title: Comparison between exhaled breath condensate analysis as a marker for cobalt and tungsten exposure and biomonitoring in workers of a hard metal alloy processing plant.
abstract: OBJECTIVE
  Cobalt (Co), Tungsten (W) and Tungsten Carbides (WC) are major constituents of hard metal alloys. Whereas little is known about potential health hazards due to tungsten carbide exposure, occupational exposure to cobalt has been shown to induce a variety of respiratory diseases. Since the concentration of a potentially hazardous substance in the target organ is the most meaningful risk indicator in occupational medicine, the detection of hard metals in exhaled breath condensate (EBC) has been proposed to be a valuable instrument. The present study examines the correlation of Co and W concentrations in EBC and urine with one another and various spirometrical and clinical parameters to scrutinize this potential.
  
  
  METHODS
  A total of 62 subjects (90.3% males, age 40.6 +/- 9.2 years) were recruited from a hard metal processing plant in Germany. Examinations included the airborne workplace exposure, a complete spirometry, measurements of Co and W concentrations in EBC and urine with high resolution inductive coupled plasma mass spectrometry (HR ICP-MS) and graphite furnace atomic absorption spectrometry (GFAAS).
  
  
  RESULTS
  Air concentrations ranged between 0.0019 mg/m(3) and 0.074 mg/m(3) for Co and 0.012 mg/m(3) and 0.021 mg/m(3) for W. Median urine concentrations and interquartile ranges of the exposed subjects ranged from 0.81 (0.0-1.46) microg/l for Co and 30.5 (14.5-57.7) microg/l for W. Median breath condensate metal concentrations and interquartile ranges ranged from 8.4 (5.0-13.9) microg/l for Co and 8.8 (4.4-18.5) microg/l for W. Urine concentrations of Co and W were closely related to the airborne workplace exposure that had been assessed by air monitoring. EBC concentrations of Co and W showed no correlations to urinary W and Co concentrations and the ambient monitoring results of the individual workplace, respectively. Cobalt EBC concentration was elevated in subjects who reported to have suffered from respiratory disease; both Co and W concentrations in EBC, however, decreased with increasing spirometrical signs of obstruction.
  
  
  CONCLUSIONS
  According to our study, urinary concentrations of Co and W seem to be more reliable indicators of current workplace exposure than EBC concentrations. As far as new methods and exposure matrices for valid concentration measurements in respiratory organs and possible hazardous effects--especially of cobalt--in the lung are concerned, the present results are less clear-cut, and further research is required.
authors.affiliation: Institute and Outpatient Clinic for Occupational-, Social- and Environmental Medicine, Friedrich-Alexander-University Erlangen-Nuremberg, 91054 Erlangen, Germany. broding@rzmail.uni-erlangen.de
authors.forename: Horst Christoph
authors.initials: HC
authors.lastname: Broding
authors.forename: Bernhard
authors.initials: B
authors.lastname: Michalke
authors.forename: Thomas
authors.initials: T
authors.lastname: Göen
authors.forename: Hans
authors.initials: H
authors.lastname: Drexler
mesh_terms: D000328:Adult; D000388:Air / Q000032:analysis; D000497:Alloys; D015415:Biomarkers / Q000378:metabolism; D001944:Breath Tests; D003035:Cobalt / Q000493:pharmacokinetics* / Q000652:urine; D004784:Environmental Monitoring / Q000379:methods*; D045853:Exhalation; D005260:Female; D006801:Humans; D008297:Male; D008669:Metallurgy; D008875:Middle Aged; D016273:Occupational Exposure; D017973:Tungsten Compounds / Q000032:analysis / Q000493:pharmacokinetics*; D055815:Young Adult
chemical_list: D000497:Alloys; D015415:Biomarkers; D017973:Tungsten Compounds; C002802:tungsten carbide; D003035:Cobalt