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Cancer mortality among arc welders exposed to fumes containing chromium and nickel. Results of a third follow-up: 1989-1995.

For the historical follow-up study among arc welders exposed to chromium and nickel, which was started in 1980 in Germany, a third follow-up extending the observation period to the years 1989 through 1995 has been carried out. By 1995, of the 1213 welders and 1688 turners (control group) who were originally included in the study, 274 welders and 448 turners had died. Death certificates could be obtained for approximately 96% of the deceased. Results of the evaluation presented in this article showed that cancer mortality remains significantly increased, compared with the general population and the control group, by approximately 35%. There was an elevation of approximately 50% or 60% in mortality from cancers of the respiratory tract, which is also statistically significant. However, this increase is predominantly due to a large excess in mortality from mesothelioma, which is known to be caused chiefly by asbestos exposure. Lung cancer mortality is nonsignificantly increased by approximately 20% to 30%. An indirect assessment of asbestos-related lung cancers and total cancer indicates that the observed increase of mortality might be mainly due to asbestos exposure. Beyond that, no indication of an elevated cancer risk specifically associated with the exposure to welding fumes containing chromium and nickel could be determined.

Adult↗

A geographical information system technique for record-matching in a study of cancer deaths in welders.

Retrospective studies are frequently complicated by incomplete worker identifiers. We encountered this problem when evaluating the risk of cancer death in a welding cohort. We dealt with it by developing birth-date ranges for each welder with unknown birth dates and using geographical information system techniques in conjunction with last name, gender, and birth-date range to assign death certificates to welders on the basis of residential proximity to the worksite. Deaths for total malignant cancers and lung/tracheobronchial/pleural cancers among these welders were not significantly different from those in county, state, and US populations, using standardized mortality ratios. The ratios in our study subjects were consistent with ratios found in other published welder cohorts.

Adult↗

Medical insurance claims and surveillance for occupational disease: analysis of respiratory, cardiac, and cancer outcomes in auto industry tool grinding operations.

To evaluate medical insurance claims for chronic disease investigation, claims from eight automotive machining plants (1984 to 1993) were linked with work histories (1967 to 1993), and associations with respiratory, cardiac, and cancer conditions were investigated, in a case-control design analyzed with logistic regression. The primary focus was tool grinding, but other important processes examined were metal-working, welding, forging, heat treat, engine testing, and diverse-skilled trades work. Considerable variability in claim-derived incidence rates across plants was not explained by age or known exposure differences. Asthma incidence increased in tool grinding (at mean cumulative duration: odds ratio [OR], 3.0; 95% confidence interval [CI], 0.90 to 10.0), as did non-ischemic heart disease (cardiomyopathy, cor pulmonale, rheumatic heart disease, or hypertension; OR, 3.1; 95% CI, 1.26 to 7.6). These trends appeared in models with deficits (OR < 1.0) for those ever exposed to tool grinding because of exposure-response miss-specification, demographic confounding, or removal of high-risk workers from the exposed group. The apparent cancer rates identified from claims greatly exceeded the expected rates from a cancer registry, suggesting that diagnostic, "rule-out," and surveillance functions were contributing. This study supports the epidemiologic use of medical insurance records in surveillance and, possibly, etiologic investigation and identifies issues requiring special attention or resolution.

Adolescent↗

Employment as a welder and Parkinson disease among heavy equipment manufacturing workers.

OBJECTIVE: We investigated whether employment as a welder with potential exposure to manganese and other substances is associated with Parkinson disease (PD), parkinsonism or related neurological disorders, or accelerates the age of onset of PD. METHODS: We selected cases and controls from 12,595 persons ever employed at three Caterpillar Inc. (CAT) plants between 1976 and 2004 with potential to make a medical insurance claim between 1998 and 2004. Cases had filed a claim for 1) PD, 2) "secondary parkinsonism", 3) "other degenerative diseases of the basal ganglia" or 4) "essential and other specific forms of tremor". Cases were grouped by claims: Group 1-claims 1 and 2 and Group 2-claims 1 to 4, and as study period incident (SPI) or prevalent. Each case was matched to two series of 10 controls each on date of case's first claim, year of birth, race and sex. Series I was also matched on plant. RESULTS: Odds ratios (OR) and 95% confidence intervals (CI) for the variable, "ever welder in any CAT plant" were: Group 1-SPI Cases: Series I (OR = .76, CI = .26-2.19), Series II (OR = .81, CI = .29-2.25); Group 1- Prevalent Cases: Series I (OR = .82, CI = .36-1.86), Series II (OR = .97, CI = .42-2.23); Group 2- SPI Cases: Series I (OR = 1.03, CI = .57-1.87), Series II (OR = 1.21, CI = .67-2.20) Group 2-Prevalent Cases: Series I (OR = 1.02, CI = .62-1.71), Series II (OR = .86, CI = .51-1.43). Our finding of no statistically significant associations for welding employment was maintained following adjustment for potential confounding and evaluation of possible effect modification. Employment as a welder did not accelerate the age of onset of PD. CONCLUSIONS: Our study supported the conclusion that employment as a welder is not associated with Parkinson disease, parkinsonism or a related neurological disorder.

