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Occupational health risks among the workers

employed in leather tanneries at Kanpur
lung and nasal cancers.[6-12] Cr-specific Subodh Kumar
Abstract health hazards like carcinoma of the Rastogi, Amit
In a cross-sectional study, a random sample of 197 larynx and lung parenchyma and Pandey2,
male workers drawn from different sections of 10 leather paranasal sinuses have also been Sachin Tripathi1
tanneries in Kanpur were selected for the assessment Epidemiology Division,
reported.[13-18] 1
Cardiovascular
of health risks. A control group comprising of 117
Toxicology, Indian
male subjects belonging to a similar age group and The purpose of the study was, Institute of Toxicology
socioeconomic strata, who never had any occupational therefore, to investigate the adverse Research, Post Box No.
exposure in the leather tanneries, were also examined health effects of exposure to basic 80, Mahatma Gandhi
for the comparison purpose. The Þndings revealed a tanning pigments (both trivalent and Marg, 2Biochemistry,
signiÞcantly higher prevalence of morbidity among the hexavalent chromium salts), organic Hind Medical College,
exposed workers in contrast to that observed in the solvents and other chemicals used Lucknow - 226 001,
controls (40.1% vs. 19.6%). The respiratory diseases Uttar Pradesh, India.
in the leather tanning industries at
(16.7%) were mainly responsible for a higher morbidity Kanpur.
among the exposed workers whereas the gastrointestinal For correspondence:
tract problems were predominant in the control group. Dr. Subodh Kumar
MATERIALS AND METHODS Rastogi,
The urinary and blood samples collected from the
Epidemiology Division,
exposed group showed signiÞcantly higher levels of
In a cross-sectional study, a random Indian Institute of
chromium, thereby reßecting the body burden of Cr in
sample of 197 male workers drawn Toxicology Research,
the exposed workers as a result of a high concentration Post Box No. 80,
from different sections of 10
of environmental Cr at the work place. Mahatma Gandhi Marg,
leather tanneries in Kanpur was
Lucknow - 226 001,
selected for the health survey. A
Key words: Chromium, health risk, leather tanneries, Uttar Pradesh,
reference group of 117 male subjects
India.
morbidity belonging to a similar age group and E-mail:
socioeconomic strata, who never had subodhkrastogi@
any occupational exposure in any gmail.com
process in the tanneries, served as a
INTRODUCTION control. Most of the control subjects
were self employed in petty shops
Kanpur is a major leather-processing centre in Uttar Pradesh and thus having no exposure to the
in North India, with an estimated 20,000 tannery workers. toxicants prevailing in the tannery
Leather production includes many operations with different work environment.
exposures, which can be harmful for the health of the workers,
and particularly be carcinogenic. [1-3] Some compounds The following parameters were
in the tanning process are considered as probably being studied:
carcinogenic to humans (some benzene-based dyes and 1. Pe r s o n a l a n d o c c u p a t i o n a l
formaldehyde).[4-5] Besides these, scores of other chemicals history
and organic solvents such as chromate and bichromate salts, The personal history included
aniline, butyl acetate, ethanol, benzene, toluene, sulfuric acid details of personal characteristics,
and ammonium hydrogen sulfide are used in the tannery age, smoking history, alcohol and
industry. An important health risk factor for the tannery tobacco consumption and family
workers is occupational exposure to chromium, mainly in the history, socioeconomic status
organic Cr (ш) form or in the protein bound-form (leather dust). and living conditions whereas
Chromium may enter the body by inhalation, ingestion and the occupational history included
by direct cutaneous contact. Professional exposure to Cr (ш) details of job, duration and type of
increases the risk of dermatitis, ulcers and perforation of the exposure and details of toxicants
nasal septum and respiratory illnesses as well as increased at the work place.

Indian Journal of Occupational and Environmental Medicine - December 2008 - Volume 12 - Issue 3 132
 Rastogi et al.: Health risk of tanneries workers

