Inorganic chloramines: a critical review of the toxicological and epidemiological evidence as a basis for occupational exposure limit setting.

Inorganic chloramines are not commercially available, but monochloramine is produced in situ for disinfection or for use in chemical synthesis. Inorganic chloramines are also formed when free chlorine reacts with nitrogen containing substances, e.g. ammonia and urea, present in chlorinated water sources. Occupational exposure may, therefore, occur in e.g. swimming pool facilities and the food processing industry. Monochloramine is soluble and stable in water and the dominating inorganic chloramine in chlorinated water sources. No clinical effects were seen in healthy volunteers given monochloramine in drinking water during 4 or 12 weeks in doses of 0.043 or 0.034 mg/kg bw/day, respectively. Limited data indicate that monochloramine is weakly mutagenic in vitro but not genotoxic in vivo. One drinking water study indicated equivocal evidence of carcinogenicity in female rats but not in male rats and mice. No reproductive or developmental effects were shown in rodents in the few studies located. Dichloramine is soluble but unstable in water. In the only study located, mild histological effects in kidneys, thyroid and gastric cardia were observed in rats administered dichloramine in drinking water for 13 weeks. Trichloramine is immiscible with water and evaporates easily from water into air. Therefore, the primary exposure route of concern in the occupational setting is inhalation. Occupational exposure to trichloramine has been demonstrated in indoor swimming pool facilities and in the food processing industry where chlorinated water is used for disinfection. Exposure-response relationships between airborne levels and self-reported ocular and upper airway irritation have been shown in several studies. Exposure to trichloramine may aggravate asthma symptoms in individuals with existing asthma. The risk of developing asthma following long-term exposure to trichloramine cannot be evaluated at present. No data on genotoxic, carcinogenic, reproductive or developmental effects were located. The toxicological data for mono- and dichloramine are insufficient to recommend health-based occupational exposure limits (OELs).As regard trichloramine, the critical effect is judged to be irritation observed in several studies on pool workers, starting at approximately 0.4 mg/m3 (stationary sampling). Based on these data, a health-based OEL of 0.1 mg/m3 (8-h time-weighted average) is recommended. This corresponds to 0.2 mg/m3 for stationary measurements in swimming pool facilities. No short-term exposure limit (STEL) is recommended.

Blood biomarkers for vibration-induced white fingers. A case-comparison study.

BACKGROUND: Vibration induced white fingers (VWF) is one form of secondary Raynaud's phenomenon (RP). METHODS: Vibration exposed workers with RP and vibration exposed controls without RP participated. Blood samples were collected before and after cold challenge exposure (COP). The concentration of von Willebrand factor (vonWf), thrombomodulin (TM), serotonin (SER), endothelin-1 (ET1 ), calcitonin gene-related peptide, or thromboxane A2 was calculated. The diagnostic usefulness of the substances for ruling in the diagnosis of Raynaud's was evaluated. RESULTS: The cases showed a significant lower concentration of vonWf before and after COP, a significant increase of ET1  and a decrease of TM after COP. The diagnostic usefulness of vonWf showed a likelihood of defining a true case by 35%. CONCLUSIONS: vonWf, TM, SER, or ET1 are suggested biomarkers for VWF. Diagnostic evaluation of vonWf showed a likelihood of defining a true case by 35% in the diagnosis of RP related to vibration.

Occupational exposure to trichloramine and trihalomethanes: adverse health effects among personnel in habilitation and rehabilitation swimming pools.

