Toxi exam 3

Modern Definition of IH ( Industrial hygiene)

(AIHA 1994) The science and art devoted to the Anticipation, Recognition, Evaluation, and Control of those environmental factors or stresses arising in or from the workplace that may cause sickness, impaired health and well-being, or among the citizens of the community.

Bernardo Ramazzini

- 1700 - Published Discourse on the Diseases of Workers - Known as the Father of Occupational Medicine - Asked an important question to all of his patients "Of what trade are you?"

Charles Turner Thackrah

- 1832 - Published "The Effects of Arts, Trades and Professions and of civic states and habits of living on Health and Longevity with suggestions for removal of many of the agents which produce disease and shorten the duration of life" - Asserted "Each master has in great measure the health and happiness of his work people in his power; and let his actions be directed to the prevention rather than relief of the evils"

Minamata Disease

- 1956 neurological disease -identified in a population centered around Minamata Bay in Japan - symptoms include: impaired neurological functioning in adults such as sensory and motor impairment and neurological and developmental defects in children - Some fatalities resulted in the Minamata exposure - compound responsible for the effects is methylmercury -cause was not at first understood, but was traced to methylmercury poisoning - In each case, the sources of the mercury in these mercury poisonings was a single chemical industrial facility discharging mercury-containing waste into surface waters. Prior to the M inamata Disease being attributed to methylmercury, industrial discharge of mercury was not considered a human health concern.

Hippocrates

- 4th century BC - recognized Pb toxicity with mining

Chemical workplace hazards

- Air contaminants (inhalation toxicants) • Gasses • Vapors • Particulates - Chemical contact hazards • Skin irritants • Corrosives • Poisons Chemicals are used throughout industry, however, over the past ten to twenty years many industries have successfully substituted less hazardous/toxic chemicals for more hazardous/toxic chemicals. Chemical hazards tend to be industry specific, that is, each type of manufacturing process has certain chemicals that common to that type of process. No chemicals are common throughout all industries.

Aromatic hydrocarbons

- Benzene, toluene, polyaromatic hydrocarbons

Biological Workplace Hazards

- Blood-borne pathogens • HIV • HBV - Airborne pathogens • Fungi/mold spores • Airborne bacteria - Macro animals • Spider & insects • Farm animals • Wildlife - Micro Plants • Poison ivy

Halogenated hydrocarbons

- Chloroform, carbon tetrachloride

Alcohols, glycols

- Ethanol, methanol, ethylene glycol

Nonspecific Effects of Solvents

- Irritation • Liquid - skin irritation • Vapors-respiratory and eye irritation - CNS depression • Disorientation, giddiness, euphoria (reason for substance abuse) • Paralysis, unconsciousness, convulsions, death • Narcosis related to lipid solubility; disruption of the cell membrane -Many solvents will penetrate the cell membrane and disrupt the normal function of the cell. Narcosis is a state of stupor or unconsciousness.

Aliphatic hydrocarbons (CH-CH-CH-CH)

- Methane (CH4), ethane, propane, butane - Classified as asphyxiants - Exception; hexane - metabolized to a diketone which causes delayed neurotoxicity --An asphyxiant will replace the oxygen in the atmosphere. (solvents)- many compounds are used as solvents

Industrial Revolution

- More/larger factories - More people exposed to potential occupational hazards - More people suffering the consequences of working in an industrial environment - started the "ball rolling" rapidly. More and more people were leaving the rural lifestyle of farming and hand craftsmanship for life in the "big" city working in the factories. The result of this migration was more and more people being exposed to occupational hazards and suffering the effects of these exposures.

Ergonomic Workplace Hazards

- Musculoskeletal disease • Repetitive motion, lifting injuries - Carpel Tunnel Syndrome - Tendonitis - Lower Back Pain Ergonomic hazards (cumulative trauma disorders) are musculoskeletal diseases that result from repetitive motions over prolonged periods of time, may result from sudden awkward movements, or attempting to move or lift heavy objects

Addictive effects

- Nicotine activates the brain circuitry that regulates feelings of pleasure (reward pathways) • Nicotine increases dopamine in the reward circuits • Nicotine levels peak within 10 seconds then dissipate in a few minutes - user must smoke frequently to maintain effects

Other Specific Effects

- Testicular degeneration and cardiovascular malformation - ethylene glycol monoethyl ether - Retinal damage - methanol - Cardiac arrhythmia - chloroform - Certain solvents are practically nontoxicpropylene glycol (used as a food additive) -Several male workers have become sterile following chronic exposure to EGME in the industrial setting. -Methanol is metabolized to formaldehyde and then to formic acid which will damage the retina and cause metabolic acidosis. -Chloroform was once used as an surgical anesthetic. However, the compound was associated with heart abnormalities such as arrhythmias. An arrhythmia is an alteration in rhythm of the heartbeat either in time or force.

Hazardous agents and tobacco

- increase risk of disease A well documented example is the interaction of asbestos exposure and cigarette smoke. Among the non-asbestos exposed population, smoking increases the lung cancer rate approximately 15-20-fold. In non-smoking asbestos workers, the lung cancer rate is increased 5-fold. But among asbestos workers who smoke, the lung cancer rate is increased 50-fold. Combined with cigarette smoking, exposures to coal dust, grain, silica, cotton dust, welding, sulphur dioxide and cement dust exposure generates a higher incidence of respiratory disease.

Industrial Hygiene

- is a field that offers great diversity. - may be field hygienist, laboratory (analytical) hygienist, teacher/ instructors/professors, researcher. - may be employed in many different types of industries.

