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Health effects for the population living near a cement plant:
An epidemiological assessment
Martina Bertoldi
, Alessandro Borgini
, Andrea Tittarelli
, Elena Fattore
, Alessandro Cau
Roberto Fanelli
, Paolo Crosignani
Environmental Epidemiology and Cancer Registry Unit, National Cancer Institute, Via G. Venezian 1, 20133 Milano, Italy
Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Via G. La Masa 19, 20154 Milano, Italy
abstractarticle info
Article history:
Received 20 January 2011
Accepted 23 December 2011
Available online 14 January 2012
Cement plant
Health effects
Air pollution
Nitrogen oxides
Epidemiological studies have shown the association between the exposure to air pollution and several ad-
verse health effects. To evaluate the possible acute health effects of air pollution due to the emissions of a ce-
ment plant in two small municipalities in Italy (Mazzano and Rezzato), a casecontrol study design was used.
The risks of hospital admission for cardiovascular or respiratory diseases for increasing levels of exposure to
cement plant emissions were estimated, separately for adults (age >34 years) and children (014 years).
Odds ratios (OR) were estimated using unconditional regression models. Attributable risks were also calcu-
Statistically signicant risks were found mainly for respiratory diseases among children: OR 1.67 (95% CI
1.082.58)for the moderately exposedcategory (E1), OR 1.88 (95% CI 1.192.97) for the highlyexposed category
(E2), with an attributable riskof 38% of hospital admissions dueto the exposure to cement plant exhausts. Adults
had a weaker risk: OR 1.38 (95% CI 1.181.61) for group E1, OR 1.31 (95% CI 1.101.56) for group E2; the
attributable risk was 23%. Risks were higher for females and for the age group 3564. These results showed
an association between the exposure to plant emissions and the risk of hospital admission for cardiovascu-
lar or respiratory causes; this association was particularly strong for children.
© 2011 Elsevier Ltd. All rights reserved.
1. Introduction
A cement plant can be an important source of air pollutants. Few
studies have focused on the health effects attributable to the emis-
sions of a cement plant on the population living in the proximity
(Rovira et al., 2010; Schuhmacher et al., 2004), some of them investi-
gating different outcomes, such as respiratory symptoms (Legator et
al., 1998), preterm delivery (Yang et al., 2003) or psychasthenia
(Brockhaus et al., 1981). Occupational studies have focused only on
cement plant workers (Al-Neaimi et al., 2001; Alvear-Galindo et al.,
1999) and other studies analysed the chemicals in soil (Asubiojo et
al., 1991; Schuhmacher et al., 2002) or their impact on air quality
(Kabir and Madugu, 2010).
The local authorities of two small municipalities (Mazzano and
Rezzato, Brescia province, Lombardy region, Northern Italy) asked
the authors of this paper to evaluate the health impact on people living
in the area surrounding a cementplant. The area is highly industrialized
and densely populated and local authorities are more and more in-
volved in decisions whose fallout can have consequences on population
health conditions.
We carried out a risk assessment of the acute health effects due to
the emissions of the cement plant on the population of the two mu-
nicipalities adopting a casecontrol study design. The evaluation of
the health effects was carried out choosing nitrogen oxides (NO
a proxy for cement plant emissions (Canpolat et al., 2002; Ekinci et
al., 1998).
We used a Geographic Information System (GIS) to attribute the
exposure to air pollution for all the subjects analysed. As health out-
comes we considered all hospital admissions for respiratory or car-
diovascular causes for residents in the two municipalities.
2. Materials and methods
2.1. Study base
The population considered included all the residents of the munic-
ipalities of Mazzano and Rezzato in the years between 2002 and 2005,
inclusive: 22,721 people per year on average, 9997 resident in Maz-
zano and 12,724 in Rezzato (Italian National Statistical Institute,
ISTAT data on 31 December 2003).
As cases, we considered all hospital admissions of Mazzano or
Rezzato residents between January 1st 2002 and December 31st,
2005. These data were provided by the Brescia Local Health Unit
(ASL). The hospital admissions of interest for this study were selected
Environment International 41 (2012) 17
Corresponding author. Tel.: +39 02 23903540; fax: + 39 02 23902762.
E-mail address: (M. Bertoldi).
0160-4120/$ see front matter © 2011 Elsevier Ltd. All rights reserved.
Contents lists available at SciVerse ScienceDirect
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using the ICD-IX code of the principal diagnosis of discharge. Diagno-
ses of interest were chosen on the basis of evidence in the literature
indicating a signicant association between exposure to air pollutants
and some acute cardiovascular (Ballester et al., 2001; Poloniecki et al.,
1997) and respiratory diseases (Prescott et al., 1998; Wong et al.,
1999). People from 15 to 34 years were excluded from the analysis
because of the small number of hospital admissions. Tables 1 and 2
list the diagnostic codes considered for adults (age from 35 years
on) and for children (younger up to 14 years).
The unit of observation considered was the single hospital admis-
sion, not the person: all admissions were taken as single cases even if
referring to the same patient. Thus some subjects will have been
counted as cases more than once, if they had multiple admissions.
Controls were randomly sampled from the total population of the
two municipalities, extracted from the Lombardy Region Health Ser-
vice archives, excluding all the subjects already included as cases,
proportioning without individual matching for sex and age. For age
classes with more hospital admissions (65 years and over) two con-
trols were extracted for each case, while for age classes with fewer
hospital admissions (children and adults between 35 and 64 years)
four controls were taken for each case, to boost the power of the sta-
tistical analysis.
