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Occupational air pollutants and non-malignant respiratory disorders especially in miners: thesis IX
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim. To assess associations between occupational air pollution and respiratory health, especially in miners.

Background. Indications of associations between occupational exposure or social economic status and respiratory health have been found in several population-based studies. However, there have been few longitudinal studies of the putative correlations, the effects of environmental and genetic factors have seldom been simultaneously studied, and studies of miners have generated conflicting results.

Material and methods. Population-based Obstructive Lung Disease in Northern Sweden (OLIN) cohorts surveyed in 1986, 1992 and 1996, and two industry-based materials, were used in cross-sectional and longitudinal studies. Inflammatory markers were compared in sputa from miners after a vacation of at least four weeks, after repeated occupational exposures for at least three months, and controls. The mortality from silicosis was studied in 7729 miners with at least 1 year of exposure. Multivariate analyses were used to adjust for confounders.

Results. Up to about 30-40% (etiologic fraction) of incident symptoms in persons both with and without a family history of asthma (FHA) could be explained by exposure to occupational air pollution. Low socio-economic status (SES) was associated with impaired respiratory health. Population attributable risks for most examined disorders were about 10%. Current and ex-miners had increased prevalence of recurrent wheeze, longstanding cough, physician-diagnosed chronic bronchitis, and a trend for increased sputum production. For physician-diagnosed chronic bronchitis a multiplicative interaction was found between exposure and smoking habits. Ex-miners that had been exposed for on average 13 years and whose exposure had ceased 16 years before the study had an increased prevalence of physician-diagnosed chronic bronchitis and chronic productive cough and a trend to increased use of asthma medicines.

Miners exposed underground for 18 years, on average, to diesel exhaust (with 0.28 mg/m3 nitrogen dioxide and 27 μg/m3 elemental carbon on average, EC) and particles (3.2 mg/m3 inhalable dust on average) had signs of higher inflammatory activity in their airways, i.e. significantly higher frequencies of macrophages, neutrophils, and total cells compared with referents. The activity in miners was similar after a vacation of at least four weeks and after repeated exposures for three months.

There were 58 deaths from silicosis (underlying and contributing cause of death) and a clear dose-response relationship. The data indicated an increased risk of severe silicosis after long-term exposure to 0.1 mg/m3 respirable quartz, the current maximum allowable concentration (MAC) in Sweden and many other countries.

Conclusion. Occupational exposure to dust, gases, and fumes impaired respiratory health, accounting for up to 30-40% of some respiratory symptoms in the general population. Low socio-economic status was associated with impaired respiratory health. The complex profiles of dust and diesel exhaust substances found in mines may cause inflammatory reactions in their lungs and persistent respiratory symptoms in occupationally exposed miners. Long-term exposure to quartz at the present MAC level may cause severe silicosis.

Place, publisher, year, edition, pages
Umeå: Yrkes- och miljömedicin , 2008. , p. 80
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1159
Keyword [en]
respiratory symptoms, occupational epidemiology, mining, asthma, airway inflammation, dust, diesel exhaust, quartz, chronic bronchitis, silicosis
Research subject
Occupational and Environmental Medicine
Identifiers
URN: urn:nbn:se:umu:diva-1591ISBN: 978-91-7264-510-3 (print)OAI: oai:DiVA.org:umu-1591DiVA, id: diva2:141483
Public defence
2008-04-11, Sal B, 1D, NUS, Umeå, 14:00 (English)
Opponent
Available from: 2008-03-20 Created: 2008-03-20 Last updated: 2011-03-23Bibliographically approved
List of papers
1. Occupational exposure to dust, gases and fumes, a family history of asthma and impaired respiratory health
Open this publication in new window or tab >>Occupational exposure to dust, gases and fumes, a family history of asthma and impaired respiratory health
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2008 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 34, no 5, p. 381-386Article in journal (Refereed) Published
Abstract [en]

Objectives: This study assessed the impact of occupational exposure to dust, gases, and fumes on respiratory symptoms, obstructive lung diseases, or the use of asthma medication among persons with and without a family history of asthma.

