A meta-analysis of airborne asbestos fiber concentrations from work with or around asbestos-containing floor tile.

In this meta-analysis, exposures to airborne asbestos during work with or around floor tiles were characterized according to several variables: study, sample type, activity, and task. Personal breathing zone, bystander, and area sample exposure concentrations were differentiated and compared against current occupational exposure limits to asbestos. In total, 22 studies, including 804 personal, 57 bystander, and 295 area samples, were included in the analysis. The arithmetic mean airborne fiber concentrations were 0.05, 0.02, and 0.01 f/cm3 for personal, bystander, and area samples, respectively. Arithmetic mean time-weighted-average fiber concentrations over an 8-h working day were 0.02 and 0.01 f/cm3 for personal and bystander samples, respectively. Phase contrast microscopy (PCM) personal airborne fiber concentrations were highest for maintenance activities, followed by removal and installation. Tasks that involved buffing or burnishing, scoring or snapping, and scraping or lifting had the highest personal PCM concentrations, while stripping floor tile and removing it with chemical solvent had the lowest concentrations. Exposures associated with handling asbestos floor tiles, under working conditions normally encountered, do not generally produce airborne concentrations at levels that exceed the current OSHA PEL nor do they appear to approach the threshold cumulative asbestos dose concentrations that have been previously associated with an increased risk of asbestos-related disease.

Best-practices approach to determination of blood alcohol concentration (BAC) at specific time points: Combination of ante-mortem alcohol pharmacokinetic modeling and post-mortem alcohol generation and transport considerations.

Alcohol concentrations in biological matrices offer information regarding an individual's intoxication level at a given time. In forensic cases, the alcohol concentration in the blood (BAC) at the time of death is sometimes used interchangeably with the BAC measured post-mortem, without consideration for alcohol concentration changes in the body after death. However, post-mortem factors must be taken into account for accurate forensic determination of BAC prior to death to avoid incorrect conclusions. The main objective of this work was to describe best practices for relating ante-mortem and post-mortem alcohol concentrations, using a combination of modeling, empirical data and other qualitative considerations. The Widmark modeling approach is a best practices method for superimposing multiple alcohol doses ingested at various times with alcohol elimination rate adjustments based on individual body factors. We combined the selected ante-mortem model with a suggestion for an approach used to roughly estimate changes in BAC post-mortem, and then analyzed the available data on post-mortem alcohol production in human bodies and potential markers for alcohol production through decomposition and putrefaction. Hypothetical cases provide best practice approaches as an example for determining alcohol concentration in biological matrices ante-mortem, as well as potential issues encountered with quantitative post-mortem approaches. This study provides information for standardizing BAC determination in forensic toxicology, while minimizing real world case uncertainties.

Historical ambient airborne asbestos concentrations in the United States - an analysis of published and unpublished literature (1960s-2000s).

Outdoor concentrations of airborne asbestos have been measured throughout the US over time. However, a thorough review and analysis of these data has not been conducted. The purpose of this study is to characterize asbestos concentrations in ambient air by environment type (urban, rural) and by decade, using measurements collected in the absence of known asbestos emission sources. A total of 17 published and unpublished studies and datasets were identified that reported the results of 2058 samples collected from the 1960s through the 2000s across the US. Most studies did not report asbestos fiber type, and data based on different analytical methods (e.g. Phase Contrast Microscopy, Transmission Electron Microscopy, etc.) were combined in the dataset; however, only fibers ≥5 µm in length were considered. For a small subset of the measurements (n = 186, 9.0%), a conversion factor was used to convert mass-based data (e.g. ng/m(3)) to count-based values (i.e. f/cc ≥5 µm). The estimated overall mean and median ambient asbestos concentrations for the 1960s through 2000s were 0.00093 f/cc and 0.00022 f/cc, respectively. Concentrations generally increased from the 1960s through the early 1980s, after which they declined considerably. While asbestos use decreased throughout the 1970s, these results indicate that ambient concentrations peaked during the early 1980s, which suggests the possible contribution of abatement or demolition activities. Lastly, ambient asbestos concentrations were higher in urban than rural settings, which is consistent with the greater use of asbestos-containing materials in more densely populated areas.

