Skip to main content
SpringerLink
Log in

Adaptation to Occupational Exposure to Moderate Endotoxin Concentrations: A Study in Sewage Treatment Plants in Germany

  • Chapter
  • First Online:
Clinical Medicine Research

Part of the book series: Advances in Experimental Medicine and Biology ((CLEXBI,volume 1116 ))

Abstract

Acute or chronic inhalation of endotoxin may lead to changes of lung function and inflammatory markers in the airways. Adaptation to workplace exposure may be possible. In this study, we investigated the possible difference in inflammatory markers assessed in nasal lavage fluid (NALF) in chronical exposure compared to voluntary subjects exposed acutely to endotoxin. We sought to define the variability of inflammatory markers in NALF and the dose-related changes after moderate exposure in naïve subjects. Endotoxin exposure (4–1039 EU/m3) resulted from routine work during one shift in sewage treatment plants. Subjects were matched to pairs (8 workers escorted by 10 students). Inflammatory markers were investigated before, directly after, and 16 h after the shift end. Additional NALF samples were collected in students without any specific exposure after 3 days. In NALF, total cell count, and interleukin (IL)-8 and IL-1β concentrations were significantly higher in workers than in students at all times pointing to workplace-related long-lasting exposure resulting in adaptation. However, concentration of inflammatory markers without specific exposure in students showed a great variability, covering the whole range of values recorded in the workers. The findings of this study make us to recommend a repeated assessment of inflammatory markers in healthy volunteers before the investigation of exposure-related changes and a sample size adequate for statistical analysis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • ATS (1995) American Thoracic Society Standardization of spirometry, 1994 update. Am Rev Respir Dis 152(3):1107–1136

    Article  Google Scholar 

  • Bakirci N, Kalaca S, Francis H, Fletcher AM, Pickering C, Anthony C, Tumerdem N, Cali S, Oldham L, Niven R (2007) Natural history and risk factors of early respiratory responses to exposure to cotton dust in newly exposed workers. J Occup Environ Med 49:853–861

    Article  CAS  Google Scholar 

  • BGIA-Arbeitsmappe (1989) Verfahren zur Bestimmung der Endotoxinkonzentration in der Luft am Arbeitsplatz (Kennzahl 9450). In: Berufsgenossenschaftliches Institut für Arbeitssicherheit (ed) BIA-Arbeitsmappe Messung von Gefahrstoffen, 28. Lfg. IV/02. Erich Schmidt Verlag, Bielefeld (Article in German)

    Google Scholar 

  • Bradford MM (1976) A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Anal Biochem 72:248–254

    Article  CAS  Google Scholar 

  • Castellan RM, Olenchock SA, Kinsley KB, Hankinson JL (1987) Inhaled endotoxin and decreased spirometric values. An exposure-response relation for cotton dust. N Engl J Med 317:605–610

    Article  CAS  Google Scholar 

  • Danuser B, Rebsamen H, Weber C, Krueger H (2000) Lipopolysaccharide-induced nasal cytokine response: a dose-response evaluation. Eur Arch Otorhinolaryngol 257:527–532

    Article  CAS  Google Scholar 

  • DECOS (Dutch Expert Committee on Occupational Standards) (1998) Endotoxins: health based recommended exposure limit. In: A report of the Health Council of the Netherlands, publication no 1998/03WGD. Health Council of the Netherlands, Rijswijk, pp 1–82

    Google Scholar 

  • Doreswamy V, Alexis NE, Zhou H, Peden DB (2011) Nasal PMN response to repeated challenge with endotoxin in healthy volunteers. Inhal Toxicol 23:142–147

    Article  Google Scholar 

  • Douwes J, Wouters I, Dubbeld H, van Zwieten L, Steerenberg P, Doekes G, Heederik D (2000) Upper airway inflammation assessed by nasal lavage in compost workers: a relation with bio-aerosol exposure. Am J Ind Med 37:459–468

    Article  CAS  Google Scholar 

  • Health Council of the Netherlands (2010) Endotoxins. Health-based recommended occupational exposure limit. Health Council of the Netherlands, The Hague

    Google Scholar 

  • Hoffmeyer F, van Kampen V, Taeger D, Deckert A, Rosenkranz N, Kaßen M, Schantora AL, Brüning T, Raulf M, Bünger J (2014) Prevalence of and relationship between rhinoconjunctivitis and lower airway diseases in compost workers with current or former exposure to organic dust. Ann Agric Environ Med 21:705–711

