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Petersson Sjögren M, Kåredal M, Broberg K, Assarsson E, Thuresson S, Dierschke K, Hedmer M, Rissler J, Wollmer P, Löndahl J. Sensitive methods for assessment of lung health in welders and controls. Respir Med 2023; 212:107244. [PMID: 37062499 DOI: 10.1016/j.rmed.2023.107244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND Welders are exposed to gas and particle emissions that can cause severe lung disease, such as chronic obstructive pulmonary disease (COPD), a leading cause of mortality and morbidity worldwide. It is hard to detect COPD early and therefore mitigating measures may be delayed. The aim of this study was to investigate lung health in welders and evaluate new sensitive methods with potential to assess early onset pulmonary changes in occupational settings. METHODS This study assessed the lung health and symptoms in active welders (n = 28) and controls (n = 17). Lung measurements were performed with standard spirometry and new methods: airspace dimension assessment (AiDA), oscillometry, blood serum biomarkers (club cell secretory protein 16, surfactant protein D, matrix metalloproteinases, fibroblast, hepatocyte growth factor, interleukins), and one urine biomarker (desmosine). RESULTS According to spirometry measurements, all participants had normal lung function. However, prevalence of cough was significantly higher among welders compared with controls and lung changes were found in welders with the novel methods. Welders had significantly higher respiratory system resistance assessed with oscillometry, serum levels of metalloproteinases 9 and hepatocyte growth factor, compared with controls. Airspace dimensions were on average higher among welders compared with controls, but the difference was not significant. The number of welding years correlated with decreased respiratory system reactance and increased serum levels of matrix metalloproteinases 9, interleukin 6, and hepatocyte growth factor. Airspace dimension assessment indices significantly correlated with increasing levels of inflammatory markers and matrix metalloproteinases. CONCLUSIONS This study indicated the potential to use new and more sensitive methods for identification of changes in lungs when standard spirometry failed to do so.
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Affiliation(s)
- Madeleine Petersson Sjögren
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden; NanoLund, Lund, Sweden
| | - Monica Kåredal
- NanoLund, Lund, Sweden; Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden; Department of Occupational and Environmental Medicine, Region Skåne, Lund, Sweden
| | - Karin Broberg
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eva Assarsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Sara Thuresson
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden; NanoLund, Lund, Sweden
| | - Katrin Dierschke
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden; Department of Occupational and Environmental Medicine, Region Skåne, Lund, Sweden
| | - Maria Hedmer
- NanoLund, Lund, Sweden; Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden; Department of Occupational and Environmental Medicine, Region Skåne, Lund, Sweden
| | - Jenny Rissler
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden; NanoLund, Lund, Sweden; RISE Research Institutes of Sweden, Borås, Sweden
| | - Per Wollmer
- Department of Translational Medicine, Clinical Physiology and Nuclear Medicine, Lund University, Malmö, Sweden
| | - Jakob Löndahl
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden; NanoLund, Lund, Sweden.
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Grahn K, Gustavsson P, Andersson T, Lindén A, Hemmingsson T, Selander J, Wiebert P. Occupational exposure to particles and increased risk of developing chronic obstructive pulmonary disease (COPD): A population-based cohort study in Stockholm, Sweden. ENVIRONMENTAL RESEARCH 2021; 200:111739. [PMID: 34302831 DOI: 10.1016/j.envres.2021.111739] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/30/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Chronic Obstructive Pulmonary Disease (COPD) is a common respiratory disorder. Next to tobacco smoking, occupational exposure is the most important risk factor for COPD in high-income countries. To enable preventative measures, more knowledge is needed on which specific occupational exposures that are related to risk of developing COPD in men and women. METHODS A population-based cohort was formed from subjects responding to the Stockholm Public Health Surveys in 2002, 2006, and 2010, followed up until 2014. The dataset was linked to a quantitative job exposure matrix via occupational titles from the 1990 nation-wide Population and housing census. We identified COPD among subjects having medication for COPD and/or reporting a physician's diagnosis of COPD. The gender-specific risks to develop COPD from occupational particle-exposure were estimated by proportional hazards regression model, adjusted for age and individual data on tobacco-smoking. RESULTS Men exposed to respirable crystalline silica (RCS) (HR 1.46, CI 1.13-1.90), gypsum and insulation material (HR 1.56, CI 1.18-2.05), diesel exhaust (HR 1.18, CI 0.99-1.41) and high levels of particles from asphalt/bitumen (HR 1.71, CI 1.06-2.76) as well as welding fumes (HR 1.57, CI 1.12-2.21) had an increased smoking-adjusted risk for developing COPD. An increased risk was also observed among women highly exposed to various organic particles from soil, leather, plastic, soot, animal, textile, flour (HR 1.53, CI 1.15-2.04). Furthermore, a significant positive exposure-response trend was found among men exposed to RCS, iron dust, gypsum and insulation material, and diesel exhaust. A tendency towards an exposure-response relationship was also seen among both men and women exposed to welding fumes and various organic particles, and among men exposed to particles from asphalt/bitumen. The population attributable fraction for COPD from occupational exposure to particles was 10.6% among men and 6.1% among women. CONCLUSIONS This study indicates an increased smoking-adjusted risk of developing of COPD due to occupational exposure to particles. A positive exposure-response relationship was found for RCS, gypsum and insulation, diesel exhaust, and welding fumes. Also, exposure to high levels of asphalt/bitumen and various organic particles was associated with a higher risk for COPD. Reduction of these exposures in the work environment are important to prevent future cases of COPD. More studies are needed to investigate exposure-response relationships further, but this study indicates that the European occupational exposure limit (OEL) for RCS needs to be re-evaluated.
