Abstract: To examine the risk of sleep problems associated with work stress (job strain, job demands, and decision authority), worries and pain and to investigate the synergistic interaction between these factors and traffic noise.
Abstract: Background: The knowledge about air pollution effects on birth weight, prematurity and small for gestational age [SGA] in low-exposure areas is insufficient. Objectives: The aim of this birth cohort study was to investigate if low-level exposure to air pollution was associated with prematurity and foetal growth and if there are gender specific effects. Method: We combined high quality registry information on 81110 births with individually modeled exposure data at residence for nitrogen oxides [NOx] and proximity to roads with differing traffic density. The data were analyzed by using logistic and linear regression with and without potential confounders. Results: An increased risk for babies being SGA was observed when highest and lowest NOx quartiles were compared, adjusting for maternal age, smoking, gender and year of birth. After additional adjustment for maternal country of origin and parity (which were highly intercorrelated), the increase was no longer statistically significant. However, in subgroup analysis when highest and lowest NOx quartiles were compared, there was still an increased risk for SGA for baby girls Odds Ratio [OR] 1.12 (95% Confidence Interval [CI] 1.01, 1.24), and also if mothers had not changed residency during pregnancy OR 1.09 (95% CI 1.01, 1.18). The confounders with the greatest impact on SGA were parity and country of origin. Concerning prematurity, the prevalence was lower in the three higher NOx exposure quartiles compared to the lowest category. Conclusion: For future studies on air pollution effects on birth outcomes careful control of confounding is crucial.
Abstract: End-stage kidney disease overwhelms health services in Central America. We determined prevalences of decreased kidney function in distinct populations in the most affected region of Nicaragua.
Abstract: Short-term exposure to high levels of air pollution can increase stroke risk. In this study we investigated the short-term effects of air pollution on hospital admissions for stroke in a setting where pollutant levels are rather low. We also addressed methodological issues in evaluating the short-term effects of air pollution.
Abstract: The objective of the present study was to integrate the relative risk from mercury exposure to stream biota, groundwater, and humans in the RÃo Artiguas (Sucio) river basin, Nicaragua, where local gold mining occurs. A hazard quotient was used as a common exchange rate in probabilistic estimations of exposure and effects by means of Monte Carlo simulations. The endpoint for stream organisms was the lethal no-observed-effect concentration (NOECs), for groundwater the WHO guideline and the inhibitory Hg concentrations in bacteria (IC), and for humans the tolerable daily intake (TDI) and the benchmark dose level with an uncertainty factor of 10 (BMDLs(0.1)). Macroinvertebrates and fish in the contaminated river are faced with a higher risk to suffer from exposure to Hg than humans eating contaminated fish and bacteria living in the groundwater. The river sediment is the most hazardous source for the macroinvertebrates, and macroinvertebrates make up the highest risk for fish. The distribution of body concentrations of Hg in fish in the mining areas of the basin may exceed the distribution of endpoint values with close to 100% probability. Similarly, the Hg concentration in cord blood of humans feeding on fish from the river was predicted to exceed the BMDLs(0.1) with about 10% probability. Most of the risk to the groundwater quality is confined to the vicinity of the gold refining plants and along the river, with a probability of about 20% to exceed the guideline value.
Abstract: Humans, independent on where they live, are exposed to complex and various mixtures of chemicals, including persistent organic pollutants (POPs). The variability of the exposure depends on sources of the chemicals and is influenced by e.g. geography, social and cultural heritage. While exposures to POPs are frequently studied in populations from developed industrial countries, very little is known on levels and trends of POPs in developing countries, especially in Africa.