    Article  Google Scholar 

  • Jacobs JH, Krop EJ, de Wind S, Spithoven J, Heederik DJ (2013) Endotoxin levels in homes and classrooms of Dutch school children and respiratory health. Eur Respir J 42:314–322

    Article  CAS  Google Scholar 

  • Jacobs JH, Krop EJ, Borras-Santos A, Zock J, Taubel M, Hyvarinnen A, Pekkanen J, Doekes G, Heederik DJ (2014) Endotoxin levels in settled airborne dust in European schools: the HITEA school study. Indoor Air 24:148–157

    Article  CAS  Google Scholar 

  • Kitz R, Rose MA, Placzek K, Schulze J, Zielen S, Schubert R (2008) LPS inhalation challenge: a new tool to characterize the inflammatory response in humans. Med Microbiol Immunol 197:13–19

    Article  CAS  Google Scholar 

  • Lai PS, Hang J, Valeri L, Zhang F, Zheng B, Mehta AJ, Shi J, Su L, Brown D, Eisen EA, Christiani DC (2015) Endotoxin and gender modify lung function recovery after occupational organic dust exposure: a 30-year study. Occup Environ Med 72:546–552

    Article  Google Scholar 

  • Liebers V, Brüning T, Raulf-Heimsoth M (2006) Occupational endotoxin-exposure and possible health effects on humans. Am J Ind Med 49:474–491

    Article  CAS  Google Scholar 

  • Liebers V, Raulf-Heimsoth M, Brüning T (2008) Health effects due to endotoxin inhalation (review). Arch Toxicol 82:203–210

    Article  CAS  Google Scholar 

  • Michel O, Nagy A, Schroeven M, Duchateau J, Nève J, Fondu P, Sergysels R (1997) Dose-response relationship to inhaled endotoxin in normal subjects. Am J Respir Crit Care Med 156:1157–1164

    Article  CAS  Google Scholar 

  • Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC (1993) Lung volumes and forced ventilatory flows. Eur Respir J 6(Suppl 16):5–40

    Article  Google Scholar 

  • Quirce S, Lemière C, de Blay F, del Pozo V, van Gerth WR, Maestrelli P, Pauli G, Pignatti P, Raulf-Heimsoth M, Sastre J, Storaas T, Moscato G (2010) Noninvasive methods for assessment of airway inflammation in occupational settings. Allergy 65:445–458

    Article  CAS  Google Scholar 

  • Radon K, Garz S, Riess A, Koops F, Monso E, Weber C, Danuser B, Iversen M, Opravil U, Donham K, Hartung J, Pedersen S, Nowak D (2003) Respiratory diseases in European farmers-II. Part of the European farmers’ project. Atemwegs- und Lungenerkrankungen in der Europäischen Landwirtschaft – Teil 2: Ergebnisse der europäischen Landwirtschaftsstudie. Pneumologie (Stuttgart, Germany) 57:510–517

    Article  CAS  Google Scholar 

  • Raulf M, Hoffmeyer F, van Kampen V, Deckert A, Brüning T, Bünger J (2015) Cellular and soluble inflammatory markers in induced sputum of composting plant workers. Adv Exp Med Biol 858:19–29

    Article  CAS  Google Scholar 

  • Raulf M, van Kampen V, Neumann HD, Liebers V, Deckert A, Brüning T, Bünger J, Hoffmeyer F (2017) Airway and blood inflammatory markers in waste collectors. Adv Exp Med Biol 1021:1–14

    Article  CAS  Google Scholar 

  • Raulf-Heimsoth M, Wirtz C, Papenfuss F, Baur X (2000) Nasal lavage mediator profile and cellular composition of nasal brushing material during latex challenge tests. Clin Exp Allergy 30:110–121

    Article  CAS  Google Scholar 

  • Raulf-Heimsoth M, Hoffmeyer F, van Thriel C, Blaszkewicz M, Bünger J, Brüning T (2010) Assessment of low dose effects of acute sulphur dioxide exposure on the airways using non-invasive methods. Arch Toxicol 84:121–127

