Levels and predictors of airborne and internal exposure to manganese and iron among welders
We investigated airborne and internal exposure to manganese (Mn) and iron (Fe) among welders. Personal sampling of welding fumes was carried out in 241 welders during a shift. Metals were determined by inductively coupled plasma mass spectrometry. Mn in blood (MnB) was analyzed by graphite furnace a...
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| Veröffentlicht in: | Journal of exposure science & environmental epidemiology 2012-05, Vol.22 (3), p.291-298 |
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| creator | Pesch, Beate Weiss, Tobias Kendzia, Benjamin Henry, Jana Lehnert, Martin Lotz, Anne Heinze, Evelyn Käfferlein, Heiko Udo Van Gelder, Rainer Berges, Markus Hahn, Jens-Uwe Mattenklott, Markus Punkenburg, Ewald Hartwig, Andrea Brüning, Thomas |
| description | We investigated airborne and internal exposure to manganese (Mn) and iron (Fe) among welders. Personal sampling of welding fumes was carried out in 241 welders during a shift. Metals were determined by inductively coupled plasma mass spectrometry. Mn in blood (MnB) was analyzed by graphite furnace atom absorption spectrometry. Determinants of exposure levels were estimated with multiple regression models. Respirable Mn was measured with a median of 62 (inter-quartile range (IQR) 8.4–320)
μ
g/m
3
and correlated with Fe (
r
=0.92, 95% CI 0.90–0.94). Inhalable Mn was measured with similar concentrations (IQR 10–340
μ
g/m
3
). About 70% of the variance of Mn and Fe could be explained, mainly by the welding process. Ventilation decreased exposure to Fe and Mn significantly. Median concentrations of MnB and serum ferritin (SF) were 10.30
μ
g/l (IQR 8.33–13.15
μ
g/l) and 131
μ
g/l (IQR 76–240
μ
g/l), respectively. Few welders were presented with low iron stores, and MnB and SF were not correlated (
r
=0.07, 95% CI −0.05 to 0.20). Regression models revealed a significant association of the parent metal with MnB and SF, but a low fraction of variance was explained by exposure-related factors. Mn is mainly respirable in welding fumes. Airborne Mn and Fe influenced MnB and SF, respectively, in welders. This indicates an effect on the biological regulation of both metals. Mn and Fe were strongly correlated, whereas MnB and SF were not, likely due to higher iron stores among welders. |
| doi_str_mv | 10.1038/jes.2012.9 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1017964948</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A288537398</galeid><sourcerecordid>A288537398</sourcerecordid><originalsourceid>FETCH-LOGICAL-c510t-d63f5906b401e6608ebd1af0dcfbeb863b3d07511d9c04ec92e607f92ac3bd743</originalsourceid><addsrcrecordid>eNqNkl1rFDEUhgdRbK3e-ANkQBCx7HoymcnHZSnVFha8URC8CJnkZDvLTLImM1X_fTPu2g8VkVwk5Dzn5H3DWxTPCSwJUPF2g2lZAamW8kFxSJpGLoDVnx_enCk5KJ6ktAGoa87gcXFQVZRzJshh8WWFV9inUntbbiPazowhpjK4UnexDdHjz1LnR4xe9yV-34Y0RSzHUA7ar7XHtEdi8KUegl-X37C3GNPT4pHTfcJn-_2o-PTu7OPp-WL14f3F6clqYRoC48Iy6hoJrK2BIGMgsLVEO7DGtdgKRltqgTeEWGmgRiMrZMCdrLShreU1PSpe7-ZuY_g6YRrV0CWDfZ_FhSkpAoRLVsta_AcKQlAmQGb05W_oJkzzHyRVsRoaThvJ_0XlWVIIIgTcUmvdo-q8C2PUZn5anVRCNJRTOYtb_oXKy-LQmeDRdfn-XsOrOw2XqPvxMoV-Grvg033wzQ40MaQU0alt7AYdf2SRas6QyhlSc4bUbPzF3tLUDmhv0F-hycDxDki55NcY73r-Y9w1ly_M0w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1009881880</pqid></control><display><type>article</type><title>Levels and predictors of airborne and internal exposure to manganese and iron among welders</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Pesch, Beate ; Weiss, Tobias ; Kendzia, Benjamin ; Henry, Jana ; Lehnert, Martin ; Lotz, Anne ; Heinze, Evelyn ; Käfferlein, Heiko Udo ; Van Gelder, Rainer ; Berges, Markus ; Hahn, Jens-Uwe ; Mattenklott, Markus ; Punkenburg, Ewald ; Hartwig, Andrea ; Brüning, Thomas</creator><creatorcontrib>Pesch, Beate ; Weiss, Tobias ; Kendzia, Benjamin ; Henry, Jana ; Lehnert, Martin ; Lotz, Anne ; Heinze, Evelyn ; Käfferlein, Heiko Udo ; Van Gelder, Rainer ; Berges, Markus ; Hahn, Jens-Uwe ; Mattenklott, Markus ; Punkenburg, Ewald ; Hartwig, Andrea ; Brüning, Thomas ; The Weldox Group</creatorcontrib><description>We investigated airborne and internal exposure to manganese (Mn) and iron (Fe) among welders. Personal sampling of welding fumes was carried out in 241 welders during a shift. Metals were determined by inductively coupled plasma mass spectrometry. Mn in blood (MnB) was analyzed by graphite furnace atom absorption spectrometry. Determinants of exposure levels were estimated with multiple regression models. Respirable Mn was measured with a median of 62 (inter-quartile range (IQR) 8.4–320)
μ
g/m
3
and correlated with Fe (
r
=0.92, 95% CI 0.90–0.94). Inhalable Mn was measured with similar concentrations (IQR 10–340
μ
g/m
3
). About 70% of the variance of Mn and Fe could be explained, mainly by the welding process. Ventilation decreased exposure to Fe and Mn significantly. Median concentrations of MnB and serum ferritin (SF) were 10.30
μ
g/l (IQR 8.33–13.15
μ
g/l) and 131
μ
g/l (IQR 76–240
μ
g/l), respectively. Few welders were presented with low iron stores, and MnB and SF were not correlated (
r
=0.07, 95% CI −0.05 to 0.20). Regression models revealed a significant association of the parent metal with MnB and SF, but a low fraction of variance was explained by exposure-related factors. Mn is mainly respirable in welding fumes. Airborne Mn and Fe influenced MnB and SF, respectively, in welders. This indicates an effect on the biological regulation of both metals. Mn and Fe were strongly correlated, whereas MnB and SF were not, likely due to higher iron stores among welders.</description><identifier>ISSN: 1559-0631</identifier><identifier>EISSN: 1559-064X</identifier><identifier>DOI: 10.1038/jes.2012.9</identifier><identifier>PMID: 22377681</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>704/172/169 ; Absorption ; Adolescent ; Adult ; Air Pollutants, Occupational - toxicity ; Base metal ; Biological effects ; Biological monitoring ; Blood ; Correlation ; Epidemiology ; Exposure ; Ferritin ; Fumes ; Health aspects ; Heavy metals ; Humans ; Inductively coupled plasma mass spectrometry ; Inhalation Exposure ; Iron ; Iron - toxicity ; Manganese ; Manganese - toxicity ; Mass spectrometry ; Mass spectroscopy ; Medicine ; Medicine & Public Health ; Metal workers ; Metals ; Middle Aged ; Multiple regression models ; Occupational Exposure ; Occupational health and safety ; original-article ; Regression analysis ; Scientific imaging ; Spectroscopy ; Ventilation ; Welders (Persons) ; Welding ; Welding fumes ; Welding machines</subject><ispartof>Journal of exposure science & environmental epidemiology, 2012-05, Vol.22 (3), p.291-298</ispartof><rights>Nature America, Inc. 2012</rights><rights>COPYRIGHT 2012 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group May 2012</rights><rights>Nature America, Inc. 2012.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c510t-d63f5906b401e6608ebd1af0dcfbeb863b3d07511d9c04ec92e607f92ac3bd743</citedby><cites>FETCH-LOGICAL-c510t-d63f5906b401e6608ebd1af0dcfbeb863b3d07511d9c04ec92e607f92ac3bd743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/jes.2012.9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/jes.2012.9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22377681$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pesch, Beate</creatorcontrib><creatorcontrib>Weiss, Tobias</creatorcontrib><creatorcontrib>Kendzia, Benjamin</creatorcontrib><creatorcontrib>Henry, Jana</creatorcontrib><creatorcontrib>Lehnert, Martin</creatorcontrib><creatorcontrib>Lotz, Anne</creatorcontrib><creatorcontrib>Heinze, Evelyn</creatorcontrib><creatorcontrib>Käfferlein, Heiko Udo</creatorcontrib><creatorcontrib>Van