{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T12:59:03Z","timestamp":1776430743811,"version":"3.51.2"},"reference-count":22,"publisher":"BMJ","issue":"1","funder":[{"name":"Institute of Labor, Occupational Safety and Health, Ministry of Labor, Taiwan","award":["ILOSH112-H055"],"award-info":[{"award-number":["ILOSH112-H055"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2026,3,8]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the relationships between indium exposure biomarkers and pulmonary injury markers among indium-exposed workers, and to evaluate the exploratory diagnostic utility of indium levels for identifying subclinical ventilatory abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study recruited 30 workers from a Taiwanese indium\u2013tin oxide (ITO) facility. Participants completed standardised questionnaires, spirometry, diffusing capacity (diffusing capacity of the lungs for carbon monoxide) testing and chest radiography. Serum indium (In-S) and urinary indium (In-U) concentrations were quantified alongside pulmonary biomarkers (Krebs von den Lungen-6 (KL-6), Surfactant Protein A (SP-A), Surfactant Protein D (SP-D)) and systemic inflammatory and oxidative stress markers (Lactate Dehydrogenase (LDH), Malondialdehyde, C-Reactive Protein, 8-hydroxy-2-deoxyguanosine). Group comparisons were stratified by In-S level and workstation. Associations were assessed using Spearman\u2019s correlation. Receiver operating characteristic (ROC) analyses were performed to explore the diagnostic performance of indium biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Production workers had significantly higher In-S and In-U levels than administrative staff (p&lt;0.001). KL-6 and LDH were elevated in the high In-S group (p&lt;0.01). In-S and In-U correlated moderately with KL-6 (\u03c1=0.556\u2009and 0.536, respectively; p&lt;0.001), and with SP-D (\u03c1=0.388\u2009and 0.384; p=0.013\u2009and 0.014). In-U showed negative correlation with SP-A (\u03c1=\u20130.329, p=0.038) and positive correlation with LDH (\u03c1=0.317, p=0.046). ROC analysis demonstrated exploratory diagnostic performance within this cohort of In-S for identifying reduced maximal mid-expiratory flow and reduced FEV\u2081\/FVC ratio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In-S and In-U levels are associated with biological markers of alveolar epithelial injury and functional parameters related to airway physiology. These findings support the potential role of indium biomonitoring in occupational surveillance, while underscoring the need for cautious interpretation given the cross-sectional design and limited sample size.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/oemed-2025-110642","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T07:10:19Z","timestamp":1773904219000},"page":"36-41","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Serum and urinary indium as early biomarkers of airway dysfunction in indium-exposed workers"],"prefix":"10.1136","volume":"83","author":[{"given":"Ting-An","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Occupational Medicine, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2569-960X","authenticated-orcid":false,"given":"Jhe-Ping","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Occupational Medicine, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan"},{"name":"Department of Emergency Medicine, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao-Yi","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Occupational Medicine, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5932-4785","authenticated-orcid":false,"given":"Chia-Cheng","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Occupational Medicine, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan"},{"name":"Master of Science Degree Programme in Innovation for Smart Medicine, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9195-7833","authenticated-orcid":false,"given":"Jau-Yuan","family":"Chen","sequence":"additional","affiliation":[{"name":"College of Medicine, Chang Gung University, Taoyuan, Taiwan"},{"name":"Department of Family Medicine, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7355-5208","authenticated-orcid":false,"given":"Yu-Chung","family":"Tsao","sequence":"additional","affiliation":[{"name":"Department of Occupational Medicine, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan, Taiwan"},{"name":"Master of Science Degree Programme in Innovation for Smart Medicine, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"2026041705150874000_83.1.36.1","unstructured":"Pubchem compound summary for cid 5359967, indium. National Library of Medicine (US). n.d. Available: https:\/\/pubchem.ncbi.nlm.nih.gov\/compound\/Indium"},{"key":"2026041705150874000_83.1.36.2","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1111\/cod.13549","article-title":"Indium and iridium: Two rare metals with a high rate of contact sensitization","volume":"83","author":"Terrani","year":"2020","journal-title":"Contact Derm"},{"key":"2026041705150874000_83.1.36.3","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1620\/tjem.248.143","article-title":"Indium Lung: Discovery, Pathophysiology and Prevention","volume":"248","author":"Chonan","year":"2019","journal-title":"Tohoku J Exp Med"},{"key":"2026041705150874000_83.1.36.4","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-1880"},{"key":"2026041705150874000_83.1.36.5","unstructured":"Welding, molybdenum trioxide, and indium tin oxide. Lyon, France International Agency for Research on Cancer; 2018. 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