Beschreibung: Background MRI has developed into one of the most important medical diagnostic imaging modalities, but it exposes staff to static magnetic fields (SMF) when present in the vicinity of the MR system, and to radiofrequency and switched gradient electromagnetic fields if they are present during image acquisition. We measured exposure to SMF and motion-induced time-varying magnetic fields (TVMF) in MRI staff in clinical practice in the UK to enable extensive assessment of personal exposure levels and variability, which enables comparison to other countries. Methods 8 MRI facilities across National Health Service sites in England, Wales and Scotland were included, and staff randomly selected during the days when measurements were performed were invited to wear a personal MRI-compatible dosimeter and keep a diary to record all procedures and tasks performed during the measured shift. Results 98 participants, primarily radiographers (71%) but also other healthcare staff, anaesthetists and other medical staff were included, resulting in 149 measurements. Average geometric mean peak SMF and TVMF exposures were 448 mT (range 20–2891) and 1083 mT/s (9–12 355 mT/s), and were highest for radiographers (GM=559 mT and GM=734 mT/s). Time-weighted exposures to SMF and TVMF (GM=16 mT (range 5–64) and GM=14 mT/s (range 9–105)) and exposed-time-weighted exposures to SMF and TVMF (GM=27 mT (range 11–89) and GM=17 mT/s (range 9–124)) were overall relative low—primarily because staff were not in the MRI suite for most of their shifts—and did not differ significantly between occupations. Conclusions These results are comparable to the few data available from the UK but they differ from recent data collected in the Netherlands, indicating that UK staff are exposed for shorter periods but to higher levels. These data indicate that exposure to SMF and TVMF from MRI scanners cannot be extrapolated across countries.

Beschreibung: Background Little is known about occupational risk factors for meningioma. Objectives To study whether risk of meningioma is associated with several occupational exposures, including selected combustion products, dusts and other chemical agents. Methods The INTEROCC study was an international case-control study of brain cancer conducted in seven countries. Data collection by interview included lifetime occupational histories. A job exposure matrix was used to derive estimates of exposure for the 12 agents. ORs for ever versus never exposed and for exposure-response using duration of exposure and cumulative exposure were derived using conditional logistic regression stratified by sex, age group, country/region, adjusted for education. Results These analyses included 1906 cases and 5565 controls. For 11 of the 12 agents, no excess risk was found for ever exposed. For ever exposure to oil mists, an elevated OR of 1.57 (95% CI 1.10 to 2.22, 51 exposed cases) was found. Statistically significant exposure-response relationships were observed with cumulative exposure (p=0.01) and duration of exposure (p=0.04). Among women, there were also significant trends for cumulative and duration of exposure to asbestos and excesses in the highest exposure categories for formaldehyde. Conclusions Most agents examined did not provoke excess risks of meningioma. The main finding from this study is that it is the first study to identify a statistical association between exposure to oil mists and meningioma. This may be a chance finding or could be due to confounding with iron exposure and further research is required to understand whether the relationship is causal.

Beschreibung: Background Colorectal cancer is the third most prevalent cancer in the world and is twice as common in developed countries when compared with low-income and middle-income countries. Few occupational risk factors for colorectal cancer have been identified. This case–control study aimed to assess the association between colorectal cancer and occupational exposure to selected solvents, combustion products, metals, dusts and other agents. Methods Cases (n=918) were enrolled from the Western Australian Cancer Registry from June 2005 to August 2007. Controls (n=1021) were randomly selected from the Western Australian electoral roll. We collected lifetime occupational history from cases and controls, in addition to their demographic and lifestyle characteristics. We applied the INTEROCC job exposure matrix to convert the occupational history to occupational exposure for 18 selected agents. Three exposure indices were developed: (1) exposed versus non-exposed; (2) lifetime cumulative exposure; and (3) total duration of exposure. The associations between colorectal cancer and the selected agents were estimated using logistic regression models adjusting for sex and age. Results None of the 18 selected agents showed an association with colorectal cancer. No dose–response relationships with lifetime cumulative exposure or duration of exposure were observed. Conclusion There was no evidence to suggest that occupational exposure to 18 selected agents increased the risk of colorectal cancer.

Beschreibung: Objectives Reliable retrospective exposure assessment continues to be a challenge in most population-based studies. Several methodologies exist for estimating exposures retrospectively, of which case-by-case expert assessment and job-exposure matrices (JEMs) are commonly used. This study evaluated the reliability of exposure estimates for selected carcinogens obtained through three JEMs by comparing the estimates with case-by-case expert assessment within the Netherlands Cohort Study (NLCS). Methods The NLCS includes 58 279 men aged 55–69 years at enrolment in 1986. For a subcohort of these men (n=1630), expert assessment is available for exposure to asbestos, polycyclic aromatic hydrocarbons (PAHs) and welding fumes. Reliability of the different JEMs (DOMJEM (asbestos, PAHs), FINJEM (asbestos, PAHs and welding fumes) and Asbestos JEM (asbestos) was determined by assessing the agreement between these JEMs and the expert assessment. Results Expert assessment revealed the lowest prevalence of exposure for all three exposures (asbestos 9.3%; PAHs 5.3%; welding fumes 11.7%). The DOMJEM showed the highest level of agreement with the expert assessment for asbestos and PAHs (s=0.29 and 0.42, respectively), closely followed by the FINJEM. For welding fumes, concordance between the expert assessment and FINJEM was high (=0.70). The Asbestos JEM showed poor agreement with the expert asbestos assessment (=0.10). Conclusions This study shows case-by-case expert assessment to result in the lowest prevalence of occupational exposure in the NLCS. Furthermore, the DOMJEM and FINJEM proved to be rather similar in agreement when compared with the expert assessment. The Asbestos JEM appeared to be less appropriate for use in the NLCS.

