An analysis of occupational exposure to particulate matter and erythrocyte morphological abnormalities among charcoal-grill restaurant workers

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Yüksel B., Arsal Yıldırım S.

Frontiers In Public Health, cilt.14, sa.1, ss.1-12, 2026 (Hakemli Dergi)

Özet

Background:

Workers in charcoal- and wood-fired grill restaurants are exposed to high concentrations of combustion-derived particulate matter (PM) and carbon monoxide during long shifts in poorly ventilated kitchens. Whether this exposure is associated with measurable changes in circulating erythrocyte morphology is not established.

Methods:

This study used a comparative cross-sectional design and compared charcoal-grill workers (n = 25) with a group of office personnel (n = 25) in Kocaeli University. At each occupational unit, the researchers assessed indoor air conditions, measuring particulate matter (PM) mass concentration, carbon monoxide (CO), carbon dioxide (CO₂), ambient temperature, and relative humidity. Peripheral blood smears were processed for a subgroup of the subjects (restaurant n = 25; office n = 19). For everyone, we examined and averaged the outcomes from two distinct 1,000-cell samples to quantify 10 structural anomalies in erythrocytes. We compared groups using Benjamini-Hochberg-adjusted Mann–Whitney U tests and applied negative binomial regression for anomaly counts, adjusting for age, sex, and education.

Results:

Restaurant worksites had markedly higher PM concentrations (median 117.8 vs. 0.23 μg/m3), CO and CO₂ than offices (all p < 0.01). Restaurant workers reported more wheezing (12/25 vs. 0/25) and dyspnoea (11/25 vs. 1/25, both FDR-corrected p < 0.05). In unadjusted analyses, total anomalies were higher in restaurant workers, but no single abnormality survived correction. After adjustment for age, sex and education, four specific poikilocytes remained significantly elevated: dacrocytes (adjusted IRR 2.46, 95% CI 1.36–4.44), elliptocytes (IRR 2.33, 1.16–4.71), sickle-form cells (IRR 4.47, 1.41–14.17) and schistocytes (IRR 1.56, 1.03–2.35). The crude difference in total anomaly burden did not survive confounder adjustment (IRR 1.57, 0.65–3.78).

Conclusion:

Grill restaurant work involves high-particulate exposure associated with stress-related erythrocyte poikilocytes, suggesting mechanical and oxidative membrane damage rather than generalised morphological changes. However, due to subclinical anomaly rates, demographic confounders, and missing control data, these findings remain hypothesis-generating. Because of the limited sample size and the investigative nature of this research, the current findings should be interpreted as tentative and primarily useful for formulating future hypotheses. Furthermore, its cross-sectional design and lack of direct measurements of oxidative stress preclude establishing causality or verifying biological pathways.