Evaluation of respiratory function and biomarkers of exposure to mixtures of pollutants in brick-kilns workers from a marginalized urban area in Mexico

Brick kiln pollution and its impact on health: A systematic review and meta-analysis

Brick kiln emissions adversely affect air pollution and the health of workers and individuals living near the kilns; however, evidence of their impacts remains limited. We conducted a systematic review of brick kiln pollution (emissions, source contributions and personal exposures) and its effects on health. We extracted articles from electronic databases and through manual citation searching. We estimated pooled, sample-size-weighted means and standard deviations for personal exposures by job type; computed mean emission factors and pollutant concentrations by brick kiln design; and meta-analyzed differences in means or proportions for health outcomes between brick kiln workers and controls or for participants living near or far away from kilns. We identified 104 studies; 74 were conducted in South Asia. The most evaluated pollutants were particulate matter (PM; n = 48), sulfur dioxide (SO2; n = 24) and carbon monoxide (CO; n = 22), and the most evaluated health outcomes were respiratory health (n = 34) and musculoskeletal disorders (n = 9). PM and CO emissions were higher among traditional than improved brick kilns. Mean respirable silica exposures were only measured in 4 (4%) studies and were as high as 620 μg/m3, exceeding the NIOSH recommended exposure limit by a factor of over 12. Brick kiln workers had consistently worse lung function, more respiratory symptoms, more musculoskeletal complaints, and more inflammation when compared to unexposed participants across studies; however, most studies had a small sample size and did not fully describe methods used for sampling or data collection. On average, brick kiln workers had worse health outcomes when compared to unexposed controls but study quality supporting the evidence was low. Few studies reported silica concentrations or personal exposures, but the few that did suggest that exposures are high. Further research is needed to better understand the relationship between brick kiln pollution and health among workers, and to evaluate exposure mitigation strategies.

"Characterization of residential proximity to sources of environmental carcinogens in clusters of Acute Lymphoblastic Leukemia in San Luis Potosi, Mexico"

BACKGROUND

Acute Lymphoblastic Leukemia (ALL) is the most prevalent neoplasia in children and teenagers in Mexico. Although epidemiological data supports that children's residence close to emissions from vehicular traffic or industrial processes increases the risk of ALL; and the IARC states that benzene, PAHs, and PM 2.5 are well-known environmental carcinogens, there is a gap in linking these carcinogenic hazards with the sources and their distribution from scenario perspective.

AIM

To identify ALL clusters in the population under 19 years of age and characterize the environment at the neighborhood level by integrating information on sources of carcinogenic exposure using spatial analysis techniques in the Metropolitan Area of San Luis Potosi, Mexico.

METHODS

Using the Kernel Density test, we designed an ecological study to identify ALL clusters from incident cases in the population under 19 years of age. A multicriteria analysis was conducted to characterize the risk at the community level from carcinogenic sources. A hierarchical cluster analysis was performed to characterize risk at the individual level based on carcinogenic source count within 1 km for each ALL case.

RESULTS

Eight clusters of carcinogenic sources were located within the five identified ALL clusters. The multicriteria analysis showed high-risk areas (by density of carcinogenic source) within ALL clusters.

CONCLUSIONS

This study has a limited source and amount of available data on ALL cases, so selection bias is present as well as the inability to rule out residual confounding factors, since covariates were not included. However, in this study, children living in environments with high vehicular density, gas stations, brick kilns, incinerators, commercial establishments burning biomass, or near industrial zones may be at higher risk for ALL.

Comprehensive analysis of environmental exposure to hazardous trace elements and lung function: a national cross-sectional study

BACKGROUND

There is growing interest in the joint effects of hazardous trace elements (HTEs) on lung function deficits, but the data are limited. This is a critical research gap given increased global industrialisation.

METHODS

A national cross-sectional study including spirometry was performed among 2112 adults across 11 provinces in China between 2020 and 2021. A total of 27 HTEs were quantified from urine samples. Generalised linear models and quantile-based g-computation were used to explore the individual and joint effects of urinary HTEs on lung function, respectively.

