Job function as determinant of clinker exposure at workplaces during cement production.

OBJECTIVES: In the cement production industry, exposure to airborne particulate matter is associated with a decline in lung function and increased airway symptoms. Exposure to clinker-the major constituent of cement and supposedly the cause of the observed adverse health effects-was determined recently in 15 cement production plants located in 8 different countries (Estonia, Greece, Italy, Norway, Sweden, Switzerland, Spain, Turkey). It was shown that the median clinker abundance in the thoracic fraction varied between approximately 20% and 70% for individual plants. The present study complements the previous work by investigating the significance of job function as a determinant of clinker exposure. METHODS: The elemental composition (water and acid-soluble fractions separately) of 1,227 personal thoracic workplace samples was analyzed by positive matrix factorization (PMF) to determine the contribution of different sources to the composition of airborne particulate matter and to quantify the clinker content. RESULTS: Median thoracic mass air concentrations varied for individual job functions between 0.094 and 12 mg/m3 (estimated separately for different plants). The PMF 5-factor solution yielded median relative clinker abundances in the personal thoracic samples between 7.6% and 81% for individual job functions. Thoracic clinker air concentrations are highest for cleaning, production, and maintenance work, and lowest for administration and other work. Foremen and laboratory personnel show intermediate exposure levels. The plant was found to have a much higher contribution to the total variance of the thoracic clinker air concentrations than the job function. Thoracic clinker air concentrations (medians between 0.01 and 5.5 mg/m3) are strongly correlated with the thoracic mass air concentrations and to a lesser extent with the relative clinker abundance in an aerosol sample. CONCLUSIONS: Job function is an important predictor of exposure to clinker in the cement production industry. As clinker is suspected to be the causal agent for the observed adverse health effects among cement production workers, the clinker air concentration may be a better exposure metric than thoracic air mass concentration despite the strong correlation between the two. Reduction strategies should focus on the most exposed job categories cleaning, production, and maintenance work.

Content of clinker and other materials in personal thoracic aerosol samples from cement plants estimated by scanning electron microscopy and energy-dispersive X-ray microanalysis.

OBJECTIVES: To estimate the composition and exposure to clinker and other specific components in personal thoracic dust samples of cement production workers. METHODS: A procedure for the classification of airborne particles in cement production plants was developed based on classification trees. For this purpose, the chemical compositions of 27,217 particles in 29 material samples (clinker, limestone, gypsum, clay, quartz, bauxite, iron source, coal fly ash, and coal) were determined automatically by scanning electron microscopy (SEM) and energy-dispersive X-ray microanalysis (EDX). The concentrations of the major elements in cement (calcium, aluminium, silicon, iron, and sulphur) were used for the classifications. The split criteria of the classification trees obtained in the material samples were used to classify 44,176 particles in 34 personal thoracic aerosol samples. The contents of clinker and other materials were estimated, and the clinker contents were analysed statistically for differences between job types and job tasks. RESULTS: Between 64% and 88% of the particles from material samples were classified as actual materials. The material types with variable composition (clay, coal fly ash, and coal) were classified with the lowest consistency (64% to 67%), while materials with a more limited compositional variation (clinker, gypsum, and quartz) were classified more consistently (76% to 85%). The arithmetic mean (AM) of the clinker content in personal samples was 62.1%, the median was 55.3%, and 95% confidence interval (CI) was 42.6% to 68.1%. No significant differences were observed between job types. However, the clinker content in samples when workers handled materials with high clinker content was significantly higher than when materials with lower clinker content were handled, 85% versus 65% (P = 0.02). The limestone content was AM 14.8%, median 13.2% (95% CI 5.5 to 20.9), whereas the other materials were present with relative abundances of median ≤ 6.4%. DISCUSSION: Automated particle analysis by SEM-EDX followed by classification tree analysis quantified clinker with fairly high consistency when evaluated together with raw materials that are expected to be airborne in cement production plants. The clinker proportions for job types were similar. Tasks a priori ranked by assumed clinker content were significantly different and according to expectations, which supports the validity of the chosen methodology. CONCLUSIONS: The composition of personal samples of mineral aerosols in the cement production industry could be estimated by automated single particle analysis with SEM-EDX and classification by a classification tree procedure. Clinker was the major component in the thoracic aerosol that cement production workers were exposed to. Differences between job types were relatively small and not significant. The clinker content from tasks was in agreement with assumptions.

