An updated job-exposure matrix for occupational noise: development and validation.

OBJECTIVES: The aim of this study was to create a quantitative job-exposure matrix (JEM) for noise including a large set of measurements for the Swedish workforce, a detailed exposure-level assessment, spanning over an extensive time period from 1970 to 2014. METHODS: The JEM was developed by 2 teams, each with an experienced occupational hygienist and an occupational safety engineer. Each pair assessed the exposure using measurements performed and reported by occupational hygienists, occupational safety engineers, or similar, from 1970 to 2014. The measurements included either the original LAeq(8h) measurements or an LAeq(8h) levels calculated from partial measurements of the working day, provided that the measurement targeted a regular task usually performed during a full workday. The collection of measurement reports was done in 2008 and 2012 by contacting clinics working in the area of occupational health or occupational safety engineers and their submitted reports were added to our own material. Noise exposure assessments were inserted at the appropriate time period for the relevant job family. The final matrix was developed in a consensus procedure and the validity was investigated by comparison of the 2 team's individual results. RESULTS: The noise JEM contains 321 job families with information regarding occupational noise from 1970 to 2014. The time-period label has a 5-yr scale starting in 1970. The estimated average 8 h (TWA) noise level in decibels [dB(A)] for every job family and 5-yr period was coded as 1: <70 dB(A), 2: 70 to 74 dB(A), 3: 75 to 79 dB(A), 4: 80 to 84 dB(A) or 5: 85(+) dB(A). The validation showed no systematic difference in relative position and very high agreement in the ordering of paired ordinal classifications. The JEM has also successfully been applied in several epidemiological studies. CONCLUSIONS: We present a JEM for occupational noise using Swedish data from 1970 to 2014 with a higher degree of sensitivity in assessed noise exposure compared with the previously existing version. Repeated application of the JEM, in epidemiological studies, has shown consistent results and contributed to yielding important findings.

A historical job-exposure matrix for occupational exposure to diesel exhaust using elemental carbon as an indicator of exposure.

Any study of the long-term health effects of diesel exhaust exposure requires past exposure to be assessed. Few historical measurements of occupational exposure to elemental carbon (EC) are available, so past exposure must be assessed using models and judgments based on indirect data. A job-exposure matrix (JEM) for historical occupational exposure to diesel exhaust based on EC is presented. Past exposure to EC in occupations with a high exposure to diesel exhaust was assessed using an eight-step process. The assessments were based on technical specific data and NO2-exposure data, and a current EC-exposure measurement program. Finally, group assessment was carried out by consensus. Temporal variations in exposure were assessed for different groups. The matrix was constructed to assess annual average EC exposure for 72 occupations between 1950 and 2004. EC exposure between 1950 and 2004 varied between 1 and 247 µg/m3, for farmers in 2000 and miners in 1975 respectively, and was generally highest in the 1970s. The JEM allows lifetime diesel exhaust exposure intensity in 72 occupations to be assessed and used in epidemiological studies.

Airborne and Dermal Exposure to Polycyclic Aromatic Hydrocarbons, Volatile Organic Compounds, and Particles among Firefighters and Police Investigators.

AIMS: The main aim of this study was to assess dermal exposure to polycyclic aromatic hydrocarbons (PAHs) and airway exposure to PAHs, volatile organic compounds (VOCs; benzene and 1,3-butadiene), and particles among firefighters (FFs) and police forensic investigators (PFIs) in Sweden. METHODS: Active (pump with a filter and sorbent tube) and passive (polyurethane foam -cyl and perkin elmer carbopack-tube) personal air sampling and dermal tape stripping (wrist and collar bone) were performed on seven FF team leaders during training fires and nine PFIs investigating the aftermath of live fire events. In addition, passive personal air sampling was performed on eight FF team leaders during live emergency fires. PAHs and VOCs were analysed using high-resolution gas chromatography low-resolution mass spectrometry. The mass concentration of total dust (particles) was determined using standard gravimetric methods. RESULTS: The air samples showed that the exposure to PAHs, benzene, 1,3-butadiene, and particles was below Swedish occupational exposure limits (OELs). Naphthalene was the predominant PAH in all air samples. Benzene and 1,3-butadiene were more abundant in live emergency fires, which caused higher exposures than the other studied situations. Both gaseous- and particle-associated PAHs were present on skin. The wrists seemed to be less well protected than the collarbone area. CONCLUSIONS: FFs and PFIs are exposed to several hazardous compounds during their work. Air exposures varied considerably between working scenarios. The observed exposures were substantially higher than urban background levels but well below Swedish OELs. The measured dermal PAH exposures were comparable to previously reported doses for US FFs but lower than the exposures reported for Swedish chimney sweeps.

