scholarly journals Occupational Exposures to Organic Dust in Irish Bakeries and a Pizzeria Restaurant

2020 ◽  
Vol 8 (1) ◽  
pp. 118 ◽  
Author(s):  
Carla Viegas ◽  
Gerard T. A. Fleming ◽  
Abdul Kadir ◽  
Beatriz Almeida ◽  
Liliana Aranha Caetano ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Microbial Contamination ◽  
Geometric Mean ◽  
Occupational Exposures ◽  
Azole Resistance ◽  
Resistance Screening ◽  
Settled Dust ◽  
Inhalable Dust ◽  
Flour Dust

For decades, occupational exposure to flour dust has been linked to a range of respiratory diseases, including occupational asthma, thought to result from exposure to fungi present in the flour. Antifungal resistance is of increasing prevalence in clinical settings, and the role of occupational and environmental exposures, particularly for specific fungal species, is of concern. Occupational exposure to flour dust can occur in a range of occupational settings, however, few studies have focused on restaurant workers. The objective of this study was to measure occupational exposure to flour and microbial contamination, including azole resistance screening, in two small commercial bakeries and in a pizzeria. Personal full shift inhalable dust measurements were collected from workers, and were analyzed for inhalable dust and fungi, bacteria, azole resistance, and mycotoxins. Samples of settled dust were collected, and electrostatic dust cloths (EDC) were deployed and analyzed for microbial contamination, including azole resistance screening, and mycotoxins. Geometric mean exposures of 6.5 mg m−3 were calculated for inhalable dust, however, exposures of up to 18.30 mg m−3 were measured—70% of personal exposure measurements exceeded the occupational exposure limit for flour dust of 1.0 mg m−3. The air and EDC fungal counts were similar to those reported in previous studies for similar occupational environments. The fungi were dominated by Penicillium genera, however Aspergillus genera, including Fumigati and Flavi sections, were observed using culture-based methods, and the Fumigati section was also observed by molecular tools. Both Aspergillus sections were identified on the azole resistance screening. Mycotoxins were also detected in the settled dust samples, dominated by deoxynivalenol (DON). The role of environmental exposure in both the development of antimicrobial resistance and the total mycotoxin body burden is a growing concern; therefore, the presence of azole-resistant fungi and mycotoxin contamination, although low in magnitude, is of concern and warrants further investigation.

scholarly journals The Emerging Terbinafine-Resistant Trichophyton Epidemic: What Is the Role of Antifungal Susceptibility Testing?

Dermatology ◽  
2021 ◽  
pp. 1-20
Author(s):  
Julia J. Shen ◽  
Maiken C. Arendrup ◽  
Shyam Verma ◽  
Ditte Marie L. Saunte
Keyword(s):  
Gene Mutation ◽  
Susceptibility Testing ◽  
Geometric Mean ◽  
Antifungal Susceptibility ◽  
Antifungal Susceptibility Testing ◽  
Squalene Epoxidase ◽  
Exclusion Criteria ◽  
Huge Variation