Chemical Composition of Thoracic Dust at Workplaces During Cement Production.

OBJECTIVES: Cement belongs to the most used building materials. Clinker is the major constituent of cement, and it is believed that the strong increase of pH after hydration of clinker minerals is responsible for the observed decline in lung function of cement production workers. Information on clinker exposure at workplaces in the cement production industry is scarse. The aims of this study are to determine the chemical composition of thoracic dust and to quantify workplace exposure to clinker in cement production. METHODS: The elemental composition of 1250 personal thoracic samples collected at workplaces in 15 plants located in 8 different countries (Estonia, Greece, Italy, Norway, Sweden, Switzerland, Spain, Turkey) was determined by inductively coupled plasma optical emission spectrometry (ICP-OES), separately for water- and acid-soluble fraction. Positive matrix factorization (PMF) was used to determine the contribution of different sources to the dust composition and to quantify the clinker content in 1227 of the thoracic samples. In addition, 107 material samples were analysed to facilitate interpretation of the factors obtained by PMF. RESULTS: The median thoracic mass concentrations varied for individual plants between 0.28 and 3.5 mg/m3. PMF with 8 water-soluble and 10 insoluble (i.e., acid-soluble) element concentrations yielded a five-factor solution: Ca, K, Na sulfates; silicates; insoluble clinker; soluble clinker-rich; and soluble Ca-rich. The clinker content of the samples was calculated as sum of the insoluble clinker and soluble clinker-rich factors. The median clinker fraction of all samples was 45% (range 0-95%), and varied between 20% and 70% for individual plants. DISCUSSION: The 5-factor solution of PMF was selected on the basis of several mathematical parameters recommended in the literature as well as the mineralogical interpretability of the factors. In addition, interpretation of the factors was supported by the measured apparent solubility of Al, K, Si, Fe, and to a lesser extent Ca in material samples. The total clinker content obtained in the present study is considerably lower than estimates based on the Ca concentrations in a sample, and somewhat lower than estimates based on Si concentrations after selective leaching with a methanol/maleic acid mixture. The clinker abundance in workplace dust of one plant investigated in the present contribution was also estimated in a recent study by electron microscopy, and the good agreement between both studies gives confidence in the results of PMF. CONCLUSIONS: The clinker fraction in personal thoracic samples could be quantified from the chemical composition by positive matrix factorization. Our results allow for further epidemiological analyses of health effects in the cement production industry. As these estimates are more accurate for clinker exposure than aerosol mass, stronger associations with respiratory effects are expected if clinker is the main cause of these effects.

Physicochemical characterization of particulate matter in a cement production plant.

Employees working in cement production plants are exposed to airborne particulate matter (PM) which may lead to lung function impairments and airway symptoms. The PM consists of raw materials, clinker and additives which vary depending on cement blend. The aim of this work was to characterize the thoracic fraction of PM with regard to size, phase composition and mixing state. Both stationary and personal impactors were used to collect size-fractionated samples in a cement production plant in Norway. Stationary samples were measured with aerosol particle counters and collected with a 13-stage cascade impactor, which were stationed at three locations of the cement production plant: at the raw meal mill, clinker conveyor belt and cement mill. Sioutas cascade impactors, and thoracic and respirable dust samplers were used in parallel for personal sampling. Additionally, particles for electron microscopy were collected with the stationary cascade impactor for size-fractionated single particle characterization. Gravimetric measurements and element compositions of the samples from the stationary impactors show that the PM mass is dominated by calcium-rich particles of size >1 µm. The size distribution results of stationary and personal impactors were similar. Characterization of single particles reveals that limestone is the dominating material in the raw meal mill, whereas clinker and limestone dominate at the clinker conveyor belt and at the cement mill. The element composition of clinker PM did not change with particle size. The PM collected on impactor stages with aerodynamic diameter cut-offs below 0.56 µm was dominated by soot and volatile secondary particles at the three locations. The number of ultrafine particles of the cement related compounds was low. Air concentrations of PM in personal respirable and thoracic samples ranged from 0.14-10 mg m-3 to 0.37-9.5 mg m-3, respectively. Considerable local variations exist, both in composition and air concentration of the PM.

