Jönsson Lena S, Lindh Christian H, Bergendorf Ulf, Axmon Anna, Littorin Margareta, Jönsson Bo A G
Division of Occupational and Environmental Medicine, Lund University Hospital, SE-221 85 Lund, Sweden.
Scand J Work Environ Health. 2009 May;35(3):203-11. doi: 10.5271/sjweh.1323. Epub 2009 Apr 29.
The aim of this study was twofold: (i) to evaluate the air levels of N-nitrosamines in the Swedish rubber industry and (ii) to estimate the risk of symptoms and changed levels of immunologic markers in relation to these levels.
Using adsorption tubes, we collected samples of N-nitrosamines in the breathing zone of 96 rubber workers and analyzed them with liquid chromatography tandem mass spectrometry. Of these 96 workers, 66 were included in a medical examination and blood analysis together with an additional 106 rubber workers and 118 unexposed subjects. Medical and occupational histories were obtained in structured interviews, symptoms were recorded and immunologic markers analyzed in blood.
The sum of N-nitrosamines ranged from less than the limit of detection to 36 microg/m (3)and differed with the vulcanization (ie, curing process) method used. Workers vulcanizing with a salt bath had the highest levels (median 4.2 microg/m (3)). Compared to the unexposed subjects, the rubber workers had an increased risk of nosebleeds, eye and throat symptoms, hoarseness, cough, nausea, headache, and changed levels of eosinophils and total immunoglobulin G (IgG). However, we found no clear exposure-response relationship with the symptoms or the immunologic markers studied.
High levels of N-nitrosamines were found and must be lowered considerably in order to decrease the risk of cancer. There is a need for an occupational exposure limit for N-nitrosamines in Sweden. The lack of exposure-response relationships with the subacute symptoms examined in this study may be due to a healthy-worker selection or to the possibility that the symptoms are caused by an exposure not co-varying with N-nitrosamines.
本研究有两个目的：（i）评估瑞典橡胶行业空气中N-亚硝胺的水平；（ii）评估与这些水平相关的症状风险以及免疫标志物水平的变化。
我们使用吸附管收集了96名橡胶工人呼吸带中的N-亚硝胺样本，并采用液相色谱串联质谱法进行分析。在这96名工人中，66人参与了医学检查和血液分析，另外还有106名橡胶工人和118名未接触者。通过结构化访谈获取医学和职业病史，记录症状并分析血液中的免疫标志物。
N-亚硝胺的总量范围从低于检测限到36微克/立方米，且因所使用的硫化（即固化过程）方法而异。采用盐浴硫化的工人水平最高（中位数为4.2微克/立方米）。与未接触者相比，橡胶工人鼻出血、眼睛和喉咙症状、声音嘶哑、咳嗽、恶心、头痛以及嗜酸性粒细胞和总免疫球蛋白G（IgG）水平变化的风险增加。然而，我们未发现与所研究的症状或免疫标志物有明确的暴露-反应关系。
发现了高水平的N-亚硝胺，为降低癌症风险必须大幅降低其水平。瑞典需要制定N-亚硝胺的职业接触限值。本研究中未发现与所检查的亚急性症状存在暴露-反应关系，可能是由于健康工人的选择，或者是这些症状可能由与N-亚硝胺不相关的暴露引起。
