Cetintepe Sultan Pinar, Demirbas Osman Burak, Dinke Bilginer, Ilhan Mustafa Necmi
Department of Public Health, Division of Occupational Medicine, Gazi University, Ankara, Turkey
Department of Public Health, Division of Occupational Medicine, Gazi University, Ankara, Turkey.
BMJ Open. 2025 Jul 8;15(7):e102214. doi: 10.1136/bmjopen-2025-102214.
To assess the relation of exposure to cement dust and heavy metal (aluminium, cadmium and lead) exposures to pulmonary function among male cement plant workers. The study also aimed to evaluate dose-response relationships and prevalence and severity of respiratory symptoms among exposure categories compared with a control group.
Cross-sectional study.
Secondary-level occupational health clinic in Ankara, Türkiye.
461 male non-smoking cement plant employees were included in total. Participants were categorised into packaging (n=101), milling (n=162) and office unexposed workers (n=198). Inclusion criteria were more than 70% work history in the cement industry and exclusion of pre-existing respiratory disease and missing data from the participants.
Not applicable.
Pulmonary function tests (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC and peak expiratory flow (PEF)) and urinary, cadmium and blood lead concentrations were measured. Lung function impairment was the primary outcome measure; secondary outcomes included metal exposure-pulmonary measure correlations.
Significant negative correlations existed between FEV1 and urine aluminium (r=-0.622, p<0.001), blood cadmium (r=-0.430, p<0.001) and lead (r=-0.473, p<0.001). Adjusted generalised linear models showed much lower FVC, FEV1 and PEF in the high-exposure milling group compared with controls (p<0.001). Workers with blood aluminium levels≥35 µg/L had lower FVC (4.26 L), FEV1 (3.61 L) and PEF (7.07 L/min) than those with lowered levels (p<0.001). Dose-dependent pulmonary function loss with increased metal levels was observed.
Occupational cement dust and heavy metal exposure is closely linked to impaired pulmonary function in cement plant employees, particularly those who work in higher exposure jobs. The implications are robust endorsement of targeted monitoring and preventive interventions. Long-term longitudinal research is necessary to identify long-term outcome and efficacy of exposure reduction approaches.
评估男性水泥厂工人接触水泥粉尘和重金属（铝、镉和铅）与肺功能之间的关系。该研究还旨在评估剂量反应关系，以及与对照组相比，各暴露类别中呼吸道症状的患病率和严重程度。
横断面研究。
土耳其安卡拉的二级职业健康诊所。
总共纳入了461名男性非吸烟水泥厂员工。参与者被分为包装组（n = 101）、研磨组（n = 162）和未接触粉尘的办公室工作人员组（n = 198）。纳入标准为在水泥行业的工作年限超过70%，且排除参与者既往存在的呼吸系统疾病和缺失数据。
不适用。
测量肺功能测试（用力肺活量（FVC）、第1秒用力呼气量（FEV1）、FEV1/FVC和呼气峰值流速（PEF））以及尿镉和血铅浓度。肺功能损害是主要结局指标；次要结局包括金属暴露与肺功能指标的相关性。
FEV1与尿铝（r = -0.622，p < 0.001）、血镉（r = -0.430，p < 0.001）和血铅（r = -0.473，p < 0.001）之间存在显著负相关。调整后的广义线性模型显示，与对照组相比，高暴露研磨组的FVC、FEV1和PEF显著更低（p < 0.001）。血铝水平≥35 μg/L的工人的FVC（4.26 L）、FEV1（3.61 L）和PEF（7.07 L/min）低于血铝水平较低的工人（p < 0.001）。观察到随着金属水平升高，肺功能呈剂量依赖性下降。
职业性水泥粉尘和重金属暴露与水泥厂员工的肺功能受损密切相关，尤其是那些从事高暴露工作的员工。这意味着强烈支持有针对性的监测和预防性干预措施。有必要进行长期纵向研究，以确定减少暴露方法的长期效果和疗效。