The same methods were applied to trauma and injuries (3-digit
ICD-IX codes from 800 to 959, considering the principal diagnosis of
discharge), a group of pathologies potentially not related with air
2.2. Air pollution data
Air concentrations of cement plant emissions were estimated by
Consulenze Ambientali s.p.a (
bin/les/indaginearia.pdf), both by modelling emissions and by direct
measuring. Pollutants were measured using mobile stations placed in
four different areas (two in each municipality) during two 20-day cam-
paigns, one in summer (September 2006) and one in winter (January
In this study we focused on NO
, because the comparison between
cement plant emissions modelling and direct measures showed that
the contribution of the cement plant was particularly signicant for
2.3. Geocoding
The address of residence (municipality, street and number) of all
the subjects included in the study was retrieved through the Lombar-
dy Region Health Service archives.
From the addresses we obtained the geographical coordinates
(latitude and longitude) for almost all the subjects.
Then, using the ArcGis 9.2 software package, we created a layer
displaying the geographical distribution of subjects (cases and
2.4. Estimated exposure
To estimate the average exposure to NO
for each person we used
the iso-concentration maps of the pollutants for the winter measure-
ment campaign. NO
distribution in the considered area was over a
wider range during the winter (from 81 μg/m
to 207 μg/m
). Although
winter concentrations are not representative of annual average con-
centrations because they are generally higher, the exposure distribu-
tion may give a picture of individual exposure differences for the
whole year.
In the study area there were no security zoneswhere exposure
was low, the minimum winter NO
concentration being 81 μg/m
However, it was possibleto distinguish areaswith higher levels of expo-
sure and areas with lower levels. The health risk estimates were based
on these differences. Fig. 1 shows a map of the iso-concentrations of
in the winter campaign.
Using the ArcGis desktop software we created a two layer map in
which we displayed NO
concentrations and subjects (cases and con-
trols). Using the spatial join technique we assigned an exposure value
for each subject depending on the location. The subjects were then di-
vided into three groups (less exposed as reference category, moderately
exposed, highly exposed). Exposure categories were chosen consider-
ing the distribution ofthe contaminant in the entire area and to provide
a narrow reference category. Thus the reference category had a low me-
dian value.
The three groups, according to the estimated exposure to NO
were as follows:
Less exposed (E
)81110 μg/m
Moderately exposed (E
) 111150 μg/m
Highly exposed (E
) >150 μg/m
Fig. 2 shows the division of the area for these groups. The zone
with the highest concentration of NO
is in the neighbourhood of
the cement plant.
2.5. Statistics
Odds ratios were calculated applying an unconditional logistic re-
gression model, considering the casecontrol status as dichotomised
Table 1
Diseases considered (adults, age >34 years).
Groups ICD-IX
Cardiovascular 410414 Ischemic heart disease
415416 Diseases of pulmonary circulation
426 Conduction disorders
427 Cardiac dysrhythmias
428 Heart failure
429 Other heart diseases
444 Arterial embolism and thrombosis
785 Symptoms involving cardiovascular system
Respiratory 478 Other diseases of upper respiratory tract
480487 Pneumonia and inuenza
490496 Chronic obstructive pulmonary disease and allied
510 Empyema
511 Pleurisy
518 Other diseases of lung
786 Symptoms involving respiratory system
Table 2
Diseases considered (children, age 014 years).
Groups ICD-IX codes Description
Respiratory 460 Acute nasopharyngitis
461 Acute sinusitis
462 Acute pharyngitis
463 Acute tonsillitis
464 Acute laryngitis and tracheitis
465 Acute upper respiratory infections
466 Acute bronchitis and bronchiolitis
472 Chronic pharyngitis and nasopharyngitis
473 Chronic sinusitis
474 Chronic disease of tonsils and adenoids
475 Peritonsillar abscess
476 Chronic laryngitis and laryngotracheitis
477 Allergic rhinitis
478 Other diseases of upper respiratory tract
490496 Chronic obstructive pulmonary disease and
allied conditions
2M. Bertoldi et al. / Environment International 41 (2012) 17
dependent variable, and the level of NO
exposure (E
dependent variable. Sex and age group were used as adjusting vari-
ables. Analyses were also conducted by different subgroups, i.e. by
sex, age group and group of pathologies (this last only for adults).
pfor trend was calculated considering exposure as a continuous
Fig. 1. NO
iso-concentration map (winter campaign).
Fig. 2. Division of the area into three levels of NO
3M. Bertoldi et al. / Environment International 41 (2012) 17
Attributable risks were also calculated to supply an indicator of
the impact of exposure on the population's health (Breslow and
Day, 1980).
Statistical analyses were done using the package Stata SE, version
3. Results
Hospital admissions selected were 2209 for adults (1623 for cardiovascular causes,
586 for respiratory causes) and 277 for children (only respiratory diseases). Controls
totalled 4081 adults and 1108 children. Cases and controls together totalled 7675 sub-
jects, 6290 adults and 1385 children.
Only a small number (55 out of 7675, 0.72%) were excluded from the analysis, be-
cause we could not obtain their precise geographical coordinates. The analysis consid-
ered all geocoded subjects (7620), for whom it was possible to estimate the exposure
to NO
, separately for the children (1372 total, 274 cases and 1098 controls) and adults
(6248 total, 2182 cases and 4066 controls).
3.1. Adults
Table 3 reports the analysis on the adults, considered overall and then stratifying
for sex and the two age groups: younger adults (from 35 to 64 years) and older people
(over 65). The overall analysis showed a signicant risk for the subjects in the two cat-
egories most exposed compared to those less exposed (E0): the probability of hospital
admission was about 30% higher for both these categories, though the risk was a little
higher for the moderately exposed (E1) than the highest exposed (E2). This gure
slightly decreased when adjusting for sex and age group, and the risk for E2 group
lost statistical signicance. The attributable risk of 23% indicated that 501 out of the
2182 cases could be due to the excess of exposure to the cement plant pollutants com-
pared with the reference level (E0).
