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In deze rubriek passeren foto's of schilderijen waarin het onderwerp 'Arbeid' centraal staat de revue.

This report is the final output of a major project that was commissioned to address exposure to biological agents in the workplace and the related health effects. The study included a scientific literature review, interviews with experts, focus group sessions and a stakeholder workshop. The report presents a consolidated summary of the outcomes of the project as a whole according to important themes identified throughout the review, such as sectors of concern, vulnerable groups, emerging risks and monitoring systems operating in European countries. Currently, there is no systematic approach to preventing exposure to biological agents in the workplace and recognising the related health problems. By analysing existing knowledge of these risk factors, identifying data gaps and proposing future policy options, the report aims to raise awareness of the issue and provide reliable information that can support efforts to establish effective preventive measures.

Background: Prenatal exposure to organophosphate (OP) pesticides has been associated with altered neuronal cell development and behavioral changes in animal offspring. However, the few studies investigating the association between prenatal OP pesticide exposure and neurodevelopmental outcomes such as Attention-Deficit Hyperactivity Disorder (ADHD) and autistic traits in children produced mixed findings. Objective: The objective of the present study was to examine whether maternal urinary concentrations of OP pesticide metabolites are associated with ADHD and autistic traits in children participating in the Generation R Study, a population-based birth cohort from Rotterdam, the Netherlands. Method: Maternal concentrations of 6 dialkylphosphates (DAPs) were measured using gas chromatography coupled with tandem mass spectrometry in urine samples collected at 25 weeks of gestation in 784 mother-child pairs. DAP metabolite concentrations were expressed as molar concentrations divided by creatinine levels and log10 transformed. ADHD traits were measured at ages 3, 6, and 10 years using the Child Behavior Checklist (CBCL) (n = 781) and autistic traits were measured at age 6 years using the Social Responsiveness Scale (SRS) (n = 622). First, regression models were fit for the averaged prenatal exposure across pregnancy. Second, we investigated associations for each collection phase separately, and applied a mutually adjusted model in which the effect of prenatal DAP concentrations from each time period on ADHD and autistic traits were jointly estimated. All associations were adjusted for relevant confounders. Results: Median DAP metabolite concentration was 309 nmol/g creatinine at 25 weeks of gestation. Overall, DAP metabolite concentrations were not associated with ADHD traits. For instance, a log10 increase in averaged total DAP concentrations across gestation was not associated with a lower ADHD score (-0.03 per SD 95 CI: −0.28 to 0.23). Similarly, no associations between maternal DAP concentrations and autistic traits were detected. Conclusions: In this study of maternal urinary DAP metabolite concentrations during pregnancy, we did not observe associations with ADHD and autistic traits in children. These are important null observations because of the relatively high background DAP concentrations across pregnancy, the relatively large sample size, and the 10-year follow-up of the offspring. Given the measurement error inherent in our OP pesticide exposure biomarkers, future studies using more urine samples are needed to accurately measure OP pesticide exposure over pregnancy in relation to ADHD and autistic traits. © 2019 The Authors.

This report forms part of a major project to address the risks posed by biological agents in the workplace. The aim of the project is to raise awareness of exposures to these hazards at work, provide more information on the related health problems and support efforts to prevent them. The report presents the results of a scientific literature review, a survey of experts and an analysis of selected systems used by European Union Member States for monitoring diseases and exposures. It assesses the existing knowledge on the subject, including on new and emerging risks, identifies gaps in the data, and makes recommendations to improve the monitoring and prevention of these widespread but poorly understood risks. Including executive summary.

