Reactive hyperemia and baseline pulse amplitude among smelter workers exposed to fine and ultrafine particles

Int Arch Occup Environ Health. 2020 Apr;93(3):399-407. doi: 10.1007/s00420-019-01491-8. Epub 2019 Nov 26.


Objective: Ambient exposure to fine particles is associated with increased cardiovascular morbidity and mortality. Associations between occupational particulate matter (PM) exposure and cardiovascular disease have been studied less. The objective of this study was to examine associations between PM exposure and endothelial function among workers in Norwegian smelters.

Methods: We examined endothelial function with Endo-PAT equipment after a working day (WD) and on a day off (DO) in 59 furnace workers recruited from three metal smelters in Norway. The difference in baseline pulse amplitude (BPA) and reactive hyperemia index (RHI) between the 2 days was analysed in relation to individual exposure to PM < 250 nm (PM250) or the respirable aerosol fraction of particles, and adjusted for relevant covariates.

Results: The exposure to PM250 ranged from 0.004 to 5.7 mg/m3. The mean BPA was significantly higher on WD relative to DO (772 vs. 535, p = 0.001). This difference was associated with PM concentrations among participants ≥ 34 years, but not among the younger workers. Reactive hyperemia was significantly lower on workdays relative to days off (1.70 vs. 1.84, p = 0.05). This difference was observed only among participants above the age 34. No associations with PM exposure were observed.

Conclusions: PM exposure was associated with higher BPA among participants older than 34 years. BPA reflects microvessel pulsatility. Our results may indicate an age-dependent cardiovascular susceptibility to PM exposure. Endothelial function measured by RHI was reduced on WD among participants 34 years and older, but we found no associations between PM exposure and RHI.

Keywords: CVD; Cardiovascular disease; Endo-PAT2000®; Endothelial function; Metal smelters; Ultrafine particles.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Distribution
  • Air Pollutants, Occupational / adverse effects*
  • Air Pollutants, Occupational / analysis
  • Air Pollution / adverse effects
  • Environmental Monitoring / methods
  • Humans
  • Hyperemia / chemically induced*
  • Hyperemia / epidemiology*
  • Industry
  • Manganese / adverse effects*
  • Manganese / analysis
  • Middle Aged
  • Norway / epidemiology
  • Occupational Exposure / adverse effects*
  • Occupational Exposure / analysis
  • Particle Size
  • Particulate Matter / adverse effects
  • Particulate Matter / analysis
  • Pulse
  • Silicon / adverse effects*
  • Silicon / analysis


  • Air Pollutants, Occupational
  • Particulate Matter
  • Manganese
  • Silicon