Cigarette smoking

- most prevalent form of nicotine addiction in the U.S. Basically, a cigarette is a nicotine delivery device. It is well documented that most smokers identify tobacco as harmful and express a desire to reduce or stop using it, and nearly 35 million smokers make a serious attempt to quit each year. Less than 7% of those who try to quit on their own achieve more than 1 year of abstinence; most relapse within a few days of attempting to quit.

industrial hygienist

- participate in the "general practice" of industrial hygiene, meaning that they practice all of the principals of industrial hygiene. However, some industrial hygienist specialize in certain aspects of the profession or certain types of industry.

OSHA (Occupational Safety and Health Administration)

- regulatory agency designated to carry out the laws developed under the OSHAct - resides in the department of Labor - involvement in industry and occupational safety and health is very broad - standards (laws) cover all aspects of an industrial setting, including the infrastructure, machinery, raw material, intermediates and byproducts, and finished goods, and employee work routines.

DEA

- used in very few cosmetics However, DEA-related ingredients are used in a wide variety of cosmetics (in amounts 1-5% of a products formulation) Although there was an associated between DEA and cancer in lab animals, The National Toxicology Program conducted a study in 1998 which concluded that consumers have no reason to be alarmed of the use of these products in cosmetics.

Industrial Hygiene

- very diverse profession with many sub-specialties -work environment is any place where employees perform work -hospital employees, nursing home employees, employees that work in an office building, etc

Agricola (geologist)

-1556 means of ventilation

Walsh-Healey

-1936 Public Contracts Act -1960 safety standards -US Gov't shift from reactive to proactive approach to H & S issues

35 metals that concern us because of occupational or residential exposure

-2 3 of these are the heavy elements or "heavy metals": antimony, arsenic, bismuth, cadmium, cerium, chromium, cobalt, copper, gallium, gold, iron, lead, manganese, mercury, nickel, platinum, silver, tellurium, thallium, tin, uranium, vanadium, and zinc. -small amounts of these elements are common in our environment and diet and are actually necessary for good health, but large amounts of any of them may cause acute or chronic toxicity

Aniline

-Aniline will cause methemoglinemia. • Important organic base; parent compound for more than 300 chemical products • Bioactivated by CytP450 • Acute toxicity - methemoglobinemia prevents ability of RBC to carry oxygen • Probable human carcinogen

Hot issues for industrial hygienist

-constantly changing as industry continues to evolve. All of the organizations associated with occupational safety and health are constantly evaluating many safety and health parameters to anticipate current and potential future issues for industrial hygienist Task Force Studies by AIHA Emergency Response Planning Ergonomics/Cumulative Trauma Disorders Exposure and Risk Assessment Strategies Indoor Environmental Quality Workplace Environmental Exposure Levels -Update PELs (esp. chromium, beryllium, silica) Noise Hazards -Recent OSHA delay on recordkeeping requirement Respiratory Protection Sample and Laboratory Analysis Aging of the Workforce -Mean worker age in 2008 = 41 (35 in 1980)

typical industrial hygienist

-is a generalist that has a "working" knowledge of many scientific disciplines. - must be able to understand the relationships between workers, the machinery they operate, and the materials used in the process.

"classic" industrial environment

-papermill, automobile plant, or chemical plant

Industrial hygienists working in private industry must be able to negotiate through several paths of communication.

1) They must be able to communicate with plant and corporate management teams to ensure that health and safety need and concerns of plant employees are understood by management. 2) They must be able to communicate with plant employees; discusses their concerns with real facts and science but do so in terminology that can be understood by the employees. 3) They must be able to communicate with state and federal regulatory agencies; explain their company's safety and health programs (those related to industrial hygiene)

Alice Hamilton

1910 -- Director of the IL Occupational Disease Commission when IL worker's compensation laws passed 1919 -1935 Assistant professor of industrial medicine at Harvard Medical School [1922 - Harvard offered 1st IH degree in US] Published Industrial Poisons in the United States (1925) and Industrial Toxicology (1934). 1935+ - consultant for the Division Of Labor Standards of the U.S. Labor Department. - Hamilton recognized a variety of health effects with occupational hazards • lead poisoning among enamellers of bathtubs • carbon monoxide poisoning in steelworkers • "dead fingers" syndrome among laborers using jackhammers. -Dr. Alice Hamilton is considered to be the found of the modern practice of industrial hygiene (the Mother of Industrial Hygiene). She is given this recognition because she was the first person to utilize all four principles of industrial hygiene. Even though she was an M.D. she did not hesitate to include other professionals when dealing with complex occupational health issues.

Alice Hamilton

1910 -- Director of the IL Occupational Disease Commission when IL worker's compensation laws passed 1919 -1935 Assistant professor of industrial medicine at Harvard Medical School [1922 - Harvard offered 1st IH degree in US] Published Industrial Poisons in the United States (1925) and Industrial Toxicology (1934). 1935+ - consultant for the Division Of Labor Standards of the U.S. Labor Department. Hamilton recognized a variety of health effects with occupational hazards

H. & L. Hoover

1950 Translation The development of the roots of industrial hygiene paralleled the development of other sciences, including medicine, toxicology, pathology, physiology, biology, chemistry, etc. Many of the early scholars that were instrumental in the development of the sciences contributed to the early development of industrial hygiene.

