Health status of workers of a thermal power station exposed for prolonged periods to arsenic and other elements from fuel.

The Nováky Power Station (NPS) has been using since 1953 as fuel coal with a high content of As and with a low content of other metals. This involves a constant risk for the workers as well as pollution of the surroundings. The authors described 16 cases of chronic As intoxication in NPS workers after 22.3 +/- 8.4 years of exposure (especially stokers, maintenance workers, boiler cleaners). Among clinical symptoms prevailed sensory and motor polyneuropathy (13 cases), pseudoneurasthenic syndrome (10 cases), toxic encephalopathy (6 cases) and nasal septum perforation (2 cases). After 1989 the intoxications with As did not occur any more due to technical measures and health protection of the workers. The authors present a review of actual results of clinical, haematological and biochemical investigations and tests for metals (AAS methods) in biological materials of workers at risk in NPS (n = 70), exposed on average for 11.9 +/- 0.5 years, of average age 35.91 +/- 1.7 years (mean +/- SE) and compared the results to a matched control group of blood donors not exposed to metals (n = 29). In NPS workers significantly lower Hb values, higher serum creatinine, higher serum beta 2-microglobulin, higher As content in hair as well as higher serum Mn and Pb concentrations compared with the C-group were found. The exposed group had significantly lower serum Se concentrations (0.64 +/- 0.025 mumol/l (mean +/- SE) compared to Se levels of persons from an adjacent district. The authors stress the necessity of individual evaluation of the metal concentrations in relation to clinical findings. With prolonged exposure the situation can become more urgent not only because of chronic poisoning but also because of the cancerogenic effects of these elements on the human organism.