Personnel in swimming pool facilities typically experience ocular, nasal, and respiratory symptoms due to water chlorination and consequent exposure to disinfection by-products in the air. The aim of the study was to investigate exposure to trichloramine and trihalomethanes (chloroform, bromodichloromethane, dibromochloromethane, and bromoform) from the perspective of adverse health effects on the personnel at Swedish habilitation and rehabilitation swimming pools. The study included 10 habilitation and rehabilitation swimming pool facilities in nine Swedish cities. The study population comprised 24 exposed swimming pool workers and 50 unexposed office workers. Personal and stationary measurements of trichloramine and trihalomethanes in air were performed at all the facilities. Questionnaires were distributed to exposed workers and referents. Spirometry, fraction of exhaled nitric oxide (FENO), and peak expiratory flow (PEF) were measured. Personal and stationary measurements yielded trichloramine levels of 1-76 µg/m3 (average: 19 µg/m3) and 1-140 µg/m3 (average: 23 µg/m3), respectively. A slightly higher, but not significant, prevalence of reported eye- and throat-related symptoms occurred among the exposed workers than among the referents. A significantly increased risk of at least one ocular symptom was attributed to trichloramine exposure above the median (20 µg/m3). Lung function (FVC and FEV1) was in the normal range according to the Swedish reference materials, and no significant change in lung function before and after shift could be established between the groups. Average FENO values were in the normal range in both groups, but the difference in the values between the exposed workers and referents showed a significant increase after shift. Hourly registered PEF values during the day of the investigation did not show any unusual individual variability. In conclusion, the increased risk of developing at least one ocular symptom at personal trichloramine concentrations over 20 µg/m3 combined with an increase in the difference in FENO during the work shift of the exposed workers should not be neglected as an increased risk of respiratory inflammation in the habilitation and rehabilitation swimming pool environment.

Early life swimming pool exposure and asthma onset in children - a case-control study.

BACKGROUND: Trichloramine exposure in indoor swimming pools has been suggested to cause asthma in children. We aimed to investigate the risk of asthma onset among children in relation to individual trichloramine exposure. METHODS: A longitudinal nested case-control study of 337 children with asthma (cases) and 633 controls aged 16-17 years was performed within a population-based cohort from The Obstructive Lung Disease in Northern Sweden studies (OLIN). Year of asthma onset and exposure time at different ages were obtained in telephone interviews. Trichloramine concentrations in the pool buildings were measured. Skin prick test results for inhalant allergens were available from previous examinations of the cohort. The risk for asthma was analyzed in relation to the cumulative trichloramine exposure before onset of asthma. RESULTS: The participation rate was high in the original cohort (88 to 96%), and in the case-control study (80%). Trichloramine concentrations ranged from 0.020 to 0.55 mg/m3 (mean 0.15 mg/m3). Swimming pool exposure in early life was associated with a significantly higher risk of pre-school asthma onset. A dose-response relationship between swimming pool exposure and asthma was indicated in children with asthma onset at 1 year of age. Children who were both sensitized and exposed had a particularly high risk. CONCLUSIONS: Early life exposure to chlorinated swimming pool environments was associated with pre-school asthma onset.

Swimming pool attendance is related to asthma among atopic school children: a population-based study.

BACKGROUND: By-products of water disinfectants have been suggested to cause asthma, especially in atopic children. However, studies on indoor swimming pool attendance and asthma in children have presented conflicting results. The present study examined the relationship between indoor swimming pool attendance and asthma among sensitized and non-sensitized children aged 11-12 years. METHODS: An extended ISAAC questionnaire was sent to the families of all children attending fifth or sixth grade, aged 11-12 years, in two municipalities in Northern Sweden in 2010. A total of 1866 participated (96% of those invited) in the questionnaire study and 1652 (89%) also participated in skin prick testing for 10 standard airborne allergens. Asthma was defined as physician-diagnosed asthma in combination with wheeze or use of asthma medication in the last 12 months. Current swimming pool attendance was reported as ≥ 1/week or <1/week. Logistic regression models were used for data analysis. RESULTS: The prevalence of current asthma was 8.9% (10.0% of boys; 7.9% of girls) and 14% had attended indoor pools ≥ 1/week. Children currently attending swimming pools ≥ 1/week had an increased risk of current asthma. Stratified analyses for allergic sensitization adjusted for sex, parental smoking, parental asthma, and damp housing, showed a statistically significant association for current asthma only among sensitized subjects (OR 95% CI 1.90 1.09-3.32). No association was found between current pool attendance and wheeze, sensitization, rhinitis or eczema. CONCLUSIONS: The present study supports the proposed link between indoor swimming pool attendance and asthma in sensitized children.

Occupational Exposure to Trichloramine and Trihalomethanes in Swedish Indoor Swimming Pools: Evaluation of Personal and Stationary Monitoring.