<b><i>Background:</i></b> Dermatophytosis is commonly encountered in the dermatological clinics. The main aetiological agents in dermatophytosis of skin and nails in humans are <i>Trichophyton</i> (<i>T</i>.) <i>rubrum</i>, <i>T. mentagrophytes</i> and <i>T. interdigitale</i> (former <i>T. mentagrophytes-</i>complex). Terbinafine therapy is usually effective in eradicating infections due to these species by inhibiting their squalene epoxidase (SQLE) enzyme, but increasing numbers of clinically resistant cases and mutations in the SQLE gene have been documented recently. Resistance to antimycotics is phenotypically determined by antifungal susceptibility testing (AFST). However, AFST is not routinely performed for dermatophytes and no breakpoints classifying isolates as susceptible or resistant are available, making it difficult to interpret the clinical impact of a minimal inhibitory concentration (MIC). <b><i>Summary:</i></b> PubMed was systematically searched for terbinafine susceptibility testing of dermatophytes on October 20, 2020, by two individual researchers. The inclusion criteria were <i>in vitro</i> terbinafine susceptibility testing of <i>Trichophyton (T.) rubrum</i>, <i>T. mentagrophytes</i> and <i>T. interdigitale</i> with the broth microdilution technique. The exclusion criteria were non-English written papers. Outcomes were reported as MIC range, geometric mean, modal MIC and MIC<sub>50</sub> and MIC<sub>90</sub> in which 50 or 90% of isolates were inhibited, respectively. The reported MICs ranged from &#x3c;0.001 to &#x3e;64 mg/L. The huge variation in MIC is partly explained by the heterogeneity of the <i>Trichophyton</i> isolates, where some originated from routine specimens (wild types) whereas others came from non-responding patients with a known SQLE gene mutation. Another reason for the great variation in MIC is the use of different AFST methods where MIC values are not directly comparable. High MICs were reported particularly in isolates with SQLE gene mutation. The following SQLE alterations were reported: F397L, L393F, L393S, H440Y, F393I, F393V, F415I, F415S, F415V, S443P, A448T, L335F/A448T, S395P/A448T, L393S/A448T, Q408L/A448T, F397L/A448T, I121M/V237I and H440Y/F484Y in terbinafine-resistant isolates.

Do regulations protect workers from occupational exposures to carcinogenic, mutagenic and reprotoxic (CMR) agents in France?

2017 ◽  
Vol 75 (5) ◽  
pp. 389-397
Author(s):  
Nathalie Havet ◽  
Alexis Penot ◽  
Morgane Plantier ◽  
Barbara Charbotel ◽  
Magali Morelle ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Occupational Exposures ◽  
International Agency ◽  
The European Union ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Protection Measures ◽  
Limit Value ◽  
Logistic Regressions ◽  
The Impact

ObjectiveThis article explores the impact of regulations on the implementation of collective protections in France to occupational exposure to carcinogenic, mutagenic and reprotoxic (CMR) agents.MethodsIndividual data from the French national cross-sectional survey of occupational hazards conducted in 2010 were analysed. We investigated whether stricter regulations and longer exposures were associated with higher level of collective protection using multivariate logistic regressions.ResultsGeneral ventilation, for which effect is limited as collective protection for CMR products, was present in 19% of situations involving CMR agents while isolation chambers, the most effective form of protection, were only very rarely implemented. Multilevel logistic regressions show that exposure situations to products classified as category 1 or 2 by the European Union do not have a higher probability of benefiting from a collective protection measures. Exposures to products with a Binding Occupational Exposure Limit Value selectively benefited from a better level of protection. Exposures to agents entered on the International Agency for Research on Cancer (IARC) list of proven or probable carcinogens benefited more from effective collective protections than products suspected to be carcinogens but not yet classified by IARC.ConclusionsThese results suggest that the dissemination of evaluations of carcinogens by the IARC translate into improved protective measures even though the IARC classification has no mandatory impact on regulations.

scholarly journals Occupational Exposure to Varicella Zoster in a Tertiary-Care Healthcare Setting

2020 ◽  
Vol 41 (S1) ◽  
pp. s333-s334
Author(s):  
Zachary Yetmar ◽  
Debra Apenhorst ◽  
Priya Sampathkumar ◽  
Elena Beam
Keyword(s):  
Occupational Exposure ◽  
Varicella Zoster Virus ◽  
Tertiary Care ◽  
Occupational Exposures ◽  
Inpatient Setting ◽  
Solid Organ ◽  
Immunocompromised Patients ◽  
Varicella Zoster ◽  
Delayed Initiation ◽  
Immunosuppressed Patients