    Article  CAS  Google Scholar 

  • Raulf-Heimsoth M, Pesch B, Kendzia B, Spickenheuer A, Bramer R, Marczynski B, Merget R, Brüning T (2011) Irritative effects of vapours and aerosols of bitumen on the airways assessed by non-invasive methods. Arch Toxicol 85(Suppl 1):S41–S52

    Article  Google Scholar 

  • Reynolds SJ, Milton DK, Heederik D, Thorne PS, Donham KJ, Croteau EA, Kelly KM, Douwes J, Lewis D, Whitmer M, Connaughton I, Koch S, Malmberg P, Larsson B, Deddens J, Saraf A, Larsson L (2005) Interlaboratory evaluation of endotoxin analyses in agricultural dusts-comparison of LAL assay and mass spectrometry. J Environ Monit 7:1371–1377

    Article  CAS  Google Scholar 

  • Rieger MA, Diefenbach H (2007) Biological stress and strain in the field of waste water management – how important is endotoxin? Gefahrstoffe – Reinhaltung der Luft 67:363–366

    CAS  Google Scholar 

  • Rieger MA, Lohmeyer M, Nübling M, Neuhaus S, Diefenbach H, Hofmann F (2005) A description of the standardized measurement procedures and recommended threshold limit values for biological hazards in Germany. J Agric Saf Health 11:185–191

    Article  CAS  Google Scholar 

  • Rylander R (1995) Endotoxins in the environment. In: Lewin J, Alving CR, Munford RS, Redl H (eds) Bacterial endotoxins, lipopolysaccharids from genes to therapy. Proceedings of the third conference of the international endotoxin society. Wiley-Liss Inc, New York, pp 79–90

    Google Scholar 

  • Rylander R (2002) Endotoxin in the environment – exposure and effects. J Endotoxin Res 8:241–252

    CAS  PubMed  Google Scholar 

  • Rylander R, Bake B, Fischer JJ, Helander IM (1989) Pulmonary function and symptoms after inhalation of endotoxin. Am Rev Respir Dis 140:981–986

    Article  CAS  Google Scholar 

  • Sahlander K, Larsson K, Palmberg L (2012) Daily exposure to dust alters innate immunity. PLoS One 7:e31646

    Article  CAS  Google Scholar 

  • Schantora AL, Casjens S, Deckert A, van Kampen V, Neumann HD, Brüning T, Raulf M, Bünger J, Hoffmeyer F (2015) Prevalence of work-related rhino-conjunctivitis and respiratory symptoms among domestic waste collectors. Adv Exp Med Biol 834:53–61

    Article  CAS  Google Scholar 

  • Sigsgaard T, Bonefeld-Jørgensen EC, Kjaergaard SK, Mamas S, Pedersen OF (2000) Cytokine release from the nasal mucosa and whole blood after experimental exposures to organic dusts. Eur Respir J 16:140–145

    Article  CAS  Google Scholar 

  • Sigsgaard T, Bonefeld-Jørgensen EC, Hoffmann HJ, Bønløkke J, Krüger T (2005) Microbial cell wall agents as an occupational hazard. Toxicol Appl Pharmacol 207:310–319

    Article  CAS  Google Scholar 

  • Sigsgaard T, Thorne PS, Schlünssen V, Bønløkke J, Riddervold IS, Hoppe KA, Andersen NT, Mackenzie NM (2015) The change in nasal inflammatory markers after intranasal challenges with particulate chitin and lipopolysaccharide: a randomized, double-blind, placebo-controlled, crossover study with a positive control. Int Forum Allergy Rhinol 5:716–723

    Article  Google Scholar 

  • Spierenburg EA, Smit LA, Heederik D, Robbe P, Hylkema MN, Wouters I (2015) Healthy worker survivor analysis in an occupational cohort study of Dutch agricultural workers. Int Arch Occup Environ Health 88:1165–1173

    Article  CAS  Google Scholar 

  • Steinberg R (2001) Belastungen und Beanspruchungen von Beschäftigten in Arbeitsbereichen der Abwasserwirtschaft unter besonderer Berücksichtigung der Gefährdung durch biologische Arbeitsstoffe. Gesellschaft für Abwassertechnik e.V. (GFA), Hennef (Article in German)

    Google Scholar 

  • Thorn J (2001) The inflammatory response in humans after inhalation of bacterial endotoxin: a review. Inflamm Res 50:254–261

