Exposure to soluble platinum salts in precious metal refinery workers over a 17-year period.

BACKGROUND: Occupational exposure to soluble chlorinated platinum (Pt) salts, commonly called chloroplatinates, is a known cause of Pt salt sensitisation (PSS) and occupational asthma. We aimed to model inhalable soluble Pt salts exposure levels based on measurements in precious metal refineries for use in a retrospective cohort study on PSS. METHODS: Five platinum refineries located in the United Kingdom (3 sites), United States, and South Africa provided time weighted average inhalable soluble Pt salts exposure data, measured in 2,982 personal air samples over a 17-year period (2000-2016). We used a Bayesian hierarchical model to estimate geometric mean (GM) exposure levels for each refinery and job title over time. RESULTS: The GM of measured exposure levels over all facilities was 92 ng/m3 with a geometric standard deviation (GSD) of 9.07. Facility-specific GMs ranged from 48 ng/m3 (GSD 15.3) to 242 ng/m3 (GSD 5.99). Exposure modelling showed that soluble Pt salts exposure levels declined approximately 10% per year in two of the five facilities, but there were no clear time trends in the other facilities. A priori specified exposure groups captured most of the between-jobs differences, which helps to accurately predict exposures for jobs with no measurement data available. CONCLUSIONS: We applied exposure modelling to estimate time, refinery, and job-specific soluble Pt salts exposures. A significant annual decline in exposure levels was observed in two of the five participating facilities. Modelled exposure levels can be linked to individual workers' job history for exposure-response analysis of PSS in an epidemiological study.

Temporal Trends in Variability of Respirable Dust and Respirable Quartz Concentrations in the European Industrial Minerals Sector.

While between- and within-worker variability have been studied quite extensively, hardly any research is available that examines long-term trends in the variability of occupational exposure. In this first study on trends in occupational exposure variability temporal changes in the variability of respirable dust and respirable quartz concentrations within the European industrial minerals sector were demonstrated. Since 2000 the European Industrial Minerals Association's Dust Monitoring Program (IMA-DMP) has systematically collected respirable dust and respirable quartz measurements. The resulting IMA-DMP occupational exposure database contains at present approximately 40 000 personal full-shift measurements, collected at 177 sites owned by 39 companies, located in 23 European countries. Repeated measurements of workers performing their duties within a specific site-job-campaign combination allowed estimation of within- and between-worker variability in exposure concentrations. Overall day-to-day variability predominated the between-worker variability for both respirable dust concentrations and quartz concentrations. The within-worker variability in concentrations by job was two to three times higher for respirable quartz than for respirable dust. The median between-worker variability in respirable dust concentrations was low and further reduced over time. For quartz concentrations the same phenomenon albeit somewhat less strong was observed. In contrast, for the within-worker variability in concentrations downward and upward temporal trends were apparent for both respirable dust and respirable quartz. The study shows that the (relative) size of temporal variability is large and unpredictable and therefore regular measurement campaigns are needed to ascertain compliance to occupational exposure limit values.

Is the New EN689 a Better Standard to Test Compliance With Occupational Exposure Limits in the Workplace?

OBJECTIVE: To evaluate the performance of three measurement strategies to test compliance with occupational exposure limits of similarly exposed groups (SEGs): the old and new versions of EN689, and the BOHS-NVvA guidance on measuring compliance. METHODS: Respirable dust exposures concentrations (n = 1383) measured within the member companies of IMA-Europe were used to compare compliance decisions between the three measurement strategies. A total of 210 SEGs of which 158 with repeated measurements were analysed. An R studio OHcomplianceStrategies package was created for the purpose. RESULTS: The old EN689 strategy resulted in the highest number of compliant SEGs in the preliminary tests and statistical test (49-52% and 83%) with lower percentages of compliance with the new EN689 standard (32-44% and 71%). The percentage of non-compliant SEGs was relatively similar between the old and new EN689 for the preliminary tests (1-12% versus 6-11%). However, the new EN689 declared almost twofold more SEGs non-compliant when applying the statistical test (29% versus 17%). The BOHS-NVvA individual test showed results in between the 26% non-compliant SEGs. CONCLUSION: This study showed differences in compliance decisions between the old and new EN689, with the new EN689 being considerably more stringent and resulting in more non-compliant SEGs.

Temporal trends in respirable dust and respirable quartz concentrations within the European industrial minerals sector over a 15-year period (2002-2016).

