Respiratory Health and Urinary Trace Metals among Artisanal Stone-Crushers: A Cross-Sectional Study in Lubumbashi, DR Congo
Abstract
:1. Introduction
2. Methods
3. Results
3.1. Study Population
3.2. Urinary Biomonitoring
3.3. Symptoms
3.4. Spirometry
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Kullman, G.J.; Greife, A.L.; Costello, J.; Hearl, F.J. Occupational Exposures to Fibers and Quartz at 19 Crushed Stone Mining and Milling Operations. Am. J. Ind. Med. 1995, 27, 641–660. [Google Scholar] [CrossRef]
- Semple, S.; Green, D.A.; McAlpine, G.; Cowie, H.; Seaton, A. Exposure to Particulate Matter on an Indian Stone-Crushing Site. Occup. Environ. Med. 2008, 65, 300–305. [Google Scholar] [CrossRef]
- Bahrami, A.R.; Golbabai, F.; Mahjub, H.; Qorbani, F.; Aliabadi, M.; Barqi, M. Determination of Exposure to Respirable Quartz in the Stone Crushing Units at Azendarian-West of Iran. Ind. Health 2008, 46, 404–408. [Google Scholar] [CrossRef] [Green Version]
- Sivacoumar, R.; Mohan Raj, S.; Chinnadurai, S.J.; Jayabalou, R. Modeling of Fugitive Dust Emission and Control Measures in Stone Crushing Industry. J. Environ. Monit. 2009, 11, 987–997. [Google Scholar] [CrossRef] [PubMed]
- Mukhopadhyay, K.; Ramalingam, A.; Ramani, R.; Dasu, V.; Sadasivam, A.; Kumar, P.; Prasad, S.N.; Sambandam, S.; Balakrishnan, K. Exposure to Respirable Particulates and Silica in and around the Stone Crushing Units in Central India. Ind. Health 2011, 49, 221–227. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Leghari, S.K.; Zaidi, M.A.; Siddiqui, M.F.; Sarangzai, A.M. Dust Exposure Risk from Stone Crushing to Workers and Locally Grown Plant Species in Quetta, Pakistan. Environ. Monit. Assess. 2019, 191. [Google Scholar] [CrossRef] [PubMed]
- Hoy, R.F.; Chambers, D.C. Silica-Related Diseases in the Modern World. Allergy 2020. [Google Scholar] [CrossRef] [Green Version]
- Brüske, I.; Thiering, E.; Heinrich, J.; Huster, K.; Nowak, D. Biopersistent Granular Dust and Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. PLoS ONE 2013, 8, e80977. [Google Scholar] [CrossRef] [Green Version]
- Narendrula, R.; Nkongolo, K.K.; Beckett, P. Comparative Soil Metal Analyses in Sudbury (Ontario, Canada) and Lubumbashi (Katanga, DR-Congo). Bull. Environ. Contam. Toxicol. 2012, 88, 187–192. [Google Scholar] [CrossRef]
- Banza, C.L.N.; Nawrot, T.S.; Haufroid, V.; Decrée, S.; De Putter, T.; Smolders, E.; Kabyla, B.I.; Luboya, O.N.; Ilunga, A.N.; Mutombo, A.M.; et al. High Human Exposure to Cobalt and Other Metals in Katanga, a Mining Area of the Democratic Republic of Congo. Environ. Res. 2009, 109, 745–752. [Google Scholar] [CrossRef]