Methods: A population-based cohort was followed for 10 years. This study included all 1739 men and 1594 women occupationally active at the first survey. Exposure and respiratory health were assessed from questionnaires. Multiple logistic regression was used to estimate the effects in relation to occupational groups, with age, gender, and smoking habits as possible confounders, using both cross-sectional and longitudinal analyses. The susceptibility to impaired respiratory health was determined from a family history of asthma.

Results: A family history of asthma was reported by 27% of the men and 34% of the women. Both occupational exposure and a family history of asthma were associated with impaired respiratory health. The etiologic fractions showed that up to about 70% of the symptoms could be explained by a family history of asthma among those exposed to low levels of air pollutants, as well as among those with high exposure. However, high exposure contributed up to 35% of the symptoms both among those with and among those without a family history of asthma. The study indicates that the relative risk of occupational exposure to pollutants is similar for both persons with and those without a family history of asthma.

Conclusions: The relative risk for impaired respiratory health after exposure to occupational air pollutants seems to be similar for persons with and those without a susceptibility to impaired respiratory health.

Place, publisher, year, edition, pages
Helsinki: Finnish Institute of Occupational Health, 2008
Keyword
asthma, chronic bronchitis, disease susceptibility, epidemiology, etiologic fraction, respiratory symptom
Identifiers
urn:nbn:se:umu:diva-24849 (URN)18956125 (PubMedID)
Available from: 2009-07-20 Created: 2009-07-20 Last updated: 2018-06-08Bibliographically approved
2. Socio-economic status is related to incidence of asthma and respiratory symptoms in adults.
Open this publication in new window or tab >>Socio-economic status is related to incidence of asthma and respiratory symptoms in adults.
2006 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 28, no 2, p. 303-310Article in journal (Refereed) Published
Keyword
Adult, Age Factors, Aged, Aged; 80 and over, Asthma/*epidemiology, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Risk Factors, Sex Factors, Social Class, Sweden
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-5746 (URN)10.1183/09031936.06.00108105 (DOI)16540503 (PubMedID)
Available from: 2007-11-29 Created: 2007-11-29 Last updated: 2018-06-09Bibliographically approved
3. Respiratory symptoms and obstructive lung diseases in iron ore miners: report from the obstructive lung disease in northern Sweden studies.
Open this publication in new window or tab >>Respiratory symptoms and obstructive lung diseases in iron ore miners: report from the obstructive lung disease in northern Sweden studies.
2004 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 19, no 10, p. 953-958Article in journal (Refereed) Published
Abstract [en]

This is a population-based study on the prevalence of respiratory symptoms assessed by a mail questionnaire. The objective was to examine if work in an iron mine increased the risk of airway symptoms or obstructive diseases. The exposed group consisted of 114 previous or current male miners. Referents, 2472 males from the province, had never been employed by the mining company or worked as miners. Age, smoking and a family history of asthma were considered as possible confounders. The miners had an increased risk for respiratory symptoms (OR=2.2, 95% CI=1.4-3.1) including recurrent wheeze (OR= 2.4, 95% CI= 1.5-3.9), longstanding cough (OR= 1.8, 95% CI = 1.0-3.2), and for physician-diagnosed chronic bronchitis (OR=2.2, 95% CI= 1.0-4.5). Attacks of shortness of breath and asthma manifestations were similar between miners and referents. Higher risks in miners were found particularly among the non-smokers for physician-diagnosed chronic bronchitis (OR=9.2, 95% CI= 3.0-28) and for symptoms as well. A family history of asthma was less common among miners (9.2% vs. 17%, p < 0.05). We conclude that miners in a modern underground iron mine had an increased risk of respiratory symptoms. In contrast to other studies, this increased risk was particularly found in nonsmokers. A family history of asthma may be an important confounder in occupational studies of respiratory diseases.