Occupational and Environmental Health and Safety Professional (OEHS)

A descriptive name often used by IH's

Evaluation

An appraisal of the significance of the worker's exposure to potential occupational hazards

Lead

Another heavy metal implicated in human poisonings is lead. Like mercury, lead affects sensitive target populations like children because their nervous system is still developing. •Young children are often exposed to lead by eating or chewing on wood chips painted wih lead-based paints. •In the inner cities, lead has contaminated the soil due to fallout from particulates containing lead from leaded gasoline. Even though lead has been banned in gasoline, the soil levels are still high in certain areas. Heavy metals do not biodegrade like some organic pollutants; they may change forms but never "go" away.

four general principals of industrial hygiene

Anticipation, Recognition, Evaluation, Control - These are the basic procedural steps used by the professional when working towards the protection of employees in the workplace - anticipation and recognition principals deal with the first impressions of what potential hazards may be present in a particular workplace, but we do not know to what degree the hazards may effect the employees -Once we have made our subjective evaluation of a workplace we must evaluate those potential hazards that we feel constitute a significant concern to employee heath and safety. -When the evaluation process has been completed we must develop a control strategy for protecting employees exposed to the hazard

What is a workplace?

Anyplace that people perform work. Including: Manufacturing facilities, healthcare facilities, slaughter houses, office buildings, etc. -From an industrial hygienist's standpoint a workplace is anyplace that people work. Any and all occupations have some type of potential hazards associated with them, including being an industrial hygienist. The hazards associated with particular occupations vary greatly and cover a large spectrum.

Anthropogenic activity

Can allow mercury to be released from its depositories in the earth's crust and through industrial activities, resulting in concentrations of mercury in environmental zones that are detrimental to human and animal health

Smoking and pregnancy

Carbon monoxide and nicotine in tobacco smoke interferes with oxygen supply to the fetus • Developmental delays seen in infants • Greater risk for premature delivery • Risk of lower birth weights • Spontaneous abortions

Mar 20, 2001

Congressional repeal of OSHA ergonomics standard (1st standard ever repealed by Congressional Act)

Minamata Bay mercury exposure for the first time

Demonstrated the susceptibility of the fetus to damage, as evidenced by some children with severe neuromotor defects acquired by in-utero mercury exposure, while the mothers only suffered mild effects. The World Health Organization and the U.S. Food and Drug Administration use data from the Japanese studies to set standards for maximum mercury content in food.

1977

Federal Mine Safety and Health Act (est. Mine S&H Adm. in DOL)

Recognition

Identifying the presence of potential occupational hazards in the workplace

Practical Definition of IH ( Industrial Hygiene)

Industrial hygiene is the science of keeping people safe at work and in their communities.

Lice shampoo

Lindane - vomiting, diarrhea, convulsions, circulatory collapse, may cause liver damage

Lung

Lung cancer - smoking has been linked to about 80% of all lung cancer cases • Chronic bronchitis • Emphysema • Exacerbates asthma • Cancers of mouth, pharynx, larynx, esophagus, stomach, pancreas, cervix, kidney, bladder

OHSAct

Major Activities: "To assure safe and healthful working conditions" Secretary of Labor (via Occupation Safety & Health Administration): • establish & enforce "standards" • maintain stats on worker illnesses & injuries Employer: • furnish place of employment free from recognized hazards • comply with OSHA standards • recordkeeping of workplace illness & injury Employee: • comply with OSHA standards and rules, regulations of the act applicable to own actions and conduct "encouraging the States" -OSHA approval of state H&S plans, financial assistance "providing for research" -Establish National Inst. Occupational Health & Safety (NIOSH)

Control

Managing an employee's exposure to potential occupational hazards to ensure a healthful working life

Dyes

Many dyes contain Aromatic nitrogen compounds - Aniline - Naphthylamines

Non-essential

Mercury, lead, arsenic, cadmium, chromium VI

What is it about tobacco that makes it so harmful?

Nicotine causes irritation to the lining of the blood vessels. This may cause "bad" LDL cholesterol to adhere to the lining of the vessel walls and accelerate hardening of the arteries which can eventually lead to heart attack or stroke. At least 40 of these chemicals in cigarettes are known to cause cancer in humans.

Effects

Nicotine: stimulant and sedative • "kick" after exposure due to release of epinephrine by the adrenal glands - Sudden release of glucose - Increase in blood pressure - Suppression of insulin from pancreas • Release of dopamine (pleasure centers) • Sedative effect

July 2006

OSHA Chromium VI Standard published

1970

Passage of OSH Act (Williams-Steiger Act of 1970)

