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PubMed2006

Use of a (proposed) standard protocol to validate Terumo TSCD-II connections between dissimilar blood bag tubing.

BACKGROUND AND OBJECTIVES: ISO standards for blood bags do not adequately define and control the dimensions of blood bag transfer tubing. This lack of standardization presents potential difficulties when making sterile connections between the wide range of tubing that has evolved in the absence of such standards. We aim to validate the suitability of the TSCD-II and provide a minimum standard for assessing the suitability of sterile connections (welds) between dissimilar tubing. MATERIALS AND METHODS: The Terumo TSCD-II was used in this study to connect by hermetic welding seven tubing types with a wide range of dimensions from five suppliers. Thirty sterile connections were made between each combination split between dry/dry, wet/wet and dry/wet connections. Welds were assessed for visual defects, by tensile stress test (TST) and pressure tests. RESULTS: All welds passed visual inspection and pressure tests. All welds had a minimum tensile strength of greater than 40 N and mean of greater than 45 N. CONCLUSION: Successful connections have been made between dissimilar tube types and this work does not support the requirement for 'tight' tubing dimensional specifications. We have recommended to the ISO Technical Committee 76 Work Group 1 that ISO 3826-1 be revised and should include a minimum standard validation protocol for joining dissimilar tubing.

Blood Component Transfusion↗
PubMed1989

Case-control study of lung cancer in Los Angeles county welders.

A case-control study of lung cancer in white male welders was undertaken to investigate possible environmental and occupational causes of a 50% excess of lung cancer observed in this occupational group. The subjects were identified from a population-based cancer registry in Los Angeles County. A standardized questionnaire was administered to either subjects or proxy informants of 90 lung cancer cases and 116 non-lung-cancer controls. Significantly increased risks of lung cancer were associated with tobacco smoking (odds ratio 7.6, p less than .005) and shipyard welding with at least a 10-year latency since first exposure (odds ratio 1.7, p less than .05). Although there were elevated risks associated with some specific welding processes, none were statistically significant. Control subjects were more likely to have had exposure to confined-space welding (odds ratio 0.6, 95% CI = 0.3-1.2), and this association was greatest where there had been at least a 20-year latency since first exposure (0.5, 95% CI = 0.3-1.0). We conclude that the excess of lung cancer in this welding population is contributed to by a higher frequency of smoking and probable exposure to asbestos in shipyards. Other factors may be important, but probably because of limited power and reliance on proxy information, this study failed to detect other statistically significant risks.

Adult↗
PubMed1994

Retention of asbestos bodies in the lungs of welders.

Examination of asbestos bodies (AB) retained in the lungs is a useful way of assessing past occupational exposure to this material. AB retention has been extensively studied in workers directly exposed to asbestos, but less so in those end users, such as welders, who use asbestos-containing products. We therefore retrospectively studied AB retention in 211 welders, for whom biological testing procedures had been requested by a chest physician, between 1988 and 1991. Optical microscopy of AB was performed on samples of sputum (40 subjects), bronchoalveolar lavage fluid (BAL) (147 subjects), and lung tissue obtained after thoracotomy (38 subjects). Information on previous jobs and exposure was obtained using a questionnaire (the mean duration of welding activities was 16.6 years). Eighty-two subjects (38.9%) had elevated lung retention of AB in all the samples studied. Significant AB retention occurred in only 30% of sputum samples, but in 40.1% of BAL samples and 39.5% of lung tissue samples. The duration of welding activities correlated with the density of AB in BAL or lung tissue (r = 0.31, p < 0.01 and r = 0.49, p < 0.05, respectively). On the basis of the questionnaire, only two of the welders with significant AB retention had other occupational exposure to asbestos. Our findings suggest that welding activities may increase lung retention of AB, and consequently might produce higher risks of fibrotic and/or malignant pulmonary diseases. These potential risks need to be brought to the attention of doctors; a longitudinal follow-up may also be warranted in such populations, even after individuals have ceased their welding jobs.

Asbestos↗
PubMed1981

Lung-retained contaminants, urinary chromium and nickel among stainless steel welders.

