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A cross-sectional study of exposures, lung function and respiratory symptoms among aluminium cast-house workers
  1. F G B G J van Rooy1,2,3,
  2. R Houba1,
  3. H Stigter1,
  4. V A C Zaat1,
  5. M M Zengeni1,2,
  6. J M Rooyackers1,4,
  7. H E Boers5,
  8. D J J Heederik2,6
  1. 1Netherlands Expertise Centre for Occupational Respiratory Disorders, Utrecht, The Netherlands
  2. 2Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, The Netherlands
  3. 3Arbo Unie Expert Centre for Chemical Risk Management, Utrecht, The Netherlands
  4. 4Department of Respiratory Medicine, Division of Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands
  5. 5Arbo-adviesburo Akkoord, Beerta, The Netherlands
  6. 6Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
  1. Correspondence to Dr F G B G J van Rooy, Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, PO Box 80.178, Utrecht NL-3508 TD, The Netherlands; f.vanrooy{at}


Objectives To investigate exposures, respiratory symptoms, lung function and exposure–response relationships among aluminium cast-house workers.

Methods A cross-sectional study was conducted among 182 workers. Exposure data were used to model exposure to irritants. Lung function and questionnaire data on respiratory symptoms were compared to a general population sample and an internal reference group. Blood samples were taken from 156 workers to examine total IgE, eosinophils and sensitisation to common allergens.

Results Average daily mean exposure to inhalable dust, metals, hydrogen fluoride, fluoride salts and sulphur dioxide was relatively low compared to reference values. Airflow patterns in the hall were disturbed regularly and resulted in pot emissions with high concentrations of fluorides. Peak exposures to chlorine gas occurred intermittently due to production process disturbances. Workers reported significantly more respiratory symptoms (continuous trouble with breathing (prevalence ratio (PR) 2.5; 95% CI 1.2 to 5.3), repeated trouble with breathing (PR 1.8; 95% CI 1.1 to 3.0), wheezing (PR 1.4; 95% CI 1.1 to 1.8), asthma attack (ever) (PR 2.8; 95% CI 1.7 to 4.6) and doctor diagnosed asthma (PR 2.6; 95% CI 1.5 to 4.4). Regression analysis showed significantly lower FEV1 values (−195 ml) and FVC values (−142 ml) compared to a general population sample. Lung function did not differ between groups.

Conclusion This epidemiological study suggests cast-house workers in the aluminium industry are exposed to respiratory hazards. Exposure–response relationships could not be demonstrated but this study supports preventive measures in the work environment with a focus on (peak) exposures to irritants.

  • Occupation
  • aluminium smelting
  • cast-house workers
  • respiratory symptoms
  • lung function
  • cross-sectional study
  • fluorides
  • chlorine
  • respiratory irritants
  • occupational health practice
  • occupational asthma
  • cross sectional studies
  • aluminium

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  • Funding This study was supported. A contract guaranteed independence of the research group according to criteria set by the Dutch Royal Academy of Sciences (KNAW) in close collaboration with the occupational health service.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.