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

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  • Diseases of the kidney and the urinary system


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.

CIS 97-923 Ouellet-Hellstrom R., Rench J.D.
Bladder cancer incidence in arylamine workers
Cancer incidence was investigated in a cohort of 700 workers employed at a chemical plant between mid-1965 and 1989. The plant produced a variety of chemicals including arylamines such as dichlorobenzidine, o-dianisidine and o-tolidine; benzidine production ceased prior to mid-1965. The principal finding was a significant increase in the standardized incidence ratio for bladder cancer in men. Based on an exposure classification system, the observed association between bladder cancer cases and exposure to arylamines increased with increasing exposure. Smoking probably contributed to the bladder cancer risk, as all case subjects were known to be current or former cigarette smokers.
Journal of Occupational and Environmental Medicine, Dec. 1996, Vol.38, No.12, p.1239-1247. 18 ref.

CIS 96-1762 Novara R., Coda R., Martone T., Vineis P.
Exposure to aromatic amines and ras and c-erB-2 overexpression in bladder cancer
Since overexpression of ras and c-er B-2 oncogenes occurs in bladder cancer, immunohistochemical analysis of the encoded protein products p21 and p185 was performed in six bladder cancer biopsies of workers exposed to high levels of 2-naphthylamine and benzidine. Eleven unexposed bladder cancer patients, 6 subjects with benign bladder conditions and 16 healthy subjects were similarly analyzed. In the latter group biopsies were obtained during cystoscopies prompted by clinical symptoms. Overexpression of ras was found in 4 of 6 exposed cancer patients, 3 of 11 unexposed cancer patients, 0 of 6 benign disease patients and none of 16 healthy subjects. No association was found between occupational exposure and c-er B-2 overexpression.
Journal of Occupational and Environmental Medicine, Apr. 1996, Vol.38, No.4, p.390-393. 26 ref.


CIS 97-179 Nishijo M., Nakagawa H., Morikawa Y., Tabata M., Senma M., Miura K., Takahara H., Kawano S., Nishi M., Mizukoshi K., Kido T., Nogawa K.
Mortality of inhabitants in an area polluted by cadmium: 15 year follow-up
Follow-up study for 15 years (from 1974-5 to 1991) carried out on 2408 inhabitants of the Kakehashi River basin in Ishikawa Prefecture, Japan. The inhabitants had been the subjects of the health impact survey in 1974-5 to evaluate (by measurement of urinary retinol binding protein (RBP)) renal dysfunction induced by cadmium. Analysis of mortality was performed by dividing subjects into a urinary RBP positive group and RBP negative group. After adjustment for age, RBP positive group showed a significant relation to mortality in both sexes. When the standardized mortality ratios according to causes of deaths in the RBP positive group were compared with those of the RBP negative group or the overall Japanese population, increases of this ratio for cardiovascular diseased, especially heart failure, and renal diseases were found in both sexes. The results suggest that the prognosis of the exposed inhabitants with renal tubular dysfunction is unfavourable and the increase of mortality is due to heart failure and renal diseases.
Occupational and Environmental Medicine, Mar. 1995, Vol.52, No.3, p.181-184. 22 ref.

CIS 96-831 Chia K.S., Jeyaratnam J., Lee J., Tan C., Ong H.Y., Lee E.
Lead-induced nephropathy: Relationship between various biological exposure indices and early markers of nephrotoxicity
Current blood lead levels were determined in 128 lead-exposed workers and in 93 non-exposed controls. For the exposed workers, time-integrated blood indices were derived from serial blood lead measurements taken during the years of exposure. Urinary α1-microglobulin, urinary β2-microglobulin and urinary retinol-binding protein were also measured as markers of lead-induced kidney damage. In the exposed workers, all the effect markers had better correlation with the time-integrated blood lead indices than with current blood lead levels; urinary α1-microglobulin was the only marker that was significantly higher in the exposed group, with a good dose-response and dose-effect relationship with the time-integrated blood lead indices.
American Journal of Industrial Medicine, June 1995, Vol.27, No.6, p.883-895. 37 ref.

CIS 96-270 Tremblay C., Armstrong B., Thériault G., Brodeur J.
Estimation of risk of developing bladder cancer among workers exposed to coal tar pitch volatiles in the primary aluminum industry
In a study of aluminium production workers in a plant using the Soderberg process, 69 cases of bladder cancer were diagnosed between 1980 and 1988. A previous study had identified 69 cases between 1970 and 1979. Smoking habits were determined and exposure to benzene-soluble matter (BSM) and benzo(a)pyrene (BaP) was assessed. Men who had worked in the Soderberg potrooms were at higher risk of developing the disease, the risk increasing with time spent in these departments. The magnitude of risk was of the same order as in the previous study. A strong association was found between risk and cumulative exposure to BSM or BaP.
American Journal of Industrial Medicine, Mar. 1995, Vol.27, No.3, p.335-348. 20 ref.

CIS 96-259 Savolainen H.
Cadmium-associated renal disease
The metabolism, toxicity and renal effects of cadmium are reviewed. The long half-life of cadmium in the human organism causes its accumulation in the liver and kidneys. Renal effects include early tubular dysfunction manifested by proteinuria, amino aciduria, glucosuria, phosphaturia and calcium wastage. Chronic effects include decrease in the glomerular filtration rate and increased rate of kidney stone disease. Biological monitoring of cadmium absorption includes determination of urinary cadmium and of low molecular weight marker proteins.
Renal Failure, 1995, Vol.17, no.5, p.483-487. 30 ref.

CIS 96-150 Nuyts G.D., Van Vlem E., Thys J., De Leersnijder D., D'Haese P.C., Elseviers M.M., De Broe M.E.
New occupational risk factors for chronic renal failure
Occupational histories of 272 men and women with chronic renal failure were compared with those of 272 matched controls. Significantly increased risks of chronic renal failure were found for exposure to lead, copper, chromium, tin, mercury, welding fumes, silicon-containing compounds, grain dust and oxygenated hydrocarbons. The frequencies of various occupational exposures were high among patients with diabetic nephropathy. The study confirms previously identified risk factors and suggests that additional occupational exposures, for which there is some other experimental evidence, may be important in the development of chronic renal failure.
Lancet, 1 July 1995, Vol.346, No.8966, p.7-11. Illus. 30 ref.

