Particle and metal exposure in Parisian subway: Relationship between exposure biomarkers in air, exhaled breath condensate, and urine

Assessing the inhaled dose of nanomaterials by nanoparticle tracking analysis (NTA) of exhaled breath condensate (EBC) and its relationship with lung inflammatory biomarkers

The widespread and increasing use of nanomaterials has resulted in a higher likelihood of exposure by inhalation for nanotechnology workers. However, tracking the internal dose of nanoparticles deposited at the airways level, is still challenging. To assess the suitability of particle number concentration determination as biomarker of internal dose, we carried out a cross sectional investigation involving 80 workers handling nanomaterials. External exposure was characterized by portable counters of particles DISCminiTM (Testo, DE), allowing to categorize 51 workers as exposed and 29 as non-exposed (NE) to nanoparticles. Each subject filled in a questionnaire reporting working practices and health status. Exhaled breath condensate was collected and analysed for the number of particles/ml as well as for inflammatory biomarkers. A clear-cut relationship between the number of airborne particles in the nano-size range determined by the particle counters and the particle concentration in exhaled breath condensate (EBC) was apparent. Moreover, inflammatory cytokines (IL-1β, IL-10, and TNF-α) measured in EBC, were significantly higher in the exposed subjects as compared to not exposed. Finally, significant correlations were found between external exposure, the number concentration of particles measured by the nanoparticle tracking analysis (NTA) and inflammatory cytokines. As a whole, the present study, suggests that NTA can be regarded as a reliable tool to assess the inhaled dose of particles and that this dose can effectively elicit inflammatory effects.

Metal and oxidative potential exposure through particle inhalation and oxidative stress biomarkers: a 2-week pilot prospective study among Parisian subway workers

OBJECTIVE

In this pilot study on subway workers, we explored the relationships between particle exposure and oxidative stress biomarkers in exhaled breath condensate (EBC) and urine to identify the most relevant biomarkers for a large-scale study in this field.

METHODS

We constructed a comprehensive occupational exposure assessment among subway workers in three distinct jobs over 10 working days, measuring daily concentrations of particulate matter (PM), their metal content and oxidative potential (OP). Individual pre- and post-shift EBC and urine samples were collected daily. Three oxidative stress biomarkers were measured in these matrices: malondialdehyde (MDA), 8-hydroxy-2'deoxyguanosine (8-OHdG) and 8-isoprostane. The association between each effect biomarker and exposure variables was estimated by multivariable multilevel mixed-effect models with and without lag times.

RESULTS

The OP was positively associated with Fe and Mn, but not associated with any effect biomarkers. Concentration changes of effect biomarkers in EBC and urine were associated with transition metals in PM (Cu and Zn) and furthermore with specific metals in EBC (Ba, Co, Cr and Mn) and in urine (Ba, Cu, Co, Mo, Ni, Ti and Zn). The direction of these associations was both metal- and time-dependent. Associations between Cu or Zn and MDAEBC generally reached statistical significance after a delayed time of 12 or 24 h after exposure. Changes in metal concentrations in EBC and urine were associated with MDA and 8-OHdG concentrations the same day.

CONCLUSION

Associations between MDA in both EBC and urine gave opposite response for subway particles containing Zn versus Cu. This diverting Zn and Cu pattern was also observed for 8-OHdG and urinary concentrations of these two metals. Overall, MDA and 8-OHdG responses were sensitive for same-day metal exposures in both matrices. We recommend MDA and 8-OHdG in large field studies to account for oxidative stress originating from metals in inhaled particulate matter.

