Diseases of the kidney and the urinary system - 286 entries found

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2011

CIS 12-0122 Wang T., Jia G., Zhang J., Ma Y., Feng W., Liu L., Zhang N., Yan L., Wang X., Zhang X., Liu Z., Du X., Zhen S.
Renal impairment caused by chronic occupational chromate exposure
The objective of this study was to determine the nephritic toxicity of chromate after chronic occupational exposure. The environmental contamination was assessed by measuring the chromium (Cr) in 8-h airborne sampler. The integrated level of Cr was determined by Cr concentrations in the whole blood (WB-Cr) and the urine (U-Cr). The renal glomerular and tubule impairment was evaluated by determination of cystatin C (Cys-C) in the serum and microalbumin (mALB), urinary beta(2)-microglobulin (ß(2)M), N-acetyl-beta-D-glucosaminidase (NAG) activity in the urine. The mean occupational exposure time to Cr was 12.86 years with average daily air level of 27.13 ¿g/m³ comparing to 0.11 ¿g/m³ of the background level. The WB-Cr and U-Cr were 23.49 ¿g/L and 17.41 ¿g/g creatinine (Cre), respectively in the chromate-exposed workers comparing to 3.32 ¿g/L and 1.52 ¿g/g Cre in the controls. The serum Cys-C and urinary mALB were significantly increased in the chromate-exposed workers. Exposure to Cr seems to induce an enhanced level of urinary NAG activity and ß(2)M concentration. The increased serum Cys-C concentration was positively correlated with the level of serum Cre. The U-Cr was positively correlated to the concentrations of urinary mALB, ß(2)M, and the activity of NAG. It is concluded that chronic occupational exposure to chromate causes comprehensive renal impairment though more severity could occur in the tubule than in the glomerular function.
International Archives of Occupational and Environmental Health, Apr. 2011, Vol.84, No.4, p.393-401. Illus. 52 ref.
Renal_impairment_[INTERNET_FREE_ACCESS] [in English]

2010

CIS 11-0506 Heck J.E., Charbotel B., Moore L.E., Karami S., Zaridze D.G., Matveev V., Janout V., Kollárová H., Foretova L., Bencko V., Szeszenia-Dabrowska N., Lissowska J., Mates D., Ferro G., Chow W.H., Rothman N., Stewart P., Brennan P., Boffetta P.
Occupation and renal cell cancer in Central and Eastern Europe
Central and Eastern Europe has among the highest rates of renal cell cancer worldwide. Few studies have been conducted in these areas to investigate the possible role of occupational exposures in renal cell cancer aetiology. The purpose of this study was to examine the association of renal cell cancer with employment in specific occupations and industries. From 1999 to 2003, a hospital-based case-control study was conducted in seven areas of the Czech Republic, Poland, Romania and Russia. A detailed occupational history was collected from renal cell cancer cases and controls, together with information on potential confounders. Odds ratios (ORs) of cancer risk were calculated for having ever been employed in selected jobs and industries, with follow-up analyses examining duration of employment. A total of 992 histologically-confirmed incident renal cell cancer cases and 1459 controls were included in the analysis. An increased risk of renal cell cancer was observed for workers in agricultural labour and animal husbandry (OR 1.43), particularly among women employed as general farm workers (OR 2.73). Risk gradients for agricultural work increased with longer employment. An overall increased risk of renal cell cancer was seen among architects and engineers (OR 1.89), and mechanical engineers (OR 1.71).
Occupational and Environmental Medicine, Jan. 2010, vol.67, No.1, p.47-53. 42 ref.

CIS 10-0343 Chang T.Y, Huang K.H, Liu C.S., Shie R.H., Chao K.P, Hsu W.H.;, Bao B.Y.
Exposure to volatile organic compounds and kidney dysfunction in thin film transistor liquid crystal display (TFT-LCD) workers
Many volatile organic compounds (VOCs) are emitted during the manufacturing of thin film transistor liquid crystal displays (TFT-LCDs), exposures to some of which have been reported to be associated with kidney dysfunction, but whether such an effect exists in TFT-LCD industry workers is unknown. This cross-sectional study aimed to investigate the association between exposure to VOCs and kidney dysfunction among TFT-LCD workers. The results showed that ethanol, acetone, isopropyl alcohol and propylene glycol monomethyl ether acetate were the four dominant VOCs present in the workplace. The 63 array workers studied had a risk of kidney dysfunction 3.21-fold and 3.84-fold that of 61 cell workers and 18 module workers, respectively. Workers cumulatively exposed to a total level of isopropyl alcohol, PGMEA and propylene glycol monomethyl ether of 324 ppb-year or more had a significantly higher risk of kidney dysfunction (adjusted odds ratio=3.41) compared with those exposed to less than 25 ppb-year, after adjustment for potential confounding factors. Implications of these findings are discussed.
Journal of Hazardous Materials, June 2010, Vol.178, No.1-3, p.934-940. Illus. 34 ref.

2009

CIS 11-0498 Héry M.
Institut national de recherche et de sécurité, eds.
Bladder cancer and occupational hazards
Cancers de la vessie et risques professionnels [in French]
This publication provides a comprehensive review of the issue of bladder cancer in an occupational context, together with its prevention. Topics addressed include: epidemiology; description of the sectors of activity which involved exposures in recent years; main responsible substances; current situation with respect to exposures; description of the main preventive actions undertaken during recent years; elements aimed at helping occupational physicians recognize exposures and diagnose the disease; research activities underway in occupational health.
EDP Sciences, 17 avenue du Hoggar, Parc d'activités de Courtabœuf, BP 112, 91944 Les Ulis Cedex A, France, 2009. 346p. Illus. Bibl.ref. Price: EUR 42.00.

2008

CIS 09-42 Samanic C.M., Kogevinas M., Silverman D.T., Tardón A., Serra C., Malats N., Real F.X., Carrato A., García-Closas R., Sala M., Lloreta J., Rothman N., Dosemeci M.
Occupation and bladder cancer in a hospital-based case-control study in Spain
The association between occupation and bladder cancer was investigated in case-control study conducted in Spain. Detailed information on life-time occupational history, smoking habits, medical history and other factors was obtained for 1219 patients with transitional cell carcinoma of the urinary bladder and 1271 controls selected from 18 hospitals in Spain. Statistically significant increased risks were observed among men employed as machine operators in the printing industry (OR 5.4), among men employed in the transportation equipment industry (OR 1.6) and among those who had worked for ≥10 years in the electrical/gas/sanitary services (OR 3.9) and in hotels and other lodgings (OR 3.1). Men who worked as miscellaneous mechanics and repairers (OR 2.0) and as supervisors in production occupations (OR 2.1) also had excess risks for bladder cancer. Male farmers and those who worked in crop and livestock production had decreased risks for bladder cancer. No significant associations between occupation or industry and bladder cancer risk were found among women.
Occupational and Environmental Medicine, May 2008, Vol.65, No.5, p.347-353. 38 ref.