The magnetic method of measuring the amount of lung retained contaminants as well as urinary chromium and nickel determinations have been performed among 83 stainless steel (SS) welders who have used manual metal arc (MMA) and tungsten inert gas (TIG) welding techniques. The welders were divided into four groups according to the time percentage used for MMA welding. Only exposure to MMA/SS welding fumes resulted in clearly elevated chromium concentrations in the urine, the correlation coefficient between the values of urinary chromium and MMA/SS percentage being very significant (p less than 0.001). Among the smokers the urinary chromium values were increased (p less than 0.05) perhaps owing to contaminated cigarettes. In many workplaces the urinary chromium values of several welders exceeded the value of 30 microgram/l which is the recommended reference value in Finland. Owing to the solubility properties of nickel compounds in SS welding fumes urinary nickel concentrations were only slightly elevated among MMA/SS welders, and therefore, the urinary nickel determinations do not reflect the level of exposure to nickel compounds. The measured average remanent magnetic field of the chest area correlated well (p less than 0.01) with the use of the MMA technique. A very significant correlation (p less than 0.001) existed between the average remanent magnetic fields of the chest and the urinary chromium values of MMA/ss welders.

Adult↗
PubMed1996

MDA in plasma as a biomarker of exposure to pyrolysed MDI-based polyurethane: correlations with estimated cumulative dose and genotype for N-acetylation.

The object of this study was to investigate whether exposure of pipe-layers to thermal degradation products of diphenylmethane diisocyanate (MDI) could be assessed by analysing 4,4-methylenedianiline (MDA) in hydrolysed plasma and urine, and whether the genotype for N-acetylation affected these biomarker levels. Blood and urine samples were drawn from 30-pipe-layers who had been welding polyurethane (PUR) insulated pipes during the preceding 3 months. MDA in hydrolysed plasma and urine was determined with a gas chromatography-mass spectrometry technique, and genotype for N-acetylation was analysed with a polymerase chain reaction technique. MDA in plasma was detected in 18 of the 30 pipe-layers. Their plasma concentrations of MDA varied from 0.05 to 8.48 micrograms/l. There was a significant negative correlation between time since last welding of PUR-insulated pipes and P-MDA (rs = 0.50, P = 0.005). There was also a significant positive correlation between the estimated number of welded PUR-insulated pipes during the preceding 3 months and P-MDA (rs = 0.68, P = < 0.001). No significant association between genotype of N-acetylation and P-MDA was observed in a multiple regression analysis when adjustment was made for the estimated cumulative exposure to thermal degradation products of MDI. MDA in urine was detected in only four of the 30 pipe-layers. These four subjects had been welding PUR pipes on the same day as the sampling, or on the day before. The present results indicate the spot plasma samples analysed for MDA may give a rather good estimate of exposure to MDI during the preceding months. P-MDA, but not U-MDA, therefore seems to be a useful biomarker of long-term exposure to MDI. The individual N-acetylation capacity did not affect the plasma levels of MDA.

Acetylation↗
PubMed1985

Lung function and clinical findings in a cross-sectional study of arc welders. An epidemiological study.

An epidemiological, cross-sectional study was conducted in order to assess non-neoplasic effects on the lung due to chronic exposure to arc welding fumes and gases. The study involved 346 arc welders and 214 control workers from a factory producing industrial vehicles. These workers (welders and controls) had never been exposed to asbestos. Respiratory impairments were evaluated by using a standardized questionnaire, a clinical examination, chest radiophotography and several lung function tests (spirometry, bronchial challenge test to acetylcholine, CO transfer tests according to the breath-holding and the steady-state methods, N2 washout test). The only significant differences between the welders overall compared to the controls were a slightly higher bronchial hyper-reactivity to acetylcholine and a lower lung diffusing capacity for CO in the welders. However, non-specific, radiologic abnormalities (reticulation, micronodulation) and obstructive signs were more frequent in the most exposed welders (welding inside tanks) than in welders working in well ventilated workplaces. The nature of the metal welded (mild-steel, stainless steel, aluminium) did not seem to have an influence on respiratory impairments. In the mild-steel welders, respiratory symptoms (dyspnoea, recurrent bronchitis) and obstructive signs were more frequent in the welders using a manual process than in the welders involved with the semi-automatic process (MIG). For all the workers (welders and controls), smoking had a markedly adverse effect on respiratory symptoms and lung function. Moreover, smoking seemed to interact with welding since CO lung transfer was more impaired in smoking welders than in smoking controls.

