Comparison of pulmonary functions in petrol pump workers and residents of oil refinery

Satyanath Reddy Kodidala; Ali Mohamad Ahanger; Asha Gandhi

doi:10.4103/INJMS.INJMS_80_20

ORIGINAL ARTICLE

Year : 2020 | Volume : 11 | Issue : 4 | Page : 197-200

Comparison of pulmonary functions in petrol pump workers and residents of oil refinery

Satyanath Reddy Kodidala, Ali Mohamad Ahanger, Asha Gandhi
Department of Physiology, Faculty of Medical and Health Sciences, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana, India

Date of Submission	09-Jul-2020
Date of Decision	27-Aug-2020
Date of Acceptance	08-Sep-2020
Date of Web Publication	12-Oct-2020

Correspondence Address:
Dr. Satyanath Reddy Kodidala
Department of Physiology, Faculty of Medical and Health Sciences, Shree Guru Gobind Singh Tricentenary University, Budhera, Gurugram - 122 505, Delhi-NCR, Haryana
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/INJMS.INJMS_80_20

Abstract

Background: Health of human beings depends on their environment. Petrol pump workers (PPWs) are exposed to petrol/diesel fumes containing toxic compounds, which may affect the capability of lungs. Similarly, residents living around the oil refinery are exposed to pollutants, which may have deleterious effects on pulmonary health. Objectives: The study aimed to assess pulmonary function tests (PFTs) in residents living near an oil refinery and PPWs and compared with the control group. Materials and Methods: The study group (age: 20–45 years) comprised PPWs in Mathura district generally exposed to petrol fumes as well as dust particles and residents living within 5 km of Mathura oil refinery. Control group comprised unexposed staff residing in the campus. PFT values were recorded and compared in the three groups. Results: Lowering of mean PFT values in residents and PPWs was observed. Forced vital capacity (FVC) (L), forced expiratory volume in 1 s (FEV1) (L), FEV1/FVC, and peak expiratory flow rate (L/s) were, respectively, 3.37, 2.93, 87.25, and 8.44 in control group (C); 3.09, 2.61, 85.2, and 7.94 in PPW and 3.0, 2.58, 86.0, and 7.94 in residents (R). Maximum ventilatory volume and forced expiratory flow rate 25–75% were also reduced in the latter groups. Conclusion: Acute exposure to a polluted environment results in an alteration of pulmonary functions.

Keywords: Petrol pump workers and residents, pulmonary function tests, oil refinery pollution

How to cite this article:
Kodidala SR, Ahanger AM, Gandhi A. Comparison of pulmonary functions in petrol pump workers and residents of oil refinery. Indian J Med Spec 2020;11:197-200

How to cite this URL:
Kodidala SR, Ahanger AM, Gandhi A. Comparison of pulmonary functions in petrol pump workers and residents of oil refinery. Indian J Med Spec [serial online] 2020 [cited 2023 Jun 9];11:197-200. Available from: http://www.ijms.in/text.asp?2020/11/4/197/297947

Introduction

With quick urbanization and rapid industrial growth, poor environmental conditions are the leading cause of health-related issues. In Asian countries, air pollution has been alarmingly high because of rapid development occurring in the last decade.^[1] Oil refineries majorly pollute air, water, and land in nearby areas. Petrol/diesel vapors are released into the atmosphere at petrol pumps, which also affects the lung functions of petrol pump workers (PPWs) on inhalation. There is a demand for petrol/diesel due to fast urbanization and a tremendous rise in several automobile vehicles, which has resulted in more production of the gaseous fuels (gasoline) from crude oil in an oil refinery plant.

