Tag: Lead

Workplace Chemical Exposure and Type 2 Diabetes Risk (AI).

Question 1 of 2

Can exposure to workplace chemicals such as solvents, isocyanates, organophosphates, hexavalent chromium, lead, gasoline or kerosene increase the chances of developing Type 2 Diabetes.

Answer 1 from Google Gemini AI

Recent scientific research suggests a link between exposure to certain workplace chemicals and an increased risk of developing type 2 diabetes, although the strength of the evidence varies significantly by chemical.

These substances are often classified as diabetogens—chemicals that may disrupt the body’s ability to produce or use insulin.

The following breakdown details the risk levels associated with the chemicals you listed.

1. High Risk / Strong Evidence

These chemicals have the strongest link to type 2 diabetes in occupational studies.

Organophosphates (Pesticides): 

      • The Link: There is strong evidence linking chronic exposure to organophosphate pesticides with an increased risk of type 2 diabetes.
      • Mechanism: These chemicals disrupt key enzymes (like acetylcholinesterase) and induce oxidative stress, which can damage the pancreas’s beta cells (the cells that make insulin) and disrupt glucose metabolism.
      • At-Risk Occupations: Agricultural workers, exterminators, and pesticide manufacturers.

Solvents (specifically Benzene & Chlorinated Solvents): 

      • The Link: Organic solvents, particularly benzene, trichloroethylene (TCE), and their metabolites, have been associated with insulin resistance.
      • Mechanism: They can cause chronic inflammation and liver dysfunction (fatty liver), which are precursors to type 2 diabetes.
      • At-Risk Occupations: Painters, dry cleaners, reinforced plastics workers, and shoemakers.
2. Moderate or Suggestive Evidence

For these chemicals, studies show a correlation, but the results can sometimes be mixed or dependent on the level of exposure (heavy vs. light).

Lead: 

      • The Link: Occupational exposure to lead is associated with higher fasting blood glucose levels and insulin resistance.
      • Mechanism: Lead accumulates in the body (bones) over time and can act as an endocrine disruptor. It interferes with calcium signaling, which is necessary for insulin release.
      • At-Risk Occupations: Battery manufacturing, smelting, radiator repair, and construction (renovating old buildings).

Gasoline & Kerosene (via Benzene): 

      • The Link: Gasoline and kerosene themselves are mixtures. The diabetes risk is largely attributed to their benzene content (see “Solvents” above). Short-term exposure is unlikely to cause diabetes, but chronic, long-term inhalation of vapors (e.g., at filling stations or refineries) is the primary concern.
      • At-Risk Occupations: Refinery workers, gas station attendants, and mechanics.
3. Mixed or Limited Evidence

Hexavalent Chromium: 

      • The Nuance: Chromium is confusing because trivalent chromium (Cr3+) is often sold as a supplement to help blood sugar. However, hexavalent chromium (Cr6+)—the industrial toxin—is a known carcinogen.
      • The Link: While highly toxic and capable of damaging the liver and kidneys (which help regulate blood sugar), the direct link to causing diabetes is not as strongly established in human studies as it is for arsenic or cadmium. However, animal studies suggest it can induce hyperglycaemia and insulin resistance.
      • At-Risk Occupations: Chrome plating, welding (stainless steel), and pigment manufacturing.

Isocyanates: 

      • The Link: Isocyanates are well-known for causing occupational asthma and severe skin/respiratory sensitization. Currently, there is insufficient evidence to strongly link isocyanates directly to the development of type 2 diabetes. Their primary danger remains respiratory and immune system damage.
      • At-Risk Occupations: Spray painters, foam manufacturing, and insulation installers.
What You Can Do

If you work with these chemicals and are concerned about your blood sugar:

      1. Review your Safety Data Sheets (SDS): Check if the products you use contain benzene, toluene, or organophosphates.

      2. Protective Gear: Ensure you are using the correct PPE (respirators, chemically resistant gloves) to prevent absorption through the skin and lungs.

      3. Medical Monitoring: When you get your annual check-up, specifically ask for a HbA1c test or fasting glucose test to monitor your blood sugar trends over time.

Question 2 of 2

Explain these risks further in an aviation context, maintenance (engine oils, hydraulic fluids), refueling, exhaust gasses, paint stripping, priming & painting and PR sealants.

Answer 2 from Google Gemini AI

Recent research and occupational health studies have highlighted specific risks in the aviation industry that go beyond immediate physical safety. In the context of type 2 diabetes, the primary driver is chronic inflammation and liver toxicity (hepatotoxicity), which can lead to insulin resistance.

Here is a breakdown of the specific diabetes-related risks for each aviation task you mentioned.

1. Aircraft Maintenance (Engine Oils & Hydraulic Fluids)

Risk Level: Moderate to High Primary Hazard: Organophosphates

      • Engine Oils (e.g., Mobil Jet II): Turbine engine oils contain Tricresyl Phosphate (TCP) as an anti-wear additive. TCP is an organophosphate. While historically known for “aerotoxic syndrome” and neurological damage, organophosphates are also metabolic disruptors. They can alter how your liver processes fats (lipids), leading to “fatty liver,” a direct precursor to type 2 diabetes.
      • Hydraulic Fluids (e.g., Skydrol): These fluids are phosphate ester-based (often Tributyl Phosphate). Like TCP, these chemicals are absorbed rapidly through the skin. They are difficult for the liver to process, placing stress on the organ responsible for regulating your blood sugar.

Note: Standard nitrile gloves often do not provide sufficient protection against phosphate esters (which can degrade them). Butyl rubber or specific chemically resistant gloves are usually required.

