Cardiopulmonary effects induced by occupational exposure to titanium dioxide nanoparticles

Although some toxicological studies have reported that exposure to titanium dioxide nanoparticles (nano-TiO₂) may elicit adverse cardiopulmonary effects, related data collected from human are currently limited. The purpose of this study is to explore cardiopulmonary effects among workers who were exposed to nano-TiO₂ and to identify biomarkers associated with exposure. A cross-sectional study was conducted in a nano-TiO₂ manufacturing plant in eastern China. Exposure assessment and characterization of TiO₂ particles were performed in a packaging workshop. Physical examination and possible biomarkers for cardiopulmonary effects were examined among 83 exposed workers and 85 controls. In packaging workshop, the total mass concentration of particles was 3.17 mg/m³. The mass concentration of nanoparticles was 1.22 mg/m³ accounting for 39% of the total mass. Lung damage markers (SP-D and pulmonary function), cardiovascular disease markers (VCAM-1, ICAM-1, LDL, and TC), oxidative stress markers (SOD and MDA), and inflammation markers (IL-8, IL-6, IL-1β, TNF-α, and IL-10) were associated with occupational exposure to nano-TiO₂. Among those markers, SP-D showed a time (dose)-response pattern within exposed workers. The data strongly suggest that nano-TiO₂ could contribute, at least in part, to the cardiopulmonary effects observed in workers. The studied markers and pulmonary function tests may be useful in health surveillance for workers exposed to nanomaterials.