Long-term exposure to PM10 and respiratory health among Parisian subway workers

Exposure to ambient PM10 may increase the risk of chronic obstructive pulmonary disease (COPD) and lung function decline. We evaluated the long-term exposure to PM10 and its relationship with COPD prevalence and lung function in Parisian subway workers. Participants were randomly selected from a 15,000-subway worker cohort. Individual annual external exposure to PM10 (ePM10) was estimated using a company-specific job-exposure-matrix based on PM10 measurements conducted between 2004 and 2019 in the Parisian subway network. Mean annual inhaled PM10 exposure (iPM10) was modeled as function of ePM10 exposure, inhalation rate, and filtration efficiency of the respiratory protection used. COPD diagnosis was performed in March-May 2021 based on post-bronchodilator spirometry. The relationship between iPM10 and outcomes was assessed using logistic and linear regression models, adjusted for exposure duration and potential confounders. Amongst 254 participants with complete data, 17 were diagnosed as COPD. The mean employment duration was 23.2 ± 7.3years, with annual mean ePM10 of 71.8 ± 33.7 μg/m3 and iPM10 of 0.59 ± 0.27 μg/shift, respectively. A positive but statistically non-significant association was found for COPD prevalence with iPM10 (OR = 1.034, 95%-CI = 0.781; 1.369, per 100 ng/shift) and ePM10 (OR = 1.029, 95%-CI = 0.879; 1.207, per 10 μg/m3). No decline in lung function was associated with PM10 exposure. However, forced expiratory volume during the first second and forced vital capacity lower than normal were positively associated with exposure duration (OR = 1.125, 95%-CI = 1.004; 1.260 and OR = 1.171, 95%-CI = 0.989; 1.386 per year, respectively). Current smoking was strongly associated with COPD prevalence (OR = 6.85, 95%-CI = 1.87; 25.10) and most lung function parameters. This is the first study assessing the relationship between long-term exposure to subway PM10 and respiratory health in subway workers. The risk estimates related with subway PM10 exposure are compatible with those related to outdoor PM10 exposure in the large recent studies. Large cohorts of subway workers are necessary to confirm these findings.

Adverse effects of exposure to fine particles and ultrafine particles in the environment on different organs of organisms

Particulate pollution is a global risk factor that seriously threatens human health. Fine particles (FPs) and ultrafine particles (UFPs) have small particle diameters and large specific surface areas, which can easily adsorb metals, microorganisms and other pollutants. FPs and UFPs can enter the human body in multiple ways and can be easily and quickly absorbed by the cells, tissues and organs. In the body, the particles can induce oxidative stress, inflammatory response and apoptosis, furthermore causing great adverse effects. Epidemiological studies mainly take the population as the research object to study the distribution of diseases and health conditions in a specific population and to focus on the identification of influencing factors. However, the mechanism by which a substance harms the health of organisms is mainly demonstrated through toxicological studies. Combining epidemiological studies with toxicological studies will provide a more systematic and comprehensive understanding of the impact of PM on the health of organisms. In this review, the sources, compositions, and morphologies of FPs and UFPs are briefly introduced in the first part. The effects and action mechanisms of exposure to FPs and UFPs on the heart, lungs, brain, liver, spleen, kidneys, pancreas, gastrointestinal tract, joints and reproductive system are systematically summarized. In addition, challenges are further pointed out at the end of the paper. This work provides useful theoretical guidance and a strong experimental foundation for investigating and preventing the adverse effects of FPs and UFPs on human health.

Job Exposure Matrix, a Solution for Retrospective Assessment of Particle Exposure in a Subway Network and Their Long-Term Effects

INTRODUCTION

Health effects after long-term exposure to subway particulate matter (PM) remain unknown due to the lack of individual PM exposure data. This study aimed to apply the job exposure matrix (JEM) approach to retrospectively assess occupational exposure to PM in the Parisian subway.

METHODS

Job, the line and sector of the transport network, as well as calendar period were four JEM dimensions. For each combination of these dimensions, we generated statistical models to estimate the annual average PM10 concentration using data from an exhaustive inventory of the PM measurement campaigns conducted between 2004 and 2020 in the Parisian subway and historical data from the Parisian air pollution monitoring network. The resulting JEM and its exposure estimates were critically examined by experts using the uncertainty analysis framework.

RESULTS

The resulting JEM allows for the assignment of the estimated annual PM10 concentration to three types of professionals working in the subway: locomotive operators, station agents, and security guards. The estimates' precision and validity depend on the amount and quality of PM10 measurement data used in the job-, line-, and sector-specific models. Models using large amounts of personal exposure measurement data produced rather robust exposure estimates compared to models with lacunary data (i.e., in security guards). The analysis of uncertainty around the exposure estimates allows for the identification of the sources of uncertainty and parameters to be addressed in the future in order to refine and/or improve the JEM.

CONCLUSIONS

The JEM approach seems relevant for the retrospective exposure assessment of subway workers. When applied to available data on PM10, it allows for the estimation of this exposure in locomotive operators and station agents with an acceptable validity. Conversely, for security guards, the current estimates have insufficient validity to recommend their use in an epidemiological study. Therefore, the current JEM should be considered as a valid prototype, which shall be further improved using more robust measurements for some jobs. This JEM can also be further refined by considering additional exposure determinants.

