Pulmonary function and serum pneumoproteins in professional ski waxers

Context: Professional ski waxers are exposed to particulate matter (PM) during work, but little is known about untoward pulmonary effects. Objectives: The aim was to study lung function and pneumoproteins in professional ski waxers before and during exposure to PM generated during ski waxing and ski preparation. Material and methods: Forty-five male professional ski waxers examined on an exposure-free day in the morning and at least 6 h later were re-examined during ski waxing 2 d later in a cross-shift study. Pulmonary function and gas diffusion capacity were measured and Clara cell protein 16 (CC-16), surfactant protein A and D (SP-A and SP-D), and C-reactive protein (CRP) were determined in serum. PM was collected by personal sampling. Results: The mean PM concentrations in the respirable and in the inhalable aerosol fraction in air samples collected during waxing were 3.1 mg/m3 and 6.2 mg/m3, respectively. The mid expiratory flow (MEF75%) was significantly lower during exposure. The concentrations of CRP increased significantly by more than 100% during ski waxing, and SP-D and CC-16 were significantly lower during the exposed day as compared with the non-exposed day. The results further suggest that SP-D and CC-16 in serum are affected by diurnal variations. No significant alterations were observed for the lung diffusion capacity. Discussion and conclusions: The results suggest that exposure to PM generated during ski waxing may induce pulmonary inflammation with reduced flow in small airways. The increased CRP concentrations indicate the induction of systemic inflammation in ski waxers during exposure.