CIS 95-2156 Sharpe C.R., Franco E.L., Camargo B., Lopes L.F., Barreto J.H., Johnsson R.R., Mauad M.A.
Parental exposure to pesticides and risk of Wilms' tumor in Brazil
Wilms' tumour is one of the most common abdominal childhood malignancies. The authors collected information on relevant occupational exposures by interviewing the parents of 109 Wilms' tumour cases admitted to hospitals in 4 Brazilian cities. Also interviewed were the parents of 218 age- and sex-matched control children admitted to the same or nearby hospitals. Odds ratios (ORs) adjusted for income and education were calculated by conditional logistic regression. Consistently elevated risks were seen for farm work involving frequent use of pesticides by both the father (OR=3.24, 95% confidence interval (CI) 1.2-9.0) and the mother (OR=128.6, 95% CI 6.4-2,569). These risk elevations were restricted to cases diagnosed after 2 years of age (ORs > 4), for paternal exposure, and after 4 years of age (OR=14.8, 95% CI 2.2-98.8), for maternal exposure. Risk elevations were also more pronounced among boys than among girls.
American Journal of Epidemiology, 1 Feb. 1995, Vol.141, No.3, p.210-217. 27 ref.

CIS 95-1343 Golka K., Bandel T., Urfer W., Bolt H.M.
Bundesanstalt für Arbeitsschutz
Occupational risk factors for malignant tumours of the bladder and the prostate
Berufliche Risikofaktoren für Tumoren der Harnblase und der Prostata [in German]
Case-control study of bladder and prostatic cancer among workers in a German region with a heavy concentration of mining and metallurgy with at least one year seniority in their profession. In all, 412 male victims of bladder cancer and 238 victims of prostatic cancer were compared with 414 victims of prostatic adenoma (controls). Smoking habits were taken into consideration. After controlling for smoking, bladder cancer was significantly more common among painters, workers in the chemical industry, coke plant workers and miners than among controls. The odds ratio for developing bladder cancer was 2.56 among smokers when compared with non-smokers (including persons who had stopped smoking more than 10yrs previously). The risk of developing prostatic cancer was significantly higher than for the controls among miners and gardening and forestry workers. Commentary in light of other research published concerning risk factors for these two cancers.
Wirtschaftsverlag NW, Postfach 10 11 10, Am Alten Hafen 113-115, 2850 Bremerhaven 1, Germany, 1995. 87p. 125 ref.


CIS 97-482 Piolatto G., Pira E., Meliga F.
The use and usefulness of multistage models of carcinogenesis in cohort studies
L'uso e l'utilitą dei modelli multistage di cancerogenesi negli studi di coorte [in Italian]
This is a review of multistage models applied to data on exposure to aromatic amines and bladder cancer mortality. The results suggest that aromatic amines act on more than one stage of the carcinogenic process, most probably on both early and late stages. The effect on late stages implies a decreasing risk after cessation of exposure, and in this case discontinuing it can be useful; an effect on early stages, instead, indicates the necessity of intensive medical surveillance even after cessation of exposure.
Medicina del lavoro, Jan.-Feb. 1994, Vol.85, No.1, p.78-83. 11 ref.

CIS 96-642 Boogaard P.J., Caubo M.E.J.
Increased albumin excretion in industrial workers due to shift work rather than to prolonged exposure to low concentrations of chlorinated hydrocarbons
In order to elucidate the effect of shift work, a series of renal and hepatic variables were studied in organochlorine workers but now with two different control groups. One control group comprised shift workers and the other only workers on day duty. The exposed and both control groups had roughly equal physical workloads, although one control group comprised shift workers and the other workers who work only during daytime. There were no significant changes in the results of the liver tests between the exposed group and either of the control groups, nor between the two control groups. No significant differences for any renal test were found between the exposed workers and control shift workers, but albumin was significantly lower in the control day workers than in the exposed workers and control shift workers. The results suggest that the previously reported small increase in albuminuria in industrial workers is due to alterations in circadian rhythms due to the shift work system rather than to prolonged exposure to low concentrations of potentially nephrotoxic chemicals.
Occupational and Environmental Medicine, Sep. 1994, Vol.51, No.9, p.638-641. 9 ref.

CIS 96-836 Clavel J., Mandereau L., Limasset J.C., Hémon D., Cordier S.
Occupational exposure to polycyclic aromatic hydrocarbons and the risk of bladder cancer: A French case-control study
A hospital-based case-control study of 658 male cases of bladder cancer and 658 male controls was carried out in 5 areas of France from 1984 to 1987. For each subject, occupational exposure to polycyclic aromatic hydrocarbons (PAH) was determined through questionnaires. The overall odds ratio for PAH exposure, adjusted for smoking, coffee drinking and occupational exposure to aromatic amines was estimated at 1.3 (95% confidence interval [CI]: 1.0-1.7, p<0.05). A slight but clear dose-response relationship was observed, and the trend remained significant after adjustment for cumulative smoking, with odds ratios of 1.2 (95% CI: 0.9-1.7), 1.4 (95% CI: 0.9-2.2) and 1.8 (95% CI: 0.8-3.9) for low, medium and high average exposures respectively compared to subjects unexposed to PAH (p<0.05). Moreover, a stronger association between bladder cancer and PAH exposure was detected in a heavy-smoker group.
International Journal of Epidemiology, Dec. 1994, Vol.23, No.6, p.1145-1153. 30 ref.

