Assessing airborne aflatoxin B1 during on-farm grain handling activities.

The presence of aflatoxin in corn and corn dust during relatively normal years and the increased risk of Aspergillus flavus infestation during drought conditions suggest that airborne agricultural exposures should be of considerable concern. Liquid extraction, thin layer chromatography, and high pressure liquid chromatography were used for the analysis of aflatoxin B1 in grain dust and bulk corn samples. A total of 24 samples of airborne dust were collected from 8 farms during harvest, 22 samples from 9 farms during animal feeding, and 14 sets of Andersen samples from 11 farms during bin cleaning. A total of 14 samples of settled dust and 18 samples of bulk corn were also collected and analyzed. The airborne concentration of aflatoxin B1 found in dust collected during harvest and grain unloading ranged from 0.04 to 92 ng/m3. Higher levels of aflatoxin B1 were found in the airborne dust samples collected from enclosed animal feeding buildings (5-421 ng/m3) and during bin cleaning (124-4849 ng/m3). Aflatoxin B1 up to 5100 ng/g were detected in settled dust collected from an enclosed animal feeding building; however, no apparent correlation was found between the airborne concentration of aflatoxin B1 and its concentration in settled dust or bulk corn. The data demonstrate that farmers and farm workers may be exposed to potentially hazardous concentrations of aflatoxin B1, particularly during bin cleaning and animal feeding in enclosed buildings.

Laboratory comparison of vacuum, OSHA, and HUD sampling methods for lead in household dust.

The goals of this project were to evaluate and compare the efficiency and reproducibility of three methods for sampling lead-containing dust in homes. Lead-containing dust was generated in a 1-m3 chamber and uniformly deposited onto surfaces typically found in the home (painted wood, unpainted wood, varnished wood, linoleum, and carpet). Trials with three levels of lead concentrations were performed for each surface. Replicate, side-by-side, surface samples were collected using the Occupational Safety and Health Administration (OSHA) wipe method, the Department of Housing and Urban Development (HUD) wipe method, and a vacuum-filter method. Samples were digested with nitric acid and analyzed using graphite furnace atomic absorption spectroscopy per National Institute of Occupational Safety and Health Method 7105. Recovery for the HUD method was consistently the highest on most surfaces (linoleum, 89.9 to 108.9%; painted wood, 71.2 to 153.7%; unpainted wood, 25.3 to 76.0%; varnished wood, 8.7 to 165.6%). On carpet the vacuum method had a significantly higher recovery (26.2 to 47.8%). For all sampling methods the percent recovery depended on type of surface and lead concentration. The reproducibility of percent recovery for the HUD (pooled coefficient of variation [CV] = 0.22) and OSHA (pooled CV = 0.27) methods was lower than that of the vacuum method (pooled CV = 0.46), though not statistically significant. Reproducibility for all methods did not vary significantly over surface type or lead concentration. Overall, the HUD method yielded the most accurate measurements, with recoveries closest to 100%. It was also more durable than the OSHA method, where Whatman filters were observed to tear.

Respiratory symptoms and lung function abnormalities among machine operators in automobile production.

This cross-sectional study was designed to assess differences in prevalence of respiratory symptoms and lung function between machine operators exposed to semisynthetic or soluble metal-working fluids (MWFs) and unexposed assemblers and to assess exposure-response relationships with MWF type, total aerosol, endotoxin, culturable bacteria and fungi. We evaluated 183 machine operators and 66 assemblers from one large automobile transmission plant using questionnaires, spirometry data, and cross-shift assessment of both lung function and respiratory symptoms. We found that airborne exposures to total aerosol, endotoxin, culturable bacteria and fungi were higher in machine operations than in the assembly area. There was a correlation between bulk and airborne culturable bacteria, but not between bulk and airborne culturable fungi. Machine operators had significantly more usual cough, usual phlegm, work-related chest tightness and post-shift symptoms of chest tightness, throat irritation, and cough compared with assemblers. We found exposure-response relationships between respiratory symptoms and total aerosol, as well as culturable fungi and bacteria. Associations with endotoxin were not strong or consistent, possibly because airborne levels were generally low. Cross-shift lung function decrements did not differ between machine operators and assemblers and there were no associations with MWF or specific exposures. The finding of respiratory symptoms at low levels of exposure in this study suggests the need to re-assess total aerosol thresholds. Associations between airborne fungal exposures and respiratory symptoms need further study to characterize sources of exposure other than MWF in machining operations.