Background: Disseminated varicella zoster virus (dVZV) infection is a feared complication of varicella zoster virus (VZV) reactivation in immunocompromised patients. The CDC recommends contact and airborne precautions for localized VZV in immunocompromised patients until dissemination has been ruled out. Pre-emptive isolation can be problematic for medical centers without access to negative-pressure rooms. When we identify a case of dVZV at our facility, we perform an investigation to identify occupational exposures. Methods: We conducted a retrospective, descriptive review of occupational exposure investigations related to dVZV from January 2016 to December 2018. We collected baseline characteristics of the dVZV patient, and we evaluated whether the exposure occurred due to a delay in diagnosis or a progression from “localized” to disseminated VZV disease. Results: We identified 21 immunosuppressed patients with dVZV whose infection resulted in an occupational exposure during the specified study period. Average age was 58.6 years, with 10 males and 12 females. The immunocompromised patients included 11 with hematologic malignancy, 5 with solid-organ malignancy, 3 with rheumatologic disease on immunosuppressive therapy, and 2 with a solid-organ transplant. Most of the exposures (72.7%) occurred in an inpatient setting. The exposures resulted from either delayed recognition of dVZV or delayed initiation of appropriate precautions for all of the immunosuppressed patients. Two additional exposures occurred as a result of a change from “localized” to “disseminated” VZV. These patients whose diagnosis changed from localized to dVZV were considered previously immunocompetent, and dissemination took place 2 days after seeking healthcare evaluation. Conclusions: Most occupational exposures to varicella zoster are the result of delayed initiation of appropriate isolation precautions due to delayed diagnosis of dVZV infection or failure to recognize the need for instituting precautions in disseminated disease. Instituting preemptive airborne precautions for immunocompromised patients with localized varicella zoster would be unlikely to reduce occupational exposures.Funding: NoneDisclosures: Consulting fee- Merck Priya Sampathkumar

scholarly journals Magnitude of Voriconazole Resistance in Clinical and Environmental Isolates of Aspergillus flavus and Investigation into the Role of Multidrug Efflux Pumps

2018 ◽  
Vol 62 (11) ◽  
Author(s):  
Raees A. Paul ◽  
Shivaprakash M. Rudramurthy ◽  
Manpreet Dhaliwal ◽  
Pankaj Singh ◽  
Anup K. Ghosh ◽  
...  
Keyword(s):  
Aspergillus Flavus ◽  
Efflux Pump ◽  
Efflux Pumps ◽  
Azole Resistance ◽  
Wild Type ◽  
Multidrug Efflux ◽  
Environmental Isolates ◽  
Content Type ◽  
Multidrug Efflux Pumps

ABSTRACT The magnitude of azole resistance in Aspergillus flavus and its underlying mechanism is obscure. We evaluated the frequency of azole resistance in a collection of clinical (n = 121) and environmental isolates (n = 68) of A. flavus by the broth microdilution method. Six (5%) clinical isolates displayed voriconazole MIC greater than the epidemiological cutoff value. Two of these isolates with non-wild-type MIC were isolated from same patient and were genetically distinct, which was confirmed by amplified fragment length polymorphism analysis. Mutations associated with azole resistance were not present in the lanosterol 14-α demethylase coding genes (cyp51A, cyp51B, and cyp51C). Basal and voriconazole-induced expression of cyp51A homologs and various efflux pump genes was analyzed in three each of non-wild-type and wild-type isolates. All of the efflux pump genes screened showed low basal expression irrespective of the azole susceptibility of the isolate. However, the non-wild-type isolates demonstrated heterogeneous overexpression of many efflux pumps and the target enzyme coding genes in response to induction with voriconazole (1 μg/ml). The most distinctive observation was approximately 8- to 9-fold voriconazole-induced overexpression of an ortholog of the Candida albicans ATP binding cassette (ABC) multidrug efflux transporter, Cdr1, in two non-wild-type isolates compared to those in the reference strain A. flavus ATCC 204304 and other wild-type strains. Although the dominant marker of azole resistance in A. flavus is still elusive, the current study proposes the possible role of multidrug efflux pumps, especially that of Cdr1B overexpression, in contributing azole resistance in A. flavus.

scholarly journals Bladder cancer and occupational exposure to metalworking fluid mist: a counter-matched case–control study in French steel-producing factories

