Effects of occupational exposure to metal fume PM2.5 on lung function and biomarkers among shipyard workers: a 3-year prospective cohort study.

OBJECTIVE: This study investigates the associations of α1-antitrypsin, inter-α-trypsin inhibitor heavy chain (ITIH4), and 8-isoprostane with lung function in shipyard workers exposed to occupational metal fume fine particulate matter (PM2.5), which is known to be associated with adverse respiratory outcomes. METHODS: A 3-year follow-up study was conducted on 180 shipyard workers with 262 measurements. Personal exposure to welding fume PM2.5 was collected for an 8-h working day. Pre-exposure, post-exposure, and delta (∆) levels of α1-antitrypsin, ITIH4, and 8-isoprostane were determined in urine using enzyme-linked immunosorbent assays. Post-exposure urinary metals were sampled at the beginning of the next working day and analyzed by inductively coupled plasma-mass spectrometry. Lung function measurements were also conducted the next working day for post-exposure. RESULTS: An IQR increase in PM2.5 was associated with decreases of 2.157% in FEV1, 2.806% in PEF, 4.328% in FEF25%, 5.047% in FEF50%, and 7.205% in FEF75%. An IQR increase in PM2.5 led to increases of 42.155 µg/g in ∆α1-antitrypsin and 16.273 µg/g in ∆ITIH4. Notably, IQR increases in various urinary metals were associated with increases in specific biomarkers, such as post-urinary α1-antitrypsin and ITIH4. Moreover, increases in ∆ α1-antitrypsin and ∆ITIH4 were associated with decreases in FEV1/FVC by 0.008% and 0.020%, respectively, and an increase in ∆8-isoprostane resulted in a 1.538% decline in FVC. CONCLUSION: Our study suggests that urinary α1-antitrypsin and ITIH4 could indicate early lung function decline in shipyard workers exposed to metal fume PM2.5, underscoring the need for better safety and health monitoring to reduce respiratory risks.

Longitudinal assessment of oxidative stress markers and their relationship with exposure to PM2.5 and its bound metals in healthy participants.

OBJECTIVE: Exposure to ambient PM2.5 and its bound metals poses a risk to health and disease, via, in part, oxidative stress response. A variety of oxidative stress markers have been used as markers of response, but their relevance to environmental exposure remains to be established. We evaluated, longitudinally, a battery of oxidative stress markers and their relationship with the exposure of PM2.5 and its bound metals in a panel of healthy participants. MATERIAL AND METHODS: Levels of residence- and personal-based ambient air PM2.5 and its bound metals, as well as of lung function parameters, were assessed in a total of 58 questionnaire-administered healthy never smoker participants (male, 39.7%). Levels of urinary oxidative stress markers, including Nε-(hexanoyl)-lysine (HEL; an early lipid peroxidation product), 4-hydroxynonenal (4-HNE), N7-methylguanine (N7-meG), and 8-hydroxy-2-deoxyguanosine (8-OHdG), plasma antioxidants [superoxide dismutase (SOD) and glutathione peroxidase (GPx), and urinary metals were measured by ELISA, LC-MS, and ICP-MS, respectively. The results of three repeated measurements at two-month intervals were analyzed using the Generalized Estimating Equation (GEE). RESULTS: After adjusting for confounders, residence- and personal-based PM2.5 levels were positively associated with HEL (ß = 0.22 and 0.18) and N7-meG (ß = 0.39 and 0.13). Significant correlations were observed between personal air PM2.5-Pb and urinary Pb with HEL (ß = 0.08 and 0.26). While FVC, FEV1, FEV1/FVC, MMF, and PEFR predicted% were normal, a negative interaction (pollutant*time, P < 0.05) was noted for PM2.5-V, Mn, Co, Ni, Zn, As, and Pb. Additionally, a negative interaction was found for N7-meG (ß = -21.35, -18.77, -23.86) and SOD (ß = -26.56, -26.18, -16.48) with FEV1, FVC, and PEFR predicted%, respectively. CONCLUSION: These findings emphasize potential links between environmental exposure, internal dose, and health effects, thereby offering valuable markers for future research on metal exposure, oxidative stress, and health outcomes.

Verifying the accuracy of self-reported smoking behavior in female volunteer soldiers.