Airborne asbestos exposures associated with gasket and packing replacement: a simulation study of flange and valve repair work and an assessment of exposure variables.

A simulation study was conducted to evaluate worker and area exposure to airborne asbestos associated with the replacement of asbestos-containing gaskets and packing materials from flanges and valves and assess the influence of several variables previously not investigated. Additionally, potential of take home exposures from clothing worn during the study was characterized. Our data showed that product type, ventilation type, gasket location, flange or bonnet size, number of flanges involved, surface characteristics, gasket surface adherence, and even activity type did not have a significant effect on worker exposures. Average worker asbestos exposures during flange gasket work (PCME=0.166 f/cc, 12-59 min) were similar to average worker asbestos exposures during valve overhaul work (PCME=0.165 f/cc, 7-76 min). Average 8-h TWA asbestos exposures were estimated to range from 0.010 to 0.062 f/cc. Handling clothes worn during gasket and packing replacement activities demonstrated exposures that were 0.71% (0.0009 f/cc 40-h TWA) of the airborne asbestos concentration experienced during the 5 days of the study. Despite the many variables considered in this study, exposures during gasket and packing replacement occur within a relatively narrow range, are below current and historical occupational exposure limits for asbestos, and are consistent with previously published data.

Airborne asbestos exposures associated with gasket and packing replacement: a simulation study and meta-analysis.

Exposures to airborne asbestos during the removal and installation of internal gaskets and packing associated with a valve overhaul were characterized and compared to published data according to different variables (e.g., product, equipment, task, tool, setting, duration). Personal breathing zone and area samples were collected during twelve events simulating gasket and packing replacement, clean-up and clothing handling. These samples were analyzed using PCM and TEM methods and PCM-equivalent (PCME) airborne asbestos concentrations were calculated. A meta-analysis was performed to compare these data with airborne asbestos concentrations measured in other studies involving gaskets and packing. Short-term mechanic and assistant airborne asbestos concentrations during valve work averaged 0.013f/cc and 0.008f/cc (PCME), respectively. Area samples averaged 0.008f/cc, 0.005f/cc, and 0.003f/cc (PCME) for center, bystander, and remote background, respectively. Assuming a tradesman conservatively performs 1-3 gasket and/or packing replacements daily, an average 8-h TWA was estimated to be 0.002-0.010f/cc (PCME). Combining these results in a meta-analysis of the published exposure data showed that the majority of airborne asbestos exposures during work with gaskets and packing fall within a consistent and low range. Significant differences in airborne concentrations were observed between power versus manual tools and removal versus installation tasks. Airborne asbestos concentrations resulting from gasket and packing work during a valve overhaul are consistent with historical exposure data on replacement of asbestos-containing gasket and packing materials involving multiple variables and, in nearly all plausible scenarios, result in average airborne asbestos concentrations below contemporaneous occupational exposure limits for asbestos.

A case-control study of chronic myelomonocytic leukemia (CMML) in Shanghai, China: evaluation of risk factors for CMML, with special focus on benzene.

The authors report the results of a hospital-based case-control study of all patients diagnosed with chronic myelomonocytic leukemia (CMML) (n = 36) from 28 participating hospitals over a 4-year period. Diagnoses were made by a single laboratory using 2001 World Health Organization (WHO) criteria. Subjects were matched to 2 control patients and interviewed concerning previous diseases, work histories, and exposures to potential etiologic agents. Peripheral blood and bone marrow findings revealed clinical features of both myelodysplastic syndromes (MDSs) and myeloproliferative neoplasms (MPNs), consistent with hematopoietic disease category of MDS/MPN. The frequency of clonal cytogenetic abnormalities in all CMML cases was 31%, with no consistent pattern identified. A select number of risk factors associated with occupational exposure, nonoccupational exposure, and prior medical or family history of disease were extracted from the questionnaire. The results were compared between the case and control subjects. A total of 5 study subjects (2 CMML cases and 3 control subjects) were determined to have had some benzene exposure. In addition, none of the highlighted risk factors associated with nonoccupational exposure to etiologic agents was significantly different among the study subjects. These results do not support an increased risk for developing CMML associated with historical exposures to benzene.

