BMI-based approach reveals direct impact of metal dust exposure on influenza-associated lung function decrement risk...

Metal dust exposure strongly affects human health, especially for smelters. Little is known, however, about the impact of metal dust exposure on influenza-associated lung function decrement risk in smelters. Different body mass index (BMI) groups were also associated with respiratory diseases. The purpose of this study was to use a probabilistic risk assessment approach to explicitly link occupational metal dust exposure, BMI-correlated health effects, and influenza-associated lung function decrements to investigate potential risk among smelters. Here we showed that (i) influenza A-associated metal dust exposure in SiMn/FeMn/FeCr smelters had slightly higher health risks than that in FeSi/Si-metal's, (ii) BMI≥35 had the highest risk in respiratory infection exacerbations, and (iii) the estimated smelting metal dust induced forced expiratory volume in 1s (FEV(1)) decreasing rates were 0.59 and 1.11 m(3) mg(-1) for FeSi/Si-metal and SiMn/FeMn/FeCr smelters, respectively. Our results suggested that smelters better be aware of severe weight gains (e.g., BMIs from 27-40) because it is likely to lead to 17-25% decrements in lung function. This study provides a novel probabilistic risk assessment framework to quantitatively assess the occupational health risk posed by metal dust exposure associated with influenza infection based on BMI measures.