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  • 1
    ISSN: 1432-1246
    Keywords: Biochemical investigations ; Conduction velocity measurements ; Trichloroethylene ; Chronically exposed collective ; Biochemische Untersuchungen ; Nervenleitgeschwindigkeitsmessungen ; Trichloräthylen ; chronisch exponiertes Kollektiv
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Sieben Personen, die chronisch gegenüber Trichloräthylen exponiert sind, wurden untersucht. Neben den Analysen im biologischen Material und arbeitsplatzbezogenen Raumluft-Messungen wurde die Nervenleitgeschwindigkeit (NLG) des N. ulnaris und N. radialis bestimmt. Im Blut analysierten wir die Konzentration von Trichloräthylen (TRI), Trichloräthanol (TCE) und Trichloressigsäure (TCA) und im Urin die Exkretion von WE und TCA. Durch die quantitative Erfassung der externen und internen Dosis wind die Halogenkohlenwasserstoff-Belastung arbeitsmedizinisch beurteilt. Bei einem Vergleichskollektiv von 13 Probanden, die eine ähnliche Altersverteilung zeigten, aber nicht Lösungsmittel-exponiert waxen, wurden die minimalen und maximalen Leitgeschwindigkeiten der betreffenden Nerven gemessen. Die erhaltenen Nervenleitgeschwindigkeiten stimmen für beide Kollektive mit den altersspezifischen Angaben in der Literatur überein. Zwischen den belasteten und nicht belasteten Personen ließ sich kein statistisch signifikanter Unterschied der Nervenleitgeschwindigkeit sichern. Eine Korrelation zwischen den biochemischen Parametern und den Nervenleitgeschwindigkeiten konnte nicht aufgezeigt werden.
    Notes: Summary The maximal and minimal conduction velocities of the Ulnar and Median Nerves of 7 persons, chronically exposed to trichloroethylene (TRI), were measured. To evaluate the solvent's load we analysed the biological material and the trichloroethylene-concentration in air at the working place. The amount of trichloroethylene, trichloroethanol (TCE) and trichloroacetic acid (TCA) in blood was determined as well as the excretion of TCE and TCA in urine. By the determination of the external and internal dosis the halogenated hydrocarbon load is commentable in occupational medicine. Additionally the conduction velocity of the corresponding nerves of a control group of 13 persons was measured which had a similar distribution of age, but which was not exposed to that solvent. Our results for both collectives agreed with the age-corresponding values given in the literature. There was no statistically significant difference between the exposed and non-exposed persons. Further no correlation between the biochemical parameters and the conduction velocity could be proved.
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  • 2
    ISSN: 1432-1246
    Keywords: Neurotoxicity ; Organic solvents ; Spray painters
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A multidisciplinary cross-sectional study was carried out in 105 spray painters with long-term solvent exposure (10–44 years) and in 58 control subjects not exposed to solvents. By means of air monitoring the solvent concentrations in the ambient air during spray painting were determined using charcoal and silicagel tubes with pumps and passive samplers. In general, the air concentrations of the individual compounds did not exceed the current limit values (MAK values). Aromatic hydrocarbons like toluene, xylene, ethylbenzene, trimethylbenzene, aliphatic hydrocarbons (e.g., heptane) and acetates (ethylacetate, butylacetate) were determined to be important components of paint solvents. However, in unfavorable work conditions the “exposure index” could exceed the permissible limits two or three times. To assess the body solvent load at the time of examination, biological monitoring (BM) was performed. The main finding was that there was no evidence of neuro-toxicologically relevant solvent exposure. Only in the case of methyl hippuric acid in urine spot samples did the spray painters show a higher mean value (80 mg/l) than control subjects (below 20 mg/l), indicating recent xylene exposure. Elevated urinary chromium concentrations (maximum value 29 μg/l) were found in 28 spray painters as a result of using zinc chromate-containing wash primers without taking protective measures. To assess the degree of past solvent exposure a special questionnaire was used. This included variables like duration and amount of solvent exposure, the presence of a technical ventilation system, health complaints during painting, etc. Additionally, three “solvent exposure indices” (SEI) were calculated and used for evaluation of “dose-effect relationships.” In summary, the responses to the questionnaire did not show a characteristic pattern of symptoms. The frequency of symptoms is more likely to be determined by age than by chronic solvent exposure. Health complaints like increased tiredness, deterioration in short-term memory, and headache were equally frequent in spray painters and controls. In correlation analyses no hints of a dose-response relationship could be found.