Background Dangerous substances like asbestos, dust and industrial fumes pose a profound hazard to workers across industries. In the Netherlands, annually 4100 deaths in workers can be attributed to occupational diseases, of which 2700 cases are caused by work-related cancer. However, until now, data was missing on risk-perception among companies, employers and managers, and the (lack of) use of preventive and risk-reducing measures in the workplace. In this study, answers and insights into dangerous substances as an occupational hazard across Dutch workplaces were identified. These quantitative data are combined with more qualitative data to promote health in the workplace by inspiring a national campaign on the prevention of occupational diseases resulting from exposure to hazardous substances at work. Methods In this cross-sectional study, a survey was conducted among 2288 employers/managers in companies across 17 industries in the Netherlands. Participants were stratified based on sector and company size. Participant scores were weighed to create a representative sample of the Dutch working population in these industries. Statistical analyses included descriptive analyses, t-tests and chi-square tests for statistical significance (P

In deze rubriek passeren foto's of schilderijen waarin het onderwerp 'Arbeid' centraal staat de revue.

In Nederland wordt het aantal werknemers dat een door een arts vastgestelde beroepsziekte heeft, geschat op bijna 750.000 (11%). De maatschappelijke kosten van verzuim als gevolg van gezondheidsproblemen door het werk worden geschat op zo’n 8 miljard euro per jaar (Arbobalans 2016). Voorkomen van beroepsziekten levert zowel werkgevers en werknemers als de maatschappij veel op: beperking van verzuimkosten en arbeidsongeschiktheid, betere inzetbaarheid en participatie, tevreden werknemers en het behoud van een goede gezond-heid. Preventie van beroepsziekten is om die reden een belangrijke pijler van het overheidsbeleid omtrent gezond en veilig werken. Naast de vaststelling dat beroepsziekten een groot maatschappelijk en economisch probleem zijn, valt op dat ziekten als gevolg van blootstelling aan stoffen hierin een aanzienlijk aandeel hebben. Van de 4.100 doden die in Nederland jaarlijks door beroepsziekten vallen, zijn er naar schatting 2.700 het gevolg van werkgerelateerde kanker, waarbij blootstelling aan stoffen een grote risicofactor is (Arbobalans 2016).

Sinds 1978 is asbestbeleid ontwikkeld en uitgevoerd, dat is gericht op het terugdringen van asbest in enigerlei vorm in het binnen- en buitenmilieu. Dit beleid heeft onder andere geleid tot een aanzienlijke reductie van de asbestvezelconcentratie in de buitenlucht.

In allerlei werksituaties kunnen werknemers bewust of onbewust worden blootgesteld aan biologische agentia zoals bacteriën, virussen, parasieten of schimmels. Biologische agentia kunnen een infectie veroorzaken en zo een gezondheidsrisico voor de werknemer opleveren. Als besmetting plaatsvindt vanwege de arbeid spreken we van een beroepsinfectieziekte. Het blijkt niet goed mogelijk zicht te krijgen op incidentie, ziektelast en verzuim in samenhang met beroepsinfectieziekten. Een beroepsgebonden besmetting wordt niet altijd herkend en wanneer deze relatie wel gelegd wordt, dan wordt dit vaak niet als beroepsinfectieziekte aan het Nederlands Centrum voor Beroepsziekten (NCvB) gemeld. Hierdoor is sprake van onderregistratie en een flinke onderschatting van het aantal beroepsinfectieziekten in Nederland. Preventie van beroepsinfectieziekten staat hierdoor vaak niet hoog op de agenda. In de praktijk blijkt ook dat het voor betrokken partijen niet altijd duidelijk is waar informatie over (preventie van) beroepsinfectieziekten te vinden is.

In de daarin geselecteerde branches Metaal, Chemie en Bouw zijn in het tweede tertaal bedrijfsbezoeken uitgevoerd, gekoppeld aan interviews met werkgevers en werknemers. Ook andere belangrijke stakeholders zijn geïnterviewd. Onderwerpen die aan de orde kwamen zijn o.a. de organisatie van de bedrijfsgezondheidszorg, de bedrijfscultuur met betrekking tot gevaarlijke stoffen en randvoorwaarden voor een succesvolle aanpak. Naast de verzameling van vooral kwalitatieve data is ook een vragenlijst onder bedrijven uitgezet om meer kwantitatieve gegevens te verzamelen voor de onderbouwing van een meerjarenprogramma waarmee het ministerie in 2018 wil starten.

