Health Care Workers Suffer Exposures to Antineoplastic Drugs

A recent study reveals that health care workers may be suffering from occupational exposure to chemotherapy drugs while treating cancer patients.

"Antineoplastic drugs are pharmaceuticals commonly used to treat cancer, which are generally referred to as 'chemotherapy'. Several studies have shown that exposure to antineoplastic drugs can cause toxic effects on reproduction as well as carcinogenic effects. Presence of these drugs in the urine of hospital personnel has been widely studied and dermal exposure has been suggested to be the main route of exposure. 

The main focus has been on handling the concentrated drug during preparation and administration of antineoplastic drugs and several approaches have been proposed on how to control those. Handling patient excreta has been considered to be potentially harmful to nurses working with cancer patients, since antineoplastic drugs are known to be present in patient excreta (e.g. urine, saliva, sweat, faeces, vomit), but this has not been studied in great detail in occupational exposure studies. 

The identification of occupational exposure to antineoplastic drugs in sectors outside the hospital environment (i.e. veterinary medicine, home care, nursing homes and industrial laundries) showed that the number of workers potentially exposed to antineoplastic drugs is larger than previously estimated. "

Click here to read the series of articles in The Annals of Occupational Hygiene

Exposure to Antineoplastic Drugs in Two UK Hospital Pharmacy Units 
H. J. Mason, S. Blair, C. Sams, K. Jones, S. J. Garfitt, M. J. Cuschieri, and P. J. Baxter 

A Pooled Analysis to Study Trends in Exposure to Antineoplastic Drugs among Nurses 
Wouter Fransman, Susan Peelen, Simone Hilhorst, Nel Roeleveld, Dick Heederik, and Hans Kromhout 

Occupational Dermal Exposure to Cyclophosphamide in Dutch Hospitals: A Pilot Study 
Wouter Fransman, Roel Vermeulen, And Hans Kromhout 

Postulating a dermal pathway for exposure to anti-neoplastic drugs among hospital workers 
Hans Kromhout, Fred Hoek, Ruud Uitterhoeve, Roel Huijbers, Roderik F. Overmars, Rob Anzion, and Roel Vermeulen 

Occupational Exposure Limits for Therapeutic Substances 
Raymond Agius 

Read more about "occupational exposures" and workers' compensation:

Workers' Compensation: OSHA Targets Occupational Exposure to ...

Jul 12, 2013

The Occupational Safety and Health Administration today announced a new National Emphasis Program to protect workers from the serious health effects from occupational exposure to isocyanates. OSHA develops national ...

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Workers' Compensation: Chemical Exposure: Devastating ...

Jun 03, 2013

Chemical exposure in the workplace can have an insidious--yet devasating--effect on a worker. In a wide-ranging article, the New York Times presented an in-depth view of chemical exposure at furniture factories in North ...

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Workers' Compensation: Occupational Safety and Health ...

Jul 19, 2013

Workers' compensation claims result from heat stress and exposure. As the Mid-West and Northeast heatwave is now soaring to records temperatures, workers should protect themselves from heat exposure. Today's post was ...

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The 6 Things You Need To Do If You Are Exposed To Mercury

Elemental mercury is a silver, odorless liquid.

Today's post comes from guest author Catherine Stanton from Pasternack Tilker Ziegler Walsh Stanton & Romano.

Irving J. Selikoff Center for Occupational & Environmental Medicine at Mount Sinai School of Medicine has released a guide to treatment for elemental mercury ((the pure form of the metal, when it is not combined with other chemicals) exposure. There are other forms of mercury, such as compounds found in contaminated fish, known as organic mercury and those are not covered by the guide.
Workers who experience a one-time sudden exposure to any chemical substance at work, should:

1. Gather as much information as you can about the type and amount of exposure, including labels, Material Safety Data Sheets (MSDS), and the medical emergency phone number on the MSDS. 
2. If you are feeling ill, seek medical attention at an emergency department (ED) immediately. It is best if a medical toxicologist is consulted as part of your visit to the ED. They can be reached for advice about treatment by having the healthcare professional contact the Poison Control Center at 1-800-222-1222. 
3. You can call the PCC independently for recommendations as well.
4. Once the urgent situation has been taken care of, you may contact the nearest occupational health clinic in the country for recommendations and follow-up.
5. This fact sheet is not a substitute for medical care. The purpose is to direct the exposed worker to the proper medical provider. 
6. Report any exposure to your employer immediately. Complete an incident or exposure form. If none is available, write a memo informing them of the exposure incident (date, time, location, what you were doing in the area, and for how long). Keep copies and insist that documents are placed in your personnel files.

