Respiratory health of cigar factory workers

Dry tobacco leaves: an in vivo and in silico approach to the consequences of occupational exposure

Exposure of tobacco workers handling dried tobacco leaves has been linked to an increased risk of toxicity and respiratory illness due to the presence of nicotine and other chemicals. This study aimed to evaluate the DNA damage caused by the exposure of tobacco growers during the dry leaf classification process and the relation to cellular mechanisms. A total of 86 individuals participated in the study, divided into a group exposed to dry tobacco (n = 44) and a control group (n = 42). Genotoxicity was evaluated using the alkaline comet assay and lymphocyte micronucleus (MN) assay (CBMN-Cyt), and measurement of telomere length. The levels of oxidative and nitrosative stress were evaluated through the formation of thiobarbituric acid reactive species, and nitric oxide levels, respectively. The inorganic elements were measured in the samples using particle-induced X-ray emission method. The combination of variables was demonstrated through principal component analysis and the interactions were expanded through systems biology. Comet assay, MN, death cells, thiobarbituric acid reactive species, and nitrosative stress showed a significant increase for all exposed groups in relation to the control. Telomere length showed a significant decrease for exposed women and total exposed group in relation to men and control groups, respectively. Bromine (Br) and rubidium (Rb) in the exposed group presented higher levels than control groups. Correlations between nitrate and apoptosis; Br and MN and necrosis; and Rb and telomeres; besides age and DNA damage and death cells were observed. The systems biology analysis demonstrated that tobacco elements can increase the nuclear translocation of NFKB dimers inducing HDAC2 expression, which, associated with BRCA1 protein, can potentially repress transcription of genes that promote DNA repair. Dry tobacco workers exposed to dry leaves and their different agents showed DNA damage by different mechanisms, including redox imbalance.

Tobacco Worker's Lung: A Neglected Subtype of Hypersensitivity Pneumonitis

Tobacco worker's lung (TWL) is a type of hypersensitivity pneumonitis (HP) affecting workers exposed to tobacco leaves and molds in the humidified environment of the tobacco production industry. Limited epidemiological data point to a prevalence of TWL that is not negligible and probably underestimated. As in other types of HP, an acute vs. chronic presentation depends on the pattern of the exposure. Therefore, the clinical presentation can vary from an acute influenza-like syndrome, mostly self-limiting with the removal of the exposure, to an insidious onset of cough, exertional dyspnea, fatigue and weight loss in chronic presentations, where fibrotic changes may be observed. The main treatment strategy is the removal of the exposure to tobacco dust and molds, while the main aim of corticosteroid therapy is to reduce morbidity and prevent complications, namely the development of pulmonary fibrosis and permanent lung dysfunction. Despite the fact that TWL is quite well described, preventive measures are not usually adopted in the tobacco production industry. We present here a state of the art review of this neglected, preventable, but still prevalent and occupational-related subtype of HP.

Biomarkers of Exposure among U.S. Adult Cigar Smokers: Population Assessment of Tobacco and Health (PATH) Study Wave 1 (2013-2014)

BACKGROUND

Given the diverse cigar market and limited data on biomarker patterns by cigar type, we compared biomarkers of nicotine and tobacco toxicants among cigar smokers and other groups.

METHODS

Using Wave 1 urinary biomarker data from 5,604 adults in the Population Assessment of Tobacco and Health (PATH) Study, we compared geometric mean concentrations among cigar-only smokers (all cigars and separately for traditional, cigarillo, and filtered cigars), cigarette-only smokers, dual cigar/cigarette smokers, and never users of tobacco. We calculated geometric mean ratios comparing groups with never users adjusting for sex, age, race/ethnicity, education and creatinine.

RESULTS

Some day cigar-only smokers had lower biomarker concentrations than every day cigar-only smokers, but higher than never users. Every day cigar-only smokers (n = 61) had lower TNE-2 (cotinine+trans-3'-hydroxycotinine) compared to every day cigarette-only (n = 2217; P < 0.0001) and dual cigar/cigarette smokers (n = 601; P < 0.0001). Several biomarkers, including NNAL (NNK metabolite) and CYMA (metabolite of acrylonitrile), were comparable in these groups. In exploratory analyses, every day filtered cigar-only (n = 7) smokers had higher biomarker concentrations compared with every day traditional cigar-only smokers (n = 12) and cigarillo-only smokers (n = 24). Every day smokers of each cigar type were similar to exclusive cigarette smokers. For some biomarkers, particularly for every day filtered cigar-only smokers, concentrations were higher.