Naar aanleiding van de (op handen zijnde) verlaging van de grenswaarde voor asbest is binnen het Kennisinvesteringsproject (KIP) “Innovaties voor veilig werken met asbest” een van de doelstellingen om de onderliggende meetgegevens van het huidige SMA-rt systeem opnieuw te evalueren, als opmaat voor de verdere ontwikkeling van dit systeem. Aanleiding hiervoor is dat op advies van de Gezondheidsraad (2010) de grenswaarden voor asbest zijn of zullen worden aangepast. Deze rapportage beschrijft de evaluatie van de thans beschikbare meetgegevens. Daarnaast geeft deze rapportage inzicht in de (verdere) ontwikkeling van de database met blootstellingsgegevens en de onderbouwing van het huidige SMA-rt systeem

Endotoxin exposure occurs in homes and occupational environments and is known to cause adverse health effects. In order to compare results from different studies and establish standards, airborne endotoxin exposures should be assessed using standardized methods. Although the European Committee for Standardization (CEN) developed guidelines for endotoxin exposure assessment, these leave room for individual interpretation. The influence of methods of sampling, extraction, and analysis has never been investigated in a full experimental design. Thus, we sought to fully elucidate the importance of all facets of endotoxin assessment. Inhalable dust samples collected simultaneously were used to investigate the effects on and interactions with airborne endotoxin concentration in two working environments of filter type (glass fiber or Teflon), transport conditions (with/without desiccant), sample storage (-20 or 4°C), extraction solution (pyrogen-free water [PFW] or PFW plus 0.05% Tween 20), extract storage (-20 or 4°C), and assay solution (PFW or PFW plus 0.05% Tween 20). Four hundred samples were collected and randomly distributed over the 20 combinations of treatments. There were no differences found for transport conditions and storage temperature of extracts. Also, no interactions between study variables existed. Sampling on glass-fiber filters, storage of samples in the freezer, and extraction in PFW plus 0.05% Tween 20 resulted in 1.3-, 1.1-, and 2.1-fold-higher estimated endotoxin concentrations, respectively. Use of PFW plus 0.05% Tween 20 in the assay solution had an additive effect. Thus, this study investigated gaps in the CEN protocol and provides data with which to fully specify a protocol for standardization of endotoxin exposure assessment. Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Dit protocol is opgesteld als onderdeel van het programma “Innovaties voor veilig werken met asbest”, dat TNO uitvoert in opdracht van het ministerie van Sociale zaken en Werkgelegenheid (SZW). Het doel van dit programma is het advisering van het ministerie van SZW met betrekking tot haar beleid rondom asbestverwijdering, het komen tot een state‐of‐the‐art onderbouwing van de blootstellingsniveaus tijdens het saneren van asbesthoudende materialen in zowel de publieke als de industriële sector, en het beschikbaar komen van nieuwe innovatieve methoden voor zowel het verwijderen van asbesthoudende materialen als het detecteren van asbest (monstername en analysetechniek). Het doel van dit protocol is het beschrijven van de methodiek voor het landelijk valideren van nieuwe werkmethoden en/of technieken voor asbestverwijdering, en daarmee het vastleggen van objectieve criteria op basis waarvan(nieuwe) werkmethoden na acceptatie in SMA‐rt kunnen worden ingevoerd. Deze methodiek is opgesteld op basis van de huidige ‘stand der techniek’ op dit gebied. Het goed omschrijven en valideren van een werkmethode, op basis van het op een uniforme manier verzamelen en beoordelen van asbestconcentratiemetingen, kan daarmee resulteren in het algemeen geldend verklaren van de risico‐klasse en het bijbehorende beheersregime van een werkmethode. De methodiek zoals beschreven in dit protocol dient als input voor het door de Stichting Certificatie Asbest (Ascert) opgesteld asbestcertificatieschema SCi‐547, met betrekking tot de validatie van werkmethoden, en is in dit kader ook besproken met afgevaardigden van Ascert, het ministerie van SZW, Inspectie SZW, en het Centraal College van Deskundigen (CCvD). Deze afgevaardigden hebben de inhoud goedgekeurd, evenals de werkkamer van Ascert. Naast de hier beschreven methodiek heeft Ascert in deze SCi‐547 ook een procesbeschrijving (de implementatie en borging van de toepassing van deze methodiek in de praktijk) opgenomen, waarin onder andere taken en verantwoordelijkheden en de gegevensstroom zijn omschreven. Deze procesbeschrijving omvat ook de toetsing van de haalbaarheid (robuustheid) van een werkmethode in de praktijk, evenals de uiteindelijk opname van een werkmethode in SMA‐rt. Deze procesbeschrijving is opgesteld door Ascert in samenspraak met betrokken partijen.

