Biological Monitoring of Occupational Exposure to Polycyclic Aromatic Hydrocarbons in Prebake Smelting Ross Di Corleto Bachelor of Applied Science (Applied Chemistry) Postgraduate Diploma Occupational Hygiene Master of Science A thesis submitted for the degree of Doctor of Philosophy School of Public Health, Faculty of Health Queensland University of Technology 2010 Keywords • 1-hydroxypyrene • prebake • smelting • biological monitoring • benzene-soluble fraction • coal tar pitch volatiles • polycyclic aromatic hydrocarbons • anode plant • personal monitoring ii Abstract In 1984, the International Agency for Research on Cancer determined that working in the primary aluminium production process was associated with exposure to certain polycyclic aromatic hydrocarbons (PAHs) that are probably carcinogenic to humans. Key sources of PAH exposure within the occupational environment of a prebake aluminium smelter are processes associated with use of coal-tar pitch. Despite the potential for exposure via inhalation, ingestion and dermal adsorption, to date occupational exposure limits exist only for airborne contaminants. This study, based at a prebake aluminium smelter in Queensland, Australia, compares exposures of workers who came in contact with PAHs from coal-tar pitch in the smelter’s anode plant (n = 69) and cell-reconstruction area (n = 28), and a non-production control group (n = 17). Literature relevant to PAH exposures in industry and methods of monitoring and assessing occupational hazards associated with these compounds are reviewed, and methods relevant to PAH exposure are discussed in the context of the study site. The study utilises air monitoring of PAHs to quantify exposure via the inhalation route and biological monitoring of 1-hydroxypyrene (1-OHP) in urine of workers to assess total body burden from all routes of entry. Exposures determined for similar exposure groups, sampled over three years, are compared with published occupational PAH exposure limits and/or guidelines. Results of paired personal air monitoring samples and samples collected for 1-OHP in urine monitoring do not correlate. Predictive ability of the benzene-soluble fraction (BSF) in personal air monitoring in relation to the 1-OHP levels in urine is poor (adjusted R2 < 1%) even after adjustment for potential confounders of smoking status and use of personal protective equipment. For static air BSF levels in the anode plant, the median was 0.023 mg/m3 (range 0.002–0.250), almost twice as high as in the cell-reconstruction area (median = 0.013 mg/m3, range 0.003–0.154). In contrast, median BSF personal exposure in the iii anode plant was 0.036 mg/m3 (range 0.003–0.563), significantly lower than the median measured in the reconstruction area (0.054 mg/m3, range 0.003–0.371) (p = 0.041). The observation that median 1-OHP levels in urine were significantly higher in the anode plant than in the reconstruction area (6.62 µmol/mol creatinine, range 0.09–33.44 and 0.17 µmol/mol creatinine, range 0.001–2.47, respectively) parallels the static air measurements of BSF rather than the personal air monitoring results (p < 0.001). Results of air measurements and biological monitoring show that tasks associated with paste mixing and anode forming in the forming area of the anode plant resulted in higher PAH exposure than tasks in the non-forming areas; median 1-OHP levels in urine from workers in the forming area (14.20 µmol/mol creatinine, range 2.02–33.44) were almost four times higher than those obtained from workers in the non-forming area (4.11 µmol/mol creatinine, range 0.09–26.99; p < 0.001). Results justify use of biological monitoring as an important adjunct to existing measures of PAH exposure in the aluminium industry. Although monitoring of 1-OHP in urine may not be an accurate measure of biological effect on an individual, it is a better indicator of total PAH exposure than BSF in air. In January 2005, interim study results prompted a plant management decision to modify control measures to reduce skin exposure. Comparison of 1-OHP in urine from workers pre- and post-modifications showed substantial downward trends. Exposure via the dermal route was identified as a contributor to overall dose. Reduction in 1-OHP urine concentrations achieved by reducing skin exposure demonstrate the importance of exposure via this alternative pathway. Finally, control measures are recommended to ameliorate risk associated with PAH exposure in the primary aluminium production process, and suggestions for future research include development of methods capable of more specifically monitoring carcinogenic constituents of PAH mixtures, such as benzo[a]pyrene. iv Contents Page 1.0 INTRODUCTION 1 1.1 Background to the research 1 2 1.1.1 What are polycyclic aromatic hydrocarbons (PAHs)? 1.1.2 PAH carcinogenicity associated with aluminium smelting 4 1.2 Research contribution 1.3 Thesis outline 8 10 11 12 2.0 LITERATURE REVIEW 13 2.1 Routes of exposure 1.2.1 Aims and objectives 1.2.2 Hypotheses 2.4 2.5 2.6 2.7 Non-occupational exposures Biological exposure index Biological effect monitoring Summary 14 15 16 16 20 22 23 25 28 29 30 32 34 3.0 METHODS 35 3.1 3.2 3.3 Introduction Study context – plant process description Exposure groups 35 36 43 47 47 48 48 49 49 49 50 50 50 51 51 52 54 2.1.1 Inhalation 2.1.2 Ingestion 2.1.3 Skin absorption 2.2 2.3 Measures of PAH biological effect Exposure monitoring 2.3.1 Air monitoring 2.3.2 Biological monitoring 2.3.3 Exposure quantification 3.3.1 Forming group 3.3.1.1 Former technician 3.3.1.2 Tower technician 3.3.1.3 Equipment technician 3.3.2 Non-forming group 3.3.2.1 Mezzanine floor technician 3.3.2.2 Raw materials technician 3.3.2.3 Controller 3.3.2.4 Crew leader 3.3.2.5 Bake crane operator 3.3.2.6 Bake floor operator 3.3.3 Reconstruction group 3.3.3.1 Process technician 3.3.3.2 Bricklayer v 3.3.4 Non-production group 3.3.5 Exposure profile 3.3.6 Personal protective equipment 3.4 Recruitment of study participants 3.5 Exposure monitoring 3.4.1 Sample size calculations 3.5.1 Airborne exposure monitoring 3.5.1.1 Stationary monitoring of the process 3.5.1.2 Occupational monitoring of workers 3.5.1.3 Pre-shift briefing and daily work log 3.5.1.4 Analysis of air monitoring 54 54 55 56 57 58 58 59 64 65 3.6 Data management and statistical analysis 3.6.1 Outliers 66 70 70 72 73 74 75 77 4.0 RESULTS 79 4.1 4.2 Introduction Exposure variation in a prebake smelter (hypothesis 1) 79 81 81 81 82 3.5.2 Biological marker monitoring 3.5.2.1 3.5.2.2 3.5.2.3 3.5.2.4 Biological sample collection Combined sampling Potential confounders Participant communication 4.2.1 Static exposure levels 4.2.2 Personal exposure levels 4.2.3 Biological 1-OHP levels 4.3 Exposure variation in an anode plant of a prebake smelter (hypothesis 2) 4.3.1 Static exposure levels 4.3.2 Personal exposure levels 4.3.3 Biological 1-OHP levels 4.4 Personal air monitoring of BSF exposure and relationship to 1-OHP levels in urine (hypothesis 3) 4.4.1 Preliminary analysis ignoring potential confounders 4.4.1.1 Sensitivity of conclusion to presence of multiple measures 4.4.1.2 Impact of outlier 4.4.2 Multiple linear regressions 4.4.2.1 Role of confounders 4.4.2.2 Adjustment for identified confounders 4.4.2.3 Skin Exposure 4.4.2.4 Potential effect modification (subgroup differences in size of association) 4.5 Process intervention results 84 84 85 85 85 86 86 86 87 87 89 93 94 95 vi 5.0 DISCUSSION 97 5.1 Introduction 97 5.1.1 Exposures compared between the anode plant and the cell-reconstruction area of a prebake smelter 5.1.2 Exposures compared between forming and non-forming areas of the anode plant of a prebake smelter 5.1.3 Impact of unscheduled process interactions 5.1.4 Personal protective equipment 5.1.5 Assessment of the relationship between BSF in personal air samples and 1-OHP in urine 5.2 5.3 5.4 5.5 5.6 Strengths and limitations Process intervention as a result of early findings Additional key points Future research Recommendations for control measures 5.6.1 Engineering 5.6.2 Administrative 5.6.3 Personal protective equipment 5.6.4 Occupational health practice 5.6.5 Monitoring 5.6.6 Site Policy 5.7 Conclusions 98 102 106 107 109 111 114 116 123 125 125 126 128 128 129 129 129 REFERENCES 131 APPENDICES 143 Appendix 1: Appendix 2: Appendix 3: Appendix 4: Appendix 5: Appendix 6: 143 149 151 152 153 Participant recruitment presentation Participant consent form Participant daily work log Participant questionnaire Statistical analysis roadmap Aluminium smelting protocol for coal tar pitch volatile (CTPV) risk management. Appendix 7: Green Carbon PPE matrix 154 162 vii List of Tables Page Table 2.1: Absorption indices of pyrene and PAH for different anatomical sites (Adapted from van Rooij et al., 1993b) 18 Table 2.2: Comparison of RPFs for PAHs (Willes et al., 1992) 22 Table 3.1: Number of study participants and % participation 57 Table 3.2: Data for power and sample size calculations for the various SEGs 58 Average levels of PAH compounds in air monitoring in anode plant green carbon assessed by gas chromatography (Method 5515 in NIOSH, 1994) 69 Median static and personal measures of BSF in air and 1-OHP in urine, by sections within a prebake smelter 81 Identification of potential confounding variables of the association between 1-OHP levels and personal BSF levels 88 Relationship of 1-OHP levels and BSF for all samples in the anode plant and reconstruction areas at a prebake smelter site: impact of identified confounding variables (n = 58) 90 Table 3.3: Table 4.1: Table 4.2: Table 4.3: Table 4.4: Relationship of 1-OHP levels and BSF in the anode plant at the prebake smelter site: impact of identified confounding variables (n = 39) 91 Table 4.5: Relationship of 1-OHP levels and BSF in the anode plant forming area at the prebake smelter site: impact of identified confounding variables (n = 17) 92 Relationship of 1-OHP levels and BSF in the anode plant non-forming area at the prebake smelter site: impact of confounding variables (n = 22) 93 Table 4.6: Table 4.7: Relationship of 1-OHP levels and skin exposure in the anode plant and reconstruction area at the prebake smelter site: impact of identified confounding variables (n = 66) 94 Table 4.8: Degree of effect modification, by work area, of the relationship between 1-OHP levels and BSF among workers in all the combined groups 95 Table 4.9: 1-OHP in urine post-shift minus pre-shift for green carbon maintenance SEG sampled before and after changes implemented in 2005 96 viii List of Figures Page Figure 1.1: PAH ring structures of naphthalene, pyrene, benzo[a]pyrene and dibenzo[a,e]pyrene (Freeman, 2008) 3 Prebake aluminium reduction cell showing key components including anodes and cathodes (Boyne Smelters Ltd, 2001) 6 Figure 1.3: Relationship of SEGs studied within the prebake smelter 10 Figure 2.1: Level of dose of UVA required for a reaction on the skin in relation to varying lengths of skin contact time with coal-tar pitch (Adapted from Diette et al., 1983) 19 Metabolism sequence of BaP to the bay region diol epoxide, (+)-BaP-7,8-diol-9,10-epoxide-2 (Hodgson & Smart, 1985) 20 Different routes of exposure, distribution and metabolism of pyrene (ACGIH, 2005) 26 Figure 1.2: Figure 2.2: Figure 2.3: Figure 3.1: Centre-break prebake smelter aluminium reduction cell as used in the smelter in which the study was undertaken (IPAI, 1982) 38 Figure 3.2: Side-break prebake smelter aluminium reduction cell (IPAI, 1982) 38 Figure 3.3: New anode being installed into a prebake cell showing a typical configuration of a rod assembly and the carbon block which has been spray-coated with aluminium 39 Figure 3.4: Consumed anode being removed from a cell in a prebake smelter reduction line 40 Figure 3.5: Vertical-stud Söderberg aluminium reduction cell (IPAI, 1982) 41 Figure 3.6: Horizontal-stud Söderberg aluminium reduction cell (IPAI, 1982) 41 Figure 3.7: Vertical-stud Söderberg aluminium smelter reduction line 42 Figure 3.8: Structure and location of the study’s exposure groups 44 Figure 3.9: Carbon anode process within the anode plant 45 Figure 3.10: Carbon bake crane lowering green anodes into the bake furnace pit 51 Figure 3.11: Mechanical ramming of paste into the joints between the carbon blocks of the cathode using a Brochet machine 53 Figure 3.12: Ramming of paste into side-wall join using hand rammers 53 ix Figure 3.13: Potential exposure levels of SEGs 55 Figure 3.14: Clothing and PPE worn for working with coal-tar pitch paste 56 Figure 3.15: Monitoring pump and sample train configuration for NIOSH method 5042 60 Static sample pump setup in the green carbon paste area on the 6th floor of the anode plant 62 Carbon bake furnace for reduction lines 1 & 2; locations of static samples 62 Carbon bake furnace for reduction line 3; locations of static samples 62 Figure 3.19: Cell-reconstruction site static sample locations 63 Figure 3.20: Monitoring pump and sample train configuration with XAD tube for NIOSH method 5515 63 The 300 mm hemispherical breathing zone for positioning of the personal sampling head (Victorian Workcover Authority, 2000) 65 Contents of the 1-OHP in urine sampling kit provided to study participants at the beginning of each sample run 71 Figure 3.23: Enzymatic development of the metabolite 1-OHP 72 Figure 4.1: Static air BSF measures in the anode plant, anode plant forming area, anode plant non-forming area and reconstruction area in a prebake smelter in Queensland, Australia, 2002–04 83 Figure 4.2: Personal air BSF measures of workers in the anode plant, anode plant forming area, anode plant non-forming area and reconstruction area in a prebake smelter in Queensland, Australia, 2002–04 83 Figure 4.3: 1-OHP in urine of workers in the anode plant, anode plant forming area, anode plant non-forming area and reconstruction area in a prebake smelter in Queensland, Australia, 2002–04 84 Figure 5.1: Mechanical equipment technician performing maintenance on the anode former (Photograph taken after implementation of several changes to the requirement of PPE; note use of Tyvek® coveralls and impermeable gloves) 116 Figure 3.16: Figure 3.17: Figure 3.18: Figure 3.21: Figure 3.22: x Abbreviations 1-OHP 1-hydroxypyrene AAC Australian Aluminium Council ACGIH American Conference of Governmental Industrial Hygienists ANOVA analysis of variance ATSDR Agency for Toxic Substances and Disease Registry BaP benzo[a]pyrene BEI biological exposure index BEL biological exposure limit BHP Broken Hill Proprietary BSF benzene-soluble fraction BSM benzene-soluble matter ºC degree Celsius cr creatinine CTPV coal-tar pitch volatile EHL Environmental Health Laboratory eq equivalents Eq equation FID flame ionisation detector g gram h hour HPLC high-performance liquid chromatography IARC International Agency for Research on Cancer ID internal diameter IPAI International Primary Aluminium Institute J joule kg kilogram kPa kilopascal L litre m3 cubic metre mg milligram min minute mL millilitre mm millimetre NATA National Association of Testing Authorities xi ng nanogram NIOSH National Institute of Occupational Safety and Health NOHSC National Occupational Health and Safety Commission OEL occupational exposure limit OHS occupational health and safety OSHA Occupational Health and Safety Administration P450 cytochrome P450 PAC polycyclic aromatic compound PAH polycyclic aromatic hydrocarbon PPE personal protective equipment PTFE polytetrafluoroethylene PVC polyvinyl chloride RF reduction factor RPF relative potency factor SD standard deviation SEG similar exposure group TEF toxic equivalence factor TLV® threshold limit value® TWA time-weighted average UV ultraviolet UVA ultraviolet A V volume µg microgram µg micrograms µL microlitre µm micrometre µmole/mol cr micromole per mole creatinine xii Statement of Original Authorship The work contained in this thesis has not been previously submitted to meet the requirements for an award at this or any other higher education institution. To the best of my knowledge and belief, the thesis contains no material previously published or written by another person except where due reference is made. Signed: _____________________________________ Date: _____________________________________ xiii Acknowledgements I would like to gratefully acknowledge my principal supervisor Professor Beth Newman and associate supervisor Dr Diana Battistutta for all their assistance and patience over the years. My sincere thanks also go to Dr Gerry Walpole who was there with guidance and encouragement from day one until the finish of the project. I would also like to acknowledge the occupational health team at the smelter for their continued support in the many sampling programs undertaken across the site over the duration of the project as their assistance was a key factor in the success of the monitoring program. Also the leadership team at the smelter who were supportive of what was a relatively new concept and were always keen to try new ideas to improve their control programs. Many thanks to those employees in Reconstruction and Carbon who participated in the program over the years, wore the monitoring pumps and provided the necessary samples as required. Many of the control ideas were developed by them as they went about their work. And finally to my family, Ellen, Luke, Claire and my ever patient wife Gillian, for all they have put up with over the life of this thesis and all those weekends lost. I owe them much. xiv 1.0 INTRODUCTION Advances in modern industrial technology have played a major role in the social and economic progress of many nations. Associated with these technological advances can be the generation of health hazards with varying levels of impact; some of these hazards are easy to identify, but others are discovered only after significant research and investigation. It is important to identify and characterise potential harmful industrial exposures to individuals and the tasks or environments that generate them, and to develop methods to eliminate or control these exposures. The aluminium industry is one in which the process of production has potential to impact on the health of individuals associated with it. Developed in the mid-1800s, aluminium production is a relatively new industry. The Australian aluminium industry has grown dramatically since 1955 when production commenced at the Bell Bay smelter in Tasmania. By 2007, Australia accounted for 5.2% of world production of primary aluminium, produced 67 million tonnes of bauxite and was the world’s leading producer of alumina, and delivered 19 million tonnes of metallurgical or smelter-grade alumina, which is 26% of global production (AAC, 2007). According to the Australian Aluminium Council (AAC), since 1990 alumina production has increased by 70% and aluminium production by 58%. In 2007, the economic contributions of aluminium production to the Australian economy included direct employment of 17,000 workers, a capital replacement value of more than $30 billion, and exports of alumina and aluminium valued at $11.2 billion (AAC, 2007). 1.1 Background to the research In 1775, Sir Percival Pott, an English surgeon, published the first detailed description of an occupationally-induced cancer – chimney-sweeps’ cancer of the scrotum. This was attributed to soot penetrating the clothing of chimney sweeps and poor hygiene practices, resulting in prolonged contact of the scrotal skin where cancers were 1 developed (Pott, 1775). Chimney soot is now known to contain high levels of polycyclic aromatic hydrocarbons (PAHs) (Doll, 1975). In 1918, two Japanese scientists, Yamagiwa and Ichikawa, induced skin cancer in rabbits using coal tar (Pickering, 1999). Repeated application of crude coal tar, which contains PAHs, to the ears of rabbits for several months produced benign, and later malignant, epidermal neoplasms. 1.1.1 What are polycyclic aromatic hydrocarbons (PAHs)? PAHs are ubiquitous contaminants in the environment. They are also referred to as: PNAs (polynuclear aromatics), PACs (polycyclic aromatic compounds) and POM (polycyclic organic matter). PAHs are a mixture of organic compounds comprised of aromatic hydrocarbons. The major building block of their structure is the benzene ring, resulting in molecules containing fused-ring systems. This structure includes the most basic two-ring naphthalene or four-ring pyrene and higher five-ring benzo[a]pyrene and six-ring dibenzo[a,e]pyrene molecular compounds (Figure 1.1). PAHs with three or fewer benzenic ring structures exist predominately in the vapour phase with boiling points between 217 and 295ºC. Those with four rings can exist in both the vapour and particulate phases. Where the compound comprises five or more rings with boiling points greater than 375ºC, they mainly exist in the particulate phase (Cirla et al., 2007). The key carcinogenic PAH compounds of interest tend to be in the 4-6 ring structures, i.e., benzo(a)pyrene. There are hundreds of different configurations with some sources claiming up to 500 different PAH constituents (Lauwerys & Hoet, 2001); however, the vast majority of these compounds are rarely monitored. The most common approach by regulatory and institutional bodies is to concentrate on a limited number of key PAHs. The most common groupings are: • acenaphthene • acenaphthylene • anthracene • benz[a]anthracene • benzo[a]pyrene 2 • benzo[e]pyrene • benzo[b]fluoranthene • benzo[g,h,i]perylene • benzo[j]fluoranthene • benzo[k]fluoranthene • chrysene • dibenz[a,h]anthracene • fluoranthene • fluorene • indeno[1,2,3-c,d]pyrene • phenanthrene • pyrene Naphthalene Pyrene Benzo(a)pyrene Dibenzo(a,e) pyrene Figure 1.1: PAH ring structures of naphthalene, pyrene, benzo[a]pyrene and dibenzo[a,e]pyrene (Freeman, 2008) PAHs are formed when natural or synthetic organic materials incompletely combust with oxygen. They are derived from the elements of carbon and hydrogen. PAHs do not generally exist in the environment as discrete compounds, but are found as 3 complex mixtures of many different concentrations and compositions. Sources can include motor vehicle combustion engines, residential coal- or oil-fired heating systems, industrial environments, and natural sources such as bush fires and volcanoes. PAHs also can be found in substances such as crude oil, coal, coal-tar pitch, creosote, dyes, plastics, pesticides and, in a few instances, medical preparations. Due to their low vapour pressures, most PAHs entering the atmosphere as vapour will be adsorbed onto existing particles, condense on particles such as soot or form very small particles themselves. Their presence in the environment is not restricted to the air; they are often found in surface waters as a result of airborne fallout or industrial discharges, and also in the soil. Human exposure occurs through a variety of sources, including diet, tobacco smoking, pollution and occupational exposure. The route of entry to the body may be via inhalation, ingestion or dermal absorption. Coal tars are a viscous black or dark brown material byproduct formed during the destructive distillation of coal in a process known as carbonisation, or coking. They contain high-molecular-weight hydrocarbons, such as benzene, toluene, phenol, styrene, cresol, naphthalene and numerous PAHs, which volatilise when heated (Kurtz, Verma, & Sahai, 2003). The composition and properties of a coal tar depend primarily on the temperature of the carbonisation process and, to a lesser extent, on the nature (source) of the coal used as feedstock. In general, coal tars are complex combinations of hydrocarbons, phenols, and heterocyclic oxygen, sulphur and nitrogen compounds. More than 400 compounds have been identified in coal tars, and as many as 10,000 may be present. The content of PAHs in coal tars increases as the carbonisation temperature increases (ATSDR, 2002). Low-temperature coal tars (formed at temperatures below 700°C) contain a lower percentage (40–50%) of aromatic compounds than high-temperature coal tars (formed at temperatures above 700°C) (IARC, 1984). 1.1.2 PAH carcinogenicity associated with aluminium smelting Since Pott’s (1775) keen observations, other cancers related to exposure to PAHcontaining compounds have been identified. The International Agency for Research on Cancer (IARC) determined that key PAHs – benz[a]anthracene and 4 benzo[a]pyrene – are probably carcinogenic to humans; benzo[b]fluoranthene, benzo[j]fluoranthene, benzo[k]fluoranthene and indeno[1,2,3-c,d]pyrene are possibly carcinogenic to humans (IARC, 2005). Several epidemiological studies have revealed an increased mortality risk for neoplasms among workers exposed to mixtures of chemicals containing PAHs. In 1984, the IARC evaluated the carcinogenic risk of PAHs in industries, including primary aluminium production, coal gasification, coke production, and iron and steel founding. A cancer risk associated with the primary aluminium production process was identified: A number of individual polynuclear aromatic compounds for which there is sufficient evidence of carcinogenicity in experimental animals have been measured at high levels in air samples taken from certain areas in aluminium production plants. Taken together, the available evidence indicates that certain exposures in the aluminium production industry are probably carcinogenic to humans (IARC, 1984). It is important to note that the above statement is directed at aluminium smelting in general; levels of exposure can vary dramatically between different aluminium smelting processes. The 1984 IARC monograph did not differentiate between the two processes employed in the aluminium industry – the ‘Söderberg’ and the ‘prebake.’ Exposure to PAHs occurs during several tasks in the occupational environment of an aluminium smelter. The main source of exposure to PAHs is coal-tar pitch, which is used as a binding agent for the carbon anodes and cathodes, and utilised in the reduction cell (Figure 1.2). During the production of these components, there are varying exposures to PAHs via inhalation, ingestion and dermal adsorption. Konstantinov and Kuz’minykh (1971) found that concentrations of benzo[a]pyrene (BaP) generally were lower in the prebake reduction line than in the Söderberg reduction line, and that pitch-volatile concentrations were lower in carbon plant areas associated with prebake facilities than in the Söderberg reduction line. Bjørseth, Bjørseth and Fjeldstad (1978) also found PAH levels to be lower in prebake smelters; importantly they determined that a higher fraction of PAHs in the 5 Söderberg samples belonged to the higher-boiling, more hazardous PAH compound BaP than in the prebake anode facilities. Konstantinov and Kuz’minykh (1971) compared cancer mortality rates from Söderberg and prebake primary aluminium production plants in the USSR. Excesses of all cancers and of lung cancer specifically were claimed for the Söderberg-process Figure 1.2: Prebake aluminium reduction cell showing key components including anodes and cathodes (Boyne Smelters Ltd, 2001) workers, and an increased incidence of skin cancer was reported, particularly among young workers (IARC, 1984). Konstantinov, Simakhina, Gotlib and Kuz’minykh (1974) conducted further cancer mortality studies among reduction line workers in three aluminium plants, two using the Söderberg process and the other using the prebake process. Elevated ratios for lung cancer were reported in both Söderberg plants and for skin cancer in one Söderberg plant. No elevated ratios for lung or skin cancer were associated with the prebake plant. Milham (1979) noted an increase in the standardised mortality ratio in workers at a prebake smelter in Washington State for cancer of the pancreas and for lymphoma. Exposure was defined as occurring in carbon plants manufacturing anodes, relining or reconstruction of potrooms. 6 The existence of an association between exposure to coal-tar pitch volatiles (CTPV) in Söderberg potrooms and excess risk of bladder cancer has been established in several studies (Gibbs & Horowitz, 1979; Theriault, Cordier, Tremblay, & Gingras, 1984; Armstrong, Tremblay, Cyr, & Theriault, 1986). A case-control study in Chicoutimi, Quebec, revealed an increased risk of bladder cancer associated with employment in the reduction line of an aluminium plant that utilised the Söderberg technology (Theriault, De Guire, & Cordier, 1981). This association in those who did not smoke cigarettes (relative risk 1.90) was not much greater than the association between cigarette smoking and bladder cancer (relative risk 1.82); however, those aluminium reduction process workers who smoked cigarettes had a much higher relative risk (5.70) (Theriault et al., 1981). Tremblay, Armstrong, Theriault and Brodeur (1995) also demonstrated a clear association between bladder cancer and work in Söderberg smelter potrooms and cumulative exposure to CTPVs. In an extension of Gibbs’ (1985) study of the mortality of aluminium reduction plant workers, Armstrong, Tremblay, Baris and Theriault (1994) investigated the association between exposure and lung cancer in a case-cohort study of men who worked at least one year in manual jobs at a large aluminium smelter. The authors found that lung cancer rate ratios rose with cumulative exposure to CTPVs measured as benzene-soluble material (BSM), and predicted a lifelong excess risk of 2.2% after 40 years exposure at the current hygiene standard (0.2 mg/m3). The plant in this study employed both Söderberg and prebake types of cells, making it difficult to ascertain the respective influences of the technology in use. A meta-analysis prepared for the UK Health and Safety Executive (Armstrong, Hutchinson, & Fletcher, 2003) supported conclusions of previous studies that associated lung cancer with PAH exposure. While results for bladder cancer were not conclusive, predominately due to the much lower incidence of this cancer, a positive association of bladder cancer with the aluminium production industry was reported. A correlation between the aluminium industry and bladder cancer was reported also by Negri and La Vecchia (2007); however, it should be noted that this association was based on only two studies of aluminium production workers (Romundstad, Haldorsen, & Andersen, 2000; Tremblay et al., 1995). 7 A recent study undertaken in two prebake smelters in Australia found no excess of cancer or mortality; however, there was elevation of risks to incident mesothelioma and kidney cancer (Sim et al., 2009). 1.2 Research contribution Historically, research on occupational PAH exposure has taken place in a variety of settings, such as chimney sweeping, firefighting, paving industries and laboratories, however the composition of the pitch used in these settings can be quite different from that used in aluminium smelting. Studies relating to exposure to PAHs in aluminium smelting have tended to focus on the Söderberg process rather than the prebake process due to the higher levels within the Söderberg reduction lines. However, there are areas of potential exposure within the prebake process, particularly associated with the build of the reduction cells, i.e. the cathode and anode construction, which are addressed in this thesis. Moreover, previous limited research in modern prebake aluminium smelters has largely taken place overseas, failing to address the specific work conditions present in Australian plants, Australian work and safety guidelines, and the Australian climate, all of which are relevant to occupational health standards in this country. This study quantifies the levels of static and personal airborne exposure across the two key exposure areas of a prebake aluminium smelter in Queensland, Australia. It investigates correlations between airborne and biological levels to elucidate the exposure profile in a prebake smelter, in particular what are the important routes of exposure, proposes the most effective monitoring approach and suggests where measures to ameliorate risk associated with exposure to PAHs in the primary aluminium production process may be instigated. Several research questions are addressed: • What are the comparative levels of airborne exposure associated with reconstruction of the carbon cathode lining in the cell and the manufacture of the carbon anode? • Is there a significant exposure risk associated with routes other than air in primary aluminium prebake smelting? 8 • What contribution to exposure risk do skin contact and ingestion of particulates/residues represent? • Is the focus on airborne monitoring of PAHs (e.g. BSF and/or BaP) in the aluminium industry adequate to accurately characterise total occupational exposure to PAHs? Although biological monitoring can provide a measure of combined exposures from all routes and is being used at some sites, it has not been adopted as a routine method for exposure characterisation in this industry because the key route of exposure is still regarded as airborne. As occupational exposure limits for PAHs only exist for airborne contaminants, all regulatory and surveillance process-control monitoring is undertaken using personal air sampling or static sampling. Both of these methods are utilised in this study as they are the current methodology in use in the primary aluminium industry. Although international guideline values exist, no biological exposure limits for PAHs are used by a regulatory body in Australia. To identify where the higher levels of exposure to PAHs occur in a prebake smelter, exposures of workers comprising similar exposure groups (SEGs), utilising static and personal air monitoring and biological monitoring to measure the PAH exposure levels, were compared. The relationships of these SEGs within the smelter are illustrated in Figure 1.3. Reduction line or potline workers were not included in this assessment due to limited time and resources, however, previous monitoring undertaken at the smelter indicated low levels of exposure in the reduction line. 9 Non Production Aluminium Smelter Anode Plant Reconstruction Forming Non-forming Figure 1.3: Relationship of SEGs studied within the prebake smelter 1.2.1 Aims and objectives Airborne monitoring of PAHs has been the standard recommended approach for risk assessment where there is a potential for exposure to products or processes allied with PAHs. Static monitoring has been utilised to assess the potential fugitive emissions of the plant and process whilst personal monitoring of the individuals has been compared with known exposure standards utilised by many regulatory and nongovernment bodies. The primary aim of this study was to investigate whether airborne monitoring methods, accepted as the “gold” standard method for exposure assessment to PAHs, are still the most appropriate approach for the monitoring of exposure to PAHs in a pre-bake aluminium smelter and whether there has been any value added by the inclusion of biological monitoring. Furthermore, it was anticipated that a study of worker exposure to PAHs at this plant could serve as a model for biological monitoring of human-process interactions where fugitive CTPVs represent an occupational hazard. 