All Hazards
Pregnancy and Ceramics
Possible hazards concerning pregnant or nursing women
There are four (4) large groups of hazards pregnant or nursing women must face in the world of ceramics and crystalware making :
-biological hazards,
-chemical hazards,
-ergonomic hazards,
-physical hazards.
For women who work, a certain number of countries such as Quebec have a specific legislation with regard to pregnant or nursing women.
There are various methods to eliminate at the source hazards to pregnancy :
- modification of the task which eliminates hazards,
- reassignment to a work station which does not involve hazards,
- pure and simple withdrawal from work when the two preceding options cannot apply.
I- Biological Hazards
A-Opportunistic infections
1-Introduction :
Micro-organisms are present everywhere in our environment: in the air, water, on surfaces, and on individuals of all kinds. They are invisible and relatively unperceived.
Micro-organisms are very numerous: 1 gram of earth may contain up to 25 billions micro-organisms (4 times the population of our planet).
The vast majority of micro-organisms in nature are saprophytes, i.e. that in the majority of situations they do not cause infections unless there are particular host conditions we will describe further : they are the opportunistic infections.
Pregnancy not being a disease, these infections have few chances to occur more frequently among pregnant ceramists than among those who are not.
2-Definition :
Infections among patients whose defence mechanisms are weakened, and this makes individuals particularly susceptible to infections. These infections are due to micro-organisms which usually are not very pathogenic.
Defence mechanisms, physiological, immunological can be disturbed, or a breach made in them, by a disease, a traumatism, or by procedures or products used for diagnostic or therapeutic goals.
Following are a few exemples.
3-Antibiotics and host defence mechanisms reduction :
A treatment by antibiotics modifies the normal flora of the skin, mucous membranes, digestive tract, and can lead to colonization of these organs by new micro-organisms.
This colonization is inoffensive if it is not followed by superinfection (invasion by indigenous germs, or micro-organisms from the environment).
Predisposing factors are :
Extremes of life
Chronic infections
Debilitating diseases
Use of excessive amounts of
antibiotics
Use of broad spectrum antibiotics
4- Modifications of anatomical barriers :
Ex : a)Patients suffering from extensive burns
b)Patients having undergone therapeutic or diagnostic procedures.
The normal anatomical barriers of these patients are broken and they can not fight infections any more.
5-Disturbances of cellular or humoral defence mechanisms :
Neoplastic and immunodeficiency diseases
Ex : - Leukemias
- Myelomas
- Aplastic anemia
-AIDS
-Gammapathies
- Systemic lupus erythematosus
-Etc.
Treatments by radiotherapy.
Intensive immunosuppressive therapy.
Etc.
6- Cytotoxic drugs :
Opportunist infections are then due to a severe leucopenia (lowering of white blood cells).
7-Corticosteroids :
Their systemic use disturbs many aspects of the host defence mecanisms.
In addition, those who suffer from Cushing’s syndrome (increased secretion of an endogenous corticosteroid, cortisol) have an increased susceptibility to infections
B-Biological hazards of the pregnant worker in educational and pre-school settings.
This part applies to women who work in the school world, in nurseries and in other similar places where the presence of children is the main characteristic.
1-Introduction :
For the majority of biological hazards, we consider close contact as the sharing of the same room as the customers at risk, usually six (6) children and more, for a period of one hour or
more. Generally, we do not consider significant the « one on one » type of contact with the customers at risk.
2-Without awaiting the occurence of cases :
a-Cytomegalovirus :
Immediate preventive withdrawal until the end of pregnancy for immune and non-immune workers in close contact with groups of children (6), younger than 5 years, in the following places :
Nurseries.
Serology is not necessary.
b-Parvovirus B 19 (5th disease) :
Preventive withdrawal from the beginning until the 20th week of pregnancy for non-immune workers (IgG) in close contact with groups of children (6) in the following places :
Elementary and secondary schools.
Preventive withdrawal while awaiting the result of serology.
c-Rubella :
Preventive withdrawal until the end of pregnancy for non-immune workers in close contact with groups of children (6) in the following places :
Elementary and secondary schools.
Preventive withdrawal while awaiting the result of serology in the absence of vaccination.
d-Chicken pox :
Preventive withdrawal until the end of pregnancy for unprotected workers in close contact with groups of children (6), 12 years old and less, in the following places :
Elementary schools and nurseries.