Abstract: Background: The aim was to investigate whether the effects of major risk factors for ischemic stroke were modified by long-term exposure to air pollution in Scania, southern Sweden. Methods: Cases were defined as first-ever ischemic strokes in patients born between 1923 and 1965 during 2001-2006 (n = 7,244). Data were collected from The Swedish National Stroke Register (Riks-stroke) and the Malmö and Lund Stroke Registers. Population controls were matched on age and sex. Modeled outdoor annual mean NO(x) concentrations were used as proxy for long-term exposure to air pollution. Heterogeneity across NO(x) categories was tested for smoking, hypertension, diabetes mellitus, atrial fibrillation and physical inactivity. Data were analyzed as case-control data and to some extent as case-only data, with logistic regression analysis. Results: The case-control odds ratios for ischemic stroke in association with diabetes were 1.3 [95% confidence interval (CI): 1.1-1.6] and 2.0 (95% CI: 1.2-3.4) in the lowest and highest NO(x) category, respectively (p value for testing heterogeneity across the categories = 0.056). The case-only approach gave further support for the risk associated with diabetes to increase with NO(x) (p for trend = 0.033). We observed no main effect of mean NO(x) or any conclusive effect modifications between NO(x) and smoking, hypertension, atrial fibrillation or physical inactivity. Conclusions: In a low-level air pollution area, the risk for ischemic stroke associated with diabetes seemed to increase with long-term exposure to air pollution.
Abstract: Most epidemiologic studies use traffic at residential address as a surrogate for total traffic exposure when investigating effects of traffic on respiratory health. This study used GIS (Geographical Information Systems) to estimate traffic exposure, not only on residential, but also on workplace address, in addition to survey questions on time spent in traffic during commuting or other daily activities.The aim was to investigate 1) if there is an association between traffic exposure and prevalence of adult asthma and asthma symptoms, and 2) if so, does this association become stronger using more complete traffic exposure information.
Abstract: There is growing evidence that air pollution from traffic has adverse long-term effects on chronic respiratory disease in children, but there are few studies and more inconclusive results in adults. We examined associations between residential traffic and asthma and COPD in adults in southern Sweden. A postal questionnaire in 2000 (n = 9319, 18-77 years) provided disease status, and self-reported exposure to traffic. A Geographical Information System (GIS) was used to link geocoded residential addresses to a Swedish road database and an emission database for NOx.
Abstract: There is conflicting evidence that traffic-related air pollution is a risk factor for allergic conditions. Few studies have investigated this in adults. In adults, a high proportion of asthma, rhinitis and eczema is triggered by non-allergic factors. We investigated traffic as a risk factor for allergic versus non-allergic asthma and rhinitis, and eczema, in adults. A questionnaire from 2000 (n = 9319, 18-77 years) provided individual data about disease outcome and self-reported traffic exposure. Additional exposure assessments were obtained using Geographical Informations Systems (GIS). Residential addresses were linked to the national Swedish Road Database and to a pollutant database with modelled annual means of NOx (Nitrogen Oxids).
Abstract: Long-term exposure to air pollution is a hypothesized risk factor for ischemic stroke. In a large case-control study with a complete study base, we investigated whether hospital admissions for ischemic stroke were associated with residential concentrations of outdoor NOx, as a proxy for exposure to air pollution, in the region of Scania, Southern Sweden.
Abstract: Our aim was to investigate exposure to polybrominated diphenyl ethers (PBDEs) in a young urban population in a developing country, with focus on potentially highly exposed children working informally as scrap scavengers at a large municipal waste disposal site. We also set out to investigate whether hydroxylated metabolites, which not hitherto have been found retained in humans, could be detected.
Abstract: Commercial aircrafts need a high degree of fire protection for passenger safety. Brominated flame retardants (BFRs), including polybrominated diphenyl ethers (PBDEs), may be used for this purpose. Because PBDEs readily absorb to dust particles, aircraft crew and passengers may receive significant PBDEs exposure via inhalation. The aims of this work were to assess whether PBDEs could be found in aircraft cabin dust and whether serum levels of PBDEs increased in passengers after long-distance flights. Hence nine subjects on intercontinental flights collected cabin dust samples, as well as donated blood samples before departure and after return to Sweden. Two subjects who were domestic frequent flyers were also investigated. The levels of PBDEs in dust and serum were determined by GC/MS in electron capture negative ionization (ECNI) mode. Authentic reference substances were used for identification and quantitation. PBDEs were found in all aircraft dust samples at high concentrations, higher than in common household dust. Congener patterns indicated that the technical products PentaBDE, OctaBDE and DecaBDE were used in the aircrafts. Serum concentrations in the travellers were similar to those observed in Swedish residents in general. Post-travel serum levels of BDE-28, BDE-99, BDE-100, BDE-153, and BDE-154 were significantly higher (p<0.05) than concentrations prior to travel. The findings from this pilot study call for investigations of occupational exposures to PBDEs in cabin and cockpit crews.