The widespread use of organophosphate (OP) pesticides has resulted in ubiquitous exposure in humans, primarily through their diet. Exposure to OP pesticides may have adverse health effects, including neurobehavioral deficits in children. The optimal design of new studies requires data on the reliability of urinary measures of exposure. In the present study, urinary concentrations of six dialkyl phosphate (DAP) metabolites, the main urinary metabolites of OP pesticides, were determined in 120 pregnant women participating in the Generation R Study in Rotterdam. Intra-class correlation coefficients (ICCs) across serial urine specimens taken at o18, 18–25, and 425 weeks of pregnancy were determined to assess reliability. Geometric mean total DAP metabolite concentrations were 229 (GSD 2.2), 240 (GSD 2.1), and 224 (GSD 2.2) nmol/g creatinine across the three periods of gestation. Metabolite concentrations from the serial urine specimens in general correlated moderately. The ICCs for the six DAP metabolites ranged from 0.14 to 0.38 (0.30 for total DAPs), indicating weak to moderate reliability. Although the DAP metabolite levels observed in this study are slightly higher and slightly more correlated than in previous studies, the low to moderate reliability indicates a high degree of within-person variability, which presents challenges for designing well-powered epidemiological studies.

Dit protocol is opgesteld als onderdeel van het programma “Innovaties voor veilig werken met asbest”, dat TNO uitvoert in opdracht van het ministerie van Sociale zaken en Werkgelegenheid (SZW). Het doel van dit programma is het advisering van het ministerie van SZW met betrekking tot haar beleid rondom asbestverwijdering, het komen tot een state‐of‐the‐art onderbouwing van de blootstellingsniveaus tijdens het saneren van asbesthoudende materialen in zowel de publieke als de industriële sector, en het beschikbaar komen van nieuwe innovatieve methoden voor zowel het verwijderen van asbesthoudende materialen als het detecteren van asbest (monstername en analysetechniek). Het doel van dit protocol is het beschrijven van de methodiek voor het bepalen van de respirabele vezelconcentratie tijdens het uitvoeren van asbestverwijderingshandelingen op een unieke locatie volgens een bepaalde werkmethode, op basis van de huidige ‘stand der techniek’ op dit gebied. Het op een uniforme manier uitvoeren van asbestconcentratiemetingen waarbij op eenzelfde manier contextuele informatie wordt verzameld is een eerste stap richting standaardisatie. En wanneer de data die wordt verzameld van goede kwaliteit is, kan ook de blootstelling van saneerders aan asbestvezels tijdens saneringswerkzaamheden en daarmee het (potentiele) gezondheidsrisico op een valide manier worden ingeschat. Verder kan data die op een uniforme manier wordt verzameld worden gebundeld en worden gebruikt voor bijvoorbeeld blootstelling aan determinanten van blootstelling. De methodiek zoals beschreven in dit protocol dient ook als input voor het door de Stichting Certificatie Asbest (Ascert) opgesteld asbestcertificatieschema SCi‐548, met betrekking tot de uitvoering van validatiemetingen, en is in dit kader ook besproken met afgevaardigden van Ascert, het ministerie van SZW, Inspectie SZW, en het Centraal College van Deskundigen (CCvD). Deze hebben de inhoud goedgekeurd. Naast de methodiek is in deze SCi‐548 ook de procesbeschrijving (de implementatie en borging van de toepassing van deze methodiek in de praktijk) opgenomen, waarin onder andere taken en verantwoordelijkheden en de gegevensstroom zijn omschreven.

