Respiratory health effects and exposure to superabsorbent polymer and paper dust - an epidemiological study

Abstract Background The primary aim of the present study was to investigate if exposure to dust from absorbent hygiene products containing superabsorbent polymer is related to symptoms from the airways and from the eyes. The secondary aim was to estimate the current exposure to superabsorbent polymer among production and maintenance workers in a plant producing hygiene products. Methods The cohort comprised 1043 workers of whom 689 were exposed to super absorbent polymer and 804 were exposed to paper dust (overlapping groups). There was 186 workers not exposed to either superabsorbent polymer or to paper dust They were investigated with a comprehensive questionnaire about exposure, asthma, rhinitis and symptoms from eyes and airways. The results were analyzed with logistic regression models adjusting for sex, age, atopy and smoking habits. An aerosol sampler equipped with a polytetrafluoroethylene filter with 1 μm pore size was used for personal samplings in order to measure inhalable dust and superabsorbent polymer. Results The prevalence of nasal crusts (OR 1.4, 95% CI 1.01-2.0) and nose-bleeding (OR 1.7, 95% CI 1.2-2.4) was increased among the paper dust exposed workers (adjusted for superabsorbent polymer exposure). There were no significant effects associated with exposure to superabsorbent polymer (adjusted for paper dust exposure). The average exposure to inhalable levels of total dust (paper dust) varied between 0.40 and 1.37 mg/m3. For superabsorbent polymer dust the average exposure varied between 0.02 and 0.81 mg/m3. Conclusions In conclusion, our study shows that workers manufacturing diapers in the hygiene industry have an increased prevalence of symptoms from the nose, especially nose-bleeding. There was no relation between exposure to superabsorbent polymer and symptoms from eyes, nose or respiratory tract, but exposure to paper dust was associated with nose-bleeding and nasal crusts. This group of workers had also a considerable exposure to superabsorbent polymer dust.</p

Occupational exposure and new-onset asthma in a population-based study in Northern Europe (RHINE).

To access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.OBJECTIVES: In a large population-based study among adults in northern Europe the relation between occupational exposure and new-onset asthma was studied. METHODS: The study comprised 13 284 subjects born between 1945 and 1973, who answered a questionnaire 1989-1992 and again 1999-2001. Asthma was defined as 'Asthma diagnosed by a physician' with reported year of diagnose. Hazard ratios (HR), for new-onset adult asthma during 1980-2000, were calculated using a modified job-exposure matrix as well as high-risk occupations in Cox regression models. The analyses were made separately for men and women and were also stratified for atopy. RESULTS: During the observation period there were 429 subjects with new-onset asthma with an asthma incidence of 1.3 cases per 1000 person-years for men and 2.4 for women. A significant increase in new-onset asthma was seen for men exposed to plant-associated antigens (HR = 3.6; 95% CI [confidence interval] = 1.4-9.0), epoxy (HR = 2.4; 95% CI = 1.3-4.5), diisocyanates (HR = 2.1; 95% CI = 1.2-3.7) and accidental peak exposures to irritants (HR = 2.4; 95% CI = 1.3-4.7). Both men and women exposed to cleaning agents had an increased asthma risk. When stratifying for atopy an increased asthma risk were seen in non-atopic men exposed to acrylates (HR = 3.3; 95% CI = 1.4-7.5), epoxy compounds (HR = 3.6; 95% CI = 1.6-7.9), diisocyanates and accidental peak exposures to irritants (HR = 3.0; 95% CI = 1.2-7.2). Population attributable risk for occupational asthma was 14% for men and 7% for women. CONCLUSIONS: This population-based study showed that men exposed to epoxy, diisocyanates and acrylates had an increased risk of new-onset asthma. Non-atopics seemed to be at higher risk than atopics, except for exposure to high molecular weight agents. Increased asthma risks among cleaners, spray painters, plumbers, and hairdressers were confirmed.Icelandic Research Council Swedish Heart and Lung Foundation Vardal Foundation for Health Care and Allergic Research Swedish Association Against Asthma and Allergy Swedish Council for Working Life and Social Research Bror Hjerpstedt Foundation Norwegian Research Council 135773/330 Norwegian Asthma and Allergy Association Danish Lung Association Estonian Science Foundation 435