10 Specific objectives of this study were: 1. To investigate the exposure levels of five similar exposure groups (SEGs) to airborne PAHs utilising both static and personal monitoring methods specifically within prebake smelting. 2. To evaluate the utility and benefit of monitoring 1-hydroxypyrene (1-OHP) in urine of workers as a routine method for determining exposure to PAHs in an anode-manufacturing facility in a modern prebake aluminium smelter. 3. To correlate the BSF of airborne samples, both static and personal, with the level of 1-OHP in urine of the workers in the plant. 4. To assess the contribution of non-respiratory PAH exposure, i.e. skin contact and particulate ingestion, to total body burden within a pre-bake aluminium smelter. 5. To evaluate whether the airborne monitoring of BSF or the biological method for 1-hydroxypyrene monitoring, either in isolation or as a multi-factorial exposure regime, is the most appropriate method for monitoring PAH exposure in a prebake aluminium smelter. 1.2.2 Hypotheses This project is of sufficient size to test the following alternative hypotheses with adequate statistical power. In a prebake smelter, based on the results of static air monitoring of the process, personal air monitoring of the individual and biological monitoring: 1. Workers in the carbon anode plant will have higher exposure to PAHs than workers in the cell-reconstruction area of the smelter. 2. Within the carbon anode plant, exposure to PAHs will be higher among workers involved in tasks associated with the paste-mixing and anodeforming areas than those in the non-forming areas of the carbon anode plant. 3. There is no evidence of a relationship between personal air monitoring for the BSF and 1-OHP in urine of workers involved with tasks in a prebake smelter. 11 1.3 Thesis outline Chapter 2 of this thesis reviews the literature in relation to the differing routes of exposure to PAHs and the monitoring of those exposures. It considers the applicability of biological exposure indices and how these are calculated for specific environments. The chapter concludes with a review of the role of biological effect monitoring in the assessment of exposure to PAHs and risk quantification. Chapter 3 outlines the research methods used to achieve the study objectives. After explaining the study site and the aluminium reduction process, it describes the exposure groups and study participants, and provides details of air and biological monitoring sample collection and analysis, and data management and statistical analysis. Chapter 4 presents the results for air and biological monitoring for the particular areas of interest in the prebake aluminium smelter. Statistical relationships are examined, and the results from comparison of the data sets in relation to the three hypotheses are presented. Also included are results from data collected before and after a plant process intervention. Chapter 5 discusses the research findings, and examines the results in relation to other relevant studies. Strengths and limitations of the study are considered, and recommendations are made for future research and implementation of control measures. 12 2.0 LITERATURE REVIEW In 1984, the IARC listed employment in the primary aluminium industry as an occupation where there are exposures to compounds that are carcinogenic to humans, potentially giving rise to cancer of the lung and bladder (IARC, 1984). Based on multiple studies carried out within the aluminium industry around the world prior to 1984, the IARC identified pitch fume as a possible causative agent and, to date, has not reviewed this classification. With a selection of literature relating to PAH carcinogenicity associated with aluminium smelting reviewed in section 1.1.2, this chapter focuses on the routes of exposure to PAHs and the monitoring of those exposures. There have been a number of studies that examine PAH exposure and its assessment both biological and via inhalation over the years with some of these having been based in varied environments, such as chimney sweeping (Pavanello et al., 1999) and firefighting (Moen & Øvrebø, 1997), and others have been in controlled environments, such as laboratories (van Rooij et al., 1993b; Clonfero et al. 1989). Some ( Jongeneelen (2001); Unwin, Cocker, Scobbie, & Chambers, 2006) examined PAH exposure across several industries and occupations. These and a number of other studies that are referenced in this thesis have assessed PAH exposure from a number of different perspectives and across industries. Borak et al. 2002; McClean et al. 2004; Cirla et al. 2007, focussed on the paving industries and whilst there are some similarities in the exposures and the analysis undertaken, it is important to note that the composition of the pitch component in the paving and asphalt industries has a lower proportion of PAHs and is quite different from that used in the aluminium industry as is the Boogard et al. 1993 study based around the petrochemical industries looking at the manufacture and maintenance operations. The work undertaken in the carbon or graphite anode plants by Angerer, et al. (1997) provide a number of useful parallels for this study, however, again there are aspects missing that need to be addressed for the Australian context. In particular, the occupational exposure limit used in the Australian workplace is that of BSF whereas the Angerer paper undertook comparisons with specific components such as pyrene, phenanthrene and benzo(a)pyrene, which is more relevant for the German environment as they have an exposure limit for benzo(a)pyrene. Without 13 knowing the composition of the parent pitch compound, comparison with the aluminium industry is difficult. An anode graphitisation plant is also quite different from a prebake aluminium anode plant or cathode reconstruction process. The work by van Rooij et al., (1994a), (1993a); Buchet, Gennart et al. (1992); Wu et al. (1998); Jongeneelen, (1992) are all coke oven studies which provide valuable insight into the characteristics of exposure to PAHs, the history of the development of the 1hydroxypyrene biological monitoring process and establish correlations between air exposure and biological monitoring. However, the exposure profile of a coke oven is quite different to that of a prebake aluminium smelter and caution needs to be exercised when drawing comparisons. It is here where the studies undertaken by van Rooij et al., (1992); Friesen et al, (2008) Tjoe Ny et al. (1993) and Jessep (2007), help fill in some of the gaps. Whilst all of these studies were undertaken at primary aluminium smelters, which is the area of interest, with the exception of Jessep (2007), each of these were plants employing the Söderberg technology, which is quite different to the modern pre-bake process used at the smelter which is the subject of this study (see section 3.2 Study context – plant process description). This is an important aspect as previously discussed in section 1.1.2 as many of the epidemiological studies undertaken over the years which have shown a relationship between PAH exposure in aluminium smelting and cancer (Gibbs & Horowitz, 1979; Theriault, Cordier, Tremblay, & Gingras, 1984; Armstrong, Tremblay, Cyr, & Theriault, 1986) were undertaken at Söderberg smelters not prebake. The report by Jessep (2006) is the most similar study having been based at a relatively modern prebake smelter, carbon anode plant in the United Kingdom. The key differences being that the anode plant configurations were different, with the UK plant being a batching plant and the Australian, a continuous operation plant. The climates at the two locations were dramatically different, the UK plant being cold/temperate and the Australian sub-tropical. Also, the exposure associated with cell reconstruction was not considered and a comparison of the BSF and biological data was not undertaken. 2.1 Routes of exposure Occupational exposure to PAHs may occur via three different routes: inhalation, ingestion and skin absorption (ATDSR, 1995). The main route of exposure will be 14 dependent on the environment, process, work practices and, in some cases, the level and type of PPE worn. The route of exposure to PAHs can play a major role in their fate within the body. Inhaled compounds may bypass the liver and reach peripheral tissues in higher concentrations than would be seen via oral exposures (ACGIH, 2005). To date, the predominant method of assessment of exposure to PAHs has been the monitoring of contaminant levels in the air. This method is based on the assumption that the key route of exposure is via inhalation and does not consider ingestion or skin absorption as discussed below. 2.1.1 Inhalation Although occupational studies have shown that humans absorb inhaled PAHs, the extent of the absorption is unknown. Some animal studies have indicated that this absorption may be affected by the medium on which the PAHs are being transported (Gerde & Scholander, 1989; ATDSR, 1995). This absorption occurs through the mucous lining of the bronchi. As PAHs are generally lipophilic, they can cross the lungs through passive diffusion and partitioning into lipids and water of cells (Gerde, Medinsky, & Bond, 1991). Creasia, Poggenburg and Nettesheim (1976) showed that the elimination of benzo[a]pyrene (BaP) from the lungs following intratracheal administration of pure BaP crystals and BaP-coated carbon particles varied; while 50% of the pure BaP crystals was cleared from the lungs within 1.5 hours and more than 95% cleared within 24 hours, only 50% of the BaP that was adsorbed onto the carbon particles had cleared within 36 hours. The clearance period was even longer for the larger particle size carbon (4–5 days). This indicates that the bioavailability of BaP is affected by the nature of the carrier and the particle size. Gerde and Scholander (1989) concluded that the rate-determining step in the transport of PAHs from particles to the bronchial epithelium is the release rate of the PAHs from the carrier particles. Becher and Bjørseth (1983) found that the high concentration of PAHs in an occupational setting did not correlate with the results of the amount found in the testing of the subjects’ urine samples. They concluded that PAHs adsorbed to airborne particulate may not be readily bioavailable and that the doseuptake relationship may vary over the PAH concentration range. Whilst this is a feasible conclusion, Becher and Bjørseth (1983) did not indicate whether subjects used respiratory PPE. 15 2.1.2 Ingestion There is limited information available in relation to exposure to PAHs via ingestion; the majority of occupational exposure studies focus on inhalation or dermal routes. It is known that consumption of some foods results in the detection of metabolites in the urine. Factors affecting the concentration of PAHs in food include the location in which it was grown, the manner of preparation, the time of exposure to and distance from heat sources, and the use of fat (IARC, 1973). Approximately 100 PAHs have been found in smoked fish, and concentrations of up to 2.0 µg BaP per kg smoked fish have been detected (Zedeck, 1980). The effect of a diet that may contain high levels of PAHs impacts on urinary 1-hydroxypyrene (1-OHP) levels to a lesser extent. Borak, Sirianni, Cohen, Chermerynski and Jongeneelen (2002) found that levels of 1-OHP in urine did not differ significantly among creosote facility workers who did and did not eat grilled foods, and the number of grilled servings was unrelated to urinary 1-OHP. Where there is a low environmental exposure, grilled food consumption is likely to be more easily detected, and where there are other significant sources such as occupational exposure, the impact of food is less likely to be distinguished from total body burden. In relation to oral absorption, it is known that uptake will increase with an increase in the lipophilic nature of the compound or the presence of oils in the gastrointestinal tract. Busbee, Norman and Ziprin (1990) found that virtually all gastrically instilled BaP is absorbed via uptake of fat-soluble compounds. 2.1.3 Skin absorption Over the years, mixtures of PAHs have been used to treat skin conditions and disorders in humans, providing substantial data describing the dermal effects of PAH exposure. Percutaneous absorption of PAHs appears to be rapid for both humans and animals, but can depend on the solvent (ATDSR, 1995). PAHs tend to accumulate in membranes and thus impact cell function if not removed (Klaassen, 2001). They are hydroxylated by cytochrome P450 isozymes in epidermal cells. Oxidative biotransformation, however, produces electrophilic epoxides that 16 can form DNA adducts. Phenols produced by re-arrangement of the epoxides can be oxidised further to quinones, resulting in active oxygen species, and they are also toxic electrophiles (Klaassen, 2001). In an investigation of exposure among paving workers utilising skin contamination monitors, Jongeneelen et al. (1988c) found a correlation that indicated the internal doses might be affected by dermal exposure. A study of anode plant workers in an aluminium reduction plant in the Netherlands (van Rooij, Bodelier-Bade, de Looff, Dijkmans, & Jongeneelen, 1992) found the total skin contamination in exposed workers was estimated to be more than three times higher than the intake via the respiratory tract. From measurements taken on exposure pads located at six skin sites (jaw/neck, shoulder, upper arm, wrist, groin, ankle), van Rooij, Bodelier-Bade, Hopmans and Jongeneelen (1994a) reported that skin contact accounted for approximately 75% of total absorbed pyrene in a study of coke oven workers, not only on the uncovered skin but also on skin covered with working clothes. The authors concluded that the latter was probably due to contact with contaminated clothing rather than deposition from the air. In a study of PAH exposure among asphalt paving workers, McClean et al. (2004) estimated that dermal exposure was eight times the impact of inhalation exposure. Similar results were reported by Borak et al. (2002) in their study of creosote facility workers. Van Rooij, De Roos, Bodelier-Bade and Jongeneelen (1993b) demonstrated low but significant differences in the dermal PAH absorption between anatomical sites listed in Table 2.1. Also of note is the potential impact on percutaneous absorption by such factors as hydration, friction or temperature. 17 Table 2.1: Absorption indices of pyrene and PAH for different anatomical sites (Adapted from van Rooij et al., 1993b) Anatomical site Pyrenea PAHb Arm 1 1 Hand 0.8 0.5 Leg/ankle 1.2 0.8/0.5 Trunk/shoulder 1.1 2.0 Head/neck 1.3 1.0 a Based on excreted amount of 1-OHP in urine after coal-tar ointment application b Based on the PAH absorption rate constant (Ka) after coal-tar ointment application Within industries associated with coal-tar pitch, there are particular skin reactions that often manifest amongst workers. One of these reactions, colloquially referred to as ‘pitch burn,’ is a form of phototoxicity that results in delayed erythema and skin pain. This sensitisation was first recognised by Lewin (1913), who described “workers in contact with coal-tar products who developed dermatitis and itching upon exposure to sunlight.” In 1930, Fleischauer demonstrated “that even 15 min of tar application resulted in photo sensitivity to irradiation with a quartz lamp or sunlight through window glass” (Diette, Gange, Stern, Arndt, & Parrish, 1983). The presence of pitch burn within an industry is often an indication that there are issues with exposure to PAHs, hence the reporting of such instances should be monitored and could possibly be used as a gauge of control effectiveness. Figure 2.1 illustrates this time effect in relation to pitch exposure and phototoxicity. The phototoxic dose is the minimum level of UVA required to produce delayed erythema of the skin. The x-axis refers to the length of time the 5% crude coal tar mixture was allowed to remain in contact with the skin. 18 Minutes of Tar application vs Dose of UVA required for reaction (Adapted from Diette, K.M., et al Coal Tar Phototoxic Dose (J/cm2) UVA 25 Phototoxic dose required with no pitch on skin exposure for an erythema 20 After 15 minutes skin contact 2/3 of the dose of UV required for an erythema 15 After 30 minutes skin contact only 1/2 of the level of UV required for an erythema 10 After 60 minutes skin contact less than a 1/4 of the level of UV required for a erythema 5 0 0 15 30 60 90 120 180 Time (minutes) Figure 2.1: Level of dose of UVA required for a reaction on the skin in relation to varying lengths of skin contact time with coal-tar pitch (Adapted from Diette et al., 1983) An additional method that has been employed at a smelter in Australia was the use of ultraviolet light to identify areas of the skin where exposure and contact has taken place (A. Riley, personal communication, 2004). In the presence of ultraviolet light, areas contaminated with tar fluoresce and are easy to identify. This method has been used as a training tool to illustrate where contact is occurring and the effectiveness of general hygiene practices such as hand washing and showering. A study undertaken in the early 1990s used this tool to prepare ‘skin maps’ of exposure of workers to determine possible causes or sources of contact in the different tasks. Whilst a formal report was never completed, the results revealed that certain tasks led to higher levels of skin contact with the areas of highest contamination around the wrists, head and neck. This identification method has proved to be of value and is still in use at the site (A. Riley, personal communication, 2004). 19 2.2 Measures of PAH biological effect Of the PAH groupings listed in section 1.1.1, the carcinogenic potency tends to be highest amongst those particle-bound PAHs (4-6 ring compounds), the most notable being: • benzo[a]anthracene, • benzo[b]fluoranthene, • benzo[k]fluoranthene, • benzo[a]pyrene, • dibenz[a,h]anthracene, • benzo[g,h,i]perylene and • indeno[1,2,3-c,d]pyrene. Benzo[a]pyrene (BaP) is the most prominent carcinogen and the one most often used as an index of toxicity (Rappaport, Waidyanatha, & Serdar, 2004). BaP is the parent carcinogen that requires metabolic activation by cellular enzymes or cytochromes, such as P450, to form BaP-7,8 epoxide, which is then hydrated by epoxide hydrolase to form BaP-7,8-diol (Hodgson & Smart, 1985). This metabolite is considered to be the proximate carcinogen (intermediate metabolite), which is then further metabolised by cytochrome P450 to form the ultimate carcinogen, the bay region diol epoxide, (+)-BaP-7,8-diol-9,10-epoxide-2. The bay region theory suggests that the bay region diol epoxides are the ultimate carcinogenic metabolites of PAHs (Hodgson & Smart, 1985). This process is illustrated in Figure 2.2. (-)-BP-7,8-Diol-9,10-Epoxide-2 O (-)-BP-7,8-oxide Epoxide Hydrolase P-450 P-450 O Benzo(a)pyrene HO OH HO OH (+)-BP-7,8-Dihydrodiol Figure 2.2: Metabolism sequence of BaP to the bay region diol epoxide, (+)-BaP-7,8-diol-9,10-epoxide-2 (Hodgson & Smart, 1985) 20 The actual toxicity level of the components in mixtures of PAHs is difficult to ascertain because of the possible presence of other toxic compounds that may be tumour promoters, initiators and/or co-carcinogens in the mixtures. One of the most important complications is the potential for interaction among the many different components of the mixture, including synergistic or multiplicative effects in which the combined effect of two or more substances is greater than the sum or product of the effects of each agent alone (Klaassen, 2001). This also makes it very difficult to evaluate the individual contribution of any one compound to the total toxicity and carcinogenicity of the mixture. Hence, evaluating the risks of exposures to mixed compounds presents significant problems. The application of toxic equivalence factors (TEFs) to determine relative potency factors (RPFs) is often employed when dealing with PAH mixtures. RPF is defined as the ratio between the airborne concentrations of BaP equivalents to the concentration of BaP alone (Petry, Schmid, & Schlatter, 1996): RPF = Conc BaP eq Conc BaP Where the sum of the BaP equivalent concentrations (Conc BaP eq) is equal to the sum of carcinogenic PAH concentrations expressed as BaP multiplied by the TEF of PAH compound of interest such as those shown in table 2.2. There is inconsistency in application of RPFs, as they vary from source to source. An example is presented in Table 2.2, which includes five different variations of RPFs currently in use. Petry et al. (1996) produced an additional four lists from different sources. Added to this is the inconsistent and incorrect interchangeable use of the terms, relative potency, RPF and TEF in the literature. Petry et al.’s (1996) table of TEFs referred to Thorslund and Farrer’s TEFs which were duplicated in Willes, Friar, Orr and Lynch (1992) but referred to as RPFs as illustrated in table 2.2. The confusion can arise due to the similarity of the terminology used as the relative 21 potency of a compound is measured by the TEF and this can be used to determine a relative potency factor. Table 2.2: Comparison of RPFs for PAHs (Willes et al., 1992) Source PAHs ATSDR 1995 1.0 Krewski et al., 1989 1.0 Thorslund & Farrer, 1991 1.0 Rugen et al., 1989 1.0 Willes et al., 1992 1.0 benzo[a]pyrene benzo[e]pyrene NDA 0.004 0.007 NDA 0.05 benzo[a]anthracene 0.145 0.145 0.145 0.006 0.033 benzo[b]fluoranthene 0.167 0.14 0.12 0.02 0.1 benzo[k]fluoranthene 0.020 0.066 0.052 NDA 0.01 benzo[g,h,i]perylene NDA 0.022 0.021 NDA 1.0 Chrysene 0.0044 0.0044 0.0044 NDA 0.26 dibenz[a,h]anthracene 1.11 1.11 1.11 0.60 1.4 fluoranthene NDA NDA NDA NDA 0.034 indeno[1,2,3-c,d]pyrene 0.055 0.232 0.278 0.006 0.1 Pyrene NDA 0.081 NA NDA NA NDA = no data available; NA = Not applicable as not regarded as a genotoxic carcinogen 2.3 Exposure monitoring Human exposure monitoring in relation to carcinogenic chemicals is used to: • establish and maintain exposure limits; • identify populations at risk; • elucidate dose-effect relationships; and • assess the risk of developing cancer (van Delft, Baan, & Roza, 1998). In the past, the assessment of exposure to carcinogenic compounds within the aluminium industry has been heavily slanted towards external exposure monitoring of the work environment. 22 2.3.1 Air monitoring In the case of PAHs, the most common air monitoring methods employed are based on National Institute for Occupational Safety and Health (NIOSH) methods 5042, 5515 and 5506, which utilise a personal monitoring pump and a polytetrafluoroethylene (PTFE) membrane filter with a cellulose support pad in a 37 mm cassette filter holder and, in some cases, combined with an XAD-2® tube (NIOSH, 1998). Alternatively, the Occupational Safety and Health Administration method 58 that utilises glass fibre filters can be used (OSHA, 1986). In both cases the analysis is similar in that filters are analysed by extraction with benzene and then gravimetrically determine the benzene-soluble fraction (BSF), also known as benzene-soluble matter (BSM). Where more detailed characterisation of the sample is required, the presence of specific PAHs is assessed by analysing the sample via high-performance liquid chromatography (HPLC) with a fluorescence or ultraviolet detector. The pump and filter system can be utilised as a static sampler positioned in the vicinity of a specific work area to assess the performance of a plant or of controls implemented to reduce the release of contaminants from a particular section of the process. It is important to note that these results cannot be compared with occupational exposure standards, as the latter have been developed from occupational exposure measured via a personal monitoring pump attached to the individual. Alternatively, and more commonly, the pump and sample filter head are worn by the process operator, with the filter head positioned in the individual’s breathing zone, recognised as a 300 mm hemispherical area about the inhalation zone of the nose and mouth (Victorian Workcover Authority, 2000). This method assumes the equivalent uptake by the individual. The results obtained from this analysis may be compared with current occupational exposure standards such as those listed by the National Occupational Health and Safety Commission (NOHSC, 1995). The NOHSC guidelines are based on those established by the American Conference of Governmental Industrial Hygienists (ACGIH). This threshold limit 23 value/time-weighted average (TLV/TWA) is listed as 0.2 mg/m3 for BSF (the recommended occupational exposure limit to CTPVs) which …is defined operationally in terms of the benzene (or cyclohexane) extractable fraction of total airborne particulate as collected by a personal sampler. If the extractable material contains detectable quantities of ben[a]anthracene, benzo[b]fluoranthene, chrysene, anthracene, benzo[a]pyrene, phenanthrene, acridine, or pyrene, then the TLV-TWA for that material is 0.2 mg/m3 total aerosol (ACGIH, 2007). This method assumes that the PAHs measured as the BSF of the particulate collected are completely desorbed along with other hydrocarbons in the analysis process. The method has some shortcomings in that the true carcinogenic potential may be either overestimated or underestimated, depending on the specific PAHs present in the mixture, as has been previously discussed in relation to TEFs. An additional complication is that any other substances that are benzene soluble will be measured also. It should be noted that methods involving benzene as a solvent are no longer recommended due to the health implications associated with its use (ATDSR, 2007). In more recent times, cyclohexane has been used as an alternative in this method and, whilst effective, does not extract PAHs as effectively as benzene (Harrison & Thomas, 1987). The TWA is that exposure over an 8-hour day, for a 5-day working week, over an entire working life that should neither impair the health of, nor cause undue discomfort to, nearly all workers (ACGIH, 2007). Whilst the standard is based on an 8-hour day, 40-hour week, the current trend in industry is that the main shift tends to be of 12 hours duration with a common rotation being two day shifts followed by two night shifts then four days rostered off. The NOHSC guidance note advises that the TWA exposure standard may need to be reduced by a suitable factor to take into account these extended shifts to ensure adequate worker protection (NOHSC, 1995). A 12-hour work shift involves a period of daily exposure that is 50% greater than that of the standard 8-hour work-day and the period of recovery before re-exposure is shortened from 16 to 12 hours. For some systemic toxins having half-lives between 5 and 500 hours, it can be predicted that working longer than 8-hour shifts is likely to result in a greater hazard than that incurred during normal work weeks (Paustenbach, 1994). Models to determine the appropriate adjustment have been proposed by several researchers, including Brief and Scala, OSHA, Iuliucci, and the 24 pharmacokinetic models of Mason and Dershin, Hickey and Reist (Harris, 2000). NOHSC (1995) recommended use of the Brief and Scala model due to its simplicity and effectiveness. It can, however, be considerably more conservative than some of the other models. It is based on the following equation: 8 x 24 – h h 16 Where RF is the reduction factor and h is the hours of the shift. RF = Hence, for the situation where an employee works a 12-hour shift for 4 days, the RF would be 0.5. Unfortunately this exposure model is based on inhalation and does not take into account skin absorption, ingestion, differences in metabolism, bioavailability, distribution, excretion or the use of PPE. Also, there is the issue of exposure via other sources such as diet, personal health products and cigarette smoking. 2.3.2 Biological monitoring A method of estimating an individual’s internal exposure utilises biological monitoring (Jongeneelen et al., 1988b). This method usually involves the determination of a parent chemical, which may be representative of a mixture of chemicals (e.g. pyrene for PAHs), by assessing the level of a metabolite of that chemical in body fluids (blood or urine) or expired air. The use of 1-OHP as a biological marker was primarily developed by Jongeneelen through a range of studies and with some human validation carried out via therapeutically treated human subjects (Jongeneelen et al., 1985, 1988a,b,c; Tsai, Shieh, Lee, Chen, & Shih, 2002). Pyrene is metabolised into the intermediary 1-OHP to form 1-hydroxypyrene-glucuronide, which is excreted (Jongeneelen, Anzion, & Henderson, 1987). Pyrene is rapidly distributed, metabolised and eliminated from the body, and 1-OHP is a reliable indicator of systemic exposure to this PAH (Bouchard, Krishnan, & Viau, 1998). The distribution and metabolism of pyrene within the body can vary dependent on the route of entry. Ingested pyrene is metabolised in the liver, with the majority being eliminated in bile as glucuronides; this is quite different to pyrene absorbed through the skin as it is partially metabolised in the skin, with the majority being transported via the vascular system to the lungs where 25 it is metabolised to a greater extent (ACGIH, 2005). Pyrene metabolites in the lung will also be distributed to the liver and kidneys. Only pyrene absorbed via the lung and skin has the potential to accumulate in body fat to a significant extent, since the ingested pyrene will be metabolised in the liver (ACGIH, 2005). These alternative routes of exposure and metabolism are illustrated in Figure 2.10. Figure 2.3: Different routes of exposure, distribution and metabolism of pyrene (ACGIH, 2005) The half-life for urinary excretion of 1-OHP has been shown to vary in at least three studies; it was determined to be 18 hours (Buchet et al., 1992), a range of 6–35 hours (Jongeneelen et al., 1990) and 13 hours (Boogaard & van Sittert, 1994). Taking into account this variation when developing a biological monitoring protocol, it would be prudent to follow ACGIH (2005) guidelines, which recommend pre-shift and end-ofwork-week post-shift urine samples for monitoring. In most studies, urine samples were immediately frozen and kept at –20°C (Jongeneelen et al., 1985, 1988c; 26 Clonfero et al., 1989; Tolos et al., 1990; Boos, Lintelmann, & Kettrup, 1992; Burgaz, Borm, & Jongeneelen, 1992). Quinlan et al. (1995) reported that 1-OHP in urine was stable when matched samples were stored at 4°C or –20°C until analysis. Work undertaken by Boos et al. (1992) indicated that samples were stable for at least 6 months. The analytical method consists of analysis of urine samples via enzymatic hydrolysis, sample extraction and purification with a C18 cartridge, reverse-phase HPLC for separation, and detection with spectrofluorescence (Buckley & Lioy, 1992). The parent compound, pyrene, represents a relatively high proportion of the higher-molecular-weight occupational airborne PAHs. 1-OHP has been found to be stable and has only one known precursor, pyrene (Jongeneelen et al., 1988b). One other important consideration is that there are currently a significant number of laboratories around the world that are capable of carrying out the analysis required for the determination of 1-OHP, with many participating in round-robins and quality assurance testing (R. Geyer, personal communication, 2002). More recently, there have been studies where alternative biomarkers for exposure to PAHs have been utilised. Naphthalene was proposed (Rappaport et al., 2004), utilising its biomarkers 1- and 2-hydroxynaphthalene in urine as an alternative to 1OHP. Naphthalene (with two rings) is present almost entirely in the gaseous phase and would be a suitable marker for industries where the predominant exposure is airborne; however, where there is a mixture of dermal and airborne exposure, an alternative marker correlating better with the higher-number ring compounds could be more suitable. It is interesting to note that the carcinogenic potency tends to be greatest among the 4- to 6-ring compounds (ATDSR, 1995). Another parent-metabolite pairing – BaP and 3-hydroxybenzo[a]pyrene – was the subject of a study carried out in a selection of industries in France; results showed this to be a potentially useful method for determining a biological limit marker, as the parent compound BaP is a known carcinogen (Lafontaine & Gendre, 2003). The brief report recommended the determination of such a limit by using the French airborne exposure limit of 150 ng/m3. Again, this assumes that the main level of 27 exposure is via air and may not accurately take into account absorption via other routes such as dermal and ingestion. 2.3.3 Exposure quantification There is continued uncertainty about the best method of quantifying exposure and risk for lung and bladder cancers associated with PAHs. Partially responsible for this uncertainty is the fact that the mechanisms of action for PAH mixtures are still not completely known (ACGIH, 2005). Some of the potential pathways include: 1. direct binding to DNA by reactive species to form DNA-PAH adducts; 2. binding to the aryl hydrocarbon (Ah) receptor on cell membranes, with subsequent signals to the nucleus resulting in changes to the internal cell milieu; and/or 3. induction of P450 metabolic enzymes, which may then enhance the toxicity of some components of these mixtures. PAHs are metabolised and biotransformed through the cytochrome P450 system and are eliminated from the body mainly through the liver, biliary tract and the excretion of faeces (Chong, Haines, & Verma, 1989). In an early study, Dufresne, Lesage and Perrault (1987) found that the strong adsorption of PAHs onto the surface of some airborne particles, such as coke, can prevent their determination as BSF, resulting in uncertainty of the true measure of PAH in air. This adsorption onto particles can also alter their bioavailability and kinetics in the respiratory tract (Pelfrene, 1976; Gerde et al., 1991). Two NIOSH health hazard evaluations of PAH exposures in coal-liquefaction processes found no correlation between BSF and the total level of 29 PAHs analysed (Tolos et al., 1990). A significant correlation between PAH concentration in air levels and the resultant level of 1-OHP in urine has been found in several studies (Jongeneelen et al., 1990; Tolos et al., 1990; Buchet et al., 1992; Tjoe Ny, Heederik, Kromhout, & Jongeneelen, 1993; Boogaard & van Sittert, 1994, 1995; Lafontaine, Payan, Delsaut, 28 & Morele, 2000). For this situation to occur, the PAH profile of the workenvironment air would need to remain relatively constant, and contribution from dermal uptake would have to be minimal. The above studies involved coke plants and aluminium plants; however, the aluminium plants were sampled on the reduction lines of a Söderberg plant where the air levels remain relatively constant. Levels in carbon electrode plants of a prebake smelter would be expected to show a lower correlation due to the nature of the work. Whilst there is a presence of fume and airborne particulate in areas such as paste mixing and anode forming, most plants have invoked mandatory respiratory protection in these operating areas to minimise inhalation of airborne PAHs. In these plants, dermal contact and uptake is likely to be a key issue rather than the air content. This has been illustrated by Ferreira et al. (1994) and Angerer, Mannschreck and Gündel (1997) in graphite electrode plants, by van Rooij et al. (1992) in the electrode production departments of a prebake aluminium smelter, and by van Rooij et al. (1993a, 1994a) in a coke oven. Also, the impact of dermal exposure on the total level would vary depending on the task being undertaken and most likely in which part of the production process the exposure took place. Early in the manufacturing of the anode, the paste is mixed at lower temperatures (160–170°C) and exposure at this point is more likely to include a greater number of the lower-boiling-point PAHs. There would be less exposure after the bake cycle where most of the PAH compounds have been driven off at higher temperatures in excess of 1000°C or in the Söderberg smelter reduction line in which the higher-boiling-point fraction has been identified. 