2. Refueling & Ground Operations

Risk Level: High Primary Hazard: Ultrafine Particles (UFPs) & Benzene

      • Refueling (Jet-A1): Jet fuel contains benzene and other aromatics. Chronic inhalation of fuel vapours (especially during “hot” refueling or in enclosed hangars) exposes you to solvents that increase the risk of insulin resistance.
      • Exhaust Gases (Tarmac/Ramp Work): This is perhaps the most significant, overlooked risk. Jet exhaust emits Ultrafine Particles (UFPs).
          • The Evidence: A major European study linked living near airports (and thus high UFP exposure) to significantly higher rates of diabetes.
          • The Mechanism: These particles are so small they pass from your lungs directly into your bloodstream, causing systemic inflammation that blocks insulin receptors. If you work on the ramp or near running APUs without respiratory protection, your exposure is extremely high.
3. Paint Stripping

Risk Level: High Primary Hazard: Methylene Chloride & Phenols

      • Chemical Strippers: Aviation paint strippers are among the harshest chemicals used in industry. Many contain Methylene Chloride (Dichloromethane).
      • The Diabetes Link: Methylene chloride is a severe metabolic toxin. It causes oxidative stress in the liver. Research indicates that chronic exposure to chlorinated solvents is linked to a higher prevalence of type 2 diabetes because the liver becomes too “busy” detoxifying the solvents to properly manage insulin and glucose levels.
Photo of dichloromethane as stored by Irish Air Corps in 2015. Dichloromethane was banned in the EU in 2012.
4. Priming & Painting

Risk Level: Moderate (Mixed Risks) Primary Hazard: Hexavalent Chromium & Isocyanates

      • Priming (Alodine / Chromates): The yellow/green primers (like zinc chromate or strontium chromate) contain Hexavalent Chromium (Cr6+). While primarily a cancer risk, heavy metal toxicity stresses the kidneys and pancreas.
      • Painting (Topcoats): Polyurethane topcoats use Isocyanates as hardeners.
          • Clarification: The primary risk here is sensitization (occupational asthma), not diabetes. However, the solvents used to thin these paints (MEK, Toluene, Xylene) are the metabolic risks.
          • Diabetes Connection: Solvents like Toluene affect cell membrane signalling, which can make cells “deaf” to insulin’s signal (Insulin Resistance).
5. PR Sealants (Polysulfide Sealants)

Risk Level: Moderate Primary Hazard: Solvents & Dichromate Curing Agents

      • The Sealant: The sealant itself (the grey goo) is generally low risk once cured.
      • The Curing Agents: Be careful with the “hardener” part of the kit. Some two-part sealants use a dichromate cure (contains chromium), which carries the heavy metal toxicity risks mentioned above.
      • The Solvents: You likely use MEK (Methyl Ethyl Ketone) or MPK to clean surfaces before sealing or to wipe up excess. These solvents are rapidly absorbed by the skin. Frequent, unprotected contact with MEK “degreases” your skin and enters your bloodstream, adding to the total “solvent load” your liver must filter.
Immediate Protective Actions
      1. Respirators for Ramp Work: If you are spending hours on a tarmac with running APUs or engines, a standard dust mask is useless against UFPs. You need P100 filtration or activated carbon layers if vapours are present.
      2. Glove Selection:
          • Skydrol/Hydraulics: Use Butyl or Neoprene. Nitrile breaks down quickly.
          • Fuel/Solvents: High-grade Nitrile is usually acceptable, but change them immediately if splashed.
      3. Liver Support: Since the liver is the primary organ fighting these chemicals and regulating blood sugar, reducing other liver stressors (alcohol, processed fructose) is critical for aviation workers.

State attempting to reach settlements with Air Corps chemical victims, Tánaiste says

Cases relating to exposure to dangerous chemicals used in aircraft maintenance are due before the courts

The State Claims Agency (SCA) is attempting to reach settlements with Air Corps members who were exposed to dangerous chemicals during their work, Tánaiste Simon Harris has said.

It follows the conclusion of a landmark court case earlier this year in which a former Air Corps technician was awarded €2 million.

In what was seen as a major test case, Gary Coll (51), from Lifford, Co Donegal, alleged his exposure to chemicals in the workshops of Casement Aerodrome caused him severe and lifelong health problems.

On the opening day of the hearing last February the parties agreed a settlement that did not include any admission of responsibility by the State.

Campaigners accused the State of dragging out the legal process for more than a decade.

The case against the Department of Defence was the first of 10 personal injuries cases due before the courts relating to the exposure of Air Corps members to dangerous chemicals and solvents used in aircraft maintenance.

Campaigners say there are many other Air Corps veterans who have died prematurely or suffered severe health problems in connection with their work.

Now, Mr Harris, who is also Minister for Defence, has signalled the State is keen to settle the remaining cases.

“I want to see a resolution in this regard,” Mr Harris told the Dáil this week. “I am advised there is currently active engagement between the State Claims Agency and litigants to determine if mutually agreeable resolutions can be found to their cases.

“I want to see that happen and I encourage the State Claims Agency to continue that approach, as I know it will. Trying to bring this issue to a resolution that works is important.”

The Tánaiste said an engagement process with former Air Corps personnel is “now genuinely under way” and that it should be allowed proceed “to a point where there is an achievable outcome that is acceptable to all parties”.

Gavin Tobin, a former Air Corps technician, estimates there have been nearly 100 deaths that may have involved exposure to dangerous chemicals.

He rejected Mr Harris’s claim that the State is engaging with veterans and accused it of only coming to an agreement in Mr Coll’s case at the 11th hour.

“A haggle on the corridors of the High Court where the State Claims Agency attempts to destroy reputations by calling injured personnel liars is not engagement,” said Mr Tobin who has been campaigning for years on the issue and who also suffers serious health issues.

He accused the Government of “using the might of the State to threaten financial ruin” on plaintiffs if they reject settlement offers.

“Threatening bankruptcy unless we accept settlement is not an engagement process,” he said. “Nobody is engaging with us.”

Read full article by  Conor Gallagher at  the Irish Times
https://www.irishtimes.com/ireland/2025/05/14/state-attempting-to-reach-settlements-with-air-corps-chemical-victims-tanaiste-says/

*****

Delay – Deny – Die

Ex-Air Corps members demand ‘truth’ after €2m chemicals case

Despite a promise of justice, Air Corps chemical exposure survivors say the Irish State continues to deny and delay accountability

A former member of the Defence Forces who says his health has been destroyed by exposure to dangerous chemicals during his service has called for the Government to “let the truth come out”.