Sub-analysis by sex showed greater risks for females, with OR from 1.70 to 1.88
(from 1.60 to 1.75 when adjusted for age) and an attributable risk over 40% (378 out
of 915 cases). The probabilities of risk for males were much lower (OR about 1.10, or
around 1 when adjusted for age) and not statistically signicant; consequently the attrib-
utable riskwas also very low (less than 10%), estimating that 125 hospital admissions out
of 1267 might have been due to the exposure.
The analysis stratied for age showed a higher risk for those under 65, with a sig-
nicant trend with increasing levels of exposure: about 1.60 for the moderately ex-
posed group and 1.80 for the highest exposed. The attributable risk of 34% indicated
193 hospital admissions out of 565 attributable to the plant pollution. The risks were
not found in the older subjects: OR were near to 1 for both exposure levels (crude or
adjusted for sex).
Table 4 reports sub-analyses on the two groups of pathologies (cardiovascular and
respiratory), overall and separately for age. There were no major differences for the two
pathologies: an association between exposure and risk appeared (though losing some
signicance on adjusting for age and sex), with no exposureresponse trend for respi-
ratory pathologies. For the adults under 65 the association was stronger (particularly
hospital admissions for respiratory symptoms), while for older people the risks were
3.2. Children
Exposure to air pollution appeared to have a stronger negative effect on children
than on adults (Table 5). The overall risks are higher: 1.67 for the moderately exposed
group (E1) compared to the less exposed (E0), and almost double (OR 1.90) for the
most exposed children (E2), with a signicant pfor trend (b0.001).
The attributable risk indicated that 38% of all hospital admissions involving chil-
dren (105/274) could be avoided if the NO
concentration was not higher than
110 μg/m
in all the areas considered.
The analysis stratied by sex showed a slightly different situation from adults. The
risk appeared clear in males (but withoutan increasing exposureresponse trend), while
for the females the OR, indicating an increasing risk, were not statistically signicant. This
might dependon the limited number of hospital admissions for young females. The attrib-
utable risks were not really different: 41% for the males (67/163 cases) and 33% for fe-
males (37/111).
Sub-analysis by age group showed lower risks (with a loss of statistical signi-
cance) for pre-school children (from 0 to 5 years), but even higher risks for school-
age children (614), with an attributable risk higher than 50%.
3.3. Check analysis
Table 6 reports the analysis on trauma and injuries, considered overall and then
stratifying for sex. We identied 1018 hospital admissions of all ages and sampled
3868 controls from the same population. The calculated OR did not show the same
risk as for cardiovascular and respiratory causes: 1.15 (95% C.I. 0.891.47) for moder-
ately exposed (E1), 1.11 (95% C.I. 0.851.46) for highest exposed (E2).
4. Discussion
Our results showed an increase in hospital admissions for pathol-
ogies potentially related to the exposure to air pollution due to plant
emissions. This appeared particularly strong for children, that are par-
ticularly susceptible to air pollution (Gouveia and Fletcher, 2000), but
the adults presented signicant risks too.
These results conrmed the ndings of many epidemiological
studies on health effects of air pollution (Boezen et al., 1999; Brauer
et al., 2002; Calderón-Garcidueñas et al., 2007; Van der Zee et al.,
1999; Wilson et al., 2004), showing how children are a particularly
vulnerable population because they spend more time outdoors, are
generally more active, and have higher ventilation rates than adults
(Just et al., 2002; Ostro et al., 2001; Wiley et al., 1993).
The differences in risk between males and females, particularly
adults, might reect the fact that women spend more time at home
than men, so the subjects' addresses are more indicative of the real
exposure for women than for men.
All the sub-analyses on children (by sex or age) might be affected
by the small number of the hospital admissions for children (274 in
total), generating less stable results from a statistical point of view.
For this reason, the risks calculated considering all the children had
to be considered the most signicant information.
Table 3
Adults: exposure to NO
and risks of hospital admission.
Cases Controls Total Crude
95% CI Adj.
95% CI
Overall analysis
E0 267 646 913 1 1
E1 1312 2306 3618 1.377 1.1761.612 1.296 1.1011.525
E2 603 1114 1717 1.310 1.1011.558 1.161 0.9711.388
Tot 2182 4066 6248
p for
E0 182 380 562 1 1
E1 747 1368 2115 1.140 0.9351.390 1.079 0.8791.324
E2 338 637 975 1.108 0.8891.381 0.952 0.7571.199
Tot 1267 2385 3652
p for
E0 85 266 351 1 1
E1 565 938 1503 1.885 1.4452.458 1.753 1.3362.299
E2 265 477 742 1.739 1.3052.316 1.600 1.1952.140
Tot 915 1681 2596
p for
3564 yrs
E0 72 375 447 1 1
E1 346 1139 1485 1.582 1.1972.092 1.578 1.1932.088
E2 147 423 570 1.810 1.3222.479 1.813 1.3242.483
Tot 565 1937 2502
p for
Age>65 yrs
E0 195 271 466 1 1
E1 966 1167 2133 1.150 0.9391.409 1.162 0.9481.424
E2 456 691 1147 0.917 0.7371.141 0.931 0.7471.160
Tot 1617 2129 3746
p for
OR adjusted for age and sex (overall), for age (males and females), or for sex (age
Attributable risk.
4M. Bertoldi et al. / Environment International 41 (2012) 17
The analyses on the older subjects (more than 64 years) depicted
an apparently paradoxical situation: no risk was found, though older
people, like children, are usually more sensitive to air pollution
(Anderson et al., 2003; Katsouyanni et al., 2001). This might be
explained by the presence of two hospices in the two municipalities.
