Lung Function in Pakistani Welding Workers

Effects of occupational exposures on respiratory health in steel factory workers

Background

The steel factory work environment contains various chemical exposures that can affect indoor air quality and have impact on respiratory health of the workers.

Aims

The objective of this study was to assess potential effects of occupational exposures in steel factory workers in Iran on the respiratory symptoms, occurrence and the lung function levels.

Method

This was a cross-sectional study of 133 men working in a steel factory forming the exposed group and 133 male office workers forming the reference group from a steel company in Iran. The participants filled in a questionnaire and underwent spirometry. Work history was used both as dichotomous (exposed/reference) and a quantitative measure of exposure, the latter measured as duration of exposure in the specified work (in years) for the exposed group and zero for the reference group.

Results

Multiple linear regression and Poisson regression were used to adjust for confounding. In Poisson regression analyses, an increased prevalence ratio (PR) of all respiratory symptoms was observed in the exposed group. Lung function parameters were significantly reduced in the exposed group (p < 0.001). There was a dose-response relation between duration of occupational exposures and reduction in the predicted value of FEV1/FVC level (0.177, 95% CI -0.198 to -0.156) in all models.

Conclusion

The results of these analyses showed that occupational exposures in steel factory work increase the prevalence of respiratory symptoms and reduce lung function. Safety training and workplace conditions were found to need improvement. In addition, use of proper personal protective equipment is recommended.

Metal Exposure-Related Welder's Pneumoconiosis and Lung Function: A Cross-Sectional Study in a Container Factory of China

Long-term inhalation of welding fume at high exposure can cause welder's pneumoconiosis, and metals in welding dust are associated with respiratory dysfunction. This cross-sectional study, which contains 384 Chinese male workers who were or had been working in a container factory, aimed to assess the potential risk of haemal and urinary metal content in welder's pneumoconiosis. Further, we investigated their effects on lung function parameters. Metal content and lung function were measured using inductively coupled plasma-mass spectrometry (ICP-MS) and spirometer, respectively. The concentration and metal content of respirable dust as well as total dust were collected at this container factory. Lung function of cases with welder's pneumoconiosis was significantly worse, as indicated by lower values of FVC, FVC% predicted, FEV1, FEV1% predicted, MEF25% predicted, and MMEF% predicted (p < 0.05). Results of logistic regression models showed that haemal Cr and Zn were risk factors of welder's pneumoconiosis (OR = 4.98, 95%CI: 1.73-21.20, p = 0.009 for Cr; OR = 5.23, 95%CI: 1.56-41.08, p = 0.033 for Zn) after adjusted with age, BMI, working years, welding dust exposure years, and smoking status. Multiple linear regression models showed that several metals (haemal Cd and Pb; urinary Cd and Fe) were significantly associated with different lung function indices in the welder's pneumoconiosis group. Compared to non-welders, welders were exposed to considerably higher levels of respirable dust, total dust, and six kinds of metals (p < 0.05). In conclusion, haemal Cr and Zn are positively related to welder's pneumoconiosis. Meanwhile, Cd and Pb might worsen lung function in welder's pneumoconiosis.

The Nexus between Workplace Exposure for Wood, Welding, Motor Mechanic, and Oil Refinery Workers and the Prevalence of Prediabetes and Type 2 Diabetes Mellitus

Workplace exposure in various occupational and industrial sectors is an emerging health concern worldwide. This study aimed to investigate the nexus between workplace exposure for wood, welding, motor mechanic, and oil refinery workers and the prevalence of prediabetes and type 2 diabetes mellitus. Initially, 2500 male volunteers who were wood, welding, motor mechanic, and oil refinery workers were interviewed. After an examination of their demographics and medical history, 1408 non-smoking wood (158), welding (560), motor mechanic (272), and oil refinery workers (217), along with 201 control subjects, were selected. The participants' mean age was 36.59 ± 0.29 years and the mean body mass index was 26.14 ± 0.11 kg/m². The selected industry workers had been exposed to their respective wood, welding, motor mechanic, and oil refinery workplaces for 8 h per day, six days per week. The American Diabetic Association (ADA)-based glycated hemoglobin (HbA1c) criterion was used to diagnose prediabetes and type 2 diabetes mellitus. Subjects with an HbA1c of less than 5.7% were regarded as non-diabetics, subjects with an HbA1c of 5.7%-6.4% were considered prediabetics, and subjects with an HbA1c of more than 6.4% were considered diabetics. In wood industry workers, the prevalence of prediabetes (PD) was 64 (40.50%) and in type 2 diabetes mellitus (T2DM), it was 21 (13.29%); in welding workers, the prevalence of prediabetes was 261 (46.60%), and for T2DM, it was 90 (16.07%); in motor mechanic workers, the prevalence of prediabetes was 110 (40.44%), and for T2DM, it was 126 (46.32%); and in oil refinery workers, the prevalence of prediabetes was 80 (36.86%), and for T2DM, it was 35 (16.12%). However; the combined prevalence of prediabetes and T2DM among wood, welding, motor mechanic, and oil refinery workers was 421 (34.79%) and 515 (42.66%), respectively. The prevalence of prediabetes and T2DM among workers increased with the duration of working exposure in the wood, welding, motor mechanic, and oil refinery industries. A one-year working exposure in these industries caused an increase of 0.03% in HbA1c. Workplace exposure in wood, welding, motor mechanic, and oil refinery industries increased the risk of prevalence of prediabetes and T2DM among the workers and affected the diabetes etiology.

