title: Inflammatory markers and exposure to airborne particles among workers in a Swedish pulp and paper mill.
abstract: OBJECTIVE
  To study the relationship between exposure to airborne particles in a pulp and paper mill and markers of inflammation and coagulation in blood.
  
  
  METHODS
  Personal sampling of inhalable dust was performed for 72 subjects working in a Swedish pulp and paper mill. Stationary measurements were used to study concentrations of total dust, respirable dust, PM10 and PM2.5, the particle surface area and the particle number concentrations. Markers of inflammation, interleukins (IL-1b, IL-6, IL-8, and IL-10), C-reactive protein (CRP), serum amyloid A (SAA), and fibrinogen and markers of coagulation factor VIII, von Willebrand, plasminogen activator inhibitor, and D-dimer were measured in plasma or serum. Sampling was performed on the last day of the work free period of 5 days, before and after the shift the first day of work and after the shifts the second and third day. In a mixed model analysis, the relationship between particulate exposures and inflammatory markers was determined. Sex, age, smoking, and BMI were included as covariates.
  
  
  RESULTS
  The average 8-h time-weighted average (TWA) air concentration levels of inhalable dust were 0.30 mg/m(3), range 0.005-3.3 mg/m(3). The proxies for average 8-h TWAs of respirable dust were 0.045 mg/m(3). Significant and consistent positive relations were found between several exposure metrics (PM 10, total and inhalable dust) and CRP, SAA and fibrinogen taken post-shift, suggesting a dose-effect relationship.
  
  
  CONCLUSIONS
  This study supports a relationship between occupational particle exposure and established inflammatory markers, which may indicate an increased risk of cardiovascular disease.
authors.affiliation: Department of Occupational and Environmental Medicine, Örebro University Hospital, 701 85, Örebro, Sweden. hakan.westberg@orebroll.se.
authors.forename: Håkan
authors.initials: H
authors.lastname: Westberg
authors.affiliation: Department of Applied Environmental Science, Atmospheric Science Unit, Stockholm University, 106 91, Stockholm, Sweden.
authors.forename: Karine
authors.initials: K
authors.lastname: Elihn
authors.affiliation: Occupational and Environmental Medicine, Sahlgrenska University Hospital, Box 414, 405 30, Göteborg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Andersson
authors.affiliation: Department of Occupational and Environmental Medicine, Institute of Laboratory Medicine, University Hospital, 221 85, Lund, Sweden.|Department of Occupational and Environmental Medicine, Linköping University Hospital, 581 85, Linköping, Sweden.
authors.forename: Bodil
authors.initials: B
authors.lastname: Persson
authors.affiliation: Department of Occupational and Environmental Medicine, Örebro University Hospital, 701 85, Örebro, Sweden.
authors.forename: Lennart
authors.initials: L
authors.lastname: Andersson
authors.affiliation: Department of Occupational and Environmental Medicine, Örebro University Hospital, 701 85, Örebro, Sweden.
authors.forename: Ing-Liss
authors.initials: IL
authors.lastname: Bryngelsson
authors.affiliation: Billerud AB, 664 28, Grums, Sweden.
authors.forename: Cathe
authors.initials: C
authors.lastname: Karlsson
authors.affiliation: Work Environment Toxicology, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Sjögren
mesh_terms: D000328:Adult; D000336:Aerosols / Q000009:adverse effects; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D001779:Blood Coagulation Factors / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D004391:Dust / Q000032:analysis; D004784:Environmental Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D019570:Inhalation Exposure / Q000009:adverse effects; D007378:Interleukins / Q000097:blood; D008297:Male; D066192:Manufacturing Industry; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D010209:Paper; D052638:Particulate Matter / Q000009:adverse effects; D000685:Serum Amyloid A Protein / Q000032:analysis; D011795:Surveys and Questionnaires; D013548:Sweden
chemical_list: D000336:Aerosols; D000395:Air Pollutants, Occupational; D015415:Biomarkers; D001779:Blood Coagulation Factors; D004391:Dust; D018836:Inflammation Mediators; D007378:Interleukins; D052638:Particulate Matter; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein
keywords: C-reactive protein (CRP); Fibrinogen; Interleukins (IL-1b, IL-6, IL-8 and IL-10); PM10; PM2.5; Respirable dust; Serum amyloid A (SAA)