Full-time exposure to occupational noise during pregnancy was associated with reduced birth weight in a nationwide cohort study of Swedish women.

Noise is a common exposure in the occupational work environment. Earlier studies of occupational noise and pregnancy outcome are few and show mixed results. To investigate if objectively assessed exposure to occupational noise during pregnancy is associated with reduced intrauterine growth and/or preterm birth a nationwide cohort study of 857,010 single births was initiated. Individual information on occupation and risk factors was retrieved from prenatal care interviews at pregnancy week 10. Occupational noise was classified into three exposure categories <75, 75-85, >85 dBA by a job exposure matrix. Odds ratios were adjusted for BMI, smoking, parity, education, physically strenuous work and low job control. Exposure to high (>85 dBA) levels of occupational noise throughout the pregnancy (full time workers) was associated with an increased risk of the child being born small for gestational age, OR 1.44 (95% CI 1.01 to 2.03) compared to noise exposure <75 dBA. A similar increase was seen for low birth weight OR 1.36 (95% CI 1.03 to 1.80) for high levels of noise. No clear association was seen for preterm birth. No consistent effects on birth outcome was observed in women who had worked part-time or were on leave of absence >21 days (median). In summary, full-time exposure to high levels of noise during pregnancy was associated with a slightly reduced fetal growth but not with preterm birth. The effect of intermediate occupational noise exposure (75-85 dBA) showed a small, but statistically increased risk for all studied birth outcomes. The study strengthens the evidence that pregnant women should not be long-term exposed to high levels >85 dBA of occupational noise during pregnancy. Intermediate exposure should be studied further.

An improved method for determining dermal exposure to polycyclic aromatic hydrocarbons.

Many workers are occupationally exposed to polycyclic aromatic hydrocarbons (PAHs), which may cause various health problems, and some PAHs are known or suspected carcinogens. PAH exposure is primarily monitored by air sampling, but contamination may also occur through dermal exposure. PAHs adsorbed to the skin can be sampled by tape-stripping, but subsequent extraction of sampling tapes in organic solvent also releases diverse co-eluting substances that are difficult to remove before analysis of the PAHs by gas chromatography/mass spectrometry (GC/MS). The objective of this study was to optimise a procedure for analytical clean-up after extraction of 32 PAHs from tape-strips, by dialysis in organic solvent using semipermeable membranes. With triplicate subsamples, the developed method yields acceptable precision and repeatability for both the 32 PAHs, across the concentration range 10-160 ng per sample, and for a certified reference material (urban dust). The optimized clean-up procedure and GC/MS methodology was used to assess PAHs on skin from the lower part of the ventral side of the wrist and just below the collar bone of three firefighters and seven controls (office workers). Several gaseous and particle-bound PAHs were detected in all samples, including controls. Thus, the optimized procedure using semipermeable membranes for clean-up of tape-strip extracts can be used to assess the dermal exposure of both occupational and general populations to multiple PAHs. The results also show that both gaseous and particle-bound PAHs, including alkylated species, may be present on skin.

Evaluation of polyurethane foam passive air sampler (PUF) as a tool for occupational PAH measurements.