The two hospices are in fact in the area of maximum exposure, and
could have lead to an oversampling of highly exposed controls. More-
over, it is also possible that a number of hospital admissions of these
people were missing because some patients were treated by doctors
inside the hospices.
From the point of view of public health, the attributable risks indi-
cated that almost a quarter of adult hospital admissions and more
than one third of children's admissions could be avoided if the plant
emissions, expressed as average exposure concentrations of NO
were reduced to expose the whole population to the same level con-
sidered as the reference category in our study.
As the acute effects are often indicators of a chronic effect, the re-
sults can also be read in terms of a general increase of cardiovascular
and respiratory diseases in this population.
It is important to note that the general standing is seriously com-
promised, also due to other air pollution sources (industrial sites,
quarries, highways and major roads). NO
values are generally more
elevated in comparison with the average of Brescia province. There
were no secure zonesin the surroundings with null or low
exposure: the lowest winter value is 83 μg/m
. But we were able to
distinguish between higher exposure and lower exposure zones.
These differences allowed to assess health risk values.
The results do not describe health effects exclusively attribut-
able to the cement plant. They represent an overall evaluation of
the possible health effects due to the high air pollution levels, but,
considering NO
concentrations, the cement plant has a very impor-
tant role.
To check that our ndings were not due to a bias in the casecontrol
selection, we applied the same methods to a group of pathologies po-
tentially not related with air pollution, i.e. trauma and injuries. This
kind of analysis, showing no relation between environmental exposure
and those pathologies, can be read as reinforcement of our results.
5. Conclusions
We found an association between the exposure to the cement
plant emissions and the risk of hospital admission for cardiovascular
or respiratory causes, particularly strong for children. The cement
plant certainly has an important role as a producer of air pollution.
Though in the area considered there are also other important sources,
these could not be considered as confounders for the health effects
brought to light by this analysis, as their spatial distribution is not as-
sociated with the exposure to cement plant emissions.
Table 4
Adults: exposure to NO
and risks of hospital admission (sub-analysis for disease groups and age).
Exposure groups Cases Controls Total Crude OR 95% CI Adj. OR
95% CI
Cardiovascular diseases
E0 206 646 852 1 1
E1 939 2306 3245 1.277 1.0731.520 1.177 0.9841.409
E2 457 1114 1571 1.287 1.0631.557 1.128 0.9271.373
Tot 1602 4066 5668
p for trend 0.011
Cardiovascular diseases (age 3564 yrs)
E0 60 375 435 1 1
E1 235 1139 1374 1.290 0.9491.752 1.281 0.9421.741
E2 112 423 535 1.655 1.1742.332 1.654 1.1732.331
Tot 407 1937 2344
p for trend 0.012
Cardiovascular diseases (age >64 yrs)
E0 146 271 417 1 1
E1 704 1167 1871 1.120 0.8971.398 1.123 0.9001.403
E2 345 691 1036 0.927 0.7301.177 0.933 0.7341.185
Tot 1195 2129 3324
p for trend 0.734
Respiratory diseases
E0 61 646 707 1 1
E1 373 2306 2679 1.713 1.2892.277 1.612 1.2092.149
E2 146 1114 1260 1.388 1.0141.900 1.182 0.8571.630
Tot 580 4066 4646
p for trend 0.160
Respiratory diseases (age 3564 yrs)
E0 12 375 387 1 1
E1 111 1139 1250 3.045 1.6605.588 3.052 1.6635.600
E2 35 423 458 2.586 1.3235.054 2.658 1.3575.206
Tot 158 1937 2095
p for trend 0.010
Respiratories diseases (age >64 yrs)
E0 49 271 320 1 1
E1 262 1167 1429 1.242 0.8911.731 1.257 0.9001.754
E2 111 691 802 0.888 0.6171.279 0.908 0.6281.312
Tot 422 2129 2551
p for trend 0.310
OR adjusted for age and sex (overall cardiovascular and respiratory diseases) or for sex (age subgroups).
Attributable risk.
5M. Bertoldi et al. / Environment International 41 (2012) 17
This work was partially nanced by the municipalities of Mazzano
and Rezzato, Lombardy Region, Italy.
The authors are grateful to the municipalities of Mazzano and
Rezzato for nancial support; Brescia Local Health Unit for health
data; Consulenze Ambientali for the iso-concentrations maps of
; SEAT for geocoding; GIS Italia for help using ArcGis software;
Roberto Carrara for the precious work of coordination; J. D. Baggott
for revising the English.
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Table 5
Children: exposure to NO
and risk of hospital admission.
Cases Controls Total Crude
95% CI Adj.
95% CI
Overall analysis
E0 28 182 210 1 1
E1 149 580 729 1.670 1.0792.584 1.676 1.0792.602
E2 97 336 433 1.876 1.1882.965 1.907 1.1963.043
Tot 274 1098 1372
p for
E0 17 115 132 1 1
E1 90 322 412 1.891 1.0803.311 1.913 1.0883.365
E2 56 210 266 1.804 1.0023.249 1.801 0.9873.283
Tot 163 647 810
p for
E0 11 67 78 1 1
E1 59 258 317 1.393 0.6932.798 1.358 0.6742.738
E2 41 126 167 1.982 0.9574.107 2.071 0.9854.353
Tot 111 451 562
p for
Age 04 yrs
E0 20 106 126 1 1
E1 107 424 531 1.338 0.7932.256 1.342 0.7952.265
E2 72 272 344 1.403 0.8142.417 1.401 0.8132.413
Tot 199 802 1001
p for
514 yrs
E0 8 76 84 1 1
E1 42 156 198 2.558 1.1445.716 2.662 1.1865.975
E2 25 64 89 3.711 1.5668.794 3.675 1.5498.720
Tot 75 296 371
p for
OR adjusted for age and sex (overall), for age (males and females), or for sex (age
Attributable risk.