Is considered protected : a woman who has a documented history of chicken pox (serology is then not necessary) and a woman whose serology is positive.
Preventive withdrawal while awaiting the result of serology.
d-Mumps :
At the time of the declaration of one case in the class or the group (or in the environment at risk, during the course of an epidemic), preventive withdrawal up to
28 days after the last case.
Is considered protected : a woman born after 1969 and having received one dose of the vaccine, a woman having a doctor's certificate certifying that she suffered from the disease and a woman
having had a positive serology.
Are considered at risk the following places :
Nurseries, schools, vacation camps.
3-When there are cases in the work environment :
Here are recommendations for biological hazards in the work environment when there is an outbreak of cases.
a-Parvovirus B 19 :
When the presence of cases is confirmed in secondary schools, preventive withdrawal until the 20th week of pregnancy for the non-immune workers (IgG) in close
contact with groups of children (6).
Preventive withdrawal while awaiting the result of serology.
b-Whooping cough :
At the time of the declaration of a case
in the classroom or in the group of the worker (index case) or two
cases in the work environment. Are considered at the risk the
following places :
Nurseries, elementary and secondary
schools, holiday camps and youth reception centers.
Preventive withdrawal from the 30th
week of pregnancy until the end.
c-Measles :
At the time of the declaration of one
case in the work environment, preventive withdrawal up to 21 days after the last declared case for
the unprotected workers considered among the contacts.
Is considered protected
: a woman born in 1980 or after
and having received two doses of the vaccine, a woman born between
1970 and 1979 and having received one dose of the vaccine, a woman
born before January 1, 1970, a woman having a doctor's certificate
certifying that she suffered from measles and a woman having had a
positive serology.
Are defined as contacts
: Personnel of the whole nursery,
elementary or secondary schools, school buses.
d-Mumps :
At the time of the declaration of one
case in the class or the group (or in the environment at risk,
during an epidemic), preventive
withdrawal up to 28 days after
the last case.
Is considered protected
: a woman born after 1969 and
having received one dose of the vaccine, a woman having a doctor's
certificate certifying that she suffered from the disease and a
woman having had a positive serology.
Are considered at the risk the
following places :
Nurseries, schools, vacation
camps.
II-Chemical
Hazards
Introduction
To be harmful to the ceramist who is
pregnant or nurses, the chemical must be toxic, reach the
embryo/fœtus/infant in a sufficient amount and for a long enough
period of time.
It is not always easy to evaluate the
risk because in several cases the exposure to chemicals is
difficult to evaluate. There is not one ceramist who works exactly
in the same manner, who uses the same materials, or uses the same
amounts of a material in particular over a given period of
time.
It is obvious that the wearing of an
approved dust mask is good practice when dust air exposure
justifies it, as at the time of mixing, spraying of glazes, and
cleaning of the workshop, among other things.
In addition, exposure to carbon monoxide
can occur at the beginning of bisque firing, and during reduction
firing in a kiln using fossil fuel. It is also necessary to have
good ventilation of the workshop during firings.
Here are some definitions concerning
the effects on pregnancy :
Development (Effects on)
Indicate that effects can occur during
the antenatal (before birth) and/or postnatal (after birth until
puberty) development. These effects include/comprise congenital
malformations (teratogenic effect), effects on the embryo or
foetus (delay of growth, reduction in body weight, death, etc.) as
well as postnatal effects (behavioural problems etc).
Reproduction (Effects on)
Indicate that harmful biological effects
can occur during reproduction. These effects include/comprise the
deterioration of the functions or of the capacity of reproduction,
that is to say in particular spermatogenesis (formation of
spermatozoa), oogenesis (formation of ovules), hormonal activity
which could affect fecundation, conception.
Breast Milk (Data on)
Effects on the milk provided by the
mother to feed her child. The data presented relate to the
excretion or the detection of chemicals in milk as well as the
deterioration of the quality of the milk or the amount of milk
produced.
