RESUMO
OBJECTIVES: Examine associations between pesticide exposure and signs or symptoms of parkinsonism. METHODS: Prior to the 2014 pesticide spray season, the authors examined 38 active pesticide handlers aged 35 to 65 (median: 43.5) who participated in the State of Washington's cholinesterase monitoring program in the Yakima Valley, where cholinesterase-inhibiting insecticides are applied in fruit orchards. A movement disorder specialist assessed the workers using the Unified Parkinson's Disease Rating Scale (UPDRS) motor subscore 3 (UPDRS3). Participants also self-reported work and medical histories, including the UPDRS activities of daily living subscore 2 (UPDRS2). The authors explored the relation between these scores and lifetime occupational pesticide exposure while accounting for age. RESULTS: All participants were Hispanic men born in Mexico who had worked in agriculture for 4 to 43 years (median: 21 years, including 11 years applying pesticides, mostly in the United States). Ten participants (26%) reported difficulty with one or more UPDRS2 activities of daily living (maximum = 2), and nine (24%) had a UPDRS3 >0 (maximum = 10). The most common symptom and sign, respectively, were excess saliva (n = 6) and action tremor (n = 5). UPDRS2 and UPDRS3 scores were unrelated to the number of years applying pesticides, but UPDRS3, especially action tremor, was positively associated with living on or by a farm. CONCLUSIONS: Symptoms and signs of parkinsonism were absent to mild in this small sample of active workers who apply cholinesterase-inhibiting insecticides in Washington State, USA. Future studies should be larger and examine older, retired workers with greater cumulative exposure to agricultural pesticides at work and home, including other types of agricultural pesticides.
Assuntos
Doenças dos Trabalhadores Agrícolas/diagnóstico , Agricultura , Transtornos Parkinsonianos/diagnóstico , Praguicidas/economia , Praguicidas/toxicidade , Adolescente , Adulto , Idoso , Doenças dos Trabalhadores Agrícolas/etnologia , Doenças dos Trabalhadores Agrícolas/etiologia , Criança , Pré-Escolar , Fazendeiros , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Transtornos Parkinsonianos/etnologia , Transtornos Parkinsonianos/etiologia , Washington/etnologia , Recursos Humanos , Adulto JovemRESUMO
Diesel exhaust presents a community exposure hazard, but methods to measure internal exposure are lacking. We report results from a community-based study using 1-nitropyrene (1-NP) and its urinary metabolites as markers of exposure to traffic-related diesel particulate matter (DPM). The study participants were Tijuana, Mexico residents who commuted on foot into San Diego, California for work or school using the International San Ysidro Port of Entry, placing them within feet of idling traffic (referred to as border commuters). The comparison group (non-border commuters) was comprised of residents of south San Diego who did not commute into Mexico. Air concentration of 1-NP in fine particulate matter (PM2.5) was measured in personal samples from participants. Spot urine samples were analyzed for 1-NP urinary metabolites 8-hydroxy-1-nitropyrene (8-OHNP) and 8-hydroxy-N-acetyl-1-aminopyrene (8-OHNAAP). Compared with non-border commuters, border commuters had two- to threefold higher mean urinary concentrations for unadjusted and creatinine-adjusted 8-OHNP and 8-OHNAAP. Urinary 8-OHNAAP and the sum of 8-OHNP and 8-OHNAAP were both associated with personal exposure to 1-NP in the prior 24 h. These results suggest that 1-NP urinary metabolites reflect recent exposure to DPM-derived 1-NP in community settings and can be useful for exposure analysis.
Assuntos
Poluentes Atmosféricos/urina , Biomarcadores/urina , Pirenos/urina , Emissões de Veículos/análise , Poluição do Ar/análise , California , Cromatografia Líquida de Alta Pressão , Creatinina/urina , Humanos , Modelos Lineares , México , Material ParticuladoRESUMO
BACKGROUND: Informal recycling is widespread in developing countries and involves the collection, sorting, and selling of recyclable materials. Workers are exposed to hazards including the risk of cuts and musculoskeletal injury, infection, exposure to medical waste, and respiratory conditions like bronchitis, pneumonia, and sinusitis and often use insufficient personal protective equipment. OBJECTIVE: Assess the occupational and environmental health hazards faced by informal recyclers working at a landfill in Asunción, Paraguay. METHODS: We surveyed 102 informal recyclers and 12 formal recyclers about occupational health, workplace safety, general health, and household economics. Personal air samples were used to assess respirable dust and nobel metal exposure on 18 workers. RESULTS: Exposures to hazards such as syringes, medical waste, and broken glass as well as risk factors such as eating food found in the trash, lack of personal protective equipment (PPE), and inadequate sanitation were frequent among informal recyclers. Minors under 18 years of age constituted 13% of the workforce and experienced equal or greater exposure to these hazards. Formal recyclers had better access to water, sanitation, PPE, and experienced fewer cuts, injuries, and illnesses than formal recyclers. Informal recyclers were exposed to respirable dust that were considerably higher than they would have been exposed to at home or doing other work in their neighborhood. CONCLUSIONS: Better regulation of sharps and medical waste and the provision of adequate sanitation and personal protective equipment would address the most pressing occupational health issues in this high risk group.
