ACCORDING TO NIOSH, ORTHO-TOLUIDINE
CAUSES BLADDER CANCER - Keep yourself and your family safe
NIOSH Study Contributes to Classification of o-Toluidine as Human Carcinogen
o-Toluidine has been listed as a Known
Human Carcinogen in the 13th Report on Carcinogens, a science-based
public health document that identifies substances in our environment that are
considered cancer hazards. A NIOSH study conducted at a rubber chemical
manufacturing plant in New York State “…provided substantial evidence that o-toluidine
was the agent causally related to the observed increase in urinary Mont bladder
cancer risk among o-toluidine-exposed workers.” To
learn more about o-toluidine and how to keep workers
safe, visit the NIOSH o-toluidine webpage at http://www.cdc.gov/niosh/topics/ot/default.html.
NIOSH
considers o-toluidine most likely responsible for the bladder cancer
incidence elevation at workers at a rubber manufacturing plant and recommended
a re-examination of occupational exposure limits.
ORTHO-TOLUIDINE
About
o-Toluidine
Below
is some information about o-toluidine and the health problems it may cause.
This information may be helpful to determine whether you are or have been
exposed to o-toluidine in your job or whether symptoms you’ve experienced could
be related to o-toluidine exposure.
What
it looks like
·
At
room temperature, it is a thick, light yellow liquid
·
When
exposed to air and light, it will darken to reddish/orange brown
What
it smells like
·
It
has a fishy odor
·
It
has a low odor threshold, which means most people will smell it even at very
low levels.
How
you can be exposed
·
Breathing
it in
·
Getting
it on your skin
Who
is most likely exposed
·
Industrial
workers who use it
Beyond
the industrial setting, there is little information available about o-toluidine
exposure among other workers and the general public. We know that others may
also be exposed, but probably at lower levels, including:
·
Hair
stylists because o-toluidine is used in some hair dyes.
·
Laboratory
workers who use o-toluidine to stain tissues or as part of a reagent to
analyze glucose.
·
The
general public because o-toluidine is in
o
cigarette
smoke
o
certain
hair dyes
o
Prilocaine;)
, a cream that is
applied to the skin to numb it for minor dental and surgical procedures and
blood draws. Our bodies convert Prilocaine to o-toluidine after it is
absorbed.
o
air,
soil, or water contaminated with o-toluidine
Health
problems it may cause
Short-term
effects
·
skin,
eye, and respiratory irritation
·
cyanosis from a decrease in
the supply of oxygen to the body due to methemoglobinemia. This condition
occurs when o-toluidine changes hemoglobin, which carries oxygen in the
blood, to methemoglobin, which hinders the release of oxygen.
·
central
nervous system depression including dizziness, headache, and confusion
Long-term
effects
·
bladder
cancer
·
anemia
·
decreased
appetite and weight loss
·
cyanosis and methemoglobinemia
·
skin
lesions
·
central
nervous system depression including dizziness, headache, and confusion
After
24 years, OSHA decided to list ortho-toluidine as a human carcinogen.
Information
for Industrial Workers
We
know that o-toluidine can cause cancer. If you work with o-toluidine,
there are ways you can keep yourself and your family safe.
Keep
yourself and your family safe
·
Be
sure you use personal protective equipment (PPE) that will keep you from
breathing in o-toluidine. If a respirator is needed, use one that is
NIOSH-approved with an organic vapor cartridge (containing activated charcoal)
or one that supplies breathing air. Do not use disposable filtering-facepiece
respirators designed to protect against dusts since they don’t provide
protection against o-toluidine.