The State agreed last week to pay €2m to Gary Coll, 51, to settle a legal case taken by him in relation to his claims, without accepting liability.

Mr Coll served as an aviation technician with the Irish Air Corps in Casement Aerodrome, Baldonnel, between 1991 and 1997.

His case is the first of ten which have been taken by former members in relation to what they say was the failure by the State to protect them from exposure to dangerous chemicals.

Speaking on RTÉ’s Upfront with Katie Hannon, Mr Coll said the State is “hiding behind the State Claims Agency, hiding behind the Courts.”

“The minister stands up and says he can’t look at a health and safety issue because he has to wait for the go-ahead from the State Claims Agency, or the Courts? No. It’s a cop-out to hide behind the court cases,” he said.

Mr Coll says he now suffers from chronic fatigue, has issues with his heart, breathing, and memory, recurring ulcers, and is unable to maintain his core body temperature.

He says during his service there was exposure to chemicals during basic work tasks.

“There was fumes, chemicals being used openly with no extraction systems, within feet of where you worked,” Mr Coll said.

“The place was a mess, the floors were that dirty that people were afraid they would catch fire, there was that much oil and chemicals spilled on the floor of the hangers,” he said.

There was also a tradition of ‘tubbing’ in the Air Corps, whereby individuals would be dunked into tanks of chemicals for various purposes, including as part of initiations or hazing.

He said such tubbing happened to him several times.

https://x.com/RTEUpfront/status/1889094673647440041

Mr Coll joined the Air Corps as a teenager, and represented it in national and international rugby and rowing tournaments in the earlier years of his service.

He said he left his job in his mid-20s due to a slew of medical conditions he experienced while he was still serving, including headaches, vomiting, diarrhoea and nosebleeds.

He now requires the use of a mobility scooter or walking stick to get around.

“I suffered anxiety for years, about 2004 or 2005 I started developing neurological problems, pins and needles, tremors and shakes, it started effecting my balance, my memory’s gone, my short-term memory.”

“In a few months time, I’ll probably forget being here tonight,” Mr Coll said.

Two other former Air Corps members also spoke on the programme. Neither are currently taking legal cases, but both believe exposure to chemicals during their service has significantly damaged their health.

Paul Flynn, 52, spoke to presenter Katie Hannon by video call from his hospital bed. He has been in hospital for 15 months.

He joined the Air Corps in 1988 a week after his 16th birthday. From 1991 to 1998, when he left the service, he worked preparing aircraft parts for painting with primers, topcoats, and spraying.

He said in his early days working in the role there was no protective equipment “at all” provided. Several years later, he said he bought his own air-fed mask, but the line installed to feed it was placed beside a compressor in another room where chemicals were also present.

“I have issues with breathing, sometimes I’m on oxygen… I would like the Government to acknowledge that the chemicals have injured people,” Mr Flynn said, who accepts he cannot definitively link his health issues to chemical exposure.

“The Australian and Dutch government have admitted the same chemicals that we used caused the same injuries we have. I want the Irish Government to admit to that and provide us with whatever care they we need.”

Mr Flynn, aged 52, says his medical team is now advising he move to a nursing home.

https://x.com/RTEUpfront/status/1889090652786286649

Michael Byrne joined the Air Corps having served earlier in the army, he entered to train as a winchman, having passed a fitness selection course.

Unlike Mr Coll and Mr Flynn, he did not serve in the paint shop, but he says he was exposed to chemicals during refuelling of aircraft without PPE.

He said he was splashed with chemicals, and had to breathe in chemicals, as he was required to keep his face close to the refuelling point on the aircrafts.

“There was often – a common occurrence – you’d get an airlock, a backwash of fuel into the eyes, into the mouth, ingested it,” he said.

Within a year of joining the Air Corps after the army, Mr Byrne said, his health began to deteriorate, and he eventually left his job.

“I joined the Air Corps to hang out of helicopters. I joined it for the adventure. When I became sick and I wasn’t able to do the duties anymore – and because under aviation law because I was on high dose steroids, you’re not allowed to fly – I was given jobs like answering phones, I was cleaning toilets at times. So I left, disheartened, and I left.”

“I’ve had two knee replacements, I’m due two hip replacements, I currently have a fractured spine, I’m in a brace at the moment, from just doing menial tasks around the house.”

He said he can not definitively trace his health issues to chemical exposure, but says the timeline is significant.

“I was perfectly healthy, from that point – within a year – I went from running ten miles a day to not being able to run across the road when a car came.”

Mr Byrne is not taking a legal case because he is “just trying to get through day-to-day at the moment, just with pain and managing everything like that.

“I want answers, I’m going downhill, my elbows swell, my knees swell … It was proven in Australia, why can’t they use those templates? At home, most days I don’t move, I can’t get up” he said.

In Australia, in 2009 there was a parliamentary inquiry into similar issues which resulted in payments and healthcare services – including cancer screening – being provided to former Royal Australian Air Force members who were exposed to dangerous chemicals.

Several former Air Corps members who say they have been exposed are calling on the Government to take similar action. In particular, they are calling on Taoiseach Micheál Martin to act.

The Taoiseach and other ministers note that the handling of complaints raised about chemical exposed fall under a Tribunal of Inquiry which was set up after the so-called ‘Women of Honour’, which revealed concerns about bullying, misogyny and sexual assault within the Defence Forces.

In June 2017, Mr Coll and others met Mr Martin, then the leader of the opposition, to outline their concerns and issues related to chemical exposure.

Mr Martin subsequently told the Dáil that three whistleblowers had warned in November 2015 about conditions in the Air Corps maintenance units in Baldonnel, and the degree to which staff were “exposed to very dangerous solvents and chemicals.”

Mr Martin at the time called on the government of the day to commission an independent board of inquiry “into this entire affair and scandal,” summarising the then-government’s response as “deny, deny, deny, resist, resist, resist.”

“The linkage of the particular chemicals to cancer-causing diseases, genetic mutation, neurological conditions and chronic diseases have been well-established”, Mr Martin said at the time.

