Anemia occupational exposure

In humans, severe cases of acrylonitrile poisoning have resulted in low grade anemia (Wilson 1944 Wilson et al. 1948), but complete recovery was reported. Chronic occupational exposure to low levels of acrylonitrile has not resulted in detectable effects on the hematological system (Sakurai et al. 1978). In intermediate and chronic studies in animals, decreased red cell count, hemoglobin concentration and hematocyte were observed (Bio/dynamics 1980a, 1980b, 1980c Quast et al. 

Hematological Effects. Intermediate and chronic inhalation exposure of humans to mixtures of heptachlor, chlordane, and other chemicals has been associated with leukemia and aplastic and hemolytic anemias. These exposures were either occupational or followed the use of termiticides in homes. These exposures were probably primarily inhalation combined with dermal. There are oral animal studies that confirm that the hematopoietic system, specifically the white cells, can be affected by heptachlor exposure. Rats fed 0.5 mg/kg/day heptachlor in the diet showed a statistically significant increase in total white blood count (Enan et al. 1982). It appears that although the hematopoietic system is not a primary target for heptachlor or heptachlor epoxide, it can be measurably affected. 

Okubo T, Shigeta S. 1982. Anemia cases after acute m-dinitrobenzene intoxication due to an occupational exposure. Industrial Health 20 297-304. 

Lead exposure can produce a number of other effects. One of the most common effects is on the red blood cells, which results in anemia. The red blood cells become fragile and hemoglobin synthesis is impaired. Changes in the red blood cells and some enzymatic changes were used as a marker for lead exposure. Similar to other metals, lead adversely affects kidney function, but this is now rare with reductions in occupational exposure. Several studies have demonstrated that elevated lead exposure is related to elevated blood pressure levels, particularly in men. There appears to be a weak association between lead exposure and increased incidence of lung and brain cancer. Lead exposure is a reproductive hazard for both males and females. In males, lead affects sperm count and sperm motility, resulting in decreased offspring. 

Lead is an acute and a chronic toxicant. Acute effects are ataxia, headache, vomiting, stupor, hallucination, tremors and convulsions. Chronic symptoms from occupational exposure include weight loss, anemia, kidney damage and memory loss. (Patnaik, P. 1999. A Comprehensive Guide to the Hazardous Properties of Chemical Substarwes, 2nbrain damage has been noted among children. Lead bioaccumulates in bones and teeth. The metal is classified as an environmental priority pollutant by the US EPA. 

White Phosphorus. Anemia (marked decrease in red blood cells or hemoglobin) and leukopenia (very low levels of white blood cells or leukocytes) were observed in workers chronically exposed to airborne white phosphorus (Ward 1928). Because the workers handled white phosphorus contaminated rags, it is possible that exposure occurred via oral and dermal routes also. No information on exposure levels was provided. In another occupational exposure study, no alterations in hemoglobin or total or differential leukocyte levels were observed (Hughes et al. 1962). 

Epidemiological studies have associated ethylene oxide with hematological diseases (mainly anemia, leukopenia, and leukemia) (SEDA-24, 271). To determine whether occupational exposure to low concentrations of ethylene oxide can cause hematological abnormalities and whether... 

In one study, occupational exposure to ethylene glycol was not associated with adverse effects (4). However, other adverse effects of occupational exposure have been noted, including anemia, subfertihty, and renal stones. 

Chronic occupational exposure to oxalic acid fumes has been associated with headache, vomiting, pain of the lower back, anemia, and fatigue. Chronic exposure may also lead to chronic inflammation of the upper respiratory tract and hypocalcemia. Prolonged contact of oxalic acid with the hands or feet may produce dermatitis, localized pain, cyanosis, and possibly gangrenous changes as a result of localized vascular damage. 

Chloracne has been reported in chronic occupational exposure to pentachlorophenol. However, commercial preparations are commonly contaminated with dioxins and furans, and chloracne may be linked to these compounds. In addition, hemolytic and aplastic anemia and weight loss have been reported in humans. Pentachlorophenol is classified as a probable human carcinogen (group 2B). 