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  • 3
    ISSN: 1432-1246
    Keywords: Key words Painters ; Organic solvents ; Neurotoxicity ; Symptoms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: The main aim of the study was to examine possible solvent-associated effects on the nervous system in currently employed painters. Special attention was paid to evaluate subtle health effects. Materials and methods: A total of 401 painters and 209 construction workers without solvent exposure with at least 10 years of professional experience were subjected to a clinical, neurological, psychiatric, neuropsychological and neurophysiological examination. For personal medical and occupational history, standardized questionnaires were used. A quantitative rating of exposure was obtained by expert rating of the respective occupational history without knowledge of the individual test results. Results: There was no excess of somatic disorders or solvent-associated adverse effects on the nervous system. No distinct effects of solvent exposure on nerve conduction velocities (NCV) or cognition were found. Discrete NCV deficits in painters were not considered a sign of subclinical polyneuropathy. Painters, however, reported an excess of specific symptoms that could be assigned to “mood and behaviour”. The differences between specific and non-specific questionnaire outcomes on the one hand and the positive correlation between chronic exposure index and symptom scores on the other hand support the hypothesis of solvent-induced effects. Because data is lacking on past solvent exposure, it is not possible to relate these effects to current exposure limits. Conclusions: Currently employed painters differ from controls not exposed to solvents with respect to the frequency of certain symptoms in mood and behaviour. These symptoms are related to life-long solvent exposure rather than to current exposure. At present, the issue of time course and reversibility or irreversibility of these symptoms cannot be answered. The predictive value for subsequent neuropsychiatric morbidity remains to be elucidated in follow-up studies.
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  • 4
    ISSN: 1432-1246
    Keywords: Key words Manganese ; Biomonitoring ; Ambient air monitoring ; Hair analysis ; Dry cell manufacturing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: A cross-sectional study was carried out on 100 workers from three different workplace areas in a dry cell battery manufacturing plant and on 17 currently nonexposed referents, to examine the relationship between the external exposure to manganese dioxide (MnO2) and the body burden of manganese in blood, urine and hair. Methods: Inhalable dust was measured gravimetrically after stationary active sampling. Manganese was analyzed in dust samples, blood, urine and axillary hair by atomic absorption spectro- metry. Results: The average air concentrations of manganese in the three workplace areas were 4 μg/m3 (range: 1–12 μg/m3), 40 μg/m3 (12–64 μg/m3) and 400 μg/m3 (137–794 μg/m3). Manganese in blood and axillary hair correlated with airborne manganese in group-based calculations but not on an individual level. The manganese concentrations varied between 3.2 μg/l and 25.8 μg/l in the blood (mean: 12.2 ± 4.8 μg/l) and between 0.4 μg/g and 49.6 μg/g in hair (mean: 6.2 ± 6.2 μg/g in the proximal sequence), respectively. The results for the nonexposed referents were 7.5 ± 2.7 μg/l (mean) in the blood (range: 2.6–15.1 μg/l) and 2.2 ± 1.8 μg/g (mean) in axillary hair (range: 0.4–6.2 μg/g). In these matrices, manganese differed significantly between the highly exposed workers and both the reference and the low-exposure group. Manganese in blood revealed the lowest background variance. No differences for manganese in urine were observed between workers (mean: 0.36 ± 0.42 μg/l, range: 0.1–2.2 μg/l) and referents (mean: 0.46 ± 0.47 μg/l, range: 0.1–1.7 μg/l). Conclusions: Manganese in blood is a specific and suitable parameter for the biomonitoring of MnO2 exposure, although its validity is limited to group-based calculations. Urinary manganese failed to allow a differentiation between exposed workers and referents. The suitability of manganese analysis in hair for biomonitoring purposes suffers from a relatively great background variation as well as from analytical problems.