Abstract: Many nitrosamines are suspected of being human carcinogens, with the highest concentrations in the environment being measured in the rubber industry. Time trends of personal exposure to N-nitrosodimethylamine (NDMA) and to N-nitrosomorpholine (NMor) during the past two decades in the German rubber industry were analysed and compared with cross-sectional studies in the same period in the Netherlands, Poland, the UK and Sweden. In the majority of the surveyed departments exposures reduced over time, but considerable heterogeneity was present between departments and sectors. Significant reductions were primarily found in curing and post-treating departments and ranged from -3% year(-1) to -19% year(-1). In contrast, NDMA levels increased (+13% year(-1)) in maintenance and engineering in the tyres industry. Average NDMA-levels in general rubber goods (GRG) and NMor-levels in tyre production in Germany did not decrease significantly in the past two decades, whereas NDMA-levels in tyre production (-10% year(-1)) and NMor-levels in GRG (-7% year(-1)) declined significantly after the introduction of an exposure limit for total nitrosamines in Germany in 1988. Confidence intervals of average exposures in other studied countries largely overlap trends observed in Germany. Exposure to N-nitrosamines decreased on average two-to-five fold in the German rubber industry with comparable concentration levels in other European countries. Although average levels are well below the current limits exposure has not been eliminated, and incidental high exposures do still occur.
Abstract: We examined to what degree annoyance ratings to noise, air pollution and other common environmental factors in the home environment could be considered to mirror personality disposition in terms of habitual anxiety level and, when appropriate, objectively modeled noise and nitrogen emission (NOx).
Abstract: The aim of the present study was to model apparent serum half-lives of polybrominated diphenyl ethers (PBDEs) with 7-10 bromine substituents. Workers with occupational exposure to PBDEs have elevated serum levels of PBDEs, but these substances are also found in the general population and are ubiquitous environmental contaminants. The calculations were based on exposure assessments of rubber workers (manufactured flame-retarded rubber compound) and electronics dismantlers who donated blood during a period with no work-related exposures to PBDEs, and referents without any known occupational exposure (clerks, cleaners, and abattoir workers). The workers had previously been found to have elevated levels of high- and medium-brominated diphenyl ethers compared with the referent populations. We performed nonlinear mixed-effects modeling of kinetics, using data from previous and present chemical analyses. The calculated apparent half-life for decabromodiphenyl ether (BDE-209) was 15 days (95% confidence interval, 11-18 days). The three nona-BDEs and four octa-BDE congeners were found to have half-lives of 18-39 and 37-91 days, respectively. BDE-209 has a short half-life in human blood. Because BDE-209 is commonly present in humans in general, the results of this study imply that humans must be more or less continuously exposed to BDE-209 to sustain the serum concentrations observed. BDE-209 is more readily transformed and/or eliminated than are lower brominated diphenyl ether congeners, and human health risk must be assessed accordingly.
Abstract: Several studies have been done in Europe to evaluate exposure to dust and fumes in the rubber industry. However, different aerosol sampling devices have been used which perform differently depending on the environmental conditions and particle size distribution. To compare measurements of rubber dust and fumes among countries and surveys we initiated a field comparison of personal inhalable samplers using a novel reference inhalable aerosol sampler (CALTOOL). Measurements were done in four factories in the Netherlands, Sweden, Poland and Germany in the mixing and milling and curing department. The Seven-hole sampler, PAS-6 sampler, Millipore (25 and 37 mm) cassette, IOM sampler and a Polish sampler were mounted on the reference CALTOOL device and used simultaneously. All samplers except the IOM sampler under-sampled inhalable dust. To compare measurements from different studies and countries, correction factors should be applied to all but the IOM sampler, which was the only sampler that performed similar to the CALTOOL sampler.
