Objective: To investigate the implementation of Diagnostic Criteria of Occupational Acute Neurotoxic Diseases Caused by Chemicals (GBZ 76-2002) for accumulating basis of standard revision. Methods: In February 2020, 85 experts in occupational diseases and neurology from 39 medical and health institutions were selected as the respondents. The modified Delphi method was used to establish the standard evaluation index system and special group was organized for discussing the pre-survey and completing the questionnaire survey. Questionnaire survey was performed to investigate the grasp of the standards, application and modification suggestions of respondents. Results: The respondents' mastery of standard-related knowledge mainly came from work experience (84.7%, 72/85) , standard learning (81.2%, 69/85) and training (75.3%, 64/85) . Among the institutions in which the respondents worked, 98.8% (84/85) could carry out CT examinations, 96.5% (82/85) could carry out nerve conduction velocity and electromyography examinations, 89.4% (76/85) could carry out EEG examinations, 80% (68/85) could carry out evoked potential examinations and 72.9% (62/85) could carry out MRI examinations. Among the toxicants diagnosed as occupational acute toxic myelopathy, 10.6% (9/85) were organic phosphorus and 9.4% (8/85) were asphyxiating gas; Among the toxicants diagnosed as delayed peripheral neuropathy, pesticides accounted for 25.9% (22/85) and asphyxiating gases accounted for 12.9% (11/85) . 85.9% (73/85) of the respondents believed that the basis for the classification of acute toxic encephalopathy needed to supplement objective evidence; 80.0% (68/85) of the respondents thought that the diagnosis and classification of peripheral neuropathy should be refined according to the abnormal indexes of neuroelectromyography. Conclusion: The applicability of the criteria needs to be improved because the current criteria has a long application cycle without enough objective investigation bases in classification criteria index.
Humans ; Occupational Exposure/adverse effects* ; Occupational Diseases/diagnosis* ; Hazardous Substances ; Neurotoxicity Syndromes/diagnosis* ; Peripheral Nervous System Diseases

Objective: To investigate the clinical significance of blood purification on changes in serum toxicant concentration and prognosis of acute benzene-based thinner poisoning. Methods: A total of 44 patients with acute benzene-based thinner poisoning admitted to the emergency department of Characteristic Medical Center of Armed Police from August 2013 to August 2020 were collected and divided into a blood purification group (24 cases) and a conventional treatment group (20 cases) , the general data, toxicant concentrations and prognosis of the two groups of patients were analyzed, and logistic regression analysis was performed on the influencing factors of the prognosis to explore the clinical effect of blood purification. Results: The concentration of poisons in the blood purification group at 24 hours after treatment was significantly lower than that in the conventional treatment group (t=6.76, P<0.001) , and the reduction in the concentration of poisons was significantly higher than that in the conventional treatment group (t=3.33, P=0.002) . The overall improvement rate in the blood purification group was 91.7% (22/24) , which was higher than that in the conventional treatment group (60.0%, 12/20) . Logisitic regression analysis showed that blood purification treatment method was the main factor affecting the prognosis of patients (OR=7.605×10(-5), 95%CI: 6.604×10(-8)-0.087, P=0.008) , and the toxic dose was a synergistic effect on the prognosis of patients factor (OR=1.038, 95%CI: 1.008-1.068, P=0.011) . Conclusion: Early blood purification treatment in patients with acute benzene-based thinner poisoning can rapidly reduce blood toxin concentration, avoid disease progression, and ultimately improve patient prognosis.
Benzene ; Hazardous Substances ; Humans ; Poisoning/therapy* ; Prognosis ; Retrospective Studies

BACKGROUND: The photolithography process in the semiconductor industry uses various chemicals with little information on their constitution. This study aimed to identify the chemical constituents of photoresist (PR) products and their by-products and to compare these constituents with material safety data sheets (MSDSs) and analytical results. METHODS: A total of 51 PRs with 48 MSDSs were collected. Analysis consisted of two parts: First, the constituents of the chemical products were identified and analyzed using MSDS data; second, for verification of the by-products of PR, volatile organic compounds were analyzed. The chemical constituents were categorized according to hazards. RESULTS: Forty-five of 48 products contained trade secrets in amounts ranging from 1 to 65%. A total of 238 ingredients with multiple counting (35 ingredients without multiple counting) were identified in the MSDS data, and 48.7% of ingredients were labeled as trade secrets under the Korea Occupational Safety and Health Act. The concordance rate between the MSDS data and the analytical result was 41.7%. The by-product analysis identified 129 chemicals classified according to Chemical Abstracts Service No., with 17 chemicals that are carcinogenic, mutagenic, and reprotoxic substances. Formaldehyde was found to be released from 12 of 21 products that use novolak resin. CONCLUSION: We confirmed that several PRs contain carcinogens, and some were not specified in the toxicological information in the MSDS. Hazardous chemicals, including benzene and formaldehyde, are released from PRs products as by-products. Therefore, it is necessary to establish a systematic management system for chemical compounds and the working environment.
Benzene ; Carcinogens ; Constitution and Bylaws ; Formaldehyde ; Hazardous Substances ; Korea ; Material Safety Data Sheets ; Occupational Health ; Semiconductors ; Volatile Organic Compounds