You can download a copy of the fact sheet by clicking here. It contains more information about the following topics:

Exposed to "Forever Chemicals": NJ Workers' Compensation for PFAS Illness

Per and polyfluoroalkyl substances (PFAS), also known as "forever chemicals," are a growing concern in the workplace. These man-made chemicals are nearly impossible to break down and can build up in the body over time. Unfortunately, some New Jersey workers are facing serious health consequences due to PFAS exposure.

Hazards exist in the surface refinishing business

University of Iowa, College of Public health, recently reported the death of a bathtub refinishingt technician who died from the inhalation of paint stripper vapors.

In 2012, a 37-year-old female technician employed by a surface-refinishing business died from inhalation exposure to methylene chloride and methanol vapors while she used a chemical stripper to prep the surface of a bathtub for refinishing. The technician was working alone without respiratory protection or ventilation controls in a small bathroom of a rental apartment. When the technician did not pick up her children at the end of the day, her parents contacted her employer, who then called the apartment complex manager after determining the victim’s personal vehicle was still at the refinishing company’s parking lot.

The apartment complex manager went to the apartment unit where the employee had been working and called 911 upon finding the employee unresponsive, slumped over the bathtub. City Fire Department responders arrived within 4 minutes  of the 911 call. The apartment manager and first responders reported a strong chemical odor in the  second story apartment. There was an uncapped gallon can of Klean Strip Aircraft® Low Odor Paint  Remover (80-90% methylene chloride, 5-10% methanol) in the bathroom. The employee’s tools and knee pad were found in the tub, suggesting the employee had been kneeling and leaning over the tub wall to manually remove the loosened original bathtub finish coat.

The factors contributing to this lethal exposure include use of a highly concentrated methylene chloride chemical stripper having poor warning properties (“Low Odor”); working in a small room without local exhaust ventilation to remove chemical vapors or provide fresh air; and working without a respirator that could have protected the employee from exposure.

Read More about "occupational exposure"

Breast cancer risk in relation to occupations with exposure to ...

Nov 23, 2012

"Odds ratios (ORs) were increased for the usual risk factors for breast cancer and, adjusting for these, risks increased with occupational exposure to several agents, and were highest for exposures occurring before age 36 .

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The 6 Things You Need To Do If You Are Exposed To Mercury

Nov 26, 2012

"Odds ratios (ORs) were increased for the usual risk factors for breast cancer and, adjusting for these, risks increased with occupational exposure to several agents, and were highest for exposures occurring before age 36 .

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Occupational Exposure to Silica During Hydraulic Fracking

May 24, 2012

While focus has been on environmental concerns with the advent of fracking, a process to release oil and gas, a new concern has emerged over the potential occupational exposure to silica by workers who are involved in the ...

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Breast Cancer Linked to Occupational Exposures - Workers ...

May 29, 2010

"Odds ratios (ORs) were increased for the usual risk factors for breast cancer and, adjusting for these, risks increased with occupational exposure to several agents, and were highest for exposures occurring before age 36 ...

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The Compensability of a Cellphone Radiation Exposure

A pending case in California may have significant impact on potential workers’ compensation claims throughout the country. The case involves the causal relationship of radio frequency [RF] radiation emitted by cellphones and human cancer. Cohen v. Apple, Inc., et. al, Case 5:19-cv-05322 (Filed 08/23/19) USDCT-North District California - San Jose Division.

Workers’ Compensation Benefits for Occupational Exposure to Cellphone Radiation

Last week, the French government requested that Apple stop selling the iPhone 12 model because of excessive radiation detected during recent tests. The Agence National des Fréquences [ANFR] stated that “…Apple must immediately take all measures to prevent the availability on the market of the phones concerned present in the supply chain. Regarding phones already sold, Apple must take corrective measures as soon as possible to make the phones concerned compliant. Otherwise, it will be up to Apple to recall them.”

Beryllium Exposure Standard Enforcement Delayed Until May 2018

The Trump Administration has yet again delayed the implementation of a stricter standard for occupational exposure to beryllium. The new date for enforcement is May 11, 2018.

Trump Administration May Bring a Surge in Occupational Disease Claims

Mesothelioma death rates remain high in the US even on the eve of an anticipated national ban of the asbestos fiber. Things may radically change for the worse as the Trump Administration goes forward with its announced intention to dismantle environmental regulation now in place and placed on-track for enactment during the former Obama Administration. With anticipated less EPA and OSHA regulation under the Trump administration, there is the potential for a serious surge of future occupational disease claims in the United States.

