OBJECTIVE: The use of nanotechnology is growing enormously and occupational physicians have an increasing interest in evaluating potential hazards and finding biomarkers of effect in workers exposed to nanoparticles. METHODS: A study was carried out with 36 workers exposed to (nano)TiO2 pigment and 45 controls. Condensate (EBC) titanium and markers of oxidation of nucleic acids (including 8-hydroxy-2-deoxyguanosine (8-OHdG), 8-hydroxyguanosine (8-OHG), 5-hydroxymethyl uracil (5-OHMeU)) and proteins (such as o-tyrosine (o-Tyr), 3-chlorotyrosine (3-ClTyr) and 3-nitrotyrosine (3-NOTyr)) were analysed from samples of their exhaled breath. RESULTS: In the production workshops, the median total mass 2012 and 2013 TiO2 concentrations were 0.65 and 0.40 mg/m(3), respectively. The median numbers of concentrations measured by the scanning mobility particle sizer (SMPS) and aerodynamic particle sizer (APS) were 1.98 × 10(4) and 2.32 × 10(4) particles/cm(3), respectively; and about 80% of those particles were smaller than 100 nm in diameter. In the research workspace, lower aerosol concentrations (0.16 mg/m(3) and 1.32 × 10(4) particles/cm(3)) were found. Titanium in the EBC was significantly higher in production workers (p<0.001) than in research workers and unexposed controls. Accordingly, most EBC oxidative stress markers, including in the preshift samples, were higher in production workers than in the two other groups. Multiple regression analysis confirmed an association between the production of TiO2 and the levels of studied biomarkers. CONCLUSIONS: The concentration of titanium in EBC may serve as a direct exposure marker in workers producing TiO2 pigment; the markers of oxidative stress reflect the local biological effect of (nano)TiO2 in the respiratory tract of the exposed workers.

1st Faculty of Medicine Charles University Prague and General University Hospital Prague Institute of Biophysics and Informatics Prague Czech Republic

1st Faculty of Medicine Charles University Prague and General University Hospital Prague Institute of Biophysics and Informatics Prague Czech Republic Faculty of Physical Education and Sport Department of Kinanthropology and Humanities Charles University Prague Prague Czech Republic

1st Faculty of Medicine Department of Occupational Medicine Charles University Prague and General University Hospital Prague Prague Czech Republic

Faculty of Health Sciences and Social Work Department of Public Health Trnava University Trnava Slovakia

Institute of Chemical Process Fundamentals of the AS CR vvi Prague Czech Republic

Institute of Chemical Process Fundamentals of the AS CR vvi Prague Czech Republic Institute of Chemical Process Fundamentals of the AS CR vvi Prague Czech Republic

Institute of Chemical Technology Prague Czech Republic

Interdepartmental Centre G Scansetti for Studies on Asbestos and Other Toxic Particulates and NIS Interdepartmental Centre for Nanostructured Interfaces and Surfaces University of Torino Torino Italy

J Heyrovský Institute of Physical Chemistry of the AS CR vvi Prague Czech Republic 1st Faculty of Medicine Charles University Prague and General University Hospital Prague Institute of Medical Biochemistry and Laboratory Diagnostics Prague Czech Republic

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