Health Assessment Document for Diesel Emissions - NSCEP | US ...

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1 The corresponding odds ratios for petrol exhausts were 0.6 (95% Cl = 0.3, 1.3), 1.4 (95% CI = 2 .0.5, 3.7), and 3.9 (95% CI = 0.4, 35.5). Restricting the analysis to only moderate or high annual 3 doses of exposure adjusted for year of birth and smoking showed a sevenfold increased risk for· 4 subjects exposed to both diesel and petrol exhausts (OR= 7.1, 95% CI = 0.9, 58.8). For · 5 exposure to diesel (OR= 1.1) and petrol (OR= 1.0) exhausts alone, no excess risk was detected 6 in this analysis. Odds ratios were calculated for low, moderate, and high exposure to benzene, 7 with rates of 1.7 (95% CI = 0.6, 5.1) for low annual doses, 1.1 (95% CI = 0.3, 4.5) for moderate 8 annual doses, and 3.0 (95% CI = 1.0, 8.7) for high annual doses. 9 The authors discuss misclassification and confounding as sources of bias in this study. 10 To examine misclassification they compared hygienist-assessed exposure and self-reported 11 exposure for printing ink and found a higher relative risk and fewer exposed subjects for 12 hygienist-assessed exposure, indicating that specificity was a problem for self-reported exposure. 13 It is not known to what extent this may have affected the risk estimates for diesel exhausts since 14 data on self-reported exposure to diesel are not presented. They also mention the possibility of 15 exposure misclassification from using an average annual dose in which a person exposed to an 16 agent at a high level for a few working days and a person exposed to a low level for many days 17 are both rated as exposed to low annual doses. Although statistically nonsignificant elevated 18 odds ratios of 1.3, 2.3, and 2.9 were derived for low, moderate, and high levels of diesel 19 exposure, the authors state that some of their subjects may have later worked in jobs with 20 benzene exposure, and because an elevated risk was detected for benzene exposure, this 21 ·confounding effect may explain some of the excess risk. An almost statistically significant 22 interaction was observed for exposure to combined diesel and petrol exhausts (OR =·7.1, 95% CI 23 = 0.9, 58.8), which changed to 5.1 (95% CI = 0.6, 43.3) after adjustment for benzene exposure, 24 again providing evidence for the confounding role of benzene exposure in explaining some of the 25 observed results. 26 Table 8-3 summarizes the bladder cancer case-control studies. 27 28 8.5. DISCUSSION AND SUMMARY 29 Certain extracts of diesel exhaust have been demonstrated to be both mutagenic and 30 carcinogenic in animals and in humans. Animal data suggest that diesel exhaust is a pulmonary 31 carcinogen among rodents exposed by inhalation to high doses over long periods of time. 32 Because large working populations are currently exposed to diesel exhaust and because 33 nonoccupational ambient exposures currently are of concern as well, the possibility that exposure 34 to this complex mixture may be carcinogenic to humans has become an importantpublic health 35 issue. 2/1/98 8-54 DRAFT--DO NOT CITE OR QUOTE
N ...... --- \0 ---- 00 00 I VI VI 0 § I I 0 0 z 0 >-1 n ...... >-1 tT1 0 :::0 tO c:: 0 >-1 tT1 Authors Population studied Howe et al. 480 male case-control pairs (1980) 152 female case-contro.l pairs · Wynder et al. (1985) Table 8-3. Epidemiologic studies of the-health effects of exposure to diesel exhaust: case-control studies of bladder cancer Cases diagnosed between April 1974 and June 1976 in three Canadian provinces Matched on age and sex 194 histologically confirmed male cases between the ages of 20 and 80 years 582 matched controls (age·, race, year of interview, and hospital of admission); diseases not related to tobacco use From 18 hospitals located in six U.S. cities between Januarv 1981 and Mav 1983 Diesel exhaust exposure assessment Based on occupational history of jobs involving exposure to dust and fumes A priori suspect industries Occupational titles were defined by Industrial Hygiene Standard into dichotomous "exposed" and "not exposed" Also defmed by NIOSH standards into "high exposure," "moderate exposure," and "low exposure" Results Limitations SNS RR = 2.8 for diesel and Exposure based on occupational traffic fumes history, which was not validated SS RR = 9.00 for railroad workers SNS ORs were 1.68 and 0.16 for high, and moderate exposure, respectively, as compared to low exposure Diesel exhaust and traffic fumes were combined Only 77% of eligible population included in the study Exposure based on usual occupation may have led to misclassification Dichotomous classification made dose-response analysis unattainable No data on other confounders such as smoking
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DRAFT DO NOT CITE OR QUOTE Health A
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CONTENTS (continued) 2.5.1. Volatil
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CONTENTS (continued) 11.2.1. H.fl.Z
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LIST OF TABLES (continued) 2-14. Me
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PREFACE This draft health assessmen
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AUTHORS, REVIEWERS, AND CONTRIBUTOR
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l. INTRODUCTION 1 Diesel engines ar
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1 achieved by using specific solven
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Nitro-PAH• Table 2-10. Concentrat
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1 pollutants depends on the amount
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1 For the simplest alkoxy radicals,
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1 2 3 4 5 6 7 8 9 10 11 12 13 H ON0
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1 conditions (Pitts et al., 1985c )
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Table 2-14. Mean particle, gas, and
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1 sample collection. There was no b
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1 of downtown Los Angeles (Arey et
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1 exposures. This is a complex ques