OBJECTIVES: Since 2000 the European Industrial Minerals Association's Dust Monitoring Programme (IMA-DMP) has systematically collected respirable dust and respirable quartz measurements from 35 companies producing industrial minerals. The IMA-DMP initiative allowed for estimating overall temporal trends in exposure concentrations for the years 2002-2016 and for presenting these trends by type of mineral produced, by jobs performed and by time of enrolment into the DMP. METHODS: Approximately 32 000 personal exposure measurements were collected during 29 sampling campaigns during a 15-year period (2002-2016). Temporal trends in respirable dust and respirable quartz concentrations were studied by using linear mixed effects models. RESULTS: Concentrations varied widely (up to three to four orders of magnitude). However, overall decreases in exposure levels were shown for the European minerals industry over the 15-year period. Statistically significant overall downward temporal trends of -9.0% and -3.9% per year were observed for respirable dust and respirable quartz, respectively. When analyses were stratified by time period, no downward trends (and even slight increasing concentrations) were observed between 2008 and 2012, most likely attributable to the recent global economic crisis. After this time period, downward trends became visible again. CONCLUSIONS: Consistent and statistically significant downward trends were found for both exposure to respirable dust and respirable quartz. These downward trends became less or even reversed during the years of the global economic crisis. To our knowledge, this is the first time that analyses of long-term temporal trends point at an effect of a global economic crisis on personal exposure concentrations of workers from sites across Europe.

Serum levels of decabromodiphenyl ether (BDE-209) in women from different European countries and possible relationships with lifestyle and diet.

To determine possible effects of lifestyle, diet, housing and professional activities on differences in individual levels of decabromodiphenyl ether (BDE-209) in serum of women, 20 to 40years of age, in The Netherlands, the United Kingdom, Norway and Spain. BDE-209 was measured in serum of 145 female volunteers with no known occupational exposure from Norway, United Kingdom, The Netherlands and Spain. Blood levels of BDE-209 in a subgroup of 40 Dutch women were determined twice at a six months' interval. An extensive questionnaire was used to obtain detailed information about lifestyle factors that might contribute to BDE-209 exposure. Serum levels were used to determine margin of systemic exposure compared with a 28d rat toxicity study. Median BDE-209 serum concentrations were highest in The Netherlands and United Kingdom, respectively 8.8 and 9.3pg/gww. or 2.6 and 2.8ng/g lipid. Median levels in Spain and Norway were lower, respectively 7.4 and 5.2pg/gww. or 3.3 and 0.8ng/g lipid. Maximum levels in individual women were higher by one order of magnitude than the mean or median. The country of residence was the only variable significantly associated with BDE-209 levels; we found that the differences between countries could not be explained by any of the investigated exposure variables, and that these did not explain differences between individuals either. No consistent relationships were determined between diets, household, clothes, number and duration of use of electronics and occupational activities for the whole study group. We could not identify which of the multiple sources of exposure accounted for individual differences in blood levels. Although small differences in mean BDE-209 serum levels were recognized between countries, these differences are unlikely to cause a differential result with respect to risk assessment.

15 years of monitoring occupational exposure to respirable dust and quartz within the European industrial minerals sector.

INTRODUCTION: In 2000, a prospective Dust Monitoring Program (DMP) was started in which measurements of worker's exposure to respirable dust and quartz are collected in member companies from the European Industrial Minerals Association (IMA-Europe). After 15 years, the resulting IMA-DMP database allows a detailed overview of exposure levels of respirable dust and quartz over time within this industrial sector. Our aim is to describe the IMA-DMP and the current state of the corresponding database which due to continuation of the IMA-DMP is still growing. The future use of the database will also be highlighted including its utility for the industrial minerals producing sector. METHODS: Exposure data are being obtained following a common protocol including a standardized sampling strategy, standardized sampling and analytical methods and a data management system. Following strict quality control procedures, exposure data are consequently added to a central database. The data comprises personal exposure measurements including auxiliary information on work and other conditions during sampling. RESULTS: Currently, the IMA-DMP database consists of almost 28,000 personal measurements which have been performed from 2000 until 2015 representing 29 half-yearly sampling campaigns. The exposure data have been collected from 160 different worksites owned by 35 industrial mineral companies and comes from 23 European countries and approximately 5000 workers. CONCLUSION: The IMA-DMP database provides the European minerals sector with reliable data regarding worker personal exposures to respirable dust and quartz. The database can be used as a powerful tool to address outstanding scientific issues on long-term exposure trends and exposure variability, and importantly, as a surveillance tool to evaluate exposure control measures. The database will be valuable for future epidemiological studies on respiratory health effects and will allow for estimation of quantitative exposure response relationships.

