A cross-shift study of lung function, exhaled nitric oxide and inflammatory markers in blood in Norwegian cement production workers

This study investigated the possible effects of aerosol exposure on lung function, fractional exhaled nitric oxide (FeNO) and inflammatory markers in blood from Norwegian cement production workers across one work shift (0 to 8 h) and again 32 h after the non-exposed baseline registration. Ninety-five workers from two cement plants in Norway were recruited for the study. Assessment of lung function included spirometry and gas diffusion pre- and post-shift (0 and 8 h). FeNO concentrations were measured and blood samples collected at 0, 8 and 32 h. Blood analysis included cell counts of leukocytes and mediators of inflammation. The median respirable aerosol level was 0.3 mg/m3 (range 0.02-6.2 mg/m3). FEV1, FEF25-75% and DLCO decreased by 37 mL (p)0.04), 170 mL/s (p<0.001) and 0.17 mmol/min/kPa (p)0.02), respectively, across the shift. A 2 ppm reduction in FeNO between 0 and 32 h was detected (p)0.01). The number of leukocytes increased by 0.6 x 109 cells/l (p<0.001) across the shift, while fibrinogen levels increased by 0.02 g/l (p<0.001) from 0 to 32 h. TNF-R level increased and IL-10 decreased across the shift. Baseline levels of fibrinogen were associated with the highest level of respirable dust, and increased by 0.39 g/l (95% CI 0.06 to 0.72). The authors concluded that small cross-shift changes in lung function and inflammatory markers among cement production workers were observed, indicating that inflammatory effects may occur at exposure levels well below 1 mg/m3. However, because the associations between these acute changes and personal exposure measurements were weak and as the long-term consequences are unknown, these findings should be tested in a follow-up study.

Authors: Fell, Anne Kristin M.; Notoe, Hilde; Skogstad, Marit; Nordby, Karl-Christian; Eduard, Wijnand; Svendsen, Martin Veel; Oevsteboe, Reidun; Troeseid, Anne Marie Siebke; Kongerud, Johny Full Source: Occupational and Environmental Medicine 2011, 68(11), 799-805 (Eng) ;