Is potroom asthma due more to sulphur dioxide than fluoride? An inception cohort study in the Australian aluminium industry

Abramson, Michael J.; Benke, Geza; Cui, James JiSheng; Klerk, Nicholas de; Monaco, Anthony Del; Dennekamp, Martine; Fritschi, Lin; Musk, Arthur W.; Sim, Malcolm Ross

doi:10.1136/oem.2009.046458

Cited by 26 publications

(16 citation statements)

References 28 publications

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“…The frequent use of bleach (hypochlorite), ammonia, and degreasing sprays has been consistently associated with asthma among workers exposed to cleaning agents (42,44,48), although the precise chemical exposures and the mechanisms responsible for the increased incidence of asthma have not been clarified since cleaning materials typically contain a wide variety of ingredients, some of which are respiratory irritants, while others are potential airway sensitizers (Table 6). Other occupations associated with increased risk of asthma that cannot be readily or completely explained on the basis of a clear sensitizing exposure are presented in Table 6 (47,(49)(50)(51)(52)(53)(54)(55)(56).…”

Section: Epidemiological Evidence For Irritant-induced Asthmamentioning

confidence: 99%

EAACI position paper: irritant‐induced asthma

Vandenplas

Wiszniewska

Raulf

et al. 2014

Allergy

129

108

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The term irritant-induced (occupational) asthma (IIA) has been used to denote various clinical forms of asthma related to irritant exposure at work. The causal relationship between irritant exposure(s) and the development of asthma can be substantiated by the temporal association between the onset of asthma symptoms and a single or multiple high-level exposure(s) to irritants, whereas this relationship can only be inferred from epidemiological data for workers chronically exposed to moderate levels of irritants. Accordingly, the following clinical phenotypes should be distinguished within the wide spectrum of irritant-related asthma: (i) definite IIA, that is acute-onset IIA characterized by the rapid onset of asthma within a few hours after a single exposure to very high levels of irritant substances; (ii) probable IIA, that is asthma that develops in workers with multiple symptomatic high-level exposures to irritants; and (iii) possible IIA, that is asthma occurring with a delayed-onset after chronic exposure to moderate levels of irritants. This document prepared by a panel of experts summarizes our current knowledge on the diagnostic approach, epidemiology, pathophysiology, and management of the various phenotypes of IIA.Abbreviations IIA, irritant-induced asthma; NSBH, nonspecific bronchial hyperresponsiveness; OA, occupational asthma; RADS, reactive airways dysfunction syndrome; TRP, transient receptor potential.

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Section: Epidemiological Evidence For Irritant-induced Asthmamentioning

confidence: 99%

EAACI position paper: irritant‐induced asthma

Vandenplas

Wiszniewska

Raulf

et al. 2014

Allergy

129

108

View full text Add to dashboard Cite

show abstract

“…One US study did document an excess asthma incidence14 and found an association with gaseous fluoride. On the contrary, a recent Australian study15 found a stronger association with sulfur dioxide exposure. By far, the largest study ever undertaken of pulmonary health in the primary aluminum industry (personal communication; Richard Martin; Quebec smelter studies of 1982 and 1995–1998) involved more than 5000 Quebec smelter workers.…”

Section: Methodsmentioning

confidence: 76%

“…In aboriginal children living near an aluminum smelter in upstate New York, respiratory obstruction was associated with increased urinary fluoride 38. The previously mentioned study by Abramson et al15 on pot-room asthma may shed some light on the relative importance of fluoride versus SO 2 on respiratory impact in the communities neighboring smelters. Median fluoride levels in the Årdal region over a 30-day period were 1.6 μg/m 3 with a 10th percentile of 0.08 μg/m 3 and 90th percentile of 2.8 μg/m 3 .…”

Section: Methodsmentioning

confidence: 88%

Community Health Risk Assessment of Primary Aluminum Smelter Emissions

Martin

Larivière

2014

Journal of Occupational &Amp; Environmental Medicine

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Objective:Primary aluminum production is an industrial process with high potential health risk for workers. We consider in this article how to assess community health risks associated with primary aluminum smelter emissions.Methods:We reviewed the literature on health effects, community exposure data, and dose–response relationships of the principal hazardous agents emitted.Results:On the basis of representative measured community exposure levels, we were able to make rough estimates on health risks associated with specific agents and categorize these as none, low, medium, or high.Conclusions:It is possible to undertake a rough-estimate community Health Risk Assessment for individual smelters on the basis of information available in the epidemiological literature and local community exposure data.

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“…In two Australian aluminum smelters, an inception cohort study was conducted where 446 employees (77% of eligible workforce) participated over a period of 9 years 32. Cumulative exposures between interviews were estimated from job histories by using a site-specific task exposure matrix based on routine air monitoring for the following airborne contaminants: fluorides, SO 2 , coal tar pitch volatiles (as benzene-soluble fraction), oil mist, and inhalable dust.…”

Section: Methodsmentioning

confidence: 99%

“…Repeated measurements of bronchial responsiveness have shown that the level of bronchial responsiveness is associated with the level of exposure to irritants as well as blood fluorides 31,32…”

Section: Methodsmentioning

confidence: 99%

Respiratory Disorders in Aluminum Smelter Workers

Kongerud

Søyseth

2014

Journal of Occupational &Amp; Environmental Medicine

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Objectives:Summarizing the knowledge status, including the morphology, possible etiological factors, and clinical expression of aluminum potroom asthma and chronic obstructive pulmonary disease related to aluminum potroom exposure.Methods:A review of the literature from the last two decades as it appears in PubMed.Results:There is substantial evidence for the existence of potroom asthma, although the incidence seems to decline over the last 10 years. Increased mortality from chronic obstructive pulmonary disease and longitudinal decline in forced expiratory volume in the first second of expiration has been shown in aluminum potroom workers. Morphological manifestations in bronchial biopsies and the inflammatory markers NO and eosinophils in airway tissue and blood are consistent with asthma in general. The causative agent(s) is (are) not known.Conclusions:Reduction of exposure and cessation of smoking seem to be the major preventive measures to avoid respiratory disorders in the aluminum industry.

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Is potroom asthma due more to sulphur dioxide than fluoride? An inception cohort study in the Australian aluminium industry

Abstract: The observed effects were detected at contaminant levels within occupational exposure standards, so further reductions are required, particularly in SO(2) exposures.

Cited by 26 publications

References 28 publications

EAACI position paper: irritant‐induced asthma

EAACI position paper: irritant‐induced asthma

Community Health Risk Assessment of Primary Aluminum Smelter Emissions

Respiratory Disorders in Aluminum Smelter Workers

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