Exposure-response analyses for platinum salt-exposed workers and sensitization: A retrospective cohort study among newly exposed workers using routinely collected surveillance data.

BACKGROUND: Chloroplatinate salts are well-known respiratory sensitizing agents leading to work-related sensitization and allergies in the work environment. No quantitative exposure-response relation has been described for chloroplatinate salts. OBJECTIVE: We sought to evaluate the quantitative exposure-response relation between occupational chloroplatinate exposure and sensitization. METHODS: A retrospective cohort study was conducted using routinely collected health surveillance data and chloroplatinate exposure data. Workers who newly entered work between January 1, 2000, and December 31, 2010, were included, and the relation between measured chloroplatinate exposure and sensitization (as determined by skin prick test responses) was analyzed in more than 1000 refinery workers from 5 refineries for whom a total of more than 1700 personal exposure measurements were available. RESULTS: A clear exposure-response relation was observed, most strongly for more recent platinum salt exposure. Average or cumulative exposure over the follow-up period was less strongly associated with sensitization risk. The exposure-response relation was modified by smoking and atopy. CONCLUSIONS: Indications exist that recent exposure explains the risk of platinum salt sensitization most strongly. The precision of the estimate of the exposure-response relation derived from this data set appears superior to previous epidemiologic studies conducted on platinum salt sensitization and as a result, might have possible utility for the development of preventive strategies.

Cost-benefit analysis in occupational health: a comparison of intervention scenarios for occupational asthma and rhinitis among bakery workers.

OBJECTIVES: Use of cost-benefit analysis in occupational health increases insight into the intervention strategy that maximises the cost-benefit ratio. This study presents a methodological framework identifying the most important elements of a cost-benefit analysis for occupational health settings. One of the main aims of the methodology is to evaluate cost-benefit ratios for different stakeholders (employers, employees and society). The developed methodology was applied to two intervention strategies focused on reducing respiratory diseases. METHODS: A cost-benefit framework was developed and used to set up a calculation spreadsheet containing the inputs and algorithms required to calculate the costs and benefits for all cost elements. Inputs from a large variety of sources were used to calculate total costs, total benefits, net costs and the benefit-to-costs ratio for both intervention scenarios. RESULTS: Implementation of a covenant intervention program resulted in a net benefit of €16 848 546 over 20 years for a population of 10 000 workers. Implementation was cost-effective for all stakeholders. For a health surveillance scenario, total benefits resulting from a decreased disease burden were estimated to be €44 659 352. The costs of the interventions could not be calculated. CONCLUSION: This study provides important insights for developing effective intervention strategies in the field of occupational medicine. Use of a model based approach enables investigation of those parameters most likely to impact on the effectiveness and costs of interventions for work related diseases. Our case study highlights the importance of considering different perspectives (of employers, society and employees) in assessing and sharing the costs and benefits of interventions.

Bronchiolitis obliterans syndrome in chemical workers producing diacetyl for food flavorings.

RATIONALE: Workers in microwave popcorn plants are at risk of developing bronchiolitis obliterans associated with exposure to butter flavoring volatiles, including diacetyl. OBJECTIVES: To investigate the risk of bronchiolitis obliterans for chemical workers producing diacetyl, with exposure to less complex mixtures of chemicals. METHODS: We interviewed and conducted spirometry on 175 of 196 workers from a chemical production plant that produced diacetyl between 1960 and 2003. We used all available historical exposure data to classify all workers into three exposure groups with varying exposure profiles to diacetyl, based on frequency and level of exposure. MEASUREMENTS AND MAIN RESULTS: Workers with fixed airway obstruction underwent further pulmonary function testing (including diffusing capacity and lung volumes) and paired inspiratory and expiratory high-resolution computed tomography studies. We identified three cases consistent with bronchiolitis obliterans syndrome with air trapping on high-resolution computed tomography of the lungs, in the highest exposure group of 102 process operators. Two of these cases were lifelong nonsmokers. Potential exposures included acetoin, diacetyl, acetaldehyde, and acetic acid, with diacetyl exposures in the range previously reported to be associated with fixed airway obstruction in the microwave popcorn industry. CONCLUSIONS: Exposure to an agent during diacetyl production appears to be responsible for causing bronchiolitis obliterans syndrome in chemical process operators, consistent with the suspected role of diacetyl in downstream food production.