CIS 08-1382 Lohi J., Kyyrönen P., Kauppinen T., Kujala V., Pukkala E.
Occupational exposure to solvents and gasoline and risk of cancers in the urinary tract among Finnish workers
The aim of this study was to estimate the risk of cancers of the urinary tract in relation to occupational exposure to solvents and gasoline. A cross-sectional cohort of all economically active Finns from the 1970 population census was followed up for bladder cancer (BC, 10,277 cases) and renal cell cancer (RCC, 9954 cases). Exposure to hydrocarbons solvents and gasoline were assessed with a job exposure matrix. Relative risks (RR) were defined using Poisson regression models, adjusted for smoking and obesity. Exposure to solvents was positively associated with the incidence of BC in women but not in men. The RRs were above 1.2 in nearly all exposures studied but a statistically significant excess was only seen for middle levels of chlorinated solvents (1.7) and low levels of aromatic solvents (1.6). The RRs for RCC were close to unity in all exposures studied.
American Journal of Industrial Medicine, Sep. 2008, Vol.51, No.9, p.668-672. 15 ref.

CIS 08-1379 Jacob S., Héry M., Stengel B.
Exposure to organic solvents - Risk of evolution of chronic renal diseases towards terminal renal insufficiency
Exposition aux solvants organiques - Risque de progression des maladies rénales chroniques vers l'insuffisance rénale terminale [in French]
This article describes a retrospective cohort study involving 338 patients suffering from glomerular nephropathies for which biopsies were performed between 1994 and 2001, and who were followed up until 2004. Their exposures to solvents were evaluated by industrial hygienists on the basis of interview data. Terminal renal insufficiency (TRI) was defined either as the patient requiring dialysis or a glomerular filtration rate of less than 15mL/min per 1.73m². The relative risks of TRI associated with solvents were estimated using Cox regression models. It was found that high solvent exposure levels were associated with twofold to fourfold higher TRI risks. Products or chemicals giving rise to the greatest risks were printing inks, fuels, toluene, xylene, petroleum products and acetone. The most exposed workers were mechanics and fitters, plumbers and welders. These findings highlight the importance of screening for glomerular diseases and increased medical supervision of workers exposed to solvents in occupational settings.
Documents pour le médecin du travail, June 2008, No.114, p.233-241. Illus. 33 ref.
http://www.dmt-prevention.fr/inrs-pub/inrs01.nsf/IntranetObject-accesParReference/TF%20170/$File/TF170.pdf [in French]

CIS 08-567 Wilson R.T., Donahue M., Gridley G., Adami J., El ghormli L., Dosemeci M.
Shared occupational risks for transitional cell cancer of the bladder and renal pelvis among men and women in Sweden
Using the Swedish national census and cancer registry data for 1971-1989, transitional cell cancers of the renal pelvis (N=1374) and bladder (N=21,591) were identified. Both cancer sites were significantly elevated among women and men employed in the machinery and electronics industries, sedentary work and indoor work; the highest proportion of the bladder (12%) and renal pelvis (14%) cancers occurred among men in the metal industry. Cancers of the renal pelvis were elevated in several occupational and industry groups for which there was no elevated bladder cancer risk. Other findings are discussed.
American Journal of Industrial Medicine, Feb. 2008, Vol.51, No.2, p.83-99. Approx 130 ref.

2007

CIS 08-571 Delépine A.
Let's be done with bladder cancer in occupational settings
Pour en finir avec le cancer de la vessie en milieu professionnel [in French]
Review of a symposium on the medical and technical aspects of occupational bladder cancer, held in Paris, France, on 15-16 March 2007. Main topics covered: epidemiology of bladder cancer; risk factors; exposure and genetic susceptibility factors; trends in industrial exposure to bladder carcinogens; screening; hazard management.
Documents pour le médecin du travail, 4th Quarter 2007, No.112, p.531-542. Illus.
http://www.dmt-prevention.fr/inrs-pub/inrs01.nsf/IntranetObject-accesParReference/TD%20158/$File/TD158.pdf [in French]

CIS 08-81 Daly L., Hajaiej K., Nouaigui H.
Renal damage and work
Atteintes rénales et travail [in French]
Contents of this collection of articles on renal damage caused by occupational exposures: kidney function; toxic renal disease caused by occupational factors (glomerular diseases, tubulointerstitial injuries, tubular necrosis, haemoglobinuria, myoglobinurea, nephritis); biomarkers of renal damage; main nephrotoxic substances encountered at the place of work (lead, cadmium, mercury, arsenic, chromium, uranium, hydrocarbons, solvents, chlorinated phenyls, amines, silica); renal diseases and work aptitude; role of occupational physicians in the rehabilitation of patients with renal insufficiency; compensation of occupational renal diseases; diagnosis and medical treatment algorithm for diabetic nephropathy.
SST - Santé et Sécurité au Travail, Apr. 2007, No.41, p.2-15. Illus. 7 ref.

CIS 08-85 Durcy M.
Bladder cancer: Identifying and controlling the risks
Cancer de la vessie: identifier et réduire les risques [in French]
Each year, there are approximately 10,000 new cases of bladder cancer incidence in France, among which the number of cases due to occupational exposures is estimated at between 600 and 1100. In the construction sector, coal tar pitch used in roofing is a known carcinogen. Occupational exposures likely to cause bladder cancer have decreased. However, further progress is still required for screening and preventing this disease in occupational settings. Besides a brief review of occupational bladder cancer, an occupational physician answers a few questions on exposure hazards, the low proportion of bladder cancers that are recognized as being due to occupational factors and preventive measures.
Prévention BTP, May 2007, No.96, p.48-50. Illus.

