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Chemical risk in the footwear industry
Abstract
The footwear industry is an industry with great social and economic impact in Portugal. Two shoe factories in northern Portugal were subject to an evaluation of chemical agents present in the working environment. Air samples were collected and analyzed according to the NIOSH method. The results show that some solutions and products used in shoe manufacturing contain organic solvents in amounts considered harmful to the health of workers. The Assembly section registered the higher values for both companies. The concentration of ethylacetate, toluene, acetone, tetrahrydofuran and MEK in this section were higher than the Occupational Exposure Limit values (OEL) indicated by the NP 1796: 2014 and Decree Law 24/2012 of 6 February. This scenario requires urgent measures to reduce the concentration of these compounds in the air at the workplace.
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In case-control studies on glomerulonephritis and organic solvents several authors have assessed exposure to organic solvents with a score based on the self reported occupational history. The underlying principle is that all exposures can be weighted by an intensity factor and then added to get one number representative of lifetime exposure. As this score has hitherto not been validated the relation between this exposure score and kidney function tests in a population of workers with past or present exposure to organic solvents was examined. The results suggest that such relations do exist for the N-acetyl-beta-D-glucosaminidase (NAG) activity, erythrocyturia, and, perhaps, albuminuria but not for the protein creatinine ratio or for leucocyturia.
Shoe manufacturing is a traditional industry in northern Portugal. There are nearly 1500 factories that employ about 54,000 workers. Among the materials used in the shoe manufacturing process, that could be occupational hazards, are the adhesives, especially adhesives solutions based on organic solvents. The National Institute of Health (Oporto Branch) carried out a study of 100 factories in northern Portugal to study solvent exposure in shoe manufacturing. The surveyed population, (4615 workers) was young (mean age = 33 years; range = 18-45) and predominantly female (68.5%). The results from the air samples analyses show 20 different organic compounds existing in the workplaces. The more common compounds found were n-hexane, toluene, and acetone. The results of the study show that in 53.7 percent of the factories there are operations where the solvent exposure is significant and represents a health hazard to the workers. These operations are mainly gluing, waxing, and polishing stations. Occupational risk of exposure to solvents concerned 44.2 percent of the workers. This study points out the existence of inadequate ventilation in the workplaces and inappropriate personal protective equipment to prevent dermatitis risk from adhesives, wax, and polish. The organic solvents present in workplaces also increase fire risk.
Several studies have suggested an association between occupational exposure to solvents and lymphoma risk. However, findings are inconsistent and the role of specific chemicals is not known. Objective To investigate the role of occupational exposure to organic solvents in the aetiology of B-cell non-Hodgkin's lymphoma (B-NHL) and its major subtypes, as well as Hodgkin's lymphoma and T-cell lymphoma.
2348 lymphoma cases and 2462 controls participated in a case-control study in six European countries. A subset of cases were reviewed by a panel of pathologists to ensure diagnostic consistency. Exposure to solvents was assessed by industrial hygienists and occupational experts based on a detailed occupational questionnaire.
Risk of follicular lymphoma significantly increased with three independent metrics of exposure to benzene, toluene and xylene (BTX) (combined p=4 x 10(-7)) and to styrene (p=1 x 10(-5)), and chronic lymphocytic leukaemia (CLL) risk increased with exposure to solvents overall (p=4 x 10(-6)), BTX (p=5 x 10(-5)), gasoline (p=8 x 10(-5)) and other solvents (p=2 x 10(-6)). Risk of B-NHL for ever exposure to solvents was not elevated (OR=1.1, 95% CI 1.0 to 1.3), and that for CLL and follicular lymphoma was 1.3 (95% CI 1.1 to 1.6) and 1.3 (95% CI 1.0 to 1.7), respectively. Exposure to benzene accounted, at least partially, for the association observed with CLL risk. Hodgkin's lymphoma and T-cell lymphoma did not show an association with solvent exposure.
This analysis of a large European dataset confirms a role of occupational exposure to solvents in the aetiology of B-NHL, and particularly, CLL. It is suggested that benzene is most likely to be implicated, but we cannot exclude the possibility of a role for other solvents in relation to other lymphoma subtypes, such as follicular lymphoma. No association with risk of T-cell lymphoma and Hodgkin's lymphoma was shown.
