Qualitative Assessment of Perceived Organizational Support for Employed Breast Cancer Survivors.

OBJECTIVE: A more detailed understanding of unmet organizational support needs and workplace-based best practices for supporting cancer survivors is needed. METHODS: Ninety-four working breast cancer survivors responded to an open-ended survey question regarding the desired types of organizational support that were and were not received during early survivorship. We performed content-analysis of qualitative data. RESULTS: Major themes included instrumental support, emotional support, and time-based support. The need for flexible arrangements and reduced workloads was mostly met. Unmet needs included navigation/coordination, understanding/empathy, and time off for treatment and recovery. CONCLUSIONS: Organizational support can help cancer survivors manage their health and work roles, diminishing work-health conflict and turnover intent. Study findings can be used to design targeted interventions to fulfill cancer survivors' unmet organizational support needs, which may also apply to workers with other chronic health conditions.

GuLF DREAM: A Model to Estimate Dermal Exposure Among Oil Spill Response and Clean-up Workers.

Tens of thousands of individuals performed oil spill response and clean-up (OSRC) activities following the 'Deepwater Horizon' oil drilling rig explosion in 2010. Many were exposed to oil residues and dispersants. The US National Institute of Environmental Health Sciences assembled a cohort of nearly 33 000 workers to investigate potential adverse health effects of oil spill exposures. Estimates of dermal and inhalation exposure are required for those individuals. Ambient breathing-zone measurements taken at the time of the spill were used to estimate inhalation exposures for participants in the GuLF STUDY (Gulf Long-term Follow-up Study), but no dermal measurements were collected. Consequently, a modelling approach was used to estimate dermal exposures. We sought to modify DREAM (DeRmal Exposure Assessment Method) to optimize the model for assessing exposure to various oil spill-related substances and to incorporate advances in dermal exposure research. Each DREAM parameter was reviewed in the context of literature published since 2000 and modified where appropriate. To reflect the environment in which the OSRC work took place, the model treatment of evaporation was expanded to include vapour pressure and wind speed, and the effect of seawater on exposure was added. The modified model is called GuLF DREAM and exposure is estimated in GuLF DREAM units (GDU). An external validation to assess the performance of the model for oils, tars, and fuels was conducted using available published dermal wipe measurements of heavy fuel oil (HFO) and dermal hand wash measurements of asphalt. Overall, measured exposures had moderate correlations with GDU estimates (r = 0.59) with specific correlations of -0.48 for HFO and 0.68 for asphalt. The GuLF DREAM model described in this article has been used to generate dermal exposure estimates for the GuLF STUDY. Many of the updates made were generic, so the updated model may be useful for other dermal exposure scenarios.

Perceptions of clinical support for employed breast cancer survivors managing work and health challenges.

PURPOSE: A substantial portion of breast cancer survivors are active in the workforce, yet factors that allow survivors to balance work with cancer management and to return to work are poorly understood. We examined breast cancer survivors' most valued/desired types of support in early survivorship. METHODS: Seventy-six employed breast cancer survivors answered an open-ended survey question assessing the most valued/desired support to receive from healthcare providers during early survivorship to manage work and health. Cutrona's (Journal of Social and Clinical Psychology 9:3-14, 1990) optimal matching theory and House's (1981) conceptualization of social support types informed our analyses. Data were content-analyzed to identify themes related to support, whether needed support was received or not, and the types of healthcare providers who provided support. RESULTS: We identified six themes related to types of support. Informational support was valued and mostly received by survivors, but they expected more guidance related to work. Emotional support was valued but lacking, attributed mainly to providers' lack of personal connection and mental health support. Instrumental (practical) support was valued but received by a small number of participants. Quality of life support to promote well-being and functionality was valued and often received. Other themes included non-specific support and non-support. CONCLUSIONS: This study expands our understanding of how breast cancer survivors perceive work-related support from healthcare professionals. Findings will inform targeted interventions designed to improve the support provided by healthcare professionals. IMPLICATIONS FOR CANCER SURVIVORS: Breast cancer survivors managing work and health challenges may benefit by having their unmet support needs fulfilled.

The Characterization of Polycyclic Aromatic Hydrocarbons in Northeastern US Trucking Terminals.