Abstract: Workers at an electronics recycling plant have previously been shown to have elevated serum levels of polybrominated diphenyl ethers (PBDEs) compared to referents without occupational PBDE exposure. Subsequent structural changes and industrial hygiene measures at the plant were applied to improve the work environment. The present study aims to assess the impact of these work environment changes on the occupational exposure to PBDEs. Blood were drawn from the workers and analyzed at two different laboratories, and serum concentrations of several PBDE congeners were determined by GC/MS or GC/HRMS. Cross-sectional studies were performed prior to (in 1997; N=19) and after (in 2000; N=27) workplace improvements. Longitudinal studies were performed on twelve of the workers that were sampled at both occasions. Even though the amount of processed goods had doubled in 2000 as compared to 1997, there was a significant decrease in the serum levels of BDE-183 and BDE-209. For BDE-209 the levels observed in year 2000 were even lower than in referents with no occupational exposure. In contrast to the decrease of higher brominated diphenyl ethers, the concentrations of BDE-47 did not significantly change. For BDE-153, the cross-sectional study indicated no change, whereas the longitudinal follow up indicated a significant increase. This study shows that the industrial hygiene improvements clearly reduced the occupational exposure to BDE-183 and BDE-209 at the plant. Still, the levels of hexa- to nonaBDEs but not BDE-209 were elevated, compared to referents with no occupational exposure.
Abstract: The aim of this study was to assess persistent organochlorine pollutant (POP) levels in serum collected from children (11-15 years old) working and sometimes also living at the municipal waste-disposal site in Managua, located at the shore of Lake Managua, and in nonworking children living both nearby and also far away from the waste-disposal site. The influence of fish consumption was further evaluated by assessing POPs levels in serum from young women (15-24 years old) with markedly different patterns of fish consumption from Lake Managua. 2,2-bis(4-chlorophenyl)-1,1,1-trichloro-ethane (4,4'-DDT) and 2,2-bis(4-chlorophenyl)-1,1-dichloro-ethene (4,4'-DDE), gamma-hexachlorocyclohexane (gamma-HCH), polychlorinated biphenyls, pentachlorophenol, and polychlorobiphenylols were quantified in all samples. In general, the levels observed were higher than those reported in children from developed countries, such as Germany and United States. Toxaphene, aldrin, dieldrin, and beta-HCH could not be identified in any sample. The children working at the waste-disposal site had higher levels of POPs compared with the nonworking reference groups. In children not working, there were also gradients for several POPs, according to vicinity to the waste-disposal site. Moreover, in children, as well as in young women, there were gradients according to fish consumption. The most abundant component was 4,4'-DDE, but at levels still lower than those reported in children from malarious areas with a history of recent or current application of 4,4'-DDT for vector control.
Abstract: Commercial decabromodiphenyl ether (DecaBDE) is commonly used as a flame retardant in different electrical and textile applications. It is also used in the production of flame-retarded rubber compound. DecaBDE is the major technical polybrominated diphenyl ether (PBDE) in use today and consists mainly of decabromodiphenyl ether (BDE-209). PBDEs, including BDE-209, are well-known environmental pollutants, ubiquitous both in aquatic and terrestrial environments. The aim of the present study was to assess the exposure to PBDEs in workers manufacturing or handling rubber which was flame retarded with DecaBDE. A referent group, abattoir workers (slaughterhouse workers), with no occupational exposure to PBDEs, was also investigated. Moreover, the methodology for analysis of PBDEs in serum was refined, with special emphasis on congeners with a high number of bromine substituents, i.e., octa- to decaBDEs. The highest BDE-209 concentration observed among the rubber workers was 280 pmol/g lipid weight (I.w.) (270 ng/g I.w.). The median concentration of BDE-209 among rubber workers was 37 pmol/g I.w. (35 ng/g I.w.). Among referents, the median was 2.5 (range 0.92-9.7) pmol/g I.w. (median 2.4 ng/g I.w.). In rubber workers the BDE-209 concentrations were up to 32% (median 4%) of the 2,2',4,4',5,5'-chlorobiphenyl (CB-153) concentrations, on a molar basis, whereas the referents had BDE-209 concentrations which were similar to that of 2,2',4,4'-bromodiphenyl ether (BDE-47), below 1.4% (median 0.3%) of the CB-153 concentration. Concentrations of all nonabromodiphenyl ethers (nonaBDEs) and several octabrmodiphenyl ethers (octaBDEs) congeners, including BDE-203, were also elevated among the rubber workers, with 2.5- to 11-fold higher median concentrations, compared to the referents. The results confirm a significant uptake of BDE-209 in the workers exposed to DecaBDE and indicate a potential for in vivo formation of lower BDEs in these persons.