- Banza Lubaba Nkulu, C.; Casas, L.; Haufroid, V.; De Putter, T.; Saenen, N.D.; Kayembe-Kitenge, T.; Musa Obadia, P.; Kyanika Wa Mukoma, D.; Lunda Ilunga, J.-M.; Nawrot, T.S.; et al. Sustainability of Artisanal Mining of Cobalt in DR Congo. Nat. Sustain. 2018, 1, 495–504. [Google Scholar] [CrossRef]
- Sekkal, S.; Haddam, N.; Scheers, H.; Poels, K.L.; Bouhacina, L.; Nawrot, T.S.; Veulemans, H.A.; Taleb, A.; Nemery, B. Occupational Exposure to Petroleum Products and Respiratory Health: A Cross-Sectional Study from Algeria. J. Occup. Environ. Med. 2012, 54, 1382–1388. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Burney, P.G.; Laitinen, L.A.; Perdrizet, S.; Huckauf, H.; Tattersfield, A.E.; Chinn, S.; Poisson, N.; Heeren, A.; Britton, J.R.; Jones, T. Validity and Repeatability of the IUATLD (1984) Bronchial Symptoms Questionnaire: An International Comparison. Eur. Respir. J. 1989, 2, 940–945. [Google Scholar] [PubMed]
- Annesi-Maesano, I.; Mourad, C.; Daures, J.-P.; Kalaboka, S.; Godard, P. Time Trends in Prevalence and Severity of Childhood Asthma and Allergies from 1995 to 2002 in France. Allergy 2009, 64, 798–800. [Google Scholar] [CrossRef] [PubMed]
- Miller, M.R.; Crapo, R.; Hankinson, J.; Brusasco, V.; Burgos, F.; Casaburi, R.; Coates, A.; Enright, P.; van der Grinten, C.P.M.; Gustafsson, P.; et al. General Considerations for Lung Function Testing. Eur. Respir. J. 2005, 26, 153–161. [Google Scholar] [CrossRef] [Green Version]
- Hoet, P.; Jacquerye, C.; Deumer, G.; Lison, D.; Haufroid, V. Reference Values and Upper Reference Limits for 26 Trace Elements in the Urine of Adults Living in Belgium. Clin. Chem. Lab. Med. 2013, 51, 839–849. [Google Scholar] [CrossRef]
- Cocker, J.; Mason, H.J.; Warren, N.D.; Cotton, R.J. Creatinine Adjustment of Biological Monitoring Results. Occup. Med. 2011, 61, 349–353. [Google Scholar] [CrossRef] [Green Version]
- Tembo, B.D.; Sichilongo, K.; Cernak, J. Distribution of Copper, Lead, Cadmium and Zinc Concentrations in Soils around Kabwe Town in Zambia. Chemosphere 2006, 63, 497–501. [Google Scholar] [CrossRef]
- Tuakuila, J.; Lison, D.; Lantin, A.-C.; Mbuyi, F.; Deumer, G.; Haufroid, V.; Hoet, P. Worrying Exposure to Trace Elements in the Population of Kinshasa, Democratic Republic of Congo (DRC). Int. Arch. Occup. Environ. Health 2012, 85, 927–939. [Google Scholar] [CrossRef] [Green Version]
- Smolders, E.; Roels, L.; Kuhangana, T.C.; Coorevits, K.; Vassilieva, E.; Nemery, B.; Lubaba Nkulu, C.B. Unprecedentedly High Dust Ingestion Estimates for the General Population in a Mining District of DR Congo. Environ. Sci. Technol. 2019, 53, 7851–7858. [Google Scholar] [CrossRef]