Adult↗

Studies in oral galvanism: mercury and copper levels in urine, blood and saliva in submerged electrically cutting divers.

The aim of the study was to analyse the concentration levels of mercury and copper in urine, blood/blood plasma and saliva in relation to intra-oral electrical activity. Five Swedish Navy divers took part in the study in order to determine whether working submerged with electrical cutting equipment produced changes in the presence and level of oral galvanism and whether this posed a serious occupational health risk. The investigation concluded that the risk of seriously increased intra-oral electrical activity during welding or cutting activities was small. Development of the study is suggested, with long-term sampling of urine and blood samples of divers supported.

Adult↗

Organic solvents and multiple sclerosis: a case-control study.

A case-control study of multiple sclerosis (MS) has been carried out in western Norway. The study included 93% of the patients who had clinical onset of MS in the county of Hordaland during the years 1976-86 (N = 155) and 200 controls, marginally matched for age, sex and residence. There was no statistically significant difference between MS patients and controls with regard to exposure to organic solvents, exposure to the combination organic solvents and welding or to organic solvents and other chemical compounds.

Adult↗

LIPOLYTIC ACTIVITIES OF STAPHYLOCOCCUS AUREUS. I. NATURE OF THE ENZYME PRODUCING FREE FATTY ACIDS FROM PLASMA LIPIDS.

O'Leary, William M. (Cornell University Medical College, New York, N.Y.), and Julia T. Weld. Lipolytic activities of Staphylococcus aureus. I. Nature of the enzyme producing free fatty acids from plasma lipids. J. Bacteriol. 88:1356-1363. 1964.-The enzyme of Staphylococcus aureus, Guy strain, which is responsible for producing free fatty acids in human plasmas was purified approximately 225-fold from extracts of cultures in which the organism was grown. Purification procedures included ammonium sulfate precipitation, ethanol precipitation, gel filtration, and diethylaminoethyl-cellulose chromatography. Stability characteristics, pH and temperature optima, and substrate requirements were established. The principal plasma substrate is plasma lipoprotein, and the major reaction product is free octadecenoic acid. The ability of this compound to uncouple oxidative phosphorylation may be involved in the pathological effects of S. aureus at the molecular level.

Blood↗

Recent progress in the study of occupational lung diseases in Romania.

This paper reviews studies of occupational lung diseases in Romania in the last two decades. Work concerned with the effects of exposure to textile fibres, irritant gases and fumes in the chemical industry, welding fumes, asbestos, cadmium oxide, and the relation between dust exposure, pneumoconiosis, and chronic bronchitis is briefly presented.

Asbestosis↗

Absences attributed to respiratory diseases in welders.

Certified sickness rates of 36 male welders were examined for the period 1970-9. They were compared with 36 male controls from the same petrochemical plant, matched for age, smoking habits, duration of employment, and social class. Indices of severity (average annual duration), duration (average length of spell), and frequency (inception rate of spells and inception rate per worker) were calculated. Absences for all diseases were similar, but absences attributed to respiratory diseases were slightly higher in welders in severity, duration, and frequency. The proportion of days lost attributed to respiratory diseases was 2.3 times higher in welders compared with controls. This was due to a large increase in absences attributed to lower respiratory tract diseases, the ratio of welders to controls being more than four to one for both severity and inception rate of spells. The comparison between welders and controls in smokers and non-smokers confirms other studies which show that smokers tend to be more affected by welding fumes than non-smokers.

Absenteeism↗

Mortality of welders and other craftsmen at a shipyard in NE England.

Personnel records of over 1000 welders and electricians but only 235 caulkers and 557 platers employed at a shipyard in NE England between 1940 and 1968 were obtained and the mortality followed up to December 1982. The observed number of deaths (13 from mesothelial tumours, nine among the electricians) were compared with the number to be expected in the Newcastle connurbation. Welders and caulkers were most exposed to welding fumes, electricians to asbestos. The study was limited by the lack of accurate job exposure details, and there was no record of smoking habits, but welders and caulkers showed a higher standardised mortality ratio for all causes, lung cancer, ischaemic heart disease, pneumonia, and accidents than platers and electricians.