Smoking rates in the military are evaluated through questionnaire surveying. Because the accurate identification of smokers facilitates the provision of smoking cessation services, this study conducted urine cotinine concentration testing to verify the accuracy of self-reported smoking behavior by female volunteer soldiers and analyzed the effects of second-hand smoking on urine cotinine concentrations. This study is a cross-sectional study conducted using purposive sampling on female volunteer soldiers receiving training at the Taichung Recruit Training Center in May 2014. This study simultaneously collected questionnaires and urine samples, and urine samples were analyzed with an enzyme-linked immunosorbent assay. The self-reported smoking rate of female volunteer soldiers was 19.3%, whereas the smoking rate as determined by urine cotinine concentration testing was 26.3%, indicating an overall underestimation of 7.0%. Chi-square (χ2) goodness of fit test results indicated that the distribution of self-reported smoking behaviors and that verified from urine cotinine concentration testing were significantly different. The sensitivity of self-reported smoking behavior was 66.7% with a specificity of 97.6%. There was no significant association between second-hand smoking and urine cotinine concentrations. Questionnaire survey self-reporting methods could underestimate the smoking behavior of female volunteer soldiers and routine testing with biochemical verification is necessary.

Exposure to Heavy Metals and Serum Adiponectin Levels among Workers: A 2-Year Follow-Up Study.

The workers exposed to metal fumes had an increased risk of metabolic syndrome, which was correlated with decreased serum adiponectin. Thus, we aimed to explore whether heavy metal exposure affects the adiponectin level. There were 96 male workers recruited from a shipyard at baseline. Apart from 82 participants completed the follow-up assessments, new participants were recruited in next year. Finally, there were 100 welding workers in the exposure group and 31 office workers in the control group. Inferential statistics on repeated measures were performed using generalized estimating equations. A weighted quantile sum (WQS) regression model was conducted to examine the joint effect of the multimetal exposure with serum adiponectin. Significantly negative associations of metals with adiponectin were detected in the welding workers, including Cr (ß = -0.088; 95% CI: -0.148, -0.027), Mn (ß = -0.174; 95% CI: -0.267, -0.081), Co (ß = -0.094; 95% CI: -0.158, -0.029), Ni (ß = -0.108; 95% CI: -0.208, -0.008), Cd (ß = -0.067; 95% CI: -0.115, -0.018), and Pb (ß = -0.089; 95% CI: -0.163, -0.015). The WQS regression suggested that Pb was the greatest contributor. In conclusion, our findings highlighted that welding workers exposed to heavy metals would reduce serum adiponectin.

Return to Work and Mortality in Breast Cancer Survivors: A 11-Year Longitudinal Study.

Breast cancer is the most commonly occurring cancer in women, and it is a major cause of cancer death around the world. With the development of diagnostic methods and improvements in treatment methods, the incidence rate of breast cancer and the number of breast cancer survivors continue to simultaneously increase. We used national registry database to analyze the features that affect employment and return to work among breast cancer survivors. A total of 23,220 employees, who were newly diagnosed with breast cancer were recruited based on the Labor Insurance Database (LID), the Taiwan Cancer Registry (TCR), and National Health Insurance Research Database (NHIRD) during the period 2004-2015. The correlations between return to work (RTW) and independent confounding factors were examined using Cox proportional hazards model. Survival probability was analyzed using the Kaplan-Meir method. After adjusting for confounding variables, cancer stage, chemotherapy and higher income were significantly negatively correlated with RTW. Among breast cancer survivors, RTW was found to be related to a lower risk of all-cause mortality in both the unadjusted and fully adjusted model. Patients who had RTW exhibited better survival in all stages. Work-, disease- and treatment-related factors influenced RTW among employees with breast cancer. RTW was associated with better breast cancer survival. Our study demonstrates the impact of RTW and the associated factors on breast cancer survivorship.

Factors influencing smoking cessation counselors' intention to stay: An application of a conceptual model of intention to stay verified with path analysis.

