PAH exposure-associated lung cancer: an updated meta-analysis.

Background: Occupational exposure to polycyclic aromatic hydrocarbons (PAHs) has been shown to be associated with lung cancer in various epidemiological studies in industries such as aluminium reduction/smelting, coal gasification, coke production, iron/steel foundries, coal/coke and related products and carbon/graphite electrodes production. Aims: To update data on the association between PAH exposure and morbidity and mortality due to lung cancer among workers in different occupations, including smoking data. Methods: A comprehensive literature search was conducted to retrieve relevant papers for meta-analysis. Cohort studies with standardized mortality ratios or standardized incidence ratios and calculated overall risk ratio with their corresponding 95% confidence intervals (CIs) were included in the analysis. Chi-square test for heterogeneity was used to evaluate the consistency of findings between the studies. Results: A significant risk of lung cancer was observed among the coal/coke and related product industry 1.55 (95% CI 1.01-2.37) and the iron/steel foundry industry 1.52 (95% CI 1.05-2.20). There was a wide variation in smoking habits and PAHs exposure among studies. Conclusions: Coal/coke industry and iron/steel industry workers showed a higher risk of lung cancer compared with other occupations exposed to PAHs. The confounding effects of smoking and individual exposure levels of PAH should be taken into account.

Fast agitated directly suspended droplet microextraction technique for the rapid analysis of eighteen organophosphorus pesticides in human blood.

A new sample preparation technique named as fast agitated directly suspended droplet microextraction (FA-DSDME) was proposed as an improved version of directly suspended droplet microextraction (DSDME) for the extraction and pre-concentration of wide-range organophosphorus pesticides (OPPs) from human blood prior to liquid chromatography tandem mass spectrometric (LC-MS/MS) analysis. In this method, instead of protecting the unwanted rupturing of extraction droplet (organic solvent), it was deliberately splintered into fine droplets by providing automated high-speed agitation to the biphasic extraction system (extraction solvent and sample solution). Fine organic droplets were then recollected into one, not by using a centrifuge machine but just by giving a very slow stirring to the bottom of the extraction system. The present method has surmounted the problem of prolonged extraction time associated with old DSDME. Under optimum extraction conditions, the method showed good sensitivity with low detection limits ranging from 0.0009 to 0.122µgL(-1). Mean recoveries were achieved in the range of 86-109% at three levels of spiking concentration (low, middle and high) from linearity range of individual analyte. Intra-day and inter-day precisions were ≤4.68 and ≤9.57 (%RSD) respectively. Enrichment factor (EF) for each analyte varied from 30 to 132 which prove the ability of this technique to pre-concentrate the extracted analytes up to a good extent. The sample matrices have shown an insignificant influence on method's sensitivity. The proposed method may find immense use in epidemiological, toxicological, regulatory and forensic laboratories.

Seasonal variations in cholinesterase activity, nerve conduction velocity and lung function among sprayers exposed to mixture of pesticides.

Pesticide spraying operation is associated with the increased risk of adverse health effects among sprayers who do not follow safe farm work practices. A study was conducted among pesticide sprayers in North India to evaluate the clinical and subclinical variations in their vital health parameters before and after the pesticide spraying season. Blood cholinesterase levels, pulmonary function test, nerve conduction velocity and self-reported symptoms were studied among 18 eligible and consenting male sprayers. Mean acetylcholinesterase activity was reduced by 55 % in the post-exposure assessment (P<0.001) as compared to pre-exposure levels. Mean forced expiratory volume in 1 s was 20 % lower in the post-exposure assessment as compared to the pre-exposure level (P<0.05). No significant change was observed in the motor and sensory nerve conduction velocity in the median nerve of sprayers before and after the spraying activity. Also, no significant variation was observed with respect to self-reported symptoms except weakness in arms and legs (P<0.05). The significant decline in lung function and acetylcholinesterase level after pesticide exposure reflects the strongly negative effect of exposure to pesticides during spraying activity. More longitudinal studies among pesticide sprayers must be undertaken to further substantiate the cause-effect relationship between pesticide exposure and its subclinical effects. There is a strong necessity to minimise the exposure through the use of personal protective equipment in pesticide sprayers.

Particulate matter concentration in ambient air and its effects on lung functions among residents in the National Capital Region, India.