In recent years, significant attention has been given to polycyclic aromatic hydrocarbons (PAHs) exposures given their mutagenic and carcinogenic properties. However, levels of exposure and the key determinants of exposure are not well defined for the trucking industry. We measured ultrafine particle characteristics at 10 trucking terminals of varying operating size and location in the Northeast region of the United States using particle concentration counter and a surface area analyzer. Multivariate mixed-effects linear regression models were used to assess determinants of the concentration of total bound PAHs (tPAH), the total aerosol active surface area (AS), and the ratio tPAH/AS overall and individually within docks, trucking cabs, and administrative offices. Associations between PAH measures with integrated measures of elemental carbon (EC), organic carbon (OC), and particulate matter (PM)2.5 were assessed by Spearman rank correlation. In adjusted models, tPAH, AS, and tPAH/AS average concentrations (95% confidence interval) were significantly higher in truck cabs compared to office locations (1.26 (ng m-3) (1.18, 1.35); 0.99 (mm2 mm-3) (0.91, 1.08); 0.26 (ng mm-2) (0.18, 0.33), respectively). In the loading dock, AS concentrations were significantly higher than in the office (0.67 (0.61, 0.71), while the tPAH/AS was not (-0.63 (-0.67, -0.58). In each location, average tPAH concentrations were moderately but significantly correlated with EC (r = 0.47-0.63) and with tPAH/AS (r = 0.34-0.40) in the truck cabs and loading docks. In conclusion, key predictors of tPAH, AS, and tPAH/AS within the trucking industry are work location (in particular truck cabs and terminal docks) and terminal characteristics (size). The association of tPAH and tPAH/AS with EC concentrations in dockworkers and pick-up and delivery drivers is consistent with occupational exposure attributable to vehicle exhaust. Therefore, measurement of tPAH, AS, and tPAH/AS to characterize ultrafine particles and bound PAH concentrations provide additional information regarding exposures in the trucking industry not captured by integrated measures by EC, OC, and PM2.5.

Time Course of Heart Rate Variability Response to PM2.5 Exposure from Secondhand Smoke.

PURPOSE: Exposure to secondhand smoke (SHS) has been associated with decreased heart rate variability (HRV). However, the time course of this association is unclear. Therefore, the objective of this study was to investigate the association between 15-240 minute SHS-related fine particulate matter (PM2.5) moving averages and indices of HRV. METHODS: With a panel study design, we used personal monitors to continuously measure PM2.5 and HRV of 35 participants who were exposed to SHS for approximately 6 hours. RESULTS: We observed negative, significant associations between 5-minute HRV indices and 15 minute PM2.5 moving averages and 240 minute PM2.5 moving averages: there was a significant (p<0.01) 7.5% decrease in the 5-minute square root of the mean squared differences of successive normal heart beats associated with (RMSSD), and a significant (p<0.01) 14.7% decrease in the 5-minute high frequency (HF) power associated with the 15 minute PM2.5 moving averages; there was also a significant (p<0.01) 46.9% decrease in the 5-minute RMSSD, and a significant (p<0.01) 77.7% decrease in the 5-minute high frequency (HF) power associated with the 240 minute PM2.5 moving averages. CONCLUSIONS: Our findings that exposure to SHS related PM2.5 was associated with HRV support the hypothesis that SHS can affect the cardiovascular system. The negative associations reported between short and longer term PM2.5 and HRV indicate adverse effects of SHS on the cardiovascular system.

Environmental and occupational particulate matter exposures and ectopic heart beats in welders.

