title: Accidental exposure to gas emissions from transit goods treated for pest control.
abstract: BACKGROUND
  International phytosanitary standards ISPM 15 require (since 2007) fumigation or heat treatment for shipping and storage. Those dealing with fumigated freight might be accidentally exposed. In this paper we report a series of three accidents of six storage room workers in a medium sized company regularly importing electronic production parts from abroad.
  
  
  METHODS
  Patients (n=6, aged from 32-54 yrs.) and control group (n=30, mean 40 yrs.) donated blood and urine samples. The fumigants: ethylene oxide, methyl bromide, chloropicrin, ethylene dichloride, other halo-alkanes and solvents were analyzed by headspace gas chromatography/mass spectrometry (GCMS). For the quantitation of long term exposure/s, macromolecular reaction products (hemoglobin adducts) were used (with GCMS) as molecular dosimeter; additionally 8-OHdG and circulating mtDNA (cmtDNA) were analyzed as nonspecific biological effect markers.
  
  
  RESULTS
  The hemoglobin adducts N-methyl valine (MEV) and N-(2-hydroxy ethyl) valine (HEV) were elevated after exposure to the alkylating chemicals methyl bromide and ethylene oxide. Under the consideration of known elimination kinetics and the individual smoking status (biomonitored with nicotine metabolite cotinine and tobacco specific hemoglobin adduct: N-(2 cyan ethyl) valines, CEV), the data allow theoretical extrapolation to the initial protein adduct concentrations at the time of the accident (the MEV/CEV levels were from 1,616 pmol/g globin to 1,880 pmol/g globin and HEV/CEV levels from 1,407 pmol/g globin to 5,049 pmol/g globin, and correlated with inhaled 0.4-1.5 ppm ethylene oxide. These integrated, extrapolated internal doses, calculated on the basis of biological exposure equivalents, confirmed the clinical diagnosis for three patients, showing severe intoxication symptoms. Both, cmtDNA and 8-OHdG, as non-specific biomarkers of toxic effects, were elevated in four patients.
  
  
  CONCLUSIONS
  The cases reported here, stress the importance of a suitable risk assessment and control measures. We put emphasis on the necessity of human biomonitoring guidelines and the urgency for the relevant limit values.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kloth
authors.forename: Xaver
authors.initials: X
authors.lastname: Baur
authors.forename: Thomas
authors.initials: T
authors.lastname: Göen
authors.affiliation: Division of Occupational Toxicology and Immunology, Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, University of Hamburg, Marckmannstrasse 129 b, Bld, 3, 20539 Hamburg, Germany. L.Budnik@uke.de.
authors.forename: Lygia Therese
authors.initials: LT
authors.lastname: Budnik
mesh_terms: D000080242:8-Hydroxy-2'-Deoxyguanosine; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D004272:DNA, Mitochondrial / Q000097:blood*; D003849:Deoxyguanosine / Q000031:analogs & derivatives* / Q000097:blood; D004784:Environmental Monitoring; D005260:Female; D005651:Fumigation; D008401:Gas Chromatography-Mass Spectrometry; D005740:Gases / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D010575:Pesticides / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D004272:DNA, Mitochondrial; D005740:Gases; D010575:Pesticides; D000080242:8-Hydroxy-2'-Deoxyguanosine; D003849:Deoxyguanosine