Table 6
Exposure to NO
and risks of hospital admission for trauma and injuries.
Cases Controls Total Crude
95% CI Adj.
95% CI
Overall analysis
E0 122 532 654 1 1
E1 586 2130 2716 1.199 0.9661.490 1.146 0.8941.471
E2 303 1158 1461 1.141 0.9031.442 1.113 0.8511.456
Tot 1011 3820 4831
p for
E0 78 338 416 1 1
E1 344 1301 1645 1.146 0.8721.506 0.999 0.7221.381
E2 185 705 890 1.137 0.8471.527 1.001 0.7051.423
Tot 607 2344 2951
p for
E0 44 194 238 1 1
E1 242 829 1071 1.287 0.9001.840 1.383 0.9352.045
E2 118 453 571 1.149 0.7821.688 1.294 0.8501.970
Tot 404 1476 1880
p for
OR adjusted for age and sex (overall) or for age (males and females).
6M. Bertoldi et al. / Environment International 41 (2012) 17
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... García-Pérez et al. (2013) did an ecological study in Spain to analyse cement dust impacts on people living nearby cement factories. Study results indicated that residents living within 3 km of cement factories have a high risk of lung cancer (Bertoldi et al., 2012). scrutinised dust spread and how fogging method can be used as a mitigation alternative. ...
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Distance between cement factories and human settlements is key to determining the extent to which neighbourhoods are affected by cement dust. A key influencer of settlement patterns is zoned development and physical planning for healthy living. Wind patterns are also a factor in determining the proximity of settlements, an aspect requiring zoned development. This study focuses on cement factories in Athi River Township, established as early as 1933 when there was barely any settlement. They include East African Portland Cement Company (1933), Bamburi (1951), Athi River Mining (1974) and Mombasa (2007). Zoning development failure and unclear guidelines on the appropriate distance away from cement factories are major threats to human health. This study uses Geographic Information System and Remote Sensing Techniques for proximity analysis of the spatial relations between cement factories and homes. Study results show that residential homes are built on the wind shadow side of factories, thus affected by dust blown by easterly flowing winds. More than 1,888 residential homes in Athi River are within the 3.5 km buffer protection area. 47% of interviewed respondents consider cement factories as the main pollution source. Key Informant Interviews were administered to health officials from the nearby hospital. They reported, from hospital records, that 29.42% (n = 5084) were upper respiratory infections (URI), 17.20% skin infections (n = 2972), 7.72% (n = 1335) eye irritations, 16.32% pneumonia (n = 2821) and 11.49 % (n =1985) asthma, all traced to cement dust. Vegetation mapping using Landsat imagery classification showed a variance in the area under pasture (0.54%) and cropland (4.42%). These impacts point to a need for the implementation of zoned development to safeguard communities against cement dust impacts
... Therefore, it becomes one of the major occupational health hazards for the silica dust exposed workers working in relevant industries. Regrettably, most of the silicosis cases remain undiagnosed or misdiagnosed at an early stage due to asymptomatic or mild symptomatic nature of the initial stage of the disease, lack of suitable biomarker for early detection, poor health-seeking behavior of the workers and poor occupational health care delivery service at the workplaces, particularly in unorganized sectors [7][8][9] . ...
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Silicosis is an irreversible, incurable and progressive occupational disease caused by prolonged exposure to crystalline-silica dust while working in the relevant industries. Conventionally diagnosis is done by chest radiology, often in an advanced stage as early symptoms often go unnoticed. Early detection and necessary intervention (secondary prevention) could be a realistic possible control strategy for controlling silicosis as no effective treatment is available to stop and/or reverse the pathological process. Additionally, these patients are also vulnerable to pulmonary tuberculosis, which often becomes difficult to treat and with uncertain treatment outcome. Considering India has a huge burden of silicosis and silico-tuberculosis, a rapid and inexpensive screening method was realized to be an urgent need for early detection of silicosis among silica dust exposed workers. Serum club cell protein 16 (CC16) is evidenced to be a useful proxy screening marker for early detection of silicosis as evidenced from the recent research work of ICMR-National Institute of Occupational Health (ICMR-NIOH), India. In this study a lateral-flow assay for semi-quantitative estimation of serum CC16 level was developed. The detection was performed using gold nanoparticles conjugated anti-CC16 monoclonal antibodies. A sum of 106 serum samples was tested to do the performance evaluation of the assay. A concentration of 6 ng/ml or less produced one band, 6.1–9 ng/ml produced two bands, while more than 9 ng/ml produced all the three bands at the test zone. The sensitivity of the assay was 100% while the specificity was 95%. This assay may be used as a sensitive tool for periodic screening of silica dust exposed vulnerable workers for early detection of silicosis in them.
... Some research groups have also speculated about the translocation of inhaled particles from the respiratory tract to the placenta and fetus, potentially affecting the offspring [20]. Studies have shown that suspended cement particles not only affect cement workers but also residents living near a cement factory or other sources of cement dust from manufacturing operations [21][22][23][24]. ...
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Construction is an important segment of the economy that employs millions of people. Construction dust is an occupational health hazard to millions of construction workers worldwide. The hazards associated with respirable dust depend upon its particulate size distribution and chemical composition, as these determine the deposition pattern in the respiratory tract and reactivity, respectively. This study presents characterization of the size and composition of the dust from two key construction materials—cast cement and poured concrete. The dust was generated by cutting the cured cement and concrete blocks using an 18” hand-held circular saw as used in highway and building construction. Transmission electron microscopy, scanning electron microscopy, dynamic light scattering, and laser diffraction were performed for the size analysis of the particles. Energy dispersive spectroscopy and X-ray photoelectron spectroscopy were used for chemical analysis. X-ray diffraction was used for phase identification. Electron diffraction patterns were obtained to assess the crystallinity of individual particles. They confirm the crystallinity of particles of different size and shapes. With a particle size range between 0.5 μm and 10 μm, greater than 90% of particles fell below 2.5 μm, presenting a respirable health concern. Crystalline compounds including the metals Al, Ca, Fe, Mg, Na, and K were detected. The concrete particles were most enriched in crystalline silica with a concentration of more than 30% by weight. The presence of metals and high crystalline silica content pose a serious health concern to construction workers.
