Advertisement

Adaptation to Occupational Exposure to Moderate Endotoxin Concentrations: A Study in Sewage Treatment Plants in Germany

  • M. A. RiegerEmail author
  • V. Liebers
  • M. Nübling
  • T. Brüning
  • B. Brendel
  • F. Hoffmeyer
  • M. Raulf
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1116)

Abstract

Acute or chronic inhalation of endotoxin may lead to changes of lung function and inflammatory markers in the airways. Adaptation to workplace exposure may be possible. In this study, we investigated the possible difference in inflammatory markers assessed in nasal lavage fluid (NALF) in chronical exposure compared to voluntary subjects exposed acutely to endotoxin. We sought to define the variability of inflammatory markers in NALF and the dose-related changes after moderate exposure in naïve subjects. Endotoxin exposure (4–1039 EU/m3) resulted from routine work during one shift in sewage treatment plants. Subjects were matched to pairs (8 workers escorted by 10 students). Inflammatory markers were investigated before, directly after, and 16 h after the shift end. Additional NALF samples were collected in students without any specific exposure after 3 days. In NALF, total cell count, and interleukin (IL)-8 and IL-1β concentrations were significantly higher in workers than in students at all times pointing to workplace-related long-lasting exposure resulting in adaptation. However, concentration of inflammatory markers without specific exposure in students showed a great variability, covering the whole range of values recorded in the workers. The findings of this study make us to recommend a repeated assessment of inflammatory markers in healthy volunteers before the investigation of exposure-related changes and a sample size adequate for statistical analysis.

Keywords

Cumulative effect Dose-response relationship Endotoxin exposure Inflammation Nasal lavage fluid Occupational exposure Sewage 

Notes

Acknowledgments

The study was financed by a grant of the Lieselotte und Dr. Karl Otto Winkler Stiftung für Arbeitsmedizin and own research funds of the institutions involved (Department of Applied Physiology, Occupational Medicine and Infectiology, University of Wuppertal, Germany, and Department of Allergology/Immunology, Institute for Prevention and Occupational Medicine, Institute of the German Social Accident Insurance, Ruhr University Bochum, Germany). The work of the Institute of Occupational and Social Medicine and Health Services Research (IASV) is supported by an unrestricted grant of the employers’ association of the metal and electric industry Baden-Württemberg (Südwestmetall).

The authors thank the Emscher-Genossenschaft/Lippeverband (EGLV) for giving access to their sewage treatment plants, all volunteers for study participation, and the involved staff of IPA, IASV, and University Wuppertal, especially Monika Lahr, Heiko Diefenbach, and Nicole Blomberg for technical assistance in collection of specimens and on the sewage treatment plants and Gerda Borowitzki, Susanne Freundt, and Sabine Bernard for technical assistance in analysis of the NALF samples.

