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Early changes in clinical, functional, and laboratory biomarkers in workers at risk of indium lung disease.

Authors
Cummings-KJ; Virji-MA; Trapnell-BC; Carey-B; Healey-T; Kreiss-K
Source
Ann Am Thorac Soc 2014 Nov; 11(9):1395-1403
NIOSHTIC No.
20045275
Abstract
RATIONALE: Occupational exposure to indium compounds including indium-tin oxide (ITO) can result in potentially fatal indium lung disease. However, the early effects of exposure on the lungs are not well understood. OBJECTIVES: To determine the relationship between short-term occupational exposures to indium compounds and development of early lung abnormalities. METHODS: Among ITO production and reclamation facility workers, we measured plasma indium, respiratory symptoms, pulmonary function, chest computed tomography, and serum biomarkers of lung disease. The relationships between plasma indium concentration and health outcome variables were evaluated using restricted cubic spline and linear regression models. MEASUREMENTS AND MAIN RESULTS: Eighty-seven (93%) of 94 ITO facility workers (median tenure=2 years; median plasma indium=1.0 mcg/L) participated in the study. Spirometric abnormalities were not in excess and few had radiographic evidence of alveolar proteinosis (n=0), fibrosis (n=2), or emphysema (n=4). Compared to participants with plasma indium concentrations <1.0 mcg/L, those with values >/=1.0 mcg/L had more dyspnea, lower mean FEV1% and FVC%, and higher median serum KL-6 and SP-D levels. Spline regression demonstrated non-linear exposure-response, with significant differences occurring at plasma indium concentrations as low as 1.0 mcg/L for FEV1%, FVC%, KL-6, and SP-D compared to the reference. Associations between health outcomes and plasma indium were evident in linear regression models and not explained by age, smoking status, or facility tenure. CONCLUSIONS: In ITO facility workers with short-term, low-level exposure, plasma indium concentrations lower than previously reported were associated with lung symptoms, abnormal spirometry, and increased serum biomarkers of lung disease.
Keywords
Respiratory-system-disorders; Pulmonary-system-disorders; Lung-disorders; Indium-compounds; Tin-oxides; Oxides; Lung-disease; Employee-exposure; Short-term-exposure; Lung-function; Biomarkers; Chemical-manufacturing-industry; Chemical-factory-workers; Humans; Spirometry; Alveolar-cells; Lung-fibrosis; Blood-serum; Dose-response; Mathematical-models
Contact
Kristin J Cummings CDC/NIOSH, Division of Respiratory Disease Studies, Morgantown, West Virginia, United States, 26505
CODEN
PATSBB
CAS No.
7440-74-6; 71243-84-0
Publication Date
20141101
Document Type
Journal Article
Email Address
cvx5@cdc.gov
Fiscal Year
2015
NTIS Accession No.
NTIS Price
Identifying No.
M102014
Issue of Publication
9
ISSN
2329-6933
NIOSH Division
DRDS
Priority Area
Manufacturing
Source Name
Annals of the American Thoracic Society
State
WV; OH; RI
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