2.4 Non-occupational exposures Whilst the measure of total body burden is a useful tool, it must take into account absorption of PAHs from other sources apart from the occupational environment, including soaps, shampoos, medicinal balms, food intake and cigarette smoking (Buratti, Pellegrino, Brambilla, & Colombi, 2000). It has long been known that tobacco smoking increases the level of 1-OHP in urine, but the relative impact is dependent on the individual’s other exposures (van Rooij et al., 1994b). In one study, average daily consumption of approximately 20 cigarettes was required to bring the levels of 1-OHP in urine to 200 ng/L (Buratti et al., 2000); in another, 30 cigarettes 29 per day resulted in an increase of about 1.0 µg/L (van Rooij et al., 1994b). Levels of 1-OHP in urine did not differ significantly between smokers and non-smokers in a study by Borak et al. (2002). Variations in the level may be a result of the fractional retention of PAH in the lungs of the smokers as well as general variation in the rate of metabolism of the pyrene between individuals. There are also confounding factors such as the type of tobacco smoked, the tar and pyrene content, whether the cigarette is filtered or unfiltered, and inhalation practices of the individual. For low general environmental exposures, the cigarette smoker is likely to have a more significant increase in 1-OHP level (Jongeneelen et al., 1990; Viau, Carrier, Vyskocil, & Dodd, 1995); however, at the level in the occupational environment where the exposure to PAHs is high, it is most likely that the occupational exposure will overshadow the effects of cigarettes’ contribution (Buratti et al., 2000). Interestingly, Jongeneelen et al. (1990) and van Schooten et al. (1995) observed that differences between levels of 1-OHP in urine of smokers and non-smokers were more pronounced in the most-exposed workers, suggesting the existence of a synergistic effect of smoking in combination with PAH exposure in the work environment on the excretion of 1-OHP in urine. 2.5 Biological exposure index It is one thing to collect sample results for monitoring, but without some form of a guideline, the results have limited value. Jongeneelen (2001) proposed three benchmarks for measurements based on 1-OHP levels in urine: • • • A no observed effect level equivalent to a measurement of 1.4 µmol/mol creatinine 1-OHP. This is the level below which Buchet et al. (1995) found no increased level of high frequency – sister chromatid exchanges (HF-SCE). The lowest observed level of genotoxic effects indicated by 1.9 µmol/mol creatinine for coke oven workers and 3.8 µmol/mol creatinine for aluminium plant workers. A level that equates to the present occupational exposure limits for PACs (0.2 mg/m3 benzene-soluble matter and/or 2 µg/m3 benzo[a]pyrene (BaP). The value used is dependent on industry type and pyrene content of the exposure and is equivalent to 2.3 µmol/mol creatinine for coke oven workers and 4.9 µmol/mol creatinine for aluminium workers (Brandt & Watson, 2003). 30 One of the confounders associated with the development of such a guideline is the variation in the pyrene to BaP ratio in the different blends of coal-tar pitch and the changes that occur to the product when it is exposed to different temperatures and conditions as it moves through the different stages of the production process (Brandt, de Groot, & Blomberg, 1999; Tjoe Ny et al., 1993; Jongeneelen, 2001; Brandt & Watson, 2003). The ratio of potentially carcinogenic PAHs to pyrene will not remain constant amongst different CTPV fractions; this marker value will need to be individually assessed (Bouchard & Viau, 1999). Exposure limits for the aluminium industry have been calculated (Bouchard & Viau, 1999) by using the TEFs obtained by Krewski et al. (1989) and Collins, Brown, Dawson and Marty (1991), and the known PAH profile of pyrene and carcinogenic PAHs in the work environments of interest. This can be readily done for any site if the above information is known and substituted into the following formula utilising Jongeneelen’s (1992, 1993) proposed BEI for coke ovens. This is predicated on linear 1-OHP urinary excretion increases with airborne pyrene concentrations. ΣBaP eq pyrene c BEIw = BEIc ΣBaP eq pyrene w Where BEIw = BEI in the work environment of interest BEIc = BEI proposed by Jongeneelen (1992, 1993) for coke oven workers ΣBaP eq pyrene c = Sum of BaP equivalents to pyrene airborne concentrations in the coke plant ΣBaP eq pyrene w = Sum of BaP equivalents to pyrene airborne concentrations in the work environment of interest 31 Bouchard et al. (1998) found that relative BEIs can vary up to eight times from one work environment to another. This is a key element when assessing the potential risks associated with a particular work environment; a factor of up to eight can have a significant impact on how the risk is assessed, approached and managed in an industrial environment. Whilst this variation exists, it can significantly compromise the value of the test. However, if sufficient monitoring is undertaken over an extended period of time, it could prove to be of significant value in determining the presence of trends, particularly after modifications are made to processes or controls. The American Conference of Governmental Industrial Hygienists, in their BEIdocumentation of PAH (ACGIH, 2005), stated that at present a biological exposure limit is non-quantifiable and recommended that a level of 1 µg/L 1-OHP (equivalent to 0.49 µmol/mol cr) should be considered as a post-shift level indicating occupational exposure to PAH. This level is based on an exposure to PAHs that would “result in urinary 1-hydroxypyrene levels greater than at least 99% of the population without occupational or significant environmental exposure” (ACGIH, 2005). This in itself presents a quandary in its application in the industrial environment. It merely advises that there has been a potential occupational exposure to PAHs but does not give guidance as to the potential health impact. If not used correctly, it can cause considerable confusion. Also, it can result in a significant economic burden on an industry, which may erroneously interpret this as an exposure limit and attempt to meet this low-level guideline, which is intended for a different application. 2.6 Biological effect monitoring As previously discussed, there are currently multiple BEIs being put forward for the assessment of risk associated with exposure to PAHs in the primary aluminium industry (Angerer et al., 1997; Jongeneelen, 2001; Lauwerys & Hoet, 2001). Whilst 1-OHP is regarded as a suitable biomarker of exposure to PAHs, there are further methods currently being investigated to assist with the evaluation of the risk of cancer. Many PAHs are known to have mutagenic and carcinogenic properties (Lijinsky, 1991) and, whilst biological monitoring will assist in determining the dose 32 of exposure to PAHs, it may not provide the best indicator of the internally effective dose, which is the actual level of effect at the target site for carcinogenesis. DNA adducts arise from the reactions of reactive oxidation products of PAHs with DNA in various target organs, such as skin, lungs and liver (Brandt & Watson, 2003). One of the limitations of biological effect monitoring is that many effects cannot be directly analysed in the target organ/tissue but are necessarily determined in surrogates that are more easily available, such as blood cells, oral mucosa cells and exfoliated urothelial cells (van Delft et al., 1998). The metabolic activation of PAH to reactive metabolites that bind to DNA is a critical event in the initiation of chemical carcinogenesis (Weyand & Wu, 1994). The development of human cancer is a multifactorial process requiring several genetic changes in the cell and, as such, the relationship between biomarkers and cancer has been the subject of several animal studies focussed on DNA adducts. Some of the markers investigated include DNA or protein adducts (dell’Omo & Lauwerys, 1993; Haugen, Øvrebø, & Drablos, 1992), cytogenic markers (e.g. micronuclei, chromosomal aberrations, sister chromatid exchanges) (Tucker & Preston, 1996) and cells with a high frequency of sister chromatid exchanges. Some of these markers are indicative of an early biological effect, although it may not be permanent and may not have further consequences (van Delft et al., 1998). It is important when selecting a method for exposure monitoring or risk assessment that the method be relatively user-friendly and readily applied with some form of target or exposure level. At this stage, biological effect monitoring is complex, expensive and invasive. Whilst the air and 1-OHP in urine methods do have some deficiencies, measurements of DNA adducts as yet do not show good correlations with exposure to PAHs in a variety of workplace and other situations (Hemminki, 1993; Hemminki et al., 1997; Brandt & Watson, 2003). As these methods, and new methods based on novel chemical markers, are established along with specific exposure guidelines, the potential for their application in the field may prove valuable for PAH-exposure risk assessment; however, currently they are not readily applicable as routine tests. 33 For this study, the analysis procedure chosen must be capable of detecting analytes arising from PAH exposure via all exposure routes with potential for comparison with benchmark studies. From the literature reviewed, it is apparent that the most appropriate methods available for the assessment of exposure to CTPVs (and hence PAHs) in the primary aluminium reduction industry are: • assessments for benzene/cyclohexane-soluble fraction of airborne contaminants for personal monitoring and static monitoring of the process or controls, and • the determination of 1-OHP in urine to assess the level of total body burden from the three main exposure routes. The first of these two methods has been utilised for many years by occupational hygienists and occupational physicians and compared with exposure limits listed by both governmental and non-governmental organizations to determine risk. However, there continues to be uncertainty in the efficacy of the true measure of exposure, particularly with a compound that has another significant route of entry through the skin. 2.7 Summary Exposure to PAHs in aluminium smelting has been formally identified by the IARC as a carcinogenic health risk to individuals employed in the industry since 1984, with the known routes of exposure being inhalation, ingestion and skin absorption. To date, the only accepted forms of exposure monitoring with an associated occupational exposure level have been related to air exposure with limited emphasis being placed on the other two routes. From the literature, it is obvious that skin contact can play a significant role in the total body burden of the individual with this form of exposure. It is unclear as to whether the methods of assessment and monitoring regimes in place within aluminium smelting adequately characterise these exposures or whether the air monitoring correlates with the total body burden in these areas. Monitoring of both the air and a biological marker should provide the information necessary to determine if this correlation exists and whether the highest exposures are in the areas associated with air or skin exposures. 34 3.0 METHODS This chapter outlines the research methods used to achieve the study objectives listed in section 1.2.1. After explaining the aluminium plant process, it describes the exposure groups and study participants, and provides details of air and biological monitoring sample collection and analysis, and data management and statistical analysis. 3.1 Introduction This study utilises air monitoring of PAHs to quantify exposure via the inhalation route and biological monitoring of 1-OHP to assess total body burden from all routes of entry. Exposures determined for different sample groups comprised of workers who undertake tasks in areas of potential PAH exposure in a prebake plant are compared with published occupational PAH exposure limits and/or guidelines. Analyses compare results from airborne and biological monitoring to determine if the outcomes are correlated and whether sampling airborne exposure alone is a true indicator of total exposure. The study site was a large prebake smelter in Queensland, Australia. This smelter produces in excess of 500,000 tonnes of aluminium annually and employs 1250 people. As plant occupational hygienist, the author was primarily involved with the anticipation/recognition of tasks or areas of potential exposure of employees to materials that may impact negatively on their health and wellbeing. Where such situations were expected, monitoring was undertaken of the employee and, in some instances, the process, to identify areas where controls may be implemented or improved to eliminate or minimise exposure. This allowed for a high level of interaction with employees during the assessment process. Sampling was undertaken across the similar exposure groups (SEGs) over nearly three years from February 2002 – September 2004. A separate set of post hoc 35 samples was collected over 15 months (March 2005 – June 2006) to assess the effectiveness of controls implemented as a result of the initial review of data. Each SEG was monitored at least twice during the three-year period and included a control group. The size and composition of the SEGs varied. Ethical approval for the project was granted by the Queensland University of Technology Human Research Ethics Committee (Ref No 28591/H). 3.2 Study context – plant process description Aluminium does not occur in the free state in nature and must be extracted from its oxide (alumina) by an electrolytic process. Alumina has a melting point of 2000°C and it would be impractical to operate the process at such a temperature. The process to overcome this, developed simultaneously in 1886 by the French and the Americans, is referred to as the Hall-Heroult process after the two key developers of the method. The Hall-Heroult process involves the use of a fluorinated compound of sodium and aluminium called cryolite, which melts at approximately 1000°C and has the capability in the molten state to dissolve up to 8% of alumina. At this point it becomes practical for the application of an electrolysis process. This process is commonly referred to as the reduction process and is carried out in electrolytic cells (also known as pots). In the aluminium reduction plant, long rows of pots are connected in series to form a potline or potroom. Pots generally operate at a current of approximately 200,000 – 300,000 amps and will produce in the vicinity of 1 tonne of aluminium per day. This can vary dependent on the technology and the size of the cells utilised. Internationally, there are two distinct technologies used for the production of aluminium – the Söderberg anode process and the prebake anode process. These processes involve varying configurations of the pots. The four basic types of primary aluminium reduction technology based on these processes are: • centre-break prebake, • side-break prebake, • vertical-stud Söderberg, and • horizontal-stud Söderberg. 36 In the prebake anode cell, the anodes are preformed and baked in a carbon plant external to the potline. The pots in prebake plants are classified as centre-break prebake (Figure 3.1) or side-break prebake (Figure 3.2) depending on where the pot working (crust breaking and alumina addition) takes place. The anode is made up of pure calcined petroleum coke, which has been ground to a specific particle size. This is then mixed with a binder, coal-tar pitch, formed into blocks weighing between 940 and 1200 kg, depending on the reduction technology being employed, and then baked in a large gas-fired oven at 1250°C, prior to mounting on aluminium rods for insertion into the electrolytic cell (Figure 3.3). The carbon anodes are inserted into the pot and replaced as the electrolytic process consumes them (Figure 3.4). As a result of this prebaking of the anodes, the level of CTPVs released in the reduction line is significantly lower than in the Söderberg process. In addition, a centre-break prebake anode cell can be fed alumina without opening the hood, resulting in a better fume-extraction system allowing fewer fugitive emissions into the working environment. These are important factors to note as the majority of the research and epidemiology that led to the IARC classification was based on work in Söderberg smelters. Söderberg pots are not prebaked; the paste is dropped into a steel casing hanging above the pots and is baked on the pot itself by the heat from the molten bath. Söderberg pots are thus differentiated by the positioning of the current-carrying studs in the anodes, which may be inserted vertically as in a vertical-stud Söderberg cell (Figure 3.5) or horizontally in a horizontal-stud Söderberg cell (Figure 3.6). As a consequence, the resulting emission of CTPV is often significantly higher in the older-style Söderberg potroom (Figure 3.7). Collection efficiency of the fumes for this process can operate anywhere between 95% in the best case to 60% in the worst systems, allowing CTPV fumes to escape into the reduction line environment. Most PAH evaluations have been undertaken based on this process technology; fewer studies based on prebake technology are available. 37 Figure 3.1: Centre-break prebake smelter aluminium reduction cell as used in the smelter in which the study was undertaken (IPAI, 1982) Figure 3.2: Side-break prebake smelter aluminium reduction cell (IPAI, 1982) 38 Figure 3.3: New anode being installed into a prebake cell showing a typical configuration of a rod assembly and the carbon block which has been spray-coated with aluminium 39 Figure 3.4: Consumed anode being removed from a cell in a prebake smelter reduction line 40 Figure 3.5: Vertical-stud Söderberg aluminium reduction cell (IPAI, 1982) Figure 3.6: Horizontal-stud Söderberg aluminium reduction cell (IPAI, 1982) 41 Figure 3.7: Vertical-stud Söderberg aluminium smelter reduction line It should be noted that there are differences between individual plants depending on age and manufacturer. Some processes are batch-style, allowing for a discrete start and finish in the manufacturing cycle; others are continuous processes much the same as a production assembly line. Also, there can be variations in: • the temperatures at which the plants operate, hence impacting on where in the process the different PAHs may volatilise; • raw ingredients, e.g. solid pencil pitch or liquid pitch; and • the inherent variation in the pitch composition dependent on the source. The process investigated in this study was a continuous process using liquid pitch rather than solid pencil pitch hence not requiring a pre-melt section. Pitch composition was monitored during the investigation, and regular reports were provided by the pitch supplier to the site and the corporate carbon technical team to ensure major variations in pitch composition did not occur. 42 3.3 Exposure groups At the site at which the study was undertaken, the roles of the workers were divided initially into three groups: anode plant, non-production and reconstruction (Figure 3.8). The anode plant was further subdivided into green carbon and the carbon bake furnaces (Figure 3.9). Green carbon is that portion of the plant (shaded in green in Figure 3.9) where the calcined coke and coal-tar pitch are mixed then formed into anode blocks via a vacuum press and die process, prior to baking. Within the green plant is a smaller area (shaded in yellow) referred to as the forming area where there is more potential for exposure to coal-tar pitch and associated volatiles. This is the area where the ‘forming group’ participants of this study spent the majority of their time. The blue-shaded area in Figure 3.9 represents the carbon bake furnace where the formed anodes are baked at high temperatures to achieve the final product. In this area, large oven pits lined with brick and ceramic fibre are loaded with the carbon anode blocks. Each anode is transported by overhead crane and placed in layers into the pit then covered by a layer of coke. The next layer of anodes is placed on top of the first and also covered with coke and so on until the pit is filled. It is then heated by natural gas to a temperature of approximately 1200°C for a total of 32 – 48 hours. This area along with raw materials, the mezzanine floor and the control room are regarded as the ‘non-forming’ areas of the process. For this study, qualitative exposure levels were based on the expected levels in comparison with the occupational exposure limit (OEL) for BSF of 0.2 mg/m3 (ACGIH, 2007); ‘high’ was greater than the OEL, ‘moderate’ was less than the OEL but greater than 50% of the OEL, and ‘low’ was less than 50% of the OEL. The shift rotation for the SEGs within the study is based on two 12-hour day shifts followed by two 12-hour night shifts followed by a four-day break. 43 Anode Plant Forming Non-Forming Former Technicians Bake Crane Operators Tower Technicians Bake Floor Operators Non-Production Reconstruction Process Technicians Bricklayers Mezzanine Floor Technicians Raw Materials Technicians Controller Equipment Technician (Mechanical) Equipment Technician (Electrical) Occupational Health Human Resources Analytical Laboratory Figure 3.8: Structure and location of the study’s exposure groups 44 Carbon Anode Plant Process Map Delivery Feed Liquid Pitch Pitch Storage Tank Storage Transport to Plant Tanker Transport Day Tank Storage Tank Storage Mixing Paste Transport/ Anode Forming Fume Treatment Anode Cooling/ Storage Volatiles 200 Degrees Inject Pitch in Mixer 200 degrees 160 - 170 Degrees Paste Transport Anode Forming Volatile Deposition in Ducts Volatile Collection in Scrubber Green Anode Stacks Anode Cooling in Trough Recycle in Anodes <100 Degrees Baking Anode Loading Anode Preheating Anode Baking End 200 - 600 degrees Unburnt Volatiles Carbon Bake Furnace Fume Treatment ESP Tar Tar Carry Over to Scrubber Tar Collected Figure 3.9: Carbon anode process within the anode plant. The green-lined area is regarded as green carbon with the smaller yellow area known as the forming area. The blue-lined area contains the bake furnace non-forming area. 45 Within the anode plant green area, a production operator rotated through six sets of role-specific tasks grouped together as: • former technician • tower technician • mezzanine floor technician • raw materials technician • controller • crew leader An operator was normally assigned to one of these groups for the full four days of the rotation but could be required to cross tasks depending on staff availability and process condition. A separate crew that undertook different tasks and did not interact directly with the green plant operated the carbon bake furnace area of the anode plant. As former and tower technicians spend more than 50% of the shift directly exposed to coal-tar pitch in the early stages of the manufacturing process, they were allocated to the forming category. Also within the anode plant were electrical and mechanical equipment technicians who undertook routine and breakdown maintenance on the former plant. Their exposure varied depending on whether the task took them into the forming area of the anode plant. To determine their group allocation, equipment technicians’ work log sheets and sampling sheets were reviewed and a simple criterion was applied. When an individual spent 50% or more of their shift in the forming area of the plant, they were allocated to the forming group; if less than 50% of their time was spent in the forming area, they were allocated to the non-forming group. Therefore, the anode plant forming group comprised: • former technicians • tower technicians • equipment technicians (>50%) 46 The anode plant non-forming group consisted of the four remaining anode green plant operator roles, those maintenance technicians whose exposure time was less than 50% and operators from the carbon anode bake plant: • mezzanine floor technicians • raw materials technician • controller • crew leader • equipment technicians (<50%) • bake crane operators • bake floor operators The reconstruction group, based in a separate location closer to the aluminium reduction lines, comprised: • process technicians • bricklayers The non-production group consisted of personnel from: • occupational health team • human resources team • analytical laboratory 3.3.1 Forming group The roles of members of the forming group are detailed below. With the exception of the controller, who would normally spend fewer than 2 hours in the plant, the roles require operators to be in the plant environment for approximately 10 hours per shift. 3.3.1.1 Former technician The role of former technician involves tasks such as manual measuring, cleaning, fault rectification, and quality and equipment checking. These tasks occur in the early part of the anode manufacturing process when the paste is mixed and ‘formed’ into anodes prior to the baking process. This may involve interaction with the anode 47 paste mixing, movement of the paste along the conveyor belt system, and the process of injecting the paste into the vacuum former where the anode shapes are moulded. Also, there is interaction with the paste when blockages occur, particularly in relation to the former vibration plate. In this task, hot paste is fed down a chute to a vibrating plate for distribution to the anode vacuum former. On occasion, the paste is not evenly distributed and can result in a blockage requiring attention of the former technician. The lid of the plate is lifted to obtain access and a long spatula-type tool is used to clear the blockage of the hot paste. This task can take from 2 – 10 minutes to complete. Another area for potential exposure to the paste is during the cleaning of some of the equipment. Here the technician must clear away any gross contamination of paste adhering to the equipment prior to hand over to the maintenance team. As a result, the former technician’s role has the highest contact level with ‘green’ anode paste material. Green material is a term used to indicate that the pitch/coke mixture has not been baked. 3.3.1.2 Tower technician Of the green carbon operators, the role of tower technician covers the widest area of the plant. The role may require sampling, equipment checks, cleaning and fault rectification on any of the 10 levels of the green carbon process building. There is potential contact with pitch-contaminated raw materials and fume and airborne dust associated with the petroleum coke. The tower technician’s level of exposure to pitch material is expected to be lower than that of the former technician, but higher than other technicians. Exposure has the potential to increase when assisting the former technician with cleaning tasks around the paste mixers, conveyer belts and former. 3.3.1.3 Equipment technician Mechanical The mechanical equipment technician role is one of maintenance in the anode forming plant. This involves interaction with all pieces of the equipment at one time or another. The equipment technician team is made up predominantly of mechanical fitters who are required to undertake preventative and breakdown maintenance on the equipment. Contact with pitch-contaminated equipment is a regular occurrence; the level of contamination will vary depending on the state of machinery when the 48 work is carried out and whether the work is undertaken in the plant or the workshop. As the study site is a continuous-process plant rather than a batch plant, breakdown maintenance usually results in higher exposures as less time is available to completely clean down prior to undertaking repairs. The mechanical equipment technician’s time in the plant varies depending on the tasks, but would generally involve working on equipment for at least 8 hours of the 12-hour shift; exposure is expected to be moderate to high. Electrical The electrical equipment technician role is similar to its mechanical equivalent, involving varying levels of interaction with equipment during breakdown and preventative maintenance. Because the nature of the work concentrates on electrical components, which tend to be less heavily coated with coal-tar pitch and associated product, it is likely to result in lower exposure to pitch compounds; exposure is normally fewer than 8 hours per day. 3.3.2 Non-forming group 3.3.2.1 Mezzanine floor technician The mezzanine floor technician’s exposure is predominately associated with the cleaning and processing of ‘spent’ anodes, i.e. anodes that have been returned from the reduction lines after use. These anodes are cleaned via an automated shot-blaster followed by some manual intervention using small jackhammers or ‘scabble guns.’ The anodes are then crushed in a butts-thimble press, and the resulting product used as a portion of one of the raw material streams in the new anodes. As returned anodes have been baked and have spent time in the reduction cell, unless mezzanine floor technicians are requested to assist in one of the other technician roles, their exposure to pitch materials and volatiles is minimal. 3.3.2.2 Raw materials technician The raw materials technician is responsible for maintaining material levels of green scrap and used butts in the process. This requires the operation of loaders, forklifts and trucks within the bunker areas, crushing plant and ‘green’ scrap sheds. The term ‘green carbon’ is used to refer to carbon paste or block that has not been baked in the 49 furnace ovens and hence levels of PAHs are higher. Exposure occurs during handling of the green scrap. The raw materials technician also assists the general green carbon team in the other roles. Exposure to pitch is expected to be low to moderate. 3.3.2.3 Controller The controller monitors the process from the main control room in the green carbon building. Under normal circumstances, the controller would not be involved in work outside of this area; exposure to pitch is likely to be very low. 3.3.2.4 Crew leader The crew leader co-ordinates and manages the shift team comprised of the controller, and former, tower, mezzanine and raw materials technicians. The crew leader is required to move throughout the plant to ensure all processes are functioning correctly. Under most circumstances, exposure is limited to the ambient fume levels within the plant, but there are occasions when the crew leader participates in duties resulting in greater exposure. When this occurred during the study, log sheet details were reviewed and the appropriate group allocation was made based on the same criterion used for equipment technicians (section 3.3.1.3). 3.3.2.5 Bake crane operator The bake furnace crane operator role involves placement of ‘green’ anode blocks into the bake furnace pit utilising large overhead cranes such as those illustrated in Figure 3.10. A green anode is one that has been formed into shape but is yet to go through the final baking process. The crane cabins are air conditioned and normally sealed; however, the integrity of the seals can deteriorate between maintenance services, which can impact on the potential for exposure. Exposure to pitch is expected to be low to moderate during the shift. Operators generally spend 8 – 10 hours in the crane. 50 Figure 3.10: Carbon bake crane lowering green anodes into the bake furnace pit 3.3.2.6 Bake floor operator Bake floor operator duties, associated with operation and maintenance of the furnaces, include monitoring and relocating furnace burners, draft fans and associated ancillary equipment; management of tar from the electrostatic precipitators; on occasion, breaking up reject anodes for recycling into the process; and general housekeeping duties around the bake furnace. Exposure to pitch is expected to be low to moderate during the shift. Operators generally spend 8 – 10 hours in the bake furnace building or in the immediate surrounds. 3.3.3 Reconstruction group The reconstruction team’s role is the rebuilding of reduction cells once they have been removed from service. The average life of a reduction cell used at the smelter in the study is approximately 1800 days. The cell-rebuilding process involves four stages: • clean out of the old cell 51 • structural steel repairs • refractory replacement • carbon cathode replacement − paste preparation − paste transfer − paste loading − Brochet machine ramming − hand ramming 3.3.3.1 Process technician Reconstruction process technicians undertake carbon cathode replacement tasks and therefore have the greatest potential for exposure to PAHs in this group, as the paste used contains coal-tar pitch. The task of ramming involves forcing the paste into the crevices of the cathode to ensure there are no gaps where the molten aluminium may collect. Much of the ramming is carried out using a mechanical rammer, called a Brochet machine (Figure 3.11), but some hand ramming (Figure 3.12) is also carried out. Whilst the paste may be used warm or cold in the process, cold-paste ramming is used on the study site. In recent years, the level of exposure during these tasks has been reduced by the introduction of cold paste and some mechanisation, but there is still potential for exposure during paste preparation and hand ramming. Also, there is a task that involves the painting of liquid pitch on the carbon cathode block prior to ramming, to improve the adhesion of the ramming process, which has the potential to increase exposure. Neverteheless, exposure levels are expected to be lower than for those tasks in the employee groups that involve working with coal-tar pitch at temperatures above 100°C. Workers generally spend 8 – 10 hours in the areas where exposure is most likely. The level of the exposure is expected to vary from low to moderate depending on the task; brick-working tasks is likely to be in the lower region with ramming tasks in the moderate range. 