- Nemery, B.; Banza Lubaba Nkulu, C. Assessing Exposure to Metals Using Biomonitoring: Achievements and Challenges Experienced through Surveys in Low- and Middle-Income Countries. Toxicol. Lett. 2018, 298, 13–18. [Google Scholar] [CrossRef] [PubMed]
- Musa Obadia, P.; Kayembe-Kitenge, T.; Haufroid, V.; Banza Lubaba Nkulu, C.; Nemery, B. Preeclampsia and Blood Lead (and Other Metals) in Lubumbashi, DR Congo. Environ. Res. 2018, 167, 468–471. [Google Scholar] [CrossRef] [PubMed]
- Buist, A.S.; Vollmer, W.M.; Sullivan, S.D.; Weiss, K.B.; Lee, T.A.; Menezes, A.M.B.; Crapo, R.O.; Jensen, R.L.; Burney, P.G.J. The Burden of Obstructive Lung Disease Initiative (BOLD): Rationale and Design. COPD 2005, 2, 277–283. [Google Scholar] [CrossRef] [PubMed]
- Rajaee, M.; Yee, A.K.; Long, R.N.; Renne, E.P.; Robins, T.G.; Basu, N. Pulmonary Function and Respiratory Health of Rural Farmers and Artisanal and Small Scale Gold Miners in Ghana. Environ. Res. 2017, 158, 522–530. [Google Scholar] [CrossRef]
- Eisen, E.A.; Wegman, D.H.; Louis, T.A. Effects of Selection in a Prospective Study of Forced Expiratory Volume in Vermont Granite Workers. Am. Rev. Respir. Dis. 1983, 128, 587–591. [Google Scholar] [CrossRef]
- Eisen, E.A.; Wegman, D.H.; Louis, T.A.; Smith, T.J.; Peters, J.M. Healthy Worker Effect in a Longitudinal Study of One-Second Forced Expiratory Volume (FEV1) and Chronic Exposure to Granite Dust. Int. J. Epidemiol. 1995, 24, 1154–1162. [Google Scholar] [CrossRef]
- Malmberg, P.; Hedenstrom, H.; Sundblad, B.M. Changes in Lung Function of Granite Crushers Exposed to Moderately High Silica Concentrations: A 12 Year Follow Up. Br. J. Ind. Med. 1993, 50, 726–731. [Google Scholar] [CrossRef] [Green Version]
- Rego, G.; Pichel, A.; Quero, A.; Dubois, A.; Martínez, C.; Isidro, I.; Gil, M.; Cuervo, V.; González, A. High Prevalence and Advanced Silicosis in Active Granite Workers: A Dose-Response Analysis Including FEV1. J. Occup. Environ. Med. 2008, 50, 827–833. [Google Scholar] [CrossRef]
- Ng, T.P.; Chan, S.L. Lung Function in Relation to Silicosis and Silica Exposure in Granite Workers. Eur. Respir. J. 1992, 5, 986–991. [Google Scholar]
- Tiwari, R.R.; Narain, R.; Patel, B.D.; Makwana, I.S.; Saiyed, H.N. Spirometric Measurements among Quartz Stone Ex-Workers of Gujarat, India. J. Occup. Health 2003, 45, 88–93. [Google Scholar] [CrossRef] [Green Version]