Abstract: Numerous studies have shown that exposure to air pollutants in the area of residence and the socio-economic status of an individual may be related. Therefore, when conducting an epidemiological study on the health effect of air pollution, socio-economy may act as a confounding factor. In this paper we examine to what extent socio-economic status and concentrations of NO2 in the county/region of Scania, southern Sweden, are associated and if such associations between these factors differ when studying them at county or city level. To perform this study we used high-resolution census data and modelled the annual exposure to NO2 using an emission database, a dispersion modelling program and a geographical information system (GIS).
Abstract: This study investigates exposure to polybrominated diphenyl ethers (PBDEs) and tetrabromobisphenol A (TBBPA), which are used as flame retardants in electronic equipment, in a group of technicians with intense computer work. Thirteen PBDE congeners and TBBPA were quantified in serum from 19 computer technicians. Previously investigated groups of hospital cleaners with no computer experience, and clerks working full-time at computer screens were used for comparison. The computer technicians had serum concentrations of BDE-153, BDE-183 and BDE-209 that were five times higher than those reported among hospital cleaners and computer clerks. The median levels observed among the computer technicians were 4.1, 1.3, and 1.6 pmol/g lipid weight, respectively. In contrast, for BDE-47 there was no difference between the computer technicians and the others. BDE-100, BDE-203, and three structurally unidentified octa-BDEs and three nona-BDEs, were present in almost all samples from the computer technicians. Further, TBBPA was detected in 8 out of 10 samples. The levels of BDE-153, BDE-183, and one of the octa-BDEs were positively correlated with duration of computer work among technicians. On a group level an exposure gradient was observed, from the least exposed cleaners to the clerks, and to the highest exposed group of computer technicians. A dose (duration of computer work)-response relationship among computer technicians was demonstrated for some higher brominated PBDE congeners. Thus, it is evident that PBDEs used in computers and electronics, including the fully brominated BDE-209, contaminate the work environment and accumulate in the workers tissues.
Abstract: To study the prevalence of symptoms from the eyes and the upper and lower respiratory tract, lung function, and immunological sensitisation towards isocyanates in pipelayers exposed to thermal degradation products from methylene diphenyl diisocyanate (MDI)-based polyurethane (PUR).
Abstract: To study cause specific mortality and cancer morbidity in workers exposed to the dust of grinding materials, grinding agents, and stainless steel, especially with regard to a possibly increased risk of respiratory, stomach, and colorectal cancer.
