Biomarkers of inflammation in workers exposed to compost and sewage dust

Heldal, Kari Kulvik; Barregård, Lars; Ellingsen, Dag G.

doi:10.1007/s00420-015-1109-z

Cited by 14 publications

(12 citation statements)

References 34 publications

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“…The elevated level of CRP observed in this study, particularly among sewer net workers, suggests a systemic inflammatory response, which may originate from the airways. In agreement with an earlier study among sewage plant workers (Heldal et al, 2016), we found that the elevated level of CRP was associated with impaired lung function among the WWWs. However, no association between exposure to endotoxins and levels of CRP was observed among the WWWs in previous studies.…”

Section: Discussionsupporting

confidence: 93%

“…A lower level of the lung-specific pneumoprotein CC16 and a close to significant higher level of the adhesion molecule ICAM-1 were observed among the sub group of sewer net workers compared to the referents. This result may indicate early signs of both lung specific and systemic inflammation, which has been previously reported among sewage plant workers exposed to sewage dust (Heldal et al, 2013(Heldal et al, , 2016. A lower concentration of CC16 compared to the reference suggested that chronic exposure may compromise the synthesis or secretion of the protein.…”

Section: Discussionsupporting

confidence: 64%

“…In addition, a dose-response relationship between exposure to bacterial cells and CC16 measured in blood taken the same day as the exposure was measured for that individual, indicated a more acute response in a previous study (Heldal et al, 2013). Among the same sewage plant workers, an association between sewage dust exposure and elevated serum concentration of the adhesion molecule ICAM were observed, suggesting that the increase in ICAM-1 may be initiated by a local inflammatory response in the pulmonary tissue caused by exposure to bacteria and dust (Heldal et al, 2016). In the present study, we found associations between estimated exposure to H2S and serum concentration of ICAM-1, indicating that H2S may also contribute to the observed inflammatory response.…”

Section: Discussionmentioning

confidence: 64%

“…Symptoms from the airways and impaired lung function among sewage plant workers compared to controls have been related to endotoxin exposure (Douwes et al, 2001, Thorn and Beijer 2004, Heldal et al, 2010. Recent studies have reported associations between exposure when handling sewage-related dust and both specific inflammatory pneumoproteins and systemic inflammatory biomarkers (Heldal et al, 2013(Heldal et al, , 2016. Both the inflammatory effects of endotoxins and irritant effects of H2S may have the respiratory system as a target organ.…”

Section: Introductionmentioning

confidence: 99%

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Endotoxin and Hydrogen Sulphide Exposure and Effects on the Airways Among Waste Water Workers in Sewage Treatment Plants and Sewer Net System

Heldal

Austigard

Svendsen

et al. 2019

Annals of Work Exposures and Health

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Background: The purpose of this study is to investigate whether airborne exposure to endotoxins, hydrogen sulphide (H2S) and inhalable particles negatively impacts the respiratory system and inflammatory blood proteins in sewage plant and sewer net system workers, and further to determine dose-response associations between exposure and health outcomes.Methods: In total, 148 waste water workers (WWWs) from urban and rural sewage plants and the sewer net system participated. One hundred and twenty-one workers were exposed to sewage, 46 from sewage plants and 75 from the sewer net system.Twenty-seven workers were characterized as little or not exposed and served as an internal reference group. Personal inhalable samples were analysed for endotoxins (Limulus assay), particle dust (gravimetrically) and Salmonella and Yersinia spp. (polymerase chain reaction method, PCR). Levels of H2S were measured using personal electro chemical sensors. Intercellular adhesion molecule 1(ICAM-1), interleukin 8 (IL-8), surfactant protein D (SP-D), club cell protein 16 (CC16) and macrophage inflammatory protein (MIP) were determined by enzyme-linked immunosorbent assay and C-reactive protein (CRP) by an HS-MicroCRP assay in blood samples.Results: Workers in sewage plants were exposed to significantly higher levels of endotoxins compared to workers in the sewer net system (median 55 EU/m 3 (4-262 EU/m 3 ) and median 27 EU/m 3 (1-304 EU/m 3 ), respectively). The estimated H2S index showed higher values when working in the sewer net system (median 3.1 (0.5-78.1) compared to workers at the sewage plants (median 1.3 (0.5-9.3), and the most excessive exposure was collecting sewage from cesspools (273 ppm). No viable airborne Salmonella and Yersinia spp. were detected. The exposed workers had significantly higher CRP compared to the referents (1.2 µg/ml (0.1-19.0 µg/ml) and 0.8 µg/ml (0.1-5.0 µg/ml), respectively) and lower forced expiratory volume in 1 s (FEV1 %) (92.6 %, SD 14.6) and 102.0 %, SD10.1, respectively), with numbers given as mean and standard deviation. The serum concentration of CRP was significantly and negatively associated with FEV1% (β = -7.7, R 2 = 0.05) and FVC% (β = -8.5, R 2 = 0.08), and the serum concentration of ICAM-1 with the estimated exposure to H2S (β = -19.9, R 2 = 0.07). Conclusion:Despite moderate levels of endotoxin and H2S exposure, the results indicate an impact of these agents on lung function and the adhesion molecule ICAM-1, and a low-grade systemic inflammation was indicated in increased levels of CRP.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