OBJECTIVES: Links between arrhythmias and particulate matter exposures have been found among sensitive populations. We examined the relationship between personal particulate matter ≤2.5 µm aerodynamic diameter (PM2.5) exposures and ectopy in a panel study of healthy welders. METHODS: Simultaneous ambulatory ECG and personal PM2.5 exposure monitoring with DustTrak Aerosol Monitor was performed on 72 males during work and non-work periods for 5-90 h (median 40 h). ECGs were summarised hourly for supraventricular ectopy (SVE) and ventricular ectopy (VE). PM2.5 exposures both work and non-work periods were averaged hourly with lags from 0 to 7 h. Generalised linear mixed-effects models with a random participant intercept were used to examine the relationship between PM2.5 exposure and the odds of SVE or VE. Sensitivity analyses were performed to assess whether relationships differed by work period and among current smokers. RESULTS: Participants had a mean (SD) age of 38 (11) years and were monitored over 2993 person-hours. The number of hourly ectopic events was highly skewed with mean (SD) of 14 (69) VE and 1 (4) SVE. We found marginally significant increases in VE with PM2.5 exposures in the sixth and seventh hour lags, yet no association with SVE. For every 100 µg/m(3) increase in sixth hour lagged PM2.5, the adjusted OR (95% CI) for VE was 1.03 (1.00 to 1.05). Results persisted in work or non-work exposure periods and non-smokers had increased odds of VE associated with PM2.5 as compared with smokers. CONCLUSIONS: A small increase in the odds of VE with short-term PM2.5 exposure was observed among relatively healthy men with environmental and occupational exposures.

Are the Associations of Cardiac Acceleration and Deceleration Capacities With Fine Metal Particulate in Welders Mediated by Inflammation?

OBJECTIVE: The aim of this study was to investigate whether associations of acceleration capacity (AC) and deceleration capacity (DC) with metal-PM2.5 are mediated by inflammation. METHODS: We obtained PM2.5, C-reactive protein, interleukin (IL)-6, 8, and 10, and electrocardiograms to compute AC and DC, from 45 male welders. Mediation analyses were performed using linear mixed models to assess associations between PM2.5 exposure, inflammatory mediator, and AC or DC, controlling for covariates. RESULTS: The proportion of total effect of PM2.5 on AC or DC (indirect effect) mediated through IL-6 on AC was 4% at most. Controlling for IL-6 (direct effect), a 1 mg/m increase of PM2.5 was associated with a decrease of 2.16 (95% confidence interval -0.36 to 4.69) msec in AC and a decrease of 2.51 (95% confidence interval -0.90 to 5.93) msec in DC. CONCLUSION: IL-6 may be mediating the effect of metal particulates on AC.

Short-term metal particulate exposures decrease cardiac acceleration and deceleration capacities in welders: a repeated-measures panel study.

OBJECTIVE: Acceleration (AC) and deceleration (DC) capacities measure heart rate variability during speeding up and slowing down of the heart, respectively. We investigated associations between AC and DC with occupational short-term metal PM2.5 exposures. METHODS: A panel of 48 male welders had particulate matter less than 2.5 microns in diameter (PM2.5) exposure measurements over 4-6 h repeated over 5 sampling periods between January 2010 and June 2012. We simultaneously obtained continuous recordings of digital ECG using a Holter monitor. We analysed ECG data in the time domain to obtain hourly AC and DC. Linear mixed models were used to assess the associations between hourly PM2.5 exposure and each of hourly AC and DC, controlling for age, smoking status, active smoking, exposure to secondhand smoke, season/time of day when ECG reading was obtained and baseline AC or DC. We also ran lagged exposure response models for each successive hour up to 3 h after onset of exposure. RESULTS: Mean (SD) shift PM2.5 exposure during welding was 0.47 (0.43) mg/m(3). Significant exposure-response associations were found for AC and DC with increased PM2.5 exposure. In our adjusted models without any lag between exposure and response, a 1 mg/m(3) increase of PM2.5 was associated with a decrease of 1.46 (95% CI 1.00 to 1.92) ms in AC and a decrease of 1.00 (95% CI 0.53 to 1.46) ms in DC. The effect of PM2.5 on AC and DC was maximal immediately postexposure and lasted 1 h following exposure. CONCLUSIONS: There are short-term effects of metal particulates on AC and DC.

Heart rate variability and DNA methylation levels are altered after short-term metal fume exposure among occupational welders: a repeated-measures panel study.