52 Figure 3.11: Mechanical ramming of paste into the joints between the carbon blocks of the cathode using a Brochet machine Figure 3.12: Ramming of paste into side-wall join using hand rammers 53 3.3.3.2 Bricklayer Tasks associated with the bricklayer role are less likely to bring these workers into direct contact with coal-tar pitch or its products. The main bricklayer task is to line the steel shell with refractory bricks onto which the carbon blocks that make up the cathode will later be placed. As the bricklayers work in the same area as the process technicians and it is not unusual to have the two groups working on adjacent shells, there is potential for exposure resulting from fumes from the adjacent shell. While the level of exposure is expected to be lower for bricklayers than process technicians, generally they also spend 8 - 10 hours in the area. 3.3.4 Non-production group Non-production personnel from the occupational health team, the human resources team and the site laboratory were used as controls for the 1-OHP monitoring in this study. During the period of participation, none of these personnel were involved in any tasks associated with exposure to coal-tar pitch; no exposure is expected. 3.3.5 Exposure profile Except for the non-production group, the SEGs have the potential for significantly varying exposures depending on the task and location. This is indicated in Figure 3.13 by the positioning of groups across boundaries between exposure levels. 54 HIGH Anode Plant Forming MODERATE Reconstruction t LOW Anode Plant Non-Forming Non-Production Figure 3.13: Potential exposure levels of SEGs 3.3.6 Personal protective equipment Respiratory PPE was mandatory in all areas where there was a potential exposure to airborne PAHs, such as in the forming area of the anode plant and in the cell during paste ramming and pitch painting. All individuals having the need for a respirator were trained in the use and maintenance of their respirator and were required to undergo a quantitative face-fit test. Quantitative face fitting of the respirators utilises a method based on the comparison of particle counts taken simultaneously inside and outside of the respirator when worn, providing an accurate measure of the face seal of the respirator for the individual. This information is then used in the selection of the respirator best suited for that individual. There was some variation in the type and level of protection provided, i.e. full-face or half-face mask respirators. Wearing of respiratory protection in the non-forming areas of the anode plant was task based and not mandated. Long-sleeved cotton drill shirts, long trousers, a cotton balaclava 55 (optional) and leather ‘riggers’ gloves were normally worn when working with coaltar pitch paste (Figure 3.14). Also, disposable coveralls were utilised in the reconstruction area when liquid pitch was painted onto the walls of the cell. If the exposure to PAHs is via inhalation, a correctly worn respirator should prevent exposure, and the level of 1-OHP in urine will not be elevated. .Figure 3.14: Clothing and PPE worn for working with coal-tar pitch paste 3.4 Recruitment of study participants Initially, a presentation was made by the author and the site’s medical officer to the site’s senior management team to outline the context and purpose of the monitoring and the value of being able to characterise PAH exposures that were not necessarily associated with airborne exposures. With the full support of the leadership team, further presentations were made to each of the work groups in the areas of the proposed investigation, outlining the study, the monitoring to be undertaken and 56 requesting volunteers. A copy of the presentation is located in Appendix 1. Personal monitoring at the smelter has been undertaken on a routine basis for more than 20 years and, whilst it is not compulsory, all workers are encouraged to become involved. From Table 3.1 it can be seen that the response rate was very positive, with participation ranging from a high level (96%) in the monitoring program for the anode plant forming production operators to a lower level (65%) in the reconstruction group bricklayers. The lowest level of participation (50%) was for analytical laboratory and human resources personnel in the non-production group, These people worked in locations where they would not be expected to be exposed to PAHs. All participants were asked to sign a consent form (Appendix 2) at the beginning of the study and a ‘permission to sample’ authorisation form prior to each sample collection. Table 3.1: Number of study participants and % participation Sample group Size of group (N) Participation (n) (%) Forming production operators 25 24 96 Non-forming production operators 24 21 86 Equipment technicians 27 24 88 Process technicians 19 15 80 Bricklayers 20 13 65 Analytical Laboratory 12 6 50 Occupational Health 10 7 71 Human Resources 8 4 50 Anode plant Reconstruction Non-production 3.4.1 Sample size calculations Calculations to ensure that the available sample sizes would be sufficient to test the project hypotheses had to address two important limitations. Due to the size of the plant in which the study was undertaken, there was a logistical maximum number of 57 staff who could be utilised. An additional consideration was the cost of analyses as the tests undertaken were quite expensive. Calculations to determine how these constraints would impact on the sample size for a viable study were performed based on preliminary monitoring results. The sample size requirements varied depending on the range of the standard deviation of the sample group and the difference in means between the two sample groups being compared. Table 3.2 shows data obtained from the initial sample runs on which the power and sample size calculations were based. The initial set of sampling results were assessed for normality against the Anderson-Darling test and found not to be normally distributed. To carry out the power and sample size calculations, Minitab V14.0 software was employed utilising the power and sample size function. An α of 0.05 was used in the two-tailed calculations. Using the data from Table 3.3, comparing the anode plant in general and the reconstruction plant using a difference of 8.22, the sample sizes to achieve a power of 0.90 were calculated to be 37 for each group. For the comparison of the forming plant and reconstruction and non-forming groups with a difference of 11.6, the size of each group was calculated to be 21. Table 3.2: Data for power and sample size calculations for the various SEGs Anode Plant Forming Anode Plant Non-Forming Reconstruction No. Samples Total Anode Plant 33 22 11 13 Post-shift 1-OHP results (µmol/mol cr) Means 9.42 13.3 1.64 1.2 SD 10.67 11.17 1.59 0.81 3.5 Exposure monitoring 3.5.1 Airborne exposure monitoring Historically, exposure monitoring has involved the airborne monitoring of particulates and fumes of the process or absorption by the individual. These results 58 are then related to occupational exposure limits as set by bodies such as the American Conference of Governmental Industrial Hygienists (ACGIH) in the United States and the Health and Safety Executive in the United Kingdom. This may then be evaluated in comparison to known exposure guidelines and, where necessary, controls established. 3.5.1.1 Stationary monitoring of the process Whilst stationary (static) monitoring is not used for direct comparison against occupational exposure standards, it is generally utilised to monitor a process to assess the controls in place and identify potential areas of fugitive emissions. It was used in this study to obtain the levels of PAHs being emitted from the processes in areas of the plant where the reconstruction of the cells is undertaken and in the anode production plant. High levels of fugitive emissions from a particular section of the process or a piece of equipment can provide valuable information in relation to the potential exposure profile and working habits of the individuals undertaking activities in and around the area. This information was used in the analyses to determine whether there were any relationships associated with the airborne levels at specific locations in the workplace, the personal monitoring of the individual and lastly the biological monitoring. A sample head and pump is located in one position for the duration of the monitoring period. As this is not a true representation of the exposure of an individual who would normally be moving, the results cannot be compared with occupational exposure limits. Stationary monitoring was carried out according to NIOSH method 5042 (Schlecht & O’Connor, 2003). Sampling was carried out using a PTFE laminated membrane, 2-µm pore size, 37 mm diameter Zefluor pre-filter, backed by a 37 mm diameter cellulose support pad in a cassette filter holder. The filter heads were attached to a SKC PCXR4, SKC PCXR8 or Aircheck personal monitoring pump (SKC Inc., Pennsylvania, USA) set at 2 L/min (Figure 3.15). 59 Figure 3.15: Monitoring pump and sample train configuration for NIOSH method 5042 Sampling locations were selected after discussions with plant employees and inspection of the process. Pumps were positioned in the work environment contained in a protective case with plastic Tygon® tubing connected to the pump inlet and run inside a PVC pipe up to the filter head at a height of 1.5 m above the ground (Figure 3.16). Locations selected were perceived to be areas of significant exposure or concern and accessed by technicians during the undertaking of their tasks. Each sample was run for 10 - 12 hours. After sampling, the sampling head was removed and the two plastic plugs were installed in the open ends of the cassette. At this stage, pre- and post-flow calibrations, exposure times and sampling details were added to the sample log sheet. Glass fibre filters were handled only when necessary and with clean tweezers at all times. Each sample head was uniquely labelled then wrapped in aluminium foil or placed in an opaque container to protect the sample from light. 60 At least one field blank was submitted with each set of samples containing up to 10 samples and an additional blank for each subsequent 10 samples. Blanks were handled in the same manner as other samples except that no air was drawn through them. At this point, the appropriate custody documents were completed, and the samples were sent by secure courier for analysis by BHP Environmental Health Laboratories at the Port Kembla Steelworks site, New South Wales. The results were used to develop a profile of the plant. Sample locations for the green carbon plant were: • Integrated Paste Plant 6th Floor Centre Beam • Integrated Paste Plant 6th Floor south west Corner • Control Room • L1&2 Mixer Bottom right hand side • L1&2 Mixer Top left hand side • L1&2 Preheat • L1&2 Vibro Paste Feeder • L3 Mixer Bottom hand side • L3 Mixer Top left hand side • L3 Paste Belt • L3 Preheat East End • L3 Preheat Magnetic Separator • Pitch Day Tank • Tail End 501 Conveyor Belt, Back • Tail End 501 Conveyor Belt, Front • Between Anode Former Lines 1 & 2 and Anode Former Line 3 Figures 3.17 and 3.18 show locations of sample points in the carbon bake area and Figure 3.19 shows locations in the cell-reconstruction building. 61 Figure 3.16: Static sample pump setup in the green carbon paste area on the 6th floor of the anode plant 22 30 40 10 33 43 56 4 7 2 3 6 9 10 8 1 5 Figure 3.17: Carbon bake furnace for reduction lines 1 & 2; locations of static samples 1 8 2 4 1 2 9 6 11 12 10 lower level 3 lower level near stairs 1 5 7 8 Figure 3.18: Carbon bake furnace for reduction line 3; locations of static samples 62 Figure 3.19: Cell-reconstruction site static sample locations Figure 3.20: Monitoring pump and sample train configuration with XAD tube for NIOSH method 5515 Where there was a potential for vapours and gases, a resin-filled sorbent tube was connected in series after the filter (Figure 3.20) as per NIOSH method 5515 (Schlecht & O’Connor, 2003) to determine what level of fume and volatiles 63 contributed to the sample and the characterisation of that fume (this is the main difference between NIOSH methods 5042 and 5515). Previous studies (Jessep, 2007; Tjoe Ny, 1993) at aluminium smelters have indicated that there was no gaseous phase PAHs of the 4-6 ring structure detected in the sorbent tubes of the sampling train. Monitoring undertaken in an earlier study at this site (Clarke. 2001) also returned the same result. In the initial stages of this monitoring program this method was repeated and again levels of PAHs from the resin-filled tubes were below the level of detection (<0.05µg); hence the results were reported as total BSF rather than differentiating between particulate, fume and vapour. Whilst this approach can limit the ability to differentiate between the different phases and may impact on the control approach taken where the vapour phase is a significant component, the small proportion of the gaseous phase in this case was not regarded as a major issue for this study. As there were no PAHs detected in the sorbent tubes in the initial samples, NIOSH method 5042 was adopted for the analysis during the remainder of the project. A series of samples using NIOSH method 5515 were run towards the end of the sampling exercise as a check, and again nothing was detected in the sorbent tubes. On completion of the monitoring, the filter heads were wrapped in aluminium foil and forwarded to the analytical laboratory for analysis. This analysis method is detailed in section 3.5.1.4. 3.5.1.2 Occupational monitoring of workers Each SEG was monitored. Wherever possible, personal air monitoring samples were allocated to coincide with the biological monitoring. Participants were asked to report to the Occupational Hygiene Laboratory prior to commencement of their shift to be fitted with a personal monitor. The configuration and method used was the same as that for the static monitoring except that the pumps were worn by the individuals and the sampling head was positioned in the individual’s breathing zone, which is a 300 mm hemispherical region about the nose and mouth (Figure 3.13). The cassette was attached to the sampling pump with plastic Tygon® tubing so that the glass fibre filters in the sampling cassette were exposed directly to the atmosphere. The sampler was attached vertically in the worker's breathing zone in 64 such a manner that it did not impede work performance. The sampling device was protected from direct sunlight. Figure 3.21: The 300 mm hemispherical breathing zone for positioning of the personal sampling head (Victorian Workcover Authority, 2000) 3.5.1.3 Pre-shift briefing and daily work log At the beginning of each shift when the personal monitor was worn, each participant was briefed in relation to the monitoring process and what to do in case of pump or sample head malfunction. Personal details were recorded on a monitoring sheet, and each participant was asked to record tasks and other pertinent details of his/her role on a daily work log during the shift (Appendix 3). On completion of the shift, the 65 participant returned to the laboratory where the monitor was removed, flow details were recorded and the log sheet filed in a secure location. Each sample was uniquely labelled and sent to a NATA-certified analytical laboratory for analysis. The data collected were used to develop a profile for each exposure group. 3.5.1.4 Analysis of air monitoring Analyses of the air samples (both personal and stationary) were undertaken at BHP Environmental Health Laboratories (EHL) at the Port Kembla Steelworks site. The same analysis method was used for both. The method for the determination of BSF was in-house method EHL 3 based on the Occupational Safety and Health Authority method 58 (OSHA, 1986). Air samples submitted for analysis were collected by drawing known amounts of air through cassettes containing pre-weighed glass fibre filters as per NIOSH methods 5515 and 5042 (Schlecht & O’Connor, 2003). The absolute detection limit is defined in the OSHA method as 0.006 mg on the filter. As the method subdivides the extract in two, the lowest detectable mass is 0.003 mg. The precision determined at a filter loading of 0.207 mg was 16.2%. At the limit of quantitation of 0.033 mg the precision was ±25% or better. The accuracy of the method was determined by recovery of coal tar from spiked filters and found to be 89.4%. Unexposed glass fibre or Teflon filters, taken from the batch used for collection, were processed as system blanks in triplicate. If one blank was seen to be different from the other two, it was considered an outlier if its value differed by more than 50% of the mean of the two closer results. If all three results differed widely, the triplicate blank measurement was repeated. The means of the three results (after rejecting outliers) were used in calculations. Briefly the procedure followed was: • Immediately prior to analysis, the description of the filter was noted particularly in relation to odour, colour and loading. • 2 mL Teflon cups were placed in a vacuum oven set at 40°C and –40kPa pressure for 1 h. An extra Teflon cup was included as a blank check weight. • Cups were allowed to cool in a desiccator for 10 – 15 min then equilibrate at room temperature. • Each cup was passed over a static eliminator, weighed to within 0.001 mg and the weight was recorded. 66 • Each filter was removed from its cassette, folded into quarters (sampling surface inside) and placed into correspondingly labelled 4 mL glass vials using flat-tipped stainless steel tweezers. To avoid losing any particulate material, the inside of the cassette was wiped with the folded filter paper. • 1.5 mL of benzene was added to each sample in the vial, tightly capped and vibrated in an ultrasonic bath for 1 h. • Solutions were filtered through Pasteur pipettes containing a 1 cm piece of glass fibre filter. A pipette filler was used to push the solution through to a labelled 2 mL glass vial which was immediately capped. • A 1 mL graduated syringe was used to deliver exactly half of the original extraction volume used to the separate weighed Teflon cups, which were then placed in the vacuum oven for 2 h at 40°C and –40kPa pressure. After this time, the vacuum pump was turned off, the vent valve was closed and the cups were left in the oven for a further 1 h at 40°C. • Sample cups were removed from the oven and placed in a desiccator for a minimum of 10 min, then equilibrated at room temperature. • Each cup was passed over a static eliminator and re-weighed to within 0.001 mg. If the BSF result exceeded the appropriate exposure limit, the sample could be further analysed by HPLC with a fluorescence or ultraviolet (UV) detector. This allowed the determination of the presence of selected PAHs (Table 3.3). In the early stages of the investigation, the sampling process was undertaken as per NIOSH method 5515 (Schlecht & O’Connor, 2003) and involved a sorbent tube after the filter (as described in section 3.5.1.1) to characterise the presence and type of fume. Desorption of the PAHs from the sorbent contained in the glass tube was carried out according to the following procedure. • The front glass wool plug and front sorbent section were transferred to one culture tube with the back sorbent section and the middle glass wool plug placed into a second culture tube. Acetone was added to each culture tube; tubes were capped and allowed to stand for 30 min, swirled occasionally. 67 • The solution was filtered through a 0.45 µm membrane filter and prepared for analysis via gas chromatography, using a 30 m x 0.32 mm ID, fused silica capillary column. • Temperature at the injector head was set at 200°C with the flame ionisation detector (FID) temperature set at 250°C. The temperature program was set to 130°C ramping up to 290°C at 4°C/min. • Carrier gas was pre-purified helium flowing at a rate of 1 mL/min with further helium makeup at 20 mL/min. Hydrogen gas was used as the fuel for the FID. • Calibration graphs of peak area versus µg of each PAH per sample were prepared for the calculations. • The limit of detection for this method was 0.3 – 0.5 µg per sample. • The sample aliquot was injected into the sample port and the temperature program started. Results were provided via a graph from which retention times and the areas under the peaks were calculated. If the peak area was above the calibration range, the sample was diluted with appropriate solvent, re-analysed and the appropriate dilution factor applied in calculations. The substances analysed are detailed in Table 3.3 Calibration graphs were used to calculate the concentration in air via the mass (µg) of each analyte found on the: • filter (W), • front sorbent (Wf), • back sorbent (Wb) sections, • average media blank filter (B), • front sorbent (Bf) and • back sorbent (Bb) sections. 68 Table 3.3: Average levels* of PAH compounds in air monitoring in anode plant green carbon assessed by gas chromatography (Method 5515 in NIOSH, 1994) *Based on 100 static air samples. Compound Synonym Average level µg/m3 acenaphthene 4.56 acenaphthylene 0.07 anthracene 0.83 benz[a]anthracene 1,2-benzanthracene benzo[b]phenanthrene 1.14 Benzo[A]fluorene 0.28 Benzo(B)fluorene 0.14 benzo[b]fluoranthene 3,4-benzofluoranthene 2,3-benzofluoranthene benz[e]acephenanthrylene 1.06 benzo[k]fluoranthene 11,12-benzofluoranthene 0.86 benzo[g,h,i]perylene 1,12-benzoperylene 0.50 benzo[a]pyrene 3,4-benzopyrene 6,7-benzopyrene 0.82 benzo[e]pyrene 1,2-benzopyrene 4,5-benzopyrene 0.68 chrysene 1,2-benzophenanthrene benzo[a]phenanthrene 1.13 dibenz[a,h]anthracene 1,2,5,6-dibenzanthracene 0.25 Dienzopyrene Isomers 0.34 fluoranthene benzo[jk]fluorene 2.17 fluorene o-biphenylenemethane 1.80 indeno[1,2,3-c,d]pyrene 2,3-phenylenepyrene 0.56 naphthalene naphthene 4.64 phenanthrene pyrene 5.45 benzo[def]phenanthrene 1.74 69 The concentration, C (mg/m3), in air as the sum of the particulate concentration and the vapour concentration was calculated using the actual air volume sampled, V (L), utilizing equation 3.1: C = (W-B+W f+W b-Bf-Bb) mg/m 3 Eq 3.1 V 3.5.2 Biological marker monitoring Each of the similar exposure groups outlined in section 3.3 was studied by monitoring the level of 1-OHP, a metabolite of pyrene excreted in the urine of individuals exposed to pyrene. As pyrene is a ubiquitous component of PAH compound groups, it has been utilised as a surrogate marker for other PAH compounds. 3.5.2.1 Biological sample collection As described in section 2.3.2, the half-life for urinary excretion of 1-OHP has been shown to vary in at least three studies. Taking into account this variation, ACGIH (2005) guidelines for biological monitoring were adopted; these recommend preshift and end-of-work-week post-shift spot urine samples for monitoring with urinary creatinine levels between 0.3 g/L and 3.0 g/L. On the shift prior to the sampling shift, each participant was provided with a sampling pack containing: • sample jars, • biological hazard bags, • work log, and • questionnaire and instructions (Figure 3.22). 70 Figure 3.22: Contents of the 1-OHP in urine sampling kit provided to study participants at the beginning of each sample run Participants were asked to provide two containers with samples of mid-stream urine prior to the commencement of their first shift of the next rotation. Sample jars were placed in a biological hazard sample bag and then in a labelled, designated container in the laboratory freezer; they were collected the following day and relocated to the medical centre freezer. The same process was followed immediately following the last shift of the rotation. The pre- and post-shift samples were uniquely labelled and sent to the NATA-certified Workcover NSW Chemical Analysis Branch for analysis along with the control samples. The analysis method used at the analytical laboratory was based on the method first described by Jongeneelen et al. (1987), then Tolos, Lowry and MacKenzie (1989) and Hansen, Poulsen, Christensen and Hansen (1993). All samples were analysed by Workcover NSW Chemical Analysis Branch utilising method WCA158 (Workcover NSW, 2005). Briefly, duplicate urine samples were adjusted to pH 5.0 with acetic 71 acid. An acetate buffer was added, followed by β-glucuronidase. The mixture was then heated for 3 h in a water bath at 60ºC to hydrolyse the glucuronide and sulphate conjugates (Figure 3.23). A 50 µL sample was injected into C18 Solid Phase Extracting column with a mobile phase of methanol:water to isolate the analyte, 1OHP. Cleaned extracts were analysed by HPLC with fluorescence detection with an excitation wavelength of 242 nm and an emission wavelength of 388 nm. The method has a detection limit of 0.5 µg/L. H OOC HO O O Enzyme OH OH OH β -D-G lucur onide 1-Hydroxypyrene Figure 3.23: Enzymatic development of the metabolite 1-OHP Results were reported as µg/L 1-OHP and the creatinine value was determined. The creatinine (cr) value was used to correct for variations arising from urine dilution. Results were finally reported as µmol/mol cr. As part of the sampling protocol, samples were also collected from a control group whose numbers were not involved in production roles and hence were not exposed to CTPV. All results for this group had levels below the level of detection of the method of analysis. 3.5.2.2 Combined sampling To assess whether there was a correlation between the level of 1-OHP in urine and personal monitoring of BSF in the air, combined sampling was undertaken on 58 occasions. During this process, participants were required to wear a personal airsampling pump during the same shift rotation they were tested for 1-OHP. 72 3.5.2.3 Potential confounders Prior to providing a urine sample, each participant completed a self-administered questionnaire (Appendix 4). This was introduced to collect data in relation to potential sources of exposure that might confound the relationship between the air and the urine measures. There are several possible confounders that may impact in varying degrees on the results including: • Exposures during the 48 hours prior to monitoring, such as non-occupational use of creosote, burning off or natural bush fires, and use of tar-based skin products or shampoos. Whilst these may noticeably impact on the levels of 1OHP in the urine samples of non-occupationally exposed individuals, as discussed in section 2.4, these levels would not be of concern in the occupationally exposed group of this study. • Potential food sources of PAHs were assessed as these have been known to elevate the 1-OHP levels in urine; however, from the literature search (section 2.1.2), it would appear unlikely that these were significant enough to impact on the measurement of occupational exposures. • Smoking habits were targeted, as the literature review indicated a potential elevation of 1-OHP in urine due to inhalation of cigarette smoke. As in the case of food intake, it was not expected to impact significantly on occupationally acquired levels of pyrene (see section 2.4). • PPE was mandatory in all areas where there was a potential exposure to PAHs. There was some variation in the type and level of protection provided, i.e. full-face or half-face mask respirators. Wearing of respiratory protection in the carbon bake furnaces was task-based. Also, disposable coveralls and impermeable gloves were implemented towards the latter stages of the project as one of many additional controls as part of a process intervention strategy. • Also of interest were potential elevated exposures from previous unmonitored shifts due to 1-OHP which may not have been fully excreted. Prior to the commencement of each monitored shift, the participant was asked to provide details of any potential high exposures in the two work shifts immediately prior on the questionnaire submitted with the urine sample. This information was transferred to a spreadsheet that could be 73 referenced if elevated pre-shift samples were identified. The potential impact on the final 1-OHP result was addressed by using the difference between preshift and post-shift results as one of the variables instead of only the postshift result. Buchet et al. (1992) reported that there was not a significant difference when expressing 1-OHP urine excretion as the change over the work shift instead of post-shift value alone. • A potential variation in the ratio of pyrene to BaP in different suppliers’ coaltar pitch formulations can impact on the level of 1-OHP. Obviously, pitches with higher pyrene ratios will result in more 1-OHP being metabolised and hence a higher result. Therefore, it was important to note if there were any trials of different pitches being undertaken during the study. Review of site records and discussions with green carbon workers indicated that no pitch trials were undertaken during the periods of the study when sampling was undertaken. • Individual behavioural characteristics can significantly impact on the results (‘dirty worker effect’). An individual who is more prone to come in contact with the pitch due to the way s/he works, or does not wash as frequently or uses PPE incorrectly can introduce additional variation into the analysis. This can be a difficult aspect to address, as a decision must be made as to whether the elevation in results is specifically due to the individual’s behaviour. To be able to confirm this with a degree of confidence would require multiple sampling of individuals over an extended period of time. As no individuals were sampled more than three times during the study, there are insufficient data available to undertake this assessment. Hence, interpretation of results will need to assume the effect is not significant enough to impact on this occasion, but will acknowledge this particular limitation. 3.5.2.4 Participant communication Feedback sessions were held on a regular basis to outline the general group results obtained, and each participant was given the option of viewing his/her personal results by contacting the author as the project leader or the site’s Principal Medical Officer. 74 3.6 Data management and statistical analysis Quantitative data collected were entered into Microsoft Excel for Windows for initial review, with further descriptive data analysis carried out via a selection of statistical tools utilising a commercial statistics software package called Minitab®. Variables were based on the different monitoring measures for the work groups and areas being investigated as outlined in section 3.3. These were: • static sampling results of the specific work areas, • personal air sampling results of SEGs in these areas and • biological monitoring results of SEGs in these areas. For the latter group, data were presented in three forms, pre-shift result, post-shift result and a difference result. The difference variable was obtained by subtracting the pre-shift from the post-shift result to remove any potential effect of the pre-shift loading of 1-OHP. Results were assessed for normality to determine whether parametric or nonparametric analysis would be utilised. In the first instance, the Anderson-Darling normality test within the Minitab® statistical program was utilised. This approach was initially chosen as it was the most commonly used test for this purpose within the aluminium industry where this project was undertaken. The results of this analysis showed that only one of the 34 sets of variables was normally distributed. As a consequence, transformation of the data was undertaken. Different transformations may be used depending on the condition of the original data. For example, for positively skewed data either a square root or logarithmic approach is best; however, if the data tend more to the lognormal distribution or display a standard deviation proportional to the mean, then a logarithmic approach is preferred. In the case of negatively skewed data, squaring is more suitable (Kirkwood & Sterne, 2003). Initial review showed no specific trends across all the 34 measures; however, there was a predominance of lognormal distributions so the variables were transformed 75 using a logarithmic approach then re-assessed via the Anderson-Darling test. There was an improvement in the result, with approximately 30% of the logarithmically transformed variables found to be normally distributed. At this stage, there was some consideration given to the possibility that the Anderson-Darling test may have been overly conservative, as it was detecting relatively small departures from normality. Ultimately, the decision as to whether the descriptive statistics on this occasion should be approached via means as averages or a median average does not require perfect normality, and hence an alternative approach was adopted. A set of criteria (Appendix 5) to determine normality more appropriate to the investigation was applied to both the crude data and the transformed data. Data were required to meet each of the six criteria to be classified as normally distributed. The majority of the data could not be normalised and, whilst it would be possible to split the data interrogation into parametric and non-parametric analyses, the benefit of being able to utilise the more powerful parametric methods would come at a cost of introducing significantly more complexity to the analysis than was warranted. As such, non-parametric methods were selected for analysis of the data, describing and comparing median averages rather than means. This involved the use of the MannWhitney and Kruskal-Wallis sample tests for the two- and three-population median comparisons, respectively, in hypotheses 1 and 2. For hypothesis 3, multiple linear regressions were utilised to determine the predictability of the personal air monitoring for the 1-OHP in urine. Dichotomous variables (forming = 1, nonforming = 0) (no PPE = 1, PPE = 0) and (smoking = 1, non-smoking = 0) were also used in the regression analyses. As there were both continuous and categorical data to be analysed, linear regression was well suited to predict the outcome on the basis of the available independent variables, which was further simplified by eliminating some of the predictors. From here the simplified equation for the prediction of 1-hydroxypyrene from initially BSF and potentially other elements (i.e. smoking, PPE) was assessed for its predictive power. Regression is best when observations are independent of each other and this assumption was met by reviewing the data set, and where identified, 76 removing results that were repeated from the same individuals as is discussed in section 4.4.1.1. Extreme cases have too much impact on the regression solution and also affect the precision of estimation of the regression coefficient estimates (Tabachnick, Fidell 2007). Hence the data were reviewed to ascertain the possible presence of outliers. Outliers were identified (see section 3.6.1) and consequently not included in the analyses. As the presence of multicollinearity can affect the estimation of the regression coefficients, correlations between the independent variables were tested and found to be low, hence indicating an absence of multicollinearity. Finally, the normality of residuals was also tested for the models and displayed some differences between the groups. The anode plant forming and non-forming groups exhibited some minor curvature in the tail of the normal probability plot which indicated some skewness of the data. The data from reconstruction had a higher level of skewness due to the increased number of results in the lower values. These deviations from the model could also have resulted from the non-normality of the data. The standardised normal probability plot for the all-data model did not fit the line but displayed some curvature. This is not unexpected given that it included data from reconstruction which would have a significant impact. Additionally there is the possibility that this could indicate a missing variable from the model and also an issue with the homogeneity of the variances, particularly between the reconstruction and anode plant areas (as highlighted in section 4.2.3). 