Julia Roberts

People can be exposed to chromiumthrough breathing, eating or drinking and through skin contact with chromiumor chromiumcompounds. The level ofchromiumin air and water is generally low. In drinking water the level ofchromiumis usually low as well, but contaminated well water may contain the dangerous chromium(IV); hexavalent chromium. For most people eating food that contains chromium(III) is the main route ofchromiumuptake, as chromium(III) occurs naturally in many vegetables, fruits, meats, yeasts and grains. Various ways offood preparation and storage may alter the chromiumcontents offood. When food in stores in steel tanks or cans chromiumconcentrations may rise. Chromium(III) is an essential nutrient for humans and shortages may cause heart conditions, disruptions of metabolisms and diabetes. But the uptake oftoo much chromium(III) can cause health effects as well, for instance skin rashes. The movie " Erin Brockovich" highlighted the toxicity ofchromium. However, many claims were not backed up by science. Chromium-6, also known as hexavalent chromium, is a known carcinogen, as classified by the U.S. EPA (Time.com). It is also referred to as industrial chromiumbecause it is used in various industrial processes, including the hardening ofsteel and in the production ofmany steel alloys (ETC.org). In the case ofHinkley, Calif., it was being used as a rust inhibitor by Pacific Gas and Electric Company, which they carelessly dumped and let seep into the groundwater used by the residents of Hinkley (Time.com). If it is inhaled regularly over a long period oftime, it can cause lung cancer and cancer ofthe septum(Time.com). For example, studies have shown that the risk ofdeveloping respiratory cancer is twenty times greater for chromate plant workers than for the general population (ETC.org). But what about the ingestion (not inhalation) ofChromium-6 as in the case ofHinkley? In 1998, an Environmental Protection Agency (EPA) report on Chromium-6 stated, "No data were located in the available literature that suggested that it is carcinogenic by the oral route ofexposure."The reason for this, as explained by Joe Schwarcz, director ofMcGill University's Office for Chemistry and Society, "is that ingested chromium-6 encounters hydrochloric acid in the stomach's gastric juices, and is converted to chromium-3, which is innocuous." Chromium-3 is a trace mineral and is found in such foods as broccoli, cheese, meats, cereal, brewer's yeast, whole grains, and mushrooms (ETC.org). Chromium-3 is considered essential in man and animals for efficient lipid, glucose, and protein metabolism(GreatDreams.com). Schwarcz also pointed out, "no single toxin causes the wide array ofconditions that afflict Hinkley residents."

Physical Workplace Hazards

Physical - Electromagnetic energy - Ultra Violet (UV) - Infrared (IR) - Radio Frequency (RF) - Ionizing radiation - X & Gamma rays - Alpha & Beta radiation - Sound & vibration - Temperature extremes From an IH view these are typically forms of energy

Today's Description of an Industrial Hygienist

Professionals dedicated to protecting people in the workplace and the community.

Classic Description of an Industrial Hygienist

Professionals dedicated to the health, safety, and well-being of industrial workers.

Semi-permanent and temporary hair coloring products

Solutions of various coal- tar. Several coal-tar dye ingredients have been found to cause cancer in lab animals. In the case of 4-methoxy-m-phenylenediamine (4-MMPD) which had also been demonstrated in humans and animal studies to penetrate the skin, the FDA considered the risk associated with its use in hair dyes a "material fact" which should be made known to the consumers.

Adverse Health Effects

Studies show smoking high-tar unfiltered cigarettes as opposed to medium-tar filtered cigarettes, greatly increases your risk of lung cancer. So, cigarettes labeled as low tar or ultra light are an even safer choice? No. A recent study comparing the lung cancer risks of different types of cigarettes found the that the risk of lung cancer death was no different among smokers of medium, low and very low-tar cigarettes. A previous study showed smokers of low-tar cigarettes compensate for the decrease in tar level by changing their inhalation pattern. By blocking ventilation holes in the filter, increasing the drag time, holding the puff longer and deeper, or smoking more cigarettes, addicted smokers may maintain their nicotine intake (and exposure to carcinogens) with low-tar cigarettes.

external appearance of a normal heart

The epicardial surface is smooth and glistening. The amount of epicardial fat is usual. The left anterior descending coronary artery extends down from the aortic root to the apex.

Anticipation

The expectation of potential hazards in the workplace

normal coronary artery

The lumen is large, without any narrowing by plaques. The muscular wall is of normal proportion.

Epinephrine is adrenaline

The release stimulates the central nervous system, and other endocrine glands, which causes a sudden release of glucose. Stimulation is followed by depression and fatigue, leading the abuser to seek more nicotine. Smoking will also inhibit the enzyme that breaks down dopamine. The reaction of nicotine on dopamine levels is similar to that seen with other drugs of abuse such as cocaine and heroin. In contrast, nicotine can also exert a sedative effect, depending on the level of the smoker's nervous system arousal and dose of nicotine taken.

Classic Definition of IH ( Industrial Hygiene )

The science of protecting man's health through control of the work environment

Alice in wonderland

There is some question as to whether or not the Hatter in Alice in Wonderland (1865) was mad because of mercury poisoning. For one thing, the diagnosis may be questioned since it was made rather casually by the Cheshire Cat. On December 2, 1955 the New York Times ran a full-column story, with a dateline from Danbury, Connecticut and headlines: "600 Hatters Mark 1941 Nitrate Ban." The story notes that "The occasion was the 14th anniversary of the outlawing of the use of nitrate of mercury in the hat industry." This notable event had come to pass since "On December 1, 1941, the United States Public Health Service brought an end to mercury's use by hat manufacturers in 26 states through mutual agreements." Credit for this achievement was claimed in whole or in part by the Public Health Service, the hat manufacturers, and the secretary-treasurer of the local union of United Hatters, Cap and Millinery Workers. Cynics have suggested that credit for this "triumph" should be attributed to a war-time shortage of mercury. For close to a century prior to 1955, the ravages of mercurialism among hatters had been known and tolerated in the United States. First among the major studies of mercury poisoning in the American felt-hat industry was that made by Dr. J. A. Freeman of New Jersey and reported in 1860. Freeman's findings were confirmed in a report published by the Board of Health of the State of New Jersey in 1878 (Dennis). In 1910, under the aegis of the Women's Welfare Department of the New York and New Jersey section of the National Civic Federation, Mrs. Lindon W. Bates, assisted by Miss Florence Roehm, undertook a survey of industrial mercury poisoning in the New York metropolitan area. T he results were published in 1912 (Bates). Dozens of cases of severe mercurialism were found among hatters, a state of affairs which was confirmed by the New York City Department of Health in 1915.

