Investigation of the health effects on workers exposed to respirable crystalline silica during outdoor and underground construction projects

Keramydas,Dimitrios; Bakakos,Petros; Alchanatis,Manos; Papalexis,Petros; Konstantakopoulos,Ioannis; Tavernaraki,Kyriaki; Dracopoulos,Vasileios; Papadakis,Antonios; Pantazi,Eugenia; Chelidonis,Georgios; Chaidoutis,Elias; Constantinidis,Theodoros C.; Tsitsimpikou,Christina; Kavantzas,Nikolaos; Patsouris,Efstratios; Tsarouhas,Konstantinos; Spandidos,Demetrios A.; Lazaris,Andreas Ch.

doi:10.3892/etm.2020.8786

Investigation of the health effects on workers exposed to respirable crystalline silica during outdoor and underground construction projects

Authors:
- Dimitrios Keramydas
- Petros Bakakos
- Manos Alchanatis
- Petros Papalexis
- Ioannis Konstantakopoulos
- Kyriaki Tavernaraki
- Vasileios Dracopoulos
- Antonios Papadakis
- Eugenia Pantazi
- Georgios Chelidonis
- Elias Chaidoutis
- Theodoros C. Constantinidis
- Christina Tsitsimpikou
- Nikolaos Kavantzas
- Efstratios Patsouris
- Konstantinos Tsarouhas
- Demetrios A. Spandidos
- Andreas Ch. Lazaris
View Affiliations

Affiliations: 1st Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece, 1st Department of Pneumonology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece, Ministry of Labor and Social Affairs, National Focal Point of the European Agency for Safety and Health at Work (EU‑OSHA), 10110 Athens, Greece, Department of Imaging and Interventional Radiology, ‘Sotiria’ Hospital, 11527 Athens, Greece, Hellenic Institute for Occupational Health and Safety (ELINYAE), 10445 Athens, Greece, Directorate of Public Health, Region of Crete, 71201 Heraklion, Greece, Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece, National Actuarial Authority, 10559 Athens, Greece, Ministry of Interior, 10563 Athens, Greece, Laboratory of Hygiene and Environmental Protection, Democritus University of Thrace, School of Health Sciences, Faculty of Medicine, 68100 Alexandroupolis, Greece, General Chemical State Laboratory of Greece, 11521 Athens, Greece, Cardiology Department, University General Hospital of Larissa, 41110 Larissa, Greece, Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
Published online on: May 25, 2020 https://doi.org/10.3892/etm.2020.8786
Pages: 882-889
Copyright: © Keramydas et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Chronic exposure of workers to powder containing crystalline silica (Silicon dioxide; SiO2) can lead to chronic lung diseases (lung cancer, silicosis, etc.). Aim of this study was to evaluate the exposure of Greek construction workers to SiO2 and describe their pulmonary function. The study involved 86 outdoor and underground workers. Medical and professional history was obtained, and breath samples were collected at morning hours through a mask for the determination of SiO2 levels. Pulmonary function tests, radiological examination and evaluation of radiographs were also performed. Pulmonary function examination showed that the majority of the workers were within normal range (61.4%) while the rest were diagnosed with mild (26.5%) and more severe impairment (7.24%). Working conditions (underground‑outdoor) were statistically significantly related to the categorization of pulmonary function (P=0.038). During radiological examination, the type of working activity/ conditions (underground‑outdoor) were statistically significantly related to the categorization of these findings (P=0.044). Of the 69 employees, 52 did not present findings (75.4%) and 5 were diagnosed with findings specific to occupational diseases (7.23%). Environmental exposure to respirable crystalline silica (RCS) was detected at 0.0125 mg/m3 in the workplace, which is not beyond the legal limits. Underground workers with more than 15 years of exposure to SiO2 are more likely to present chronic silicosis compared to the workers of outdoor activities.

