Lung Function Tests On Petrol Pump Workers Biology Essay

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Introduction: Air pollution from vehicles is an inescapable part of urban life. Long term exposure to petrol and diesel fumes lead to deleterious effect on respiratory function. In-addition to exposure to hazardous exhaust of vehicles, petrol-pump workers are also exposed to vapours of petrol.

Aim & objectives: Aim was to study changes in pulmonary functions in petrol-pump workers exposed to petrol/diesel fumes and compare changes with age-matched healthy controls.

Material & Methods: The study comprised of 150 petrol-pump workers who were categorized into three groups depending on duration of exposure. Fifty healthy age-matched males served as controls. Each subject's age, smoking habits, duration of exposure and health conditions were recorded. The pulmonary-function tests were performed at their workplace with Med-spiror. The statistical analysis was done using one-way anova with post-hoc turkey.

Results: The results showed statistically significant decline in values of FVC, FEV0.5, FEV1, FEV3 and FEF 50%, FEF 25-75% in petrol-pump workers. However, decline in PEFR, MVV, FEF 25%, FEF 75%, FEV 0.5 / FVC, FEV1/FVC, FEV3 / FVC was statistically insignificant.

Conclusion: Our findings are suggestive of adverse effects of petrol/diesel fumes on pulmonary functions.

Key words : Petrol & diesel fumes, respiratory function, Pulmonary function tests, Timed vital capacity

INTRODUCTION

Air pollution from vehicles is an inescapable part of urban life throughout the world. Long term exposure to air pollutants leads to deleterious effects on respiratory functions. The rapidly multiplying number of automobiles in most cities is causing corresponding increase in air pollution which is a cause of grave concern.

Petrol is a mixture of volatile hydrocarbons, while the diesel fuel is a distillate of petroleum which contains paraffins, alkenes and aromatics. Both petrol and diesel undergo combustion in automobile engines and give rise to combustion-derived nano-particles (CDNP). Diesel exhaust particles are the most common CDNP in urban environmental air. These particles are highly respirable and have large surface area where organics can be adsorbed easily. Particles generated from diesel exhaust are sub-micronic, -by virtue of their greater surface area-to-mass ratio- can carry a larger fraction of toxic hydrocarbons and metals on their surface. They can remain airborne for longer time and deposit in greater numbers and deeper into lungs than larger-sized particles.

Benzene occurs naturally in crude oil and is a constituent of petrol. Petrol-pump workers exposed to petrol fumes exhibit a number of clinical signs and symptoms. The symptoms are more commonly observed in summer, when exposure to gasoline vapours is greater because of higher environmental temperature.

MATERIAL & METHODS

This study was conducted in the Department of Physiology, Govt. Medical College, Amritsar. Subjects comprised of 150 males working in different petrol pumps. Age, smoking habits, duration of exposure, physical status and health conditions were recorded through questionnaire. After recording brief history, examination was done as per the Performa attached. The ethical committee clearance and an informed consent of the subjects were taken.

Subjects with clinical abnormalities of vertebral column and thorax, diabetes mellitus, pulmonary tuberculosis, bronchial asthma, chronic bronchitis, bronchiectesis, emphysema and malignancy, drug addicts, cigarette smokers, tobacco chewers and those who had undergone abdominal or chest surgery were excluded from the study.The study group was categorized according to the duration of service at the petrol pumps which is as under:-

Group

Duration of service

No. of cases

I

Upto 1 year of service

50

II

1-5 years of service

50

III

More than 5 years of service

50

There were 50 controls which comprised of age and sex matched healthy adult males, non-smokers working in the hospital as attendants, medical assistant and other hospital personnel (Group IV).

The pulmonary function tests were performed at the workplace with Med-spiror (Recorders and Medicare System, Chandigarh). It is a computerized spirometer designed to be used with electromechanical pneumotach. Testing procedures were quite simple and non invasive and are harmless to the patients. Only 2 manoeuvers were required from the subject to accumulate all test data, a forced vital capacity and maximal voluntary ventilation.

FVC, FEV 0.5, FEV 1, FEV 3, PEFR, FEF 25-75%, FEF 25%, FEF 50%, FEF 75%, FEV 0.5/FVC, FEV 1/FVC, FEV3 /FVC, MVV were calculated. All gas volumes were corrected to B.T.P.S (Body temperature, ambient pressure and saturated with water vapour) automatically by the instrument.

The data was analyzed using computer software Microsoft Excel Statistical Package of Social Sciences (SPSS version 10.0). Mean and standard deviation (SD) was calculated and reported for quantitative variables. The statistical difference in mean value was tested using one way ANOVA (analysis of variance) with post-hoc turkey. A p-value of < 0.05 was considered as statistically significant.