BACKGROUND: In occupational settings, boilermakers are exposed to high levels of metallic fine particulate matter (PM2.5) generated during the welding process. The effect of welding PM2.5 on heart rate variability (HRV) has been described, but the relationship between PM2.5, DNA methylation, and HRV is not known. METHODS: In this repeated-measures panel study, we recorded resting HRV and measured DNA methylation levels in transposable elements Alu and long interspersed nuclear element-1 (LINE-1) in peripheral blood leukocytes under ambient conditions (pre-shift) and right after a welding task (post-shift) among 66 welders. We also monitored personal PM2.5 level in the ambient environment and during the welding procedure. RESULTS: The concentration of welding PM2.5 was significantly higher than background levels in the union hall (0.43 mg/m3 vs. 0.11 mg/m3, p < 0.0001). The natural log of transformed power in the high frequency range (ln HF) had a significantly negative association with PM2.5 exposure (ß = -0.76, p = 0.035). pNN10 and pNN20 also had a negative association with PM2.5 exposure (ß = -0.16%, p = 0.006 and ß = -0.13%, p = 0.030, respectively). PM2.5 was positively associated with LINE-1 methylation [ß = 0.79%, 5-methylcytosince (%mC), p = 0.013]; adjusted for covariates. LINE-1 methylation did not show an independent association with HRV. CONCLUSIONS: Acute decline of HRV was observed following exposure to welding PM2.5 and evidence for an epigenetic response of transposable elements to short-term exposure to high-level metal-rich particulates was reported.

Toenail metal concentration as a biomarker of occupational welding fume exposure.

In populations exposed to heavy metals, there are few biomarkers that capture intermediate exposure windows. We sought to determine the correlation between toenail metal concentrations and prior 12-month work activity in welders with variable, metal-rich, welding fume exposures. Forty-eight participants, recruited through a local union, provided 69 sets of toenail clippings. Union-supplied and worker-verified personal work histories were used to quantify hours welded and respirator use. Toenail samples were digested and analyzed for lead (Pb), manganese (Mn), cadmium (Cd), nickel (Ni), and arsenic (As) using ICP-MS. Spearman correlation coefficients were used to examine the correlation between toenail metal concentrations. Using mixed models to account for multiple participation times, we divided hours welded into three-month intervals and examined how weld hours correlated with log-transformed toenail Pb, Mn, Cd, Ni, and As concentrations. Highest concentrations were found for Ni, followed by Mn, Pb and As, and Cd. All the metals were significantly correlated with one another (rho range = 0.28-0.51), with the exception of Ni and As (rho = 0.20, p = 0.17). Using mixed models adjusted for age, respirator use, smoking status, and BMI, we found that Mn was associated with weld hours 7-9 months prior to clipping (p = 0.003), Pb was associated with weld hours 10-12 months prior to clipping (p = 0.03) and over the entire year (p = 0.04). Cd was associated with weld hours 10-12 months prior to clipping (p = 0.05), and also with the previous year's total hours welded (p = 0.02). The association between Ni and weld hours 7-9 months prior to clipping approached significance (p = 0.06). Toenail metal concentrations were not associated with the long-term exposure metric, years as a welder. Results suggest Mn, Pb, and Cd may have particular windows of relevant exposure that reflect work activity. In a population with variable exposure, toenails may serve as useful biomarkers for occupational metal fume exposures to Mn, Pb, and Cd during distinct periods over the year prior to sample collection.

Traffic-related exposures and biomarkers of systemic inflammation, endothelial activation and oxidative stress: a panel study in the US trucking industry.

BACKGROUND: Experimental evidence suggests that inhaled particles from vehicle exhaust have systemic effects on inflammation, endothelial activation and oxidative stress. In the present study we assess the relationships of short-term exposures with inflammatory endothelial activation and oxidative stress biomarker levels in a population of trucking industry workers. METHODS: Blood and urine samples were collected pre and post-shift, at the beginning and end of a workweek from 67 male non-smoking US trucking industry workers. Concurrent measurements of microenvironment concentrations of elemental and organic carbon (EC & OC), and fine particulate matter (PM2.5) combined with time activity patterns allowed for calculation of individual exposures. Associations between daily and first and last-day average levels of exposures and repeated measures of intercellular and vascular cell adhesion molecule-1 (ICAM-1 & VCAM-1), interleukin 6 (IL-6) and C-reactive protein (CRP) blood levels and urinary 8-Hydroxy-2'-Deoxyguanosine (8-OHdG) were assessed using linear mixed effects models for repeated measures. RESULTS: There was a statistically significant association between first and last-day average PM2.5 and 8-OHdG (21% increase, 95% CI: 2, 42%) and first and last-day average OC and IL-6 levels (18% increase 95% CI: 1, 37%) per IQR in exposure. There were no significant findings associated with EC or associations suggesting acute cross-shift effects. CONCLUSION: Our findings suggest associations between weekly average exposures of PM2.5 on markers of oxidative stress and OC on IL-6 levels.

