Humoral immune responses of workers occupationally exposed to wheat flour

Wheat flour is a complex organic dust likely to induce immune responses when inhaled in work environment conditions. We compared the humoral status of 159 exposed workers from 11 flour mills and one industrial bakery with that of 41 workers from a salt factory. IgG, IgA, and IgM levels of antibodies to whole flour and to gliadin were assayed using ELISA tests in serum and saliva samples. Serum levels of IgG and IgA to both antigens were significantly higher (p < 0.0001) in occupationally exposed workers. Exposed workers had significantly higher levels of salivary IgG (p = 0.005) and IgA (p < 0.0001) to whole flour and of salivary IgG (p = 0.0005) to gliadin. In both groups, similar levels of anti-gliadin salivary IgA antibodies were observed. These data suggest that occupational exposure to wheat flour triggers specific immune responses, most likely through stimulation of the mucosal immune system. The presence of significant levels of serum antibodies, however, indicates that a systemic immunologic response is also present among exposed individuals.     

Bakers' exposure to flour dust

We aimed to characterize bakers' personal exposure to airborne flour dust with respect to the health-related aerosol fractions inhalable, extrathoracic, and thoracic dust, and to examine possible production-related determinants of dust exposure.

Sixty-eight bakers from 7 bakeries in Bergen, Norway (2009–2012) participated in the exposure assessment, comprising full-shift personal samples of inhalable dust (n = 107) and thoracic dust (n = 61). The relation between possible determinants and exposure was estimated using mixed effects models, while associations between the various aerosol fractions across task groups and type of bakeries were described by Pearson's correlation coefficients.

Bakers' overall geometric mean personal exposure to inhalable, extrathoracic, and thoracic dust were 2.6 mg/m³ (95% CI: 2.0, 3.2), 2.2 mg/m³ (95% CI: 1.9, 2.7), and 0.33 mg/m³ (95% CI 0.3, 0.4), respectively. A total of 29% of the measurements of inhalable dust were above the Norwegian Occupational Exposure Limit of 3 mg/m³. The exposure variability of inhalable dust could not be explained by any of the examined production-related determinants, while the daily production volume explained 18% of the variance in thoracic dust exposure. Overall, the thoracic dust represented 15% of the inhalable dust, being rather stable across the production-related determinants. The overall correlation between inhalable and thoracic dust was nevertheless moderate (r = 0.52, p < 0.001), with the highest correlation for craft bakers (r = 0.62) and no correlation during dough forming (r = 0.01).

Bakers are exposed to flour dust at a level that most likely represents an excess risk of developing chronic diseases of the respiratory system, and a decrease of present exposure level is imperative. Extrathoracic dust—likely the most relevant sub-fraction in respect to flour-induced sensitization and occupational rhinitis—represented the main proportion of the measured inhalable dust. The variation in correlation coefficients between the dust fractions across bakery types and task groups underlines the need of more knowledge about how these aerosol fractions are distributed across the production process and bakery types.     

Occupational exposure to flour dust and the risk of head and neck cancer

Background

To investigate the association between head and neck squamous cell cancer (HNSCC) risk and occupational exposure to flour dust in women and men, using data from ICARE, a French population‐based case‐control study.

Methods

The analysis included 2053 cases of HNSCC and 3507 controls. Lifelong occupational history was collected. A job‐exposure matrix was used to assess exposure to flour dust. Odds‐ratios (ORs) and 95% confidence intervals (CI), adjusted for smoking, alcohol drinking, and asbestos exposure, were estimated with logistic regression models.

Results

Ever exposure to flour dust was associated with elevated ORs in women (OR = 2.15, 95%CI: 1.01 4.55) and in men (OR = 1.55, 95%CI: 1.11 2.17). In women, the risk increased with the probability, the duration, and the cumulative level of exposure. No dose‐response relationships were observed in men.

Conclusions

Although the results were less conclusive in men than in women, overall, these findings provide some support to the hypothesis of a role of flour dust in the occurrence of HNSCC.

