2005), and a lower SP-A was found among asthmatic workers (Widmeier et al. 2007). However, no associations between the exposure measurements

and surfactant proteins were reported (Steiner et al. 2005; Widmeier et al. 2007; Tabrizi et al. 2010; Thiazovivin manufacturer Tchopp et al. 2011). The purpose of this study was to examine the serum levels of the pneumoproteins CC16, SP-A, and SP-D among sewage workers and to study the associations between the exposure levels and the pneumoprotein concentrations. Materials and methods Subjects All exposed workers employed in eight municipal sewage treatment plants were invited to participate in the study (n = 44). Nineteen of the exposed workers were recruited from plants where BAY 80-6946 sludge was dried in separate sludge driers, while 25 were recruited from plants with chemical and mechanical sewage treatment without sludge drying. The referents were office workers (n = 38) from compost (n = 28) and sewage treatment plants (n = 10). All invited exposed workers and referents participated in the study. Information on smoking habits was obtained from a general questionnaire. The subjects were classified as current or former smokers. Former smokers were defined as having stopped smoking more than 12 months earlier. Atopy was defined as positive reaction to at least one of nine common respiratory allergens (birch, timothy, wormwood, mold

spores, cat, dog, horse, rabbit, mites) tested by a Phadiatop test (FEIA, UniCap system, Fürst Laboratory, Norway). Background variables of the participants are shown in Table 1. Table 1 Characteristics of the population   Referents Selleck Anlotinib (N = 38) Sewage workers (N = 44) Age, AM (SD) 43 (19) 40 (11) Men (%) 74 96 Atopy (%) 26 18 Current smokers (%) 16* 36 Amount of current smoking, cigarette/day, AM (SD) 2 (5) 4 (6) Tobacco consumption, packyears, AM (SD) 2.3 (7) 3.9 (7) AM arithmetic means, SD standard deviations * p < 0.05 The study was approved by the Regional Medical Ethics Board. All participants were informed about the purpose of the study and

gave their GNAT2 written informed consent. Exposure assessment The sewage drying process at the plants has been described in detail previously (Heldal et al. 2010). All work operations at the sewage plants were performed indoors. The exposure was assessed by parallel sampling using two inhalable PAS 6 cassettes (Van der Wal 1983), mounted in the breathing zone of each worker. The cassettes were connected to two pumps (PS101) operated at a flow of 2.0 l/min. The sampling time was approximately 4 h. All together 44 air measurements were collected. Aerosols for the determination of dust particles and bacteria were collected on polycarbonate filters with pore size 0.8 μm (Poretics, Osmonics, Livermore, USA), while endotoxins were collected on glass fiber filters (Whatman GF/A, Maidstone, USA). Dust mass concentrations were determined gravimetrically in a climate-controlled weighing room.