Vol 1,issue 7 Effect of occupational exposure of cement dust on some haematological parameters of workers in a cement company in Sokoto, Nigeria

  • 240 views
Uploaded on

Cement dust exposures has been reported to result in significant occupational health problems and long term complications and symptoms. …

Cement dust exposures has been reported to result in significant occupational health problems and long term complications and symptoms.

In this present study we monitored some haematological parameters; Packed Cell Volume (PCV), Haemoglobin (HB), Erythrocyte Sedimentation Rate (ESR), White Cell Count (WBC) and Platelet (PLC) count of 100 workers (mean age 37.42 ± 10.14 years) who were occupationally exposed to cement dust (mean years of exposure 9.9 ±5.6 years).

Fifty age and gender matched non -exposed individuals were monitored as controls. The PCV was significantly lower among exposed subjects compared to non-exposed (31.1 ± 3.3 versus 40.7 ± 3.8), p=0.001. Platelet, WBC and ESR were significantly higher among exposed subjects (262 ± 57.2, 15.5 ± 11.9 and 13.2 ±1.7) compared to non-exposed controls (204 ±36.7, 12.9 ± 10.2 and 10.4 ± 1.3) respectively.

We observed an age dependent higher PCV and ESR among non-exposed controls as well as a lower age-related lower WBC and platelet count. We observed a significant positive correlation between age of exposure and WBC (r= 0.48). Our finding does indicates that occupational exposure to cement dust may have a negative impact on the haemopoietic function.

There is need for cement producing companies to provide appropriate personalprotective equipment for their staff as ensure that staff are compliant in the use of these equipment. There is also the need to periodically monitor the health and well being of staff exposed to cement dust.

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
240
On Slideshare
0
From Embeds
0
Number of Embeds
0