Routine monitoring of workplace exposure to polycyclic aromatic hydrocarbons (PAHs) is performed mainly via active sampling. However, active samplers have several drawbacks and, in some cases, may even be unusable. Polyurethane foam (PUF) as personal passive air samplers constitute good alternatives for PAH monitoring in occupational air (8 h). However, PUFs must be further tested to reliably yield detectable levels of PAHs in short exposure times (1-3 h) and under extreme occupational conditions. Therefore, we compared the personal exposure monitoring performance of a passive PUF sampler with that of an active air sampler and determined the corresponding uptake rates (Rs). These rates were then used to estimate the occupational exposure of firefighters and police forensic specialists to 32 PAHs. The work environments studied were heavily contaminated by PAHs with (for example) benzo(a)pyrene ranging from 0.2 to 56 ng m-3, as measured via active sampling. We show that, even after short exposure times, PUF can reliably accumulate both gaseous and particle-bound PAHs. The Rs-values are almost independent of variables such as the concentration and the wind speed. Therefore, by using the Rs-values (2.0-20 m3 day-1), the air concentrations can be estimated within a factor of two for gaseous PAHs and a factor of 10 for particulate PAHs. With very short sampling times (1 h), our method can serve as a (i) simple and user-friendly semi-quantitative screening tool for estimating and tracking point sources of PAH in micro-environments and (ii) complement to the traditional active pumping methods.

Occupational exposure to diesel motor exhaust and risk of lung cancer by histological subtype: a population-based case-control study in Swedish men.

We investigated occupational exposure to diesel motor exhaust (DME) and the risk of lung cancer by histological subtype among men, using elemental carbon (EC) as a marker of DME exposure. 993 cases and 2359 controls frequency-matched on age and year of study inclusion were analyzed by unconditional logistic regression in this Swedish case-control study. Work and smoking histories were collected by a questionnaire and telephone interviews. DME was assessed by a job-exposure matrix. We adjusted for age, year of study inclusion, smoking, occupational exposure to asbestos and combustion products (other than motor exhaust), residential exposure to radon and exposure to air pollution from road traffic. The OR for lung cancer for ever vs. never exposure to DME was 1.15 (95% CI 0.94-1.41). The risk was higher for squamous and large cell, anaplastic or mixed cell carcinoma than for alveolar cell cancer, adenocarcinoma and small cell carcinoma. The OR in the highest quartile of exposure duration (≥34 years) vs. never exposed was 1.66 (95% CI 1.08-2.56; p for trend over all quartiles: 0.027) for lung cancer overall, 1.73 (95% CI 1.00-3.00; p: 0.040) for squamous cell carcinoma and 2.89 (95% CI 1.37-6.11; p: 0.005) for the group of undifferentiated, large cell, anaplastic and mixed cell carcinomas. We found no convincing association between exposure intensity and lung cancer risk. Long-term DME exposure was associated with an increased risk of lung cancer, particularly to squamous cell carcinoma and the group of undifferentiated, large cell, anaplastic or mixed carcinomas.

Exposure to Particles, Polycyclic Aromatic Hydrocarbons, and Nitrogen Dioxide in Swedish Restaurant Kitchen Workers.

AIMS: The aim of this study was to measure the exposure to total dust, polycyclic aromatic hydrocarbons (PAHs), and nitrogen dioxide (NO2) of kitchen workers in four different types of restaurants in Sweden (Large scale, European, Fast food, and Asian). METHODS: One hundred full work-shift (8 h) personal exposure samples were taken from 36 workers in 21 commercial kitchens. Most workers were sampled three times. Mass concentration of total dust was determined using standard gravimetric methods; the filters were analyzed for their content of particulate PAHs. Gas-phase PAHs were sampled using adsorbent tubes (XAD-II) placed after the filter and analyzed with high-resolution gas chromatography/low-resolution mass spectrometry. NO2 was measured using passive dosimeters. Stationary measurements in the kitchen were made in parallel with the personal sampling. RESULTS: Group geometric mean concentrations for personal exposure to total dust ranged from 77 µg m-3 (Fast food) to 320 µg m-3 (European kitchens). Individual exposure samples of total dust ranged from ~40 to 3900 µg m-3. In the Large-scale and European kitchens, the time spent frying was identified as a determinant increasing personal exposure to total dust. The within-worker variance dominated the exposure variability of total dust in Large-scale and European kitchens, whereas between-worker variance dominated in Fast food and Asian kitchens. Exposure to total PAHs was statistically significantly higher for workers in the Asian kitchens. Also, exposure to NO2 was higher in the Asian kitchens, which all used gas stoves for cooking. The stationary measurements of total dust showed lower levels than personal exposures for most kitchens, whereas for PAHs, stationary levels were closer to personal exposure levels for all kitchen types. CONCLUSIONS: The results of this study increase the knowledge about exposure to air pollutants for kitchen workers of restaurant types that are common in Sweden and the rest of Europe. Personal sampling is essential for an accurate exposure assessment, and the large day-to-day variability in exposure levels points to the importance of repeated sampling.