I-Following is a list of chemicals
for which no data was found in the consulted documentary sources
:
-Alumina,
-Alumina Hydrate,
-Antimony Trioxide,
-Arsenic Trioxide,
-Bismuth Trioxide,
-Cadmium Carbonate,
-Cadmium-Selenium Pigments,
-Cadmium Encapsulated Pigments,
-Calcium Carbonate,
-Cesium Monoxide,
-Chromium (Green Oxide),
-Cobalt Oxide,
-Copper, Black Oxide,
-Copper, Red Oxide,
-Copper Carbonate,
-Cristobalite,
-Cryolite,
-Dolomite,
-Dysprosium Oxide,
-Feldpars and Feldspathoids,
-Germanium Dioxide,
-Gold Chloride,
-Hafnium Oxide,
-Ilmenite,
-Iron, Red Oxide,
-Iron, Black Oxide,
-Iron, Yellow Oxide,
-Lead, Basic Carbonate,
-Lead, Red Oxide,
-Lead, Yellow Oxide,
-Lead Frits,
-Magnesium Carbonate,
-Man-Made Vitreous Fibers,
-Molybdene Trioxide,
-Nickel, Black Oxide,
-Nickel, Green Oxide,
-Niobium Pentoxide,
-Paraffin, thermal decomposition
products,
-Potassium Permaganate,
-Platinium Resinate,
-Potassium Carbonate,
-Rubidium Oxide,
-Rutile,
-Silica, Quartz,
-Silver Nitrate,
-Sodium Azide,
-Sodium Carbonate,
-Sodium Silicate,
-Strontium Carbonate,
-Talc,
-Tantalum Pentoxide,
-Rare Earths,
-Thallium Oxide,
-Thorium Dioxide,
-Tin Dioxide,
-Titanium Dioxide,
-Tungstene Dioxide,
-Uranium, Depleted ,
-Wollastonite,
-Wood Ash,
-Zinc Oxide,
-Zircomium Silicate.
II-Now, a list of chemicals for
which information was available in the consulted documentary
sources :
Ammonia
Effects on development :
No data concerning an effect on the
development was found in the consulted documentary sources
Ammonia is produced by the body. It is
also an essential constituent for the normal development of human
beings. An exposure in the work environment is not very likely to
lead to an increase in the blood ammonia level and thus, it does
not represent a hazard to development.
Effects on reproduction :
No data concerning the effects on
reproduction was found in the consulted documentary
sources.
Ammonia is normally produced by the
body. It is also an essential constituent for the normal
development of human beings. An exposure in the work environment
is not very likely to lead to an increase in the blood ammonia
level and thus, it does not represent a hazard for
reproduction.
Effects on breast milk :
It is detected in human mother's
milk.
Ammonia is a natural component of this
milk.
Antimony
Effects on development :
I-In rats :
One did not observe harmful effects in
the off-spring of female rats to which were given low
concentrations of antimony trichloride in drinking water.
II-In humans :
A Russian study suggests that the
exposure to antimony increases the risk of abortion and
prematurity; it was also reported in this study that antimony
crossed the placental barrier and was present in the amniotic
fluid, placental tissue and umbilical blood.
Effects on the reproduction :
It was suggested that antimony is the
cause of menstrual disturbances.
Effects on breast feeding :
Antimony can be excreted in mother's
milk.
Asbestos
Effects on development :
The available data do not make it
possible to make an adequate evaluation of the effects on
development.
Effects on reproduction :
The available data do not make it
possible to make an adequate evaluation of the effects on
reproduction.
Effects on breast milk :
There is no data concerning its
excretion or detection in milk.
Barium
Carbonate
Effects on development :
In animals :
No harmful anatomical effect was
observed in the off-springs of rats and mice receiving up to 4000
ppm of barium chloride dihydrate in water, even if the weight at
birth of the young ones was reduced.
Effects on reproduction :
In animals :
In rats and mice receiving up to 4000
ppm barium chloride dihydrate in water, the indices of
reproduction were not altered.
Effects on breast milk :
There is no data concerning its
excretion or detection in milk.
Beryllium
Oxide
Effects on the development :
It crosses the placental barrier in
humans.
The available data do not make it
possible to make an adequate evaluation of the effects on
development.
Effects on the reproduction
:
The data do not make it possible to make
an adequate evaluation of the effects on reproduction.
Effects on breast milk :
I-In animals :
It is excreted in the mother's
milk.
II-In humans :
There is no data concerning the
excretion of beryllium oxide in breast milk.
However, beryllium was measured in milk
(colostrum) in humans, but the source of the exposure is
unknown.
The reported values varied from less
than 0,05 to 1,6 µg/l.
Boron
Effects on development :
Concerning malformations, it seems that
no case was reported in man in the pertaining literature.
