How important is inadvertent ingestion of hazardous substances at work?
How important is inadvertent ingestion of hazardous substances at work?
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DOI：
10.1093/annhyg/mel035
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发表时间：
2006-10-01
影响因子：
--
通讯作者：
Philips, Andrew
中科院分区：
文献类型：
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作者：
Cherrie, John W.;Semple, Sean;Philips, Andrew
人们对人类通过吸入和皮肤接触接触工作场所有害物质的了解很多，但对工作中使用的有害物质摄取的系统研究很少。这篇综述试图确定无意中摄入有害物质是否是工作场所暴露的重要途径，并检查可用于量化摄入暴露的可能方法。一些论文强调了意外摄入可能很重要的工作和物质，通常是通过案例报告或理论分析。这些情况涉及接触一些金属或金属化合物、药品、杀虫剂、一些感染剂、未密封的放射源和一些高分子过敏原。我们估计，在英国，总共约有450万工人可能会因无意摄入而经常摄入有害物质。对不慎摄入暴露的概念性分析强调了手对嘴和对象对嘴事件作为主要接触过程的作用。定义了两个暴露‘隔间’：口腔周围区域(即口腔外侧的皮肤区域)和口腔。强调了与暴露有关的测量的几个选择，包括口腔周围擦拭、唾液样本、口腔漱口样本、手擦和指甲下刮痕。有必要进行进一步的研究，以确定哪些测量可能是最具信息量的。人类行为在确定无意摄取暴露方面起着关键作用。例如，有些人习惯咬指甲或反复触摸嘴巴，这两种情况都会增加他们手中摄入污染物的机会。人们触摸面部的频率取决于他们工作的环境，可能还有他们承受的心理压力的程度。正确理解这些因素的重要性将有助于设计干预措施，以减少工作中摄入危险物质的风险。在进行吸入或皮肤暴露测量时，我们建议记录个人行为的细节，以便可以推断摄取风险的一些估计。随着雇主更加重视控制吸入和皮肤暴露，在工作中无意中摄入有害物质可能会变得更加重要。有必要进行进一步研究，以确保针对无意摄入危险物质的风险降低战略是适当和有效的。
Much is known about human exposure to workplace hazardous substances by inhalation and from skin contact, but there has been little systematic research into ingestion of hazardous substances used at work. This review attempts to identify whether inadvertent ingestion of hazardous substances is an important route of exposure in the workplace and examines possible methods that could be used to quantify ingestion exposure. A number of papers highlight jobs and substances where inadvertent ingestion may be important, typically through case reports or from a theoretical analysis. These scenarios involve exposure to some metals or metal compounds, pharmaceuticals, pesticides, some infectious agents, unsealed radioactive sources and some high molecular weight allergens. In total we estimate that about 4.5 million workers in the UK could have some regular non-trivial intake of hazardous substances by inadvertent ingestion. A conceptual analysis of inadvertent ingestion exposure highlights the role of hand-to-mouth and object-to-mouth events as the primary exposure processes. Two exposure 'compartments' are defined: the peri-oral area (i.e. the area of skin around the outside of the mouth) and the oral cavity. Several options are highlighted for exposure-related measurements, including peri-oral wipes, saliva samples, mouth-rinse samples, hand-wipes and under-nail scrapings. Further research is necessary to define which measurements may be most informative. Human behaviour has a key role in determining inadvertent ingestion exposure. For example, some people are habitual nail biters or repeatedly touch their mouth, both of which will increase the chance of ingesting contaminants on their hands. The frequency that people touch their face is dependant on the circumstances of their work and probably the degree of psychological stress they are under. A proper understanding of the importance of these factors will help in designing interventions to reduce the risks from ingesting hazardous substances at work. When making inhalation or dermal exposure measurements we recommend that details of personal behaviours should be recorded so that some estimate of ingestion risks can be inferred. It is possible that inadvertent ingestion of hazardous substances at work may become more important as employers put more emphasis on controlling inhalation and dermal exposures. Further research is necessary to ensure that risk reduction strategies for inadvertent ingestion of hazardous substances are appropriate and effective.