De Re Metallica

Treatise on mining - Diseases of miners (silicosis) - Preventive measures (ventilation worker protection)

1995

U.S. Bureau of Mines closed (est. 1910, authorized to inspect 1941)

1966, '69

Various acts addressing safety in mining & construction

F, D, & C dye

Yellow No. 5 is certified today but companies must tell consumers on label due to allergic reactions. Red is banned in cosmetics and externally applied drugs.

WHO (World Health Organization)

advices a maximum concentration of 10 ppb. Although arsenic may be found in surface water, groundwater is the main source of arsenic in water. Consequentially, concentrations above 10 ppb may be found naturally in groundwater.In groundwater arsenic exists as water-insoluble anorganic arsenic AS-V anions or AS-III molecules.In Bangladesh groundwater concentrations of arsenic may exceeds 100 ppb on some locations. These people drinking water with high arsenic experience skin problems (hyperkeratosis) and skin cancer.

Color

came from natural products including turmeric, paprika, saffron, etc. In the late 1800s, food producers used colors to mask poor product quality or spoiled stock. Color additives were not monitored and many were synthesized from aniline or petroleum products. In 1906, the Pure Food and Drug Act was passed to protect the consumer.

coronary artery with atherosclerotic narrowing

can be caused by smoking.

Heavy metal toxicity

can result in damaged or reduced mental and central nervous function, lower energy levels, and damage to blood composition, lungs, kidneys, liver, and other vital organs. Long-term exposure may result in slowly progressing physical, muscular, and neurological degenerative processes that mimic Alzheimer's disease, Parkinson's disease, muscular dystrophy, and multiple sclerosis. Allergies are not uncommon and repeated long-term contact with some metals or their compounds may even cause cancer.

Lye

caustic, burns skin and eyes, if ingested will damage esophagus and stomach - Oven Cleaner - Lye (sodium hydroxide)

Essential trace heavy metals

cobalt, copper, iron, zinc

Draize eye and skin irritancy tests

continue to be considered among the most reliable methods currently available for evaluating the safety of a substance introduced into or around the eye or placed on the skin.

FDA

continues to work with other governments and private organizations to develop validated alternatives to animal testing in assessing cosmetic safety and considerable progress has been made in some areas. Nevertheless, until a method has been proven to be reliable and accepted by the scientific community, FDA believes that the use of animals remains necessary to ensure the safety of cosmetic ingredients and products.

Food, Drug & Cosmetic Act

does not specifically mandate animal testing, they strongly urge manufacturers to conduct whatever tests are appropriate to establish that their cosmetics are safe. Manufacturers bear a responsibility to ensure their products are safe for consumer use. In fact, cosmetic products that have not been adequately tested for safety must have a warning statement on the front label which reads, "WARNING -The safety of this product has not been determined."

Heavy metals

elements having atomic weights between 63.546 and 200.590 and a specific gravity greater than 4.0. - common in industrial applications such as in the manufacture of pesticides, batteries, alloys, electroplated metal parts, textile dyes, steel, and so forth. Many of these products are in our homes and actually add to our quality of life when properly used.

Risk management of mercury

focuses on two schemes: •one to reduce the human intake of mercury from environment sources • second to reduce the mobilization and concentration of mercury from industrial activities.

Arsenic

found naturally in certain soils. When arsenic comes in contact with groundwater it may end up in water, as well.

early 1900's to present time

government bodies, federal, state, and local have taken an increased roll in occupational safety.

FDA

has two categories of color additives: colors that the agency certifies (derived from petroleum; coal tar dyes), and colors that are exempted from certification (mineral, plant, and animal sources). Only those approved can be used. The FDA requires manufacturers to submit samples of certain colors from each batch produced. FDA scientists test each sample to confirm that each batch is within established specifications. Certified colors are listed on labels as FD&C, D&C or external D&C. Using uncertified versions are illegal. The law requires manufacturers to pay FDA a user fee for each pound of color the agency certifies.

Methemoglobin

is a soluble brown crystalline basic blood pigment that differs from hemoglobin in containing ferric iron and in being unable to combine reversibly with molecular oxygen.

typical for hypertensive heart disease.

left ventricle is very thickened (slightly over 2 cm in thickness), but the rest of the heart is not greatly enlarged -The hypertension creates a greater pressure load on the heart to induce hypertrophy (enlargement). Smokers generally have high blood pressure.

Dishwasher detergents

most contain chlorine in a dry form that is highly concentrated. #1 cause of child poisonings

Drain Cleaner

most contain lye, hydrochloric acid or trichloroethane

Dopamine

natural chemical in the brain and is a nerve cell messenger implicated in the positive reinforcement underlying addiction.

ammoniacal dye solution and the hydrogen peroxide solution

often called the developer, are mixed shortly before application to the hair.

Arsenic

one of the most toxic elements that can be found. Despite their toxic effect, inorganic arsenic bonds occur on earth naturally in small amounts. Humans may be exposed to arsenic through food, water and air. Exposure may also occur through skin contact with soil or water that contains arsenic.

Furniture Polish

petroleum distillates - highly flammable, cans cause skin and lung cancer • Contains phenol and nitrobenzene (easily absorbed through skin)

Progressive hair dye products

products contain lead acetate as the active ingredient.