The World Health Organization has estimated that air pollution is responsible for 1.4 % of all deaths and 0.8 % of disability-adjusted life years. NOIDA, located at the National Capital Region, India, was declared as one of the critically air-polluted areas by the Central Pollution Control Board of the Government of India. Studies on the relationship of reduction in lung functions of residents living in areas with higher concentrations of particulate matter (PM) in ambient air were inconclusive since the subjects of most of the studies are hospital admission cases. Very few studies, including one from India, have shown the relationship of PM concentration and its effects of lung functions in the same location. Hence, a cross-sectional study was undertaken to study the effect of particulate matter concentration in ambient air on the lung functions of residents living in a critically air-polluted area in India. PM concentrations in ambient air (PM(1,) PM(2.5)) were monitored at residential locations and identified locations with higher (NOIDA) and lower concentrations (Gurgaon). Lung function tests (FEV(1), PEFR) were conducted using a spirometer in 757 residents. Both air monitoring and lung function tests were conducted on the same day. Significant negative linear relationship exists between higher concentrations of PM(1) with reduced FEV(1) and increased concentrations of PM(2.5) with reduced PEFR and FEV(1). The study shows that reductions in lung functions (PEFR and FEV(1)) can be attributed to higher particulate matter concentrations in ambient air. Decline in airflow obstruction in subjects exposed to high PM concentrations can be attributed to the fibrogenic response and associated airway wall remodeling. The study suggests the intervention of policy makers and stake holders to take necessary steps to reduce the emissions of PM concentrations, especially PM(1,) PM(2.5), which can lead to serious respiratory health concerns in residents.

Lung function impairment in women exposed to biomass fuels during cooking compared to cleaner fuels in Uttar Pradesh, India.

A national survey has shown that approximately 75-80% use of fire wood and chips, 10% of dung cake rural women in Uttar Pradesh, India. Considering the respiratory health risk of biomass fuel exposure to women, a cross sectional study was conducted to elucidate the relationship between cooking smoke and lung function impairments. The present study showed significant decline in air flow limitation based on reduced PEFR (3.69 | sec(-1)) and FEV1 (1.34 | sec(-1)) in women cooking with biomass fuels compared to PEFR (4.26 | sec(-1)) and FEV1 (1.73 | sec(-1)) in women cooking with cleaner fuels. The noxious gases and particles generated from biomass fuels during cooking reported in earlier studies may be the reason for the slight decline in airway status PEFR (3.69 | sec(-1)) and lung volumes FEV1 (1.34 | sec(-1)). The higher mean bio-fuels exposure index (52.5 hr-yrs) can attribute to reduced lung function in rural women.

Studies on oxidative stress induced nerve conduction deficits in cigarette smokers.

An important role of oxidative stress for the development of vascular and neurological complications has encouraged us to undertake a study to assess the oxidative stress induced nerve conduction deficits among cigarette smokers. Eighteen regular male cigarette smokers and twenty nine male non-smokers were diagnosed for clinical neuro-physiological tests viz., motor and sensory nerve conduction velocity (MNCV and SNCV) and redox status. Significant depletion of reduced glutathione (GSH) level (p < 0.05) and significant increase in malondialdehyde (MDA) level (p < 0.01) was found in smokers compared to non-smokers. Motor and sensory nerve conduction velocity showed no significant difference among smokers compared to non-smokers. The present study shows that smoking can induce oxidative stress among smokers but could not exacerbate to nerve conduction deficits.

Musculoskeletal pain and its associated risk factors in residents of National Capital Region.

BACKGROUND: Musculoskeletal (MS) pain is responsible for poor quality of life and decreased productivity. Objective information about the burden of musculoskeletal disorders among the general community in India is scanty, and the few reports that exist are based on a small sample size. MATERIALS AND METHODS: This paper examines the issue of MS pain and its associated risk factors in a cross-sectional study of 2086 subjects from National Capital Region (NCR). RESULTS: Overall prevalence of MS pain was found to be 25.9%. Pain was found to be more frequent among females (31.3%) as compared with males (20.9%). Significant association of pain in joints/limbs/knee/lower legs with obesity (OR = 2.1, P < 0.001) and high body fat (OR = 2.2, P < 0.001) was established. More than 50% of the subjects complained of backache. CONCLUSIONS: Our findings confirm that MS pain is a significant burden of disease among the residents of NCR. Women and subjects doing heavy work load, like agriculture and dairy farming, constitute the chief demographic groups. It is high time that a policy is framed to reduce this load of sickness.

