Postulating a dermal pathway for exposure to anti-neoplastic drugs among hospital workers. Applying a conceptual model to the results of three workplace surveys

Dermal exposure to anti-neoplastic drugs has been suggested as a potentially important route of exposure of hospital workers. Three small-scale workplace surveys were carried out in several hospitals focusing on contamination by leakage from IV infusion systems; contamination by spilled urine of patients treated with anti-neoplastic drugs and particulate phase anti-neoplastic drugs in the air of outpatient and nursing clinics. A new visual scoring technique using a fluorescent tracer was developed. The method showed a very low limit of detection (0.02 μl of contamination) and a very high inter-observer agreement (ICC = 0.99). Evaluation of IV systems and connectors showed distinct differences between the systems. It was estimated that 0.5-250 μg of a drug can become available for contamination during each infusion. Differences in average contamination between nurses were negligible in the experimental set-up. Widespread and frequent contamination due to spillage of contaminated urine was revealed and appeared not to be restricted to the patient's room. Airborne particulate concentrations went undetected for 80% of the measurements. However, in a few cases concentrations up to 2 ng/m3 of cyclophosphamide were measured predominantly in a room of a patient treated with this anti-neoplastic drug. Based on these results and a recently proposed conceptual model for dermal exposure a most likely exposure scenario was postulated both for nurses involved in administering drugs and nurses caring for treated patients. Estimation of all relevant mass transport rates will be a challenge for the near future. (C) 2000 British Occupational Hygiene Society

Evaluation of the use of 1-nitropyrene, pyrene, and 1-hydroxypyrene as markers of diesel exhaust exposure in underground mining: Results from the biomodem study

The exposure to diesel exhaust was studied in underground mining of oil shale in Estonia. The purpose of this study was to evaluate different approaches to exposure assessment. Fifty men who drove diesel-powered excavators underground were compared with 50 surface workers who had no known occupational exposure to diesel exhaust. Samples of respirable air were analyzed for 1-nitropyrene and pyrene. Urine samples were collected at the start and after the first and the last shift of the same week, and were analyzed for 1-hydroxypyrene. Although ambient monitoring of 1-nitropyrene indicated a relatively high exposure of underground workers to diesel exhaust compared to surface workers (approximately 10-fold higher), only a small increase in the excretion of 1-hydroxypyerene was observed. Nonoccupational exposures such as smoking, recent consumption of grilled food, and recent proximity to an open fire had a greater impact on urinary excretion of 1-hydroxypyrene than occupational exposure to diesel exhaus

Influence of combined dust reducing carpet and compact air filtration unit on the indoor quality of a classroom

Primary schools mostly rely on natural ventilation but also have an interest in affordable technology to improve indoor air quality (IAQ). Laboratory tests show promising results for dust reducing carpets and compact air filtration systems but there is no information available on the performance of these interventions in actual operating classrooms. An exploratory study was performed to evaluate a combination of the two systems in a primary school. Measurements of PM-10 and PM-2.5 were performed by filter sampling and aerosol spectrometry. Other IAQ parameters included black smoke (BS), volatile organic compounds (VOC), nitrogen dioxide (NO2) and formaldehyde. Both interventions were introduced in one classroom during one week, using another classroom as a reference. In a second week the interventions were moved to the other classroom, using the first as a reference (cross-over design). In three remaining weeks the classrooms were compared without interventions. Indoor IAQ parameters were compared to the corresponding outdoor parameters using the indoor/outdoor (I/O) ratio. When the classrooms were occupied (teaching hours) interventions resulted in 27-43% reductions of PM-10, PM-2.5 and BS values. During the weekends the systems reduced these levels by 51-87%. Evaluations using the change in I/O ratios gave comparable results. Levels of VOC, NO2 and formaldehyde were rather low and a contribution of the interventions to the improvement of these gas phase IAQ parameters was inconclusive.crosscheck: This document is CrossCheck deposited related_data: Supplementary Information copyright_licence: The Royal Society of Chemistry has an exclusive publication licence for this journal copyright_licence: The accepted version of this article will be made freely available after a 12 month embargo period history: Received 24 September 2014; Accepted 31 October 2014; Accepted Manuscript published 31 October 2014; Advance Article published 7 November 2014; Version of Record published 11 February 2015status: publishe

Relationship between total urinary PAH, 1-OH pyrene levels and mutagenicity of urinary extracts from psoriatic patients exposed to therapeutical coal tar-based ointment.

