Exposure/Effect Biomarkers and Respiratory Adverse Outcomes in Metal Plating Workers

Abstract

<b>Aim:</b> Heavy metals (Cr, Cd, Ni) exposure is an extremely serious occupational hazard, due to the impact on specific target organs (lungs, upper respiratory tract, kidney, skin). This study highlights the link between respiratory tract adverse outcomes and exposure/effect markers during chronic metal exposure. <b>Material/method:</b> 48 plating workers (26 men, 48% smokers) were assessed clinically and biochemically through urinary, blood and skin metal levels and urinary β2-microglobulins (B2M). Blood SOD, GSHPx, serum TBARS were used as oxidative stress effect markers. Nasal biopsy was performed in case of suspicious lesions and BALF was collected by bronchoscopy in 30% of exposed. <b>Results:</b> Workplace air revealed higher Cr levels than TLV. Skin Cr, Cd and Ni were statistically higher in exposed vs controls. Chronic ENT conditions diagnosed were: 36% rhino-pharyngitis; 12% atrophic rhinitis with anosmia; 25% hypertrophic rhinitis and 2% septum perforation. Oxidative stress markers were elevated in the exposed group: SOD in 72% of workers, GSHPx in 50% and TBARS in 54%. TBARS were higher in exposed vs controls (r=0.39 p&lt;0.001). 40% of exposed had simultaneous SOD, GSHPx and TBARS elevated and a third of them had different stages of ENT diseases linked to Cr exposure. GSHPx correlated with skin Cd levels (r=0.40 p&lt;0.01) and SOD with the gravity of ENT diseases (r=0.30 p&lt;0.05). B2M was elevated in 43% of exposed and correlated with TBARS (r=0.36 p&lt;0.05). SOD in BALF varied inversely with blood SOD (r=-0.33 p&lt;0.05). <b>Conclusions:</b> Changes in blood and BALF oxidative stress markers correlated with chronic heavy metals exposure and were also linked to the occupationally-induced upper respiratory tract conditions.