Malignant pleural mesothelioma in US automotive mechanics: reported vs expected number of cases from 1975 to 2007.

Until the 1980s, chrysotile asbestos was a component of automotive brakes manufactured in the US. The current OSHA Bulletin (2006) for brake repair cites a single study (Lemen, 2004) which concluded that the number of mesothelioma cases reported in the literature in "end-product users of friction materials" indicated an asbestos-related risk for auto mechanics. However, Lemen (2004) did not compare the reported number of cases to an "expected" value, even though pleural mesothelioma occurs in the general population in the absence of asbestos exposure. We compare the number of malignant pleural mesothelioma (MPM) cases reported in the US literature among auto mechanics between 1975-2007 to an expected value derived from estimated numbers of current and former auto mechanics. A total of 106 cases categorized as mesothelioma or malignant neoplasm of the pleura were found in the literature. Using background incidence rates for MPM of two and three cases per million individuals per year, we estimated that a range of 278-515 cases of non-asbestos-related MPM, respectively, would have occurred in current or former auto mechanics from 1975-2007. Our findings are consistent with the numerous epidemiology studies that have found no increased risk of MPM in auto mechanics.

Re-analysis of Ranch Hand study supports reverse causation hypothesis between dioxin and diabetes.

A dose-response relationship between serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin) and adult diabetes risk has been reported among U.S. Vietnam veterans in the Ranch Hand (RH) cohort. We examine the hypothesis that diabetes progression leads to higher serum dioxin (reverse causation) rather than higher serum dioxin leading to diabetes (causation) across the longitudinal medical monitoring data on these airmen. Lipid-adjusted serum dioxin levels and clinical parameters relating to diabetes progression were examined. Potential confounding due to age, race, diabetes family history, serum total lipid, and body mass index (BMI) was accounted for. The similar incidence of diabetes in RH and Comparison veterans, along with generally similar incidence trends with dioxin decile and lipid decile despite the large differential in serum dioxin, is evidence consistent with reverse causation. Of 135 RH diabetics with at least two dioxin measurements, 32.6% had a temporary serum dioxin increase more than a decade after Vietnam tour and another 22.2% had an interval of unusually slow half-life (>15.5 years); these diabetes-related changes shifted more diabetics into the higher dioxin deciles. Further, the increased diabetes odds ratio among the generally younger RH veterans in the highest dioxin decile is associated with a higher incidence of adult obesity in this RH subgroup, both at tour of duty and decades later. Change in serum dioxin levels is likely due to diabetes progression or poor control and is not independently related to serum dioxin concentrations. In summary, the data from the Ranch Hand studies does not indicate that dioxin increases adult diabetes risk.

Perinatal exposure to low doses of dioxin can permanently impair human semen quality.

BACKGROUND: In recent decades, young men in some industrialized areas have reportedly experienced a decrease in semen quality. OBJECTIVE: We examined effects of perinatal dioxin exposure on sperm quality and reproductive hormones. METHODS: We investigated sperm quality and hormone concentrations in 39 sons (mean age, 22.5 years) born between 1977 and 1984 to mothers exposed to dioxin after the accident in Seveso, Italy (1976), and 58 comparisons (mean age, 24.6 years) born to mothers exposed only to background dioxin. Maternal dioxin levels at conception were extrapolated from the concentrations measured in 1976 serum samples. RESULTS: The 21 breast-fed sons whose exposed mothers had a median serum dioxin concentration as low as 19 ppt at conception had lower sperm concentration (36.3 vs. 86.3 million/mL; p = 0.002), total count (116.9 vs. 231.1; p = 0.02), progressive motility (35.8 vs. 44.2%; p = 0.03), and total motile count (38.7 vs. 98 million; p = 0.01) than did the 36 breast-fed comparisons. The 18 formula-fed exposed and the 22 formula-fed and 36 breast-fed comparisons (maternal dioxin background 10 ppt at conception) had no sperm-related differences. Follicle-stimulating hormone was higher in the breast-fed exposed group than in the breast-fed comparisons (4.1 vs. 2.63 IU/L; p = 0.03) or the formula-fed exposed (4.1 vs. 2.6 IU/L; p = 0.04), and inhibin B was lower (breast-fed exposed group, 70.2; breast-fed comparisons, 101.8 pg/mL, p = 0.01; formula-fed exposed, 99.9 pg/mL, p = 0.02). CONCLUSIONS: In utero and lactational exposure of children to relatively low dioxin doses can permanently reduce sperm quality.