Job Tasks as Determinants of Thoracic Aerosol Exposure in the Cement Production Industry.

Background: The aims of this study were to identify important determinants and investigate the variance components of thoracic aerosol exposure for the workers in the production departments of European cement plants. Methods: Personal thoracic aerosol measurements and questionnaire information (Notø et al., 2015) were the basis for this study. Determinants categorized in three levels were selected to describe the exposure relationships separately for the job types production, cleaning, maintenance, foreman, administration, laboratory, and other jobs by linear mixed models. The influence of plant and job determinants on variance components were explored separately and also combined in full models (plant&job) against models with no determinants (null). The best mixed models (best) describing the exposure for each job type were selected by the lowest Akaike information criterion (AIC; Akaike, 1974) after running all possible combination of the determinants. Results: Tasks that significantly increased the thoracic aerosol exposure above the mean level for production workers were: packing and shipping, raw meal, cement and filter cleaning, and de-clogging of the cyclones. For maintenance workers, time spent with welding and dismantling before repair work increased the exposure while time with electrical maintenance and oiling decreased the exposure. Administration work decreased the exposure among foremen. A subjective tidiness factor scored by the research team explained up to a 3-fold (cleaners) variation in thoracic aerosol levels. Within-worker (WW) variance contained a major part of the total variance (35-58%) for all job types. Job determinants had little influence on the WW variance (0-4% reduction), some influence on the between-plant (BP) variance (from 5% to 39% reduction for production, maintenance, and other jobs respectively but an 79% increase for foremen) and a substantial influence on the between-worker within-plant variance (30-96% for production, foremen, and other workers). Plant determinants had little influence on the WW variance (0-2% reduction), some influence on the between-worker variance (0-1% reduction and 8% increase), and considerable influence on the BP variance (36-58% reduction) compared to the null models. Conclusion: Some job tasks contribute to low levels of thoracic aerosol exposure and others to higher exposure among cement plant workers. Thus, job task may predict exposure in this industry. Dust control measures in the packing and shipping departments and in the areas of raw meal and cement handling could contribute substantially to reduce the exposure levels. Rotation between low and higher exposed tasks may contribute to equalize the exposure levels between high and low exposed workers as a temporary solution before more permanent dust reduction measures is implemented. A tidy plant may reduce the overall exposure for almost all workers no matter of job type.

Thoracic dust exposure is associated with lung function decline in cement production workers.

We hypothesised that exposure to workplace aerosols may lead to lung function impairment among cement production workers.Our study included 4966 workers in 24 cement production plants. Based on 6111 thoracic aerosol samples and information from questionnaires we estimated arithmetic mean exposure levels by plant and job type. Dynamic lung volumes were assessed by repeated spirometry testing during a mean follow-up time of 3.5 years (range 0.7-4.6 years). The outcomes considered were yearly change of dynamic lung volumes divided by the standing height squared or percentage of predicted values. Statistical modelling was performed using mixed model regression. Individual exposure was classified into quintile levels limited at 0.09, 0.89, 1.56, 2.25, 3.36, and 14.6 mg·m(-3), using the lowest quintile as the reference. Employees that worked in administration were included as a second comparison group.Exposure was associated with a reduction in forced expiratory volume in 1 s (FEV1), forced expiratory volume in 6 s and forced vital capacity. For FEV1 % predicted a yearly excess decline of 0.84 percentage points was found in the highest exposure quintile compared with the lowest.Exposure at the higher levels found in this study may lead to a decline in dynamic lung volumes. Exposure reduction is therefore warranted.

Relationships between Personal Measurements of 'Total' Dust, Respirable, Thoracic, and Inhalable Aerosol Fractions in the Cement Production Industry.

