Health survey of former workers in a Norwegian coke plant: Part. 1. Estimation of historical exposures.

OBJECTIVE: To estimate historical exposure levels at a coke plant for all agents considered to be of importance for epidemiological studies of mortality and cancer incidence. METHODS: Time weighted average exposure (8 h TWA) was estimated based on personal measurements for polycyclic aromatic hydrocarbons (PAHs) and carbonaceous particulates. Exposure to quartz was estimated relative to the concentration of carbonaceous particulates. These estimates were adjusted for the use of airstream helmets. Exposure to other agents were estimated qualitatively (asbestos, benzene, and arsenic) or semi-quantitatively (carbon monoxide (CO) and heat) based on measurements and other indicators of exposure. RESULTS: Exposure to PAHs was highest for those who worked at the top of the ovens (300 micrograms/m3) in the period from 1970-6. The estimated PAH exposure was reduced to an average of 65 micrograms/m3 after the introduction of exposure control measures in 1976. The estimates for carbonaceous particulates ranged from 1 to 16 mg/m3, with the highest exposure for workers at the top of the ovens and at the coke screening station. CONCLUSIONS: The exposure of greatest concern in this study is to PAHs, but exposures to carbonaceous particulates and CO may also be of importance. The major limitations of this study are the lack of personal measurements before 1975 and the total lack of measurements for some of the exposed categories of workers. Despite these limitations, we think that this assessment reflects the actual exposures for most of the former employees. The assessment thus provides a reasonable tool for the subsequent epidemiological study and for future epidemiological follow up studies at the coke plant.

Glutathione S-transferase M1 and P1 genotypes and urinary excretion of 1-hydroxypyrene in coke oven workers.

The objective of this study was to analyze the effect of the GSTM1 and GSTP1 genotypes on urinary 1-hydroxypyrene, a biomarker for exposure to polycyclic aromatic hydrocarbon. Urine samples were collected from coke oven workers at two time points (from 66 and 46 workers, respectively) and 1-hydroxypyrene was quantitated by HPLC chromatography. The genotype of GSTM1 and GSTP1 was determined by a PCR methods discriminating between GSTM1 present or absent and three different alleles for GSTP1. The mean value of urinary 1-hydroxypyrene was higher at both time points in coke oven workers with GSTM1 gene present compared to workers having the GSTM1 null genotype, but this difference was not statistically significant. The GSTM1 and GSTP1 genotypes were not significant parameters in a multiple regression analysis with urinary 1-hydroxypyrene as the dependent variable and with GSTM1, GSTP1, exposure group and smoking habit as explanatory variables. The biomarker 1-hydroxypyrene is not or only marginally influenced by the GSTM1 genotype. No systematic influence of the GSTP1 genotypes was found.

Operator safety during injection vaccination of fish.

Reports of adverse health effects to vaccinators after self-injection of fish vaccine motivated the present study which aimed at identifying risk factors and improving risk management. Information was collected through interviews with members of professional vaccinator teams, and with physicians who had treated injured vaccinators. In addition, a questionnaire was distributed among salmon farmers. Professional vaccinators reported from one to more than 50 stabs or self-injections during the vaccination season. Two cases of hospitalization due to anaphylactic reactions are described. Self-injections occurred exclusively on fingers and hands. The clinical picture is classified into four categories according to the type and severity of the reaction. The overall risk of self-injection leading to serious health effects was low, although the data do not allow a precise estimate. The collected information suggests that allergic hypersensitivity reactions occurred in two vaccinators, whereas increasing tolerance was reported from others. No information indicating infectious reactions was obtained, suggesting that non-steroid anti-inflammatory drugs constitutes an appropriate therapy for self-injection events. The use of a safety bow attached to the syringe and improved training and awareness of personnel apparently have reduced the incidence of self-injection since this study was conducted. Health risks for vaccinators have further been reduced by equipping vaccinators with adrenaline and the improved knowledge of local doctors regarding recommended treatment.

