Bitumen fumes: review of work on the potential risk to workers and the present knowledge on its origin

Bitumens fumes contain polycyclic aromatic compounds (PAC). There is a possibility of long-term health effects following chronic exposure by inhalation or skin contamination in asphalt road pavers and highway maintenance workers. Epidemiological and experimental studies on this topic are reviewed and the possible causes of cancer discussed with a primary focus on heterocyclic polyaromatic compounds. In 2001, the results of the IARC epidemiological study confirmed an excess of lung cancer despite a lower cancer mortality. In vitro genotoxicity and mechanistic studies demonstrated a mutagenic effect of bitumen fume condensates (BFC) and some data suggested that the polycyclic aromatic hydrocarbons (PAH) analysed were not the major genotoxic compounds in bitumen fume condensates. Other compounds such as nitrogen-, sulfur- and/or oxygen-containing PAH or their alkyl substituted analogues, mutagenic in the Ames mutation assay, may be involved in the genotoxic effect of BFC. After skin painting with BFC, DNA adducts were found in skin, lung and lymphocytes of all the treated animals. Differences in the adduct patterns were also observed, but a more polar adduct was common to the three tissues and not observed in those from rats treated with coal-tar fume condensates (CTFC). Rat inhalation experiments with bitumen fumes confirmed the presence of a DNA-adduct in the lungs with the same Rf as the previous polar adduct. This adduct therefore merits further investigation as a potential biomarker in lymphocyte DNA to follow exposed workers. All the analytical data and the mechanistic data are complementary and suggest the potential role of thiophenes in the genotoxicity of bitumen fumes. Some thiophenes have lower mutagenic activity than their isosteric PAH, whereas others are very potent carcinogens. Generally, the sulfur analogues of PAH (SPAH) in bitumen fumes have a higher concentration than the PAH of similar molecular weight, whereas the SPAH in coal-tar fumes have a much lower concentration than the corresponding PAH. This may explain why the more polar adducts have been detected only in animals exposed to bitumen fume. In a skin carcinogenicity study of condensed asphalt roofing fumes, it has been demonstrated that the most active fractions were those containing a variety of aromatic SPAH. In conclusion to this review, there is an interest in determining the chemical identity of the major DNA adducts induced by BFC. This would allow experimental studies on the carcinogenic potency of these compounds and their validation as potential biomarkers. These compounds could thus merit further analytical investigation in preference to the PAH included in the list of the US Environmental Protection Agency that are currently being analysed by the industry in field studies.     

Spatial distribution of moderated neutrons along a Pb target irradiated by high-energy protons

High-energy protons in the range of 0.5–7.4 GeV have irradiated an extended Pb target covered with a paraffin moderator. The moderator was used in order to shift the hard Pb spallation neutron spectrum to lower energies and to increase the transmutation efficiency via (n,γ) reactions. Neutron distributions along and inside the paraffin moderator were measured. An analysis of the experimental results was performed based on particle production by high-energy interactions with heavy targets and neutron spectrum shifting by the paraffin. Conclusions about the spallation neutron production in the target and moderation through the paraffin are presented. The study of the total neutron fluence on the moderator surface as a function of the proton beam energy shows that neutron cost is improved up to 1 GeV. For higher proton beam energies it remains constant with a tendency to decline.     

Laboratory investigation of the mass stability of sampling cassettes from inhalable aerosol samplers

A study was conducted to evaluate the mass stability of the materials used in the construction of samplers with internal cassettes for the gravimetric measurement of inhalable aerosol exposures. The internal cassettes from IOM samplers were studied. Results indicate that the mass stability of filters is uniform, but the mass stability of the cassette material may dramatically affect the results of the measurement. Cassettes constructed from plastic exhibited drastic shifts in mass depending on the environmental conditions of their storage. Under room humidity, the plastic cassettes absorbed 1 to 2 mg of water over several days. When these cassettes were placed in a desiccator, they lost mass consistently but did not approach a stable mass. Studies repeated with cassettes made of stainless steel showed negligible mass variability. Based on this study, the use of stainless steel cassettes is recommended for gravimetric determinations of aerosol exposure, although field blanks may in some cases be used for correction of data from plastic cassettes. This study shows the need to evaluate the mass stability of the cassette material of any sampling device where an internal cassette is weighed together with the filter.     

