Pulmonary function in workers exposed to diesel exhausts: the effect of control measures

Diesel engine exhaust exposure in underground mines: Comparison between different surrogates of particulate exposure

Exposure to diesel particulate matter (DPM) is frequently assessed by measuring indicators of carbon speciation, but these measurements may be affected by organic carbon (OC) interference. Furthermore, there are still questions regarding the reliability of direct-reading instruments (DRI) for measuring DPM, since these instruments are not specific and may be interfered by other aerosol sources. This study aimed to assess DPM exposure in 2 underground mines by filter-based methods and DRI and to assess the relationship between the measures of elemental carbon (EC) and the DRI to verify the association of these instruments to DPM. Filter-based methods of respirable combustible dust (RCD), EC, and total carbon (TC) were used to measure levels of personal and ambient DPM. For ambient measurements, DRI were used to monitor particle number concentration (PNC; PTrak), particle mass concentration (DustTrak DRX and DustTrak 8520), and the submicron fraction of EC (EC_1;Airtec). The association between ambient EC and the DRI was assessed by Spearman correlation. Geometric mean concentrations of RCD, respirable TC (TC_R) and respirable elemental EC (EC_R) were 170 µg/m³, 148 µg/m³, and 83 µg/m³ for personal samples, and 197 µg/m³, 151 µg/m³, and 100 µg/m³ for ambient samples. Personal measurements had higher TC_R:EC_R ratios compared to ambient samples (1.8 vs. 1.50) and weaker association between EC_R and TC_R. Among the DRI, the measures of EC₁ by the Airtec (ρ = 0.86; P < 0.001) and the respirable particles by the DustTrak 8520 (ρ = 0.74; P < 0.001) showed the strongest association with EC, while PNC showed a weak and non-significant association with EC. In conclusion, this study provided important information about the concentrations of DPM in underground mines by measuring several indicators using filter-based methods and DRI. Among the DRI, the Airtec proved to be a good tool for estimating EC concentrations and, although the DustTrak showed good association with EC, interferences from other aerosol sources should be considered when using this instrument to assess DPM.

Long-term exposure to diesel engine exhaust induced lung function decline in a cross sectional study

To clarify the effects of lung function following exposure to diesel engine exhaust (DEE), we recruited 137 diesel engine testing workers exposed to DEE and 127 non-DEE-exposed workers as study subjects. We performed lung function tests and measured cytokinesis-block micronucleus (CBMN) cytome index and levels of urinary polycyclic aromatic hydrocarbons (PAHs) metabolites. There was a significant decrease of forced expiratory volume in 1 second (FEV₁), ratio of forced expiratory volume in 1 second to forced vital capacity (FEV₁/ FVC), maximal mid expiratory flow curve (MMF), forced expiratory flow at 50% of FVC (FEF_50%), and forced expiratory flow at 75% of FVC (FEF_75%) in the DEE-exposed workers than non-DEE-exposed workers (all p<0.05). Among all study subjects, the decreases of FEF_75% were associated with the increasing levels of PAHs meta-bolites (p<0.05), and there were negative correlations between FEV₁, FEV₁/FVC, MMF, FEF_50%, and FEF_75% with CBMN cytome index (all p<0.05). Our results show that long-term exposure to DEE can induce lung function decline which shows mainly obstructive changes and influence of small airways function. The decreased lung function is associated with internal dosage of DEE exposure, and accompany with the increasing CBMN cytome index.

[Health effects of diesel exhaust: a state of the art]

INTRODUCTION

This review presents the state of knowledge regarding the acute and chronic toxicity of diesel engine exhaust in humans.

STATE OF ART

The health effects of diesel engine exhaust, which is a complex mixture of gas and particulate matter (ultrafine and fine particles), are mainly irritation of the respiratory tract and carcinogenicity. They may also facilitate the development of respiratory allergies. A recent reassessment by the International Agency for Research on Cancer concluded that there is sufficient evidence of a causal association between exposure to diesel engine exhaust and lung cancer.

PERSPECTIVES

The epidemiologic data collected during the last two decades also show limited evidence of increased risks of bladder cancer, as well as of chronic obstructive pulmonary disease in diesel engine exhaust exposed workers. Both experimental and epidemiological studies have involved the effect of emissions from traditional diesel engine technology. Major developments in this technology have occurred recently and the toxicity of emissions from these new engines is still to be characterized.

