Metalworking fluid exposure and cancer risk in a retrospective cohort of female autoworkers.

OBJECTIVES: Metalworking fluids (MWFs) have been associated with cancer of several sites, but the risks have been primarily examined in men or in studies that adjusted for gender in analyses. To evaluate whether risks were similar in women, we report cancer mortality risk among 4,825 female autoworkers within the united autoworkers-general motors autoworkers cohort. METHODS: Standardized mortality rates (SMRs) were calculated based on Michigan death rates (1980-2004). Internal comparisons (1941-2004) were examined using Cox regression for straight, soluble, and synthetic MWFs, and their corresponding oil- and water-based fractions. RESULTS: MWF exposure levels in the female cohort were generally less than two-third the MWF levels in the male cohort. Female autoworkers had an excess of cancer from all sites (SMR, 1.10; 95 % confidence interval (CI), 0.98-1.22) and lung cancer (SMR, 2.08; 95 % CI, 1.71-2.52). Colon cancer risk increased with straight (mineral oil) MWF exposure (exposure > median; hazard ratio = 3.1; 95 % CI, 1.2-8.0). A protective effect was observed for ovarian cancer with the soluble MWFs and water-based MWF metrics. Although bladder, rectal, and laryngeal cancers and malignant melanoma have been associated with straight MWF exposure and pancreatic cancer with synthetic MWF in men, there were too few deaths in this female subcohort to examine exposure-response relations for these sites. Results were null for lung and breast cancer. CONCLUSIONS: Our findings support an association between colon cancer and straight MWFs, but we found limited evidence of risk for other tumor sites at the lower exposure levels experienced by the female autoworkers.

Association between use of synthetic metalworking fluid and risk of developing rhinitis-related symptoms in an automotive ring manufacturing plant.

The main objective of this study was to determine the association between synthetic metalworking fluid (MWF) and rhinitis-related symptoms. At a plant manufacturing piston rings for automobiles, we interviewed grinders (19) and manufacturing workers (142) in operations where synthetic or semisynthetic MWF is handled, and administrative office workers (44) regarding the principal symptoms of rhinitis (nasal stuffiness, runny nose, anosmia, nasal itchiness, rhinorrhea, headache, epistaxis, and post-nasal drip). In addition, we assessed the current exposure of workers handling MWF to MWF aerosols, fungi, and endotoxins. Logistic regression analysis was used to examine the association between MWF surrogates indicative of MWF exposure and each rhinitis-related nasal symptom. Odds ratios (ORs) and 95% confidence intervals were adjusted for sex, age, smoking habit, and duration of employment. Among grinders handling synthetic MWF, the frequency of complaints of the dominant symptoms was 66.7% for nasal stuffiness, 77.8% for anosmia, 77.8% for runny nose, and 50.0% for headache. These rates are quite high even allowing for the common occurrence of rhinitis in the general population. Twenty eight of 34 grinding and manufacturing workers (82.4%) sampled were exposed to MWF mist above the threshold limit of 0.2 mg/m(3) listed as a notice of intended change by the American Conference for Governmental Industrial Hygienists (ACGIH). The percentage of workers exposed to MWF mist >0.5 mg/m(3) was 17.6%. Most workers were exposed to fungi levels >103 CFU/m(3). All exposures to endotoxins were <50 EU/m(3). Logistic regression analysis found that use of synthetic MWF was significantly associated with excess risk of nasal stuffiness (OR 3.5), nasal itchiness (OR 2.0), and runny nose (OR 2.1). The use of semi-synthetic MWF had little or no impact on the risk of developing rhinitis-related nasal symptoms. Grinding workers handling synthetic MWF had an increased risk of nasal stuffiness (OR 7.9), anosmia (OR 23.2), nasal itchiness (OR 8.3), runny nose (OR 20.4), post nasal drip (OR 18.4), and headache (OR 7.4) compared to administrative workers. Synthetic MWF may play an important role in the development of the dominant symptoms of rhinitis. Further study is needed to establish the risk of rhinitis or rhinitis-related symptoms according to MWF type.

[Chemical pneumonia following ingestion of lamp oil]. / Chemische pneumonie na ingestie van lampolie.

