Maternal exposure to benzene and toluene and preterm birth. A longitudinal study

ABSTRACT BACKGROUND: Exposure to air pollutants has several effects on human health, including during pregnancy. OBJECTIVE: To identify whether exposure to benzene and toluene among pregnant women contributes to preterm delivery. DESIGN AND SETTING: Longitudinal study using data on newborns from mothers living in São José dos Campos (SP) in 2016, who had been exposed to benzene and toluene. METHODS: A logistic regression model with three hierarchical levels was constructed using maternal variables relating to newborns, and using benzene and toluene concentrations in quartiles. Occurrences of cesarean births, twins or malformations were excluded. Maternal exposure windows of 5, 10, 15, 30, 60 and 90 days prior to delivery were considered. RESULTS: Out of the 9,562 live births, 3,671 newborns were included and 343 newborns were born at less than 37 weeks of gestation (9.3%). The average birth weight was 3,167.2 g. Exposure to benzene and toluene was significantly associated (P = 0.04) with preterm delivery in the five-day window. There was no association in any of the other exposure windows. CONCLUSIONS: It was possible to identify that maternal exposure to benzene and toluene has an acute effect on preterm delivery.

Environmental exposure to benzene: evaluation of urinary S-PMmorphism (CYP2E1-129A and poly3G>C and NQO1 609C> T) in Campos Elíseos residents, Duque de Caxias, Rio de Janeiro State, Brazil / Exposição ambiental ao benzeno: avaliação do S-PMA urinário e de polimorfismos (CYP2E1-1293G>C e NQO1 609C> T) em residentes de Campos Elíseos, Duque de Caxias, Rio de Janeiro, Brasil / Exposición ambiental al benceno: análisis del S-PMA en la orina y polimorfismo (CYP2E1-1293G>C y NQO1 609C> T) en residentes de Campos Elíseos, Duque de Caxias, Río de Janeiro, Brasil

Benzene is one of the most important substances for assessment, due to its significant use, the environmental contamination resulting from its emission and the effects on human health. It is classified by the International Agency for Research on Cancer (IARC) as a known carcinogen to humans (group 1) and associated with the development of leukemia. In general, the population is exposed to this substance by inhaling contaminated air, which varies according to the location and intensity of its potential sources. The petrochemical industry is one of the most important sources of this compound. The municipality of Duque de Caxias, specifically the Campos Elíseos district, in Rio de Janeiro State, Brazil, houses the Industrial Complex of Campos Elíseos (PICE), a grouping of over 25 industries, which includes the second largest oil refinery in Brazil. Environmental contamination from the PICE has been recognized, but there is a lack of studies concerning its impact on the health of the surrounding population. S-phenylmercapturic acid (S-PMA) concentrations ranging from 0.80 to 8.01μg.g-1 creatinine were observed in the local population, apparently related to hematological changes also observed in exposed population. The quantifiable presence of urinary S-PMA from the benzene metabolism is associated with the fact that 60% of the participants present specific hematological changes, which may be due to the environmental benzene exposure. The allele and genotype frequencies of the CYP2E1 and NQO1 enzymes observed in the study population were similar to those reported in other studies. The presence of the variant allele in the NQO1 genotype may be a risk factor for the observed hematological changes.

