https://doi.org/10.33573/ujoh2025.01.31
Separate subdivision Scientific and Practical Medical Centre of Occupational Health of Shupyk National Healthcare University of Ukraine, Kryvyi Rih, Ukraine
Full article (PDF), UKR
Introduction.
Occupational exposure to industrial pollutants is a major cause of lung diseases, with pneumoconiosis being one of the most prevalent. Early diagnostic measures remain uncertain, and rapid disease progression often leads to severe complications, resulting in significant socio-economic burdens. Systemic and local inflammatory processes play a crucial role in pneumoconiosis, particularly when combined with chronic obstructive pulmonary disease (COPD). Identifying accessible and informative laboratory markers in peripheral blood could improve risk assessment and prevention strategies.
Objective. To evaluate the significance of general clinical laboratory parameters in predicting pneumoconiosis risk among mining and metallurgical industry workers with COPD, with the goal of informing preventive measures. Materials and Methods. A total of 98 mining and metallurgical workers diagnosed with pneumoconiosis and COPD were examined. Key hematological parameters were assessed, including erythrocytes, hemoglobin levels, leukocyte subpopulations (myelocytes, metamyelocytes, neutrophils, eosinophils, basophils, monocytes, lymphocytes), erythrocyte sedimentation rate (ESR), and a range of leukocyte intoxication and inflammation indices. Significant risk indicators were determined, including critical values, sensitivity, specificity, false positive/negative associations, predictive values, and Kappa statistics.
Results and Discussion.
Among mining and metallurgical industry workers diagnosed with pneumoconiosis and COPD, the following laboratory indicators demonstrated the greatest diagnostic value: rod-shaped leukocyte content exceeding 3.3%; inflammation and intoxication indices, including leukocyte-to-ESR ratio >2.7, leukocyte-to-ESR ratio >6.0, neutrophil-to-ESR ratio >6.5, unsegmented neutrophil-to-ESR ratio >3.7, Total activity index >16.2. These indicators strongly influenced the probabilistic characteristics of disease progression. Notably, rod-shaped leukocyte content demonstrated the highest negative predictive value (0.86), indicating a strong association with disease absence when below the threshold. Meanwhile, inflammation and intoxication indices, particularly leukocyte-to-ESR and neutrophil-to-ESR ratios (0.45–0.46 positive predictive values), were highly indicative of disease presence. Furthermore, Kappa statistical analysis (0.1) confirmed that inflammation and intoxication indices – leukocyte-to-ESR ratio and neutrophil-to-ESR ratio – were the strongest predictors of combined pneumoconiosis and COPD risk. These findings highlight the significance of hematological markers in assessing disease probability and progression.
Conclusion. Key laboratory markers, including leukocyte and neutrophil indices, provide critical insight into pneumoconiosis risk among COPD-affected workers. These findings support the development of targeted early diagnostic and preventive strategies for at-risk industrial workers.
Keywords: occupational health, pneumoconiosis, COPD, laboratory markers, inflammation indices, mining workers, disease risk assessment.
REFERENCES
1. Barnes H, Goh NSL, Leong TL, Hoy R. Silica-associated lung disease: An old-world exposure in modern industries. Respirology. 2019;24(12):1165-75. DOI: https://doi.org/10.1111/resp.13695
2. Pavlichenko OF. [Peculiarities of occupational morbidity among employees of enterprises of the modern mining industry of Ukraine]. Ukrainian journal of occupational health. 2023;19(1):21-5. Ukrainian. DOI: https://doi.org/10.33573/ujoh2023.01.021
3. Blanc PD, Annesi-Maesano I, Balmes JR, et al. The occupational burden of nonmalignant respiratory diseases. An official American thoracic society and European respiratory society statement. Am J Res Crit Care Med. 2019;199(11):1312-34. DOI: https://doi.org/10.1164/rccm.201904-0717ST.