INTRODUCTION: Chlorination is a method commonly used to keep indoor swimming pool water free from pathogens. However, chlorination of swimming pools produces several potentially hazardous by-products as the chlorine reacts with nitrogen containing organic matter. Up till now, exposure assessments in indoor swimming pools have relied on stationary measurements at the poolside, used as a proxy for personal exposure. However, measurements at fixed locations are known to differ from personal exposure. METHODS: Eight public swimming pool facilities in four Swedish cities were included in this survey. Personal and stationary sampling was performed during day or evening shift. Samplers were placed at different fixed positions around the pool facilities, at ~1.5 m above the floor level and 0-1 m from the poolside. In total, 52 personal and 110 stationary samples of trichloramine and 51 personal and 109 stationary samples of trihalomethanes, were collected. RESULTS: The average concentration of trichloramine for personal sampling was 71 µg m(-3), ranging from 1 to 240 µg m(-3) and for stationary samples 179 µg m(-3), ranging from 1 to 640 µg m(-3). The air concentrations of chloroform were well below the occupational exposure limit (OEL). For the linear regression analysis and prediction of personal exposure to trichloramine from stationary sampling, only data from personal that spent >50% of their workday in the pool area were included. The linear regression analysis showed a correlation coefficient (r2) of 0.693 and a significant regression coefficient ß of 0.621; (95% CI = 0.329-0.912, P = 0.001). CONCLUSION: The trichloramine exposure levels determined in this study were well below the recommended air concentration level of 500 µg m(-3); a WHO reference value based on stationary sampling. Our regression data suggest a relation between personal exposure and area sampling of 1:2, implying an OEL of 250 µg m(-3) based on personal sampling.

Evaluation of a tape-stripping technique for measuring dermal exposure to pyrene and benzo(a)pyrene.

Epidemiological studies have shown an increased incidence of cancer among workers occupationally exposed to polycyclic aromatic hydrocarbons (PAHs). As the dermal route is considered important for exposure to PAHs in the workplace, the aim of this study was to develop and evaluate a tape-stripping technique for monitoring dermal exposure to pyrene and benzo(a)pyrene. The tape-stripping method was evaluated by applying different concentrations of pyrene and benzo(a)pyrene directly onto tape strips (spiked tapes), clean glass plates, and on the skin of five volunteers. The glass plates were stripped using a single strip of tape and the skin of the volunteers was stripped with five consecutive strips of tape after 0 and 30 minutes. The method was also tested on five chimney sweeps at three exposure sites. High-performance liquid chromatography with fluorescence detection was employed for the quantification of pyrene and benzo(a)pyrene. The mean recovery from the spiked tapes was 97% for pyrene and 93% for benzo(a)pyrene. The mean overall recovery from the glass plates was 88% and 76% for pyrene and 88 and 85% for benzo(a)pyrene. The recovery from human skin was 70% and 63% for pyrene and 60 and 54% for benzo(a)pyrene, after 0 and 30 minutes, respectively. A concentration gradient was clearly detected between the five consecutive strips. Detectable amounts of pyrene and benzo(a)pyrene were found on all chimney sweeps at all exposure sites. This method can thus be used to detect and quantify dermal exposure to pyrene and benzo(a)pyrene. The results also show that pyrene and benzo(a)pyrene may be taken up by the skin.

Determination of resin acids during production of wood pellets--a comparison of HPLC/ESI-MS with the GC/FID MDHS 83/2 method.

Resin acids are constituents of natural and technical products of widespread use. Exposure is known to cause health effects in the airways and on the skin. Liquid chromatography/positive ion electrospray-mass spectrometry (HPLC/pos ESI-MS) was investigated for determination of 7-oxodehydroabietic (7-OXO), dehydroabietic (DHAA) and abietic acid (AA) in wood dust-containing air samples as a derivatisation-free alternative to the GC/FID HSE method 83/2, developed by the Health and Safety Executive UK. The resin acid 7-OXO was measured as a marker for oxidised resin acids, which are known to be the main contact allergens in colophonium. The found detection limits were 0.42 ng m(-3) for 7-OXO, 5.2 ng m(-3) for DHAA and 9.4 ng m(-3) for AA, respectively, which are considerably lower than with the GC/FID method (24, 115 and 89 ng m(-3)). The two methods correlated well, although consistently and significantly lower concentrations of 7-OXO were detected with LC/MS. The higher concentration of this compound with MDHS 83/2 is suggested to be an artefact from the derivatisation step in the presence of soluble wood dust remains.

