Adverse respiratory effects associated with cadmium exposure in small-scale jewellery workshops in India

Abstract

Background Cadmium (Cd) is an important metal with both common occupational and environmental sources of exposure. Although it is likely to cause adverse respiratory effects, relevant human data are relatively sparse. Methods A cross-sectional study of 133 workers in jewellery workshops using Cd under poor hygienic conditions and 54 referent jewellery sales staffs was performed. We assessed symptoms, performed spirometry, measured urinary Cd levels in all study subjects and quantified airborne total oxidant contents for 35 job areas in which the studied workforce was employed. We tested the association of symptoms with exposure relative to the unexposed referents using logistic regression analysis, and tested the association between urinary Cd levels and lung function using multiple regression analysis, adjusting for demographics, smoking and area-level airborne oxidants. Results Exposed workers had 10 times higher urinary Cd values than referents (geometric mean 5.8 vs 0.41 mg/dl; p<0.01). Of the exposed subjects, 75% reported respiratory tract symptoms compared with 33% of the referents (OR=3.1, 95% CI 1.4 to 7.3). Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV 1 ) were also lower among the exposed workers than the referents (>600 ml decrement for each, p<0.001). For every 1 mg increase in urinary Cd there was a 34 ml decrement in FVC and a 39 ml decrement in FEV 1

Impact of occupational cadmium exposure on spirometry, sputum leukocyte count, and lung cell DNA damage among Indian goldsmiths

“…With chronic Cd-exposure, some reports have identified a strong exposure-response relationship for adverse respiratory effects [Davison et al, 1988;Nemery, 1990;Fuortes et al, 1991;Sorahan et al, 1995;Sorahan and Esmen, 2004;Fireman et al, 2008;Rokadia and Agarwal, 2013], while others have not [Chan et al, 1988;Jakubowski et al, 2004]. However, there are substantial reports, which have demonstrated adverse respiratory effects due to occupational cadmium exposure [Baker et al, 1979;Mason et al, 1999;Panchal and Vaideeswar, 2006;Sethi et al, 2006;Moitra et al, 2013]. Fireman et al [2008] observed that Cd-induced respiratory impairment involved elevated neutrophil infiltration in alveolar bed in induced sputum among a group of welders exposed to heavy metals.…”

“…The recruitment criteria of the participants in the main cohort have been reported elsewhere [Moitra et al, 2013]. 187 male participants were recruited from a preliminary screened pool of 276 workers of whom 133 were actively involved in jewelry manufacturing and 54 were unexposed referent workers (mainly sales persons) in the same industry.…”

Trawler fuel exhaust and respiratory impairments: a cross-sectional pilot study among Indian fishermen working in informal sectors

“…17 To subjectively asses respiratory health, participants were asked if they had experienced any of the following symptoms in the previous 12 months: prolonged cough, chronic phlegm, morning cough with sputum, acute or chronic wheezing or whistling in chest, breathing trouble, nasal allergy, and/or a runny or stuffed nose.…”

Respiratory Morbidity among Indian Tea Industry Workers

“…The questionnaire was a modified version of the European Community Respiratory Health Survey-II (ECRHS-II) that has been used in prior studies. [17][18][19] Subjective respiratory complaints in the previous 12 months questioned were (1) acute or chronic wheezing or whistling of the chest, (2) tightness in chest, (3) breathing trouble, (4) acute or chronic cough, and (5) nasal allergy.…”

“…Pressure waves at frequencies >15 Hz generally fade before reaching peripheral airways, while those at frequencies <10-15 Hz can penetrate much further into the lung periphery. 23 We used resistance at 5 Hz (R 5 ), 20 Hz (R 20 ), frequency dependence (R [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] ) as indicators of total, large, and small airway resistance, respectively; reactance at 5 Hz (X 5 ) was used as an index of the reactance of the overall respiratory system. [23][24][25][26] We also measured resonant frequency (F res ) and integrated area of low-frequency X (AX) as a sensitive measure of small airways obstruction.…”