In a statement to Upfront from Katie Hannon, a spokesperson for Mr Martin said “throughout his time as Taoiseach, and as Minister for Defence, the health and safety of the men and women of the Defence Forces has been a priority.

“There are a number of other personal injury claims currently active before the courts, and it wouldn’t be appropriate to encroach on the independence of the legal process.

“The Defence Forces Tribunal of Inquiry was established in June 2024 and, as part of its terms of reference, will investigate the response to complaints made regarding the use of hazardous chemicals within Air Corps’ headquarters at Casement Aerodrome, Baldonnel.”

The Department of Defence told Upfront with Katie Hannon: “The Health and Wellbeing of the men and women working in the Air Corps is a priority for the Tánaiste and Minister for Defence, as it is for the Defence Forces Management and the Department of Defence.

“The decision to take litigation is a matter for each individual, as is the decision to engage in dialogue to explore and potentially reach a settlement in relation to such matters. In respect of the recently reported case, the parties agreed to settle the matter before the commencement of the trial, on terms agreed by both sides, with the benefit of legal advice at every stage of the process.”

https://www.rte.ie/news/upfront/2025/0211/1495941-ex-air-corps-members-demand-truth-after-2m-chemicals-case

*****

Delay – Deny – Die

Air Corps chemical poisoning: Betrayal, legal battles, and a decade-long fight for justice

Despite a promise of justice, Air Corps chemical exposure survivors say the Irish State continues to deny and delay accountability

Meeting Micheál Martin on Tuesday, June 20, 2017 is a moment that is etched on Gary Coll’s brain.

As the then leader of the opposition, the now Taoiseach spent the best part of an hour with the former Air Corps aviation technician and five of his colleagues in Leinster House.

They had met him, at his invitation, to plead their case about the need for urgent State intervention into the issues around chemical poisoning in the air corps.

At the time, around 40 Air Corps personnel under the age of 65 were understood to died in the previous 27 years from suicide, cardiovascular events and cancer. Hundreds more were suffering a raft of chemical exposure-related illnesses.

They all mostly maintained aircraft without using PPE, and with little or no training or advice about the toxic chemicals they were either working with or in the vicinity of.

At the end of the meeting Mr Martin, who went on to become Taoiseach in June 2020, vowed to be an advocate to their cause.

Just before the meeting concluded, Gary limped over to him and asked if he would still support air corps chemical exposure survivors when he became Taoiseach.

Gary, who last Wednesday was awarded €2m in a settlement to his High Court claim for damages against the State, recalled:

“He looked me firmly in the eye, and — as he shook my hand — said he would because it was, in his words, ‘the right thing to do’.”

Gary bristles with anger as he recalls the moment.

Read full article by Neil Michael at  the Irish Examiner
https://www.irishexaminer.com/news/spotlight/arid-41570956.html

*****

Delay – Deny – Die

Over a decade on, ill Air Corps technicians still await a fair hearing

The settlement between the State and Gary Coll closes one chapter in the allegations by former Air Corps technicians that they were exposed to dangerous chemicals while working on military vehicles. However, as Joe Leogue outlines, many more cases and issues of disclosure remain unresolved

Ex-Air Corps member Gary Coll from Lifford, Co. Donegal. The State has agreed to pay €2 million to a former Air Corps technician who was allegedly exposed to toxic chemicals which he says caused severe health difficulties. Photo by Joe Dunne

A settlement on the steps of a court usually marks the conclusion of a dispute — however, the reported €2m pay-out to Defence Forces mechanic Gary Coll on Wednesday is but another development in a bitter dispute between the State and former Air Corps technicians that has raged on for over a decade.

Mr Coll settled his High Court action against the State having alleged he was exposed to various dangerous chemicals while he worked at Casement Aerodrome in Baldonnel, Dublin. The settlement was made without an admission of liability.

The State contended it provided a safe workplace at Casement, and did not allow inappropriate work practices there.

The settlement is a milestone in an ongoing saga that is complex, but at its core comes down to two simple, related, questions; did the State fail in its duty to protect scores of Defence Forces staff from the impact of harmful chemicals, and were there attempts to cover this up?

Mr Coll’s case was the first of 10 such legal actions to come to an end, with all 10 cases bearing similar complaints. The first legal claims were lodged with the High Court in 2013, and all litigants worked in repair and service workshops based in Casement Aerodrome.

All 10 say that they suffered chronic conditions including cancer and neurological problems as a direct result of their exposure to the chemicals with which they came into contact as part of their duties when servicing Air Corps aircraft.

In 2017, then in opposition, Fianna Fáil leader Micheál Martin was scathing of the report, accusing the government of knowingly appointing a reviewer who, by his own admission, was unable to meet the terms of reference of the investigation.

“It’s farcical. It seems to me there are no records of compliance with health regulations, which is very, very serious because in their absence one has to conclude that the probability is they were not complied with,” he said.

“The government needs to establish a forensic examination into this,” Mr Martin added.

“I don’t think it is acceptable to wait for court cases against the State to conclude as there is no guarantee these legal proceedings will establish what happened in the past.”

That line has proven particularly prescient eight years later. The settlement of Mr Coll’s case this week means that no evidence was heard. Nothing has yet established what has happened in the past.

This matters to the former Air Corps mechanics for many reasons. Chief among these is that since 2018 the government rejected opposition calls for a healthcare programme for these workers — similar to the Australian model — on the basis that the courts were the place to establish liability.

Read full article by Joe Leogue at  the Irish Examiner
https://www.irishexaminer.com/opinion/columnists/arid-41569999.html

*****

Delay – Deny – Die

State agrees €2m settlement in Air Corps chemical ‘tubbing’ case

Central to Gary Coll’s claims was that he underwent ‘tubbing’, a form of hazing where workers were submerged in a bath of unspecified chemicals and oil

The State has agreed to pay €2 million to a former Air Corps technician who was allegedly exposed to toxic chemicals which he says caused severe health difficulties.

