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Multi-organ toxicity and death following acute unintentional
inhalation of paint thinner fumes.Clin
Toxicol (Phila). 2007;45(3):287-9.
BACKGROUND: Paint
thinners containing a mixture of volatile organic solvents have
considerable potential for solvent abuse. Deaths from solvent
inhalation have been reported but most of them relate to intentional
solvent abuse and occur soon after exposure. Accidental death due to
unintentional inhalation of solvent vapors can also occur suddenly but
more often, death results from late complications secondary to
multi-organ toxicity. Malfunctioning of the cardiorespiratory, renal,
and central nervous systems as a result of latent-toxic effects of
solvent exposure has received little attention. CASE REPORT: An adult
male unintentionally inhaled an excessive amount of paint thinner
vapors and immediately developed central nervous system effects,
followed by severe cardiorespiratory and renal pathologies that
ultimately led to death 11 days after exposure. CONCLUSION: Acute
unintentional inhalation of paint thinner fumes resulted in serious
multi-organ toxicity and death. This case strongly suggests the need
to employ suitable precautionary measures while handling volatile
organic solvents in a confined area.
Benzene
exposure and risk of non-Hodgkin lymphoma.Cancer
Epidemiol Biomarkers Prev. 2007
Mar;16(3):385-91.
Exposure to
benzene, an important industrial chemical and component of gasoline,
is a widely recognized cause of leukemia, but its association with
non-Hodgkin lymphoma (NHL) is less clear. To clarify this issue, we
undertook a systematic review of all case-control and cohort studies
that identified probable occupational exposures to benzene and NHL
morbidity or mortality. We identified 43 case-control studies of NHL
outcomes that recognized persons with probable occupational exposure
to benzene. Forty of these 43 (93%) studies show some elevation of NHL
risk, with 23 of 43 (53%) studies finding statistically significant
associations between NHL risk and probable benzene exposure. We also
identified 26 studies of petroleum refinery workers reporting
morbidity or mortality for lymphomas and all neoplasms and found that
in 23 (88%), the rate of lymphoma morbidity or mortality was higher
than that for all neoplasms. A substantial healthy-worker effect was
evident in many of the studies and a comprehensive reevaluation of
these studies with appropriate adjustments should be undertaken.
Numerous studies have also reported associations between benzene
exposure and the induction of lymphomas in mice. Further, because
benzene is similar to alkylating drugs and radiation in producing
leukemia, it is plausible that it might also produce lymphoma as they
do and by similar mechanisms. Potential mechanisms include
immunotoxicity and the induction of double-strand breaks with
subsequent chromosome damage resulting in translocations and
deletions. We conclude that, overall, the evidence supports an
association between occupational benzene exposure and NHL.
Estimating
risk during showering exposure to VOCs of workers in a
metal-degreasing facility.
J Toxicol Environ Health A.
2007 Apr 1;70(7):627-37.
The
incremental risk of workers in a metal-degreasing facility exposed to
volatile organic compounds (VOCs) present in the water supply during
showering was estimated. A probabilistic and worst-case approach using
specific-site concentration data and a generalized multipathway
exposure model was applied. Estimates of hazard index and lifetime
cancer risk were analyzed for each chemical and each route of exposure
(inhalation and dermal absorption). The results showed that dermal
exposure to trichloroethylene (TCE) and tetrachloroethylene (perchloroethylene,
PCE) represented the main contribution to total risk. Although the
inhalation route did not produce significant exposure, it was mainly
influenced by the liquid flow rate of the shower. Lower values of this
parameter during showering resulted in a significant reduction of both
carcinogenic and noncarcinogenic risk, while decreasing water
temperature produced a minimal effect on exposure by this pathway. The
results obtained in the present study indicated that significant
exposures of workers may be produced during showering in metal
degreasing installations where releases to water of VOCs occur. A
sensitivity analysis was developed for investigating the effect of
scenario parameters on exposure. Although site-specific data were
employed, the exposure of workers was assessed in a model scenario and
thus the quantification of risk is associated with uncertainty.
Considering that occupational exposure to organic solvents of workers
in metal-degreasing facilities may also be significant, risk
assessment must be included in the planning of this kind of industrial
installation.
Dangerous and
cancer-causing properties of products and chemicals in the oil
refining and petrochemical industries. Part XXX: Causal relationship
between chronic myelogenous leukemia and benzene-containing solvents.Ann
N Y Acad Sci. 2006 Sep;1076:110-9.
