Blood biomarkers for occupational hand-arm vibration exposure.

Hand-arm vibration is a common occupational exposure that causes neurological impairment, myalgia, and vibration-induced Raynaud's phenomena or vibration white fingers (VWF). The pathological mechanism is largely unknown, though several mechanisms have been proposed, involving both immunological vascular damage and defective neural responses. The aim of this study was to test whether the substances interleukin-33 (IL-33), macrophage-derived chemokine (MDC), interleukin-10 (IL-10), endothelin-1 (ET-1), C-C motif chemokine ligand 20 (CCL20), calcitonin, and thromboxane (TXA2) changed before and after occupational hand-arm vibration exposure. 38 full-time shift workers exposed to hand-arm vibration were recruited. All the participants underwent medical examinations regarding symptoms of Raynaud's phenomena. In 29 of the participants, the concentration of IL-33, MDC, IL-10, ET-1, CCL20, calcitonin, and TXA2 was measured before and after a workday. There was a significant increase in ET-1 and calcitonin concentration and a decrease in the CCL20 concentration after the work shift in all participants. In the group suffering from VWF, but not in the non-VWF group, MDC was statistically significantly lower before the work shift (p = .023). The VWF group also showed a significant increase in MDC after the work shift. Exposure to occupational hand-arm vibration is associated with changes in ET-1, calcitonin, and MDC concentration in subjects suffering from vibration white fingers, suggesting a role of these biomarkers in the pathophysiology of this condition.

The risk for ophthalmological conditions in ulcerative colitis: A population-based case-control study. Is silica dust-exposure associated with inflammatory eye disease?

PURPOSE: To study the risk for eye diseases in individuals with Ulcerative Colitis (UC), and to assess whether silica dust-exposure could contribute to the development of inflammatory eye diseases. METHODS: A case-control study was conducted using a patient register processed by the National Board of Health and Welfare (NBHW) and Statistics Sweden. Cases were diagnosed with UC between 2007 and 2016. Matching was done with two random controls having the same age, sex and county of residence, without a systemic inflammatory disease. Using a job-exposure matrix, cases and controls were assessed for work-related silica dust exposure. The risk for eye disease was estimated by Cox regression analysis with calculation of Hazard Ratio (HR). RESULTS: A total of 58 989 individuals were included, comprising 19 663 cases and 39 326 controls. The sex distribution was similar. Overall, individuals with UC had an increased risk for eye disease, specified in ICD 10 chapter VII (H00-H59) with HR 1.25 (CI 1.20-1.32). The highest HR on block-level for cases was 1.52 (CI 1.36-1.70), (H15-H22), which includes episcleritis, keratitis and anterior uveitis. The risk for ocular disease was higher in silica dust-exposed than non-exposed with a HR of 1.44 (CI 1.16-1.78) and 1.25 (CI 1.19-1.31), respectively. Among cases, the risk for iridocyclitis (H20) was further elevated by silica dust exposure, with HR of 3.84 (CI 1.64-8.97) in exposed compared to 1.94 (1.57-2.41) in non-exposed. CONCLUSION: UC is associated with an increased risk for eye diseases, including inflammatory conditions. Our findings highlight that silica dust-exposure may be of importance in the pathogenesis of uveitis.

A cross-sectional study on occupational exposure to microorganisms, endotoxin, hydrogen sulfide, and dust during work at drilling waste treatment plants.