- Tiwari, R.R.; Sharma, Y.K.; Saiyed, H.N. Tuberculosis among Workers Exposed to Free Silica Dust. Indian J. Occup. Environ. Med. 2007, 11, 61–64. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Tiwari, R.R.; Sharma, Y.K. Respiratory Health of Female Stone Grinders with Free Silica Dust Exposure in Gujarat, India. Int. J. Occup. Environ. Health 2008, 14, 280–282. [Google Scholar] [CrossRef]
- Tiwari, R.R.; Narain, R.; Sharma, Y.K.; Kumar, S. Comparison of Respiratory Morbidity between Present and Ex-Workers of Quartz Crushing Units: Healthy Workers’ Effect. Indian J. Occup. Environ. Med. 2010, 14, 87–90. [Google Scholar] [CrossRef] [Green Version]
- Singh, S.K.; Chowdhary, G.R.; Purohit, G. Assessment of Impact of High Particulate Concentration on Peak Expiratory Flow Rate of Lungs of Sand Stone Quarry Workers. Int. J. Environ. Res. Public Health 2006, 3, 355–359. [Google Scholar] [CrossRef] [PubMed]
- Singh, S.K.; Chowdhary, G.R.; Chhangani, V.D.; Purohit, G. Quantification of Reduction in Forced Vital Capacity of Sand Stone Quarry Workers. Int. J. Environ. Res. Public Health 2007, 4, 296–300. [Google Scholar] [CrossRef]
- Rajavel, S.; Raghav, P.; Gupta, M.K.; Muralidhar, V. Silico-Tuberculosis, Silicosis and Other Respiratory Morbidities among Sandstone Mine Workers in Rajasthan—A Cross-Sectional Study. PLoS ONE 2020, 15, e230574. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Nwibo, A.N.; Ugwuja, E.I.; Nwambeke, N.O.; Emelumadu, O.F.; Ogbonnaya, L.U. Pulmonary Problems among Quarry Workers of Stone Crushing Industrial Site at Umuoghara, Ebonyi State, Nigeria. Int. J. Occup. Environ. Med. 2012, 3, 178–185. [Google Scholar]
- Isara, A.R.; Adam, V.Y.; Aigbokhaode, A.Q.; Alenoghena, I.O. Respiratory Symptoms and Ventilatory Functions among Quarry Workers in Edo State, Nigeria. Pan Afr. Med. J. 2016, 23. [Google Scholar] [CrossRef]
- Draid, M.M.; Ben-Elhaj, K.M.; Ali, A.M.; Schmid, K.K.; Gibbs, S.G. Lung Function Impact from Working in the Pre-Revolution Libyan Quarry Industry. Int. J. Environ. Res. Public Health 2015, 12, 5006–5012. [Google Scholar] [CrossRef] [Green Version]
- Ahadzi, D.F.; Afitiri, A.-R.; Ekumah, B.; Kanatey, V.; Afedzi, A. Self-Reported Disease Symptoms of Stone Quarry Workers Exposed to Silica Dust in Ghana. Health Sci. Rep. 2020, 3, e189. [Google Scholar] [CrossRef]
- Chattopadhyay, B.P.; Gangopadhyay, P.K.; Bandopadhyay, T.S.; Alam, J. Comparison of Pulmonary Function Test Abnormailities between Stone Crushing Dust Expsoed and Nonexposed Agricultural Workers. Environ. Health Prev. Med. 2006, 11, 191–198. [Google Scholar] [CrossRef] [PubMed]
Variables | All (n = 98) | Stone-Crushers (n = 48) | Taxi Drivers (n = 50) | p-Value |
---|---|---|---|---|