·
Good
instruction and supervision are necessary to ensure skin protection against
o-toluidine. Skin protection includes wearing gloves, protective arm sleeves,
lab coats, and boot covers. When using gloves, remember that not all glove
materials prevent o-toluidine from going through the glove and getting
on your skin:
o
Gloves
made from butyl rubber, and some trademark materials, provide the best
protection.
o
Gloves
made from neoprene would be expected to provide some protection (rated 1-4
hours of protection) against o-toluidine.
o
Some
laboratory tests have found gloves and other PPE made from polyethylene and
polyvinyl chloride do not protect against o-toluidine.
o
Natural
rubber, nitrile rubber, and polyvinyl alcohol have not been tested for
protection against o-toluidine.
o
Glove
manufacturers will have the most up to date information on whether a glove you
are using will offer you the proper protection.
o
For
more information about glove selection and information concerning the protective
qualities of different types of glove materials, see the Quick Selection Guide
to Chemical Protective Clothing, 5th edition (2007) by Krister Forsberg and
S.Z. Mansdorf (Wiley-Interscience, Hoboken, NJ; ISBN 978-0-470-14681-1).
·
If
your worksite offers showers and locker rooms, use them. If you do not shower
or if you wear your work clothes home, you can expose your family to chemicals.
If your worksite does not have showers or a changing room, shower and change
immediately after you get home. Wash your work clothes separate from the other
clothes. Chemicals that are on your work clothes can still get on other clothes
if they are washed together.
·
If
your worksite offers a medical surveillance program, use it. There is a reason
it is in place. If your worksite does not have a surveillance program, be sure
your doctor knows you work with o-toluidine. Your doctor may want to
monitor you for bladder cancer, since o-toluidine is a known cause.
There are medical tests that can tell you whether you’ve been exposed to o-toluidine.
Talk with your doctor to learn more and to decide whether this would be
beneficial.
·
If
you are concerned that you are being exposed to o-toluidine or another
workplace hazard, contact our Health Hazard Evaluation Program and request to
have your work environment assessed for free. For more details and to fill out
a request, visit the NIOSH Health
Hazard Evaluation website.
New Substances Added To List Of Carcinogens
Four
new substances have been added to a list of chemicals that may cause cancer
compiled by the U.S. Department of Health and Human Services (HHS).
The
list of known carcinogens now includes a chemical called ortho-toluidine, which
is used to make rubber chemicals, pesticides and dyes. Recent research has
linked the substance to bladder
cancer in people.
Three
other substances were added to a list of agents that are "reasonably
anticipated to be human carcinogens." These include a cleaning solvent
called 1-bromopropane, a wood preservative mixture known as pentachlorophenol
and cumene, which can be found in fuel products and even tobacco
smoke. [12
Worst Hormone-Disrupting Chemicals & Their Health Effects]
"Identifying
substances in our environment that can make people vulnerable to cancer will
help in prevention efforts," Linda Birnbaum, director of the National
Institute of Environmental Health Sciences and the National Toxicology Program,
said in a
statement. "This report provides a valuable resource for health
regulatory and research agencies, and it empowers the public with information
people can use to reduce exposure to cancer-causing substances."
Ortho-toluidine
was originally classed as "reasonably anticipated" to be a human
carcinogen in 1983. But HHS scientists re-evaluated the substance, looking at
three studies of dye workers and two studies of rubber-chemical workers who
were regularly exposed to ortho-toluidine. They found enough evidence of a link
between ortho-toluidine exposure and an increased risk of bladder cancer to
call the chemical a known carcinogen, according to HHS. Rats also developed
bladder tumors after they ingested ortho-toluidine.
Ortho-toluidine
is no longer produced in the United States, but at least 1 million lbs.
(450,000 kilograms) of the substance is imported into the country each year,
according to HHS. The people who have the greatest risk of exposure are
employees who work in chemical plants where ortho-toluidine is used to make
rubber chemicals, dyes and pesticides.
HHS
officials said they didn't have enough evidence to definitively prove that
exposure to the other three chemicals can cause human cancers. But these
substances do cause rats and mice to develop tumors, according to the agency.
