Dust exposure is associated with increased lung function loss among workers in the Norwegian silicon carbide industry

Early Detection Methods for Silicosis in Australia and Internationally: A Review of the Literature

Pneumoconiosis, or occupational lung disease, is one of the world’s most prevalent work-related diseases. Silicosis, a type of pneumoconiosis, is caused by inhaling respirable crystalline silica (RCS) dust. Although silicosis can be fatal, it is completely preventable. Hundreds of thousands of workers globally are at risk of being exposed to RCS at the workplace from various activities in many industries. Currently, in Australia and internationally, there are a range of methods used for the respiratory surveillance of workers exposed to RCS. These methods include health and exposure questionnaires, spirometry, chest X-rays, and HRCT. However, these methods predominantly do not detect the disease until it has significantly progressed. For this reason, there is a growing body of research investigating early detection methods for silicosis, particularly biomarkers. This literature review summarises the research to date on early detection methods for silicosis and makes recommendations for future work in this area. Findings from this review conclude that there is a critical need for an early detection method for silicosis, however, further laboratory- and field-based research is required.

Exposure to Ultrafine Particles in the Ferroalloy Industry Using a Logbook Method

Background: It is difficult to assess workers’ exposure to ultrafine particles (UFP) due to the lack of personal sampling equipment available for this particle fraction. The logbook method has been proposed as a general method for exposure assessment. This method measures the time and concentration components of the time-weighted average concentration separately and could be suitable for investigation of UFP exposure. Objectives: In this study, we have assessed workers’ exposure to UFP in a ferrosilicon plant. The main tasks of the furnace workers were identified, and the logbook method was used in combination with stationary measurements of UFP taken as close to the identified task areas as possible. In order to verify the results, respirable particles were collected using stationary sampling in close proximity to the UFP measuring instrument, and personal full-shift sampling of respirable particles was performed simultaneously. Thus, exposure to respirable particles determined using the logbook method could be compared to the results of standard measurement. Methods: The particle number concentration of ultrafine particles was determined using a NanoScan SMPS. Respirable particle concentration and exposure were determined using a sampling train consisting of a pump, filter, filter cassettes, and SKC Cyclone for the respirable fraction. Attendance times for workers at each work location were registered via thorough observations made by the research team. Results: The logbook method for exposure estimation based on stationary sampling equipment made it possible to calculate UFP exposure for workers operating the furnaces at a ferrosilicon plant. The mid-size furnace and the large furnace were evaluated separately. The workers operating the largest furnace were exposed to 1.47 × 10⁴ particles/cm³, while workers operating the mid-size furnace were exposed to 2.06 × 10⁴ particles/cm³, with a mean of 1.74 × 10⁴ particles/cm³. Substantial contributions from the casting area, ladle transport corridor, and both tapping areas were made. Exposure to respirable particles was 2.04 mg/m³ (logbook); 2.26 mg/m³ (personal sampling) for workers operating the large-sized furnace, 3.24 mg/m³ (logbook); 2.44 mg/m³ (personal sampling) for workers operating the medium-sized furnace, and 2.57 mg/m³ (logbook); 2.53 mg/m³(personal sampling) on average of all tappers. The average ratio of these two methods’ results was 1.02, which indicates that the logbook method could be used as a substitute for personal sampling when it is not possible to perform personal sampling, at least within this industry. Conclusions: The logbook method is a useful supplement for exposure assessment of UFP, able to identify the most polluted areas of the workplace and the contribution of different work tasks to the total exposure of workers, enabling companies to take action to reduce exposure.