... Moreover, if discarded in agricultural land, this waste can damage plants and reduce soil fertility (Siqueira-Silva et al., 2017). Besides, this waste diffused into the atmosphere with the wind, posing severe health hazards (Asaad & Tawfik, 2011;Bertoldi et al., 2012). As the amount of CBPD waste generated increases day by day, the pollution problems associated with its disposal becomes more expensive and labour intensive. ...
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This article explored the potential of cement bypass dust, a waste produced during cement manufacturing, as filler in automotive brake friction composites. Five different cement bypass dust particles (10-25, 88-105, 210-250, 354-400 and 600-700 µm) were used to manufacture non-asbestos/non-copper type friction materials. The composite's tribological properties were obtained from a chase friction testing machine. Maximum friction, fade, and recovery coefficients improve, whereas friction fluctuations and wear resistance of the brake friction composites decrease with cement bypass dust particle size. The worn surface morphology revealed that the cement bypass dust particle size played a considerable role in forming the contact plateaus and deciding the wear behaviour. Multi-objective optimization based on the ratio analysis approach was utilized to determine the composite's performance ranking.
Актуальность. Загрязнение атмосферного воздуха является важной и актуальной проблемой современности. Одними из главных источников поступления твердых частиц являются предприятия строительной отрасли. Твердые частицы поступают в атмосферный воздух в результате добычи, транспортировки и измельчения сырьевых компонентов, обжига клинкера, помола и транспортировки цемента. В этой связи актуальным является экологическая оценка пылеаэрозольного загрязнения атмосферного воздуха в районах размещения цементных заводов. Цель: оценить состояние атмосферного воздуха в окрестностях цементного завода на основе изучения пылевой нагрузки, уровней накопления химических элементов и форм их нахождения в составе твердых частиц, осевших в снеговом покрове в окрестностях цементного завода г. Искитим. Объекты: твердая фаза снегового покрова, содержащая пылеаэрозольные частицы, осевшие из атмосферного воздуха в снеговой покров в районе расположения цементного завода, сырьевые компоненты для производства цемента (известняк, глина, шлак, пиритные огарки). Методы: атмогеохимический метод, включающий отбор и подготовку проб снегового покрова для получения твердой фазы снегового покрова; аналитические методы исследования проб: масс-спектрометрия с индуктивно-связанной плазмой, инструментальный нейтронно-активационный анализ, рентгенофазовый метод, сканирующая электронная микроскопия; методы статистической обработка результатов в программном обеспечении «STATISTICA 8»; эколого-геохимический анализ данных путем расчета показателей – пылевая нагрузка (Pn), коэффициент концентрации (Kc), суммарный показатель загрязнения (Zспз), картографическое представление результатов в ПО «Surfer 11» и «CorelDraw X7». Результаты. Уровни пылевой нагрузки в окрестностях цементного завода находятся в широком диапазоне (от 57 до 1028 мг/(м2∙сут.) при среднем значении 318 и фоне 7 мг/(м2∙сут.). По нормативным градациям формируются уровни пылевого загрязнения от низкого до очень высокого. По мере удаления от предприятия в север-северо-западном направлении на расстояние от 0,6 до 2,8 км уровни пылевой нагрузки уменьшаются от 436 и до 78 мг/(м2∙сут.). Наибольший уровень пылевой нагрузки формируется в ближней зоне влияния (до 500 м) – 1028 мг/(м2∙сут.), а также в районе расположения карьера, где добываются основные сырьевые компоненты – 932 мг/(м2∙сут.). Минеральный состав твердой фазы снегового покрова представлен минералами сырьевых компонентов – кальцитом (CaCO3) – 82,1 %, кварцем (SiO2) – 4,4 %, магнезитом (MgCO3) – 7,6 %; минералами цементного клинкера – браунмиллеритом (Ca2(Al, Fe)2O5) и хатруритом (Ca3(SiO4)O)) – 6,4 и 26,6 %, соответственно. В твердой фазе снегового покрова выделены микрочастицы оксидов кальция и железа, а также микрочастицы алюмосиликатного состава с размерами от 2,7 до 64,5 мкм. Техногенная геохимическая специализация твёрдой фазы снегового покрова характеризуется повышенными уровнями накопления Ca (в 14–23 раза выше фона), Zn, Sr, Sb, Tb, Yb, La, Sm, U (в 2–7 раз выше фона), которые формируют низкий уровень загрязнения. Распределение Ca и пылевой нагрузки по мере удаления от границ завода в северо-западном направлении имеет схожий характер. Максимальные уровни пылевой нагрузки (1028 мг/(м2∙сут.)) и накопления Ca (24 %) в твердой фазе снегового покрова определены на расстоянии 0,5 км, а по мере удаления от границ завода (от 0,5 до 2,8 км) наблюдается снижение уровня пылевой нагрузки в среднем от 7 до 13 раз (140–78 мг/(м2∙сут.)) и накопления Ca в 1,5 раза (16–17 %). Микроэлементы-индикаторы (Cr, Sb, Zn), которые определены в справочнике наилучших доступных технологий как специфичные в составе выбросов цементного производства, в твердой фазе снегового покрова превышают фоновые уровни от 2 до 7 раз. Для твердой фазы снегового покрова характерными являются геохимические ассоциации Zn-Cr, As-Ta, Yb-U-Sb, Tb-Ba, Th-Na, Fe-La. Отмечаются корреляционные связи между микроэлементами-индикаторами (Ca, Ba, Cr, As, Fe, Sb, Zn), характерными для выбросов производства цемента, с редкоземельными и радиоактивными (U, Th) химическими элементами. Этот факт может указывать на единый источник поступления этих элементов (при положительных корреляционных связях), а также отражать разницу в составе корректирующих добавок для производства цемента и разные формы нахождения химических элементов в составе твердых частиц в окрестностях цементного завода (при отрицательных корреляционных связей). Выявленные геохимические ассоциации с высокой долей вероятности отражают геохимическую специализацию используемого сырья, корректирующих и минеральных технологических добавок для производства цемента.