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

References

  1. ATS (1995) American Thoracic Society Standardization of spirometry, 1994 update. Am Rev Respir Dis 152(3):1107–1136CrossRefGoogle Scholar
  2. Bakirci N, Kalaca S, Francis H, Fletcher AM, Pickering C, Anthony C, Tumerdem N, Cali S, Oldham L, Niven R (2007) Natural history and risk factors of early respiratory responses to exposure to cotton dust in newly exposed workers. J Occup Environ Med 49:853–861CrossRefGoogle Scholar
  3. BGIA-Arbeitsmappe (1989) Verfahren zur Bestimmung der Endotoxinkonzentration in der Luft am Arbeitsplatz (Kennzahl 9450). In: Berufsgenossenschaftliches Institut für Arbeitssicherheit (ed) BIA-Arbeitsmappe Messung von Gefahrstoffen, 28. Lfg. IV/02. Erich Schmidt Verlag, Bielefeld (Article in German)Google Scholar
  4. Bradford MM (1976) A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Anal Biochem 72:248–254CrossRefGoogle Scholar
  5. Castellan RM, Olenchock SA, Kinsley KB, Hankinson JL (1987) Inhaled endotoxin and decreased spirometric values. An exposure-response relation for cotton dust. N Engl J Med 317:605–610CrossRefGoogle Scholar
  6. Danuser B, Rebsamen H, Weber C, Krueger H (2000) Lipopolysaccharide-induced nasal cytokine response: a dose-response evaluation. Eur Arch Otorhinolaryngol 257:527–532CrossRefGoogle Scholar
  7. DECOS (Dutch Expert Committee on Occupational Standards) (1998) Endotoxins: health based recommended exposure limit. In: A report of the Health Council of the Netherlands, publication no 1998/03WGD. Health Council of the Netherlands, Rijswijk, pp 1–82Google Scholar
  8. Doreswamy V, Alexis NE, Zhou H, Peden DB (2011) Nasal PMN response to repeated challenge with endotoxin in healthy volunteers. Inhal Toxicol 23:142–147CrossRefGoogle Scholar
  9. Douwes J, Wouters I, Dubbeld H, van Zwieten L, Steerenberg P, Doekes G, Heederik D (2000) Upper airway inflammation assessed by nasal lavage in compost workers: a relation with bio-aerosol exposure. Am J Ind Med 37:459–468CrossRefGoogle Scholar
  10. Health Council of the Netherlands (2010) Endotoxins. Health-based recommended occupational exposure limit. Health Council of the Netherlands, The HagueGoogle Scholar
  11. Hoffmeyer F, van Kampen V, Taeger D, Deckert A, Rosenkranz N, Kaßen M, Schantora AL, Brüning T, Raulf M, Bünger J (2014) Prevalence of and relationship between rhinoconjunctivitis and lower airway diseases in compost workers with current or former exposure to organic dust. Ann Agric Environ Med 21:705–711CrossRefGoogle Scholar
  12. Jacobs JH, Krop EJ, de Wind S, Spithoven J, Heederik DJ (2013) Endotoxin levels in homes and classrooms of Dutch school children and respiratory health. Eur Respir J 42:314–322CrossRefGoogle Scholar
  13. Jacobs JH, Krop EJ, Borras-Santos A, Zock J, Taubel M, Hyvarinnen A, Pekkanen J, Doekes G, Heederik DJ (2014) Endotoxin levels in settled airborne dust in European schools: the HITEA school study. Indoor Air 24:148–157CrossRefGoogle Scholar
  14. Kitz R, Rose MA, Placzek K, Schulze J, Zielen S, Schubert R (2008) LPS inhalation challenge: a new tool to characterize the inflammatory response in humans. Med Microbiol Immunol 197:13–19CrossRefGoogle Scholar
  15. Lai PS, Hang J, Valeri L, Zhang F, Zheng B, Mehta AJ, Shi J, Su L, Brown D, Eisen EA, Christiani DC (2015) Endotoxin and gender modify lung function recovery after occupational organic dust exposure: a 30-year study. Occup Environ Med 72:546–552CrossRefGoogle Scholar
  16. Liebers V, Brüning T, Raulf-Heimsoth M (2006) Occupational endotoxin-exposure and possible health effects on humans. Am J Ind Med 49:474–491CrossRefGoogle Scholar
  17. Liebers V, Raulf-Heimsoth M, Brüning T (2008) Health effects due to endotoxin inhalation (review). Arch Toxicol 82:203–210CrossRefGoogle Scholar