Maternal Occupational Exposure to Noise during Pregnancy and Hearing Dysfunction in Children: A Nationwide Prospective Cohort Study in Sweden.

BACKGROUND: Many women of childbearing age are occupationally active, which leads to a large number of pregnancies potentially exposed to occupational exposures. Occupational noise has been identified as a risk factor for hearing impairment in adults. However, very few studies have assessed the effect of occupational noise on the fetus. OBJECTIVES: The aim of this study was to investigate whether occupational exposure to noise during pregnancy is associated with hearing dysfunction in children. METHODS: This population based cohort study included 1,422,333 single births in Sweden 1986-2008. Data on mothers' occupation, smoking habits, age, ethnicity, body mass index, leave of absence, and socioeconomic factors were obtained from interviews performed by prenatal care unit staff at approximately 10 weeks of gestation and from national registers. Occupational noise exposure was classified by a job-exposure-matrix as < 75, 75-84, or ≥ 85 dBLAeq,8h. Diagnosed cases of hearing dysfunction (ICD-10 codes H90.3-7, 91.0, 91.2-3, 91.8, 93.1-2) were identified from a register of specialized medical care. Cox proportional hazards models were used to estimate associations. RESULTS: In the full sample, containing a mixture of part-time and full-time workers during pregnancy, the adjusted HR for hearing dysfunction associated with maternal occupational noise exposure ≥ 85 vs. < 75 dBLAeq,8h was 1.27 (95% CI: 0.99, 1.64; 60 exposed cases). When restricted to children whose mothers worked full-time and had < 20 days leave of absence during pregnancy, the corresponding HR was 1.82 (95% CI: 1.08, 3.08; 14 exposed cases). CONCLUSIONS: This study showed an association between occupational noise exposure during pregnancy and hearing dysfunction in children. In view of mechanistic evidence and earlier indicative epidemiological and experimental findings, the results support that pregnant women should not be exposed to high levels of noise at work. CITATION: Selander J, Albin M, Rosenhall U, Rylander L, Lewné M, Gustavsson P. 2016. Maternal occupational exposure to noise during pregnancy and hearing dysfunction in children: a nationwide prospective cohort study in Sweden. Environ Health Perspect 124:855-860; http://dx.doi.org/10.1289/ehp.1509874.

Myocardial infarction and occupational exposure to motor exhaust: a population-based case-control study in Sweden.

There is a well-established association between particulate urban air pollution and cardiovascular disease, but few studies have investigated the risk associated with occupational exposure to particles from motor exhaust. This study investigated the risk of myocardial infarction (MI) after occupational exposure to motor exhaust, using elemental carbon (EC) as a marker of exposure. A population-based case-control study of first-time non-lethal MI was conducted among Swedish citizens in ages 45-70 living in Stockholm County 1992-1994, including 1,643 cases and 2,235 controls. Working histories and data on potential confounders were collected by questionnaire and medical examination. The exposure to EC was assessed through a job-exposure matrix. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated by unconditional logistic regression. We investigated various exposure metrics: intensity, cumulative exposure and years since exposure. There was an exposure-response relation between the highest average exposure intensity during the work history and the risk of MI when adjusting for smoking and alcohol drinking (p for trend 0.034), with an OR of 1.30 (95% CI 0.99-1.71) in the highest tertile of exposure compared to the unexposed. An exposure-response pattern was observed in the analysis of years since exposure cessation among formerly exposed. Additional adjustments for markers of the metabolic syndrome reduced ORs and trends to non-significant levels, although this might be an over-adjustment since the metabolic syndrome may be part of the causal pathway. Occupational exposure to motor exhaust was associated with a moderately increased risk of MI.

Comparison of ambient airborne PM2.5, PM2.5 absorbance and nitrogen dioxide ratios measured in 1999 and 2009 in three areas in Europe.