Cigarette Smoking

related to more than 80% of lung cancer cases - risk of developing lung cancer is 15 to 20 times greater for cigarette smokers than for non-smokers - According to the American Cancer Society, lung cancer is now the leading cause of cancer deaths among men and women. - Smoking has also been linked to coronary heart disease, stroke, chronic bronchitis, gastric ulcers, and emphysema. -Children that have parents who smoke are more susceptible to respiratory problems (asthma and bronchitis). -While cigar and pipe smokers who do not inhale are less at risk for lung cancer, their risk of developing mouth and throat cancer is just as great.

emphysema

smoker's lung with cystic spaces due to destruction of airsac walls.

ultimate goal of the industrial hygienist

to help ensure that workers are protected from occupational health hazards throughout their working life time.

Dr. Ramazzini and Dr. Thackra

very instrumental in changing the general think regarding occupational hazard from one of a reactive nature to one of a proactive nature. In other words, instead of treating occupational illnesses and injuries lets attempt to prevent them from occurring

Extent of tobacco use

• 1999 survey - 57 million Americans were current smokers; 7.6 million use smokeless • More than 2,000 under age of 18 begin smoking • CDC reports 34.8% of high school students are smokers

Household Chemicals

• Air fresheners - Carpet and upholstery shampoo - Dishwasher detergents - Drain Cleaner - Lye - Furniture Polish - Mold and mildew cleaners - Antibacterial cleaners - Laundry room products - Toilet bowl cleaners - Pesticides - Flea powders - Lice shampoo - Car wash and polish Household products should be kept on high shelves away from small children or cabinet doors be secured with child-protection devices.

Chemicals in smoke

• Benzene, 4-aminobiphenyl, benzene, cadmium, carbon monoxide, chromium, 2naphthylamine, nickel, vinyl chloride, acrylonitrile, benzo[a]pyrene, formaldehyde, n-nitrosodiethylamine, acetaldehyde, lead, 2-nitropropane, orthotoluidine, urethane, chrysene......... These are just a few of the hazardous and carcinogenic chemicals in cigarette smoke

Deadly Bleach Mixtures

• Bleach and acid (phosphoric acid cleaner) can produce chlorine gas • Pulmonary irritant - fatal pulmonary edema • Bleach and ammonia can produce a gas - chloramine • Highly irritating to lungs There have been many cases over the years of injuries and/or fatalities resulting from mixing bleach and acids to clean bathrooms.

Flea powders

• Carbaryl - very toxic, causes skin, respiratory and cardiovascular damage • Dichlorophene - skin irritation

Minamata Bay

• Chisso-Minamata factory - mercury used in the process of compounds • Methylmercury formed in process and discharged into Bay • Human cases extended from 1941-72 • Large human exposure - diet consisted mainly of fish and shellfish from Bay

Cadmium toxicity

• Chronic exposure from any route will target the heart, lungs, bones, gonads and kidneys • Obstructive pulmonary disease, emphysema, chronic renal tubular disease • Skeletal changes related to calcium loss - Osteomalacia and skeletal changes - Itai-Itai (ouch-ouch) disease

Hair dye products

• Coal-tar hair dye ingredients • 4-methoxy-m-phenylenediamine • Found to cause cancer in lab animals • Can penetrate skin • Progressive hair dye products contain lead acetate • Ammoniacal dye solution and hydrogen peroxide solution (developers; applied to hair prior to dye) -may be divided into three categories - permanent, semi-permanent and temporary hair colors. Permanent hair colors are the most popular hair dye products. They may be further divided into oxidative hair dyes and progressive hair dyes. Oxidative hair dye products consist of (1) a solution of dye intermediates (phenylenediamine), which form hair dyes on chemical reaction, and preformed dyes (2-nitro-p-phenylenediamine), which already are dyes and are added to achieve the intended shades, in an aqueous, ammoniacal vehicle containing soap, detergents and conditioning agents, and (2) a solution of hydrogen peroxide, usually 6%, in water or a cream lotion.

Mechanism of action

• Elemental and methylmercury—CNS toxicity. Methylmercury is teratogenic • Inorganic mercury—nephrotoxic • MOA—mercury reacts with sulfhydryl (SH) groups, resulting in enzyme inhibition and pathologic alteration of cellular membranes.

Lead Mechanism of action

• Enzyme inhibition via sulfhydryl group binding • Interacts with essential cations such as calcium, zinc and iron • Alterations in heme synthesis

Cadmium Mechanism of toxicity

• Enzyme inhibitor; high affinity for sulfhydryl groups • Inhibits plasma membrane calcium channels and Ca++-ATPases • Inhibits repair of DNA • Inhibits oxidative phosphorylation • Detoxified by metallothionein Metallothionein is a low-molecular-weight metal binding protein that probably functions in the homeostatic regulation of essential metals such as zinc and copper. However, non-essential heavy metals like cadmium can displace zinc from the protein. The cadmium protein complex is not biologically active and cadmium is therefore detoxified. Metallothionein can be synthesized in large amounts in the liver and to a lesser degree in other organs.

Plastics

• Ethylene - asphyxiant • Vinyl chloride - potent liver carcinogen • Polyurethane • Toluene diisocyanate-asthma • Urea formaldehyde-irritant, asthma • Phthalate esters-blood disorders (increase blood clotting - thrombus, embolism), endocrine disruptor? Phthalate esters, used in plastics, are found in trace amounts just about everywhere in the environment. A controversial issue surrounding phthalate esters is the link to disruption of the endocrine system in wildlife and humans. Compounds that mimic estrogen have been implicated in a variety of effects including breast cancer and reproductive abnormalities. However, there is little scientific evidence that these compound pose a threat to humans at the low concentrations found in the environment.