Gelder, Rainer</creatorcontrib><creatorcontrib>Berges, Markus</creatorcontrib><creatorcontrib>Hahn, Jens-Uwe</creatorcontrib><creatorcontrib>Mattenklott, Markus</creatorcontrib><creatorcontrib>Punkenburg, Ewald</creatorcontrib><creatorcontrib>Hartwig, Andrea</creatorcontrib><creatorcontrib>Brüning, Thomas</creatorcontrib><creatorcontrib>The Weldox Group</creatorcontrib><title>Levels and predictors of airborne and internal exposure to manganese and iron among welders</title><title>Journal of exposure science & environmental epidemiology</title><addtitle>J Expo Sci Environ Epidemiol</addtitle><addtitle>J Expo Sci Environ Epidemiol</addtitle><description>We investigated airborne and internal exposure to manganese (Mn) and iron (Fe) among welders. Personal sampling of welding fumes was carried out in 241 welders during a shift. Metals were determined by inductively coupled plasma mass spectrometry. Mn in blood (MnB) was analyzed by graphite furnace atom absorption spectrometry. Determinants of exposure levels were estimated with multiple regression models. Respirable Mn was measured with a median of 62 (inter-quartile range (IQR) 8.4–320)
μ
g/m
3
and correlated with Fe (
r
=0.92, 95% CI 0.90–0.94). Inhalable Mn was measured with similar concentrations (IQR 10–340
μ
g/m
3
). About 70% of the variance of Mn and Fe could be explained, mainly by the welding process. Ventilation decreased exposure to Fe and Mn significantly. Median concentrations of MnB and serum ferritin (SF) were 10.30
μ
g/l (IQR 8.33–13.15
μ
g/l) and 131
μ
g/l (IQR 76–240
μ
g/l), respectively. Few welders were presented with low iron stores, and MnB and SF were not correlated (
r
=0.07, 95% CI −0.05 to 0.20). Regression models revealed a significant association of the parent metal with MnB and SF, but a low fraction of variance was explained by exposure-related factors. Mn is mainly respirable in welding fumes. Airborne Mn and Fe influenced MnB and SF, respectively, in welders. This indicates an effect on the biological regulation of both metals. Mn and Fe were strongly correlated, whereas MnB and SF were not, likely due to higher iron stores among welders.</description><subject>704/172/169</subject><subject>Absorption</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Air Pollutants, Occupational - toxicity</subject><subject>Base metal</subject><subject>Biological effects</subject><subject>Biological monitoring</subject><subject>Blood</subject><subject>Correlation</subject><subject>Epidemiology</subject><subject>Exposure</subject><subject>Ferritin</subject><subject>Fumes</subject><subject>Health aspects</subject><subject>Heavy metals</subject><subject>Humans</subject><subject>Inductively coupled plasma mass spectrometry</subject><subject>Inhalation Exposure</subject><subject>Iron</subject><subject>Iron - toxicity</subject><subject>Manganese</subject><subject>Manganese - toxicity</subject><subject>Mass spectrometry</subject><subject>Mass spectroscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metal workers</subject><subject>Metals</subject><subject>Middle Aged</subject><subject>Multiple regression models</subject><subject>Occupational Exposure</subject><subject>Occupational health and safety</subject><subject>original-article</subject><subject>Regression analysis</subject><subject>Scientific imaging</subject><subject>Spectroscopy</subject><subject>Ventilation</subject><subject>Welders (Persons)</subject><subject>Welding</subject><subject>Welding fumes</subject><subject>Welding machines</subject><issn>1559-0631</issn><issn>1559-064X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkl1rFDEUhgdRbK3e-ANkQBCx7HoymcnHZSnVFha8URC8CJnkZDvLTLImM1X_fTPu2g8VkVwk5Dzn5H3DWxTPCSwJUPF2g2lZAamW8kFxSJpGLoDVnx_enCk5KJ6ktAGoa87gcXFQVZRzJshh8WWFV9inUntbbiPazowhpjK4UnexDdHjz1LnR4xe9yV-34Y0RSzHUA7ar7XHtEdi8KUegl-X37C3GNPT4pHTfcJn-_2o-PTu7OPp-WL14f3F6clqYRoC48Iy6hoJrK2BIGMgsLVEO7DGtdgKRltqgTeEWGmgRiMrZMCdrLShreU1PSpe7-ZuY_g6YRrV0CWDfZ_FhSkpAoRLVsta_AcKQlAmQGb05W_oJkzzHyRVsRoaThvJ_0XlWVIIIgTcUmvdo-q8C2PUZn5anVRCNJRTOYtb_oXKy-LQmeDRdfn-XsOrOw2XqPvxMoV-Grvg033wzQ40MaQU0alt7AYdf2SRas6QyhlSc4bUbPzF3tLUDmhv0F-hycDxDki55NcY73r-Y9w1ly_M0w</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Pesch, Beate</creator><creator>Weiss, Tobias</creator><creator>Kendzia, Benjamin</creator><creator>Henry, Jana</creator><creator>Lehnert, Martin</creator><creator>Lotz, Anne</creator><creator>Heinze, Evelyn</creator><creator>Käfferlein, Heiko