Epidemiological studies often use nitrogen dioxide (NO2) or proximity to roads to characterize exposure to more health-relevant pollutants (e.g., fine particles or black carbon aerosol) in vehicle exhaust. Due to the introduction of diesel-soot filters, particle-to-NO2 ratios may have decreased, but little information is available about these ratios over time. Our study aim was to evaluate the change in particle-to-NO2 ratios between 1999 and 2009. We compared data collected during measurement campaigns in 1999 and 2009 from Munich, the Netherlands, and Stockholm. Traffic-impacted and urban and regional background sites were studied during each campaign. The same pollutants were measured in each campaign (mass concentration of particles ≤ 2.5 microns in diameter (PM2.5), PM2.5 absorbance (a marker for black carbon), and NO2) using the same methods except for NO2: Palmes tubes were used in 1999 and Ogawa badges in 2009. Both NO2 methods were validated against side-by-side chemiluminescence measurements. The levels of PM2.5 absorbance and PM2.5 were significantly lower (p<0.05) in 2009 at traffic and urban background sites in Stockholm, but only slightly lower in Munich and the Netherlands. In contrast, NO2 levels were not significantly different in the three areas in 2009 compared to 1999. Statistically-significant decreases between 1999 and 2009 pollutant ratios in the Netherlands (PM2.5 absorbance/NO2 and PM2.5/NO2) and in Stockholm (PM2.5 absorbance/NO2 and PM2.5 absorbance/PM2.5) were observed. Smaller decreases in these ratios were observed in Munich. The contrast between traffic and urban background locations was larger in 2009 than 1999 for NO2, whereas it was smaller for PM2.5 absorbance and PM2.5. The lower PM2.5 absorbance/NO2 and PM2.5/NO2 ratios in 2009 is likely explained by the introduction of oxidative particle filters for diesel vehicles that reduce particles but produce NO2. The changed contrasts may affect estimates of health effects related to NO2 as a marker of proximity to roads.

A job-exposure matrix for occupational noise: development and validation.

OBJECTIVE: To develop a job-exposure matrix (JEM) for occupational noise in Sweden and to estimate its validity. METHODS: The JEM, developed by a group of experienced occupational hygienists, contains 321 job families with information regarding occupational noise from 1970 to 2004. The occupational noise information derives from measurements collected from different sources. The time period label has a 5-year scale starting in 1970. The estimated average 8h (TWA) noise level in decibel [dB(A)] for every 5-year period was coded either as <75 dB(A), 75-84 dB(A), or ≥85 dB(A) and the risk of peak level exposure assessed. The validity of the JEM is tested, using Svensson's non-parametric methods based on classification consensus, reached by a second group of occupational hygienists. RESULTS/DISCUSSION: Validation results show ~ 80% agreement and no systematic differences, in classification, between the two different groups of occupational hygienists, classifying the occupational noise exposure. However, classification of peak level exposure did show a systematic difference in relative position. The results will give more power to the JEM that it gives a good general estimate for the occupational noise levels in Sweden for different job families during 1970-2004. We, thus, intend to use it in further studies and also make it available to collaborators.

Incidence of myocardial infarction among cooks and other restaurant workers in Sweden 1987-2005.

OBJECTIVES: The aim of this study was to investigate the incidence of myocardial infarction (MI) among cooks and other restaurant workers. METHODS: A prospective cohort study comprised manual workers in the service sector in the Swedish National Census of 1985, totaling 543 497 women and 233 999 men. Restaurant workers were identified by occupational codes. Information on first time MI during 1987-2005 was obtained from nation-wide registers. We used Cox proportional hazards modeling, with separate analyses for men and women, adjusting for age, hypertension, diabetes, and socioeconomic status. RESULTS: Female cooks, restaurant and kitchen assistants, and wait staff all showed a statistically significant increase in risk of MI [hazard ratio (HR) 1.34, 95% confidence interval (95% CI) 1.21-1.48; HR 1.12, 95% CI 1.03-1.21; and HR 1.25, 95% CI 1.06-1.47, respectively]. No increased risk was found among female cold-buffet managers. Among men, there was no statistically significant increase in risk for any of these occupations. The association was not stronger for subjects working ≥5 years. Group level information on smoking habits showed a similar percentage of daily smokers among female cooks compared to female manual workers in general. CONCLUSIONS: We found an increased risk of MI among female but not male cooks, restaurant and kitchen assistants, and wait staff. The excess risk may be related to occupational factors, but the results do not clearly support the hypothesis of cooking fumes as a risk factor for MI. Job strain could be a potential explanation for the findings.