Secondhand tobacco smoke exposure and heart rate variability and inflammation among non-smoking construction workers: a repeated measures study.

BACKGROUND: Although it has been well recognized that exposure to secondhand tobacco smoke (SHS) is associated with cardiovascular mortality, the mechanisms and time course by which SHS exposure may lead to cardiovascular effects are still being explored. METHODS: Non-smoking workers were recruited from a local union and monitored inside a union hall while exposed to SHS over approximately 6 hours. Participants were fitted with a continuous electrocardiographic monitor upon enrollment which was removed at the end of a 24-hr monitoring period. A repeated measures study design was used where resting ECGs and blood samples were taken from individuals before SHS exposure (baseline), immediately following SHS exposure (post) and the morning following SHS exposure (next-morning).Inflammatory markers, including high sensitivity C-reactive protein (CRP) and white blood cell count (WBC) were analyzed. Heart rate variability (HRV) was analyzed from the ECG recordings in time (SDNN, rMSSD) and frequency (LF, HF) domain parameters over 5-minute periods. SHS exposure was quantified using a personal fine particulate matter (PM2.5) monitor.Linear mixed effects regression models were used to examine within-person changes in inflammatory and HRV parameters across the 3 time periods. Exposure-response relationships with PM2.5 were examined using mixed effects models. All models were adjusted for age, BMI and circadian variation. RESULTS: A total of 32 male non-smokers were monitored between June 2010 and June 2012. The mean PM2.5 from SHS exposure was 132 µg/m3. Immediately following SHS exposure, a 100 µg/m3 increase in PM2.5 was associated with declines in HRV (7.8% [standard error (SE) =3%] SDNN, 8.0% (SE = 3.9%) rMSSD, 17.2% (SE = 6.3%) LF, 29.0% (SE = 10.1%) HF) and increases in WBC count 0.42 (SE = 0.14) k/µl. Eighteen hours following SHS exposure, a 100 µg/m3 increase in PM2.5 was associated with 24.2% higher CRP levels. CONCLUSIONS: Our study suggest that short-term SHS exposure is associated with significantly lower HRV and higher levels of inflammatory markers. Exposure-associated declines in HRV were observed immediately following exposure while higher levels of CRP were not observed until 18 hours following exposure. Cardiovascular autonomic and inflammation responses may contribute to the pathophysiologic pathways that link SHS exposure with adverse cardiovascular outcomes.

Predictors of airborne exposures to polycyclic aromatic compounds and total organic matter among hot-mix asphalt paving workers and influence of work conditions and practices.

OBJECTIVES: We evaluated personal airborne exposures to polycyclic aromatic compounds (PACs) and total organic matter (TOM) among hot-mix asphalt (HMA) paving workers. The primary objectives of this study were to identify predictors of airborne PAC exposures, identify PAC exposure sources, and characterize how work practices may affect personal airborne exposure to PACs. METHODS: Four workers were recruited from each of three asphalt paving crews (12 workers) and were monitored for three consecutive days over 4 weeks for a total of 12 sampling days per worker (144 worker-days). Three sampling weeks were conducted while maintaining standard working conditions with regard to airborne exposures. The fourth week included the substitution of biodiesel for diesel oil used to clean tools and equipment. Linear mixed-effects models were used to evaluate predictors of airborne exposures including weather parameters (air temperature, wind speed, and relative humidity), worksite conditions (HMA application temperature, work rate, asphalt grade, and biodiesel use), and personal factors (minutes sampled, minutes of downtime, and smoking status). RESULTS: Concentrations of the 33 individual PACs measured in personal air samples were generally below detection limits under all conditions with the exception of fluorene [geometric mean (GM) = 65 ng m(-3)], naphthalene (GM = 833 ng m(-3)), phenanthrene (GM = 385 ng m(-3)), and pyrene (GM = 57 ng m(-3)). The summary measures of TOM (GM = 864 µg m(-3)) and four- to six-ring PAC (GM = 0.13 µg m(-3)) were detected in the majority of air samples. Although task was not a predictor of airborne exposures, job site characteristics such as HMA application temperature were found to significantly (P ≤ 0.001) affect summary and individual PAC exposures. Based on the results of multivariate linear mixed-effects models, substituting biodiesel for diesel oil as a cleaning agent was associated with significant (P ≤ 0.01) reductions in TOM, four- to six-ring PACs, and naphthalene and pyrene concentrations that ranged from 31 to 56%. Using multivariate linear mixed-effects models under standard conditions, reducing the application temperature of HMA from 149°C (300°F) to 127°C (260°F) could be expected to reduce airborne exposures by 42-82%, varying by analyte. CONCLUSIONS: Promising strategies for reducing airborne exposures to PACs among HMA paving workers include substituting biodiesel for diesel oil as a cleaning agent and decreasing the HMA application temperature.