Toxic Lead Exposure Results in OSHA Fines for NJ Company

Exposure to lead can cause serious medical problem in both children and adults. Strict safety precautions must be observed when working with lead.

Many initial occupational exposure claims in workers' compensation resulted from the

exposure to lead in factories. Lead pigment was used in paints for many years leading to a many serious blood disorders and neurological conditions.

The U.S. Department of Labor's Occupational Safety and Health Administration has cited Henry RAC Holding Corp. with four repeat and four serious safety and health violations, including workers exposed to lead hazards, at the company's Bayonne facility. The inspection was initiated in September 2012 after health hazards were discovered during an earlier OSHA safety inspection at the facility. Proposed penalties total $72,000.

EC Publishes Criteria to Diagnose Occupational Illness

The European Commission has published a listing of the criteria for diagnosis occupational disease. The 272 page report is available on-line. It reviews hundreds of established occupational medical conditions.

a) The clinical features must fit in with what is known about the health effects following  exposure to the specified agent. The symptoms and signs should fit, and this may be supported in some cases by suitable diagnostic tests.

b) There must be indication of sufficient occupational exposure. Evidence on exposure may be obtained through taking the occupational history, results of occupational hygiene measurements taken at the workplace, biological monitoring results, and/or records of incidents of over-exposure.

c) The time interval between exposure and effect must be consistent with what is known about the natural history and progress of the disease. Exposure must precede health effects. However, in some conditions such as occupational asthma, a past history of childhood asthma and/or asthmatic attacks occurring before occupational exposure, does notautomatically rule out the possibility of a workplace agent causing subsequent asthmatic attacks.

d) The differential diagnosis must be considered. There are non-occupational conditions that have similar clinical features as occupational diseases, and a physician will have to take this into account before diagnosing or excluding an occupational disease.


To read more about occupational exposures and workers' compensation.

Click here for more information on how Jon L Gelman can assist you in a claim for workers' Compensation claim benefits. You may e-mail Jon  Gelman or call 1-973-696-7900.

Analysis of US EPA's Draft Risk Evaluation for Formaldehyde and Worker Health

The U.S. Environmental Protection Agency's (EPA) draft risk evaluation of formaldehyde, released on March 15, 2024, raises significant concerns for worker health and worker compensation risk exposure.

NIOSH to Propose New Criteria for Diacetyl Exposure

The National Institute for Occupational Safety and Health (NIOSH) invites public comment on a draft document, "Criteria for a Recommended Standard: Occupational Exposure to Diacetyl and 2,3-pentanedione.”


For public review and comment, the draft document summarizes current scientific knowledge about the occupational safety and health implications of the food flavorings diacetyl and 2,3-pentanedione, and recommends occupational exposure limits and measures for controlling work related exposures to diacetyl and 2,3-pentanedione, based on the current state of knowledge.


The draft document is available athttp://www.cdc.gov/niosh/docket/review/docket245/default.html for written public comment until Oct. 14, 2011. NIOSH will also hold a public meeting to discuss and obtain comments on Aug. 26, 2011, in Washington D.C.


"Occupational exposure to diacetyl has been associated with severe obstructive lung disease, bronchiolitis obliterans, and decrease in lung function," said NIOSH Director John Howard, M.D. "NIOSH has provided over a decade of research and leadership in this important scientific area. In addition to the recommended exposure limits (RELs), this draft document provides for public comment a comprehensive review of scientific literature, a quantitative risk assessment, and valuable guidance to reduce occupational exposures to diacetyl and 2,3-pentanedione. We invite public comment on the draft Criteria Document to help us develop final recommendations."

The draft document includes, for comment:
For Diacetyl, a recommended exposure limit (REL) of 5 parts per billion (ppb) as an eight-hour, time-weighted average, (TWA) during a 40-hour work week. To further protect against effects of short-term exposures, NIOSH recommends in the draft document a short-term exposure limit (STEL) for diacetyl of 25 ppb for a 15-minute time period.


For 2,3-pentanedione, a recommended exposure limit (REL) of 9.3 parts per billion (ppb) as an eight-hour, time-weighted average, (TWA) during a 40-hour work week. The REL for 2,3-pentanedione in the draft document is based upon the lowest level at which the substance reliably can be detected using the existing analytical method, and should not be misconstrued to imply that 2,3-pentanedione is of lower toxicity than diacetyl. Further, NIOSH recommends a STEL of 31 ppb to limit peak exposures for 2,3-pentanedione on the same basis of analytic method limitation.