Adult↗
PubMed2006

Monitoring of chromium and nickel in biological fluids of grinders grinding stainless steel.

OBJECTIVE: Stainless steel (SS) welders usually spend some of their working time grinding, to finish and smoothen the welding groove. The aim of this study was to investigate possible relations between the concentrations of nickel (Ni) and chromium (Cr) in the work atmosphere generated by grinders grinding SS, and to compare the air levels to the levels of Cr and Ni in their biological fluids. Hereby, it might be possible to identify the contribution of grinding to the levels of Cr and Ni in biological fluids in SS welders. Also the airborne levels of Cr and Ni in SS grinders were compared to corresponding levels in SS welders. METHOD/DESIGN: The subjects examined in this study were selected among SS grinders not performing welding. Nine grinders were monitored for 1 workweek, measuring Cr and Ni in air, blood and urine. They were questioned about their exposure to Cr and Ni during their working careers. RESULTS: Air levels of total Cr up to 95 microg/m(3) and Ni levels up to 25 microg/m(3) were measured. Chromium(VI) (Cr(VI)) was detectable only in five air samples; the levels in the remaining samples were below the detection limit. The levels of Cr in blood and urine were also low. The levels of Ni in urine were close to those for MMA and MIG/MAG SS welders. In spite of high levels of total Cr and Ni observed in air, the levels found in biological fluids were low. The Cr levels in more than 50% of the whole blood and red cell samples and about 1/3 of the Cr-plasma levels were below the detection limits. The mean blood levels for Cr were 0.43, 0.60 and 0.35 microg/l, in whole blood, plasma and red cells, respectively. The mean levels for Cr in the urine was 1.6, 1.4 and 1.4 microg/g creatinine for the first void, just before and just after work. For Ni the mean blood levels were 0.87 microg/l in whole blood and 0.68 microg/l in plasma. The mean levels and ranges of Ni from the first void, just before and after work in urine were 3.79 microg/g creatinine, 3.39 and 4.56, respectively. The Cr concentrations found in whole blood, plasma and red cells were approximately the same as those found in the unexposed controls and among TIG SS welders, while the urinary levels were somewhat higher, but still lower than in the welders applying other welding techniques. The mean levels of Ni in the urine of grinders were higher than those of welders, except for SS welders welding the MIG/MAG-method. CONCLUSION: SS Grinding seems not to contribute significantly to the uptake of Cr, which may be explained by the fact that most of Cr in the air is present in the metallic (0-valent) or trivalent form, and hardly any as Cr(VI), and therefore hardly being taken up in the airways. The grinders' uptake of Ni seems to take place to the same extent as in SS welders.

Adult↗
PubMed1994

Nickel-related cancer in welders.

During stainless steel (SS) welding, solid aerosols are generated from elemental compounds which are generally considered to be human carcinogens; i.e. compounds of hexavalent chromium (CrVI) and nickel. Epidemiological studies among groups of SS-welders have indicated that they may carry a higher risk of acquiring lung cancer than mild steel (MS) welders using the same welding techniques. This excess risk has been demonstrated in cohort as well as by case-control studies. The present evidence does not support the view that exposure to SS-welding fumes poses a hazard of cancer at any other site. Exposure to asbestos and smoking are generally major confounders in these studies. The number of SS-welders world-wide seems to be increasing, thus these findings may be of significance to SS-welders and to the welding industry. Despite the information on the possible cancer hazard among SS-welders, current epidemiological data on cancer incidence and mortality do not offer clear evidence to determine whether exposure to nickel or CrVI compounds constitutes the more important risk factor for lung cancer.

Humans↗
PubMed2004

Photokeratoconjunctivitis caused by different light sources.

