Five-year cohort study: Emphysematous progression of indium-exposed workers

Makiko Nakano, Kazuyuki Omae, Kazuhiko Uchida, Takehiro Michikawa, Noriyuki Yoshioka, Miyuki Hirata, Akiyo Tanaka

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

BACKGROUND: Dose-dependent adverse lung effects due to indium exposure have been reported in a cross-sectional study. This is a 5-year longitudinal cohort study of indiumexposed and unexposed workers, assessing indium exposure levels and its clinical lung effects. METHODS: From 2008 to 2011, a 5-year follow-up study was conducted on 40 unexposed and 240 workers formerly or currently exposed to indium at 11 factories. Indium exposure was assessed by serum indium (In-S) ( μ/L). Lung effects were assessed by subjective symptoms, serum biomarkers, spirometry, and chest high-resolution CT scan. Effect biomarkers used were Krebs von den Lungen and surfactant protein D. RESULTS: Mean values of In-S, Krebs von den Lungen, and surfactant protein D among the workers exposed to indium at baseline declined during the 5-year follow-up by 29.8%, 27.2%, and 27.5%, respectively. Of the exposed subjects with In-S levels > 20 μg/L, 26.3% experienced emphysematous progression on high-resolution CT scan. Ninety percent (18 of 20) of workers with emphysematous progression during follow-up were current smokers at baseline, and a trend of increasing incidence of emphysematous progression at higher In-S levels was observed among the smokers ( P = .005). Emphysematous changes among subjects with In-S levels > 20 μg/L were likely to progress, after adjusting for age, mean duration since initial indium exposure, and smoking history (OR = 10.49, 95% CI = 1.54-71.36). CONCLUSIONS: Long-term adverse effects on emphysematous changes were observed. The results suggest workers exposed to indium with In-S levels > 20 μg/L should be immediately removed from exposure.

Original languageEnglish
Pages (from-to)1166-1175
Number of pages10
JournalChest
Volume146
Issue number5
DOIs
Publication statusPublished - Nov 1 2014

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Indium
Cohort Studies
Pulmonary Surfactant-Associated Protein D
Lung
Biomarkers
Spirometry
Serum
Longitudinal Studies
Thorax
Cross-Sectional Studies
Smoking
History
Incidence

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Five-year cohort study : Emphysematous progression of indium-exposed workers. / Nakano, Makiko; Omae, Kazuyuki; Uchida, Kazuhiko; Michikawa, Takehiro; Yoshioka, Noriyuki; Hirata, Miyuki; Tanaka, Akiyo.

In: Chest, Vol. 146, No. 5, 01.11.2014, p. 1166-1175.

Research output: Contribution to journalArticle

Nakano, M, Omae, K, Uchida, K, Michikawa, T, Yoshioka, N, Hirata, M & Tanaka, A 2014, 'Five-year cohort study: Emphysematous progression of indium-exposed workers', Chest, vol. 146, no. 5, pp. 1166-1175. https://doi.org/10.1378/chest.13-2484
Nakano M, Omae K, Uchida K, Michikawa T, Yoshioka N, Hirata M et al. Five-year cohort study: Emphysematous progression of indium-exposed workers. Chest. 2014 Nov 1;146(5):1166-1175. https://doi.org/10.1378/chest.13-2484
Nakano, Makiko ; Omae, Kazuyuki ; Uchida, Kazuhiko ; Michikawa, Takehiro ; Yoshioka, Noriyuki ; Hirata, Miyuki ; Tanaka, Akiyo. / Five-year cohort study : Emphysematous progression of indium-exposed workers. In: Chest. 2014 ; Vol. 146, No. 5. pp. 1166-1175.
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abstract = "BACKGROUND: Dose-dependent adverse lung effects due to indium exposure have been reported in a cross-sectional study. This is a 5-year longitudinal cohort study of indiumexposed and unexposed workers, assessing indium exposure levels and its clinical lung effects. METHODS: From 2008 to 2011, a 5-year follow-up study was conducted on 40 unexposed and 240 workers formerly or currently exposed to indium at 11 factories. Indium exposure was assessed by serum indium (In-S) ( μ/L). Lung effects were assessed by subjective symptoms, serum biomarkers, spirometry, and chest high-resolution CT scan. Effect biomarkers used were Krebs von den Lungen and surfactant protein D. RESULTS: Mean values of In-S, Krebs von den Lungen, and surfactant protein D among the workers exposed to indium at baseline declined during the 5-year follow-up by 29.8{\%}, 27.2{\%}, and 27.5{\%}, respectively. Of the exposed subjects with In-S levels > 20 μg/L, 26.3{\%} experienced emphysematous progression on high-resolution CT scan. Ninety percent (18 of 20) of workers with emphysematous progression during follow-up were current smokers at baseline, and a trend of increasing incidence of emphysematous progression at higher In-S levels was observed among the smokers ( P = .005). Emphysematous changes among subjects with In-S levels > 20 μg/L were likely to progress, after adjusting for age, mean duration since initial indium exposure, and smoking history (OR = 10.49, 95{\%} CI = 1.54-71.36). CONCLUSIONS: Long-term adverse effects on emphysematous changes were observed. The results suggest workers exposed to indium with In-S levels > 20 μg/L should be immediately removed from exposure.",
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AU - Nakano, Makiko