CONCLUSION

Further studies are needed to explore the link between diesel engine exhaust exposure and the risks of bladder cancer, as well as of chronic obstructive pulmonary disease and respiratory allergies. Research is also needed to get more information about the toxicity of the new diesel technology emissions.

Evaluation of in vitro cytoxicity and genotoxicity of size-fractionated air particles sampled during road tunnel construction

In tunnel construction, workers exposed to dust from blasting, gases, diesel exhausts, and oil mist have shown higher risk for pulmonary diseases. A clear mechanism to explain how these pollutants determine diseases is lacking, and alveolar epithelium's capacity to ingest inhaled fine particles is not well characterized. The objective of this study was to assess the genotoxic effect exerted by fine particles collected in seven tunnels using the cytokinesis-block micronuclei test in an in vitro model on type II lung epithelium A549 cells. For each tunnel, five fractions with different aerodynamic diameters of particulate matter were collected with a multistage cascade sampler. The human epithelial cell line A549 was exposed to 0.2 m(3)/mL equivalent of particulate for 24 h before testing. The cytotoxic effects of particulate matter on A549 cells were also evaluated in two different viability tests. In order to evaluate the cells' ability to take up fine particles, imaging with transmission electron microscopy of cells after exposure to particulate matter was performed. Particle endocytosis after 24 h exposure was observed as intracellular aggregates of membrane-bound particles. This morphologic evidence did not correspond to an increase in genotoxicity detected by the micronucleus test.

Occupational exposure to diesel engine exhaust: a literature review

Diesel exhaust (DE) is classified as a probable human carcinogen. Aims were to describe the major occupational uses of diesel engines and give an overview of personal DE exposure levels and determinants of exposure as reported in the published literature. Measurements representative of personal DE exposure were abstracted from the literature for the following agents: elemental carbon (EC), particulate matter (PM), carbon monoxide (CO), nitrogen oxide (NO), and nitrogen dioxide (NO(2)). Information on determinants of exposure was abstracted. In total, 3528 EC, 4166 PM, 581 CO, 322 NO, and 1404 NO(2) measurements were abstracted. From the 10,001 measurements, 32% represented exposure from on-road vehicles and 68% from off-road vehicles (30% mining, 15% railroad, and 22% others). Highest levels were reported for enclosed underground work sites in which heavy equipment is used: mining, mine maintenance, and construction (EC: 27-658 microg/m(3)). Intermediate exposure levels were generally reported for above-ground (semi-) enclosed areas in which smaller equipment was run: mechanics in a shop, emergency workers in fire stations, distribution workers at a dock, and workers loading/unloading inside a ferry (generally: EC<50 microg/m(3)). Lowest levels were reported for enclosed areas separated from the source, such as drivers and train crew, or outside, such as surface mining, parking attendants, vehicle testers, utility service workers, surface construction and airline ground personnel (EC<25 microg/m(3)). The other agents showed a similar pattern. Determinants of exposure reported for enclosed situations were ventilation and exhaust after treatment devices. Reported DE exposure levels were highest for underground mining and construction, intermediate for working in above-ground (semi-) enclosed areas and lowest for working outside or separated from the source. The presented data can be used as a basis for assessing occupational exposure in population-based epidemiological studies and guide future exposure assessment efforts for industrial hygiene and epidemiological studies.

Evaluation of primary DNA damage, cytogenetic biomarkers and genetic polymorphisms for CYP1A1 and GSTM1 in road tunnel construction workers

In tunnel construction workers, occupational exposure to dust (alpha-quartz and other particles from blasting), gases (nitrogen dioxide, NO(2)), diesel exhausts, and oil mist has been associated with lung function decline, induction of inflammatory reactions in the lungs with release of mediators that may influence blood coagulation, and increased risk of chronic obstructive pulmonary disease. The present molecular epidemiology study was designed to evaluate whether occupational exposure to indoor pollutants during road tunnel construction might result in genotoxic effects. A study group of 39 underground workers and a reference group of 34 unexposed subjects were examined. Primary and oxidative DNA damage, sister-chromatid exchanges (SCE), and micronuclei (MN) were measured in peripheral blood cells. The possible influences of polymorphisms in gene encoding for CYP1A1 and GSTM1 xenobiotic-metabolizing enzymes were also investigated. Exposure assessment was performed with detailed interviews and questionnaires. There were no significant differences in the level of primary and oxidative DNA damage and frequency of SCE between the tunnel workers and controls, whereas the frequency of MN showed a significant increase in exposed subjects compared to controls. No effects of CYP1A1 or GSTM1 variants were observed for the analyzed biomarkers. Since MN in peripheral blood lymphocytes are recognized as a predictive biomarker of cancer risk within a population of healthy subjects, the genotoxic risk of occupational exposure to various indoor environmental pollutants during road tunnel construction cannot be excluded by this biomonitoring study.