Effects on reproduction :
I-In animals :
Animal experiments have shown disorders
of reproduction related to the exposure to boric acid or borax.
Effects on testicles and fertility were highlighted. The mechanism
of this toxicity is not completely elucidated. In the female rat,
an increase in the number of miscarriages and a fall of the number
of litters were observed.
A study relating to development shows
that boric acid causes malformations in three (3) species studied
(rat, rabbit, mouse).
II-In humans :
An old study carried out in Russia on
levels varying from 20 to 83 mg/m3 at 50% of the studied work
stations i.e. 2 to 8 times the standard of exposure currently
allowed, showed a reduction of sexual activity and a deterioration
of the quality of the sperm.
In the USA, these results were not
confirmed in a study in 542 workers whose average exposure was
19.7 mg/m3.
Effects on breast milk :
There is no data concerning its
excretion or detection in milk.
Cadmium
Oxide
Effects on development :
It has an embryotoxic and/or foetotoxic
effect in the animal. It crosses the placental barrier in the
animal.
Effets on reproduction :
Toxic effects on reproduction were
observed in the rat : a reduced number of spermatozoa per testicle
and an increase in the length of the oestrous cycle.
No toxicity of reproduction was observed
in the mouse.
Effects on breast feeding :
It is excreted in the mother's milk in
the animal.
Carbon
Monoxide
Effects on the development :
I-In animals :
It has an embryotoxic and/or foetotoxic
effect in the animal. It can affect the postnatal development in
the animal.
II-In humans :
It crosses the placental barrier in
humans.
Effects on reproduction :
The available data do not make it
possible to make an adequate evaluation of its effects on
reproduction.
Data on breast milk :
There is no data concerning its
excretion or detection in mother's milk
Carbon monoxide intoxication and
pregnancy :
Carbon monoxide intoxication during
pregnancy poses particular problems. It seems that a significant
risk of foetal death and neurological anomalies exist following
exposure of the mother to CO, with a risk of foetal death varying
from 36 to 67 %. Ventilation being increased during pregnancy, it
is possible that CO pulmonary absorbtion is greater in the
pregnant woman. The affinity of foetal hemoglobin for CO is
greater than that of maternal hemoglobin. An equilibrium state
will be reached in the foetus and the elimination of CO is slower
for the foetal circulation. The maximum level of carboxyhemoglobin
reached during the intoxication could be greater in the foetus
than in the mother.
On the basis of retrospective data, it
seems that oxygen therapy is safe for the foetus and the mother.
Precise information on hyperbaric is not established in a final
manner but a carboxyhemoglobin of 15 % is often used by several
experts as a critical value because of the greatest
physiopathological sensitivity of the foetal circulation.
Cigarette smoke :
The exposure to tobacco smoke is also a
source of exposure to carbon monoxide which can be the cause of a
maternal and foetal carboxyhemoglobinemy. The exposure to tobacco
smoke during pregnancy can cause an increase in the frequency of
miscarriages, premature births, a reduction in the weight at
birth, etc.
Recommendation :
The lady worker should not be exposed to
CO levels exceeding 10 ppm weighted over 8 hours per workshift
from now on.
Cobalt Carbonate
Effects on development :
No data concerning antenatal development
was found in the consulted documentary sources.
It crosses the placental barrier in the
animal.
Effects on reproduction :
No data concerning reproduction was
found in the consulted documentary sources.
Effects on breast milk :
There is no data concerning its
excretion or detection in milk.
Dioxin (TCDD)
Effects on development :
I-In animals :
TCDD is teratogenic and toxic to the
foetus. Studies in laboratory animals suggest that dioxins alter
development (low birth weight, miscarriages, congenital
malformations, etc.)
TCDD crosses the placental
barrier.
II-In humans :
There are reports which indicate an
increase in miscarriages or congenital malformations, more
especially of the spine. We do not know much of the potential
effects of dioxins and other chlorinated compounds on the
development of the nervous system of children.
Effects on reproduction :
I-In animals :
The effects on reproduction seem to be
very sensitive indicators of the toxicity of dioxin. Sudies in
laboratory animals suggest unfavourable changes in reproduction
(fertility, development of sexual organs, disturbances in the
behaviour related to reproduction).
II-In humans :
We know few things of the potential
effects of dioxins and other chlorinated compounds on human
fertility. But occupational exposure to TCDD alters serum
concentrations of male reproduction hormones.
