcs
438 (3%)
– Asbestos and PAH (33%; 4% high) – PAH and diesel (32%; 4% high) – PAH and silica (26%; 5% high) – Silica and diesel (20%; 3% high)
The power to detect interactions in epidemiological studies is low:
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I m proved Exposure Assessm ent
Required data: Personal measurement data is preferred above stationary Individual data points needed to build multivariate models Auxiliary data, such as:
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Data collection – So far
2000 4000 6000 8000 10000 12000 14000 16000 18000 20000
** Canada ** ** Czech Rep. ** Denmark Finland ** France ** ** Germany ** ** Hungary ** Iceland ** Italy ** ** NL ** Norway ** Poland ** ** Sweden ** ** UK ** ** Slovakia ** ** Romania ** ** Russia ** Data being entered at moment Data already in ExpoSYN (n ~28,000)