Benzene and
benzene-containing products and solvents have long been associated
with bone marrow toxicity. Both animal studies and human
epidemiological studies have shown statistically significant increases
of leukemia and other lymphohematopoietic cancers in workers exposed
to benzene. The most common leukemia that has been associated with
benzene exposure, also called benzene poisoning, is acute myelocytic
leukemia (AML). A review of the epidemiological literature on workers
exposed to benzene or benzene-containing solvents and products shows,
without question, that this exposure is significantly related to other
types of leukemia and lymphoma. In this article, we review the
literature on the relationship between benzene exposure and chronic
myelogenous leukemia (CML) and find that benzene and
benzene-containing products are significantly related to morbidity and
mortality from CML.
Formaldehyde
as a potential human leukemogen: an assessment of biological
plausibility.Crit
Rev Toxicol. 2006 Feb;36(2):135-53.
The
International Agency for Research on Cancer (IARC, 2004) recently
reevaluated the epidemiological data on formaldehyde and concluded
that there was "strong but not sufficient evidence for a causal
association between leukaemia and occupational exposure to
formaldehyde." This conclusion was tempered since a mechanism for
leukemia induction could not be identified. Chemically induced
leukemia is a well-studied phenomenon with benzene and a number of
cancer chemotherapeutic drugs recognized as capable of causing this
effect. Abundant in vitro and in vivo data in animals and humans
demonstrate that exposure to sufficient doses of these recognized
leukemogens can initiate a cascade of events leading to hematopoietic
toxicity and the subsequent development of leukemia. This review
addresses the biological plausibility that formaldehyde might be
capable of causing any type of leukemia by providing a broad overview
of the scientific data that must be considered in order to support or
refute a conclusion that a particular substance might be leukemogenic.
Data on benzene and selected chemotherapeutic cancer drugs are used as
examples and are briefly summarized to demonstrate the similar
biological events thought to result in leukemogenesis. These data are
compared and contrasted with the available data on formaldehyde in
order to judge whether they fulfill the criteria of biological
plausibility that formaldehyde would be capable of inducing leukemia
as suggested by the epidemiological data. Based on the epidemiological
data, it is reasonable to expect that if formaldehyde was capable of
inducing leukemia, in vivo and in vitro data would offer supporting
evidence for biological plausibility. In particular, there is (1) no
evidence to suggest that formaldehyde reaches any target organ beyond
the site of administration including the bone marrow, (2) no
indication that formaldehyde is toxic to the bone marrow/hematopoietic
system in in vivo or in vitro studies, and (3) no credible evidence
that formaldehyde induces leukemia in experimental animals. As
discussed in this review, based on the key biological events that
occur in the process of chemically induced leukemia, there is
inadequate biological evidence currently available to corroborate
existing weak epidemiological associations. This provides an
insufficient database to conclude that there is a causal relationship
for formaldehyde and leukemia risk.
Case report:
hydroquinone and/or glutaraldehyde induced acute myeloid leukaemia?J
Occup Med Toxicol. 2006 Jul 26;1:19.
ABSTRACT:
BACKGROUND: Exposures to high doses of irradiation, to chemotherapy,
benzene, petroleum products, paints, embalming fluids, ethylene oxide,
herbicides, pesticides, and smoking have been associated with an
increased risk of acute myelogenous leukemia (AML). Although there in
no epidemiological evidence of relation between X-ray developer, fixer
and replenisher liquids and AML, these included glutaraldehyde which
has weakly associated with lymphocytic leukemia in rats and
hydroquinone has been increasingly implicated in producing leukemia,
causing DNA and chromosomal damage, inhibits topo-isomerase II, alter
hematopoiesis and inhibit apoptosis of neoplastic cells. CASE
PRESENTATION: Two white females (A and B) hired in 1985 as medical
radiation technologists in a primary care center, in Greece. In July
2001, woman A, 38-years-old, was diagnosed as having acute monocytic
leukaemia (FAB M5). The patient did not respond to therapy and died
threeweeks later. In August 2001, woman B, 35-year-old, was diagnosed
with acute promyelocytic leukaemia (FAB M3). Since discharge, she is
in continuous complete remission. Both women were non smokers without
any medical history. Shortly after these incidents official inspectors
and experts inspected workplace, examined equipment, archives of
repairs, notes, interviewed and monitored employees. They concluded
that shielding was inadequate for balcony's door but personal
monitoring did not show any exceeding of TLV of 20 mSv yearly and
cytogenetics analysis did not reveal findings considered to be
characteristics of ionizing exposure. Equipment for developing photos
had a long list of repairs, mainly leakages of liquids and increases
of temperature. On several occasions the floor has been flooded
especially during 1987-1993 and 1997-2001. Inspection confirmed a
complete lack of ventilation and many spoiled medical x-ray films.