Mortality from myocardial infarction in relation to exposure to vibration and dust among a cohort of iron-ore miners in Sweden.

OBJECTIVES: The aim of this study was to investigate myocardial infarction (MI) mortality in relation to exposure to hand/arm vibration (HAV) and whole body vibration (WBV) as well as exposure to dust among men employed in two Swedish iron-ore mines. METHODS: This study comprised employed men at two iron-ore mines in Sweden who had been employed for at least 1 year from 1923 up to 1996. The causes of death were obtained from the national cause of death register from 1952 to 2001. Myocardial infarction mortality was obtained by linking personal identification numbers to the national cause of death register. Poisson regression was used for risk estimations on exposure-response relation, and analyses were made on the two age groups < or =60 years and >60 years. RESULTS: Relative risks for MI mortality in relation to exposure were significantly increased for exposure (0/>0) to WBV (RR 1.18, 95% CI 1.06 to 1.31) and dust (RR 1.15, 95% CI 1.02 to 1.31), and the results indicated an exposure-response relation for WBV and dust separately. For 60 years and younger, exposure to HAV (0/>0) (RR 1.34, 95% CI 1.03 to 1.74) and WBV (0/>0) (RR 1.39, 95% CI 1.13 to 1.72) increased the risk of MI mortality. An exposure-response was found for HAV and WBV, as the medium and high exposed categories showed significantly increased risk estimates. None of the exposures significantly increased the risk in the group above 60 years. The increased risk estimates for exposure to WBV remained when adjusting for exposure to dust. CONCLUSIONS: The results for the working age (< or =60 years) group showed significantly increased MI mortality for univariate exposure to HAV, WBV and dust. We found an association between increased mortality from MI and occupational exposure to WBV, and the risk remained after adjustment for dust exposure.

Lung cancer and exposure to quartz and diesel exhaust in Swedish iron ore miners with concurrent exposure to radon.

OBJECTIVES: Studies of underground miners have documented an increased risk of lung cancer mainly linked to radon exposure but possibly influenced by other concurrent exposures. METHODS: A cohort study was carried out in 8321 iron ore miners with low exposure to radon, employed in 1923-1998 and followed up for lung cancer in 1958-2000. Historical exposures to radon, crystalline silica and diesel exhaust were assessed. Data including exposure to radon, quartz and diesel exhaust from another mine with higher exposure to radon were reanalysed. RESULTS: Miners had increased risk for lung cancer (SIR 1.48 (95% CI 1.22 to 1.78), based on 112 cases during 227,000 person-years). The increased risk could not be explained by exposure to radon or diesel exhaust but was associated with exposure to crystalline silica: SIR 0.96 (0.53 to 1.62), 1.45 (1.10 to 1.87), 1.99 (1.31 to 2.90) and 1.77 (0.92 to 3.10) in groups with exposure to 0, 0-2, 2-5 and >5 mg years/m3, respectively. Reanalysis of data from the other mine indicated that quartz was a possible confounder in the analysis of relationship between radon and lung cancer. In the highest radon exposed group, the point estimate for the RR decreased from 5.65 to 3.90 when adjusting for concurrent exposure to quartz. CONCLUSIONS: Crystalline silica, a known carcinogen, probably affects lung cancer risk in iron ore miners. The main implication of the results is for interpretation of the dose-response curve for radon and lung cancer in underground iron ore miners. Since exposure to radon and quartz is often correlated, quartz exposure can be an important confounder.

Lung cancer risk and radon exposure in a cohort of iron ore miners in Malmberget, Sweden.