Background: The Taiwanese military trains smoking cessation counselors to counsel officers and soldiers on quitting smoking as part time. The intention to stay among smoking cessation counselors affects the promotion of smoking cessation. This study investigated smoking cessation counselors' intention to stay by applying a conceptual model of intent to stay (CMIS) to analyze influencing factors. Methods: In this cross-sectional study, we applied the CMIS to design a questionnaire. We invited 577 smoking cessation counselors trained in the military from 2016 to 2017. The response rate was 46.7%, and the questionnaire responses of 260 military smoking cessation counselors were analyzed. We used path analysis to verify the relationships among the various aspects of the CMIS. Results: We determined that smoking cessation counselors' intention to stay is directly affected by job satisfaction (ß = 0.150, p = 0.014), job stress (ß = -0.225, p < 0.001), and institutional identification (ß = 0.431, p < 0.001). Career opportunities indirectly affect intention to stay through institutional identification, working environment indirectly affects intention to stay through job stress, and co-worker support and self-fulfillment indirectly affect intention to stay through job satisfaction and institutional identification. Our model could explain 36.7% of the variance in intent to stay among smoking cessation counselors. Conclusion: Our results suggest that relevant policies should be formulated to enhance smoking cessation counselors' recognition, affirmation, and sense of belonging as related to smoking cessation counseling work, thereby raising their institutional identification and promoting their intention to stay.

A Long-Term National Survey of Compliance with the Ban on Selling Tobacco Products to Adolescents of Taiwan's Tobacco Hazards Prevention Act.

The data on long-term trends and factors of tobacco retailers' compliance in Taiwan are limited. The new regulations of the Tobacco Hazards Prevention Act were established in 2009. Now, the government is planning to raise the minimum legal age (MLA) for purchasing tobacco products from 18 to 20, so the results of this study will be an important reference to promote new regulations in the future. We carried out an observational mystery shopping study design and data were collected from 2009 to 2019. In total, 6320 undercover tests were conducted to investigate selling by tobacco retailers to persons aged less than 18 years by an impartial third party annually. Logistic regression was used to analyze the factors influencing compliance by adjusting test variables and independent variables. The compliance rate increased by 8.4% annually and was better among tests conducted during summer vacation (AOR = 1.324), chain convenience stores (AOR = 3.651), supermarkets or hypermarkets (AOR = 1.973), and verifications with age (AOR = 15.345). It is the first study to explore long-term and national tobacco retailers' enforcement effects by an impartial third party in Asia. The findings suggest that local health agencies should enhance enforcement on those stores which were tested during non-summer holidays and weekends, betel nut stands, and grocery stores.

Clinical association between trace elements of tear and dry eye metrics.

Trace elements exposure is proposed to play a role in the pathogenesis of the systemic disease. Emerging studies have suggested that trace metal exposure may contribute to dry eye disease. Our study primarily aimed to investigate the association between trace metal exposure in tear samples and the presence of dry eye metrics in the shipyard industry. Overall, 84 eligible participants from the shipyard industry were included in this cross-sectional study. The parameters for identifying dry eye symptoms included O.S.D.I., SPEED, N.I.B.U.T., and ocular surface conditions, such as tear meniscus height, eye blinking, and meibomian gland area were performed by S.B.M. sistemi ocular surface analyzer. The concentration of tear trace elements was detected by inductively coupled plasma mass spectroscopy (ICP-MS). The association between tear trace elements and dry eye parameters was investigated using regression models. Participants in the exposure group had significantly higher levels of tear Pb than the control group. In the exposure group, tear Pb was significantly associated with increased SPEED and O.S.D.I. score with beta coefficients of 0.144 (95% CI 0.092, 0.197), 0.121 (95% CI 0.049, 0.194), respectively, and decreased lower and upper meibomian gland area with beta coefficients of - 0.158 (- 0.283, - 0.033) and - 0.228 (- 0.396, - 0.061), respectively. Tear trace elements exposure is considered to impact the appearance of dry eye metrics. Improving the occupational environment and monitoring the ocular surface health may benefit workers under exposure to trace elements.

Associations between Biomarkers of Metal Exposure and Dry Eye Metrics in Shipyard Welders: A Cross-Sectional Study.