The utility of preliminary surveys to detect the cause of acute metalworking fluid hazards.

This paper describes preliminary studies undertaken to optimize a later epidemiologic study, the aim of which was to identify a causative agent of adverse respiratory effects and dermatitis among production machinists. Two methods were used to rate coolant system hazards. The results of a voluntary plantwide questionnaire with an 18% participation rate showed that both dermatologic and respiratory symptoms were higher among machine operators than among maintenance or assembly workers, that symptoms were not more prevalent early in the week, and that dermatitis may be associated with smoking status; however, the questionnaire was not helpful in rating individual coolant system hazards. The hazard ratings provided by an in-plant expert panel were strongly associated with particular synthetic coolant containing an ethoxylated phenol; however, the resulting design for a later epidemiologic study could not be implemented due to changes in coolants used at the plant.

Dermatitis among automobile production machine operators exposed to metal-working fluids.

This cross-sectional study was designed to assess differences in prevalence of contact dermatitis between machine operators exposed to metal-working fluids (MWFs) and unexposed assemblers, and to assess potential risk factors for contact dermatitis among these machine operators. In their work, machine operators were exposed to either semisynthetic or soluble oil MWFs. We evaluated 158 machine operators and 51 assemblers from one large automobile transmission plant using questionnaires, dermatologist examination of the skin, and dermal dosimetry to measure wetness and metal exposures. We found that machine operators had more combined (definite plus possible) dermatitis (27.2% vs. 13.7%, chi(2) = 3.9, p = 0.05, 1 df) compared with assemblers. Among machine operators, risk factors significantly associated with (combined) dermatitis were subjective assessment of wetness of the work, exposure to semisynthetic as opposed to soluble oil MWF, current cigarette smoking, and increasing worker age. These risk factors suggested preventive and control measures including control of wet work, surveillance program including early self-report of dermatitis, consideration of replacement of semisynthetic with soluble oil MWFs, and strictly limiting smoking among machine operators exposed to MWFs.

Aflatoxin B1 in common Egyptian foods.

Samples of common Egyptian foods (17 nuts and seeds, 10 spices, 31 herbs and medicinal plants, 12 dried vegetables, and 28 cereal grains) were collected from markets in Cairo and Giza. A portion of each sample was extracted with chloroform, and the concentrated extract was cleaned by passing through a silica gel column. Aflatoxin B1 was determined by reversed-phase liquid chromatography with UV detection. The highest prevalence of aflatoxin B1 was in nuts and seeds (82%), followed by spices (40%), herbs and medicinal plants (29%), dried vegetables (25%), and cereal grains (21%). The highest mean concentration of aflatoxin B1 was in herb and medicinal plants (49 ppb), followed by cereals (36 ppb), spices (25 ppb), nuts and seeds (24 ppb), and dried vegetables (20 ppb). Among nuts and seeds, the prevalence of aflatoxin B1 was highest (100%) in watermelon seeds, inshell peanuts, and unshelled peanuts. The lowest prevalence and concentrations were in hommos (garbanzo beans). The highest concentrations of aflatoxin B1 were detected in foods that had no potential for field contamination but required drying during processing and storage, such as pomegranate peel, watermelon seeds, and molokhia.

Longitudinal evaluation of dose-response relationships for environmental exposures and pulmonary function in swine production workers.

