Surfactant Protein A Serum Level in Cement Worker

Gunawan Gunawan, Sita Laksmi Andarini, Muhammad Ilyas, Arif Santoso, Ahmad Hudoyo, Irawaty Djaharudin, Harun Iskandar, Nur Ahmad Tabri


Background: Pneumoconiosis occurs almost in entire worldwide. Pneumoconiosis had threatened cement workers. Serologic abnormalities had found in pneumoconiosis. Surfactant Protein A (SP-A) levels increased in silica-exposed workers. Surfactant Protein A (SP-A) may be a helpful biomarker for the early diagnosis of pneumoconiosis, but it has not yet been studied in Indonesia.

Methods: The design of this study was observational with cross-sectional. A sampling of cement-exposed workers was done by consecutive sampling. The subjects were 88, approach population of 67 cement exposed workers from September 2017 – March 2018 and 17 healthy people as control. The serum level of SP-A was measured by the ELISA method. Cement exposed workers is a worker in the production area and workers in the quarry area.

Results: The total number of research subjects met the criteria was 67, and the control subjects were 21. The mean serum SP-A level in the study subject group or the exposed group was 6.02 ng/ml, and the mean SP-A level in the control group was 4.50 ng/ml. The difference in SP-A levels between the exposed and control groups was different but not significant, with value of P=0.084.

Conclusion: SP-A levels in the exposed and control groups were different but not statistically significant.


Cement workers, Serum surfactant A, Silica exposure

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Susanto AD. Pneumokoniosis. Journal of The Indonesian Medical Association. 2011;61(12):503–10.

Mwaiselage J, Bråtveit M, Moen B, Mashalla Y. Cement dust exposure and ventilatory function impairment: an exposure-response study. J Occup Environ Med. 2004;46(7):658–67.

Mengkidi D, Nurjazuli, Sulistiyani. Gangguan fungsi paru dan faktor-faktor yang mempengaruhinya pada karyawan PT. Semen Tonasa pangkep sulawasi selatan | Mengkidi. Jurnal Kesehatan Lingkungan Indonesia. 2006;5(2):59–63.

Stellman JM, International Labour Office. Encyclopaedia of occupational health and safety. 4th ed. Vol. 1. Geneva: International Labor Office; 1998. 10 p.

Salawati L. Silikosis. Jurnal Kedokteran Syiah Kuala. 2017;17(1):20–6.

Kolegium Pulmonologi dan Kedokteran Respirasi. Buku ajar pulmonologi dan kedokteran respirasi. 1st ed. Rasmin M, Yusuf A, Amin M, Taufik, Nawas MA, Rai IBN, et al., editors. Jakarta: UI Press; 2017.

Mazur W, Toljamo T, Ohlmeier S, Vuopala K, Nieminen P, Kobayashi H, et al. Elevation of surfactant protein A in plasma and sputum in cigarette smokers. Eur Respir J. 2011;38(2):277–84.

Kobayashi H, Kanoh S, Motoyoshi K. Serum surfactant protein-A, but not surfactant protein-D or KL-6, can predict preclinical lung damage induced by smoking. Biomarkers. 2008;13(4):385–92.

Kuroki Y, Takahashi H, Chiba H, Akino T. Surfactant proteins A and D: disease markers. Biochim Biophys Acta. 1998;1408(2–3):334–45.

National Institute for Occupational Safety and Health (NIOSH). Work-related lung disease surveillance report 2007 [Internet]. Division of Respiratory Disease Studies National Institute for Occupational Safety and Health. 2008. Available from:

Fernández-Real JM, Chico B, Shiratori M, Nara Y, Takahashi H, Ricart W. Circulating surfactant protein A (SP-A), a marker of lung injury, is associated with insulin resistance. Diabetes Care. 2008;31(5):958–63.

Nomori H, Horio H, Fuyuno G, Kobayashi R, Morinaga S, Suemasu K. Serum surfactant protein A levels in healthy individuals are increased in smokers. Lung. 1998;176(6):355–61.

Department of Labour South Africa. National Programme for the Elimination of Silicosis. 2007. p. 1–12.

Dutt KL. Sandstone quarry workers Karauli, Rajasthan, India. Retrieved from, Canberra: Australian National University. 2015;1–21. Available from: 1161.pdf

Holmskov U, Thiel S, Jensenius JC. Collections and ficolins: humoral lectins of the innate immune defense. Annu Rev Immunol. 2003;21:547–78.

Spech RW, Wisniowski P, Kachel DL, Wright JR, Martin WJ 2nd. Surfactant protein A prevents silica-mediated toxicity to rat alveolar macrophages. Am J Physiol Lung Cell Mol Physiol. 2000;278(4):L713-8.

Lesur O, Veldhuizen RA, Whitsett JA, Hull WM, Possmayer F, Cantin A, et al. Surfactant-associated proteins (SP-A, SP-B) are increased proportionally to alveolar phospholipids in sheep silicosis. Lung. 1993;171(2):63–74.

Rinawati P. Coal worker’s pneumoconiosis. Medical Journal of Lampung University. 2015;4(1):49–56.



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