2006

CIS 07-799 Héry M., Conso F., Goutet P.
Bladder cancer in occupational settings - INRS presents the current situation with respect to prevention measures
Cancer de la vessie en milieu professionnel - l'INRS fait le point sur la prévention [in French]
This article serves as an introduction to a seminar entitled "Ending bladder cancer at the workplace", organized by the INRS in Paris in March 2007. It provides information on the disease and reviews preventive measures such as the prohibition or restriction of use of substances known to cause bladder cancer and modifications in industrial processes. It concludes that, while there is still much to be achieved, the level of exposure has been reduced.
Documents pour le médecin du travail, Dec. 2006, No.108, p.479-484. Illus. 2 ref.
http://www.dmt-prevention.fr/inrs-pub/inrs01.nsf/IntranetObject-accesParReference/TF%20154/$File/TF154.pdf [in French]

CIS 07-642 Böcher A., Müller M., Buchter A.
Arsenic diseases of wine-growers and medical importance of environmental arsenic exposure
Die Arsenerkrankungen der Winzer und umweltmedizinische Bedeutung der Arsenbelastung [in German]
Five cases of arsenic diseases have recently been identified among elderly wine growers who had been occupationally exposed in the 1930s and 1940s to arsenic-containing pesticides and who had consumed arsenic-containing home made wine. The exposure circumstances in these cases and the diagnosed arsenic-related diseases are described. In all cases the latency period between termination of exposure and first diagnosis of an arsenic-related disease was extremely long, ranging from 40 to 60 years. In two cases a urinary transitional cell carcinoma was diagnosed in addition to typical skin diseases caused by arsenic. Based on epidemiologic data from Asian and South American countries that provided evidence of a significantly increased risk of urinary transitional cell carcinoma following long-term arsenic exposure, it is recommended that this cancer should be recognized as an occupational disease in patients with skin diseases caused by occupational arsenic exposure.
Zentralblatt für Arbeitsmedizin, Arbeitsschutz und Ergonomie, 2006, Vol.56, No.3, p.58-67. Illus. Bibl.ref.

CIS 07-314 Héry M., Conso F., Goutet P.
Doing away with bladder cancer in occupational settings
En finir avec le cancer de la vessie en milieu professionnel [in French]
According to various sources, between 625 and 1110 bladder cancers are attributable each year to occupational exposures in France. These levels imply that this disease ranks as the second most important occupational disease, behind lung cancer. Various aromatic amines and aromatic or polycyclic hydrocarbons have been proven aetiologically to cause bladder cancer. The role of nitrosamines and chlorinated solvents is more doubtful. Trends in the use of these substances over the last thirty years were examined. It was found that warnings (or certain regulatory measures) were effective, such as marked decreases in the use of certain aromatic amines and coal tar derivatives, and the use of better-quality cutting oils. However, some pathways to further improvement have yet to be implemented.
Cahiers de notes documentaires - Hygiène et sécurité du travail, June 2006, No.203, p79-83. Illus. 4 ref.
http://www.inrs.fr/INRS-PUB/inrs01.nsf/inrs01_catalog_view_view/CA2A8EECE79493CBC125719D0038C7D8/$FILE/pr23.pdf [in French]

CIS 07-309 't Mannetje A., Pearce N.
Bladder cancer risk in sales workers: Artefact or cause for concern?
A large number of epidemiological studies have reported positive associations between bladder cancer and sales occupations. This study investigated whether these findings are likely to be due to chance, confounding or publication bias, or truly involve causal associations. Studies reporting bladder cancer risk-estimates for sales occupations were reviewed. Heterogeneity and publication bias were assessed using meta-analyses. Findings are discussed. Publication bias explained most of the reported increased bladder cancer risk, but sales-work still appeared to be associated with a small risk in women. Possible causal factors include lower frequency of urination and reduced fluid intake.
American Journal of Industrial Medicine, Mar. 2006, Vol.49, No.3, p.175-186. Illus. 50 ref.

CIS 07-157 González-Yebra A.L., Kornhauser C., Wrobel K., Pérez-Luque E.L., Barbosa G.
Occupational exposure to toluene and its possible causative role in renal damage development in shoe workers
Many shoe workers in Leon, Mexico, are in continuous contact with toluene-based glues. The objective of this case-control study involving 50 toluene-exposed shoe workers and 25 control subjects was to evaluate the relationship between toluenel exposure and renal damage. Urinary o-cresol excretion was used as a measure of toluene exposure. Urinary albumin excretion and N-acetyl-Β-D-glucosaminidase (NAG) enzymatic activity were tested to assess renal dysfunction. Urinary o-cresol levels were higher in exposed subjects. Albumin excretion was similar in the exposed and control groups. NAG enzymatic activity was greater in the exposed group compared to the control group (3.5 U/g vs 1.9 U/g creatinine). An inverse relationship was found between schooling years and the NAG enzymatic activity for the two studied groups. The findings support the hypothesis that toluene may be a factor associated with the presence of renal damage in exposed shoe workers.
International Archives of Occupational and Environmental Health, Mar. 2006, Vol.79, No.3, p.259-264. Illus. 27 ref.

CIS 07-171 Radican L., Wartenberg D., Rhoads G.G., Schneider D., Wedeen R., Stewart P., Blair A.
A retrospective occupational cohort study of end-stage renal disease in aircraft workers exposed to trichloroethylene and other hydrocarbons
Various case-control studies suggest that hydrocarbons increase end-stage renal disease (ESRD) risk. No cohort studies have been conducted. In this study, an occupational database was matched to the U.S. Renal Data System, and the outcome of ESRDs was examined using multivariable Cox regression. Sixteen individual hydrocarbons were studied. For the 1973-2000 period there was an approximate twofold increased risk of ESRD among workers exposed to trichloroethylene, 1,1,1-trichloroethane, and JP4 gasoline compared with unexposed subjects. Relative risk was greater than unity for several other hydrocarbons. Associations attenuated when 2001-2002 data were included in the analyses. It is concluded that certain hydrocarbons may increase ESRD risk, although some findings are contradictory and further research is needed.
Journal of Occupational and Environmental Medicine, Jan. 2006, Vol.48, No.1, p.1-12. 32 ref.