CONCLUSIONS

For some biomarkers, every day cigar-only smokers were comparable with every day cigarette-only smokers. Exploratory analyses suggest that biomarkers vary by cigar type with every day filtered cigar-only smokers having the highest concentrations.

IMPACT

High exposure to harmful constituents among cigar smokers is a continuing health issue.

Respiratory Health Status of Workers in a Bottling Factory in Benin City, Nigeria

Introduction: There is a paucity of data on the respiratory health status of workers in bottling factories in Benin City, Nigeria. Such data will help to drive future studies and influence policy development on occupational health and safety in the country. This study assesses the respiratory symptoms and spirometric indices of exposed workers and controls. Methods: Respiratory symptoms and spirometric parameters of 18 workers on routine mandatory annual lung screening were assessed using the modified MRC (Medical Research Council) questionnaire and spirometer respectively, according to the European Respiratory Society and American Thoracic Society (ERS/ATS) guidelines. Results: The mean age of workers was 35.1 ± 6.7 years. Workers and controls were similar in age, sex, BMI (Body Mass Index) and health status (p > 0.05). Respiratory symptoms were significantly higher among workers compared to controls. Overall, the result was statistically significant in the variables of wheeze in a smoky or dusty environment, presence of at least one respiratory symptom, better symptoms at weekends and better symptoms during holidays (p < 0.05). In particular, 6 (33.3%) exposed workers had wheeze in a smoky or dusty environment, 9 (50.0%) exposed workers reported at least one respiratory symptom compared with 2 (11.1%) controls, 5 (27.8%) had better symptoms at weekends, and 7 (38.9%) had better symptoms at holidays (p < 0.05). Generally, the reported frequency of respiratory symptoms among exposed workers were: cough (22.2%), sputum production (5.6%), breathlessness (11.1%) and wheeze (44.4%). Similarly, workers had significantly lower spirometric indices than controls, particularly in forced expiratory volume in 1 s (FEV₁), FEV₁/forced vital capacity (FVC) ratio and forced expiratory flow between 25% and 75% of FVC (FEF 25–75%) measurements. Conclusions: This study provides evidence of adverse respiratory health effects among bottling factory workers which requires further investigation.

Tobacco dust induced genotoxicity as an occupational hazard in workers of bidi making cottage industry of central India

CONTEXT

To explore genotoxicity in bidi rollers occupationally exposed to bidi tobacco dust.

AIMS

To assess the extent of genotoxicity of tobacco dust to bidi rollers of Jabalpur, Madhya Pradesh, India and cytotoxicity of bidi tobacco extract.

SETTINGS AND DESIGN

Blood samples from 31 bidi rollers and 30 controls taken after written informed consent were analyzed for chromosome aberrations (CA) and comet assay.

MATERIALS AND METHODS

Genotoxicity was studied by CA in cultured peripheral blood lymphocytes of bidi rollers and the deoxyribonucleic acid (DNA) damage studies were done by comet assay of their blood. The toxicity of bidi tobacco extract to normal human lymphocytes was studied by MMT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay as drop in viability.

STATISTICAL ANALYSIS USED

Student's t-test and DMRT.

RESULTS

There is a general trend of increase in CA% of both in exposed and control groups with age, but in every group the bidi rollers have a significantly higher CA% than the controls. The CA % is also directly related to exposure. The comet assay findings reveal that the mean comet length and tail length increases with exposure time. The toxicity of bidi tobacco extract (TE) to normal human lymphocytes was tested in vitro by 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay at 2 h of incubation. The trend of drop in viability with increasing concentrations of TE was clearly evident from the data from four donors in spite of their individual differences in viability.

CONCLUSIONS

The results obtained in this investigation indicate that bidi rollers seem to be facing the occupational hazard of genotoxicity due to handling bidi tobacco and inhalation of tobacco dust. They should be advised to work under well-ventilated conditions.