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Biden Administration Targets Occupational Exposure to PFAS

The Biden-Harris Administration announced accelerated efforts to protect American workers from per- and polyfluoroalkyl substances (PFAS), which can cause severe health problems and persist in the environment once released, posing a severe threat across rural, suburban, and urban areas. 

Employee Allowed to Sue Employer for Negligence Resulting From an Occupational Exposure

Guest Blog by John R. Boyd

A Court of Appeals in Missouri has ruled that an employee, who became ill as a result of an occupational exposure to asbestos fiber, may sue his employer for negligence. The Court ruled that the limitations on recovery of the Workers' Compensation Act did not bar a claim where an occupational exposure occurred.

On September 13, 2011, the Court of Appeals for the Western District of Missouri issued a very rare en banc opinion on a writ of prohibition allowing the employee's claim to go forward. The ill worker was exposed to asbestos, a known cancer causing agent, while working for KCP&L Greater Missouri Operations Company (KCP&L)  from 1954 to 1988 and was diagnosed with mesothelioma in 2010. Mesothelioma is a rare, but fatal, asbestos related disease.

His claims against his employer, KCP&L,  relied upon premises liability and negligence theories. The employee alleged that KCP&L had a duty to exercise "reasonable care" in preventing an "unreasonable risk of injury."   KCP&L argued that the Missouri Workers' Compensation Act was his exclusive remedy, and sought summary judgment, which was ultimately denied by the trial court.

The Appeals Court held in its 7-2 opinion, that a strict reading of the  Missouri Statutes §287.020.2 and §287.120 defeated KCP&L's argument that the claimant's occupational disease was covered by the Act, and that workers' compensation was the employee's exclusive remedy available. The Court reasoned that the 2005 amendments to the Missouri Workers' Compensation Act required a "strict construction" of the Act. 

The exposure at work was deemed not to be a specific accident, but rather a continuous occupational exposure over 34 years. The Appeals Court differentiated the occupational exposure to asbestos from a specific accident that is defined as "an unexpected traumatic event or unusual strain identifiable by time and place of occurrence and producing at the time objective symptoms of an injury caused by a specific event during a single work shift."

The Court's ruling opened the door for this worker and others who have been exposed in such a fashion to pursue a lawsuit against his or her employer directly, and not be constrained by the limited economic bounds of the Workers' Compensation Act.

This change in the law came about as a result of previous aggressive actions by business and industry to modify the Missouri Workers' Compensation Act in an to attempt to eliminate claims. The ultimate lesson to be learned is that when a pro-business Legislature deforms the law, and attempts to carve-out certain types of injuries from being compensable, they force such cases into the civil arena. Be careful what you ask for----you just might get what you deserve.

Following the Appeals Court's  ruling, an Application for Transfer to the Missouri Supreme Court was filed by counsel for the appellant's on 9/27/11. No ruling on the transfer request has been made by the Missouri Supreme Court.

State ex rel KCP&L Greater Missouri Operations Company v. Hon. Jacqueline Cook WD73642 2011 WL 4031146 (Mo.App. W.D.) (September 13, 2011)

John R. Boyd  is President of the Workers' Injury Law and Advocacy Group (WILG). He is the managing partner of Boyd & Kenter, P.C., Kansas City, MO, and is licensed to practice in Missouri, the United States Court of Appeals for the Eighth Circuit; and the United States District Court for the Western District of Missouri. He is currently a member of the Missouri Bar Association, the Kansas City Metropolitan Bar Association (Chairman of the Workers' Compensation Committee 2000-2001), the Missouri Association of Trial Attorneys (MATA), and the American Association for Justice. 

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OSHA To Focus on Infections in the Workplace

OSHA schedules meetings to
discuss occupational exposure to infectious diseases

The Occupational Safety and Health Administration has scheduled two informal stakeholder meetings to solicit comments on exposure to infectious diseases in the workplace. OSHA will use information gathered during these meetings to explore the possible development of a proposed rule to protect workers from occupational exposure to infectious agents in healthcare settings where direct patient care is provided and other settings where workers perform tasks with occupational exposure. Both meetings are scheduled for July 29 in Washington, D.C.