Doppler velocimetry determined redistribution of fetal blood flow: correlation with growth restriction in diamniotic monochorionic and dizygotic twins

OBJECTIVE: Our purpose was to study fetal growth and blood flow distribution in diamniotic monochorionic compared with dizygotic (diamniotic dichorionic) twins by use of Doppler velocimetry of the umbilical artery and middle cerebral artery. STUDY DESIGN: Study candidates were divided into group A, consisting of 33 pairs (66 fetuses) of diamniotic monochorionic twins, and group B, 50 pairs (100 fetuses) of diamniotic dichorionic twins. Diamniotic monochorionic placentation was confirmed by microscopic placental examination for group A. Diamniotic dichorionic placentation was ensured for group B by selecting only twins with different-sex pairs (dizygotic twins). Targeted ultrasonography with biometry was performed in each twin, and Doppler recordings of the umbilical artery and middle cerebral artery were obtained. Waveforms were analyzed and the systolic/diastolic ratio, the resistance index, and a measure of blood flow redistribution (brain-sparing effect), the cerebral/placental ratio, was calculated for each fetus. Growth status at birth was assessed by the number of small-for-gestational-age infants (< or = 10th percentile), low-birth-weight infants (< or = 25th percentile), and percent of growth discordance between twins. Intertwin differences were assessed by delta values (value of larger twin minus value of smaller twin). RESULTS: Diamniotic monochorionic compared with dizygotic twins demonstrated a significantly greater probability of blood flow redistribution. For the study population as a whole, the brain-sparing effect was noted in 67% of small-for-gestational-age babies and only 7% of non-small-for-gestational-age infants (p < or = 0.001). For the diamniotic monochorionic pregnancies blood flow redistribution occurred in 6 of 10 small-for-gestational-age infants (60%) and 6 of 46 non-small-for-gestational-age infants (13%). In the diamniotic monochorionic group small-for-gestational-age compared with non-small-for-gestational-age infants were more likely to show blood flow redistribution, which was the result of significantly decreased resistance in the middle cerebral artery and significantly increased resistance in the umbilical artery. Small-for-gestational-age infants (< or = 10th percentile) occurred much less frequently in the dizygotic group. Two of two small-for-gestational-age infants in the dizygotic group showed blood flow redistribution. Although the extremes of birth weight were more common in the diamniotic monochorionic group, both groups had relatively large numbers of small babies with birth weights in the lower 25th percentile (50.0% for diamniotic monochorionic and 44.0% for dizygotic twins, not significant). However, 42.3% (11/26) of diamniotic monochorionic twins who were in the low-birth-weight group showed blood flow redistribution compared with only 3.3% (1/30) whose birth weights were > or = 25th percentile (p < or = 0.001). In the dizygotic twins 10% of lower-birth-weight infants redistributed blood flow compared with 1% in the higher-birth-weight group, a nonsignificant difference. Diamniotic monochorionic compared with dizygotic twins were delivered earlier (32.9 weeks vs 34.8 weeks, p < or = 0.001), were smaller (1832 gm vs 2304 gm, p < or = 0.001), showed higher birth weight discordance (29.8% vs 14%, p < or = 0.05), and had greater numbers (19.7% vs 2.3%, p < or = 0.01) of infants at < or = 10th percentile birth weight. CONCLUSIONS: Diamniotic monochorionic twins from the lower-birth-weight groups more often show blood flow redistribution compared with dizygotic twins of similar low birth weights. Placental vascular connections and the attendant hemodynamic changes in the fetuses of diamniotic monochorionic twins probably account for this difference. Brain-sparing events occur commonly without clinical twin transfusion syndrome in this group. These findings have implications for management.     

Discordance of databases designed for claims payment versus clinical information systems. Implications for outcomes research

OBJECTIVE: To determine the suitability of insurance claims information for use in clinical outcomes research in ischemic heart disease. DESIGN: Concordance study of two databases. SETTING: Tertiary care referral center. PATIENTS: A total of 12,937 consecutive patients hospitalized for cardiac catheterization for suspected ischemic heart disease between July 1985 and May 1990. INTERVENTIONS: Two-by-two tables were used to compute overall and kappa measures of agreement comparing clinical versus claims data for 12 important predictors of prognosis in patients with ischemic heart disease. MEASUREMENTS: Kappa statistics (agreement adjusted for chance agreement) were used to quantify agreement rates. RESULTS: Agreement rates between the clinical and claims databases ranged from 0.83 for the diagnosis of diabetes to 0.09 for the diagnosis of unstable angina (kappa values). Claims data failed to identify more than one half of the patients with prognostically important conditions, including mitral insufficiency, congestive heart failure, peripheral vascular disease, old myocardial infarction, hyperlipidemia, cerebrovascular disease, tobacco use, angina, and unstable angina, when compared with the clinical information system. CONCLUSIONS: Our results suggest that insurance claims data lack important diagnostic and prognostic information when compared with concurrently collected clinical data in the study of ischemic heart disease. Thus, insurance claims data are not as useful as clinical data for identifying clinically relevant patient groups and for adjusting for risk in outcome studies, such as analyses of hospital mortality.     

