title: Dose-response relationships between occupational exposure to potash, diesel exhaust and nitrogen oxides and lung function: cross-sectional and longitudinal study in two salt mines.
abstract: OBJECTIVE
  Several studies have shown that underground salt miners may have an increased incidence of chest symptoms and sometimes decreased lung function. Miners of two salt mines were investigated to evaluate relationships between the lung function and the workplace exposure. The effect of nitrogen monoxide (NO) and nitrogen dioxide (NO(2)) was investigated in view of the recent debate on European occupational exposure limits.
  
  
  METHODS
  A total of 410/463 miners (mine A/mine B) were examined cross-sectional and 75/64% of the first cohort were examined after a 5-year period. Exposure was measured by personal sampling. Personal lifetime exposure doses of salt dust, diesel exhaust, NO(2) and NO were calculated for all miners. Dose-response relationships were calculated by multiple regression analysis. Each exposure component acted as an indicator for the complex exposure.
  
  
  RESULTS
  Exposure response relationships were shown in the cross-sectional and longitudinal investigations in both mines. In the 5-year period, the adjusted (age, smoking, etc.) effect of the exposure indicators resulted in a mean decrease of FEV(1) between -18 ml/year (mine A) and -10 ml/year (mine B). The personal concentrations related to this effect were 12.6/7.1 mg/m(3) inhalable dust, 2.4/0.8 mg/m(3) respirable dust, 0.09/0.09 mg/m(3) diesel exhaust, 0.4/0.5 ppm NO(2) and 1.7/1.4 ppm NO (mine A/B). Exposure was related to symptoms of chronic bronchitis only in mine B.
  
  
  CONCLUSIONS
  The effects found in both mines indicate that the mixed exposure can cause lung function disorders in salt miners exposed over a long time. Because of the high correlation of the concentrations it was not possible to determine the effects of a single exposure component separately or to recommend a specific occupational exposure limit. However, possible maximum effects associated with the mixed exposure can be evaluated in the ranges of concentrations of the individual substances in the mines.
authors.affiliation: Federal Institute for Occupational Safety and Health, Berlin Office, Germany. lotz.gabriele@baua.bund.de
authors.forename: Gabriele
authors.initials: G
authors.lastname: Lotz
authors.forename: Sabine
authors.initials: S
authors.lastname: Plitzko
authors.forename: Erhardt
authors.initials: E
authors.lastname: Gierke
authors.forename: Ulrike
authors.initials: U
authors.lastname: Tittelbach
authors.forename: Norbert
authors.initials: N
authors.lastname: Kersten
authors.forename: W Dietmar
authors.initials: WD
authors.lastname: Schneider
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D045424:Complex Mixtures / Q000032:analysis / Q000506:poisoning; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects / Q000032:analysis; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008171:Lung Diseases / Q000139:chemically induced*; D008875:Middle Aged; D008906:Mining / Q000706:statistics & numerical data; D009589:Nitrogen Oxides / Q000032:analysis* / Q000506:poisoning; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D012129:Respiratory Function Tests; D012492:Salts; D001335:Vehicle Emissions / Q000032:analysis*
chemical_list: D015415:Biomarkers; D045424:Complex Mixtures; D009589:Nitrogen Oxides; D012492:Salts; D001335:Vehicle Emissions; C518454:potash