Last data update: Jun 24, 2024. (Total: 47078 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Boylstein R [original query] |
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Evidence for environmental-human microbiota transfer at a manufacturing facility with novel work-related respiratory disease
Wu BG , Kapoor B , Cummings KJ , Stanton ML , Nett RJ , Kreiss K , Abraham JL , Colby TV , Franko AD , Green FHY , Sanyal S , Clemente JC , Gao Z , Coffre M , Meyn P , Heguy A , Li Y , Sulaiman I , Borbet TC , Koralov SB , Tallaksen RJ , Wendland D , Bachelder VD , Boylstein RJ , Park JH , Cox-Ganser JM , Virji MA , Crawford JA , Edwards NT , Veillette M , Duchaine C , Warren K , Lundeen S , Blaser MJ , Segal LN . Am J Respir Crit Care Med 2020 202 (12) 1678-1688 INTRODUCTION: Workers' exposure to metalworking fluid (MWF) has been associated with respiratory disease. As part of a public health investigation of a manufacturing facility, we performed paired environmental and human sampling to evaluate cross-pollination of microbes between environment and host and possible effects on lung pathology present among workers. METHODS: Workplace environmental microbiota was evaluated in air and MWF samples. Human microbiota was evaluated in lung tissue samples from workers with respiratory symptoms found to have lymphocytic bronchiolitis and alveolar ductitis with B-cell follicles and emphysema, lung tissue controls, and in skin, nasal and oral samples from 302 workers from different areas of the facility. In vitro effects of MWF exposure on murine B-cells were assessed. RESULTS: Increased similarity of microbial composition was found between MWF samples and lung tissue samples of case workers compared to controls. Among workers in different locations within the facility, those that worked in machine shop area had skin, nasal and oral microbiota more closely related to the microbiota present in MWF samples. Lung samples from four index cases, and skin and nasal samples from workers in machine shop area were enriched with Pseudomonas, the dominant taxa in MWF. Exposure to used MWF stimulated murine B-cell proliferation in vitro, a hallmark cell subtype found in pathology of index cases. CONCLUSIONS: Evaluation of a manufacturing facility with a cluster of workers with respiratory disease supports cross-pollination of microbes from MWF to humans and suggests the potential for exposure to these microbes to be a health hazard. |
Work-related adverse respiratory health outcomes at a machine manufacturing facility with a cluster of bronchiolitis, alveolar ductitis and emphysema (BADE)
Cummings KJ , Stanton ML , Kreiss K , Boylstein RJ , Park JH , Cox-Ganser JM , Virji MA , Edwards NT , Segal LN , Blaser MJ , Weissman DN , Nett RJ . Occup Environ Med 2020 77 (6) 386-392 OBJECTIVES: Four machine manufacturing facility workers had a novel occupational lung disease of uncertain aetiology characterised by lymphocytic bronchiolitis, alveolar ductitis and emphysema (BADE). We aimed to evaluate current workers' respiratory health in relation to job category and relative exposure to endotoxin, which is aerosolised from in-use metalworking fluid. METHODS: We offered a questionnaire and spirometry at baseline and 3.5 year follow-up. Endotoxin exposures were quantified for 16 production and non-production job groups. Forced expiratory volume in one second (FEV1) decline >/=10% was considered excessive. We examined SMRs compared with US adults, adjusted prevalence ratios (aPRs) for health outcomes by endotoxin exposure tertiles and predictors of excessive FEV1 decline. RESULTS: Among 388 (89%) baseline participants, SMRs were elevated for wheeze (2.5 (95% CI 2.1 to 3.0)), but not obstruction (0.5 (95% CI 0.3 to 1.1)). Mean endotoxin exposures (range: 0.09-28.4 EU/m(3)) were highest for machine shop jobs. Higher exposure was associated with exertional dyspnea (aPR=2.8 (95% CI 1.4 to 5.7)), but not lung function. Of 250 (64%) follow-up participants, 11 (4%) had excessive FEV1 decline (range: 403-2074 mL); 10 worked in production. Wheeze (aPR=3.6 (95% CI 1.1 to 12.1)) and medium (1.3-7.5 EU/m(3)) endotoxin exposure (aPR=10.5 (95% CI 1.3 to 83.1)) at baseline were associated with excessive decline. One production worker with excessive decline had BADE on subsequent lung biopsy. CONCLUSIONS: Lung function loss and BADE were associated with production work. Relationships with relative endotoxin exposure indicate work-related adverse respiratory health outcomes beyond the sentinel disease cluster, including an incident BADE case. Until causative factors and effective preventive strategies for BADE are determined, exposure minimisation and medical surveillance of affected workforces are recommended. |
