Serial evaluations at an indium-tin oxide production facility

• Published in: American journal of industrial medicine Vol. 56; no. 3; pp. 300 - 307
• Main Authors: Cummings, Kristin J., Suarthana, Eva, Edwards, Nicole, Liang, Xiaoming, Stanton, Marcia L., Day, Gregory A., Saito, Rena, Kreiss, Kathleen
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.03.2013; Wiley-Liss; Wiley Subscription Services, Inc
• Subjects: Adult; Air Pollutants, Occupational - adverse effects; Air Pollutants, Occupational - analysis; Air Pollutants, Occupational - blood; Biological and medical sciences; Biomarkers - blood; Chemical and industrial products toxicology. Toxic occupational diseases; Ergonomics; Forced Expiratory Volume; Humans; Indium; Indium - adverse effects; Indium - analysis; Indium - blood; indium-tin oxide; interstitial lung disease; Logistic Models; Lung diseases; Lung Diseases, Interstitial - blood; Lung Diseases, Interstitial - chemically induced; Lung Diseases, Interstitial - diagnosis; Lung Diseases, Interstitial - prevention & control; Male; Medical sciences; Metals and various inorganic compounds; Middle Aged; Occupational Diseases - blood; Occupational Diseases - chemically induced; Occupational Diseases - diagnosis; Occupational Diseases - prevention & control; Occupational Exposure - adverse effects; Occupational Exposure - analysis; Occupational Exposure - prevention & control; Occupational Health; occupational illness; Pneumology; Population Surveillance; Program Evaluation; Respiratory system : syndromes and miscellaneous diseases; Spirometry; surveillance; Time Factors; Tin Compounds - adverse effects; Toxicology; Lung disease; Evaluation; Respiratory disease; Toxicity; occupational illness; Industrial plant; Metallurgical industry; Occupational exposure; Indium; Heavy metal; Surveillance; interstitial lung disease; Tin; Interstitial pneumonitis; Occupational medicine; indium-tin oxide
• ISSN: 0271-3586; 1097-0274
• DOI: 10.1002/ajim.22125

Background We evaluated the effectiveness of workplace changes to prevent indium lung disease, using 2002–2010 surveillance data collected by an indium‐tin oxide production facility. Methods We assessed pulmonary function using lower limits of normal. Blood indium concentration and personal air sampling data were used to estimate exposure. Results Abnormalities were uncommon at hire. After hire, prevalence of spirometric restriction was 31% (n = 14/45), about fourfold higher than expected. Excessive decline in FEV1 was elevated at 29% (n = 12/41). Half (n = 21/42) had blood indium ≥5 µg/l. More recent hires had fewer abnormalities. There was a suggestion that abnormalities were more common among workers with blood indium ≥5 µg/l, but otherwise an exposure‐response relationship was not evident. Peak dust concentrations were obscured by time averaging. Conclusions Evolving lung function abnormalities consistent with subclinical indium lung disease appeared common and merit systematic investigation. Traditional measures of exposure and response were not illustrative, suggesting fresh approaches will be needed. Workplace changes seemed to have had a positive though incomplete impact; novel preventive interventions are warranted. Am. J. Ind. Med. 56:300–307, 2013. © 2012 Wiley Periodicals, Inc.