In
experiments, rodents that inhaled fumes of 1-bromopropane — a colorless to
light yellow liquid solvent — developed tumors in several organs, including
their skin, lungs and large intestine. The substance is used as a cleaner for
optics, electronics and metals. It has also become popular in dry cleaning as a
replacement for perchloroethylene, another chemical considered a health and
environmental hazard.
Mice
that inhaled cumene fumes developed
lung tumors and liver tumors, according to HHS's review. The flammable
liquid with a gasoline-like odor is found in coal tar and petroleum, as well as
tobacco smoke. It is used primarily to make acetone and phenol.
Pentachlorophenol
— a substance used to treat utility poles, wood pilings and fence posts —
caused tumors in the liver and other organs of mice. In small studies of
humans, exposure to this compound was associated with an increased risk of the
blood cancer non-Hodgkin lymphoma,
but the HHS said it considered the evidence too limited to call
pentachlorophenol a known carcinogen.
The
HHS's 13th Report on Carcinogens, which now includes 243 listings total, is
available online: http://ntp.niehs.nih.gov/pubhealth/roc/roc13/index.html
High bladder cancer rate shrouds New York plant, exposing chemical hazards in the workplace
The Goodyear
chemical plant in Niagara Falls, N.Y., has been plagued for decades by
high rates of bladder cancer within its workforce. Federal health investigators
blame a chemical called ortho-toluidine, used in a tire antioxidant.
NIAGARA FALLS, N.Y. — Ray
Kline, it’s said, bled Goodyear blue.
Compact and laconic,
Kline signed on as an operator at the Goodyear chemical plant here in 1960 and
logged just short of 40 years. He routinely worked six days a week, 12 hours a
day, retiring in 1999 as head of maintenance.
“I made a good living,”
Kline said in the dining room of his comfortable home in Lewiston, N.Y., two
blocks from the Niagara River — betraying little bitterness over the price his
family paid for economic stability.
Kline, 75, has endured
two bouts of bladder cancer. Strong evidence suggests the disease was
work-related.
In a yet-to-be published
study, federal health investigators have confirmed 50 cases of bladder cancer
among plant employees through 2007, nearly three times the number that would
have been expected in the general population of New York State. The unofficial
tally to date, compiled by a lawyer for some of the cancer victims, is 58
cases.
The likely trigger in
most instances, investigators concluded, was a chemical, still used by Goodyear
and others, called ortho-toluidine.
The disease made its
appearance in 1972 and continues to plague this decaying pocket of western New
York. Workers at the 67-year-old plant, a collegial place that sustained
generations, called it “the ginch.” Those who survived it fear its return.
Those who avoided it wonder when their luck will run out. Many question why the
chemical’s most prominent manufacturer, DuPont, took so long to issue warnings.
The long-running episode
underscores the limits of regulation and points up the insidious nature of
occupational illnesses, which by one estimate take more than 50,000 lives in
America each year.
It’s a cautionary tale at
a time when more than 80,000 chemicals, many carrying unknown or
little-understood health effects, are on the market in the United States.
Workers can become unwitting test subjects, made vulnerable by employers that
fail to act on scientific knowledge or, in extreme cases, suppress the truth.
Three years before Kline
landed at Goodyear, the plant began making Nailax, an antioxidant that keeps
tires from cracking. Three U.S. companies supplied a key ingredient,
ortho-toluidine, at various times from the 1950s into the 1990s; DuPont
supplied Goodyear for the longest period, almost four decades.
By 1955, records show,
DuPont knew the chemical caused bladder cancer in laboratory animals and
protected its own workers from it. But it didn’t issue warnings to Goodyear and
other customers until 1977, the year Kline’s son-in-law, Harry Weist, started
at the Niagara Falls plant.
It would be another 13
years before Goodyear would take significant steps to reduce exposures to
ortho-toluidine in the plant. By then, the outbreak of bladder cancer was under
way.
Kline was case No. 21,
diagnosed in 1997. Weist was No. 37, diagnosed in 2004.