Severe lung disease characterized by lymphocytic bronchiolitis, alveolar ductitis, and emphysema (BADE) in industrial machine-manufacturing workers
Cummings KJ , Stanton ML , Nett RJ , Segal LN , Kreiss K , Abraham JL , Colby TV , Franko AD , Green FHY , Sanyal S , Tallaksen RJ , Wendland D , Bachelder VD , Boylstein RJ , Park JH , Cox-Ganser JM , Virji MA , Crawford JA , Green BJ , LeBouf RF , Blaser MJ , Weissman DN . Am J Ind Med 2019 62 (11) 927-937 BACKGROUND: A cluster of severe lung disease occurred at a manufacturing facility making industrial machines. We aimed to describe disease features and workplace exposures. METHODS: Clinical, functional, radiologic, and histopathologic features were characterized. Airborne concentrations of thoracic aerosol, metalworking fluid, endotoxin, metals, and volatile organic compounds were measured. Facility airflow was assessed using tracer gas. Process fluids were examined using culture, polymerase chain reaction, and 16S ribosomal RNA sequencing. RESULTS: Five previously healthy male never-smokers, ages 27 to 50, developed chest symptoms from 1995 to 2012 while working in the facility's production areas. Patients had an insidious onset of cough, wheeze, and exertional dyspnea; airflow obstruction (mean FEV1 = 44% predicted) and reduced diffusing capacity (mean = 53% predicted); and radiologic centrilobular emphysema. Lung tissue demonstrated a unique pattern of bronchiolitis and alveolar ductitis with B-cell follicles lacking germinal centers, and significant emphysema for never-smokers. All had chronic dyspnea, three had a progressive functional decline, and one underwent lung transplantation. Patients reported no unusual nonoccupational exposures. No cases were identified among nonproduction workers or in the community. Endotoxin concentrations were elevated in two air samples; otherwise, exposures were below occupational limits. Air flowed from areas where machining occurred to other production areas. Metalworking fluid primarily grew Pseudomonas pseudoalcaligenes and lacked mycobacterial DNA, but 16S analysis revealed more complex bacterial communities. CONCLUSION: This cluster indicates a previously unrecognized occupational lung disease of yet uncertain etiology that should be considered in manufacturing workers (particularly never-smokers) with airflow obstruction and centrilobular emphysema. Investigation of additional cases in other settings could clarify the cause and guide prevention. |
Fatal chlorine gas exposure at a metal recycling facility: Case report
Harvey RR , Boylstein R , McCullough J , Shumate A , Yeoman K , Bailey RL , Cummings KJ . Am J Ind Med 2018 61 (6) 538-542 At least four workers at a metal recycling facility were hospitalized and one died after exposure to chlorine gas when it was accidentally released from an intact, closed-valved cylinder being processed for scrap metal. This unintentional chlorine gas release marks at least the third such incident at a metal recycling facility in the United States since 2010. We describe the fatal case of the worker whose clinical course was consistent with acute respiratory distress syndrome (ARDS) following exposure to high concentrations of chlorine gas. This case report emphasizes the potential risk of chlorine gas exposure to metal recycling workers by accepting and processing intact, closed-valved containers. The metal recycling industry should take steps to increase awareness of this established risk to prevent future chlorine gas releases. Additionally, public health practitioners and clinicians should be aware that metal recycling workers are at risk for chlorine gas exposure. |
Elemental properties of copper slag and measured airborne exposures at a copper slag processing facility
Mugford C , Gibbs JL , Boylstein R . J Occup Environ Hyg 2017 14 (8) D120-D129 In 1974, the National Institute for Occupational Safety and Health recommended a ban on the use of abrasives containing >1% silica, giving rise to abrasive substitutes like copper slag. We present results from a National Institute for Occupational Safety and Health industrial hygiene survey at a copper slag processing facility that consisted of the collection of bulk samples for metals and silica; and full-shift area and personal air samples for dust, metals, and respirable silica. Carcinogens, suspect carcinogens, and other toxic elements were detected in all bulk samples, and area and personal air samples. Area air samples identified several areas with