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Doenças Profissionais/etiologia , Exposição Ocupacional , Saúde Ocupacional , Adolescente , Adulto , Estudos Transversais , Países em Desenvolvimento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/epidemiologia , Paraguai/epidemiologia , Reciclagem , Fatores Socioeconômicos , Inquéritos e Questionários , Migrantes , Adulto JovemRESUMO
Public transport vehicle drivers, especially in highly polluted or trafficked areas, are exposed to high levels of air pollutants. In this study, we assessed the influence of traffic on levels of hydroxy polycyclic aromatic hydrocarbons (OH-PAHs) in commercial bus drivers in Trujillo, Peru, by measuring the within-shift changes in the urinary whole weight and creatinine-corrected concentrations of the PAH metabolites. We measured personal PM(2.5) as a proxy of exposure to traffic emission. Urine samples were collected daily from two bus drivers and three minivan drivers in Trujillo, pre-, mid-, post-work shift and on days when the drivers were off work (total n = 144). Ten OH-PAH metabolites were measured in the urine samples. Drivers were also monitored for exposure to PM(2.5) (n = 41). Daily work shift (mean = 13.1 ± 1.3 hr) integrated PM(2.5) was measured in the breathing zones of the drivers for an average of 10.5 days per driver. The differences across shift in OH-PAH concentrations were not statistically significant except for urinary 2-hydroxyfluorene (2-FLU) (p = 0.04) and 4-hydroxyphenanthrene (4-PHE) (p = 0.01) and creatinine-corrected 4-hydroxyphenanthrene (p = 0.01). Correlation between pairs of hydroxy-PAHs (ρ = 0.50 to 0.93) were highest for mid-shift samples. Concentrations of PM(2.5) (geometric mean = 64 µg/m(3); 95% confidence limits = 52 µg/m(3), 78 µg/m(3)) is similar to those measured in many other studies of traffic exposure. There was significant change across work shift for concentrations of only two of the OH-PAHs (2-FLU and 4-PHE). Results indicate that the drivers may have had limited time for clearance of PAH exposure from the body between work shifts. Comparisons of the concentrations of creatinine-corrected hydroxy-PAH to those reported in other studies indicate that exposure of public transport drivers to PAH could be similar. By following the subjects over multiple days, this study gives an indication of appropriate exposure situations for the use of hydroxy-PAHs and will be beneficial in designing future occupational studies of PAH exposure.
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Poluentes Atmosféricos/análise , Exposição por Inalação/análise , Exposição Ocupacional/análise , Material Particulado/análise , Hidrocarbonetos Policíclicos Aromáticos/urina , Adulto , Biomarcadores/urina , Fluorenos/urina , Humanos , Pessoa de Meia-Idade , Veículos Automotores , Peru , Fenantrenos/urina , Fatores de Tempo , Emissões de VeículosRESUMO
Introducción: la apnea obstructiva del sueño (AOS) severa ha sido asociada con disfunción autonómica. La presión positiva continua en la vía aérea (CPAP) es el tratamiento estándar para la AOS, aun cuando su impacto sobre la disfunción autonómica no haya sido plenamente investigado. La variabilidad de la frecuencia cardíaca (VFC) es una técnica cuantitativa no invasiva para la evaluación de la actividad autonómica. Nuestro objetivo fue determinar si los pacientes con AOS severa presentan niveles mayores de disfunción autonómica que los pacientes con un índice de apnea-hipopnea (IAH) normal, y si la CPAP mejora los parámetros de VFC a la vez que mejora el IAH.Métodos: todos los pacientes fueron sometidos a una polisomnografía (PSG) completa en una clínica de trastornos del sueño. Se definió como severa a una AOS que tuviera un IAH ³ 30 (eventos por hora), y se definió al grupo control como aquellos que tuvieran un IAH < 5. Se calculó la VFC antes y después de la CPAP, analizando trazados electrocardiogáficos de 10 minutos, conforme las pautas de normalización. Los pacientes con AOS severa fueron tratados con CPAP durante un período de 4-6 semanas (titulados durante la polisomnografía), y los pacientes control no recibieron ninguna intervención entre sus dos registros de electrocardiograma (ECG).Resultados: el estudio incluyó a un total de 20 pacientes con AOS severa y 10 controles. En los pacientes con AOS severa, el IAH se redujo al utilizar CPAP de 38,0 ± 11,0 a 23,0 ± 11,0 (p<0,01). Aparte de una diferencia significativa en el índice de masa corporl (IMC) entre los paciente con AOS y los controles (35,3±4,7 versus 26,6±4,6 kg/m2, p<0,01), los grupos fueron comparables en cuanto a edad, condición de hipertensión y género. No hubo ninguna diferencia significativa (p<0,05) en ningún parámetro de VFC entre los pacientes con AOS severa y los controles, ni entre los pacientes con AOS antes y después de CPAP (tabla 2).