Effects on breast milk :
TCDD is found in mother's milk; high
levels of TCDD can be detected among adult children of mothers who
were exposed to dioxins as production workers.
Lead
In lead glazes, it is necessary to use
with precaution colouring materials such as oxides and carbonates
of copper, cobalt and nickel, because they tend to increase the
release of lead.
Sensitive populations :
People suffering from a neurological
dysfonction;
People suffering from a renal
disease;
People having certain genetic diseases,
such as thalassemia, glucose-6 phosphate dehydrogenase deficiency,
porphyrias, an excessive activity of the ALA synthase.
Children;
Pregnant or breast-feeding women;
The embryo or foetus;
Elderlies;
Smokers;
Alcoholics.
Inorganic Lead :
Effects on development :
In humans, harmful effects were reported
on embryonic, fœtal and postnatal (mental) development. The
nervous system under development appears more sensitive to lead
than the already developed nervous system, making the exposure to
lead dangerous during pregnancy and breast feeding. There is a
possibility of an increased incidence of miscarriages in
humans.
Research suggests an association between
paternal exposure to lead and the risk of miscarriages. In humans,
it crosses the placental barrier, and this transfer increases with
the duration of the pregnancy.
Effects on reproduction :
Harmful effects of lead on human
reproduction have been reported, but information on its possible
impact among exposed populations is limited. Lead intoxication
could cause a disturbance of LH secretation by the
hypophyso-hypothalamic axis, and could also result in direct
damage to the seminiferous testicular tubes.
Occupational exposure to lead seems to
cause menstrual problems.
Effects on breast milk :
Breast-fed children can be exposed to
lead via the mother's milk, but few data exist to evaluate and
quantify this relation. This route of exposure is a potential
hazard to children of nursing mothers currently exposed to lead
just as for the children of mothers having a former exposure to
lead, due to the release of the lead already stored in their bone
stores.
Pre-employment Examination
:
Women who are pregnant or who nurse
should not be exposed to lead.
Preventive Withdrawal from Work
:
Physicians must recommend that a lady
worker be withdrawn from work when she is pregnant.
Lithium
Carbonate
Effects on development :
I-In animals :
Animal studies suggest the possibility
of an increase in congenital malformations but the relation
between the exposure and the effect is not satisfactory because of
experimental limitations.
II-In humans :
In a study in humans, only one (1)
patient out of twenty-five (25) delivered a malformed baby.
It crosses the placental barrier.
Effects on reproduction :
In humans, no data concerning
reproduction was found in the consulted documentary sources
Effects on breast milk :
It is excreted in human mother's
milk.
Manganese, and Some
Inorganic Compounds
(Carbonate, Dioxide,
Oxide)
Effects on development :
Exposed pregnant women can present
spontaneous miscarriages. In Russia, there was an excess of
miscarriages among wives of workers employed in manganese
processing plants.
Effects on reproduction :
Manganese could disturb libido according
to some studies. It was indicated that a loss of libido and
impotence, sometimes preceded by a phase of hypersexuality, were
observed in subjects suffering from manganism.
Some studies showed a reduction of the
number of children generated by some male workers during the
period when they were exposed to manganese.
Effects on breast milk :
There is no data concerning excretion or
detection in milk.
Nickel, General
Information
Effects on development :
I - In animals :
Exposure of animals in gestation was
associated with delayed embryonic development, an increase in
resorptions, and an increase in structural malformations. It was
noted, however, that the doses used were high and cannot reflect
at all human exposures.
II-In humans :
Inceased incidences of congenital
malformations were observed, and also increased threatened
abortion and spontaneous miscarriages at the time of a study among
758 Russian women who were employed in a hydrometallurgic refinery
of nickel.
An increase by six (6) of the relative
risk of cardiovascular malformations was noted in the infants of
women exposed to nickel.
Effects on reproduction :
I-In animals:
In laboratory animals, a range of
effects on reproduction can be induced by nickel. In male rats,
exposure to nickel salts resulted in degenerative changes of the
testicles and epididymis, and effects on spermatogenesis.
II-In humans :
In the light of the results observed in
rodents, investigations are necessary to study the unfavourable
effects on reproduction among women exposed to nickel.
Effects on breast milk :
There is no data concerning its
excretion or detection in milk.