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Affiliation(s)
- Karin Grahn
- Institute of Environmental Medicine, Unit for Occupational Medicine, Karolinska Institutet, Solnavägen 4, Plan 10, SE-113 65, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Solnavägen 4, Plan 10, SE-113 65, Stockholm, Sweden.
| | - Per Gustavsson
- Institute of Environmental Medicine, Unit for Occupational Medicine, Karolinska Institutet, Solnavägen 4, Plan 10, SE-113 65, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Solnavägen 4, Plan 10, SE-113 65, Stockholm, Sweden.
| | - Tomas Andersson
- Institute of Environmental Medicine, Unit for Occupational Medicine, Karolinska Institutet, Solnavägen 4, Plan 10, SE-113 65, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Solnavägen 4, Plan 10, SE-113 65, Stockholm, Sweden.
| | - Anders Lindén
- Department of Respiratory Medicine and Allergology, NB6:03 Karolinska University Hospital, SE-171 76, Stockholm, Sweden; Institute of Environmental Medicine, Unit for Lung & Airway Research, Karolinska Institutet, PO Box 210, SE-171 77, Stockholm, Sweden.
| | - Tomas Hemmingsson
- Institute of Environmental Medicine, Unit for Occupational Medicine, Karolinska Institutet, Solnavägen 4, Plan 10, SE-113 65, Stockholm, Sweden; Department of Public Health Sciences, Stockholm University, SE-106 91, Stockholm, Sweden.
| | - Jenny Selander
- Institute of Environmental Medicine, Unit for Occupational Medicine, Karolinska Institutet, Solnavägen 4, Plan 10, SE-113 65, Stockholm, Sweden.
| | - Pernilla Wiebert
- Institute of Environmental Medicine, Unit for Occupational Medicine, Karolinska Institutet, Solnavägen 4, Plan 10, SE-113 65, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Solnavägen 4, Plan 10, SE-113 65, Stockholm, Sweden.
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Mehrifar Y, Zamanian Z, Pirami H. Respiratory Exposure to Toxic Gases and Metal Fumes Produced by Welding Processes and Pulmonary Function Tests. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2019; 10:40-49. [PMID: 30685776 PMCID: PMC6522216 DOI: 10.15171/ijoem.2019.1540] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 12/29/2019] [Indexed: 11/25/2022]
Abstract
Background: Welding is a common industrial process and is harmful to welders' health. Objective: To determine the effect of toxic gases and metal fumes produced during 3 welding processes on welders' incidence of respiratory symptoms and pulmonary function. Methods: This cross-sectional study was conducted in an Iranian shipbuilding industrial factory in 2018. Using the simple census method, 60 welders were selected as the exposed group. 45 staff members of the administrative unit were also recruited to be served as the control group. Welders' demographic data and respiratory complaints were collected employing a questionnaire. Fumes and gases produced were sampled from the welders' respiratory tract and analyzed by standard methods suggested by the National Institute of Occupational Safety and Health (NIOSH). Pulmonary function test was also performed for each participant. Results: The prevalence of respiratory symptoms in all welders was significantly (p<0.05) higher than the control group. The mean FVC, FEV1 and FEV1/FVC measured in welders involved in all 3 processes were significantly lower than those recorded in the control group. The spirometry pattern in welders involved in flux cored arc welding and shielded metal arc welding was obstructive; that in those involved in gas metal arch welding was mixed (obstructive and restrictive pattern). Conclusion: Exposure to welding fumes and gases was associated with pulmonary function deterioration. Welders involved in gas metal arch welding had a prevalence of pulmonary disorders compared with those involved in gas metal arch welding and flux cored arc welding.
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Affiliation(s)
- Younes Mehrifar
- Research Committee, School of Health Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Zamanian
- Department of Occupational Health, School of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamideh Pirami
- Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Berlinger B, Weinbruch S, Ellingsen DG, Zibarev E, Chashchin V, Chashchin M, Thomassen Y. On the bio-accessibility of 14 elements in welding fumes. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2019; 21:497-505. [PMID: 30788473 DOI: 10.1039/c8em00425k] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The bio-accessibility of 14 elements in welding fume particulate matter was investigated in 325 personal air samples collected during welding in two shipyards and one factory producing heavy machinery. The apparent solubility in a synthetic lung lining fluid (Hatch's solution) was used as proxy for the bio-accessibility. The Hatch solubility of the different elements was highly variable with a median < 1% for Al, Fe, Pb, Ti, between 4 and 6% for Co, Cr, Ni, V, W, between 13 and 27% for Cd, Cu, Mn, Zn, and 41% for Mo. For many elements, the solubility varied over a wide range of several tens of percent. The welding techniques used influenced the solubility of Co, Cr, Cu, Mn and V significantly. The plants investigated (i.e., the welded materials and used electrodes) had a significant influence on the solubility of Co, Cr, Cu, Mn, Mo, V and W. According to principal component analysis (PCA), the variation in solubility can be described by four components, which explain 69% of the variance. The first principal component mostly comprises elements that can predominantly occur as divalent cations, the second principal component elements often forming oxyanions. The principal components are independent of the absolute value of the Hatch solubility. The results of PCA indicate that the co-variation of Hatch solubility is mainly controlled by the most soluble compounds in contrast to the absolute value of apparent solubility, which is strongly influenced by the distribution of the elements between compounds with different equilibrium solubilities. The observed large variability and the significant differences between welding techniques and plants clearly show that the bio-accessibility cannot be obtained from the literature but has to be studied experimentally at each location of interest.