elevated levels of inhalable and respirable dust, and respirable silica: quality control check area (236 mg/m3 inhalable; 10.3 mg/m3 respirable; 0.430 mg/m3 silica), inside the screen house (109 mg/m3 inhalable; 13.8 mg/m3 respirable; 0.686 mg/m3 silica), under the conveyor belt leading to the screen house (19.8 mg/m3 inhalable), and inside a conveyor access shack (11.4 mg/m3 inhalable; 1.74 mg/m3 respirable; 0.067 mg/m3 silica). Overall, personal dust samples were lower than area dust samples and did not exceed published occupational exposure limits. Silica samples collected from a plant hand and a laborer exceeded the American Conference of Governmental Industrial Hygienist Threshold Limit Value of 0.025 microg/m3. All workers involved in copper slag processing (n = 5) approached or exceeded the Occupational Safety and Health Administration permissible exposure limit of 10 microg/m3 for arsenic (range: 9.12-18.0 microg/m3). Personal total dust levels were moderately correlated with personal arsenic levels (Rs = 0.70) and personal respirable dust levels were strongly correlated with respirable silica levels (Rs = 0.89). We identified multiple areas with elevated levels of dust, respirable silica, and metals that may have implications for personal exposure at other facilities if preventive measures are not taken. To our knowledge, this is the first attempt to characterize exposures associated with copper slag processing. More in-depth air monitoring and health surveillance is needed to understand occupational exposures and health outcomes in this industry. |
Elemental properties of coal slag and measured airborne exposures at two coal slag processing facilities
Mugford C , Boylstein R , Gibbs JL . J Occup Environ Hyg 2016 14 (5) 0 In 1974, the National Institute for Occupational Safety and Health recommended a ban on the use of silica sand abrasives containing >1% silica due to the risk of silicosis. This gave rise to substitutes including coal slag. An Occupational Safety and Health Administration investigation in 2010 uncovered a case cluster of suspected pneumoconiosis in four former workers at a coal slag processing facility in Illinois, possibly attributable to occupational exposure to coal slag dust. This article presents the results from a National Institute for Occupational Safety and Health industrial hygiene survey at the same coal slag processing facility and a second facility. The industrial hygiene survey consisted of the collection of: a) bulk samples of unprocessed coal slag, finished granule product, and settled dust for metals and silica; b) full-shift area air samples for dust, metals, and crystalline silica; and c) full-shift personal air samples for dust, metals, and crystalline silica. Bulk samples consisted mainly of iron, manganese, titanium, and vanadium. Some samples had detectable levels of arsenic, beryllium, cadmium, and cobalt. Unprocessed coal slags from Illinois and Kentucky contained 0.43-0.48% (4,300-4,800 mg/kg) silica. Full-shift area air samples identified elevated total dust levels in the screen (2-38 mg/m3) and bag house (21 mg/m3) areas. Full-shift area air samples identified beryllium, chromium, cobalt, copper, iron, nickel, manganese, and vanadium. Overall, personal air samples for total and respirable dust (0.1-6.6 mg/m3 total; and 0.1-0.4 mg/m3 respirable) were lower than area air samples. All full-shift personal air samples for metals and silica were below published occupational exposure limits. All bulk samples of finished product granules contained less than 1% silica, supporting the claim coal slag may present less risk for silicosis than silica sand. We note that the results presented here are solely from two coal slag processing facilities, and more in-depth air monitoring is needed to better characterize occupational exposure to coal slag dust, metals, and silica at similar facilities. |
Respiratory symptoms and lung function abnormalities related to work at a flavouring manufacturing facility