Air Pollutants, Occupational↗

Risk of cancer for arc welders in the Federal Republic of Germany: results of a second follow up (1983-8).

An extended follow up of 1221 chromium and nickel exposed welders in the Federal Republic of Germany confirmed an increased relative risk of 1.6 for all cancers compared with an internal reference group of 1694 turners. In an external comparison an excess of deaths from malignant tumours compared with that expected from the national mortality rates was found (standardised mortality ratio (SMR) = 109), which was clearly related to both time since first exposure and duration of exposure. Mortality from lung cancer was increased among welders (SMR = 113) but also among turners (SMR = 108). The difference remained when the subgroups were compared according to smoking information. A large excess of mesothelioma as a cause of death could be attributed to exposure to asbestos. The significantly increased SMR seen for urogenital tumours and "other or unspecified tumours" showed, however, an inverse relation with time since first exposure. This and other inconsistencies in the analysis by type of welding do not permit conclusive statements. Thus a further extension of follow up seems warranted.

Follow-Up Studies↗

Evidence of aluminium accumulation in aluminium welders.

Using atomic absorption spectrometry the aluminium concentrations in blood and urine and in two iliac bone biopsies obtained from welders with long term exposure to fumes containing aluminium were measured. The urinary excretion of two workers who had welded for 20 and 21 years varied between 107 and 351 micrograms Al/l, more than 10 times the concentration found in persons without occupational exposure. Urinary aluminium excretion remained high many years after stopping exposure. Blood and bone aluminium concentrations (4-53 micrograms Al/l and 18-29 micrograms Al/g respectively) were also raised but not to the same extent as urine excretion. It is concluded that long term exposure to aluminium by inhalation gives rise to accumulation of aluminium in the body and skeleton of health persons, and that the elimination of retained aluminium is very slow, in the order of several years.

Aluminum↗

Small airways dysfunction among non-smoking shipyard arc welders.

Increased volume of trapped gas (VTG), indicating small airways dysfunction, was found among 14 never smoking non-atopic welders who had worked for 10-31 (mean 22) years in their occupation. Spirometry and nitrogen wash out data were compared with those from a reference group of 14 never smoking men not exposed to welding. A methacholine provocation test was carried out. The effect was measured by change in forced expiratory volume in one second (FEV1) and VTG. The maximum decrease in FEV1 after inhalation of methacholine was 6% in welders and 2% among referents. Before provocation VTG and VTG total lung capacity (TLC) was higher among welders (127 ml v 98 ml and 1.76% v 1.38%). The increase in VTG and VTG/TLC was higher in welders after inhalation of methacholine at concentrations of 0.001% to 2% and remained increased after inhalation of salbutamol. The differences indicate small airways disease among shipyard welders.

Adult↗

Occupational exposure to dust and lung disease among sheet metal workers.

A previous large medical survey of active and retired sheet metal workers with 20 or more years in the trade indicated an unexpectedly high prevalence of obstructive pulmonary disease among both smokers and non-smokers. This study utilised interviews with a cross section of the previously surveyed group to explore occupational risk factors for lung disease. Four hundred and seven workers were selected from the previously surveyed group on the basis of their potential for exposure to fibreglass and asbestos. Selection was independent of health state, and excluded welders. A detailed history of occupational exposure was obtained by telephone interview for 333 of these workers. Exposure data were analysed in relation to previously collected data on chronic bronchitis, obstructive lung disease, and personal characteristics. Assessment of the effects of exposure to fibreglass as distinct from the effects of exposure to asbestos has been difficult in previous studies of construction workers. The experienced workers studied here have performed a diversity of jobs involving exposure to many different types of materials, and this enabled exposure to each dust to be evaluated separately. The risk of chronic bronchitis increased sharply by pack-years of cigarettes smoked; current smokers had a double risk compared with those who had never smoked or had stopped smoking. The occurrence of chronic bronchitis also increased with increasing duration of exposure to asbestos. Workers with a history of high intensity exposure to fibreglass had a more than doubled risk of chronic bronchitis. Obstructive lung disease, defined by results of pulmonary function tests at the medical survey, was also related to both smoking and occupational risk factors. Number of pack years smoked was the strongest predictor of obstructive lung disease. Duration of direct and indirect exposure to welding fume was also a positive predictor of obstructive lung disease. Duration of exposure to asbestos was significantly associated with obstructive lung disease but the dose-response relation was inconsistent, especially for those with higher pack-years of smoking exposure. Exposure to fibreglass was not a risk factor for obstructive lung disease.

Aged↗

Respiratory health of young shipyard welders and other tradesmen studied cross sectionally and longitudinally.