CIS 95-2071 Hours M., Dananche B., Fevotte J., Bergeret A., Ayzac L., Cardis E., Etard J.F., Pallen C., Roy P., Fabry J.
Bladder cancer and occupational exposures
A hospital-based case-referent study (116 bladder cancer patients, 232 controls) was carried out in Lyon, France, with the purpose of generating hypotheses about the role of occupational exposures to 320 compounds in bladder carcinogenesis. Significantly elevated odds ratios were observed for exposure to pyrolysis and combustion products (odds ratio (OR) 2.3, 95% (CI) 1.0-4.0) when the general referents were used and for cutting fluids (OR 2.6, 95% CI 1.2-5.4) when adjusted for smoking. The latter was highest among blue-collar and unskilled workers, supervisors, and agricultural workers, while the odds ratio for the others was 0.8 (95% CI 0.3-2.7). An elevated odds ratio for exposure to inks was observed for women (OR 14.0, 95% CI 1.8-106.5) on the basis of 14 exposed cases, but confounding factors could have been responsible for this result. The observations of this investigation should be further tested in future studies.
Scandinavian Journal of Work, Environment and Health, Oct. 1994, Vol.20, No.5, p.322-330. 40 ref.

CIS 95-1680 Burnett C.A., Silverman D.T., Lalich N.R.
A comparison of analyses of occupational bladder cancer: Death certificate vs. population-based case-control interview data
The ability of death certificate data to identify high-risk occupations for bladder cancer was compared with that of a population-based case-control study. Death certificate data for 1979-1987 were compared with data from cancer registry cases for 1977-1978. Results were compared for 21 suspect occupations. There was broad agreement for 62% of the occupations; the death certificate study identified eight of 15 occupations identified by the case-control study and neither study identified five of the categories. While death certificate data have many limitations, results indicate that such data can provide clues to some occupational health problems.
American Journal of Industrial Medicine, May 1994, Vol.25, No.5, p.677-688. 33 ref.

CIS 95-1403 Lundberg I., Nise G., Hedenborg G., Högberg M., Vesterberg O.
Liver function tests and urinary albumin in house painters with previous heavy exposure to organic solvents
Occupational and Environmental Medicine, May 1994, Vol.51, No.5, p.347-353. Illus. 38 ref. ###

CIS 95-1330 Aupérin A., Benhamou S., Ory-Paoletti C., Flamant R.
Occupational risk factors for renal cell carcinoma: A case-control study
A case-control study of 196 histologically proved cases of renal cell carcinoma and 347 controls matched for age at interview, sex, hospital and interviewer was conducted in France between 1987 and 1991. A complete occupational history was recorded for each patient and occupations were coded blindly according to the International Standard Classification of Occupations. In women, none of the risks were significant. Among men, after adjustment for educational level, cigarette smoking and Quetelet index before diagnosis, significantly increased matched odds ratios (ORs) were found for sales workers (OR=2.1, 95% confidence interval (95% CI) 1.2-4.0), managers (OR=3.3, 95% CI 1.2-8.9), and textile workers and tailors (OR=6.2, 95% CI 1.1-33.7). For this last occupational group, an increase in risk was found with an increased duration of exposure.
Occupational and Environmental Medicine, June 1994, Vol.51, No.6, p.426-428. 25 ref.

CIS 95-1356 Leon D.A.
Mortality in the British printing industry - A historical cohort study of trade union members in Manchester
A historical cohort study of the printing industry was conducted after an anecdotal report of a cluster of cases of bladder cancer in a newspaper factory in Manchester. The cohort comprised some 9,500 men who were members of either of two trade unions (the NGA and NATSOPA) in the Manchester area between 1949 and 1963. During the follow-up period (1949-1983) 3,482 deaths occurred among men born in 1890 or later; follow-up was 97% complete. The results of the study do not support the hypothesis of an occupational risk of bladder cancer in the printing industry. A high mortality rate from lung cancer (SMR=179, 95% CI 144-218) was found among men involved in newspaper letterpress printing that is consistent with the findings of previous studies. Increased mortality from cancer of the buccal cavity and pharynx was found for NATSOPA workers in the newspaper industry. The lower mortality in the NGA compared with that in NATSOPA may well be due to socioeconomic differences in union composition, rather than occupational factors.
Occupational and Environmental Medicine, Feb. 1994, Vol.51, No.2, p.79-86. 33 ref.

CIS 95-1314 Boujemaa W., Lauwerys R., Bernard A.
Early indicators of renal dysfunction in silicotic workers
The aim of the study was to determine whether silicosis is associated with renal alterations detectable in urinary or blood-borne indicators of nephrotoxicity. Subjects comprised 116 male workers who had been exposed to silica for a least two years and had been diagnosed as having silicosis and 61 age-matched controls. The considered outcome measures were the concentrations of beta2-microglobulin and creatinine in serum and the urinary excretion of albumin, retinol-binding protein and beta-N-acetyl-D-glucosaminidase. Compared with the controls, the silicotic subjects excreted, on average, slightly higher amounts of albumin, retinol-binding protein and beta-N-acetyl-D-glucosaminidase. The concentration of beta2-microglobulin in the serum of silicotic subjects showed a tendency to rise that became significant in the subgroup with pseudotumoral opacities. These results confirm that silicosis is associated with some infraclinical renal alterations. However, in the absence of a relationship with length of exposure or severity of silicosis, the implication of silica in their causation needs to be examined further.
Scandinavian Journal of Work, Environment and Health, June 1994, Vol.20, No.3, p.180-183. 17 ref.

CIS 95-1335 Mellemgaard A., Engholm G., McLaughlin J.K., Olsen J.H.
Occupational risk factors for renal-cell carcinoma in Denmark
Risk factors for renal-cell carcinoma, the most frequent type of kidney cancer, remain uncertain. Time trends in incidence and changes in the regional distribution of this cancer are suggestive of environmental risk factors. This study reports on occupational risk factors for renal-cell carcinoma in Denmark. In a population-based study, 365 persons with histologically verified renal-cell carcinoma and 396 controls were interviewed. Information was collected on occupation, education and occupational exposure to a number of suspected factors, including hydrocarbons, asbestos and radiation. Risk of renal-cell carcinoma was found to be associated with employment as a truck driver, exposure to gasoline, other hydrocarbons, and insecticides and herbicides. The risk of renal-cell carcinoma was higher in the lower socioeconomic strata for both men and women, and previously identified or suspected risk factors do not explain the excess in risk. This study adds additional support to the hypothesis of a link between renal-cell carcinoma and hydrocarbons and also demonstrates the need for further studies on occupational risk factors for renal-cell carcinoma.
Scandinavian Journal of Work, Environment and Health, June 1994, Vol.20, No.3, p.160-165. 35 ref.