Health risks of employees working in pesticide retail shops: An exploratory study.

BACKGROUND: Shop keepers dealing with pesticides are exposed to multiple pesticides that include organophosphates, organochlorines, carbamates, pyrethroids. Hence an exploratory health study was conducted on shopkeepers selling pesticides in urban areas of Lucknow and Barabanki District, Uttar Pradesh, India. MATERIALS AND METHODS: Detailed information regarding socio-economic status, family history, personal habits and work practices were recorded for 20 subjects and controls by the investigator on a pre-tested questionnaire. Clinical examination including neurological studies of the shopkeepers and control subjects was done. RESULTS: The study revealed significant slowing of motor nerve conduction velocity and low peak expiratory flow rate among shopkeepers as compared to control subjects. Prevalence of significantly higher gastro-intestinal problems was also observed among exposed subjects. Neurological, ocular, cardiovascular and musculo-skeletal symptoms were also found to be higher among shopkeepers. This was not statistically significant. Significantly higher relative risk for sickness related to systems viz., cardio-vasular, genito-urinary, respiratory, nervous and dermal was observed among exposed subjects compared to controls. CONCLUSIONS: These findings provide a prima facie evidence of clinical manifestations because of multiple exposures to pesticides and poor safety culture at work place.

Can physical activity maintain normal grades of body mass index and body fat percentage?

BACKGROUND/AIMS: A cross-sectional study was undertaken on 767 urban male volunteers performing physical activity and 469 age and socioeconomic status matched controls not doing any physical activity from the city limits of North India. MATERIALS AND METHODS: Height and weight were recorded for each participant to determine their Body Mass Index (BMI). Body fat percentage and weight was measured using a body fat monitor. RESULTS: Fifty three percent of the physical activity performers showed normal BMI compared to 49% nonphysical activity performers. Overweight was observed in 43.3% physical activity performers compared to 44.7% nonphysical activity performers. Fifty two percent of physical activity performers had normal body fat percent compared to 48.5% nonphysical activity performers. Low body fat percent was observed in 23.4% physical activity performers compared to 2.7% nonphysical activity performers. High body fat percent was observed in 48.7% nonphysical activity performers compared to 45.8% physical activity performers. CONCLUSIONS: Overall, the study suggested that physical activity alone cannot maintain BMI and body fat percent, but it can reduce the risk of overweight and high body fat percent in the population.

Monitoring of plasma butyrylcholinesterase activity and hematological parameters in pesticide sprayers.

To evaluate the health impact of spraying organophosphorus insecticides (OPs), 34 male sprayers in the mango belt of Malihabad, a small town located 27 km from Lucknow in North India was selected. Plasma butyryl cholinesterase (PBChE) and complete blood count were assessed among sprayers after spraying pesticides and the findings obtained were compared with those determined in a reference group (n = 18). The most common symptoms observed were burning sensation in the eyes (8.82%), itching/skin irritation (23.52%) and chest symptoms (32.35%) in the exposed workers. Plasma butyrylcholinesterase (PBChE) was significantly decreased in workers. The results indicated significant decrease in the mean value of hemoglobin, hematocrit and platelets count; however, significantly higher count of leukocytes was also observed in the exposed group (sprayers) compared to that observed in the control group (P < 0.05). Monitoring of PBChE in pesticide sprayers could be useful to predict and prevent health hazards of OPs.

Biomonitoring of organochlorines, glutathione, lipid peroxidation and cholinesterase activity among pesticide sprayers in mango orchards.

