Response to "Obesity is a Pulmonary Function Confounder"

Evidence of seasonal changes in airborne particulate matter concentration and occupation-specific variations in pulmonary function and haematological parameters among some workers in Enugu Southeast Nigeria: a randomized cross-sectional observational study

Background

Upsurge in cardiopulmonary dysfunctions in Enugu, Nigeria, involved mainly cement workers, automobile spray painters, woodworkers, and Cleaners and was worsened in the dry season, suggesting the need for an occupation-specific characterization of the disease features and seasonal evaluation of air quality for prevention and management.

Methods

We conducted a randomized cross-sectional study of eighty consenting participants (in Achara Layout, Enugu), comprising 20 cement workers (39.50 ± 14.95 years), 20 automobile spray painters (40.75 ± 9.85 years), 20 woodworkers (52.20 ± 9.77 years), and 20 cleaners (42.30 ± 9.06 years). The air quality, some haematological (fibrinogen-Fc, and C-reactive protein-CRP), and cardiopulmonary parameters were measured and analyzed using ANCOVA, at p < 0.05.

Results

The dry season particulate matter (PM) in ambient air exceeded the WHO standards in the New layout [PM₁₀ = 541.17 ± 258.72 µg/m³; PM_2.5 = 72.92 ± 25.81 µg/m³] and the University campus [PM₁₀ = 244 ± 74.79 µg/m³; PM_2.5 = 30.33 ± 16.10 µg/m³], but the former was twice higher. The PM differed significantly (p < 0.05) across the sites. Forced expiratory volume at the first second (FEV₁) (F = 6.128; p = 0.001), and Peak expiratory flow rate (PEFR) (F = 5.523; p = 0.002), differed significantly across the groups. FEV₁/FVC% was < 70% in cement workers (55.33%) and woodworkers (61.79%), unlike, automobile spray painters (72.22%) and cleaners (70.66%). FEV₁ and work duration were significantly and negatively related in cement workers (r = -0.46; r2 = 0.2116; p = 0.041 one-tailed). CRP (normal range ≤ 3.0 mg/L) and Fc (normal range—1.5–3.0 g/L) varied in cement workers (3.32 ± 0.93 mg/L versus 3.01 ± 0.85 g/L), automobile spray painters (2.90 ± 1.19 mg/L versus 2.54 ± 0.99 mg/L), woodworkers (2.79 ± 1.10 mg/L versus 2.37 ± 0.92 g/L) and cleaners (3.06 ± 0.82 mg/L versus 2.54 ± 0.70 g/L).

Conclusion(s)

Poor air quality was evident at the study sites, especially in the dry season. Cement workers and automobile spray painters showed significant risks of obstructive pulmonary diseases while woodworkers had restrictive lung diseases. Cement workers and cleaners recorded the highest risk of coronary heart disease (CRP ≥ 3.0 mg/L). The similarity in Fc and CRP trends suggests a role for the inflammation-sensitive proteins in the determination of cardiovascular risk in cement workers and cleaners. Therefore, there are occupation-specific disease endpoints of public health concern that likewise warrant specific preventive and management approaches among the workers.