CIS 95-651 Schaller K.H., Schiele R., Weltle D., Breitstadt R., Angerer J.
Studies on the exposure and occurrence of proteinuria among employees of the pigment industry with long-term exposure to cadmium
Untersuchungen zur Belastung und zur Proteinurie bei langjähriger Cadmiumexposition in der Pigmentindustrie [in German]
Cadmium levels in blood and urine samples of 152 workers with long-term exposure to cadmium in 2 plants producing cadmium pigment and cadmium glaze frits were not significantly different from those in 214 members of the control group. Neither were the early indicators of proteinuria such as total protein, albumin, beta-2-micro-globulin, transferrin and alpha-1-microglobulin in urine significantly different from the control group. Increased levels occurred only among employees whose exposure dated back to the 1970s. With today's exposure levels of 5µg cadmium/m3 no elevated internal cadmium levels are found.
Arbeitsmedizin - Sozialmedizin - Umweltmedizin, Nov. 1994, Vol.29, No.11, p.464-466, 468. Illus.


CIS 96-2188 Hotz P., Thielemans N., Bernard A., Gutzwiller F., Lauwerys R.
Serum laminin, hydrocarbon exposure, and glomerular damage
It has been postulated that occupational exposure to hydrocarbons may damage the kidney and lead to glomerulonephritis and chronic renal failure. As laminin is a ubiquitous basement membrane component that seems to play a central part in the structure and function of basement membranes and as the normal renal filtration process is highly dependent on an intact glomerular basement membrane, the serum laminin concentration was examined in a population of workers exposed to hydrocarbons. The hydrocarbon exposure was assessed by exposure surrogates (exposure duration and exposure score). An interaction between occupational exposure to hydrocarbons and hypertension increased the laminin concentration whereas the laminin concentration decreased in workers exposed for a long time probably because of a selection effect. In a subgroup of printers exposed to toluene whose hippuric acid excretion had been recorded for several years this interaction was confirmed when the hippuric acid excretion was substituted for the other exposure indices. In the exposed group, the age-related decline in creatinine clearance was accelerated. These results seem to confirm that occupational exposure to hydrocarbons is a non-specific factor that may promote a deterioration of renal function.
British Journal of Industrial Medicine, Dec. 1993, Vol.50, No.12, p.1104-1110. 30 ref.

CIS 96-2197 Case R.A.M., Hosker M.E., McDonald D.B., Pearson J.T.
Tumours of the urinary bladder in workmen engaged in the manufacture and use of certain dyestuff intermediates in the British chemical industry
Editor's choice: reprint of a classic paper originally published in 1954 (BJIM 11: 75-96). It presents the results of a follow up on more that 4600 men in the British chemical industry from 1920 to 1949. The overall risk of dying from bladder cancer was about 30 times that of the general population and contact with benzidine, alpha-naphthylamine or beta-napthylamine (but not aniline) in either manufacture or use was liable to cause an excess number of tumours. Furthermore, this study confirms what was known for other occupational tumours, that is, that both onset and death occurred at an earlier age than in non-occupational cases.
British Journal of Industrial Medicine, May 1993, Vol.50, No.5, p.389-411. Illus.

CIS 96-749 Ng T.P., Lee H.S., Phoon W.H.
Further evidence of human silica nephrotoxicity in occupationally exposed workers
It has previously been shown that granite workers with heavy exposure to silica had glomerular and proximal tubular dysfunction evidenced by increased urinary excretions of albumin. The investigation was replicated in another group of granite workers to further elucidate the exposure effect relation. The urinary excretion of albumin, α-1-microglobulin (AMG), β-2-microglobulin (BMG), and β-N-acetyl-glucosaminidase (NAG) was determined in two groups of granite workers with low and high exposure to silica. Low molecular weight proteinuria and enzymuria were significantly correlated with duration of exposure in the high but not the low exposure group. These increases were most pronounced in those with 10 or more years of heavy exposure, and in those with radiological evidence of pulmonary fibrosis, particularly those with rounded small opacities denoting classical silicosis. These results provide further evidence that prolonged and heavy exposure to silica is associated with nephrotoxic effects in granite workers.
British Journal of Industrial Medicine, Oct. 1993, Vol.50, No.10, p.907-912. Illus. 18 ref.

CIS 95-1683 Rushton L.
A 39-year follow-up of the UK oil refinery and distribution center studies - Results for kidney cancer and leukemia
This paper reports the principal results of a mortality analysis of workers at UK oil refineries and distribution centres, together with detailed results for kidney cancer and leukaemia. The mortality from all causes of death is lower than that of the general population, and reduced mortality is also found for many of the major nonmalignant causes of death. In the refinery study, some increased mortality patterns are found for diseases of the arteries, and no healthy worker effect is found in the distribution centre study for ischaemic heart disease. Mortality from all neoplasms is lower than expected overall in both studies, largely due to a deficit of deaths from lung neoplasms. Mortality from kidney neoplasms is increased overall in the distribution centre study, and in drivers in particular. The deaths from leukaemia are slightly less than expected in the refinery study and slightly more than expected in the distribution centre study.
Environmental Health Perspectives, Dec. 1993, Vol.101, Suppl.6, p.77-84. 71 ref.

CIS 95-1787 Poole C., Dreyer N.A., Satterfield M.H., Levin L., Rothman K.J.
Kidney cancer and hydrocarbon exposures among petroleum refinery workers
A review of 18,323 death certificates of male refinery workers identified 102 kidney cancer cases, to each of whom four controls were matched by refinery location and decade of birth. Work histories were found containing an average of 15.7 job assignments per subject. To each job, semiquantitative ratings were assigned for the intensity and frequency of exposures to three hydrocarbon categories: non-aromatic liquid gasoline distillates, aromatic hydrocarbons and volatile hydrocarbons. Each exposure had either no association or a weak association with kidney cancer. For the non-aromatic liquid gasoline distillates the estimated relative risk (RR) for any exposure above refinery background was 1.0. In an analysis of the longest job held by each subject, three groups appeared to be at increased risk: labourers (RR = 1.9), workers in receipt, storage, and movements (RR = 2.5), and unit cleaners (RR = 2.3).
Environmental Health Perspectives, Dec. 1993, Vol.101, Suppl.6, p.53-62. 53 ref.

