Increased sister chromatid exchanges and tumor markers in workers exposed to elemental chromium-, cobalt- and nickel-containing dusts.

Sister-chromatid exchange (SCE) in blood lymphocytes, serum tumors markers, carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA), and urinary excretion of chromium, cobalt and nickel were determined in 26 male workers occupationally exposed to chromium, cobalt and nickel dust and in 25 controls matched for age and smoking habits. The differences in the urinary excretion of metals between exposed persons and controls were statistically significant. An analysis of variance on the SCE rank values revealed that both exposure status (exposed persons vs. controls) and smoking habits (smokers and former smokers vs. never smokers) had a statistically significant effect. For the tumor markers, the analysis of variance did not reveal a statistically significant difference between exposed persons and controls. However, CEA serum levels were significantly correlated not only with smoking habits but also with duration of exposure. As cobalt is only weakly mutagenic, these results suggest that the small amount of absorbed chromium and nickel may have been sufficient to induce SCE. The hypothesis that tumor markers may be increased in groups of subjects exposed to genotoxic substances deserves further study.

Cost-benefit analysis of hepatitis-B vaccination.

Since 1983 the Belgian insurance Fund for Occupational Disease (FOD) has refunded the cost of hepatitis-B (HB) vaccination. Vaccination has been carried out by occupational physicians selectively on staff in hospitals and medical-care institutions. At the end of 1986, 40,000 people at high risk of HBV infection had been vaccinated. The vaccination costs are largely offset by the benefits resulting from the striking fall in the number of HB cases. The financial investment has proved economically beneficial for the insurance fund.