2018 ◽  
Vol 75 (5) ◽  
pp. 328-336 ◽  
Author(s):  
Régis Colin ◽  
Michel Grzebyk ◽  
Pascal Wild ◽  
Guy Hédelin ◽  
Ève Bourgkard
Keyword(s):  
Bladder Cancer ◽  
Occupational Exposure ◽  
Case Control Study ◽  
Occupational Exposures ◽  
Case Control ◽  
Metalworking Fluids ◽  
Cumulative Exposure ◽  
Cancer Case ◽  
Increased Risk ◽  
Control Study

ObjectivesTo assess the relationship between occupational exposure to metalworking fluids (MWFs) in the steel-producing industry and bladder cancer incidence.MethodsA nested case–control study on bladder cancer was set up in a cohort of workers from six French steel-producing factories. Three controls were randomly selected for each incident bladder cancer case diagnosed from 2006 to 2012. Controls were matched to cases on age at diagnosis and counter-matched on a surrogate measure of exposure to MWFs derived from a job-exposure matrix. Cases (n=84) and controls (n=251) were face-to-face interviewed. Experts assessed occupational exposure to MWFs (straight, soluble and synthetic) using questionnaires and reports from factory visits. Occupational exposures were based on three metrics: duration, frequency-weighted duration and cumulative exposure index. Conditional multiple logistic regressions were used to determine ORs and 95% CIs, taking non-occupational and occupational exposure into account.ResultsIn the 25 years before diagnosis, ORs increased significantly with duration of exposure to straight MWFs (OR=1.13 (1.02–1.25)) and increased with frequency-weighted duration of exposure to straight MWFs (OR=1.44 (0.97–2.14)). These results remained valid after adjusting for duration of smoking, average number of cigarettes smoked per day, time since smoking cessation and exposure to polycyclic aromatic hydrocarbons (PAHs). ORs also increased with soluble MWFs but not significantly. No significant association was found with older exposures to MWFs or with exposure to synthetic MWFs.ConclusionThe increased risk of bladder cancer observed among workers exposed to straight MWFs and to a lesser extent to soluble MWFs may be explained by the presence of carcinogens (such as PAH) in mineral oils component of straight and soluble oils. Prevention therefore remains necessary in sectors using MWFs.

Insights in the molecular mechanisms of an azole stress adapted laboratory-generated Aspergillus fumigatus strain

2021 ◽  
Author(s):  
Marion Aruanno ◽  
Samantha Gozel ◽  
Isabelle Mouyna ◽  
Josie E Parker ◽  
Daniel Bachmann ◽  
...  
Keyword(s):  
Transcription Factor ◽  
Aspergillus Fumigatus ◽  
Molecular Mechanisms ◽  
Drug Transporters ◽  
Major Facilitator Superfamily ◽  
Ergosterol Biosynthesis ◽  
Azole Resistance ◽  
Drug Transporter

Abstract Aspergillus fumigatus is the main cause of invasive aspergillosis, for which azole drugs are the first-line therapy. Emergence of pan-azole resistance among A. fumigatus is concerning and has been mainly attributed to mutations in the target gene (cyp51A). However, azole resistance may also result from other mutations (hmg1, hapE) or other adaptive mechanisms. We performed microevolution experiment exposing an A. fumigatus azole-susceptible strain (Ku80) to sub-minimal inhibitory concentration of voriconazole to analyze emergence of azole resistance. We obtained a strain with pan-azole resistance (Ku80R), which was partially reversible after drug relief, and without mutations in cyp51A, hmg1, and hapE. Transcriptomic analyses revealed overexpression of the transcription factor asg1, several ATP-binding cassette (ABC) and major facilitator superfamily transporters and genes of the ergosterol biosynthesis pathway in Ku80R. Sterol analysis showed a significant decrease of the ergosterol mass under voriconazole exposure in Ku80, but not in Ku80R. However, the proportion of the sterol compounds was similar between both strains. To further assess the role of transporters, we used the ABC transporter inhibitor milbemycine oxime (MLB). MLB inhibited transporter activity in both Ku80 and Ku80R and demonstrated some potentiating effect on azole activity. Criteria for synergism were reached for MLB and posaconazole against Ku80. Finally, deletion of asg1 revealed some role of this transcription factor in controlling drug transporter expression, but had no impact on azole susceptibility. This work provides further insight in mechanisms of azole stress adaptation and suggests that drug transporters inhibition may represent a novel therapeutic target. Lay Summary A pan-azole-resistant strain was generated in vitro, in which drug transporter overexpression was a major trait. Analyses suggested a role of the transporter inhibitor milbemycin oxime in inhibiting drug transporters and potentiating azole activity.