CIS 95-652 Teass A.W., DeBord D.G., Brown K.K., Cheever K.L., Stettler L.E., Savage R.E., Weigel W.W., Dankovic D., Ward E.
Biological monitoring for occupational exposures to o-toluidine and aniline
In a tyre manufacturing plant where an excess of bladder cancers was attributed to o-toluidine and aniline the exposure of workers was evaluated. The unmetabolized aniline and o-toluidine as well as the metabolites acetanilide and N-acetyl-o-toluidine were determined in a total of 209 pre- and post-shift urine samples from 53 exposed and 36 nonexposed workers. A method using high-performance liquid chromatography (HPLC) followed by electrochemical detection was employed. In addition, a total of 84 whole blood samples were analyzed for aniline-haemoglobin and o-toluidine-haemoglobin adducts. Two alternative procedures were tested, one using HPLC and the other gas chromatography with electron capture detection. First results provide evidence of a carryover of a part of the o-toluidine dose from one workshift to the next. For haemoglobin adduct determination the HPLC fluorescence method appeared useful.
International Archives of Occupational and Environmental Health, 1993, Vol.65, Suppl.1, p.S115-S118. Illus. 10 ref.

CIS 94-1973 Popp W., Ohndorf U., Stommel P., Vahrenholz C., Norpoth K.
Multiple primary cancers after exposure to aromatic amines
Primäre Mehrfachtumoren nach Einwirkung aromatischer Amine [in German]
Of 313 cases with bladder tumour due to occupational exposure, 55 had multiple primary cancers. The lung, liver, pancreas, stomach, breast, prostate, colon, nose and haemopoietic system were affected. A close study of 18 cases with multiple primary cancers in other organs than the bladder was conducted. From the case studies as well as the presently available results of animal experiments and epidemiologic studies and the present knowledge of the metabolism of aromatic amines a relationship with occupational exposure is derived. The compensation of these additional primary tumours as occupational diseases is recommended.
Arbeitsmedizin - Sozialmedizin - Umweltmedizin, May 1993, Vol.28, No.5, p.183-191. 78 ref.

CIS 94-1601 Bolm-Audorff U., Jöckel K.H., Kilguss B., Pohlabeln H., Siepenkothen T.
Malignant tumours of the lower urinary tract and occupational risk factors
Bösartige Tumoren der ableitenden Harnwege und Risiken am Arbeitsplatz [in German]
Chemists, chemical workers, employees in the rubber industry and hairdressers run a significantly higher risk of developing malignant tumours of the lower urinary tract. Painters were found to be at higher risk also, but not on a statistically significant level. Smoking and the consumption of beer and coffee were identified as non-occupational risk factors.
Wirtschaftsverlag NW, Postfach 10 11 10, Am Alten Hafen 113-115, 27511 Bremerhaven, Germany, 1993. 179p. Illus. Bibl.ref.

CIS 94-1609 Sinclair M.I., McNeil J.J, Atkins R.C., Turnidge J.D., Wood C.J., Matthews B.J.
Investigation of hematuria at a printing company
An investigation was undertaken at a printing company into an apparently high prevalence of trace dipstick haematuria discovered during routine medical examinations. In both the printing employees and a control group from other industries, the prevalence of haematuria exceeded that described in most previous reports (using the criterion of >12 glomerular red cells or >2 non-glomerular red cells/mL of urine). No focus of abnormality was identified within the printing plant and no association was identified between reported exposure to potentially toxic substances and the degree of haematuria. An occupational hygiene inspection and medical follow-up of selected workers did not reveal any significant abnormalities. The limitations of available information concerning "normal" urinalysis results suggests that haematuria may not be a useful test for the screening of occupational groups at risk of bladder cancer.
Journal of Occupational Medicine, Oct. 1993, Vol.35, No.10, p.1055-1061. Illus. 23 ref.

CIS 94-1227 Notani P.N., Shah P., Jayant K., Balakrishnan V.
Occupation and cancers of the lung and bladder - A case-control study in Bombay
Associations between occupation and cancers of the lung (n=246) and bladder (n=153) were examined in a case-control study of males. Controls (n=212) comprised cases of oral and pharyngeal cancers and non-neoplastic oral diseases. For lung cases, significantly elevated risks (adjusted for smoking) were found for textile workers (odds ratio [OR]=1.99, 95% confidence interval [CI] : 1.3-3.6) and cooks (OR=4.48, 95% CI : 1.2-16.9). High risks were also observed among ship and dockyard workers (OR=2.87, 95% CI : 0.8-10.1) and wood workers (OR=2.88, 95% CI : 0.9-9.6). For bladder cancers, significantly elevated risks were observed only for chemical/pharmaceutical plant workers (OR=4.48, 95% CI : 1.2-16.5). Two other sets of risk estimates were obtained: one by comparison with a second unexposed group made up of occupations with little exposure to cancer causing agents, and the other by fitting logistic regression models to the data. All methods yielded similar risk estimates.
International Journal of Epidemiology, Apr. 1993, Vol.22, No.2, p.185-191. 14 ref.

CIS 94-978 Bolt H.M., Golka K.
On the past exposure of painters to azo colorants
Zur früheren Exposition von Malern gegenüber Azofarbmitteln [in German]
Present experimental data indicate that the bladder cancer risk of painters using azo dyes depends on the kind of azo dyes used. Only bioavailable soluble azo dyes may have a carcinogenic effect. An examination of past exposures of painters to bioavailable azo dyes reveals that up to the 1950's bioavailable, soluble azo dyes including dyes based on benzidine were used for the surface treatment of wood. In those days painters had to mix and prepare the dyes from powders. Skin contact and inhalation were unavoidable. After 1960 the carcinogenic azo dyes were no longer used by painters.
Arbeitsmedizin - Sozialmedizin - Umweltmedizin, 1993, Vol.28, No.10, p.417-421. Illus. 23 ref.