OBJECTIVE: To assess the effectiveness of current measures for protecting shipyard welders and caulker/burners (WCBs) from the respiratory effects of fumes. METHODS: Shipyard tradesmen born after 1953 (cohort 1), and 181 older men, subjects of a previous study (cohort 2), were assessed, then followed up after an average interval of 6.7 years. The respiratory associations with shipyard trades were assessed cross sectionally and longitudinally and an estimate made of the likely effects of selection bias. Cohort 1 comprised 90% of the 462 eligible WCBs and 239 other tradesmen; there were 31 exclusions. At follow up 139 of 146 men still in the shipyard and 43% of those who had left were reassessed. The lapses were mainly due to migration. All members of cohort 2 were followed up for respiratory symptoms (from MRC questionnaire), were recorded, and indices reflecting all aspects of lung function were measured. RESULTS: At the initial assessment and independent of smoking, trade as a WCB was associated with increased prevalences of chronic cough, phlegm, and wheeze, a reduced transfer factor, and an enhanced age related deterioration in peak expiratory flow (measured cross sectionally). Continued work as a WCB was associated with enhanced deterioration in lung function despite some amelioration of respiratory symptoms; the deterioration was influenced by whether or not exhaust ventilation had been used for every weld. The effects of fume on forced expiratory volume, flow-volume curvilinearity, mean transit time, and moment ratio were independent of and at least as large as those due to smoking. Enhanced deterioration in peak expiratory flow was confined to WCBs who smoked. These effects of trade, but not those of smoking, were nearly independent of atopy. CONCLUSION: In WCBs the working practices over the period of the study did not prevent the development of mild respiratory impairment. In WCBs who used exhaust ventilation at all times, the impairment seemed to reverse by discontinuation of exposure. Thus existing hygiene measures should be applied rigorously. The biological effectiveness of these and any other necessary supplementary measures should be assessed by long term monitoring of forced expiratory volume and peak expiratory flow.

Adult↗

Incidence of cancer among Norwegian boiler welders.

OBJECTIVES: The cancer incidence among 2957 boiler welders was investigated. The subjects were registered electrical welders from 1942 to 1981. A subcohort of 606 stainless steel welders was studied separately. METHODS: The investigation was a historical prospective cohort study based on a national registry. The loss of follow up was 4.9%. RESULTS: There were 625 deaths (659 expected). There were 269 cancer cases (264 expected). An excess of lung cancer was found; 50 cases v 37.5 expected. There were three cases of pleural mesotheliomas v 1.1 expected. The subcohort of stainless steel welders had six cases of lung cancer v 5.8 expected, and one case of pleural mesothelioma v 0.2 expected. CONCLUSIONS: The welders in the study were assumed to represent a qualified work force. These welders had a small excess risk of lung cancer. The excess risk did not seem to be associated with stainless steel welding. Smoking and asbestos exposure were potential confounders.

Cohort Studies↗

Occupational exposure to carcinogens and risk of lung cancer: results from The Netherlands cohort study.

OBJECTIVES: To investigate risk of lung cancers associated with common established carcinogenic occupational exposures (asbestos, paint dust, polycyclic aromatic hydrocarbons, and welding fumes) in a prospective cohort study among the general population, and to estimate the proportion of lung cancer cases attributable to these occupational exposures. METHODS: A prospective cohort study on diet, other lifestyle factors, job history, and cancer risk that started in 1986 in The Netherlands on 58,279 men, aged 55-69 years. Based on information about job history obtained from a self-administered questionnaire, case by case expert assessment was carried out to assign to each study subject a cumulative probability of occupational exposure for each carcinogenic exposure. For analysis, a case-cohort approach was used, in which the person-years at risk were estimated from a randomly selected subcohort (n = 1688). After 4.3 years of follow up, 524 lung cancer cases with complete job history were available. RESULTS: After adjustment for age, each of the other occupational exposures, and for smoking habits and intake of vitamin C, beta-carotene, and retinol, significant associations were found between risk of lung cancer and cumulative probability of occupational exposure to asbestos (relative risk (RR) highest/no exposure = 3.49, 95% confidence interval (95% CI) 1.69 to 7.18, trend P < 0.01 or paint dust (RR highest/no exposure = 2.48, 95% CI 0.88 to 6.97, trend P < 0.01). The population attributable risks (PARs) for the four exposures based on the multivariately adjusted RRs for ever exposed versus never exposed workers were calculated. The PAR of lifetime occupational exposure to asbestos was calculated to be 11.6%. CONCLUSIONS: This prospective cohort study among the general population showed that occupational exposure to asbestos or paint dust is associated with higher RRs for lung cancer. This study shows that after adjustment for smoking and diet about 11.6% of the cases of lung cancer in men is attributable to lifetime occupational exposure to asbestos.

Aged↗