Lung epithelial cellular proliferative activity associated with conventional gold mining in Sudan

OBJECTIVE: Traditional Sudanese gold mining poses serious health challenges to workers and communities. This issue requires early detection of at-risk populations using affordable, non-invasive sputum cytology. Thus, the present study aimed to evaluate the proliferative activity of lung epithelial cells in Sudanese individuals associated with traditional gold mining.

MATERIALS AND METHODS: This study is a cross-sectional, descriptive, clinic-based pilot investigation conducted in El-Obeid, North Kordofan State, Sudan. Participants in the study are individuals actively involved in traditional gold mining. The selection of candidates was based on their willingness to participate in the study, independent of demographic characteristics. Lung cytology was performed, and the results were categorized as normal, metaplasia, cytological atypia, and cellular degenerative changes.

RESULTS: Squamous metaplasia was identified in 17 out of 109 individuals (15.6%). Mild cytological atypia was identified in 3.7% of individuals. All four smears with cytological atypia showed squamous metaplasia of the lung. The risk of cytological atypia among individuals with respiratory squamous metaplasia is represented by the Odds Ratio (OR) and the 95% confidence interval (95% CI), which are OR = 28.3 (2.9333 to 273.1792) and p = 0.0038.

CONCLUSIONS: Pulmonary squamous metaplasia was common and linked with cytological degeneration and inflammation. Mild cytological atypia was infrequent and only linked with respiratory metaplasia. A substantial link exists between inflammatory state, particularly CICI, and respiratory metaplasia (OR = 5.4; p < 0.003).