Predictors of dermal exposures to polycyclic aromatic compounds among hot-mix asphalt paving workers.

OBJECTIVES: The primary objective of this study was to identify the source and work practices that affect dermal exposure to polycyclic aromatic compounds (PACs) among hot-mix asphalt (HMA) paving workers. METHODS: Four workers were recruited from each of three asphalt paving crews (12 workers) and were monitored for three consecutive days over 4 weeks for a total of 12 sampling days per worker (144 worker days). Two sampling weeks were conducted under standard conditions for dermal exposures. The third week included the substitution of biodiesel for diesel oil used to clean tools and equipment and the fourth week included dermal protection through the use of gloves, hat and neck cloth, clean pants, and long-sleeved shirts. Dermal exposure to PACs was quantified using two methods: a passive organic dermal (POD) sampler specifically developed for this study and a sunflower oil hand wash technique. Linear mixed-effects models were used to evaluate predictors of PAC exposures. RESULTS: Dermal exposures measured under all conditions via POD and hand wash were low with most samples for each analyte being below the limit of the detection with the exception of phenanthrene and pyrene. The geometric mean (GM) concentrations of phenanthrene were 0.69 ng cm(-2) on the polypropylene layer of the POD sampler and 1.37 ng cm(-2) in the hand wash sample. The GM concentrations of pyrene were 0.30 ng cm(-2) on the polypropylene layer of the POD sampler and 0.29 ng cm(-2) in the hand wash sample. Both the biodiesel substitution and dermal protection scenarios were effective in reducing dermal exposures. Based on the results of multivariate linear mixed-effects models, increasing frequency of glove use was associated with significant (P < 0.0001) reductions for hand wash and POD phenanthrene and pyrene concentrations; percent reductions ranged from 40 to 90%. Similar reductions in hand wash concentrations of phenanthrene (P = 0.01) and pyrene (P = 0.003) were observed when biodiesel was substituted for diesel oil as a cleaning agent, although reductions were not significant for the POD sampler data. Although task was not a predictor of dermal exposure, job site characteristics such as HMA application temperature, asphalt grade, and asphalt application rate (tons per hour) were found to significantly affect exposure. Predictive models suggest that the combined effect of substituting biodiesel for diesel oil as a cleaning agent, frequent glove use, and reducing the HMA application temperature from 149°C (300°F) to 127°C (260°F) may reduce dermal exposures by 76-86%, varying by analyte and assessment method. CONCLUSIONS: Promising strategies for reducing dermal exposure to PACs among asphalt paving workers include requiring the use of dermal coverage (e.g. wearing gloves and/or long sleeves), substituting biodiesel for diesel oil as a cleaning agent, and decreasing the HMA application temperature.

Assessment of occupational exposure to manganese and other metals in welding fumes by portable X-ray fluorescence spectrometer.