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  • 5
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Polyneuropathie ; Enzephalopathie ; Organische Lösungsmittel ; Berufskrankheit ; Key words Polyneuropathy ; Encephalopathy ; Organic solvents ; Occupational disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Solvent induced polyneuropathy and encephalopathy have been acknowledged quite recently as occupational diseases in Germany. For compensation first of all the diagnosis has to be proven. For differential diagnosis other known causes as well as non-organic mental diseases must be taken into consideration. The causality between proven exposures and diagnosed disease has at least to be probable. To evaluate causation extensive experience of the experts is needed. In this context scientific criteria regarding neurotoxicity of the solvent, duration of exposure, individual aspects of non-occupational influences, time course of the disease are important within a thorough synoptic evaluation. Possibilities and limitations of sensitive diagnostic measures such as neurographic, neuropsychologic and neuroimaging examinations are discussed. The prognosis of toxic polyneuropathy and encephalopathy is in general favorable if exposure has stopped. Additionally, adequate therapy and rehabilitation measures are supportive for a good prognosis.
    Notes: Zusammenfassung Polyneuropathie und Enzephalopathie sind seit kurzem als Berufskrankheit (BK 1317) zu entschädigen, wenn sie durch organische Lösungsmittel oder Lösungsmittelgemische am Arbeitsplatz verursacht worden sind. Medizinische Voraussetzung ist die Diagnose der Polyneuropathie oder Enzephalopathie sowie deren differentialdiagnostische Abgrenzung gegenüber anderen organischen Ursachen sowie – im Falle der Enzephalopathie – gegenüber andersartigen psychischen Störungen, z.B. depressiven Störungen oder Somatisierungsstörungen. Die Beurteilung des Ursachenzusammenhanges zwischen Einwirkungen am Arbeitsplatz einerseits und der Erkrankungen andererseits ist schwierig und erfordert besondere Erfahrungen von seiten der Gutachter. Im Rahmen des interdisziplinären Vorgehens müssen zahlreiche internistische und neuropsychiatrische Differentialdiagnosen berücksichtigt werden. Die gesicherten arbeitsmedizinisch-neurotoxikologischen Kriterien, die für und gegen einen Ursachenzusammenhang sprechen, sind im Einzelfall umfassend zu prüfen. Möglichkeiten und Grenzen moderner diagnostischer Verfahren (Neurophysiologie, Neuropsychologie, bildgebender Methoden) sind bei der Kausalanalyse zu beachten. Für die Prognose sind die Beendigung der ursächlichen Expositionen und Maßnahmen der Rehabilitation entscheidend. Die Berufskrankheit ist im Einzelfall entsprechend der dadurch ausgelösten Minderung der Erwerbsfähigkeit zu entschädigen.
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  • 6
    ISSN: 1432-1246
    Keywords: 1.1.2-Trichloro-1.2.2-trifluoroethane ; External-internal dose ; Occupational exposure ; 1,1,2-Trichlor-1,2,2-trifluoräthan ; externe-interne Dosis ; berufliche Exposition
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Im Rahmen einer arbeitsmedizinischen Studie wurden 10 Frauen und 3 Männer untersucht, die beruflich gegenüber dem Halogenkohlenwasserstoff 1,1,2-Trichlor-1,2,2-trifluoräthan (Frigen R 113) kurzfristig exponiert waren. Neben der Durchfürhrung von Erstuntersuchungen nach den Bestimmungen der Berufsgenossenschaftlichen Grundsätze erfolgte die quantitative Bestimmung der externen und internen Dosis des Halogenkohlenwasserstoffes. Die Analyse von 1,2,2-Trichlor-1,2,2-trifluoräthan in der Raum- und Ausatemluft führten wir infrarotspektrometrisch durch. Die Raumluftkonzentrationen schwankten von Tag zu Tag zwischen ca. 13 and 111 ppm. Zur Ermittlung der internen Dosis wurden die Serumproben gaschromatographisch untersucht. Die Halogenkohlenwasserstoff-Konzentrationen bewegten sich fur die länger belasteten Arbeiterinnen zwischen 3,15 und 9,75 mg/l und für die weniger stark exponierten Männer zwischen 1,20 und 4,85 mg/l. In der Ausatemluft fanden sich Lösungsmittelkonzentrationen zwischen 1,0 and 33,8 ppm am Ende der täglichen Exposition. Die Auswertung der klinisch-chemischen Parameter ergab keinen Hinweis für Lösungsmittel-bedingte adverse Effekte.