RESULTS

Overall, there were negative associations between forced expiratory volume in 1 s (FEV1) and urinary arsenic (As) (z-score coefficient, -0.150; 95% CI, -0.262 to -0.038 per 1 ln-unit increase), barium (Ba) (-0.148, 95% CI: -0.258 to -0.039), cadmium (Cd) (-0.132, 95% CI: -0.236 to -0.028), thallium (Tl) (-0.137, 95% CI: -0.257 to -0.018), strontium (Sr) (-0.147, 95% CI: -0.273 to -0.022) and lead (Pb) (-0.121, 95% CI: -0.219 to -0.023). Similar results were observed for forced vital capacity (FVC) with urinary As, Ba and Pb and FEV1/FVC with titanium (Ti), As, Sr, Cd, Tl and Pb. We found borderline associations between the ln-quartile of joint HTEs and decreased FEV1 (-20 mL, 95% CI: -48 to +8) and FVC (-14 mL, 95% CI: -49 to+2). Ba and Ti were assigned the largest negative weights for FEV1 and FVC within the model, respectively.

CONCLUSION

Our study investigating a wide range of HTEs in a highly polluted setting suggests that higher urinary HTE concentrations are associated with lower lung function, especially for emerging Ti and Ba, which need to be monitored or regulated to improve lung health.

Association between lead and circulating markers of inflammation among traffic enforcers in Metro Manila, Philippines: the MMDA traffic enforcer's health study

PURPOSE

Several epidemiological studies have linked lead (Pb) exposure to induced oxidative stress and the promotion of inflammatory response. We performed a within-subjects study (repeated measures study) to evaluate the relationship between the concentration of blood lead (B-Pb) and toenail lead (T-Pb) and circulating markers of inflammation.

METHODS

We evaluated the associations between B-Pb concentrations and T-Pb concentrations and circulating markers of inflammation, soluble intracellular adhesion molecule-1 (s-ICAM-1), soluble vascular adhesion molecule-1 (s-VCAM-1), and high-sensitivity C-reactive protein (hs-CRP) on 158 traffic enforcers from the Metropolitan Manila Development Authority (MMDA) traffic enforcer's health study. Linear mixed-effects models with random subject-specific intercepts were fitted to estimate the association between B-Pb and T-Pb exposure and circulating markers of inflammation, adjusting for confounding factors.

RESULTS

Traffic enforcers were middle-aged men (89.4%) with a mean age (± SD) of 37.1 years ± 8.9 years and had a total of 293 valid markers of inflammation measurements. B-Pb concentration was related to increased hs-CRP levels. A 10% increase in B-Pb was associated with a 5.7% increase in hs-CRP level [95% confidence interval (95% CI): 1.3-10.1]. However, B-Pb was not associated with s-ICAM-1 and s-VCAM-1. Furthermore, no associations were observed between T-Pb and all the circulating markers of inflammation.

CONCLUSIONS

Low-level B-Pb may increase hs-CRP among traffic enforcers. Moreover, the study suggests that Pb via the oxidative and inflammation pathways may have an essential role in the development of cardiovascular disease. Furthermore, MMDA and the Department of Labor and Employment can use our study's findings as evidence to conduct routine screening of blood heavy metals, especially Pb, among MMDA and other traffic enforcers as part of their yearly medical examination.

Atherogenic Index as a Cardiovascular Biomarker in Mexican Workers from Marginalized Urban Areas Occupationally Exposed to Metals

BACKGROUND

Cardiovascular disease (CVD) is one of the main causes of death and disability worldwide. The etiology of CVD is often associated with multiple risk factors, with environmental factors receiving considerable attention. Individuals with precarious jobs are among the groups most affected by chronic exposure to environmental pollutants.

AIM

This study aimed to evaluate occupational exposure to heavy metals among individuals in precarious job settings and investigate atherogenic indices as biomarkers of cardiovascular risk.

METHODS

A total of 137 workers participated in this cross-sectional study conducted in three work environments in San Luis Potosi, Mexico. Urine and blood samples were collected to assess metal exposure and biochemical profiles, including atherogenic indices.

