Assessment of the Risk of Developing Hemic Hypoxia in Metallurgical Productionт

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Introduction

A high level of urbanization leads to artificial atmospheric pollution, increasing the risk of developing bronchopulmonary diseases [1]. Hemic hypoxia is a pathological condition characterized by impaired gas transport function of the blood despite normal total hemoglobin levels. This condition is associated with the disruption of hemoglobin's oxygen transport function. Several forms of hemoglobin are found in circulating blood: oxyhemoglobin, deoxyhemoglobin, carbhemoglobin, carboxyhemoglobin, and methemoglobin. The last two forms are pathological. The binding of heme to carbon monoxide or the oxidation of heme iron makes oxygen transport to organs and tissues impossible. The accumulation of carboxyhemoglobin (HbCO) depends entirely on the CO content in the inhaled air, although some amount of CO is produced endogenously [2]. The consequences of chronic CO accumulation in the blood, even at low concentrations (below 10%), can manifest clinically over years as heart diseases and neuropsychiatric disorders. Therefore, it is important to assess the risk of developing hemic hypoxia under hazardous occupational conditions.

Objective

To assess the risk of developing hemic hypoxia in metallurgical industry workers by determining the concentration of HbCO in the blood.

Materials and Methods

Biological material: whole venous blood from male metallurgical industry workers aged 20–50 years (n = 90). The concentration of HbCO was determined spectrophotometrically [3] following the recommendations of the Ministry of Health of the Russian Federation (1980). Total hemoglobin concentration was measured using a Swelab alfa hematology analyzer. Statistical data processing was performed using Microsoft Office Excel software.

Research Results

The HbCO concentration varied over a wide range, from 3.8% to 18%. Data analysis revealed details that allowed the entire examined cohort to be divided into three groups based on HbCO concentration. The data on the degree of risk of hemic hypoxia development in metallurgical workers depending on HbCO concentration in the blood are as follows:

• Group 1 (HbCO 3.8–5.0%): 20.0% of workers. The average total hemoglobin concentration was 142±4.6 g/L. Risk of hemic hypoxia – minimal.
• Group 2 (HbCO 5.3–10.4%): 54.0% of workers. The average total hemoglobin level was 140±6.4 g/L. Risk of hemic hypoxia – moderate.
• Group 3 (HbCO 10.6–18%): 26.0% of workers. The average total hemoglobin level was 150±10.8 g/L. Risk of hemic hypoxia – high.

As shown by the data, HbCO concentration in the blood was not interdependent with total hemoglobin concentration (r = -0.2). Thus, one-third of the examined cohort is predicted to have a high risk of developing hemic hypoxia.

Conclusion

Carboxyhemoglobin is formed from both exogenous and endogenous CO (heme breakdown in the reticuloendothelial system, activity of intestinal bacteria). Carbon monoxide accumulates not only in the form of HbCO. Myoglobin, including that in cardiomyocytes, accumulates CO and releases it into the blood at a slower rate due to molecular characteristics and tertiary structure. Natural lung ventilation, regardless of vital capacity, cannot influence this process. Carbon monoxide also binds to other heme-containing molecules, such as mitochondrial cytochromes [4], primarily disrupting ATP production in cardiomyocytes. Given CO's ability to accumulate in biological structures, it is logical to assume that more than one-third of the examined workers are at risk of developing hemic hypoxia. Normally, HbCO concentration is about 6%, but in smokers, this level increases to 12% [5]. Considering that most workers smoke, an additional amount of CO enters the body. Thus, in the conditions of metallurgical production with all its harmful factors, at least 30% of workers are at significant risk of developing hemic hypoxia.

About the authors

Ilia Vladimirovich Gusev

Author for correspondence.
Email: ilagusev67882@mail.ru
ORCID iD: 0009-0002-1271-2198
Russian Federation, 394036, Russia, Voronezh, Studencheskaya St., 10

Gasan Rashidovich Tagirov

Email: gasan.tagirov2005@gmail.com
ORCID iD: 0009-0006-0350-8725
394036, Russia, Voronezh, Studencheskaya St., 10

References

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