Evaluation of bystander exposures to asbestos in occupational settings: a review of the literature and application of a simple eddy diffusion model.

This article presents a review of the publicly available information as it relates to airborne asbestos concentrations at varying distances from a source in an occupational environment. Personal and area samples collected 5-75 feet from the primary worker from workplace surveys conducted in the 1970s and area samples collected 5-50 feet from the primary worker during more recent simulation studies were identified, compiled, and analyzed. As expected, airborne asbestos concentrations generally decreased with distance from the worker who performed a given task. Based on this review, however, the authors found that no systematic research to quantitatively relate fiber concentration with distance from the source (including consideration of fiber length, dilution ventilation, and initial momentum of the particle) has been conducted to date. A simple mathematical model was therefore used, and the results were considered, along with available published data comparing exposure data for both workers and persons/areas near workers. From this analysis, the authors offer guidance for estimating airborne asbestos concentrations at distance from a source. Based on the available data and our modeling results, the authors propose the following approach as a rule of thumb: for persons 1-5 feet from the source, airborne asbestos concentrations can be roughly approximated at 50% of the source concentration; 35% at >5-10 feet, 10% for >10-30 feet, and less than 1% at distances greater than 30 feet. This approach should be helpful for bracketing the range of likely exposures to bystanders being evaluated in asbestos-related dose-reconstruction analyses.

Soil suspension/dispersion modeling methods for estimating health-based soil cleanup levels of hexavalent chromium at chromite ore processing residue sites.

The primary health concern associated with exposures to chromite ore processing residue (COPR)-affected soils is inhalation of hexavalent chromium [Cr(VI)] particulates. Site-specific soil alternative remediation standards (ARSs) are set using soil suspension and dispersion models to be protective of the theoretical excess cancer risk associated with inhalation of soil suspended by vehicle traffic and wind. The purpose of this study was to update a previous model comparison study that identified the 1995 AP-42 particulate emission model for vehicle traffic over unpaved roads and the Fugitive Dust Model (FDM) as the most appropriate model combination for estimating site-specific ARSs. Because the AP-42 model has been revised, we have updated our past evaluation. Specifically, the 2006 AP-42 particulate emissions model; the Industrial Source Complex-Short Term model, version 3 (ISCST3); and the American Meteorological Society/Environmental Protection Agency Regulatory Model (AERMOD) air dispersion models were evaluated, and the results were compared with those from the previously used modeling approaches. Two sites with and two sites without vehicle traffic were evaluated to determine if wind erosion is a significant source of emissions. For the two sites with vehicle traffic, both FDM and ISCST3 produced total suspended particulate (TSP) estimates that were, on average, within a factor of 2 of measured; whereas AERMOD produced estimates that were as much as 5-fold higher than measured. In general, the estimated TSP concentrations for FDM were higher than those for ISCST3. For airborne Cr(VI), the ISCST3 model produced estimates that were only 2- to 8-fold of the measured concentrations, and both FDM and AERMOD estimated airborne Cr(VI) concentrations that were approximately 4- to 14-fold higher than measured. Results using the 1995 AP-42 model were closer to measured than those from the 2006 AP-42 model. Wind erosion was an insignificant contributor to particulate emissions at COPR sites.

An adaptable internal dose model for risk assessment of dietary and soil dioxin exposures in young children.

