Objectives To evaluate the possible associations between occupational exposure to cleaning products and cancers of the following sites: bladder, pancreas, prostate, colon, stomach, kidney, non-Hodgkin’s lymphoma, and lymphoid tissue (Hodgkin’s and Non-Hodgkin’s lymphomas and myelomas combined). Methods We conducted a case-control study of occupational exposures and cancer in Montreal including 3730 cancer cases and 533 population controls. Occupational exposure to a set of agents was evaluated using a combination of subject-reported job history and expert assessment. We evaluated the association between each of eight cancer sites and each of eight cleaning-related occupations, and each of seven cleaning-related exposures (ammonia, hypochlorite, spray gases, waxes/polishes, caustic solutions, chlorine, and cleaning agents as a class). Analyses were done using multivariate logistic regression. Results In general, we found no increased risk of cancer for the evaluated occupations as compared to never cleaners with the exceptions of pancreatic cancer (Odds Ratio; 95% CI (OR): 3.0; 1.3–6.8) and cancers of lymphoid origin (lymphomas and myelomas) (OR: 2.1; 1.1–4.1) in relation to long term employment as ‘janitors and cleaners’. Among specific agents, we found an indication of excess risk for substantial exposure to ammonia and hypochlorite with a pooled set of lymphoid cancers (Non-Hodgkin’s lymphoma, Hodgkin’s lymphoma and myeloma) (OR: 2.2; 1.2–4.0 and 2.0; 1.0–4.0, respectively). For the rest of the agents and cancer sites evaluated we found no evidence of increased risk. Conclusions Overall, our results do not support a clear association between occupational exposure to cleaning products or cleaning-related occupations and the examined cancer sites, with the exception of a potential link between lymphoid cancers (Hodgkin’s and Non-Hodgkin’s lymphomas and myeloma) and exposure to ammonia and to hypochlorite. Elevated ORs among janitors and cleaners should be further explored. Our results must be interpreted in a context of multiple hypotheses testing.

The air index (ψi air ) of the PARIS II software (Environmental Protection Agency), the Indiana Relative Chemical Hazard Score (IRCHS), and the Final Hazard Score (FHS) used in the P2OASys system (Toxics Use Reduction Institute) are comprehensive hazard screening indices that can be used in solvent substitution. The objective of this study was to evaluate these indices using a list of 67 commonly used or recommended solvents. The indices ψi air , IRCHS and FHS were calculated considering 9, 13, and 33 parameters, respectively, that summarized health and safety hazards, and environmental impacts. Correlation and sensitivity analyses were performed. The vapor hazard ratio (VHR) was used as a reference point. Two good correlations were found: (1) between VHR and ψi air (ρ = 0.84), (2) and between IRCHS and FHS (ρ = 0.81). Values of sensitivity ratios above 0.2 were found with ψi air (4 of 9 parameters) and IRCHS (3 of 13 parameters), but not with FHS. Overall, the three indices exhibited important differences in the way they integrate key substitution factors, such as volatility, occupational exposure limit, skin exposure, flammability, carcinogenicity, photochemical oxidation potential, atmospheric global effects, and environmental terrestrial and aquatic effects. These differences can result in different choices of alternatives between indices, including the VHR. IRCHS and FHS are the most comprehensive indices but are very tedious and complex to use and lack sensitivity to several solvent-specific parameters. The index ψi air is simpler to calculate but does not cover some parameters important to solvents. There is presently no suitably comprehensive tool available for the substitution of solvents. A two-tier approach for the selection of solvents is recommended to avoid errors that could be made using only a global index or the consideration of the simple VHR. As a first tier, one would eliminate solvent candidates having crucial impacts. As a second tier, other parameters would be considered, with emphasis on the VHR.