3.6.1 Outliers Whilst data were spread over a wide range of values, there were two urine sample results with significantly larger 1-OHP concentrations than any other measures obtained: one from a former technician (112.85 µmol/mol cr) and another from a mechanical maintenance technician (85.14 µmol/mol cr). Both were working in the forming area of the anode plant at the time. All other urine sample values were below 50.0 µmol/mol cr. Further investigation of the samples, which involved discussions with the individuals concerned and review of work logs, revealed that on both occasions there were significant plant disruptions that required manual intervention on the part of the operator. In both cases a paste ‘dig out’ was required. 77 In this scenario, the operator must enter the area where the blockage has occurred and physically shovel out the coal-tar paste before it cools and sets. This results in much higher levels of skin contact with the coal-tar pitch along with longer intervals between washing of the skin due to the nature of the task. This is not a common occurrence, but there have been a few such instances in the past. Whether these results should be included as part of the routine operating of a carbon anode plant is dependent on the view taken. If a plant is operating to specification, i.e. within operating parameters and in control, then this is an uncommon situation. However, where a plant is being operated at or beyond its design capacity or the preventative maintenance program is not in control, these situations become more common, making them a part of the routine tasks and a serious concern. The impact of these outliers will be assessed in section 4.4.1.2, and discussed in relation to the issue of poor maintenance and failing equipment in section 5.1.3. 78 4.0 RESULTS This chapter presents the results for air and biological monitoring in various areas of the prebake smelter. Statistical relationships are examined, and the results from comparison of the data sets in relation to the three hypotheses are presented. Also included are results from data collected before and after the plant process intervention. 4.1 Introduction A total of 166 sets of pre- and post-shift urine samples were collected from the cohort for analysis of 1-OHP. Of these, 20 were not within the creatinine range specified by the method’s guideline and 18 were missing the post-shift sample, and were therefore excluded from the analysis. From the control group, 24 sets of samples were collected. In addition, 167 personal air samples and 249 static air samples were collected and analysed for BSF, and there were 58 matched sets of 1OHP urine results with a corresponding personal BSF in air result. As detailed in section 3.6, non-parametric analyses were selected as the approach for the data interrogation to test the hypotheses: In a prebake smelter, based on the results of static air monitoring of the process, personal air monitoring of the individual and biological monitoring: 1. Workers in the carbon anode plant will have higher exposure to PAHs than workers in the cell-reconstruction area of the smelter. 2. Within the carbon anode plant, exposure to PAHs will be higher among workers involved in tasks associated with the paste-mixing and anodeforming areas than those in the non-forming areas of the carbon anode plant. 3. There is no evidence of a relationship between personal air monitoring for the BSF and 1-OHP in urine of workers involved with tasks in a prebake smelter. 79 To test hypotheses 1 and 2, the two-sample Mann-Whitney test (equivalent to the two-sample rank or two-sample Wilcoxon rank sum tests) was used to make inferences about the difference between two population medians, based on data from two independent, random samples. A significance level of α = 0.05 (two-tailed) was used in these assessments. The Mann-Whitney test was the non-parametric test of choice for comparing the groups where the tests only involved comparison of two groups at a time, i.e. anode plant and cell-reconstruction group, or anode forming area and anode non-forming area. Where three populations were assessed (i.e. reconstruction, anode plant forming and anode plant non-forming areas for hypothesis 2), the Kruskal-Wallis test for one-way analysis of variance was utilised, as it is an extension of the Mann-Whitney test for three or more independent groups. This assessment primarily looked at the exposure of two anode-plant areas (forming and non-forming), including a comparison with the reconstruction area. Whilst not strictly addressing hypothesis 2, it was considered valuable as an overall gauge of exposure across the sites for later discussion. Hypothesis 1 was considered in terms of three groups of different sample measurements: • BSF in air static samples for anode plant and the cell-reconstruction area; personal BSF in air samples for operators in the anode plant and cellreconstruction area; and • 1-OHP samples in urine of the operators for the anode plant and cellreconstruction areas. • A similar comparison process was utilised to assess the 1-OHP levels in urine of the different groups for hypothesis 2. For hypothesis 3, BSF and 1-OHP results were assessed via bivariate correlations in the first instance and multivariable linear regression analysis in the second, which considered potential confounders of smoking and PPE. Measurements of the confounders were addressed in the pre-sampling questionnaire. 80 4.2 Exposure variation in a prebake smelter (hypothesis 1) Workers in the carbon anode plant will have higher exposure to PAHs than workers in the cell-reconstruction area of the smelter Table 4.1 presents average (median) exposure levels from both static and personal BSF monitoring and 1-OHP levels in urine as discussed in the sections below. All 1OHP levels in urine for the control group were below the level of detection. Table 4.1: Median static and personal measures of BSF in air and 1-OHP in urine, by sections within a prebake smelter Reconstruction Static BSF exposure No. samples Median (range, mg/m3) Personal BSF exposure No. samples Median (range, mg/m3) 1-OHP No. samples Median (range, µmol/mol cr) Anode Plant Anode plant total Forming Non-forming 66 0.013 (0.003-0.154) 183 0.023 (0.002-0.250) 66 0.030 (0.002-0.250) 117 0.019 (0.003-0.197) 27 0.054 (0.003-0.371) 140 0.036 (0.003-0.563) 71 0.046 (0.003-0.563) 69 0.028 (0.003-0.128) 25 0.17 (0.001-2.47) 94 6.62 (0.090-33.44) 44 14.20 (2.02-33.44) 50 4.11 (0.09-26.99) 4.2.1 Static exposure levels The median static BSF in air in the anode plant was 0.023 mg/m3, almost twice as high as that in the cell-reconstruction area (median 0.013 mg/m3). This difference was statistically significant (p = 0.030). The range of variation of the static BSF in air within the anode plant was also greater than that of the reconstruction area, indicating that there were a variety of point sources within the anode plant with higher fugitive emissions. 4.2.2 Personal exposure levels Median BSF exposure level in the anode plant was 0.036 mg/m3, significantly lower (p = 0.041) than the median exposure level in the reconstruction area, which was 81 0.054 mg/m3. Variation in the personal air monitoring of BSF was higher in the anode plant than in the reconstruction area. 4.2.3 Biological 1-OHP levels Comparison of the median 1-OHP levels from the anode-plant workers and the reconstruction-area workers showed that 1-OHP concentrations were significantly higher in the anode-plant workers (p < 0.001); 6.62 compared with 0.17 µmol/mol cr, respectively. A comparison of the variances within the reconstruction area and the anode plant identified the difference in variation to be substantial. Transformation of the data using squared, log and natural logarithm functions produced marginal improvement, but insufficient to demonstrate a homogeneity of the variances between the reconstruction and anode plant areas. Therefore, it should be noted that in the comparisons undertaken in the first hypothesis this anomaly exists. Based on static monitoring of air levels for BSF and of 1-OHP levels in urine, the anode plant had the higher exposure. However, the personal BSF air monitoring indicates that the monitored section of the cell-reconstruction area of the plant had a higher level of airborne PAHs reaching the workers. These results suggest that workers in the reconstruction area were exposed to higher levels of airborne PAHs than workers in the carbon anode plant, but that anode-plant workers potentially had higher exposure via other routes than air. This may be due to processes involved, one being a more controlled construction of a cell compared with a production role that can require a higher level of process intervention due to failures or breakdowns in the anode plant. This can result in increased skin contact and additional exposure. Another consideration is that the reconstruction workers were positioned within a smaller physical location and their work took place mainly within the confines of the reduction cell being constructed. Although the actual levels may be lower, these workers are spending more time in areas where there are fugitive emissions. The anode-plant workers operated across a much larger plant area, with a greater variation of sources and exposure levels and this is reflected in the range of measured values. 82 Static BSF Monitoring 0.25 BSF (mg/m3) 0.20 0.15 0.10 0.05 0.00 Anode Plant Anode Plant Forming Anode Plant non-Forming Reconstruction Figure 4.1: Static air BSF measures in the anode plant, anode plant forming area, anode plant non-forming area and reconstruction area in a prebake smelter in Queensland, Australia, 2002–04 Personal BSF Monitoring 0.6 0.5 BSF (mg/m3) 0.4 0.3 0.2 0.1 0.0 A node Plant A node Plant Forming A node Plant non-Forming Reconstruction Figure 4.2: Personal air BSF measures of workers in the anode plant, anode plant forming area, anode plant non-forming area and reconstruction area in a prebake smelter in Queensland, Australia, 2002-04 83 1-Hydroxypyrene in Urine 35 1-OHP (umol/mol cr) 30 25 20 15 10 5 0 Anode Plant Anode Plant Forming Anode Plant non-Forming Reconstruction Figure 4.3: 1-OHP in urine of workers in the anode plant, anode plant forming area, anode plant non-forming area and reconstruction area in a prebake smelter in Queensland, Australia, 2002-04 4.3 Exposure variation in an anode plant of a prebake smelter (hypothesis 2) Within the carbon anode plant, exposure to PAHs will be higher among workers involved in tasks associated with the paste-mixing and anode-forming areas than those in the non-forming areas of the carbon anode plant. 4.3.1 Static exposure levels Median static BSF in air in the forming area of the anode plant was 0.030 mg/m3 compared to 0.019 mg/m3 in the anode plant non-forming area. This difference was statistically different (p = 0.041). 84 4.3.2 Personal exposure levels A Kruskal-Wallis test comparing the reconstruction group, anode forming group and anode non-forming group detected significant differences in personal BSF exposure levels across areas of the prebake smelter (p < 0.001). Post hoc Mann-Whitney pairwise comparisons identified statistically significant differences in personal BSF levels between the forming and non-forming sections of the anode plant (p < 0.001), with more individual variation in measurements in the forming compared to nonforming area and a higher median of 0.046 mg/m3 compared to a median of 0.028 mg/m3, respectively. Comparing each of these anode plant areas to the reconstruction area, which had a median personal BSF exposure of 0.054 mg/m3, exposure was statistically similar in the forming area of the anode plant (p = 0.880), but approximately half that of the non-forming area (p = 0.0002). 4.3.3 Biological 1-OHP levels The 1-OHP results present a greater difference between the two plant areas within the anode plant than the differences between BSF-monitored PAH concentrations. The median result from the forming area of the anode plant (14.20 µmol/mol cr) is more than three times higher than that from the non-forming area (4.11 µmol/mol cr, p < 0.001). Both are significantly higher than the measures obtained from the reconstruction area (0.17 µmol/mol cr). Based on the results presented in Table 4.1, it follows that within the carbon anode plant, exposure to PAHs appears highest among workers involved in tasks associated with the anode-forming areas. 4.4 Personal air monitoring of BSF exposure and relationship to 1-OHP levels in urine (hypothesis 3) There is no evidence of a relationship between personal air monitoring for the BSF and 1-OHP in urine of workers involved with tasks in a prebake smelter. 85 4.4.1 Preliminary analysis ignoring potential confounders On 58 occasions, personal BSF air monitoring was undertaken to correspond to a 1OHP monitoring run on the participants in the anode plant forming area, anode plant non-forming area and the reconstruction area. This information was analysed by regression analysis to determine the predictive value of BSF in air personal monitoring in relation to the 1-OHP in urine samples post-shift (collected at the end of the last shift rotation) minus pre-shift (collected at the beginning of the first shift of the rotation). 4.4.1.1 Sensitivity of conclusion to presence of multiple measures Within this group of samples were six participants who were sampled twice or more. This is inevitable in a sampling program where there are limited numbers of employees and low staff turnover during the sampling period. There were two participants in the anode plant forming area who provided samples on two and three occasions. Also, one participant in each of the anode plant non-forming and reconstruction areas provided samples on two occasions. Hence, five out of 66 samples were not strictly independent observations. To determine the potential impact of recurrent individuals in the sample (since their inclusion violates the assumption of independence of samples required for valid application of the statistical tests), only their first-occurrence sample results were included. 4.4.1.2 Impact of outlier Within the data was one pair of results from the anode plant forming area that was substantially higher than any of the others. This sample was previously discussed in section 3.6.1. This participant’s 1-OHP value for post-shift minus pre-shift was 111.38 µmol/mol cr, more than three times the next highest sample value. The corresponding personal BSF result was 0.44 mg/m3, also significantly higher than the other BSF results. Investigation of the cause of these differences revealed that 86 there were significant plant problems during the shift and manual intervention was required to dig out the pitch from the equipment before it set hard. Because this is not a common occurrence, the outlier was not included in the final analyses. When the outlier was removed from the combined analysis, anode plant analysis and the anode plant forming analysis, there was a significant impact on the R2 (adj) result for the three regression analyses. The result for all the plant reduced from 38.7 – 0.7%, the anode plant from 39.9 – 0.4% and the anode plant forming from 35.6 – 0.0%. This presented a very different picture and showed that BSF in air is a poor predictor of 1-OHP in urine across the prebake smelter. 4.4.2 Multiple linear regressions The bivariate analyses above may be biased by potential confounding influences of smoking, diet, use of PPE, and contact with other coal-tar products outside of the occupational environment. These may distort the magnitude of the noted associations between smelter area and exposure to PAHs as measured by 1-OHP, by varying degrees as discussed in section 2.4. The multiple linear regression analyses considered the potential for confounding of these variables by extending the original bivariate associations to adjust for all identified confounders. Adjusted and unadjusted results were compared and any regression coefficients that differed by more than 10% are reported in terms of adjusted results, as these are closer to a truthful association than the bivariate results. 4.4.2.1 Role of confounders As part of the monitoring program for 1-OHP, participants were asked to complete a questionnaire prior to the collection of the sample as described in section 3.5.2.3. Statistically, a variable is identified as a potential confounder if it is associated with both the outcome of interest, in this case 1-OHP levels, and the independent variable (in this case BSF for hypothesis 3) in the main bivariate analysis. Associations between potential confounders and outcome are presented in Table 4.2. These associations were evaluated for statistical significance using the Mann-Whitney test in relation to possible impacts on the 1-OHP levels. 87 The comparison for smoking and non-smoking groups showed a statistically significant difference at both the pre- and post-shift timepoints, with the median of the pre-shift values among smokers at 0.82 µmol/mol cr (p = 0.009), which is higher than that of the non-smokers (0.31 µmol/mol cr). The comparison of the post-shift results showed that the smokers’ median was 10.75 µmol/mol cr, which was a higher value than the non-smokers’ at 4.97 µmol/mol cr (p = 0.011). Table 4.2: Identification of potential confounding variables of the association between 1-OHP levels and personal BSF levels n Median 1-OHP (µmol/mol cr) 30 0.82 0.21 – 9.59 No 123 0.31 0.21 – 13.6 Yes 26 10.75 0.21 – 112.85 0.011 No 109 4.97 0.21 – 31.79 Yes 31 0.77 0.21 – 28.09 No 254 0.83 0.21 – 112.85 Use of coal-tar products Yes 15 (pre-shift) No 137 0.51 0.21 – 0.85 0.32 0.13 – 13.60 Yes 227 0.93 0.21 – 85.14 No 13 2.7 0.21 – 112.85 Yes 11 7.39 1.28 - 19.46 No 21 8.45 3.69 – 46.0 Potential confounder Smoking (pre-shift) Smoking (post-shift) PAH exposure at home PPE used Yes Range p-value (µmol/mol cr) 0.009 0.89 0.91 0.27 Overalls used in forming area 0.10 For non-occupational exposure to PAH from sources such as food, wood preservatives and personal care coal-tar products (e.g. soaps, shampoo), there was no significant difference between the use and non-use groups. Further investigation of pre- and post-shift response for the use of coal-tar products also did not yield a significant difference between urine measures. The median value of 1-OHP among those who did not use PPE was approximately three times that for those who did report using PPE (2.70 µmol/mol cr compared to 88 0.93 µmol/mol cr); however, the difference did not reach statistical significance (p = 0.27). The different mandatory base levels of PPE required depending on the area and task (as discussed in section 3.5.2.3) could have impacted on this result; it is also possible that the selected PPE may not have been effective. The use of overalls by a specific group of employees in the forming area was also assessed to determine if there was a significant impact. The median values between those who wore the overalls and those who did not showed only a small difference (7.35 vs 8.45 respectively); however there was a much larger variation in the range, and whilst the difference was not statistically significant (p = 0.10), it was believed it merited further assessment. Of the potential confounders reviewed in Table 4.2, the use of coal-tar products at home and the consumption of foods that may potentially contain PAHs (e.g. smoked products or barbecued foods) appeared to have little impact and therefore were not considered further in the multivariate analyses. In contrast, these analyses identified different levels of potential impact for smoking and use of PPE; therefore, these warranted further investigation. 4.4.2.2 Adjustment for identified confounders The possible impact of smoking and PPE on the results required further analysis to determine whether smoking or not wearing PPE served as confounders or displayed effect modification of the relationship between BSF and the level of 1-OHP in urine. Multivariate regression analyses were undertaken on the data, which were presented in four models: 1. All groups combined (Table 4.3) 2. Anode plant (Table 4.4) 3. Anode plant forming area (Table 4.5) 4. Anode plant non-forming area (Table 4.6) Each model was assessed by comparing the 1-OHP concentration in urine against: • BSF in air personal monitoring; • smoking; • PPE; and 89 • BSF, smoking and PPE. The analyses of the impact of smoking and PPE were not undertaken for the reconstruction area as all participants in this group were non-smokers and wore PPE at all times. However, data from reconstruction area workers were included in the ‘All groups combined’ analyses. Table 4.3: Relationship of 1-OHP levels and BSF for all samples in the anode plant and reconstruction areas at a prebake smelter site: impact of identified confounding variables (n = 58) Variables in model Bivariate regression coefficients (SE) p-value Adjustedb regression coefficients (SE) p-value BSF (mg/m3) 24.0 (20.3) 0.24 24.3 (21.0) 0.25 0.71 0a 1.1 (3.0) 0.71 0.82 0a -0.19 (2.4) 0.94 Smoking PPE adj R2 (%) a b No Yes 0a 1.1 (2.9) Yes No 0a 0.5 (2.3) 0.7 0 referent category adjusted for all other variables in the table There appears to be no confounding of the bivariate relationship between 1-OHP levels and BSF across all samples taken. For every 1 mg/m3 increase in BSF there was a 24.3 µmol/mol cr increase of 1-OHP in the adjusted model compared with the unadjusted value of 24.0 µmol/mol cr. Smoking and PPE did not display significant relationships with 1-OHP in this model. The predictive ability of the model to estimate 1-OHP levels was minimal, with the adjusted R2 < 1.0. A similar approach as that taken for the combined group model was then utilised to assess the samples from workers in the anode plant only. These are summarised in Table 4.4. 90 Table 4.4: Relationship of 1-OHP levels and BSF in the anode plant at the prebake smelter site: impact of identified confounding variables (n = 39) Variables in model Bivariate regression coefficients (SE) p-value Adjustedb regression coefficients (SE) p-value BSF (mg/m3) 26.1 (23.9) 0.28 33.5 (24.0) 0.17 0.47 0a -1.5 (3.1) 0.63 0.17 0a -4.3 (2.7) 0.13 Smoking PPE No Yes 0a -2.3 (3.2) Yes No 0a -3.7 (2.6) adj R2 (%) a b 0.4 0 referent category adjusted for all other variables in the table There appears to be some confounding of the bivariate relationship between 1-OHP levels and BSF across the anode plant. On average, for each 1 mg/m3 increase in BSF, 1-OHP levels increased by 33.5 µmol/mol cr, after adjustment for smoking and the use of PPE. This was different from the unadjusted estimate of 26.1 µmol/mol cr. This variation was deemed to warrant further investigation. The predictive ability of this model to estimate 1-OHP levels was still minimal, as evidenced by the adjusted R2 of 0.4 and 0. The anode plant warranted further investigation in terms of the forming and nonforming areas. These are summarised in Tables 4.5 and 4.6 91 Table 4.5: Relationship of 1-OHP levels and BSF in the anode plant forming area at the prebake smelter site: impact of identified confounding variables (n = 17) Variables in model Bivariate regression coefficients (SE) p-value Adjustedb regression coefficients (SE) p-value BSF (mg/m3) 3.6 (30.7) 0.92 -0.4 (37.6) 0.99 0.37 0a 3.6 (7.1) 0.62 No Yes 0a 3.9 (5.2) PPE Yes No 2.9 (4.2) 0a Overalls Yes No Smoking adj R2 (%) a b 1.7 (5.4) 0a 0.76 -0.81 (6.2) 0a -1.9 (7.9) 0a 0.82 0 0 0.50 referent category adjusted for all other variables in the table As part of the questionnaire individuals were also asked to specify what PPE they were wearing. This information was able to be used to determine whether individuals were wearing overalls during the performance of their work or only other PPE. These impermeable overalls are intended to provide additional protection from skin contamination and their use was included as an additional variable in the regression analysis of the anode plant forming area as this is an area where skin contact is a particular issue. On reviewing the results for the anode plant forming area, there was a small difference between the unadjusted and adjusted results for BSF. An increase of 1 mg/m3 of BSF resulted in an increase of 3.6 µmol/mol cr in the unadjusted model but resulted in a minor decrease in the adjusted model, a difference of only 4.0 µmol/mol cr. The use of overalls appeared to result in a small negative result which decreased from -0.81 to -1.9 µmol/mol cr. The predictive ability was non-existent with the adjusted R2 = 0.0 in both cases. In the case of the anode plant non-forming model (Table 4.6), there appeared to be a difference indicating a potential confounding of the bivariate relationship, with the 92 unadjusted model coefficient at –27.7 and the adjusted model coefficient at –31.3. However, considering the impact of smoking and PPE on the association with BSF separately, there appeared to be a lowering of the 1-OHP in the urine of smokers and those wearing PPE. It would be expected that the levels would reduce if PPE is worn as it protects the individual from exposure, but it appears counter intuitive in the lowering of 1-OHP among smokers. Evaluation of the group via a cross tabulation of the smoking and PPE, showed that 40% of the smokers also wore PPE. There was also an increase in the predictive ability of the unadjusted model increasing from 0% for the bivariate association to 11.4% for the adjusted. Table 4.6: Relationship of 1-OHP levels and BSF in the anode plant non-forming area at the prebake smelter site: impact of identified confounding variables (n = 22) Variables in model Bivariate regression coefficients (SE) p-value Adjustedb regression coefficients (SE) p-value BSF (mg/m3) -27.7 (37.4) 0.45 -31.3 (40.6) 0.45 0.06 0a -4.9 (3.4) 0. 17 0.07 0a -1.71 (3.1) 0.59 Smoking PPE adj R2 (%) a b No Yes 0a -5.4 (2.7) Yes No 0a -4.48 (2.4) 0.00 11.4 referent category adjusted for all other variables in the table 4.4.2.3 Skin Exposure. On the questionnaire, were three questions relating to perceived skin contamination. Employees were asked to select one which they believed was the closest representation of their exposure during the shifts. These were: • Level 1: Minimal to no opportunity noted for visible contamination of skin or clothing with CTP, or carbon material known to contain CTP. • Level 2: Periodic opportunities for visible contamination of skin or clothing. • Level 3: Regular or routine visible contamination of skin or clothing 93 This information was then assessed via linear regression with results presented in table 4.7. The perceived skin exposure appears to have some relationship with the increase of 1-hydroxypyrene in urine. There is an increase of 7.4 µmol/mol cr associated with the skin exposure as rated by the employees. The PPE has a much smaller impact (1.7 µmol/mol cr) which includes a reduction in the adjusted R2 value from 11.5% to 10.2 % Table 4.7: Relationship of 1-OHP levels and skin exposure in the anode plant and reconstruction area at the prebake smelter site: impact of identified confounding variables (n = 66) Variables in model Bivariate regression coefficients (SE) Skin Exposure 1 2or 3 0a 7.4 (2.4) PPE Yes No 1.7 (4.0) 0a adj R2 (%) 11.5 p-value Adjustedb regression coefficients (SE) p-value 0.003 7.3 (2.4) 0.003 0.67 1.2 (3.7) 0a 0.75 10.2 4.4.2.4 Potential effect modification (subgroup differences in size of association) As established in studies by Ferreira et al. (1994) and Angerer et al. (1997) in graphite electrode plants, by van Rooij et al. (1992) in an aluminium smelter and by van Rooij et al. (1993a, 1994a) in a coke oven, there is reason to further test the relationship between work-area PAH exposure effects, BSF and 1-OHP. This effect was considered by extending the model in Table 4.4 with a term reflecting the interaction of the work area variable (Table 4.7). As hypothesised, work area location was a significant modifier of the relationship between 1-OHP levels and BSF. On average, those who worked in the anode plant had increased levels of 1-OHP, 26.14 (SE± 23.86) µmol/mol cr for every 1 mg/m3 of BSF. Compared to this overall group, those who worked in the forming area had substantially higher levels of 70.1 (SE± 16.98) µmol/mol cr on average. 94 Table 4.8: Degree of effect modification, by work area, of the relationship between 1-OHP levels and BSF among workers in all the combined groups Variables in model Adjustedb regression coefficient (SE) p-value BSF (mg/m3) 26.1 (23.9) 0.25 No Yes 0a 10.8 (1.67) <0.001 No Yes 0a 70.1 (16.98) <0.001 Work area (Forming) BSF x work area (Forming) adj R2(%) a b 22 referent category adjusted for all other variables in the table 4.5 Process intervention results During preliminary data analysis, it was identified that there were potential areas of improvement available to enable a reduction in exposure for some of the SEGs. Whilst not part of the original research project, this provided an opportunity to further assess the exposure of the workers. After consultation with site and area management teams, it was decided that, rather than wait until extensive data analysis was completed, the improvement opportunities should be implemented and trialled as soon as possible. Six months after the implementation of these changes, a small monitoring program was undertaken and continued each six months from then on to track whether the changes had any impact on measured exposure level. Results for the green carbon maintenance team from early 2005 through to June 2006 are presented in Table 4.8. It was not possible to directly compare all the results during this period as the SEGs had changed significantly as part of the improvement plan. However, by selecting an unaltered work group of maintenance employees, it was possible to compare the results before and after the changes. 95 Table 4.9: 1-OHP in urine post-shift minus pre-shift for green carbon maintenance SEG sampled before and after changes implemented in 2005 1-OHP levels Green carbon maintenance staff pre-January 2005 Green carbon maintenance staff post-January 2005 No. participants 32 32 Median (range, µmol/mol cr) 5.49 (0.39-27.0) 2.36 (0.00-8.53) Comparison of the 1-OHP levels from the green carbon maintenance workers preJanuary 2005 with post-January 2005 results showed substantial decreases in both median values and the range of measurements. The upper end of the range decreased by a factor of three, and the median was substantially higher prior to the modifications than after the modifications (5.49 µmol/mol cr compared with 2.36 µmol/mol cr, respectively; p < 0.001). 96 5.0 DISCUSSION This chapter discusses the research findings and examines the results in relation to other relevant studies. The study’s strengths and limitations are considered, and recommendations are made for future research and implementation of control measures. 5.1 Introduction This study identified two areas within a prebake smelter in which there was an identified exposure to PAHs; both areas involved tasks associated with the construction of an aluminium reduction cell. Initially, static and personal air samples, the traditional measures of exposure, were analysed and compared. A total of 249 static BSF air samples, 167 personal BSF air samples and 119 1-OHP in urine samples were available for assessment of the anode plant and cell-reconstruction areas. Included in these were 58 personal BSF air samples with a corresponding 1OHP urine sample. Biological monitoring of 1-OHP was reviewed to determine if there was an alignment of the predicted exposures across and within SEGs. Levels of PAH in air at static sampling locations, air in the participants’ personal breathing zone and the level of 1-OHP in urine of these participants were determined. Assessing BSF in air and 1-OHP in urine provided information covering the inhalation route of exposure and also any potential exposures arising from ingestion or skin contact. The latter was particularly important, as the dermal route has been identified as a possible source of exposure. The third assessment was based around the 58 personal samples for BSF and 58 sets of urine samples for 1-OHP collected during the same work period. This was utilised to investigate the predictive ability of the personal BSF of airborne samples in relation to the level of 1-OHP in urine of the workers in the plant. This would also help address study objectives relating to the assessment of the potential impact of 97 skin contact to compounds containing PAHs, and evaluation of the utility of monitoring 1-OHP in urine of workers as a routine method for determining exposure to PAHs in an anode-manufacturing facility in a modern prebake aluminium smelter. Should this be viable, then a review of the applicability of a biological exposure index guideline for 1-OHP in urine for aluminium smelting at an Australian smelter is warranted. 