     

Pulmonary function and intradermal tests in workers exposed to soft-paper dust

A survey was carried out in the processing department of a paper mill, consisting of environmental and personal monitoring, a short questionnaire concerning chronic non-specific lung disease (CNSLD), spirometry, and intradermal tests. Spirometry was performed on Monday, Wednesday, and Friday. Exposures to paper dust regularly exceeded the Dutch Maximal Allowable Concentrations (MACs) for total and respirable dust. There were indications of a qualitatively different exposure to molds inside the mill in comparison with the outdoor air. A comparison between a group of workers exposed to paper dust and a control group showed significantly more persons with positive late and delayed intradermal test reactions in the exposed population. The analysis of the spirometric measurements after correction for differences between the groups in age, height, and smoking habits gave evidence of the existence of lower FEV1, MMEF, MEF50, and MEF25 among exposed workers with a positive immediate intradermal reaction on Friday. The same workers showed a decline in pulmonary function over the week compared with the controls. These changes suggest an obstructive airway reaction with an immunologic mechanism to dust exposure in a paper mill.     

Ventilatory function of workers exposed to cobalt and diamond containing dust

Summary The ventilatory function of 48 workers occupied on the average for six years in a plant producing diamond-cobalt circular saws was compared with that of 23 control subjects. The geometric mean airborne cobalt concentrations in the two main work areas amounted to 15.2 and 135.5 g/m³ respectively. The spirometric changes found in the exposed workers were compatible with a moderate restrictive syndrome and were correlated with duration of exposure.     

Respiratory symptoms and pulmonary function in flour processing workers in the baking industry

Respiratory symptoms and ventilatory capacity were studied in 63 flour processing male bakery workers in Umtata, Transkei, Southern Africa. The controls were from a bottling plant in the same city. Both groups were black Africans from the Xhosa-speaking population. The studied population was nonsmoking and no significant difference was noted in age, race, sex, or height between the groups. The exposed workers had significantly lower forced expiratory indices than the control group. Mean percent predicted values of forced expiratory volume in one second (FEV₁), forced expiratory ratio (FEV₁/FVC x 100), forced mid-expiratory flow between 25% and 75% of FVC (FMF), forced expiratory flow between the first 200 ml and 1.200 ml of FVC (FEF 200-1,200), and peak expiratory flow rate (PEF) were, respectively, 11.2%, 20.0%, 31.0%, 27.4%, and 36.1% lower in the exposed group compared with the controls. The prevalence of forced expiratory ratio less than 70% in the exposed group was 37% while in the controls it was 8%. The prevalence of PEF rate less than 5 l/s in the exposed group was 32% while in the controls it was 11%. The exposed workers reported a significantly higher prevalence of respiratory symptoms compared to the controls. The prevalence of nasal symptoms, phlegm, and cough in the exposed workers was 53.9%, 30.1%, and 25.4%, respectively. The present study demonstrated that exposure to flour dust in flour processing workers in the baking industry is associated with significantly lower pulmonary functions and a higher prevalence of respiratory symptoms, and that these workers show signs of airway obstruction, compared to workers not exposed to flour. Flour processing workers have a significant occupationally related respiratory impairment.     

玛瑙尘引起急进型矽肺——附15例分析

目的　检测接触玛瑙尘作业工人生产环境与矽肺病发病状况。方法　测定广州某珠宝加工厂33名玛瑙尘接触工人作业环境玛瑙尘的总尘浓度、分散度和游离SiO     

A cross sectional study of the respiratory health of workers handling printing toner dust

Background

Although recent case reports have suggested possible respiratory effects of solid toner dust inhalation, this hypothesis has not been verified by epidemiological studies.

Objectives

To conduct a cross sectional study to evaluate the association between the biological indices of lung fibrosis and toner dust exposure in an occupational cohort handling solid toner dust in their work life.

Methods

A total of 600 male toner workers and 212 control subjects were surveyed in terms of their subjective respiratory symptoms, pulmonary functions, and chest radiographic findings. In addition to the exposure history, the current working conditions and personal exposure levels to toner dust were also examined.

Results

Although subjects handling toner for more than 20 years tended to show a higher prevalence of respiratory symptoms and minimal chest x ray abnormalities, there was no consistent relation between the exposure to toner dust and the biological responses of the respiratory system.

Conclusion

Deterioration of respiratory health related to toner dust exposure is less likely to occur in current well controlled work environments, especially if the powdered toner is handled carefully. Nonetheless, it is important to collect further epidemiological evidence on the biological effects of toner dust inhalation, preferably using a longitudinal study design.     

