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Initiation of health-behaviour change among employees participating in a web-based health risk assessment with tailored feedback
Authors:Ersen B Colkesen  Maurice AJ Niessen  Niels Peek  Sandra Vosbergen  Roderik A Kraaijenhagen  Coenraad K van Kalken  Jan GP Tijssen  Ron JG Peters
Affiliation:1. Occupational Health Unit, Department of Public Health, Medical School, University of Patras, GR-26500, Rio Patras, Greece
2. Medical School, Athens University, Athens, Greece
3. Department of Pulmonology, Medical School, Democritus University of Thrace, Athens, Greece
4. Department of Pulmonology, ‘SOTIRIA’ Chest Hospital, Athens, Greece
5. Institute of Pulmonology ‘M. Nasta’, Bucharest, Romania
6. Pulmonology Clinic, General Hospital of Lamia, Athens, Greece
Abstract:

Background

Biological monitoring of healthy workers exposed to hazardous dusts lack validated screening tools. Induced sputum (IS) cellular profile was compared with bronchoalveolar lavage fluid (BALF) profile in asbestos exposed workers in order to assess its usefulness in monitoring workers exposed to asbestos for a long period of time.

Methods

IS and BALF analysis was performed in 39 workers of a car brakes and clutches factory that uses chrysotile asbestos. Selection criteria were an employment history of > 15 years and the absence of a diagnosis of pneumonoconiosis. The type of cells, the existence of dust cells, of iron laden macrophages and of asbestos bodies were assessed and compared between IS and BALF samples.

Results

35 IS samples (90%) had dust cells, 34 (87%) iron laden macrophages and in 8 samples (21%) asbestos bodies were found. In most samples neutrophils were dominated. Samples with asbestos bodies (ABs) had significantly higher lymphocytes and lower neutrophils count compared with the samples without ABs. Macrophages and neutrophils in IS and BALF exhibited significant inter-relations (Spearman's rho: 0.26-0.29, p < 0.05) while IS lymphocytes count showed an inverse relation with BALF neutrophils (Spearman's rho: -0.36). Neutrophils and dust cells were highly correlated between the samples (Spearman's rho: 0.35, p < 0.05) while IS dust cells and lymphocytes were inversely related (Spearman's rho: -0.36, p < 0.05). More years of employment in the company was related with more neutrophils (Spearman's rho: 0.26) and less lymphocytes (Spearman's rho: -0.33) count. In multivariate analysis the presence of AB in IS samples was strongly related to the presence of asbestos bodies and lymphocytes count in BALF samples.

Conclusions

IS and BALF analysis showed a similar cellular profile indicating that IS sampling in exposed workers to asbestos as a less invasive and expensive method may be useful in providing an insight both for inhalation of dusts and inflammatory processes in the lung.
Keywords:
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