Associations of occupational solvent exposure and/or work in electronics production with adverse pregnancy outcomes were examined in a large cross-sectional community-based reproductive health study of 1038 California women pregnant between 1980 and 1985. Occupational solvent exposure was determined by two different methods: Bureau of Census codes judged by experts to probably include solvent exposure and self-reported exposure. First trimester solvent exposure classified by either method (n = 52) was significantly associated with spontaneous abortion, adjusted odds ratio 3.34 (95% confidence interval 1.42, 7.81). Among 29 women reporting regular and daily solvent exposure, the adjusted odds ratio increased to 4.44 (95% confidence interval 1.86, 10.58). Work in electronics assembly was significantly associated with delivering a low birth weight infant (adjusted odds ratio 5.38; 95% confidence interval 1.42, 20.46) but was not associated with spontaneous abortions. Further research using biologic monitoring and/or other objective measures of exposure is needed to validate these findings.
In a large case-control study (n = 1,926) of spontaneous abortion (SAB), exposure to solvents was ascertained by a telephone interview that asked about occupational use of 18 specific solvents or products, as well as an open-ended "other" solvent category. The adjusted odds ratio for use of any solvent was 1.1 (0.8, 1.5). Solvents for which at least a doubled crude risk of SAB was found included perchlorethylene (OR = 4.7, 95% CI = 1.1, 21.1), trichloroethylene (OR = 3.1, CI = 0.9, 10.4), and paint thinners (OR = 2.3, CI = 1.0, 5.1). Comparing exposure greater than 10 hours per week versus less did not show consistent dose-response effects. By solvent class, an association was seen with aliphatic solvents (adjusted OR = 1.8, 95% CI = 1.1, 3.0), but there was no dose-response effect by hours of use. Household use of solvent-containing products was generally not strongly associated with SAB, nor did it appear to confound the association seen with occupational use. From this and other studies, occupational exposure to at least some solvents appears associated with SAB. The associations of solvent exposure and fetal growth among liveborn offspring of controls was also examined.
Occupational risk of exposure to organic solvents concerned many shoe manufacturing workers. The most common organic solvents found in workplace environments were n-hexane and others hexane isomers. The aim of this study was to evaluate the exposure of shoe manufacturing workers to n-hexane, with 2,5 hexanedione in urine (2,5HD) as a biomarker and to investigate effect in 2,5 HD excretion of the co-exposure to other organic solvents. Post-shift urine samples from workers who performed gluing tasks (n = 45) in five shoe manufacturers were collected, as well as urine samples from a similar number of unexposed controls (n = 51) in the same factories. 2,5 HD was measured by capillary gas chromatography. Air monitoring of organic solvents in the workplaces was performed and the compounds were analyzed by gas chromatography. Significant more 2,5 HD was found in the urine of personnel who performed gluing tasks than in the unexposed workers. A significant correlation was observed between n-hexane exposure and urinary 2,5 HD, with a high correlation coefficient. Multiple regression analysis indicated that n-hexane exposure and co-exposure to others solvents were significant predictors of the concentration of 2,5 HD. Co-exposure led to higher urinary 2,5 HD concentrations. The significant effect of co-exposure reinforces the interest of biological monitoring for n-hexane exposure evaluation. In case of multiple exposures, biological monitoring can be a better predictive measurement for early detection of n-hexane neurotoxic lesions than air monitoring data.
To investigate whether fertility is reduced among female shoe manufacturing workers exposed to organic solvents.
A retrospective study was conducted on time to pregnancy (TTP) among 250 Portuguese shoe manufacturing workers exposed to solvents and 250 unexposed women working in stores of food units and storehouses. Data on TTP and related factors were collected by face-to-face interviews. The participation rate was 92%, and 81% of the workers (197 exposed women and 209 unexposed women) provided data for the analyses. Exposure assessment was based on hygienic measurements in the workplaces. TTP data were analysed with discrete proportional hazards regression.
Female exposure to solvents was associated with reduced fertility (adjusted fecundability density ratio (FDR) 0.55, CI 0.40 to 0.74 for low exposure, and FDR 0.70, CI 0.52 to 0.94 for high exposure). The findings were robust in different sensitivity analyses. A slightly stronger association was found among women with regular menstrual cycles. Exposure for less than 6 years was more strongly associated with reduced fertility (FDR 0.50, CI 0.30 to 0.83 and FDR 0.50, CI 0.28 to 0.90 for low and high exposure, respectively) than at least 6 years of exposure (FDR 0.60, CI 0.39 to 0.92 and FDR 0.86, CI 0.57 to 1.29 for low and high exposure, respectively). There was an interaction between solvent exposure and female smoking or use of coffee, the exposed women who smoke or use coffee being highly fecund.
The findings provide further evidence that exposure to organic solvents is hazardous for female reproduction. The observed association may be related to any of the following solvents commonly used in shoe manufacturing: n-hexane and hexane isomers, toluene, methyl ethyl ketone, acetone, ethyl acetate and dichloromethane.
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