The potential hazardous effect of exposure to iron dust in Egyptian smoking and nonsmoking welders

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.

Association between the Type of Workplace and Lung Function in Copper Miners

The aim of the analysis was to retrospectively assess changes in lung function in copper miners depending on the type of workplace. In the groups of 225 operators, 188 welders, and 475 representatives of other jobs, spirometry was performed at the start of employment and subsequently after 10, 20, and 25 years of work. Spirometry Longitudinal Data Analysis software was used to estimate changes in group means for FEV1 and FVC. Multiple linear regression analysis was used to assess an association between workplace and lung function. Lung function assessed on the basis of calculation of longitudinal FEV1 (FVC) decline was similar in all studied groups. However, multiple linear regression model used in cross-sectional analysis revealed an association between workplace and lung function. In the group of welders, FEF75 was lower in comparison to operators and other miners as early as after 10 years of work. Simultaneously, in smoking welders, the FEV1/FVC ratio was lower than in nonsmokers (p < 0,05). The interactions between type of workplace and smoking (p < 0,05) in their effect on FVC, FEV1, PEF, and FEF50 were shown. Among underground working copper miners, the group of smoking welders is especially threatened by impairment of lung ventilatory function.

Model for predicting peak expiratory flow rate of Nigerian workers in a cement factory in Itori, Ogun State, Nigeria

The main aim of the study was to propose a model for predicting the peak expiratory flow rate (PEFR) of Nigerian workers in a cement factory. Sixty randomly selected non-smoker and healthy workers (30 in production sections, 30 in the administrative section of the factory) participated in the study. Their physical characteristics and PEFR were measured. Multiple correlations using SPSS version 16.0 were performed on the data. The values of PEFR, using the obtained model, were compared with the measured values using a two-tailed t test. There were positive correlations among age, height and PEFR. A prediction equation for PEFR based on age, height, weight and years of exposure (experience) was obtained with R² = .843 (p < 0.001). The developed model will be useful for the management in determining PEFR of workers in the cement industry for possible medical attention.

Lung function impact from working in the pre-revolution Libyan quarry industry

The purpose of this study was to determine the lung impact from working within the Libyan quarry industry, and if the length of work impacted the degree of degradation. Eighty three workers from eight silica quarries in the Nafusa Mountains of Libya opted to participate. These quarries were working the upper cretaceous geological structure. Eighty-five individuals who lived in Gharyan City with no affiliation to quarry operations participated as controls. Spirometry variables evaluated were Forced Vital Capacity (FVC), Forced Expiratory Volume at 1.0 second (FEV1), FVC/FEV1 and Peak Expiratory Flow (PEF). Control and exposed groups had no differences in terms of height, weight, or smoking status (p = 0.18, 0.20, 0.98, respectively). Prior to adjustment for other variables, FVC, FEV1, and PEF are all significantly lower in the exposed group (p = 0.003, 0.009, 0.03, respectively). After adjustment for age, height, weight, and smoking status, there remain significant differences between the control and exposed groups for FVC, FEV1, and PEF. This analysis demonstrated that exposure to quarry dust has a detrimental effect on lung function, and that pre-revolution Libyan quarry workers were being exposed. This study shows that any exposure is harmful, as the reduction in lung function was not significantly associated with years of exposure.

Respiratory and general health complaints in subjects exposed to sandstorm at Riyadh, Saudi Arabia

Objective: Sandstorms are metrological events and frequently occur in many regions throughout the world. Sandstorms are a main source of long-distance transport of dust, air pollution and cause various health problems. This study aimed to investigate the acute respiratory and general health complaints in subjects exposed to sandstorm at Riyadh, Saudi Arabia.

Methodology: The present descriptive study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia during the period March 2011- June 2012. We selected 517 (308 males, 59.58%) and (209 females, 40.42%), apparently healthy volunteers with mean age 28.6± 3.14 years, who had single outside exposure to sandstorm for the period of 24±2.68 minutes. The acute respiratory and general health complaints were recorded through a comprehensive questionnaire.

