Association between Cumulative Dose of Brick Dust with Serum Levels of Interleukin-4 and Lung Function Among Brick Makers in Badung, Bali

Abstract

Background: Brickmakers have a high risk of occupational lung diseases. Dust particles that are inhaled continuously for a long time and exceed the Threshold Limit Value (TLV) can cause lung damage. When inhaled particles are not efficiently cleared from the lungs, damaged macrophages will activate Reactive Oxygen Species (ROS), Reactive Nitrogen Species (RNS), chemokines, and cytokines. Interleukin-4 (IL-4) produced by T helper-2 (Th2) then stimulates tissue proliferation and remodeling. Inflammation may occur as a result of either changes in epithelial permeability or mucus hypersecretion is associated with pulmonary function disorders. Methods: We conducted an observational analytic study among brickmakers in Badung, Bali with 24 subjects. Therefore, IL-4 levels and lung function were examined. The cumulative dose of dust is determined by multiplying the Total Suspended Particles (TSP) and the exposure time. Total Suspended Particles were measured using the gravimetric method with a Middle Volume Sampler (MVS). The association was analysed using Chi Square test, and then Relative Prevalence (PR) was assessed. Results: A significant relationship was found between high cumulative doses of dust and pulmonary function disorder (p = 0.018). High-exposed workers have an 11.4 times greater risk of experiencing lung function disorders compared to a low cumulative dose of dust. However, there was no significant relationship between the cumulative dose of dust and IL-4 levels (p = 1.00). Conclusion: Our results suggested a significant association between the cumulative dose of brick dust with lung function but no significant association with IL-4 levels.