    Notes: Summary 10 women and 3 men, occupationally exposed to the halogenated hydrocarbon 1.1.2-trichloro-1.2.2-trifluoroethane (Frigen R 113) were examined. Additionally to the performance of the ‘Primary Examinations’ (‚Erstuntersuchungen’) concerning the specifications of the Berufsgenossenschaftlichen Grundsätze’ the external and internal dose of the solvent was quantitatively determined. 1.1.2-trichloro-1.2.2-trifluoroethane in the air at the working place and in exhaled air was analysed by infrared-spectrometry. The concentration in the air at the working place varied from day to day between about 13 and 111 ppm. The serum samples were analyzed gaschromatographically to determine the internal dose. The halogenated hydrocarbon concentrations ranged between 3.15 and 9.75 mg/l in women and between 1.20 and 4.85 mg/l in men who were less exposed than the women. At the end of the daily exposure the solvent concentration in exhaled air was between 1.0 and 33.8 ppm. The evaluation of the clinical-chemical parameters showed no indication of solvent caused adverse effects.
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  • 7
    ISSN: 1432-1246
    Keywords: Neurotoxicity ; Organic solvents ; Painters
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a multi-disciplinary retrospective study we examined 105 house painters employed for at least ten years (median 27 years, range 10–36 years). Fifty-three workers from various professions (non-painters), who were matched with regard to age, occupational training and socio-economic status served as the control group. In both groups no cases of a clinically manifest polyneuropathy or encephalopathy were found. The neurophysiological examinations (EEG and NCV-measurement) showed no differences in painters and controls that would indicate adverse effects of organic solvents. There were no cases with neuroradiological findings of a diffuse cerebral atrophy. Furthermore the evaluation of certain brain structures (ventricular diameter, cella media index) of the CAT films did not reveal any significant differences. In the neurobehavioral tests significant differences in the results were only found in the subtests “change of personality” and “short term memory capacity” in a subgroup of painters with repeated prenarcotic symptoms at the workplace. Ambient air monitoring measurements at 30 representative work-places showed that the concentrations of the main components of the solvent-mixtures were well below the MAK-values. The results of the “Erlangen Painter Study” does not confirm former epidemiologic findings from other countries, mainly Denmark. However, there are some aspects, such as minor solvent exposure in German house painters, insufficient diagnostic and etiological procedures as well as mis-classifications which may explain the different experiences.
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  • 8
    ISSN: 1432-1246
    Keywords: Neurotoxicity ; Organic solvents ; Spray painters
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A multidisciplinary cross-sectional study was performed to examine the chronic neurotoxicity of organic solvents. Participating in the study were 105 persons employed as spray painters and having long-term solvent exposure (10–44 years) and a control group consisting of 58 construction workers, electricians, and plumbers without occupational contact to solvents. Samples were matched for age, preexposure intelligence level, occupation, and socioeconomic status. After controlling for potentially non occupational confounding factors (neuropsychiatric diseases, metabolic disorders, high blood pressure, alcohol intake) 83 spray painters and 42 controls were entered finally into the study. The evaluation included work history, self-rating questionnaire, neurologic investigation, psychiatric analysis using the Present State Examination (PSE), psychological testing, and computerized axial tomography (CAT) of the brain. Physical and neurologic examinations demonstrated no case of overt disorders of the central or peripheral nervous system. An important result of the psychiatric analysis was that the syndromes “special features of depression” and “loss of interest and concentration” occurred significantly more frequently among spray painters than among controls. Further analyses demonstrated an association with chronic exposure over 30 years and repeated acute neurotoxic effects during solvent exposures. Neither psychological nor performance tests demonstrated any statistically significant differences in the performance sets after adjustment according to premorbid intelligence level; this finding supports the presumption of only a low grade of mental dysfunction. Correlation analyses indicated a relationship between subjective health complaints and long-term solvent exposure; however, the effect of age cannot be completely ruled out. Visual evaluation of CAT scans of the brain demonstrated significantly higher values for spray painters on the Cella media index, a measure of the inner liquor system of the brain. None of the other CAT parameters of inner or external brain atrophy showed significant differences. The rate of diffuse cerebral atrophy was not increased in spray painters. No statistical relationship between the solvent exposure index and CAT parameters was found by correlation analysis. In summary, the results do not support the hypothesis of an increased risk of solvent-induced encephalopathy among spray painters. It is not possible to establish a typical picture of central nervous system dysfunction due to chronic solvent exposure. Differences in the frequency of PSE symptoms “special features of depression” and “loss of interest and concentration” could be considered solvent related only if long-term (on average 30-year) exposure in combination with repeated acute neurotic effects had occurred. Cerebral atrophy beyond that of normal aging was not found in long-term exposed spray painters.