Studies describing respiratory health hazards for workers in swine production facilities have been published in the United States, Sweden, Canada, the Netherlands, and Denmark. Up to 50% of these workers experience bronchitis, organic dust toxic syndrome, hyper-reactive airways disease, chronic mucous membrane irritation, and other respiratory effects. These studies clearly point to the fact that this occupational environment poses a significant health risk hazard, and that control methods are needed to protect the worker. Before precise control strategies can be developed, implemented, and evaluated, dose-response studies are required to determine acceptable target levels for exposure. A previous manuscript described the development of multiple regression equations characterizing the relationships between environmental exposures and pulmonary response in a cohort of 207 swine producers. Baseline pulmonary function was included as a significant predictor of cross-shift decrements in pulmonary function in addition to personal measurements of dust, endotoxin, and ammonia concentrations. These equations were then used to predict specific exposure levels of dust and ammonia that could be expected to elicit significant decrements in cross-shift pulmonary function. This paper presents the results from analysis of follow-up data obtained on this same cohort 2 years after the initial measurements. At the second measurement period of the study (time-2), swine workers were found to have a mean cross-shift decrease in FEV1 of 2%. Cross-shift change in FEV1 was significantly correlated with personal exposures to total dust, total endotoxin, respirable endotoxin, and ammonia. The magnitude of the decrease in FEV1 was associated with increasing airborne concentrations of these environmental parameters thus confirming the dose-response relationship observed in the initial study (time-1). The correlation of dust with FEV1 changes in workers with more than 6 years of exposure (time-1 data) and more than 10 years of exposure (time-2 data) suggests that dust exposure is an important factor in chronic respiratory disease. Additionally, the correlation of endotoxins with FEV1 changes in the group with less than 6 years exposure (time-2 data) suggests endotoxins may have more significance for subacute respiratory effects. The agreement between observed cross-shift FEV1 changes measured in time-2 with changes predicted using regression equations derived from time-1 data demonstrates a consistent dose-response relationship over time for this cohort of swine production workers. This finding provides further support for conclusions of the previous study that levels of 2.5 mg/m3 (total dust) and 7.5 ppm (ammonia) are reasonable guidelines for occupational exposure limits in this environment.

Exposures while applying commercial disinfectants.

Measurements were made on 40 applicators applying chemical disinfectants to floors, walls, other hard surfaces, or carpeting by high-pressure spray, low-pressure spray, mopping, wiping, or aerosol spray. Inhalation exposure was assessed with air samples. Clothing and skin deposition was assessed with dermal gauze dosimeters attached both outside applicators' work clothing and inside their clothing against their skin. As is typical of agricultural pesticide applications, the airborne route of exposure was very low, usually below the chemical limit of detection. The primary route of exposure and dosing was to the skin. The normal work clothing worn by applicators consistently reduced clothing deposition to lower values reaching the skin. The effects of chemical detection limits and short use durations caused the analyte on many individual dosimeters to be below the method detection limit. Mean measured total dose of the active ingredient onto the skin (ranging from 0.1 to 26 mg per task) was converted to equivalent dose of the applied mixture (ranging from 0.1 to 2.7 g) to adjust for widely varying disinfectant concentrations. A discussion is also presented on the serious limitations of applying the assumption that undetectable samples are "one-half the detection limit" to a study of this nature where results are the sum of multiple measurements.

Exposure while applying industrial antimicrobial pesticides.

Forty-three assessments were made of dermal and/or inhalation chemical exposure while applying industrial antimicrobial pesticide products, either by manually pouring or pumping liquids or by pouring a solid (powder or flake) product. Inhalation exposure was assessed via a personal air sample but was usually below the chemical limit of detection. Dermal exposure outside work clothing and dermal deposition inside the clothing was assessed via dermal gauze dosimeters. While dosimeters at discrete body locations often received exposures below the limit of detection, one or more dosimeters on individual applicators almost always showed measurable exposure. The median measured dose was between 30% and 70% of the maximum credible summed dose calculated by assuming that each dosimeter showed either the level of measurable deposition or one-half of the detection limit at locations where the chemical was unmeasurable. Because of differences in settings and the low level of control implicit in these application processes, measurable dermal doses were highly variable. Mean measurable dose rates were near 3, 8, and 10 mg product/hr, and daily total deposited doses were 2, 3.5, and 5 mg of product for pouring and pumping liquids and for pouring solids, respectively. Although the effect of gloves cannot be directly determined, wearers of gloves had geometric mean hand total doses 155- to 290-fold less than those not wearing gloves. Similar to the statistics for agricultural pesticides, the dermal route of exposure for these industrial pesticides exceeds the inhalation route by 5X to 100X, depending on assumptions regarding nondetectable values.