O benzeno é uma das substâncias mais importantes para a biomonitorização, em função do uso disseminado, da contaminação ambiental que resulta da emissão e dos efeitos sobre a saúde humana. O benzeno é classificado pela Agência Internacional de Pesquisa em Câncer (IARC) como carcinógeno conhecido em seres humanos (grupo 1) e está associado ao desenvolvimento de leucemias. Em geral, a população fica exposta a essa substância através da inalação do ar contaminado, que varia de acordo com a localização e a intensidade das fontes potenciais. A indústria petroquímica é uma das fontes mais importantes desse composto. O Município de Duque de Caxias, especificamente o Distrito de Campos Elíseos, no Estado do Rio de Janeiro, Brasil, é sede do Polo Industrial de Campos Elíseos (PICE), um conjunto de mais de 25 indústrias que inclui a segunda maior refinaria de petróleo no Brasil. A contaminação ambiental produzida pelo PICE já é conhecida, mas faltam estudos sobre o impacto na saúde da população local. Foram observadas concentrações de ácido S-fenilmercaptúrico (S-PMA) entre 0,80 e 8,01μg.g-1 creatinina na população local, aparentemente implicadas nas alterações hematológicas também observadas na população exposta. A presença quantificável do S-PMA urinário do metabolismo do benzeno está associada ao fato de 60% dos participantes apresentarem alterações hematológicas específicas, o que pode ser devido à exposição ambiental ao benzeno. As frequências alélicas e genotípicas das enzimas CYP2E1 e NQO1, observadas na população do estudo, foram semelhantes àquelas relatadas em outros estudos. A presença da variante alélica do genótipo NQO1 pode ser um fator de risco para as alterações hematológicas observadas.

El benceno es una de las sustancias más importantes susceptibles de estudio, debido a su uso significativo, la contaminación ambiental resultante de sus emisiones y sus efectos sobre la salud humana. Está clasificado por el Centro Internacional de Investigaciones sobre el Cáncer (IARC) como un conocido carcinógeno para los humanos (grupo 1) y está asociado con el desarrollo de leucemias. En general, la población está expuesta a esta sustancia por inhalación de aire contaminado, que varía según el lugar y la intensidad de las emisiones. La industria petroquímica es un de las fuentes emisoras más importantes de este compuesto. La municipalidad de Duque de Caxias, específicamente el distrito de Campos Elíseos, en Río de Janeiro, Brasil, alberga el Complejo Industrial de Campos Elíseos (PICE), un conglomerado de más de 25 industrias, que incluye la segunda mayor refinería de petróleo en Brasil. La contaminación ambiental procedente del PICE ya ha sido reconocida, pero es notable la falta de estudios respecto a su impacto en la salud de la población circundante. Se observaron en la población local concentraciones de ácido s-fenilmercaptúrico (SPMA por sus siglas en inglés) que oscilan entre los 0,80 a 8,01μg.g-1 creatinina, aparentemente relacionadas con cambios hematológicos también hallados en la población expuesta. La presencia cuantificable de SPMA en la orina, procedente del metabolismo del benceno, está asociada con el hecho de que un 60% de los participantes presenta cambios específicos hematológicos, los cuales tal vez se deben a la exposición ambiental al benceno. Las frecuencias alélicas y genotípicas del CYP2E1 y enzimas NQO1 observadas en el estudio fueron similares a las reportadas en otros estudios. La presencia de la variante alélica en el genotipo NQO1 podría ser un factor de riesgo para los cambios hematológicos observados.

Polimorfismos metabólicos e alterações clínicas e laboratoriais relacionadas à exposição ao benzeno em trabalhadores de postos de combustíveis da cidade do Rio de Janeiro / Metabolic polymorphisms and clinical and laboratory changes related to exposure to benzene in city gas station workers in Rio de Janeiro

A exposição ao benzeno representa um sério problema de Saúde Pública, apesar das medidas de limitação e controle empregadas nas últimas décadas. Os trabalhadores depostos de combustíveis representam uma categoria que vem sendo continuamente exposta a substâncias presentes na gasolina, dentre as quais o benzeno, capaz de causar um conjunto de sinais e sintomas denominado benzenismo, cujo diagnóstico é epidemiológico e clínico baseado na busca de alterações clínicas, principalmente hematológicas. Este estudo avaliou alterações clínicas relacionadas ao benzenismo e seis polimorfismos de genes de metabolização do benzeno em trabalhadores de postos de combustíveis do município do Rio de Janeiro. (...) A população foi categorizada em dois grupos, de acordo com a presença das alterações clínicas, principalmente sinais hematológicos. A maioria dos trabalhadores, 63,2 por cento, apresentou alterações clínicas compatíveis com o benzenismo. Estes trabalhadores mostraram diminuição na contagem de células sanguíneas, com diferença significativa para os valores de neutrófilos e MCV (indicativo de macrocitose). Este grupo mostrou maior frequência de sintomas como cefaléia, infecções repetidas, câimbras musculares,formigamentos, sonolência, tontura e perda de peso, embora nem todos com diferença significativa. (...) A mostraram freqüências mais altas dos alelos relacionados ao risco entre os trabalhadores com alterações clínicas. Foi observada uma associação entre as alterações clínicas relacionadas ao benzenismo e o genótipo nulo da GSTM1 e também com maior número de alelos relacionados ao risco (em conjunto). Entretanto, estudos baseados em maior tamanho amostral, são necessários para confirmação destes achados. Variações em genes de metabolização do benzeno devem ser consideradas nos estudos de avaliação de risco de trabalhadores expostos, por serem capazes de modificar a toxicidade do composto.