AIMS: The aims of this study were to examine the relationships and establish conversion factors between 'total' dust, respirable, thoracic, and inhalable aerosol fractions measured by parallel personal sampling on workers from the production departments of cement plants. 'Total' dust in this study refers to aerosol sampled by the closed face 37-mm Millipore filter cassette. METHODS: Side-by-side personal measurements of 'total' dust and respirable, thoracic, and inhalable aerosol fractions were performed on workers in 17 European and Turkish cement plants. Simple linear and mixed model regressions were used to model the associations between the samplers. RESULTS: The total number of personal samples collected on 141 workers was 512. Of these 8.4% were excluded leaving 469 for statistical analysis. The different aerosol fractions contained from 90 to 130 measurements and-side-by side measurements of all four aerosol fractions were collected on 72 workers.The median ratios between observed results of the respirable, 'total' dust, and inhalable fractions relative to the thoracic aerosol fractions were 0.51, 2.4, and 5.9 respectively. The ratios between the samplers were not constant over the measured concentration range and were best described by regression models. Job type, position of samplers on left or right shoulder and plant had no substantial effect on the ratios. CONCLUSIONS: The ratios between aerosol fractions changed with different air concentrations. Conversion models for estimation of the fractions were established. These models explained a high proportion of the variance (74-91%) indicating that they are useful for the estimation of concentrations based on measurements of a different aerosol fraction. The calculated uncertainties at most observed concentrations were below 30% which is acceptable for comparison with limit values (EN 482, 2012). The cement industry will therefore be able to predict the health related aerosol fractions from their former or future measurements of one of the fractions.

Speciation of fluoride in workroom air during primary production of aluminium.

Exposure to fluorides (F(-)) and particulate matter (PM) was assessed by personal sampling with use of Respicon® sampler in Prebake and Søderberg pot rooms in seven aluminium smelters. The inhalable PM mass was dominated by the extra-thoracic aerosol sub-fraction, which contributed with around 70% for both Prebake and Søderberg pot room workers. Quantitative and qualitative differences in exposure were found between pot room workers in smelters using these two technologies. Prebake pot room workers were exposed to 1.4 to 1.7 times higher PM concentrations than Søderberg pot room workers, depending on aerosol sub-fraction. Prebake pot room workers were also exposed to 2.5 to 2.9 higher air concentrations of water-soluble F(-) (FWS(-)) and 2.8 to 5.3 higher air concentrations of non water-soluble F(-) (FAS(-)) than Søderberg pot room workers, depending on aerosol sub-fraction. However, exposure to hydrogen fluoride (HF) was 1.3 times higher among Søderberg pot room workers. The relative amount of FWS(-), however, was higher among Søderberg pot room workers, while the relative amount of particulate F(-) (sum of FWS(-) and FAS(-)) was higher among Prebake pot room workers (6.5 vs. 3.9%). Exposure to the same PM concentration yielded higher FWS(-) and FAS(-) air concentrations among Prebake compared to Søderberg pot room workers.

Exposure to thoracic aerosol in a prospective lung function study of cement production workers.

INTRODUCTION: An exposure study was conducted as part of a multi-national longitudinal study of lung function in cement production workers. AIM: To examine exposure to thoracic aerosol among cement production workers during a 4-year follow-up period. METHODS: Personal shift measurements of thoracic aerosol were conducted among the cement production workers within seven job types, 22 plants, and eight European countries (including Turkey) in 2007, 2009, and 2011. The thoracic sub-fraction was chosen as the most relevant aerosol fraction related to obstructive dynamic lung function changes. Production factors, job type, and respirator use were recorded by questionnaire. The exposure data were log-transformed before mixed models analysis and results were presented by geometric mean (GMadj) exposure levels adjusted for plant or job type, worker, and season as random effects. RESULTS: A total of 6111 thoracic aerosol samples were collected from 2534 workers. Repeated measurements were obtained from 1690 of these workers. The GMadj thoracic aerosol levels varied between job types from 0.20 to 1.2mg m(-3). The highest exposure levels were observed for production, cleaning, and maintenance workers (0.79-1.2mg m(-3)) and could reach levels where the risk of lung function loss may be increased. The lowest levels were found for administrative personnel (0.20mg m(-3)) serving tasks in the production areas. Office work was not monitored. GMadj exposure levels between plants ranged from 0.19 to 2.0mg m(-3). The time of year/season contributed significantly to the total variance, but not year of sampling. Production characteristics explained 63% of the variance explained by plant. Workers in plants with the highest number of employees (212-483 per plant) were exposed at a level more than twice as high as those in plants with fewer employees. Other production factors such as cement production, bag filling, and tidiness were significant, but explained less of the exposure variability. These determinants factors can be useful in qualitative exposure assessment and exposure prevention in the cement production industry. Respirator use was minor at exposure levels <0.5mg m(-3) but more common at higher levels. CONCLUSION: Production, cleaning, and maintenance work were the job types with highest exposure to thoracic aerosol in cement production plants. However, plant had an even larger effect on exposure levels than job type. The number of employees was the most important factor explaining differences between plants. Exposure reached levels where the risk of lung function loss may be increased. No significant differences in exposure between sampling campaigns were observed during the 4-year study period.