Elemental analysis of welding fume samples can be done using several laboratory-based techniques. However, portable measurement techniques could offer several advantages. In this study, we sought to determine whether the portable X-ray fluorescence spectrometer (XRF) is suitable for analysis of five metals (manganese, iron, zinc, copper, and chromium) on 37-mm polytetrafluoroethylene filters. Using this filter fitted on a cyclone in line with a personal pump, gravimetric samples were collected from a group of boilermakers exposed to welding fumes. We assessed the assumption of uniform deposition of these metals on the filters, and the relationships between measurement results of each metal obtained from traditional laboratory-based XRF and the portable XRF. For all five metals of interest, repeated measurements with the portable XRF at the same filter area showed good consistency (reliability ratios are equal or close to 1.0 for almost all metals). The portable XRF readings taken from three different areas of each filter were not significantly different (p-values = 0.77 to 0.98). This suggested that the metal rich PM(2.5) deposits uniformly on the samples collected using this gravimetric method. For comparison of the two XRFs, the results from the portable XRF were well correlated and highly predictive of those from the laboratory XRF. The Spearman correlation coefficients were from 0.325 for chromium, to 0.995 for manganese and 0.998 for iron. The mean differences as a percent of the mean laboratory XRF readings were also small (<5%) for manganese, iron, and copper. The differences were greater for zinc and chromium, which were present at very low amounts in our samples and below the limits of detection of the portable XRF for many of the samples. These five metals were moderately to strongly correlated with the total fine particle fraction on filters (Spearman rho = 0.41 for zinc to 0.97 for iron). Such strong correlations and comparable results suggested that the portable XRF could be used as an effective and reliable tool for exposure assessment in many studies.

PM2.5 metal exposures and nocturnal heart rate variability: a panel study of boilermaker construction workers.

BACKGROUND: To better understand the mechanism(s) of particulate matter (PM) associated cardiovascular effects, research priorities include identifying the responsible PM characteristics. Evidence suggests that metals play a role in the cardiotoxicity of fine PM (PM2.5) and in exposure-related decreases in heart rate variability (HRV). We examined the association between daytime exposure to the metal content of PM2.5 and night HRV in a panel study of boilermaker construction workers exposed to metal-rich welding fumes. METHODS: Twenty-six male workers were monitored by ambulatory electrocardiogram (ECG) on a workday while exposed to welding fume and a non-workday (baseline). From the ECG, rMSSD (square root of the mean squared differences of successive intervals) was summarized over the night (0:00-7:00). Workday, gravimetric PM2.5 samples were analyzed by x-ray fluorescence to determine metal content. We used linear mixed effects models to assess the associations between night rMSSD and PM2.5 metal exposures both with and without adjustment for total PM2.5. Matched ECG measurements from the non-workday were used to control for individual cardiac risk factors and models were also adjusted for smoking status. To address collinearity between PM2.5 and metal content, we used a two-step approach that treated the residuals from linear regression models of each metal on PM2.5 as surrogates for the differential effects of metal exposures in models for night rMSSD. RESULTS: The median PM2.5 exposure was 650 microg/m3; median metal exposures for iron, manganese, aluminum, copper, zinc, chromium, lead, and nickel ranged from 226 microg/m3 to non-detectable. We found inverse linear associations in exposure-response models with increased metal exposures associated with decreased night rMSSD. A statistically significant association for manganese was observed, with a decline of 0.130 msec (95% CI: -0.162, -0.098) in night rMSSD for every 1 microg/m3 increase in manganese. However, even after adjusting for individual metals, increases in total PM2.5 exposures were associated with declines in night rMSSD. CONCLUSION: These results support the cardiotoxicity of PM2.5 metal exposures, specifically manganese. However the metal component alone did not account for the observed declines in night HRV. Therefore, results suggest the importance of other PM elemental components.

Time course of heart rate variability decline following particulate matter exposures in an occupational cohort.

Although research suggests that particles influence cardiac autonomic response as evidenced by decreases in heart rate variability (HRV), the time course of the response remains unclear. Using a crossover panel study, we monitored 36 male boilermaker welders, occupationally exposed to metal-rich particulate matter (PM) to investigate the temporal trend of hourly HRV subsequent to PM exposure. Ambulatory electrocardiograms were collected over work (exposure) and non-work (control) periods and the mean of the standard deviations of all normal-to-normal intervals for all 5-min segments (SDNN(i)) was calculated hourly for up to 14-hrs post-work. The exposure-response relationship was examined with linear mixed effects regression models to account for participants monitored over multiple occasions. Models were adjusted for non-work HRV to control for diurnal fluctuations and individual predictors of HRV. The mean (SD) work PM(2. 5) concentration was 1.12 (0.76) mg/m(3). Hourly SDNN(i) was consistently lower post-work as compared to the same time period on a non-work day. HRV was inversely associated with work PM(2. 5) exposures in each of the 14-hrs post-work. The hourly associations suggested an early and later phase response, with the largest regression coefficients observed 2-3 hrs (beta = -6.86 (95% CI: -11.91, -1.81) msec/1 mg/m(3) at 3-hrs), and then 9-13 hrs (beta = -8.60 (95% CI: -17.45, 0.24) msec/1 mg/m(3) at 11-hrs), after adjusting for non-work HRV, smoking status, and age. This investigation demonstrates declines in HRV for up to 14 hours following PM exposure and a multiphase cardiovascular autonomic response with immediate (2 hrs) and delayed (9-13 hrs) responses.