Chromosome damage in workers in cigarette manufacturing industry

To investigate whether occupational exposure to tobacco dust is genotoxic, a group of employees in a tobacco factory was tested for structural chromosome aberrations (CA), cytokinesis-block micronucleus assay (CBMN) and sister chromatid exchanges (SCE) that are well established as indicators of early biological effects. The study group consisted of 40 tobacco workers and an equal number of matched controls. The results obtained in the exposed group showed a significant increase in chromosome aberrations (R=0.26), micronucleus frequency (R=0.56) and in sister chromatid exchanges (R=0.75), which was additionally influenced by smoking. A significant increase in high frequency cells (HFC) in the exposed group was also observed. Like the SCE frequency, the HFC frequency increased significantly in smokers of the control and exposed smokers. The study indicates that occupational exposure to tobacco dust induces genome damage. A higher risk was observed in women. The micronucleus frequency and sister chromatid exchange tests seem to be more reliable indicators of genome damage than chromosome aberrations in monitoring chronically exposed subjects.

Environmental mycological study and allergic respiratory disease among tobacco processing workers

This study presents the results of an investigation of respiratory symptoms, lung function, chest X-ray examinations, analysis of specific IgE antibodies and skin prick tests to fungi on 130 tobacco-processing workers and 112 control workers. Industrial hygiene survey and environmental mycological studies were also performed. The average dust concentrations ranged from 13.76 to 29.55 mg/m(3) in the tobacco processing workshops. Also, the numbers of fungi colonies in the processing environments were much higher than those in the control environments. The prevalences of chronic respiratory or nasal symptoms in exposed workers were significantly higher than those in control workers (p<0.05 or p<0.01). The prevalences of lung function abnormalities in the exposed workers were significantly higher than those in control workers (p<0.05). The positive prevalences of specific IgE reactions to fungi (26.92% for A.fumigatus and 51.54% for Rhizopus nigricans) in exposed workers were also significantly higher than those in control workers (p<0.01). The positive prevalences of the skin prick test showed that 18.46% of the exposed workers were positive to A. fumigatus and 23.85% were positive to Rhizopus nigricans. Our results suggested that tobacco processing workers may develop respiratory diseases related to tobacco dust and we consider that fungi might be one of the allergens causing allergic respiratory or nasal diseases in tobacco processing workers.

Immunological and respiratory changes in tobacco workers

BACKGROUND

Tobacco workers develop respiratory changes following occupational exposure to tobacco dust.

METHODS

This study investigated 102 tobacco workers as well as a group of 30 matched control workers. Immunological testing, symptom questionnaire, and lung function measurements were performed in all workers.

RESULTS

Increased total IgE was found in 12.7% of tobacco workers but in none of the controls (P < 0.05). Increased specific IgE (tobacco allergen) was recorded in 26.7% of tobacco workers with positive skin tests to tobacco extract but in none of the controls (P < 0.05). Regression analysis of ventilatory tests in female tobacco workers indicated a significant association of FEF75 to employment and smoking among workers with positive skin tests to tobacco. There were, however, no other associations between positive immunologic findings and lung function abnormalities and symptoms.

CONCLUSIONS

Our study found increased immunological reactions in the tobacco workers. However, with the possible exception of lung function at low lung volume in female workers, these reactions do not appear to contribute significantly to the symptoms and lung function abnormalities seen in these workers. Am. J. Ind. Med. 45:76-83, 2004.

Cytogenetic effects in workers occupationally exposed to tobacco dust

Tobacco dust mainly contains nitrosamines, which are readily absorbed by the body tissues like skin, respiratory epithelium, and mucous membrane of mouth, nose and intestines. Exposure to tobacco dust is known to affect the respiratory tracts in humans. In the present study, cytogenetic effects of exposure to tobacco dust are evaluated in 154 male tobacco factory workers and 138 age and sex matched controls by analysing chromosomal aberrations in their peripheral blood lymphocytes. The workers were in the age group of 20-55 years and were employed in the tobacco processing factory for 1-32 years. Heparinised blood samples were collected from workers and control subjects and lymphocyte cultures were carried out by using standard technique. Slides were prepared and 150 metaphases were screened for each sample for various structural and numerical types of abnormalities. A statistically significant increase was observed in the frequencies of chromosomal aberrations in non-smoking and smoking exposed groups when compared to the respective controls. An increase in the frequencies of chromosomal aberrations was also observed with increase in years of service in the exposed subjects.