Cumulative exposure to dust and gases as determinants of lung function decline in tunnel construction workers

AIMS

To study the relation between lung function decrease and cumulative exposure to dust and gases in tunnel construction workers.

METHODS

A total of 651 male construction workers (drill and blast workers, tunnel concrete workers, shotcreting operators, and tunnel boring machine workers) were followed up by spirometric measurements in 1989-2002 for an average of six years. Outdoor concrete workers, foremen, and engineers served as a low exposed referent population.

RESULTS

The between worker component of variability was considerably reduced within the job groups compared to the whole population, suggesting that the workers within job groups had similar exposure levels. The annual decrease in FEV1 in low-exposed non-smoking workers was 21 ml and 24 ml in low-exposed ever smokers. The annual decrease in FEV1 in tunnel construction workers was 20-31 ml higher than the low exposed workers depending on job group for both non-smokers and ever smokers. After adjustment for age and observation time, cumulative exposure to nitrogen dioxide showed the strongest association with a decrease in FEV1 in both non-smokers, and ever smokers.

CONCLUSION

Cumulative exposure to nitrogen dioxide appeared to be a major risk factor for lung function decreases in these tunnel construction workers, although other agents may have contributed to the observed effect. Contact with blasting fumes should be avoided, diesel exhaust emissions should be reduced, and respiratory devices should be used to protect workers against dust and nitrogen dioxide exposure.

Respiratory symptoms and lung function in workers in heavy and highway construction: a cross-sectional study

BACKGROUND

Occupational exposures for workers in heavy and highway (HH) construction include cement-containing dusts and diesel exhaust (DE). To investigate possible health effects, respiratory symptoms and lung function were examined in laborers, tunnel workers (TW), and operating engineers (OE) in HH and tunnel construction. The principal outcome of interest was airways disease.

METHODS

Subjects were recruited through their unions. Medical and occupational histories and flow-volume loops were obtained. Based on self-report, asthma and chronic bronchitis were categorized as (1) physician-diagnosed or (2) for asthma, undiagnosed likely, and (3) for chronic bronchitis, symptomatic. Trade and time in the union were used as surrogates of exposure. Prevalence of asthma and chronic bronchitis, lung function outcome, and relationships with exposure variables were examined.

RESULTS

Data were obtained on 389 workers: 186 laborers, 45 TWs, and 158 OEs. Prevalence of asthma was 13 and 11.4% for laborers (including TW) and OEs, respectively, and of symptomatic chronic bronchitis, 6.5 and 1.9%, respectively. Odds ratios (OR) for undiagnosed asthma likely were significantly elevated in TWs compared to OEs, and marginally elevated for chronic bronchitis. Inverse relationships were observed between time in the union, and risk for asthma and chronic bronchitis. Asthma (physician-diagnosed or undiagnosed likely) predicted lower FEV(1). Current cigarette use was associated with chronic bronchitis but not asthma.

CONCLUSIONS

TWs, laborers, and OEs in HH construction are at increased risk for asthma. TWs also appear to be at increased risk for chronic bronchitis. Our data suggest that symptomatic workers are self-selecting out of their trade. Asthma was associated with lower lung function in those affected.

Airway inflammation after controlled exposure to diesel exhaust particulates

Epidemiologic evidence suggests a link between morbidity and mortality and levels of particulate matter in the atmosphere. We studied the inflammatory response to inhalation of diesel exhaust particulates (DEP) in normal volunteers. DEP were collected from the exhaust of a stationary diesel engine and were resuspended in an exposure chamber. Ten nonsmoking healthy volunteers were exposed for 2 h at rest to a controlled concentration of DEP (monitored at 200 microg/m(3) particulate matter of less than 10 microm aerodynamic diameter [PM(10)]) or air in a double-blind, randomized, crossover study. Exposures were followed by serial spirometry and measurement of pulse, blood pressure, exhaled carbon monoxide (CO), and methacholine reactivity, as well as sputum induction and venesection for up to 4 h after exposure, and a repeat of all these procedures at 24 h after exposure. There were no changes in cardiovascular parameters or lung function following exposure to DEP. Levels of exhaled CO were increased ater exposure to DEP, and were maximal at 1 h (air: 2.9 +/- 0.2 ppm [mean +/- SEM]; DEP: 4.4 +/- 0.3 ppm; p < 0.001). There was an increase in sputum neutrophils and myeloperoxidase (MPO) at 4 h after DEP exposure as compared with 4 h after air exposure (neutrophils: 41 +/- 4% versus 32 +/- 4%; MPO: 151 ng/ml versus 115 ng/ml, p < 0.01), but no change in concentrations of inflammatory markers in peripheral blood. Exposure to DEPs at high ambient concentrations leads to an airway inflammatory response in normal volunteers.