BACKGROUND: Pesticide sprayers in mango orchards of Malihabad, Lucknow (India) are generally exposed to organophosphate (OP) and pyrethroid pesticides. We determined the pesticide exposure levels along with their biochemical and clinical effects in 31 sprayers, compared with 18 controls. METHODS: Assay of acetyl and butyrylcholinesterases (AChE, BChE respectively) as an indirect measurement of OP exposure and levels of malondialdehyde (MDA) and glutathione (GSH) were estimated in blood samples to determine their impact on redox potential. Organochlorines were estimated by GLC-ECD. RESULTS: Significantly inhibited AChE, BChE activities and higher MDA level were found among sprayers compared to controls (p<0.05). Mean of total organochlorines were surprisingly higher (97.65+/-13.38 ppb) in sprayers than in those of controls (20.42+/-3.56 ppb) (p<0.05). Respiratory morbidity (32.4%), ocular problems (8.8%), gastrointestinal (17.6%) and skin problems (23.5%) were found in sprayers. There was significant correlation between AChE and GSH (r=0.29, p<0.05) and AChE with MDA (r=-0.34, p<0.05). CONCLUSION: Results indicated the significantly enhanced lipid peroxidation in sprayers correlated with cholinesterases inhibition. A small sample size limits the significance of this study. However, it paves the way for a larger Indian study with extended practical significance.

Occupational cancers in leather tanning industries: A short review.

Work in leather tanning involves exposure to a wide range of chemicals. Some of these are carcinogens or suspected carcinogens. Increased risks for a number of cancers have been reported among the tannery workers. In the present review, a detailed account of lung cancer, testicular cancer, soft tissue sarcoma, pancreatic cancer, bladder cancer among tannery workers is mentioned.

Possible mechanism of pesticide toxicity-related oxidative stress leading to airway narrowing.

The study was conducted to assess the magnitude of oxidative stress and lung function abnormalities in 34 male pesticide sprayers on exposure to pesticides in mango plantations. Biochemical studies on blood antioxidant enzymes revealed an unchanged glutathione level and increased level of malondialdehyde (P < 0.001), which indicates that pesticide sprayers may have suffered from oxidative stress. Decreased acetyl-cholinesterase levels (P < 0.001) in sprayers compared to the controls suggest inhibition of cholinesterase activity. The present study shows that pesticide toxicity might lead to oxidative stress and airway narrowing resulting in decreased peak expiratory flow rate.

Working conditions and health among employees at information technology--enabled services: a review of current evidence.

Workers in information technology (IT)-enabled services like business process outsourcing and call centers working with visual display units are reported to have various health and psycho-social disorders. Evidence from previously published studies in peer- reviewed journals and internet sources were examined to explore health disorders and psycho-social problems among personnel employed in IT-based services, for a systematic review on the topic. In addition, authors executed a questionnaire- based pilot study. The available literature and the pilot study, both suggest health disorders and psychosocial problems among workers of business process outsourcing. The details are discussed in the review.

Pulmonary function in patients with diabetes mellitus.

The present study was carried out to assess the lung functions in oral medicated and insulin administered patients with normal controls. 20 subjects were selected as the study group for oral medication (Group I), 20 subjects were selected as the study group for insulin treatment (Group II) and 40 subjects were selected as normal controls. Age group of Group I and Group II were 51.25 +/- 6.28 and 50.8 +/- 6.56 respectively and controls were age and height matched. Seventeen patients of Group I were undergoing treatment for the last 10-20 years and 20 patients in Group II were undergoing treatment for the last 30 years. Only male subjects were selected for the study. Lung function test were carried out with Spirometer (Vitallograph Compact II). A significant reduction in forced expiratory volume/forced vital capacity (FEV1/FVC%) was observed in oral pills used subjects and insulin administered subjects as compared to controls. Significant decrease in forced expiratory flow rate (FEF25-75%) in group I subjects was also observed as compared to controls. Forced mid flow time (FMFT) showed a significant increase in group II in comparison to controls. These changes clearly show the expiratory flow rates are reduced both in orally medicated and insulin administered patients. Increase in FMFT in group I may be due to the reduced respiratory ability to carry out the FVC test along with the side effects of oral medication for diabetes mellitus.

Effect of oral contraceptives on respiratory function.