Cadmium

• Exposure common during the mining and smelting of zinc, copper and lead • Metallic form used in electroplating • Metallic salts used as pigments and stabilizers in plastics • Alloys used in soldering, welding and batteries •mainly found in the earth's crust • always occurs in combination with zinc • also consists in the industries as an inevitable by-product of zinc, lead and copper extraction. After being applied it enters the environment mainly through the ground, because it is found in manures and pesticides.

Color additives

• FD&C Yellow No. 5 (tartrazine) • Color found widely in beverages, desserts, drugs, cosmetics, etc. • May cause itching or hives (hypersensitivity) • FD&C Red No. 3 • Foods and oral medications • Small cancer risk (1/100,000 over 70-yr life) have had a long history in human culture. Cosmetic colors date back to 5,000 BC. Color additives surround us - in soaps, shampoos, shaving creams, toothpaste, deodorant, contact lenses, lipstick, juice, cereal, coffee creamers, vitamins, and of course, candy.

Target organ effects of lead

• General—fatigue, malaise, irritability, anorexia, hypertension • GI—abdominal pain, nausea, constipation, diarrhea • CNS—impaired concentration, headache, diminished visual-motor coordination. Encephalopathy (hyperirritability, ataxia, delirium, convulsions and coma • Chronic exposure in children—decreased intelligence, growth, neurobehavioral development • Peripheral motor neuropathy—severe extensor muscle weakness (wrist drop) • Hematologic-anemia • Nephrotoxic—reversible tubule damage, chronic interstitial fibrosis • Reproduction—decreased sperm counts, increased rate of miscarriage

Toilet bowl cleaners

• Hydrochloric acid - highly corrosive to skin and eyes • Hypochlorite bleach - corrosive, irritates or burns eyes, skin and respiratory tract. May cause pulmonary edema, vomiting or coma if ingested • Contact with other chemicals may cause chlorine fumes - fatal

Aniline

• Important organic base; parent compound for more than 300 chemical products • Bioactivated by CytP450 • Acute toxicity - methemoglobinemia prevents ability of RBC to carry oxygen • Probable human carcinogen -Aniline will cause Methemoglobinemia

Air Freshener

• Interfere with your ability to smell by coating your nasal passages with an oil film or by releasing a nerve deadening agent • Formaldehyde - known carcinogen • Phenol - highly caustic to tissues; can cause damage to CNS, heart, liver, kidneys

Naphthylamines

• Known to cause bladder cancer; banned from the workplace • Metabolized and conjugated in liver; subjected to acid hydrolysis and converted into an electrophile in bladder -2-naphthylamines is no longer used to manufacture dyes because it has been shown to cause bladder cancer.

Uses of lead

• Lead storage batteries • Used in production of pipes, brass, steel, ceramics, glass, corrosive- resistant industrial paints • Removed from gasoline, house paints and most food containers • Older houses (built before 1950) -exposure risk

Specific effects of Solvents

• Liver - fatty liver, necrosis, cirrhosis, cancer - Many liver lesions are induced by reactive metabolites - Active metabolite of carbon tetrachloride is trichloromethyl radical • Kidneys-proximal tubule damage • Hematopoietic system- benzene causes aplastic anemia (depresses bone marrow) and leukemia • Carcinogenesis -Some solvents will undergo bioactivation by the cytchrome P-450 system. One example is carbon tetrachloride that is metabolized to a highly reactive free radical. This metabolite will destroy cell membranes and can cause fatty liver and/or cell death. -Ethylene glycol, the active ingredient in antifreeze, is metabolized to a compound that precipitates out in the kidney tubules and causes damage.

Antibacterial cleaners

• May contain triclosan • May promote resistant bacteria • Interferes with an enzyme crucial to the growth of bacteria; but also trips a genetic master switch called the multiple antibiotic resistance (mar) operon. This activates a pump in cell wall that expels unwanted chemicals (antibiotics)

Neuronopathies

• Methylmercury - Clinical symptoms - sensory and visual disturbances and cerebrellular ataxia - MOA = decrease in glycolysis, nucleic acid and protein synthesis - Injured neurons die; results in a diffuse encephalopathy - Dementia - Children - profound mental retardation and paralysis

Pesticides

• Most pesticides have ingredients that affect CNS • Diazinon • Organophosphates • Pyrethroids - Most pesticides have ingredients that affect the nervous system of insects. They also have similar effects in humans.

Mercury

• Naturally occurring element mined as cinnabar ore (HgS) • Three primary forms-elemental (Hg°), inorganic (salts, HgCl2) and organic (methyl, CH3Hg) • Industrial uses—manufacture of chlorine and caustic soda, electrical equipment, thermometers, dental amalgams, paints • total mass of mercury on the earth is not increased or decreased by human activity •

Minamata Bay Poisoning

• Neurotoxin -necrosis of neurons • Cats - paroxysmal fits (convulsions, circular running) "cat-dancing" disease • Hunter-Russell syndrome - Ataxia (inability to coordinate voluntary muscular movements that is symptomatic of some nervous disorders) - Impairment of speech - constriction of visual field - impairment of hearing - sensory disturbances - paresthesia (sensation of pricking, tingling, or creeping on the skin. This is the most sensitive effect of mercury poisoning) - Dementia •Prenatal - fetuses at risk due to impairment of developing nervous system - severe cerebral palsy - gross motor and mental impairment - blindness and deafness - Teratogenicity (birth defects)