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  • 9
    ISSN: 1432-1246
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 10
    ISSN: 1432-1246
    Keywords: Trichloroethylene ; Chronically exposed collective ; Psychological and biochemical examinations ; Trichloräthylen ; Chronisch belastetes Kollektiv ; Psychologische and biochemische Untersuchungen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei arbeitsmedizinischen Studien sollte zwischen akuten, kurzfristigen and chronischen Belastungen unterschieden warden. In der vorliegenden Arbeit wurden an acht chronisch mit 260 mg/m3 (50 ppm) Trichloräthylen-Konzentration belasteten Personen psychologische and biochemische Untersuchungen durchgeführt. Mit den psychologischen Testverfahren wurde versucht zu klären, ob eine psychomentale Funktionsänderung im Sinne eines “Psychoorganischen Syndroms” beim untersuchten Personenkreis festzustellen ist. Die Ergebnisse der psychologischen Austestung ergaben keine Anhaltspunkte für eine Alteration des ZNS trotz nachgewiesener Lösungsmittelinkorporation. Die biochemischen Analysen sollten zum einen zeigen, in welcher Konzentration die verschiedenen Parameter im menschlichen Organismus auftreten. Zum anderen wurde geprüft, in welchem Umfang sich arbeitsfreie Intervalle auf den Trichloräthylen-, Trichloräthanol- und Trichloressigsäurespiegel in Blut und Urin auswirken. Die Gesamtmetabolitenausscheidungen, als auch die Blutspiegel zeigten bei dem untersuchten Kollektiv starke interindividuelle Schwankungen. Mit Ausnahme der Trichloressigsäure ergaben die Blut-parameter nach den expositionsfreien Intervallen einen Konzentrationsabfall. Dieses Verhalten wurde auch für die Trichloräthanol- und Trichloressigsäureexkretion im Urin gefunden. In den arbeitsfreien Zeiträumen kommt es nur langsam zu einer Elimination der Trichloräthylenabbauprodukte. Der für die Gesamtmetabolitenausscheidung derzeit diskutierte arbeits-medizinisch tolerierbare Grenzwert von 250 mg/g Kreatinin wurde bei unserem Kollektiv überschritten. Der Median lag am Ende einer Arbeitsschicht bei 330 bzw. 319 mg Trichlorathanol and Trichloressigsäure/g Kreatinin. Eine Erhöhung des arbeitsmedizinisch akzeptablen Grenzwertes wind diskutiert.
    Notes: Summary In studying occupational medicine one should differ between acute, short-term and chronic loads. In the authors' study psychological and biochemical examinations were made of eight chronically exposed persons with 260 mg/m3 (50 ppm) trichloroethylene concentration. The purpose of the psychological examinations was to clarify mental functioning alterations in the sense of “psychoorganicsyndrome” in the number of persons examined. In spite of proved incorporation of solvent the results of the psychological tests gave no hints of an alteration of the CNS. Biochemical analysis should show on the one hand, in which concentrations the different parameters appear in the human organism. On the other hand it should be determined to what extent non-exposure intervals have effect at the trichloroethylene, trichloroethanol and trichloroacetic acid levels in blood and urine. Excretion of total metabolites, as well as blood levels showed large-scale variations in the examined collective. With the exception of trichloroacetic acid the blood parameters showed a decrease of concentration after non-exposed intervals. This result could also be found for the excretion of trichloroacetic acid in urine. During the work-free periods the metabolites of trichloroethylene are eliminate only slowly. The threshold value of 250 mg trichloroethanol and trichloroacetic acid/g creatinine tolerated in occupational medicine today was surpassed by our collective. The median value was 330 and 319 mg trichloroethanol and trichloroacetic acid/g creatinine respectively at the end of a working shift. It is considered to increase the acceptable threshold value in occupational medicine.
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