Udo</creator><creator>Van Gelder, Rainer</creator><creator>Berges, Markus</creator><creator>Hahn, Jens-Uwe</creator><creator>Mattenklott, Markus</creator><creator>Punkenburg, Ewald</creator><creator>Hartwig, Andrea</creator><creator>Brüning, Thomas</creator><general>Nature Publishing Group US</general><general>Nature Publishing 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and predictors of airborne and internal exposure to manganese and iron among welders</title><author>Pesch, Beate ; Weiss, Tobias ; Kendzia, Benjamin ; Henry, Jana ; Lehnert, Martin ; Lotz, Anne ; Heinze, Evelyn ; Käfferlein, Heiko Udo ; Van Gelder, Rainer ; Berges, Markus ; Hahn, Jens-Uwe ; Mattenklott, Markus ; Punkenburg, Ewald ; Hartwig, Andrea ; Brüning, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c510t-d63f5906b401e6608ebd1af0dcfbeb863b3d07511d9c04ec92e607f92ac3bd743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>704/172/169</topic><topic>Absorption</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Air Pollutants, Occupational - toxicity</topic><topic>Base metal</topic><topic>Biological effects</topic><topic>Biological monitoring</topic><topic>Blood</topic><topic>Correlation</topic><topic>Epidemiology</topic><topic>Exposure</topic><topic>Ferritin</topic><topic>Fumes</topic><topic>Health aspects</topic><topic>Heavy metals</topic><topic>Humans</topic><topic>Inductively coupled plasma mass spectrometry</topic><topic>Inhalation Exposure</topic><topic>Iron</topic><topic>Iron - toxicity</topic><topic>Manganese</topic><topic>Manganese - toxicity</topic><topic>Mass spectrometry</topic><topic>Mass spectroscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metal workers</topic><topic>Metals</topic><topic>Middle Aged</topic><topic>Multiple regression models</topic><topic>Occupational Exposure</topic><topic>Occupational health and safety</topic><topic>original-article</topic><topic>Regression analysis</topic><topic>Scientific imaging</topic><topic>Spectroscopy</topic><topic>Ventilation</topic><topic>Welders (Persons)</topic><topic>Welding</topic><topic>Welding fumes</topic><topic>Welding machines</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pesch, Beate</creatorcontrib><creatorcontrib>Weiss, Tobias</creatorcontrib><creatorcontrib>Kendzia, Benjamin</creatorcontrib><creatorcontrib>Henry, Jana</creatorcontrib><creatorcontrib>Lehnert, Martin</creatorcontrib><creatorcontrib>Lotz, Anne</creatorcontrib><creatorcontrib>Heinze, Evelyn</creatorcontrib><creatorcontrib>Käfferlein, Heiko Udo</creatorcontrib><creatorcontrib>Van Gelder, Rainer</creatorcontrib><creatorcontrib>Berges, Markus</creatorcontrib><creatorcontrib>Hahn, Jens-Uwe</creatorcontrib><creatorcontrib>Mattenklott, Markus</creatorcontrib><creatorcontrib>Punkenburg, Ewald</creatorcontrib><creatorcontrib>Hartwig, Andrea</creatorcontrib><creatorcontrib>Brüning, Thomas</creatorcontrib><creatorcontrib>The Weldox Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE 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Science Collection</collection><collection>ProQuest Central Basic</collection><collection>Environment Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of exposure science & environmental epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pesch, Beate</au><au>Weiss, Tobias</au><au>Kendzia, Benjamin</au><au>Henry, Jana</au><au>Lehnert, Martin</au><au>Lotz, Anne</au><au>Heinze, Evelyn</au><au>Käfferlein, Heiko Udo</au><au>Van Gelder, Rainer</au><au>Berges, Markus</au><au>Hahn, Jens-Uwe</au><au>Mattenklott, Markus</au><au>Punkenburg, Ewald</au><au>Hartwig, Andrea</au><au>Brüning, Thomas</au><aucorp>The