Impact of aluminum exposure on lung

Aluminum (Al) metal is considered one of the most benign industrial metals. Although the harmful effects of Al on respiratory health have been denied by some studies, others reported its noxious effect on the lung through spirometric measurements. This work aimed at studying the effect of Al fumes on pulmonary functions of occupationally exposed workers. It investigated the possible relationship between inhalation exposure to Al fumes and levels of C-reactive protein (CRP) and alpha-1-antitrypsin (A1AT). The study participants comprised a group of 56 male Al workers with a mean duration of occupational exposure of 10.1 +/- 9.5years and 52 male participants who were not exposed to Al fumes as the control group. All participants filled a questionnaire, underwent full clinical examination and their spirometric pulmonary functions were measured. Blood samples were collected for the determination of serum CRP and A1AT and urine samples for measuring Al. Results revealed that urinary Al (UAl) was significantly higher in Al workers compared with controls (p<0.05). However, spirometric measures showed no significant difference between the exposed group and the controls. A1AT was significantly lowered in Al workers compared with the controls (p<0.000). Serum CRP was positive in only two (3.6%) of the exposed workers. Smokers of both groups (exposed and controls) showed significantly higher UAl and lower A1AT compared with nonsmokers. There was only significant negative correlation between the duration of exposure and A1AT (p<0.05). There was a positive significant correlation between smoking index (SI) and UAl. There was also significant negative correlation between SI and some of the pulmonary function tests namely the percentage of predicted forced vital capacity, forced expiratory volume in the first second and peak expiratory flow in the exposed group. Those correlations point to the importance of the combined effect of smoking and Al exposure on the impairment of lung functions. The study recommends the determination of CRP and A1AT in Al-exposed workers. It is expected that those parameters may undergo changes before reduction in pulmonary functions takes place.