The present study was carried out to assess the lung functions in oral contraceptive administered women. Lung function tests were carried out with Spirometer (Vitallograph Compact II). A significant increase in vital capacity (VC) was observed in these women as compared to normal control. There was also a significant decrease in forced expiratory volume in 1 sec./vital capacity (FEV1/VC%) and forced expiratory volume in 1 sec./forced vital capacity (FEV1/FVC%) among oral contraceptive administered women as compared to controls. Further, a significant increase in peak expiratory flow rate (PEF), reduction in forced expiratory flow rate (FEF75-85%) and FEF75% were observed among oral contraceptive administered women as compared to controls. The increase in VC and PEF might be due to the synthetic form of progesterone (progestins) present in oral contraceptive pills which causes hyperventilatory changes. Synthetic progesterone during luteal phase of menstrual cycle might increase the static and dynamic volumes of lung i.e. VC and PEF. But FEF75% showed a decrease which might be due to the lower neuromuscular coordination during breathing.

Pulmonary functions in workers of fertiliser and chemical industry.

The present study was undertaken to assess the pulmonary functions in fertiliser and chemical industry workers of Kerala. Pulmonary function test was performed with Vitalograph Compact-II spirometer. Exposure to different chemicals, noxious gases and particulate matter of fertiliser and chemical industry was injurious to the normal pulmonary function. Significant decline in lung volumes, viz. FVC, FEV1, FEV1/FVC% (P < 0.01) and flow rates, viz. FEF25-75%, FEF0.2-1.2, FEF25%, FEF50%, FEF75% (P < 0.01) among non-smokers and smokers than that of normal controls was observed. The findings of this study also suggest that with increased duration of exposure to industrial pollutants, lung volumes and flow rates were significantly reduced in workers.

Lung volumes in swimmers performing different styles of swimming.

The alteration of lung volumes in swimmers performing different strokes was the theme of the present study. The study was carried out due to lack of knowledge regarding the lung volumes of different strokers. As the energy expenditure, O2 consumption rate, body movements, viz. arm and leg movements differ with each stroke, the lung function status and mechanics of breathing in swimmers has to cope up with the stroke techniques. Lung volumes, viz. VC, FVC, FEV1 and RVind decrease from resting condition to after swimming performance in freestyle swimmers and butterfly stroke swimmers. The primary reason for the decline in lung volumes after exercise bout, found out from several reports is that it may be due to the fatigue of respiratory muscle. When lung volumes of different swimming strokers were compared with age and height matched controls a higher lung volume were observed in swimmers performing different strokes. Higher breath holding ability of swimmers may facilitate the increase in the strength of respiratory musculature. This may have lead to higher lung volumes in swimmers. From the results of different strokers of swimmers, it is clear that lung volumes differ with respect to the stroke technique employed by the swimmer. Here the age and height, training duration of the swimmers performing different strokes were almost matched, so it is more or less clear that lung volumes are influenced by different swarming strokes. The results of the study can be utilised for the selection trials of swimmers. The study outlines the need for research work in swimmers to be more specific with regard to strokes than generalizing swimmers of different strokes as a category together.

Spirometric impairments in undernourished children.

The present study elucidates the effect of undernutrition on pulmonary functions in children. The study was carried out in healthy normals, wasted, wasted and stunted children. Spirometry was performed with Vitalograph Compact-II spirometer. Wasted, wasted and stunted children showed lower lung volumes, forced mid expiratory flow time and inspiratory flow rates than healthy normals. Wasted and stunted children had lower VC, FVC and FIF50% than wasted children. The reduction in lung volumes and flow rates in wasted children may be due to ventilatory muscle wasting. But in wasted and stunted children along with muscular wasting diminished skeletal growth is also a reason for lower lung functions. No airflow limitation was observed in undernourished children.

Respiratory function during warm-up exercise in athletes.

The theme of the present study is to stress the importance of duration of warm-up exercise on respiratory functions in athletes. Significant improvements in athletic performance was achieved due to warm-up exercise owing to increase in blood flow, muscle and core temperature. The optimum intensity and duration are required to bring about the desired warm-up. A close examination on respiratory functions and its relationship with exercise has not been studied extensively. The present investigation is to explore the various respiratory functions in relation to the intensity and duration in preadolescent athletes before and after warm-up exercise. The results show a significant increase in vital capacity after 25 min and a significant reduction in FEV0.5, FEF75% and FEF25-75% after 45 min of warm-up exercise. The results suggest that a warm-up exercise of short duration (25 min) and mild intensity was beneficial than long duration (45 min) and intense exercise. Although the performance of athletes was not directly measured during exercise, these data demonstrate the benefit of warm-up.