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Affiliation(s)
- Balázs Berlinger
- National Institute of Occupational Health, PO Box 5330 Majorstuen, N-0304 Oslo, Norway.
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Baumann R, Brand P, Chaker A, Markert A, Rack I, Davatgarbenam S, Joraslafsky S, Gerhards B, Kraus T, Gube M. Human nasal mucosal C-reactive protein responses after inhalation of ultrafine welding fume particles: positive correlation to systemic C-reactive protein responses. Nanotoxicology 2018; 12:1130-1147. [DOI: 10.1080/17435390.2018.1498930] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- R. Baumann
- Institute for Occupational and Social Medicine, Aachen University of Technology, Aachen, Germany
| | - P. Brand
- Institute for Occupational and Social Medicine, Aachen University of Technology, Aachen, Germany
| | - A. Chaker
- Department of Otorhinolaryngology and Center of Allergy and Environment (ZAUM), Technical University Munich, Munich, Germany
| | - A. Markert
- Institute for Occupational and Social Medicine, Aachen University of Technology, Aachen, Germany
| | - I. Rack
- Institute for Occupational and Social Medicine, Aachen University of Technology, Aachen, Germany
| | - S. Davatgarbenam
- Institute for Occupational and Social Medicine, Aachen University of Technology, Aachen, Germany
| | - S. Joraslafsky
- Institute for Occupational and Social Medicine, Aachen University of Technology, Aachen, Germany
| | - B. Gerhards
- Welding and Joining Institute (ISF), Aachen University of Technology, Aachen, Germany
| | - T. Kraus
- Institute for Occupational and Social Medicine, Aachen University of Technology, Aachen, Germany
| | - M. Gube
- Institute for Occupational and Social Medicine, Aachen University of Technology, Aachen, Germany
- Health Office of the City and Area of Aachen, Aachen, Germany
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Gobba NAEK, Hussein Ali A, El Sharawy DE, Hussein MA. The potential hazardous effect of exposure to iron dust in Egyptian smoking and nonsmoking welders. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2018; 73:189-202. [PMID: 28375782 DOI: 10.1080/19338244.2017.1314930] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 03/28/2017] [Indexed: 06/07/2023]
Abstract
Exposure to iron dust and welding fumes is widespread and may increase the risk of lung inflammation. The aim of this study was to identify associations between exposure to iron/welding fumes and the levels of inflammatory parameters and allergic mediators among 120 Egyptian men. Forty nonsmoking and 40 smoking Egyptian welders as well as 40 healthy volunteers who were never exposed to welding fumes and were nonsmoking were enrolled in the study. Peak expiratory flow rates (PEFR) assessed at the end of the shift of work on working days revealed an impairment in lung function, with the smoking workers showing the worse results, followed by nonsmoking workers, as compared to healthy volunteers. Moreover, the results of the present study showed a significant increase in serum iron and immunoglobulin E, as well as plasma thiobarbaturic acid reactive substances, C-reactive protein, tumor necrosis factor-alpha, haptoglobin, interleukin-2, interleukin-6 and interleukin-23 histamine, lactate dehydrogenase isoenzyme-3, and calcitonin. In addition, the results revealed significant decrease in plasma α-1-antitrypsin and serum transferrin, as well as blood activities of antioxidant enzymes: catalase, superoxide dismutase, glutathione peroxidase, and glutathione reductase (as compared with control group). However, there was a nonsignificant change in arginase and α-L-fucosidase in smoking and nonsmoking welders exposed to iron dust and welding fumes. In conclusion, occupational exposure to iron dust and welding fumes increases lung inflammation risk among Egyptian blacksmith workers, a condition that worsens with smoking.
