ArticleBMJ open2025
Is exposure to cement dust and heavy metals associated with reduced pulmonary function? A cross-sectional study among cement factory workers in Türkiye.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Exposure to cement industry emissions and respiratory health outcomes: a global systematic review and meta-analysis from 2000 to 2025.Frontiers in public health · 2026Pooled it
- Research progress on molecular mechanisms and signaling pathways of toxic metal exposure-induced lung fibrosis.Frontiers in immunology · 2026Review
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the relation of exposure to cement dust and heavy metal (aluminium, cadmium and lead) exposures to pulmonary function among male cement plant workers. The study also aimed to evaluate dose-response relationships and prevalence and severity of respiratory symptoms among exposure categories compared with a control group.
designCross-sectional study.
settingSecondary-level occupational health clinic in Ankara, Türkiye.
participants461 male non-smoking cement plant employees were included in total. Participants were categorised into packaging (n=101), milling (n=162) and office unexposed workers (n=198). Inclusion criteria were more than 70% work history in the cement industry and exclusion of pre-existing respiratory disease and missing data from the participants.
interventionsNot applicable. PRIMARY AND SECONDARY OUTCOME MEASURES: Pulmonary function tests (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC and peak expiratory flow (PEF)) and urinary, cadmium and blood lead concentrations were measured. Lung function impairment was the primary outcome measure; secondary outcomes included metal exposure-pulmonary measure correlations.
resultsSignificant negative correlations existed between FEV1 and urine aluminium (r=-0.622, p<0.001), blood cadmium (r=-0.430, p<0.001) and lead (r=-0.473, p<0.001). Adjusted generalised linear models showed much lower FVC, FEV1 and PEF in the high-exposure milling group compared with controls (p<0.001). Workers with blood aluminium levels≥35 µg/L had lower FVC (4.26 L), FEV1 (3.61 L) and PEF (7.07 L/min) than those with lowered levels (p<0.001). Dose-dependent pulmonary function loss with increased metal levels was observed.
conclusionsOccupational cement dust and heavy metal exposure is closely linked to impaired pulmonary function in cement plant employees, particularly those who work in higher exposure jobs. The implications are robust endorsement of targeted monitoring and preventive interventions. Long-term longitudinal research is necessary to identify long-term outcome and efficacy of exposure reduction approaches.
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