211057 2,4,6-Trinitrotoluene (TNT) Air Concentrations, Hemoglobin Changes, and Anemia Cases in Respirator Protected TNT Munitions Demilitarization Workers

Monday, November 9, 2009

Mel Bradley, PhD , University of South Florida College of Public Health, Tampa, FL
Background: 2,4,6-Trinitrotoluene (TNT) is an explosive used in munitions production that is known to cause both aplastic and hemolytic anemia in exposed workers. Anemia in a TNT worker is considered a SHE(O). Deaths have been reported secondary to aplastic anemia. Studies have shown that TNT systemic absorption is significant by both the respiratory and dermal routes. No studies encountered looked at hemoglobin change or anemia cases in respiratory protected workers.

Hypothesis: Respiratory protection is insufficient to protect TNT workers from the risk of anemia development and hemoglobin concentration drop.

Methods: A records review of eight groups of respiratory protected TNT workers' pre-exposure hemoglobin levels were compared with their during-exposure hemoglobin levels for statistically significant (alpha level 0.05) hemoglobin level changes; and anemia cases were recorded. Mean hemoglobin changes within each of the 8 groups of workers were then regressed on mean TNT air concentrations using air sampling that was performed closest in time to during-exposure hemoglobin follow-ups.

Results: Statistically significant hemoglobin level drops and anemia cases were apparent at TNT air concentrations about the REL and PEL in respiratory protected workers. There were no anemia cases or statistically significant hemoglobin level drops at concentrations about the TLV, however. For TNT air concentrations from 0.12mg/m^3 to 0.31mg/m^3 there was a strong positive linear association with regard to magnitude of hemoglobin change (r=0.996). Conclusion: Respiratory protection may be inadequate to prevent workers who are at risk for TNT skin absorption from developing anemia.

Learning Objectives:
Identify a potentially deadly form of anemia that 2,4,6-Trinitrotoluene has been associated with. Identify an occupational significant health event (SHE(O)) in a TNT munitions worker. List 2 routes of exposure by which munitions workers can be systemically exposed to TNT.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Delta Omega student nominee
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.