Exposure assessment and heart rate variability monitoring in workers handling titanium dioxide particles: a pilot study

Titanium dioxide (TiO2) particles are used for surface coating and in a variety of products such as inks, fibers, food, and cosmetics. The present study investigated possible respiratory and cardiovascular effects of TiO2 particles in workers exposed to this particle at high concentration in a factory in China. The diameter of particles collected on filters was measured by scanning electron microscopy. Real-time size-dependent particle number concentration was monitored in the nostrils of four workers using condensation particle counter and optical particle counter. Electrocardiogram was recorded using Holter monitors for the same four workers to record heart rate variability. Sixteen workers underwent assessment of the respiratory and cardiovascular systems. Mass-based individual exposure levels were also measured with personal cascade impactors. The primary particle diameter ranged from 46 to 562 nm. Analysis of covariance of the pooled data of the four workers showed that number of particles with a diameter <300 nm was associated positively with total number of N-N and negatively with total number of increase or decrease in successive RR intervals greater than 50 ms (RR50+/-) or percentage of RR 50+/- that were parameters of parasympathetic function. The total mass concentration was 9.58-30.8 mg/m(3) during work, but significantly less before work (0.36 mg/m(3)). The clear abnormality in respiratory function was not observed in sixteen workers who had worked for 10 months to 13 years in the factory. The study showed that exposure to particles with a diameter <300 nm might affect HRV in workers handling TiO2 particles. The results highlight the need to investigate the possible impact of exposure to nano-scaled particles on the autonomic nervous system.