Exposure to benzene, especially in developing countries like Brazil, continues to represent a serious Public Health problem despite limiting exposure measures used inrecent decades. The gas station workers represent a category that has been continuously exposed to substances present in gasoline, especially benzene, which can cause a number of signs and symptoms which characterize the benzene poisoning. The diagnosis of benzene poisoning is epidemiological and clinical, based on the search for clinical findings, mainly hematologic. This study evaluated clinical alterations related to benzene poisoning and six polymorphisms of benzene metabolism genes in gas station workers in the city of Rio de Janeiro. (...) metabolic polymorphisms of benzene were analyzed in this study. The population was categorized into two groups according to the presence of clinical changes, hematological signs mainly. Most workers presented clinical findings, 63.2 percent. These workers showed a decrease in blood cells count, with a significant difference to the values of neutrophils and Mean Corpuscular Volume (MCV) (indicative of macrocytosis). This group showed a higher frequency of symptoms such as headache, repeated infections, muscle cramps, tingling, drowsiness, dizziness and weight loss, although not all with significant differences. (...) A genotypes. Moreover, an association was found between alterations related to benzene poisoning and GSTM1 null and the highest number of alleles related to risk. Further studies of larger samples are needed to confirm these findings. Variations in benzene metabolizing genes may modify benzene toxicity and should be taken into consideration during risk assessment evaluations.

Exposição ao benzeno em postos de revenda de combustíveis no Brasil: Rede de Vigilância em Saúde do Trabalhador (VISAT) / Exposure to benzene in gas stations in Brazil: occupational health surveillance (VISAT) network

O objetivo deste artigo é apresentar a experiência da rede de vigilância da exposição ao benzeno em Postos de Revenda de Combustíveis, descrevendo seus componentes, desenvolvida no Sistema Único de Saúde. Relato e análise de experiência de vigilância e seus impactos à saúde dos trabalhadores de postos de combustíveis em seis estados do Brasil. Apresenta a perspectiva de ação operada pela circulação de informações, encontros nacionais, discussões de estratégias particulares e compartilhadas das experiências, metodologias e instrumentos comuns. São descritos procedimentos de inspeção, avaliações individuais e formação. Foram identificadas situações de risco e exposições ocupacionais e ambientais em 1.312 postos e 564 trabalhadores foram avaliados. Estavam expostos frentistas, chefes de pista e encarregados de medição, descarga e testes. As características integradas e complementares desta vigilância, articuladas às áreas ocupacional e ambiental, contemplam a intervenção a territórios ampliados e conectados em rede. A intervenção supera as fragmentações entre práticas individuais e coletivas e entre serviços e ensino, tornando-se um exemplo de ação para avaliação e redução do impacto à saúde em trabalhadores, pela articulação da ação sanitária, ambiental e de conexão intersetorial.