Gasoline is volatile in nature, a complex combination of aliphatic and aromatic hydrocarbons with vital constituents such as benzene, toluene, ethylbenzene, and xylene (B-TEX), which are most hazardous for human health. Particularly, benzene is classified as a carcinogen by the International Agency for Research on Cancer and the United States Environmental Protection Agency.^[2] Simultaneously, in an assessment of volatile organic compounds (VOCs) and B-TEX at the petrol pumps in Mathura-Agra, VOCs concentration was higher than standards laid by the Indian National Ambient Air Quality Standards.^[3] PPWs come in contact with these B-TEX compounds mainly through inhalation and dermal contacts. Petroleum products cause significant health problems such as breathlessness and wheezing by inflammatory responses.^[4] To reduce the occupational workplace exposure to these compounds, various international organizations such as the Occupational Safety and Health Administration, the National Institute for Occupational Safety and Health, European Union, and the World Health Organization (WHO) have laid their standards and guidelines in the form of occupational exposure limits and air quality guidance values for exposure to benzene, toluene, and xylene.^[5] In India, the Central Pollution Control Board in 2009 also revised and established the annual ambient air quality standard concentration of benzene to be 5 μg/m.^[6] The primary pollutants emitted by the refineries are VOCs, particulate matter, and greenhouse gases, found in the ambient air near to the petrochemical sites.^[7] Crude oil contains relatively high quantities of sulfur on heating, while refining converts into sulfur dioxide gas (SO₂). Exposure to very high concentrations of SO₂ can result in painful irritation of the eyes, nose, and throat and difficulty in breathing, nausea, vomiting, headaches, and even death. On daily exposure, it causes narrowing of air passages, resulting in lung diseases and provokes asthma attacks. Communities within 5 km of the refinery have much higher exposure than other areas.^[8],[9] The aim of the study was a comparison of pulmonary functions in PPWs and residents living around the refinery.

Materials and Methods

The present cross-sectional study was conducted in the department of physiology. After taking the ethical committee approval for clearance, the study was conducted on three groups, as mentioned in [Table 1]. The study group comprised 25 healthy nonsmoker male PPWs, working from 6 months in the age group of 20–45 years and fifty healthy nonsmoker male residents in the age group of 20–45 years living near Mathura oil refinery, from villages situated within 5 km of an oil refinery in reference to a study.^[10] The study group was compared with fifty unexposed healthy male staff residing within the college campus, which served as a control group. Informed consent was obtained from all participants; they were asked about the history of complaints, occupational exposure, personal history and health habits, surgical history, and any use of protective masks. Participants having a chronic or acute illness, smokers, history of major surgeries (either cardiothoracic or abdominal), or taking any drugs that affect the respiratory system were excluded from the study. Age (years), height (cm), and weight (kg) were recorded for all the participants. A standard proforma was used to record the details of participants including anthropometric parameters, duration of exposure, and pulmonary function tests (PFTs).

Table 1: Anthropometric parameters of all groups (mean±standard deviation)

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Pulmonary function tests

All parameters such as forced vital capacity (FVC) in liters, forced expiratory volume in 1 s (FEV₁), FEV1/FVC, maximum ventilatory volume (MVV), peak expiratory flow rate (PEFR), forced expiratory flow rate 25–75% (FEF_25%-75%), FEV in 3 s (FEV₃), FEV₃/FVC, and FEV in 6 s (FEV₆) were recorded using a RMS Helios electronic spirometer version 1.0.13 made by RMS company. The criteria for spirometry laid by the American Thoracic Society/European Respiratory Society^[11] were followed strictly. All participants were made familiar with the instrument and procedure. At first, the participant was made to sit and relax for 10 min; meanwhile, all the basic data and details were entered on the computer. All the PFTs were recorded in sitting position, and three recordings were made.

Forced vital capacity

By putting a nose clip to participant, then mouthpiece was cleaned and kept into mouth and asked to hold tightly with lips closed. Then, participant was asked to perform a procedure by taking deep maximal inspiration and exhale as rapidly and as completely as possible into mouthpiece. Parameters recorded in this maneuver were FVC, FEV₁, FEV1/FVC%, PEFR, FEV_3, and FEV₆.

Maximum ventilatory volume

Participant asked to take a deep breath as rapidly as possible continuously for 15 s. Graphs and flow-volume loops were obtained. A maximum of five attempts was made, but if the participants were not able to perform the accepted procedure within this, they were discontinued for that session.

Statistical analysis

Mean and standard deviation were calculated using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, Illinois, USA, version 25.0). The readings were compared using one-way ANOVA; P < 0.05 was considered statistically significant.

Results

The mean age, height, and weight of all groups are shown in [Table 1] and were comparable in the three groups. The comparison of various parameters of PFTs in the study groups and controls is shown in [Table 2]. PFT parameters were found to be significantly decreased in PPWs and residents as compared to controls.