Nicotine

• Nicotine, one of more than 4,000 chemicals found in tobacco smoke, is the primary component that acts on the brain • Smoking is the most prevalent form of nicotine addiction in the US • Average cigarette contains 10 mg of nicotine • Average smoker inhales more than 1-2 mg • Nicotine reaches the brain within 10 seconds by inhalation; slower with smokeless tobacco

Carpet and upholstery shampoo

• Perchlorethylene - known carcinogen; damages liver, kidney, CNS • Ammonium hydroxide - corrosive, extremely irritable to eyes, skin and respiratory passages - can be used safely but misuse or accidental ingestion can cause severe toxicity

Car wash and polish

• Petroleum distillates • Associated with skin and lung cancer, irritant to skin, eyes, nose and lungs • Entry into lungs may cause fatal pulmonary edema

Side stream smoke

• Side-stream smoke contains more harmful ingredients than mainstream smoke • Twice as much tar and nicotine and 4x as much carbon monoxide • 70% of healthy nonsmokers exposed to smoke suffered from eye irritation; nasal symptoms, headache, cough, sore throat -Exposure to smoke is likely to be harmful to people already suffering chronic lung and heart disease • Children had higher heart rates and blood pressure • Illnesses affecting breathing (bronchitis, asthma) occurred more often in children with parents who smoked

Coronary heart disease

• Smoking increases risk of stroke, heart attack, vascular disease and aneurysm • Estimated that nearly one-fifth of deaths from heart disease are attributable to smoking

Mold and mildew cleaners

• Sodium hypochlorite, formaldehyde

Laundry room products

• Sodium or calcium hypocrite - corrosive • Linear alkylate sulfonate - absorbed through skin, known liver toxicant • Sodium tripolyphosphate - irritates skin and mucous membranes

Impact of Smoking

• Tobacco kills more than 430,000 US citizens each year • Leading preventable cause of death • Estimated $80 billion of total US health care cost each year is attributable to smoking • Indirect - fires,perinatal care, secondhand smoke • Total of direct and indirect are estimated at $138 billion

IH's typical Generalist Expertise

• Toxicology • Chemistry • Biology • Geology • Microbiology • Physics • Engineering • Safety • Nursing - The knowledge in these areas may be a result of on-the-job training, attending continuing education classes, attending industrial hygiene or safety meetings and seminars, or by self-study program

solvents

• Used extensively in paints, inks, thinners, adhesives, pharmaceuticals, cosmetics, dry-cleaning, degreasing • Potential exposures - industrial workers, consumers (household products), environmental contamination - many compounds are used as solvents -Since solvents are heavily used in a variety of industrial applications, there is a high potential for exposure to humans and the environment.

Chromium

• Uses: pigments, electroplating, catalysts, wood preservative • Toxicity mainly involves hexavalent VI - Easily absorbed and forms complexes with proteins. - Acute renal tubular necrosis - Skin ulcers - Bronchial asthma and pulmonary congestion - Human carcinogen (lung cancer)

Blood levels

• Whole blood level most useful indicator • Normal population--<10 μg/dL • Subtle decreases in intelligence and impaired neurobehavioral development in children— 10 to 25 μg/dL • Headache, irritability, difficulty in concentrating, anemia—25 to 60 μg/dL • GI symptoms—60-80 μg/dL • Nephropathy80 μg/dL • Encephalopathy and neuropathy100 μg/dL

Cosmetics and household chemicals

• involved in home poisonings. In many households, they are often kept within the easy reach of children. In addition, some cleaning products look like food. Compare jars of Comet Cleanser and Kraft Parmesan Cheese. Other cleaning products, such as lemon oil furniture polish, smell like food. •

Cosmetics

•Diethanolamine and cosmetic products • Association between topical application of DEA and cancer in lab animals; not link to cancer in humans • DEA-related products used as emulsifiers and foaming agents • Products containing DEA; cocamide DEA, Lauramide DEA, Oleamide DEA, TEA-Lauryl sulfate, triethanolamine

Cosmetics

•Perfumes • Contain alcohols - GI irritation and CNS depression • Nail polish removers • Acetonitrile - breaks down to cyanide when ingested • Fatal poisonings in children reported • Acetone - GI irritation, narcosis, liver and kidney damage Many of the products in the next slides can be used safely. However, they may become a problem if available to small children.

Shampoos

•Shampoos are anionic detergents; salts of fatty acids • Generally toxicities are low; GI upset common • Conditioners are cationic detergents • Can block neurotransmitters at high oral doses and cause neurotoxicity

Bleach

•Sodium hypochlorite • A strong corrosive. • Will irritate or burn skin, eyes, and respiratory tract. • May cause pulmonary edema and coma if ingested three most dangerous cleaning products in the average home are probably drain cleaners, oven cleaners and acid-based toilet bowl cleaners. The next few slides will highlight several of these chemicals.

Arsenic poisoning

•easy to diagnose and treat— if you think of it • Exposure to inorganic arsenics can cause various health effects, such as irritation of the stomach and intestines, decreased production of red and white blood cells, skin changes and lung irritation. •It is suggested that the uptake of significant amounts of inorganic arsenic can intensify the chances of cancer development, especially the chances of development of skin cancer, lung cancer, liver cancer and lymphatic cancer. •very high exposure to inorganic arsenic can cause infertility and miscarriages with women, and it can cause skin disturbances, declined resistance to infections, heart disruptions and brain damage with both men and women and can damage DNA •Organic arsenics can cause neither cancer, nor DNA damage. But exposure to high doses may cause certain effects to human health, such as nerve injury and stomach aches.