The scope of this article is to present the surveillance network's experience of exposure to benzene in gas stations, describing its components developed in the Unified Health System. It is a report and analysis of the experience of monitoring and its impact on the health of gas station workers in six Brazilian states. It presents the prospect of action, operated by the circulation of information, national meetings, discussions of specific strategies and shared experiences, methodologies and common tools. Inspection procedures, individual assessments and training are described. Risk situations and occupational and environmental exposure were identified in 1,311 gas stations and 564 workers were assessed. Forecourt attendants, superintendents and measuring, offloading and testing employees were all exposed. The integrated and complementary features of this surveillance, implemented in the occupational and environmental areas, suggest intervention in a broader and network-linked territory. The intervention would transcend fragmentation between individual and collective practices, services and education, becoming an example of action for assessment and mitigation of the impact on health workers, the articulation of action in health, the environment and intersectorial connection.

Occupational exposure of petroleum depot workers to BTEX compounds

Benzene, toluene, ethylbenzene and xylene [BTEX] are the most important toxic volatile compounds in the air and could be easily absorbed through the respiratory tract. In recent years, the risk of exposure to BTEX compounds, especially benzene as a carcinogen, has been considered in petroleum depot stations. To assess the occupational exposure of petroleum depot workers in Iran to BETX compounds. After completing a questionnaire and assessing occupational exposure to BETX compounds, 78 [46 exposed and 32 non-exposed] depot workers were randomly selected to participate in this study. Air sampling and analysis of BTEX was conducted according to the NIOSH method No. 1501. Analysis of urinary hippuric acid, as an indicator of toluene exposure, was carried out according to NIOSH method no. 8300. Personal monitoring of the high exposure group to BTEX compounds was repeated to verify the results obtained in the first phase of the monitoring. Among the 9 operating groups studied, occupational exposure to benzene and toluene was higher in quality control and gasoline loading operators - the median exposure ranged from 0.16 to 1.63 ppm for benzene and 0.2 to 2.72 ppm for toluene. Median exposure of other group members to BTEX compounds was below the detection limit of analytical method [0.07, 0.06, 0.05, and 0.05 ppm, respectively]. The level of toluene exposure measured showed correlation with neither post-shift urinary hippuric acid [Spearman's rho = 0.128, p=0.982] nor with the difference between post- and pr-shift urinary hippuric acid [Spearman's rho=0.089, p=0.847] in depot operational workers. Gasoline loading operators are exposed to a relatively high level of benzene

Saúde do trabalhador e a sustentabilidade do desenvolvimento humano local: ensaios em Pernambuco / Occupational Health and sustainability of local human development: Essays in Pernambuco

Desde meados da década de 80 diversas experiências locais de internalização da saúde do trabalhador na rede pública de atenção à saúde foram realizadas no Brasil. A saúde como qualidade de vida humana deve estar no centro das politicas para o desenvolvimento. Mas este é um desafio que se coloca para a consolidação do SUS. Este livro tenta trazer o tema para os contextos locais, onde se materializam os processos de trabalho e oferecer aos profissionais de saúde, e outros interessados, alguns cenários e metodologias para auxiliar a organização da proteção e da promoção da saúde, nos contextos de desenvolvimento humano, como dever do Estado.

BTEX Exposure and its Health Effects in Pregnant Women Following the Hebei Spirit Oil Spill / 예방의학회지

OBJECTIVES: We evaluated the health effects of exposure to BTEX (Benzene, Toluene, Ethylbenzene, m,p-Xylene, o-Xylene) in the Taean area after the Hebei Spirit oil spill. METHODS: We used a questionnaire survey to look for health effects among 80 pregnant women 2 to 3 months following the Hebei Spirit oil spill. Their BTEX exposures were estimated using the CALPUFF method. We then used a multiple logistic regression analysis to evaluate the effects of BTEX exposure on the women's health effets. RESULTS: Pregnant women who lived near the accident site reported more symptoms of eye irritation and headache than those who lived farther from the site. There was a trend of decreasing symptoms with an increase in distance from the spill site. Pregnant women exposed to higher ambient cumulative levels of Xylene were significantly more likely to report symptoms of the skin (OR 8.01 95% CI=1.74-36.76) in the first day after the accident and significantly more likely to report abdominal pain (OR 3.86 95% CI=1.02-14.59 for Ethylbenzene, OR 6.70 95% CI=1.82-24.62 for Xylene) during the 1st through 4th days following the accident. CONCLUSIONS: This study suggests that exposure to BTEX from an oil spill is correlated with an increased risk of health effects among pregnant women. This implies the need to take proper measures, including the development of a national policy for environmental health emergencies and a plan for studying the short- and long-term chronic health effects associated with such spills.