Table 2: Comparison of pulmonary function tests between control group, petrol pump workers, and residents around refinery

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Discussion

In the present research work, PFTs such as FVC (L), FEV1 (L), FEV1/FVC%, PEFR (L/s), MVV (L/min), FEF_25%–75%(L/s), FEV₃(L), FEV₃/FVC%, and FEV6 (L) were recorded and also compared between groups. We observed that on exposure of 6 months to the polluted environment; the mean values of all parameters were altered in PPWs and also in people residing near an oil refinery, when compared to controls. The study results prove that pulmonary functions can be altered in as early as 6-month exposure and might progress when increased exposure is there.^[12] Lungs are the only organs in our body located internally and continuously exposed to the outer environment. In a survey conducted in 2015 by the Centre for Science and Environment (CSE), New Delhi, it was reported that 80% of cities in India exceeded the PM10 (pollutants that emit particulate matter < 10 μm in size), 90 cities have critical, and 26 cities have very critical PM10. CSE, New Delhi again conducted a survey in 2017, which showed that India has the second highest number of early deaths due to PM2.5 nearly, equaling to China in the world.^[13] Thus, any dust particles/gases which pollute air environment can likely affect the function of particular subjects living or working in the same environment.

The present study demonstrates that, on the exposure of 6 months to solvents, the lowering of pulmonary functions starts along with lung diseases. Going in detail, it is a known fact that PPWs are exposed to volatile petrol fumes which contain benzene. Benzene toxicity can lead to a systemic pulmonary inflammatory response in healthy human volunteers. Benzene present in petrol fumes can be absorbed into lungs by inhalation, benzene content in petrol at 1%–5% of range can exaggerate the derangements in lung functions in PPWs.^[14],[15] Furthermore, the present results were in agreement with reports of other various studies done in PPWs and the general population of Jammu, Delhi, Karnataka, and Chennai.^{[16],[17],[18],[19]} FEF_25%–75% is a good indicator of small airway function measuring 2 mm in diameter. FEF_25%–75% was found to be lower in the two study groups, when compared to controls. Particulate matter emitted from refinery carry toxic chemicals to deeper parts and on chronic exposure leads to inflammation of respiratory tract and parenchyma.^[20] These findings indicate better lung functions in the control group when compared to the study group as this group was less exposed to vapors and gases.

Refinery operations are associated with a wide variety of emission into the atmosphere consisting VOC and particulate matters. Some studies concluded decrement in lung functions in persons who live near industrial complexes. Pulmonary functions in residents living around the refinery were decreased in our findings, which is also reported by other studies.^{[10],[21],[22]} The WHO recently estimated that 35% of respiratory diseases could be attributable due to the environment and proposed interventions in industrial, commercial, transport, and housing/community sectors to decrease population exposures to air pollution.^[23] Reduced FVC is associated with particulate matter of size between 2.5 μm and 10 μm as they remain airborne for long period and get deposited in small airway of lungs. Residents are most affected as they live around oil refinery because refineries emit pollutants and contaminate with such small dust particles while refining crude oil.^[24]

Epidemiological studies have shown that living in the close proximity of an industrial refinery complex, in general, is associated with an increase in acute irritative symptoms of the respiratory tract and eyes and asthma.^[10],[22] Impaired lung function characterized by reduced FEV₁ is a powerful marker of future morbidity and mortality.^[25] Excess risk of respiratory diseases is found in residents living in close proximity to oil refineries which corroborates with the findings of our study.^[26]

Studies conducted among residents living nearby large petrochemical industrial complexes and oil refineries found an association between acute respiratory problems when the place of residence is closer (>5 km) to the refinery complex.^[9],[12] This may be attributable to the reduced pulmonary functions occurring as early as 6 months, as observed in our study.

Conclusion

We conclude that pulmonary functions start altering when exposed to a polluted environment after as early as 6 months of exposure duration. Although the clinical implication in the form of future onset of respiratory illnesses and the timelines of developing such illnesses cannot be deduced by the present study, further follow-up studies or cohort studies (with larger sample sizes) can indicate at what time point it may be prudent to advise persons to change their occupation or place of residence, to avoid continued exposure. Further, the present study cannot elucidate if the reduction of pulmonary functions observed at 6 months is transient, reversible or persistent, and progressive.

Financial support and sponsorship

None.

Conflicts of interest

There are no conflicts of interest.

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