Abstract
PurposeTo study the relationship between exposure to airborne particles in a pulp and paper mill and markers of inflammation and coagulation in blood. MethodsPersonal sampling of inhalable dust was performed for 72 subjects working in a Swedish pulp and paper mill. Stationary measurements were used to study concentrations of total dust, respirable dust, PM10 and PM2.5, the particle surface area and the particle number concentrations. Markers of inflammation, interleukins (IL-1b, IL-6, IL-8, and IL-10), C-reactive protein (CRP), serum amyloid A (SAA), and fibrinogen and markers of coagulation factor VIII, von Willebrand, plasminogen activator inhibitor, and D-dimer were measured in plasma or serum. Sampling was performed on the last day of the work free period of 5 days, before and after the shift the first day of work and after the shifts the second and third day. In a mixed model analysis, the relationship between particulate exposures and inflammatory markers was determined. Sex, age, smoking, and BMI were included as covariates.ResultsThe average 8-h time-weighted average (TWA) air concentration levels of inhalable dust were 0.30 mg/m3, range 0.005–3.3 mg/m3. The proxies for average 8-h TWAs of respirable dust were 0.045 mg/m3. Significant and consistent positive relations were found between several exposure metrics (PM 10, total and inhalable dust) and CRP, SAA and fibrinogen taken post-shift, suggesting a dose–effect relationship.ConclusionThis study supports a relationship between occupational particle exposure and established inflammatory markers, which may indicate an increased risk of cardiovascular disease.
Highlights
Production of pulp and paper is an important sector of Swedish industry with around 42,000 employed
The highest exposure was found in the mixing department, 3.3 mg/m3 and the average 8–h time-weighted average (TWA) exposure in this department was 1.6 mg/m3
The calculated mean 8-h TWA of inhalable dust based on stationary measurement, 0.36 mg/m3, did not differ substantially from the mean of the personal measurements, 0.30 mg/m3, but the variation was larger for the stationary measurements
Summary
Production of pulp and paper is an important sector of Swedish industry with around 42,000 employed. Some studies have observed an increased risk of cardiovascular diseases among pulp and paper mill workers (Andersson et al 2007; Hammar et al 1992; Jäppinen and Tola 1990; Langseth and Kjaerheim 2006; Milham and Demers 1984; Persson et al 2007; Torén et al 1996) and others have not (Henneberger et al 1989; Matanoski et al 1998; Robinson et al 1986; Sala-Serra et al 1996; Solet et al 1989; Wingren et al 1991; Wong et al 1996)
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