2005

CIS 06-1341 Chia S.E., Zhou H.J., Yap E., Tham M.T., Dong N.V., Hong Tu N.T., Chia K.S.
Association of renal function and δ-aminolevulinic acid dehydratase polymorphism among Vietnamese and Singapore workers exposed to inorganic lead
The effect of δ-aminolevulinic acid dehydratase (ALAD) polymorphisms on the association between blood lead and renal function was investigated among Vietnamese and Singaporean workers exposed to low to medium levels of inorganic lead. The distribution of ALAD polymorphism among Vietnamese, Chinese, Malays and Indians was also studied. Blood and urine samples were analysed for blood lead, ALAD genotype, urinary δ-aminolevulinic acid and renal function. ALAD1-1 was the predominant genotype for all ethnic groups while ALAD2-2 was the rarest. Results indicated that workers with the ALAD2 allele appeared to be more susceptible to the effects of lead (especially at higher levels) on renal function.
Occupational and Environmental Medicine, 2006, Vol. 63, p.180-186. Illus. 23 ref.

CIS 06-1340 Chia S.E., Zhou H., Tham M.T., Yap E., Dong N.V., Hong Tu N.T., Chia K.S.
Possible influence of δ-aminolevulinic acid dehydratase polymorphism and susceptibility to renal toxicity of lead: A study of a Vietnamese population
In a cross-sectional study of 276 lead-exposed workers in Vietnam, all workers were measured for blood lead levels and for various urinary markers of renal toxicity. Six newly identified polymorphisms located on the ALAD (δ-aminolevulinic acid dehydratase) gene were examined to determine whether they could modify the relationship between blood lead and some renal parameters. It was found that one polymorphism was able to modify the association of blood lead concentrations with certain renal parameters. Further studies are needed to confirm this observation.
Environmental Health Perspectives, Oct. 2005, Vol.113, No.10, p.1313-1317. Illus. 33 ref.

CIS 06-564 Band P.R., Le N.D., MacArthur A.C., Fang R., Gallagher R.P.
Identification of occupational cancer risks in British Columbia: A population-based case-control study of 1129 cases of bladder cancer
Data on lifetime occupational histories, smoking, and alcohol consumption were collected by self-administered questionnaire from 15,463 cancer patients. A matched case-control design was used to identify occupational risk factors for bladder cancer. Cases were those patients diagnosed with bladder cancer and controls consisted of all other cancer sites excluding lung cancers. Data were subjected to statistical analysis. Excess bladder cancer risks were observed in a number of occupations and industries, particularly those involving exposure to metals, paint and solvents, polycyclic aromatic hydrocarbons, diesel engine emissions, textiles, silica and electromagnetic fields. These results are in line with those from the literature.
Journal of Occupational and Environmental Medicine, Aug. 2005, Vol.47, No.8, p.854-858. 22 ref.

CIS 06-615 Voss J.U., Roller M., Brinkmann E., Mangelsdorf I.
Nephrotoxicity of organic solvents: Biomarkers for early detection
An analysis of the available literature was performed with respect to markers measured in cross-sectional studies that might be useful for the early detection of solvent-induced effects on the kidney. Various markers were analysed with respect to their suitability as biomarkers for renal damage. An increased albumin excretion was observed more frequently in groups of workers exposed to solvents such as toluene, styrene, mixtures of aliphatic and aromatic hydrocarbons, tetrachloroethylene, and mixtures of chlorinated hydrocarbons than in controls. No clear pattern emerged for the other markers. It is concluded that the determination of albumin excretion in the urine appears to be a useful parameter for monitoring solvent-exposed workers.
International Archives of Occupational and Environmental Health, July 2005, Vol.78, No.6, p.475-485. Illus. 74 ref.

CIS 06-394 Steenland K.
One agent, many diseases: Exposure-response data and comparative risks of different outcomes following silica exposure
Evidence in recent years indicates that silica causes lung cancer and renal disease in addition to its well-known relationship to silicosis. The available exposure-response data for silica and silicosis, lung cancer and renal disease were reviewed. The risks of death or disease incidence by age 75 were compared for these three diseases, subsequent to 45 years of exposure to silica at the current exposure limit of 0.1mg/m³ respirable crystalline silica. The absolute risk of silicosis ranged from 47% to 77%. The absolute risk of death from silicosis was estimated at 1.9%. The excess risk of lung cancer death, assuming US male background rates, was 1.7%. The excess risk of end-stage renal disease was 5.1%, and the excess risk of death from renal disease was estimated to be 1.8%. Given that the usual OSHA acceptable excess risk of serious disease or death for workers is 0.1%, it is clear that the current limit is far from sufficiently protective of workers' health. Kidney disease emerges as a higher risk than either mortality from silicosis or lung cancer, although the data are based on fewer studies.
American Journal of Industrial Medicine, July 2005, Vol.48, No.1, p.16-23. Illus. 40 ref.

CIS 05-552 McGregor D.B.
Risk of kidney tumours in firemen
Risque de tumeurs du rein chez les pompiers [in French]
This project consists of a critical analysis of literature on the relationship between the development of kidney tumours and fire-fighting. Based on limited evidence, results indicate that kidney tumours may be linked to occupational exposures to contaminants among firefighters having more than 20 years of employment. Genetic characteristics and lifestyles may also be involved.
Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 boul. de Maisonneuve Ouest, Montreal (Quebec) H3A 3C2, Canada, 2005. 24p. 78 ref. Price: CAD 5.35. Downloadable version (PDF format) free of charge.
http://www.irsst.qc.ca/files/documents/PubIRSST/R-398.pdf [in French]

CIS 05-551 McGregor D.B.
Risk of urinary bladder tumours in firemen
Risque de tumeurs de la vessie urinaire chez les pompiers [in French]
This project consists of a critical analysis of the literature on the relationship between the development of bladder tumours and fire-fighting. On the basis of limited evidence, cases of bladder tumour could be related to the fire-fighting occupation if other factors such as smoking are excluded. Prior use of analgesics containing phenacetin and a medical history of multiple infections of the urinary tract that could contribute to the development of bladder cancer should be taken into consideration in establishing the diagnosis.
Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 boul. de Maisonneuve Ouest, Montreal (Quebec) H3A 3C2, Canada, 2005. 26p. 82 ref. Price: CAD 5.35. Downloadable version (PDF format) free of charge.
http://www.irsst.qc.ca/files/documents/PubIRSST/R-400.pdf [in French]

2004

CIS 03-1772 Markowitz S.B., Levin K.
Continued epidemic of bladder cancer in workers exposed to ortho-toluidine in a chemical factory
Ortho-toluidine (o-toluidine), an aromatic amine, is classified by the International Agency for Research on Cancer as a probable human carcinogen. A cohort study published in 1991 reported a 6.5-fold excess incidence of bladder cancer in a US chemical plant that used o-toluidine. This article reports 19 additional cases of bladder cancer among workers in this cohort, yielding a total of 34 cases of bladder cancer in the cohort to date. The number of bladder cancers diagnosed in the recent period has increased. The timing of onset of exposure to o-toluidine of numerous cases of bladder cancer after 1968, and especially 1975, suggests that occupational exposures other than o-toluidine were probably not responsible for the observed excess bladder cancer. This study further supports the bladder carcinogenicity of o-toluidine.
Journal of Occupational and Environmental Medicine, Feb. 2004, Vol.46, No.2, p.154-160. Illus. 15 ref.