Respiratory dysfunction in swine production facility workers: dose-response relationships of environmental exposures and pulmonary function.

Human respiratory health hazards for people working in livestock confinement buildings have been recognized since 1974. However, before comprehensive control programs can be implemented, more knowledge is needed of specific hazardous substances present in the air of these buildings, and at what concentrations they are harmful. Therefore, a medical epidemiological and exposure-response study was conducted on 207 swine producers using intensive housing systems (108 farms). Dose-response relationships between pulmonary function and exposures are reported here. Positive correlations were seen between change in pulmonary function over a work period and exposure to total dust, respirable dust, ammonia, respirable endotoxin, and the interactions of age-of-producer and dust exposure and years-of-working-in-the-facility and dust exposure. Relationships between baseline pulmonary function and exposures were not strong and therefore, not pursued in this study. The correlations between exposure and response were stronger after 6 years of exposure. Multiple regression models were used to identify total dust and ammonia as the two primary environmental predictors of pulmonary function decrements over a work period. The regression models were then used to determine exposure concentrations related to pulmonary function decrements suggestive of a health hazard. Total dust concentrations > or = 2.8 mg/m3 were predictive of a work period decrement of > or = 10% in FEV1. Ammonia concentrations of > or = 7.5 ppm were predictive of a > or = 3% work period decrement in FEV1. These predictive concentrations were similar to a previous dose-response study, which suggested 2.5 mg/m3 of total dust and 7 ppm of NH3 were associated with significant work period decrements. Therefore, dust > or = 2.8 mg/m3 and ammonia > or = 7.5 ppm should be considered reasonable evidence for guidelines regarding hazardous exposure concentrations in this work environment.

Determinants of longitudinal changes in spirometric function among swine confinement operators and farmers.

To assess whether working in a swine confinement facility causes an excess or accelerated decline in lung function, we conducted a population-based study to evaluate the determinants of longitudinal changes in airflow in a population of swine confinement operators. Spirometric measures of lung function were compared between swine confinement operators (N = 168) and neighborhood farmer control subjects (N = 127). Study subjects were randomly selected from a cohort of swine confinement operators in eastern Iowa. The control farming population was matched by geographic location, age, and sex to the swine confinement operators. On average, the follow-up time was approximately 2 yr, with a range of follow-up between 56 and 1,900 d. Although swine confinement operators and neighborhood farmers had similar demographic characteristics (age, gender, racial background, smoking history, and atopy status), swine confinement operators tended to have less farming experience and were more extensively followed (more measures of lung function and longer periods of observation) than the neighborhood farmer control group. Swine confinement operators were also exposed to higher environmental dust concentrations and other irritants than the farmer control subjects. Interestingly, the cross-sectional data indicated that swine confinement operators tended to have slightly lower measures of airflow and greater workshift declines in forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and mid-expiratory flow (FEF25-75) than the neighborhood farmer control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Reentry field data and conclusions.

