Association of respirable cement mineral dust exposure with fractional exhaled nitric oxide and interleukin-8 on airways inflammation among cement workers in Negeri Sembilan, Malaysia
Prolonged exposure to cement dust may induce immunologic response due to high-level irritant-exposure. This study was to investigate the association of exposure to respirable cement mineral dust with the respiratory health performance by interpretation of Fractional Exhaled Nitric Oxide (FENO) an...
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| Format: | Thesis |
| Language: | English |
| Published: |
2020
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| Subjects: | |
| Online Access: | http://psasir.upm.edu.my/id/eprint/84715/1/FPSK%28p%29%202020%209%20UPM%20IR.pdf |
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| Summary: | Prolonged exposure to cement dust may induce immunologic response due to high-level
irritant-exposure. This study was to investigate the association of exposure to respirable
cement mineral dust with the respiratory health performance by interpretation of
Fractional Exhaled Nitric Oxide (FENO) and Interleukin-8 (IL-8) concentrations. A
cross-sectional comparative study was carried out among 179 cement workers consist
of manufacturing and administrative workers while 173 school staffs as a comparative
group in Negeri Sembilan by simple random sampling method. Personal respirable dust
exposure was collected by using air sampling pump. The cement mineral dust were
analysed by using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) for
Arsenic (As) and Chromium (Cr) while for the Silica (Si) by using X-ray powder
Diffraction (XRD) method. IL-8 concentrations were analysed using human ELISA kit
while FENO levels and Lung Function test were obtained by using NIOX MINO and
Chestgraph H1-105 spirometer. Mean and standard deviation of cement respirable dust
was higher in manufacturing workers with 4.94±3.32 mg/m³ and administrative workers
with 1.99±2.02 mg/m³ compared with comparative group at 1.18±0.78 mg/m³.
Geometric mean (GM) of Si, As and Cr concentrations in manufacturing workers were
5.23 ± 2.29 mg/m³, 0.10 ± 0.02 mg/m³ and 1.51 ± 2.47 mg/m³ respectively. Occurrence
of phlegm (χ2=26.868, p= <0.001) and cough (χ2=14.576, p= <0.001) were significantly
higher among cement workers compared to the comparative group. Lung function
abnormalities of FVC% predicted and FEV₁% predicted showed significantly
difference between cement workers and comparative group with (χ2=31.228, p =
<0.001) and (χ2=34.855, p = <0.001) respectively. IL-8 and FENO were significantly
higher among cement workers with GM, 239.33±1.67 pg/mL and 30.02 ± 26.55 ppb
respectively. There was positive correlation between respirable Si and Cr dust with
FENO level among administrative workers with (r= 0.646, p=0.004 and r=0.521,
p=0.013). There was significant correlation between respirable As dust with IL-8 concentrations among manufacturing workers (r=0.464, p=<0.001). After controlling
for confounders, the abnormalities of FVC% predicted and FEV₁% predicted were
significantly associated with the respirable Si dust among cement workers (OR=6.913;
CI=1.965-24.322 and OR=18.320; CI=3.078-109.027). Production of IL-8
concentrations in manufacturing workers were significantly influenced by the exposure
to respirable As dust concentrations and factor of not wearing a mask or respirator
(R2=0.402, all p=<0.05). FENO concentrations in administrative workers were
significantly influenced by the exposure to respirable Si dust (R2=0.584, p=0.006). The
higher concentration of FENO and IL-8 production are the indicator of airways
inflammation. Probability of cancer risks for Si, As and Cr VI dust exposure among
manufacturing workers were at 4.34 x 10-5, 1.11 x 10-3 and 6.99 x 10-3, respectively
after considering the control measures. Exposure to respirable cement dust contributed
to a high risk of lung impairment through various respiratory health symptoms, reducing
lung function level, increased IL-8 and FENO concentrations. Both manufacturing and
administrative workers showed a high prevalence of respiratory disease. Cement
workers were at high risk of getting cancerous and non-cancerous diseases while
working. It is recommended for the cement industry to improve their control measure
on exposure to cement dust and strictly enforce on wearing respirator among workers
especially administrative workers. |
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