2003

CIS 04-551 Buzio L., De Palma G., Mozzoni P., Tondel M., Buzio C., Franchini I., Axelson O., Mutti A.
Glutathione S-transferases M1-1 and T1-1 as risk modifiers for renal cell cancer associated with occupational exposure to chemicals
This study investigates the possible interaction between occupational risk factors and genotype for glutathione S-transferases M1 and TI (GSTM 1 and GSTT 1) in renal cell cancer (RCC). One hundred patients with RCC and 200 outpatient controls were enrolled at Parma University Hospital. The polymorphisms of GSTM1 and GSTT1 were investigated by PCR; occupational history was collected by a structured questionnaire. Subjects with GSTM 1 present genotype showed higher risks for RCC, compared to GSTM 1 null subjects, if exposed to metals (OR 2.73) or pesticides (OR 3.46). The GSTT 1 present genotype also enhanced about twofold the risk of RCC among subjects exposed to solvents and pesticides, compared with those GSTT1 null. The results support the hypothesis that GSTM1 and GSTT1 polymorphisms can interact with several occupational exposures to significantly modify the risk of RCC among exposed subjects.
Occupational and Environmental Medicine, Oct. 2003, Vol.60, No.10, p.789-793. 30 ref.

CIS 03-814 Armstrong B., Hutchinson E., Fletcher T.
Health and Safety Executive
Cancer risk following exposure to polycyclic aromatic hydrocarbons (PAHs): A meta-analysis
Airborne polycyclic aromatic hydrocarbons (PAHs) have long been known to cause cancer in animals and are classified as human carcinogens. A meta-analysis of published epidemiological studies that include assessments of occupational exposure to PAHs was carried out, in order to identify the determinants of lung and bladder cancer risk. Relevant reports published up to early 2001 were identified systematically using bibliographic databases. From each study that met the inclusion criteria, unit relative risk was estimated by Poisson regression from published tables of risk against estimated cumulative exposure. Distribution and determinants of unit relative risks (URRs) were investigated using standard meta-analytic methods. On average, the URR for lung cancer was 1.20 with significant variation across industries, while for bladder cancer, the average URR was 1.33, with little variation across industries.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2003. viii, 61p. Illus. 64 ref. Price: GBP 15.00.
http://www.hse.gov.uk/research/rrpdf/rr068.pdf [in English]

CIS 03-759 Brüning T., Pesch B., Wiesenhütter B., Rabstein S., Lammert M., Baumüller A., Bolt H.M.
Renal cell cancer risk and occupational exposure to trichloroethylene: Results of a consecutive case-control study in Arnsberg, Germany
Findings of German studies on the relation between exposure to high levels of trichloroethylene (TRI) and renal cell cancer (RCC) are contradictory. A hospital-based case-control study with 134 RCC cases and 401 controls was conducted in order to re-evaluate the risk due to TRI in the German region of Arnsberg, which had been estimated in a previous study. Exposure was self-assessed to compare these studies. Job history was analysed using expert-based exposure information. The logistic regression results adjusted for age, sex and smoking confirmed a TRI- related RCC risk. Using the CAREX database for a comparison of industries with and without TRI exposure, a significant excess risk was estimated for the longest held job in TRI-exposing industries (odds ratio (OR) 1.80). The OR in metal degreasing activities was 5.57. Self-reported narcotic symptoms, indicative of peak exposures, were also associated with an excess risk (OR=3.71). The study supports the human nephro-carcinogenicity of trichloroethylene.
American Journal of Industrial Medicine, Mar. 2003, Vol.43, No.3, p.274-285. 42 ref.

2002

CIS 03-279 Wang V.S., Lee M.T., Chiou J.Y., Guu C.F., Wu C.C., Wu T.N., Lai J.S.
Relationship between blood lead levels and renal function in lead battery workers
The aim of this study was to investigate the correlation between blood lead (PbB) levels and renal function indices of blood-urea nitrogen (BUN), serum creatinine (SC) and uric acid (UA) among lead battery industry workers with exposure to lead. 229 workers of both genders from two lead battery factories were recruited in this cross-sectional study. Personal airborne and blood samples were collected on the same day. A positive correlation between PbB levels and individual renal function index of BUN, SC, and UA was found. PbB levels and renal function indices showed significant difference between male and female workers. An increment of 10µg/dL PbB produced an increase of 0.62mg/dL BUN and an increase of 0.085mg/dL UA. For all workers, there was a significant dose-response relationship between PbB and BUN and UA levels. It is suggested that blood-urea nitrogen and uric acid be considered as indicators of renal dysfunction in lead-exposed workers.
International Archives of Occupational and Environmental Health, Oct. 2002, Vol.75, No.8, p.569-575. 40 ref.

CIS 02-1243 Zheng T., Cantor K.P., Zhang Y., Lynch C.F.
Occupation and bladder cancer: A population-based, case-control study in Iowa
The objective of this study was to investigate the role of occupation and industry in the risk of bladder cancer. A population-based, case-control study was conducted in the state of Iowa, including 1452 incident bladder cancer cases and 2434 controls. Occupational history was collected from respondents for each job held for five years or longer since the age of 16. Among men, excess risk was observed for industries including plumbing, heating, and air conditioning (odds ratio (OR)=2.2); rubber and plastic products (OR=3.1), motor vehicle parts and supplies (OR=4.5), and occupations including supervisors for transportation and material moving (OR=6.5), material-moving-equipment operators (OR=1.9), automobile mechanics (OR=1.6), painters (OR=2.7), and metal- and plastic-working machine operators (OR=2.0). Among women, significant excess risk was observed for secondary school teachers and record clerks. Housekeepers and butlers and workers in laundering and dry cleaning were also at increased risk.
Journal of Occupational and Environmental Medicine, July 2002, Vol.44, No.7, p.685-691. 40 ref.