scholarly journals O4A.6 Occupational exposure to extremely low frequency magnetic fields and melatonin in male rotating shift workers

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A33.3-A33
Author(s):  
Michelle C Turner ◽  
Esther Gracia-Lavedan ◽  
Gemma Castaño-Vinyals ◽  
Debra J Skene ◽  
Benita Middleton ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Magnetic Fields ◽  
Geometric Mean ◽  
Night Shift ◽  
Low Frequency ◽  
Personal Characteristics ◽  
Peak Time ◽  
Shift Workers ◽  
Extremely Low Frequency ◽  
Melatonin Production

BackgroundOccupational exposure to extremely low frequency magnetic fields (ELF-MF) is a suspected cancer risk factor, however, the epidemiological literature is limited and potential biological mechanisms unclear. Night shift work and associated circadian misalignment, leading to decreased melatonin production is also suspected in cancer. It has been suggested that ELF-MF exposure may decrease melatonin production leading to the promotion of cancer development, however previous findings are inconsistent. We assessed ELF-MF exposure and melatonin production in a recent study of male rotating shift workers.MethodsA total of 50 male shift workers rotating in a 3 week night, 3 week evening, and 3 week morning schedule were recruited at a local car manufacturing facility. Personal full-shift measurements of ELF-MF exposure were performed (EMDEX II, 40–800 Hz) and urine samples from all voids over 24 hour collected on two working days (end of 3 week night and end of 3 week morning shifts). Urinary concentrations of 6-sulfatoxymelatonin (aMT6s), the main melatonin metabolite, were measured in all samples (creatinine corrected), with the mesor (24 hour mean) derived based on cosinor models.ResultsArithmetic mean (AM (SD)) and geometric mean (GM (GSD)) ELF-MF levels were 0.05 (0.06) µT and 0.03 (0.02) µT, respectively. Peak production of aMT6s occurred 9 hours later in night compared with morning shifts, though with a similar mesor indicating adaptation. The adjusted mesor varied somewhat by age group and other personal characteristics, and was somewhat lower among those with higher AM and GM ELF-MF levels (i.e. ≥50 th or 75th percentile), with differences ranging from 0.94–1.38 ng/mg creatinine/hour in the morning to 0.96–4.33 in the night shift observed, with some differences significant.ConclusionsOverall, small differences in mean aMT6s levels were observed according to ELF-MF. Workers during the night shift adapted, showing a delay in the peak time of aMT6s production compared to the day shift.

scholarly journals Occupational exposure to gases/fumes and mineral dust affect DNA methylation levels of genes regulating expression

2019 ◽  
Vol 28 (15) ◽  
pp. 2477-2485 ◽  
Author(s):  
Diana A van der Plaat ◽  
Judith M Vonk ◽  
Natalie Terzikhan ◽  
Kim de Jong ◽  
Maaike de Vries ◽  
...  
Keyword(s):  
Gene Expression ◽  
Dna Methylation ◽  
Occupational Exposure ◽  
Health Effects ◽  
Mineral Dust ◽  
Occupational Exposures ◽  
Expression Levels ◽  
Adverse Health Effects ◽  
Never Smokers ◽  
Gene Expression Levels