Total PAH, 1-OH pyrene and mutagenicity levels have been investigated in urine from psoriatic patients exposed to therapeutical coal tar-based ointment

Comparative performance testing of respirator versus surgical mask using a water droplet spray model

Background During the SARS-CoV-2 pandemic, there was shortage of the standard respiratory protective equipment (RPE). The aim of this study was to develop a procedure to test the performance of alternative RPEs used in the care of COVID-19 patients. Methods A laboratory-based test was developed to compare RPEs by total inward leakage (TIL). We used a crossflow nebulizer to produce a jet spray of 1–100 µm water droplets with a fluorescent marker. The RPEs were placed on a dummy head and sprayed at distances of 30 and 60 cm. The outcome was determined as the recovery of the fluorescent marker on a membrane filter placed on the mouth of the dummy head. Results At 30 cm, a type IIR surgical mask gave a 17.7% lower TIL compared with an FFP2 respirator. At 60 cm, this difference was similar, with a 21.7% lower TIL for the surgical mask compared to the respirator. When adding a face shield, the TIL at 30 cm was further reduced by 9.5% for the respirator and 16.6% in the case of the surgical mask. Conclusions A safe, fast and very sensitive test method was developed to assess the effectiveness of RPE by comparison under controlled conditions

Personal exposure assessment of pesticides in residents : The association between hand wipes and urinary biomarkers

Background: Residential exposure to pesticides may occur via inhalation of airborne pesticides, direct skin contacts with pesticide-contaminated surfaces, and consumption of food containing pesticide residues. The aim was to study the association of dermal exposure to pesticides between the use and non-use periods, between farmer and non-farmer families and between dermal exposure and the excretion of metabolites from urine in residents living close to treated agricultural fields. Methods: In total, 112 hand wipes and 206 spot urine samples were collected from 16 farmer and 38 non-farmer participants living within 50 m from an agricultural field in the Netherlands. The study took place from May 2016 to December 2017 during the use as well as the non-use periods of pesticides. Hand wipes were analysed for the parent compound and urines samples for the corresponding urinary metabolite of five applied pesticides: asulam, carbendazim (applied as thiophanate-methyl), chlorpropham, prochloraz and tebuconazole. Questionnaire data was used to study potential determinants of occurrence and levels of pesticides in hand wipes according to univariate and multivariate analysis. Results: Carbendazim and tebuconazole concentrations in hand wipes were statistically significantly higher in the pesticide-use period compared to the non-use period. In addition, especially during the use periods, concentrations were statistically significantly higher in farmer families compared to non-farmer families. For asulam, chlorpropham and prochloraz, the frequency of non-detects was too high (57–85%) to be included in this analysis. The carbendazim contents in urine samples and hand wipes were correlated on the first and second day after taking the hand wipe, whereas chlorpropham was only observed to be related on the second day following the spray event. Conclusions: Concentrations in hand wipes were overall higher in pesticide use periods compared to non-use periods and higher in farmer families compared to non-farmer families. Only for carbendazim a strong correlation between concentrations in hand wipes and its main metabolite in urine was observed, indicating dermal exposure via contaminated indoor surfaces. We expect this to be related to the lower vapour pressure and longer environmental lifetime of carbendazim compared to the other pesticides studies

Biological monitoring of human exposure to coal tar. Urinary excretion of total polycyclic aromatic hydrocarbons, 1-hydroxypyrene and mutagens in psoriatic patients.

Three methods for the biological monitoring of human exposure to coal tar were compared. Levels of 1-hydroxypyrene(1-OH PYR), polycyclic aromatic hydrocarbons (PAH) and mutagens (Ames plate incorporation assay using Salmonella typhimurium strain TA98 in the presence of S9 and beta-glucuronidase) were determined in urinary samples from psoriatic patients undergoing topical treatment with mineral coal tar. A single sample of urine with a high content of PAH was diluted with urine of nonexposed, non-smoking subjects in order to obtain nine samples with a decreasing content of PAh metabolites. Mutagenicity of the extracts was detectable down to the dilution corresponding to a content in 1-OH PYR of about 50 micrograms/g creatinine and total PAH of 7 micrograms/g creatinine. In a second phase the three indicators of exposure to PAH were compared in 16 urinary samples from four psoriatic patients. The total PAH levels determined by the acidic deconjugation/reduction method were confirmed to be nearly always lower than the corresponding levels of 1-OH PYR alone. Most of the extracts were mutagenic, however, some of the samples with a high content in PAh metabolites were not mutagenic. In all the urinary samples analyzed the excretion of 1-OH PYR was markedly greater than in control subjects. 1-OH PYR and urinary mutagenicity levels were well correlated. The present data suggest that both the determination of mutagenicity and 1-OH PYR in urine may be used to monitor occupational exposure to PAH, the latter method being cheaper and of greater specificity and sensitivity