Shipyard welders are often exposed to welding metal fumes. Ocular surfaces are continually exposed to environmental hazards. However, limited information on the associations between metal exposure and dry eye metrics in occupational settings is available. This study employed a cross-sectional design that involved the participation of 59 welders and 25 administrative staff in a shipyard in northern Taiwan from September 2020 to October 2020. The participants' individual information, laboratory data, exposure to particulate matter < 2.5 µm, urinary, and toenail metal concentrations were collected. Dry eye metrics were evaluated using standardized questionnaires and a noninvasive ocular surface analyzer. Urinary V and Cr and toenail V, Cr, Mn, Fe, Ni, Zn, As, and Cd and Pb were significantly higher in the exposed group than in the control group. After adjustment for confounding factors, dry eye metrics were associated with urinary Cd (ß = 0.407; p = 0.007) and toenail Pb (ß = 0.482; p = 0.002). The participants with higher urinary Cd exhibited higher odds ratios for elevated dry eye metrics. Our study revealed that exposure to welding procedures increases several metal biomarkers. In addition, urinary Cd, and toenail Pb might be related to dry eye disease in shipyard welders.

Association of Particulate Matter from Cooking Oil Fumes with Heart Rate Variability and Oxidative Stress.

Many studies have reported various cardiovascular autonomic responses to ambient particulate matter (PM) pollution, but few have reported such responses to occupational PM exposures. Even fewer have demonstrated a relationship between PM pollution and oxidative stress in humans. This panel study evaluates the association between occupational exposure to PM in cooking oil fumes (COFs), and changes in both heart rate variability (HRV) and oxidative stress responses in 54 male Chinese cooks. Linear mixed-effects regression models were adopted to estimate the strength of the association between PM and HRV. Participants' pre- and post-workshift urine samples were analyzed for 8-hydroxy-2'-deoxyguanosine (8-OHdG) and malondialdehyde (MDA). Exposure to PM in COFs from 15 min to 2 h were associated with a decrease in HRV and an increase in heart rate among cooks. The urinary 8-OHdG levels of cooks were significantly elevated after workshift exposure to COFs. The levels of PM2.5, PM1.0, and particulate benzo(a)pyrene in COFs were all positively correlated with cross-workshift urinary 8-OHdG levels. Furthermore, the levels of benzo(a)pyrene in COFs were positively correlated with cross-workshift urinary MDA levels. The effects of COFs on HRV were independent of cross-workshift urinary 8-OHdG levels. Exposure to COFs leads to disturbed autonomic function and an increased risk of oxidative DNA injury among cooks in Chinese restaurants.

Gender Differences in the Extended Theory of Planned Behaviour on Smoking Cessation Intention in Young Soldiers.

BACKGROUND: The theory of planned behaviour (TPB) explanation of smoking cessation intentions consists of gender differences. The purpose of this study is to adopt the extended TPB to discuss factors influencing the smoking cessation intentions of young adult volunteer soldiers and to further compare the respective factors for both genders. METHODS: This is a cross-sectional study. Data were collected from 139 and 165 male and female volunteer soldiers who smoked, respectively. Research participants completed a self-administered questionnaire that comprised items pertaining to the participants' demographic characteristics, smoking behaviours, smoking cessation experiences, social environments, and TPB variables. RESULTS: Subjective norms (friends) are a positive key factor for young adult male (ß = 0.033, p = 0.012) and female (ß = 0.076, p < 0.001) volunteer soldiers' smoking cessation intentions, and perceived behavioural control is a key factor for male young (ß = 0.226, p = 0.040) adult volunteer soldiers' smoking cessation intention. The extended TPB accounted for 27.9% and 53.2% of the variance in the intention to quit smoking in the male and female volunteer soldiers, respectively. CONCLUSIONS: We suggest that smoking cessation strategies can reinforce gender-specific intervention strategies to assist young adult volunteer soldiers in smoking cessation.

Occupation and subcategories of asthma: a population-based incident case-control study.