Increased risk of obstructive pulmonary disease in tunnel workers

BACKGROUND

Tunnel workers are exposed to gases and particles from blasting and diesel exhausts. The aim of this study was to assess the occurrence of respiratory symptoms and airflow limitation in tunnel workers and to relate these findings to years of exposure.

METHODS

Two hundred and twelve tunnel workers and a reference group of 205 other heavy construction workers participated in a cross sectional investigation. Exposure measurements were carried out to demonstrate the difference in exposure between the two occupational groups. Spirometric tests and a questionnaire on respiratory symptoms and smoking habits were applied. Atopy was determined by a multiple radioallergosorbent test (RAST). Radiological signs of silicosis were evaluated. Respiratory symptoms and lung function were studied in relation to years of exposure and adjusted for smoking habits and atopy.

RESULTS

Compared with the reference subjects the tunnel workers had a significant decrease in forced vital capacity (FVC) % predicted and forced expiratory volume in one second (FEV(1)) % predicted when related to years of exposure. Adjusted FEV(1) decreased by 17 ml for each year of tunnel work exposure compared with 0.5 ml in outdoor heavy construction workers. The tunnel workers also reported significantly higher occurrence of respiratory symptoms. The prevalence of chronic obstructive pulmonary disease (COPD) was 14% in the tunnel workers compared with 8% in the reference subjects.

CONCLUSION

Exposure to dust and gases from diesel exhaust, blasting, drilling and rock transport in tunnel work enhances the risk for accelerated decline in FEV(1), respiratory symptoms, and COPD in tunnel workers compared with other heavy construction workers.

Bronchoalveolar inflammation after exposure to diesel exhaust: comparison between unfiltered and particle trap filtered exhaust

OBJECTIVES

Air pollution particulates have been identified as having adverse effects on respiratory health. The present study was undertaken to further clarify the effects of diesel exhaust on bronchoalveolar cells and soluble components in normal healthy subjects. The study was also designed to evaluate whether a ceramic particle trap at the end of the tail pipe, from an idling engine, would reduce indices of airway inflammation.

METHODS

The study comprised three exposures in all 10 healthy never smoking subjects; air, diluted diesel exhaust, and diluted diesel exhaust filtered with a ceramic particle trap. The exposures were given for 1 hour in randomised order about 3 weeks apart. The diesel exhaust exposure apperatus has previously been carefully developed and evaluated. Bronchoalveolar lavage was performed 24 hours after exposures and the lavage fluids from the bronchial and bronchoalveolar region were analysed for cells and soluble components.

RESULTS

The particle trap reduced the mean steady state number of particles by 50%, but the concentrations of the other measured compounds were almost unchanged. It was found that diesel exhaust caused an increase in neutrophils in airway lavage, together with an adverse influence on the phagocytosis by alveolar macrophages in vitro. Furthermore, the diesel exhaust was found to be able to induce a migration of alveolar macrophages into the airspaces, together with reduction in CD3+CD25+ cells. (CD = cluster of differentiation) The use of the specific ceramic particle trap at the end of the tail pipe was not sufficient to completely abolish these effects when interacting with the exhaust from an idling vehicle.

CONCLUSIONS

The current study showed that exposure to diesel exhaust may induce neutrophil and alveolar macrophage recruitment into the airways and suppress alveolar macrophage function. The particle trap did not cause significant reduction of effects induced by diesel exhaust compared with unfiltered diesel exhaust. Further studies are warranted to evaluate more efficient treatment devices to reduce adverse reactions to diesel exhaust in the airways.

Efficiency of automotive cabin air filters to reduce acute health effects of diesel exhaust in human subjects

OBJECTIVES

To evaluate the efficiency of different automotive cabin air filters to prevent penetration of components of diesel exhaust and thereby reduce biomedical effects in human subjects. Filtered air and unfiltered diluted diesel exhaust (DDE) were used as negative and positive controls, respectively, and were compared with exposure to DDE filtered with four different filter systems.