  18. Michel O, Nagy A, Schroeven M, Duchateau J, Nève J, Fondu P, Sergysels R (1997) Dose-response relationship to inhaled endotoxin in normal subjects. Am J Respir Crit Care Med 156:1157–1164CrossRefGoogle Scholar
  19. Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC (1993) Lung volumes and forced ventilatory flows. Eur Respir J 6(Suppl 16):5–40CrossRefGoogle Scholar
  20. Quirce S, Lemière C, de Blay F, del Pozo V, van Gerth WR, Maestrelli P, Pauli G, Pignatti P, Raulf-Heimsoth M, Sastre J, Storaas T, Moscato G (2010) Noninvasive methods for assessment of airway inflammation in occupational settings. Allergy 65:445–458CrossRefGoogle Scholar
  21. Radon K, Garz S, Riess A, Koops F, Monso E, Weber C, Danuser B, Iversen M, Opravil U, Donham K, Hartung J, Pedersen S, Nowak D (2003) Respiratory diseases in European farmers-II. Part of the European farmers’ project. Atemwegs- und Lungenerkrankungen in der Europäischen Landwirtschaft – Teil 2: Ergebnisse der europäischen Landwirtschaftsstudie. Pneumologie (Stuttgart, Germany) 57:510–517CrossRefGoogle Scholar
  22. Raulf M, Hoffmeyer F, van Kampen V, Deckert A, Brüning T, Bünger J (2015) Cellular and soluble inflammatory markers in induced sputum of composting plant workers. Adv Exp Med Biol 858:19–29CrossRefGoogle Scholar
  23. Raulf M, van Kampen V, Neumann HD, Liebers V, Deckert A, Brüning T, Bünger J, Hoffmeyer F (2017) Airway and blood inflammatory markers in waste collectors. Adv Exp Med Biol 1021:1–14CrossRefGoogle Scholar
  24. Raulf-Heimsoth M, Wirtz C, Papenfuss F, Baur X (2000) Nasal lavage mediator profile and cellular composition of nasal brushing material during latex challenge tests. Clin Exp Allergy 30:110–121CrossRefGoogle Scholar
  25. Raulf-Heimsoth M, Hoffmeyer F, van Thriel C, Blaszkewicz M, Bünger J, Brüning T (2010) Assessment of low dose effects of acute sulphur dioxide exposure on the airways using non-invasive methods. Arch Toxicol 84:121–127CrossRefGoogle Scholar
  26. Raulf-Heimsoth M, Pesch B, Kendzia B, Spickenheuer A, Bramer R, Marczynski B, Merget R, Brüning T (2011) Irritative effects of vapours and aerosols of bitumen on the airways assessed by non-invasive methods. Arch Toxicol 85(Suppl 1):S41–S52CrossRefGoogle Scholar
  27. Reynolds SJ, Milton DK, Heederik D, Thorne PS, Donham KJ, Croteau EA, Kelly KM, Douwes J, Lewis D, Whitmer M, Connaughton I, Koch S, Malmberg P, Larsson B, Deddens J, Saraf A, Larsson L (2005) Interlaboratory evaluation of endotoxin analyses in agricultural dusts-comparison of LAL assay and mass spectrometry. J Environ Monit 7:1371–1377CrossRefGoogle Scholar
  28. Rieger MA, Diefenbach H (2007) Biological stress and strain in the field of waste water management – how important is endotoxin? Gefahrstoffe – Reinhaltung der Luft 67:363–366Google Scholar
  29. Rieger MA, Lohmeyer M, Nübling M, Neuhaus S, Diefenbach H, Hofmann F (2005) A description of the standardized measurement procedures and recommended threshold limit values for biological hazards in Germany. J Agric Saf Health 11:185–191CrossRefGoogle Scholar
  30. Rylander R (1995) Endotoxins in the environment. In: Lewin J, Alving CR, Munford RS, Redl H (eds) Bacterial endotoxins, lipopolysaccharids from genes to therapy. Proceedings of the third conference of the international endotoxin society. Wiley-Liss Inc, New York, pp 79–90Google Scholar
  31. Rylander R (2002) Endotoxin in the environment – exposure and effects. J Endotoxin Res 8:241–252PubMedGoogle Scholar
  32. Rylander R, Bake B, Fischer JJ, Helander IM (1989) Pulmonary function and symptoms after inhalation of endotoxin. Am Rev Respir Dis 140:981–986CrossRefGoogle Scholar
  33. Sahlander K, Larsson K, Palmberg L (2012) Daily exposure to dust alters innate immunity. PLoS One 7:e31646CrossRefGoogle Scholar