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Affiliation(s)
- Naglaa Abd El Khalik Gobba
- a Department of Pharmacology and Toxicology, College of Pharmacy , Misr University for Science and Technology (MUST) , 6th of October City , Egypt
| | - Abdelmaksoud Hussein Ali
- b Department of Biochemistry, Faculty of Veterinary Medicine , Benha University , Qalioubeya , Egypt
| | - Dalia E El Sharawy
- c Department of Chest Diseases, Faculty of Medicine , Tanta University , Cairo , Egypt
| | - Mohammed Abdalla Hussein
- d Department of Biochemistry, Faculty of Applied Medical Sciences , October 6 University , 6th of October City , Egypt
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7
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Koh DH, Lee SW, Ye BJ, Kim JI. Grouping schemes of welding fume exposure in shipyard welders. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2018; 15:413-421. [PMID: 29494296 DOI: 10.1080/15459624.2018.1447115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Welding fume exposure can increase the risk of chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the optimal grouping schemes of welding fume exposure in shipyard welders for future accurate examination of the association between welding fume exposure and COPD. Industrial hygiene records, including welding fume measurements between 2002 and 2009 were collected from a shipyard. A total of 2,360 personal welding fume measurements was compiled with a geometric mean of 1.66 mg/m3 and a geometric standard deviation of 4.02. Welding jobs were categorized into 8 groups. There were 9 working areas. To obtain the optimal grouping scheme, various grouping schemes were created using job, area, and job*area combination. To compare various grouping schemes, contrast and precision were calculated for each grouping scheme. For all measurement data, group mean ranking method created by ranking geometric means of the job*area combination into 3 groups (group mean ranking method) showed the best contrast and precision values among various grouping schemes, followed by grouping based on the job. For a subset of the data excluding job*area combinations with less than 10 measurements, grouping based on the job showed greater contrast than group mean ranking method, while for other subsets, including only repeated measurement data or further excluding job*area combinations with less than 10 measurements from the repeated measurement subset, group mean ranking method showed greater contrast than grouping based on the job. Our results showed that group mean ranking or grouping based on the job could be a candidate for the optimal grouping schemes in this shipyard. Our efforts for optimal grouping scheme may aid future cohort study to elucidate the association between welding fume exposure and COPD.
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Affiliation(s)
- Dong-Hee Koh
- a Department of Occupational Environmental Medicine , International St. Mary's Hospital, Catholic Kwandong University , Incheon , Korea
| | - Sun-Woo Lee
- b Gaon Institute of Occupational Environment Research , Busan , Korea
| | - Byeong-Jin Ye
- c Gimhae Clinic, Occupational Health Center , Inje University , Busan , Korea
| | - Jung-Il Kim
- d Department of Occupational and Environmental Medicine , Dong-A University Hospital , Busan , Korea
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8
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Berlinger B, Harper M. Interlaboratory comparison for the determination of the soluble fraction of metals in welding fume samples. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2018; 15:152-156. [PMID: 29157175 DOI: 10.1080/15459624.2017.1395961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
There is interest in the bioaccessible metal components of aerosols, but this has been minimally studied because standardized sampling and analytical methods have not yet been developed. An interlaboratory study (ILS) has been carried out to evaluate a method for determining the water-soluble component of realistic welding fume (WF) air samples. Replicate samples were generated in the laboratory and distributed to participating laboratories to be analyzed according to a standardized procedure. Within-laboratory precision of replicate sample analysis (repeatability) was very good. Reproducibility between laboratories was not as good, but within limits of acceptability for the analysis of typical aerosol samples. These results can be used to support the development of a standardized test method.
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Affiliation(s)
- Balazs Berlinger
- a Department of Chemical and Biological Work Environment , National Institute of Occupational Health , Oslo , Norway
| | - Martin Harper
- b Zefon International Inc. , Ocala , Florida
- c Department of Environmental Engineering Science , University of Florida , Gainesville , FL
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9
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Antonini JM, Afshari A, Meighan TG, McKinney W, Jackson M, Schwegler-Berry D, Burns DA, LeBouf RF, Chen BT, Shoeb M, Zeidler-Erdely PC. Aerosol characterization and pulmonary responses in rats after short-term inhalation of fumes generated during resistance spot welding of galvanized steel. Toxicol Rep 2017; 4:123-133. [PMID: 28959633 PMCID: PMC5615112 DOI: 10.1016/j.toxrep.2017.02.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/06/2017] [Accepted: 02/20/2017] [Indexed: 11/30/2022] Open
Abstract
An automated welder was designed to expose animals to galvanized spot welding fume. Generated particles generally were in the submicron and ultrafine size ranges. The primary metals present in galvanized spot welding fumes were iron and zinc. Zinc appeared to be the causative agent in the development of acute lung inflammation.
Resistance spot welding is a common process to join metals in the automotive industry. Adhesives are often used as sealers to seams of metals that are joined. Anti-spatter compounds sometimes are sprayed onto metals to be welded to improve the weldability. Spot welding produces complex aerosols composed of metal and volatile compounds (VOCs) which can cause lung disease in workers. Male Sprague-Dawley rats (n = 12/treatment group) were exposed by inhalation to 25 mg/m3 of aerosol for 4 h/day × 8 days during spot welding of galvanized zinc (Zn)-coated steel in the presence or absence of a glue or anti-spatter spray. Controls were exposed to filtered air. Particle size distribution and chemical composition of the generated aerosol were determined. At 1 and 7 days after exposure, bronchoalveolar lavage (BAL) was performed to assess lung toxicity. The generated particles mostly were in the submicron size range with a significant number of nanometer-sized particles formed. The primary metals present in the fumes were Fe (72.5%) and Zn (26.3%). The addition of the anti-spatter spray and glue did affect particle size distribution when spot welding galvanized steel, whereas they had no effect on metal composition. Multiple VOCs (e.g., methyl methacrylate, acetaldehyde, ethanol, acetone, benzene, xylene) were identified when spot welding using either the glue or the anti-spatter spray that were not present when welding alone. Markers of lung injury (BAL lactate dehydrogenase) and inflammation (total BAL cells/neutrophils and cytokines/chemokines) were significantly elevated compared to controls 1 day after exposure to the spot welding fumes. The elevated pulmonary response was transient as lung toxicity mostly returned to control values by 7 days. The VOCs or the concentrations that they were generated during the animal exposures had no measurable effect on the pulmonary responses. Inhalation of galvanized spot welding fumes caused acute lung toxicity most likely due to the short-term exposure of particles that contain Zn.