BACKGROUND: We hypothesised that occupational exposures differently affect subtypes of adult-onset asthma. OBJECTIVE: We investigated potential relations between occupation and three subtypes of adult asthma, namely atopic asthma, non-atopic asthma and asthma-COPD overlap syndrome (ACOS). METHODS: This is a population-based case-control study of incident asthma among working-age adults living in Pirkanmaa Hospital District in Southern Finland. The determinant of interest was occupation at the time of diagnosis of asthma or the job that the subject had quit due to respiratory symptoms. Asthma was divided into three mutually exclusive subtypes on the basis of any positive IgE antibody (atopic and non-atopic asthma) and presence of persistent airways obstruction in spirometry (ACOS). We applied unconditional logistic regression analysis to estimate adjusted OR (aOR), taking into account gender, age and smoking. RESULTS: The following occupational groups showed significantly increased risk of atopic asthma: chemical industry workers (aOR 15.76, 95% CI 2.64 to 94.12), bakers and food processors (aOR 4.69, 95% CI 1.18 to 18.69), waiters (aOR 4.67, 95% CI 1.40 to 15.56) and those unemployed (aOR 3.06, 95% CI 1.52 to 6.17). The following occupations showed clearly increased risk of non-atopic asthma: metal workers (aOR 8.37, 95% CI 3.77 to 18.59) and farmers and other agricultural workers (aOR 2.36, 95% CI 1.10 to 5.06). Some occupational groups showed statistically significantly increased OR of ACOS: electrical and electronic production workers (aOR 30.6, 95% CI 6.10 to 153.35), fur and leather workers (aOR 16.41, 95% CI 1.25 to 215.85) and those retired (aOR 5.55, 95% CI 1.63 to 18.97). CONCLUSIONS: Our results show that different occupations are associated with different subtypes of adult-onset asthma.

Erratum: Su, T.Y., et al. Effects of Heavy Metal Exposure on Shipyard Welders: A Cautionary Note for 8-Hydroxy-2'-Deoxyguanosine. Int. J. Environ. Res. Public Health 2019, 16, 4813.

The authors wish to correct the following in this paper [...].

Chronic exposure to metal fume PM2.5 on inflammation and stress hormone cortisol in shipyard workers: A repeat measurement study.

Particulate matter with an aerodynamic diameter of ≤ 2.5 µm (PM2.5) has been linked to adverse health outcomes in welding workers. The objective of this study was to investigate associations of chronic exposure to metal fume PM2.5 in shipyard workers with health outcomes. A longitudinal study was conducted to determine the effects of metal fume PM2.5 on FeNO, urinary metals, urinary oxidative stress, inflammation, and stress hormones in workers. There were 20 office workers and 49 welding workers enrolled in this study who were followed-up for a second year. We observed that Fe, Zn, and Mn were abundant in PM2.5 to which welding workers were personally exposed, whereas PM2.5 to which office workers were personally exposed was dominated by Pb, Cu, and Zn. We observed in the first and/or second visits that urinary 8-iso-prostaglandin F2-α (PGF2α) and 8-hydroxy-2'-deoxy guanosine (8-OHdG) were significantly increased by exposure. An increase in urinary interleukin (IL)-6 and decreases in urinary serotonin and cortisol were observed in the first and/or second visits after exposure. PM2.5 was associated with decreases in urinary 8-OHdG and cortisol among workers. Next, we observed that urinary Ni, Co, and Fe had significantly increased among workers after a year of exposure. Urinary metals were associated with decreases in urinary 8-iso-PGF2α and cortisol among workers. Urinary Ni, Cu, and Fe levels were associated with an increase in urinary IL-6 and a decrease in urinary cortisol among workers. In conclusion, chronic exposure to metal fume PM2.5 was associated with inflammation and a cortisol deficiency in shipyard workers, which could associate with adrenal glands dysfunction.

Association between the use of antidepressants and the risk of preterm birth among pregnant women with depression: a retrospective cohort study in Taiwan.

Our study was aimed to investigate the association between the use of antidepressants and the risk of preterm birth in pregnant women who have had perinatal depression. We extracted data from the Taiwanese National Health Insurance Research Database (NHIRD) and analyzed them using multivariate Cox proportional hazard regression models. Identified from the NHIRD, we matched 1789 women aged 18-55 years who were using antidepressants during pregnancy and 1789 women who were experiencing depression but who were not using antidepressants during pregnancy for age, index date, and medical comorbidities. We enrolled the women in our study, which we conducted using 12 years' worth of data between 2000 and 2012, and then followed up individually with them for up to 1 year to identify any occurrence of preterm birth. Results highlighted that, compared with the women with perinatal depression who were not using antidepressants during pregnancy, the women taking antidepressants had a 1.762-fold risk of preterm birth (adjusted HR=1.762, 95% CI 1.351 to 2.294, p<0.001). The use of antidepressants in women with perinatal depression may increase the risk of preterm birth. However, the decision to start, stop, or change the use of antidepressants during pregnancy requires evaluating the risks of treatment versus untreated depression for both mother and child.