A harmonized protocol for an international multicenter prospective study of nanotechnology workers: the NanoExplore cohort

Nanotechnology applications are fast-growing in many industrial fields. Consequently, health effects of engineered nanomaterials (ENMs) should be investigated. Within the EU-Life project NanoExplore, we developed a harmonized protocol of an international multicenter prospective cohort study of workers in ENM-producing companies. This article describes the development of the protocol, sample size calculation, data collection and management procedures and discusses its relevance with respect to research needs. Within this protocol, workers' ENM exposure will be assessed over four consecutive working days during the initial recruitment campaign and the subsequent follow-up campaigns. Biomonitoring using noninvasive sampling of exhaled breath condensate (EBC), exhaled air, and urine will be collected before and after 4-day exposure monitoring. Both exposure and effect biomarkers, will be quantified along with pulmonary function tests and diagnosed diseases reported using a standardized epidemiological questionnaire available in four languages. Until now, this protocol was implemented at seven companies in Switzerland, Spain and Italy. The protocol is well standardized, though sufficiently flexible to include company-specific conditions and occupational hygiene measures. The recruitment, to date, of 140 participants and collection of all data and samples, enabled us launching the first international cohort of nanotechnology workers. All companies dealing with ENMs could join the NanoExplore Consortium, apply this harmonized protocol and enter in the cohort, concieved as an open cohort. Its protocol meets all requirements of a hypotheses-driven prospective study, which will assess and reassess effects of ENM exposure on workers' health by updating the follow-up of the cohort. New hypothesis could be also considered.

Oxidative Potential in Exhaled Air (OPEA) as a Tool for Predicting Certain Respiratory Disorders in the General Adult Population: Cross-Sectional Analysis Nested in the Swiss Health Study

In a pilot clinical study, OPEA allowed for distinguishing participants with and without chronic obstructive pulmonary disease. This study aimed to assess whether abnormal spirometry parameters and immunity against SARS-CoV-2 are associated with increased OPEA and estimating the OPEA reference interval. Swiss adult residents of the Vaud Canton aged 20–69 years randomly selected from the Federal Statistical Office’s registries, speaking French or German, were included and examined between 1 October 2020 and 31 December 2021. General health status and presence of respiratory diseases were assessed by questionnaire and spirometry. Spirometric results were compared with the predicted values and their lower limits of norms of the Global Lung Function Initiative. SARS-CoV-2-seroprevalence was assessed using the Luminex-based test of IgG. Statistical analysis consisted of unilateral t-tests and ANOVA. Lower and upper limit of OPEA reference interval with associated 90%-confidence interval (90%CI) were estimated for the sub-sample of healthy adults by bootstrap, after excluding outliers. The study sample included 247 participants. SARS-CoV-2-seropositive participants and those with an obstructive syndrome had a significantly higher OPEA than seronegative and healthy participants. The estimated reference interval was: −0.0516 (90%CI = −0.0735; −0.0316); −0.0044 (90%CI = −0.0224; 0.0153). OPEA could predict inflammatory-based respiratory disorders, but needs further validation in different settings and for other pathologies.

Single and Combined Associations of Plasma and Urine Essential Trace Elements (Zn, Cu, Se, and Mn) with Cardiovascular Risk Factors in a Mediterranean Population

Trace elements are micronutrients that are required in very small quantities through diet but are crucial for the prevention of acute and chronic diseases. Despite the fact that initial studies demonstrated inverse associations between some of the most important essential trace elements (Zn, Cu, Se, and Mn) and cardiovascular disease, several recent studies have reported a direct association with cardiovascular risk factors due to the fact that these elements can act as both antioxidants and pro-oxidants, depending on several factors. This study aims to investigate the association between plasma and urine concentrations of trace elements and cardiovascular risk factors in a general population from the Mediterranean region, including 484 men and women aged 18−80 years and considering trace elements individually and as joint exposure. Zn, Cu, Se, and Mn were determined in plasma and urine using an inductively coupled plasma mass spectrometer (ICP-MS). Single and combined analysis of trace elements with plasma lipid, blood pressure, diabetes, and anthropometric variables was undertaken. Principal component analysis, quantile-based g-computation, and calculation of trace element risk scores (TERS) were used for the combined analyses. Models were adjusted for covariates. In single trace element models, we found statistically significant associations between plasma Se and increased total cholesterol and systolic blood pressure; plasma Cu and increased triglycerides and body mass index; and urine Zn and increased glucose. Moreover, in the joint exposure analysis using quantile g-computation and TERS, the combined plasma levels of Zn, Cu, Se (directly), and Mn (inversely) were strongly associated with hypercholesterolemia (OR: 2.03; 95%CI: 1.37−2.99; p < 0.001 per quartile increase in the g-computation approach). The analysis of urine mixtures revealed a significant relationship with both fasting glucose and diabetes (OR: 1.91; 95%CI: 1.01−3.04; p = 0.046). In conclusion, in this Mediterranean population, the combined effect of higher plasma trace element levels (primarily Se, Cu, and Zn) was directly associated with elevated plasma lipids, whereas the mixture effect in urine was primarily associated with plasma glucose. Both parameters are relevant cardiovascular risk factors, and increased trace element exposures should be considered with caution.