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Affiliation(s)
- James M Antonini
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Aliakbar Afshari
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Terence G Meighan
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Walter McKinney
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Mark Jackson
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Diane Schwegler-Berry
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Dru A Burns
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Ryan F LeBouf
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Bean T Chen
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Mohammad Shoeb
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Patti C Zeidler-Erdely
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
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Sriram K, Jefferson AM, Lin GX, Afshari A, Zeidler-Erdely PC, Meighan TG, McKinney W, Jackson M, Cumpston A, Cumpston JL, Leonard HD, Frazer DG, Antonini JM. Neurotoxicity following acute inhalation of aerosols generated during resistance spot weld-bonding of carbon steel. Inhal Toxicol 2015; 26:720-32. [PMID: 25265048 DOI: 10.3109/08958378.2014.954654] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Welding generates complex metal aerosols, inhalation of which is linked to adverse health effects among welders. An important health concern of welding fume (WF) exposure is neurological dysfunction akin to Parkinson's disease (PD). Some applications in manufacturing industry employ a variant welding technology known as "weld-bonding" that utilizes resistance spot welding, in combination with adhesives, for metal-to-metal welding. The presence of adhesives raises additional concerns about worker exposure to potentially toxic components like Methyl Methacrylate, Bisphenol A and volatile organic compounds (VOCs). Here, we investigated the potential neurotoxicological effects of exposure to welding aerosols generated during weld-bonding. Male Sprague-Dawley rats were exposed (25 mg/m³ targeted concentration; 4 h/day × 13 days) by whole-body inhalation to filtered air or aerosols generated by either weld-bonding with sparking (high metal, low VOCs; HM) or without sparking (low metal; high VOCs; LM). Fumes generated under these conditions exhibited complex aerosols that contained both metal oxide particulates and VOCs. LM aerosols contained a greater fraction of VOCs than HM, which comprised largely metal particulates of ultrafine morphology. Short-term exposure to LM aerosols caused distinct changes in the levels of the neurotransmitters, dopamine (DA) and serotonin (5-HT), in various brain areas examined. LM aerosols also specifically decreased the mRNA expression of the olfactory marker protein (Omp) and tyrosine hydroxylase (Th) in the olfactory bulb. Consistent with the decrease in Th, LM also reduced the expression of dopamine transporter (Slc6a3; Dat), as well as, dopamine D2 receptor (Drd2) in the olfactory bulb. In contrast, HM aerosols induced the expression of Th and dopamine D5 receptor (Drd5) mRNAs, elicited neuroinflammation and blood-brain barrier-related changes in the olfactory bulb, but did not alter the expression of Omp. Our findings divulge the differential effects of LM and HM aerosols in the brain and suggest that exposure to weld-bonding aerosols can potentially elicit neurotoxicity following a short-term exposure. However, further investigations are warranted to determine if the aerosols generated by weld-bonding can contribute to persistent long-term neurological deficits and/or neurodegeneration.
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Affiliation(s)
- Krishnan Sriram
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health , Morgantown, WV , USA
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11
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Abstract
Objective: The aim was to identify respiratory symptoms and respiratory function of welders in comparison to a “nonexposed group.” Materials and Methods: Information was collected by means of a questionnaire completed during an interview, and spirometry of all subjects. Results: This study involved 41 welders and 41 comparable nonexposed group. Sixteen (39%) welders reported bringing up phlegm from the chest first thing in the morning, compared with seven individuals (17.1%) in the nonexposed group. The difference is significant (Chi-square = 3.87 odds ratio (OR) 3.11 [1.0-9.9], P = 0.0182). Eleven welders had chronic bronchitis, which they had experienced most days for as long as 3 months, compared with one person in the nonexposed group. The difference was statistically significant, and OR was 1.7 (95% confidence interval 1.19-2.53). On the other hand, the difference in cough, shortness of breath and lung function was statistically insignificant when the welders were compared with the nonexposed group. Conclusion: This study showed more respiratory complaints, particularly chronic bronchitis, among welders compared with the nonexposed group, which is believed to be the result of welding emissions. Spirometry showed no impairment in lung function in both the welders and the nonexposed group.
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Affiliation(s)
- Sultan T Al-Otaibi
- Department of Family and Community Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia
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Koh DH, Kim JI, Kim KH, Yoo SW. Welding fume exposure and chronic obstructive pulmonary disease in welders. Occup Med (Lond) 2014; 65:72-7. [PMID: 25324483 DOI: 10.1093/occmed/kqu136] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Occupational exposure is estimated to contribute 15% to the burden of chronic obstructive pulmonary disease (COPD). Welding fumes are suspected to accelerate the decline of lung function and development of COPD. AIMS To examine the relationship between welding fume exposure and COPD in Korean shipyard welders. METHODS The study involved a group of male welders working at two shipyards who underwent an annual health examination in 2010. Subjects completed a questionnaire about smoking habits and occupational history and a pulmonary function test (PFT) was carried out with strict quality control measures. Welding fume exposure concentrations were estimated using 884 measurements taken between 2002 and 2009 in one of the shipyards. Multiple linear and logistic regression was employed to evaluate the association between cumulative fume exposure and lung function parameters, controlling for age, height and cigarette smoking. RESULTS Two hundred and forty subjects participated, with a mean age of 48 and mean work duration of 15 years. The mean cumulative fume exposure was 7.7mg/m(3). The prevalence of COPD was 15%. FEV1 and FVC showed non-significant negative correlations with cumulative fume exposure. Odds ratios of COPD were significantly elevated for the middle (3.9; 95% CI 1.4-13.3) and high exposure groups (3.8; 95% CI 1.03-16.2) compared with the low fume exposure group. CONCLUSIONS Our findings support an association between welding fume exposure and increased risk of COPD. Further prospective study is needed to investigate whether this is a causal relationship.