Exposure profiles of workers from indium tin oxide target manufacturing and recycling factories in Taiwan.

Indium tin oxide exposure poses a potential health risk, but the exposure assessment in occupational setting remains incomplete and continues to be a significant challenge. To this end, we investigated the association of work type, airborne indium concentration, respirable fraction of total indium, and cumulative indium exposure index (CEI) with the levels of plasma indium (P-In) and urinary indium (U-In) among 302 indium tin oxide target manufacturing and recycling workers in Taiwan. We observed that recycling-crushing produced the highest concentrations of total indium (area: 2084.8 µg/m3; personal: 3494.5 µg/m3) and respirable indium (area: 533.4 µg/m3; personal: 742.0 µg/m3). Powdering produced the highest respirable fraction of total indium (area: 58.6%; personal: 81.5%), where the workers had the highest levels of P-In (geometric mean: 2.0 µg/L) and U-In (1.0 µg/g creatinine). After adjusting for the confounder, the CEIs of powdering (ßPR = 0.78; ßPR = 0.44), bonding (ßPT = 0.61; ßPT = 0.37), and processing workers (ßPT = 0.43; ßPT = 0.28) showed significant associations with P-In and U-In, validating its utility in monitoring the exposure. Also, the respirable fraction of total indium significantly contributed to the increased levels of P-In and U-In among workers. The varying levels of relationship noted between indium exposure and the levels of P-In and U-In among workers with different work types suggested that setting the exposure limits among different work types is warranted.

Epidemiological Study of Return to Work and Mortality in Lung Cancer Survivors.

Lung cancer is the second most common cancer and the leading cause of cancer-related deaths worldwide. Return to work (RTW) plays an important role for lung cancer survivors. Few studies focus solely on the relationship among possible variables and the RTW of lung cancer patients. The aim of our study was to examine sociodemographic, disease-related and work-related factors associated with RTW among lung cancer survivors in Taiwan. A total of 2206 employees who had been diagnosed with lung cancer at the Labor Insurance Database (LID), Taiwan Cancer Registry (TCR) and the National Health Insurance Research Database (NHIRD) during the period 2004-2015, were included in the study. We used the Cox proportional hazards model to investigate the associations between sociodemographic, disease-related and work-related factors on one hand and RTW on the other hand. The Kaplan-Meier method was used for analyzing the survival probability. Patients with an early cancer stage and those who underwent surgery had a higher likelihood of RTW. Factors including older age, male, higher monthly income and receipt of radiotherapy were inversely correlated with RTW. For lung cancer patients, RTW was a predictor of a lower risk of all-cause mortality in both the unadjusted and fully adjusted model. A better survival rate was found in stage III and IV lung cancer patients who had RTW. Sociodemographic and clinical-related variables had an impact on RTW among employees with lung cancer. RTW was correlated with a lower risk of all-cause mortality and better lung cancer survival. Our study showed the influence of RTW and independent confounding factors in lung cancer survivorship.

Polycyclic aromatic hydrocarbon metabolites and mortality risk in an adult population.

Occupational polycyclic aromatic hydrocarbons (PAHs) exposure has been shown to increase the risk of various cancers and may be associated with carcinogenic mortality. However, no study has explored the relationship between environmental PAH exposure and mortality in general population. The aim of our study was to explore the association between PAH exposure and all-cause, cardiovascular, and cancer mortality in a general US adult population. We analyzed data from the National Health and Nutrition Examination Survey (NHANES 2001-2006) based on the information in this dataset on 692 males and 717 females. PAH exposure was detected using biomarkers from urine samples. Follow-up data on mortality were derived from initial examination of the subjects until death or 31 December 2006 in the NHANES database. We calculated hazard ratios (HRs) of PAH metabolites among all-cause, cardiovascular, and cancer mortality using the multivariate Cox proportional hazards regression model after adjusting for covariates. Among males, 3-phenanthrene was positively associated with increased risk of all-cause mortality (HR 1.043, 95%CI 1.019-1.066). Female participants with higher 2-napthol (HR 1.043, 95%CI 1.014-1.072), 3-fluorene (HR 2.159, 95%CI 1.233-3.779), and 1-phenanthrene (HR = 1.259, 95%CI 1.070-1.481) levels had increased all-cause mortality. In addition, high 3-phenanthrene (HR 1.333, 95%CI 1.008-1.763) and 1-phenanthrene (HR 1.463, 95%CI 1.126-1.900) levels increased the risk of cardiovascular mortality. However, there were no significant findings for cancer mortality in both genders. Environmental PAH exposure among the adult population is associated with non-carcinogenic but not cancer mortality. Future studies are warranted to determine the underlying mechanisms related to these findings.