OBJECTIVES: Lung cancer caused by radon in miners is a well-known risk. However, the risk estimates vary between studies and between mines. We have studied the dose response-relationship in a Swedish iron ore mine where two other studies have previously reached different risk estimates. As this mine has relatively low radon levels, the results are highly relevant for risk estimation in non-uranium underground mines. METHODS: A new cohort of 5486 male workers employed from 1923 to 1996 was established. Cumulative radon exposures were assessed based on a large number of measurements, including reconstructions of historical conditions. 122 lung cancer cases occurred during the follow-up period of 1958-2000. RESULTS: The average cumulative exposure in underground workers was 32 kBq year/m(3) (65 working level months (WLM)), experienced over 14.6 years. The excess RR (ERR) per kBq year/m(3) was 0.046 (95% CI 0.015 to 0.077; 0.022 ERR/WLM). Confounding by quartz may affect these results but appears to account only for 10-20% of the risk. The results for squamous cell and small cell lung cancer were 0.049 and 0.072, respectively. However, no increased risk was observed for adenocarcinoma (0.000 ERR per kBq year/m(3), 95% CI -0.017 to 0.017). CONCLUSION: Our overall risk estimate is about half of that found in the first Malmberget study but twice that found in the same cohort in the previously published pooled analysis. Radon did not increase the risk for adenocarcinoma in the lung.

Field validation of the Ogawa diffusive sampler for NO2 and NOx in a cold climate.

A small-scale field trial in Umeå, Sweden with Ogawa samplers and a chemiluminescence instrument indicated that the NO(2) concentration was underestimated with respect to the reference monitor, if calculated according to the manufacturer's Ogawa sampling protocol. By co-locating Ogawa samplers and reference monitors at six sites in two Swedish cities, uptake rates were determined for NO(2) and NO(x) better applicable to the Swedish conditions and climate. The concentrations of NO(2) and NO(x) calculated according to the instruction manual of the sampler and using the field-determined uptake rates were compared with values derived from chemiluminescence monitors for each week over which samples were taken. When calculated according to the manufacturer's suggested protocol, the Ogawa sampler underestimated the NO(2) concentrations by 9.1% on average for all samples (N = 53), with respect to the reference monitor. In contrast, NO(x) concentrations were overestimated by a mean value of 15% for all samples (N = 45). By using the field determined uptake rates for the calculation of NO(2) and NO(x) a better estimation of the concentrations was obtained. The ratio between concentrations determined with the Ogawa samplers and chemiluminescence monitors was then 1.02 for all measurements of NO(2) and 1.00 for NO(x). Precision, expressed as the mean coefficient of variation, was 6.4% for six, 6-replicate measurements of NO(2) and 3.7% for five, 6-replicate measurements of NO(x).

Serum Metabolites in Hand-Arm Vibration Exposed Workers.

OBJECTIVE: To investigate whether low molecular organic biomarkers could be identified in blood samples from vibration exposed workers using a metabolomics. METHODS: The study population consisted of 38 metalworkers. All participants underwent a standardized medical examination. Blood samples were collected before and after work shift and analyzed with gas chromatography time-of-flight mass spectrometry. Multivariate modeling (orthogonal partial least-squares analysis with discriminant analysis [OPLS-DA]) were used to verify differences in metabolic profiles. RESULTS: Twenty-two study participants reported vascular symptoms judged as vibration-related. The metabolic profile from participants with vibration-induced white fingers (VWF) was distinctly separated from participants without VWF, both before and after vibration exposure. CONCLUSION: Metabolites that differed between the groups were identified both before and after exposure. Some of these metabolites might be indicators of health effects from exposure to vibrations. This is the first time that a metabolomic approach has been used in workers exposed to vibrations.

Occupational exposure to dust, gases and fumes, a family history of asthma and impaired respiratory health.