5.1.1 Exposures compared between the anode plant and the cellreconstruction area of a prebake smelter The median static BSF in air in the anode plant was 0.023 mg/m3 (range 0.002– 0.250), almost twice as high as that in the cell-reconstruction area (median 0.013 mg/m3, range 0.003–0.154). The median BSF personal exposure level in the anode plant was 0.036 mg/m3 (range 0.003–0.563), significantly lower (p = 0.041) than the median exposure level in the reconstruction area which was 0.054 mg/m3 (range 0.003–0.371). Both these results were below the recommended occupational exposure limit of 0.1 mg/m3 based on a 12-hour shift rotation. There is an inconsistency in relation to the static BSF samples and the personal BSF samples in the reconstruction area; the low level of BSF in air in the static samples does not correspond to the relatively high levels in the personal BSF in air samples. There are, however, different scenarios that can result in such an outcome. Firstly, this is an important example of the difference between static air monitoring and personal air monitoring which underpins the rationale for not using static air monitoring to assess personal exposure of a worker. Static monitoring gives an indication of the airborne levels of contaminant in a particular location of the plant and hence is a useful tool for identifying where fugitive emissions may be occurring and if controls are either not present or ineffective. This does not mean that a worker will necessarily be exposed at that level. The results are based on a TWA. As such, a worker who is usually very mobile, due to the nature of his/her tasks, will move through different areas of the plant and may only spend a short period of time in an area of high emission or, alternatively, may spend a longer period of time in an area of lower emissions. In the case of the reconstruction area, the static BSF levels may 98 be lower than the anode-plant sources, but the reconstruction-area worker will spend the majority of his/her shift in the cell where rebuilding is taking place, which is the main environment of his/her potential exposure. The anode-plant worker is more mobile and may be required to move through many areas during the day, varying from low to high potential exposures, and thus experience an overall average lower exposure to the airborne contaminants, despite the fact that the sources with the highest absolute air levels occur in this work location. Secondly, the results can reflect incorrect selection of the location of the static samples. When the static sample locations are not in the vicinity of the main sources of the exposure, the results produced may be artificially low. The location of the static reconstruction area samples were widely dispersed, including the work areas and walkways inside and around the cell. These were further from the emission sources, but were regarded as part of the main work area of the reconstruction crews. Some of the resulting exposure would have been minimised by the sampling protocol, but this cannot be completely ruled out as the tasks undertaken will vary the movement of the individual. To ensure all variations are accounted for would require larger sample numbers to cover more locations for a greater number of days. Thirdly, and discussed in more detail in section 5.1.4, is the wearing of PPE, particularly respirators, in areas where the primary route of exposure is inhalation of fume or particulate in the air. Levels can be quite high in the air, but wearing an appropriately fitted and maintained respirator has the capacity to minimise the amount of contaminant getting into the body. To gain a clearer picture of personal exposure, it is appropriate to refer to the biological monitoring results for the different work locations. The median of the 1-OHP measures showed that levels were significantly higher from the anode plant than the reconstruction area: 6.62 µmol/mol cr (range 0.09– 33.44) compared with 0.17 µmol/mol cr (range 0.001–2.47), respectively (p < 0.001). This is more than an order of magnitude different, with a much wider range, and aligns with the static monitoring results. As the biological samples provide an indication of the total body burden, they may indicate that whilst the personal air samples from the reconstruction area were higher than from the anode plant, the 99 actual dose being absorbed by the worker is much lower for the reconstruction area compared with the anode plant, which is counter intuitive. Three possible reasons for this are: 1. The exposure in the reconstruction area is predominantly airborne and the respiratory protection is effective in reducing the actual dose being absorbed into the body. Observation of the tasks undertaken in the reconstruction area indicated that the majority of exposure comes from fumes emitted from the ramming paste and from the liquid pitch that is painted onto the walls of the cell to increase the adhesion of the paste during the ramming process. Respiratory protection is mandated when working in the cell, with air-fed respirators and disposable coveralls required whenever working with liquid pitch. Those not working directly with liquid pitch application use negative-pressure silicone half-face cartridge respirators. As explained in section 3.3.6, all workers are ‘quantitatively’ face-fitted for their respirator and trained in the use and maintenance of the equipment. There is limited opportunity for ramming paste or liquid pitch to come in contact with skin, but a strong organic bitumous odour pervades the air in the vicinity of the cells when ramming is undertaken. Although it is possible that fume could be absorbed onto the skin along with some of the particulate matter originating from airborne dried paste residue, this is inconsistent with the low results of the 1-OHP measures and would indicate that it is not a major contributor to the total dose in the reconstruction area. Incidentally, operators have commented that the odour is a very useful early warning sign if the face seal on the respirator is broken or the filters are losing effectiveness and require replacement. It appears that the volatile fumes of the pitch and particulate are the main source of exposure for reconstruction-area workers. Whilst personal air samples may be elevated, the body burden is quite low, indicating that the respiratory protection is effective and there is minimal exposure via ingestion or skin contact. This aligns with the static and personal BSF results obtained. 2. The higher body dose in workers from the anode plant is due to failure or inefficiency of their respiratory protection. 100 In the anode plant there are numerous and varied types of air exposures, ranging from high fume exposure when maintaining some pieces of equipment, such as the vibration plate in green carbon and in the vicinity of the vibro-former, to the lower fume levels associated with the anode bake furnaces. Also, there is potential for contact with the pitch paste when cleaning pieces of equipment prior to release for maintenance or as a result of a process intervention or general maintenance on the plant and equipment. The respiratory PPE requirements within the anode plant are similar, but not identical, to those in the reconstruction area and follow the same testing, training and maintenance program. The PPE requirements can vary according to task, and the requirement for respiratory protection is not mandated across all parts of the plant allowing some worker discretion. For example, while all areas of the green carbon plant require respiratory protection, only when in the immediate vicinity of the bake furnace is use of a respirator mandatory. Half-face, silicon negative-pressure cartridge respirators are the main units in use with full-face negative-pressure respirators used for some specific tasks. Compliance with respirator-wearing requirements is very good and is regularly monitored by the manager and peer interactions. There appears to be no reason why the efficiency of the respirators in the anode plant should be any lower than in the reconstruction area given the care and attention administered to this control. Consequently, this would exclude the likelihood that the higher body dose in the anode plant has resulted from failure or inefficiency of respiratory protection. 3. There is another route of entry for which an effective control has not been put in place, i.e. ingestion or skin contamination of materials containing PAHs. If fume levels are relatively low, but there exists the opportunity for skin contact or ingestion, it is possible to exhibit high levels of 1-OHP in urine. This route of exposure cannot be measured via the traditional BSF air monitoring program. Hence, it would be possible to detect low levels in air monitoring when, in fact, there is a higher body burden as a result of exposure via the skin and/or ingestion. As discussed in section 2.1.3, Jongeneelen et al. (1988c), van Rooij et al. (1992, 1994a) and Borak et al. (2002) have demonstrated that the dermal route can be a major source of contamination. It is therefore quite feasible that skin contact is either the main cause of exposure or a major contributor. If the main source of exposure in the 101 anode plant is via skin contact, then this would account for the higher comparative ratio of 1-OHP levels in urine for the anode plant, which were almost 40 times higher than the reconstruction area, relative to the air levels where the difference was a factor of two. If the source of contamination is via skin contact with the coal-tar pitch, this becomes a quite feasible scenario, as this contact cannot be evaluated via air monitoring. Jongeneelen (1992, 1993) developed a biological exposure index (BEI) that relates to the present occupational exposure limits for CTPVs (0.2 mg/m3 BSM and/or 2 µg/m3 BaP), and which was dependent on industry type and pyrene content of the exposure. This was determined to be 4.9 µmol/mol cr for aluminium workers. In a graphite electrode producing plant in Germany, the level suggested was 21 µmol/mole cr (Angerer et al., 1997). If the BEI developed from the Jongeneelen equation (1992, 1993) for the aluminium industry is considered here, there is a noticeable inconsistency. The equation value of 4.9 µmol/mol cr was calculated from the 0.2 mg/m3 BSF exposure standard; assuming linearity, a median value of 0.054 mg/m3 in the reconstruction area personal air BSF monitoring results would be expected to be in the vicinity of 1.3 µmol/mol cr. However, it is only 0.17 µmol/mol cr. This can be readily explained as the result of effective use of respiratory protection, but what of the result for the anode plant? Here the personal air BSF monitoring results were 0.036 mg/m3 and the expected 1-OHP result should be in the vicinity of 0.88 µmol/mol cr or even lower, given the use of respiratory protection. This is not the case, as the resultant median level is 6.62 µmol/mol cr, suggesting poor alignment and the possibility of exposure via a route other than inhalation. To further investigate this line of thought, it would be advantageous to look more closely at exposure results within the subgroups of the anode plant, i.e. forming and non-forming areas, as the potential for skin contact presents more readily in the forming area. 5.1.2 Exposures compared between forming and non-forming areas of the anode plant of a prebake smelter Within the anode plant, the median 1-OHP in urine result for workers from the forming area was 14.20 µmol/mol cr (range 2.02–33.44), more than three times 102 higher than those from the non-forming area, with a median of 4.11 µmol/mol cr (range 0.09–26.99) (p < 0.001). There are two main types of skin contact: contact with the fume and contact with the actual product, e.g. paste used for manufacturing the anode. Contact with PAHs >4 rings in the gaseous phase in this study will be limited due to the low levels identified in the initial monitoring as detailed in section 3.5.1.1. The potential for fume contact is greatest in areas within the anode plant where elevated fume levels exist. One regular task involving increased fume contact is associated with the clearing of blockages or poor flow of paste from the conveyor onto the vibrator plate associated with the anode former. To reduce the potential for paste going to waste, the task is undertaken whilst the paste is still being fed to the vibration plate. The hot paste emits a substantial amount of fume and, due to the nature of the task, the operator must stand close to the plate to clear it with a long spatula-type tool. Despite wearing a respirator, balaclava (optional) and gloves, there are still areas around the face, neck and forearms that are exposed to the fume, hence there is potential for fume-skin contact. The task duration varies from 2–10 minutes, depending on the nature of the blockage, and can be required to be undertaken up to six times per shift. Static and personal air monitoring within the forming area has shown that fume levels around the former are elevated and, depending on the amount of time spent in this area, there is a potential for additional skin absorption. Discussions with the operators in the forming area have provided anecdotal evidence that cases of phototoxicity, which results in delayed erythema and skin pain (known as ‘pitch burn’), are more prevalent when working in this area of the plant, thus indicating higher levels of skin contact. In a study of the relative impact of skin contact, it was shown that after only 30 minutes of skin contact the dose level of ultraviolet radiation required to produce skin reddening was halved (Diette et al., 1983). The recording of the occurrence of pitch burn was recommended as a potential additional qualitative measure of exposure of workers in the plant. Review of the personal BSF in air results compared with the 1-OHP urinary results and the Jongeneelen (1992, 1993) equation again shows an inconsistency with the forming area BSF 0.046 mg/m3 – expected 1.13 µmol/mol cr (14.20 µmol/mol cr, 103 actual) – and the non-forming area BSF 0.028 mg/m3 – expected 0.69 µmol/mol cr (4.11 µmol/mol cr, actual). Within the non-forming areas of the anode plant, such as the bake furnaces, the mezzanine floor and the raw materials area, fume levels were quite low. The low levels obtained in historic monitoring were used in the past as the justification of the non-mandatory respiratory protection policy in these areas. Routine monitoring has indicated that this has not changed. Both static and personal BSF air monitoring collected as part of this study confirmed that PAH levels in the bake furnaces remain low. Skin contact associated with the paste is the second potential area of concern. This can occur in several of the tasks associated with plant maintenance and also process intervention where a blockage or equipment failure has occurred. Preventive and breakdown maintenance occurs on a regular basis, requiring maintenance workers to access the plant equipment to perform repairs. Where equipment has not been cleaned prior to this access, maintenance workers have a much higher potential for contact with the product and skin contamination. The longer the paste is allowed to remain in contact with the skin and is not washed off, the higher the levels of PAHs that are absorbed through the skin (ATSDR, 1995). Tasks such as the cleaning of the fume-extraction ductwork, where thick tar deposits collect and are manually shovelled out into wheelbarrows, or maintenance of the fume-extraction beds, which requires entry into an enclosed space that may contain contaminated dust, are tasks providing ample opportunity for skin contamination. A fume-extraction system was installed to remove the fume from the main sources around the forming area of the anode plant and the levels of fume at these locations have been reduced. However, a consequence of this extraction system is the concentration and condensation of the fume into the exhaust ventilation ductwork, which requires the manual intervention of the production operators for cleaning; this produces a potentially hazardous skin exposure scenario which previously did not exist. This is also the case for cleaning of the fume bed as described above. Ironically, a control mechanism for fume in air has solved one exposure issue, but created opportunity for exposure via a different route. The latter was unlikely to be 104 identified, as only air sampling was undertaken as part of the site’s monitoring program. This is an important lesson that is often overlooked in the design of control systems. Once a contaminant is removed from a location by some process, it is important to note how the resulting waste product is presented and how it is to be dealt with to avoid further contamination of individuals and/or the environment. Whilst there are tasks and scenarios within the forming area of the anode plant where the potential for skin contamination exists, there are fewer associated within the reconstruction area. This does not necessarily translate to lower exposures. Levels of BSF in the personal breathing zone of the reconstruction area workers were higher than in workers from the anode plant, but the average level of 1-OHP in their urine was lower. The task of painting pitch on the walls of the cell does present as a possible avenue of significant exposure, but the strict adherence of the workers to the use of full-faced respirators and impermeable coveralls for this task has effectively reduced the dose by minimising opportunities for direct contact with the pitch and fume. Ingestion is also a potential route of exposure to be considered. The opportunities for ingestion mainly occur as a secondary transfer after cross-contamination, e.g. contaminated hands transferring to food or cigarettes. The comparison between smoking and non-smoking groups did show a statistically significant difference at both the pre-shift and post-shift time-points. Reflecting on the reviewed literature relating to the low levels of contribution from cigarette smoking to 1-OHP levels in urine (section 2.4), it is unlikely that this was limited to PAH content of the cigarettes, and the additional contribution from ingestion of contamination on cigarettes cannot be ruled out. However, further analysis utilising multivariate regression models did not demonstrate that smoking substantially confounded relationships between personal air BSF and urinary 1-OHP levels. Contamination of food products was possible, and there were instances when workers were observed not following the site’s hygiene protocols prior to food consumption. Although this was not assessed quantitatively in this study, anecdotal information was obtained from supervisors and employees who indicated the majority of workers in the areas of exposure risk did follow the protocol. 105 Overall general hygiene is an area where improvements can be made to reduce levels of potential contact by ensuring the skin is washed clean as soon as possible following work exposure, and clothing is kept clean by the use of impermeable coveralls or contaminated clothing is changed regularly. The utilisation of a segregated clean/dirty change-house facility similar to that used in the lead industry would be of value, and the cleaning of equipment before maintenance would also potentially reduce contact opportunities. 5.1.3 Impact of unscheduled process interactions When breakdown maintenance or repairs are required, there is less opportunity to prepare and the contact levels can be higher, as was demonstrated in the case of the paste dig-out described in section 3.6.1. This scenario does flag a very important issue in relation to plant reliability. Whilst these situations are not common in a well maintained and operated plant, if a major plant breakdown does occur that results in an increased level of intervention between the operators and the plant equipment, there is a higher potential for exposure. This is particularly the case in a continuousoperation process, where a plant outage can result in process disruptions further down the line. Data obtained from a batch-plant process in the UK described in section 5.4, along with anecdotal information from other plants in the Australasian region, highlight the issues associated with the continuous-process type of plant. A batch process can be more readily stopped and the necessary maintenance undertaken with additional time to prepare for an outage and less pressure to return it to service. Where the interruption is associated with coal-tar pitch in a hot liquefied or paste state, this can be further exacerbated. If the product is allowed to cool, it can solidify, and a 2–3 hour cleanout of a conveyor chute or pipework can be magnified to an outage lasting several days, with significant loss of production and disruption of downstream processes within the smelter. Hence, there is a strong incentive to intervene and clean it out as soon as possible. Due to the nature of the process and equipment, these scenarios usually occur in enclosed areas and, as the product is still warm, the level of volatiles being emitted can be high. This type of interaction can result in increased skin contact due to time constraints and, consequently, reduced opportunities to clean the product off the skin and clothing. If strict guidelines are 106 not in place and adhered to, the pressure to get the fault corrected as soon as possible to minimise the flow-on effect can be manifested in the deterioration or short-cutting of safe operating procedures. It is important that unplanned people-process interventions must be kept to an absolute minimum to reduce this risk when individuals must place themselves in a position of direct contact with the pitch paste. Furthermore, when this becomes inevitable, it is crucial that strict procedures and guidelines are implemented to minimise any impact on the individual. 5.1.4 Personal protective equipment Whilst the preferred methods for exposure reduction are the higher levels within the hierarchy of controls, inevitably personal protective equipment will be utilised as a mitigating control. This is particularly true where an engineering control has a lag time associated with the provision of budget and resources to implement. It was identified during the study that as there were a number of different tasks and associated exposures requiring different levels and combinations of PPE, it would be useful to establish a PPE matrix to assist with the selection of the appropriate PPE. Utilising the initial results, task exposures were rated using the following criteria based on the 1-hydroxypyrene guidance level for biological and the ACGIH occupational exposure level for air monitoring, depending on whether the exposure was via skin, inhalation or both. • 1=High (> 4.9 µmol/mol cr or > 0.2mg/m3 BSF), • 2=Medium (<4.9 µmol/mol cr >2.5 µmol/mol cr or,<0.2mg/m3>0.1mg/m3 BSF) or • 3=Low (<2.5 µmol/mol or <0.1mg/m3 BSF). In addition, a frequency or duration of exposure component was also included and considered when determining the PPE required. Also included in the matrix was a column that identified whether showering was mandated immediately on completion of the task. This matrix whilst initially developed by a specific working group became the accountability of the green carbon employees and leadership team and it has been their responsibility to maintain and update the matrix over the years as tasks or conditions change. The most recent version is included in appendix 7. 107 Given that skin contact is another potential significant exposure route, it is important to determine what PPE is used in this context and its effectiveness. For all but the very dirty tasks, the standard apparel in the plant has been long-sleeved cotton drill shirts, long trousers, a cotton balaclava, light leather riggers gloves, safety glasses and a hard hat (Figure 3.14). Depending on the task and location, a half-face negative-pressure cartridge respirator also has been utilised. Cotton drill provides little protection from CTPVs and, when in contact with liquid pitch or paste residue, can absorb and retain these harmful substances which then remain in contact with the skin for extended periods of time (Masek, Jach, & Kandus, 1972). This increases the absorption potential and maintains exposure long after the worker has left the work area. Such contamination from clothing and other pieces of equipment has not been quantified at this stage, but it is recognised as an area of concern. The site at which the study was undertaken did have a policy whereby all workers’ clothing was deposited in a specified area at the end of the shift and was laundered by the company; however, at the time this was not a requirement for contractor employees. Contaminated work articles, such as clothing, must not be allowed to be taken home or worn off-site, as this can create the possibility of cross-contamination of nonoccupational clothing or other individuals from direct contact. Riggers gloves are quite porous and will readily absorb the pitch and associated PAH compounds. Also, they are short, allowing the wrists and lower forearm to become exposed (particularly when working overhead) as well as providing an area around the wrists for the larger particulate to fall into and become entrapped. This could result in increased close skin contact whilst the worker believes they are being protected, and prolonged periods of exposure due to a false sense of protection. Anecdotal evidence from a trial at a similar prebake smelter (Wilson, 2002) indicated that the use of a water-based barrier cream had the potential to reduce absorption of PAHs into the skin and could be used as a further control. However, it was noted that in an animal study (Prior, 1996), results indicated fat-based barrier creams facilitated the absorption of pyrene and should be avoided. When considering respiratory protection in areas where elevated fume levels may be present, full-face rather than half-face mask respirators should be employed so as to 108 provide additional protection for the face and eyes from fume and fine particulate, and to reduce the amount of exposed skin. PPE was investigated as a potential correlate of 1-OHP and was considered to have an association based on the results of the Mann-Whitney analysis, but showed only negligible association after adjustment for smoking and BSF. With respect to the association of BSF and 1-OHP there was some minor confounding associated with smoking and PPE, particularly in relation to the anode plant non-forming area. The Mann-Whitney analysis also identified an association between smoking and 1-OHP in the pre- and post-shift comparisons. In both cases, there were significant increases associated with the smokers in the group. This was dissimilar to the study by Borak et al. (2002) in which levels of 1-OHP in urine did not differ significantly between smokers and non-smokers, but did align with results of other studies (van Rooij et al., 1994b; Gündell & Angerer et al., 1999; Jongeneelen, 2001) in which there were significant contributions from smoking to urinary 1-OHP levels. It should be noted that the levels in these studies were quite low (<1.0 µmol/mol cr) and a small change would be more readily observed compared to the larger median values detected in this study, where the range was 0.001–33.44 µmol/mol cr. As highlighted in section 2.4, an average daily consumption of approximately 20 cigarettes was required to bring the levels of 1OHP in urine to 200 ng/L (Buratti et al., 2000). These levels would be difficult to detect in the study samples, where post-shift sample results were an order of magnitude higher. Hence, it is quite possible that the increase is not related to the absorption of pyrene from the cigarette smoke, but more likely from crosscontamination of the cigarettes with coal-tar products arising from poor hygiene practices of the individuals as they smoke. 5.1.5 Assessment of the relationship between BSF in personal air samples and 1-OHP in urine Paired samples of personal BSF air monitoring and 1-OHP in urine monitoring were obtained to look for a correlation between PAH exposure and 1-OHP concentrations in urine. The regression analysis of the 1-OHP in urine and BSF in personal air samples showed a poor adjusted R2 value in the four models examined. Of the adjusted 109 models, BSF in the combined group model and anode plant forming area models also accounted for less than 1% of the variation in 1-OHP levels in urine. Adjusted R2 values from the anode plant and non-forming area regression models were at 3.2% and 11.4%, respectively. Thus, there appears to be no predictive relationship between personal air monitoring for the BSF and 1-OHP in urine of workers involved with tasks in the prebake smelter in this study. This suggests that the use of BSF as a stand-alone measure of exposure in the anode plant of the prebake smelter is a poor indicator of actual total exposure. Also, there is a strong indication that the main route of exposure in the anode plant is dermal and not via inhalation. This aligns with studies in which the dermal contribution to total exposure was estimated to be more than three times higher than intake via the respiratory tract and estimated to be 51% in another (van Rooij et al., 1992, 1993a). In their study on paving workers, McClean et al. (2004) estimated that dermal exposure was eight times the impact of inhalation exposure. Similar results were reported by Borak et al. (2002) in their study of creosote facility workers. Therefore, significant dermal contribution to total exposure is not unexpected considering the potential for skin contact across the anode plant. The regression analysis of the personal air BSF monitoring levels and urine 1-OHP levels are in line with the findings of other studies which showed that the relation between air monitoring data and biological monitoring data was not strong (Unwin, Cocker, Scobbie, & Chambers, 2006; Jongeneelen, Leeuwan et al. 1990). In a study undertaken in a carbon anode plant of a prebake smelter, van Rooij et al. (1992) also found that the increase in 1-OHP over a 5-day work-week did not correlate well with air concentrations (r = 0.18). In contrast, there have been studies that have indicated a good, if not predictive, correlation between the 1-OHP and air levels of PAH; Wu et al. (1998), studying workers in a coke oven, reported r = 0.70 (p = 0.001), Buchet, Gennart et al. (1992) also in a coke oven reported (r = 0.72, p<0.0001) and Tjoe Ny et al. (1993), conducting research in an aluminium plant, reported r = 0.84 (p = 0.0001). It is important to note that the coke oven exposures were air exposures and that in the Wu study it was acknowledged that there was a poor respiratory protection practise. The Tjoe Ny et al. (1993) study was based on a Söderberg technology potroom, where once again the main route of exposure to PAH was predominately air-centred. 110 5.2 Strengths and limitations In the investigation of exposure in industry, particularly in the area of biological monitoring, one of the most difficult aspects is the ability to obtain participation from employees in the workplace. Average participation in this study was 83% which provided a solid basis for the investigation. Whilst it would have been ideal to obtain 100% participation in the study from the cohorts, average participation was still quite high. Participation rates were lowest for analytical laboratory and human resources workers (50%) in the non-production group. Members of this group, chosen specifically for their non-involvement in any processes associated with PAH exposure, were unlikely to have the same level of interest in the study as those workers with potential for exposure. As all of the results for this control group were below the level of detection, the impact of a lower participation rate on the study was minimal. The monitoring program was developed to meet the requirements outlined in the international occupational hygiene texts and guidance literature. Monitoring was conducted over the period of February 2002 to September 2004 and this enabled the key processes and associated tasks undertaken by the work groups to be covered within the monitoring program. A total of 166 sets of pre- and post-shift urine samples were collected from the cohort for analysis of 1-OHP. Of these, 20 were not within the creatinine range specified by the method’s guideline and 18 were missing the post-shift sample, and were therefore excluded from the analysis. From the control group, 24 sets of samples were collected. In addition, 167 personal air samples and 249 static air samples were collected and analysed for BSF, and there were 58 matched sets of 1OHP urine results with a corresponding personal BSF in air result. Monitoring of 1-OHP on a pre-shift and post-shift basis could have been improved by sampling at the beginning and end of each day of the full-shift rotation to ensure peaks were not missed. Unfortunately, the adoption of this approach would have increased the cost of this project beyond the proposed budget to a point where it would have been unaffordable. However, the adopted approach did meet the 111 requirements for biological monitoring as set out in the ACGIH guidelines as previously discussed in section 3.5.2.1. There are some limitations to using urinary 1-OHP levels for monitoring purposes, particularly in relation to the actual biological effect on the body. The measure does not provide a level with which to quantify risk of cancer to the individual, as the measure is of a metabolite of a surrogate, non-carcinogenic compound. There are also some issues of sampling relating to the differing half-life of the excretion rates for 1-OHP in urine and individual physiological variability. Depending on the timing of the post-shift 1-OHP sample, it is possible to miss an exposure if it occurs very early or very late in a shift rotation. In the first case, the 1-OHP may be completely excreted before the sample is taken and, in the latter, there may not be enough time for the 1-OHP to have made it through to the urine, resulting in an underestimation. This issue can be resolved by utilising 24-hour urine sampling or increased frequency of spot urine sampling, but there are problems with both approaches. The 24-hour sampling was not acceptable to the participants in the study nor would it be practical as a routine method. Increased spot sampling would dramatically increase the cost of the sampling program to a point that it would become unviable. Another limitation of the biological monitoring approach is due to the nature of the sampling. There are workplaces where the sampling of urine is not readily accepted due to privacy or cultural issues, a perception that it is an invasive procedure and, in some cases, because of mistrust of management. With the introduction of drug testing at the workplace, this can be perceived as a ‘test by stealth’, i.e. what else are they going to test for once they have the sample? In this study, the inclusion of a clause in the participants’ ‘permission to sample’ authorisation form specifying that no other testing was being authorised was seen by the participants as an important part of their willingness to take part in the monitoring program. In the initial development of this project, there was only limited involvement of a statistician in the study design. As a consequence, the author spent significant additional time redesigning sampling and data collection protocols to more comprehensively address the study hypotheses. It would have been prudent for the advice of a statistician to be sought at the beginning of the project as part of the planning process in order to more accurately determine sampling requirements for 112 the different groups and avoid re-work associated with an inappropriate statistical analysis plan. For completeness, it would have been very useful to have included the exposure levels of one other SEG associated with the bake-out of new cells on the reduction line of the prebake smelter as part of this study. This was another group within the smelter with known exposure to PAHs whilst undertaking one of their tasks. The exposure is predominantly via inhalation in the reduction lines when cells are first brought on-line and are exposed to high temperatures. There is no physical contact with coal-tar pitch during the operation, but monitoring could have provided some additional information in relation to exposure and dermal adsorption of fume at high temperatures. Unfortunately, inclusion of this group would have extended the time and cost beyond that which had been determined to be appropriate. The level to which the results of this study manifest in other smelters or, for that matter, in other industries that utilise coal-tar pitch, is obviously a function of the processes employed and the controls utilised. The results do bring into question the applicability and validity of using airborne monitoring for exposure to PAHs as the only method of assessment without some form of biological monitoring as an adjunct. It has been known for centuries that skin contact with coal-tar byproducts has the potential to generate carcinomas of the skin and, in more recent times, that PAHs are readily absorbed through the skin and into other key organs such as the lungs and liver. So, it should not come as a surprise that in an industry where there is a potential for this contact to occur there may be exposures that are not being quantified. Unwin et al. (2006) reviewed exposures to PAHs across 19 industries in the United Kingdom to determine if one or more target analytes were suitable as markers for assessing total exposure to PAHs. Whilst this study used BSF in air, rather than BaP as used by Unwin et al. (2006), the two parameters are both air measures that align well. Initially, the air and the biological monitoring did not correlate in the UK study (R2 = 0.008). However, when the industries that utilised respiratory protection were taken out, the correlation improved dramatically (R2 = 0.77). The non-forming area of the anode plant was the only area of the plant where PPE was not mandatory across the board and workers had some discretion as to whether it was worn. It was in this section of the plant for which a potential 113 confounding effect was noticed from the regression B-coefficients for BSF (-27.7 unadjusted; -31.3 adjusted). Also, there was an increase in the predictability of the overall percentage variance in the 1-OHP, adjusted R2; however, it was not large (0.00 unadjusted, 11.4 adjusted). Exposure within the aluminium smelting industries requires careful assessment and review to ensure that all pathways of potential exposure are identified and some form of quantitative assessment is put in place to enable the determination either directly or indirectly of the relative contributions to the dose. This is where the initial walkthrough survey plays a pivotal role in the development of the monitoring plan for a site. When it can be seen that there is potential for PAH-containing ingredients or product to come in contact with the skin, then some form of biological monitoring must be considered. A question that does arise is why there has not been more activity in the application of this form of measurement. There have been a variety of reasons put forward in the past; one of the most prominent is that 1-OHP is not a measure of the actual carcinogens, but of a metabolite of pyrene which does not provide significant information in relation to potential carcinogenic impact. This is true, but the use of biological markers to gauge overall exposure can prove to be of immeasurable value in relation to the effectiveness of controls and interventions. The sampling of urine is less intrusive than blood sampling, and there are now increasing numbers of analytical laboratories that are competent in analysis of 1-OHP. The approach of incorporating biological monitoring into the monitoring program will capture the contribution of skin and/or ingestion exposures. 