RESULTS

The results showed that workers in the brick sector exhibited the highest levels of metal exposure, particularly arsenic (44.06 µg/L), followed by stonecutters and garbage collectors (24.7 and 16.9 µg/L, respectively). Similarly, Castelli risk index (CRI) and the atherogenic index of plasma (AIP) were higher in brickmakers (3.883 and 0.499) compared to stonecutters (3.285 and 0.386) and garbage collectors (3.329 and 0.367).

CONCLUSIONS

Evidence of exposure to heavy metals was observed in the three populations, in addition to the fact that individuals with greater exposure to arsenic also exhibited higher CRI and AIP.

Respirable dust and crystalline silica concentrations among workers at a brick kiln in Bhaktapur, Nepal

Exposure to respirable dust and crystalline silica (SiO2) has been linked to chronic obstructive pulmonary disease, silicosis, cancer, heart disease, and other respiratory diseases. Relatively few studies have measured respirable dust and SiO2 concentrations among workers at brick kilns in low- and middle-income countries. The purpose of this study was to measure personal breathing zone (PBZ) respirable dust and SiO2 concentrations among workers at one brick kiln in Bhaktapur, Nepal. A cross-sectional study was conducted among 49 workers in five job categories: administration, fire master, green (unfired) brick hand molder, green brick machine molder, and top loader. PBZ air samples were collected from each worker following Methods 0600 (respirable dust) and 7500 (respirable crystalline SiO2: cristobalite, quartz, tridymite) of the U.S. National Institute for Occupational Safety and Health. Eight-hour time-weighted average (TWA) respirable dust and quartz concentrations were also calculated. SiO2 percentage was measured in one bulk sample each of wet clay, the release agent used by green brick hand molders, and top coat soil at the brick kiln. The geometric mean (GM) sample and TWA respirable dust concentrations were 0.20 (95% confidence interval [CI]: 0.16, 0.27) and 0.12 (95% CI: 0.09, 0.16) mg/m3, respectively. GM sample and TWA quartz concentrations were 15.28 (95% CI: 11.11, 21.02) and 8.60 (95% CI: 5.99, 12.34) µg/m3, respectively. Job category was significantly associated with GM sample and TWA respirable dust and quartz concentrations (all p < 0.0001). Top loaders had the highest GM sample and TWA respirable dust concentrations of 1.49 and 0.99 mg/m3, respectively. Top loaders also had the highest GM sample and TWA quartz concentrations of 173.08 and 114.39 µg/m3, respectively. Quartz percentages in bulk samples were 16%-27%. Interventions including using wet methods to reduce dust generation, administrative controls, personal protective equipment, and education and training should be implemented to reduce brick kiln worker exposures to respirable dust and SiO2.

Long-Term Atmosphere Surveillance (2016-2021) of PM2.5-bound Polycyclic Aromatic Hydrocarbons and Health Risk Assessment in Yangtze River Delta, China

Long-term atmospheric quality monitoring of fine particulate matter (PM2.5) and PM2.5-bound polycyclic aromatic hydrocarbons (PAHs) was performed in Wuxi from 2016 to 2021. In total, 504 atmospheric PM2.5 samples were collected, and PM2.5-bound 16 PAHs were detected. The PM2.5 and ∑PAHs level decreased annually from 2016 to 2021, from 64.3 to 34.0 μg/m3 and 5.27 to 4.22 ng/m3, respectively. The benzo[a]pyrene (BaP) levels of 42% of the monitoring days in 2017 exceeded the recommended European Union (EU) health-based standard of 1 ng/m3. Five- and six-ring PAHs were found, including benz[a]anthracene, benzo[k]fluoranthene (Bkf), BaP, and benzo[g,h,i]perylene, which were the dominant components (indicating a prominent petroleum, biomass, and coal combustion contribution) using molecular diagnostic ratios and positive matrix factorization analysis. Moreover, PM2.5 and PAHs were significantly negatively associated with local precipitation over a period of six years. Statistically significant temporal and spatial distribution differences of PM2.5, and ∑PAHs were also found. The toxicity equivalent quotient (TEQ) of total PAHs was 0.70, and the TEQ of BaP (0.178) was the highest, followed by that of Bkf (0.090), dibenz[a,h]anthracene (Dah) (0.048), and indeno[1,2,3-cd]pyrene (0.034). The medians of the incremental lifetime cancer risk for long-term exposure to PAHs were 2.74E-8, 1.98E-8, and 1.71E-7 for children, teenagers, and adults, respectively, indicating that the carcinogenic risk of PAHs pollution in air was acceptable to local residents in this area. Sensitivity analysis revealed that BaP, Bkf, and Dah significantly contributed to carcinogenic toxicity. This research provides comprehensive statistics on the local air persistent organic pollutants profile, helps to identify the principal pollution source and compounds, and contributes to the prevention of regional air pollution.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1007/s12403-023-00572-x.

