Sinonasal adenoid cystic carcinoma following formaldehyde exposure in the operating theatre.

We present a case report of an auxiliary nurse who developed an adenoid cystic carcinoma in her left maxillary sinus following occupational exposure to formaldehyde in the operating theatre. Currently, the epidemiological evidence that formaldehyde can cause cancer in humans is considered to be limited. Previous case-control-studies of formaldehyde and sinonasal cancer have mainly investigated subjects who were concomitantly exposed to wood dust, a known risk factor to the development of sinonasal adenocarcinoma of intestinal type.

Gregorius Agricola memorial lecture: Lung cancer-A work-related disease for 500 years, as predicted by Agricola.

In the early 16th century Gregorius Agricola reported on Bergsucht (miner's consumption) in mine workers in the Erzgebirge. About 350 years later, Härting and Hesse reported on large numbers of lung cancers among the mine-workers in the same mine district, thus confirming that Bergsucht primarily was lung cancer, but could also have been pnumoconiosis or tuberculosis or a combination of both. Mining for bismuth continued another 75 years--through World War II.

Hypersensitivity pneumonitis in a cluster of sawmill workers: a 10-year follow-up of exposure, symptoms, and lung function.

Background: The long-term prognosis of repeated acute episodes of hypersensitivity pneumonitis (HP) is not well described. We report on a 10-year follow-up of a 10-person cluster from a Norwegian sawmill who had all experienced relapsing episodes of HP.

Objectives: To evaluate the health symptoms, work-related sick-leave, and lung function of 10 workers exposed to mold in a Norwegian sawmill.

Methods to recognize work-related cancer in workplaces, the general population, and by experts in the clinic, a Norwegian experience.

Background: In most countries, the numbers of work-related cancer identified are much lower than are the estimated total burden of cancer caused by exposure at work. Therefore, there is a great need to use all available practical as well as epidemiological methods for identification as well as to develop new methods of recognizing cases of work-related cancers.

Methods: Primarily based on practical experiences from Norway, methods to identify cases of possible work-related cancers in the general population and at workplaces as well as methods to recognize more specific cases after referral to specialized clinics are reviewed in this publication.

Exposure assessment for a nested case-control study of lung cancer among European asphalt workers.

Objective: Development of a method for retrospective assessment of exposure to bitumen fume, bitumen condensate, organic vapour, polycyclic aromatic hydrocarbons, and co-exposures to known or suspected lung carcinogens for a nested case-control study of lung cancer mortality among European asphalt workers.

Methods: Company questionnaires and structured questionnaires used in interviews and industry-specific job-exposure matrices (JEMs) were elaborated and applied. Three sources of information were eventually used for exposure assessment and assignment: (i) data obtained in cohort phase, (ii) data from living subjects, next-of-kin, and fellow-workers questionnaires, and (iii) JEMs for bitumen exposure by inhalation and via skin and co-exposures to known or suspected lung carcinogens within and outside cohort companies.

A case-control study of lung cancer nested in a cohort of European asphalt workers.

Background: We conducted a nested case-control study in a cohort of European asphalt workers in which an increase in lung cancer risk has been reported among workers exposed to airborne bitumen fume, although potential bias and confounding were not fully addressed.

Objective: We investigated the contribution of exposure to bitumen, other occupational agents, and tobacco smoking to the risk of lung cancer among asphalt workers.

Methods: Cases were cohort members in Denmark, Finland, France, Germany, the Netherlands, Norway, and Israel who had died of lung cancer between 1980 and the end of follow-up (2002-2005).

Bladder cancer incidence and exposure to polycyclic aromatic hydrocarbons among asphalt pavers.

Objectives: To investigate the association between exposures to polycyclic aromatic hydrocarbons (PAH) that arises during asphalt paving, and risk of bladder cancer.

Methods: 7298 men included in the historical cohort were first employed between 1913 and 1999 in companies applying asphalt in Denmark, Norway, Finland and Israel. The minimal duration of employment for inclusion in the cohort was two seasons of work.

A critique of benzene exposure in the general population.