Actions

Shares
Downloads
2
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. International Journal of Medical Sciences and Health Care Vol-1 Issue-7 (Ijmshc-704) http://www.ijmshc.com Page 2
  • 2. International Journal of Medical Sciences and Health Care Vol-1 Issue-7 (Ijmshc-704) http://www.ijmshc.com Page 21 Effect of occupational exposure of cement dust on some haematological parameters of workers in a cement company in Sokoto, Nigeria Erhabor O, Kebbe BI 1 , Isaac IZ 1 , Yakubu A 1 , Marafa Y 1 , Okwesili AN 1 , Buhari HA 1 , Wase A 1 , Onuigwe FU 1 Aghedo F 2 , Ikhuenbor D 2 , Mainasara A 3 , Dallatu MK 3 , Uko EK 4 , Udomah FP 5 , , Iwueke IP 6 , Adias TC 7 , Igbineweka OO 8 1. Department of Haematology and Transfusion Medicine Faculty of Medical Laboratory Science UsmanuDanfodio University Sokoto, Nigeria 2. Department of Haematology and Transfusion Medicine UsmanuDanfodio University Teaching Hospital Sokoto, Nigeria 3. Department of Chemical Pathology Faculty of Medical Laboratory Science, UsmanuDanfodio University Sokoto, Nigeria 4. Department of Haematology University of Calabar 5. Department of Medical Laboratory Sciences, University of Calabar Teaching Hospital, Calabar, Nigeria 6. Pathology Department, Federal Neuro Psychiatric Hospital Kware, Sokoto, Nigeria 7. College of Health Technology Bayelsa State, Nigeria 8. One Brigade Medical Centre Sokoto, Nigeria . All Correspondence to: DrErhaborOsaro-Associate Professor of Haematology and Transfusion Medicine,Faculty of Medical Laboratory Science-UsmanuDanfodiyo University,Sokoto, Nigeria Abstract: Cement dust exposures has been reported to result in significant occupational health problems and long term complications and symptoms. In this present study we monitored some haematological parameters; Packed Cell Volume (PCV), Haemoglobin (HB), Erythrocyte Sedimentation Rate (ESR), White Cell Count (WBC) and Platelet (PLC) count of 100 workers (mean age 37.42 ± 10.14 years) who were occupationally exposed to cement dust (mean years of exposure 9.9 ±5.6 years). Fifty age and gender matched non -exposed individuals were monitored as controls. The PCV was significantly lower among exposed subjects compared to non-exposed (31.1 ± 3.3 versus 40.7 ± 3.8), p=0.001. Platelet, WBC and ESR were significantly higher among exposed subjects (262 ± 57.2, 15.5 ± 11.9 and 13.2 ±1.7) compared to non-exposed controls (204 ±36.7, 12.9 ± 10.2 and 10.4 ± 1.3) respectively. We observed an age dependent higher PCV and ESR among non-exposed controls as well as a lower age-related lower WBC and platelet count. We observed a significant positive correlation between age of exposure and WBC (r= 0.48). Our finding does indicates that occupational exposure to cement dust may have a negative impact on the haemopoietic function.There is need for cement producing companies to provide appropriate personalprotective equipment for their staff as ensure that staff are compliant in the use of these equipment. There is also the need to periodically monitor the health and well being of staff exposed to cement dust. Key Words:Occupational exposure, cement dust, haematological parameters, worker Introduction World demand for cement and concrete additives is projected to increase 8.3 percent annually to $15.8 billion in 2015, a significant improvement over the performance of the 2005-2010 period. In developing markets, growth has been boosted by sustained levels of construction activity with associated increased cement consumption. Exposure to cement dust has long been associated with the prevalence of diseases including lung and laryngeal cancer, gastrointestinal tumours and dermatitis 1, 2 . Industrial production is often associated with the generation of waste, some of which have a significant negative health hazard. Cement industry is often associated with cement dust exposure. Cement is adhesive mineral dust containing mixture of calcium oxide, silicon oxide, aluminum tri oxide, ferric oxide, magnesium oxide and also clay, shale, sand and other impurities. High concentration and prolonged inhalation of cement dust can potentially provoke clinical symptoms and inflammatory response that may result in functional, structural as well as other abnormalities 3 . Haematological parameters are a sensitive and important diagnostic indices in the monitoring to changes resulting from exposures to toxins. Most studies have previously attempted to evaluate the effects of cement dust exposure on the respiratory system. However, there is paucity of data on the effects of cement dust on the haemopoietic systems in humans. Exposure to Cement dusts is even a larger problem in developing countries as personal protection equipment is often limited and health and safety as well as occupational issues and safety and occupational health regulations are often compromised 4 . Therefore, the aim of this case control study is to investigate the potential toxic effects of occupational exposure of cement dust and to minimize the health risks among workers in cement factories by providing them with evidenced- based information about the hazards of cement dust. Materials and methods Study design This case-control study was designed to determine the effect of occupational exposure to cement dust on some haematological parameters. We monitored the PCV, HB, ESR, WBC and PLC count of 100 workers (mean age 37.42 ± 10.14 years) who were occupationally exposed to cement dust (mean years of exposure 9.9 ±5.6 years). Fifty age and gender matched non -exposed individuals were monitored as controls. Haematologicalvalues obtained from subjects were compared with that of controls and the difference analyzed statistically. The