Abstract: The object of this study was to investigate whether exposure of pipe-layers to thermal degradation products of diphenylmethane diisocyanate (MDI) could be assessed by analysing 4,4-methylenedianiline (MDA) in hydrolysed plasma and urine, and whether the genotype for N-acetylation affected these biomarker levels. Blood and urine samples were drawn from 30-pipe-layers who had been welding polyurethane (PUR) insulated pipes during the preceding 3 months. MDA in hydrolysed plasma and urine was determined with a gas chromatography-mass spectrometry technique, and genotype for N-acetylation was analysed with a polymerase chain reaction technique. MDA in plasma was detected in 18 of the 30 pipe-layers. Their plasma concentrations of MDA varied from 0.05 to 8.48 micrograms/l. There was a significant negative correlation between time since last welding of PUR-insulated pipes and P-MDA (rs = 0.50, P = 0.005). There was also a significant positive correlation between the estimated number of welded PUR-insulated pipes during the preceding 3 months and P-MDA (rs = 0.68, P = < 0.001). No significant association between genotype of N-acetylation and P-MDA was observed in a multiple regression analysis when adjustment was made for the estimated cumulative exposure to thermal degradation products of MDI. MDA in urine was detected in only four of the 30 pipe-layers. These four subjects had been welding PUR pipes on the same day as the sampling, or on the day before. The present results indicate the spot plasma samples analysed for MDA may give a rather good estimate of exposure to MDI during the preceding months. P-MDA, but not U-MDA, therefore seems to be a useful biomarker of long-term exposure to MDI. The individual N-acetylation capacity did not affect the plasma levels of MDA.
Abstract: Experimental data indicate that active oxygen species may be casually involved in the development of asbestos-related disease. Thus, it was hypothesized that individual differences in glutathione transferase activity, which may affect the ability to inactivate molecules formed in relation to oxidative stress, could influence the biological response to asbestos exposure. We could, however, not demonstrate an increased risk for radiographic changes or reduced lung function among asbestos cement workers deficient for glutathione transferase theta (GSTT1), glutathione transferase mu (GSTM1), or having a combined deficiency of enzyme activity.
Abstract: To investigate whether a lack of glutathione-S-transferase mu (GSTM1) activity was related to an increased risk for adverse outcome after asbestos exposure.
Abstract: To explore associations between exposure to cement dust and cause specific mortality and tumour morbidity, especially gastrointestinal tumours.
Abstract: Histological types of lung carcinoma were examined in a case series of workers exposed to asbestos cement dust (n = 29) and matched controls (n = 87). The proportion of adenocarcinomas was 31% among the exposed subjects and 15% among the controls (mid-p = 0.05). Among workers with high exposure the proportion of adenocarcinoma was even higher (45%, 5/11; mid-p = 0.03). The proportion of peripheral tumours tended to be higher among exposed cases than controls (24 v 12%, mid-p = 0.12). Lobe of origin did not differ, however, between exposed cases and controls. Thus the study indicates an association between the degree of exposure to asbestos and adenocarcinoma of the lung, and a peripheral rather than central localisation of the tumours, but with virtually the same distribution of lobe of origin as in the general population.
Abstract: Total and cause specific mortality and cancer morbidity were studied among 1929 asbestos cement workers with an estimated median cumulative exposure of 2.3 fibre (f)-years/ml (median intensity 1.2 f/ml, predominantly chrysotile). A local reference cohort of 1233 industrial workers and non-case referents from the exposed cohort were used for comparisons. The risk for pleural mesothelioma was significantly increased (13 cases out of 592 deaths in workers with at least 20 years latency). No case of peritoneal mesothelioma was found. A significant dose response relation was found for cumulative exposure 40 years or more before the diagnosis, with a multiplicative relative risk (RR) of 1.9 for each f-year/ml. No relation was found with duration of exposure when latency was accounted for. There was a significant overrisk in non-malignant respiratory disease (RR = 2.6). The overall risks for respiratory cancer, excluding mesothelioma, and for gastrointestinal cancer were not significantly increased. Surprisingly, colorectal cancer displayed a clear relation with cumulative dose, with an estimated increase of 1.6% in the incidence density ratio for each f-year/ml (but not with duration of exposure).