CIS 94-969 Emara M., Tolba F., Salem M., El-Mahdy A.
β2-Microglobulin in agricultural workers exposed to organophosphorus compounds
Twenty agricultural workers in Egypt were investigated for the effects of organophosphorus insecticides on kidney function by estimation of serum-β2-microglobulin. There was a significant increase in the level of serum-β2-microglobulin compared to the control group; serum creatinine levels were within the normal range. The use of serum-β2-microglobulin was thus found to be a more sensitive test for detecting moderate changes of glomerular filtration rate than serum creatinine.
Agricultural Medicine and Rural Health, Winter 1993, Vol.17, No.1, p.21-23. 4 ref.

CIS 94-579 Rocskay A.Z., Robins T.G., Schork M.A., Echeverria D., Proctor S.P., White R.F.
Renal effects of naphtha exposure among automotive workers
A part of a study on health effects of naphtha exposure, the association between naphtha exposure and urinary excretion of total protein, albumin, β-N-acetyl-D-glucosaminidase (β-NAG), and β2-microglobulin was assessed prospectively over one year among 248 workers (of whom 181 were retested one year later) at an automotive plant that used naphtha to calibrate fuel injectors. Naphtha air concentration at the plant ranged 6-790mg/m3, while length of exposure by the worker ranged 0.8-7.3 years. Overall, there was no significant effect of naphtha exposure on renal function, with the exception of a change in β-NAG which was positively associated with changes in recent naphtha exposures (p=0.009).
Journal of Occupational Medicine, June 1993, Vol.35, No.6, p.617-622. 21 ref.

CIS 94-316 Golsdmith J.R., Goldsmith D.F.
Fibreglass or silica exposure and increased nephritis or ESRD (End-Stage Renal Disease)
A U.S. multi-plant cohort mortality study of workers producing manufactured mineral fibres is finding increasing mortality from nephritis and/or nephrosis. Other data were examined to see if similar effects can be identified. In a case-referent study among Michigan patients with end-stage renal disease (ESRD), men with exposures to silica have an elevated odds ratio for ESRD. In a California study based on 1979-81 data, some construction trades, farmers, and farm laborers showed excess mortality for renal disease. The highest mortality ratio was found in the category including insulation workers. California mortality data from 20 years earlier fail to show much excess renal disease in construction workers, but do for farmers. In Singapore, granite workers with a long-term exposure to silica have excess excretion of albumin and similar compounds, suggesting that silica exposure can lead to silica nephrotoxicity. Nephropathy has also been linked to non-occupational silica exposure. Although high blood concentrations of silica are found in persons with renal failure, the close association with elevated creatinine has been interpreted as evidence that the buildup of silica is due to renal failure, rather than vice-versa.
American Journal of Industrial Medicine, June 1993, Vol.23, No.6, p.873-881. 27 ref.

CIS 94-310 Nuyts G.D., Elseviers M.M., De Broe M.E.
Healthy worker effect in a cross-sectional study of lead workers
A cross-sectional study of workers at a lead-smelting plant was conducted in order to study the role lead may play in the development of renal disease. Renal function was defined based on calculated creatinine clearance using the prevalence of values under the third percentile to compare groups. The prevalence of clearance values under the third percentile in these workers (n=1782) as a whole was 2.81%, a result comparable to that expected for the general population. Closer analysis, however, showed significantly lower prevalence of calculated creatinine clearance under the third percentile in some workers. These subgroups were workers between the ages of 30 and 39, workers over 50, and Belgian workers who had worked in the plant for longer than 10 years. In conclusion, these observations once more clearly demonstrate a "healthy worker effect" on the measurement of renal function in this work force, a major problem in epidemiological cross-sectional studies.
Journal of Occupational Medicine, Apr. 1993, Vol.35, No.4, p.387-391. Illus. 21 ref.

CIS 93-1880 McCredie M., Stewart J.H.
Risk factors for kidney cancer in New South Wales. IV. Occupation
In a population-based case-control study of kidney cancer in New South Wales, data from structured interviews with 489 cases of renal cell cancer (RCC), 147 cases of renal pelvic cancer (CaRP), and 523 controls from the electoral rolls were obtained about employment in certain industries or occupations, and exposure to particular chemicals chosen because of suspected associations with kidney cancer. A low level of education increased the risk for CaRP but not RCC. After adjustment for known risk factors, exposure to asbestos significantly increased the risk for RCC (relative risk (RR) = 1.62; 95% confidence interval (95% CI) 1.04-2.53). Working in the dry cleaning industry had a stronger link with CaRP (RR = 4.68; 95% CI 1.32-16.56) than with RCC (RR = 2.49; 95% CI 0.97-6.35). Working in the iron and steel industry doubled the risk for CaRP (RR = 2.13; 95% CI 1.04-4.39) whereas employment in the petroleum refining industry had a non-significant association with CaRP (RR = 2.60; 95% CI 0.88-7.63) and none with RCC.
British Journal of Industrial Medicine, Apr. 1993, Vol.50, No.4, p.349-354. 32 ref.

CIS 93-1874 Bi W.F., Rao J.Y., Hemstreet G.P., Fang P., Asal N.R., Zang M., Min K.W., Ma Z., Lee E., Li G., Hurst R.E., Bonner R.B., Wang Y., Fradet Y., Yin S.
Field molecular epidemiology - Feasibility of monitoring for the malignant bladder cell phenotype in a benzidine-exposed occupational cohort
The primary objective of this study was to demonstrate the feasibility of using cellular and molecular methods in combination with medical and epidemiological methods in field studies to identify cancer cases, risk factors, and markers. A previously identified cohort of Chinese workers exposed to benzidine was studied by medical and exposure history questionnaires and interviews, physical examinations and sample collection for laboratory analysis. Three groups were included in this study: 23 bladder cancer cases who had been exposed to benzidine, 20 subjects with previous exposure history but not previously diagnosed with bladder cancer and a group of non-exposure and non-bladder cancer controls. Very sophisticated molecular techniques for measurement of DNA ploidy, tumour antigens, and oncogene proteins was successfully applied.
Journal of Occupational Medicine, Jan. 1993, Vol.35, No.1, p.20-27. Illus. 25 ref.