  • 3. International Journal of Medical Sciences and Health Care Vol-1 Issue-7 (Ijmshc-704) http://www.ijmshc.com Page 22 effect of socio-demographic factors were also be compared statistically. Eligibility Criteria All consenting adult male (> 18 years) who have been occupational exposed to cement dust (1-24 years), who had no previous history of haematological condition, who had not been transfused in the last 3 months were enrolled into this study. Exclusion criteria included; age < 18 years, non-exposure to cement dust, history of haematological co-morbidities, red cell transfusion in the last 3 months and failure to give written informed consent after counselling. Informed consent and ethical clearance Written informed consent was obtained from all participants recruited into this study (controls and subjects). Ethical clearance was obtained from the ethical review board of the Ethical committee of the Faculty of Medical Laboratory Science Hospital Sokoto, Nigeria. Study Area This present research work was carried out at the Department of HaematologyUsmanuDanfodiyo University Teaching Hospital Sokoto State, Nigeria. The hospital is a tertiary health hospital in the Northwest geopolitical zone of Nigeria offering routine quality care to residents of Sokoto metropolis and neighbouring states of Zamfara and Kebbi. Sokoto State is located in the extreme North Western part of Nigeria near to the confluence of the Sokoto River and the Rima River.With an annual average temperature of 28.3 °C (82.9 °F), Sokoto is, on the whole, a very hot area. However, maximum daytime temperatures are for most of the year generally under 40 °C (104.0 °F). The warmest months are February to April when daytime temperatures can exceed 45 °C (113.0 °F). The rainy season is from June to October during which showers are a daily occurrence. There are two major seasons, wet and dry which are distinct and are characterized by high and low malarial transmission respectively. Report from the 2007 National Population Commission indicated that the state had a population of 3.6 million 5 . Statistical analysis Statistical analyses were conducted using SPSS (version 11; SPSS Inc., Chicago, IL) software. Data were expressed as mean ± standard deviation. Comparisons between exposed subjects and non-exposed controls were made using the Student's t-test for parametric data and the Mann-Whitney test for non-parametric data. Descriptive analyses of percentages of categorical variables were reported. An alpha value of < 0.05 denoted a statistically significant difference in all statistical comparisons. Correlation was compared using a version of linear regression. Study population Subjects (100) for this case control study were recruited from among the staff working in Cement Company of Northern Nigeria a cement manufacturing factory in Sokoto Nigeria. The need to meet the increasing demand for cement for construction has led to the increased number and production capacity in most cement companies in Nigeria. Age and gender matched non- exposed individuals were monitored as controls (50). Sample collection Three milliliters of blood sample was drawn aseptically with MonovetteVacutainer blood collection system (Sarstedt, Germany) from the median antecubital vein for all the subjects into dipotassiumethylenediaminetetracetic acid (K2EDTA) anticoagulated blood containers. The EDTA anticoagulated sample was used for the determination of Packed Cell Volume using a microhaematocrit centrifuge (Hawksley, UK). Platelet count and Total White Cell count was determined using standard manual methods using a Neubauer chamber. Despite the recent technical development of scientific laboratories and the development of automated blood counter, Neubauer chamber remains the most common method used for blood cell counting particularly in resource-limited settings around the world. ESR was determined using the Westergreen method. The standard operating procedures as prescribed by the manufacturers was strictly followed. Standard methods as described by Dacie and Lewis 6 were used for all haematological analysis. Result The PCV was significantly lower among exposed subjects compared to non-exposed (31.1 ± 3.3 versus 40.7 ± 3.8), p=0.001. Platelet, WBC and ESR were significantly higher among exposed subjects (262 ± 57.2, 15.5 ± 11.9 and 13.2 ±1.7) compared to non-exposed controls (204 ±36.7, 12.9 ± 10.2 and 10.4 ± 1.3) respectively. Table 1 show the mean and standard deviation of PCV; ESR; WBC and PLTC of exposed subjects and non-exposed control. We observed a significant positive correlation between age of exposure and WBC (r= 0.48). Tables 2 show the mean and standard deviation of PCV; ESR; WBC and PLTC of exposed workers according to their years of exposure. We observed an age dependent higher PCV and ESR among non-exposed controls as well as a lower age- related lower WBC and platelet count. Table 3 show the mean and standard deviation of PCV; ESR; WBC and PLTC of unexposed (control) according to their age group.We did not observe any age-related differenced in the mean haematological values of exposed workers. Table 4 show the mean and standard deviation of PCV; ESR; WBC and platelet count of exposed workers according to their age groups.