Benzene risk assessment indicates that exposure to a time-weighted average (TWA) of 1-5 parts per million (ppm) benzene in ambient air for 40 years is associated with an increased risk of acute myeloid leukemia. Decreased white blood cell count, platelet count and other hematological indices have also been observed in persons exposed to as low as 1 ppm airborne benzene. Evidence from studies worldwide consistently shows elevated levels of benzene biomarkers that are equivalent to 0.

Monitoring of chromium and nickel in biological fluids of grinders grinding stainless steel.

Objective: Stainless steel (SS) welders usually spend some of their working time grinding, to finish and smoothen the welding groove. The aim of this study was to investigate possible relations between the concentrations of nickel (Ni) and chromium (Cr) in the work atmosphere generated by grinders grinding SS, and to compare the air levels to the levels of Cr and Ni in their biological fluids. Hereby, it might be possible to identify the contribution of grinding to the levels of Cr and Ni in biological fluids in SS welders.

Nordic experience: expected decline in the incidence of mesotheliomas resulting from ceased exposure?

Background: As a result mainly of information to workers and the public on prevention of effects of asbestos exposure, the use of asbestos for insulation was reduced to a minimum in the Nordic countries during the second half of the 1970's and the early 1980's. Stringent regulations when handling asbestos were introduced, and prohibition of use began in the early 1980's. Depending on the duration of the latency period between first exposure and the period of most intense exposure, a decline might be expected in the incidence of Malignant Mesothelioma (MM) 20-45 years after interruption of exposure.

Polycyclic aromatic hydrocarbons and fatal ischemic heart disease.

Background: Several toxicologic and epidemiologic studies have produced evidence that occupational exposure to polycyclic aromatic hydrocarbons (PAH) is a risk factor for ischemic heart disease (IHD). However, a clear exposure-response relation has not been demonstrated.

Methods: We studied a relation between exposure to PAH and mortality from IHD (418 cases) in a cohort of 12,367 male asphalt workers from Denmark, Finland, France, Germany, Israel, The Netherlands and Norway.

Monitoring of chromium and nickel in biological fluids of stainless steel welders using the flux-cored-wire (FCW) welding method.

Objective: This study was undertaken to investigate the exposure to chromium (Cr) and nickel (Ni) in flux-cored wire (FCW) welders welding on stainless steel (SS).

Method/design: Seven FCW welders were monitored for 3 days to 1 workweek, measuring Cr and Ni in air, blood, and urine. The welders were questioned about exposure to Cr and Ni during their whole working careers, with emphasis on the week of monitoring, about the use of personal protective equipment and their smoking habits.

Cancer incidence of Nordic asphalt workers.

Objectives: The aim of the study was to investigate cancer risk following employment in the asphalt industry.

Methods: Cancer incidence was studied among 22 362 male asphalt workers employed for more than one season in jobs entailing exposure to bitumen (mainly road pavers) in Denmark, Finland, Norway, and Sweden. These workers are part of a European cohort of asphalt workers, for which results on mortality have been reported.

Mortality among workers employed in the titanium dioxide production industry in Europe.

Objectives: To assess the risk of lung cancer mortality related to occupational exposure to titanium dioxide (TiO2).

Methods: A mortality follow-up study of 15,017 workers (14,331 men) employed in 11 factories producing TiO2 in Europe. Exposure to TiO2 dust was reconstructed for each occupational title; exposure estimates were linked with the occupational history.

Risk of fatal industrial accidents and death from other external causes among asphalt workers.

The hypothesis that asphalt workers are at increased risk of mortality from industrial accidents and other external causes was tested. Mortality rates for external and violent causes of death in a cohort of asphalt industry employees from seven European countries and Israel were compared to that of the general population. There was no evidence that mortality from external causes was increased among long term employees in asphalt application and mixing.

Mortality from obstructive lung diseases and exposure to polycyclic aromatic hydrocarbons among asphalt workers.