This cross-sectional study aims to obtain knowledge about workers' exposure to airborne dust, bacterial and fungal species, endotoxin, biofilm formation, and hydrogen sulfide (H2S) in drilling waste treatment plants. In total, 408 full-shift personal samples, 66 work areas, 40 drilling waste, and reference (outdoor air and seawater) samples were analyzed. Some workers were exposed to high levels of endotoxin (207 EU/m3), bacteria (3.8 × 104 colony forming units (CFU)/m3 and 9.8 × 104 DNA copies/m3), or fungi (1.4 × 107 CFU/m3 and 3,600 copies/m3). The exposure levels to endotoxin, bacteria, and peaks of H2S were dependent on the treatment technique. All types of drilling waste contained large concentrations of bacteria compared to the seawater references. Elevated concentrations of airborne bacteria were found close to drilling waste basins. In total, 116, 146, and 112 different bacterial species were found in workers' exposure, work areas, and the drilling waste, respectively. An overlap in bacterial species found in the drilling waste and air (personal and work area) samples was found. Of the bacterial species found, 49 are classified as human pathogens such as Escherichia coli, Enterobacter cloacae, and Klebsiella oxytoca. In total, 44 fungal species were found in the working environment, and 6 of these are classified as human pathogens such as Aspergillus fumigatus. In conclusion, across the drilling waste treatment plants, human pathogens were present in the drilling waste, and workers' exposure was affected by the drilling waste treated at the plants with elevated exposure to endotoxin and bacteria. Elevated exposure was related to working as apprentices or chemical engineers, and working with cleaning, or slop water, and working in the daytime.

Occupational exposure to inhalable pathogenic microorganisms in waste sorting.

This study assessed microorganisms in personal inhalable work air samples aiming to identify potential human pathogens, and correlate exposure to adverse health outcomes in waste workers. Full-shift personal exposure was measured in six different waste sorting plants. Microbial concentrations in inhalable air samples were analysed using MALDI-TOF MS for cultivable, and next generation sequencing (NGS) for non-cultivable microorganisms. Concentrations of bacterial and fungal CFUs varied substantially within and between waste sorting plants, ranging from no identifiable organisms to a maximum concentration in the order of 105 CFU/m3. Bacillus and Staphylococcus were among the most abundant bacterial genera, whilst fungal genera were dominated by Aspergillus and Penicillium. Approximately 15% of all identified species were human pathogens classified in risk group 2, whereas 7% belonged to risk group 1. Furthermore, significant correlations between concentrations of fungi in risk group 1 and self-reported adverse symptoms, such as wheezing were identified in exposed workers. The combination of culture-based methods and NGS facilitated the investigation of infectious microbial species with potential pathophysiological properties as well as non-infectious biological agents in inhalable work air samples and thereby contributed to the risk assessment of occupational exposure in waste sorting.

Measurements of airborne asbestos fibres during refurbishing.

Although the use of asbestos fibres in building materials has been prohibited in Norway since 1985, asbestos-containing materials (ACMs) are still found in many buildings. Lack of knowledge and awareness of these materials may lead to exposure during refurbishing. The aim of this study was to investigate the airborne fibre concentration and classify fibres found during the abatement of various ACMs. The release of fibres during short-term work tasks, such as drilling and sawing, was also investigated. Parallel air samples were collected during asbestos abetment of different building materials and analysed with scanning electron microscope (SEM) and phase-contrast microscope (PCM), respectively. Material samples were analysed with SEM. A real-time fibre monitor was used to measure asbestos during short-term work. The highest fibre concentrations were measured for samples collected during the removal of asbestos insulating boards (1.5-4.5 fibres/cm3 [f/cm3]), and the numbers were relatively similar for SEM and PCM. A large difference in asbestos concentrations was found between SEM and PCM when analysing floor materials, which were probably caused by a high number of gypsum fibres that the PCM operator counted. Thin fibres (<0.2 µm in width) were included in the SEM count and constituted up to 50% of the total fibre concentration for the asbestos cement materials. The presence of other inorganic and organic fibres on these samples probably led to similar results between SEM and PCM. Short-term work led to peak concentrations above 30 f/cm3.

Chloroform exposure in air and water in Swedish indoor swimming pools-urine as a biomarker of occupational exposure.