外周血细胞形态学观察在苯接触工人健康监护和苯中毒诊断的意义

目的 探讨血细胞形态学观察对苯作业工人健康监护和早期预防苯中毒的意义。方法 常规采苯作业工人末梢或静脉血进行ＷＢＣ、ＲＢＣ和ＰＬＴ计数,测定ＨＧＢ浓度,并对ＷＢＣ、ＲＢＣ、ＰＬＴ作形态学观察。结果 在１２０名苯作业工人中共检出３５名异常工人,其中有１８名全血细胞减少;血细胞的形态学改变以中性细胞胞浆出现中毒颗粒和空泡最常见。结论 中性粒出现中毒颗粒和空泡是接触苯后血液系统的早期改变,随后是白细胞减     

Lung function in workers exposed to soft paper dust

In a cross-sectional study, 13 nonsmoking men with heavy exposure to paper dust were compared with 14 unexposed men, mainly office workers, employed at the same paper mill. They were studied using questionnaires, physical examinations, pulmonary function studies, and chest radiographs. Among those exposed there was an increased lung elastic recoil pressure (Pel) compared with controls which was significant (p less than 0.05) at the maximal level of total lung capacity (100% TLC). Furthermore, among the exposed workers there was also a significantly (p less than 0.05) decreased residual volume (RV). Two of the exposed men underwent lung biopsies, one of which showed fibrotic alveolar walls. Among the exposed there was also a significant (p less than 0.05) predominance of symptoms from the lower respiratory tract. We suggest that the observed pulmonary function impairment taken together with the histological examination of the lung biopsies are signs of a nonspecific reaction to high levels of paper dust.     

职业砷接触工人某些遗传毒性指标的变化

目的探讨职业砷接触工人某些遗传毒性指标的变化。方法选择云南某砒霜厂40人为接触组,当地无明显毒物接触史28人为对照组,检测并评价外周血淋巴细胞微核细胞率、微核率、彗星试验拖尾率和尾长,以及尿中总砷、有机砷水平。结果接触组外周血淋巴细胞微核细胞率、微核率、彗星试验拖尾率、尾长均极显著高于对照组(P<0.01)。尿中总砷、有机砷浓度也高于对照组(均低于0.02mg/L)。微核细胞率和微核率随有机砷浓度、工龄乘积增加有升高趋势(rs=0.356,P=0.024;rs=0.347,P=0.028)。结论职业性砷暴露可导致外周血淋巴细胞染色体和DNA损伤。     

Airway responsiveness to methacholine,respiratory symptoms,and dust exposure levels in grain and flour mill workers in eastern france

Our goal was to assess the relation between dust exposure levels and the respiratory health status of workers in grain and flour mills in eastern France. We studied 118 male workers from 11 mills and 164 unexposed male controls. Dust concentration was measured by personal sampling methods. Outcome variables included respiratory symptoms, routine pulmonary function tests, and indices of airway responsiveness to methacholine. A great within- and between-area variability of inhalable dust concentration was found in all mills. A dose-response relationship was observed between dust exposure levels and chronic respiratory symptoms, suggesting that exposure to grain and flour dust may lead to chronic bronchitis. A significant relation was found between dust exposure and airway hyper-responsiveness; this finding is important since it has been hypothesized that the latter abnormality may lead to or be a predisposing factor in subsequent chronic, irreversible airflow obstruction.     

食管鳞癌患者外周血T淋巴细胞亚群的变化

目的研究食管鳞癌患者外周血T淋巴细胞亚群的变化特点。方法采用流式细胞技术，对108例食管鳞癌患者（食管鳞癌组）术前检测其外周血T淋巴细胞亚群水平，并与50例健康献血者（对照组）对比，分析食管鳞癌患者T淋巴细胞亚群的变化特点。结果（1）与对照组比较，食管鳞癌组患者外周血CD3^＋ 、NK细胞水平差异无统计学意义（P=0．890；P=0．320）；CD4^＋和CD8^＋水平显著增高（P=0．001；P〈0．001），由于CD8^＋增高的程度大于CDZ增高的程度，使得CDgCDs~较对照组降低（P〈0．001）。（2）早期食管鳞癌患者外周血CD4^＋/CD8^＋低于对照组，但差异无统计学意义（P=0．112）；中晚期食管鳞癌患者CDgCDs~进一步降低，与对照组比较差异有统计学意义（P〈0．001），但与早期食管鳞癌患者相比，差异无统计学意义（P=0．218）。（3）有淋巴结转移食管鳞癌患者CD4^＋和CD4^＋/CD8^＋均低于无淋巴结转移患者（P均〈0．001），CD8^＋和NK细胞均高于无淋巴结转移患者，差异均有统计学意义（P=0．002；P=0．005）。结论食管鳞癌患者存在免疫功能低下，随着肿瘤的进展免疫功能进一步受到削弱；监测CD4^＋/CD8^＋的变化可作为食管鳞癌病情进展的标志之一。     