  34. Schantora AL, Casjens S, Deckert A, van Kampen V, Neumann HD, Brüning T, Raulf M, Bünger J, Hoffmeyer F (2015) Prevalence of work-related rhino-conjunctivitis and respiratory symptoms among domestic waste collectors. Adv Exp Med Biol 834:53–61CrossRefGoogle Scholar
  35. Sigsgaard T, Bonefeld-Jørgensen EC, Kjaergaard SK, Mamas S, Pedersen OF (2000) Cytokine release from the nasal mucosa and whole blood after experimental exposures to organic dusts. Eur Respir J 16:140–145CrossRefGoogle Scholar
  36. Sigsgaard T, Bonefeld-Jørgensen EC, Hoffmann HJ, Bønløkke J, Krüger T (2005) Microbial cell wall agents as an occupational hazard. Toxicol Appl Pharmacol 207:310–319CrossRefGoogle Scholar
  37. Sigsgaard T, Thorne PS, Schlünssen V, Bønløkke J, Riddervold IS, Hoppe KA, Andersen NT, Mackenzie NM (2015) The change in nasal inflammatory markers after intranasal challenges with particulate chitin and lipopolysaccharide: a randomized, double-blind, placebo-controlled, crossover study with a positive control. Int Forum Allergy Rhinol 5:716–723CrossRefGoogle Scholar
  38. Spierenburg EA, Smit LA, Heederik D, Robbe P, Hylkema MN, Wouters I (2015) Healthy worker survivor analysis in an occupational cohort study of Dutch agricultural workers. Int Arch Occup Environ Health 88:1165–1173CrossRefGoogle Scholar
  39. Steinberg R (2001) Belastungen und Beanspruchungen von Beschäftigten in Arbeitsbereichen der Abwasserwirtschaft unter besonderer Berücksichtigung der Gefährdung durch biologische Arbeitsstoffe. Gesellschaft für Abwassertechnik e.V. (GFA), Hennef (Article in German)Google Scholar
  40. Thorn J (2001) The inflammatory response in humans after inhalation of bacterial endotoxin: a review. Inflamm Res 50:254–261CrossRefGoogle Scholar
  41. Visser MJ, Spaan S, Arts HJ, Smit LA, Heederik DJ (2006) Influence of different cleaning practices on endotoxin exposure at sewage treatment plants. Ann Occup Hyg 50(7):731–736PubMedGoogle Scholar
  42. von Essen S, Romberger D (2003) The respiratory inflammatory response to the swine confinement building environment: the adaptation to respiratory exposures in the chronically exposed worker. J Agric Saf Health 9:185–196CrossRefGoogle Scholar
  43. Walser SM, Gerstner DG, Brenner B, Bünger J, Eikmann T, Janssen B, Kolb S, Kolk A, Nowak D, Raulf M, Sagunski H, Sedlmaier N, Suchenwirth R, Wiesmüller G, Wollin K, Tesseraux I, Herr CE (2015) Evaluation of exposure-response relationships for health effects of microbial bioaerosols – a systematic review. Int J Hyg Environ Health 218(7):577–589CrossRefGoogle Scholar
  44. Wang Z, Larsson K, Palmberg L, Malmberg P, Larsson P, Larsson L (1997) Inhalation of swine dust induces cytokine release in the upper and lower airways. Eur Respir J 10:381–387CrossRefGoogle Scholar
  45. Wilcoxon F (1945) Individual comparisons by ranking methods. Biom Bull 1:80–83CrossRefGoogle Scholar
  46. Wouters IM, Hilhorst SK, Kleppe P, Doekes G, Douwes J, Peretz C, Heederik D (2002) Upper airway inflammation and respiratory symptoms in domestic waste collectors. Occup Environ Med 59(2):106–112CrossRefGoogle Scholar
  47. Zheng Y, Schlünssen V, Bønløkke J, Madsen AM, Skov S, Sigsgaard T (2014) Change in airway inflammatory markers in Danish energy plant workers during a working week. Ann Agric Environ Med 21(3):534–540CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • M. A. Rieger
    • 1
    Email author
  • V. Liebers
    • 2
  • M. Nübling
    • 3
  • T. Brüning
    • 2
  • B. Brendel
    • 4
  • F. Hoffmeyer
    • 2
  • M. Raulf
    • 2
  1. 1.Institute of Occupational and Social Medicine and Health Services ResearchUniversity Hospital of TübingenTübingenGermany
  2. 2.Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA)Ruhr University BochumBochumGermany
  3. 3.Research Center for Occupational and Social Medicine (FFAS)FreiburgGermany
  4. 4.Institute for Clinical Epidemiology and Applied BiometryTübingen University HospitalTübingenGermany

Personalised recommendations