Monica Dahlqvist

Small airways function in aluminium and stainless steel welders

SummaryThe effect of welding fumes on small airways was studied in 25 male subjects who welded in aluminium (Al) and to some extent also in stainless steel (SS). Despite a low exposure to welding fumes as compared to the permissible exposure limits, excretion of Al in urine was found to be increased in all subjects (median value: 0.29 mmol/mol creatinine on Friday afternoon, as compared to an upper reference level of 0.10 mmol/mol creatinine). In addition, the welders displayed increased prevalences of work-related eye and airways (pharyngitis and non-specific bronchial hyper-reactivity) symptoms, as compared to 25 matched controls. Short-term welders (≤ 2.5 years) had more symptoms related to the upper airways than did long-term welders, which may indicate a selection. Spirometry, closing volume and volume of trapped gas (VTG) did not deviate. However, after methacholine inhalation, the long-term welders had a significantly steeper slope of the alveolar plateau on the single-breath nitrogen wash-out test, and a slight increase in VTG, as compared to the short-term welders and the controls. These findings may indicate a welding fume-induced increase in the reactivity of the small airways. Because Al welding was far more frequent than SS welding, an association with the former seems likely.

Impeded lung function in moulders and coremakers handling furan resin sand

SummaryA total of 39 moulders and coremakers exposed to furan resin sand and 27 unexposed local controls were examined by lung-function tests before and after a work shift. In all, 28 of the subjects exposed to furan resin sand and the control group were evaluated by dynamic spirometry and nitrogen washout. The remaining 11 subjects exposed to furan resin sand were studied using both static and dynamic spirometry and the CO single-breath technique. The time-weighted average exposure to furfuryl alcohol was about 7 mg/m3, with peak values exceeding the present Swedish short-term exposure limit (40 mg/m3). The exposure to respirable dust and formaldehyde as time-weighted over the shift was < 2 mg/m3 and 0.4 mg/m3, respectively, in all groups. During the work shift studied, the 28 exposed subjects had more complaints of airway symptoms than did the controls, showing an average decrease of 0.21 in forced vital capacity but no fall in any other lung-function variable. The remaining 11 exposed subjects demonstrated a post-shift decrease in total lung capacity. The results indicate an acute restrictiveness induced by exposure to furan resin sand, but the underlying mechanism is unclear. Chronic impairment of lung function was not observed.

Serum IgE and lung function in workers exposed to phthalic anhydride

SummaryA total of 23 phthalic anhydride (PA)-exposed workers (air levels up to 17 mg/m3) showed significantly (P<0.01) more workrelated symptoms in their eyes (48% vs 6%) and nose (39% vs 0) than did 18 unexposed control subjects. Two of the exposed workers had PA-associated asthma. Surprisingly, the control group exhibited significantly (P<0.05) more symptoms of nonspecific bronchial hyperreactivity (44% vs 13%). The exposed workers showed significantly higher levels of total serum IgE (medians, 32 vs 15 kIU/l, P<0.05), although values for specific IgE against PA did not differ. This may indicate that such exposure can facilitate the entry of common allergens. There was a significant difference in PA-specific IgG [enzyme-linked immunosorbent assay (ELISA) ratios 0.21 vs 0.12; P<0.01]. There were no differences in lung function with regard to vital capacity (VC) and forced expiratory volume (FEV1), closing volume expressed as a percentage of VC (CV%), volume of trapped gas (VTG) before and after inhalation of metacholine, or carbon monoxide transfer factor (TLCO), whereas exposed workers displayed significantly higher late expiratory flow rates (MEF5O and MEF25). In a [99mTc]-diethylenetriamine penta-acetate (DTPA) clearance test, there was no difference between exposed subjects and controls. In summary, exposure to PA did not cause subclinical effects of the lungs. Subjects with lower-airway symptoms showed lower FEV1, MEF50, and MEF25 values and higher VTG (after metacholine) than did those without symptoms. Six subjects with chronic bronchitis displayed significantly (P<0.05) higher VTG (before metacholine) and TLCO, than those without this ailment. Thus, VC, CV and the [99m99mTc]-DTPA test were not affected by the lung disorder.

Lung function and exposure to paper dust in bookbinders—A pilot study

Lung function deterioration has been reported among workers exposed to heavy exposure to paper dust (greater than 5 mg/m3). This pilot study was undertaken in order to evaluate the health effects of low exposure to paper dust (less than or equal to 1 mg/m3) in bookbinders. The study population consisted of 20 exposed subjects and 18 local office subjects. They were studied during identical conditions by means of dynamic and static spirometry, single breath wash-out with nitrogen (N2) and carbon monoxide (CO). The 90th percentile for daily average values of total dust was 0.6 mg/m3. Non-smoking exposed subjects had on the average an increase in FEV% (forced expiratory volume in one second in percentage of vital capacity) when compared to non-smoking local control subjects. We found a weak correlation between the increase in FEV% and daily average values of total dust (probably reflecting a higher exposure in the past). The results suggest that a low exposure to paper dust in bookbinders with a time of employment more than 10 years might cause a slight lung function deterioration without a clinical relevance.

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.