    Article  CAS  Google Scholar 

  • Visser MJ, Spaan S, Arts HJ, Smit LA, Heederik DJ (2006) Influence of different cleaning practices on endotoxin exposure at sewage treatment plants. Ann Occup Hyg 50(7):731–736

    CAS  PubMed  Google Scholar 

  • von Essen S, Romberger D (2003) The respiratory inflammatory response to the swine confinement building environment: the adaptation to respiratory exposures in the chronically exposed worker. J Agric Saf Health 9:185–196

    Article  Google Scholar 

  • Walser SM, Gerstner DG, Brenner B, Bünger J, Eikmann T, Janssen B, Kolb S, Kolk A, Nowak D, Raulf M, Sagunski H, Sedlmaier N, Suchenwirth R, Wiesmüller G, Wollin K, Tesseraux I, Herr CE (2015) Evaluation of exposure-response relationships for health effects of microbial bioaerosols – a systematic review. Int J Hyg Environ Health 218(7):577–589

    Article  Google Scholar 

  • Wang Z, Larsson K, Palmberg L, Malmberg P, Larsson P, Larsson L (1997) Inhalation of swine dust induces cytokine release in the upper and lower airways. Eur Respir J 10:381–387

    Article  CAS  Google Scholar 

  • Wilcoxon F (1945) Individual comparisons by ranking methods. Biom Bull 1:80–83

    Article  Google Scholar 

  • Wouters IM, Hilhorst SK, Kleppe P, Doekes G, Douwes J, Peretz C, Heederik D (2002) Upper airway inflammation and respiratory symptoms in domestic waste collectors. Occup Environ Med 59(2):106–112

    Article  CAS  Google Scholar 

  • Zheng Y, Schlünssen V, Bønløkke J, Madsen AM, Skov S, Sigsgaard T (2014) Change in airway inflammatory markers in Danish energy plant workers during a working week. Ann Agric Environ Med 21(3):534–540

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The study was financed by a grant of the Lieselotte und Dr. Karl Otto Winkler Stiftung für Arbeitsmedizin and own research funds of the institutions involved (Department of Applied Physiology, Occupational Medicine and Infectiology, University of Wuppertal, Germany, and Department of Allergology/Immunology, Institute for Prevention and Occupational Medicine, Institute of the German Social Accident Insurance, Ruhr University Bochum, Germany). The work of the Institute of Occupational and Social Medicine and Health Services Research (IASV) is supported by an unrestricted grant of the employers’ association of the metal and electric industry Baden-Württemberg (Südwestmetall).

The authors thank the Emscher-Genossenschaft/Lippeverband (EGLV) for giving access to their sewage treatment plants, all volunteers for study participation, and the involved staff of IPA, IASV, and University Wuppertal, especially Monika Lahr, Heiko Diefenbach, and Nicole Blomberg for technical assistance in collection of specimens and on the sewage treatment plants and Gerda Borowitzki, Susanne Freundt, and Sabine Bernard for technical assistance in analysis of the NALF samples.

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

Author information

Authors and Affiliations

  1. Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tübingen, Tübingen, Germany

    M. A. Rieger

  2. Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Ruhr University Bochum, Bochum, Germany

    V. Liebers, T. Brüning, F. Hoffmeyer & M. Raulf

  3. Research Center for Occupational and Social Medicine (FFAS), Freiburg, Germany

    M. Nübling

  4. Institute for Clinical Epidemiology and Applied Biometry, Tübingen University Hospital, Tübingen, Germany

    B. Brendel

Authors
  1. M. A. Rieger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. Liebers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Nübling
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T. Brüning
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. Brendel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F. Hoffmeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Raulf
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. A. Rieger .

Editor information

Editors and Affiliations

  1. Opole Medical School, Opole, Poland

    Mieczyslaw Pokorski

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Rieger, M.A. et al. (2018). Adaptation to Occupational Exposure to Moderate Endotoxin Concentrations: A Study in Sewage Treatment Plants in Germany. In: Pokorski, M. (eds) Clinical Medicine Research. Advances in Experimental Medicine and Biology(), vol 1116 . Springer, Cham. https://doi.org/10.1007/5584_2018_261

Download citation

Publish with us

Policies and ethics

Search

Navigation