Association between duration of coal dust exposure and respiratory impairment in coal miners of West Bengal, India

Purpose. The prevalence and severity of respiratory disorders are very high among coal miners as continuous exposure of workers in such an environment leads to accumulation of dust in the lungs. This study was designed to assess the prevalence of lung function impairment and to determine whether there is any correlation between dust exposure duration and lung function indices. Materials. Two hundred and thirty underground coal dust-exposed workers and 130 age-matched non-exposed workers were recruited from an underground mine in West Bengal, India. A spirometry test was performed for lung function and also basic information on personnel's dust exposure, smoking and respiratory morbidity was collected. Student's t test, Pearson's correlation coefficient (r), uncorrected Pearson's χ² test and Fischer's exact test were performed for statistical analysis. Results. Lung function indices were significantly (p < 0.050) impaired between the exposed (43.91%) and non-exposed (23.85%) groups. In addition, highly significant decrements in the pulmonary volumes of exposed subjects were also noted. Furthermore, a high negative correlation was observed between spirometric results and exposure time in the exposed group compared with the non-exposed group. Conclusion. This study suggested a positive relationship between exposure time and lung function deterioration.

Do Various Respirator Models Fit the Workers in the Norwegian Smelting Industry?

Background

Respirator fit testing is a method to assess if the respirator provides an adequate face seal for the worker.

Methods

Workers from four Norwegian smelters were invited to participate in the study, and 701 respirator fit tests were performed on 127 workers. Fourteen respirator models were included: one FFABE1P3 and 11 FFP3 respirator models produced in one size and two silicone half masks with P3 filters available in three sizes. The workers performed a quantitative fit test according to Health and Safety Executive 282/28 with 5–6 different respirator models, and they rated the respirators based on comfort. Predictors of overall fit factors were explored.

Results

The pass rate for all fit tests was 62%, 56% for women, and 63% for men. The silicone respirators had the highest percentage of passed tests (92–100%). The pass rate for the FFP3 models varied from 19–89%, whereas the FFABE1P3 respirator had a pass rate of 36%. Five workers did not pass with any respirators, and 14 passed with all the respirators tested. Only 63% passed the test with the respirator they normally used. The mean comfort score on the scale from 1 to 5 was 3.2. The respirator model was the strongest predictor of the overall fit factor. The other predictors (age, sex, and comfort score) did not improve the fit of the model.

Conclusion

There were large differences in how well the different respirator models fitted the Norwegian smelter workers. The results can be useful when choosing which respirators to include in respirator fit testing programs in similar populations.

Size distribution and single particle characterization of airborne particulate matter collected in a silicon carbide plant

The global SiC market is projected to grow in the coming years, and research on potential health effects as well as epidemiological studies is therefore of importance. A detailed characterization in terms of the phase composition, morphology and mixing state of airborne PM is still missing, though highly necessary to identify sources and to understand the risk factors in this industry. Particles in the size range of 10 nm to 10 µm were collected with a 13-stage NanoMOUDI impactor in the Acheson Furnace Hall as well as in processing departments during two sampling campaigns. Particle mass concentrations, including the fraction of ultrafine particles (UFPs), were lower in the processing departments in comparison to those in the Acheson Furnace Hall. The particle number size distribution measured with a scanning mobility particle sizer confirmed the low amount of UFPs in the processing departments compared to the furnace hall. Significant differences in the particle mass concentration and distribution were observed in the Acheson Furnace Hall during the two sampling campaigns. The PM size distribution depends upon the sampling location, on the cycle of the nearby furnaces and on special incidents occurring during a furnace run. Scanning and transmission electron microscopy (SEM and TEM) showed that the size range of 0.32-10 µm (aerodynamic diameter) is dominated by carbon (C)-rich particles, which were identified as petroleum coke, graphite, soot and amorphous spherical C-rich particles. Soot was further classified into three types based on the primary particle size, morphology and composition. Diesel-powered vehicles, pyrolysis of petroleum coke and incomplete combustion of volatile components from this pyrolysis are suggested as sources of different soot particle types. Amorphous spherical C-rich particles were also sub-classified based on their morphology and composition as tar balls (TBs) and C-spherical type 2. The amount of SiC fibers and crystalline SiO2 was found to be low. In the size fraction below 0.32 µm (aerodynamic diameter), sulphur (S)-rich particles dominate. This knowledge of the particle size distribution, and chemical and physical properties of the PM occurring in the SiC production is fundamental for an appropriate risk assessment, and these findings should have implications for future epidemiological studies and for the mitigation of worker exposure.

