Exposure-response relationships for platinum salt sensitization in precious metal refinery workers: a 16-yr retrospective study.

IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Lidwien A M Smit, José Jacobs, Frits van Rooy, Dick Heederik, Remko Houba, Lützen Portengen
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Abstract

Background: Occupational allergy to soluble chlorinated platinum (Pt) salts, also known as chloroplatinates, poses a serious health problem in precious metal refineries. We aimed to assess the exposure-response relationship between soluble Pt salts exposure and Pt salt sensitization (PSS) in a 16-yr retrospective cohort study (2000 to 2015).

Methods: We analyzed routinely collected data from 5 Pt refineries. In total, 1,614 newly hired workers who entered the industry since 2000 regularly underwent skin prick tests. Exposure to soluble Pt salts was modeled using 2,982 personal air samples. The relationship between time-varying exposure levels and PSS development was analyzed by Cox proportional hazards regression, adjusting for smoking, atopy, and facility.

Results: PSS was diagnosed in 117 workers (1.48 per 100 person-years of follow-up time) with median time to PSS of 1.9 yr, and with an estimated median exposure level of 53 ng/m3 (P5-P95: 8 to 302 ng/m3) at the time of PSS development. Statistically significant quantitative exposure-response relationships between PSS and cumulative and current exposure were found. Exposure-response curves showed a steep increase in PSS incidence at exposure levels up to 100 ng/m3, with no or only a slight further increase at higher levels.

Conclusions: We found a clear exposure-response relationship between soluble Pt salts exposure and PSS incidence among newly hired workers. Despite the limitations inherent to the retrospective study design, this cohort study contributes to the growing body of evidence that the widely adopted occupational exposure limit of 2,000 ng/m3 does not adequately prevent PSS and should be reevaluated.

贵金属精炼厂工人铂盐敏化的暴露-反应关系:一项16年回顾性研究。
背景:对可溶性氯化铂(Pt)盐(也称为氯铂酸盐)的职业性过敏,在贵金属精炼厂造成了严重的健康问题。在一项为期16年的回顾性队列研究(2000 - 2015)中,我们旨在评估可溶性Pt盐暴露与Pt盐敏化(PSS)之间的暴露-反应关系。方法:对5pt精炼厂常规收集的数据进行分析。2000年以后进入该行业的1614名新就业者定期接受了皮肤点刺试验。使用2982个个人空气样本模拟了可溶性铂盐的暴露情况。通过Cox比例风险回归分析时变暴露水平与PSS发展之间的关系,调整吸烟、特应性和设施。结果:117名工人被诊断为PSS(每100人年随访时间1.48人),中位PSS时间为1.9年,PSS发展时估计中位暴露水平为53 ng/m3 (P5-P95: 8至302 ng/m3)。PSS与累积和当前暴露之间存在统计学上显著的定量暴露-反应关系。暴露-反应曲线显示,当暴露水平达到100 ng/m3时,PSS发病率急剧增加,而在更高水平时,PSS发病率没有或仅略有增加。结论:我们发现可溶铂盐暴露与新入职工人PSS发病率之间存在明显的暴露-反应关系。尽管回顾性研究设计存在固有的局限性,但这项队列研究提供了越来越多的证据,表明广泛采用的2000 ng/m3的职业暴露限值不能充分预防PSS,应该重新评估。
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来源期刊
Annals Of Work Exposures and Health
Annals Of Work Exposures and Health Medicine-Public Health, Environmental and Occupational Health
CiteScore
4.60
自引率
19.20%
发文量
79
期刊介绍: About the Journal Annals of Work Exposures and Health is dedicated to presenting advances in exposure science supporting the recognition, quantification, and control of exposures at work, and epidemiological studies on their effects on human health and well-being. A key question we apply to submission is, "Is this paper going to help readers better understand, quantify, and control conditions at work that adversely or positively affect health and well-being?" We are interested in high quality scientific research addressing: the quantification of work exposures, including chemical, biological, physical, biomechanical, and psychosocial, and the elements of work organization giving rise to such exposures; the relationship between these exposures and the acute and chronic health consequences for those exposed and their families and communities; populations at special risk of work-related exposures including women, under-represented minorities, immigrants, and other vulnerable groups such as temporary, contingent and informal sector workers; the effectiveness of interventions addressing exposure and risk including production technologies, work process engineering, and personal protective systems; policies and management approaches to reduce risk and improve health and well-being among workers, their families or communities; methodologies and mechanisms that underlie the quantification and/or control of exposure and risk. There is heavy pressure on space in the journal, and the above interests mean that we do not usually publish papers that simply report local conditions without generalizable results. We are also unlikely to publish reports on human health and well-being without information on the work exposure characteristics giving rise to the effects. We particularly welcome contributions from scientists based in, or addressing conditions in, developing economies that fall within the above scope.
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