2001

CIS 02-309 Drake P.L., Rojas M., Reh C.M., Mueller C.A., Jenkins F.M.
Occupational exposure to airborne mercury during gold mining operations near El Callao, Venezuela
The National Institute for Occupational Safety and Health (NIOSH) conducted a cross-sectional study during gold mining operations near El Callao, Venezuela to assess mercury exposures and mercury-related micro-damage to the kidneys. Mercury was used to remove gold by forming a mercury-gold amalgam. The gold was purified either by heating the amalgam in the open with a propane torch or by using a small retort. 38 workers participated in this study. Mercury exposure was monitored by sampling air from the workers' breathing zones. These air samples were used to calculate time-weighted average (TWA) mercury exposure concentrations. Results showed that 20% of the TWA airborne mercury exposure measurements were above the NIOSH recommended exposure limit of 50µg/m³, and 26% exceeded the American Conference of Governmental Industrial Hygienists Threshold Limit Value of 25µg/m³. Recommendations were made for improving retort design, for ventilation in gold shops, for medical surveillance and for educational programs.
International Archives of Occupational and Environmental Health, Apr. 2001, Vol.74, No.3, p.206-212. Illus. 35 ref.

CIS 02-203 Bladder cancer - Detection, reporting and compensation
Cancers de la vessie - Comment les repérer, les déclarer, les faire reconnaître, les faire indemniser [in French]
Contents of this booklet describing the compensation system for occupational bladder cancer in France: introduction and general considerations on occupational cancers; reporting procedures; occupational activities having possibly given rise to exposures to agents known to cause bladder cancer (aromatic amines, tars, soot, coal combustion products - in particular polycyclic aromatic hydrocarbons) as well as the corresponding compensation systems. It duplicates the section of the general booklet on the compensation of occupational cancers in France (see CIS 02-201) applicable specifically to bladder cancer.
Ligue nationale contre le cancer, 14 rue Corvisart, 75013 Paris, France, 2001. 13p.

2000

CIS 01-1682 Parent M.E., Hua Y., Siemiatycki J.
Occupational risk factors for renal cell carcinoma in Montreal
To assess role of workplace exposures on the risk of renal cancer, a case-control study was undertaken involving total of 142 male patients with pathologically confirmed renal cell carcinoma, 1900 controls with cancer at other sites and 533 population-based controls. Detailed job histories and relevant data on potential confounders were obtained, and exposure to 294 reference substances was evaluated. There were indications of excess risks among printers, garden nursery workers, aircraft mechanics, farmers, and horticulturists, as well as in printing-related services, defense services, wholesale trade, and retail trade. The following workplace exposures showed some evidence of excess risk: chromium compounds, chromium (VI) compounds, inorganic acid solutions, butadiene-styrene rubber, ozone, hydrogen sulfide, ultraviolet radiation, hair dust, felt dust, jet engine emissions, jet fuel, aviation gasoline, phosphoric acid and inks.
American Journal of Industrial Medicine, Dec. 2000, Vol.38, No.6, p.609-618. 55 ref.

CIS 01-1426 Schulz M.R., Loomis D.
Occupational bladder cancer mortality among racial and ethnic minorities in 21 States
Occupational bladder cancer mortality among minority racial and ethnic groups is not well documented in the United States. Race, ethnicity and sex-specific bladder cancer mortality (1985-1992) of workers employed in 21 states was examined. Mortality of specific racial-ethnic occupational groups was compared separately with workers in the specific occupation and with members of the specific racial/ethnic group. This study identified elevated bladder cancer mortality among African American males and females and Hispanic males in several occupational groups with exposure to suspected bladder carcinogens as well as among Asian males in sales (PMR = 2.13) and Asian females in the precision production sector (PMR = 5.25).
American Journal of Industrial Medicine, July 2000, Vol.38, No.1, p.90-98. 43 ref.

CIS 01-496 Ravnskov U.
Hydrocarbons may worsen renal function in glomerulonephritis: A meta-analysis of the case-control studies
The association between stage of glomerulonephritis and degree of previous hydrocarbon exposure was studied by a meta-analysis of all published case-control studies and by reviewing all follow-up studies. Odds ratios (OR) for exposure could be calculated for 16 patient groups from 14 case-control studies. After exclusion of four patient groups with 5-17% drop-outs due to death, the mean weighted OR for patient groups with acute or early glomerulonephritis, chronic renal failure and end-stage renal failure were 0.95, 3.1 and 5.9, respectively. At follow-up, reported in four studies, renal failure was mainly seen in patients with extensive exposure, and improvement was seen only in patients who had discontinued the exposure. In conclusion, hydrocarbon exposure in glomerulonephritis is associated with the advancement of the disease and inversely associated with renal function. Early elimination of the exposure may, therefore, prevent the progress of renal failure in many patients.
American Journal of Industrial Medicine, June 2000, Vol.37, No.6, p.599-606. Illus. 38 ref.

1999

CIS 00-727 Rapiti E., Sperati A., Miceli M., Forastiere F., Di Lallo D., Cavariani F., Goldsmith D.F., Perucci C.A.
End stage renal disease among ceramic workers exposed to silica
To evaluate whether ceramic workers exposed to silica experience an excess of end stage renal disease, a cohort of 2,980 male ceramic workers was enrolled during the period 1974-91 in Civitacastellana, Lazio, Italy. For each worker, employment history, smoking data and X-ray film readings were available. Vital status was ascertained for all cohort members. All 2,820 people still alive and resident in the Lazio region as of June 1994 were searched for a match in the regional end stage renal diseases registry, which records all patients undergoing dialysis treatment in public and private facilities of the region. A total of 6 cases was detected when 1.87 were expected. The excess risk was present among non-smokers and smokers, as well as among workers without silicosis and workers with silicoses. The risk was higher among subjects with <20 years since first employment than among those employed >20 years. These results provide further evidence that exposure to silica dust among ceramic workers is associated with nephrotoxic effects.
Occupational and Environmental Medicine, Aug. 1999, Vol.56, No.8, p.559-561. 28 ref.

