US EPA

1759133 

Journal Article 

Is potroom asthma due more to sulphur dioxide than fluoride? An inception cohort study in the Australian aluminium industry 

Abramson, MJ; Benke, GP; Cui, J; de Klerk, NH; Del Monaco, A; Dennekamp, M; Fritschi, L; Musk, AW; Sim, MR 

2010 

1 

Occupational and Environmental Medicine
ISSN: 1351-0711
EISSN: 1470-7926 

67 

10 

679-685 

English 

20798006 

10.1136/oem.2009.046458 

WOS:000295469100006 

OBJECTIVES: Although an asthma-like syndrome has been recognised in aluminium smelter workers for over 70 years, the causal agent has been difficult to identify.

METHODS: An inception cohort study was conducted at two Australian aluminium smelters where 446 employees participated over a period of 9 years. Cumulative exposures between interviews were estimated from job histories using a task exposure matrix based on measurements in the smelters. Participants completed an MRC respiratory questionnaire, spirometry and methacholine challenge test. Data were analysed with generalised estimating equations to allow for repeated measurements of each participant.

RESULTS: Wheeze and chest tightness, the two symptoms most closely related to asthma, showed associations with occupational exposures. SO(2) exposure was significantly associated with these symptoms, bronchial hyper-responsiveness (BHR) to methacholine (a feature of asthma), airflow limitation (reduced forced expiratory volume in 1 second/forced vital capacity ratio) and longitudinal decline in lung function. Fluoride exposure was associated with the same outcomes, but less strongly. Inhalable dust and the benzene soluble fraction (BSF) were associated with symptoms of asthma and BHR. Although many of the exposures were highly correlated, further modelling suggested that of the known respiratory irritants, SO(2) was more likely than fluoride to be primarily responsible for the symptoms observed. Fluoride, inhalable dust and SO(2) were the most important airborne contaminants associated with effects on lung function.

CONCLUSIONS: The observed effects were detected at contaminant levels within occupational exposure standards, so further reductions are required, particularly in SO(2) exposures.