On May 6, 2010, OSHA published a Request for Information on Infectious Diseases. OSHA wanted to gather comments on strategies that are currently used to reduce the risk of workplace exposure to infectious agents, and to more accurately distinguish the nature and extent of occupationally-acquired infectious diseases. Based on responses received and an ongoing review of literature on this subject, OSHA is considering development of a proposed program standard to control worker exposures to infectious agents.

"We know that workers in healthcare and related facilities may be exposed to infectious agents, and they deserve to be protected," said Assistant Secretary of Labor for Occupational Safety and Health Dr. David Michaels. "Information gained from these meetings will help us determine the best approach to assure that workers don’t put themselves at risk while caring for patients and doing their job. After all, a good job is a healthy and safe job."

The two meetings will be held July 29, from 9 a.m. to noon and from 1:30 p.m. to 4:30 p.m., at the U.S. Department of Labor, 200 Constitution Ave., N.W., Room N-4437, Washington, DC 20210. To participate in one of the stakeholder meetings, or be a nonparticipating observer, individuals must submit a notice of intent electronically, by facsimile or by hard copy no later than July 22. See the Federal Register notice for details.

Meeting discussions will focus on issues including the advantages and disadvantages of using a program standard to limit occupational exposure to infectious diseases; whether and to what extent an OSHA standard should require employers to develop a written worker infection control plan that documents how employers will implement infection control measures to protect workers; and whether and to what extent OSHA should take alternative approaches to rulemaking to improve compliance with current infection control guidelines issued by the Centers for Disease Control and Prevention, the National Institutes of Health, and other authoritative agencies.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to ensure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit http://www.osha.gov.

For over 3 decades the Law Offices of Jon L. Gelman  1.973.696.7900  jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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Increased in risk of specific NHL subtypes associated with occupational exposure to TCE

Trichloroethylene

Study published linking trichloroethylene exposure to cancer.

The chemical compound trichloroethylene (C2HCl3) is a chlorinated hydrocarbon commonly used as an industrial solvent. It is a clear non-flammable liquid with a sweet smell.

"Objectives We evaluated the association between occupational exposure to trichloroethylene (TCE) and risk of non-Hodgkin lymphoma (NHL) in a pooled 

analysis of four international case-control studies.

Methods Overall, the pooled study population included 3788 NHL cases and 4279 controls. Risk of NHL and its major subtypes associated with TCE exposure was calculated with unconditional logistic regression and polytomous regression analysis, adjusting by age, gender and study.

Results Risk of follicular lymphoma (FL), but not NHL overall or other subtypes, increased by probability (p=0.02) and intensity level (p=0.04), and with the combined analysis of four exposure metrics assumed as independent (p=0.004). After restricting the analysis to the most likely exposed study subjects, risk of NHL overall, FL and chronic lymphocytic leukaemia (CLL) were elevated and increased by duration of exposure (p=0.009, p=0.04 and p=0.01, respectively) and with the combined analysis of duration, frequency and intensity of exposure (p=0.004, p=0.015 and p=0.005, respectively). Although based on small numbers of exposed, risk of all the major NHL subtypes, namely diffuse large B-cell lymphoma, FL and CLL, showed increases in risk ranging 2–3.2-fold in the highest category of exposure intensity. No significant heterogeneity in risk was detected by major NHL subtypes or by study.

Conclusions Our pooled analysis apparently supports the hypothesis of an increase in risk of specific NHL subtypes associated with occupational exposure to TCE.

Found on

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Caution Your Job May Cause Cancer

The United Nations World Health Organization (WHO) through the International Agency for Cancer Research  (IARC) has issued a new monograph causally relating cancer to certain employments. The IARC warns that doing shift work, painting or just being a firefighter will raise the risk of developing a malignancy.

IARC MONOGRAPHS PROGRAMME FINDS CANCER HAZARDS ASSOCIATED WITH SHIFTWORK, PAINTING, AND FIREFIGHTING


After a thorough review and discussion of the published scientific evidence, an expert Working Group convened by the IARC Monographs programme has concluded that


• Shiftwork that involves circadian disruption is probably carcinogenic to humans (Group 2A).


• Occupational exposure as a painter is carcinogenic to humans (Group 1).


• Occupational exposure as a firefighter is possibly carcinogenic to humans (Group 2B).


These three occupations involve complex exposure patterns that make it difficult to attribute risk to specific factors. The Working Group, comprising 24 scientists from 10 countries, met at the International Agency for Research on Cancer (IARC), the cancer research agency of the World Health Organization.


A summary of these conclusions is being published in the December issue of The Lancet Oncology. Full results will be published next year as volume 98 of the IARC Monographs.


