Assessing the impact of metalworking exposures on respiratory health: the role of fractional exhaled nitric oxide levels

Objective: The significance of measuring Fractional Exhaled Nitric Oxide (FeNO) has grown, particularly in monitoring respiratory diseases like asthma. FeNO levels indicate inflammation and a rise in response to respiratory irritants. This study investigates whether repeated exposure to irritants in metal casting and coating leads to respiratory inflammation and assesses the benefits of including FeNO measurement in periodic occupational health screenings. Methods: This cross-sectional study involved 99 workers aged 18–65 in the foundry and metal coating sectors in the İkitelli Organized Industrial Zone. The study group included 54 workers exposed to metal dust and fumes, while the control group comprised 45 workers in non-exposure roles (e.g. secretarial, assembly, packaging). Data were collected through face-to-face interviews, recording demographics, smoking habits, symptoms. FeNO levels were measured and analyzed with pulmonary function test parameters. Results: FeNO levels were significantly higher in the study group compared to the control group (p = 0.02). No significant relationships were found between FeNO levels and age, height, weight, BMI, waist circumference, years of work, or symptom presence, but a significant negative correlation was observed between FeNO levels and FEV1/FVC. Additionally, current smokers had significantly lower FeNO levels compared to those who had quit or never smoked (study, p = 0.014; control, p = 0.011). Conclusions: Monitoring FeNO levels in occupational health assessments may facilitate early intervention and preventive measures, protecting worker health. Incorporating FeNO measurement into periodic screenings could enhance occupational health practices.