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La concienciación ambiental en el sector cementero español, unido a la normalización en cuanto a la cuantificación de emisiones nocivas para la salud, seguridad y ambiente, ha propiciado el desarrollo de factores de emisión como herramienta de estandarización a nivel país. Gracias a estos factores es posible establecer su evolución y analizar las causas técnicas que inciden en el comportamiento de las emisiones contaminantes. El presente trabajo de investigación recoge la evolución de dichos factores en una serie histórica que abarca el periodo 2009-2018. El análisis estadístico desarrollado permite establecer factores de emisión para el sector de estudio de forma robusta y fiable. Los resultados recogen la evolución de las emisiones, así como los últimos valores tomados de todo un sector de la industria española. La evolución de los factores de emisión muestra una concienciación cada vez mayor hacia la reducción de gases contaminantes, validando la herramienta factores de emisión y su metodología.
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Cement plants located in urban areas can increase health risk. Although children are particularly vulnerable, biomonitoring studies are lacking. Toenail concentration of 24 metals was measured in 366 children (6–10 years), who live and attend school in a city hosting a cement plant. Living addresses and schools were geocoded and attributed to exposed or control areas, according to modeled ground concentrations of PM10 generated by the cement plant. Air levels of PM10 and NO2 were monitored. PM10 levels were higher in the exposed, than in the control area. The highest mean PM10 concentration was recorded close to the cement plant. Conversely, the highest NO2 concentration was in the control area, where vehicular traffic and home heating were the prevalent sources of pollutants. Exposed children had higher concentrations of Nickel (Ni), Cadmium (Cd), Mercury (Hg), and Arsenic (As) than controls. These concentrations correlated each other, indicating a common source. Toenail Barium (Ba) concentration was higher in the control- than in the exposed area. The location of the attended school was a predictor of Cd, Hg, Ni, Ba concentrations, after adjusting for confounders. In conclusion, children living and attending school in an urban area exposed to cement plant emissions show a chronic bioaccumulation of toxic metals, and a significant exposure to PM10 pollution. Cement plants located in populous urban areas seem therefore harmful, and primary prevention policies to protect children health are needed.
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Silicosis is an irreversible, incurable and progressive occupational disease caused by prolonged exposure to crystalline-silica while working in related industries. Conventionally diagnosis is done by chest radiology in advanced stage as early symptoms often go unnoticed. Early detection and secondary prevention could be the only realistic possible control strategy for controlling silicosis as no other method of treatment is available. Additionally, these patients are also vulnerable to drug resistant tuberculosis. Developing countries like India has a huge burden of silico-tuberculosis. Hence, a rapid and inexpensive screening method is a need for early detection of silicosis among silica dust exposed workers. Serum CC16 is a useful proxy screening marker for early detection of silicosis. In this study a lateral-flow assay for semi-quantitative estimation of serum CC16 level was developed. The detection was performed using gold nanoparticles conjugated anti-CC16 monoclonal antibodies. A sum of 47 serum samples was tested to do performance evaluation of the assay. A concentration of 6ng/ml or less produced one band, 6.1 – 9 ng/ml produced two bands, while more than 9 ng/ml produced all the three bands at the test zone. This assay can be used as a proxy marker for periodic screening and early detection of silicosis in vulnerable workers.
The use of industrial plant wastes such as fly ash (FA) and cement kiln dust (CKD) is an optimal solution to improve some of the fresh and hardened properties of concrete and also a rational choice to reduce the effect of carbon dioxide in the construction industry. In this study, different amounts of CKD (0–40%), as a waste material, and FA (0–30%) as a pozzolanic material, were used as a single and hybrid replacement of cement. Then, Taguchi method with two parameters of water to binder ratios and cement replacement ratio was used to determine the optimal mixing designs before construction from environmental and economic points of view. Comparison of the Taguchi method and experimental results for selecting the most favorable mixture designs showed that Taguchi method exhibited suitable choices in the range of optimal experimental results with regard to the initial parameters. This means that if the water-to-cement, CKD-to-cement, and the fly ash-to-cement ratios were 0.45, 9%, and 14%, respectively, it would be possible to obtain the best possible values for the strength to price, CO2 emission factor, and the standard deviation ratio.