Results: A large proportion of the subjects who were exposed to sandstorm had complaints of cough 247 (47.77%), runny nose 264(51.06%), wheeze 173(33.46%), acute asthmatic attack 108 (20.88%), eye irritation / redness 252(48.74%), headache 179 (34.62%), body ache 199 (38.5%), sleep disturbance 157(30.36%) and psychological disturbances 194 (37.52%).

Conclusion: Exposure to sandstorm causes cough, runny nose, wheeze, acute asthmatic attack, eye irritation / redness, headache, body ache, sleep and psychological disturbances. These results indicate that sandstorm is a prolific source of respiratory and general ailments. It is therefore, suggested that an unnecessary exposure to sandstorm must be avoided.

Effect of duration of exposure to cement dust on respiratory function of non-smoking cement mill workers

This study aimed to determine the effect of long term exposure to cement dust on lung function in non-smoking cement mill workers. This is a cross-sectional study of respiratory functions. Spirometry was performed in 100 apparently healthy volunteers; 50 non-smoking cement mill workers and 50 non-smoking un-exposed subjects. Based on the duration of exposure, cement mill workers were divided into three groups, less than 5, 5–10 and greater than 10 years. All subjects were individually matched for age, height, weight, and socioeconomic status. Pulmonary function test was performed by using an electronic spirometer. Significant reduction was observed in the mean values of Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV₁), Peak Expiratory Flow (PEF) and Maximal Voluntary Ventilation in cement mill workers who had been working in the cement industry for more than 10 years compared to their matched un-exposed group. Lung functions in cement mill workers were significantly impaired and results show a long term duration response effect of years of exposure to cement dust on lung functions.

BMI-based approach reveals direct impact of metal dust exposure on influenza-associated lung function decrement risk in smelters

Metal dust exposure strongly affects human health, especially for smelters. Little is known, however, about the impact of metal dust exposure on influenza-associated lung function decrement risk in smelters. Different body mass index (BMI) groups were also associated with respiratory diseases. The purpose of this study was to use a probabilistic risk assessment approach to explicitly link occupational metal dust exposure, BMI-correlated health effects, and influenza-associated lung function decrements to investigate potential risk among smelters. Here we showed that (i) influenza A-associated metal dust exposure in SiMn/FeMn/FeCr smelters had slightly higher health risks than that in FeSi/Si-metal's, (ii) BMI≥35 had the highest risk in respiratory infection exacerbations, and (iii) the estimated smelting metal dust induced forced expiratory volume in 1s (FEV(1)) decreasing rates were 0.59 and 1.11 m(3) mg(-1) for FeSi/Si-metal and SiMn/FeMn/FeCr smelters, respectively. Our results suggested that smelters better be aware of severe weight gains (e.g., BMIs from 27-40) because it is likely to lead to 17-25% decrements in lung function. This study provides a novel probabilistic risk assessment framework to quantitatively assess the occupational health risk posed by metal dust exposure associated with influenza infection based on BMI measures.

Metal-induced asthma and chest X-ray changes in welders

OBJECTIVES

The aim of this study was to evaluate the coexisting factors and usefulness of diagnostic methods in metal-induced asthma in Polish welders.

MATERIALS AND METHODS

Examination of 50 welders occupationally exposed to metals and with suspicion of metal-induced asthma (group A), 100 welders occupationally exposed to metals but without suspicion of metal-induced asthma (group B), and two control groups (10 patients with atopic asthma and 10 healthy subjects) was carried out. Questionnaire survey, clinical examination, skin prick tests to common aeroallergens and metal salts, rest spirometry tests, X-ray, metacholine challenge and a single-blind, placebo controlled specific inhalation challenge tests with metals (or work-like conditions challenge tests) were performed.

RESULTS

In group A--in 9 cases we obtained positive results of specific inhalation challenge tests with metals (in 3 cases with nickel, in 4 cases with chromium, in 1 case with cobalt and in 1 case with manganese). Nine cases of metal-induced occupational asthma were recognized. In group B--only in one case we obtained positive results of work-like conditions challenge test (clinical and spirometry changes, eosinophil influx in induced sputum), which confirmed the diagnosis of occupational asthma. In most of examined welders (62%), pulmonary changes in chest X-ray images were noted. The statistical analysis revealed that working as a welder for more than 10 years is the coexisting factor of presence of chest X-ray changes (p- or q-type nodular changes or interstitial changes). Positive results of skin prick tests with metal salts were the coexisting factors of occupational asthma due to metals among examined group of welders.

CONCLUSIONS

Specific inhalation challenge plays the key role in diagnostics of metal-induced asthma in welders. Pulmonary changes in chest X-ray were found in a significant percentage of examined welders.