The case against the Department of Defence is the first of 10 personal injuries cases due before the courts relating to the exposure of Air Corps members to dangerous chemicals and solvents used in aircraft maintenance.

Gary Coll (51), from Lifford, Co Donegal, joined the Air Corps in 1991, when he was 17, and worked in the avionics section until 1997.

In a statement of claim, he made a large number of allegations against his former employer including that he was not provided with a safe working environment at the Air Corps headquarters in Baldonnell, Co Dublin, and that there was inadequate supervision regarding the use of dangerous chemicals.

Central to Mr Coll’s claims was that he underwent “tubbing”, a form of hazing where workers were submerged in a bath of unspecified chemicals and oil.

Mr Coll, who was once an accomplished athlete, detailed several psychological and physical issues that he alleged were caused by the chemicals. He said he is unable to walk any significant distance without a cane.

Read full article by Conor Gallagher at the Irish Times
https://www.irishtimes.com/crime-law/courts/2025/02/05/state-agrees-2m-settlement-in-air-corps-chemical-tubbing-case/

*****

Delay – Deny – Die

Bilateral Vestibular Dysfunction Associated With Chronic Exposure to Military Jet Fuel

Abstract

We describe three patients diagnosed with bilateral vestibular dysfunction associated with the jet propellant type-eight (JP-8) fuel exposure. Chronic exposure to aromatic and aliphatic hydrocarbons, which are the main constituents of JP-8 military aircraft jet fuel, occurred over 3–5 years’ duration while working on or near the flight line.

Exposure to toxic hydrocarbons was substantiated by the presence of JP-8 metabolite n-hexane in the blood of one of the cases. The presenting symptoms were dizziness, headache, fatigue, and imbalance. Rotational chair testing confirmed bilateral vestibular dysfunction in all the three patients. Vestibular function improved over time once the exposure was removed.

Bilateral vestibular dysfunction has been associated with hydrocarbon exposure in humans, but only recently has emphasis been placed specifically on the detrimental effects of JP-8 jet fuel and its numerous hydrocarbon constituents. Data are limited on the mechanism of JP-8-induced vestibular dysfunction or ototoxicity.

Early recognition of JP-8 toxicity risk, cessation of exposure, and customized vestibular therapy offer the best chance for improved balance. Bilateral vestibular impairment is under-recognized in those chronically exposed to all forms of jet fuel.

CASE REPORTS

Case 1: Military Flight Refueler

A37-year-old woman presented with several years of progressively worsening continuous dizziness, headache, and fatigue. The dizziness consisted of sensations of spinning, tilting, disequilibrium, and head fullness. She did not report tinnitus or hearing loss. She was employed as a military flight refueler and exposed to JP-8 vapors and exhaust while working full-time on and around a KC-135E tanker aircraft, a plane used for performing in-flight refueling missions. She worked in a large enclosed hangar that housed all but the tail section of the tanker aircraft. During inspection and maintenance of the aircraft, up to 9,750 gallons of fuel would be loaded. Jet fuel vapors were always present in the hangar due to venting, small leaks, and fuel residue. Fuel vapor concentrations were even greater when engine maintenance necessitated removal of fuel filters and fuel components, draining of fuel into buckets, and opening of fuel lines. She worked in engine maintenance with over 4 years of inhalational and dermal exposure to JP-4 and JP-8.

Her examination showed moderately impaired equilibrium to walk only three steps in tandem before taking a sidestep. Romberg testing revealed more sway during eye closure but no falling. Her medical and neurological examinations were normal. There was no spontaneous, gaze, or positional nystagmus. Qualitative head impulse test was not performed at that time.
Cases 2 and 3

The following two patients were employees in a small purchasing warehouse, located 75 feet south of the fight path, which was separated from the blast and heat emissions from jet aircraft engines by a metal-coated and chain-link fence. Neither air conditioning vents nor carpet had not been cleaned or replaced for over a decade. On inspection, the vents were found to be mal-functioning such that air was able to enter the building but unable to escape. Subsequent inspection by the U. S. Occupational Safety and Health Administration (OSHA) confirmed poor ventilation evidenced by carbon dioxide concentrations >1,500ppm (nor-mal <1,000 ppm according to the U.S. Department of Labor). Hydrocarbons discovered in the carpet via an independent analysis using gas chromatography/mass spectrometry included undecane (C11), dodecane (C12), tridecane (C13), tetradecane (C14), and toluene (C8)—all known JP-8 constituents (2). The chemicals present in the office carpet likely reflected poor indoor air quality. Vapor, aerosol, dermal, and eye absorption of JP-8 are presumed.

Case 2: Warehouse Employe 1

A 45-year-old female contracting officer for the National Guard reported several years of imbalance, headache, fatigue, eye and skin irritation, coughing, sinus congestion, recurrent urinary tract infections, chest tightness, irritability, depression, shortness of breath, palpitations, and numbness. She described her dizziness as an intermittent floating and a rightward tilting sensation with imbalance lasting minutes to hours without any particular pattern. She had a history of asthma and allergies including reaction to aspirin causing urticaria and airway obstruction. In 1998, she developed syncope and dizziness though no specific cause was found. She started working in the building in 1994 and worked there full-time for 5 years.

Case 3: Warehouse Employe 2

A 54-year-old female National Guard contract specialist presented with 2 years of intermittent dizziness, blurred vision, and occasional palpitations. Dizziness was experienced at least 3 days a week. She reported intermittent problems with erratic heart beats, cough, sneezing, headaches, fatigue, recurrent sinus infections, upper respiratory tract, and bladder infections. She worked in the purchasing warehouse full-time for 3 years. When away from the workplace her symptoms were improved. After moving with her colleagues into a new building, the frequency of dizziness was lessened.

Human Exposure and Absorption of Jet Fuel

Military duties such as fuel transportation, aircraft fueling and defueling, aircraft maintenance, cold aircraft engine starts, maintenance of equipment and machinery, use of tent heaters, and cleaning or degreasing with fuel may result in jet fuel exposure. Fuel handlers, mechanics, flight line personnel, especially crew chiefs, and even incidental workers remain at risk for developing illness secondary to chronic JP-8 fuel exposure in aerosol, vapor or liquid form. JP-8 is one of the most common occupational chemical exposures in the US military (1).