Introduction: severe obstructive sleep apnea (OSA) has been associated with autonomic dysfunction. Continuous positive airway pressure (CPAP) is standard treatment for OSA, although its impact on autonomic dysfunction was not fully investigated. Heart rate variability (HRV) is a non-invasive quantitative technique for assessment of autonomic activity. We aimed to determine if patients with severe OSA exhibit greater levels of autonomic dysfunction than patients with normal apnea-hypopnea index (AHI), and if CPAP improves heart rate variability (HRV) parameters while improving AHI.Methods: all patients underwent full polysomnography (PSG) at a Sleep Disorder Clinic. Severe OSA was defined as AHI ³ 30 (events per hour), and control was defined as AHI < 5. HRV was calculated pre and post-CPAP from a 10-minute electrocardiogram (ECG) recording in accordance with guidelines for standardization. Patients with severe OSA were treated with CPAP for a period of 4-6 weeks (titrated during PSG), and control patients underwent no intervention between their two ECG recordings.Results: a total of 20 patients with severe OSA and 10 controls were included (Table 1). In patients with severe OSA, AHI was reduced by CPAP from 38.0 ± 11.0 to 23.0 ± 11.0 (P<0.01). Aside from a significant difference in BMI between OSA patients and controls (35.3±4.7 vs. 26.6±4.6 kg/m2, P<0.01), groups were comparable in age, hypertension, and gender. There was no significant difference (P<0.05) in any HRV parameters between patients with severe OSA and controls, and between OSA patients pre- and post-CPAP (table 2).
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Humanos , Respiração com Pressão Positiva , Síndromes da Apneia do SonoRESUMO
Urinary methoxyphenols have been proposed as biomarkers for woodsmoke exposure, but few field studies have been undertaken. We evaluated these biomarkers for assessing the exposure to woodsmoke of householders in rural Guatemala. The study population was a subset (10 female cooks, 2 female non-cooks, and 8 male non-cooks ranging in age from 7 to 60) drawn from those participating in a longterm randomized intervention trial (RESPIRE) in the highlands. All households rely solely on woodburning for cooking and home heating. Approximately half of the homes in the trial used open woodfires in the home, while the intervention group used cookstoves, called "planchas, "that vent most of the woodsmoke outdoors through a chimney. Corrected for creatinine levels, 16 of the 19 methoxyphenols measured were lower in the urine of cooks using the plancha; and 11 of the 19 compounds were lower in the urine of non-cooks from homes using the plancha. Furthermore, the 4 low-molecular-weight syringyl methoxyphenols (syringol, methysyringol, ethylsyringol, propylsyringol) were each moderately correlated (r2 = 0.71,0.64, 0.68, 0.53 respectively, with all p < 0.05) with personal exposure measurements determined by carbon monoxide (CO) passive diffusion tubes, but not with CO in exhaled breath. 48-Hour kitchen area measurements of PM2.5 mass, PM2.5 levoglucosan, and CO were highly correlated (>0.89) with each other and moderately correlated (0.54-0.78) with personal CO measurements. Although based on relatively few measurements, this study demonstrates that the urinary concentrations of specific methoxyphenols may be effective biomarkers of short-term exposures to inhaled woodsmoke in field conditions.