INTRODUCTION: Disinfection by-products are produced in water disinfected with chlorine-based products. One such group is trihalomethanes, and chloroform is the most abundant trihalomethane in swimming pool areas. Chloroform can be absorbed by inhalation, ingestion, and dermal absorption, and is classified as possibly carcinogenic. AIM: To investigate if chloroform concentrations in air and water affect the chloroform concentration in urine samples of exposed swimming pool workers. METHODS: Workers from 5 adventure indoor swimming pools carried personal chloroform air samplers and provided up to 4 urine samples during one workday. Chloroform concentrations were analyzed with a linear mixed model analysis to investigate a possible correlation between air and urine concentrations. RESULTS: The geometric mean chloroform concentration was 11 µg/m3 in air and 0.009 µg/g creatinine in urine among individuals with ≤2 h at work, 0.023 µg/g creatinine among those with >2-5 working hours, and 0.026 µg/g creatinine in the group with >5-10 working hours. A risk of higher levels of chloroform in urine was associated with longer hours at work (≤2 h versus >5-10 h, odds ratio [OR] 2.04, 95% confidence interval [CI] 1.25-3.34), personal chloroform concentrations in air (≤17.00 µg/m3 versus >28.00 µg/m3, OR 9.23, 95% CI 3.68-23.13) and working at least half the working day near the swimming pools (OR 3.16, 95% CI 1.33-7.55). Executing work tasks in the swimming pool water was not associated with higher chloroform concentrations in urine compared to only working on land (OR 0.82, 95% CI 0.27-2.45). CONCLUSION: There is an accumulation of chloroform concentrations in urine during a workday and a correlation between personal air and urine concentrations of chloroform among workers in Swedish indoor swimming pools.

Bioaerosol-induced in vitro activation of toll-like receptors and inflammatory biomarker expression in waste workers.

PURPOSE: Occupational exposure to bioaerosols during waste handling remains a health concern for exposed workers. However, exposure-related health effects and underlying immunological mechanisms are still poorly described. METHODS: The present study assessed the inflammatory potential of work-air samples (n = 56) in vitro and investigated biomarker expression in exposed workers (n = 69) compared to unexposed controls (n = 25). These quantitative results were compared to self-reported health conditions. RESULTS: Personal air samples provoked an activation of TLR2 and TLR4 HEK reporter cells in one-third of all samples, indicating that the work environment contained ligands capable of inducing an immune response in vitro. Monocyte levels, as well as plasma biomarker levels, such as IL-1Ra, IL-18 and TNFα were significantly higher in exposed workers, compared to the control group when confounding factors such as BMI, sex, age and smoking habits were accounted for. Furthermore, a significant exposure-related increase in midweek IL-8 levels was measured among exposed workers. Tendencies of increased prevalence of health effects of the respiratory tract were identified in exposed workers. CONCLUSION: Inhalable dust provoked TLR activation in vitro, indicating that an exposure-related immune response may be expected in susceptible workers. However, despite significant differences in inflammatory plasma biomarker levels between exposed and unexposed workers, prevalence of self-reported health effects did not differ between the groups. This may be due to the healthy worker effect, or other factors such as adequate use of personal protective respiratory devices or adaptation to the work environment with reduced activation of the immune system.

Effects on blood parameters from hand-arm vibrations exposure.

Vibration exposure from handheld tools can affect the hands with neurological symptoms and vibration-induced Raynaud's phenomenon (VRP). The underlying pathophysiological mechanisms are not fully known, however, changes in the composition of blood parameters may contribute to VRP with an increase in blood viscosity and inflammatory response. The aim of this study was to examine the effect on blood parameters in capillary blood from fingers that had been exposed to a vibrating hand-held tool. This study involved nine healthy participants who had been exposed to vibration and an unexposed control group of six participants. Capillary blood samples were collected before and after vibration exposure for the exposed group, and repeated samples also from the control group. The exposed groups were exposed to vibration for a 15-min period or until they reached a 5.0 m/s2 vibration dose. Analysis of blood status and differential counting of leucocytes was performed on the capillary blood samples. The results of the blood samples showed an increase in mean value for erythrocyte volume fraction (EVF), hemoglobin, red blood cell count, white blood cell count and neutrophils, as well as a decrease of mean cell volume, mean cell hemoglobin, and mean cell hemoglobin concentration. The increase of EVF and neutrophils was statistically significant for samples taken from the index finger but not the little finger. Even though the study was small it showed that an acute vibration exposure to the hands might increase EVF and neutrophilic granulocytes levels in the capillary blood taken from index fingers.