The Air Force has set recommended exposure limits for JP-8 at 63ppm (447mg/m3 as an 8-h time-weighted average) (22).In addition to exposure by JP-8 vapor inhalation, toxicity may also occur by absorption through the skin, which is proportional to the amount of skin exposed and the duration of exposure (23, 24). In addition to the standard operating procedure and safety guidelines, double gloving, immediate onsite laundering of contaminated/soiled jumpsuits, regular washing of safety goggles and masks, reduced foam handling time, smoking cessation, adequate cross ventilation, and frequent shift breaks may reduce the overall risk of JP-8 induced illness

At this time, OSHA has not determined a legal limit for jet fuels in workroom air. The U.S. National Institute of Occupational Safety and Health set a recommended limit of 100mg/m3 for kerosene in air averaged over a 10-h work day. Multi-organ toxicity has been documented from JP-8 exposure in animal experiments over the past 15 years. More recently, toxicology researchers are investigating the adverse tissue effects of JP-8 jet fuel in concentrations well below permissible exposure limits.

Ultimately, the new data may help us to better understand the emerging genetic, metabolic and inflammatory mechanisms underpinning JP-8 cellular toxicity—including auditory and vestibular toxicity—and lead to a reassessment of the safe JP-8 exposure limits (25, 26).

CONCLUSION

Bilateral vestibular dysfunction in these three patients with prolonged vapor and dermal JP-8 fuel exposure should raise awareness in people with occupations that expose them to jet fuels, liquid hydrocarbons, or organic solvents. Dizziness and mild imbalance may be the main initial symptoms. Early recognition and limiting further exposure as well as treatment with vestibular therapy (32) may improve their function and quality of life


Bilateral Vestibular Dysfunction… (PDF Download Available). Available from: https://www.researchgate.net/publication/325175906_Bilateral_Vestibular_Dysfunction_Associated_With_Chronic_Exposure_to_Military_Jet_Propellant_Type-Eight_Jet_Fuel

*****

Difference between Jet A1 & JP-8

Jet fuel, aviation turbine fuel (ATF), or avtur, is a type of aviation fuel designed for use in aircraft powered by gas-turbine engines. It is colorless to straw-colored in appearance. The most commonly used fuels for commercial aviation are Jet A and Jet A-1, which are produced to a standardized international specification. The only other jet fuel commonly used in civilian turbine-engine powered aviation is Jet B, which is used for its enhanced cold-weather performance.

Jet fuel is a mixture of a large number of different hydrocarbons. The range of their sizes (molecular weights or carbon numbers) is defined by the requirements for the product, such as the freezing or smoke point. Kerosene-type jet fuel (including Jet A and Jet A-1) has a carbon number distribution between about 8 and 16 (carbon atoms per molecule); wide-cut or naphtha-type jet fuel (including Jet B), between about 5 and 15.[1]

Additives

The DEF STAN 91-91 (UK) and ASTM D1655 (international) specifications allow for certain additives to be added to jet fuel, including:[13][14]

  • Antioxidants to prevent gumming, usually based on alkylated phenols, e.g., AO-30, AO-31, or AO-37; 
  • Antistatic agents, to dissipate static electricity and prevent sparking; Stadis 450, with dinonylnaphthylsulfonic acid (DINNSA) as a component, is an example
  • Corrosion inhibitors, e.g., DCI-4A used for civilian and military fuels, and DCI-6A used for military fuels;
  • Fuel system icing inhibitor (FSII) agents, e.g., Di-EGME; FSII is often mixed at the point-of-sale so that users with heated fuel lines do not have to pay the extra expense.
  • Biocides are to remediate microbial (i.e., bacterial and fungal) growth present in aircraft fuel systems. Currently, two biocides are approved for use by most aircraft and turbine engine original equipment manufacturers (OEMs); Kathon FP1.5 Microbiocide and Biobor JF.[15]
  • Metal deactivator can be added to remediate the deleterious effects of trace metals on the thermal stability of the fuel. The one allowable additive is N,N’-disalicylidene 1,2-propanediamine.

As the aviation industry’s jet kerosene demands have increased to more than 5% of all refined products derived from crude, it has been necessary for the refiner to optimize the yield of jet kerosene, a high value product, by varying process techniques. New processes have allowed flexibility in the choice of crudes, the use of coal tar sands as a source of molecules and the manufacture of synthetic blend stocks. Due to the number and severity of the processes used, it is often necessary and sometimes mandatory to use additives. These additives may, for example, prevent the formation of harmful chemical species or improve a property of a fuel to prevent further engine wear.

https://en.wikipedia.org/wiki/Jet_fuel

JP-8, or JP8 (for “Jet Propellant 8”) is a jet fuel, specified and used widely by the US military. It is specified by MIL-DTL-83133 and British Defence Standard 91-87, and similar to commercial aviation’s Jet A-1, but with the addition of corrosion inhibitor and anti-icing additives.

A kerosene-based fuel, JP-8 is projected to remain in use at least until 2025. It was first introduced at NATO bases in 1978. Its NATO code is F-34.

https://en.wikipedia.org/wiki/JP-8

Ototoxicity – Ototoxicants in the environment and workplace

Ototoxicity is the property of being toxic to the ear (oto-), specifically the cochlea or auditory nerve and sometimes the vestibular system, for example, as a side effect of a drug.