National surveillance of dialysis associated diseases in the United States, 1995

Many fundamental and hot band absorption lines of 28Si35Cl+, 28Si37Cl+, 29Si35Cl+, and 30Si35Cl+ have been detectedbetween 630 and 700 cm-1 in a SiCl4/He discharge using diode laser velocity modulation spectroscopy. The datahave been fitted to give seven mass independent coefficients Ukl. The derived spectroscopic constants for 28Si35Cl+ include omegae = 678.24316(18) cm-1 and Be = 0.2870288(14) cm-1. The equilibrium internuclear distance is re =1.9439105(46) ?. The equilibrium dissociation energy calculated from Dunham's expanded Morse potential is De =49 431(57) cm-1. Copyright 1998 Academic Press.     

Pediatric hepatic trauma: does clinical course support intensive care unit stay?

PURPOSE: The objective of this study is to determine if grade of liver injury predicts outcome after blunt hepatic trauma in children and to initiate analysis of current management practices to optimize resource utilization without compromising patient care. METHODS: A retrospective review of 36 children who had blunt hepatic trauma treated at a pediatric trauma center from 1989 to present was performed. Hepatic injuries graded (AAST Organ Injury Scaling) ranged from grade I to IV. Injury Severity Score (ISS), Glasgow Coma Score (GCS), transfusion requirements, liver transaminase levels, associated injuries, intensive care unit (ICU) length of stay, and survival were analyzed. RESULTS: Mean (+/-SEM) age was 6.6+/-0.8 years, mean grade of hepatic injury was 2.4+/-0.2, mean ISS was 17+/-2.6, mean GCS was 13+/-1, and mean transfusion was 15.4 mL/kg of packed red blood cells (PRBC). There were three deaths with a mean ISS of 59+/-9 and a mean GCS of 3+/-0. Death was not associated with a high-grade liver injury, survivors versus nonsurvivors, 2.3+/-0.2 versus 2.7+/-0.3, but was associated with ISS, 13+/-1.4 versus 59+/-9 (P = .005) and GCS, 14+/-1 versus 3+/-0 (P = .005). Only one patient (grade III, ISS = 43) underwent surgery. There were no differences in mean ISS or GCS between grades I to IV patients. The hepatic injury grades of patients requiring transfusion versus no transfusion were significantly different, 3.4+/-0.2 versus 2.2+/-0.2 (P = 0.04). Abused patients had high-grade hepatic injuries and significant laboratory and clinical findings. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were significantly higher in grade III and IV injuries than in grades I and II, 1,157+/-320 versus 333+/-61 (P= .02) and 1,176+/-299 versus 516+/-86 (P= .04), respectively. No children with grade I or II injury had a transfusion requirement or surgical intervention. There were no liver-related complications. CONCLUSIONS: Mortality and morbidity rates in pediatric liver injuries, grades I to IV, correlate with associated injuries not the degree of hepatic damage. ALT, AST, and transfusion requirements are significantly related to degree of liver injury. Low-grade and isolated high-grade liver injuries seldom require transfusion. Blunt liver trauma rarely requires surgical intervention. In retrospect, the need for expensive ICU observation for low-grade and isolated high-grade hepatic injuries is questionably warranted.     

A Golgi localization signal identified in the Menkes recombinant protein

Menkes disease arises from a genetic impairment in copper transport. The gene responsible for the phenotype has been identified as a copper transporting ATPase ( ATP7A ). Recently, the protein encoded by the ATP7A gene has been localized to the Golgi complex. In order to investigate the role of the Menkes disease protein in copper transport, recombinant constructs containing both the full-length open reading frame and an alternatively spliced form have been successfully expressed and localized in mammalian cells. Other studies of a patient with occipital horn syndrome, an allelic variant of Menkes disease, have demonstrated that only this alternatively spliced isoform and not the full-length form is expressed in this patient. The milder form of this patient's phenotype suggests that the alternatively spliced isoform has some functional role in copper transport. In the present study the full-length recombinant Menkes protein was shown by immunofluorescence to localize to the Golgi apparatus and the alternatively spliced form, lacking sequences for transmembrane domains 3 and 4 encoded by exon 10, was shown to localize to the endoplasmic reticulum. Using sequences from exon 10 fused to a non-Golgi reporter molecule, a 38 amino acid sequence containing transmembrane domain 3 of the Menkes protein was found to be sufficient for localization to the Golgi complex. Therefore, the protein sequence encoded by exon 10 may be responsible for this differential localization and both isoforms may be required for comprehensive transport of copper within the cell.