Assessment and mapping of total suspended particulate and soil quality around brick kilns and occupational health issues among brick kilns workers in Pakistan

Brick kilns constitute one of the major sources of environmental degradation in Pakistan. The present study was conducted to determine the soil quality and total suspended particulates (TSPs) around the brick kilns and assess the health effects on brick kiln workers. Four brick kilns were selected, two each at Sheikhupura and Pattoki city. The soil quality was assessed by analyzing pH, electrical conductivity, moisture content, nitrogen, phosphorus, potassium content, and heavy metal concentration while TSPs were measured by hand-held Microdust Pro Real time monitor. Average TSP concentration around brick kilns at Sheikhupura and Pattoki ranged between 1100 and 1200 µg/m³ and between 550 and 600 µg/m³ respectively which exceeded the Punjab Ambient Air Standards. The soil was slightly acidic (Sheikhupura: average pH = 6.41; Pattoki: average pH = 6.6) while all other analyzed parameters, except heavy metals, were lower than the required FAO Standards for good quality agriculture soil. Heavy metal accumulation in soil samples followed the general order zinc (Zn) > chromium (Cr) > nickel (Ni) > manganese (Mn) > cadmium (Cd) > copper (Cu). For assessment of occupational health and safety issues, all 440 brick kiln workers from the study areas were interviewed. Mostly, brick kiln workers suffered from chronic back pain (84%), skin issues (80.5%), dry cough (72.9%), common cold (46.1%), and shortness of breath (17.1%). The vulnerability risk varied with the nature of the work as workers engaged in brick baking were more vulnerable to respiratory issues than were those in molding task. The study concludes that brick kilns are a source of increased TSP, deteriorated surrounding soil quality, and impaired worker health. It is necessary to regulate these activities and implement requisite health and safety measures.

Evaluation of cytokines in exhaled breath condensate in an occupationally exposed population to pneumotoxic pollutants

The quarrying is considered a precarious occupation with high toxicity, is an informal economic activity that employs low technology, limited protection, and poses a risk to workers and their families. In quarrying, silica dust is generated and there is also occupational exposure to significant mixtures of pneumotoxic pollutants, including mineral dust (crystalline silica, carbon or cement, polycyclic aromatic hydrocarbons (PAHs), solvents, and others, which are aggravated by the lack of use of protective equipment, causing irreversible damage to the worker's respiratory health. Thus, the objective of this work focused on the evaluation of the respiratory health of artisan stonemasons in San Luis Potosí, Mexico through the study of exhaled breath condensate (EBC) (pH, pro-inflammatory cytokines) as well as the study of the exposure to pollutants present in the work area (PAHs, toluene, and 2.5 µm particulate matter) through biomarkers of exposure (hippuric acid and hydroxylated metabolites of PAHs). The results show the presence of crystalline SiO₂ in 100% of the samples analyzed; the PM_2.5 concentrations were 5 to 10 times the permitted levels. Regarding exposure to PAHs, all the stonemasons presented urine concentrations of at least 5 of the OH-PAHs evaluated; 9-OH-FLU occurred at higher concentrations of 171.2 (122.7-279.4) µg L^-1; hippuric acid, which was present in 100% of the workers evaluated in concentrations of 283.4 (27.72-1119) mg L^-1, 100% of which were above the values established for occupational scenarios. The pH values obtained for the EBC samples were presented at an average of 7.07 (6.33-7.66). Pro-inflammatory cytokines were present in 86.1% of the study population. The cytokine that was found in higher concentrations was IL-2, with a mean of 178.01 pg mL^-1 and 3124.01 pg mL^-1 for the pH < 7 and pH > 7 groups, respectively. Some correlations between the cytokines and the exposure biomarkers were presented. Stonemasons are highly exposed to pneumotoxic pollutants and markers of inflammation at the pulmonary level; in addition, a high risk of developing silicosis. Quarrying should be addressed as a carcinogenic activity, which would imply the design of monitoring and control strategies for these pollutants that our country currently lacks, particularly in precarious occupations. It is necessary to develop strategies to protect the health of precarious workers.