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Affiliation(s)
- D-H Koh
- National Cancer Control Institute, National Cancer Center, Goyang 410-769, Korea
| | - J-I Kim
- Department of Occupational and Environmental Medicine, Dong-A University, Busan 602-715, Korea,
| | - K-H Kim
- Department of Occupational and Environmental Medicine, Busan Paik Hospital, Inje University, Busan 614-735, Korea
| | - S-W Yoo
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon 403-711, Korea
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Zeidler-Erdely PC, Meighan TG, Erdely A, Fedan JS, Thompson JA, Bilgesu S, Waugh S, Anderson S, Marshall NB, Afshari A, McKinney W, Frazer DG, Antonini JM. Effects of acute inhalation of aerosols generated during resistance spot welding with mild-steel on pulmonary, vascular and immune responses in rats. Inhal Toxicol 2014; 26:697-707. [PMID: 25140454 DOI: 10.3109/08958378.2014.944287] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Spot welding is used in the automotive and aircraft industries, where high-speed, repetitive welding is needed to join thin sections of metal. Epoxy adhesives are applied as sealers to the metal seams. Pulmonary function abnormalities and airway irritation have been reported in spot welders, but no animal toxicology studies exist. Therefore, the goal of this study was to investigate vascular, immune and lung toxicity measures after exposure to these metal fumes in an animal model. Male Sprague-Dawley rats were exposed by inhalation to 25 mg/m³ to either mild-steel spot welding aerosols with sparking (high metal, HM) or without sparking (low metal, LM) for 4 h/d for 3, 8 and 13 d. Shams were exposed to filtered air. Bronchoalveolar lavage (BAL), lung gene expression and ex vivo BAL cell challenge were performed to assess lung toxicity. Lung resistance (R(L)) was evaluated before and after challenge with inhaled methacholine (MCh). Functional assessment of the vascular endothelium in isolated rat tail arteries and leukocyte differentiation in the spleen and lymph nodes via flow cytometry was also done. Immediately after exposure, baseline R(L) was significantly elevated in the LM spot welding aerosols, but returned to control level by 24 h postexposure. Airway reactivity to MCh was unaffected. Lung inflammation and cytotoxicity were mild and transient. Lung epithelial permeability was significantly increased after 3 and 8 d, but not after 13 d of exposure to the HM aerosol. HM aerosols also caused vascular endothelial dysfunction and increased CD4+, CD8+ and B cells in the spleen. Only LM aerosols caused increased IL-6 and MCP-1 levels compared with sham after ex vivo LPS stimulation in BAL macrophages. Acute inhalation of mild-steel spot welding fumes at occupationally relevant concentrations may act as an irritant as evidenced by the increased R(L) and result in endothelial dysfunction, but otherwise had minor effects on the lung.
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Affiliation(s)
- Patti C Zeidler-Erdely
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health , Morgantown, WV , USA
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14
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Afshari A, Zeidler-Erdely PC, McKinney W, Chen BT, Jackson M, Schwegler-Berry D, Friend S, Cumpston A, Cumpston JL, Donny Leonard H, Meighan TG, Frazer DG, Antonini JM. Development and characterization of a resistance spot welding aerosol generator and inhalation exposure system. Inhal Toxicol 2014; 26:708-19. [DOI: 10.3109/08958378.2014.941118] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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15
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Haluza D, Moshammer H, Hochgatterer K. Dust is in the Air. Part II: Effects of Occupational Exposure to Welding Fumes on Lung Function in a 9-Year Study. Lung 2013; 192:111-7. [DOI: 10.1007/s00408-013-9529-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 10/22/2013] [Indexed: 10/26/2022]
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17
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Subhashree AR, Shanthi B, Parameaswari PJ. The red cell distribution width as a sensitive biomarker for assessing the pulmonary function in automobile welders- a cross sectional study. J Clin Diagn Res 2012; 7:89-92. [PMID: 23449620 DOI: 10.7860/jcdr/2012/5051.2678] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 10/01/2012] [Indexed: 11/24/2022]
Abstract
CONTEXT Welding fumes are considered as a risk factor for pulmonary diseases and a periodic spirometry is essential to evaluate the lung function of the welders. The Red Cell Distribution Width (RDW) is a red cell measurement which is provided by automated haematology analyzers. It reflects the range of the red cell sizes which are measured within a sample. Few studies have shown a relationship between the RDW values and the changes in the spirometry. AIMS This study was aimed at correlating the RDW% and the spirometry FEV1/FVC ratio (%) among automobile welders (cases). Further, we have analyzed the effect of smoking on the FEV1/FVC ratio% and the RDW% in the cases. SETTINGS AND DESIGN A cross sectional study was done on 50 welders and 50 non-welding office workers (controls) who were working in an automobile industry on the outskirts of Chennai, india. All the cases were arc welders and the controls were from the same production unit, who had never worked as welders. This study was conducted during the period from March 2012 to May 2012. METHODS AND MATERIAL The demographic data, smoking habits, work history and the respiratory symptoms were gathered by using a standard self -administered questionnaire. A complete haemogram study was done and pulmonary function tests were performed for both the cases and the controls. All the cases and the controls were examined in the hospital outpatients room and subsequently, their blood samples were collected. The pulmonary function tests were conducted in the spirometry room in the hospital. The statistical analysis was done using the SPSS, version 15.0. RESULTS A statistically significant inverse correlation was found between the RDW% and the FEV1/FVC ratio% in the cases. CONCLUSIONS RDW can be used as a biomarker to identify the pulmonary compromise in automobile welders.