[Incidence and physicians' registration of assumed occupational lung cancer in Norway]. / Hyppighet og legers registrering av antatt arbeidsbetinget lungekreft i Norge.

About 20% of al lung cancers among men are attributable to occupational exposure. During the years 1991 through 1993, Norwegian doctors reported 161 (4.6%) of 3.510 incidents of cancer in Norwegian men to the Labour Inspection as probably caused by occupational exposure. The proportion of such assumed occupational lung cancer cases varied with geographical region from 0.7% to 6.7%. Notification of an occupational cancer can be justification for economic benefits to the patient and his/her family. The most common assumed causes of the 161 cases notified as occupational lung cancers were asbestos dust exposure (148 cases), exposure to nickel (21 cases), and exposure to stone dust containing crystalline silica (18 cases). The predominating occupations of the patients at the time of the assumed carcinogenic exposure were machinist, industrial worker in metallurgical or chemical industry, mechanic, or metal worker (metal sheet worker, welder).

[The occupational injury act--an improvement for persons with occupational diseases?]. / Lov om yrkesskadeforsikring--en forbedring for de skadelidte?

The aim of the study was to find out what degree employees with occupational injuries and diseases knew about the new Act, and had received compensation in accordance with the provisions. In 1994, 6,755 questionnaires were sent to persons reported to the Labour Inspection as suffering from occupational injury or disease, 3,762 (56%) responded. The study shows that at the time of the investigation only a small minority of the persons who had been reported as having occupational injuries or diseases had received compensation. Even among those who had experienced loss of income, actual expenses, or medical disability, only one subject in four had filed a claim. A number of claims may have been rejected on unlawful grounds.

[Health risks of vaccination of farmed fish]. / Helserisiko ved vaksinasjon av oppdrettsfisk.

In 1991, three cases of anaphylactoid reactions among vaccinators of farmed fish were registered in Norway. The reactions developed after repeated accidental self-injection of vaccine against salmon furunculosis. In 1991, some 60 million salmon were vaccinated against furunculosis at approximately 50 grams body weight. Following such self-injection of vaccine, inflammatory reactions are seen in the injected finger, also spreading occasionally to the hand. More seldom a "flu" like syndrome with fever, muscle aches, and general malaise is experienced probably caused by endotoxins in the vaccine. Devices to protect the fingers against accidental self-injection have been developed and, so far, the results are promising.

Irritant cutaneous reactions to N-methyl-2-pyrrolidone (NMP).

Several workers in a small electrotechnical company in Norway experienced irritant reactions of the skin after a few days of working with the solvent N-methyl-2-pyrrolidone (NMP). Due to concern about the health risk of commonly-used organic solvents, the company had chosen to use NMP when one of its products had to be treated with a solvent. After 2 days of work with NMP, 10 of the 12 involved workers displayed acute irritant contact dermatitis of the hands. According to published reports, NMP is not considered to be particularly irritant to the skin. The Safety Data Sheet of a Norwegian sales firm contained no information on cutaneous hazards, but the Safety Data Sheet of an American producer of NMP stated the risk of severe dermatitis upon prolonged contact. NMP seems to be more irritant to the human skin than reported thus far.

Cerebral magnetic resonance imaging and cerebral computerized tomography for patients with solvent-induced encephalopathy.

To compare the results of cerebral magnetic resonance imaging (MRI) and computerized tomography (CT) for patients with solvent-induced encephalopathy, a parallel study was performed with nine patients. The diagnosis had been given three to five years earlier on the basis of relevant exposure to solvents, findings on neuropsychological tests, a neurological examination, and cerebral CT. There was no progression of pathological lesions from the first to the second CT examination. Four patients with atrophy in the CT examination also had atrophy in the MRI examination. In addition three patients with normal CT findings showed atrophy in the MRI examination. It was concluded that MRI should be the modality of choice whenever diagnostic imaging is necessary in the clinical workout of patients with diagnosed or suspected solvent-induced encephalopathy.