Epidemiological survey of workers exposed to inorganic germanium compounds

OBJECTIVES—To assess occupational exposure to inorganic germanium (Ge) in workers from a producing plant, and to assess the health of these workers, with a special focus on respiratory, kidney, and liver functions.
METHODS—Cross sectional study of 75 workers exposed to Ge and 79 matched referents. Exposure was characterised by measuring air and urine concentrations of the element during a typical working week, and health was assessed by a questionnaire, clinical examination, lung function testing, chest radiography, and clinical chemistry in serum and urine, including high and low molecular weight urinary proteins.
RESULTS—Airborne concentrations of Ge (inhalable fraction) ranged from 0.03 to 300 µg/m, which was reflected by increased urinary excretion of Ge (0.12-200 µg/g creatinine, after the shift at the end of the working week). Lung, liver, and haematological variables were not significantly different between referents and workers exposed to Ge. A slightly higher urinary concentration of high molecular weight proteins (albumin and transferrin) was found in workers exposed to Ge, possibly reflecting subclinical glomerular changes. No relation was found between the intensity or duration of exposure and the urinary concentration of albumin. No difference between referents and workers exposed to Ge was found for other renal variables.
CONCLUSIONS—Measurement of urinary Ge can detect occupational exposure to inorganic Ge and its compounds. It is prudent to recommend the monitoring of renal variables in workers exposed to Ge.


Keywords: inorganic germanium; occupational exposure; biological monitoring     

三氯乙烯药疹样皮炎患者及健康接触工人外周血淋巴细胞亚群分析

目的 研究二氯乙烯(TCE)对接触工人淋巴细胞亚群的影响,寻找TCE药疹样皮炎早期的免疫学效应标志物.方法 选取TCE药疹样皮炎患者28例(病例组),来自发生病例车间的健康ICE作业工人56名(接触组)和未从事过TCE作业的健康工人28名(非接触对照组)作为研究对象.所有研究对象采集静脉血2 ml,EDTA抗凝处理,应用流式细胞技术检测淋巴细胞各亚群的百分比,结合血常规检测结果计算T细胞、CD4+T细胞、CD8+T细胞、B细胞、自然杀伤(NK)细胞绝对数及CD3+ CD4 +/CD3+ CD8+比值,比较各组之间外周血淋巴细胞业群的变化情况.结果 病例组外周血淋巴细胞总数、T细胞、CD4+T细胞、CD8+T细胞绝对数(中位数依次为2810.00、1846.17、831.87、904.05个/μl全血)均明显高于接触组(中位数依次为2101.00、1218.59、643.87、482.81个/μl全血,Z值分别为-3.19、-4.96、-3.22、-4.99,P值均＜0.001)和非接触对照组(中位数依次为1900.00、1223.60、558.60、325.80个/μl全血,Z值分别为- 3.30、-4.46、-3.45、-5.03,P值均＜0.001);病例组CD3+ CI4+/CD3+ CD8+比值和NK细胞绝对数(中位数分别为1.11、255.50个/μl全血)明显低于非接触对照组(中位数分别为1.96、642.60个/μl全血,Z值分别为-3.11、-3.56,P值均＜0.01);接触组CD8+T细胞数(中位数为482.81个/μl全血)明显高于非接触对照组(中立数为325.80个/μl全血,Z=-2.63,P值＜0.01);接触组CD3+ CD4+/CD3+ CD8+比值和NK细胞数(中位数分别为1.27、318.76个/μl全血)均明显低于非接触对照组(中位数分别为1.96、642.60个/μl全血,Z值分别为-2.29、-3.52,P值均＜0.05).结论 TCE接触可导致作业工人外周血淋巴细胞亚群发生变化;总淋巴细胞、T细胞和CD4+T细胞计数升高可作为TCE药疹样皮炎早期的免疫学效应标志物.     

Concentrations and number size distribution of fine and nanoparticles in a traditional Finnish bakery

In bakeries, high concentrations of flour dust can exist and ovens release particles into the air as well. Particle concentrations (mass, number) and number size distribution may vary considerably but the variation is not commonly studied. Furthermore, the role of the smallest size fractions is rarely considered in the exposure assessment due to their small mass. The objectives of this work were to find out how concentrations and number size distribution of fine and nanoparticles vary in a traditional Finnish bakery and to determine the exposure of a dough maker to the nanoparticle fraction of the inhalable dust.

