Effects of occupational exposure to metal fume PM2.5 on lung function and biomarkers among shipyard workers: a 3-year prospective cohort study

Objective This study investigates the associations of alpha 1-antitrypsin, inter-alpha-trypsin inhibitor heavy chain (ITIH4), and 8-isoprostane with lung function in shipyard workers exposed to occupational metal fume fine particulate matter (PM2.5), which is known to be associated with adverse respiratory outcomes. Methods A 3-year follow-up study was conducted on 180 shipyard workers with 262 measurements. Personal exposure to welding fume PM2.5 was collected for an 8-h working day. Pre-exposure, post-exposure, and delta ( increment ) levels of alpha 1-antitrypsin, ITIH4, and 8-isoprostane were determined in urine using enzyme-linked immunosorbent assays. Post-exposure urinary metals were sampled at the beginning of the next working day and analyzed by inductively coupled plasma-mass spectrometry. Lung function measurements were also conducted the next working day for post-exposure. Results An IQR increase in PM2.5 was associated with decreases of 2.157% in FEV1, 2.806% in PEF, 4.328% in FEF25%, 5.047% in FEF50%, and 7.205% in FEF75%. An IQR increase in PM2.5 led to increases of 42.155 mu g/g in Delta alpha 1-antitrypsin and 16.273 mu g/g in Delta ITIH4. Notably, IQR increases in various urinary metals were associated with increases in specific biomarkers, such as post-urinary alpha 1-antitrypsin and ITIH4. Moreover, increases in Delta alpha 1-antitrypsin and Delta ITIH4 were associated with decreases in FEV1/FVC by 0.008% and 0.020%, respectively, and an increase in Delta 8-isoprostane resulted in a 1.538% decline in FVC. Conclusion Our study suggests that urinary alpha 1-antitrypsin and ITIH4 could indicate early lung function decline in shipyard workers exposed to metal fume PM2.5, underscoring the need for better safety and health monitoring to reduce respiratory risks.