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  • 1.
    Andersson, Lena
    et al.
    Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden; Man-Technology-Environment Research Centre (MTM), Department of Science, Örebro University, Örebro, Sweden.
    Bryngelsson, Ing-Liss
    Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden.
    Ngo, Yen
    Swedish Institute for Infectious Disease Control, Solna, Sweden.
    Ohlson, Carl-Göran
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Clinical Medicines, Örebro University, Örebro, Sweden; Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden.
    Westberg, Håkan
    Örebro University, School of Science and Technology. Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden.
    Exposure assessment and modeling of quartz in Swedish iron foundries for a nested case-control study on lung cancer2012In: Journal of Occupational and Environmental Hygiene, ISSN 1545-9624, E-ISSN 1545-9632, Vol. 9, no 2, p. 110-119Article in journal (Refereed)
    Abstract [en]

    Exposure assessment of quartz in Swedish iron foundries was performed based on historical and present measurement data. To evaluate the exposure response relationship between quartz exposure and lung cancer, we modeled quartz exposure from our database of measurements using determinants job title, time period and company. Based on these modeled exposure data, we conducted a nested case– control evaluation.

    In our database, the overall individual daily time-weighted average (TWA) quartz concentrations of current and historical data varied between 0.0018 and 4.9 mg/m3, averaging 0.083 mg/m3. The job titles with mean TWAs for the whole study period exceeding the European Union recommended occupational exposure limit of 0.05 mg/m3 were fettlers (0.087 mg/m3), furnace and ladle repair (0.42 mg/m3) and maintenance (0.054 mg/m3) workers.

    The mixed model analysis demonstrated significant determinants on the job level for furnace and ladle repair (β=4.06; 95% CI 2.78-5.93). For all jobs significantly higher exposure levels occurred only during the first time period, 1968-1979 (β=2.08; 95% CI 1.75-2.47), and a decreasing but not significant trend was noted for the three following 10 year time periods up to 2006 (β=1.0, 0.96 and 1, respectively). Two iron foundries had significantly higher quartz concentration levels than the others (β=1.31; 95% CI 1.00-1.71 and β=1.63; 95% CI 1.00-2.65, respectively). The individual cumulative quartz exposure measures were categorized in low, medium and high exposure (0.5-<1, 1-1.9 and ≥2 mg/m3 *years, respectively).

    In the nested case-control analysis, we found the highest odds ratios of lung cancer (OR 1.17; 95% CI 0.53-2.55) for the medium exposure group. No dose– response trend or significantly increased risk was determined for our high exposed group (≥2 mg/m3), representing 40 years of exposure at >0.05 mg/m3 of quartz. To conclude, certain foundry workers are still exposed to high levels of quartz, but an increased risk of lung cancer caused by quartz exposure in these Swedish iron foundries could not be confirmed at our exposure levels.