OBJECTIVES: This study assessed the impact of occupational exposure to dust, gases, and fumes on respiratory symptoms, obstructive lung diseases, or the use of asthma medication among persons with and without a family history of asthma. METHODS: A population-based cohort was followed for 10 years. This study included all 1739 men and 1594 women occupationally active at the first survey. Exposure and respiratory health were assessed from questionnaires. Multiple logistic regression was used to estimate the effects in relation to occupational groups, with age, gender, and smoking habits as possible confounders, using both cross-sectional and longitudinal analyses. The susceptibility to impaired respiratory health was determined from a family history of asthma. RESULTS: A family history of asthma was reported by 27% of the men and 34% of the women. Both occupational exposure and a family history of asthma were associated with impaired respiratory health. The etiologic fractions showed that up to about 70% of the symptoms could be explained by a family history of asthma among those exposed to low levels of air pollutants, as well as among those with high exposure. However, high exposure contributed up to 35% of the symptoms both among those with and among those without a family history of asthma. The study indicates that the relative risk of occupational exposure to pollutants is similar for both persons with and those without a family history of asthma. CONCLUSIONS: The relative risk for impaired respiratory health after exposure to occupational air pollutants seems to be similar for persons with and those without a susceptibility to impaired respiratory health.

Variability and determinants of wood dust and resin acid exposure during wood pellet production: measurement strategies and bias in assessing exposure-response relationships.

Production of wood pellets is a relatively new and expanding industry in which the exposure profiles differ from those in other wood-processing industries like carpentries and sawmills where there are lower levels of wood dust. Sixty-eight personal exposure measurements of wood dust (inhalable and total dust) and resin acids were collected for 44 participants at four production plants located in Sweden. Results were used to estimate within- and between-worker variability and to identify uniformly exposed groups and determinants of exposure. In addition, overexposure, whether the risk of the long-term mean exposure of a randomly selected worker exceeding the occupational exposure limit is acceptably low, was calculated as well as the underestimation of the exposure-response relationship (attenuation). Greater variability in exposure between work shifts than between workers was observed with the within-worker variation accounting for 57-99% of the total variance in the individual-based model. Several uniformly exposed groups were detected but were mostly associated with a between-worker variation of zero which is an underestimation of the between-worker variation but an indication of uniformly exposed groups. Cleaning was identified as a work task that increases exposure slightly; so reducing workers' exposure during this operation is advisable. The levels of wood dust were high and were found to pose unacceptable risks of overexposure at all plants for inhalable dust and at three out of four plants for total dust. These findings show that exposure to dust needs to be reduced in this industry. For resin acids, the exposure was classed as acceptable at all plants. According to an individual-based model constructed from the data, the level of attenuation was high, and thus there would be substantial bias in derived dose-response relationships.

Exposure to wood dust, resin acids, and volatile organic compounds during production of wood pellets.

The main aim of this study was to investigate exposure to airborne substances that are potentially harmful to health during the production of wood pellets, including wood dust, monoterpenes, and resin acids, and as an indicator of diesel exhaust nitrogen dioxide. In addition, area measurements were taken to assess background exposure levels of these substances, volatile organic compounds (VOCs), and carbon monoxide. Measurements were taken at four wood pellet production plants from May 2004 to April 2005. Forty-four workers participated in the study, and a total of 68 personal measurements were taken to determine personal exposure to wood dust (inhalable and total dust), resin acids, monoterpenes, and nitrogen dioxide. In addition, 42 measurements of nitrogen dioxide and 71 measurements of total dust, resin acids, monoterpenes, VOCs, and carbon monoxide were taken to quantify their indoor area concentrations. Personal exposure levels to wood dust were high, and a third of the measured levels of inhalable dust exceeded the Swedish occupational exposure limit (OEL) of 2 mg/m3. Parallel measurements of inhalable and total dust indicated that the former were, on average, 3.2 times higher than the latter. The data indicate that workers at the plants are exposed to significant amounts of the resin acid 7-oxodehydroabietic acid in the air, an observation that has not been recorded previously at wood processing and handling plants. The study also found evidence of exposure to dehydroabietic acid, and exposure levels for resin acids approached 74% of the British OEL for colophony, set at 50 microg/m3. Personal exposure levels to monoterpenes and nitrogen dioxide were low. Area sampling measurements indicated that aldehydes and terpenes were the most abundant VOCs, suggesting that measuring personal exposure to aldehydes might be of interest. Carbon monoxide levels were under the detection limit in all area measurements. High wood dust exposure levels are likely to have implications for worker health; therefore, it is important to reduce exposure to wood dust in this industry.

Temporal Trend in Wood Dust Exposure During the Production of Wood Pellets.