CIS 94-1646 Edelman D.A.
Does asbestos exposure increase the risk of urogenital cancer?
The risk of urogenital cancer in workers exposed to asbestos was evaluated using the results of published studies. The pooled standardized mortality ratios (SMRs), based on the results of cohort studies, were significantly increased (p≤0.05) for ovarian and kidney cancer in North American studies but not elsewhere. In part, this increase is probably due to the use of inappropriate comparison populations and the failure to take into account risk factors associated with urogenital cancer. Other types of studies generally did not indicate that exposure to asbestos increases the risk of urogenital cancer. Generally, there is not enough information to determine whether there is a relationship between exposure to asbestos and urogenital cancers.
International Archives of Occupational and Environmental Health, 1992, Vol.63, No.7, p.469-475. 49 ref.

CIS 94-298 Chia K.S., Tan A.L., Chia S.E., Ong C.N., Jeyaratnam J.
Renal tubular function of cadmium exposed workers
A study was made of renal tubular dysfunction among a group of 92 cadmium exposed workers from a nickel-cadmium battery factory and a control group. The urinary excretion of N-acetyl-D-glucosaminidase (NAG), beta-2-microglobulins (β2m) and alpha-1-microglobulins (α1m) was measured from morning spot urine samples. Excretion of NAG and α1m showed an increasing trend with rising urinary cadmium levels and with increasing length of exposure; levels were significantly raised when the urinary cadmium was above 5µg Cd/g creatinine. Results indicate that renal tubular dysfunction is present among cadmium exposed workers with levels below the current critical concentration (10µg Cd/g creatinine).
Annals of the Academy of Medicine - Singapore, Nov. 1992, Vol.21, No.6, p.756-759. 25 ref.

CIS 94-314 Mueller P.W., Paschal D.C., Hammel R.R., Klincewicz S.L., MacNeil M.L., Spierto B., Steinberg K.K.
Chronic renal effects in three studies of men and women occupationally exposed to cadmium
Sensitive indicators of renal damage were measured in three different populations occupationally exposed to cadmium. The degree of variation in damage and the relative sensitivity of different types of indicators were also examined. The three studies included: (1) men exposed in a cadmium recovery plant; (2) men exposed in a nickel/cadmium battery plant; and (3) women exposed in the latter plant. Renal damage was indicated by three categories of urinary protein. These tests indicate that exposed groups with higher urine cadmium levels had varying degrees of renal damage. All exposed groups showed evidence of renal damage when compared with control groups. Highly significant dose-response relationships for all of the urinary protein tests, including fractional clearances, were found. All of the tests were more sensitive in detecting evidence of subclinical renal damage than serum creatinine, a commonly used indicator of renal function.
Archives of Environmental Contamination and Toxicology, July 1992, Vol.23, No.1, p.125-136. Illus. 44 ref.

CIS 94-320 Liesivuori J., Laitinen J., Savolainen H.
Kinetics and renal effects of formic acid in occupationally exposed farmers
Twelve male farmers (38 ± 14 years of age, mean ± SD) were exposed to 7.3 ± 2.2mg formic acid/m3 for 8h in silage making (mean ± SD, N=12). Each gave urine samples immediately, 15h and 30h after the end of the exposure. The excretion of formate was linearly related to the exposure 15 and 30h after exposure. Exposure increased renal ammoniagenesis and urinary calcium at 30h post-exposure. Both biochemical effects may be explained by the interaction of formic acid with the oxidative metabolism of renal tubular cells, as formic acid is a known inhibitor of the cytochrome oxidase. In view of these renal effects, the current hygiene limits may not entirely protect exposed individuals.
Archives of Toxicology, 1992, Vol.66, No.7, p.522-524. Illus. 17 ref.

CIS 94-192 Wedeen R.P.
Renal diseases of occupational origin
Environmental toxicants, including those from industrial sources, represent potentially preventable causes of chronic kidney disease. This review focuses on the aetiology of chronic renal failure of recognized occupational origin other than malignancies. Agents discussed are: heavy metals (lead, cadmium, mercury, arsenic, chromium, copper, and uranium), organic solvents (hydrocarbons), beryllium and silicon.
Occupational Medicine: State of the Art Reviews, July-Sep. 1992, Vol.7, No.3, p.449-463. 80 ref.

CIS 93-1676 Skerfving S.
Nordic Expert Group for the Documentation of Exposure Limits. 104. Inorganic lead
Nordiska Expertgruppen för Gränsvärdesdokumentation. 104. Oorganiskt bly [in Swedish]
Review and evaluation of the relevant literature. Lead is present in the environment, and additional exposure may occur in many industrial settings. Its metabolism is adequately described by a two-compartment model: lead in soft tissues has a half-life of about one month and the bone lead pool has a half-life of about 10 years. The whole-blood level (B-Pb) is the most valuable tool for biological monitoring. Basal levels are highly variable, but average about 0.4µmol/L in the Nordic countries. Effects on the nervous system and kidneys are critical for the establishment of exposure limits. Sensitive adults show effects at exposure corresponding to B-Pbs of 1.5-2.0µmol/L, and foetuses may suffer non-specific central nervous system effects at maternal B-Pbs of 0.5-0.75µmol/L.
Arbetsmiljöinstitutet, Förlagstjänst, 171 84 Solna, Sweden, 1992. 111p. Illus. 897 ref.

CIS 93-1675 Nordberg G.
Nordic Expert Group for the Documentation of Exposure Limits. 101. Cadmium
Nordiska Expertgruppen för Gränsvärdesdokumentation. 101. Kadmium [in Swedish]
Review and evaluation of relevant literature. Cadmium is used in dry cells and storage batteries, and in some alloys. Many other uses (in pigments, coatings and plastic products) are limited by law in Sweden and other countries. Exposure occurs mainly by inhalation. Lung damage occurs, and inhaled cadmium is carried by the blood to the kidney, where it accumulates and produces tubular damage on prolonged exposure. It produces lung cancer in animals, and there is evidence of an increased risk of lung cancer in exposed workers.
Arbetsmiljöinstitutet, Förlagstjänst, 171 84 Solna, Sweden, 1992. 60p. Illus. 138 ref.

