ABSTRACT
Aluminum is an extremely versatile metal. Inhalation of aluminum dust and / or fumes can induce a wide range of pulmonary health effects, including airways disorders, cancer, and parenchymal diseases. This cross sectional study was conducted to determine the adverse pulmonary health effects of occupational aluminum exposure and some of the associated personal and occupational risk factors among a group of aluminum foundry workers. 33 male aluminum foundry workers, from different work sections, and 28 apparently healthy subjects, as a control group, were included in this study. All participants were interviewed using a pre-constructed questionnaire based mainly on the modified British Medical Research Council questionnaire; furthermore, they were subjected to serum aluminum level estimation, spirometry, and chest radiological examinations [chest X-ray was done for all participants, while High Resolution Computed Tomography [HRCT] was done for those with free chest X-ray films or with early parenchymal changes]. Significantly higher serum aluminum level along with significantly higher prevalence of both acute work-related symptoms and chronic respiratory symptoms were observed among the studied aluminum foundry workers compared to the control group. Moreover, spirometric examination of the studied aluminum foundry workers revealed mixed pattern of pulmonary dysfunction suggesting both obstructive ventilatory problems and restrictive parenchymal disorders. Chest X-ray films of furnace and rolling-mill workers showed excess fibrotic strands at upper and mid-zones of both lung fields; while, chest X-ray films and HRCT of the finishing aluminum foundry workers showed mild to moderate fibrotic changes. On the other hand, there were no detected abnormalities in chest X-ray films of the administrative aluminum foundry workers; while, their HRCT chest examination revealed fine reticulo-nodular opacities noticed at upper and mid-zones of both lungs. Moreover, there were no detected abnormalities in chest X-ray films and HRCT of the control group. It could be concluded that, unprotected occupational exposure to different aluminum forms can impair the pulmonary health of aluminum foundry workers. Moreover, serum aluminum can be a useful biomarker for assessing workers' exposure. Finally, HRCT was found to be more valuable than chest X-ray in early diagnosis of aluminum-induced lung fibrosis. Periodic medical examinations and biological monitoring of aluminum foundry workers along with improving working conditions are recommended