Subclinical interstitial lung damage in workers exposed to indium compounds

Abstract

Objectives: The present study was designed to determine whether there is a relationship between indium compound exposure and interstitial lung damage in workers employed at indium tin oxide manufacturing and reclaiming factories in Korea.

Methods: In 2012, we conducted a study for the prevention of indium induced lung damage in Korea and identified 78 workers who had serum indium or Krebs von den Lungen-6 (KL-6) levels that were higher than the reference values set in Japan (3 μg/L and 500 U/mL, respectively). Thirty-four of the 78 workers underwent chest high-resolution computed tomography (HRCT), and their data were used for statistical analysis.

Results: Geometric means (geometric standard deviations) for serum indium, KL-6, and surfactant protein D (SP-D) were 10.9 (6.65) μg/L, 859.0 (1.85) U/mL, and 179.27 (1.81) ng/mL, respectively. HRCT showed intralobular interstitial thickening in 9 workers. A dose-response trend was statistically significant for blood KL-6 levels. All workers who had indium levels ≥50 μg/L had KL-6 levels that exceeded the reference values. However, dose-response trends for blood SP-D levels, KL-6 levels, SP-D levels, and interstitial changes on the HRCT scans were not significantly different.

Conclusions: Our findings suggest that interstitial lung changes could be present in workers with indium exposure. Further studies are required and health risk information regarding indium exposure should be communicated to workers and employers in industries where indium compounds are used to prevent indium induced lung damage in Korea.

Figure 1

High-resolution computed tomography scans on prone position of a worker with no history of smoking, who had been employed at an indium tin oxide target production facility for 7 years (sintering room for 4 years and indium oxide powder room for 3 years). The image shows subpleural interlobular interstitial thickening in both lower lung fields (arrows). The patient had no history of respiratory diseases. Results of health examinations were as follows: serum indium, 50 μg/L; KL-6, 1769 U/mL; FVC, 86% predicted; FEV1/FVC, 109.6% predicted.