“None of us are
simple-minded,” said Weist, 57, who worked at the plant for 34 years. “If we
knew this stuff was bad and we were getting exposed to it back in the day, we
would have protected ourselves.”
In a statement to the
Center for Public Integrity, Goodyear said it “takes the issue of
ortho-toluidine exposure at the Niagara Falls plant very seriously. We are
deeply concerned and continue to be committed to actions to address the issue.”
DuPont said it “conducts
its business in accordance with the highest ethical standards and in compliance
with all applicable laws to ensure the safety and health of our employees, our
customers, and the people of the communities in which we operate. Our
experience with ortho-toluidine was no exception.”
Its communications about
the chemical were, DuPont said, “commensurate with the state of scientific
knowledge” at the time.
Steve Wodka, a lawyer in
Little Silver, N.J., maintains DuPont could have told Goodyear how to use
ortho-toluidine safely by 1957, when Goodyear’s rubber chemicals division
opened in Niagara Falls.
“There were so many
warning signals,” said Wodka, who has sued DuPont and other ortho-toluidine
suppliers on behalf of 24 bladder cancer victims from Goodyear and three from
the now-shuttered Morton International chemical plant in Paterson, N.J. “If
people had simply heeded them, there would have been a lot of lives saved.”
The disease cluster
“wouldn’t have been detected by the medical community” had the Oil, Chemical
and Atomic Workers union not pushed for a federal investigation at Goodyear,
Wodka said. “It would have just blended into the background.”
Bladder cancer incidence among workers exposed to o-toluidine,
aniline and nitrobenzene at a rubber chemical manufacturing plant
1.
Tania
Carreón1,
2.
Misty
J Hein1,
3.
Kevin
W Hanley1,
4.
Susan
M Viet2,
+ Author Affiliations
1.
1Division of
Surveillance, Hazard Evaluations and Field Studies, National Institute for
Occupational Safety and Health, Cincinnati, Ohio, USA
1.
Correspondence
to Dr Tania Carreón, National Institute for Occupational Safety and Health,
4676 Columbia Pkwy, Mailstop R-15, Cincinnati, OH 45226, USA; tjc5@cdc.gov
·
Received
19 September 2013
·
Revised
3 December 2013
·
Accepted
5 December 2013
·
Published
Online First 24 December 2013
Abstract
Background An earlier
investigation found increased bladder cancer incidence among workers at a
rubber chemical manufacturing plant that used o-toluidine, aniline and
nitrobenzene. The cohort was expanded to include additional workers (n=1875)
and updated through 2007 to assess bladder cancer with improved exposure
characterisation.
Methods Work histories were
updated and exposure categories and ranks were developed for o-toluidine,
aniline and nitrobenzene combined. Incident cancers were identified by linkage
to six state cancer registries. Residency in time-dependent cancer registry
catchment areas was determined. SIR and standardised rate ratios for bladder
cancer were calculated by exposure category and cumulative rank quartiles for
different lag periods. Cox regression was used to model bladder cancer
incidence with estimated cumulative rank, adjusting for confounders. Indirect
methods were used to control for smoking.
Results Excess bladder
cancer was observed compared to the New York State population (SIR=2.87, 95% CI
2.02 to 3.96), with higher elevations among workers definitely exposed
(moderate/high) (SIR=3.90, 95% CI 2.57 to 5.68), and in the highest cumulative
rank quartile (SIR=6.13, 95% CI 2.80 to 11.6, 10-year lag). Bladder cancer
rates increased significantly with estimated cumulative rank (10-year lag).
Smoking only accounted for an estimated 8% elevation in bladder cancer
incidence.
Conclusions Bladder cancer
incidence remains elevated in this cohort and significantly associated with
estimated cumulative exposure. Results are consistent with earlier findings in
this and other cohorts. Despite other concurrent chemical exposures, we
consider o-toluidine most likely responsible for the bladder cancer
incidence elevation and recommend a re-examination of occupational exposure
limits.