Werknemers in de agro-foodsectoren worden naar verwachting blootgesteld aan hoge concentraties organisch stof en endotoxinen. Endotoxinen zijn onderdeel van de celwand van Gram-negatieve bacteriën en alomtegenwoordig in het milieu. Het totale aantal (potentieel) werknemers dat in de agrarische en voedingssectoren aan organisch stof en/of endotoxinen wordt blootgesteld, is recent geschat op 350.000 (Spaan et al., 2011). Blootstelling kan leiden tot gezondheidsklachten, tot productieverlaging, afname van de motivatie, ziekteverzuim, en in ernstige gevallen arbeidsongeschiktheid. Er zijn reeds verschillende claims voor gezondheidsschade door endotoxinen toegekend

Objectives: A multidisciplinary intervention study aimed at reducing quartz exposure in the Dutch construction industry was performed. We aimed to assess the effect of the intervention on exposure level and psycho-social and organisational factors. Method: Eight participating construction companies were randomly allocated to an intervention (n = 4) or control group (n = 4). Following the Intervention Mapping approach, the intervention aimed at engineering, organisational and psycho-social factors. Pre and post-intervention respirable quartz measurements (n = 300) were taken from workers from all eight companies. Questionnaires and observation forms were used to assess pre and post psycho-social and organisational factors. Results: Pre-intervention assessment demonstrated highest respirable quartz levels for concrete drillers, tuck pointers and demolishers (GM respectively 0.20, 0.18 and 0.12 mg/m(3)), exceeding the Dutch occupational exposure limit (OEL) in 62% of the measurements. Identified control measures resulted in 30% reduction in quartz exposure. More social influence was associated with a 1.5 fold increased use of control measures. The post intervention assessments will become available early 2014. Conclusions:High exposure levels exceeding the Dutch OEL were observed. Associations between organisational, psycho-social and use of control measures found during the pre-intervention, were taken into consideration when developing the intervention strategy. A comparison between pre and post intervention outcomes will be presented during the conference. The effect of changes in exposure levels as a result of the intervention will be assessed with a health impact assessment model incorporating population dynamics.

Endotoxin, one of the specific agents in organic dust that cause health effects, is part of the cell wall of Gram-negative bacteria. Gram-negative bacteria are present on for instance the surfaces of plants and in animal feces, and their occurrence, growth and amplification is influenced by many factors. As a consequence, endotoxin levels may be highly variable and occurs exposure to endotoxin in various industries. Inhalation exposure is thought to be the major route of exposure. Endotoxin exposure was investigated among workers of various agricultural industries and sewage treatment plants. Exposure was found to be generally high in agricultural industries, and moderate to low in sewage treatment workers. These studies were combined with eight other exposure studies in a database, which showed that endotoxin exposure was highly variable. In general more variability between workers than with workers (from day to day) was found. Several determinants of exposure could be determined. For example, dustiness of the product, contact with animals or plant material and bulk production were associated with higher endotoxin exposure, which ‘wet’ processes were associated with lower exposure levels. Information about exposure levels and variance components were input for the formulation of a measurement strategy for the assessment of endotoxin exposure. This strategy has a tiered approach, and every phase can result in a conclusion that the exposure situation is acceptable, advice on control measures or a more precise estimation of the exposure situation. The emphasis is on control measures when the circumstances indicate (elevated) endotoxin exposure. For exposure assessment and possible comparison with an occupational exposure limit (OEL) the procedure for measurement and analysis of airborne endotoxin is very important, and preferably standardized. Existing gaps in European guidelines were explored and investigated by means of full experimental designs and the use of parallel collected inhalable dust samples, in which the effects on and interactions with airborne endotoxin concentration of filter type, transport conditions, sample storage, extraction solution, extract storage and assay solution were investigated in several working environments. This led to the recommendation to use glass-fiber filters, transport with desiccation, frozen sample storage, extraction in PFW with 0.05% Tween-20 with rocking/shaking, frozen storage of extracts, and dilution and LAL analysis in PFW. With this information a protocol for standardization of endotoxin exposure assessment can be fully specified. Although it is yet unknown whether endotoxin will be part of the public or private part of the current (new) Dutch occupational exposure limit system, both the government and industry can use the intended health-based recommended OEL of the Health Council, which is a tool for controlling exposure and reduce the risk of health effects for workers. Standardization of methods is important to be able to compare results and for compliance testing, and this thesis provides information on some of the issues around introducing an OEL for endotoxin. Generally, one should be aware that endotoxin exposure poses a potential threat to the working population, which should be rendered into monitoring and controlling this exposure.