Employees reported that an "osmic" level was continuously evident and
frequently developed symptoms of respiratory irritation and dizziness.
CONCLUSION: The findings support the hypothesis that the specific AML
cases might have originated from exposure to chemicals, especially
hydroquinone and/or glutaraldehyde. The report also emphasises the
crucial role of inspection of facilities and enforcement of compliance
with regulations in order to prevent similar incidents.
Study of
chemical composition of glue "RAZI" used by solvent abusers in
Tbilisi.
Georgian Med News. 2006 Apr;(133):65-7.
The analysis
of the glue "RAZI" was carried out at the Republican Chromatographic
Center of Georgia, with high-efficient liquid chromatographic
equipment "Millipore Waters" (USA), by I. Wagner's Method. We were
able to determine presumable composition of the glue chemical
components. The different substances were evaporated at different
times fixed by appropriate peaks on chromatogram. There have been at
least five toxic substances identified within the glue composition,
which are used as industrial or household chemical goods and as some
authors explain, may be used as inhaling psychoactive substances.
These substances are: benzol (benzene), toluene (toluol), phenol
(carbolic acid), chloroform, and methyl-ketone. The glue is inhaled
with a small polyethylene bag. The substances are evaporated during
inhalation and join arterial blood through lungs. In several minutes
leap forward a situation similar to alcohol intoxication. The
evaporated substances characterized by strong toxicity and influence
to the organism in different ways. The results of chronic glue abuse
is serious, such as lethal aplastic anemia, leukemia, marrow damage,
chromosome aberrations, functional disorders of CNS, dystrophic
changes in myocardium, cirrhosis, liver atrophy and so on. Abuse of
the glue "RAZI" can lead to very serious medical consequences and
represents emerging public health problem in Georgia.
Classification
of risk occupation for benzene exposure by urine trans, trans-munconic
acid level.
Asian Pac J Cancer Prev. 2006
Jan-Mar;7(1):149-50.
Leukemogenesis
due to benzene exposure is of particular concern because of ongoing
exposure to thousands of workers in industrial plants. Monitoring of
at-risk workers is recommended and of several biomarkers, urine
trans,trans-muconic acid (ttMA) determination is a helpful test. The
aim of this work was to classify risk occupation for benzene exposure
by urine ttMA level. Here, the author compared exposure risk ratios
from 6 previous reports concerning urine ttMA determination. Of
interest, the high risk occupations were found to be those which have
direct contact with benzene in environmental ambient air, with
petroleum fuel as the common source.
Occupational
exposure to solvents and the risk of lymphomas.Epidemiology.
2006 Sep; 17(5): 552-61.
BACKGROUND: A
number of studies have shown possible associations between
occupational exposures, particularly solvents, and lymphomas. The
present investigation aimed to evaluate the association between
exposure to solvents and lymphomas (Hodgkin and non-Hodgkin) in a
large population-based, multicenter, case-control study in Italy.
METHODS: All newly diagnosed cases of malignant lymphoma in men and
women age 20 to 74 years in 1991-1993 were identified in 8 areas in
Italy. The control group was formed by a random sample of the general
population in the areas under study stratified by sex and 5-year age
groups. We interviewed 1428 non-Hodgkin lymphoma cases, 304 Hodgkin
disease cases, and 1530 controls. Experts examined the questionnaire
data and assessed a level of probability and intensity of exposure to
a range of chemicals. RESULTS: Those in the medium/high level of
exposure had an increased risk of non-Hodgkin lymphoma with exposure
to toluene (odds ratio = 1.8; 95% confidence interval = 1.1-2.8),
xylene 1.7 (1.0-2.6), and benzene 1.6 (1.0-2.4). Subjects exposed to
all 3 aromatic hydrocarbons (benzene, toluene, and xylene; medium/high
intensity compared with none) had an odds ratio of 2.1 (1.1-4.3). We
observed an increased risk for Hodgkin disease for those exposed to
technical solvents (2.7; 1.2-6.5) and aliphatic solvents (2.7;
1.2-5.7). CONCLUSION: This study suggests that aromatic and
chlorinated hydrocarbons are a risk factor for non-Hodgkin lymphomas,
and provides preliminary evidence for an association between solvents
and Hodgkin disease.
Dermal
exposure assessment to benzene and toluene using charcoal cloth pads.J
Expo Anal Environ Epidemiol. 2005
Jan;15(1):47-50.