Cummings KJ , Boylstein RJ , Stanton ML , Piacitelli CA , Edwards NT , LeBouf RF , Kreiss K . Occup Environ Med 2014 71 (8) 549-54 OBJECTIVES: To better understand respiratory symptoms and lung function in flavouring manufacturing workers. METHODS: We offered a questionnaire and lung function testing to the current workforce of a flavouring manufacturing facility that had transitioned away from diacetyl and towards substitutes in recent years. We examined symptoms, spirometric parameters and diffusing capacity measurements by exposure variables, including facility tenure and time spent daily in production areas. We used linear and logistic regression to develop final models adjusted for age and smoking status. RESULTS: A total of 367 (93%) current workers participated. Shortness of breath was twice as common in those with tenure ≥7 years (OR 2.0, 95% CI 1.1 to 3.6). Other chest symptoms were associated with time spent daily in production. Participants who spent ≥1 h daily in production areas had twice the odds of any spirometric abnormality (OR 2.3; 95% CI 1.1 to 5.3) and three times the odds of low diffusing capacity (OR 2.8; 95% CI 0.9 to 9.4) than other participants. Mean spirometric parameters were significantly lower in those with tenure ≥7 years and those who spent ≥1 h daily in production. Mean diffusing capacity parameters were significantly lower in those with tenure ≥7 years. Differences in symptoms and lung function could not be explained by age, smoking status or employment at another flavouring plant. CONCLUSIONS: Symptoms and lung function findings were consistent with undiagnosed or subclinical obliterative bronchiolitis and associated with workplace exposures. Further efforts to lower exposures to flavouring chemicals, including diacetyl substitutes, are warranted. |
Identification of diacetyl substitutes at a microwave popcorn production plant
Boylstein R . J Occup Environ Hyg 2012 9 (2) D33-4 Diacetyl (2,3-butanedione) is a volatile diketone commercially synthesized and used to make butter flavoring for food production. It also is a naturally occurring product of fermentation and is found in butter, wine, and coffee. Diacetyl was first recognized as a respiratory health hazard at a microwave popcorn production plant.( Citation1 – Citation3 ) The inhalation of butter flavorings containing diacetyl can cause severe shortness of breath and cough in workers exposed during microwave popcorn manufacturing. These symptoms may result from a rare, disabling lung disease called bronchiolitis obliterans, which has caused death or the need for lung transplant in some exposed microwave popcorn workers. Bronchiolitis obliterans has also been identified in flavoring and diacetyl manufacturing workers.( Citation4 , Citation5 ) Accordingly, flavor manufacturers have started to substitute other chemicals for diacetyl in butter flavorings, including chemically similar diketones. |
Correcting diacetyl concentrations from air samples collected with NIOSH Method 2557
Cox-Ganser J , Ganser G , Saito R , Hobbs G , Boylstein R , Hendricks W , Simmons M , Eide M , Kullman G , Piacitelli C . J Occup Environ Hyg 2011 8 (2) 59-70 Diacetyl (2,3-butanedione), a diketone chemical used to impart a buttery taste in many flavoring mixtures, has been associated with bronchiolitis obliterans in several industrial settings. For workplace evaluations in 2000-2006, National Institute for Occupational Safety and Health (NIOSH) investigators used NIOSH Method 2557, a sampling and analytical method for airborne diacetyl utilizing carbon molecular sieve sorbent tubes. The method was subsequently suspected to progressively underestimate diacetyl concentrations with increasing sampling site humidity. Since underestimation of worker exposure may lead to overestimation of respiratory health risk in quantitative exposure-effect analyses, correction of the diacetyl concentrations previously reported with Method 2557 is essential. We studied the effects of humidity and sample storage duration on recovery of diacetyl from experimental air samples taken from a dynamically generated controlled test atmosphere that allowed control of diacetyl concentration, temperature, relative humidity, sampling duration, and sampling flow rate. Samples were analyzed with Method 2557, and results were compared with theoretical test atmosphere diacetyl concentration. After fitting nonlinear models to the experimental data, we found that absolute humidity, diacetyl concentration, and days of sample storage prior to extraction affected diacetyl recovery as did sampling flow rate to a much smaller extent. We derived a mathematical correction procedure to more accurately estimate historical workplace diacetyl concentration based on laboratory-reported concentrations of diacetyl using Method 2557, and sample site temperature and relative humidity (to calculate absolute humidity), as well as days of sample storage prior to extraction in the laboratory. With this correction procedure, quantitative risk assessment for diacetyl can proceed using corrected exposure levels for air samples previously collected and analyzed using NIOSH Method 2557 for airborne diacetyl. |
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