Abstract: A matched case-referent study was conducted to investigate the risk of gastrointestinal cancer in cement workers. All male cases of cancer in esophagus, stomach, colon and rectum in the period 1922-1988 from two parishes surrounding a cement plant were identified. For each case, four referents were chosen, matched to age and year of death. Employment in the cement plant was confirmed as from plant records or job title noted in the parish books. Of 25 cases with a definite colorectal tumour, 40% had been blue-collar cement workers for 25 years or more, compared with 20% of their referents [odds ratio (OR) 3.2; 95% confidence limits (CI) 1.1-9.4]. There were indications of a dose (time of employment)-response relationship. For 18 cases with an esophageal or stomach tumour, the OR for those ever employed as cement workers was 3.2 (CI 1.0-11), but short-term employment predominated, thus making a causal relationship less likely.
Abstract: Lung tissue from 76 deceased asbestos cement workers (seven with mesothelioma) exposed to chrysotile asbestos and small amounts of amphiboles, has been studied by transmission electron microscopy, together with lung tissue from 96 controls. The exposed workers with mesothelioma had a significantly higher total content of asbestos fibre in the lungs than those without mesothelioma, who in turn, had higher concentrations than the controls (medians 189, 50, and 29 x 10(6) fibres/g (f/g]. Chrysotile was the major type of fibre. The differences were most pronounced for the amphibole fibres (62, 4.7, and 0.15 f/g), especially crocidolite (54, 1.8 and less than 0.001 f/g), but were evident also for tremolite (2.9, less than 0.001, and less than 0.001 f/g) and anthophyllite (1.7, less than 0.001, and less than 0.001 f/g). For amosite, there was no statistically significant difference between lungs from workers with and without mesothelioma; the lungs of workers had, however, higher concentrations than the controls. Strong correlations were found between duration of exposure and content of amphibole fibres in the lungs. Asbestos bodies, counted by light microscopy, were significantly correlated with the amphibole but not with the chrysotile contents. Fibrosis was correlated with the tremolite but not the chrysotile content in lungs from both exposed workers and controls. Overall, similar results were obtained using fibre counts and estimates of mass.
Abstract: We measured lung density by means of x-ray computed tomography and lung mechanics in 33 workers exposed to asbestos cement and in 39 normal subjects. The exposed group showed evidence of lung fibrosis with reduced static lung volumes and lung compliance, although only three subjects had signs of interstitial fibrosis at standard chest radiography. Lung density was significantly increased in the exposed workers compared to control subjects, with greater differences between nonsmokers than between smokers. Lung density correlated inversely with static lung volumes. There was no appreciable difference in the regional distribution of lung density between exposed workers and control subjects. We conclude that lung density is often increased in workers with mild asbestosis, even in the presence of a normal chest radiograph. Measurement of lung density may be of value in the evaluation of asbestos-exposed workers for assessment of the extent of parenchymal disease.
Abstract: Histological slides from the lungs of 89 dead asbestos cement workers have been examined with respect to ferruginous bodies and fibrosis. The results have been compared with individually matched controls with no known exposure to asbestos, and related to asbestos exposure, expressed as duration of exposure and cumulative asbestos dose, and smoking habits. The asbestos cement workers studied had been employed for on average 15 years, with a mean cumulative dose of 26 fibre-years per ml (f-y/ml). Clear dose-response relations between exposure (duration of exposure and cumulative asbestos dose) and level of ferruginous bodies were found. An association was evident already at a low cumulative dose (1-10 f-y/ml). Fibrosis was more common and more pronounced among the exposed workers than among controls. An association between ferruginous bodies and fibrosis was also found. Among the controls, but not among exposed workers, there was an association between smoking history and fibrosis.
Abstract: A group of 137 male workers with known exposure (mean 20 fibre years per millilitre) to asbestos cement who had symptoms or signs of pulmonary disease was studied together with a reference group of 49 healthy industrial workers with no exposure to asbestos. Lung function measurements were made at rest and during exercise. Evidence of lung fibrosis was found as well as of obstructive airways disease in the exposed group compared with the reference group. Asbestos cement exposure was related to variables reflecting lung fibrosis but not to variables reflecting airflow obstruction. Smoking was related to variables reflecting obstructive lung disease. Exercise capacity was reduced in the exposed workers and was related to smoking and to lung function variables, reflecting obstructive airways disease. There was no significant correlation between exercise capacity and exposure to asbestos cement.