Objectives-To examine possible associations between daily concentrations of urban air pollutants and hospital emergency admissions and mortality due to cardiac and pulmonary disease. Methods-A time series study was conducted in the City of Edinburgh, which has a population of about 450000. Poisson log linear regression models were used to investigate the relation of the daily event rate with daily air pollution concentrations of sulphur dioxide (SO2) and black smoke from 1981 to 1995, and of nitrogen dioxide (NO2), ozone (O-3), carbon monoxide (CO), and particulate matter (PM10) from 1992 to 1995. Adjustments were made for seasonal and weekday variation, daily temperature, and wind speed. Results-The most significant findings were positive associations over the period 1981-95 between black smoke as a mean of the previous three days and daily all cause mortality in people aged greater than or equal to 65, and respiratory mortality also in this age group (3.9% increase in mortality for a 10 mu g/m(3) increment in black smoke). For hospital emergency admissions between 1992 and 1995 the two most significant findings (p<0.05) were for cardiovascular admissions of people aged greater than or equal to 65 which showed a positive association with PM10 as a mean of the 3 previous days, and a negative association with O-3 as a mean of the previous three days. Analyses of outcomes based on linkage with previous cardiorespiratory emergency admissions did not show substantially different results. Conclusion-These data suggest that in the City of Edinburgh, after correction for confounders, there was a small but significant association between concentrations of black smoke and respiratory mortality in the older age group, probably attributable to higher pollution levels in the early part of the study period. There were also generally weak and variable associations between day to day changes in concentrations of urban air pollutants at a single central point and emergency hospital admission rates from cardiac and respiratory disease.
Chronic exposure to Portland cement dust has been reported to lead to a greater prevalence of chronic respiratory symptoms and a reduction of ventilatory capacity. The seriousness of pulmonary function impairment and respiratory disease has not been consistently associated with the degree of exposure. Regular use of appropriate personal protective equipment, if available at the worksite, could protect cement workers from adverse respiratory health effects. For a variety of reasons, industrial workers in rapidly developing countries do not adequately protect themselves through personal protective equipment. This study explores the prevalence of chronic respiratory symptoms and ventilatory function among cement workers and the practice of use of personal protective equipment at work. An interviewer-administered questionnaire was used to collect information on sociodemographic characteristics, smoking profile and history of respiratory health among workers at a Portland cement plant (exposed) and workers occupationally unexposed to dust, fumes and gases (unexposed). Pulmonary function was assessed and pulmonary function impairment was calculated for the exposed and the unexposed workers. A higher percentage of the exposed workers reported recurrent and prolonged cough (30%), phlegm (25%), wheeze (8%), dyspnoea (21%), bronchitis (13%), sinusitis (27%), shortness of breath (8%) and bronchial asthma (6%). Among the unexposed, prevalences of these symptoms were 10, 5, 3, 5, 4, 11, 4 and 3%, respectively. Ventilatory function (VC, FVC, FEV1, FEV1/VC, FEV1/FVC and PEF) was significantly lower in the exposed workers compared with unexposed workers. These differences could not be explained by age, body mass index (BMI) or pack-years smoked. Ventilatory function impairment, as measured by FEV1/FVC, showed that 36% of the exposed workers had some ventilatory function impairment compared with 10% of those unexposed. Certain jobs with greater exposure to cement dust had lower ventilatory function compared with others among the exposed workers. It was concluded that adverse respiratory health effects (increased frequency of respiratory symptoms and decreased ventilatory function) observed among cement workers could not be explained by age, BMI and smoking, and were probably caused by exposure to cement dust.
PM, SO2, NO2 and CO emissions were measured by Turkish Cement Manufacturers' Association (TCMA) in cement plants by using standard techniques and equipment since 1997.Emission factors (EF) were calculated by using these availabledata for the cement sector. The emission factors were found bothfor cement and grinding-packing plants separately. The results of the study were compared with international emission factors.It was observed that Turkish Cement Sector's particulate matteremission factors are higher and SO2 emission factors are lower than the values determined for U.S.A., German, Austrian and Dutch cement sectors. When NO2 and CO emission factorsare considered, they are between minimum and maximum values ofinternational emission factors. The results showed that thereis a decrease in dust emissions of Turkish cement plants, especially in the last three years during the period of regular measurements. Also, it was found that more than 90% of air pollution is emitted from primary sources of each plant whichare few in number.
The effects of cement production on the elemental composition of soils in the neighborhood of two cement factories in Nigeria have been investigated using the XRF and PIXE/RBS techniques. The concentration of 21 elements viz:-Mg, Al, Si, P, S, K, Ca, Ti, V, Cr, Mn, Fe, Ni, Cu, Zn, Sr, Pb, As, Zr, Rb and Br, were determined in about 30 samples. Calcium, P, S, Cr, Ni, Cu and Zn, were found to be relatively enriched in the soils of the cement factory premises. Calcium, a cement marker element, was found to be well correlated with Mg, S, Fe, Ni and Cu in the soils, and inversely proportional to the Si and Ti concentrations. From Ca/Si ratios and enrichment factors of the marker elements, it was found that soil contamination due to cement drops sharply with distance from the factories, and with increasing depth from the surface.
In cement plants in Turkey CO, NO2, SO2 and particulate emissions were measured using standard measurement techniques and equipment. Emission factors are calculated by dividing the emission rates by capacity of production at the time of measurements for each plant. The results of this study show that the dominant emissions from cement production in Turkey is CO followed by NO2, dust and SO2 in decreasing order. National averages for the emission factors are calculated and compared to international emission factors. On average the Turkish dust emission factor is higher than the German factor, however NO2 and SO2 emission factors are lower in Turkey.
The Portland cement industry is the main source of particulate air pollution in Kaohsiung city. Data in this study concern outdoor air pollution and the health of individuals living in communities in close proximity to Portland cement plants. The prevalence of delivery of preterm birth infants was significantly higher in mothers living within 0-2 km of a Portland cement plant than in mothers living within 2-4 km. After controlling for several possible confounders (including maternal age, season, marital status, maternal education, and infant sex), the adjusted odds ratio was 1.30 (95% CI=1.09-1.54) for the delivery of preterm infants for mothers living close to the Portland cement plants, chosen at the start to be from 0 to 2 km. These data provide further support for the hypothesis that air pollution can affect the outcome of pregnancy.