Abtahi Shabnam, Malekzadeh Mahyar, Nikravan Ghafour, Ghaderi Abbas
Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Iran Glass Wool Company, Shiraz, Iran.
Int J Occup Environ Med. 2018 Jan;9(1):23-31. doi: 10.15171/ijoem.2018.1147.
Occupational exposures to respirable synthetic vitreous fiber (SVF) and dust are associated with many lung diseases including lung cancer. Low-dose computed tomography is used for screening patients who are highly suspicious of having lung carcinoma. However, it seems not to be cost-effective. Serum biomarkers could be a useful tool for the surveillance of occupational exposure, by providing the possibility of diagnosing lung cancer in its early stages.
To determine if serum carcinoembryonic antigen (CEA) and cytokeratin fragment (CYFRA) 21-1 levels in workers exposed more than normal population to respirable SVF and dust may be used as indicators of progression towards lung cancer.
An analytic cross-sectional study, including 145 personnel of a glass wool company, along with 25 age-matched healthy individuals, was conducted to investigate the relationship between occupational exposure to respirable SVFs and dust and serum levels of two lung/pleura serum tumor markers, CEA and CYFRA 21-1, measured by ELISA.
Individuals exposed to higher than the recommended levels of respirable SVF had higher serum concentrations of CEA and CYFRA 21-1, compared to controls (p=0.008 and 0.040, respectively), as well as in comparison to those exposed to lower than recommended OSHA levels (p=0.046 and 0.033, respectively). Workers with >9 years work experience, had significantly (p=0.045) higher levels of serum CYFRA 21-1 than those with ≤9 years of experience.
It seems that working for >9 years in sites with detectable levels of respirable SVF and dust would increase the levels of known lung cancer serum tumor markers. Transferring these workers to sites with respirable SVF concentrations lower than the limit of detection in the air is recommended.
职业性接触可吸入性合成玻璃纤维（SVF）和粉尘与包括肺癌在内的多种肺部疾病相关。低剂量计算机断层扫描用于筛查高度怀疑患有肺癌的患者。然而，它似乎不具有成本效益。血清生物标志物通过提供早期诊断肺癌的可能性，可能成为职业接触监测的有用工具。
确定接触可吸入性SVF和粉尘超过正常人群的工人血清癌胚抗原（CEA）和细胞角蛋白片段（CYFRA）21-1水平是否可作为肺癌进展的指标。
进行了一项分析性横断面研究，纳入了一家玻璃棉公司的145名员工以及25名年龄匹配的健康个体，以调查职业性接触可吸入性SVF和粉尘与两种肺/胸膜血清肿瘤标志物CEA和CYFRA 21-1的血清水平之间的关系，这些标志物通过酶联免疫吸附测定法（ELISA）进行测量。
与对照组相比（分别为p=0.008和0.040），以及与接触低于职业安全与健康管理局（OSHA）推荐水平的人群相比（分别为p=0.046和0.033），接触高于推荐水平可吸入性SVF的个体血清CEA和CYFRA 21-1浓度更高。工作经验超过9年的工人血清CYFRA 21-1水平显著高于工作经验≤9年的工人（p=0.045）。
在可检测到可吸入性SVF和粉尘水平的场所工作超过9年似乎会增加已知肺癌血清肿瘤标志物的水平。建议将这些工人转移到空气中可吸入性SVF浓度低于检测限的场所。