Examining relationship between occupational acid exposure and oral health in workplace.

BACKGROUND: Acid mist can suspend in the air and enter the body via skin contact, the respiratory tract, or even oral intake, which pose various health hazards. Previous studies have shown that occupational exposure to acid mist or acidic solutions is a major risk factor for oral diseases. However, the findings are inconsistent and do not consider individual factors and lifestyles that may cause the same oral diseases. Therefore, we conducted a comprehensive oral health survey and collected detail information to confirm the effect of acidic solution exposure on worker's oral health. METHODS: From 4 acidic solution factories, a total of 309 subjects (157 in control and 152 in exposed group) was enrolled. All participants competed oral examinations and self-report questionnaire, including the decayed, missing, and filled teeth (DMFT) index, community periodontal index (CPI), loss of attachment (LA) index, and tooth erosion. Multivariate logistic regression analysis was used to determine the association between the acidic solution exposure and oral health. RESULTS: The results showed that acid exposure was correlated with soft oral tissue injury rather than hard oral tissue in our survey. In the multivariate model (adjusted for sex, age, worked years, education level, mouthwash use, dental floss use, tooth brushing, mask use, smoking, drinking, chewing areca and dietary habits with acidic foods), significant relationships of acid exposure with LA score were observed (OR = 2.32, 95% CI 1.03-5.26). However, the presence of acid exposure was not significantly associated with tooth erosion, DMFT, and CPITN. CONCLUSION: Our study highlighted that occupational acid exposure was an independent risk factor for periodontal health, especially LA. It is important to strengthen occupational hazard control, educate workers on oral disease and related factors, and raise the awareness of oral hygiene.

Receptor for advanced glycation end products in relation to exposure to metal fumes and polycyclic aromatic hydrocarbon in shipyard welders.

Advanced glycation end products (AGE) and the receptor for AGE (RAGE) have been found to be pivotal biomarkers to predict the risk of inflammation and oxidative stress. Limited evidence focuses on the influence of occupational exposure to polycyclic aromatic hydrocarbon (PAH) and metal fumes on AGE and RAGE in shipyard welders. Our aim was to determine the relationships among PAH, metal exposure, and inflammatory biomarkers. From September 1 to December 31, 2017, 53 welding workers (exposed group) and 29 office workers (control group) were enrolled in the study. Comprehensive workups included demographic characteristics, laboratory data, AGE, RAGE, Interleukin-6 (IL-6), tumor necrosis factor-α, PAH, and urinary metal concentrations. RAGE levels were measured by flow cytometric analysis. Urinary 1-hydroxypyrene (1-OHP) was used as a biomarker of exposure to PAH. Several metals were elevated in the personal fine particulate matter (PM2.5) samples, including Mn, Fe, V, Co, Zn, and Cu. The exposed group had significantly higher exposure to PM2.5 (p = 0.015), RAGE (p = 0.020), IL-6 (p = 0.008) than the control group. After adjusting for pertinent variables, there was still a significant and positive association between Ni level and AGE (ß = 0.101; 95% CI, 0.031-0.172). Significant relationship between Cr and Cd levels and RAGE was observed (ß = 0.173; 95% CI, 0.017-0.329; ß = 0.084; 95% CI, 0.011-0.157, respectively). Participants with elevated 1-OHP level had higher odds of high RAGE level in the model 1 (OR = 3.466, 95% CI, 1.053-11.412) and model 2 (OR = 3.454, 95% CI, 1.034-11.536). The RAGE expression of participants was significantly associated with IL-6 levels in the fully adjusted model (ß = 0.294; 95% CI, 0.083-0.732). Our findings highlighted that urinary metal levels and PAH were associated with increased AGE and RAGE formation in shipyard workers. Elevated serum RAGE might induce the production of proinflammatory cytokines and trigger ensuing inflammatory cascades.