To assess the current state of photokeratoconjunctivitis (PKC) and compare patients caused by different light sources, we recruited 106 consecutive cases from August 2001 to March 2002 through the emergency department at a teaching hospital in Taiwan and conducted questionnaire interviews and telephone follow-ups. Whereas 85.8% of the cases received exposures from welding, only 3.8% were professional welders, and most cases were of other occupations with occasional use of welding. A substantial number of cases were attributable to ultraviolet (UV) lamps and sparkles from short circuits (7 each). Cases caused by different light sources (welding, UV lamps, and sparkles) had significant differences in occupations, exposure durations, and distances to light sources. In comparison with cases caused by welding, cases caused by short circuit sparkles had a more acute course, but those caused by UV lamps had a less acute course. Few cases used protection equipment, which highlighted the importance of education.

Acute Disease↗
PubMed1991

Spirometric abnormalities among welders.

A group of manual welders (N = 57) engaged in gas welding joint faces of moulded brasswares, age group 13-60 years (mean: 29.2 +/- 1.37 years), having a mean exposure period of 12.4 +/- 1.12 years (range: 1-35 years) were subjected to spirometry to evaluate the prevalence of spirometric abnormalities. The findings were compared with those obtained from a reference group (N = 131) (mean age: 31.2 +/- 1.35 years) engaged in nonwelding jobs such as packing, labelling, and transportation of the finished brassware articles. The welders showed a significantly higher prevalence of respiratory impairment (28.0%) than that observed among the unexposed controls (6.1%) (P less than 0.001), as a result of exposure to welding gases which comprised fine particles of lead, zinc, chromium, and manganese. This occurred despite the lower concentration of the pollutants at the work place. In the exposed group, the smoking welders showed a prevalence of respiratory impairment significantly higher than that observed in the nonsmoking welders (40.0 vs 18.7%) (P less than 0.10). A similar trend was observed in the control group indicating that smoking had a deteriorating effect on spirometric tests. The results of the pulmonary function tests showed a predominantly restrictive type of pulmonary impairment (12.3%) followed by a mixed ventilatory defect (8.7%) among the welders. The effect of age on pulmonary impairment was not discernible either in the exposed or unexposed group. The analysis of data in relation to duration of exposure showed significant correlation between the prevalence of respiratory abnormalities and length of exposure. Welders exposed for over 10 years showed a prevalence of respiratory abnormalities significantly higher than those exposed for less than 10 years (44.4 vs 13.3%) (P less than 0.01) thereby showing that occupational exposure to welding fumes resulted in increased prevalence of pulmonary impairment in the welders. Smoking also had a contributory role thereby suggesting an interaction between smoking and welding exposure on the prevalence of pulmonary impairment in the welders engaged in brassware industries.

Adolescent↗
PubMed2003

[Interstitial pulmonary siderofibrosis: requirements for acceptance as new occupational disease].

BACKGROUND: Pulmonary siderosis is a well established disorder in welders. Internationally more than 150 cases of interstitial pulmonary siderofibrosis are associated with long-standing and heavy exposure to welding fumes at poorly ventilated working places. PATIENTS: Characteristic job histories, lung function analyses and histological examinations as well as elemental microanalysis by energy dispersive X-ray analysis (EDX) are demonstrated from 3 welders with pulmonary siderofibrosis. RESULTS: Histological examinations show a patchy interstitial fibrosis with accumulations of particulate material typical for welding fumes. EDX disclose an increase of iron-load in activated macrophages as well as in lung tissue and a close topographical relationship of welding fume particles and interstitial fibrotic reactions. Lung function analysis showed predominantly loss of pulmonary performance during spiroergometry. CONCLUSIONS: Regarding the actual knowledge about the pathomechanisms of ultrafine particles on lung tissue, the evidence from animal experiments, the histological and electron microscopical results, our own clinical examinations of welders and some epidemiological evidence, we assume a causal relationship of interstitial pulmonary siderofibrosis in welders with long-standing exposure to high concentrations of welding fumes under poor working conditions.

Adult↗
PubMed1995

Estimation of regional pulmonary deposition and exposure for fumes from SMAW and GMAW mild and stainless steel consumables.