Abstract Many workers are daily exposed to occupational agents like gases/fumes, mineral dust or biological dust, which could induce adverse health effects. Epigenetic mechanisms, such as DNA methylation, have been suggested to play a role. We therefore aimed to identify differentially methylated regions (DMRs) upon occupational exposures in never-smokers and investigated if these DMRs associated with gene expression levels. To determine the effects of occupational exposures independent of smoking, 903 never-smokers of the LifeLines cohort study were included. We performed three genome-wide methylation analyses (Illumina 450 K), one per occupational exposure being gases/fumes, mineral dust and biological dust, using robust linear regression adjusted for appropriate confounders. DMRs were identified using comb-p in Python. Results were validated in the Rotterdam Study (233 never-smokers) and methylation-expression associations were assessed using Biobank-based Integrative Omics Study data (n = 2802). Of the total 21 significant DMRs, 14 DMRs were associated with gases/fumes and 7 with mineral dust. Three of these DMRs were associated with both exposures (RPLP1 and LINC02169 (2×)) and 11 DMRs were located within transcript start sites of gene expression regulating genes. We replicated two DMRs with gases/fumes (VTRNA2-1 and GNAS) and one with mineral dust (CCDC144NL). In addition, nine gases/fumes DMRs and six mineral dust DMRs significantly associated with gene expression levels. Our data suggest that occupational exposures may induce differential methylation of gene expression regulating genes and thereby may induce adverse health effects. Given the millions of workers that are exposed daily to occupational exposures, further studies on this epigenetic mechanism and health outcomes are warranted.

scholarly journals Occupational Exposures and Neurodegenerative Diseases—A Systematic Literature Review and Meta-Analyses

2019 ◽  
Vol 16 (3) ◽  
pp. 337 ◽  
Author(s):  
Lars-Gunnar Gunnarsson ◽  
Lennart Bodin
Keyword(s):  
Alzheimer’S Disease ◽  
Parkinson’S Disease ◽  
Alzheimer's Disease ◽  
Parkinson's Disease ◽  
Occupational Exposure ◽  
Neurodegenerative Diseases ◽  
Meta Analysis ◽  
Occupational Exposures ◽  
Increased Risk ◽  
Meta Analyses

Objectives: To carry out an integrated and stratified meta-analysis on occupational exposure to electromagnetic fields (EMFs), metals and pesticides and its effects on amyotrophic lateral sclerosis (ALS) and Parkinson’s and Alzheimer’s disease, and investigate the possibility of publication bias. Methods: In the current study, we updated our recently published meta-analyses on occupational exposures in relation to ALS, Alzheimer’s and Parkinson’s disease. Based on 66 original publications of good scientific epidemiological standard, according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines, we analysed subgroups by carrying out stratified meta-analyses on publication year, statistical precision of the relative risk (RR) estimates, inspection of the funnel plots and test of bias. Results: Based on 19 studies the weighted RR for occupational exposure to EMFs was 1.26 (95% confidence interval (CI) 1.07–1.50) for ALS, 1.33 (95% CI 1.07–1.64) for Alzheimer’s disease and 1.02 (95% CI 0.83–1.26) for Parkinson’s disease. Thirty-one studies concerned occupational exposure to pesticides and the weighted RR was 1.35 (95% CI 1.02–1.79) for ALS, 1.50 (95% CI 0.98–2.29) for Alzheimer’s disease and 1.66 (95% CI 1.42–1.94) for Parkinson’s disease. Finally, 14 studies concerned occupational exposure to metals and only exposure to lead (five studies) involved an elevated risk for ALS or Parkinson’s disease and the weighted RR was 1.57 (95% CI 1.11–2.20). The weighted RR for all the non-lead exposures was 0.97 (95% CI 0.88–1.06). Conclusions: Exposure to pesticides increased the risk of getting the mentioned neurodegenerative diseases by at least 50%. Exposure to lead was only studied for ALS and Parkinson’s disease and involved 50% increased risk. Occupational exposure to EMFs seemed to involve some 10% increase in risk for ALS and Alzheimer’s disease only.

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