Divergent TLR2 and TLR4 Activation by Fungal Spores and Species Diversity in Dust from Waste Sorting Plants.

This manuscript presents the results of an exploratory study on the relationships between NF-κB response through Toll-like receptor (TLR) activation by dust characterized by fungal spore concentrations and species diversity. Personal total dust samples were collected from Norwegian waste sorting plants and then characterized for fungal spores and fungal species diversity, as well as for other bioaerosol components, including endotoxins and actinobacteria. The ability of the dust to induce an NF-κB response by activating TLR2 and TLR4 in vitro was evaluated, as well as the relationship between such responses and quantifiable bioaerosol components. The average concentrations of bioaerosols were 7.23 mg total dust m-3, 4.49 × 105 fungal spores m-3, 814 endotoxin units m-3, and 0.6 × 105 actinobacteria m-3. The mean diversity measurements were 326, 0.59, and 3.39 for fungal richness, evenness, and Shannon index, respectively. Overall, fungal operational taxonomic units (OTUs) belonging to the Ascomycota phylum were most abundant (55%), followed by Basidiomycota (33%) and Mucoromycota (3%). All samples induced significant NF-κB responses through TLR2 and TLR4 activation. While fungal spore levels were positively associated with TLR2 and TLR4 activation, there was a trend that fungal species richness was negatively associated with the activation of these receptors. This observation supports the existence of divergent immunological response relationships between TLR activation and fungal spore levels on one hand and between TLR activation and fungal species diversity on the other. Such relationships seem to be described for the first time for dust from waste facilities. IMPORTANCE This manuscript presents results on multifactorial characterization of bioaerosol exposure in Norwegian waste sorting plants and the potential of such airborne dust to induce NF-κB reactions through TLR2 and TLR4 activations in an in vitro reporter cell model system. Our data revealed that increasing fungal spore levels in the dust is associated with increased activation of TLR2 and TLR4, whereas increasing fungal OTU richness is associated with decreasing activation of these receptors. The NF-κB-induced responses by the collected dust represent, therefore, effective measures of potential key immunological effects induced by a complex mixture of hazardous components, including characterized factors such as endotoxins, fungal spores, bacteria, and many other uncharacterized components. The key immunological events reported here are suggested as holistic alternatives to today's bioaerosol exposure characterization approaches for epidemiological studies in the future.

An assessment of occupational exposure to bioaerosols in automated versus manual waste sorting plants.

Occupational exposure during waste sorting is associated with several health outcomes. This study obtained knowledge about the impact of work in fully automated waste sorting plants (AWSP; n = 3) vs manual waste sorting plants (MWSP; n = 3) on personal exposure (n = 71) to bioaerosols and exposure-related health effects. Personal full-shift air samples were collected using various filter-based active sampling devices that were placed in the workers' breathing zone. Personal exposure to inhalable and thoracic dust, endotoxin and microorganisms varied considerably between and within types of waste sorting plants (WSP). Workers at AWSP were on average exposed to 0.34 mg/m3 inhalable dust, 0.15 mg/m3 thoracic dust, and 51 EU/m3 endotoxins (geometric mean (GM) levels), whereas GM exposure levels at MWSP were 0.66 mg/m3 for inhalable dust, 0.44 mg/m3 for thoracic dust, and 32 EU/m3 for endotoxins. Exposure to submicronic fungal fragments did not differ between types of plants and ranged from levels below the detection limit (limit of detection, LOD) to levels in the order of 106 fragments/m3. Higher levels of fungal fragments and fungal spores were found at AWSP compared to MWSP with a GM of 2.1 × 105 spores/m3and with a GM of 1.2 × 105 spores/m3, respectively. Actinobacterial spores were found in samples from AWSP only, with exposure levels ranging from 1.9 × 104 to 1.1 × 107 spores/m3. Exposure to microbial DNA varied within and between WSP and was on average in the order of 104 copies/m3 for fungi and 105 copies/m3 for bacteria. Health symptoms, such as sneezing, congested nose and runny nose were significantly more common among exposed workers compared to the unexposed control group.