  • 4. International Journal of Medical Sciences and Health Care Vol-1 Issue-7 (Ijmshc-704) http://www.ijmshc.com Page 23 Table 1: Mean and standard deviation of PCV; ESR; WBC and PLTC of exposed and control compared. Subject Groups F PCV (%) ESR (mm in 1hr) WBC (x109 /l) PLCT (x109 /l) Exposed 100 31.1±3.3 13.2±1.7 15.5±11.9 262±57.2 Unexposed 50 40.7±3.8 10.4±1.3 12.9±10.2 204±36.7 P – value 0.001 0.01 0.01 0.001 Table2: Mean and standard deviation of PCV; ESR; WBC and PLTC of exposed workers according to their years of exposure. Years of exposure F PCV (%) ESR (mm in 1hr) WBC (x109 /l) PLCT (x109 /l) 1 – 4 17 29.4±2.2 13.8±1.3 12.3±0.6 239±63.2 5 – 9 40 30.9±3.5 13.2±1.3 11.8±1.1 257±71.4 10 – 14 27 41.1±6.2 13.2±2.0 11.9±1.1 291±61.9 15 – 19 5 33.0±2.8 14.0±1.7 12.4±0.6 267±72.5 20 – 24 9 35.8±4.2 14.6±0.5 12.7±0.6 215±47.7 25 – 29 2 27.5±0.7 13.5±0.7 12.7±0.4 315±10.8 Table 3: Mean and standard deviation of PCV; ESR; WBC and PLTC of unexposed (control) according to their age group. Age Groups (years) N PCV (%) ESR (mm in 1hr) WBC (x109 /l) PLCT (x109 /l) 20 – 24 16 39.5±4.8 10.1±1.1 8.8±8.2 219±54.4 25 – 20 19 40.2±3.4 10.2±1.3 7.6±11.6 212±82.8 30 – 34 15 40.9±3.2 10.8±1.4 7.4±8.9 196±22.3 Table 4: Mean and standard deviation of PCV; ESR; WBC and PLTC of exposed workers according to their Age Group. Age group (years) F PCV (%) ESR (mm in 1hr) WBC (x109 /l) PLCT (x109 /l)
  • 5. International Journal of Medical Sciences and Health Care Vol-1 Issue-7 (Ijmshc-704) http://www.ijmshc.com Page 24 21 – 25 11 30.5±3.9 13.2±2.3 11.7±1.4 279±76.5 26 – 30 52 30.4±2.9 13.2±1.9 11.8±1.0 257±70.8 31 – 35 21 30.5±2.4 13.5±1.7 12.1±1.0 285±64.9 36 – 40 8 35.5±4.0 14.6±0.5 12.7±0.5 228±56.6 41 – 45 8 30.3±5.5 13.4±1.3 12.4±0.8 264±53.8 Discussion Occupational exposure to cement dust may enter into the systemic circulation and affect essentially all the organs of body as well as the different tissues including heart, liver, spleen, bone, muscles and hairs and ultimately affecting their micro-structure and physiological performance 7 . This present study investigated the effect of occupational exposure to cement dust on some haematological parameters in order to test the hypothesis that exposure to cement dust may perturb the haemopoietic system of exposed workers. In this study, we observed that the PCV was significantly lower among exposed subjects compared to non-exposed controls. Our finding is consistent with previous report by Mojiminiyi and co- workers 8 , Mohan and colleagues 9 as well as Jude and co-workers 10 but at variance with report of Ogunbilije and colleagues 11 in Ibadan Nigeria who observed that PCV was significantly higher among exposed workers compared to unexposed controls. The relative low number of subjects (45) included in this study may have skewed this observation. Low packed cell volume is indicative of a low amount of red blood cells per unit volume and anaemia. Low PCV observed among staff occupational exposed to cement dust may be an indication that cement dust exposure may perturb erythropoiesis. It was observed in the study that there was an increase in white blood cell count regardless of the period of exposure. High white cell count represents a primary disorder of leukocyte production or may reflect a secondary response to some disease process or toxins. White cell count is often seen as a biomedical marker for inflammatory response 12 . Changes in the number of circulating leukocytes can represent a primary disorder of leukocyte production or may reflect a secondary response to some disease process or toxin 13 . In this present study, we observed that the mean platelet count was significantly higher among exposed workers compared to non-exposed controls. Our finding is at variance with previous reports among exposed workers in Nigeria and India respectively, which observed a reduced platelet count among exposed workers compared to non-exposed controls 8, 14 . The lower study populations of 23 and 30 occupational exposed workers may have skewed the findings with regards to platelet count in both studies. In our study we investigated 100 occupationally exposed workers. Higher platelet count observed among subjects occupational exposed to cement may be associated with inflammation. High platelet count have been associated with infections. Platelet count can also potentially increase when a relatively large amount of body tissue is damaged either by exposure to toxins, following surgery or after an accident. This is often part of the body’s natural defence mechanism to ensure adequate clot formation and prevent of life threatening haemorrhage. We observed a significantly higher ESR among exposed staff compared to un-exposed controls. The ESR is a simple, inexpensive and it is especially valuable for diagnostic and prognostic purposes in silent illness including chronic diseases. The erythrocyte sedimentation rate (ESR), also called a sedimentation rate or Westergren ESR. It is the rate at which red cell sediment when contained in a vertical tube over an hour period. It is a common and non-specific haematology test often used as a measure of inflammation. The ESR remains fairly constant in healthy persons and is affected by properties of the erythrocytes and plasma and by mechanical or technical factors 15 . In general, the ESR is high when there is an infectious disease or a significant amount of tissue necrosis. It may also be increased in localized