View Figures

View References

1	NEPSI The European Network on Silica: Agreement on Workers Health Protection through the Good Handling and Use of Crystalline Silica and Products containing it. https://www.nepsi.eu/sites/nepsi.eu/files/content/editor/agreement_-_english.pdf. Updated December 18, 2017.
2	European Commission: Guidance for National Labour Inspectors on addressing risks from worker exposure to respirable crystalline silica (RCS) on construction sites. https://osha.europa.eu/en/guidance-national-labour-inspectors-on-addressing-risks-from-worker-exposure-to-respirable-crystalline-silica. Accessed October 2016.
3	Apatsidou M, Konstantopoulou I, Foufa E, Tsarouhas K, Papalexis P, Rezaee R, Spandidos DA, Kouretas D and Tsitsimpikou C: Safe use of chemicals by professional users and health care specialists. Biomed Rep. 8:160–165. 2018.PubMed/NCBI View Article : Google Scholar
4	Fenga C, Gangemi S, Giambò F, Tsitsimpikou C, Golokhvast K, Tsatsakis A and Costa C: Low-dose occupational exposure to benzene and signal transduction pathways involved in the regulation of cellular response to oxidative stress. Life Sci. 147:67–70. 2016.PubMed/NCBI View Article : Google Scholar
5	Koulaouzidou EA, Roussou K, Sidiropoulos K, Nikolaidis A, Kolokuris I, Tsakalof A, Tsitsimpikou C and Kouretas D: Investigation of the chemical profile and cytotoxicity evaluation of organic components eluted from pit and fissure sealants. Food Chem Toxicol. 120:536–543. 2018.PubMed/NCBI View Article : Google Scholar
6	Sauvé JF, Beaudry C, Bégin D, Dion C, Gérin M and Lavoué J: Silica exposure during construction activities: statistical modeling of task-based measurements from the literature. Ann Occup Hyg. 57:432–443. 2013.PubMed/NCBI View Article : Google Scholar
7	Steenland K and Ward E: Silica: A lung carcinogen. CA Cancer J Clin. 64:63–69. 2014.PubMed/NCBI View Article : Google Scholar
8	No authors listed: IARC Working Group on the Evaluation of Carcinogenic Risks to Humans: IARC Working Group on the Evaluation of Carcinogenic Risks to Humans: Silica, Some Silicates, Coal Dust and Para-Aramid Fibrils. Lyon, 15-22 October 1996. IARC Monogr Eval Carcinog Risks Hum 68: 1-475, 1997.
9	European Commission: Proposal for a Directive of The European Parliament and of The Council amending directive 2004/37/EC on the protection of workers from the risks related to exposure to carcinogens or mutagens at work. https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A52016PC0248. Accessed May 13, 2016.
10	European Comission: Commission Recommendation of 19 September 2003 concerning the European schedule of occupational diseases (Text with EEA relevance) (notified under document number C(2003) 3297). https://eur-lex.europa.eu/legal-content/EN/ALL/?uri=CELEX%3A32003H0670. Accessed September 19, 2003.
11	Hellenic Republic Presidential: Decree no. 41/2012, National list of occupational diseases, in accordance with Commission Recommendation 2003/670/EC 19.09.2003.
12	Rees D and Murray J: Silica, silicosis and tuberculosis. Int J Tuberc Lung Dis. 11:474–484. 2007.PubMed/NCBI
13	Arndt V, Rothenbacher D, Daniel U, Zschenderlein B, Schuberth S and Brenner H: All-cause and cause specific mortality in a cohort of 20,000 construction workers; results from a 10 year follow up. Occup Environ Med. 61:419–425. 2004.PubMed/NCBI View Article : Google Scholar
14	Beaudry C, Lavoué J, Sauvé J-F, Bégin D, Senhaji Rhazi M, Perrault G, Dion C and Gérin M: Occupational exposure to silica in construction workers: A literature-based exposure database. J Occup Environ Hyg. 10:71–77. 2013.PubMed/NCBI View Article : Google Scholar
15	Oliver LC, Miracle-McMahill H, Littman AB, Oakes JM and Gaita RR Jr: Respiratory symptoms and lung function in workers in heavy and highway construction: A cross-sectional study. Am J Ind Med. 40:73–86. 2001.PubMed/NCBI View Article : Google Scholar
16	Arcangeli G, Cupelli V, Montalti M, Pristera M, Baldasseroni A and Giuliano G: Respiratory risks in tunnel construction workers. Int J Immunopathol Pharmacol. 17 (Suppl):91–96. 2004.PubMed/NCBI View Article : Google Scholar
17	Ellingsen DG, Ulvestad B, Bakke B, Seljeflot I, Barregard L and Thomassen Y: Serum pneumoproteins in tunnel construction workers. Int Arch Occup Environ Health. 88:943–951. 2015.PubMed/NCBI View Article : Google Scholar
18	Tavakol E, Azari M, Zendehdel R, Salehpour S, Khodakrim S, Nikoo S and Saranjam B: Risk Evaluation of Construction Workers' Exposure to Silica Dust and the Possible Lung Function Impairments. Tanaffos. 16:295–303. 2017.PubMed/NCBI
19	Khoza NN, Grové T and Schutte PC: Worker exposure to silica dust in South African non-mining industries in Gauteng: An exploratory study. Occup Health S Africa. 18:18–26. 2012.
20	Hellenic Pulmonary Society: Occupational and environmental lung diseases. Hellenic Pulmonary Society, Athens, 2007. http://www.hts.org.gr/assets/files/biblia_epe/epaggelmatika_nosimata.pdf.
21	Hellenic Republic Joint Ministerial Decision: F.80000/45219/1864/2017 Single Disability Identification Table.