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Endotoxin and Hydrogen Sulphide Exposure and Effects on the Airways Among Waste Water Workers in Sewage Treatment Plants and Sewer Net System

Heldal

Austigard

Svendsen

et al. 2019

Annals of Work Exposures and Health

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“…Since symptoms and lung function decline have been associated with even lower dust concentrations (0.1 -2.1 mg m -3 ) in workers at Norwegian waste recycling plants (2,50,51), exposure levels in the present study may be of concern. The dust exposure levels were higher than those measured in Dutch waste management plants (<0.2 -9.1 mg m -3 ) (4,52) as well as in Great Britain (0.07 -17.73 mg m -3 ) (53), South Korea (0.05 -4.51 mg m -3 ) (54) and in a newly built Norwegian waste treatment plant (0.51 -18.93 mg m -3 ) (27).…”

Section: Discussionmentioning

confidence: 80%

“Divergent TLR2 and TLR4 activation by fungal spores and species diversity in dust from waste-sorting plants”

Afanou

Mundra²,

Estensmo

et al. 2022

Preprint

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This manuscript presents the results of an exploratory study on the relationships between NFkB (Nuclear Factor Kappa Chain Enhancer of B-cells) response through TLRs activation by dust characterized by fungal spore concentrations and species diversity. Personal total dust samples were collected from Norwegian waste sorting plants and then characterized for fungal spores and fungal species diversity, as well as for other bioaerosol components, including endotoxins and actinobacteria. The ability of the dust to induce an NFkB response by activating Toll-like receptors 2 (TLR2) and 4 (TLR4) in vitro was evaluated as well as the relationship between such responses and quantifiable bioaerosol components. The average concentrations of bioaerosols were 7.23 mg total dust m-3, 4.49×105fungal spores m-3, 814 endotoxin units m-3, and 0.6×105actinobacteria m-3. The mean diversity measurements were 326; 0.59 and 3.39 for fungal richness, evenness, and Shannon Index, respectively. Overall, fungal OTUs belonging to the Ascomycotina phylum were most abundant (55%), followed by Basidiomycota (33%) and Mucormycota (3%). All samples induced significant NFkB responses through TLR2 and TLR4 activation. While fungal spore levels were positively associated with TLR2 and TLR4 activation, there was a trend that fungal species richness was negatively associated with the activation of these receptors. This observation supports the existence of divergent immunological responses relationship between fungal spore levels and fungal species diversity. Such relationships seem to be described for the first time for dust from waste facilities.

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Airway and Blood Inflammatory Markers in Waste Collectors

Raulf

Kampen

Neumann³

et al. 2017

Pulmonary Care and Clinical Medicine

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Waste collectors are exposed to a heterogeneous mixture of bioaerosols able to induce health effects. The study aim was to evaluate inflammatory processes in blood and in the respiratory tract via analysis of atopy and club cell secretory protein 16 (CC16) in serum, exhaled nitric oxide (FeNO), and cellular and soluble mediators in nasal lavage fluid (NALF) and induced sputum (IS). Sixty nine current waste collectors (48% smokers) and 28 former waste collectors (25% smokers) were included in the cross-sectional study. In both groups, 63 and 64% of workers reported complaints of the eyes, nose and/or upper airways. Thirty two percent of the current and 25% of the former workers were classified as atopics. More atopics suffered from rhinitis and conjunctivitis than non-atopics (64% vs. 40% in current workers; 71% vs. 40% in former workers). CC16 values of present non-smokers were significantly higher compared to smokers. In total, FeNO values of 31 participants were lower than 10 ppb, 94% of them were smokers and 85% had respiratory symptoms of lower airways. Most of the IS biomarkers were significantly higher in smokers than in non-smokers. Non-smoking workers with respiratory symptoms of lower airways had slightly elevated mediator IS concentrations compared to asymptomatic non-smokers. We conclude that inflammatory changes in waste collectors are detectable in the content of IS biomarkers, exhaled NO, and serum CC16, which all are influenced by the smoking habit. No significant differences in biomarkers are detectable between current and former waste collectors.

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Biomarkers of inflammation in workers exposed to compost and sewage dust

Cited by 14 publications

References 34 publications

Endotoxin and Hydrogen Sulphide Exposure and Effects on the Airways Among Waste Water Workers in Sewage Treatment Plants and Sewer Net System

Endotoxin and Hydrogen Sulphide Exposure and Effects on the Airways Among Waste Water Workers in Sewage Treatment Plants and Sewer Net System

“Divergent TLR2 and TLR4 activation by fungal spores and species diversity in dust from waste-sorting plants”

Airway and Blood Inflammatory Markers in Waste Collectors

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