5.3 Process intervention as a result of early findings Initial 1-OHP monitoring results of the green carbon maintenance group averaged 5.49 µmole/mole cr (range 0.39-27.0), which indicated that more than half of the exposures were above the guideline value of 4.9 µmole/mole cr adopted for the site. On the strength of this, site and area management teams decided that, rather than wait until extensive data analysis was completed, improvement opportunities should be implemented and trialled as soon as possible. A review of work practices indicated that the most likely source of contamination was arising from the workers’ 114 contact with the paste products on the equipment, as most of their work was being done whilst the plant was off-line. To try to reduce this contact, additional controls were employed. These included changes to the cleanliness and condition of the plant equipment prior to hand over to maintenance workers, improved PPE such as impermeable gloves and coveralls (Figure 5.1), use of water-based barrier creams and re-emphasis in training on the need to remove contamination from skin as soon as possible, which sometimes meant showering numerous times during the shift for particularly dirty jobs. Most of the controls were readily adopted, but the use of impermeable disposable coveralls was very unpopular due to the warm subtropical climate. A compromise was struck such that the coveralls were required to be worn only for dirty tasks, and semi-impermeable coveralls could be substituted for lesscontaminated jobs. If the equipment was well cleaned prior to commencement, the use of the coveralls would be voluntary. A matrix, developed in consultation with the workers, identified the tasks to be undertaken, the level of clean required and the necessary PPE appropriate for the task. To achieve a higher level of cleanliness, a contractor was employed to use small quantities of high-pressure water on plant equipment prior to maintenance. It became apparent very soon after the changes were implemented that they were having an impact. An initial indicator that things were going well was that reported cases of pitch burn became rare within this group and eventually ceased. Also, the reduction of the level of contamination on the work clothes became visibly noticeable. Monitoring, undertaken in two subsequent batches six months apart, showed a substantial decrease in the median and range of the levels of 1-OHP in urine. Discussions with the occupational hygiene team at the site revealed that the results continued to decline and have been maintained below the site’s guidance level for 1-OHP. 115 Figure 5.1: Mechanical equipment technician performing maintenance on the anode former (Photograph taken after implementation of several changes to the requirement of PPE; note use of Tyvek® coveralls and impermeable gloves) 5.4 Additional key points Does a BEL have value in quantifying risk considering the variation of levels and ratios of PAH: pyrene in contaminants? Consideration of the use of 1-OHP exposure limits as a monitoring tool is a complex issue. As detailed in section 2.3.2, 1-OHP is a metabolite of a component of the PAHs normally found in coal-tar pitch. The ratio of pyrene to other PAHs in coal-tar pitch is variable between suppliers; this impacts the relative concentration of 1-OHP in urine from exposed workers. In addition to this, the temperatures associated with the processes in the anode plant vary from the moderately low levels of the paste (<100°C) in reconstruction and the front section of the anode plant (160–200°C) to the elevated temperatures in the anode furnace area (>1000°C). The different PAHs 116 have varying vapour pressures and are likely to be driven off at different temperatures across the process, again impacting on the total CTPV to pyrene ratio and, consequently, concentration of 1-OHP in urine. The practical implication of this in an aluminium smelter (or other industry) is that if the composition of coal-tar pitch varies due to manufacture or change of supplier or even location within the plant, there is a potential to impact on the validity of any chosen biological exposure limit (BEL) guideline. This, in turn, would mean that a new BEL would have to be calculated for each scenario, which is cumbersome and impractical. This does not mean that the level of 1-OHP in urine cannot be used as a monitoring tool in an environment where the pyrene to PAH ratio may change because it is possible to build regular measures of total PAHs to pyrene ratios into the monitoring process and account for batch differences as required. Although it would be difficult to maintain an accurate measure of pyrene to PAH ratio, an average concentration of the exposures in air for a particular site or industry can be calculated and used to set a target value. This has been done, for example, by Bjørseth et al. (1978) for the aluminium, coke and iron industries. More recently, the UK Health and Safety Executive has introduced a benchmark guidance value for biological monitoring for PAHs based on measurement of end-of-shift urinary 1OHP concentrations (Armstrong et al., 2003). A level of 4 µmol/mol cr was recommended, as this value represents the 90th percentile of measurements taken from industries deemed to have good control. There was only one smelter in this group of industries that was assessed, which was an anode plant in a small prebake smelter. The results were quite low, with a mean of 0.72 µmol/mol cr (range 0.25– 2.60). A later study carried out at the same prebake smelter yielded similar results for an operator SEG with a mean of 1.17 µmol/mol cr (range <0.01–3.76) and maintainer SEG with a mean of 0.72 µmol/mol cr (range <0.01–5.37) (Jessep, 2007). The process in the UK anode plant was a batch process compared to the continuous process in the anode plant of this study, which would account for some of the difference. 117 Initially, adoption of a level such as that developed by Jongeneelen (1992, 1993), 4.9 µmol/mol cr for aluminium workers, provides a relative marker to work to and on which to base action levels. This can be further refined to match the composition of the pitch and associated PAHs for the site at a later stage. Looking at the results from the process intervention discussed in section 5.3, the median 1-OHP urine concentration was 5.49 µmol/mol cr prior to the control modifications. This was above the adopted guideline and warranted action. After 18 months the median was 2.36 µmol/mol cr showing a marked improvement. Hence, a form of biological exposure guideline does add value to the management of exposure to PAHs in the smelting environment. Is 1-OHP a valuable tool for the identification of levels of general exposure to PAHs in a smelting environment? Yes it is. Often professions or disciplines can become fixated on the requirement of a value against which to measure and regulate. This prescriptive mindset has been the approach for many years and, while easy to adopt and administer, it may not be the most suitable approach for the monitoring and control of PAHs in some industries. The results of this study suggest that, regardless of exposure route, fluctuations in observed concentrations of 1-OHP indicative of PAH exposure are more useful in an OHS context than an absolute concentration limit to determine action levels. This is where one of the main benefits of monitoring 1-OHP lies. To continue to monitor the air with the belief that it is providing an accurate representation of exposure to PAHs in an aluminium smelting environment is misguided and erroneous and, whilst the monitoring of 1-OHP in urine may not be an accurate measure of biological effect on an individual, it is far better than continuing with just air monitoring. How applicable this is to smelters globally will depend on the process being utilised, i.e. Söderberg or prebake, continuous or batch processes in anode plants, the technology in place, particularly in relation to extraction systems, human-machine interactions and process intervention frequency. All of these will vary to some extent across the industry and sites. As detailed previously, each one of these can have a significant impact on the route of exposure and eventual dose. What does not alter is 118 the fact that if there is a potential for dermal exposure, no matter what the process is, monitoring the levels in air will not pick up this contribution to the body burden. There have been numerous studies over the years in environments such as iron foundries (Hansen et al., 1994; Sherson et al., 1992), graphite electrode-producing plants (Angerer et al., 1997; Ferreira et al., 1994), road paving (Burgaz et al., 1992), chimney sweeping (Pavanello et al., 1999) and firefighting (Moen & Øvrebø, 1997), as well as studies across occupations (Unwin et al., 2006) in which 1-OHP has proven a useful tool. Despite the absence of a BEI to relate to the utilisation of this method, it is still a valid and potentially powerful tool. Is there a point in a multifactorial exposure regime at which BSF estimations cease to have any occupational relevance, or can they be used only if dermal exposure is controlled or excluded? The value of monitoring BSF on its own or as part of a multifactorial exposure regime within industry is debatable and there are a number of key factors that need to be considered. If the concern is specifically for the higher level, greater than 4ring PAHs (i.e. the key carcinogenic compounds) then this approach may be flawed if there is potential for exposure where the lower level PAHs predominate. This was highlighted by Unwin et al. (2006) in a study over a number of industries that showed a weak correlation between total PAH and total carcinogenic (4-6 ring) PAHs (r2 = <<0.1). This was most probably due to the high levels of naphthalene, the most volatile of the PAHs, which was present at a number of the sites. The impact in such situations is that a small variation in concentration levels of toxicologically significant PAHs would be swamped by the higher concentrations of the lower end PAHs. This can be overcome by undertaking a full scan of the compounds captured and this approach can add value in profiling the contaminants in the initial monitoring program. Unfortunately this can be a very expensive option in the long term as such analysis is costly on a large scale such as in routine monitoring surveys. In situations such as coke ovens and some aspects of the aluminium smelting process where exposure to the carcinogenic compounds could be significant, a better approach would be the monitoring of benzo(a)pyrene. This compound is a 5-ring PAH which has been shown to correlate well (r2 = 0.97) with the 4-6 ring compounds (Unwin et al. 2006). Added to this is the similarity in 119 chemical properties with the other 4-6 ring compounds such that changes resulting from condensation, absorption and evaporation will be mirrored by benzo(a)pyrene. The monitoring procedure is the same as that for the BSF so no additional equipment is required. In the industries where the 4-6 ring compounds are either not present or in very minor quantities and the main exposures of concern are the lower level PAHs, then BSF monitoring will be the preferred approach and the benzo(a)pyrene monitoring of limited value. The United Kingdom Health and Safety Executive (UK HSE) has not adopted an exposure strategy based on an airborne exposure level to BaP as it was deemed to be a poor predictive marker for exposure to the 2-4 ring gaseous compounds which were the largest group of highly exposed workers in the UK. (HSE, 2003) There may also be a need for consideration in relation to the epidemiological and historical value of the monitoring of BSF. This approach has been used for many decades as the main exposure monitoring tool to profile exposure to PAHs in industry. There could still be benefit in monitoring BSF where comparisons to historical data may be required. There is of course a key assumption being made here that the main route of exposure is inhalation and that the component of exposure related to skin absorption is minimal. Where this is not the case then the value of this monitoring approach diminishes and in some cases may even be irrelevant. Situations such as maintenance personnel working on cold equipment contaminated with coal tar pitch paste, such as in anode plants, have a small risk associated with inhalation exposure however their risk associated with skin contact can be quite high. Hence there would be minimal if any value associated with BSF monitoring in this scenario. Similarly in the situation where a respiratory protection program is in place and no other engineering modifications can be made (i.e., coke ovens), the benefit achieved by monitoring air exposures is very limited? In this case biological monitoring will provide information as to whether the PPE is actually working and would be the preferred approach. Within the aluminium industry BSF monitoring still has a role to play in the control of exposures to PAHs, particularly in the early stages of a program where information relating to the profile and characterisation is required. It is best suited as a component of a multifactorial monitoring program particularly when utilised in static monitoring to identify areas of a plant or process where 120 fugitive emissions sources may need to be identified but should not be used as the sole method. Is skin exposure a major contributor to total body burden at the prebake smelter in the study? Yes, this was indicated in the data presented, particularly in the anode plant where the expected alignment of BSF in air and 1-OHP was poor. The review of the median results in the forming area using the Mann-Whitney sample tests on those participants wearing/not wearing overalls was not conclusive but did show a reduction in the variation of the range (1.28 - 19.46 µmol/mol cr compared to 3.69 – 46.0 µmol/mol cr), where those wearing overalls showed generally lower levels of exposure. Following on from this, the regression analysis using the skin exposure questions from the questionnaire also showed some positive association with the 1hydroxypyrene levels, and with an adjusted R2 of 10.2%, the skin aspect cannot be totally disregarded. From the discussion in section 5.1.1, looking at the results of the personal BSF in air monitoring and the 1-OHP urinary measurements in light of the Jongeneelen (1992, 1993) equation, there was again a poor alignment and the possibility of exposure via a route other than inhalation indicated. Finally, the improvements achieved by targeting skin exposure in the intervention also supported the likelihood of exposure via this alternative pathway. Whilst the evidence based on the empirical data may not be strong for this conclusion, there is without doubt a robust inferential support of the likelihood of skin being a major contributor to the body burden. With further investigation based on a targeted skin contamination assessment program linked into the 1-hydroxypyrene biological monitoring, this should become clearer. What are the implications of the inadequacies of the current risk assessment metrics (in both the past and the future) for the primary aluminium industry and other occupations where there may be exposure to PAHs? One of the key aspects of this question comes back to having a thorough understanding of what the actual exposure profile at a site is. It is not as simple as saying an industry needs to undertake air monitoring as that is the only OEL in place. As has been previously discussed, this approach may be totally irrelevant in 121 situations where there is minimal air exposure but significant potential for skin contact. It can also apply in the reverse where skin exposure is limited but inhalation is the key form of exposure. Some sectors of the aluminium industry (and other industries) in the past have focused their attention on the reduction of exposure to airborne PAHs and have successfully reduced them to levels below the regulatory exposure limits. This has been the benchmark standard that businesses have sought to achieve and have been measured against by regulators. The question remains, have they been addressing the right source of contamination? Without taking into account the issue of ingestion and/or skin absorption, there is the possibility to build an erroneous risk profile with a key piece of the jigsaw missing. This has the potential to direct control strategies and resources towards areas that may not be the key source of exposure. This could result in the waste of scarce resources, both financial and human and the inadvertent continued exposure of individuals to a hazardous material. There is also another side to this for those industries that have been measuring high total BSF in air which are predominately at the lower level of <4 ring benzoics. Many regulators mandate stringent health surveillance requirements where potential exposure to PAHs exists, which are expensive and complex to administer, especially for small- to medium-sized manufacturers. Where the mixture profile indicates a presence of the carcinogenic >4 ring compounds, then this is a valid approach but what of the industries where a high BSF in air is as a result of high levels of naphthalene or similar compound without the same toxicity? Should they also be encumbered with the same requirements of an industry such as those that use coal tar pitch and higher levels of compounds such as benzo(a)pyrene? With this consideration and in light of growing intolerance of the public at large to any exposures to known carcinogens and the acceptance in principal by many industries and regulators to the ALARP principal, it is now a timely juncture for the review of the approach to the management of PAH exposures and the consideration of alternative risk assessment methodologies. In planning a risk assessment there needs to be an accurate mapping of the process covering all potential routes of exposure. This will mean personal air monitoring, with the resultant contaminants profiled to enable a characterisation of the components and static air monitoring of the process to identify if there is a particular emission source and to verify engineering control efficiency. Biological monitoring 122 also needs to be employed initially to determine the potential for exposure via ingestion or skin absorption, and where personal protective equipment is used as a critical control, to determine its ongoing effectiveness. This initial extensive analysis should provide the basis of information needed to determine the extent of further monitoring and ascertain whether an extensive monitoring and medical surveillance program needs to be employed. This approach should be adopted for any industries utilising compounds containing PAHs in their process. It may well be the case for many of these industries that this approach confirms that there are no issues with their current risk assessments and controls but without testing all potential routes of exposure when dealing with PAHs it will be difficult to remain confident that exposure is not occurring in these areas. 5.5 Future research The results of this study support the likelihood that a significant dose of PAHs is due to skin absorption in the anode plant of the prebake aluminium smelter, but there was no attempt made to quantify the amount. In studies by van Rooij et al. (1992, 1993b), McClean et al. (2004) and Borak et al. (2002), the dermal contribution was investigated in smelting and other industries. It would be useful to better quantify this component in a prebake smelter via the use of skin patches. These could be placed on areas of the skin where there is suspected exposure such as the wrists, face and neck region. Monitored in conjunction with BSF and 1-hydroxypyrene, it would provide a better quantification of the impact of skin exposure on total body burden. Also, the possible impact of the thermal environment on the absorption rate of PAHs through the skin requires further investigation. Anecdotal evidence (A. Riley, personal communication, 2004) from an internal skin mapping program, as described in section 2.1.3, indicated the presence of increased contamination on the skin in areas of high sweat production. The plant in this study was located in a subtropical climate and, as a result, most of the workers were acclimatised to the heat. One of the ways in which the body manifests this acclimatisation is that there is an increase in the production of sweat, hence the question as to whether this results in additional absorption due to increased activity of the sweat glands needs to be addressed. 123 The potential transfer of contamination from PAH-soiled clothing to skin and the effectiveness of current laundering processes needs to be investigated further to determine the level of cross-contamination that may be occurring. An alternative parent-metabolite pairing – BaP and 3-hydroxybenzo[a]pyrene – was the subject of a study carried out in a selection of industries in France; results showed this to be a potentially useful method for determining a biological limit marker, as the parent compound BaP is a known carcinogen (Lafontaine & Gendre, 2003). Lafontaine and Gendre’s (2003) brief report recommended the determination of such a limit by correlating back to the French airborne exposure limit of 150 ng/m3. This has the potential to provide a more accurate quantification of actual carcinogenic load on the body and the method should be further researched. The relationship between biomarkers and cancer has been the subject of several animal studies focussed on DNA adducts. Some of the markers investigated include DNA or protein adducts (dell’Omo & Lauwerys, 1993), cytogenic markers (e.g. micronuclei, chromosomal aberrations, sister chromatid exchanges) (Tucker & Preston, 1996) and cells with a high frequency of sister chromatid exchange. Some of these markers are indicative of an early biological effect, although it may not be permanent and may not have further consequences (van Delft et al., 1998). These tests therefore have the potential to determine a direct biological effect on the body and, consequently, be of greater value in determining the actual carcinogenic risk. Early testing has been carried out utilising blood sampling, which is regarded as a more invasive monitoring method than urine sampling. There is potential to utilise urine sampling for this testing; however, the method requires further development. There are numerous methods for the assessment of exposure of individuals to PAHs in various stages of development, some of which have the potential to become very powerful tools for the investigator. At the moment, the use of 1-OHP in urine appears to be the most practical and, importantly, is readily accepted by the target subjects. It does have some limitations, as outlined above, but based on the results of this study, it is a substantial improvement on the previous approach of monitoring air exposure alone. 124 5.6 Recommendations for control measures With respect to on-site management of PAHs, there was potential for improvements identified during the study and these are outlined below. It should be noted that the site at which the study was undertaken has adopted all of the following recommendations. In order to implement some controls, there needs to be modification or extension of site policies in some areas. When developing controls for the occupational environment, the hierarchy of OHS hazard controls is always referred to for order of preference. Wherever possible, the contaminant or its cause should be eliminated. When that is not possible, substitution of the compound is next preferred. Engineering solutions are next in line, followed by administrative controls. Use of PPE is always the last method of control to be employed and only when the higher levels of control are not practical or as a short-term, interim measure. Consultation with the employees working in the areas is an important aspect when looking at control options. Their familiarity with the process, the plant and its idiosyncrasies can prove invaluable and should always be part of the control identification process. From observations made during the study, there are additional controls that could be employed to reduce the levels of exposure to PAHs in the prebake smelter. 5.6.1 Engineering As previously outlined in section 5.1.2, key exposures exist in relation to the maintenance of the fume-extraction system. The system requires modification to prevent the CTPVs recondensing in the pipe work leading to exposure associated with the clean-out process. The injection of fine coke particulate into the airstream has been utilised at other smelters successfully and could be introduced at this site. Redesign of the fume-extraction system such that it could maintain balance would also reduce the manual intervention associated with its operation. The overall design of the vibration plate on the line 1 and 2 former appears to be flawed, as it is continually blocking and hence warrants a major redesign. In the 125 interim, the lid opening of the vibration plate should be redesigned to prevent exposure of the operator when cleaning is required, and the cleaning task should be undertaken while there is no paste flowing through the system. Process intervention must be minimised wherever possible with the key being process stability and control. 5.6.2 Administrative As discussed in sections 2.3.2 and 2.5, the variability of the coal tar pitch being used the ratio of pyrene to BaP and other carcinogenic PAHs in the different mixtures of PAH, the temperature of the different stages of the process and the personal physiological variation make it particularly difficult to allocate a definitive biological exposure index for 1-hydroxypyrene. This is compounded by the limitations of the air monitoring process to address all the potential exposure routes. Hence, due to the carcinogenic nature of the contaminant it would be prudent to ensure that the “as low as is reasonably practical” (ALARP) principal is applied for any exposures, rather than relying solely on exposure limits. Within the forming area of the plant, there exists a ‘former technician’ subgroup of workers, whose role and tasks are outlined in section 3.3.1.1. These workers spend all of their time in the forming area of the plant and are exposed at higher levels for the majority of their four-day shift rotation. As a consequence, there is the potential for not all of the absorbed contaminants to be excreted before re-exposure, resulting in a cumulative effect by the end of the four-day rotation. Under the current operational approach, when they return after their days off, they have the opportunity to be placed in a lower-exposure area of the plant, such as the mezzanine floor or raw materials area or, for those more experienced, the control room. This presents site management with an opportunity to reduce the exposure via an administrative control. Rather than keeping an individual in this role for all four days, s/he could move through the other roles during the one rotation, and hence reduce the body burden and allow full excretion of PAHs before re-exposure. This would reduce the potential for PAHs to accumulate in the body to any significant levels. There would be a corollary associated with the training and competence of the employees. This 126 approach would obviously be dependent on crew members being able to carry out all tasks associated with the green carbon plant. This is achievable, but would take time and would rely on a stable workforce with effective training programs to be implemented and maintained. Flexibility needs to be built into the shift roster to enable this training and cover for individuals on recreation and sick leave resulting in potentially one more employee per crew. This again is likely to have an economic impact on the process, but would assist with fatigue management and allow individuals more flexibility in their work and the ability to reduce the time that is taken before they break for a shower to remove skin contamination, which is potentially a major contributor to their exposure. All employees and contractors who may come in contact with PAHs must undertake awareness training in relation to the nature of PAHs, their health impacts and the controls associated with their management. Procedures should be established to increase the general cleaning of plant and equipment to prevent build-up of coal-tar pitch products and minimise the risk of gross skin contamination when maintenance must be carried out. A clean/dirty change house facility similar to that employed by the lead industry needs to be implemented and located close to the anode plant. Individuals must be encouraged to clean off any skin contamination as soon as possible and report any occurrence of pitch burn to supervisory or occupational health support teams. As discussed in section 2.1.3, access to a low-level purple UV light and mirror has proven to be a useful aid in identifying skin contamination. The level of UV light emitted is not high enough to initiate pitch burn, but causes the contaminated area to fluoresce, which assists with identifying areas of the skin that require particular attention. Employees must shower prior to leaving the site, and contaminated clothing must not be allowed to be worn off-site, nor should it be washed with domestic clothing at the employees’ homes due to the potential for crosscontamination with other clothing. Grossly contaminated clothing can result in exposure of other family members. Consequently, all clothing worn by plant and contractor employees working in the green carbon area must remain on-site and be laundered. 127 5.6.3 Personal protective equipment Some additional modification in relation to the required level of PPE is necessary. Where there is potential for the worker to come in contact with coal-tar pitch and/or its volatiles, a barrier must be established. This means that cotton drill clothing is not appropriate in some of the work areas, and the use of semi-permeable and impermeable coveralls may need to be adopted for some tasks. Also, riggers gloves are inappropriate for some situations due to their permeable nature and short length. A longer glove (to mid-forearm) impermeable to coal-tar pitch products should be utilised. Finally, where there is a high level of fume, half-face mask respirators should be replaced with full-face mask respirators to provide additional protection for the skin of the face. Water-based barrier creams should be utilised prior to exposure to minimise uptake and facilitate the cleaning process. Sunscreens should be employed at the end of the shift to aid in the prevention of pitch burn of the photosensitised skin. A simple task-and-PPE matrix needs to be developed (see section 5.1.4) based on the risk of exposure to PAHs of the individual when carrying out any particular task. This will provide guidance for new employees and those unfamiliar with the task to which they have been assigned. Caution must be exercised when utilising high levels of PPE in the subtropical climate, as this has the potential to introduce an elevated risk of heat stress. 