2. Clinical examination showed a higher prevalence (47.8%) of smoking in contrast

A detailed physical examination of the nervous, respiratory, to 42.1% observed in the tannery workers. The prevalence of
cardiovascular, ocular, dermal and musculoskeletal respiratory symptoms was found to be significantly higher
system was conducted at a health examination camp set than that reported by the control group (16.7% vs. 4.27%)
up at the work place in the tannery industry. (P < 0.001). Dry/productive cough and throat irritation were
3. X-ray chest the cardinal respiratory symptoms recorded in the exposed
The clinically positive respiratory cases were subjected workers [Table 3].
to a chest X-ray (PA view) on a 100 MA X-ray machine to
confirm the clinical findings. The overall prevalence of morbidity was found to be
4. Lung function testing significantly higher among the tanners in contrast to that
A precalibrated portable computerized spirometer (Auto found in the controls (40.1% vs. 19.6%) (P < 0.01). In the case
spiror Model HS-1, Tuda aptics, Japan) was used to record of the exposed group, it is the respiratory (16.7%), followed
the spirometric functions. The observed values were by ocular illnesses (14.7%) that afflicted the tanners, whereas
compared with the predicted values of Rastogi et al.[19] gastrointestinal tract problems were predominant in the
The peak expiratory flow rate was measured by a peak control groups (9.4%) [Table 4]. Among the leather tanners,
flow meter (standard model –clement clake, U.K) and the a group of 10 subjects (5.07%) reported redness in the
highest value was taken into account. conjunctiva with prominent bulbar vessels, seven subjects
5. Biomonitoring of chromium in blood and urine samples (3.55%) reported congestion of the nasal mucosa.
Venous blood samples were collected in heparinized
tubes and spot urine samples in sterile plastic containers. Nearly 9% (n = 17) of the leather tanners reported
The samples were transported to the laboratory under dermatological diseases such as rashes and papules along
chilled conditions. Urinary and blood chromium analysis with complaints of itching. The burning sensation was
was performed by a direct dilution method. An atomic reported by 15 subjects (7.6%) in the exposed workers.
absorption spectrophotometer (Parkin Elmar model 5000,
USA) was used for the estimation of chromium.[20] Among the respiratory morbidity in the exposed group, it
6. Air monitoring of chromium at the work place was occupational asthma that showed a prevalence of 5.0%
External exposure at the work place was estimated by whereas chronic bronchitis, allergic bronchitis, sinu sites
personal air monitoring during the work shift. The airborne and pulmonary tuberculosis were other respiratory illnesses
particulate sampling was performed on quartz microfiber observed in the tanners. No cases of asthma and allergic
filters (Whatman QM-A, diameter 37mm) in Millipore bronchitis were reported by the control group [Table 5].
filter holders. The concentrations of the total particulate
were determined by weighing the filter and calculated in All lung function values were significantly reduced in the
milligrams per cubic meter. exposed workers. The reduced values indicated bronchial
obstruction in the exposed group [Table 6].
RESULTS
The prevalence of respiratory impairment was found to be
The details of the processes and chemicals used in the significantly higher among the leather tanners in contrast
leather tanning industry are listed in Table 1. The physical to that observed in the control group (30.9% vs. 16.2%)
characteristics of the exposed group and the controls are (P < 0.001). Bronchial obstruction followed by lung restriction
shown in Table 2. The mean age, height and body weight of the was the main abnormality found in the exposed group
exposed group were found to be similar to those measured in [Table 7].
the control group. The leather tanners had a mean exposure
of 8.8 + 3.20 years in the leather tanneries. The control group The urinary and blood concentrations of Cr were found to be

Table 1: Processes and chemicals used in leather production

Processes Chemicals used Purpose
Preparation of the hide for tanning DDT, zinc chloride, phenols, formaldehyde, mineral oil, Hides are treated for defestation and disinfection
arsenious anhydride
Tanning process Calcium hydroxide, sodium sulfide, sulfuric acid, For conversion of hides and skins to leather by removing
formic acid, hydrogen sulfide and solvents such as the epidermis and subcutaneous layer and subsequently
benzene, ethanol, tetrachloride, trichloroethylene stabilizing the middle portion of the skin
and dichloromethane
Finishing process Formaldehyde as fixer, aniline and resins Includes coloring and producing surface effects to
1. Casein finishing ensure brightness, softness, elasticity and
2. Nitrocellulose finishing. impermeability

133 Indian Journal of Occupational and Environmental Medicine - December 2008 - Volume 12 - Issue 3
Rastogi et al.: Health risk of tanneries workers

Table 2: Physical characteristics and smoking prevalence Table 3: Respiratory symptoms observed among the exposed
among the leather tanners and controls and the control group
Parameters Exposed (n = 197) Controls (n = 117) Respiratory Controls (n = 117) Exposed (n = 197)
(mean, SD) (mean, SD) symptoms (N, %) (N, %)
Age (years) 35.5 + 10 38.6 + 11 Dry/productive cough 2 1.7 11 5.58
Height (cm) 164.5 + 4.82 165.8 + 5.20 Throat irritation 1 0.85 7 3.55
Weight (kg) 54.6 + 6.8 57.2 + 5.9 Chest congestion 1 0.85 6 3.04
Exposed period (years) 8.8 + 3.20 – Nasal catarrh 1 0.85 5 2.53
Smoking prevalence (%) 83 + 42.1 56 + 47.8 Dyspnoea – 4 2.03
Overall 5 4.27 33 16.7