METHODS

32 Healthy non-smoking subjects (age 21-53) participated in the study. Each subject was exposed six times for 1 hour in a specially designed exposure chamber: once to air, once to unfiltered DDE, and once to DDE filtered with the four different cabin air filters. Particle concentrations during exposure to unfiltered DDE were kept at 300 micrograms/m3. Two of the filters were particle filters. The other two were particle filters combined with active charcoal filters that might reduce certain gaseous components. Subjective symptoms were recorded and nasal airway lavage (NAL), acoustic rhinometry, and lung function measurements were performed.

RESULTS

The two particle filters decreased the concentrations of diesel exhaust particles by about half, but did not reduce the intensity of symptoms induced by exhaust. The combination of active charcoal filters and a particle filter significantly reduced the symptoms and discomfort caused by the diesel exhaust. The most noticable differences in efficacy between the filters were found in the reduction of detection of an unpleasant smell from the diesel exhaust. In this respect even the two charcoal filter combinations differed significantly. The efficacy to reduce symptoms may depend on the abilities of the filters investigated to reduce certain hydrocarbons. No acute effects on NAL, rhinometry, and lung function variables were found.

CONCLUSIONS

This study has shown that the use of active charcoal filters, and a particle filter, clearly reduced the intensity of symptoms induced by diesel exhaust. Complementary studies on vehicle cabin air filters may result in further diminishing the biomedical effects of diesel exhaust in subjects exposed in traffic and workplaces.

Acute inflammatory responses in the airways and peripheral blood after short-term exposure to diesel exhaust in healthy human volunteers

Several epidemiologic studies have demonstrated a consistent association between levels of particulate matter (PM) in the ambient air with increases in cardiovascular and respiratory mortality and morbidity. Diesel exhaust (DE), in addition to generating other pollutants, is a major contributor to PM pollution in most places in the world. Although the epidemiologic evidence is strong, there are as yet no established biological mechanisms to explain the toxicity of PM in humans. To determine the impact of DE on human airways, we exposed 15 healthy human volunteers to air and diluted DE under controlled conditions for 1 h with intermittent exercise. Lung functions were measured before and after each exposure. Blood sampling and bronchoscopy were performed 6 h after each exposure to obtain airway lavages and endobronchial biopsies. While standard lung function measures did not change following DE exposure, there was a significant increase in neutrophils and B lymphocytes in airway lavage, along with increases in histamine and fibronectin. The bronchial biopsies obtained 6 h after DE exposure showed a significant increase in neutrophils, mast cells, CD4+ and CD8+ T lymphocytes along with upregulation of the endothelial adhesion molecules ICAM-1 and VCAM-1, with increases in the numbers of LFA-1+ cells in the bronchial tissue. Significant increases in neutrophils and platelets were observed in peripheral blood following DE exposure. This study demonstrates that at high ambient concentrations, acute short-term DE exposure produces a well-defined and marked systemic and pulmonary inflammatory response in healthy human volunteers, which is underestimated by standard lung function measurements.

Persistent airway inflammation but accommodated antioxidant and lung function responses after repeated daily exposure to nitrogen dioxide

Nitrogen dioxide (NO2) is a common indoor and outdoor air pollutant that may induce deterioration of respiratory health. In this study the effects of repeated daily exposure to NO2 on airway antioxidant status, inflammatory cell and mediator responses, and lung function were examined. Healthy nonsmoking subjects were exposed under controlled conditions to air (once) and to 2 ppm of NO2 for 4 h on four consecutive days. Lung function measurements were made before and immediately after the end of each exposure. Bronchoscopy with endobronchial biopsies, bronchial wash (BW), and bronchoalveolar lavage (BAL) was carried out 1.5 h after the air exposure and after the last exposure to NO2. Repeated NO2 exposure resulted in a decrease in neutrophil numbers in the bronchial epithelium. The BW revealed a twofold increase in content of neutrophils (p < 0.05) and a 1.5-fold increase in myeloperoxidase (MPO) (p < 0.01) indicative of both migration and activation of neutrophils in the airways. After the fourth NO2 exposure, antioxidant status of the airway fluid was unchanged. Significant decrements in FEV1 and FVC were found after the first exposure to NO2, but these attenuated with repeated exposures. Together, these data indicate that four sequential exposures to NO2 result in a persistent neutrophilic inflammation in the airways, whereas changes in pulmonary function and airway antioxidants are resolved. We conclude that NO2 is a proinflammatory air pollutant under conditions of repeated exposure.