BACKGROUNDOverexposure potential indices (OPIs) can be defined as ratios between different measures of the volatility of a substance and its 8-h occupational exposure limit.OBJECTIVESThe overall objective of this study was to compare three OPIs, using a list of commonly used or recommended solvents as both single substances and mixtures. The three indices studied differ in the way they characterize volatility: vapour pressure for the vapour hazard ratio (VHR), calculated emission rate for the 'SUBstitution FACtor' (SUBFAC) index obtained from the former Danish SUBTEC software and discrete values based on relative evaporation rate for the Måleteknisk Arbejdshygiejnisk Luftbehov (MAL) index which is part of regulations in Denmark.METHODSA list of 56 pure solvents and of 50 mixtures of solvents was used for the comparison. For mixtures, VHR was calculated both as VHR(mi), where the mixture is considered as ideal, and as VHR(mc) (corrected) with the introduction of activity coefficients to take into account the nonideal behaviour of components. Activity coefficients were a standard feature of SUBFAC for mixtures (SUBFAC(m)) but are not used when calculating MAL for mixtures (MAL(m)).RESULTSPure solvents rank in overall similar order with the three systems and correlation was excellent between VHR and SUBFAC (R = 0.99) and good between VHR and MAL (R = 0.75). For solvent-based mixtures, correlation is excellent between VHR(mi) and VHR(mc) (R = 0.98) and between VHR(mc) and SUBFAC(m) (R = 0.98) but moderate between VHR(mi) and MAL(m) (R = 0.52). Ratios between VHR(mc) and VHR(mi) varied between 0.57 and 2.7, thus spanning an approximately 5-fold range, and averaged 1.2. Worse correlations involving the MAL index are attributed to the discrete nature of its numerator.CONCLUSIONSOverall, these results favour using the simple and more easily available VHR when comparing pure substances. In the case of mixtures, the effect of nonideality may be important in certain cases. As a precaution, since no integrated tool is available presently to easily calculate OPI values corrected for nonideality, substitution should be recommended only as long as the non-corrected VHR value for an alternative solvent is at least 5-fold less than that of the solvent to replace.

OBJECTIVES:This study presents a procedure allowing the numerical synthesis of exposure data reported in different ways in the literature, including summary parameters and single measurements. The procedure was applied to literature regarding formaldehyde exposure in the reconstituted wood panels industry, including oriented-strand board (OSB), medium density fibre board (MDF) and particle board (PB).METHODS:For each publication providing summary parameters we estimated geometric means (GM) and geometric standard deviations (GSD) by assuming lognormality of exposure levels. Monte Carlo simulation was performed to re-create datasets from the sample sizes and estimated GMs and GSDs, allowing their subsequent formatting together with the single measurements. The precision and bias of the methods used to estimate GMs and GSDs were evaluated.RESULTS:Altogether, the 13 articles included in our study yielded a final database of 874 data, of which 732 were simulated. For both area and personal data, exposures corresponding to MDF and PB were similar while OSB levels were lower. The most recent available personal levels (1985-1994) were highest in PB for jobs performed in the vicinity of the press (GM=0.63 mg m-3). Corresponding area levels were highest for PB in the main production zone (GM=0.43 mg m-3). Mixed-effects models fitted to area PB data explained 38% of the total variability. A 6-fold decrease in exposures from 1965 to 1995 was estimated. Replication of the simulation process yielded relative standard deviations of the calculated GMs and GSDs between 10 and 20%. The relative biases of the methods used to estimate GMs and GSDs varied across methods and decreased with higher sample sizes (from approximately 15% for n=5 to less than 5% for n=30, in absolute value). The precision also varied across methods and improved with higher sample sizes (from approximately 30% for n=5 to approximately 10% for n=30).DISCUSSION:This methodology constitutes a new meta-analysis tool that should improve the interpretation of industrial hygiene literature data, but needs to be further validated.

Aqueous cleaners used for metal degreasing are detergent formulations containing surfactants (such as linear alkylbenzene sulphonates, alkylphenol ethoxylates or alcohol ethoxylates), builders (such as hydroxides, phosphates or silicates), sequestrants (such as EDTA or NTA), anti-corrosive agents (such as ethanolamines), solvents (such as glycol ethers or d-limonene) and other specialty additives. Generally sold as concentrates, they are typically diluted between 3 and 20 times in water, leading to solutions containing only a few per cent active products. The cleaning efficiency depends on physicochemical phenomena such as wetting, solubilization, emulsification, dispersion, sequestration and saponification, and is enhanced by thermal and mechanical energy. Cleaning equipment is based on spraying or immersion of the parts and may include drying and rinsing steps. Because of the complexity and variability of the mixtures, the occupational health and environmental evaluation of aqueous cleaners is based on the study of their components. Aqueous cleaners are generally believed to present a low risk to workers' health and to the environment. However, some anionic surfactants and strong alkalis are skin and eye irritants, ethanolamines are allergenic and several glycol ethers of the ethylene glycol family are proven systemic toxicants that are easily absorbed through the skin. Although most components of aqueous cleaners are biodegradable and of low ecotoxicity, alkylphenol ethoxylates degrade into persistent and toxic compounds. Phosphates, if released directly into the environment, may cause eutrophication of rivers and lakes. Waste recycling or treatment by specialized facilities is usually required for spent solutions containing contaminants such as oils and heavy metals. From a technical, toxicological and environmental standpoint, aqueous cleaners can be used successfully to replace traditional organic solvents used in metal degreasing.

