1. Employee’s Skin
The skin of the workers is thought to play an important role in the transmission of occupational pollutants. Many studies report contamination in workers’ hands, forearms, forehead, and feet (14). Skin contamination often occurs among those who do not adhere to hygiene practices such as hand washing and showering before leaving their workplace or who do not shower immediately upon arrival. For example, in facilities with appropriate infrastructure, workers washing their hands and showering at the end of the shift led to low skin lead levels at the end of the shift (15). Pollutants carried on the skin of the workers can be transferred to the vehicles (10) and the home floor (16).
2. Contaminated Hair
Although there is little evidence to support the hypothesis that occupational pollutants are carried home by hair, measurements of potentially transported allergens in workers’ homes in this way have been reported (17, 18). The study by Krop et al. (17) shows that hair can be a source of animal allergen transport to an environment that does not contain allergens.
3. Contaminated Clothing and Shoes
Studies in the literature have shown evidence based on indirect and direct measurements that pollutants can be transported home through contaminated clothing and shoes. Significant levels of pollution have been found in locker rooms where clothes contaminated with occupational pollutants are changed. Based on these findings, contaminated clothing was thought to be a potential source of contamination in workers’ homes. Another evidence showing that clothing is a potential source of contamination is the detection of high pollutant levels in children whose parents wear contaminated clothing at home (19). In their study, Lu et al. (20) reported that the rate of pesticides taken home by means of boots was high in the swab samples taken from parents’ work boots.
4. Items Moved Home from Work
Employees can take work tools and equipment with them, carry them in their vehicles, or take them from work to home for their own use (6). For example; it is possible for agricultural workers to get pesticides from the workplace to use in their homes.
5. Contaminated Vehicles
Tools can mediate the home transport of occupational pollutants, both as a “reservoir” and as a “vector”. They also serve as a microenvironment where pollutants can contaminate all family members (2). A significant relationship has been found between home and vehicle concentrations of occupational pollutants and urine metabolite levels in workers and their children (21).
6. Workplace Visit of Family Members
Workplace visits by family members may also result in occupational contaminants being moved home, although this is different from exposures carried home by parents. For example; immunoglobulin E antibodies specific to laboratory animal allergens were detected in children who developed a cough and rhinitis clinic after they visited the workplace of their parents working in an animal laboratory (22).
7. Professional Preferences and Hobbies
It is an issue that should be taken into account that the parenting profession is also maintained by children. Children exposed to pollutants through the parent’s occupation may increase their risk of sensitization if they continue the same profession in their adulthood. Another factor to consider is the exposures associated with hobbies. It is useful and necessary to detail the anamnesis to include these areas as well as the occupation questions.
1. Chronic Beryllium Disease (Berylliosis)
In the literature, there are case series and cohort studies reported in the families of the employees regarding this potentially fatal granulomatous lung disease (25, 26). It is found in the families of employees who are exposed to beryllium in the workplaces involved in the production of fluorescent lights, beryllium and gyroscopes, and in the nuclear and aviation industries.
2. Asbestos and Its Effects
In studies evaluating the health effects of asbestos on families of asbestos workers, diseases such as asbestosis, mesothelioma, pleural plaques and cancer have been reported. Twenty percent of mesothelioma cases were attributed to take-home exposures (27), and it was reported that a large number of asbestos fibers were found in the lungs of family members of exposed workers (28). An increased risk of mesothelioma was found in a large cohort study conducted among the spouses of asbestos workers in Italy, but no relation with lung cancer was found (29).
3. Lead and Its Effects
It is evidence-based information that lead poisoning causes a variety of problems in children, ranging from behavioral disorders to brain damage. High blood lead levels may adversely affect the reproductive system in women and men, and cause irreversible neurological damage in pregnant women by affecting the fetus (30). In a meta-analysis study conducted in the United States of America (USA), it has been suggested that the risk of detecting high blood lead levels is higher in the children of workers exposed to lead (31). According to this meta-analysis, it is predicted that 723,500 employees in the USA work in industries that have the potential to take lead home, and two-thirds of them have a significant risk of taking home. In the study conducted by Whelan et al. (8), it was found that children of construction workers who were exposed to lead were six times more likely to have high blood lead levels compared to the children of those who were not exposed, and also their homes had higher lead dust levels.
4. Pesticide and Its Effects
Home transport of pesticides (main organophosphates) by agricultural workers has been well documented in the literature since the mid-1990s. The agricultural jobs of the parents were found to be significantly associated with taking home pesticides (32). Studies have consistently found high levels of organophosphate (33) in the homes of agricultural workers and high levels of metabolites (20) in the urine of their children. In the studies conducted, high organophosphate levels (33) and high metabolite levels in the urine of their children (20) were found in the homes of agricultural workers. Agricultural based take-home pesticide exposure is a major health problem among children in rural communities.