Shiftwork that involves circadian disruption is “probably carcinogenic to humans”


Epidemiological studies have found that long-term nightworkers have a higher risk of breast cancer risk than women who do not work at night. These studies have involved mainly nurses and flight attendants. The studies are consistent with animal studies that demonstrate that constant light, dim light at night, or simulated chronic jet lag can substantially increase tumour development. Other experimental studies show that reducing melatonin levels at night increases the incidence or growth of tumours.


These results may be explained by the disruption of the circadian system that is caused by exposure to light at night. This can alter sleep-activity patterns, suppress melatonin production, and disregulate genes involved in tumour development. Among the many different patterns of shiftwork, those that include nightwork are most disruptive to the circadian system.


"Nearly 20% of the working population in Europe and North America is engaged in shiftwork, which is most prevalent in the health-care, industrial, transportation, communications, and hospitality sectors: To date, most studies have focussed on breast cancer in nurses and flight attendants. Now more studies are needed to examine this potential risk in other professions and for other cancers," noted Dr Cogliano, Head of the IARC Monographs Programme.


Occupational exposure as a painter is “carcinogenic to humans”
Epidemiological studies of painters have consistently found small but significant increases in the risk of lung cancer and bladder cancer. In addition, several studies of painters have found increased levels of genetic damage.


Four of five case-control studies found significant increases in childhood leukaemia associated with maternal exposure before or during pregnancy, although findings were inconsistent for lymphatic and haematopoietic cancers in the painters themselves.


Painters are exposed to numerous chemical solvents, pigments, and additives. They can also be exposed to other workplace hazards such as asbestos and crystalline silica. The available information is not specific enough to identify particular agents as the cause of the excess lung or bladder cancers. It also cannot be determined whether the cancer risks have increased or decreased with changes in the solvents, pigments, and additives used in paints.


Occupational exposure as a firefighter is “possibly carcinogenic to humans”


Epidemiologic studies of firefighters have noted excess cancer risks compared with the general population. Consistent patterns are difficult to discern due to the large variations in exposure across different types of fires and different groups of firefighters. Relative risks were consistently increased, however, for three types of cancer: testicular cancer, prostate cancer, and non-Hodgkin lymphoma.


Acute and chronic inflammatory respiratory effects have been noted in firefighters, and this would provide a plausible mechanism for respiratory carcinogenesis. Firefighters are exposed to numerous toxic chemicals, including many known or suspected carcinogens. These intermittent exposures can be intense, and short-term exposure levels can be high for respirable particulate matter and for several carcinogens, notably benzene, benzo[a]pyrene, 1,3-butadiene, and formaldehyde.


What is new, and what do these results mean to me?


"These are IARC’s first evaluations of shiftwork and firefighting. Because there is credible evidence linking these occupations with increased risks of cancer, it is important that further studies be conducted to better identify what it is about such occupations that may increase the risk of cancer so that preventive measures can be implemented to avoid such risks", concluded Dr Peter Boyle, Director of the International Agency for Research on Cancer.


Occupational exposure as a painter has been classified since 1989 as carcinogenic to humans, and this new evaluation has linked painting to lung cancer and bladder cancer. The new evaluation also suggests that maternal exposure may be associated with childhood leukaemia. It is important that further studies be conducted in this area to confirm whether this risk is real and to identify precautionary measures that are appropriate to consider.


ABOUT THE IARC MONOGRAPHS


What are the IARC Monographs?


The IARC Monographs identify environmental factors that can increase the risk of human cancer. These include chemicals, complex mixtures, occupational exposures, physical and biological agents, and lifestyle factors. National health agencies use this information as scientific support for their actions to prevent exposure to potential carcinogens. Interdisciplinary working groups of expert scientists review the published studies and evaluate the weight of the evidence that an agent can increase the risk of cancer. The principles, procedures, and scientific criteria that guide the evaluations are described in the Preamble to the IARC Monographs.


Since 1971, more than 900 agents have been evaluated, of which approximately 400 have been identified as carcinogenic or potentially carcinogenic to humans.


Definitions


Group 1: The agent is carcinogenic to humans.


This category is used when there is sufficient evidence of carcinogenicity in humans. Exceptionally, an agent may be placed in this category when evidence of carcinogenicity in humans is less than sufficient but there is sufficient evidence of carcinogenicity in experimental animals and strong evidence in exposed humans that the agent acts through a relevant mechanism of carcinogenicity.


Group 2.


