Evaluation of potential toxic effects of occupational inhalation exposure to licorice root dust

Licorice, a plant indigenous to southern Europe, the Middle East, and northern China, exhibits several pharmacological properties, including estrogenic, anti-tumoral, anti-inflammatory, anti-allergenic, and anti-tussive activities. Prolonged use of licorice is known to produce headaches, hypertension, cardiac arrhythmias, edema, lethargy, dyspnea, sodium retention and loss of potassium in humans. However, to date, the potential adverse health effects due to occupational inhalation exposure of licorice root dust remains unknown. This study was, therefore, undertaken to address this issue. In this cross-sectional study, individuals (30 workers) occupationally exposed to licorice root dust at a licorice producing plant in Shiraz, Iran were recruited. Similarly, 30 healthy male unexposed employees at a telecommunications industry, with identical demographic and socioeconomic status, without any past or current exposure to licorice dust or habitual ingestion of this compound, served as the referent group. Systolic and diastolic blood pressures were measured. Further, individuals underwent electrocardiography, clinical examination and blood chemistry tests. To assess the extent to which subjects were exposed to licorice root dust, atmospheric concentrations of this compound were also measured in the plant. There were no differences in age, weight, height and duration of exposure to licorice dust or length of employment between exposed and referent groups. Atmospheric measurement of licorice dust showed that concentration exceeded the permissible limit of 5 mg m^?3. Systolic and diastolic blood pressures of exposed subjects were significantly higher than those of the referent group. Similarly, blood analysis revealed that serum concentrations of potassium and platelet counts were significantly lower in exposed subjects than in referent individuals. Questionnaire data demonstrated that symptoms such as headaches, lethargy, and vertigo were more common in exposed subjects. No abnormal changes were noted in the electrocardiographs of exposed or referent subjects. Our findings provide evidence that inhalation exposure to high concentrations of licorice dust is associated with an increased prevalence of headache, lethargy, and vertigo, as well as hypertension and hypokalemia. None of these changes resulted in increased morbidity and mortality in exposed workers.