An adaptable model is presented for assessing the blood lipid concentrations of polychlorodibenzodioxins and polychlorodibenzofurans (PCDD/Fs) from dietary (breast milk, formula, milk, and other foods) and soil pathway exposures (soil ingestion and dermal contact) utilizing age-specific exposure and intake estimates for young children. The approach includes a simple one-compartment (adipose volume) toxicokinetic model that incorporates empirical data on age-dependent half-lives and bioavailability of PCDD/F congeners, child body size and intake rates, and recent data on breast milk and food dioxin levels. Users can enter site-specific soil concentration data on 2,3,7,8-chlorinated PCDD/F congeners for specific assessment of body burden changes from soil pathways in combination with background dietary exposures from birth through age 7 years. The model produces a profile of the estimated PCDD/F concentration in blood lipid (in World Health Organization 1998 dioxin toxic equivalents) versus time for a child from birth through age 7 years. The peak and time-weighted average (TWA) internal dose (defined as blood lipid dioxin toxic equivalents) for a variety of specific child exposure assumptions can then be compared to safe internal dose benchmarks for risk assessment purposes, similar to an approach taken by United States Environmental Protection Agency for assessing child lead exposures. We conclude that this adaptable toxicokinetic model can provide a more comprehensive assessment of potential health risks of PCDD/Fs to children because it integrates recent empirical findings on PCDD/F kinetics in humans and allows users to assess contributions from varied dietary and site-specific environmental exposure assumptions.

Refinements on the age-dependent half-life model for estimating child body burdens of polychlorodibenzodioxins and dibenzofurans.

We modified our prior age-dependent half-life model to characterize the range of child (ages 0-7) body burdens associated with dietary and environmental exposure to polychlorodibenzodioxins and furans (PCDD/Fs). Several exposure scenarios were evaluated. Infants were assumed to be either breast-fed or formula-fed from birth to 6 months of age. They then received intakes of PCDD/Fs through age 7 from foods based on weighted means estimates [JECFA, 2001. Joint FAO/WHO Committee on Food Additives. Fifty-seventh meeting, Rome, June 5-14 , 2001, pp. 24-40], and with or without exposures (ingestion and dermal) to urban residential soils at 1ppb TCDD toxic equivalents (TEQ). A one-compartment (adipose volume) toxicokinetic model for TCDD described by Kreuzer [Kreuzer, P.F., Csanady, Gy.A., et al., 1997. 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) and congeners in infants. A toxicokinetic model of human lifetime body burden by TCDD with special emphasis on its uptake by nutrition. Arch. Toxicol. 71, 383-400] was expanded to include the key non-TCDD congeners in human breast milk and adipose tissues, and two model parameter refinements were examined: (1) use of updated and more detailed age-correlated body fat mass data [CDC, 2000. Centers for Disease Control. CDC Growth Charts: United States. Advance Data from Vital and Health Statistics of the Centers for Disease Control and Prevention, National Center for Health Statistics, Number 314, December 2000]; (2) use of breast milk PCDD/F concentration data from sampling completed in 2000-2003 [Wittsiepe, J., Fürst, P., et al., 2004. PCDD/F and dioxin-like PCB in human blood and milk from German mothers. Organohalogen Compd. 66, 2865-2872]. The updated body fat mass data nearly halved the predicted peak body burden for breast-feeding and lowered the time-weighted average (TWA) body burdens from ages 0-7 by 30-40% for breast-fed and formula-fed infants. Combined use of the updated breast milk PCDD/F concentration and body fat mass data increased the contribution of breast-feeding but reduced TWA body burdens from diet and soil. We conclude that further refinements are needed, but reliance on these better data sets for body fat mass and breast milk PCDD/F concentration significantly improves the model's ability to accurately predict body burdens during early childhood.

A methodology for estimating human exposure to perfluorooctanoic acid (PFOA): a retrospective exposure assessment of a community (1951-2003).

