Endothelial dysfunction in workers in underground mining of chrome ores

Introduction. Currently, endothelial dysfunction is considered as one of the initial stages of the pathogenesis of cardiovascular diseases. By isolating a number of biologically active compounds, the endothelium helps to maintain vascular tone and physiological rheology of the blood. Modern production of chrome ore is characterized by a variety of harmful occupational factors (chromium, dust, noise, vibration, severity and intensity of work, cooling microclimate), which can disrupt the normal functioning of the vascular endothelium and lead to the development of cardiovascular diseases.

The aim of the study was to study the features of endothelial function in workers engaged in underground mining of chrome ore in harmful working conditions.

Materials and methods. The study included 98 miners of the enterprise for the extraction of chrome ore. The comparison group (working in conditions outside the influence of the studied production factors) consisted of 75 employees-managers and specialists of administrative and managerial personnel of the enterprise, comparable in age and experience with the observation group. To assess the vasomotor function of the endothelium, a flow-dependent (endothelium-dependent) vasodilation test was performed using the D. S. Celermajer technique. Post-occlusive increase in brachial artery diameter, brachial artery sensitivity coefficient to endothelial shift change were evaluated.

Results. The endothelial function of mine workers did not differ significantly from the comparison group with work experience up to 10 years (the values of the relative increase in the diameter of the brachial artery 12.2% in the observation group and in the comparison group 12.6%, p=0.74). With experience of more than 10 years, the value of the relative increase in the diameter of the brachial artery in the observation group with experience of more than 10 years corresponded to the signs of endothelial dysfunction and amounted to 8.6%, while in the comparison group this figure was 12.4%, which corresponded to normal endothelial function (p=0.019). Endothelial function progressively deteriorated with increasing seniority in mine workers. 

Conclusions. For workers engaged in underground mining of chrome ore for more than 10 years, a reduced vasodilation reaction to reperfusion after an occlusion test and a low coefficient of sensitivity of the endothelium to shear stress are characteristic. There was no statistically significant decrease in increase in brachial artery diameter and the coefficient of sensitivity of endothelium to shear stress relative to the comparison group was selected only from persons with experience more than 10 years. The comparative analysis of the results of the evaluation of the functional activity of the endothelium in workers of the compared groups indicates that the change in the functional state of the endothelium in miners is associated not only with age, but also with working conditions. The revealed changes predispose to the development of cardiovascular pathology associated with atherosclerosis in workers of underground chrome ore mining.

1. 2018ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension and of the European Society оf Cardiology. European Heart Journal. 2018; 39: 3021–3104. DOI:10.1093/eurheartj/ehy339.

2. Shljahto E.V. Cardiology. National leadership (short edition). Moscow: GEOTAR-Media; 2019 (in Russian).

3. Omel’janenko M.G. Endothelial dysfunction and coronary heart disease in young and middle-aged women. М.; 2008 (in Russian).

4. Barac A., Campia U. Methods for Evaluating Endothelial Function in Humans. Hypertension. 2007; 49: 748–60. DOI: 10.1161/01.hyp.0000259601.38807.a6.

5. Douglas L. Mann, Douglas P. Zipes, Peter Libby, Robert O. Bonow, Eugene Braunwald., eds. Braunwald’s heart disease: a textbook of cardiovascular medicine. 10th edition; 2015.

6. Vidale S., Campana C. Ambient air pollution and cardiovascular diseases: from bench to bedside. European Journal of preventive cardiology. 2018; 25: 818–25. DOI: 10.1177/2047487318766638.

7. Bojcov S.A., Pogosova N.V., Bubnova M.G., Drapkina O.M., Gavrilova N.E., Eganjan R.A. et al. Cardiovascular Prophylaxis 2017. Russian national recommendations. Rossijskij kardiologicheskij zhurnal. 2018; 23 (6): 7–122. DOI: 1015829/560-40712018-6-7-122 (in Russian).

8. Sanidas E, Papadopoulos DP, Grassos H, Velliou M, Tsioufis K, Barbetseas J, Papademetriou V. Air pollution and arterial hypertension. A new risk factor is in the air. J Am Soc Hypertens. 2017; 11: 709–15. DOI: 10.1016/j.jash.2017.09.008.

9. Chin MT. Basic mechanisms for adverse cardiovascular events associated with air pollution. Heart. 2015 101(4): 253–6. DOI: 10.1136/heartjnl-2014-306379.

10. Bourdrel T, Bind MA, Béjot Y, Morel O, Argacha JF. Cardiovascular effects of air pollution. Arch. Cardiovasc. Dis. 2017; 110(11): 634–42. DOI: 10.1016/j.acvd.2017.05.003.

11. Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID, Lloyd JK, Deanfield JE. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet. 1992; 340(8828): 1111–5. DOI: 10.1016/0140-6736(92)93147-F.

12. Wilker EH, Ljungman PL, Rice MB, Kloog I, Schwartz J, Gold DR, Koutrakis P, Vita JA, Mitchell GF, Vasan RS, Benjamin EJ, Hamburg NM, Mittleman MA. Relation of long-term exposure to air pollution to brachial artery flow-mediated dilation and reactive hyperemia. American Journal of Cardiology. 2014; 113(12): 2057–63. DOI: 10.1016/j.amjcard.2014.03.048.

13. Ivanova O.V.Rogoza A.N., Balakhonova T.V., Soboleva G.N., Atkov O.Yu., Karpov Yu.A. Sensitivity of endothelium of the brachial artery to shear stress-method to evaluate endothelial function in patients with hypertension. Kardiologiya. 1998; 3: 37–41 (in Russian).

14. Cohen AJ, Brauer M, Burnett R. Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015. Lancet. 2017; 389: 1907–18. DOI: 10.1016/S0140-6736(17)30505-6.

15. Brook R.D., Franklin B., Cascio W., Hong Y., Howard G., Lipsett M., Luepker R., Mittleman M., Samet J., Smith S.C. Jr., Tager I. Air Pollution and Cardiovascular Disease: A Statement for Healthcare Professionals From the Expert Panel on Population and Prevention Science of the American Heart Association. Circulation. 2004; 109: 2655–71. DOI: 10.1161/01.CIR.0000128587.30041.C8.

16. Bhatnagar А. Environmental cardiology: studying mechanistic links between pollution and heart disease. Circulation research. 2006; 99: 692–705. DOI: 10.1161/01.RES. 0000243586.99701.cf.