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Affiliation(s)
- A R Subhashree
- Associate Professor, Department of Pathology, Sree Balaji Medical College & Hospital , Chrompet, Chennai, Tamil nadu, India
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Bang KM, Syamlal G, Mazurek JM. Prevalence of chronic obstructive pulmonary disease in the U.S. working population: an analysis of data from the 1997-2004 National Health Interview Survey. COPD 2010; 6:380-7. [PMID: 19863367 DOI: 10.1080/15412550903140899] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To estimate the prevalence and the population attributable fraction of chronic obstructive pulmonary disease (COPD) in the U.S. adult workers, we analyzed data obtained from the National Health Interview Surveys for the period 1997-2004. The overall COPD prevalence was 4.0% (95% confidence interval [CI] 3.9-4.1%). The prevalence was higher in females (5.4%, 95% CI 5.3-5.6%) than in males (2.8%, 95% CI 2.7-2.9%); in Whites (4.2%, 95% CI 4.1-4.3%) than in Blacks (3.4%, 95% CI 3.1-3.7%) and other races (2.4%, 95% CI 2.1-2.8%). Compared with insurance, real estate and other finance industry, the top three industries associated with significantly higher prevalence odds ratios (PORs) (adjusted for age, sex, race, and smoking) were other educational services (POR = 1.5, 95% CI 1.0-2.3); transportation equipment (POR = 1.4, 95% CI 1.1-1.8); and social services, religious and membership organizations (POR = 1.4, 95% CI 1.1-1.7). Compared with managers and administrators, except public administration occupation, the top three occupations with significantly higher PORs were health service (1.8, 95% CI 1.5-2.1), other protective service (POR = 1.6, 95% CI 1.2-2.2), and material moving equipment operators (POR = 1.6, 95% CI 1.1-2.3). The overall population attributable fraction for association of COPD with employment was 12.2% for industry and 17.4% for occupation. Further studies are needed to determine specific risk factors associated with COPD in industries and occupations with elevated prevalence and POR.
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Affiliation(s)
- Ki Moon Bang
- National Institute for Occupational Safety and Health, Centers of Disease Control and Prevention, Morgantown, West Virginia, 26505, USA.
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Nemec AA, Leikauf GD, Pitt BR, Wasserloos KJ, Barchowsky A. Nickel mobilizes intracellular zinc to induce metallothionein in human airway epithelial cells. Am J Respir Cell Mol Biol 2009; 41:69-75. [PMID: 19097988 PMCID: PMC2701961 DOI: 10.1165/rcmb.2008-0409oc] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Accepted: 12/02/2008] [Indexed: 11/24/2022] Open
Abstract
We recently reported that induction of metallothionein (MT) was critical in limiting nickel (Ni)-induced lung injury in intact mice. Nonetheless, the mechanism by which Ni induces MT expression is unclear. We hypothesized that the ability of Ni to mobilize zinc (Zn) may contribute to such regulation and therefore, we examined the mechanism for Ni-induced MT2A expression in human airway epithelial (BEAS-2B) cells. Ni induced MT2A transcript levels and protein expression by 4 hours. Ni also increased the activity of a metal response element (MRE) promoter luciferase reporter construct, suggesting that Ni induces MRE binding of the metal transcription factor (MTF-1). Exposure to Ni resulted in the nuclear translocation of MTF-1, and Ni failed to induce MT in mouse embryonic fibroblasts lacking MTF-1. As Zn is the only metal known to directly bind MTF-1, we then showed that Ni increased a labile pool of intracellular Zn in cells as revealed by fluorescence-activated cell sorter using the Zn-sensitive fluorophore, FluoZin-3. Ni-induced increases in MT2A mRNA and MRE-luciferase activity were sensitive to the Zn chelator, TPEN, supporting an important role for Zn in mediating the effect of Ni. Although neither the source of labile Zn nor the mechanism by which Ni liberates labile Zn was apparent, it was noteworthy that Ni increased intracellular reactive oxygen species (ROS). Although both N-acetyl cysteine (NAC) and ascorbic acid (AA) decreased Ni-induced increases in ROS, only NAC prevented Ni-induced increases in MT2A mRNA, suggesting a special role for interactions of Ni, thiols, and Zn release.
