Format

Send to

Choose Destination
Chest. 2014 Nov;146(5):1166-1175. doi: 10.1378/chest.13-2484.

Five-year cohort study: emphysematous progression of indium-exposed workers.

Author information

1
From the Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo. Electronic address: nakano.makiko@z8.keio.jp.
2
From the Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo.
3
Environmental Epidemiology Section, Center for Environmental Health Sciences, National Institute for Environmental Studies, Tsukuba.
4
Environmental Medicine, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.

Abstract

BACKGROUND:

Dose-dependent adverse lung effects due to indium exposure have been reported in a cross-sectional study. This is a 5-year longitudinal cohort study of indium-exposed and unexposed workers, assessing indium exposure levels and its clinical lung effects.

METHODS:

From 2008 to 2011, a 5-year follow-up study was conducted on 40 unexposed and 240 workers formerly or currently exposed to indium at 11 factories. Indium exposure was assessed by serum indium (In-S) (μg/L). Lung effects were assessed by subjective symptoms, serum biomarkers, spirometry, and chest high-resolution CT scan. Effect biomarkers used were Krebs von den Lungen and surfactant protein D.

RESULTS:

Mean values of In-S, Krebs von den Lungen, and surfactant protein D among the workers exposed to indium at baseline declined during the 5-year follow-up by 29.8%, 27.2%, and 27.5%, respectively. Of the exposed subjects with In-S levels > 20 μg/L, 26.3% experienced emphysematous progression on high-resolution CT scan. Ninety percent (18 of 20) of workers with emphysematous progression during follow-up were current smokers at baseline, and a trend of increasing incidence of emphysematous progression at higher In-S levels was observed among the smokers (P = .005). Emphysematous changes among subjects with In-S levels > 20 μg/L were likely to progress, after adjusting for age, mean duration since initial indium exposure, and smoking history (OR = 10.49, 95% CI = 1.54-71.36).

CONCLUSIONS:

Long-term adverse effects on emphysematous changes were observed. The results suggest workers exposed to indium with In-S levels > 20 μg/L should be immediately removed from exposure.

PMID:
24946105
DOI:
10.1378/chest.13-2484
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center