Academic journal article Central European Journal of Public Health

Chronic Obstructive Pulmonary Disease in Iron-Steel and Ferrochrome Industry Workers

Academic journal article Central European Journal of Public Health

Chronic Obstructive Pulmonary Disease in Iron-Steel and Ferrochrome Industry Workers

Article excerpt

SUMMARY

Metallurgical industry workers in developing countries are often exposed to high concentrations of dusts and fumes that affect pulmonary function. The aim of this cross-sectional study is to assess the prevalence and severity of chronic obstructive pulmonary disease (COPD), the prevalence of symptoms, as well as, the link between work-place air pollution and COPD.

A standardized questionnaire was used to collect data about smoking and socioeconomic status, past history of pulmonary diseases, current respiratory symptoms, education, and other variables. We have identified and assessed all risk factors and also have performed measurements of dynamic pulmonary function in 459 subjects - 90% of iron-steel and ferrochrome industry workers. The prevalence of COPD oscillated from 19.6% up to 25.7% while severity varied from mild to very severe.

Symptoms: prevalence varied from 12.0% to 46.3% white relative risk for developing COPD was 2.1-5.5 that of non-industry controls. Exposure markers' concentrations: for total suspended particles (TSP) oscillated from 0.375-25.5 mg/m^sup 3^, particulate matter (PM10) from 0.25 to 10.5 mg/m^sup 3^, and sulfur dioxide from 0.19-18.69 mg/m^sup 3^. In majority of cases its average exceeded threshold limit values.

Our conclusion was that COPD prevalence and its symptoms are high in the population studied, and that there exists a well established occupational risk between work-place air pollution and COPD.

Key words: air pollution, chronic obstructive pulmonary disease, occupational exposure, risk factors, smoking behavior, pulmonary function testing, threshold limit values (TLV)

INTRODUCTION

Metallurgical industry workers are often exposed to harmful gases and dusts that affect pulmonary function and cause chronic obstructive pulmonary disease (COPD). Occupational dusts and chemicals can cause COPD when the exposure is sufficiently intense or prolonged, such of those experienced in heavy industry or in mining. These exposures can cause COPD independently of cigarette, while the risk is substantially higher in the presence of concurrent cigarette smoking (1-4).

COPD is the most frequent chronic disease in developing country workers. Aging and archaic technology and high concentrations of workplace air pollutants are the main but definitely not the only culprits. Exposure to particulate matter, irritants, organic dusts, and sensitizing agents cause an increase in airway hyperresponsiveness, especially in airways already damaged by other occupational exposures, cigarette smoking, and/or asthma (1, 5). Most of the evidence regarding the risk factors for development of COPD comes from cross-sectional epidemiological studies that identify association (1, 6, 7, 8).

The aim of this cross-sectional study was to assess the prevalence and severity of COPD, the prevalence of symptoms, as well as, to quantify any correlation between occupational area air pollution and COPD.

MATERIALS AND METHODS

We have used a standardized questionnaire, based on a modified version of an American Thoracic Society (ATS) questionnaire, to collect data on smoking habits, socioeconomic status, past histoiy of pulmonary diseases, current respiratory symptoms (chronic cough, chronic phlegm, wheezing and whispering, breathlessness, dyspnea in efforts), education, job exposure matrix, and other parameters (9). We have performed measurement of pulmonary function in 459 subjects which represent 90% of staff working in Albanian iron-steel and ferrochrome industry, and have identified, assessed and analyzed for all risk factors. Office workers formed the reference/control group. Following variables were measured: forced vital capacity (FVC), forced expiratory volume in the first second after full inspiration (FEV1), FEV1TFVC ratio, peak expiratory flow rate (PEF), forced expiratory flow (FEF25 7S), and vital capacity (VC). Each subject produced at least three acceptable FVC curves based on ATS standards (10). …

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