CIS 93-909 Rose C.S., Heywood P.G., Costanzo R.M.
Olfactory impairment after chronic occupational cadmium exposure
Fifty-five workers with chronic occupational exposure to cadmium fumes in a brazing operation were examined. Cadmium body burden was estimated and cadmium-induced renal damage was assessed. Olfactory function was quantified using a standardised test that measured two components of olfaction, butanol detection threshold and odour identification, and workers were compared with a reference group. Forty-four percent of the cadmium-exposed workers were mildly hyposmic; 13% were either moderately or severely hyposmic. In the reference group, 31% were mildly hyposmic, and the rest were normosmic. The workers with both high urinary cadmium levels and tubular proteinuria had the most significant olfactory dysfunction, with a selective defect in odour detection threshold. The findings suggest that chronic occupational cadmium exposure sufficient to cause renal damage also is associated with impairment in olfactory function.
Journal of Occupational Medicine, June 1992, Vol.34, No.6, p.600-605. Illus. 25 ref.

CIS 93-820 Selikoff I.J., Seidman H.
Use of death certificates in epidemiological studies, including occupational hazards - Variations in discordance of different asbestos-associated diseases on best evidence ascertainment
There is extensive information on discordance in general between accuracy of medical diagnoses on death certificate categorisation of cause of death and available clinical and histopathological data. This is as true for occupational diseases as for other conditions. But occupational illnesses have a special problem. Discordance is not equal across the board - it may vary with each occupationally related disease, and no single formula can be applied. It was found that for one agent - asbestos - there were different rates of discordance for different asbestos-related diseases (e.g. lung cancer, mesothelioma, asbestosis, kidney cancer) among 4,951 deaths studies prospectively from 1967 to 1986. Caution is therefore required before accepting generalisations concerning (unstudied) discordance in occupational mortality studies, and in their use in risk assessment models.
American Journal of Industrial Medicine, Oct. 1992, Vol.22, No.4, p.481-492. 15 ref.

CIS 93-480 Zheng W., McLaughlin J.K., Gao Y.T., Silverman D.T., Gao R.N., Blot W.J.
Bladder cancer and occupation in Shanghai, 1980-1984
To investigate occupational determinants of bladder cancer in the urban area of Shanghai (China), occupation and industry information for 1,219 incident bladder cancer cases diagnosed during the period 1980-84 were compared with 1982 census data on employment. Standardised incidence ratios (SIR) for bladder cancer were estimated for occupation and industry classifications. Significant excess risks were observed for plastic products workers; textile bleachers, dyers, and finishers; metal refining and processing workers; petroleum refining workers; railway engine drivers and firemen; and workers employed in industries of apparel and other textile products manufacturing; paper processing; organic chemical manufacturing; plastic product manufacturing; and metallurgy. This study indicates that many of the industries and occupations that are responsible for increased risk throughout the world are also associated with occupational bladder cancer in Shanghai.
American Journal of Industrial Medicine, June 1992, Vol.21, No.6, p.877-885. 21 ref.

CIS 93-517 McLaughlin J.K., Malker H.S.R., Blot W.J., Weiner J.A., Stone B.J., Ericsson J.L.E., Fraumeni J.F.
Renal cell cancer among architects and allied professionals in Sweden
The Swedish Cancer-Environment Registry was used to evaluate a recent report of a large excess risk of renal cell cancer among architects in Los Angeles. We identified 131 renal cell cancers among male Swedish architects and allied professionals during a 19-year follow-up period (1961-1979). Compared with the Swedish population, there was no significant excess of renal cell cancer among architects and allied professionals (standardised incidence ratio (SIR) = 1.15; 131 cases). Although it was not possible to estimate the risk for architects alone, the SIR was only 1.06 (16 cases) in a subset of professionals employed in architectural and engineering firms. However, a significant increase in risk (SIR = 1.38) was observed in a related group of workers employed as engineers and construction supervisors in the house construction industry.
American Journal of Industrial Medicine, June 1992, Vol.21, No.6, p.873-876. 20 ref.

CIS 93-554 Zwennis W.C.M., Franssen A.C.
Assessment of occupational exposure to cadmium in the Netherlands, 1980-1989
One thousand five hundred fifty urine samples and 1,295 blood samples, collected from 919 workers, were analysed for cadmium (Cd). The workers were employed at 16 different types of workplaces. In about 7.5% of the samples, the concentration of Cd exceeded the biological limit values (CdU = 5µg/g creatinine; CdB = 5µg/L) proposed by the Dutch Expert Committee for Occupational Standards. Levels higher than these values were measured in both urine samples and blood samples of workers involved in electrochemical plating, in production of Cd stabilisers and enamels, and in soldering with silver-cadmium solder. Significantly higher concentrations of β2-microglobulin (MG) were found in urine samples with CdU >10µg/g creatinine. Cd levels in urine increased with age.
American Journal of Industrial Medicine, June 1992, Vol.21, No.6, p.793-805. Illus. 34 ref.

CIS 93-231 Mutti A., Alinovi R., Bergamaschi E., Biagini C., Cavazzini S., Franchini I., Lauwerys R.R., Bernard A.M., Roels H., Gelpi E., Rosello J., Ramis I., Price R.G., Taylor S.A., De Broe M., Nuyts G.D., Stolte H., Fels L.M., Herbort C.
Nephropathies and exposure to perchloroethylene in dry-cleaners
In a collaborative European study, the renal effects of occupational exposure to perchloroethylene (PCE) were assessed by comparing markers of nephrotoxic effects in dry-cleaners and matched controls. Exposure was evaluated by measuring the solvent concentration in blood specimens and in air samples; urinary samples were also collected. Several renal disturbances were found among PCE-exposed workers compared with the controls. The findings indicate that solvent-exposed subjects, especially dry-cleaners, need to be monitored for the possible development of chronic renal diseases.
Lancet, 25 July 1992, Vol.340, No.8813, p.189-193. 29 ref.

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