4. Kurth L, Casey ML, Mazurek JM, Blackley DJ. Pneumoconiosis incidence and prevalence among US Medicare beneficiaries, 1999-2019. Am J Ind Med. 2023 Oct;66(10):831-41. DOI: https://doi.org/10.1002/ajim.23519
5. De Matteis S, Heederik D, Burdorf A, Colosio C, Cullinan P, Henneberger PK, et al. Current and new challenges in occupational lung diseases. Eur Respir Rev. 2017;26:170080. DOI: https://doi.org/10.1183/16000617.0080-2017
6. Hoy RF, Jeebhay MF, Cavalin C, Chen W, Cohen RA, Firemanet E, et al. Current global perspectives on silicosis - Convergence of old and newly emergent hazards. Respirology. 2022;27(6):387-98. DOI: https://doi.org/10.1111/resp.14242
7. Vlasova NV, Karamova LM., Rafykova LA, Hyzatullyna LH, Abdrakhmanova ER, Borysova AY. [Informative laboratory biomarkers for diagnostics of respiratory diseases of professional etiology in modern conditions]. Occupational medicine and industrial ecology. 2022;62(12):828-833. Russian. DOI: https://doi.org/10.31089/1026-9428-2022-62-12-828-833
8. Luo Z, Zhang W, Chen L, Xu N. Prognostic value of neutrophil: lymphocyte and platelet: Lymphocyte ratios for 28-day mortality of patients with
AECOPD. Int. J. Gen. Med. 2021;14:2839-2848. DOI: https://doi.org/10.2147 /IJGM. S312045
9. Stockley RA, Halpin DMG, Celli BR, Singh D. Chronic obstructive pulmonary disease biomarkers and their interpretation. Am J Respir Crit Care Med. 2019;199(10):1195-1204. DOI: https://doi.org/10.1164/rccm.201810-1860SO
10. Kang HY, Cao SY, Shao S, Liang LR, Tong ZH. The systemic immune-inflammation index is significantly associated with the severity of silicosis: a 9-year
retrospective study in Beijing. Front Med (Lausanne). 2024 Feb 7;11:1351589. DOI: https://doi.org/10.3389/fmed.2024.1351589
11. Sharavara LP, Dmytrukha NM, Andrusyshyna IM. [Professional risk factors in the labour process of employees of a metallurgical enterprise]. Ukrainian journal of occupational health. 2023;19(4):277-284. Ukrainian. DOI: https://doi.org/10.33573/ujoh2023.04.277
12. Su X, Kong X, Yu X, Zhang X. Incidence and influencing factors of occupational pneumoconiosis: a systematic review and meta-analysis. BMJ Open. 2023 Mar 1;13(3):e065114. DOI: https://doi.org/10.1136/bmjopen-2022-065114
13. Pega F, Norris SL, Backes C, et al. RoB-SPEO: a tool for assessing risk of bias in studies estimating the prevalence of exposure to occupational risk factors from the who/llo burden of disease and injury. Environ Int. 2020;135:105039. https://doi.org/10.1016/j.envint.2019.105039
14. De Matteis S, Jarvis D, Hutchings S, et al. Occupations associated with COPD risk in the large population-based UK Biobank cohort study. Occup Environ
Med. 2016;73:378-84. DOI: https://doi.org/10.1136/oemed-2015-103406
15. Beer C, Kolstad HA, Søndergaard K, Bendstrup E, Heederik D, Olsen KE, et al. A systematic review of occupational exposure to coal dust and the risk of interstitial lung diseases. Eur. Clin. Respir. J. 2017;4:1264711. DOI: https://doi.org/10.1136/oemed-2015-103406
16. Pavord ID, Lettis S, Anzueto A, Barnes N. Blood eosinophil count and pneumonia risk in patients with chronic obstructive pulmonary disease: a patient- level meta-analysis. Lancet Respir. Med. 2016;4(9):731-741. DOI: https://doi.org/10.1016/S2213-2600 (16)30148-5.
17. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Pocket guide to COPD diagnosis, management and prevention [Internet]. 2023[cited 2023 Mar 24]. Available from: https://goldcopd.org
18. Guidelines for the use of the ILO International Classification of Radiographs of Pneumoconiosis. Revised edition 2011. Geneva: International Labour Office,
2011. 54 p. Available from: https://www.ilo.org/publications/guidelines-use-ilo-international-classification-radiographs-pneumoconioses-0
19. [Guidelines for assessment of occupational risk for workers' health. Organizational and methodological foundations, principles and evaluation criteria. Guidance: P 2.2. 1766-03]. Moscow: MZ rf, 2003. 24 p. Russian.