Acute changes in vascular function among welders exposed to metal-rich particulate matter.

BACKGROUND: Although welding fume exposure is associated with adverse cardiovascular outcomes, the mechanisms remain unclear. To investigate the role of vascular function, we assessed levels of the augmentation index (a correlate of arterial stiffness) after short-term exposure to welding-derived fine particulate matter (PM2.5). METHODS: In a panel study, we monitored 26 male welders over 24 hours on a welding day (n = 25), a non-welding day (n = 15), or both (n = 14). Augmentation index (expressed as a percent) was obtained in the morning before exposure (baseline) and after exposure in the afternoon and the following morning. Personal PM2.5 exposure was measured over 6 hours of welding or an equivalent non-welding period. We used linear mixed models adjusting for baseline augmentation index, smoking, age, and time to evaluate the effects of welding (binary) and PM2.5 (continuous) on augmentation index levels. We also assessed modification by welding exposure the day before monitoring (binary). RESULTS: Welding was associated with a 2.8% increase in afternoon augmentation index (95% confidence interval = -1.4 to 7.0) and a 2.4% decrease (-6.9 to 2.2) in next-morning augmentation index. Additional exposure the day prior to monitoring was associated with a greater afternoon increase (5.1%; 0.8 to 9.5). Using PM2.5 concentration, a positive association was observed in the afternoon and an inverse association the next morning; results differed by previous day's welding status after excluding outliers. CONCLUSIONS: Subsequent to welding fume exposure, there is an increase in afternoon augmentation index and a decrease in next-morning augmentation index, with greater changes after consecutive days of exposure. These results suggest that exposure to the PM2.5 component of welding fume elicits acute adverse vascular responses.

Urinary 8-isoprostane and 8-OHdG concentrations in boilermakers with welding exposure.

OBJECTIVE: To investigate the association of exposure to fine particulate matter (PM2.5) with DNA damage and oxidative stress in boilermakers exposed to welding fumes. METHODS: Forty-one workers were monitored over 24 hours during which baseline, postshift, bedtime, and next morning measurements were collected. Twenty-two workers participated as controls. RESULTS: Linear regression was used to model pairwise change in u-8-isoprostane and u-8-OHdG: pre- to postshift, preshift to bedtime, postshift to bedtime, and postshift to next morning. In the models, pre- to postshift change in 8-OHdG was statistically significant, whereas postshift to bedtime change in 8-isoprostane showed an unexpected inverse relationship with PM2.5. CONCLUSIONS: Acute welding exposure is associated with a postshift blunting of systemic inflammation in chronically exposed boilermakers, as measured by 8-isoprostane. The level of oxidative DNA damage as measured by 8-OHdG is less clear.

Night heart rate variability and particulate exposures among boilermaker construction workers.

BACKGROUND: Although studies have documented the association between heart rate variability (HRV) and ambient particulate exposures, the association between HRV, especially at night, and metal-rich, occupational particulate exposures remains unclear. OBJECTIVE: Our goal in this study was to investigate the association between long-duration HRV, including nighttime HRV, and occupational PM(2.5) exposures. METHODS: We used 24-hr ambulatory electrocardiograms (ECGs) to monitor 36 male boilermaker welders (mean age of 41 years) over a workday and nonworkday. ECGs were analyzed for HRV in the time domain; rMSSD (square root of the mean squared differences of successive intervals), SDNN (SD of normal-to-normal intervals over entire recording), and SDNN(i) (SDNN for all 5-min segments) were summarized over 24-hr, day (0730-2130 hours), and night (0000-0700 hours) periods. PM(2.5) (particulate matter with an aerodynamic diameter