Objectives: Workers in many industries are exposed to endotoxins, which may cause adverse health effects. In exposure assessment, information about exposure variability is essential. However, variability in exposure has rarely been investigated for biological agents and more specifically for endotoxin. Therefore, variance components and determinants of exposure were studied in a large database with >2000 endotoxin measurements. Methods: Data from 10 individual studies were combined to create a database with 2010 personal inhalable dust and endotoxin measurements, of which 1650 were repeated measurements. Exposure groups were defined based on job codes. Between- and within-worker variance components were estimated for different grouping strategies, and determinants of exposure were studied using mixed effects models. Results: Inhalable dust and endotoxin exposure levels are summarized for 46 industries and 4 broadly defined sectors. The between-worker variability exceeded the within-worker variability overall and within sectors and subsectors, and variance components were larger for endotoxin than for dust. Between-worker variability also exceeded within-worker variability in nearly half of the exposure groups based upon industries or job code within industries for endotoxin exposure and in 10% of the groups for dust exposure. Among other things, dustiness of the process, contact with animals, bulk production, presence of plant material or a cyclic process appeared as determinants of exposure, which largely explained the between-worker variability. Conclusions: Exposure groups were much less homogeneous for endotoxin exposure than for dust exposure. This is distinctly different than for chemical exposure. Large variability in measured exposure levels is inherent to endotoxin exposure, which is caused in part by determinants that influence growth of microorganisms. These findings have major consequences for the design of future occupational intervention and epidemiological studies. The measurement effort needs to be greater than exposure assessment for chemical agents which demonstrate lower exposure variability, especially when evaluating endotoxin exposure for compliance testing. The established determinants of exposure give direction for potential exposure control, although more information about determinants of day-to-day variability in exposure is still needed to be able to effectively control endotoxin exposure. © The Author 2008. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Objectives were to give an overview of endotoxin exposure and its determinants in sewage treatment workers, and to study exposure to culturable and non-culturable microorganisms and the applicability of the LAL assay in this work environment. Material and methods: In 43 Dutch sewage treatment plants 470 full-shift, 123 task-based personal and 54 stationary inhalable dust samples were collected. Endotoxin concentration was determined with the LAL-assay. Mixed effects models were used to investigate possible determinants of exposure. Simultaneous parallel fi lter samples, impinger samples and viable total bacteria and Gram-negative bacterial samples were taken to compare analytical techniques. Filter and impinger samples were analyzed with the LAL-assay, gas chromatography-mass spectrometry (GC-MS) and fl uorescence microscopy. Results: Endotoxin exposure levels were moderate to low (geometric mean personal exposure 27 EU/m³, stationary 33 EU/m³, task-based 64 EU/m³), yet differences between jobs and sources and some determinants of exposure were identifi ed. Exposure varied more from day to day than between workers. Concentrations in fi lter samples were higher and more consistent than in impinger samples. Fungi and Gram-positive bacteria were found in higher levels than Gram-negative bacteria. The LAL assay and GC-MS showed comparable endotoxin levels. Discussion and conclusion: Endotoxin exposure in Dutch sewage treatment workers was relatively low. Comparison of sampling and analytical techniques suggests that the LAL-assay did not result in much exposure misclassifi cation. It thus seems justifi ed to perform fi lter measurements in combination with the LAL-assay to measure endotoxin exposure in sewage treatment plants.