Predictors of Respiratory Protective Equipment Use in the Norwegian Smelter Industry: The Role of the Theory of Planned Behavior, Safety Climate, and Work Experience in Understanding Protective Behavior

Previous research has revealed a higher prevalence of respiratory symptoms in Norwegian smelter workers compared to average population controls. Nevertheless, respiratory protective equipment (RPE) is not always used, even in situations with high exposure risk. A questionnaire was distributed to workers in the Norwegian smelting industry to investigate the relationship between psychological factors and self-reported use of RPEs. Response rate was 567/1,253. A scale measuring attitudes toward behavior (ATT), subjective norms (SN), perceived behavioral control (PBC), and behavioral intention (BI) was constructed based on the Theory of Planned Behavior (TPB). Reliability and Confirmatory Factor Analyses partially supported the theoretical structure of the TPB-based scale, the Work Experience Measurement Scale (WEMS) and the Short Scale for Safety Climate (SC). A model explaining the relationship between observed variables, latent constructs from TPB, WEMS and SC was developed by SEM-analysis. Significant influence on BI from ATT (β = 0.31 p < 0.01), SN (β = 0.36 p < 0.01), and SC (β = 0.19, p < 0.01) emerged. Among the observed variables included, relationship status (β = −0.12 p < 0.05), education level (β = 0.09, p < 0.05), previously completed respirator fit-testing (β = −0.09, p < 0.05) and average hours spent in exposed areas (β = −0.09) p < 0.05) had significant influence on behavioral intention. The model explained 48% of the variance in BI. BI and PBC significantly predicted PB, with β = 0.65 and β = −0.06, respectively. Results of this investigation can help facilitate further work and development of health & safety routines within industrial settings.

Real-Time Measurements and Characterization of Airborne Particulate Matter from a Primary Silicon Carbide Production Plant

Airborne particulate matter in the silicon carbide (SiC) industry is a known health hazard. The aims of this study were to elucidate whether the particulate matter generated inside the Acheson furnace during active operation is representative of the overall particulate matter in the furnace hall, and whether the Acheson furnaces are the main sources of ultrafine particles (UFP) in primary SiC production. The number concentration of ultrafine particles was evaluated using an Electrical Low Pressure Impactor (ELPI^TM, Dekati Ltd., Tampere, Finland), a Fast Mobility Particle Sizer (FMPS^TM, TSI, Shoreview, MN, USA) and a Condensation Particle Counter (CPC, TSI, Shoreview, MN, USA). The results are discussed in terms of particle number concentration, particle size distribution and are also characterized by means of electron microscopy (TEM/SEM). Two locations were investigated; the industrial Acheson process furnace hall and a pilot furnace hall; both of which represent an active operating furnace. The geometric mean of the particle number concentration in the Acheson process furnace hall was 7.7 × 10⁴ particles/cm³ for the UFP fraction and 1.0 × 10⁵ particles/cm³ for the submicrometre fraction. Particulate matter collected at the two sites was analysed by electron microscopy. The PM from the Acheson process furnace hall is dominated by carbonaceous particles while the samples collected near the pilot furnace are primarily rich in silicon.

Cellular responses of human astrocytoma cells to dust from the Acheson process: An in vitro study

Silicon carbide (SiC) is largely used in various products such as diesel particulate filters and solar panels. It is produced through the Acheson process where aerosolized fractions of SiC and other by-products are generated in the work environment and may potentially affect the workers' health. In this study, dust was collected directly on a filter in a furnace hall over a time period of 24h. The collected dust was characterized by scanning electron microscopy and found to contain a high content of graphite particles, and carbon and silicon containing particles. Only 6% was classified as SiC, whereof only 10% had a fibrous structure. To study effects of exposure beyond the respiratory system, neurotoxic effects on human astrocytic cells, were investigated. Both low, occupationally relevant, and high doses from 9E-6μg/cm² up to 4.5μg/cm² were used, respectively. Cytotoxicity assay indicated no effects of low doses but an effect of the higher doses after 24h. Furthermore, investigation of intracellular reactive oxygen species (ROS) indicated no effects with low doses, whereas a higher dose of 0.9μg/cm² induced a significant increase in ROS and DNA damage. In summary, low doses of dust from the Acheson process may exert no or little toxic effects, at least experimentally in the laboratory on human astrocytes. However, higher doses have implications and are likely a result of the complex composition of the dust.