Weldox Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Levels and predictors of airborne and internal exposure to manganese and iron among welders</atitle><jtitle>Journal of exposure science & environmental epidemiology</jtitle><stitle>J Expo Sci Environ Epidemiol</stitle><addtitle>J Expo Sci Environ Epidemiol</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>22</volume><issue>3</issue><spage>291</spage><epage>298</epage><pages>291-298</pages><issn>1559-0631</issn><eissn>1559-064X</eissn><abstract>We investigated airborne and internal exposure to manganese (Mn) and iron (Fe) among welders. Personal sampling of welding fumes was carried out in 241 welders during a shift. Metals were determined by inductively coupled plasma mass spectrometry. Mn in blood (MnB) was analyzed by graphite furnace atom absorption spectrometry. Determinants of exposure levels were estimated with multiple regression models. Respirable Mn was measured with a median of 62 (inter-quartile range (IQR) 8.4–320)
μ
g/m
3
and correlated with Fe (
r
=0.92, 95% CI 0.90–0.94). Inhalable Mn was measured with similar concentrations (IQR 10–340
μ
g/m
3
). About 70% of the variance of Mn and Fe could be explained, mainly by the welding process. Ventilation decreased exposure to Fe and Mn significantly. Median concentrations of MnB and serum ferritin (SF) were 10.30
μ
g/l (IQR 8.33–13.15
μ
g/l) and 131
μ
g/l (IQR 76–240
μ
g/l), respectively. Few welders were presented with low iron stores, and MnB and SF were not correlated (
r
=0.07, 95% CI −0.05 to 0.20). Regression models revealed a significant association of the parent metal with MnB and SF, but a low fraction of variance was explained by exposure-related factors. Mn is mainly respirable in welding fumes. Airborne Mn and Fe influenced MnB and SF, respectively, in welders. This indicates an effect on the biological regulation of both metals. Mn and Fe were strongly correlated, whereas MnB and SF were not, likely due to higher iron stores among welders.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>22377681</pmid><doi>10.1038/jes.2012.9</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1559-0631 |
| ispartof | Journal of exposure science & environmental epidemiology, 2012-05, Vol.22 (3), p.291-298 |
| issn | 1559-0631 1559-064X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1017964948 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | 704/172/169 Absorption Adolescent Adult Air Pollutants, Occupational - toxicity Base metal Biological effects Biological monitoring Blood Correlation Epidemiology Exposure Ferritin Fumes Health aspects Heavy metals Humans Inductively coupled plasma mass spectrometry Inhalation Exposure Iron Iron - toxicity Manganese Manganese - toxicity Mass spectrometry Mass spectroscopy Medicine Medicine & Public Health Metal workers Metals Middle Aged Multiple regression models Occupational Exposure Occupational health and safety original-article Regression analysis Scientific imaging Spectroscopy Ventilation Welders (Persons) Welding Welding fumes Welding machines |
| title | Levels and predictors of airborne and internal exposure to manganese and iron among welders |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-11T18%3A19%3A51IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Levels%20and%20predictors%20of%20airborne%20and%20internal%20exposure%20to%20manganese%20and%20iron%20among%20welders&rft.jtitle=Journal%20of%20exposure%20science%20&%20environmental%20epidemiology&rft.au=Pesch,%20Beate&rft.aucorp=The%20Weldox%20Group&rft.date=2012-05-01&rft.volume=22&rft.issue=3&rft.spage=291&rft.epage=298&rft.pages=291-298&rft.issn=1559-0631&rft.eissn=1559-064X&rft_id=info:doi/10.1038/jes.2012.9&rft_dat=%3Cgale_proqu%3EA288537398%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1009881880&rft_id=info:pmid/22377681&rft_galeid=A288537398&rfr_iscdi=true |