Occupational exposure to motor exhaust in Stockholm, Sweden--different grouping strategies using variability in NO2 to create homogenous groups.

AIM: The aim of the present study was to investigate the personal variability in occupational exposure to NO(2), as a marker of exposure to diesel exhaust, and to compare a statistical method of grouping workers in homogenous groups with a grouping performed by a qualified occupational hygienist. METHODS: Forty-seven workers exposed to motor exhaust in their occupation were included. Personal measurements of NO(2) were performed with diffusive samplers over three full working shifts. The results from the measurements were analysed with a linear mixed effects model, taking both between and within-worker variability into consideration. The workers were divided into occupational groups in different ways in order to find a categorization, with maximal homogeneity in exposure in each group. We used (B)R(0.95) as an estimator of the between-worker variability. To study the effect of the divisions on the fit of the statistical model, we used the Akaike Information Criterion. RESULTS: The geometric mean for NO(2) for all 47 workers was 69 µg/m(3) and the between-worker variability (B)R(0.95) was 23.8. In six successive steps, the 47 workers were divided into up to eight groups, based on observed job characteristics. In the final grouping, seven groups were included with geometric means ranging from 32 µg/m(3) for outdoor workers, to 316 µg/m(3) for the most exposed group (tunnel construction workers). The (B)R(0.95) varied between 2.4 and 6.3. The within-worker variability (W)R(0.95) for the last division differed in the groups from 2.0 to 7.9. The Akaike Information Criterion decreased from 246, if all persons were included in one group, to 174 for the final grouping. CONCLUSIONS: The average level of NO(2) varied about 10 times between the different occupational groups, with the highest level for tunnel construction workers (316 µg/m(3)) and lowest for outdoor workers (32 µg/m(3)). For four of the seven groups the between-worker variability was higher than the within-worker variability.

Exposure to particles, elemental carbon and nitrogen dioxide in workers exposed to motor exhaust.

OBJECTIVES: The main aim of this study was to investigate the personal exposure to diesel and petrol exhaust fumes in occupations when exposure is prevalent and/or high. We also investigated the correlation between the five particle fractions [particles with an aerodynamic diameter <1 microm (PM(1)), particles with an aerodynamic diameter <2.5 microm (PM(2.5)), particles in size 0.1-10 microm, elemental carbon (EC) and total carbon (TC)] and nitrogen dioxide (NO(2)), in the various occupational environments. METHODS: Seventy-one workers were included in the study. They were subdivided into seven groups depending on working area, working indoors, out of doors or in vehicles and type of exposure (diesel or petrol exhaust). Personal measurements were performed during 3 days per worker. We used five indicators of the particle fraction: PM(1), PM(2.5), particle measured with a real-time monitoring instrument for particles in sizes 0.1 and 10 microm (DataRAM), EC and TC. We used NO(2) as an indicator of the gas phase. RESULTS: Tunnel construction workers showed the highest levels of exposure for all indicators, followed by diesel-exposed garage workers. For the other five groups, the levels were statistically significantly lower, and the differences between the groups were small. The full-shift geometric average of PM(1) varied between 119 microg m(-3) (tunnel construction workers) and 11 microg m(-3) (taxi drivers). For PM(2.5), the levels varied between 231 microg m(-3) (tunnel construction workers) and 16 microg m(-3) (bus and lorry drivers). For the measurements with the real-time monitoring instrument DataRAM, the levels varied between 398 microg m(-3) (tunnel construction workers) and 14 microg m(-3) (taxi drivers). For EC, the levels varied between 87 microg m(-3) (tunnel construction workers) and 4 microg m(-3) (other outdoor workers exposed to diesel exhaust), and for TC, the levels varied between 191 microg m(-3) (tunnel construction workers) and 10 microg m(-3) (taxi drivers). Finally, for NO(2), the levels varied between 350 microg m(-3) (tunnel construction workers) and 32 microg m(-3) (other outdoor workers exposed to diesel exhaust). For the indoor workers exposed to diesel exhaust fumes only, all the indicators correlated comparatively well and statistically significantly to each other (r(2) = 0.44-0.89). For the other groups, correlations were lower and showed no consistent pattern. CONCLUSIONS: The tunnel construction workers had exposure levels for all indicator substances that were considerably and significantly higher than for the other groups. The NO(2) levels were higher for indoor workers exposed to diesel exhaust than for all other groups (except tunnel construction workers). All particle fractions, as well as NO(2) correlated well in occupations with indoor exposure to diesel exhaust.