Nano- and microplastics: a comprehensive review on their exposure routes, translocation, and fate in humans.

Contamination of the environment with nano-and microplastic particles (NMPs) and its putative adverse effects on organisms, ecosystems, and human health is gaining increasing scientific and public attention. Various studies show that NMPs occur abundantly within the environment, leading to a high likelihood of human exposure to NMPs. Here, different exposure scenarios can occur. The most notable exposure routes of NMPs into the human body are via the airways and gastrointestinal tract (GIT) through inhalation or ingestion, but also via the skin due to the use of personal care products (PCPs) containing NMPs. Once NMPs have entered the human body, it is possible that they are translocated from the exposed organ to other body compartments. In our review article, we combine the current knowledge on the (1) exposure routes of NMPs to humans with the basic understanding of the potential (2) translocation mechanisms into human tissues and, consequently, their (3) fate within the human body. Regarding the (1) exposure routes, we reviewed the current knowledge on the occurrence of NMPs in food, beverages, personal care products and the air (focusing on indoors and workplaces) and found that the studies suggest an abundant presence of MPs within the exposure scenarios. The overall abundance of MPs in exposure matrices relevant to humans highlights the importance of understanding whether NMPs have the potential for tissue translocation. Therefore, we describe the current knowledge on the potential (2) translocation pathways of NMPs from the skin, GIT and respiratory systems to other body compartments. Here, particular attention was paid to how likely NMPs can translocate from the primary exposed organs to secondary organs due to naturally occurring defence mechanisms against tissue translocation. Based on the current understanding, we conclude that a dermal translocation of NMPs is rather unlikely. In contrast, small MPs and NPs can generally translocate from the GIT and respiratory system to other tissues. Thus, we reviewed the existing literature on the (3) fate of NMPs within the human body. Based on the current knowledge of the contamination of human exposure routes and the potential translocation mechanisms, we critically discuss the size of the detected particles reported in the fate studies. In some cases, the particles detected in human tissue samples exceed the size of a particle to overcome biological barriers allowing particle translocation into tissues. Therefore, we emphasize the importance of critically reading and discussing the presented results of NMP in human tissue samples.

Comprehensive assessment of occupational exposure to microbial contamination in waste sorting facilities from Norway.

Introduction: It is of upmost importance to contribute to fill the knowledge gap concerning the characterization of the occupational exposure to microbial agents in the waste sorting setting (automated and manual sorting). Methods: This study intends to apply a comprehensive field sampling and laboratory protocol (culture based-methods and molecular tools), assess fungal azole resistance, as well as to elucidate on potential exposure related health effects (cytotoxicity analyses). Skin-biota samples (eSwabs) were performed on workers and controls to identify other exposure routes. Results: In personal filter samples the guidelines in one automated industry surpassed the guidelines for fungi. Seasonal influence on viable microbial contamination including fungi with reduced susceptibility to the tested azoles was observed, besides the observed reduced susceptibility of pathogens of critical priority (Mucorales and Fusarium sp.). Aspergillus sections with potential toxigenic effect and with clinical relevance were also detected in all the sampling methods. Discussion: The results regarding skin-biota in both controls´ and workers´ hands claim attention for the possible exposure due to hand to face/mouth contact. This study allowed concluding that working in automated and manual waste sorting plants imply high exposure to microbial agents.

Bioaerosol Exposure and in vitro Activation of Toll-like Receptors in a Norwegian Waste Sorting Plant.