Chemical and physical hazards in different small workshops activities

Workers in informal small-scale industries [SSI] in developing countries involved in welding, spray painting, woodwork, and metalwork are exposed to various hazards with consequent risk to health. The present study was to assess occupational exposures to chemical and physical hazards among workers in small workshops. Three different industrial activities were selected for this study. These activities are: car repairing, welding, and wood processing. Inside the selected workshops, different physical hazards as noise, heat stress, illumination, and dust as well as air pollutants of carbon monoxide [CO] nitrogen dioxide, [NO2] sulphur dioxide [SO2], and benzene were measured at the same two periods of the day [morning and evening] using calibrated devices. Analyzed data revealed high significant increase in the selected areas in the levels of noise, thermal stress, illumination and dust during morning and evening exposure between as compared to the control area in the selected areas respectively. Only for NO2, levels of the other gases pollutants inside all exposed workshops are higher than those inside the control workshops. In conclusion, the workers at the studied industries were exposed to potential occupational hazards. These findings should be considered as s a preventive measures for monitoring and application of control strategies in such workplace environment

Safety practice and occupational exposure to physical and chemical hazards in pesticides and fertilizers packing industry

In pesticides and fertilizer formulation and packaging processes, workers may be exposed to toluene, benzene, xylene, carbon monoxide emissions as well as noise and reduced illumination during milling, mixing, loading, packaging and storage operations. Occupational hazards are associated with exposure to mixtures containing high proportions of active ingredients, and exposure to carriers/fillers and additives. The present study was designed to assess occupational exposure to chemicals, physical, hazards and safety practice in the pesticides and fertilizers packing industry. It was conducted in pesticide and fertilizer packing industry. Occupational exposure to organic solvents as toluene, benzene, xylene and carbon Monoxide as well as noise and illumination levels were carried out using calibrated instruments. Safety practice was done using safety questionnaire. Analyzed data revealed high significance increase levels of toluene, benzene, xylene, and carbon Monoxide as well as in the levels of noise and illumination in fertilizers and pesticides packing departments in comparison with administrative area. Nevertheless, the conditions of many of the safety practice are not satisfactory while the others are satisfactory and adequate, It was concluded that there are great needs for improvement, including identifying and controlling the hazards. providing information, training, monitoring and also legislative requirements that need to be met

Riesgo infantil por exposición a carcinógenos en un área de alto tránsito vehicular / Child risk exposure to carcinogens in a high traffic area

La contaminación del aire es una amenaza aguda, acumulativa y crónica para la salud y el ambiente. Las personas están expuestas a contaminantes de aire en exteriores e interiores. Las exposiciones a los mismos puede generar o agravar afecciones respiratorias, cardíacas y otras. La presente experiencia nace como la necesidad de conocer la calidad del aire en áreas de alto tránsito vehicular, con potencial riesgo para la salud de la población infantil. Experiencia que se desarrolla desde la gestión de la Dirección de Salud Ambiental, con una visión epidemiológica, con la participación de Centros de Investigación-Universidades Nacionales y recursos municipales.Sobresale en esta investigación la caracterización de escenarios de riesgo por los valores alto de benceno; con su correspondiente índice de peligro, según peso corporal del niño. También por el alto porcentaje de emisiones vehicular de material particulado. Se ha detectado la presencia en el 21 % de las muestras benzo[a]pireno, asociados con las partículas finas y se ha encontrado mayor valor de mutagenicidad (ensayo de Ames), en una de las zonas bajo estudio. Detección de tóxicos críticosque estarían presentes, durante la ventana de vulnerabilidad crítica del desarrollo del niño, llevando a intensificar las medidas correctivas y los estudios en la población vulnerable.