Beschreibung: We read with interest the recent article by Hoy et al highlighting the risk of accelerated silicosis in workers installing kitchen and bathroom worktops. 1 The Australian paper noted that artificial stone had been available in Australia since the early 2000s, and identified seven cases of silicosis diagnosed between 2011 and 2016. We were particularly interested by this, as the same type of artificial stone worktops have also been commercially available in the UK for approximately the same time period, yet there have been no published cases of accelerated silicosis from our country. To investigate further, we interrogated the Surveillance of Work-related Occupational Respiratory Disease (SWORD) national reporting scheme database and reviewed the 161 reported cases of silicosis between 2000 and 2017. 2 Interestingly, two-thirds of these cases were diagnosed in working age individuals. A review of each individual suspected cause confirmed that there have not been...

Beschreibung: Context Retrospective exposure assessment in population-based case–control studies poses a major challenge due to the wide range of occupations and industries involved. The FINJEM is a generic job-exposure matrix (JEM) developed in Finland, which represents a potentially cost-effective exposure assessment tool. While FINJEM has been used in several studies outside Finland, little is known of its applicability in other countries. Methods We compared prevalence and intensity of exposure in FINJEM with a JEM developed from expert assessments of occupational histories obtained in a population-based case–control study in Montreal. Agreement for prevalence of exposure was measured by weighted coefficients between prevalence categories. Agreement for exposure intensity was measured by Spearman correlation coefficients between cells with non-null exposure. Results The comparison involved 27 chemicals, the time period 1945–1995 and included 4743 jobs initially assessed by the Montreal experts. 4293 combinations of agent, occupational title and period were available for comparison of prevalence. Agent-specific prevalence was consistently higher in the Montreal JEM (median difference 1.7%). Agent-specific values between prevalence categories varied from 0.89 (welding fumes) to 0.07 (flour dust). The comparison of exposure levels involved 14 agents and 198 cells with non-null exposure in both sources. Agent-specific Spearman correlation varied from 0.89 (flour dust) to –0.35 (benzo(a)pyrene). Conclusion Our observations suggest that information concerning several agents (eg, metals, welding fumes) can be successfully transported from Finland to Canada and probably other countries. However, for other agents, there was considerable disagreement, and hence, transportability of FINJEM cannot be assumed by default.

Beschreibung: We appreciate the opportunity to respond to the letter of Behrens and Taeger 1 regarding our article ‘Comparison of expert and job-exposure matrix-based retrospective exposure assessment of occupational carcinogens in the Netherlands Cohort Study’. 2 Behrens and Taeger raise concerns about ‘validating’ existing job-exposure matrices (JEMs). Instead, they propose a recently developed web-based tool into which existing JEMs can be incorporated as job-specific modules (JSMs, a set of questions relevant to a specific job) and in which exposure estimates can be adapted according to available exposure measurements, expert opinion and study-specific circumstances. 3 As cohort members in the large Netherlands Cohort Study could no longer be approached, occupational exposure assessment could only be based on the available baseline information of job titles and period of employment. To better understand the implications of using a JEM as compared with expert assessment, we compared exposure estimates based...

Beschreibung: Objective To examine associations between occupational exposure to selected organic solvents and meningioma. Methodology A multicentre case–control study conducted in seven countries, including 1906 cases and 5565 controls. Occupational exposure to selected classes of organic solvents (aliphatic and alicyclic hydrocarbons, aromatic hydrocarbons, chlorinated hydrocarbons and ‘other’ organic solvents) or seven specific solvents (benzene, toluene, trichloroethylene, perchloroethylene, 1,1,1-trichloroethylene, methylene chloride and gasoline) was assessed using lifetime occupational histories and a modified version of the FINJEM job-exposure matrix (INTEROCC-JEM). Study participants were classified as ‘exposed’ when they had worked in an occupation for at least 1 year, with a 5-year lag, in which the estimated prevalence of exposure was 25% or greater in the INTEROCC-JEM. Associations between meningioma and each of the solvent exposures were estimated using conditional logistic regression, adjusting for potential confounders. Results A total of 6.5% of study participants were ever exposed to ‘any’ solvent, with a somewhat greater proportion of controls (7%) ever exposed compared with cases (5%), but only one case was ever exposed to any chlorinated hydrocarbon (1,1,1-trichloroethane). No association was observed between any of the organic solvents and meningioma, in either men or women, and no dose–response relationships were observed in internal analyses using either exposure duration or cumulative exposure. Discussion We found no evidence that occupational exposure to these organic solvents is associated with meningioma.

Beschreibung: My colleague Professor John Cherrie once said that we know more about the number of birds breeding in British meadows each year (see http://jncc.defra.gov.uk/pdf/BBSreport12_web.pdf ) than the number of workers exposed to carcinogens in the workplace. It is clearly important to monitor bird populations, but I would consider it of at least equal importance to know what hazardous agents workers are exposed to. However, there are few data sources that can provide accurate information on the prevalence of occupational exposures. In the early 1990s, Timo Kauppinen at the Finnish Institute of Occupational Health led a team that aimed to estimate the prevalence of occupational exposure in 55 industries for 15 member states of the European Union (EU). 1 This CAREX system has been extensively used in surveillance and burden of disease studies as well as by the International Agency for Research on Cancer (IARC) within the Monograph...