Biochemical and reproductive biomarker analysis to study the consequences of heavy metal burden on health profile of male brick kiln workers

The present study aims to assess the effect of a heavy metal burden on general health, biochemical parameters, an antioxidant enzyme, and reproductive hormone parameters in adult male brick kiln workers from Pakistan. The study participants (n = 546) provided demographic data including general health as well as body mass index. Blood was collected to quantitatively assess hematological, biochemical, and reproductive hormone parameters as well as heavy metal concentrations using both atomic absorption spectroscopy (AAS) and particle-induced X-ray emission (PIXE). The data showed that 10% of the brick kiln workers were underweight and 10% obese (P = 0.059), with workers also reporting multiple health issues. Heavy metal concentrations utilizing AAS revealed significantly (p = 0.000) higher levels of cadmium, chromium, and nickel, while PIXE detected more than permissible levels of Si, P, S, Cl, K, Ca, Zn, Ti (p = 0.052), Mn (p = 0.017), Fe (p = 0.055), Co (p = 0.011), Ni (p = 0.045), and Cu (p = 0.003), in the blood of kiln workers. Moreover, a significant increase in platelet count (P = 0.010), a decrease in sodium dismutase levels (p = 0.006), a major increase in reactive oxygen species (p = 0.001), and a reduction in protein content (p = 0.013) were evident. A significant increase in cortisol levels (p = 0.000) among the workers group was also observed. The concentration of LH and FSH increased significantly (p = 0.000), while that of testosterone decreased (p = 0.000) in the worker group compared with controls. A significant inverse relationship was found between cortisol, LH (r =  - 0.380), and FSH (r =  - 0.946), while a positive correlation between cortisol and testosterone was also evident (r = 0.164). The study concludes that increased heavy metal burden in the blood of brick kiln workers exposes them to the development of general and reproductive health problems due to compromised antioxidant enzyme levels, increased oxidative stress conditions, and a disturbing reproductive axis.

An appraisal of air quality, thermal comfort, acoustic, and health risk of household kitchens in a developing country

Few studies have documented the air quality, noise, thermal comfort, and health risk assessment of household kitchens related to Sub-Sahara Africa. In this paper, air quality (CO and PM_2.5), thermal comfort (relative humidity (RH) and temperature), noise, and health risk in urban household kitchens with kerosene-fueled stoves were presented. This study was carried out during the dry season (summer) in the Southwestern part of Nigeria. At the breathing zone, PM_2.5 and CO concentrations in the assessed kitchens were measured. In addition, the noise level, RH, and air temperature in the assessed kitchens were also determined. Furthermore, an evaluation of the heat index and health risk of the exposed population to the kerosene-fueled stove kitchens was carried out. During cooking, average CO and PM_2.5 concentrations were 24.77 ± 1.05 ppm and 138.10 ± 2.61 µg/m³, respectively, while the RH was 68.34 ± 0.73%, noise level was 51.14 ± 1.08 dB, and temperature was 29.86 ± 0.23 °C. The CO and noise levels were relatively slightly lower and PM_2.5 was significantly higher than the thresholds recommended by World Health Organisation. In most of the kitchens, the heat index evaluation revealed the possibility of heat exhaustion, heat cramps, and sunstroke with prolonged exposure of the vulnerable group. The air quality index depicted unhealthy (CO exposure) and very unhealthy (PM_2.5 exposure) while the hazard quotient (> 1) implied possible health risk concerning exposure by inhalation. Better design of kitchen with adequate ventilation and improved stoves are suggested.