Although the rare earth elements (REEs) recycling industry is expected to increase worldwide in high-tech industry, regulations for worker safety have yet to be established. This study was conducted to understand the potential hazard/risk of REE recycling and to support the establishment of regulations or standards. We review the extensive literature on the toxicology, occupational safety, and health issues, and epidemiological surveys related to the REEs, and propose suitable management measures. REE recycling has four key steps such as collection, dismantling, separation, and processing. In these processes, hazardous substances, such as REEs-containing dust, metals, and chemicals, were used or occurred, including the risk of ignition and explosion, and the workers can be easily exposed to them. In addition, skin irritation and toxicities for respiratory, nervous, and cardiovascular systems with the liver toxicity were reported; however, more supplementary data are needed, owing to incompleteness. Therefore, monitoring systems concerning health, environmental impacts, and safety need to be established, based on additional research studies. It is also necessary to develop innovative and environment-friendly recycling technologies, analytical methods, and biomarkers with government support. Through these efforts, the occupational safety and health status will be improved, along with the establishment of advanced REE recycling industry.
Biomarkers ; Cardiovascular System ; Dust ; Environmental Health ; Explosions ; Hazardous Substances ; Liver ; Metals ; Occupational Health ; Recycling ; Skin ; Social Control, Formal ; Toxicology

BACKGROUND: Most clinicians feel ill-equipped to assess or educate patients about toxicant exposures, and it is unclear how expert environmental medicine clinicians assess these exposures or treat exposure-related conditions. We aimed to explore expert clinicians' perspectives on their practice of environmental medicine to determine the populations and toxicants that receive the most attention, identify how they deal with toxicant exposures and identify the challenges they face and where they obtain their knowledge. METHODS: A qualitative study involving semi-structured interviews with expert environmental clinicians in Australia and New Zealand was conducted. Interviews were recorded and transcribed, and themes were identified and collated until no new themes emerged. RESULTS: Five dominant themes emerged from 16 interviews: (1) environmental medicine is a divided profession based on type of practice, patient cohort seen and attitudes towards nutrition and exposure sources; (2) clinical assessment of toxicant exposures is challenging; (3) the environmental exposure history is the most important clinical tool; (4) patients with environmental sensitivities are increasing, have unique phenotypes, are complex to treat and rarely regain full health; and (5) educational and clinical resources on environmental medicine are lacking. CONCLUSIONS Environmental medicine is divided between integrative clinicians and occupational and environmental physicians based on their practice dynamics. All clinicians face challenges in assessing toxicant loads, and an exposure history is seen as the most useful tool. Standardised exposure assessment tools have the potential to significantly advance the clinical practice of environmental medicine and expand its reach across other clinical disciplines.
Attitude of Health Personnel ; Australia ; Environmental Exposure ; Environmental Medicine ; Hazardous Substances ; New Zealand ; Physicians ; psychology

Hazardous work zones (i.e., hot, warm, and cold) are typically established by emergency response teams during hazardous materials (HAZMAT) callsbut less consistently for fire responses to segment personnel and response activities in the immediate geographic area around the fire. Despite national guidelines, studies have documented the inconsistent use of respiratory protective equipment by firefighters at the fire scene. In this case-series report, we describe warm zone gas levels using multigas detectors across five independent fire incident responses all occurring in a large South Florida fire department. Multigas detector data collected at each fire response indicate the presence of sustained levels of volatile organic compounds in the “warm zone” of each fire event. These cases suggest that firefighters should not only implement strategies for multigas detector use within the warm zone but also include respiratory protection to provide adequate safety from toxic exposures in the warm zone.
Emergencies ; Environmental Monitoring* ; Firefighters* ; Fires* ; Florida ; Hazardous Substances ; Humans ; Volatile Organic Compounds

We present the case of a 45-year-old man with a history of benzene exposure who developed splenic marginal zone lymphoma. For 6 years, he had worked in an enclosed space cleaning instruments with benzene. He was diagnosed with splenic marginal zone lymphoma 19 years after retirement. During his time of working in the laboratory in the 1980s, working environments were not monitored for hazardous materials. We indirectly estimated the cumulative level of past benzene exposure using job-exposure matrices and technical assumptions. Care must be taken in investigating the relevance of occupational benzene exposure in the occurrence of indolent B-cell lymphoma. Because of the long latency period and because occupational measurement data do not exist for the period during the patient's exposure, the epidemiological impact of benzene exposure may be underestimated.
B-Lymphocytes* ; Benzene* ; Hazardous Substances ; Humans ; Latency Period (Psychology) ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Middle Aged ; Retirement ; Spleen*