Nasal cavity lining fluid ascorbic acid concentration increases in healthy human volunteers following short term exposure to diesel exhaust

To determine if diesel exhaust (DE) exposure modifies the antioxidant defense network within the respiratory tract lining fluids, a randomized, single blinded, crossover control study using nasal lavage and flexible video bronchoscopy with bronchial and bronchoalveolar lavage was performed. Fifteen healthy, non-smoking, asymptomatic subjects were exposed to filtered air or diluted diesel exhaust (300mg m(-3) particulates, 1.6ppm nitrogen dioxide) for one hour on 2 separate occasions, at least three weeks apart. To examine the kinetics of any DE-induced antioxidant reactions, nasal lavage fluid and blood samples were collected prior to, immediately after, and 5 1/2 hours post exposure. Bronchoscopy was performed 6 hours after the end of DE exposure. Ascorbic acid, uric acid and reduced glutathione (GSH) concentrations were determined in nasal, bronchial, bronchoalveolar lavage and plasma samples. Malondialdehyde (MDA) and protein carbonyl concentrations were determined in plasma and bronchoalveolar lavage samples. Nasal lavage ascorbic acid concentration increased 10-fold during DE exposure [1.02 (0.26-2.09) Vs 7.13 (4.66-10.79) micromol/L(-1)], but returned to basal levels 5.5 hours post-exposure [0.75 (0.26-1.51) micromol/L(-1)]. There was no significant effect of DE exposure on nasal lavage uric acid or GSH concentration. DE exposure did not influence plasma, bronchial wash, or bronchoalveolar lavage antioxidant concentrations and no change in MDA or protein carbonyl concentrations were found. The physiological response to acute DE exposure is an increase in the level of ascorbic acid in the nasal cavity. This response appears to be sufficient to prevent further oxidant stress in the respiratory tract of normal individuals.

Effects on symptoms and lung function in humans experimentally exposed to diesel exhaust

OBJECTIVES

Diesel exhaust is a common air pollutant made up of several gases, hydrocarbons, and particles. An experimental study was carried out which was designed to evaluate if a particle trap on the tail pipe of an idling diesel engine would reduce effects on symptoms and lung function caused by the diesel exhaust, compared with exposure to unfiltered exhaust.

METHODS

Twelve healthy non-smoking volunteers (aged 20-37) were investigated in an exposure chamber for one hour during light work on a bicycle ergometer at 75 W. Each subject underwent three separate double blind exposures in a randomised sequence: to air and to diesel exhaust with the particle trap at the tail pipe and to unfiltered diesel exhaust. Symptoms were recorded according to the Borg scale before, every 10 minutes during, and 30 minutes after the exposure. Lung function was measured with a computerised whole body plethysmograph.

RESULTS

The ceramic wall flow particle trap reduced the number of particles by 46%, whereas other compounds were relatively constant. It was shown that the most prominent symptoms during exposure to diesel exhaust were irritation of the eyes and nose and an unpleasant smell increasing during exposure. Both airway resistance (R(aw)) and specific airway resistance (SR(aw)) increased significantly during the exposures to diesel exhaust. Despite the 46% reduction in particle numbers by the trap effects on symptoms and lung function were not significantly attenuated.

CONCLUSION

Exposure to diesel exhaust caused symptoms and bronchoconstriction which were not significantly reduced by a particle trap.

An Indicator for Assessing Respirable Soot Particles in Diesel Exhaust during Occupational Exposures

Both acute and chronic impairments of lung function have been demonstrated in humans after exposure to diesel exhaust. The concentration of soot particles in the diesel exhaust is significantly related to its effects on health. The aim of the present analysis was to study the relationship between the concentration of respirable dust as an indicator of exposure to soot particles in diesel exhaust and a biologic exposure indicator variable, i.e., transient lung function decrease. Daily time-weighted average concentrations of carbon monoxide and nitrogen dioxide amounted to 9 % and 25% of the applicable hygienic limit values. Time-weighted average concentration and the proportion of respirable dust in total dust during a workshift were significantly correlated with across-shift decreases in lung function. In the absence of a suitable measure for total diesel exhaust exposure, the ratio of the proportion of respirable dust in total dust in a workplace may serve as an indicator of the concentration of soot particles in diesel exhaust.