Bicycle messengers: energy expenditure and exposure to air pollution.

The purpose of the study was to determine the level of energy expenditure and exposure to air pollution for bicycle messengers. Relationships between heart rate (HR) and oxygen uptake, and between HR and pulmonary ventilation (VE) for each participant were established in laboratory tests. Air pollution and HR were measured during one working day. The total oxygen uptake was then described as the total energy expenditure in Joule (J) and in multiples of the energy expenditure at rest (MET). The mean energy expenditure during a working day (8 h) was 12 MJ, (4.8 MET). The level of air pollution exposure when cycling seemed to be comparable with the levels of exposure when sitting inside a vehicle. The VE during cycling was four times higher than resting value. Increased VE led to increased exposure to air pollution.

Exposure to particles and nitrogen dioxide among taxi, bus and lorry drivers.

AIM: The aims of this study have been to investigate the occurrence of systematic differences in the personal exposure to motor exhaust between different groups of taxi, bus and lorry drivers, and to study if these are influenced by the choice of exposure indicator. METHODS: We used one indicator of the gaseous phase, nitrogen dioxide (NO(2)), and one of the particle phase (measured by DataRAM), of the exhausts. A total of 121 drivers were included in the study: 39 taxi drivers, 42 bus drivers and 40 lorry drivers. Personal measurements were performed during one working day. Nitrogen dioxide was measured with passive diffusive samplers and particles with Data-RAM, a logging instrument using nephelometric monitoring. The instrument measures particles between 0.1 and 10 microm in size. RESULTS: The average exposure to NO(2) for lorry drivers was 68 microg/m(3); for bus drivers 60 microg/m(3) and for taxi drivers 48 microg/m(3). For particles the exposure was 57 microg/m(3) for lorry drivers, 44 microg/m(3) for bus drivers and 26 microg/m(3) for taxi drivers. The result remained unchanged when exposures were adjusted for variation in urban background levels of NO(2) and particulate matter with an aerodynamic diameter <10 microm (PM(10)). CONCLUSION: Lorry drivers experienced the highest exposure and taxi drivers the lowest with bus drivers in an intermediate position, regardless of whether NO(2) or particles were used as exposure indicator. The levels of both NO(2) and particles were higher for bus drivers in the city than for them driving in the suburbs. Using diesel or petrol as a fuel for taxis had no influence on the exposure for the drivers, indicating that the taxi drivers' exposure mainly depends on exhaust from surrounding traffic.

Spatial variation in nitrogen dioxide in three European areas.