Occupational COPD and job exposure matrices: a systematic review and meta-analysis

Background

The association between occupational exposure and COPD reported previously has mostly been derived from studies relying on self-reported exposure to vapors, gases, dust, or fumes (VGDF), which could be subjective and prone to biases. The aim of this study was to assess the strength of association between exposure and COPD from studies that derived exposure by job exposure matrices (JEMs).

Methods

A systematic search of JEM-based occupational COPD studies published between 1980 and 2015 was conducted in PubMed and EMBASE, followed by meta-analysis. Meta-analysis was performed using a random-effects model, with results presented as a pooled effect estimate with 95% confidence intervals (CIs). The quality of study (risk of bias and confounding) was assessed by 13 RTI questionnaires. Heterogeneity between studies and its possible sources were assessed by Egger test and meta-regression, respectively.

Results

In all, 61 studies were identified and 29 were included in the meta-analysis. Based on JEM-based studies, there was 22% (pooled odds ratio =1.22; 95% CI 1.18–1.27) increased risk of COPD among those exposed to airborne pollutants arising from occupation. Comparatively, higher risk estimates were obtained for general populations JEMs (based on expert consensus) than workplace-based JEM were derived using measured exposure data (1.26; 1.20–1.33 vs 1.14; 1.10–1.19). Higher risk estimates were also obtained for self-reported exposure to VGDF than JEMs-based exposure to VGDF (1.91; 1.72–2.13 vs 1.10; 1.06–1.24). Dusts, particularly biological dusts (1.33; 1.17–1.51), had the highest risk estimates for COPD. Although the majority of occupational COPD studies focus on dusty environments, no difference in risk estimates was found for the common forms of occupational airborne pollutants.

Conclusion

Our findings highlight the need to interpret previous studies with caution as self-reported exposure to VGDF may have overestimated the risk of occupational COPD.

Respiratory illness and air pollution from the steel industry: the case of Piquiá de Baixo, Brazil (Preliminary report)

BACKGROUND

This report is based on an independent study carried out by medical professionals of the Fondazione IRCCS Istituto Nazionale dei Tumori (National Cancer Institute) in Milan, Italy, and  aimed to assess the incidence of respiratory diseases in a Brazilian community (Piquiá de Baixo, in the city of Açailandia) exposed to extreme air pollution in connection to a local steel manufacturing plant. The study has the objective to contribute to the existing literature on the health risks associated with fine particle pollution (PM2.5) due to steel production with data from Brazil.

METHODS

The study is based on a cross-sectional sample of the resident population of Piquiá de Baixo age 16 or over consisting of 220 people. We collected data about the health conditions of participant subjects in two ways: a) medical history questionnaires and b) clinical assessment of respiratory function through spirometry testing. The results were evaluated based on comparative studies.

RESULTS

According to the spirometric tests performed, 28 % of the sample population suffers from respiratory pathologies (for the most part of restrictive rather than obstructive nature). This incidence rate is between six and two times higher than those reported in similar studies carried out in other countries (which range between 4.6 and 14.5 %). In addition, the incidence rate is also significantly high in light of the fact that our sample population did not include the category of subjects most at risk for pulmonary disorders in connection to air pollution caused by the Piquiá steel processing complex: in other words, men and women employed in the steel mills or in connection with their industrial cycle (as many as 434 Piquiá residents age 16 and over were unable to participate to our study due to "work-related reasons").

CONCLUSIONS

In light of the above considerations, we believe that our findings contribute to the existing literature on the correlation between pulmonary disease and air pollution in industrialized areas, while warranting further scientific research on the public health consequences of industrial production in Piquiá de Baixo. In turn, on the ethical plane, we believe that research of this nature strengthens the need to advocate for more severe environmental and health policies aimed at limiting the hazards associated with the steel industry in Piquiá and in similar contexts around the world.