Feasibility of urinary trans, trans-muconic acid determination using high performance liquid chromatography for biological monitoring of benzene exposure.

Benzene is an important carcinogenic substance used in many industrial processes. Inhalation of this substance can cause both acute and chronic toxicity. In this study, monitoring of benzene exposure by high-performance liquid chromatography (HPLC) for urine trans, trans-muconic acid (ttMA) determination was adapted. We described a new adapted sensitive and specific HPLC method. We mixed 0.5 mL of urine sample with 2 mL of Tris Buffer containing vanillic acid as internal standard (IS) and percolate this through a preconditioned ion-exchange column. After rinsing the column with phosphoric acid solution, acetate buffer, and deionized water, we eluated the analytes with 2 mL of an equivolume solution of 1.5 mol/L sodium chloride and methanol. Of this, 10 microliter was injected into the HPLC column. The mobile phase consisted of, per liter, 10 ml of acetic acid, 100 ml of methanol, and 5 mmol/L sodium acetate. The flow rate was started at 1.2 ml/min. The ttMA and IS were detected at 4.2 to 4.4 and 12.6-13.3 minutes, respectively. The lowest detection limit was 0.05 mg/L.

Urine trans,trans-muconic acid determination for monitoring of benzene exposure in mechanics.

Benzene is an important carcinogenic substance used in many industrial processes. Inhalation of this substance can cause both acute and chronic toxicity. In this study, monitoring of benzene exposure by high-performance liquid chromatography for urine trans,trans-muconic acid (ttMA) determination in 94 subjects, (49 control subjects and 45 mechanics) was performed. The mean urine ttMA level in the control group was 0.116 +/- 0.027 mg/g creatinine. The mean urine ttMA level in the mechanics group was 0.280 +/- 0.131 mg/g creatinine. There was a significant difference between the groups (p < 0.05). Based on this study, we recommend the use of urine ttMA determination for monitoring of benzene exposure in high risk workers.

O ácido "trans", "trans-mucônico" urinário como indicador biológico de exposiçäo ocupacional ao benzeno na indústria de refino do petróleo / Urinary trans, trans-muconic acid as occupational biological exposure indice to benzene in oil refining industry

Foram avaliados 78 trabalhadores de três setores de uma refinaria de petróleo quanto à exposição ocupacional ao benzeno. A monitorização ambiental foi realizada através da utilização de monitores passivos individuais para vapores orgãnicos. Foram coletadas amostras de urina como estratégia de monitorização biológica para a determinação de um metabólito não fenólico do benzeno - o ácido trans, trans-mucônico. Houve boa correlação linear entre as concentrações ambientais do benzeno e os níveis urinários do ácido trans, trans-mucônico mostrando um promissor indicador biológico para as exposições ocupacionais ao benzeno

Valor de referência tecnológico (VRT): a nova abordagem do controle da concentraçäo de benzeno nos ambientes de trabalho / Technological Reference Value (TRV): a new approach to benzene concentration control in the work environment

A finalidade deste artigo é apresentar um novo conceito de controle da concentração de benzeno nos ambientes de trabalho, adotado recentemente no Brasil com a concordância de empregadores, trabalhadores e governo. Trata-se do Valor de Referência Tecnológico (VRT). O artigo apresenta um breve histórico do processo de concepção e adoção do VRT no país, seguido da discussão conceitual de "Limite de Tolerância" adotado legalmente no Brasil, que atribui aos valores definidos o caráter de segurança e proteção à saúde do trabalhador, mesmo tratando-se de substâncias reconhecidamente cancerígenas, como o benzeno. Apresenta também o conceito estabelecido para o VRT que incorpora a classificação da carcinogenicidade do benzeno e a necessidade da redução permanente de seu valor, indicando-o como "guia" para as ações de prevenção em higiene ocupacional. Por fim conclui que a concepção adotada introduz na realidade brasileira a participação dos trabalhadores na discussão do risco decorrente do uso de um produto químico tão importante como o benzeno.