Inflammatory markers and exposure to airborne particles among workers in a Swedish pulp and paper mill

Purpose To study the relationship between exposure to airborne particles in a pulp and paper mill and markers of inflammation and coagulation in blood. Methods Personal sampling of inhalable dust was performed for 72 subjects working in a Swedish pulp and paper mill. Stationary measurements were used to study concentrations of total dust, respirable dust, PM 10 and PM 2.5 , the particle surface area and the particle number concentrations. Markers of inflammation, interleukins (IL-1b, IL-6, IL-8, and IL-10), C-reactive protein (CRP), serum amyloid A (SAA), and fibrinogen and markers of coagulation factor VIII, von Willebrand, plasminogen activator inhibitor, and D-dimer were measured in plasma or serum. Sampling was performed on the last day of the work free period of 5 days, before and after the shift the first day of work and after the shifts the second and third day. In a mixed model analysis, the relationship between particulate exposures and inflammatory markers was determined. Sex, age, smoking, and BMI were included as covariates. Results The average 8-h time-weighted average (TWA) air concentration levels of inhalable dust were 0.30 mg/m 3 , range 0.005–3.3 mg/m 3 . The proxies for average 8-h TWAs of respirable dust were 0.045 mg/m 3 . Significant and consistent positive relations were found between several exposure metrics (PM 10, total and inhalable dust) and CRP, SAA and fibrinogen taken post-shift, suggesting a dose–effect relationship. Conclusion This study supports a relationship between occupational particle exposure and established inflammatory markers, which may indicate an increased risk of cardiovascular disease.