Effects within the week on forced vital capacity are correlated with long term changes in pulmonary function: reanalysis of studies on car painters exposed to isocyanate

OBJECTIVES

To examine if car painters who work with polyurethane paints that contain hexamethylenediisocyanate (HDI) and hexamethylenediisocyanate biuret trimer (HDI-BT) develop acute as well as chronic impairment of lung function.

METHODS

In this study data were reanalysed from two earlier studies on a group of car painters to see if a decrease in lung function within the week is a marker of vulnerability in those workers. Data on changes in forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) within the week were available for 20 car painters who were also examined six years later.

RESULTS

10 men showed a decline in FVC within the week. There were no significant differences in age, duration of employment, exposures during the follow up period, or smoking between car painters who had decline in lung function within the week and car painters who had not. A significant correlation was found between the change in FVC within the week and the long term (six year) change in FVC, standardised for the effects of aging and smoking, and adjusted for the number of peak exposures.

CONCLUSIONS

The results suggest that the decrease in FVC within the week might serve as a guide to identify car painters at risk of a further decrement in lung function above the effects of aging, smoking, and exposure.

The significance of an across-shift decrease in vital capacity--a re-analysis of a study on subjects exposed to diesel exhaust

Occupational exposure to diesel exhaust may develop acute as well as chronic lung function impairment. In this study, data from an earlier study on a group of subjects working at tunnel construction site were analyzed. The aim of the analysis was to examine the significance of an across-shift decrease in vital capacity with concern to other lung physiological measurements. There were no statistically significant differences, either in the average age, time of employment, vital capacity before a working shift after two days of no exposure, or the distributions of smoking habits and respiratory symptoms, between the eight workers who had an across-shift decrease in vital capacity and the five workers who had not. Subjects with an across-shift decrease in vital capacity had a significantly greater across-shift decrease in residual volume and total lung capacity than subjects without an across-shift decrease in vital capacity. The pathophysiological mechanisms for this across-shift decrease in residual volume is not fully understood. However, an altered defence mechanism in the lung may play a role for a prolonged retention time for the particles in the inhaled diesel exhaust, resulting in the across-shift decrease in residual volume. The results thus suggest that measurements of across-shift vital capacity is of importance in identifying susceptible subjects with occupational exposure to diesel exhaust.

Experimental evaluation of the effect of filtration of diesel exhaust by biologic exposure indicators

The airway resistance, compliance of the respiratory system, transfer factor, and alveolar volume of 33 healthy rabbits were studied before and after exposure to diluted diesel exhaust generated in an experimental motor. Three diesel fuels and two particle traps were tested. Subsequent to the post-exposure lung function measurements, the animals were sacrificed and the lungs were processed for morphologic examination. The concentrations of particles, nitrogen dioxide, and formaldehyde were measured. The inflammatory airway changes were most pronounced in animals exposed to exhaust from standard fuel. Small changes were identified in animals exposed to exhaust filtered through the catalytic trap as well or exposed to unfiltered exhaust from fuels intended for densely built-up areas. Increase in compliance of the respiratory system was associated with the concentration of soot particles and formaldehyde. Compliance decreased significantly in animals exposed to exhaust from standard fuel filtered through the particle traps and increased almost significantly in animals exposed to unfiltered exhaust from the same fuel.

Evaluation of an exposure setup for studying effects of diesel exhaust in humans

Diesel exhaust is a common air pollutant and work exposure has been reported to cause discomfort and affect lung function. The aim of this study was to develop an experimental setup which would allow investigation of acute effects on symptoms and lung function in humans exposed to diluted diesel exhaust. Diluted diesel exhaust was fed from an idling lorry through heated tubes into an exposure chamber. During evaluations of the setup we found the size and the shape of the exhaust particles to appear unchanged during the transport from the tail pipe to the exposure chamber. The composition of the diesel exhaust expressed as the ratios CO/NO, total hydrocarbons/NO, particles/NO, NO2/NO, and formaldehyde/NO were almost constant at different dilutions. The concentrations of NO2 and particles in the exposure chamber showed no obvious gradients. New steady state concentrations in the exposure chamber were obtained within 5-7 min. In a separate experiment eight healthy nonsmoking subjects were exposed to diluted exhaust at a median steady state concentration of 1.6 ppm NO2 for the duration of 1 h in the exposure chamber. All subjects experienced unpleasant smell, eye irritation, and nasal irritation. Throat irritation, headache, dizziness, nausea, tiredness, and coughing were experienced by some subjects. Lung function was not found to be affected during the exposure. The experimental setup was found to be appropriate for creating different predetermined steady state concentrations in the exposure chamber of diluted exhaust from a continuously idling vehicle. The acute symptoms reported by the subjects were relatively similar to what patients reported at different workplaces.