Sixteen-Year Monitoring of Particulate Matter Exposure in the Parisian Subway: Data Inventory and Compilation in a Database

The regularly reported associations between particulate matter (PM) exposure, and morbidity and mortality due to respiratory, cardiovascular, cancer, and metabolic diseases have led to the reduction in recommended outdoor PM10 and PM2.5 exposure limits. However, indoor PM10 and PM2.5 concentrations in subway systems in many cities are often higher than outdoor concentrations. The effects of these exposures on subway workers and passengers are not well known, mainly because of the challenges in exposure assessment and the lack of longitudinal studies combining comprehensive exposure and health surveillance. To fulfill this gap, we made an inventory of the PM measurement campaigns conducted in the Parisian subway since 2004. We identified 5856 PM2.5 and 18,148 PM10 results from both personal and stationary air sample measurements that we centralized in a database along with contextual information of each measurement. This database has extensive coverage of the subway network and will enable descriptive and analytical studies of indoor PM exposure in the Parisian subway and its potential effects on human health.

A Real-Time Comparison of Four Particulate Matter Size Fractions in the Personal Breathing Zone of Paris Subway Workers: A Six-Week Prospective Study

We developed a Bayesian spline model for real-time mass concentrations of particulate matter (PM10, PM2.5, PM1, and PM0.3) measured simultaneously in the personal breathing zone of Parisian subway workers. The measurements were performed by GRIMM, a gravimetric method, and DiSCmini during the workers’ work shifts over two consecutive weeks. The measured PM concentrations were analyzed with respect to the working environment, the underground station, and any specific events that occurred during the work shift. Overall, PM0.3 concentrations were more than an order of magnitude lower compared to the other PM concentrations and showed the highest temporal variation. The PM2.5 levels raised the highest exposure concern: 15 stations out of 37 had higher mass concentrations compared to the reference. Station PM levels were not correlated with the annual number of passengers entering the station, the year of station opening or renovation, or the number of platforms and tracks. The correlation with the number of station entrances was consistently negative for all PM sizes, whereas the number of correspondence concourses was negatively correlated with PM0.3 and PM10 levels and positively correlated with PM1 and PM2.5 levels. The highest PM10 exposure was observed for the station platform, followed by the subway cabin and train, while ticket counters had the highest PM0.3, PM1, and PM2.5 mass concentrations. We further found that compared to gravimetric and DiSCmini measurements, GRIMM results showed some discrepancies, with an underestimation of exposure levels. Therefore, we suggest using GRIMM, calibrated by gravimetric methods, for PM sizes above 1μm, and DiSCmini for sizes below 700 nm.

Challenges in Quantifying 8-OHdG and 8-Isoprostane in Exhaled Breath Condensate

Exhaled breath condensate (EBC) has attracted substantial interest in the last few years, enabling the assessment of airway inflammation with a non-invasive method. Concentrations of 8-Hydroxydesoxyguanosine (8-OHdG) and 8-isoprostane in EBC have been suggested as candidate biomarkers for lung diseases associated with inflammation and oxidative stress. EBC is a diluted biological matrix and consequently, requires highly sensitive chemical analytic methods (picomolar range) for biomarker quantification. We developed a new liquid chromatography coupled to tandem mass spectrometry method to quantify 8-OHdG and 8-isoprostane in EBC simultaneously. We applied this novel biomarker method in EBC obtained from 10 healthy subjects, 7 asthmatic subjects, and 9 subjects with chronic obstructive pulmonary disease. Both biomarkers were below the limit of detection (LOD) despite the good sensitivity of the chemical analytical method (LOD = 0.5 pg/mL for 8-OHdG; 1 pg/mL for 8-isoprostane). This lack of detection might result from factors affecting EBC collections. These findings are in line with methodological concerns already raised regarding the reliability of EBC collection for quantification of 8-OHdG and 8-isoprostane. Precaution is therefore needed when comparing literature results without considering methodological issues relative to EBC collection and analysis. Loss of analyte during EBC collection procedures still needs to be resolved before using these oxidative stress biomarkers in EBC.

