Occupational nanoparticle exposure and its effects on pulmonary health, cardiovascular health, and systemic biomarkers: a scoping review

Abstract Background Occupational exposure to nanoparticles occurs across diverse industrial sectors. Preclinical studies indicate that such exposures may pose health risks. However, characterization of these risks in real-world occupational-environments remains limited. Objective This scoping review summarizes the evidence on health effects associated with occupational exposure to nanomaterials and ultrafine particles (UFP), the diagnostic approaches for early detection of health effects, and to identify knowledge gaps. Methods A comprehensive search was conducted in MEDLINE, EMBASE, and Web of Science from inception to April 2024. Peer-reviewed studies that assessed health outcomes among workers exposed to nanomaterials or UFP in occupational-settings were included. No appraisal of quality was performed. Results Of 6,020 unique records, 66 studies met inclusion criteria, mostly cross-sectional ( n = 37) or panel studies ( n = 18). Nanomaterials exposures included carbon nanotubes/fibers, titanium dioxide, and metal oxides mainly in manufacturing and processing industries. Studies reported pulmonary and cardiovascular outcomes along with effects on systemic biomarkers of cellular stress and molecular alterations. Pulmonary outcomes included affected lung function and increased levels of markers of inflammation and oxidative stress. Cardiovascular outcomes mainly included elevated markers of endothelial dysfunction, cardiac autonomic dysregulation, hypercoagulation, and vascular inflammation. Systemic biomarkers included immune alterations, oxidative stress, DNA damage, and epigenetic alterations. Multiple diagnostic approaches demonstrate strong potential for early detection of nanoparticles-related adverse health outcomes in occupational health. Conclusion Current evidence indicates that occupational exposure to nanoparticles may be linked with pulmonary and cardiovascular outcomes, together with alterations in systemic biomarkers. Various diagnostic methods have been reported with potential for early detection of adverse health outcomes in occupational health. However, evidence is largely based on cross-sectional and small-scale studies, with considerable heterogeneity in exposure assessment and outcome definitions. Longitudinal studies with standardized exposure characterization and harmonized diagnostic protocols are needed to establish causality and improve risk assessment in occupational settings. Clinical trial number Not applicable.