Since the ban on 1,1,1-trichloroethane, the textile industry has been using trichloroethylene (TCE) as a spot remover to clean oil and grease stains from fabrics at inspection stations. TCE is a toxic substance recently classified as a probable human carcinogen. The purpose of this study was to use a systematic substitution procedure to replace TCE with a less hazardous option for spot removing in a textile company. After documenting the problem and understanding the processes involved, numerous sources of information were searched to identify the greatest number of plausible solutions. Then criteria were established to help consider only the options that seemed technically acceptable. Five options were retained: 1-bromopropane, a petroleum-based solvent, a hydrochlorofluorocarbon-based solvent, an appliance that uses hot steam, and the elimination of the oil and grease spots at the source. The latter option, which had been partially implemented by the textile company, was not considered in this study. After being tested in the workplace and evaluated on their technical plausibility and impact on health, safety, and environment, the remaining four options were not considered as suitable replacements for TCE. Thus, local ventilation with the implementation of further measures for the reduction/elimination of stains at the source were recommended to lower TCE exposure for workers.

OBJECTIVES A case-control study was conducted in France to assess possible associations between occupational exposures and squamous cell carcinomas of the larynx and hypopharynx. METHODS The study was restricted to men, and included 201 hypopharyngeal cancers, 296 laryngeal cancers, and 296 controls (patients with other tumour sites). Detailed information on smoking, alcohol consumption, and lifetime occupational history was collected. Occupational exposure to seven substances (formaldehyde, leather dust, wood dust, flour dust, coal dust, silica dust, and textile dust) was assessed with a job exposure matrix. Exposure variables used in the analysis were probability, duration, and cumulative level of exposure. Odds ratios (ORs) with their 95% confidence intervals (95% CIs) were estimated by unconditional logistic regression, and were adjusted for major confounding factors (age, smoking, alcohol, and when relevant other occupational exposures). RESULTS Hypopharyngeal cancer was found to be associated with exposure to coal dust (OR 2.31, 95% CI 1.21 to 4.40), with a significant rise in risk with probability (p<0.005 for trend) and level (p<0.007 for trend) of exposure. Exposure to coal dust was also associated with an increased risk of laryngeal cancer (OR 1.67, 95% CI 0.92 to 3.02), but no dose-response pattern was found. A significant relation, limited to hypopharyngeal cancer, was found with the probability of exposure to formaldehyde (p<0.005 for trend), with a fourfold risk for the highest category (OR 3.78 , 95% CI 1.50 to 9.49). When subjects exposed to formaldehyde with a low probability were excluded, the risk also increased with duration (p<0.04) and cumulative level of exposure (p<0.14). No significant association was found for any other substance. CONCLUSION These results indicate that exposure to formaldehyde and coal dust may increase the risk of hypopharyngeal cancer.

BACKGROUND:In this analysis of European case-control studies on sinonasal cancer, we examined the risk for occupation and smoking, by gender and histological type.METHODS:The pooled data included 104 female and 451 male cases, and 241 female and 1,464 male controls. Lifetime smoking and occupational history were recoded following uniform criteria, and job-exposure matrices were applied for wood and leather dust.RESULTS:Wood dust exposure was associated with an excess risk in men (OR = 2.36, 95% CI 1.75-3.2) but not in women (OR = 1.17, 95% CI 0.31-4.47). Exposure to leather dust was associated with an excess risk in both genders. Both wood and leather dust were associated with adenocarcinomas rather than squamous cell carcinomas. Excess risks for smoking were higher for squamous cell carcinomas and higher in men than in women.CONCLUSIONS:In these European populations, occupation was associated with about 11% of all sinonasal cancers in women and 39% in men. This difference can, in part, be attributed to variation in exposure patterns between genders.