Identifiers
urn:nbn:se:umu:diva-18811 (URN)10.1007/s10654-004-5194-7 (DOI)15575354 (PubMedID)
Available from: 2009-02-25 Created: 2009-02-25 Last updated: 2018-06-09
4. Persistence of respiratory symptoms in ex-underground iron ore miners.
Open this publication in new window or tab >>Persistence of respiratory symptoms in ex-underground iron ore miners.
2006 (English)In: Occup Med (Lond), ISSN 0962-7480, Vol. 56, no 6, p. 380-385Article in journal (Refereed) Published
Keyword
Bronchitis; Chronic/*physiopathology, Case-Control Studies, Cross-Sectional Studies, Dust, Forced Expiratory Volume, Humans, Iron, Lung/*physiopathology, Lung Diseases; Obstructive/physiopathology, Male, Middle Aged, Mining, Multivariate Analysis, Occupational Diseases/*physiopathology, Occupational Exposure, Prevalence, Retirement, Smoking/adverse effects, Sweden
Identifiers
urn:nbn:se:umu:diva-5748 (URN)10.1093/occmed/kql035 (DOI)16766596 (PubMedID)
Available from: 2007-12-06 Created: 2007-12-06 Last updated: 2018-06-09Bibliographically approved
5. Airway inflammation in iron ore miners exposed to dust and diesel exhaust.
Open this publication in new window or tab >>Airway inflammation in iron ore miners exposed to dust and diesel exhaust.
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2006 (English)In: Eur Respir J, ISSN 0903-1936, Vol. 27, no 4, p. 714-719Article in journal (Refereed) Published
Keyword
Adult, Carbon/analysis, Dust/analysis, Fibronectins/analysis, Humans, Interleukin-10/analysis, Iron, Macrophages; Alveolar/immunology, Male, Matrix Metalloproteinase 9/analysis, Middle Aged, Mining, Neutrophils/immunology, Nitrogen Dioxide/analysis, Occupational Exposure/*adverse effects/analysis, Pneumoconiosis/*etiology, Reference Values, Risk Factors, Sputum/cytology/immunology, Vehicle Emissions/analysis/*toxicity
Identifiers
urn:nbn:se:umu:diva-15398 (URN)10.1183/09031936.06.00034705 (DOI)16455836 (PubMedID)
Available from: 2008-01-11 Created: 2008-01-11 Last updated: 2018-06-09Bibliographically approved
6. Exposure-response of silicosis mortality in Swedish iron ore miners.
Open this publication in new window or tab >>Exposure-response of silicosis mortality in Swedish iron ore miners.
2008 (English)In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 52, no 1, p. 3-7Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To assess the exposure-response relationship between exposure to quartz and fatal silicosis. METHODS: The mortality from silicosis in 7729 miners was analyzed and compared to their estimated exposure to respirable quartz. The miners had been working as a miner for at least 1 year between 1923 and 1996. Their mortality between 1952 and 2001 was studied by using information from the national cause of death register. Both underlying and contributing causes of death were considered in the analysis. The exposure to quartz was estimated from job titles and using 3239 measurements of personal exposure to respirable quartz from 1965 to 1999. The mortality rates were adjusted to attained age and years of birth using a Poisson regression. RESULTS: The median cumulative exposure among the 7729 miners was 0.9 mg x years m(-3). There were 58 deaths from silicosis. Their median cumulative exposure was 4.8 mg x years m(-3). The crude mortality rate was 53 cases per 100,000 person-years with an exposure-response relationship. CONCLUSION: There seems to be an increased risk of fatal silicosis at exposure levels around 3 mg x years m(-3) for respirable quartz.

Identifiers
urn:nbn:se:umu:diva-18816 (URN)10.1093/annhyg/mem057 (DOI)18063590 (PubMedID)
Available from: 2009-02-25 Created: 2009-02-25 Last updated: 2018-06-09

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