Cardiovascular disease mortality trends in Latvia between 2009 and 2019

Kardiovaskulārās slimības (KVS) ir biežākais nāves cēlonis Latvijā, kas, salīdzinājumā ar citām Rietumu pasaules valstīm, uzrāda salīdzinoši augstākus KVS mirstības rādītājus. Svarīgi ir pareizi identificēt šos nāves iemeslus un analizēt ikgadējos mirstības rādītājus, lai spētu saprast un izvērtēt, cik lietderīgi ir bijuši ieguldījumi veselības aprūpē, un cik efektīvi ir bijuši sasniegumi ne tikai KVS ārstēšanā, bet arī to prevencijā, kas rezultātā ļautu turpmāk spriest par izmaiņām vai uzlabojumiem veselības nozarē. Pētījuma mērķis bija izpētīt KVS izraisītas mirstības tendences Latvijā laika posmā no 2009. līdz 2019. gadam, kurā tika analizēti dati par 175 354 nāves gadījumu skaitu, kas iegūti no Veselības statistikas datubāzes. Atbilstoši pētījuma mērķim un uzdevumiem, kardiovaskulārā mirstība tika analizēta starp Latvijas lielāko pilsētu un reģionu teritorijām, pēc biežākajiem KVS nāves cēloņiem, aplūkojot atšķirības gan starp dzimumiem, gan vecuma grupām. KVS mirstība Latvijā laika periodā no 2009. līdz 2019. gadam ir palielinājusies. Galvenie KVS nāves iemesli Latvijā ir išēmiskas sirds slimības un cerebrovaskulāras slimības, no kurām šo diagnožu apakšgrupām kā biežākie nāves cēloņi ir hroniska išēmiska sirds slimība un išēmisks insults. Teritoriālā skatījumā mirstības rādītāji no KVS ir augstāki Latvijas lielāko pilsētu teritorijās, bet zemāki valsts reģionos, taču reģionu skatījumā ar izteikti KVS augstāku mirstību izceļas Latgales reģions, kaut gan straujākais mirstības rādītāju kāpums šajā laika periodā novērots Vidzemes reģionā. Pilsētu skatījumā visaugstākā mirstība konstatēta Rēzeknē. Vērtējot KVS mirstību starp dzimumiem no 2009. līdz 2019. gadam, Latvijā sieviešu vidū ir izteikti augstāka mirstība nekā vīriešu. Mirstība sirds išēmisko slimību dēļ starp dzimumiem ir līdzīga, bet sievietēm ir konstatēta izteikti augstāka mirstība no insulta. No 2009. līdz 2019. gadam Latvijā kopumā visaugstākā mirstība un straujākais mirstības pieaugums ir grupā pēc 60 gadu vecuma. Atslēgas vārdi: kardiovaskulāras slimības, kardiovaskulārā mirstība, mirstības tendences, mirstība Latvijā.Cardiovascular diseases (CVD) are the most common cause of death in Latvia, and show relatively higher CVD mortality rates comparing with other Western countries. In order to understand and assess effectiveness of the health care system’s financing and the progress made in both treatment as well as prevention of CVD to be able to decide on further improvements or changes in health care sector it is important to identify correctly these causes of death and to analyse the annual mortality rates. The aim of the study was to explore data of mortality rates caused by CVD in Latvia between 2009 and 2019. The study has analysed data on 175 354 cases of death caused by CVD obtained from the Health Statistics Database. According to the aim and tasks of the study, tendencies of cardiovascular mortality have been analyzed comparing data of most common causes of CVD between largest cities and other regions of Latvia, and seeking for differences between genders and age groups. Findings of the study show that CVD mortality in Latvia has increased in the period 2009. - 2019. The main causes of CVD death in Latvia are ischemic heart diseases and cerebrovascular diseases, of which chronic ischemic heart disease and ischemic stroke are the most common causes of death in the subgroups of these diagnoses. From a territorial point of view, it was observed that mortality rates from the CVD are higher in the territories of the largest cities , but lower in the regions of the country, but between the regions with significantly higher mortality of CVD, Latgale region stands out, although the sharpest increase in mortality rates during this time period was observed in Vidzeme region. In the view of cities, the highest mortality was observed in Rezekne. When assessing CVD mortality by gender in 2009- 2019, there is a significantly higher mortality rate among females. Mortality due to ischemic heart disease is similar for both genders, but females have a considerably higher mortality rate from stroke. Comparing data between different age groups from 2009 to 2019, the highest mortality and the sharpest increase in mortality was recorded in the group of the age of 60 and older. Keywords: cardiovascular diseases, cardiovascular mortality, mortality trendrs, mortality in Latvia

Occupational exposure and new-onset asthma in a population-based study in Northern Europe (RHINE)

OBJECTIVES: In a large population-based study among adults in northern Europe the relation between occupational exposure and new-onset asthma was studied. METHODS: The study comprised 13 284 subjects born between 1945 and 1973, who answered a questionnaire 1989-1992 and again 1999-2001. Asthma was defined as 'Asthma diagnosed by a physician' with reported year of diagnose. Hazard ratios (HR), for new-onset adult asthma during 1980-2000, were calculated using a modified job-exposure matrix as well as high-risk occupations in Cox regression models. The analyses were made separately for men and women and were also stratified for atopy. RESULTS: During the observation period there were 429 subjects with new-onset asthma with an asthma incidence of 1.3 cases per 1000 person-years for men and 2.4 for women. A significant increase in new-onset asthma was seen for men exposed to plant-associated antigens (HR = 3.6; 95% CI [confidence interval] = 1.4-9.0), epoxy (HR = 2.4; 95% CI = 1.3-4.5), diisocyanates (HR = 2.1; 95% CI = 1.2-3.7) and accidental peak exposures to irritants (HR = 2.4; 95% CI = 1.3-4.7). Both men and women exposed to cleaning agents had an increased asthma risk. When stratifying for atopy an increased asthma risk were seen in non-atopic men exposed to acrylates (HR = 3.3; 95% CI = 1.4-7.5), epoxy compounds (HR = 3.6; 95% CI = 1.6-7.9), diisocyanates and accidental peak exposures to irritants (HR = 3.0; 95% CI = 1.2-7.2). Population attributable risk for occupational asthma was 14% for men and 7% for women. CONCLUSIONS: This population-based study showed that men exposed to epoxy, diisocyanates and acrylates had an increased risk of new-onset asthma. Non-atopics seemed to be at higher risk than atopics, except for exposure to high molecular weight agents. Increased asthma risks among cleaners, spray painters, plumbers, and hairdressers were confirmed