Age, years | 28 ± 7 [18–50] | 27 ± 5 [18–37] | 30 ± 8 [18–50] | 0.013 |
Height, cm | 170 ± 8 [152–194] | 171 ± 8 [152–194] | 169 ± 7 [154–185] | 0.13 |
Education ˃12 years | 27 (28%) | 1 (2%) | 26 (52%) | 0.001 |
Tobacco smoking | 13 (13%) | 7 (15%) | 6 (12%) | 0.77 |
Regular alcohol consumption | 71 (72%) | 36 (75%) | 35 (70%) | 0.65 |
Length in work, years | 8 ± 6 [<1–25] | 7 ± 5 [<1–19] | 8 ± 7 [<1–25] | 0.13 |
Living close to mining | 17 (17%) | 7 (15%) | 10 (20%) | 0.60 |
Exclusive well water consumption | 37 (38%) | 24 (50%) | 13 (26%) | 0.021 |
Variables | Units | All (n = 75) | Stone-Crushers (n = 41) | Taxi-Drivers (n = 34) | Hoet et al. 2013 (n = 1022) | Banza et al. 2009 (n = 179) | |
---|---|---|---|---|---|---|---|
GM (95% CI) | GM (95% CI) | GM (95% CI) | p-value | GM (95% CI) | GM 25th–75th percentile | ||
Creatinine | (g/L) | 2.26 (2.05–2.48) | 2.27 (2.00–2.57) | 2.24 (1.92–2.61) | 0.99 | — | — |
Li | µg/g creat | 18.8 (16.6–21.4) | 19.5 (16.7–22.7) | 18.0 (14.5–22.5) | 0.34 | 22.5 (21.5–23.4) | — |
Al | µg/g creat | 12.9 (10.7–15.6) | 12.7 (9.6–16.7) | 13.2 (10.2–17.1) | 0.50 | 2.03 (1.94–2.13) | 12.4 (6.05–20.7) |
Cr | µg/g creat | 0.19 (0.17–0.21) | 0.17 (0.16–0.19) | 0.20 (0.17–0.25) | 0.26 | 0.101 (0.10–0.11) | 0.17 (0.10–0.24) |
Mn | µg/g creat | 0.87 (0.60–1.25) | 1.07 (0.62–1.85) | 0.67 (0.42–1.07) | 0.39 | * | 0.32 (0.05–1.87) |
Co | µg/g creat | 2.81 (2.18–3.62) | 3.29 (2.39–4.52) | 2.33 (1.53–3.54) | 0.049 | 0.150 (0.14–0.16) | 15.7 (5.27–43.2) |
Ni | µg/g creat | 1.86 (1.55–2.22) | 2.40 (1.97–2.93) | 1.36 (1.02–1.83) | 0.0007 | 1.73 (1.66–1.80) | 3.27 (1.90–4.87) |
Cu | µg/g creat | 10.4 (9.11–11.8) | 10.1 (8.45–12.0) | 10.7 (8.81–13.0) | 0.65 | 6.94 (6.77–7.12) | 17.1 (8.44–28.2) |
Zn | µg/g creat | 339 (297–388) | 358 (307–416) | 319 (250–406) | 0.28 | 229 (220–239) | 306 (199–473) |
As | µg/g creat | 25.3 (21.0–30.5) | 33.0 (27.1–40.2) | 18.3 (13.4–25.1) | 0.006 | 15.6 (14.5–16.8) | 17.8 (10.9–29.0) |
Se | µg/g creat | 18.4 (16.8–20.1) | 19.4 (17.8–21.2) | 17.2 (14.5–20.5) | 0.041 | 21.3 (21.0–21.7) | 12.4 (13.3–20.6) |
Mo | µg/g creat | 66.9 (52.5–85.2) | 77.1 (54.6–109) | 56.4 (40.0–79.4) | 0.49 | 23.2 (21.5–25.0) | 75.2 (46.8–126.7) |
Cd | µg/g creat | 0.54 (0.45–0.63) | 0.61 (0.49–0.76) | 0.46 (0.36–0.59) | 0.065 | 0.228 (0.216–0.241) | 0.75 (0.38–1.16) |
Sn | µg/g creat | 0.12 (0.10–0.14) | 0.10 (0.08–0.13) | 0.14 (0.11–0.19) | 0.029 | 0.286 (0.26–0.31) | 0.08 (0.04–0.16) |
Sb | µg/g creat | 0.05 (0.05–0.06) | 0.05 (0.04–0.05) | 0.06 (0.05–0.08) | 0.005 | 0.029 (0.03–0.03) | 0.07 (0.04–0.10) |
Te | µg/g creat | 0.18 (0.16–0.21) | 0.21 (0.17–0.24) | 0.16 (0.13–0.20) | 0.12 | 0.115 (0.11–0.12) | 0.09 (0.07–0.12) |