Acute effects on forced expiratory volume in one second and longitudinal change in pulmonary function among wood trimmers

Wood trimmers are exposed to molds that periodically grow on timber, and may develop acute as well as chronic pulmonary function impairment. This study examined whether these acute changes in pulmonary function are predictors for a longitudinal deterioration in pulmonary function, beyond normal aging and exposure. Across-shift changes in pulmonary function, measured during a working week, were evaluated in 15 wood trimmers with a follow-up time of 27 months. Twenty-six sawmill workers, employed at the same plants as the wood trimmers, served as control subjects. The highest concentration of viable mold spores for the wood trimmers was 10(6) colony-forming units (cfu)/m3, i.e., several times higher than the corresponding value for the sawmill workers. At the follow-up, wood trimmers had a lower forced vital capacity (FVC) on average, after adjustment for age and height, compared to the sawmill workers. In addition, a correlation was found between the across-week change in forced expiratory volume in 1 second (FEV1) and the decline in FEV1 between the first and the second occasion, after adjusting for normal aging in nonsmoking wood trimmers (r2 = 84%, p < 0.001). The results from the present study suggest that across-shift decrease in FEV1 (measured during a working week) might serve as a guide to identify subjects being at risk for a further decrement in pulmonary function over and above the effects of normal aging and exposure to mold spores in the wood trimming department.

Repeated measurements of transfer factor in rabbits: an animal model suitable for evaluation of short-term exposure

Acute temporary changes in lung function may be of use as a biological exposure indicator. However, studies of humans occupationally exposed to complex airborne irritants are often expensive and time demanding. Therefore, an animal model could be a valuable complement. A rabbit model has been evaluated where transfer factor was measured twice during the same day, and with the rabbit awake and available for exposure, in between. Anaesthesia and intubation in 22 rabbits (2.6 [0.2] kg [Mean (SD)]) were immediately followed by two measurements of transfer factor and alveolar volume. Transfer factor was estimated by the single breath CO-technique used in humans. The samples were analysed for CO and He on a gas chromatograph. After one pair of measurements the rabbit was allowed to wake up and after 5 h the duplicate measurements were repeated. The mean values of transfer factor, alveolar volume and transfer constant were 0.50 (0.09) mmol min-1 kPa-1, 127 (8) ml and 3.9 (0.6) mmol min-1 kPa-1 l-1, respectively. The intraindividual coefficients of variation were 7.3%, 5.3% and 6.7%, respectively. Five hours later when the duplicate measurements were repeated, transfer factor, alveolar volume and transfer constant were unchanged still. The results suggest that relatively small changes in transfer factor may be detected without losing power, and thus that this model could be used as a biological exposure indicator.

Validation of exposure information in occupational epidemiology

Exposure data may be inadequate mainly for two reasons; they may not comply with a reasonable exposure-effect model or they may be biased. In the use of historical data it is essential to keep track of what the data were supposed to mean when collected in the first place. Most measurements of air contaminants in work places are probably carried out to establish compliance or non-compliance with limit values. Sometimes measurements are also made to evaluate control measures. Unfortunately, measurement data acquired in this way may have very little to do with the true average exposure of employees. The influence of trends and variations in production on the exposure level is substantial. This influence is similar and coincidental in widely different industries. In addition the variations attributed to production levels, there can be important variations due to season.

Lung function and exposure to asbestos among vehicle mechanics

Vehicle mechanics (n = 99) exposed to asbestos (annual median value 0.08 f/ml), and local controls (n = 83) not occupationally exposed to asbestos were studied with regard to symptoms and pulmonary function. The inclusion criteria to participate in this study was an age of at least 40 years with no known exposure to lung irritating agents, and for the exposed subjects, more than 15 years occupational exposure to asbestos with at least 20 years from the first exposure. The subjects were studied during identical conditions by means of dynamic and static spirometry, single breath wash-out with nitrogen (N2) and carbon monoxide (CO). The median for cumulative exposure of asbestos during the entire work life among the studied mechanics was 2.3 f*y/ml. The mechanics had reduced transfer factor (TLCO), after adjustment for age, height, and smoking category. A significant dose-response relationship was noted between the cumulative exposure of asbestos and CV%. The findings suggest a slight influence of small airways and alveoli. The evaluation of the prognostic significance of this requires a longitudinal study.