Intersampler field comparison of Respicon(R), IOM, and closed-face 25-mm personal aerosol samplers during primary production of aluminium.

Intersampler field comparison of Respicon(®), 25-mm closed-face 'total dust' cassette (CFC), and IOM inhalable aerosol sampler was conducted in pot rooms at seven aluminium smelters. The aerosol mass and water-soluble fluoride were selected as airborne contaminants for the comparisons. The aerosol masses of 889 sample pairs of IOM and Respicon(®) inhalable aerosol sub-fraction, 165 of IOM and 25-mm CFC, and 194 of CFC and Respicon(®) thoracic aerosol sub-fraction were compared. The number of sample pairs for the comparison of water-soluble fluoride was 906, 170, and 195, respectively. The geometric mean aerosol mass collected with the inhalable Respicon(®) was 2.91 mg m(-3) compared with 3.38 mg m(-3) with the IOM. The overall ratio between IOM and Respicon(®) inhalable sub-fraction was 1.16 [95% confidence interval (CI) = 1.11-1.21] for aerosol mass and 1.13 (95% CI = 1.08-1.18) for water-soluble fluoride. The results indicate that Respicon(®) undersampled the aerosol mass and water-soluble fluoride in the inhalable sub-fraction compared with the IOM. The results indicated undersampling of the Respicon(®) at mass concentrations higher than 1.35 mg m(-3) and oversampling at lower mass concentrations. The overall ratio between aerosol mass collected with IOM and CFC was 4.19 (95% CI = 3.79-4.64) and 1.61 (95% CI = 1.51-1.72) for water-soluble fluoride. Thus, for this industry, a correction factor of 4.2 is suggested for the conversion of CFC to inhalable aerosol masses and a conversion factor of 1.6 for water-soluble fluoride if wall deposits in the CFC are included. CFC and thoracic Respicon(®) collected similar aerosol masses (ratio = 1.04; 95% CI = 0.97-1.12), whereas the ratio was 1.19 (95% CI = 1.11-1.28) for water-soluble fluoride. The variability of the exposure is substantial; thus, large data sets are required in sampler performance field comparisons.

A cross-shift study of lung function, exhaled nitric oxide and inflammatory markers in blood in Norwegian cement production workers.

OBJECTIVES: To study possible effects of aerosol exposure on lung function, fractional exhaled nitric oxide (FeNO) and inflammatory markers in blood from Norwegian cement production workers across one work shift (0 to 8 h) and again 32 h after the non-exposed baseline registration. METHODS: 95 workers from two cement plants in Norway were included. Assessment of lung function included spirometry and gas diffusion pre- and post-shift (0 and 8 h). FeNO concentrations were measured and blood samples collected at 0, 8 and 32 h. Blood analysis included cell counts of leucocytes and mediators of inflammation. RESULTS: The median respirable aerosol level was 0.3 mg/m(3) (range 0.02-6.2 mg/m(3)). FEV(1), FEF(25-75%) and DL(CO) decreased by 37 ml (p=0.04), 170 ml/s (p<0.001) and 0.17 mmol/min/kPa (p=0.02), respectively, across the shift. A 2 ppm reduction in FeNO between 0 and 32 h was detected (p=0.01). The number of leucocytes increased by 0.6×10(9) cells/l (p<0.001) across the shift, while fibrinogen levels increased by 0.02 g/l (p<0.001) from 0 to 32 h. TNF-α level increased and IL-10 decreased across the shift. Baseline levels of fibrinogen were associated with the highest level of respirable dust, and increased by 0.39 g/l (95% CI 0.06 to 0.72). CONCLUSIONS: We observed small cross-shift changes in lung function and inflammatory markers among cement production workers, indicating that inflammatory effects may occur at exposure levels well below 1 mg/m(3). However, because the associations between these acute changes and personal exposure measurements were weak and as the long-term consequences are unknown, these findings should be tested in a follow-up study.