Table 4: Type of morbidity observed in the exposed and in the

Table 5: Respiratory morbidity of the leather tanners and
control group
controls
Morbidity Controls (n = 117) Exposed (n = 197)
Respiratory Controls (n = 117) Exposed (n = 197)
(N, %) (N, %)
morbidity (N, %) (N, %)
Ocular 3 2.56 29 14.7
Chronic bronchitis 1 0.85 4 2.03
Dermal 4 3.41 17 8.6
Occupational asthma – 10 5.07
Respiratory 5 4.27 33 16.7
Allergic bronchitis – 7 3.55
Gastrointestinal 11 9.40 –
Sinusitis 2 1.7 7 3.55
Overall 23 19.6 79 40.1
Pulmonary tuberculosis 1 0.85 5 2.53
Overall 4 3.41 33 16.7
Table 6: Lung function values among the exposed and the
control groups Table 7: Type of pulmonary impairment among the tannery
Parameters Controls (n = 117) Exposed (n = 197) workers and the controls
(mean, SD) (mean, SD)
Type of pulmonary Exposed (197, %) Controls (17. %)
FVC (%P) 81.4 ± 7.4 76.8 ± 7.8 impairment
FEV (%) 83.6 ± 8.6 70.6 ± 6.8
Bronchial obstruction 29 14.7 7 5.98
FEV/FVC (%) 79.8 ± 10.4 68.6 ± 9.7
Lung restriction 17 8.6 5 4.27
FMF (1/s) 3.42 ± 0.67 2.09 ± 0.65
Mixed ventilator defects 15 7.6 7 5.98
PERF (%P) 450 ± 60.8 285 ± 40.8
Overall 61 30.9 19 16.2

Table 8: Urinary and blood chromium levels in the exposed

and in the control groups tanners in comparison to the reference values (19.6%) could
Parameters Controls Exposed P-value
be due to high levels of chromium in the biological samples of
(n = 21) (n = 39) the exposed workers and air samples collected at the worksite.
Urinary Cr (ppb) 1.37 ± 0.49 (0.67 – 2.17) 0.001 The increased morbidity in the exposed workers could be
Mean ± SD 5.39 ± 2.19 (2.59 – 11.81) attributed to high respiratory illness (16.7%) compared with
Range 4.27 % in the control group. The higher biological values
Blood Cr (ppb) 1.68 ± 0.41 (0.57 – 2.15) 0.001
Mean ±SD 2.62 ± 0.57 (1.46 – 4.95) of chromium among the tanners could be explained by
Range atmospheric pollution caused by the liberated leather dust at
the work place. The increased pulmonary morbidity is also
associated with certain characteristic symptoms such as
significantly raised among the leather tanners (P < 0.001), dry cough (5.6%), throat irritation (3.6%) and lung congestion
thereby reflecting the body burden of Cr in the exposed in 3.0% of the workers. Among the respiratory morbidity in
workers as a result of a high concentration of environmental the exposed group, the cases of occupational asthma (5.0%)
Cr at the work place [Table 8]. were more prominent than other respiratory illnesses. It
has been reported in the literature that it is the metabolism
DISCUSSION distribution and transport of the chromium in the blood that
is a causal factor for increased respiratory morbidity.[21,22]
An important health risk factor for the tannery workers is The hexavalent chromium is rapidly absorbed by the lungs
occupational exposure to chromium, which is used as a into the blood and easily penetrates the cellular membranes
basic tanning pigment. The workers on exposure to leather and binds to the hemoglobin in the red blood cells thereby
dust, which contains chromium in the protein-bound form, affecting the oxygen carrying capacity and impairing the lung
exhibited a higher mean concentration of urinary and blood function status.[23-25]
chromium than the reference values. The personal sampling
conducted at different work sites exhibited higher levels of Our study confirms the previous findings of increased
total chromium. The high morbidity (40.1%) observed in the pulmonary impairment among the chrome platers (30.9%)

Indian Journal of Occupational and Environmental Medicine - December 2008 - Volume 12 - Issue 3 134
 Rastogi et al.: Health risk of tanneries workers

as against 16.2% in the controls.[26] In an earlier study on 637-42.

chrome platers, we demonstrated cases of nasal ulcer and 12. Basketter D, Horev L, Slodovnik D, Merimes S, Trattner A, Ingber A.
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