The effects of ototoxicity can be reversible and temporary, or irreversible and permanent. It has been recognized since the 19th century.[1] There are many well-known ototoxic drugs used in clinical situations, and they are prescribed, despite the risk of hearing disorders, to very serious health conditions.[2]

Ototoxic drugs include antibiotics such as gentamicin, loop diuretics such as furosemide and platinum-based chemotherapy agents such as cisplatin. A number of nonsteroidal anti-inflammatory drugs (NSAIDS) have also been shown to be ototoxic.[3][citation needed]

This can result in sensorineural hearing loss, dysequilibrium, or both. Some environmental and occupational chemicals have also been shown to affect the auditory system and interact with noise.[4]

Signs and symptoms

Symptoms of ototoxicity include partial or profound hearing loss, vertigo, and tinnitus.[5]

The cochlea is primarily a hearing structure situated in the inner ear. It is the snail-shaped shell containing several nerve endings that makes hearing possible.[6] Ototoxicity typically results when the inner ear is poisoned by medication that damages the cochlea, vestibule, semi-circular canals, or the auditory/ vestibulocochlear nerve. The damaged structure then produces the symptoms the patient presents with. Ototoxicity in the cochlea may cause hearing loss of the high-frequency pitch ranges or complete deafness, or losses at points between.[7] It may present with bilaterally symmetrical symptoms, or asymmetrically, with one ear developing the condition after the other or not at all.[7] The time frames for progress of the disease vary greatly and symptoms of hearing loss may be temporary or permanent.[6]

The vestibule and semi-circular canal are inner-ear components that comprise the vestibular system. Together they detect all directions of head movement. Two types of otolith organs are housed in the vestibule: the saccule, which points vertically and detects vertical acceleration, and the utricle, which points horizontally and detects horizontal acceleration. The otolith organs together sense the head’s position with respect to gravity when the body is static; then the head’s movement when it tilts; and pitch changes during any linear motion of the head. The saccule and utricle detect different motions, which information the brain receives and integrates to determine where the head is and how and where it is moving.

The semi-circular canals are three bony structures filled with fluid. As with the vestibule, the primary purpose of the canals is to detect movement. Each canal is oriented at right angles to the others, enabling detection of movement in any plane. The posterior canal detects rolling motion, or motion about the X axis; the anterior canal detects pitch, or motion about the Y axis; the horizontal canal detects yaw motion, or motion about the Z axis. When a medication is toxic in the vestibule or the semi-circular canals, the patient senses loss of balance or orientation rather than losses in hearing. Symptoms in these organs present as vertigo, difficulties walking in low light and darkness, disequilibrium, oscillopsia among others.[7] Each of these problems is related to balance and the mind is confused with the direction of motion or lack of motion. Both the vestibule and semi-circular canals transmit information to the brain about movement; when these are poisoned, they are unable to function properly which results in miscommunication with the brain.

When the vestibule and/or semi-circular canals are affected by ototoxicity, the eye can also be affected. Nystagmus and oscillopsia are two conditions that overlap the vestibular and ocular systems. These symptoms cause the patient to have difficulties with seeing and processing images. The body subconsciously tries to compensate for the imbalance signals being sent to the brain by trying to obtain visual cues to support the information it is receiving. This results in that dizziness and “woozy” feeling patients use to describe conditions such as oscillopsia and vertigo.[7]

Cranial nerve VIII, is the least affected component of the ear when ototoxicity arises, but if the nerve is affected, the damage is most often permanent. Symptoms present similar to those resulting from vestibular and cochlear damage, including tinnitus, ringing of the ears, difficulty walking, deafness, and balance and orientation issues.

Ototoxicants in the environment and workplace

Ototoxic effects are also seen with quinine, pesticides, solvents, asphyxiants (such as carbon monoxide) and heavy metals such as mercury and lead.[4][5][36] When combining multiple ototoxicants, the risk of hearing loss becomes greater.[37] As these exposures are common, this hearing impairment can affects many occupations and industries.[38]

Ototoxic chemicals in the environment (from contaminated air or water) or in the workplace interact with mechanical stresses on the hair cells of the cochlea in different ways. For organic solvents such as toluene, styrene or xylene, the combined exposure with noise increases the risk of occupational hearing loss in a synergistic manner.[4][39] The risk is greatest when the co-exposure is with impulse noise.[40][41] Carbon monoxide has been shown to increase the severity of the hearing loss from noise.[39] Given the potential for enhanced risk of hearing loss, exposures and contact with products such as paint thinners, degreasers, white spirits, exhaust, should be kept to a minimum. Noise exposures should be kept below 85 decibels, and the chemical exposures should be below the recommended exposure limits given by regulatory agencies.

Drug exposures mixed with noise potentially lead to increased risk of ototoxic hearing loss. Noise exposure combined with the chemotherapeutic cisplatin puts individuals at increased risk of ototoxic hearing loss.[33] Noise at 85 dB SPL or above added to the amount of hair cell death in the high frequency region of the cochlea In chinchillas.[42]

The hearing loss caused by chemicals can be very similar to a hearing loss caused by excessive noise. A 2018 informational bulletin by the US Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) introduces the issue, provides examples of ototoxic chemicals, lists the industries and occupations at risk and provides prevention information.[43]

Treatment

No specific treatment may be available, but withdrawal of the ototoxic drug may be warranted when the consequences of doing so are less severe than those of the ototoxicity.[5] Co-administration of anti-oxidants may limit the ototoxic effects.[33]

Ototoxic monitoring during exposure is recommended by the American Academy of Audiology to allow for proper detection and possible prevention or rehabilitation of the hearing loss through a cochlear implant or hearing aid. Monitoring can be completed through performing otoacoustic emissions testing or high frequency audiometry. Successful monitoring includes a baseline test before, or soon after, exposure to the ototoxicant. Follow-up testing is completed in increments after the first exposure, throughout the cessation of treatment. Shifts in hearing status are monitored and relayed to the prescribing physician to make treatment decisions.[44]

It is difficult to distinguish between nerve damage and structural damage due to similarity of the symptoms. Diagnosis of ototoxicity typically results from ruling out all other possible sources of hearing loss and is often the catchall explanation for the symptoms. Treatment options vary depending on the patient and the diagnosis. Some patients experience only temporary symptoms that do not require drastic treatment while others can be treated with medication. Physical therapy may prove useful for regaining balance and walking abilities. Cochlear implants are sometimes an option to restore hearing. Such treatments are typically taken to comfort the patient, not to cure the disease or damage caused by ototoxicity. There is no cure or restoration capability if the damage becomes permanent,[45][46] although cochlear nerve terminal regeneration has been observed in chickens,[47] which suggests that there may be a way to accomplish this in humans.