The risk of respiratory tract infections and antibiotic use in a general population and among people with asthma

Aim: The aim of this study was to investigate occupational, environmental, early life and other risk factors associated with respiratory infections and antibiotics use in a general population and among asthmatic individuals. Method: This study included 15842 participants of the Respiratory Health in Northern Europe (RHINE) study aged 25–54 years from five Nordic countries, who answered a questionnaire covering respiratory outcomes, exposures, demographic characteristics and numbers of infections and courses of antibiotics in the last 12 months. Multiple logistic regression with and without adjustment for age, sex, smoking status, body mass index and centre were used to study the risk of infection and antibiotics in relation to asthma, and also the association between infection and antibiotics and occupations. Results: In the whole population, 11.6% reported having three or more respiratory infections, and 14.7% had used antibiotics because of respiratory tract infections within the last year. Asthmatic participants reported tripled odds for such infections (adjusted OR 2.98, 95% CI 2.53–3.52) and antibiotics use (adjusted OR 3.67, 95% CI 3.18–4.24) as compared to non-asthmatic participants. Both in the general and the asthmatic population, female sex, obesity and exposure to building dampness were associated with respiratory infections. Female sex and current smoking and living in Tartu were associated with antibiotic use. The use of antibiotics was doubled in people hospitalised for severe respiratory infection in childhood. Conclusion: In this study we identified several factors associated with increased respiratory infections and use of antibiotics in a general population and among asthmatic individuals. The frequency of respiratory infections and subsequent antibiotic treatment were increased among those with asthma

The risk of respiratory tract infections and antibiotic use in a general population and among people with asthma

Aim The aim of this study was to investigate occupational, environmental, early life and other risk factors associated with respiratory infections and antibiotics use in a general population and among asthmatic individuals. Method This study included 15 842 participants of the Respiratory Health in Northern Europe (RHINE) study aged 25–54 years from five Nordic countries, who answered a questionnaire covering respiratory outcomes, exposures, demographic characteristics and numbers of infections and courses of antibiotics in the last 12 months. Multiple logistic regression with and without adjustment for age, sex, smoking status, body mass index and centre were used to study the risk of infection and antibiotics in relation to asthma, and also the association between infection and antibiotics and occupations. Results In the whole population, 11.6% reported having three or more respiratory infections, and 14.7% had used antibiotics because of respiratory tract infections within the last year. Asthmatic participants reported tripled odds for such infections (adjusted OR 2.98, 95% CI 2.53–3.52) and antibiotics use (adjusted OR 3.67, 95% CI 3.18–4.24) as compared to non-asthmatic participants. Both in the general and the asthmatic population, female sex, obesity and exposure to building dampness were associated with respiratory infections. Female sex and current smoking and living in Tartu were associated with antibiotic use. The use of antibiotics was doubled in people hospitalised for severe respiratory infection in childhood. Conclusion In this study we identified several factors associated with increased respiratory infections and use of antibiotics in a general population and among asthmatic individuals. The frequency of respiratory infections and subsequent antibiotic treatment were increased among those with asthma

Dust-free bleaching powder may not prevent symptoms in hairdressers with bleaching-associated rhinitis

Objective: Hairdressers have an increased risk for airway symptoms especially when using hairbleaching powder containing persulfate. To minimize exposure, dust-free bleaching powder (DFP) has been made available. We studied the effects of regular powder (RP) or DFP on the airway symptoms of hairdressers with hair-bleaching associated rhinitis. Methods: Twelve hairdressers each performed three hair-bleachings on a wig in an exposure chamber. Half of the subjects used RP and half used DFP. Exposure to persulfate and ammonia was measured. Before and after each bleaching, the participants stated their degree of airway symptoms on a visual analogue scale. Nasal lavage and blood were sampled before exposure, after the last bleaching, and in the morning after exposure to measure inflammatory markers. Results: Exposure to persulfate was higher when using RP compared to DFP, 22 (11-55) vs. 12 (8- 13) μg/m3; median (min-max). Exposure to ammonia did not differ between the groups. Both groups reported an increase in asthma-like symptoms and this increase was significant. Neutrophils, lymphocytes, and monocytes increased after exposure in both groups; monocytes decreased the day after. In nasal lavage, IL-8 was increased the morning after for both types of powder, and the increase was significant in the total group. IL-6 increased immediately after exposure and the day after only in the group using RP. Conclusions: Although DFP powder emits lower levels of persulfate, effects are still elicited in symptomatic hairdressers