22	IARC monographs: Arsenic, metals, fibres, and dusts. Volume 100 C. A review of human carcinogens. IARC, Lyon, 2012. https://monographs.iarc. fr/wp-content/uploads/2018/06/mono100C.pdf.
23	Linch KD: Respirable concrete dust - silicosis hazard in the construction industry. Appl Occup Environ Hyg. 17:209–221. 2002.PubMed/NCBI View Article : Google Scholar
24	Tavakol E, Azari MR, Salehpour S and Khodakarim S: Determination of Construction Workers' Exposure to Respirable Crystalline Silica and Respirable Dust. J Saf Promot Inj Prev. 3:263–270. 2016.
25	European Commission: Regulation (EC) No. 1272/2008 of the European Parliament and of the Council of 16 December 2008 on classification, labelling and packaging of substances and mixtures, amending and repealing Directives 67/548/EEC and 1999/45/EC, and amending Regulation (EC) No. 1907/2006. https://eur-lex.europa.eu/eli/reg/2008/1272/oj. Accessed December 31, 2008.
26	Hellenic Republic Presidential: Decree 77/1993, For the protection of workers against physical, chemical and biological agents and amending and supplementing Presidential Decree 307/86 in accordance with its Directive Council Regulation 88/642/EEC.
27	Patakas D: Epithelial pulmonology. 2nd edition. University Studio Press, Thessaloniki, 2006.
28	Macintyre N, Crapo RO, Viegi G, Johnson DC, van der Grinten CP, Brusasco V, Burgos F, Casaburi R, Coates A, Enright P, et al: Standardisation of the single-breath determination of carbon monoxide uptake in the lung. Eur Respir J. 26:720–735. 2005.PubMed/NCBI View Article : Google Scholar
29	Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, et al: ATS/ERS Task Force: Standardisation of spirometry. Eur Respir J. 26:319–338. 2005.PubMed/NCBI View Article : Google Scholar
30	Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, Coates A, van der Grinten CP, Gustafsson P, Hankinson J, et al: Interpretative strategies for lung function tests. Eur Respir J. 26:948–968. 2005.PubMed/NCBI View Article : Google Scholar
31	Kreider ME and Grippi MA: Impact of the new ATS/ERS pulmonary function test interpretation guidelines. Respir Med. 101:2336–2342. 2007.PubMed/NCBI View Article : Google Scholar
32	Webb WR and Higgins CB: Thoracic imaging: pulmonary and cardiovascular radiology. 3rd edition. LWW, 2017.
33	Cox CW and Lynch DA: Medical imaging in occupational and environmental lung disease. Curr Opin Pulm Med. 21:163–170. 2015.PubMed/NCBI View Article : Google Scholar
34	Greenberg MI, Waksman J and Curtis J: Silicosis: A review. Dis Mon. 53:394–416. 2007.PubMed/NCBI View Article : Google Scholar
35	Hellenic Republic: Ministerial Decision Δ7/Α/off.12050/2223/2011 ‘Mining and Quarry Works Regulation’, Government Gazette, Series II, No. 1227/2011.
36	European Comission: Directive (EU) 2017/2398 of the European Parliament and of the Council of 12 December 2017 amending Directive 2004/37/EC on the protection of workers from the risks related to exposure to carcinogens or mutagens at work. https://eur-lex.europa.eu/eli/dir/2017/2398/oj. Accessed December 27, 2017.
37	Leung CC, Yu ITS and Chen W: Silicosis. Lancet. 379:2008–2018. 2012.PubMed/NCBI View Article : Google Scholar
38	Mazurek JM and Attfield MD: Silicosis mortality among young adults in the United States, 1968-2004. Am J Ind Med. 51:568–578. 2008.PubMed/NCBI View Article : Google Scholar
39	Hochgatterer K, Moshammer H and Haluza D: Dust is in the air: Effects of occupational exposure to mineral dust on lung function in a 9-year study. Lung. 191:257–263. 2013.PubMed/NCBI View Article : Google Scholar
40	Kachuri L, Villeneuve PJ, Parent M-É, Johnson KC and Harris SA: Canadian Cancer Registries Epidemiology Group: Occupational exposure to crystalline silica and the risk of lung cancer in Canadian men. Int J Cancer. 135:138–148. 2014.PubMed/NCBI View Article : Google Scholar
41	European Commission: Council Directive 89/391/EEC of 12 June 1989 on the introduction of measures to encourage improvements in the safety and health of workers at work. https://eur-lex.europa.eu/legal-content/EN/ALL/?uri=CELEX%3A31989L0391. Accessed June 29, 1989.
42	Hellenic Parliament: Law No. 3850 of 2010 ratifying the Code of Laws related to Occupational Safety and Health.
43	European Commission: Regulation (EU) 2016/425 of the European Parliament and of the Council of 9 March 2016 on personal protective equipment and repealing Council Directive 89/686/EEC. https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A32016R0425. Accessed March 31, 2016.
44	European Commission: Consolidated text: Directive 2004/37/EC of the European Parliament and of the Council of 29 April 2004 on the protection of workers from the risks related to exposure to carcinogens or mutagens at work (Sixth individual Directive within the meaning of Article 16(1) of Council Directive 89/391/EEC) (codified version). https://eur-lex.europa.eu/legal-content/en/TXT/?uri=CELEX%3A02004L0037-20140325. Accessed April 30, 2004.
45	Hellenic Republic Ministerial: Decision no. 48416/2564/2017 - Adoption of National Strategy for Health and Safety at Work for the years 2016-2020, 2017.