In order to estimate the spatial variation within well-defined study areas, nitrogen dioxide was measured with diffusion samplers (Palmes tube) in 40-42 sites each in Germany (Munich), the Netherlands and Sweden (Stockholm County). Each site was measured over four 2-week periods during 1 year (spring 1999 to summer 2000). In each country, one reference site was measured during all periods and the results were used to adjust for seasonal variability, to improve the estimates of the annual average. Comparisons between the chemiluminescence method (European reference method) and Palmes tube measurement indicated a good agreement in Germany (with a ratio of 1.0 for Palmes tube/chemiluminescence) but underestimation for Palmes tube measurement in the Netherlands and Sweden (0.8 for both countries). The r2 values were between 0.86 and 0.90 for all three countries. The annual average values for NO2 for different sampling sites were between 15.9 and 50.6 (mean 28.8 microg/m3) in Germany, between 12.1 and 50.8 (mean 28.9 microg/m3) in the Netherlands and between 6.1 and 44.7 (mean 18.5 microg/m3) in Sweden. Comparing spatial variation between similar sites in the three countries, we did not find any significant differences between annual average levels for urban traffic sites. In Sweden, annual average levels in urban background and suburban backgrounds sites were about 8 microg/m3 lower than comparable sites in Germany and the Netherlands. Comparing site types within each country only urban traffic sites and suburban background sites differed in Germany. In the Netherlands and Sweden, the urban traffic sites differed from all other sites and in Sweden also the urban background sites differed from the other background sites. The observed contribution from local traffic was similar in the Netherlands and Sweden (10 and 8 microg/m3, corresponding to 26-27% of the NO2 concentration found in the urban traffic sites). In Germany, the contribution from local traffic was only 3 microg/m3, corresponding to 9% of the NO2 concentration found in the urban traffic sites. The spatial variation was substantially larger for NO2 than the variation for PM2.5 and similar to PM2.5 absorbance, measured in the same locations.

Myocardial infarction among professional drivers.

BACKGROUND: Professional drivers are at an increased risk of myocardial infarction but the underlying causes for this increased risk are uncertain. METHODS: We identified all first events of myocardial infarction among men age 45-70 years in Stockholm County for 1992 and 1993. We selected controls randomly from the population. Response rates of 72% and 71% resulted in 1067 cases and 1482 controls, respectively. We obtained exposure information from questionnaires. We calculated odds ratios (ORs), with and without adjustment for socioeconomic status, tobacco smoking, alcohol drinking, physical inactivity at leisure time, overweight status, diabetes and hypertension. RESULTS: The crude OR among bus drivers was 2.14 (95% confidence interval = 1.34-3.41), among taxi drivers 1.88 (1.19-2.98) and among truck drivers 1.66 (1.22-2.26). Adjustment for potential confounders gave lower ORs: 1.49 (0.90-2.45), 1.34 (0.82-2.19) and 1.10 (0.79-1.53), respectively. Additional adjustment for job strain lowered the ORs only slightly. An exposure-response pattern (by duration of work) was found for bus and taxi drivers. CONCLUSIONS: The high risk among bus and taxi drivers was partly explained by unfavorable life-style factors and social factors. The work environment may contribute to their increased risk. Among truck drivers, individual risk factors seemed to explain most of the elevated risk.

Comparison between different traffic-related particle indicators: elemental carbon (EC), PM2.5 mass, and absorbance.

Here we compare PM(2.5) (particles with aerodynamic diameter less than 2.5 microm) mass and filter absorbance measurements with elemental carbon (EC) concentrations measured in parallel at the same site as well as collocated PM(2.5) and PM(10) (particles with aerodynamic diameter less than 10 microm) mass and absorbance measurements. The data were collected within the Traffic-Related Air Pollution on Childhood Asthma (TRAPCA) study in Germany, The Netherlands and Sweden. The study was designed to assess the health impact of spatial contrasts in long-term average concentrations. The measurement sites were distributed between background and traffic locations. Annual EC and PM(2.5) absorbance measurements were at traffic sites on average 43-84% and 26-76% higher, respectively, compared to urban background sites. The contrast for PM(2.5) mass measurements was lower (8-35%). The smaller contrast observed for PM(2.5) mass in comparison with PM(2.5) absorbance and EC documents that PM(2.5) mass underestimates exposure contrasts related to motorized traffic emissions. The correlation between PM(10) and PM(2.5) was high, documenting that most of the spatial variation of PM(10) was because of PM(2.5). The measurement of PM(2.5) absorbance was highly correlated with EC measurements and suggests that absorbance can be used as a simple, inexpensive and non-destructive method to estimate motorized traffic-related particulate air pollution. The EC/absorbance relation differed between countries and site type (background/traffic), supporting the need for site-specific calibrations of the simple absorbance method. While the ratio between PM(2.5) and PM(10) mass ranged from 0.54 to 0.68, the ratio of PM(2.5) absorbance and PM(10) absorbance was 0.96-0.97, indicating that PM(2.5) absorbance captures nearly all of the particle absorbance.