Perfluorooctanoic acid (PFOA) is a persistent chemical that was recently shown to be widely distributed in the ambient environment. Because of concerns about the possible adverse health effects on persons exposed to PFOA, a retrospective exposure assessment was conducted for a population of about 50,000 persons who reside near one of the facilities where this chemical was used. No similar study of any chemical with the properties of PFOA had ever been performed; thus, several novel methods were developed and applied in this analysis. Historical records of the emissions from the facility were the basis for the estimates of the potential intake of (PFOA) by residents over the past 53 yr. Various well-accepted environmental models were dynamically combined in order to estimate the concentrations in all relevant environmental media including ambient air, surface soil, drinking water, and homegrown vegetables. Following considerable analyses, particulate deposition from facility air emissions to soil and the subsequent transfer of the chemical through the soil was determined to be the most likely source of PFOA that was detected in groundwater. The highest off-site environmental concentrations were predicted to occur about 1 mile away. For this approximately square mile area, during the time period 1951-2003, the model-estimated average air concentration was 0.2 microg/m3, the estimated surface soil concentration was 11 microg/kg, and the estimated drinking water concentration was 4 microg/L. Similar data were generated for 20 additional geographical areas around the facility. Comparison of measured PFOA concentrations in groundwater in the various water districts indicated that the models appeared to overpredict recent groundwater concentrations by a factor of 3 to 5. The predicted historical lifetime and average daily estimates of PFOA intake by persons who lived within 5 miles of the plant over the past 50 yr were about 10,000-fold less than the intake of the chemical not considered as a health risk by an independent panel of scientists who recently studied PFOA.

The use of toxic equivalency factor distributions in probabilistic risk assessments for dioxins, furans, and PCBs.

Toxic equivalency factors (TEFs) for 2,3,7,8-substituted polychlorinated dibenzo-p-dioxins (PCDD) and dibenzofurans (PCDFs) and coplanar polychlorinated biphenyl (PCB) congeners have been developed by the World Health Organization (WHO). Each TEF was derived from a range of relative potency (REP) estimates obtained from in vivo and in vitro studies wherein the potency of the congener was evaluated relative to 2,3,7,8-TCDD (or some other appropriate benchmark). For most congeners, the range of REP values spans several orders of magnitude, and the degree of conservatism varies widely among the congeners. Although some TEFs are greater than the maximum REP value, others are less than the minimum. This suggests that the point estimate TEFs introduce a significant amount of variability and uncertainty into the PCB and PCDD/F risk assessment process. The use of REP data distributions, rather than point estimate TEFs, would permit a more informed evaluation of the variability and uncertainty in the attendant risk estimates. Further, a standardized method of choosing a TEF from an REP distribution would ensure a uniform degree of conservatism in the TEF values. In this analysis, distributions of REP values were derived for the coplanar PCBs and 2,3,7,8-substituted PCDD/Fs. There are 936 REP values in the WHO database; the number of values per congener ranges from 1 (1,2,3,7,8,9-HxCDF) to 117 (PCB126). Twenty REP values qualified by WHO as "<" were replaced with one-half the stated value; 65 values qualified as ">" were not used. Fit tests indicate that most distributions are lognormal. Mean, standard deviation, and 50th and 95th percentile values for each REP distribution are presented. In general, the WHO TEFs for the PCDD/Fs are at the upper bound (75th percentile or greater) of the underlying REP distributions, while the PCB TEFs tend to be more representative of the central tendency of the underlying REP distribution. A simplistic weighting scheme that emphasizes long-term in vivo studies suggests that the REP distributions may not be overly sensitive to weighting techniques--that is, the statistical descriptors of the weighted distributions were similar to those of the unweighted distributions. A case study using fish tissue PCB and PCDD/F data suggests that in some settings the use of WHO TEFs may understate upper bound PCB risks relative to PCDD/F risks. A preliminary sensitivity analysis suggests that measurement endpoint, tissue-type and species (or strain) may be significant contributors to the variability and heterogeneity in the underlying REP data for some congeners. Although there are fundamental shortcomings inherent in any TEF scheme, evidence suggests that some form of REP distributions should be used in lieu of or in addition to point estimate TEFs in settings where PCBs and PCDD/Fs are commingled.