5. Arsenic and Its Effects
Agricultural use of pesticides and herbicides containing arsenic can pollute the home environment. Klemmer et al. (34) concluded that arsenic could be carried home through work clothes. In a study, extremely high levels of arsenic dust were found in the homes of families working in the wood processing field in Hawaii (4). It has also been emphasized that arsenic coming from the workplace may cause cancer development in children. Four cases of hepatic angiosarcoma, a rare tumor in children, have been reported in the literature. One of the cases was associated with arsenic exposure moved home from work (35).
6. Mercury and Its Effects
Toxic mercury exposure is a health problem that is becoming common worldwide. Recent studies show that mercury exposure may be mediated by the occupational and home environment with an increasing ratio, as well as from the general environment. Children are particularly vulnerable to mercury poisoning, as it can lead to pulmonary and nephrotic damage as well as a developing central nervous system disorder. In a study, children of employees who work in a facility producing mercury thermometers were found to have higher urine mercury levels in the study group compared to the control group. At the same time, higher levels of mercury in air were measured in the homes of workers who work in facilities producing thermometers (36). This study showed that toxic mercury can be carried home through shoes or clothing.
7. Polycyclic Compounds and Their Effects
One of the leading reports of a disease in family members attributed to workplace pollutants was published in 1943. This disease was associated with Halowax, a mixture of pentachloronaphthalene, hexachloronaphthalene and chlorinated biphenyl, used for insulation of electrical cables. Acneiform lesions (chloracne) called “Halowax Acne” developed in 52 isolation workers exposed to Halowax. Workers’ spouses also had similar acneiform lesions, most likely due to contact exposure with contaminated workwear (37). Similar clinical pictures occurring in workers and their families at similar production sites where polycyclic compounds are used have been reported in the literature.
8. Synthetic Estrogens
There are few studies in the literature on exposure to synthetic estrogens that are brought home as occupational pollutants. Gynecomastia has been reported in the sons of several employees of a chemical plant producing synthetic animal estrogen called zeranol in the Indianapolis city of the USA. In the later examination, zeranol was found in the work clothes of the workers (38).
9. Radioactive Contamination
Radioactive agents as occupational pollutants transported to the home have been less studied and there is insufficient data in the relevant literature. In a study, samples taken from the hair of employees working in the nuclear energy, pharmaceutical and biotechnology industries using C14 radionuclide, were evaluated in terms of contamination with the help of accelerator mass spectrometry. C14 contamination was detected in the analyzes, but it could not be clearly distinguished whether there was an occupational contamination (39). Another case example was reported as an industrial accident due to careless handling of a source of Cs-137, a radionuclide, by the worker. Contamination was found in the urine sample of the spouse of the employee who was exposed to radionuclide body load of the employee (40).
10. Infectious Agents
Hospital and laboratory workers and agricultural workers can transmit infectious pollutants such as scabies, Coxiella Burnetti (Q fever agent) and MRSA to household members through their skin and clothing. Workers can mediate the home transport of these pollutants, both as a “reservoir” and as a “vector”. In studies conducted, MRSA contamination was found in samples taken from the homes and in the family members of healthcare workers who are MRSA carriers (41). In another study, it was determined that the spouse of a goat farm worker who was diagnosed with Q fever was also diagnosed with the same disease months later, and it was thought that the contamination occurred as a result of washing the contaminated work clothes (42).
11. Nanomaterials
If at least one dimension of the material is between 1 and 100 nm, that material is called a nanomaterial. All over the world, interest in this sector is increasing day by day. Nanomaterials are widely used in many sectors due to their superior properties, so the number of employees exposed to these materials is also increasing. The precautions to be taken during the use, transportation and most importantly the production of these materials (43), which are newly emerging with a wide variety of harmful effects on human health and which are also proven to have asbestos-like properties, are of great importance. Nanoparticles can be dispersed in the working environment by means of air, water and clothing. Therefore, it has become necessary to clean workwear in a specialized facility in order not to transport nanoparticles (especially carbon nanotubes) and limit the risk of contamination of workers’ homes (44). Despite the existence of various studies and studies in the literature, the effect of nanotoxicity on human health is not yet fully understood (45). Studies to investigate the health effects of nanomaterials, which have the potential to be moved home as an occupational pollutant, on employees and their families should be developed and continued.
