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Clara Cell Protein as a Biomarker for Lung Epithelial Injury in Asphalt Workers

Ulvestad, Bente MD, PhD; Randem, Britt Grethe MD, MPH, PhD; Andersson, Lena MSc; Ellingsen, Dag G. MD, PhD; Barregard, Lars MD, PhD

Journal of Occupational and Environmental Medicine: October 2007 - Volume 49 - Issue 10 - p 1073-1078
doi: 10.1097/JOM.0b013e3181570726
Original Articles

Objective: We investigated if asphalt workers showed signs of lung epithelial injury as shown by increased Clara cell protein 16 (CC16) in serum after 6 months of exposure.

Methods: Asphalt pavers, asphalt plant operators, and asphalt engineers underwent lung function tests and blood samples before the start of the asphalt season. The tests were repeated before the end of the asphalt season. Blood samples were analyzed for concentration of CC16 and interleukin-6 (IL-6).

Results: After adjustment for current smoking, the pavers had a significantly larger increase in CC16 concentrations after the season as compared with that of the engineers and plant operators. In pavers, the change in serum CC16 was correlated with the change in IL-6.

Conclusion: CC16 increased over the season in pavers and appears to be a useful biomarker for lung epithelial injury in exposed workers.

From the Department of Occupational Medicine (Dr Ulvestad), Mesta AS, Moss, Norway; Department of Occupational Medicine (Dr Randem), Ulleval University Hospital, Oslo, Norway; Department of Occupational and Environmental Medicine (Ms Andersson, Dr Barregard), Sahlgrenska University Hospital and Academy, Goteborg University, Goteborg, Sweden; and National Institute of Occupational Health (Dr Ellingsen), Oslo, Norway.

CME Available for this Article at

This study was supported by a grant from the Statoil Research Fund for occupational research. The authors have no affiliations with companies or products that may be mentioned in this paper.

Address correspondence to: Bente Ulvestad, Department of Occupational Medicine, Mesta, AS, P. Box 5133, 1503 Moss, Norway; E-mail:

©2007The American College of Occupational and Environmental Medicine