Objective: Wood dust data collected in the production of wood pellets during 2001 to 2013 were evaluated to study a temporal trend in inhalation exposure. Methods: A linear mixed effects model of natural ln-transformed data was used to express the relative annual difference in inhalation wood dust exposure. Results: There was an annual decrease of -20.5% of the geometric mean wood dust exposure during 2001 until 2013. The results were based on 617 inhalable dust samples collected at 14 different production units. The exposure to wood dust at the industrial premises investigated has decreased from a relatively high level of 6.4 mg m-3 in 2001 to 1.0 mg-3 in 2013. The Swedish Occupational Exposure Limit (SOEL) of 2 mg m-3 may still be exceeded. Conclusion: Analysis of the temporal trend in soft wood production units revealed declines in exposure of 20.5% per annum. It is important that precautions are taken to protect workers from a hazardous exposure to wood dust at the premises as the SOEL of 2 mg m-3 at some occasions is still exceeded. Additional measurements of wood dust exposure should be carried out on a regular basis in wood pellet production units in Sweden as well in other countries.

Respiratory and Ocular Symptoms Among Employees at Swedish Indoor Swimming Pools.

BACKGROUND: This study investigated trichloramine exposure and prevalence of respiratory and ocular symptoms among Swedish indoor swimming pool workers. METHODS: Questionnaires were distributed to pool workers and referents. Lung function and fraction of exhaled nitric oxide (FeNO) were measured before and after work. Exposure to trichloramine and trihalomethanes was measured over work shifts. RESULTS: The mean personal trichloramine exposure was 36 µg/m. Significantly more exposed workers reported ocular and nasal symptoms. There were significant differences between groups in FeNO change following work, with exposed showing increased FeNO, which grew when analyses included only nonsmokers. CONCLUSIONS: The findings indicate that indoor swimming pool environments may have irritating effects on mucous membranes. FeNO data also indicate an inflammatory effect on central airways, but the clinical relevance is unclear. Low trichloramine levels found in this study were not associated with health effects.

Quantification of melatonin in human saliva by liquid chromatography-tandem mass spectrometry using stable isotope dilution.

A method for the determination of melatonin in human saliva has been developed using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS-MS). Saliva was collected in plastic tubes. 7-D-Melatonin was added as internal standard and the samples were cleaned and concentrated by solid-phase extraction. The limit of detection was 1.05 pg x ml(-1) and the limit of quantification was 3.0 pg x ml(-1). The accuracy of the method was +/-14% at 5.60 pg x ml(-1) and +/-9% at 19.6 pg x ml(-1). The precision was +/-13% at 6.18 pg x ml(-1) and +/-11% at 31.2 pg x ml(-1), respectively. Our HPLC-MS-MS method shows a high sensitivity and specificity for melatonin and more reliable results compared with a radioimmunoassay. The chromatographic method has been used to determine the circadian rhythm of melatonin among three nurses working the night shift and a patient suffering from an inability to fall asleep at night.

Exposure to benzene, toluene, xylenes and total hydrocarbons among snowmobile drivers in Sweden.

The exposure to benzene, toluene, xylenes and total hydrocarbons among 25 individuals exposed to exhaust from a snowmobile equipped with a two-stroke engine has been evaluated. Sampling was performed by pumped and diffusive sampling in parallel. There was a relatively bad agreement between the two air-sampling methods. The bad agreement can in part be explained by back diffusion of the substances from the samplers, a high face velocity, and deposition of droplets of unburned gasoline onto or in the vicinity of the samplers. The levels of benzene ranged from not detectable (< or =0.01 mgm(-3)) to 2.5 mgm(-3). For toluene, xylenes and total hydrocarbons the exposure was 0.10-12.0, < or =0.05-13.0 and 0.90-273 mgm(-3) respectively. The result from two measurements on individuals travelling on an open sleigh at the rear of the vehicle indicated higher levels of benzene, 0.7-0.8 mgm(-3). Children are often riding as a passenger on a sledge and may thus have a higher exposure than their parents. This study indicates that spare time driving a snowmobile may cause a considerable exposure to benzene. Using a four-stroke engine equipped with a catalyst could reduce the exposure. To reduce the exposure for the passenger on a sleigh an extension of the exhaust pipe may be effective.