This category includes agents for which, at one extreme, the degree of evidence of carcinogenicity in humans is almost sufficient, as well as those for which, at the other extreme, there are no human data but for which there is evidence of carcinogenicity in experimental animals. Agents are assigned to either Group 2A (probably carcinogenic to humans) or Group 2B (possibly carcinogenic to humans) on the basis of epidemiological and experimental evidence of carcinogenicity and mechanistic and other relevant data. The terms probably carcinogenic and possibly carcinogenic have no quantitative significance and are used simply as descriptors of different levels of evidence of human carcinogenicity, with probably carcinogenic signifying a higher level of evidence than possibly carcinogenic.


Group 2A: The agent is probably carcinogenic to humans.


This category is used when there is limited evidence of carcinogenicity in humans and sufficient evidence of carcinogenicity in experimental animals. In some cases, an agent may be classified in this category when there is inadequate evidence of carcinogenicity in humans and sufficient evidence of carcinogenicity in experimental animals and strong evidence that the carcinogenesis is mediated by a mechanism that also operates in humans. Exceptionally, an agent may be classified in this category solely on the basis of limited evidence of carcinogenicity in humans. An agent may be assigned to this category if it clearly belongs, based on mechanistic considerations, to a class of agents for which one or more members have been classified in Group 1 or Group 2A.


Group 2B: The agent is possibly carcinogenic to humans.


This category is used for agents for which there is limited evidence of carcinogenicity in humans and less than sufficient evidence of carcinogenicity in experimental animals. It may also be used when there is inadequate evidence of carcinogenicity in humans but there is sufficient evidence of carcinogenicity in experimental animals. In some instances, an agent for which there is inadequate evidence of carcinogenicity in humans and less than sufficient evidence of carcinogenicity in experimental animals together with supporting evidence from mechanistic and other relevant data may be placed in this group. An agent may be classified in this category solely on the basis of strong evidence from mechanistic and other relevant data.


Group 3: The agent is not classifiable as to its carcinogenicity to humans.


This category is used most commonly for agents for which the evidence of carcinogenicity is inadequate in humans and inadequate or limited in experimental animals.


Exceptionally, agents for which the evidence of carcinogenicity is inadequate in humans but sufficient in experimental animals may be placed in this category when there is strong evidence that the mechanism of carcinogenicity in experimental animals does not operate in humans.


Agents that do not fall into any other group are also placed in this category.


An evaluation in Group 3 is not a determination of non-carcinogenicity or overall safety. It often means that further research is needed, especially when exposures are widespread or the cancer data are consistent with differing interpretations.


Group 4: The agent is probably not carcinogenic to humans.


This category is used for agents for which there is evidence suggesting lack of carcinogenicity in humans and in experimental animals. In some instances, agents for which there is inadequate evidence of carcinogenicity in humans but evidence suggesting lack of carcinogenicity in experimental animals, consistently and strongly supported by a broad range of mechanistic and other relevant data, may be classified in this group.

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Pleural mesothelioma reported in a school teacher: asbestos exposure due to DAS paste

The hazardous legacy exposures of school children and art teachers to  materials containing asbestos fiber, ie. Fibro Clay, and its causal relationship to mesothelioma, has been reported in a recent medical journal. Today's post is partially shared from ncbi.nlm.nih.gov/pubmed

BACKGROUND:

Malignant mesothelioma cases among primary school teachers are usually linked with asbestos exposure due to the mineral contained in the building structure. Among the approximately 12,000 cases of mesothelioma described in the fourth report of the National Mesothelioma Register, 11 cases of primary school teachers are reported, in spite of the fact that the "catalogue of asbestos use" does not describe circumstances of asbestos exposure other than or different to that due to asbestos contained in the buildings. Four cases in the Brescia Provincial Mesothelioma Register are identified as teachers, without this circumstance of exposure.

Health Hazard Alert: Hydraulic Fracking Workers Suffer Silica Expopsure

OSHA and NIOSH issue hazard alert on ensuring workers in hydraulic fracturing operations have appropriate protections from silica exposure

The U.S. Department of Labor's Occupational Safety and Health Administration and the National Institute for Occupational Safety and Health today issued a hazard alert on ensuring that employers in hydraulic fracturing operations take appropriate steps to protect workers from silica exposure. Today's action, which is taken after consultation with stakeholders, including industry, meets the Obama administration's focus on ensuring that this important resource continues to be developed safely and responsibly.

The hazard alert follows a cooperative study by NIOSH and industry partners that identified overexposure to silica as a health hazard to workers conducting hydraulic fracturing operations. 