infections, tuberculosis, and malignant tumors with necrosis. High ESR is often associated with an infectious disease or a significant amount of tissue necrosis. It may also be increased in localized infections, tuberculosis, and malignant tumours with necrosis 16 . We observed a significant positive correlation between age of exposure and WBC (r= 0.48). This finding indicates that there may be a long-term direct association between cement dust exposure and functional impairment among the cement factory workers 17 . A previous report among a cohort of Portland cement workers in Italy indicated that long-term exposure to cement dust had a statistically significant reduced risk of overall mortality and of all cancers and mortality. The study confirmed an increased risk of respiratory system cancer only in the subgroup with previous work exposure in a cement/asbestos plant 18 . This finding re- emphasises the need for continuing follow-up of all exposed populations to document the long-term consequences 19 . There is increasing advocacy that control measures be adopted to reduce the dust and workers should be encouraged to use respiratory protection devices during their working time 20 . Conclusion This present has shown that occupational exposure to cement dust has a significant effect on some haematological parameters. We recommended that
  • 6. International Journal of Medical Sciences and Health Care Vol-1 Issue-7 (Ijmshc-704) http://www.ijmshc.com Page 25 workers occupational exposed to cement dust be provided with appropriate personal protective equipment and respiratory protection devices (aprons, mask and goggles) to reduce the effect of exposure. Worker should have periodic medical examinations to include the evaluation of haematological profile. These measures can potentially mitigate against the effects of occupational hazards of cement dust. References 1. Al- Al-(Neaimi YI, Gomes J, Lloyd OL 2001. Respiratory illnesses and ventilatory function among workers at a cement factory in a rapidly developing country.Occup Med (Lond), 51: 367-373. 2. Stern F, Lehman E, Ruder A 2001. Mortality among unionized construction plasterers and cement ma- sons.Am J Ind Med, 39: 373-388. 3. Short, S. and Petsonk, E. L. (1996) Non-fibrous inorganic dusts. In: Occupational and environmental respiratory disease. Edited by Philip, Harber, Marc, B. Schenker and John, R. Balmes. Mosby, London: 356. 4. Oleru U G. Pulmonary function and symptoms of Nigerian workers exposed to cement dust. Environ. Research.1984; 33: 379-385. 5. National Population Commission (NPC). National Census Figures, Abuja, Nigeria. 2007. 6. Dacie, S.J.V. and Lewis, S.M. (1991) Practical Haematology. Seventh edition, Churchill livingstone Edinburgh: 521-524. 7. Meo SA. Health hazards of cement dust. Saudi Med J. 2004; 25:1153-1159. 8. Mojiminiyi FB, Merenu IA, Ibrahim MT, Njoku CH. The effect of cement dust exposure on haematological and liver function parameters of cement factory workers in Sokoto, Nigeria. Niger J Physiol Sci. 2008 Jun-Dec; 23(1-2):111-4. 9.Guguloth MR,Sambanaik A,Srinivasnaik L, Jagadishnaik M. The Effect of Cement Dust Exposure on Haematological Parameters of Cement Factory workers in Nalagonda, Andhra Pradesh. International Journal of Advancements in Research and Technology, 2012; 1(5):46-52. 10. Jude CAL, Sasikala K, Ashok Kumar R, Sudha S, Raichel J. Haematological and cytogenetic studies in workers occupational exposed to cement dust. Int J Hum Genet, 2002; 2(2):95-99. 11. John Olusegunogunbileje and OlubayoMichealakinosun, 2011.Biochemical and Haematological Profile in Nigerian Cement Factory Workers. Research Journal of Environmental Toxicology, 5: 133-140. 12. Coates and Baehner. (1991) Leukocytosis and leukopenia. In: Hematology Basic principles and practice. Edited by Hoffman, R., Benz. E. J., Shattil, S.J., Furie, B. and Cohen H.J., First edition. Churchill living stone.NewYork: 552. 13. Schwartz J, Weiss ST. Host and environmental factors influencing the peripheral blood leukocyte count. Am J Epidemiol 1991; 134: 1402-1409. 14. DivyaPriya S, Suja S. The Effect of Cement Dust Exposure on Hematological and Cytogenetic Studies of Cement Workers. Research Journal of Pharmaceutical, Biological and Chemical Sciences J. Int J Hum Genet 2002; 2 (2): 95-99. 15.Sultane A Meoos, Muhammad A Azeem, Shoukate A Arian, Merza M Subhane. Haematological changes in cement mill workers Saudi Medical Journal 2002; Vol. (11): 1386-1389. 16. Kirkeby, O. J., Risoe, C., Vikland, R. (1989) Significance of a high erythrocyte sedimentation rate in general practice. B.J.C.P. 143: (7) 252-254. 17. Kakooei H, Gholami A, Ghasemkhani M, Hosseini M, Panahi D, Pouryaghoub G. Dust exposure and respiratory health effects in cement production. Acta Med Iran. 2012; 50(2):122-6. 18. Giordano F, Dell'orco V, Fantini F, Grippo F, Perretta V, Testa A, Figà-Talamanca I. Mortality in a cohort of cement workers in a plant of Central Italy. Int Arch Occup Environ Health. 2012 May; 85(4):3739. 19. Landrigan PJ, Lioy PJ, Thurston G, Berkowitz G, Chen LC, Chillrud SN, Gavett SH, Georgopoulos PG, Geyh AS, Levin S, Perera F, Rappaport SM, Small C; NIEHS World Trade Center Working Group. Health and environmental consequences of the world trade center disaster. Environ Health Perspect. 2004 May; 112(6):731-9. 20. Ahmed HO, Abdullah AA. Dust exposure and respiratory symptoms among cement factory workers in the United Arab Emirates. Ind Health. 2012; 50(3):214- 22.