See full Wikipedia article below

Article from US National Library of Medicine National Institutes of Health

Bilateral Vestibular Dysfunction Associated With Chronic Exposure to Military Jet Propellant Type-Eight Jet Fuel

European Commission – Pregnant Worker Directive 92/85/EC

Directive 92/85/EC – Pregnant Workers

Introduced 19th of October 1992

Pregnant woman standing outside on a sunny day

Objective

The objective of this Directive is to protect the health and safety of women in the workplace when pregnant or after they have recently given birth and women who are breastfeeding.

Contents

Under the Directive, a set of guidelines detail the assessment of the chemical, physical and biological agents and industrial processes considered dangerous for the health and safety of pregnant women or women who have just given birth and are breast feeding.

The Directive also includes provisions for physical movements and postures, mental and physical fatigue and other types of physical and mental stress.

Pregnant and breastfeeding workers may under no circumstances be obliged to perform duties for which the assessment has revealed a risk of exposure to agents, which would jeopardize their safety or health. Those agents and working conditions are defined in Annex II of the Directive.

Member States shall ensure that pregnant workers are not obliged to work in night shifts when medically indicated (subject to submission of a medical certificate).

Employers or the health and safety service will use these guidelines as a basis for a risk evaluation for all activities that pregnant or breast feeding workers may undergo and must decide what measures should be taken to avoid these risks. Workers should be notified of the results and of measures to be taken which can be adjustment of working conditions, transfer to another job or granting of leave.

The Directive grants maternity leave for the duration of 14 weeks of which 2 weeks must occur before birth.

Women must not be dismissed from work because of their pregnancy and maternity for the period from the beginning of their pregnancy to the end of the period of leave from work.

Annex I – Non exhaustive list of agents and working conditions referred to in Art.4 of the directive (assessment and information)

A. Agents

1. Physical agents where these are regarded as agents causing foetal lesions and/or likely to disrupt placental attachment, and in particular:

(a) shocks, vibration or movement;

(b) handling of loads entailing risks, particularly of a dorsolumbar nature;

(c) noise;

(d) ionizing radiation (*);

(e) non-ionizing radiation;

(f) extremes of cold or heat;

(g) movements and postures, travelling – either inside or outside the establishment – mental and physical fatigue and other physical burdens connected with the activity of the worker within the meaning of Article 2 of the Directive.

2. Biological agents

Biological agents of risk groups 2, 3 and 3 within the meaning of Article 2 (d) numbers 2, 3 and 4 of Directive 90/679/EEC (¹), in so far as it is known that these agents or the therapeutic measures necessitated by such agents endanger the health of pregnant women and the unborn child and in so far as they do not yet appear in Annex II.

3. Chemical agents

The following chemical agents in so far as it is known that they endanger the health of pregnant women and the unborn child and in so far as they do not yet appear in Annex II:

(a) substances labelled R40 (limited evidence of a carcinogenic effect), R45 (May cause cancer), R46 (May cause inheritable genetic damage), and R47 (May cause birth defects) under Dangerous Substances Directive (67/548/EEC) in so far as they do not yet appear in Annex II;

(b) chemical agents in Annex I to Directive 90/394/EEC (Protection of workers from the risks related to exposure to carcinogens) ;

(c) mercury and mercury derivatives;

(d) antimitotic drugs;

(e) carbon monoxide;

(f) chemical agents of known and dangerous percutaneous absorption.

B. Processes

Industrial processes listed in Annex I to Directive 90/394/EEC.

C. Working conditions

Underground mining work.

Annex II – Non exhaustive list of agents and working conditions referred to in Art.6 of the directive (cases in which exposure is prohibited)

A. Pregnant workers within the meaning of Article 2 (a)

1. Agents

(a) Physical agents

Work in hyperbaric atmosphere, e.g. pressurized enclosures and underwater diving.

(b) Biological agents

The following biological agents:

– toxoplasma,

– rubella virus,

unless the pregnant workers are proved to be adequately protected against such agents by immunization.

(c) Chemical agents

Lead and lead derivatives in so far as these agents are capable of being absorbed by the human organism.

2. Working conditions

Underground mining work.

B. Workers who are breastfeeding within the meaning of Article 2 (c)

1. Agents

(a) Chemical agents

Lead and lead derivatives in so far as these agents are capable of being absorbed by the human organism.

2. Working conditions

Underground mining work.

*****

The Irish Army Air Corps only started carrying out “adequate” risk assessments in the past year so for 25 years pregnant females at Baldonnel were dangerously exposed to Carcinogens, Mutagens & Teratogens.

Any pregnant females working in proximity to running aircraft or aircraft being refueled, such as in the ramp area, or downwind of the ramp were exposed.

  • Exhaust gasses contain Carbon Monoxide as well as TetraEthyl Lead and other hydrocarbon fumes.
  • AVGAS – 100LL  refuelling fumes contained Gasoline, Tetraethyl Lead, Toluene, Xylene, Ethylbenzene, Cyclohexane, n-Hexane, Trimethylbenzene, Naphthalene and Isopropylbenzene.
  • AVTUR – Jet A1 refueling fumes contain Kerosine, Ethylbenzene, Xylene and Isopropylbenzene.
  • Fuel System Anti Icing additives used by the Irish Army Air Corps included 2-(2-methoxyethoxy)ethanol which is a known to cause reproductive and developmental toxic effects.

Furthermore pregnant females working in or entering into Avionics, ERF or Engineering Wing hangar were being exposed to further known Carcinogens, Mutagens and Teratogens including Dichloromethane, Isocyanates & Trichloroethylene to name but a few.

Due to the fact that the working dress & overalls of technicians were (and still are) brought home to be washed in domestic family washing machines it is extremely likely that pregnant spouses & partners of Air Corps personnel were also affected.

This may have lead to miscarriages, stillbirths, lifelong genetic diseases & developmental conditions such as autism in the children of personnel.