A review of the reported foliar residue data has revealed a number of deficiencies in the reentry intervals currently regulated, in particular, by the EPA and some by California. Deficiencies were also identified in the available information necessary to recommend better reentry intervals. Information regarding the frequency of exposure for individual or groups of harvesters is the most fundamental deficiency. It is needed to define a more realistic chronic criterion of allowable daily cholinesterase inhibition without cumulative symptoms. The second criterion of preventing acute overexposure is more readily defined. For the purposes of this study, the criteria of 4% mean daily inhibition and 50% acute inhibition were chosen as acceptable. Based on these criteria, the available data, and by using the unified field model assessment as the basis for comparison (Table 9), EPA reentry intervals for nine insecticides in Table 4 appear inadequate (i.e., not within the range of the model recommendations); 10 are adequate; and only one appears excessive as summarized in Table 10. A similar comparison of California's reentry intervals indicates only two may be inadequate or marginal; 13 are adequate; and five may be excessive. Although these conclusions are based on a considerable amount of residue data, the data are not equally distributed among all pesticides nor has the model been confirmed in all the cropping and harvest conditions examined. However, the model has been developed under realistic field tests, most of its premises have been confirmed in a limited number of tests, and its simulated predictions appear to parallel experience in California where pesticide use and decay conditions may have been most severe but recently well scrutinized. The model's recommendations largely substantiate the regulations developed in California. However, its conclusions definitely suggest that improved levels of protection are needed in other regions. Future reentry intervals will require more comprehensive residue data. The toxicities of detectable metabolites for a few insecticides will need to be determined. More crop residue dosing coefficients are also needed for manually harvested crops. These data must be interpreted in terms of the potential both for acute poisoning from variable residues and for chronic poisoning from repeated exposure to more consistent residues. Surveys of the temporal exposure patterns of harvesters or crews of harvesters are vital to assess the cumulative effects and set the most appropriate chronic cholinesterase response limits. While we await further data, there is sufficient information now to justify longer reentry intervals to protect harvesters nationally.

Preventing respiratory disease in swine confinement workers: intervention through applied epidemiology, education, and consultation.

A combined epidemiological and intervention study was conducted on 207 swine confinement farmers with matched comparison subjects. The objectives of the study were to define, in detail, the nature and disease determinants in this exposed group and to explore methods of disease prevention. This 5 year prospective study included three annual medical assessments of workers and complementary work environment assessments. Between the first and second assessment periods, an in-depth educational intervention was conducted. An industrial hygiene consultation intervention was conducted between the second and third measurement periods. Outcome measurements included changes in knowledge, attitudes, and behavior following educational intervention. Additionally, the outcomes measured included changes in medical and environmental assessment over the 3 year assessment periods. Results of the baseline respiratory symptoms assessment are reported here. Nearly 20% of swine confinement workers reported chronic cough, and 25% reported phlegm (American Thoracic Society questionnaire). Both symptoms were significantly more prevalent in the confinement workers compared to a blue collar comparison group, but only phlegm production was more prevalent compared to nonconfinement farmers. Work-related symptoms were reported much more frequently than chronic symptoms (e.g., 87% of confinement workers reported work-related cough). Bronchitis as well as airways reactivity were all significantly more prevalent in confinement workers compared to nonconfinement workers. Smoking seemed to have an additive effect with confinement exposure. Bronchitis and chest tightness symptoms were reported to be more severe upon return to work after an absence of 7 days or more. Finally, 34% of workers reported episodes of organic dust toxic syndrome.

Effects of organophosphate insecticide residue variability on reentry intervals.

A stochastic simulation program was written to study the importance of residue variability in predicting excessive chronic (seasonal) cholinesterase (AChE) inhibition and acute illness among a cohort of agricultural harvesters grouped into crews exposed to AChE-inhibiting insecticides. It was concluded that residue variability can substantially affect the cohort's AChE level only for daily mean AChE inhibitions below 4% per day, increasing end-of-season mean AChE inhibition but actually decreasing the cohort's end-of-season variability. The incidence of acute individual and group (crew) AChE inhibitions in excess of that potentially producing clinical symptoms (assumed herein to be greater than 50% in a day), exhibits a fairly clear boundary as a function of a combination of the residue's mean and deviation. The predicted acute response accurately parallelled reported rates, thus validating the simulation model.

A method for monitoring dermal exposure to volatile chemicals.