A 20-months-old girl developed a cough and became drowsy after drinking lamp oil. In the Emergency Ward, her oxygen saturation was 85%. The day after admission to hospital she showed a clinical and radiological picture of chemical pneumonia. After 3 days the patient could be discharged in good condition. The most important symptoms after the ingestion of hydrocarbon compounds such as lamp oil are respiratory problems due to aspiration and effects on the central nervous system following gastrointestinal absorption. Severe symptoms can develop in a short period of time. The treatment is supportive. The prognosis is favourable.

Pneumonitis and pneumatoceles following accidental hydrocarbon aspiration in children.

Accidental ingestion and aspiration of hydrocarbons in children are common. Among the various clinical and pathological manifestations of hydrocarbon (HC) poisoning, pneumonitis is the most significant and occurs in up to 40% of children, whereas formation of pneumatoceles is believed to be a rare event. We report two children with HC pneumonitis and pneumatoceles as a reversible complication after ingestion and aspiration of lamp oil with very low viscosity. Patient 1, a 21-month-old boy, started to cough and developed tachypnea, sternal retractions and mild cyanosis immediately after aspiration. Patient 2, a 24-month-old girl, was asymptomatic during the first days after the accident; subsequently, she started to cough and developed fever, dyspnea and chest pain. Chest x-ray and computed tomography revealed multiple patchy infiltrates in both cases; after several days, these confluent infiltrates developed into pneumatoceles. Both children were treated with antibiotics and steroids. They recovered within three and four weeks, respectively, with complete remission of the radiologic abnormalities and had an uneventful follow-up after discharge.

Metalworking fluid--the toxicity of a complex mixture.

Various chemicals are used in the manufacture of cooling and lubricating fluids and fall into the classes of straight, soluble, semisynthetic, and synthetic metalworking fluids. The diversity of chemicals and in-use contaminants makes the risk assessment of metalworking fluids quite difficult. Toxicologists have used a number of methods to evaluate the component(s) responsible for the adverse pulmonary effects of metal working fluid aerosols encountered in the workplace. Although investigators have studied the adverse effects of metalworking fluid chemicals alone and in combination, the majority of evidence strongly suggests that the microbial changes that occur in fluid composition, during use and storage in the workplace, are responsible for the pulmonary effects reported for workers exposed to metalworking fluid aerosols. This review discusses the methodologies used to examine the toxicity of the complex nature of modern metalworking fluids and the findings that point toward bacterial endotoxin as a major contributor to their adverse effects.

Cancer incidence and mortality in workers employed at a transformer manufacturing plant: update to a cohort study.

BACKGROUND: This study is an extension of a previously published analysis of cancer mortality in a transformer manufacturing plant where there had been extensive use of mineral oil transformer fluid. The objectives of the present study were to update the mortality analysis and include deaths for the past 6 years as well as to do an analysis of cancer incidence of the cohort. METHODS: A cohort of 2,222 males working at a transformer manufacturing plant between 1946 and 1975 was constructed. Using a classical historical cohort study design, cancer incidence and mortality were determined through record linkage with Canadian provincial and national registries. The rates of cancer incidence and mortality experienced by this cohort were compared to that of the Canadian male population. RESULTS: A statistically significant increased risk of developing and dying of pancreatic cancer was found but not an increase in overall cancer mortality. This was consistent with the previous report from this group. Interestingly, the cohort demonstrated a statistically significant risk of overall cancer incidence and specific increased incidence of gallbladder cancer. CONCLUSIONS: This study contributes further evidence to the growing body of literature indicating the carcinogenic properties of mineral oils used in occupational settings, in particular those used prior to 1970s.

High pressure injection injuries: an overview.

Injuries resulting from the use of high pressure injectors and spray guns are relatively rare; however, the potential tissue damage caused by the injury as well as the extent of the injury itself may go unrecognized by the primary physician. The purpose of this paper is to inform the emergency physician of the nature and standard management of this type of injury. A basic understanding of the pathophysiology of the high pressure injection injury (HPII) is essential in avoiding the mistakes in management that have been reported in the literature. The emergency management of the HPII includes: evaluation and immobilization, tetanus and antimicrobial prophylaxis, supportive and resuscitative measures, analgesia, and minimizing the time to definitive surgical treatment.