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Affiliation(s)
- Antonia A Nemec
- Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
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Loukzadeh Z, Sharifian SA, Aminian O, Shojaoddiny-Ardekani A. Pulmonary effects of spot welding in automobile assembly. Occup Med (Lond) 2009; 59:267-9. [PMID: 19286991 DOI: 10.1093/occmed/kqp033] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Spot welding is a type of resistance welding in which pieces of metals are pressed together and an electric current is passed through them. Spot welders are at risk of contact with some potentially hazardous agents but there are few studies about the respiratory effects of spot welding. AIMS Our objective was to study lung function and respiratory symptoms among spot welders and office workers at an automobile assembly factory in Iran. METHODS This was a cross-sectional study of 137 male spot welders and 129 office workers. We used a questionnaire to record demographic data, smoking habits, work history and respiratory symptoms. Spirometry was performed to assess lung function status. Metal fume samples from the respiratory zone of spot welders were analysed. RESULTS The concentrations of metal fume were less than the American Conference of Industrial Hygienists (ACGIH) threshold limit values. There were significantly lower values for average forced expiratory volume in 1st second (FEV(1)), FEV(1)/forced vital capacity and 25-75% forced expiratory flow in spot welders compared to controls. There was also a significantly raised prevalence of respiratory symptoms (sputum and dyspnoea) in spot welders. Fifteen per cent of spot welders and 1% of controls had an obstructive pattern in spirometry. CONCLUSIONS Our survey suggests that spot welders are at risk of developing respiratory symptoms and decreasing pulmonary function values despite their exposure to components of welding fume being within ACGIH guidelines.
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Affiliation(s)
- Zeeba Loukzadeh
- Department of Occupational Medicine, Yazd University of Medical Sciences, Yazd, Iran.
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Jayawardana P, Abeysena C. Respiratory health of welders in a container yard, Sri Lanka. Occup Med (Lond) 2009; 59:226-9. [DOI: 10.1093/occmed/kqn166] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Inflammatory Responses and Oxidative Stress From Metal Fume Exposure in Automobile Welders. J Occup Environ Med 2009; 51:95-103. [DOI: 10.1097/jom.0b013e31818f756e] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Objective: To study the different morbid conditions among steel pipe producing workers. Methods: The present cross-sectional study has been carried out among the workers of one of the steel pipes and tubes manufacturing factory of Gujarat. Hundred workers from the four major departments of the steel pipe production plant, namely welding, pressing machine, X-ray welding and loading/transportation department were covered. The information regarding demographic, occupational, clinical characteristics and diagnosis were recorded on a pre-designed proforma. Statistical analysis included calculation of percentages and proportions and was carried out using the statistical software Epi Info Version 3.3.2. Results: The mean age of the study subjects was found to be 38.7±7.1 years. The mean duration of exposure was found to be 9.0±3.4 years. Forty-four percent of the subjects had an upper respiratory tract infection, as evidenced by symptoms like dry cough, cough with rhinitis and cough with fever. Symptoms suggestive of allergic bronchitis were observed in 12% of the subjects while symptoms suggestive of heat stress such as prickly heat, dehydration, perspiration and pyrexia were observed in 13% of the subjects.
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Affiliation(s)
- Kirti Pandit
- Occupational Medicine Division, National Institute of Occupational Health, Meghani Nagar, Ahmedabad-380 016, India
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Fireman E, Lerman Y, Stark M, Schwartz Y, Ganor E, Grinberg N, Frimer R, Landau DA, Zilberberg M, Barenboim E, Jacovovitz R. Detection of occult lung impairment in welders by induced sputum particles and breath oxidation. Am J Ind Med 2008; 51:503-11. [PMID: 18459140 DOI: 10.1002/ajim.20586] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND We evaluated particulate matter in combined induced sputum (IS) and oxidation in exhaled breath condensate (EBC) to test whether underlying inflammatory changes are present in asymptomatic welders. METHODS Thirty welders from the Israel Defense Forces exposed to aluminum/iron (Group 1) or to cadmium/chromium/iron/lead/nickel (Group 2, N = 16) and 27 non-exposed administrators were studied. IS was recovered, particle size distribution, hydrogen peroxide and pH were measured, and exhaled breath condensate was collected. RESULTS Group 2 had a higher % neutrophils than all other participants (P = 0.0001) and a higher % particles >2 microm in diameter (P = 0.0017). Percent particles and years of exposure highly correlated (P = 0.051). All welders EBC samples had higher concentrations of hydrogen peroxide than controls (P = 0.0001). pH was lower only for Group 2 (P = 0.0001). CONCLUSIONS Combined IS and EBC measurements detect underlying inflammation in airways of asymptomatic welders. It emerged that airway inflammation is present in asymptomatic welders, and that the particle burden, inflammatory cells, and level of oxidative stress are a function of the type and the duration of welding. Am. J. Ind. Med. 51:503-511, 2008.
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Affiliation(s)
- Elizabeth Fireman
- The Institute of Pulmonary and Allergic Diseases, National Laboratory Service for ILD, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
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Effect of extremely low frequency magnetic field on antioxidant activity in plasma and red blood cells in spot welders. Int Arch Occup Environ Health 2008; 82:259-66. [DOI: 10.1007/s00420-008-0332-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2007] [Accepted: 04/30/2008] [Indexed: 10/22/2022]
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