The particle size distributions and bulk fume densities for mild steel and stainless steel welding fumes generated using two welding processes (shielded metal arc welding [SMAW] and gas metal arc welding [GMAW]) were used in mathematical models to estimate regional pulmonary deposition (the fraction of each fume expected to deposit in each region of the pulmonary system) and regional pulmonary exposure (the fraction of each fume expected to penetrate to each pulmonary region and would be collected by a particle size-selective sampling device). Total lung deposition for GMAW fumes was estimated at 60% greater than that of SMAW fumes. Considering both the potential for deposition and the fume specific surface areas, it is likely that for equal exposure concentrations GMAW fumes deliver nearly three times the particle surface area to the lungs as SMAW fumes. This leads to the hypothesis that exposure to GMAW fumes constitutes a greater pulmonary hazard than equal exposure to SMAW fumes. The implications of this hypothesis regarding the design of future health studies of welders is discussed.

Aerosols↗
PubMed1994

Transtympanic facial nerve injury in welders.

The risk for ear injury from molten metal or hot sparks produced during welding procedures is small, but the effects can be significant. Burns, tympanic membrane perforations and chronic otorrhoea are the most common results. Rare cases of inner ear injury and facial nerve paralysis have also been reported. Two cases recently encountered at our institution highlight the risk that exists for facial nerve injury. One patient suffered a significant facial nerve injury and deafness, while the other had a transient facial paresis. The injuries occurred when molten metal (slag) and a hot spark fell into the ear canal while welding. Neither subject was using ear protection at the time. These two cases are presented to highlight the rare but significant hazard of transtympanic facial nerve injury that exists during welding procedures. The use of ear protection is strongly advocated during welding operations that place the ear at risk.

Adolescent↗
PubMed1988

Case-control study of lung cancer in civilian employees at the Portsmouth Naval Shipyard, Kittery, Maine.

Case-control analysis of deaths due to lung cancer (International Classification of Diseases, Eighth Revision, code 162) among persons who worked at the Portsmouth Naval Shipyard, Kittery, Maine, between 1952 and 1977 found elevated odds ratios for exposures to ionizing radiation, asbestos, and welding byproducts. The radiation-related excess was statistically significant in persons with cumulative lifetime exposures of 1.0-4.999 rem. When asbestos and welding histories were combined into a single risk factor, odds ratios for the combined exposure were significantly elevated for two of three duration-of-exposure categories examined. Further analysis of data on radiation exposure, controlling for exposures to asbestos and welding, found reductions in initial estimates of radiation risk at all levels of radiation exposure. This reduction suggests that radiation workers were more heavily exposed to asbestos and/or welding fumes than were other workers and that those exposures confounded the observed association between radiation and lung cancer. Analysis of mortality by time since first exposure to radiation revealed no pattern of progressive increase as latency increased. By contrast, odds ratios for asbestos/welding increased with latency. Data on cigarette smoking and socioeconomic status were not available. The results of this study do not preclude a possible association between radiation exposure at the Portsmouth Naval Shipyard and excess mortality from lung cancer. However, they provide no evidence in support of such a relation.

Asbestos↗
PubMed2005

A clinical assessment of the anterior eye in arc welders.

BACKGROUND: Corneal irradiation with high doses of ultraviolet-B (UVB) has been shown to damage the corneal endothelium in animals. Human occupational exposure to ultraviolet radiation (UVR) in welding is considered a risk for endothelial damage but the evidence for such an effect is limited. METHODS: External eye photographs and non-contact specular micrographs (Topcon SP2000-P) were obtained from 102 white males aged between 32 and 62 years, 51 being arc welders (with 24 +/- 7 years experience) and 51 office workers. Most welders reported repeated occupational exposure to UVR (that is, welder's 'flashes'). RESULTS: Welders reported a higher level of ocular symptoms and a higher prevalence of pingueculae (47 versus 12 per cent), but only one case with pterygium. The average endothelial cell areas were the same in welders and office workers (398 +/- 55 microm(2) versus 400 +/- 56 microm(2); p = 0.868) as were the endothelial cell density (ECD) values (2,555 +/- 342 cells/mm(2) versus 2,541 +/- 308 cells/mm(2); p = 0.825). ECD decreased with years of welding experience (p < 0.01) but not faster than the decrease in ECD due to age. CONCLUSIONS: Repeated occupational ultraviolet radiation exposure through welding is not associated with any obvious differences in the corneal endothelium. No differences were observed in either ECD or cell polymegethism. Despite the periodic welding flashes, the exposure levels are below those needed to cause damage to the corneal endothelium.