5.6.4 Occupational health practice Medical surveillance should be carried out on individuals whose exposure is equal to or greater than the guidelines set by the company or the regulatory authorities (whichever is more stringent). The surveillance program should contain as a minimum: • occupational history and qualitative estimation of exposures to pitch (where quantitative results are unavailable); • medical history; 128 • physical examination; and • urinalysis. In addition to this, employees should have the opportunity to discuss their questions or concerns with an occupational physician and a professional occupational hygienist. 5.6.5 Monitoring It has been shown that exposure to PAHs is a multi-dimensional process with a variety of potential exposure routes. Thus it is inappropriate for monitoring to be directed to only one aspect of that exposure. When developing a monitoring program for exposure to PAHs, the program must incorporate both air and some form of biological monitoring unless statistical analysis of the data indicates that there is a strong correlation between the personal air and the biological results. 5.6.6 Site Policy The overall business group has adopted the ALARP policy for any exposures associated with PAHs. It has also developed a coal tar pitch protocol (Appendix 6) to which all of the business units must now conform. This is complemented by an audit protocol against which the sites are regularly reviewed. 5.7 Conclusions Based on the information derived from this study, it can be concluded that within an Australian aluminium prebake smelter, workers in the anode plant will have higher overall exposure to PAHs than workers in the cell-reconstruction areas of the plant. It is, however, possible that personal air exposure to BSF could be higher in the reconstruction area depending on the manufacturing process, but the overall body dose is significantly lower than that of workers from the anode plant. Within the anode plant, there is further exposure stratification in relation to the forming and non-forming areas of the plant. Those employed in tasks associated with 129 paste mixing and anode forming in the forming area of the anode plant will have higher exposure to PAHs than those in the non-forming areas; this was demonstrated in both the air and the biological monitoring results. Correlation between personal air monitoring for the BSF and 1-OHP in urine of workers involved with tasks in a prebake smelter was not demonstrated. The predictive ability of BSF in personal air monitoring in relation to the 1-OHP levels in urine was very poor overall. It did show some improvement when heterogeneity and differences across work groups were allowed for, but it was still more modest than that observed in other studies. This was most likely due to the fact that the bulk of exposure in the anode plant was as a result of skin exposure and, as a consequence, BSF in air should not be used as a sole indicator of exposure to PAHs in the prebake smelter environment. While PPE and smoking presented as confounders in the overall plant, additional analysis indicated that PPE and smoking were only significant confounders in the anode plant non-forming area. Work area location was found to be a significant modifier of the relationship between 1-OHP levels and BSF. The use of a definitive BEI in conjunction with 1-OHP in urine would not be appropriate, as there is too much variability in the ratio of pyrene to BaP and other carcinogenic PAHs in the different mixtures of PAH. 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British Journal of Industrial Medicine, 50(7), 623-632. van Rooij, J. G. M., De Roos, J. H. C., Bodelier-Bade, M. M., & Jongeneelen, F. J. (1993b). Absorption of polycyclic aromatic hydrocarbons through human skin: Differences between anatomical sites and individuals. Journal of Toxicology & Environmental Health, 38(4), 355-368. van Rooij, J. G. M, Veeger, M. M. S., Bodelier-Bade, M. M, Scheepers, P. T. J., & Jongeneelen, F. J. (1994b). Smoking and dietary intake of polycyclic aromatic hydrocarbons as sources of interindividual variability in the baseline excretion of 1-hydroxypyrene in urine. International Archives of Occupational & Enviromental Health, 66(1), 55-65. van Schooten, F. J., Jongeneelen, F. J., Hillebrand, M. J. X., van Leeuwen, F. E., de Looff, A. J. A., Dijkmans, A. P. G., van Rooij, J. G. M., den Engelse, L., & Kriek, E. (1995). Polycyclic aromatic hydrocarbon-DNA adducts in white blood cell DNA and 1-hydroxypyrene in the urine from aluminium workers: Relation with job category and synergistic effect of smoking. Cancer Epidemiology, Biomarkers & Prevention, 4(1), 69-77. Viau, C., Carrier, G., Vyskocil, A., & Dodd, C. (1995). Urinary excretion kinetics of 1-hydroxypyrene in volunteers exposed to pyrene by the oral and dermal route. Science of the Total Environment, 163(1-3), 179-186. Victorian Workcover Authority. (2000). Code of practice for hazardous substances. Code of Practice No. 24. Retrieved April 21, 2006, from http://workcover.vic.gov.au/wps/wcm/resources/file/ebd8e143a078f6c/COP24 _hazardous_substances.pdf Weyand, E. H., & Wu, Y. (1994). Genotoxicity of manufactured gas plant (MGP) residue in skin and lung of mice following MGP ingestion or topical administration. Polycyclic Aromatic Compounds, 6(1-4), 35-42. Willes, R. F., Friar, S., Orr, J., & Lynch, B. (1992). Application of risk to point sources of polycyclic aromatic hydrocarbons (PAHs). In Environment Canada, Proceedings, 5th Conference on Toxic Substances. Montreal, Quebec: Environment Canada. 141 Wilson, L. (2002). Gloves-in-a-bottle barrier cream trial [Bell Bay internal report]. Green Carbon. Comalco Aluminium Limited. Workcover NSW. (2005). Method WCA 158: Analysis of 1-hydroxypyrene in urine by high pressure liquid chromatography. Workcover laboratory methods manual [internal publication]. Wu, M. T., Mao, I. F., Ho, C. K., Wypij, D., Lu, P. L., Smith, T. J., Chen, M. L., & Christiani, D. C. (1998). Urinary 1-hydroxypyrene concentrations in coke oven workers. Occupational & Environmental Medicine, 55(7), 461-467. Zedeck, M. S. (1980). Polycyclic aromatic hydrocarbons: A review. Journal of Environmental Pathology & Toxicology, 3(5-6), 537-567. 142 Appendix 1: Participant recruitment presentation Slide 1 What are PAH’s • Often formed as a result of combustion • Exhibit structure of a cluster of benzene rings • Also known as Coal Tar Pitch Volatiles (CTPV) Polycyclic aromatic hydrocarbons (PAHs) are organic compounds consisting of 3 or more benzene rings. PAHs are not just one compound but may occur as one of a large number of different chemical structures or forms. They are often formed as a result of incomplete combustion of coal, oil, gas forest vegetation or other organic substances. The PAH group is also known as Coal Tar Pitch Volatiles. Slide 2 Examples of PAH’s Pyrene Naphthalene Anthracene benz(a)anthracene benzo(a)pyrene fluorene pyrene Benzo(a)Pyrene Naphthalene Slide 3 Occurrence • • • • • • • • There are literally hundreds of compounds in this group. The USEPA lists 16 priority compounds that are usually tested for. Some are highlighted here. Aluminium Smelters In mineral oils Asphalt Coal Tar Coal (Coking Plants) Cigarette Smoke Smoke and Soot Car Exhaust PAHs are found throughout the environment in air, water and soil. Sources include vehicle exhausts, asphalt, coal tar, coal and mineral oils, Smoking kilns for food and even the Aussie barbecue. 143 Slide 4 Routes of Entry • Inhalation • Ingestion The most common entry of PAHs into the body is via the inhalation route when people breathe in air or smoke containing them. They may also enter the body through the digestive system when food comes from cooking processes such as broiling, smoking, roasting and barbecues. • Skin In the workplace, they may also be absorbed via the skin particularly where oils are involved. Up to 75% of the total Pyrene dose can be absorbed through the skin. Slide 5 Background • Historically monitoring has been carried out since early 1983. • Always been air monitoring – Static – Personal • Have monitored a number of parameters. – – – – Benzene Soluble Fraction Total PAH Benzo(A)pyrene Specific Characterisation of PAH”S Monitoring of one form or another has been undertaken at this site for many years dating back to 1983. The parameters measured have varied over the years depending on knowledge at the time and the availability of the testing but generally the Benzene Soluble Fraction (BSF) has been a constant. BSFs are a specific group of compounds that are soluble in benzene and may be extracted for analysis. And are generally multi-ringed compounds. In more recent years air samples have been fully characterised breaking down the analysis by GC-Mass Spectrometry to identify the many individual components of the PAH”S. 144 The workplace is monitored on a regular basis to ensure an accurate profile of airborne contaminants is maintained. Slide 6 Monitoring • Atmospheric • Personal These results shall be assessed alongside current information in regard to exposure standards. • Biological Both static area monitoring and personal occupational monitoring are carried out. Slide 7 What is the Biological Test for PAH Exposure? • • • • • Very few tests available Body absorbs Pyrene in PAH’s Body converts this to 1-Hydroxypyrene (1-OHP) (1-OHP) can be found in urine. This can give some indication of total exposure. Slide 8 Plant/Process Static Monitoring Person Personal Monitoring Dose Biologically Active? Early Disease • Blood • Body Fluids Tissue Biomarker (DNA Adducts) • Blood • Body Fluids • Imaging • Tissue Sample Biological Monitoring Biomarker Levels Diagnostic Test Very few tests are available to test from exposure to PAHs. The body metabolises Pyrene to other chemical substances such as 1hydroxypyrene. 1-hydroxypyrene can be found in urine of individuals exposed to PAHs. By measuring the level of 1hydroxypyrene in urine at the beginning and at the end of a shift rotation it is possible to get some indication of a person’s exposure in the last 6–30 hours. This will account for inhaled, ingested and any absorbed through the skin. It is not possible these tests to predict resultant health effects. There is a multistage approach to the monitoring of PAHs in this project. The first of the stages involves static environmental monitoring and looks predominantly at the plant and the controls associated with the process. The second stage involves personal monitoring and gives some indication of the potential exposure levels of the individual. The third phase looks at the actual dose that has been absorbed by an individual and is the first stage of the biological monitoring. The fourth stage investigates the potential effect of the absorbed dose and the formation of DNA 145 adducts. These are indicators of damage occurring to the DNA which the body is continually repairing. The fifth and final stage is the diagnosis of early disease which would involve a range of medical diagnostic tools. This project will concentrate mostly on stages one, two and three. Slide 9 Health & Exposure Monitoring •Preliminary monitoring has shown intermittently high exposures in some specific tasks. •To see if these exposures are biologically significant we are going to carry out a staged biological and air study. •This study will look at levels of PAHs in the air as well as looking at a marker compound in the urine. Slide 10 Sampling Requirements • Environmental – Static & Personal monitoring using personal pumps (current routine procedure) • Biological – Pre shift & post shift urine sample. (current routine procedure) Early years have concentrated on environmental measures and more recently we have started looking into biological monitoring to assist us in determining the level of contaminant absorbed into the body system. We would like to undertake a study which will look at the two methods air and biological and carry out some comparisons to identify how they correlate and possibly which is the more applicable method for our site. The sampling protocols for the environmental monitoring using personal pumps and the urine sampling for 1-hydroxypyrene will not vary from the methods and procedure which are currently in place for the site routine monitoring. . 146 Slide 11 Sampling Questionaire • Prior to providing a urine sample, each participant is required to complete a self-administered questionnaire. The questions are aimed at determining such aspects as: • General demographics, ie, age, sex; • Possible exposures in the previous 48 hours, both occupational and non-occupational; • Smoking habits; • Potential food source of PAHs; and • Personal protective equipment worn. Slide 12 1-OHP Sampling Pack Prior to the sampling process we would like you to fill out the sample sheet questionnaire and to sign the authorisation form on the back. It should only take a couple of minutes but the info is very important to us. The questions are pretty straight forward and we will run through them with you on the day just in case you have any questions. The sample pack will contain Biological sampling sheet & questionnaire Work Log sheet Four sample containers, two for pre and two for post shift samples Two Biological hazard bags Two plain brown paper bags. You will be required to provide two samples before the start of your first shift of the rotation and two last thing on the completion of your final shift. The samples need to be left in the small freezer in the back of the main lab (just follow the signs at the lab) The biological sample sheet and SIGNED authorisation sheet should be placed in the back compartment of the bio-hazard bag NOT the same compartment as the sample. Don’t worry if you can’t remember this as we will be going through this again with you when we give you your sample pack. 147 Slide 13 Results • All results will be reported generically on a group basis at team meetings as per past report back sessions with the option of a one on one session on request. • There will be no individual identification of results. • All individuals will be asked to sign an authorisation form. • As this is part of a Queensland University of Technology study, Ethical approval has been sought from the university ethics committee and granted. All results will be reported back to the group as a general report with no individuals names attached. You will have access to your own personal results and can discuss them with either myself or the doctor at our medical centre. All results are strictly confidential and will be kept under lock and key in the medical centre or on a secured drive on the computer network. As mentioned before it is not compulsory to participate but it would be greatly appreciated. If you do participate in the study you will be required to sign an authorisation form. The study has QUT ethics committee approval and is available for anyone to look at on request. 148 Appendix 2: Participant consent form Consent Form Chief Investigator: Ross Di Corleto Boyne Smelters Limited Occupational Health & Hygiene Phone 4973 0319 Project Title: Biological Effect Monitoring of Occupational Exposure to PAHs in Pre-Bake Smelting The investigator conducting this research project abides by the principles governing the ethical conduct of research and at all times, avows to protect the interests, comfort and safety of all subjects. This form and the accompanying Subject Information Package have been given to you for your safety and information. They contain an outline of the experimental procedures and possible risks. Your signature below will indicate: 1. You have received the Subject Information Package and that you understand its contents. 2. You clearly understand the procedures and possible risks involved; and that you have been given the opportunity to discuss the contents of the Subject Information Package with one of the investigators from Boyne Smelters prior to the commencement of the experiment. 3. You understand that all the data, which you have provided, will only be revealed to the investigators and yourself. When the results of the study are published you will remain anonymous 4. Your participation is voluntary and therefore may be terminated at any moment by you without comment or penalty, and without jeopardising your involvement with the Boyne Island Smelter. 5. You may direct any enquiries and further questions to the Chief Investigator of this project, Ross Di Corleto on ext 2319 or Comalco Principal Medical Adviser Dr Gerry Walpole on 3867 1658. You may also direct complaints and concerns regarding the ethical conduct of this investigation to Queensland University of Technology, Secretary, University Human Research Ethics Committee (Ph no 3864 2902). 6. You will receive feedback on your results at the time of the Study, and 149 7. You agree to participate in the experimental procedures set out in the Subject Information Package for the research thesis entitled “Biological Effect Monitoring of Occupational Exposure to Polycyclic Aromatic Hydrocarbons in Pre-Bake Smelting.” Your Details: Name …………………………………… Phone ……………………………… Address ………………………………………………………………………………… ………………………………………………………………………………………….. To be signed in the presence of a witness: Signature …………………………………….. Date ……/……./……… To be signed by the person witnessing your signature: Witness Name: ……………………………………… Signature …………………………………….. Date ……/……./……… To be signed by the researcher: Ross Di Corleto Signature …………………………………….. Date ……/……./……… To date site routine monitoring has been undertaken to attempt to identify the level of exposure of individuals to Poly Aromatic Hydrocarbons (PAH). This has included personal air monitoring and biological monitoring i.e. analysis of urine for a compound called 1-hydroxypyrene. This monitoring will continue as part of a study into the effectiveness of the monitoring and the review of Biological Exposure Index guidelines. • Each participant is requested to provide 2 X 50 ml of urine, at the beginning and end of the shift rotation, which will be placed in the laboratory sample freezer in the containers provided. The researcher will transfer this to the BSL Medical Centre sample freezer. Queensland Medical Laboratory Staff will then collect it for transport to NSW Workcover Laboratories for analysis. • Each participant will be given information on the project and details of the collection time via a presentation or personal interview. • Urine samples will only be tested for 1-hydroxypyrene. No other testing will be undertaken without the permission of the participant. • All individual results will remain confidential. 150 Appendix 3: Participant daily work log 151 Appendix 4: Participant questionnaire 1-HYDROXYPYRENE BIOLOGICAL SAMPLE SHEET Urine sample code: (office use only) Name Classification Date of Birth ___/___/___ Ë Male Ë Female Job/Task MRU/Section Date and time of sampling Pre-shift Time ___/___/___ Date and time of sampling Post-Shift Time ___/___/___ Smoking (cigarettes/cigars/pipe): Yes Specify: if yes, average number per day: Use of coal tar products in the last 7 days. No Yes Specify: (eg.: coal tar ointment/shampoo, etc.) No PAH exposure at home in the last 7 Yes Specify: days: No (eg.: timber treatment with creosote, bar-bque, burning off) Personal Protective Equipment Yes Specify: i.e. Respirator, disposable overalls, No Describe conditions of exposure during the two work shifts preceding sample collection with an emphasis on skin contact and personal hygiene. (ie. high exposure cleaning ductwork previous shifts, low exposure in control room.) _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Skin Exposure Classification (Check one): Level 1: Minimal to no opportunity noted for visible contamination of skin or clothing with CTP, or carbon material known to contain CTP. Level 2: Periodic opportunities for visible contamination of skin or clothing. Level 3: Regular or routine visible contamination of skin or clothing. Comments: ________________________________________________________________________________ __________________________________________________________________________ Sampled By: _________________________ 152 Appendix 5: Statistical analysis roadmap All the data groups were sorted and four transform approaches applied: o Data was squared o Square root of data was taken o Natural Log o Logarithm to the base 10 Each of these groups of data were then analysed using the Anderson-Darling normality test and examined using six questions addressing basic criteria associated with normal distributions. Basic statistical calculations were also performed such as mean, median standard deviation, variance, skewness, kurtosis and confidence intervals for the mean & median. The six questions were: 1. Is the mean of the data set within 10% of the median? 2. Is the standard deviation ≤ 1/2 of the mean? 3. The minimum & maximum range of the mean should fall within ± 3 standard deviations. 4. Skewness –3 to +3? 5. Is the kurtosis, within –3 to +3? 6. Does the distribution have the characteristic bell shape? 153 Appendix 6 Aluminium Smelting Protocol for Coal Tar Pitch Volatile (CTPV) Risk Management Code of Practice Objective The Company shall reduce exposure of employees and contractors to CTPV and associated PAH to as low as is reasonably practicable. Program of Work 1. The Company guidelines for CTPV/PAH are: • BSM/CSM air monitoring is < 0.1 mg/ m3 per 12 hour shift • End of shift urinary 1-OH-pyrene of < 4.9 µmol/mol of creatinine1 • Benzo (a) pyrene in air monitoring is < 0.2 µg/m3 per 12 hour shift 2. Personnel exposed to CTP products will be monitored. Examples may include: • Green Carbon operations and maintenance personnel • Liquid pitch transport and storage • Cell reconstruction • Cell bake outs 3. An accredited provider with approved protocols for analysis of CTPV and associated PAHs shall be used. 4. All results will be notified to the individual and the accountable leader. Results that are greater than 3 times the 1-OH-pyrene guideline or unexpected exposures greater than three times the CSM/BSM and B(a)P OEL will be investigated and feedback given. The investigation of 1-OH-pyrene results will have two components: • Inquiry into workplace practices and procedures during the time of exposure led by the accountable leader (a record of the work activities undertaken during the exposure period will be reviewed as part of this investigation. 1 Jongeneelen, F. J., “Benchmark Guideline for Urinary 1-Hydroxypyrene as Biomarker of Occupational Exposure to Polycyclic Aromatic Hydrocarbons”. Ann. Occ. Hyg., Vol 45,No1 pp 3-13. 154 • A health consultation will be held at the site medical centre to discuss the health significance of the results, if any, and initiate any follow up actions necessary. The monitoring results, investigation outcomes and a presentation explaining the significance of these will be made available to the relevant on-site personnel/teams. Individuals will receive their own results with an explanation as to their significance. 5. Pitch burn shall be reported and where necessary, treated at the medical centres and recorded as first aid treatment cases. 6. Water-based barrier creams do not increase CTPV absorption through the skin and may be used as added protection against CTPV skin exposure and prevention of pitch burn. 7. Appropriate annual medical surveillance will be carried out on individuals in exposure groups where the 95th percentile for • BSM/CSM air monitoring is > 0.1mg/ m3, or • Urinary 1-OH-pyrene levels are > 4.9 µmol/mol of creatinine, and/or • Benzo (a) pyrene in air monitoring is > 0.2 µg/m3. 10 The common hierarchy of control will be deployed at all sites depending on the results of the exposure data. The hierarchy of control are Controls that prevent exposure • Elimination • Substitution • Isolation of the people from the hazard or the hazard from the people • Implementation of engineering controls Controls that mitigate exposure • Implementation of administrative controls such as changes in work practice. (Note increasing the number of persons exposed to reduce individual exposure 155 is not an acceptable administrative control when dealing with potentially carcinogenic substances.) • Use of PPE as an interim measure while higher control strategies are being implemented Controls that prevent exposure eliminate illnesses and are always the preferred option. Employees working with CTP will be adequately informed, instructed, trained and supervised to reduce exposure to CTP to as low as reasonably practicable. The mandatory education/training package used across the Company at commencement of exposure and annually thereafter shall include: • Definition of CTPV/PAH, exposure pathways and affects of exposure. • Potential health issues including skin, bladder and lung cancer. • Relevant exposure standards and specific hygiene measurements appropriate to the exposure group. • Respiratory protection requirements including types of respirator appropriate for the level of exposure, respirator cleaning practices and filter change requirements. There shall be a requirement to wear appropriate respiratory protection in all areas or tasks where the workplace exposure to CTP has been shown to exceed 0.05mg/ m3 BSM in air. • Use of skin cleansing, barrier creams, clothing and gloves. • Encouraged use of showers /sauna / personal hygiene /sunscreen. • Potential reproductive effects. 11. Quantitative fit testing of respirators will be performed prior to issue, with repeat testing at a maximum one-year interval. Respirator maintenance education will be repeated at each fit testing. Documented respirator maintenance programs will be put in place. 12. Laundered work and/or disposable clothes will be provided on a daily basis to designated exposure groups for the purpose of reducing skin absorption. These exposure groups will be required to shower prior to leaving the site and after any significant exposure. Under no circumstances shall any clothes, belongings or 156 PPE that are contaminated with CTP be allowed to leave sites except if taken for laundering by approved laundry contractors. 13. No eating drinking or smoking shall be allowed in production or other designated areas where CTP is processed eg in Green Carbon or where dust and/or volatiles are emitted eg in Potrooms during cell bake out. Separate washing facilities shall be provided so that exposed groups can adequately wash prior to eating or smoking in designated areas. 14. Change house facilities shall be arranged such that the potential for cross contamination of clean and dirty clothing and articles is minimised. Clean and contaminated clothing or articles shall under no circumstances be stored together. 15. All smelting sites shall identify and share information regarding improvements in exposure reduction through alterations in processing and plant. All smelting sites shall identify and share information regarding workplace monitoring and health surveillance improvements and knowledge. Auditing Guidelines The corporate occupational health and hygiene specialists in conjunction with the Carbon leadership team shall review the progress of application of this protocol on a yearly basis. The audit would involve • Visit each site • Review occupational hygiene data and improvement projects • Make recommendations to relevant site managers for further work required to support the intent of the protocol • Sites will undertake six monthly risk assessments and reviews 157 Appendix A. Medical Surveillance Protocol Definitions Exposure Criteria Medical surveillance will be carried out on individuals in exposure groups where the 95th percentile for • • • • BSM air monitoring is > 0.1mg/ m3, or Urinary 1-OH-pyrene levels are > 4.9 µmol/mol of creatinine, and/or Benzo(a)pyrene in air monitoring is > 0.2 µg/m3 There is potential for direct skin exposure to CTPV more than twelve times per year Employees/Contractors will become eligible to enter the surveillance programme after three months in the role. Equivalent exposures at other sites will qualify for entry into the surveillance programme. Medical Surveillance Criteria Mandatory medical surveillance will commence 7 years from the time of first working with pitch. Eligible employees/contractors may choose to initiate medical surveillance one year after exposure begins Site Medical Adviser Means a medical practitioner who is either a specialist in occupational medicine, OR who has satisfactorily completed a health surveillance training program supplied by the Division of Workplace Health and Safety of the relevant state, territory or local equivalent. Objectives • • Standards To have an effective and confidential medical surveillance program for the early identification of pitch related disease. To improve control measures for the Company employees and contractors who are exposed to pitch, through the identification of disease patterns and the underlying causative factors. All the Company employees and contractors who meet the exposure and health screening criteria for pitch will undergo annual health assessments These health assessments will begin 7 years from the date of first exposure to pitch at the Company or other work places. • The health screening will be undertaken with supervision and direction from a Site Medical Adviser. • Health screening will meet the standards outlined in ‘Workplace Health Surveillance’ (1993) - Australasian Faculty of Occupational Medicine.: • 158 • • • NOHSC “Competencies for Health Surveillance June 1998 To arrange appropriate medical referral for the Company employees or contractors who are identified by the health screening program as having possible pitch related disease The requirements of the ‘Hazardous Substances Compliance Act’ - 1995 will be met. Accountabilities Manager accountable for Occ Health The Manager accountable for Occ Health will be accountable for the management of the health screening program for pitch at the Company sites. Department Managers The Department Managers will • identify all the Company employees who currently work, or who have worked, in the department, and meet the exposure criteria. • ensure that all the Company employees and contractors who meet the screening criteria undergo health screening. Superintendents The Superintendents will • ensure that all crew members who meet the exposure and screening criteria undergo health screening, and to assist their team members if they have issues with the health screening program. Manager accountable for site contractors The Manager accountable for site contractors will • advise the Site Medical Adviser of all the Company contractors who meet the exposure and screening criteria. The Company employees and contractors Employees and contractors will • undergo appropriate health screening for pitch related diseases • ensure that they understand the results of their health screening Site Medical Adviser The Site Medical Adviser will• design and maintain an up to date health screening program, taking into account each employee’s or contractor’s level of exposure to pitch. • ensure that such screening is undertaken to a high level of professional and ethical standards. • ensure that the results of the screening, and their significance, are explained to each person in a way that is understood by them. • arrange appropriate referral for further medical assessment if this is indicated by the results of the health screening. • maintain normal medical confidentiality of each person’s health screening results and records. 159 • provide a report with statistical data, in a format that does not identify individual employees or contractors, to the Manager accountable for OHH to help identify any disease patterns and possible contributing factors Occupational Health Nurses The Occupational Health Nurses will• perform health screening to high professional standards. • explain procedures to each person in a manner that is understood by the company employee or contractor • maintain medical confidentiality of each person’s health screening results and records. References Hazardous Substances Compliance Code -(1995) Workplace Health Surveillance- AFOM (1993) Appendices A & B The health surveillance program consists of the following elements: • • • • Occupational history and qualitative estimation of exposures to pitch. Occupational and medical history. Physical examination. Urinalysis. 160 Pitch Health Assessment Surname: ______________________ DOB: ____/___/_______ Given Names: ____________________________ Gender: __________ Department: _______________ Smoking history, exposure to sunlight/previous sunburn, usage of sunscreens and barrier creams, previous history of pitch burn? History 1) Have you been exposed to pitch at workplaces other than this site? YES NO If YES, please outline details_____________________________________________________________________________ _____________________________________________________________________________ Years Company Job 2) How often were you exposed to pitch? Every Day Weekly (>2/7) 3) What is your present exposure to pitch? Every Day Weekly (>2/7) Monthly (>7/7 x 12) Rarely Monthly (>7/7 x 12) 4) Have you noticed any skin changes since your last medical? Rashes: Yes No Moles/sunspots: Yes No Rarely Burns: Yes No 5) Describe any other symptoms that you think may be related to your exposure to pitch. Comments: ____________________________________________________________________________ _____________________________________________________________________________ 6) When passing urine have you noticed: Blood: Burning: Yes No Yes No Frequency: Yes No Pain: Yes No Difficulty: Yes No Comments:___________________________________________________________________ ______________________________________________________________________ Biometry Medical Examination Height: ________________________ Weight: ________________________ Urinalysis: Alb ____ Blood _____ Glucose _____ Nose: __________________________ Skin:- Head/neck _________________ Legs: _____________________ Trunk: ____________________ Chest: ____________________ Arms: ____________________ Abdomen: _________________ Scalp: __________________ Other: __________________ Skin type? SPT I - VI SSMA comments: _______________________________________________________________________ _______________________________________________________________________ SSMA Signature: ___________________________ Date of next review: ________________________ Date: _____________________ 161 Appendix 7 Green Carbon PPE Matrix 162
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