  • 2.
    Westberg, Håkan
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Andersson, Lena
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Bryngelsson, Ing-Liss
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ngo, Yen
    Swedish Institute for Infectious Disease Control, Nobels väg 18, SE-171 82 Solna, Sweden.
    Ohlson, Carl-Göran
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Cancer morbidity and quartz exposure in Swedish iron foundriesManuscript (preprint) (Other academic)
  • 3.
    Westberg, Håkan
    et al.
    Örebro University, School of Science and Technology. Örebro University Hospital.
    Andersson, Lena
    Örebro University, School of Science and Technology.
    Bryngelsson, Ing-Liss
    Swedish Institute for Infectious Disease ControlSolnaSweden.
    Ngo, Yen
    Department of Clinical Medicines, Örebro University, Örebro, Sweden.
    Ohlson, Carl-Göran
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Cancer morbidity and quartz exposure in Swedish iron foundries2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 5, p. 499-507Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to determine cancer morbidity amongst Swedish iron foundry workers with special reference to quartz exposure. In addition to respirable dust and quartz, phenol, formaldehyde, furfuryl alcohols, polycyclic aromatic hydrocarbons (PAHs), carbon black, isocyanates and asbestos are used or generated by foundry production techniques and exposure to any of these substances could have potentially carcinogenic effects. Cancer morbidity between 1958 and 2004 was evaluated in a cohort of 3,045 male foundry workers employed for > 1 year between 1913 and 2005. Standardised incidence ratios (SIRs) with 95 % confidence intervals (95 % CI) were determined by comparing observed numbers of incident cancers with frequencies in the Swedish cancer register. Exposure measures were assessed using information from the personal files of employees and modelling quartz measurement based on a database of 1,667 quartz measurements. Dose responses for lung cancer were determined for duration of employment and cumulative quartz exposure for latency periods > 20 years. Overall cancer morbidity was not increased amongst the foundry workers (SIR 1.00; 95 % CI, 0.90-1.11), but the incidence of lung cancer was significantly elevated (SIR 1.61; 95 % CI, 1.20-2.12). A non-significant negative dose response was determined using external comparison with a latency period of > 20 years (SIR 2.05, 1.72 1.26 for the low, medium and high exposure groups), supported by internal comparison data (hazard ratios 1, 1.01, 0.78) for the corresponding groups. For cancers at sites with at least five observed cases and a SIR > 1.25, non-significant risks with SIRs > 1.5 were determined for cancers of the liver, larynx, testis, connective muscle tissue, multiple myeloma plasmacytoma and lymphatic leukaemia. A significant overall risk of lung cancer was determined, but using external and internal comparison groups could not confirm any dose response at our cumulative quartz dose levels.

  • 4.
    Westberg, Håkan
    et al.
    Örebro University, School of Health and Medical Sciences.
    Egelrud, Liselott
    Ohlson, Carl-Göran
    Örebro University, School of Health and Medical Sciences.
    Hygerth, Mona
    Lundholm, Cecilia
    Exposure to nitrous oxide in delivery suites at six Swedish hospitals2008In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 81, no 7, p. 829-836Article in journal (Other academic)
    Abstract [en]

    OBJECTIVE: This study presents occupational peak and average exposures to nitrous oxide in delivery suites in six Swedish hospitals and evaluates different scavenging techniques. METHODS: Exposure measurements based on four consecutive 2-h samples (n = 111) were used to calculate 8-h time-weighted averages (8-h TWAs) for 36 midwives and assistant midwives. Short-term (15 min) samples to study peak exposure were also included in the monitoring program. Diffusive samplers were used for monitoring, and analyzed by thermal desorption and gas chromatography-mass spectrometry (GC-MS). The effect on exposure of different types of scavenging systems was studied by mixed model analysis. RESULTS: The 8-h TWA (n = 36) nitrous oxide concentrations varied between 2.5 and 260 mg/m3, and the geometric means for all the 8-h TWAs was 17 mg/m3 for the midwives and 42 mg/m3 for the assistant midwives. Around 25% of all the 8-h TWAs exceeded the American Conference of Industrial Hygienists' (ACGIH) threshold limit value (TLV-TWA) of 90 mg/m3 (50 ppm). For the short-term samples (n = 29) the nitrous oxide levels varied between 19 and 4,200 mg/m3, and 14% exceeded the Swedish occupational exposure ceiling limit value of 900 mg/m3. The 8-h TWAs were four times higher when the non-ventilated and ventilated simple masks were compared to the double mask (P = 0.02). This trend, although not statistically significant, was also seen for the short-term samples. CONCLUSION: A diffusive sampling method and a GC-MS analytical technique was used for long- and short-term sampling of nitrous oxide. A large number of TWAs exceeded the ACGIH-TLV. Mask connected to scavenging systems significantly reduced the exposures. Furthermore, using a forced general air ventilation system in addition to improved work and delivery routines for the staff and the mother-to-be substantially improved the air quality in the delivery suites.

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