Clara cell protein and surfactant protein B in garbage collectors and in wastewater workers exposed to bioaerosols.
OBJECTIVE
Inhalation of bioaerosols has been hypothesised to cause "toxic pneumonitis" that should increase lung epithelial permeability at the bronchioloalveolar level. Serum Clara cell protein (CC16) and serum surfactant protein B (SPB) have been proposed as sensitive markers of lung epithelial injury. This study was aimed at looking for increased lung epithelial permeability by determining CC16 and SPB in workers exposed to bioaerosols from wastewater or garbage.


METHODS
Subjects (778 wastewater, garbage and control workers; participation 61%) underwent a medical examination, lung function tests [American Thoracic Society (ATS) criteria], and determination of CC16 and SPB. Symptoms of endotoxin exposure and several potential confounders (age, gender, smoking, kidney function, obesity) were looked for. Results were examined with multiple linear or logistic regression.


RESULTS
Exposure to bioaerosols increased CC16 concentration in the wastewater workers. No effect of exposure on SPB was found. No clue to work-related respiratory diseases was found.


CONCLUSIONS
The increase in CC16 in serum supports the hypothesis that bioaerosols cause subclinical "toxic pneumonitis", even at low exposure.
Steiner
D
D
Occupational and Environmental Medicine Unit, Sumatrastrasse 30, 8006, Zurich, Switzerland.
Jeggli
S
S
Tschopp
A
A
Bernard
A
A
Oppliger
A
A
Hilfiker
S
S
Hotz
P
P
D000328:Adult; D000336:Aerosols; D015331:Cohort Studies; D004848:Epithelium / Q000503:physiopathology; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D011446:Prospective Studies; D037701:Pulmonary Surfactant-Associated Protein B / Q000097:blood*; D012037:Refuse Disposal; D012129:Respiratory Function Tests; D013557:Switzerland; D014598:Uteroglobin / Q000097:blood*; D014865:Waste Disposal, Fluid
D000336:Aerosols; D037701:Pulmonary Surfactant-Associated Protein B; C556389:SCGB1A1 protein, human; D014598:Uteroglobin