Applying the exposome concept to working life health

Exposures at work have a major impact on noncommunicable diseases (NCDs). Current risk reduction policies and strategies are informed by existing scientific evidence, which is limited due to the challenges of studying the complex relationship between exposure at work and outside work and health. We define the working life exposome as all occupational and related nonoccupational exposures. The latter includes nonoccupational exposures that may be directly or indirectly influenced by or interact with the working life of the individual in their relation to health. The Exposome Project for Health and Occupational Research aims to advance knowledge on the complex working life exposures in relation to disease beyond the single high exposure–single health outcome paradigm, mapping and relating interrelated exposures to inherent biological pathways, key body functions, and health. This will be achieved by combining (1) large-scale harmonization and pooling of existing European cohorts systematically looking at multiple exposures and diseases, with (2) the collection of new high-resolution external and internal exposure data. Methods and tools to characterize the working life exposome will be developed and applied, including sensors, wearables, a harmonized job exposure matrix (EuroJEM), noninvasive biomonitoring, omics, data mining, and (bio)statistics. The toolbox of developed methods and knowledge will be made available to policy makers, occupational health practitioners, and scientists. Advanced knowledge on working life exposures in relation to NCDs will serve as a basis for evidence-based and cost-effective preventive policies and actions. The toolbox will also enable future scientists to further expand the working life exposome knowledge base.

Association of Metals and Metalloids With Urinary Albumin/Creatinine Ratio: Evidence From a Cross-Sectional Study Among Elderly in Beijing

Background

Environmental exposure to toxic elements contributes to the pathogenesis of chronic kidney disease (CKD). Few studies focus on the association of urinary metals and metalloids concentrations with the urinary albumin/creatinine ratio (UACR) among elderly, especially in areas and seasons with severe air pollution.

Objective

We aimed to evaluate the associations of urinary metals and metalloids concentration with UACR, which is an early and sensitive indicator of CKD.

Method

We conducted a cross-sectional study among 275 elderly people in Beijing from November to December 2016, which has experienced the most severe air pollution in China. We measured 15 urinary metals and metalloids concentration and estimated their association with UACR using a generalized linear model (GLM). Bayesian kernel machine regression (BKMR) and quantile g-computation (qgcomp) models were also conducted to evaluate the combined effect of metal and metalloid mixtures concentration.

Results

Of the 275 elderly people included in the analysis, we found that higher urinary Cu concentration was positively associated with UACR using GLM (β = 0.36, 95% CI: 0.25, 0.46). Using the BKMR model, we found that the change in UACR was positively associated with a change in urinary Cu concentration from its 25th to 75th percentile value with all other metals and metalloids concentration fixed at their 25th, 50th, or 75th percentile levels. Urinary Cu concentration had the most significant positive contribution (59.15%) in the qgcomp model. Our finding was largely robust in three mixture modeling approaches: GLM, qgcomp, and BKMR.

Conclusion

This finding suggests that urinary Cu concentration was strongly positively associated with UACR. Further analyses in cohort studies are required to corroborate this finding.

Malondialdehyde and anion patterns in exhaled breath condensate among subway workers

BACKGROUND

Underground transportation systems can contribute to the daily particulates and metal exposures for both commuter and subway workers. The redox and metabolic changes in workers exposed to such metal-rich particles have yet to be characterized. We hypothesize that the distribution of nitrosative/oxidative stress and related metabolic biomarkers in exhaled breath condensate (EBC) are modified depending on exposures.

RESULTS

Particulate number and size as well as mass concentration and airborne metal content were measured in three groups of nine subway workers (station agents, locomotive operators and security guards). In parallel, pre- and post-shift EBC was collected daily during two consecutive working weeks. In this biological matrix, malondialdehyde, lactate, acetate, propionate, butyrate, formate, pyruvate, the sum of nitrite and nitrate (ΣNO_x) and the ratio nitrite/nitrate as well as metals and nanoparticle concentrations was determined. Weekly evolution of the log-transformed selected biomarkers as well as their association with exposure variables was investigated using linear mixed effects models with the participant ID as random effect. The professional activity had a strong influence on the pattern of anions and malondialdehyde in EBC. The daily number concentration and the lung deposited surface area of ultrafine particles was consistently and mainly associated with nitrogen oxides variations during the work-shift, with an inhibitory effect on the ΣNO_x. We observed that the particulate matter (PM) mass was associated with a decreasing level of acetate, lactate and ΣNO_x during the work-shift, suggestive of a build-up of these anions during the previous night in response to exposures from the previous day. Lactate was moderately and positively associated with some metals and with the sub-micrometer particle concentration in EBC.

CONCLUSIONS

These results are exploratory but suggest that exposure to subway PM could affect concentrations of nitrogen oxides as well as acetate and lactate in EBC of subway workers. The effect is modulated by the particle size and can correspond to the body's cellular responses under oxidative stress to maintain the redox and/or metabolic homeostasis.