Increased Decline in Pulmonary Function Among Employees in Norwegian Smelters Reporting Work-Related Asthma-Like Symptoms

OBJECTIVE

To investigate associations between work-related asthma-like symptoms (WASTH) and annual pulmonary function decline among employees of 18 Norwegian smelters.

METHODS

A 5-year longitudinal study in which WASTH was defined as a combination of dyspnea and wheezing that improved on rest days and vacation.

RESULTS

A total of 12,966 spirometry examinations were performed in 3084 employees. Crude annual decline in forced expiratory volume in 1 second (FEV1) (dFEV1) was 32.9 mL/yr (95% confidence interval, 30.5 to 35.3), and crude annual decline in forced vital capacity (FVC) (dFVC) was 40.9 mL/yr (37.8 to 43.9). After adjustment for relevant covariates, employees reporting WASTH showed higher dFEV1 by 16.0 m:/yr (3.4 to 28.6) and higher dFVC by 20.5 mL/yr (6.0 to 35.0) compared with employees not reporting WASTH.

CONCLUSION

Work-related asthma-like symptom was associated with greater annual declines in FEV1 and FVC, indicating a restrictive pattern.

Annual decline in forced expiratory volume is steeper in aluminum potroom workers than in workers without exposure to potroom fumes

Background

Aluminum potroom exposure is associated with increased mortality of COPD but the association between potroom exposure and annual decline in lung function is unknown. We have measured lung volumes annually using spirometry from 1986 to 1996. The objective was to compare annual decline in forced expiratory volume in 1 s (dFEV1) and forced vital capacity (dFVC).

Methods

The number of aluminum potroom workers was 4,546 (81% males) and the number of workers in the reference group was 651 (76% males). The number of spirometries in the index group and the references were 24,060 and 2,243, respectively.

Results

After adjustment for confounders, the difference in dFEV1 and dFVC between the index and reference groups were 13.5 (P < 0.001) and −8.0 (P = 0.060) ml/year.

Conclusion

Aluminum potroom operators have increased annual decline in FEV1 relative to a comparable group with non‐exposure to potroom fumes and gases. Am. J. Ind. Med. 59:322–329, 2016. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Relationship of cumulative dust exposure dose and cumulative abnormal rate of pulmonary function in coal mixture workers

To investigate the dose-response relationship between cumulative dust exposure (CDE) and cumulative abnormal rate of pulmonary function in coal mixture workers. Three hundred and twenty eight coal mixture workers (exposed group) and 169 nondust-exposed workers (control group) were recruited. Basic information data were collected and pulmonary function tests were performed. Pulmonary function was compared between the two groups after comparing smoking behaviors. Pulmonary function indices [forced vital capacity in 1 second after full inspiration (FVC)%, forced expiratory volume (FEV)1%, and FEV1/FVC%] were compared among groups stratified by service length (exposure duration). The relationship between CDE dose and cumulative abnormal rate of pulmonary function in coal mixture workers was analyzed. Abnormal rate of pulmonary function in the exposed group (35.1%) was significantly higher than the control group (10.1%; p < 0.001); FVC%, FEV1%, and FEV1/FVC% in the exposed group decreased significantly compared with the control group (all p < 0.05). Differences in FVC%, FEV1%, and FEV1/FVC% among coal mixture workers stratified by exposure duration in the exposed group were statistically significant (all p < 0.05). The discernible increase in the cumulative abnormal rate was observed, from ≥ 1000 mg/m(3)·years group to ≥ 1700 mg/m(3)·years group. Correlation analysis revealed a positive correlation between the CDE dose and the cumulative abnormal rate of pulmonary function. Higher abnormal pulmonary function rate was found among coal mixture workers, characterized by decreased pulmonary function indices. Our results suggested a positive relationship between CDE dose and cumulative abnormal pulmonary function rate, and a rapid increase in cumulative abnormal rate within a certain range of CDE dose. A lower limit value of 1000 mg/m(3)·years has reference significance.