Charcoal cloth
pads have been used to assess volatile chemicals on the skin in a
laboratory setting; however, they have not yet been applied to measure
dermal exposure in occupational settings. This study aimed at
evaluating whether charcoal pads can be used to assess dermal exposure
to benzene and toluene in workers of a petrochemical plant. Inhalation
and dermal exposure levels to benzene and toluene were assessed for
workers of a petrochemical plant performing different jobs. Benzene
uptake was assessed by determining S-phenylmercapturic acid in
workers' urine samples. Dermal exposure levels on the charcoal pads
were adjusted for ambient air levels of benzene and toluene by
subtracting the amount of benzene or toluene measured in personal air
from the amount of benzene or toluene measured on the charcoal pad. In
general, measured external and internal exposure levels were low. The
estimated contribution of the dermal route to internal benzene
exposure levels was less than 0.06% for all jobs. Toluene personal air
concentrations and benzene and toluene dermal exposure levels differed
statistically significantly between job titles. For benzene,
differences between jobs were larger for adjusted dermal exposures
(maximum 17-fold, P = 0.02) than for inhalation exposures (maximum
two-fold, P = 0.08). Also for toluene, although less clear,
differences between jobs were larger for adjusted dermal exposures
(maximum 23-fold, P = 0.01) as compared to inhalation exposures
(maximum 10-fold, P = 0.01). Charcoal pads appeared to measure dermal
exposures to benzene and toluene in addition to ambient air levels.
Future studies applying charcoal cloth pads for the dermal exposure
assessment at workplaces with higher dermal exposure to organic
solvents may provide more insight into the biological relevance of
dermal exposure levels measured by charcoal cloth pads. In addition,
the design of the dermal sampler might be improved by configuring a
dermal sampler, where part of the sampler is protected against direct
contact and splashes, but still permeable for the gas phase. This
design would most likely result in a better ability to correct for
airborne concentrations at a given body location.
A field
method for sampling toluene in end-exhaled air, as a biomarker of
occupational exposure: correlation with other exposure indices.Ind
Health. 2004 Apr;42(2):226-34.
A sensitive
and rapid method for the determination of toluene in exhaled air is
described. We have developed a device for direct breath sampling
consisting of a sampler inserted into an empty 58 mL glass vial closed
by a Teflon rubber septum. The sorbent cartridge functions as a
diffusive sampler and employs a Tenax resin (300 mg, 35/50 mesh) to
trap volatile organic compounds from the exhaled air. End-exhaled air
is collected "in field" by removing the septum from the vial, by
forcibly exhaling into the device through a suitable Teflon tube, and
then by sealing the bottle quickly. Environmental toluene levels
ranged from 13 to 191 mg/m3, while the concentrations of the solvent
in alveolar air, in blood and urine ranged from 159 to 3354 ng/L, from
3.6 to 53.5 microg/L, and from 8.7 to 142.4 microg/L respectively. The
correlation coefficients (r) of biological measurements towards
environmental toluene levels were 0.822, 0.850 and 0.846 for alveolar
air, blood and urine samples, respectively. The breath sampler allowed
the rapid and non-invasive collection of data on elimination of
toluene.
The
endogeneous formation of highly chlorinated tetrahydro-beta-carbolines
as a possible causative mechanism in idiopathic Parkinson's disease.
Adv Exp Med Biol.
2003;527:253-63.
The causative
interrelationship between long-term, low level exposure to chlorinated
volatile organic solvents (VOSs) and neurodegenerative diseases (polyneuropathy,
encephalopathy) are still an issue of controversial debate.
Endogeneously formed chlorinated tetrahydro-beta-carbolines found by
Bringmann 1995 (TaClo hypothesis) may contribute, in particular, to
the development of (idiopathic) Parkinson's disease (PD) in the
presence of the sufficient amount of trichloroacetaldehyde, an
intermediate in metabolism of trichloroethylene (TRI). Long-term
storage of specific VOSs over years, evident frrom exhalation pattern
during the postexposure period, may serve as a promoting factor to
form continuously TaClo non-enzymatically from tryptamine and
trichloroacetaldehyde. Thus, the induction of TaClo-mediated
neurotoxic processes extends over years. The onset of Parkinson's
disease in three chronic TRI-exposed individuals during the
postexposure period could be associated with the presence of TaClo in
ng-range. Consequently, determination of TaClo and its derivatives in
blood of humans exposed to chlorinated VOSs may serve as a marker of
risk indicating either causative or supportive processes of
neurodegeneration that may lead to manifestation of PD after many
years.
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