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Rationale: Workplace inhalational hazards remain common worldwide, even though they are ameliorable. Previous American Thoracic Society documents have assessed the contribution of workplace exposures to asthma and chronic obstructive pulmonary disease on a population level, but not to other chronic respiratory diseases. The goal of this document is to report an in-depth literature review and data synthesis of the occupational contribution to the burden of the major nonmalignant respiratory diseases, including airway diseases; interstitial fibrosis; hypersensitivity pneumonitis; other noninfectious granulomatous lung diseases, including sarcoidosis; and selected respiratory infections. Methods: Relevant literature was identified for each respiratory condition. The occupational population attributable fraction (PAF) was estimated for those conditions for which there were sufficient population-based studies to allow pooled estimates. For the other conditions, the occupational burden of disease was estimated on the basis of attribution in case series, incidence rate ratios, or attributable fraction within an exposed group. Results: Workplace exposures contribute substantially to the burden of multiple chronic respiratory diseases, including asthma (PAF, 16%); chronic obstructive pulmonary disease (PAF, 14%); chronic bronchitis (PAF, 13%); idiopathic pulmonary fibrosis (PAF, 26%); hypersensitivity pneumonitis (occupational burden, 19%); other granulomatous diseases, including sarcoidosis (occupational burden, 30%); pulmonary alveolar proteinosis (occupational burden, 29%); tuberculosis (occupational burden, 2.3% in silica-exposed workers and 1% in healthcare workers); and community-acquired pneumonia in working-age adults (PAF, 10%). Conclusions: Workplace exposures contribute to the burden of disease across a range of nonmalignant lung conditions in adults (in addition to the 100% burden for the classic occupational pneumoconioses). This burden has important clinical, research, and policy implications. There is a pressing need to improve clinical recognition and public health awareness of the contribution of occupational factors across a range of nonmalignant respiratory diseases.

Introduction: Exposure to Bisphenol A (BPA) during early development particularly in-utero has been linked to a wide range of pathology. Over the last two decades the importance of vitamin D in maternal and child health has been highlighted. The aim of this pilot study was to examine the relationship of BPA and its naturally occurring metabolite BPA-glucuronide (BPA-g) with 25-hydoxy vitamin D (25OHD) levels in South African mother-child pairs. Methods: Third-trimester serum maternal samples and matching cord blood samples were analyzed for BPA and BPA-g using liquid chromatography tandem mass spectrometry (LC-MS/MS) and 25OHD3 and 25OHD2 using high performance liquid chromatography. A total of 58 maternal and child pairs were analyzed. Results: More than fifty percent of maternal-child pairs were noted to be vitamin D deficient or insufficient using the Endocrine Society Practice guidelines cut-off of 50 nmol/L. Spearman rank correlation and Kruskal Wallis analysis did not show statistically significant relationship between cord 25OHD (total) and maternal and cord BPA-g concentrations. Analysis of covariance after controlling for confounders showed a significant relationship between cord BPA-g levels and cord 25OHD levels (p=0.03) as well as between maternal BPA-g levels (p=0.04) and cord total 25OHD levels (p=0.04). Discussion: The findings of the current study indicate a possible relationship with BPA/BPA-g and fetal/early infant Vitamin D levels that needs to be further investigated in this population. [ABSTRACT FROM AUTHOR]

Evidence suggests that pollutants like particulate matter and heavy metals significantly impact health. This study investigated the determinants and sources of indoor PM2.5 heavy metals and assessed the health risk to children in Durban. Thirty households of mothers participating in the mother and child in the environment (MACE) birth cohort study were assessed for PM2.5 heavy metals. Multivariate linear regression was used to identify the determinants of PM2.5 heavy metals, while Pearson correlation and principal component analysis identified their sources. The health risk for children was assessed using measured metal concentrations. Proximity to industry, wall type, house age, and presence of windows increased some PM2.5 heavy metals, while cross ventilation reduced indoor PM2.5 As and Cu levels. Pearson correlation and principal component analysis indicated household, traffic, industrial, and natural sources as potential contributors. The health index was greater than 1, and cancer risk values for PM2.5 As and Pb exceeded acceptable levels. The findings highlight the toxicity of indoor air due to heavy metals and the potential for adverse health outcomes in children. To protect vulnerable groups, it is essential to prevent exposure to high-risk metals. [ABSTRACT FROM AUTHOR]