Background: The global shift toward greener societies demands new technologies and work operations in the waste-management sector. However, progressive industrial methods do not necessarily consider workers' health. This study characterized workers' exposure to bioaerosols and investigated the bioaerosols' potential to engage the immune system in vitro. Methods: Full shift personal aerosol sampling was conducted over three consecutive days. Dust load was analyzed by gravimetry, fungal and actinobacterial spores were analyzed by scanning electron microscopy, and endotoxin by limulus amebocyte lysate (LAL) assay. In vitro exposure of HEK cells to airborne dust samples was used to investigate the potential of inducing an inflammatory reaction. Results: The total dust exposure level exceeded the recommended occupational exposure limit (OEL) of 5.0 mg/m3 in 3 out of 15 samples. The inhalable endotoxin level exceeded the recommended exposure level by a 7-fold, whereas the fungal spore level exceeded the recommended exposure level by an 11-fold. Actinobacterial spores were identified in 8 out of 14 samples. In vitro experiments revealed significant TLR2 activation in 9 out of 14 samples vs. significant TLR4 activation in all samples. Conclusion: The present study showed that the dust samples contained potentially health-impairing endotoxin, fungi, and actinobacterial levels. Furthermore, the sampled dust contained microbial components capable of inducing TLR activation and thus have the potential to evoke an inflammatory response in exposed individuals.

Characterisation of Particles Emitted during Laser Cutting of Various Metal Sheets and an Exposure Assessment for the Laser Operators.

Laser cutting is used in many industrial settings to achieve precise cuts of metal sheets. Laser operators may be exposed to particles formed during cutting when opening the cabinet or when metal sheets are exchanged. To characterise the potential exposure, particles formed during laser cutting were studied with scanning electron microscopy equipped with an energy dispersive X-ray detector and an energy backscatter diffraction detector. The total concentration of particles (11-615 nm) was determined online with a scanning mobility particle sizer. The chemical composition of the particles formed during the cutting of the different metal sheets was determined by inductively coupled plasma mass spectrometry (ICP-MS). X-ray diffraction was applied to determine the phase composition. The occupational exposure was assessed gravimetrically and by ICP-MS for five laser operators handling different laser cutters, and materials and were found to be low. Agglomerates and aggregates of condensation particles were formed during laser cutting, independent of the sheet type. Iron, present as both magnetite and α-Fe, was the main element found in the particles formed when cutting steel sheets. The size of the particles generated was mainly below 300 nm. Open laser cutters may lead to higher metal exposures, which is especially relevant when cutting metal sheets containing heavy metals.

Occupational Exposure to Trichloramine and Endotoxins: Adverse Health Effects Among Personnel in Adventure and Rehabilitation Swimming Pool Facilities.

OBJECTIVE: To study occupational exposure totrichloramine and endotoxins in air at adventure and rehabilitation swimming pool facilities from an adverse health effects perspective. METHODS: Air concentrations of trichloramine and endotoxins were measured in five adventure and 10 rehabilitation facilities. Respiratory and ocular symptoms were self-reported, and spirometry and fraction of exhaled nitric oxide (FEno) were measured. RESULTS: Compared to rehabilitation facilities, the mean trichloramine concentrations in the adventure facilities were higher, both personal (80 µg/m3 (n  = 41) vs 19 µg/m3 (n = 21)) and stationary (183 µg/m3 (n = 51) vs 23 µg/m3 (n = 32)), with higher frequency of ocular and respiratory symptoms. Low stationary endotoxin levels (<0.64 to 25 EU/m3) were found, compared to the reference value (90 EU/m3). CONCLUSIONS: Higher trichloramine concentrations in air and more ocular and respiratory symptoms in adventure facilities call for adequate occupational exposure limits.

Carpal Tunnel Syndrome and Hand-Arm Vibration: A Swedish National Registry Case-Control Study.