CIS 00-181 Indulski J.A., Lutz W., Krajewska B.
Serum and urine p53 protein in bladder cancer patients and in workers occupationally exposed to genotoxic and mutagenic dyes
Blood serum and urine protein concentrations in patients with urinary bladder cancer and in people occupationally exposed to dusts containing genotoxic or mutagenic dyes were determined using an enzyme-linked immunosorbent assay. Increased concentrations ranging from 30 to 289pg/ml of protein p53 in blood serum were found in 10 of 21 patients with bladder cancer. Elevated urine p53 protein concentrations ranging from 27 to 496pg/ml were found in 13 of the 21 patients with bladder cancer. These concentrations did not show any relationship with tumor stage. In the group of 29 healthy persons occupationally exposed to genotoxic and mutagenic dyes, p53 protein was detected in more than 40% of the test subjects, while in the control group of healthy persons who were not occupationally exposed to the carcinogenic agents, the corresponding figure was only 20%. The p53 protein levels were considerably lower than for the persons with bladder cancer. Urine protein p53 can serve as a useful occupational and environmental carcinogens.
Central European Journal of Occupational and Environmental Medicine, 1999, Vol.5, No.1, p.17-25. Illus. 23 ref.

CIS 00-115 Carel R., Levitas-Langman A., Kordysh E., Goldsmith J., Friger M.
Case-referent study on occupational risk factors for bladder cancer in southern Israel
To evaluate the possible association between occupational exposure and male bladder cancer in the Negev region of southern Israel, 92 bladder cancer patients were studied by interview and compared with 92 males without oncological disease after matching by age and country of origin. The questionnaire was developed to gather information on demography, life-time occupational history, smoking habits, coffee consumption and health status, and the analysis of the data was performed by statistical methods. Significant associations were found between bladder cancer occurrence and occupational exposure to solvents, dusts and multiple chemicals; nephrolithiasis; and cigarette smoking. Certain types of occupational exposure, other than aromatic amines and dyes, may be considered as contributing factors in the epidemiology of bladder cancer.
International Archives of Occupational and Environmental Health, Aug. 1999, Vol.72, No.5, p.304-308. 29 ref.

CIS 99-1979 Brüning T., Chronz C., Thier R., Havelka J., Ko Y., Bolt H.M.
Occurrence of urinary tract tumours in miners highly exposed to dinitrotoluene
Higher than expected incidences of urothelial and renal cell tumours were found in a group of underground copper miners with high exposures to explosives containing dinitrotoluene. Categorization of the renal cell tumour cases by exposure revealed no dose-dependency concerning explosives and was similar to that of a representative group of formerly dinitrotoluene-exposed workers, whereas the urothelial tumour cases were predominantly confined to the high-exposure categories. These results along with results of genotyping indicate the possibility of human carcinogenicity of dinitrotoluene with regard to urothelium as the target tissue. Topics: bladder tumour; dinitrotoluene; copper mining; dose-response relationship; epidemiologic study; explosives; genito-urinary system diseases; latency; length of exposure; neoplasms; renal cancer; skin absorption.
Journal of Occupational and Environmental Medicine, Mar. 1999, Vol.41, No.3, p.144-149. 33 ref.

CIS 99-1593 Chiazze L., Watkins D.K., Fryar C., Fayerweather W., Bender J.R., Chiazze M.
Mortality from nephritis and nephrosis in the fibreglass manufacturing industry
The possible association between exposure to silica or respirable glass fibre and mortality from nephritis or nephrosis was investigated among workers in fibrous glass wool manufacturing facilities. There is no consistent relation between respirable fibres or respirable silica and nephritis or nephrosis when the analysis is based either on underlying cause only or on underlying plus contributing cause of death. None of the socio-demographic variables considered suggests an increased risk when considering both underlying and contributing cause of death. Data would seem to support the contention that the most accurate picture of renal disease will be gained from the use of all information on the death certificates and not only the underlying cause. Although results do not prove that there is no association between nephritis and nephrosis and exposure to fibreglass or silica in the fibreglass manufacturing environment, they do not support the assertion that such an association exists. Topics: silica; case-control study; fibrous glass industry; glass fibre; mortality; nephritis; nephrosis; renal diseases; respirable dust; statistical evaluation.
Occupational and Environmental Medicine, Mar. 1999, Vol.56, No.3, p.164-166. 8 ref.

CIS 99-917 Verplanke A.J.W., Leummens M.H.L., Herber R.F.M.
Occupational exposure to tetrachloroethene and its effects on the kidneys
The effects of tetrachloroethylene (TCE) exposure on the kidneys were investigated in 82 exposed and 19 nonexposed workers from four dry-cleaning shops. The mean inhaled amount of TCE in the exposed group was 8.4mg/m³, corresponding to a mean 8-hour time-weighted average exposure of 7.9mg/m³. A chronic dose index (CDI) was estimated from data on the current TCE dose and the occupational history of individual subjects. The mean CDI in the exposed group was 400 months x mg/m³. Effects on the tubules were assessed with the parameters N-acetyl-β-D-glucosaminidase, β-galactosidase, alanine aminopeptidase, and retinol-binding protein (RBP) in urine. Early effects on the glomeruli were monitored with the parameter albumin in urine. Total protein in urine was determined for the general assessment of effects on the glomeruli and tubules. The tubular parameter RBP was increased in the exposed group compared with the nonexposed group. In conclusion, occupational exposure to TCE may cause a minor effect on the tubular RBP at exposure levels below the Dutch occupational exposure limit (240mg/m³). Topics: tetrachloroethylene; beta-galactosidase; aminopeptidase; determination in urine; dry cleaning; enzymological tests; epidemiologic study; exposure evaluation; limitation of exposure; renal dysfunction; urinary metabolites.
Journal of Occupational and Environmental Medicine, Jan. 1999, Vol.41, No.1, p.11-16. 24 ref.

1998

CIS 00-1608 Grimsrud T.K., Langseth H., Engeland A., Andersen A.
Lung and bladder cancer in a Norwegian municipality with iron and steel producing industry: Population based case-control studies
To investigate the influence of occupation on lung and bladder cancer among men in a Norwegian municipality where an iron and steel plant constitutes the major industry, a population-based case-control study was performed based on lung and bladder cancer cases. Information on occupations and smoking habits was collected through interviews and from personnel files. An odds ratio for lung cancer of 2.9 was associated with exposure to PAHs. Increased risk of lung cancer was associated with work experience in the pig iron department at the ironworks. A non-significant OR of 1.8 was associated with exposure to asbestos. Bladder cancer was not associated with exposure to PAHs at the iron, steel and coke plant, or with experience at any of the production departments at the plant. One fifth of the lung cancer cases were attributed to exposure to PAHs or asbestos. More than 80% of the cases of lung cancer were attributed to tobacco smoking. The cancer risk in the pig iron department may have been due to a combination of exposures to PAH, asbestos and dust of mixed composition.
Occupational and Environmental Medicine, June 1998, Vol.55, No.6, p.387-392. Illus. 38 ref.