Ba | µg/g creat | 1.54 (1.29–1.85) | 1.61 (1.25–2.07) | 1.47 (1.11–1.93) | 0.32 | 1.68 (1.59–1.78) | — |
Tl | µg/g creat | 0.13 (0.11–0.14) | 0.12 (0.10–0.14) | 0.14 (0.12–0.17) | 0.087 | 0.169 (0.16–0.18) | — |
Pb | µg/g creat | 2.43 (2.09–2.83) | 2.47 (1.96–3.10) | 2.40 (1.95–2.94) | 0.70 | 0.73 (0.70–0.77) | 3.17 (1.47–5.49) |
U | µg/g creat | 0.01 (0.01–0.02) | 0.02 (0.01–0.02) | 0.01 (0.01–0.02) | 0.47 | * | 0.028 (0.013–0.065) |
Variables | All (n = 98) | Stone-Crushers (n = 48) | Taxi-Drivers (n = 50) | p-Value |
---|---|---|---|---|
Oculo-nasal symptoms | ||||
None | 31 (32%) | 19 (40%) | 12 (24%) | 0.13 |
Itchy nose | 13 (13%) | 6 (13%) | 7 (14%) | 1.00 |
Itchy eyes | 7 (7%) | 2 (4%) | 5 (10%) | 0.44 |
Runny nose | 13 (13%) | 5 (10%) | 8 (16%) | 0.55 |
Sneezing | 22 (22%) | 11 (23%) | 11 (22%) | 1.00 |
Stuffy nose | 12 (12%) | 5 (10%) | 7 (14%) | 0.76 |
Respiratory Symptoms | ||||
None | 44 (45%) | 17 (35%) | 27 (54%) | 0.072 |
Wheezing | 14 (14%) | 11 (23%) | 3 (6%) | 0.021 |
Cough | 14 (14%) | 6 (13%) | 8 (16%) | 0.78 |
Phlegm | 16 (16%) | 10 (21%) | 6 (12%) | 0.28 |
Shortness of breath | 10 (10%) | 4 (8%) | 6 (12%) | 0.74 |
Variables | Group (Stone-Crushers vs. Taxi-Drivers) | Age | Tobacco Smoking (Yes vs. No) | Living Close to Mining (Yes vs. No) | ||||
---|---|---|---|---|---|---|---|---|
uOR [95% CI] | aOR [95% CI] | uOR [95% CI] | aOR [95% CI] | uOR [95% CI] | aOR [95% CI] | uOR [95% CI] | aOR [95% CI] | |
Itchy nose | 0.87 [0.27–2.83] | 0.85 [0.25–2.83] | 1.23 [0.75–1.69] | 1.02 [0.92–1.12] | 0.6 [0.18–2.04] | 0.50 [0.06–4.34] | 1.32 [0.40–5.02] | 1.49 [0.35–6.19] |
Itchy eyes | 0.39 [0.07–2.12] | 0.36 [0.06–2.03] | 0.88 [0.67–1.56] | 1.06 [0.92–1.23] | 1.82 [0.54–4.88] | 2.91 [0.45–18.52] | 0.87 [0.19–4.09] | 2.35 [0.37–14.73] |
Runny nose | 0.61 [0.18–2.01] | 0.50 [0.14–1.72] | 0.99 [0.71–1.32] | 1.10 [0.99–1.24] | 0.87 [0.44–2.27] | 0.42 [0.04–3.75] | 0.70 [0.19–2.48] | 1.66 [0.38–7.29] |
Sneezing | 1.05 [0.41–2.72] | 0.94 [0.35–2.50] | 1.21 [0.88–1.52] | 1.03 [0.95–1.12] | 0.93 [0.23–3.81] | 1.21 [0.19–7.62] | 1.61 [1.22–2.28] | 0.73 [0.18–2.87] |
Stuffy nose | 0.71 [0.21–2.43] | 0.59 [0.16–2.12] | 1.15 [0.81–1.67] | 1.03 [0.93–1.13] | 2.32 [1.19–5.51] | 1.14 [0.21–6.19] | NC | NC |
Wheezing | 4.66 [1.21–17.9] | 4.45 [1.09–18.2] | 0.90 [0.81–0.99] | 1.17 [1.02–1.35] | 0.80 [0.20–3.81] | 1.10 [0.19–6.37] | 2.09 [0.45–11.6] | 2.37 [0.48–11.55] |
Cough | 0.75 [0.23–2.34] | 0.63 [0.18–2.06] | 1.02 [0.98–1.13] | 1.14 [1.01–1.29] | 1.81 [0.72–4.60] | 1.78 [0.39–8.02] | 1.83 [0.40–8.19] | 2.54 [0.47–13.10] |