Two measurement campaigns were carried out in a traditional, small-scale bakery. Sampling was performed at the breathing zone of the dough maker and three stationary locations: baking area, oven area, and flour depository. Both real-time measurements and conventional gravimetric sampling were conducted. Nanoparticle fraction of the inhalable dust was determined using an IOM sampler with a customized precyclone.

Number concentration of fine and nanoparticles, and mass concentrations of both the inhalable dust and nanoparticles were high. The nanoparticle fraction was 9–15% of the inhalable dust at the breathing zone of the dough maker. Different sources, such as ovens and doughnut baking affected the number size distribution.

Flour dust contained nanoparticles but most of the fine and nanoparticles were released into the air from the oven operations. However, nanoparticles are not a primary concern in bakeries compared to health effects linked to the large flour particles such as flour-induced sensitization or asthma and development of occupational rhinitis.     

三氯乙烯作业人群外周血淋巴细胞染色体损伤研究

目的探讨三氯乙烯(TCE)致作业人群外周血淋巴细胞染色体损伤的作用。方法以91名TCE暴露工人和59名对照作为研究对象,调查职业史、年龄、性别、吸烟和饮酒等信息。收集班后尿,测定尿中三氯乙酸(TCA)水平反映TCE暴露内剂量。抽取肘静脉血,胞质分裂阻滞微核法制备外周血淋巴细胞涂片,计数微核、核质桥和核芽发生率,评价染色体损伤水平。结果两组研究对象在年龄、性别、吸烟、饮酒状况等方面均无显著性差异。暴露组平均TCE作业工龄为1.8年。暴露组尿中TCA水平为57.5mg/L,远远高于对照组0.9mg/L。两组研究对象的微核率及核质桥率无显著差异,但暴露组核芽率[(1.6±1.0)‰]显著高于对照组[(1.2±0.8)‰,P=0.05]。核芽率的升高在尿TCA≥50.0 mg/L组和TCE作业工龄≥1.8年组中表现更为明显。同时,尿TCA≥50.0 mg/L的工人,其微核率[(1.8±0.9)‰]也显著高于对照组[(1.4±0.7)‰,P=0.05]。未发现年龄、性别、吸烟、饮酒对微核率、核质桥率、核芽率的显著影响。结论 TCE暴露可致作业工人染色体损伤增加,核芽可以较为敏感的检出由TCE职业暴露所引发的基因组不稳定性。     

某煤矿接尘作业职工接尘工龄与高千伏X线胸片及肺功能损害情况

目的通过对平煤某煤矿部分接尘职工的职业健康检查,了解接尘作业职工的健康状况和接尘作业职工胸片及肺功能变化。方法登记受检对象的一般状况,包括姓名、性别、出生年月、婚姻状况、烟酒史、既往史、职业史。检查项目为血压、心电图、高仟伏胸片、肝功、血常规、尿常规、肺功能。胸片诊断按照国家尘肺诊断标准(GBZ 70-2009);肺功能异常标准为FVC80%,FEV1.0%70%;肝功异常指标为丙氨酸转移酶40 U/L;尿常规异常为尿中有白细胞,尿蛋白阳性;高血压诊断根据WHO定义标准,收缩压≥140 mm Hg和(或)舒张压≥90 mm Hg。结果共检查9 310名接尘工人胸部X线异常1 282人(13.8%),肺功能异常405人(4.4%),其他项目异常者在0.7%～4.8%之间。结论①随着煤矿职工接尘工龄的增加,高千伏X线胸片显示肺部异常率增高。②随着接尘工龄增加肺部感染率增加。③随着接尘工龄增加肺功能损害率增高,呼吸功能慢性损害呈进行性加重。     

大型汽车制造行业工人粉尘接触情况调查分析

目的了解在新工艺、新技术及实施综合性防尘措施的条件下,大型汽车制造公司工人粉尘接触情况。方法连续6年对广西某机械股份有限公司作业工人接触粉尘浓度进行检测,采用个体采样和定点短时间采样相结合的方法,并测量空气中粉尘游离SiO2含量。结果铸造工艺造型和落砂岗位的粉尘游离SiO2含量最高,平均50%左右。大多数作业工人接触的主要是矽尘,浓度在1.58～7.25 mg/m3。其次是金属粉尘,浓度在3.41～6.80mg/m3。造型工、落砂工、熔炼工、感应炉工、气割工、工具磨工、司炉工和抛丸工接触的矽尘TWA浓度超标,其余作业工人接触粉尘浓度合格。结论大型汽车制造行业粉尘性质主要是矽尘和金属粉尘,粉尘危害以矽尘为主,应将矽尘的控制列为职业卫生工作重点。