Adult↗
PubMed2006

Parkinson's disease and other basal ganglia or movement disorders in a large nationwide cohort of Swedish welders.

INTRODUCTION: Although it has been hypothesised that metal welding and flame cutting are associated with an increased risk for Parkinson's disease due to manganese released in the welding fume, few rigorous cohort studies have evaluated this risk. METHODS: The authors examined the relation between employment as a welder and all basal ganglia and movement disorders (ICD-10, G20-26) in Sweden using nationwide and population based registers. All men recorded as welders or flame cutters (n = 49,488) in the 1960 or 1970 Swedish National Census were identified and their rates of specific basal ganglia and movement disorders between 1964 and 2003 were compared with those in an age and geographical area matched general population comparison cohort of gainfully employed men (n = 489,572). RESULTS: The overall rate for basal ganglia and movement disorders combined was similar for the welders and flame cutters compared with the general population (adjusted rate ratio (aRR) = 0.91 (95% CI 0.81 to 1.01). Similarly, the rate ratio for PD was 0.89 (95% CI 0.79 to 0.99). Adjusted rate ratios for other individual basal ganglia and movement disorders were also not significantly increased or decreased. Further analyses of Parkinson's disease by attained age, time period of follow up, geographical area of residency, and educational level revealed no significant differences between the welders and the general population. Rates for Parkinson's disease among welders in shipyards, where exposures to welding fumes are higher, were also similar to the general population (aRR = 0.95; 95% CI 0.70 to 1.28). CONCLUSION: This nationwide record linkage study offers no support for a relation between welding and Parkinson's disease or any other specific basal ganglia and movement disorders.

Adult↗
PubMed1990

Semen quality in welders before and after three weeks of non-exposure.

In a cross sectional field study concerning the male reproductive system in metalworkers, the major findings were a moderate deterioration of semen quality in mild steel welders and less reliable changes in semen quality in low exposed stainless steel welders. In the present study, a longitudinal design was adopted to deal with methodological drawbacks inherent in the cross sectional approach. The study relies on the assumption that the effect of welding is causal and reversible. The semen quality of 19 mild steel welders, 18 stainless steel welders and 16 non-welding metal-workers, was examined before and three, five, and eight weeks after a three week break in exposure (summer vacation). No consistent improvement in any semen parameter in the follow up period relative to the prevacation period was found in either mild steel or stainless steel welders. The results indicate either a non-causal nature of reported associations between welding exposure and poor semen quality, or that the effect of welding is non-reversible within the rather short non-exposure period.

Adult↗
PubMed1991

A historical prospective study of European stainless steel, mild steel, and shipyard welders.

A multicentre cohort of 11,092 male welders from 135 companies located in nine European countries has been assembled with the aim of investigating the relation of potential cancer risk, lung cancer in particular, with occupational exposure. The observation period and the criteria for inclusion of welders varied from country to country. Follow up was successful for 96.9% of the cohort and observed numbers of deaths (and for some countries incident cancer cases) were compared with expected numbers calculated from national reference rates. Mortality and cancer incidence ratios were analysed by cause category, time since first exposure, duration of employment, and estimated cumulative dose to total fumes, chromium (Cr), Cr VI, and nickel (Ni). Overall a statistically significant excess was reported for mortality from lung cancer (116 observed v 86.81 expected deaths, SMR = 134). When analysed by type of welding an increasing pattern with time since first exposure was present for both mild steel and stainless steel welders, which was more noticeable for the subcohort of predominantly stainless steel welders. No clear relation was apparent between mortality from lung cancer and duration of exposure to or estimated cumulative dose of Ni or Cr. Whereas the patterns of lung cancer mortality in these results suggest that the risk of lung cancer is higher for stainless steel than mild steel welders the different level of risk for these two categories of welding exposure cannot be quantified with precision. The report of five deaths from pleural mesothelioma unrelated to the type of welding draws attention to the risk of exposure to asbestos in welding activities.

Europe↗