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Variability in endotoxin exposure levels and consequences for exposure assessment

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Author: Spaan, S. · Schinkel, J. · Wouters, I.M. · Preller, L. · Tielemans, E. · Nij, E.T. · Heederik, D.
Institution: TNO Kwaliteit van Leven
Source:Annals of Occupational Hygiene, 5, 52, 303-316
Identifier: 240893
doi: doi:10.1093/annhyg/men024
Keywords: Safety Chemistry · Food and Chemical Risk Analysis · Endotoxin exposure · Codes (standards) · Codes (symbols) · Database systems · Dust control · Electronic equipment testing · Health · Adverse health effects · Biological agents · Bulk production · Chemical agents · Chemical exposures · Compliance testing · Cyclic processes · Day to day variability · Determinants of exposure · Effectively control · Epidemiological studies · Exposure assessment · Exposure groups · Exposure levels · Individual (PSS 544-7) · Inhalable dust · Large databases · Mixed effects models · Occupational hygiene · Oxford University · Plant materials · Potential exposures · Repeated measurements · Subsectors · Variance Components · Dust · Endotoxin · Data analysis · Dust exposure · Exposure variable · Occupational hazard · Variance · Air Pollutants, Occupational · Endotoxins · Environmental Monitoring · Humans · Inhalation Exposure · Occupational Exposure · Reproducibility of Results · Akkerbouw · Plantenteelt · Stof · Bacterien · Microorganismen · Metingen · Meetmethoden · Databanken · Beroepsgroepen · Beroepen · Zoologie · Epidemiologie


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.