Absorptive pads of charcoal cloth were developed and tested for monitoring the deposition of volatile toxic materials on skin. The dosimeters can retain over 60% of volatile deposits such as toluene or dichloropropene droplets over an 8-hr workday. Evaporation from liquid deposits and vapor adsorption onto the dosimeters are factors which can complicate the interpretation of exposure data. Evaporation was inversely proportional to the log of the deposit size (volume), vapor pressure, and the air humidity. Vapor adsorption was proportional to the vapor concentration, exposure duration, and the log of air velocity. A procedure is offered for estimating the initial size of the liquid deposit from retained mass. The charcoal cloth dosimeter's accuracy and precision are optimal in situations involving possible dermal exposure to toxic materials with low to moderate volatility or with low vapor concentration, i.e., those where dermal exposure may be equal to or more significant than respiratory exposure.

Characterization of dusts collected from swine confinement buildings.

As part of a project to evaluate health hazards for workers in swine confinement buildings, the air in 21 different buildings was sampled with 37 mm cassette filters with and without cyclone preselectors and with cascade impactors. Filter results yielded a mean total aerosol of 6.3 mg/m3, a mean respirable aerosol of 0.5 mg/m3; the geometric mean diameter was 2.9 microns. Cascade impactor measurements revealed a mean total aerosol of 7.6 mg/m3, a respirable aerosol of 2.5 mg/m3 and a mass median diameter of 9.6 microns. The two major constituents in these aerosols were grain particles and dried fecal matter. The grain particles were larger than fecal particles and proportionately more abundant in finishing buildings where 50 kg X 100 kg animals are housed. Therefore the respirable fraction was less in finishing buildings than in farrowing and nursery buildings. Culturing of settled dusts yielded six different mold species, with the highest counts for Verticillium sp. (5 X 10(2) cfu/mg dry dust) grown at 37 degrees C. Thermophilic Actinomycetes and both gram negative and gram positive bacteria were isolated. Azocasein proteinase activity was found in most dust samples analyzed. This dust had a protein content of about 23% and a mean adsorbed ammonia content of 0.4%.

The delivery of therapeutic aerosols through endotracheal tubes.

We used an in vitro model system to examine the sites of deposition of aqueous therapeutic aerosols administered through 3-mm, 6-mm, and 9-mm endotracheal tubes (commonly used in infants, children, and adults) at clinically relevant inspiratory flow rates. Aerosol was delivered to the endotracheal tube via a "T" piece and a 90 degree elbow. Aerosol exiting the endotracheal tube passed through an appropriately sized Plexiglas model of the trachea and mainstem bronchi, and then into an 80-liter bag. Aerosol deposited in the "T" and elbow, endotracheal tube, large airway model, and collection bag was quantitated separately using 0.1% uranine as a tracer. Study of a conventional aerosol typical of those in common clinical use (aerodynamic mass median diameter = 3.95 microns) showed that most of the aerosol delivered into each endotracheal tube was deposited before leaving the mainstem bronchi. Substitution of an alternative nebulizer that produced a much smaller aerosol particle size (aerodynamic mass median diameter = 0.54 micron) dramatically decreased aerosol deposition in the "T" and elbow, endotracheal tube, and large airway model, and increased the quantity of aerosol penetrating beyond the mainstem bronchi up to ninefold. The mass median particle diameter of the conventional aerosol was reduced during endotracheal tube and large airway passage by poorly defined aerodynamic mechanisms that selectively removed larger particles. The smaller submicron aerosol was not similarly affected. Thus, conventional therapeutic aerosols appear to penetrate poorly through endotracheal tubes. Use of smaller particle size aerosols in treatment of intubated patients may be an effective way to circumvent this problem.

Health effects of organic dusts in the farm environment. Report on agents.

Recommendations were formulated on sampling strategies and characteristics of different sampling methods. Microbiological products, such as endotoxins and proteases were suggested to be included apart from traditional dust measurements. It was recommended that priority should be given to establishing dose-response relationships and that the importance of anaerobic organisms be evaluated. A summary of components within organic dust suspected of contributing to respiratory disease was presented.