Chronic (long-term) occupational exposure of workers to phosphine may cause inflammation of the nasal cavity and throat, weakness, dizziness, nausea, gastrointestinal, cardiorespiratory, and central nervous system symptomology, jaundice, liver effects, and increased bone density. Chronic exposure to very low concentrations may result in anemia, bronchitis, gastrointestinal disturbances, and visual, speech, and motor disturbances. Chronic exposure may be more serious for children because of their potential longer latency period. There is no evidence of cumulative effect in grain workers exposed for long periods to phosphine. Intermittent exposures for months led to headaches but no other symptoms. 

Chronic effects associated with occupational exposures to turpentine include cerebral atrophy, behavioral changes, anemia, bone marrow damage, glomerulonephritis, and dermatitis. Urinary disturbances, albuminuria, and urinary casts were observed in workers exposed to paints and varnishes. Elowever, renal damage associated with occupational exposures to turpentine was transient and reversible. 

Zidovudine In combination with lamivudine for occupational exposures that have recognized risk for HIV transmission Basic regimen Zidovudine 300 mg BID, given with lamivudine for 28 days Nausea, vomiting, headache, fatigue, anemia, neutropenia Renal excretion of metabolite Food may affect peak plasma concentrations but not overall exposure... 

Narcotic causes somnolence, nausea, vomiting, and headache irritant chronic toxicant occupational exposure can cause bone marrow depression and anemia carcinogenic to humans flammable liquid flash point (closed cup) — 11°C (12°F) LEL and UEL values 1.3 and 7.1% by volume, respectively ... 

B. After chronic exposure, hematologic disorders such as pancytopenia, aplastic anemia, acute myelogenous leukemia, and its variants may occur. Causality is suspected for chronic myelogenous leukemia, chronic lymphocytic leukemia, multiple myeloma, Hodgkin s disease, and paroxysmal nocturnal hemoglobinuria. There is unproven association between benzene exposure and acute lymphoblastic leukemia, myelofibrosis, and lymphomas. Chromosomal abnormalities have been reported, although no effects on fertility have been described in women after occupational exposure. 

Epidemiological and Human Dosimettv Studies. Acute high-level exposure to zinc by inhalation resulted in respiratory irritation and metal fume fever (Blanc et al. 1991 Hjortso et al. 1988 Johnson and Stonehill 1961 Linn et al. 1981 Schenker et al. 1981 Sturgis et al. 1927). Welders are a subpopulation of workers who have a high potential for exposure to zinc oxide. Most of the available studies did not report exposure levels or used a small number of subjects. Studies that correlate occupational exposure to zinc with health effects would be useful. A number of human oral exposure studies have shown that excess levels of zinc can result in anemia, pancreatic damage, decreased serum HDL cholesterol levels, and immunotoxicity (Black et al. 1988 Chandra 1984 Hooper et al. 1980). There are insufficient data for establishing dose-response relationships. 

Collectively, the large body of research on lead and anemia, only briefly explored here, consistently indicates that occupational exposure to lead is associated with biochemical and morphologic damage of erythrocytes. Moreover, the notion that BLLs over 50 pg/dL are required appears to have been put to rest by more recent research. 

Occupational exposure to lead has consistently been associated with biochemical, morphologic, and physiologic effects that can impair erythrocyte formation and survival and ultimately lead to anemia. However, the hterature varies in its estimates of the BLLs required to have chnically significant effects on those outcomes. Table 4- 2 summarizes the studies and presents the BLL associated with each particular hematologic outcome. 

Wang HH, Grufferman S. 1981. Aplastic anemia and occupational pesticide exposure A case-control study. J Occup Med 23(5) 364-366. 

Prolonged exposure to nitrous oxide decreases methionine synthase activity and theoretically can cause megaloblastic anemia, a potential occupational hazard for staff working in inadequately ventilated dental operating suites. 

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