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1 Dunstan, TDJ; Mauldin, RF; Jinxia
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1 Lipkea, WH; DeJoode, AD; Christen
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1 Pitts, JN, Jr; Sweetman, JA; Ziel
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1 NOTE TO READERS CHAPTER3 2 Becaus
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1 volume basis (Table 4-1 ). This i
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1 Pritchard (1989), utilizing data
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1 4.3.3.3. Potential Mechanisms for
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1 not accurately reflect the actual
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1 Lee, PS; Chan, TL; Hering, WE. (1
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1 one-half units up to 3, strong (O
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Study Ulfvarson et a!. (1987) Batti
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N -,_. -\0 00 VI N ,_. 0 § I I 0 0
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1 control]). Heinrich et al. (1986a
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1 Heinrich et al. ( 1986a; see also
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1 thoracic area at subsequent times
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1 with matched controls for the num
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----- N \0 00 VI I 0'1 N tJ § I I
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1 In related studies, Navarro et al
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1 Mauderly et al. (1987b) evaluated
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1 pattern of adverse effects on res
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1 DPM concentrations) that resulted
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
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1 Klosterkotter, W; Blinemann, G. (
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1 Misiorowski, RL; Strom, KA; Vosta
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1 Wright, ES. (1986) Effects of sho
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1 Studies showing these effects are
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1 exposure level. In the 0.3 5 mg/m
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1 to derive the RfC. The discussion
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1 The BMC values are the lower 95%
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Table 6-5. Results of benchmark con
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1 U.S. Environmental Protection Age
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1 the latter, 16 were classified as
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
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1 burdens of the NMRI mice after 12
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1 with four to seven rings), which
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1 five daily doses of2,000 f...lg.
Page 338: 1 occupations. The observed absence
Page 346: 1 occupations). Analysis was conduc
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Page 370 and 371: 1 Approximately 20,000 miners are e
Page 375 and 376: 1 bladder cancer was found in Canad
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Page 382 and 383: 1 Kaplan, I. (1959) Relationship of
Page 385: 9. MUTAGENICITY 1 Since 1978, more
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Page 391 and 392: 1 9.5. REFERENCES 2 3 "Barfknecht,
Page 394 and 395: 1 U.S. Environmental Protection Age
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Page 399: 1 inconsequential in rats relative
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1 Caution must be exercised in extr
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1 Rister, M: Baehner, RL. ( 1977) E
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1 The potency of the other diesel e
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Table 11-2. Incidence of lung tumor
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Table 11-5. Unit risk estimates per
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
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1 to reflect the potency of several
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1 Huisingh. J; Bradow, R; Jungers,
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1 particles are fine and ultrafine
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1 are available. Exposure is most o
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1 · some of which can be informed
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1 For example, in a recent meta-ana
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1 nonthreshold-mutagen driven MOA.
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1 that their developing pulmonary a
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1 impacts. Use of these measures re
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2/1198 Appendix A Experimental Prot
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APPENDIX A. EXPERIMENTAL PROTOCOL A
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2/1198 Appendix B Alternative Model
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1 d: Dose of organics, mg/cm 2 of l
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Table B-4. Comparison of observed t
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1 uncertainties below). Based on th
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1 B.lO. RFERENCES 2 3 Bohning D., A
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1 and 2 m.(t) = (y2i - YI/exp[Ap)a/
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1 C.l. INTRODUCTION 2 As discussed
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1 For mouth breathing: 2 (DF)H . =
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TABLE C-1. LUNG MODEL FOR RATS AT T
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TABLE C-3. RATIO OF PULMONARY SURFA
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