title: A cross-shift study of lung function, exhaled nitric oxide and inflammatory markers in blood in Norwegian cement production workers.
abstract: OBJECTIVE
  To study possible effects of aerosol exposure on lung function, fractional exhaled nitric oxide (FeNO) and inflammatory markers in blood from Norwegian cement production workers across one work shift (0 to 8 h) and again 32 h after the non-exposed baseline registration.
  
  
  METHODS
  95 workers from two cement plants in Norway were included. Assessment of lung function included spirometry and gas diffusion pre- and post-shift (0 and 8 h). FeNO concentrations were measured and blood samples collected at 0, 8 and 32 h. Blood analysis included cell counts of leucocytes and mediators of inflammation.
  
  
  RESULTS
  The median respirable aerosol level was 0.3 mg/m(3) (range 0.02-6.2 mg/m(3)). FEV(1), FEF(25-75%) and DL(CO) decreased by 37 ml (p=0.04), 170 ml/s (p<0.001) and 0.17 mmol/min/kPa (p=0.02), respectively, across the shift. A 2 ppm reduction in FeNO between 0 and 32 h was detected (p=0.01). The number of leucocytes increased by 0.6×10(9) cells/l (p<0.001) across the shift, while fibrinogen levels increased by 0.02 g/l (p<0.001) from 0 to 32 h. TNF-α level increased and IL-10 decreased across the shift. Baseline levels of fibrinogen were associated with the highest level of respirable dust, and increased by 0.39 g/l (95% CI 0.06 to 0.72).
  
  
  CONCLUSIONS
  We observed small cross-shift changes in lung function and inflammatory markers among cement production workers, indicating that inflammatory effects may occur at exposure levels well below 1 mg/m(3). However, because the associations between these acute changes and personal exposure measurements were weak and as the long-term consequences are unknown, these findings should be tested in a follow-up study.
authors.affiliation: Department of Occupational and Environmental Medicine, Telemark Hospital, N-3710 Skien, Norway. anne-kristin.fell@sthf.no
authors.forename: Anne Kristin M
authors.initials: AK
authors.lastname: Fell
authors.forename: Hilde
authors.initials: H
authors.lastname: Notø
authors.forename: Marit
authors.initials: M
authors.lastname: Skogstad
authors.forename: Karl-Christian
authors.initials: KC
authors.lastname: Nordby
authors.forename: Wijnand
authors.initials: W
authors.lastname: Eduard
authors.forename: Martin Veel
authors.initials: MV
authors.lastname: Svendsen
authors.forename: Reidun
authors.initials: R
authors.lastname: Ovstebø
authors.forename: Anne Marie Siebke
authors.initials: AM
authors.lastname: Trøseid
authors.forename: Johny
authors.initials: J
authors.lastname: Kongerud
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000633:toxicity*; D015415:Biomarkers / Q000097:blood; D003252:Construction Materials / Q000633:toxicity*; D004391:Dust; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005540:Forced Expiratory Flow Rates; D005541:Forced Expiratory Volume; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D009569:Nitric Oxide / Q000097:blood; D016273:Occupational Exposure / Q000009:adverse effects*; D013147:Spirometry; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D000395:Air Pollutants, Occupational; D015415:Biomarkers; D004391:Dust; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D009569:Nitric Oxide; D005340:Fibrinogen