As noted in the alert, respirable silica is a hazard common to many industries and industrial processes.  

Because large quantities of silica sand are used during hydraulic fracturing, NIOSH began a cooperative effort in January 2010 to collect data regarding silica exposure at hydraulic fracturing operations. NIOSH worked in cooperation with oil and gas industry partners to sample the air at 11 sites in five states where hydraulic fracturing operations were taking place. NIOSH identified seven primary sources of silica dust exposure during fracturing operations and found that workers downwind of sand mover and blender operations, especially during hot loading, had the highest silica exposures. 

Workers who breathe silica day after day are at greater risk of developing silicosis, a disease in which lung tissue reacts to trapped silica particles, causing inflammation and scarring, and reducing the lungs’ ability to take in oxygen. Silica also can cause lung cancer and has been linked to other diseases, such as tuberculosis, chronic obstructive pulmonary disease, and kidney and autoimmune disease.

Today’s action responds to the NIOSH findings. The alert states that employers must ensure that workers are properly protected from overexposure to silica. The alert describes how a combination of engineering controls, work practices, protective equipment and product substitution, where feasible, along with worker training, can protect workers who are exposed to silica. Engineering controls and work practices provide the best protection for workers. According to the alert, transporting, moving and refilling silica sand into and through sand movers, and along transfer belts and into blender hoppers, can release dust into the air containing up to 99 percent silica that workers breathe. 

“Hazardous exposures to silica can and must be prevented. It is important for employers and workers to understand the hazards associated with silica exposure in hydraulic fracturing operations and how to protect workers,” said Dr. David Michaels, assistant secretary of labor for occupational safety and health. “OSHA and NIOSH are committed to continuing to work with the industry and workers to find effective solutions to address these hazards.”

“Through partnerships, both businesses and safety professionals are able to collaborate on assessing and managing occupational safety and health risks,” said NIOSH Director John Howard, M.D. “The recommendations for protecting workers in the hazard alert are practical, evidence-based and effective solutions to help support the safe growth of American-made energy.”

“We applaud the efforts of the NIOSH NORA Council for Oil and Gas Extraction, OSHA and our partners from industry for helping to raise awareness of this hazard,” said Kenny Jordan, executive director of the Association of Energy Service Companies. “We are proud of the development of an industry focus group in cooperation with those agencies which will further explore this issue, share best practices and continue to build upon the many engineering controls currently in place and those under development over the last several years. The safety and health of our workforce is a top priority, and the industry strives to follow and improve best practices for safe operations and works closely with OSHA and NIOSH to help ensure a strong culture of safety. We look forward to sharing improvements not only within our industry, but with others as well.”

AFL-CIO Health and Safety Director Margaret Seminario stated, “The AFL-CIO strongly supports this hazard alert that provides important information to employers and workers involved in hydraulic fracturing operations regarding the serious health threat from silica exposures. It is critical that OSHA and NIOSH disseminate this information, so that immediate action can be taken to protect workers from silicosis and other silica-related diseases.”

The hazard alert can be viewed at http://www.osha.gov/dts/hazardalerts/hydraulic_frac_hazard_alert.html.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to ensure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit http://www.osha.gov.


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For over 3 decades the Law Offices of Jon L. Gelman1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered work related accident and injuries.


More about fracking

Fracking: Vermont Become The First State to Outlaw

May 19, 2012

Vermont Governor Peter Shumlin signed into law on Thursday a bill [H 464 materials] outlawing hydraulic fracturing, or fracking, making Vermont the first US state to ban the controversial technique used to extract natural gas ...

http://workers-compensation.blogspot.com/

Occupational Exposure to Silica During Hydraulic Fracking

May 24, 2012

While focus has been on environmental concerns with the advent of fracking, a process to release oil and gas, a new concern has emerged over the potential occupational exposure to silica by workers who are involved in the...

http://workers-compensation.blogspot.com/

Workers' Compensation: Fracking: US EPA To Develop Natural Gas ...

Oct 22, 2011

The U.S. Environmental Protection Agency (EPA) is announcing a schedule to develop standards for wastewater discharges produced by natural gas extraction from underground coalbed and shale formations.

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Fracking: The New Threat of Industrial Pollution in the Northeast

Oct 12, 2011

Related articles. How To Determine If A Substance Causes Cancer at Work (workers-compensation.blogspot.com); 'Fracking' fluid pitch stirs Great Lakes pollution fears (ctv.ca); Doctors Urge N.Y. to Weigh Health Risks of ...

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