OBJECTIVE: To investigate the increased risk for carpal tunnel syndrome (CTS) in men and women with hand-arm vibration (HAV) exposure. DESIGN: Case-control study of CTS where 4396 cases was obtained from National Outpatient Register between 2005 through 2016. Cases were matched to controls and exposure was estimated using a job exposure matrix. RESULTS: Exposure to HAV increased the risk of CTS with an OR of 1.61 (95% CI 1.46-1.77). The risk was highest in men <30 years of age and among women <30 years no increased risk was observed. The risk increased with a mean year exposure above 2.5 m/s2 to OR 1.84 (95% CI 1.38-2.46). CONCLUSIONS: HAV exposure increase the risk of CTS in both genders, with highest risk increase in younger men. This emphasize identification of HAV exposure in patients with CTS.

Introducing a new design of digital tool to increase vibration risk assessments: challenges with education-based interventions.

Objectives. This study aimed to investigate whether introducing a digital risk assessment tool, the Swedish National Vibration Database, would increase the number of risk assessments on hand-arm and whole-body vibration. Employer and safety representatives from companies where vibration exposure is common were invited. Methods. Of the 2953 invited companies, 1916 were selected for educational intervention and the remaining 1037 companies served as a control group with no intervention. For the educational intervention, participating companies were further divided into two groups (group A, n = 26; group B, n = 47) that both received information regarding risk assessment, but group B was also informed about the digital tool. Both groups answered a questionnaire on risk assessment before the intervention and at the follow-up, 6 months later; the control group received the same questionnaire but no education (group C, n = 22). Results. Of the invited companies, only 2% chose to participate and 7% at follow-up. Seventy-eight percent of the participants had made some kind of risk assessment of vibration at follow-up. Conclusion. Due to the low participation rate among invited companies, this study is not able to draw any conclusions on whether the digital tool can be used to increase the number of risk assessments.

Metal exposure from additive manufacturing and its effect on the nasal lavage fluid proteome - a pilot study.

The use of metal additive manufacturing (AM) is steadily increasing and is an emerging concern regarding occupational exposure. In this study, non-invasive sampled nasal lavage fluid (NLF) from the upper airways was collected from metal AM operators at the beginning and end of a workweek during two consecutive years with preventive interventions in the occupational setting in-between (n = 5 year 1, n = 9 year 2). During year one, NLF was also collected from welders (n = 6) from the same company to get a comparison with a traditional manufacturing technique with known exposure and health risks. The samples were investigated using untargeted proteomics, as well as using multi-immunoassay to analyze a panel of 71 inflammatory protein markers. NLF in AM operators from year 1 showed decreased levels of Immunoglobulin J and WAP four-disulfide core domain protein 2 and increased levels of Golgi membrane protein 1, Uteroglobin and Protein S100-A6 at the end of the workweek. At year two, after preventive interventions, there were no significant differences at the end of the workweek. In welders, Annexin A1 and Protein S100-A6 were increased at the end of the workweek. The analysis of 71 inflammatory biomarkers showed no significant differences between the beginning and the end of workweek year 1 in AM operators. We identified several proteins of interest in the AM operators that could serve as possible markers for exposure in future studies with a larger cohort for validation.

Occupational Exposure to Metalworking Fluid and the Effect on Health Symptoms-An Intervention Study.

Exposure to metalworking fluid has been shown to cause health problems among workers. The aim of this study was to compare health outcomes and levels of exposure among workers exposed to metalworking fluid before and after the implementation of preventive measures. The frequencies of self-reported symptoms, as well as the concentrations of measured substances were lower after the implementation of preventive measures. Logistic regression showed statistically significant differences in the report of irritations, a stuffy or runny nose, eye irritation, a hoarse or dry throat, and a cough with odds ratios of 0.31 (95% confidence interval [CI] 0.21 to 0.47), 0.12 (95% CI 0.05 to 0.29), 0.13 (95% CI 0.06 to 0.28), and 0.24 (95% CI 0.12 to 0.46), respectively. This confirms the efficiency of the performed intervention and highlights the importance of eliminating the recirculation of contaminated air.