OBSERVATIONS AND RESULTS

TABLE 1: CHARACTERISTICS OF THE SUBJECTS

VARIABLES

MEAN ± SD

P VALUE

AGE (years) : subjects

controls

28.23 ± 9.21

23.36 ± 2.71

0.24 : NS

HEIGHT(cm) : subjects

controls

164.05 ± 8.13

165.98 ± 8.51

0.46 : NS

WEIGHT(Kg) : subjects

controls

55.23 ± 8.58

59.36 ± 10.70

0.98 : NS

BSA : subjects

controls

1.53 ± 0.11

1.57 ± 0.13

0.77 : NS

p >0.05 ; NS- Non significant

TABLE 2: MEAN VALUES OF LUNG FUNCTION PARAMETERS IN GROUPS AND CONTROLS

PARAMETERS

GROUP I

MEAN ± SD

GROUP II

MEAN ± SD

GROUP III

MEAN ± SD

GROUP IV (CONTROLS)

MEAN ± SD

FVC

3.05 ± 0.46

2.77 ± 0.42

2.38 ± 0.61

3.78 ± 0.54

FEV 0.5

1.77 ± 0.65

1.76 ± 0.59

1.27 ± 0.72

2.60 ± 0.32

FEV 1

2.65 ± 0.43

2.55 ± 0.41

1.98 ± 0.77

3.21 ± 0.55

FEV 3

3.04 ± 0.47

2.73 ± 0.42

2.36 ± 0.68

3.59 ± 0.70

PEFR

6.03 ± 1.88

6.20 ± 1.64

5.12 ± 2.84

7.91 ± 1.27

FEF 25-75%

3.29 ± 1.01

3.60 ± 1.33

2.66 ± 1.54

4.75 ± 1.11

FEF 25%

5.30 ± 1.68

5.50 ± 1.54

4.60 ± 2.13

6.61 ± 1.73

FEF 50%

3.78 ± 1.06

4.16 ± 1.22

3.30 ± 1.76

5.17 ± 1.32

FEF 75 %

2.01 ± 0.82

2.37± 1.02

1.72 ± 1.12

3.12 ± 0.91

FEV 0.5/FVC%

63.74 ± 14.34

67.80 ± 15.11

59.42 ± 21.03

67.50 ± 23.02

FEV 1/FVC%

85.70 ± 9.76

92.08 ± 8.77

79.96 ± 21.90

91.28 ± 11.14

FEV 3/FVC%

98.20 ± 3.88

98.82 ± 4.55

96.76 ± 8.61

100 ± 0.00

MVV

100.62 ± 20.05

100.30 ± 22.58

92.74 ± 23.62

130.18 ± 26.28

Graph showing intergroup comparison in mean values of FVC, FEV 0.5, FEV 1, FEV 3 and PEFR

Graph showing intergroup comparison in mean values of FEF 25-75%, FEF 25%, FEF 50% & FEF 75%

Graph showing intergroup comparison in mean values of FEV 0.5/FVC, FEV 1/FVC, FEV 3/FVC & MVV

INFERENCE

Statistically significant decline

FVC, FEV0.5, FEV1, FEV3 and FEF 50% and FEF 25-75% in petrol-pump workers.

Statistically insignificant decline

PEFR, MVV, FEF 25%, FEF 75%, FEV0.5/FVC, FEV1/FVC FEV3/FVC

DISCUSSION

The various lung function parameters were recorded and compared between the subjects and controls. In addition, intergroup comparison of various lung function parameters was done among subjects on the basis of duration of exposure.

FVC - Our findings are corroborative with another study1,2 which reported statistically significant decline in FVC and found significant relation between three exposure groups when compared with controls.

FEV 0.5 and FEV 1 - It is consistent with studies3,4 ,they showed reported statistically significant decline in FEV1 in petrol pump workers with increasing years of exposure.

FEF 50% - Our study is in agreement with above studies as they reported statistically significant decline in value of FEF 50% .

PEFR- Our results are in agreement with the study5 which showed that mean value of PEFR with years of exposure (Group I < 5 years versus Group II > 5 years) is statistically insignificant. It may be due to the short duration of exposure or a different statistical test adopted for analysis.

FEF 25-75% - The findings are same as the study4 which showed statistically significant decline. The result is in disagreement with the work7 which showed statistically insignificant changes in FEF­25-75 % during exposure to diesel exhaust.

CONCLUSION

Any decline in the lung functions with time merits attention despite the fact that the observed values may be within the normal range, since it indicates likely morbidity in the event of continuing exposure to the offending agent.

Since most individuals are likely to remain asymptomatic till significant pulmonary damage results, regular monitoring of lung function is desirable.

In order to prevent these changes in petrol filling workers, we suggest medical observation including pre-employment and periodic medical check-up like pulmonary function tests.

Early recognition and removal of susceptible workers from working place before chronic impairment develops will prove to be beneficial.

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