Tellurium Dioxide
Effects on development :
I-In animals :
According to the doses studied, TeO2
induced hydrocephaly, body oedema, exophthalmia, ocular
haemorrhages, umbilical hernias, small kidneys, and smaller
animals.
II-In humans :
No data concerning reproduction was
found in the consulted documentary sources.
Effects on reproduction :
I-In animals :
TeO2 induces maternal toxicity.
II-In humans :
No data concerning reproduction was
found in the consulted documentary sources.
Effects on breast milk :
There is no data concerning its
excretion or detection in milk.
Thallium,
Métal
Effects on development :
I-In animals :
It crosses the placental barrier.
II-In humans :
Apart from low birth weight and and
alopecia, fœtal development was not affected among 20 cases of
intoxication during pregnancy.
Effects on reproduction :
There is only a limited number of data
available on the effects of thallium on reproduction.
The menstrual cycle, libido and male
potency can be negatively affected.
Chronic intoxication can affect
sperm.
Effects on breast milk :
There is no data concerning its
excretion or detection in milk.
Vanadium
Effects on development :
In animals, high doses of vanadium can
affect to a significant degree the developpment of bones, and be
associated with fractures of the spine, but not
implantation.
Effects on reproduction :
I-In animals :
The studies of toxicity for reproduction
in the rat and the mouse are negative with nontoxic doses to the
mother.
II-In humans :
There is no indication that vanadium can
unfavourably influence reproduction.
Effects on breast milk
:
There is no data concerning its
excretion or detection in milk.
III-Ergonomic
Hazards
A-Work organization, number of hours
per day :
Recommendation
:
The pregnant worker should not work more
than 8 hours per day, 40 hours per week from the moment the
existence of her pregnancy is known.
B-Night work :
Recommendation :
The pregnant worker should avoid night
work and be reassigned to a day or evening job from the moment the
existence of her pregnancy is known.
C-Prolonged standing position :
Recommendation :
The pregnant worker should not have to
work more than 6 hours in this position per workshift starting
from the 24e week of pregnancy.
D-Pressure on the abdomen :
Recommendation :
The pregnant worker should avoid
pressure on the abdomen starting from the 24e week of pregnancy.
E-Frequent flexions of the trunk
(flexion, extension and rotation of the trunk) :
Recommendation :
The pregnant worker should avoid these
frequent movements starting from the 24e week of pregnancy.
F-Lifting of heavy loads :
Recommendation :
The pregnant worker should not lift
loads heavier than 15 kg, 10 times per day; or heavier than 10 kg,
15 times per day from the moment the existence of her pregnancy is
known.
In no time, should she lift loads
heavier than 20 kg.
IV-Physical Hazards
:
Work in a hot
environment.
Recommendation :
Considering that the standards of heat
stress are established for average and acclimatized workers, we
estimate that a pregnant worker should not be exposed to a WBGT
(Wet Bulb Globe Thermometer) greater than 25C.
Considering that the employers do not
have the appropriate equipment to measure WBGT, we will use a
chart of the temperature of ambiant air and relative humidity to
determine the thermal conditions not to exceed by a pregnant
worker who has an average workload.
This table applies if the worker is not
exposed to radiant heat and that she does not have to wear special
clothing nor an overall . Air draughts are not taken into
account.
The safe zone is located above the thick
line.
References :
1-Occupational Medicine, Carl Zenz,
last edition.
2-Clinical Environmental Health and
Toxic Exposures, Sullivan & Krieger, last edition.
3-Sax’s Dangerous Properties of
Industrial Materials, Lewis C., last edition.
4-Toxicologie Industrielle et
Intoxications Professionnelles, Lauwerys R., last
edition.
5-Chemical Hazards of the Workplace,
Proctor & Hughes, 4e édition.
6-CSST-Québec, Service du
Répertoire Toxicologique, 2005.
7-NIOSHTIC/OSHLINE, Canada,
2005.
8-National Library of Medicine,
Toxline Special, USA, 2005
9-The Biological and Clinical Basis
of Infectious Diseases, Shulman, Phair, Peterson & Warren,
last edition.
10-Vademecum Clinique du Diagnostique
et du Traitement, Fattorusso V. & Ritter O., last
edition.
By Edouard Bastarache
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Article by Edouard Bastarache
Edouard Bastarache is a well known doctor that has written many articles on the subject of toxicity of ceramic materials and books on technical aspects of ceramics. He writes in both English and French.
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