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AU - Yoshioka, Noriyuki

AU - Hirata, Miyuki

AU - Tanaka, Akiyo

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N2 - BACKGROUND: Dose-dependent adverse lung effects due to indium exposure have been reported in a cross-sectional study. This is a 5-year longitudinal cohort study of indiumexposed and unexposed workers, assessing indium exposure levels and its clinical lung effects. METHODS: From 2008 to 2011, a 5-year follow-up study was conducted on 40 unexposed and 240 workers formerly or currently exposed to indium at 11 factories. Indium exposure was assessed by serum indium (In-S) ( μ/L). Lung effects were assessed by subjective symptoms, serum biomarkers, spirometry, and chest high-resolution CT scan. Effect biomarkers used were Krebs von den Lungen and surfactant protein D. RESULTS: Mean values of In-S, Krebs von den Lungen, and surfactant protein D among the workers exposed to indium at baseline declined during the 5-year follow-up by 29.8%, 27.2%, and 27.5%, respectively. Of the exposed subjects with In-S levels > 20 μg/L, 26.3% experienced emphysematous progression on high-resolution CT scan. Ninety percent (18 of 20) of workers with emphysematous progression during follow-up were current smokers at baseline, and a trend of increasing incidence of emphysematous progression at higher In-S levels was observed among the smokers ( P = .005). Emphysematous changes among subjects with In-S levels > 20 μg/L were likely to progress, after adjusting for age, mean duration since initial indium exposure, and smoking history (OR = 10.49, 95% CI = 1.54-71.36). CONCLUSIONS: Long-term adverse effects on emphysematous changes were observed. The results suggest workers exposed to indium with In-S levels > 20 μg/L should be immediately removed from exposure.

AB - BACKGROUND: Dose-dependent adverse lung effects due to indium exposure have been reported in a cross-sectional study. This is a 5-year longitudinal cohort study of indiumexposed and unexposed workers, assessing indium exposure levels and its clinical lung effects. METHODS: From 2008 to 2011, a 5-year follow-up study was conducted on 40 unexposed and 240 workers formerly or currently exposed to indium at 11 factories. Indium exposure was assessed by serum indium (In-S) ( μ/L). Lung effects were assessed by subjective symptoms, serum biomarkers, spirometry, and chest high-resolution CT scan. Effect biomarkers used were Krebs von den Lungen and surfactant protein D. RESULTS: Mean values of In-S, Krebs von den Lungen, and surfactant protein D among the workers exposed to indium at baseline declined during the 5-year follow-up by 29.8%, 27.2%, and 27.5%, respectively. Of the exposed subjects with In-S levels > 20 μg/L, 26.3% experienced emphysematous progression on high-resolution CT scan. Ninety percent (18 of 20) of workers with emphysematous progression during follow-up were current smokers at baseline, and a trend of increasing incidence of emphysematous progression at higher In-S levels was observed among the smokers ( P = .005). Emphysematous changes among subjects with In-S levels > 20 μg/L were likely to progress, after adjusting for age, mean duration since initial indium exposure, and smoking history (OR = 10.49, 95% CI = 1.54-71.36). CONCLUSIONS: Long-term adverse effects on emphysematous changes were observed. The results suggest workers exposed to indium with In-S levels > 20 μg/L should be immediately removed from exposure.

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