A prospective study of decline in lung function in relation to welding emissions

Background

Numerous cross-sectional studies have reported reduced lung function among welders but limitations of exposure assessment and design preclude causal inference. The aim of this study was to investigate if long-term exposure to welding fume particulates accelerates the age-related decline in lung function.

Methods

Lung function was measured by spirometry in 1987 and 2004 among 68 steel welders and 32 non-welding production workers. The decline in forced expiratory volume (FEV₁) was analysed in relation to cumulated exposure to fume particulates among welders during the follow-up period.

Results

Among smokers the decline in FEV₁ through follow-up period was in average 150 ml larger among welders than non-welders while the difference was negligible among non-smokers. The results did not reach statistical significance and within welders the decline in lung function was not related to the cumulated welding particulate exposure during follow-up period

Conclusion

Long-term exposure to welding emissions may accelerate the age-related decline of lung function but at exposure levels in the range of 1.5 to 6.5 mg/m³ the average annual excess loss of FEV₁ is unlikely to exceed 25 ml in smokers and 10 ml in non-smokers.

Lung function in Pakistani wood workers

The lung function impairment is the most common respiratory problem in industrial plants and their vicinity. Therefore, the purpose was to study the affects of wood dust and its duration of exposure on lung function. This was a matched cross-sectional study of Spirometry in 46 non-smoking wood workers with age range 20 - 60 years, who worked without the benefit of wood dust control ventilation or respiratory protective devices. Pulmonary function test was performed by using an electronic Spirometer. Significant reduction was observed in the mean values of Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), and Maximum Voluntary Ventilation (MVV) in wood workers relative to their matched controls. This impairment was increased with the duration of exposure to wood industries. It is concluded that lung function in wood workers is impaired and stratification of results shows a dose-response effect of years of wood dust exposure on lung function.

Oxidant-antioxidant status and pulmonary function in welding workers

Welding is a process during which fumes, gases, electromagnetic radiation and noise are emitted as by-products. Metal oxide particles are particularly hazardous components of welding fumes. Welding has been found to be associated with respiratory symptoms and our objective in the present study was to study the effects of welding on pulmonary function and serum oxidant-antioxidant status. Fifty-one welding workers and 31 control subjects were recruited. Face to face interviews were conducted using the respiratory illness questionnaire adapted from the American Thoracic Society with the addition of demographic characteristics, work history and working conditions. Additionally physical examinations and spirometric measurements were performed at workplaces. Thiobarbituric acid reactive substances (TBARS), protein carbonyls, protein sulfhydryls (SH) and erythrocyte reduced glutathione (GSH) levels were measured to evaluate oxidant-antioxidant status in 34 welding workers and in 20 control subjects. No statistically significant differences were observed in age, height, weight, body mass index (BMI), smoking status and annual working durations between welding workers and controls. Coughing, sputting and wheezing were significantly higher in welding workers (p<0.05). When adjusted for age, BMI and smoking status in logistic regression, welding work showed a significant risk for chronic bronchitis (OR: 4.78, 95%CI: 1.30-17.54). Forced expiratory volume in one second (FEV(1))/forced vital capacity (FVC) and four parameters of forced expiratory flow (FEF: FEF(25), FEF(50), FEF(75), FEF(25-75)) levels measured in the welding workers were significantly lower than those in the control group (p<0.05). Serum TBARS and protein carbonyl levels were higher in welding workers than those in controls (p<0.001, p<0.05, respectively). On the other hand, total protein SH groups and GSH levels were significantly lower in welders than those in controls (p<0.05, p<0.001, respectively). Pulmonary function tests and oxidant-antioxidant status were found to be negatively affected in welding workers chronically exposed to welding fumes and gases. Preventive measures should be taken to improve the health status of these workers.

Respiratory health effects related to occupational spray painting and welding

OBJECTIVE

We sought to study respiratory symptoms among automobile assembly workers.

METHODS

In a cross-sectional study, we compared rates of respiratory symptoms and of physician-diagnosed asthma and COPD in painters and welders to those in assembly workers.

RESULTS

Respiratory symptom reporting was significantly increased among welders (odds ratio [OR] = 1.79-2.61) compared with painters or assembly workers, after age, race, and smoking adjustment in multiple logistic regression analyses. Welders also reported significantly more improvement in symptoms on weekends or vacation. However, no significant elevations in adjusted ORs were observed for physician-diagnosed asthma or chronic obstructive pulmonary disease for welders. In contrast, significantly more painters had physician-diagnosed chronic obstructive pulmonary disease (OR = 3.73, 95% confidence interval = 1.27, 11.0).

CONCLUSIONS

Welders and painters in this plant appeared to have increased risk of respiratory health effects compared with assembly workers.