Occupational and environmental exposure to airborne manganese has been measured for two groups of workers in Montreal, taxi drivers and garage mechanics. In Canada methylcyclopentadienyl manganese tricarbonyl (MMT) has replaced lead as an anti-knock agent in gasoline and represents a potentially important source of manganese contamination for the population in general and for the two chosen groups of workers in particular. Twenty workers (10 taxi drivers and 10 garage mechanics) wore a personal air sampler for five consecutive working days and two off-work periods. The amount of total Mn on each filter was determined by neutron activation analysis and then converted to atmospheric Mn concentrations. The values obtained varied from 0.004 microgram m-3 to 2.067 micrograms m-3. At work the garage mechanics were exposed to an average of 0.250 microgram m-3 and the taxi drivers to 0.024 microgram m-3. Off-work, the two groups were exposed respectively to an average of 0.007 microgram m-3 and 0.011 microgram m-3. In the garages there was twice as much Mn in the air on days when the doors were closed compared to days when they were left opened (0.314 micrograms m-3/0.152 microgram m-3). The levels found in this study remain well below the established limits for occupational and environmental airborne exposure. These results will lead to further studies to positively identify the source of Mn as MMT and to explore other pathways leading to the contamination of the general population.

A multicancer site, multifactor case-control study was undertaken to generate hypotheses about possible occupational carcinogens. Eligible cases, comprising all incident cases of cancer at 14 sites who were male, aged 35-70 and resident in Montreal, were subjected to probing interviews designed to obtain detailed lifetime job histories and information on potential confounders. Each job history was reviewed by a team of chemists who translated it into a history of occupational exposures. These occupational exposures were then analysed as potential risk factors in relation to the sites of cancer included. Over 3700 cases were interviewed and processed. For each site of cancer analysed as a case series, controls were selected from subjects with cancer at the other sites covered in the study. This report concerns the associations between silica exposure and each site of cancer. In initial screening analyses, there were significantly elevated odds ratios for silica and stomach cancer and for silica and non-adenocarcinoma lung cancer. More detailed analyses confirmed these associations, though there was no evidence of a dose-response relationship for stomach cancer. For lung cancer, there were significantly elevated risks in those with high-level long-term exposure. These results, which took into account several potential confounders including cigarette smoking and asbestos exposure, lend credence to the hypothesis that silica exposure increases the risk of lung cancer, and suggest the possibility of an effect on stomach cancer.

Occupational cohort studies are usually carried out without the benefit of information on smoking habits of cohort members. One common approach to avoid confounding bias related to smoking habits is to carry out an internal analysis, comparing workers with different degrees of occupational exposure. The premise behind this approach is that within a cohort there is unlikely to be correlation between degree of exposure and smoking habits. If this were untrue, smoking could confound the disease-exposure relationships. Our purpose was to verify the premise. The study sample consisted of 857 French-Canadian men born between 1910 and 1930, with 11 or fewer years of education, and interviewed around 1980 in the context of an occupational cancer case-control study. For each man we had information on smoking habits, job history, and a history of the chemicals he was exposed to in each of his jobs. We computed two indices of the dirtiness of workers' job histories: one based on the job titles held by the man and a second based on the degree of exposures to workplace substances. There was no correlation between these indices of job dirtiness and smoking history. We also examined the smoking-exposure relationship among the subsets of men who had been occupationally exposed to ten especially noticeable substances. Within the subsets, there was no indication of a consistent difference among the smoking subgroups in level or duration of exposure to these index substances. These findings do not support the view that nonsmokers sought out cleaner job environments than smokers; they imply that internal analyses of "dose-response" in cohort studies are unlikely to be seriously confounded by smoking habits.

In a large population-based case-control study designed to generate hypotheses regarding possible associations between cancer sites and occupational exposures, an innovative methodology is utilized to infer the subjects' chemical exposures. It features (1) a probing interview to obtain a detailed portrait of each job the subject has held, (2) exposure coding by a team of chemists and hygienists who review each interview, (3) a coding checklist of nearly 300 occupational exposures including the most common ones, and (4) indication by the coders of the level, frequency, and mode of exposure, as well as of their degree of confidence that the exposure occurred. In making coding decisions, the chemists draw upon their experience and upon consultants and bibliographic sources. Resultant data can be combined to produce a variety of semi-quantitative indices of exposure for epidemiologic analyses.