CIS 99-477 Bruy C., Revel M., Surot O., Libertino G., Mauny C.
Lumbago-sciatica and pollakiuria: A coincidence?
Lombosciatique et pollakiurie: une coïncidence? [in French]
Topics: back disorders; backache; construction industry; lumbar column; pollakiuria; questionnaire survey; renal dysfunction.
Revue de médecine du travail, Mar.-Apr. 1998, Vol.XXV, No.2, p.107-114. Illus. 19 ref.

CIS 99-567 Axtell C.D., Ward E.M., McCabe G.P., Schulte P.A., Stern F.B., Glickman L.T.
Underlying and multiple cause mortality in a cohort of workers exposed to aromatic amines
In a follow-up study at a synthetic dye plant that manufactured beta-naphthylamine from 1940 to 1979, underlying and nonunderlying causes of death were analyzed to end 1992 using data from the National Death Index. There were three bladder cancer deaths listed as underlying cause (standardized mortality ratio (SMR) 2.4) and a total of eight bladder cancers listed anywhere on the death certificates (SMR 5.6). Mortality from all causes was significantly higher than expected. The elevated bladder cancer risk in this cohort was detected by the multiple cause, but not the underlying cause, analysis. Elevated mortality from other causes of death, especially among short-term workers, may be related to regional and lifestyle factors. Topics: aromatic amines; bladder tumour; cohort study; dyestuff industry; long-term study; mortality.
American Journal of Industrial Medicine, Nov. 1998, Vol.34, No.5, p.506-511. 20 ref.

CIS 99-200 Liu C.S., Kuo H.W., Lai J.S., Lin T.I.
Urinary N-acetyl-β-glucosaminidase as an indicator of renal dysfunction in electroplating workers
Topics: chromium; cross-sectional study; determination in air; determination in urine; dose-response relationship; electroplating; enzyme activity determination; job-exposure relation; nephrotoxic effects; renal dysfunction; urine monitoring.
International Archives of Occupational and Environmental Health, July 1998, Vol.71, No.5, p.348-352. 30 ref.

CIS 98-1654 Gun R.T., Seymour A.E., Mathew T.H.
A cluster of haematuria cases in a pesticide-manufacturing plant
Topics: Australia; epidemiologic study; haematuria; job-exposure relation; pesticide production; pesticides; renal dysfunction; urine monitoring.
Occupational Medicine, Jan. 1998, Vol.48, No.1, p.59-62. Illus. 7 ref.

CIS 98-1339 Carney S., Ferguson M.
A cross-sectional study of renal function and cardiovascular risk factors in hydrocarbon-exposed workers
Topics: bitumen; cardiovascular diseases; creatinine; cross-sectional study; determination in blood; hydrocarbons; renal dysfunction; renal insufficiency; risk factors; road work.
Journal of Occupational Health and Safety - Australia and New Zealand, Apr. 1998, Vol.14, No.2, p.143-148. 23 ref.

1997

CIS 99-1245 Järup L., Persson B., Elinder C.G.
Blood cadmium as an indicator of dose in a long-term follow-up of workers previously exposed to cadmium
The tubular function of 46 workers initially examined in 1984 and heavily exposed to cadmium from 1955 to 1978 was investigated. Although cadmium exposure ceased in 1978, 40% of the workers showed signs of tubular dysfunction both in 1984 and 1993. The current cadmium in blood level (B-Cd) was the best dose indicator. Dose-response relationships were found for B-Cd and various tubular markers. Urinary excretion of protein HC (α₁-microglobulin) appeared to be the most sensitive, as well as an early, indicator of cadmium-induced tubular dysfunction. A history of renal stones was significantly more common for workers with high B-Cd levels. Topics: cadmium; determination in blood; determination in urine; dose-response relationship; exposure evaluation; exposure tests; long-term exposure; long-term study; nephrotoxic effects; proteinuria; renal dysfunction; soldering and brazing; urinary lithiasis; urine monitoring.
Scandinavian Journal of Work, Environment and Health, Feb. 1997, Vol.23, No.1, p.31-36. Illus. 36 ref.

CIS 98-741 Morikawa Y., Shiomi K., Ishihara Y., Matsuura N.
Triple primary cancers involving kidney, urinary bladder, and liver in a dye worker
Topics: benzidine; bladder tumour; case study; dyestuff industry; histology; Japan; liver cancer; renal cancer.
American Journal of Industrial Medicine, Jan. 1997, Vol.31, No.1, p.44-49. Illus. 18 ref.

CIS 97-1981 Calvert G.M., Steenland K., Palu S.
End-stage renal disease among silica-exposed gold miners: A new method for assessing incidence among epidemiologic cohorts
The incidence of end-stage renal disease (ESRD) was studied in a cohort of 2412 white male gold miners who had worked underground for at least one year. Exposure to silica was evaluated. Based on the 11 cohort members identified with ESRD, the risk in the cohort was elevated compared with the U.S. population. The risk was greatest for non-systemic ESRD and increased with years of employment underground. Results provide evidence that silica exposure is associated with increased risk for ESRD.
Journal of the American Medical Association, Apr. 1997, Vol.277, No.15, p.1219-1223. 37 ref.

1996

CIS 98-1620 Golka K., Schläfke S., Dickhut S., Reich S.E., Urfer W., Bolt H.M.
Using statistical methods to identify the occupational risks of malignant tumours of the bladder and prostate
Anwendung statistischer Methoden zur Identifikation beruflicher Risiken für maligne Tumoren der Harnblase und der Prostata [in German]
Topics: aromatic amines; azo compounds; bladder tumour; carcinogens; epidemiologic study; Germany; hazard evaluation; neoplasms; paints; prostatic cancer; risk factors; smoking; statistical evaluation.
Verlag Dr. Markus Hänsel-Hohenhausen, 63324 Egelsbach, Germany, 1996. 172p. Illus. 23 ref. Price: DEM 69.00.

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