Phlegm | 1.92 [0.64–5.80] | 1.76 [0.57–5.41] | 1.13 [0.90–1.62] | 1.05 [0.95–1.15] | 1.32 [0.56–3.62] | 1.57 [0.36–6.67] | 0.69 [0.20–3.29] | 1.38 [0.33–5.76] |
SOB | 0.66 [0.17–2.52] | 0.56 [0.13–2.44] | 1.05 [1.01–1.13] | 1.28 [1.06–1.55] | 2.48 [1.09–5.94] | 3.59 [0.67–19.14] | 0.51 [0.10–2.19] | 4.84 [0.83–28.32] |
Variables | All (n = 21) | Stone-Crushers (n = 10) | Taxi-Drivers (n = 11) | p-Value |
---|---|---|---|---|
FVC (% predicted) | 98.5 ± 17.8 [68.0–127.0] | 105.4 ± 15.9 [81.0–127.0] | 92.2 ± 17.8 [68.0–125.0] | 0.048 |
FEV1 (% predicted) | 95.8 ± 18.7 [50.0–124.0] | 104.4 ± 13.7 [84.0–124.0] | 88.0 ± 19.6 [50.0–124.0] | 0.052 |
FEV1/FVC (%) | 84.2 ± 8.5 [58.4–96.6] | 86.5 ± 6.9 [73.6–96.6] | 82.2 ± 9.6 [58.4–94.4] | 0.31 |
PEF (% predicted) | 95.2 ± 22.2 [56.0–138.0] | 101.5 ± 21.1 [69.0–135.0] | 89.5 ± 22.46 [56.0–138.0] | 0.16 |
MEF25–75 (% predicted) | 71.3 ± 23.3 [15.0–123.0] | 81.0 ± 18.9 [55.0–123.0] | 62.5 ± 24.2 [15.0–94.0] | 0.16 |
MEF50 (% predicted) | 80.4 ± 25.6 [18.0–125.0] | 87.8 ± 18.1 [66.0–125.0] | 73.7 ± 30.2 [18.0–117.0] | 0.16 |
MEF25 (% predicted) | 66.8 ± 28.1 [7.0–108.0] | 79.1 ± 20.7 [51.0–108.0] | 55.7 ± 30.1 [7.0–102.0] | 0.078 |
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Kayembe-Kitenge, T.; Kabange Umba, I.; Musa Obadia, P.; Mbuyi-Musanzayi, S.; Nkulu Banza, P.; Katoto, P.D.M.C.; Katshiez Nawej, C.; Kalenga Ilunga, G.; Haufroid, V.; Banza Lubaba Nkulu, C.; et al. Respiratory Health and Urinary Trace Metals among Artisanal Stone-Crushers: A Cross-Sectional Study in Lubumbashi, DR Congo. Int. J. Environ. Res. Public Health 2020, 17, 9384. https://doi.org/10.3390/ijerph17249384
Kayembe-Kitenge T, Kabange Umba I, Musa Obadia P, Mbuyi-Musanzayi S, Nkulu Banza P, Katoto PDMC, Katshiez Nawej C, Kalenga Ilunga G, Haufroid V, Banza Lubaba Nkulu C, et al. Respiratory Health and Urinary Trace Metals among Artisanal Stone-Crushers: A Cross-Sectional Study in Lubumbashi, DR Congo. International Journal of Environmental Research and Public Health. 2020; 17(24):9384. https://doi.org/10.3390/ijerph17249384
Chicago/Turabian StyleKayembe-Kitenge, Tony, Irene Kabange Umba, Paul Musa Obadia, Sebastien Mbuyi-Musanzayi, Patient Nkulu Banza, Patrick D. M. C. Katoto, Cyrille Katshiez Nawej, Georges Kalenga Ilunga, Vincent Haufroid, Célestin Banza Lubaba Nkulu, and et al. 2020. "Respiratory Health and Urinary Trace Metals among Artisanal Stone-Crushers: A Cross-Sectional Study in Lubumbashi, DR Congo" International Journal of Environmental Research and Public Health 17, no. 24: 9384. https://doi.org/10.3390/ijerph17249384