BACKGROUND: Bricks have been manufactured in Nepal for hundreds of years and are seen as a component of Nepalese sculpture and architecture. Large quantities of hazardous materials including high concentrations of particulate matter are emitted on a daily basis from brick kilns. Exposure to these hazardous materials can lead to adverse consequences on the environment and human health. This study was conducted to  estimate the prevalence of respiratory symptoms/illnesses and the magnitude of respirable and total dust exposures among Nepalese brick kiln workers. METHODS: Respiratory symptoms/illnesses were evaluated by questionnaire among brickfield workers (n = 400) and a referent group of grocery workers (n = 400) in Kathmandu valley. Work zones (WZs): green brick molding (GBM), green brick stacking/carrying (GBS/C), red brick loading/carrying (RBL/C), coal preparation (CP) and firemen (FM) were the similar exposure groups (SEGs) from where personal air samples and interviews were taken. Among brickfield workers, personal monitoring was conducted across SEGs for total (n = 89) and respirable (n = 72) dust during February–March 2015 and March–April 2016. Applying multi-stage probability proportionate to size sampling technique, 16 kilns and 400 brick workers for interview were selected. Proportions, means, medians and ranges were calculated for the demographics, samples and respiratory symptoms/illnesses. One-way ANOVA was applied to compare the significance differences of the level of particulate matter among SEGs. Bivariate and multivariate logistic regression analysis were performed to evaluate association between respiratory symptoms/illnesses and participants groups, and SEGs among brick kiln workers at 0.05 level. Statistical analyses were performed using IBM SPSS Statistics 21. RESULTS: Chronic cough (14.3%), phlegm (16.6%) and bronchitis (19.0%) were higher (P < 0.05) among brickfield compared with grocery workers (6.8, 5.8 and 10.8%). Mean respirable (5.888 mg/m3) and total (20.657 mg/m3) dust exposures were highest for red brick loading tasks. The prevalence of chronic cough, chronic phlegm, chronic bronchitis, wheezing and asthma were significantly higher for other WZs workers (p < 0.05) compared with CP; for GBM: 22.9, 34.6, 15.0 and 7.5%; for GBS/C: 13.5, 15.8, 10.0, 8.8 and 7.5%; for RBL/C: 11.1, 17.1, 27.4, 19.0 and 11.9%; for FM: 18.4, 12.5, 28.4, 4.9 and 0.0%; and for CP: 4.9, 6.3, 13.3, 9.3 and 4.0% respectively. CONCLUSION: High dust exposures identified in this study may explain the increased prevalence of respiratory symptoms/illnesses among Nepalese brickfield workers, warranting action to reduce exposures.
Asthma ; Bronchitis ; Bronchitis, Chronic ; Coal ; Cough ; Demography ; Dust ; Fungi ; Hazardous Substances ; Humans ; Logistic Models ; Nepal* ; Particulate Matter* ; Prevalence ; Respiratory Sounds ; Sculpture

The genetically engineered mice require special husbandry care and are mainly housed in Individually Ventilated Cage (IVC) systems and Static Micro Isolator Cages (SMIC) to minimize the risk for spreading undesirable microorganisms. However, the static micro isolation cage housing like SMIC are being replaced with IVC systems in many facilities due to a number of benefits like a higher density housing in limited space, better protection from biohazards and allergens and decreased work load due to decreased frequency of cage changing required in this system. The purpose of this study was to examine the reproductive performance of genetically engineered mice housed in individually ventilated cages (IVC) and Static Micro Isolator Cages (SMIC). When the B6C3-Tg (APPswe, PSEN1dE9) 85Dbo/Mmjax transgenic mice were housed in these two housing systems, the number of litters per dam, number of pups born per dam and number of pups weaned per dam were found to be slightly higher in the IVC as compared to the SMIC but the difference was not significant (P<0.05). In case of Growth Associated Protein 43 (GAP-43) knockout mice, the number of litters born per dam and the number of pups born per dam were marginally higher in the IVC as compared to those housed in SMIC but the difference was not significant (P<0.05). Only the number of pups weaned per dam were found to be significantly higher as compared to those housed in the SMIC system at P<0.05.
Allergens ; Animals ; GAP-43 Protein ; Hazardous Substances ; Housing* ; Mice* ; Mice, Knockout ; Mice, Transgenic

BACKGROUND: Management and workers in small and medium-sized enterprises (SMEs) often find it hard to comprehend the requirements related to controlling risks due to exposure to substances. An intervention study was set up in order to support 45 SMEs in improving the management of the risks of occupational exposure to chemicals, and in using the control banding tool and exposure model Stoffenmanager in this process. METHODS: A 2-year intervention study was carried out, in which a mix of individual and collective training and support was offered, and baseline and effect measurements were carried out by means of structured interviews, in order to measure progress made. A seven-phase implementation evolutionary ladder was used for this purpose. Success and failure factors were identified by means of company visits and structured interviews. RESULTS: Most companies clearly moved upwards on the implementation evolutionary ladder; 76% of the companies by at least one phase, and 62% by at least two phases. Success and failure factors were described. CONCLUSION: Active training and coaching helped the participating companies to improve their chemical risk management, and to avoid making mistakes when using and applying Stoffenmanager. The use of validated tools embedded in a community platform appears to support companies to organize and structure their chemical risk management in a business-wise manner, but much depends upon motivated occupational health and safety (OHS) professionals, management support, and willingness to invest time and means.
Hazardous Substances* ; Occupational Exposure ; Occupational Health ; Risk Management