Work in the asphalt industry has been associated with nonmalignant respiratory morbidity and mortality, but the evidence is not consistent. A historical cohort of asphalt workers included 58,862 men (911,209 person-years) first employed between 1913 and 1999 in companies applying and mixing asphalt in Denmark, Finland, France, Germany, Israel, the Netherlands, and Norway. The relations between mortality from nonmalignant respiratory diseases (including the obstructive lung diseases: chronic bronchitis, emphysema, and asthma) and specific chemical agents and mixtures were evaluated using a study-specific exposure matrix.

Mortality from non-malignant diseases among male Norwegian asphalt workers.

Background: The possible associations between asphalt work and mortality from non-malignant diseases in a cohort of male Norwegian asphalt workers that formed part of the European asphalt worker mortality study are examined.

Methods: The mortality experience among 8,610 male workers ever employed in asphalt work was observed from 01.01.

Cancer incidence among male Norwegian asphalt workers.

Background: The main objective of the present study was to investigate whether exposure to bitumen fumes could enhance the risk of cancer in asphalt workers.

Methods: A historical prospective cohort study was performed including 8,763 male asphalt workers from all main asphalt companies in Norway. Name, date of birth, and unique personal identification number, address, job type, and start and stop of employment in specific jobs was obtained for the workers.

Performance of different exposure assessment approaches in a study of bitumen fume exposure and lung cancer mortality.

Background: We compared performance of different exposure assessment approaches in a cohort study of cancer risk among European asphalt workers.

Methods: Three bitumen fume exposure indices (duration of exposure (years), average exposure (mg/m3) and cumulative exposure (mg/m3*years)) and two latency models (with and without a 15 year lag) were considered for an association between lung cancer mortality and bitumen fume.

Results: There was no association between lung cancer risk and either duration or cumulative exposure.

Cancer mortality among European asphalt workers: an international epidemiological study. II. Exposure to bitumen fume and other agents.

Background: An increased risk of lung cancers among asphalt workers has been suggested in epidemiological studies based on large scale statistical analyses.

Methods: In a multi-country study of 29,820 male workers employed in road paving, asphalt mixing and roofing, 32,245 ground and building construction workers and 17,757 other workers from Denmark, Finland, France, Germany, Israel, the Netherlands, Norway, and Sweden, with mortality that was documented from 1953-2000. Exposures to bitumen fume, coal tar, 4-6 ring polycyclic aromatic hydrocarbons, organic vapor, diesel exhaust, asbestos, and silica dust were assessed via a job-exposure matrix.

Cancer mortality among European asphalt workers: an international epidemiological study. I. Results of the analysis based on job titles.

Background: Inhalation of bitumen fumes is potentially carcinogenic to humans.

Methods: We conducted a study of 29,820 male workers exposed to bitumen in road paving, asphalt mixing and roofing, 32,245 ground and building construction workers unexposed to bitumen, and 17,757 workers not classifiable as bitumen workers, from Denmark, Finland, France, Germany, Israel, the Netherlands, Norway, and Sweden, with mortality follow-up during 1953-2000. We calculated standardized mortality ratios (SMRs) and 95% confidence intervals (CIs) based on national mortality rates.

Estimating exposures in the asphalt industry for an international epidemiological cohort study of cancer risk.

Background: An exposure matrix (EM) for known and suspected carcinogens was required for a multicenter international cohort study of cancer risk and bitumen among asphalt workers.

Methods: Production characteristics in companies enrolled in the study were ascertained through use of a company questionnaire (CQ). Exposures to coal tar, bitumen fume, organic vapor, polycyclic aromatic hydrocarbons, diesel fume, silica, and asbestos were assessed semi-quantitatively using information from CQs, expert judgment, and statistical models.

Exposure to culturable microorganisms in paper mills and presence of symptoms associated with infections.

Background: Previous studies of paper machine operators have to a large extent focused on endotoxins as a possible health hazard, but not culturable micro-organisms (MOs).

Methods: Based on exposure assessment in 11 paper mills workers exposed to culturable bio-aerosols were grouped in three exposure groups. 781 exposed and 285 unexposed workers completed a questionnaire that provided data pertaining to infections and associated symptoms.