In het kader van het Arboconvenant grondstofallergie is onderzoek gedaan naar de stof- en allergeenblootstelling (tarweallergeen en schimmel a-amylase) in industriële bakkerijen, de maalindustrie en bakkerijgrondstoffenindustrie. De resultaten zijn vergeleken met metingen uit 2000-2001. Er wordt geconcludeerd dat de doelstellingen voor wat betreft de introductie van de arbeidshygiënische strategie en werkwijze zijn gehaald. Ook de reductie van piekblootstelling voor diverse taken en handelingen is gerealiseerd. De reductie van de totale blootstelling is tot op zekere hoogte gerealiseerd met duidelijke verschillen per branche en functie. In industriële bakkerijen is de gemiddelde stof- en tarweallergeenbelasting niet of nauwelijks afgenomen. Maar blootstelling aan de schimmel a-amylase is daar duidelijk afgenomen. In de maalindustrie is de stof- en tarweallergeenbelasting afgenomen, het duidelijkst voor de stofbelasting. De schimmel a-amylase blootstelling is in de maalindustrie voor een paar functies afgenomen. In de bakkerijgrondstoffenindustrie is de stof- en tarweallergeenbelasting in beperkte mate afgenomen. De blootstelling aan schimmel a-amylase is in deze indusrtie over het geheel genomen gelijk gebleven of gestegen.

Artikel besteed aandacht aan een door een samenwerkingsverband van TNO en de Universiteit van Utrecht verbeterde analysemethode en meetprotocol voor endotoxinen. Vakmedia

INTRODUCTION: In the past decade, we studied occupational bioaerosol exposures in various sites of the waste management chain. In this paper we present an overview of exposure levels of inhalable dust, endotoxin, beta(1-->3)-glucan (known or probable inducers of airways inflammation), and extracellular polysaccharide antigens of Aspergillus and Penicillium species (EPS-Pen/Asp; a common and probably more specific marker of fungal exposure). METHODS: Over 450 personal bioaerosol samples were taken. Mixed regression analyses were performed to estimate exposure determinants, between- and within-worker variance of exposure, and determinants of these variances. Furthermore, we explored whether the type of waste affected the bioaerosol composition of the dust. RESULTS: Endotoxin and glucan exposure levels were relatively low and comparable for waste collection and transferral, green waste composting and use of biomass in power plants. Exposure levels were 5-20 times higher in domestic waste transferral with sorting, and composting of both domestic and domestic and green waste ( approximately 300-1000 EU m(-3) for endotoxin, and 5-10 mug m(-3) for glucan). Observed exposure exceeded Dutch occupational exposure limits at all sites. EPS-Pen/Asp exposure was detected in 20% of waste collectors and 49% of compost workers. Exposure variability within tasks was large (geometric standard deviation > 2), with smaller between-worker than within-worker variance. Type of company and waste largely explained between-worker variance (40-90%), although within companies no major task-related determinants could be established. Markers of exposure correlated moderately to strongly. Relative endotoxin and glucan content in the dust was only weakly associated with handled waste. CONCLUSIONS: Occupational bioaerosol exposure in the waste management chain is lowest for outdoor handling of waste and highest when waste is handled indoors. However, exposure variability is large, with greater within-worker than between-worker variance. Occupational exposure limits for organic dust and endotoxins are frequently exceeded, suggesting workers are at risk of developing adverse health effects.