Welding Fumes, a Risk Factor for Lung Diseases

Serum zinc levels and body composition variability as trajectory for hyperlipidemic and dyslipidemic effect among welders exposed to welding fumes and smoking: A biomarker for cardiovascular health

Welding is a common method for joining metals by heating them to the welding temperature. Exposure to welding fumes has a serious effect on the health of welders. This study examined serum zinc variability and body composition as route for hyperlipidemia and dyslipidemia in welders exposed to welding fumes and smoking, exploring the possibilities for the risk of possible cardiovascular disease. The experimental case control design was adopted in the study. Forty apparently healthy adult males were randomly selected comprising of twenty control group (non-smokers and smokers without welding experience) and twenty experimental group (non-smokers and smokers with welding experience) welders. Data obtained were represented as Mean ± SEM while comparison of means across group was done by one-way ANOVA followed by Tukey's multiple comparison for post hoc test at p-value < 0.05 level of significance using Graph Pad prism version 8. The data obtained showed that the body mass index (BMI) of smokers (non-welders and welders) were slightly reduced while that of non-smoking welders was increased compared to the control. The serum zinc level increased among the smoking welders, while the smoking non-welders and non-smoking welders decreased when compared to the control group (p < 0.05). Exposure to welding fumes has been shown to increase total cholesterol levels compared to the control. Weld fumes significantly (p < 0.05) increased high-density lipoproteins (HDL) levels among smoking non-welders compared to the control group, while, HDL was reduced in non-smoking welders and smoking welders, respectively (p < 0.05). Triglyceride levels significantly (p < 0.05) increased in all experimental groups compared to control levels (p < 0.05). Exposure to welding fumes and smoking caused significant changes in serum zinc, HDL and triglycerides levels with implications for the formation of plaques around the arteries interfering with the effective flow of blood through the vascular system, with implications of hyperlipidemia and dyslipidemia. This study recommends that further studies should be done using biomarkers from urine or toe nails.

Effects of occupational exposure to metal fume PM2.5 on lung function and biomarkers among shipyard workers: a 3-year prospective cohort study

OBJECTIVE

This study investigates the associations of α1-antitrypsin, inter-α-trypsin inhibitor heavy chain (ITIH4), and 8-isoprostane with lung function in shipyard workers exposed to occupational metal fume fine particulate matter (PM2.5), which is known to be associated with adverse respiratory outcomes.

METHODS

A 3-year follow-up study was conducted on 180 shipyard workers with 262 measurements. Personal exposure to welding fume PM2.5 was collected for an 8-h working day. Pre-exposure, post-exposure, and delta (∆) levels of α1-antitrypsin, ITIH4, and 8-isoprostane were determined in urine using enzyme-linked immunosorbent assays. Post-exposure urinary metals were sampled at the beginning of the next working day and analyzed by inductively coupled plasma-mass spectrometry. Lung function measurements were also conducted the next working day for post-exposure.

RESULTS

An IQR increase in PM2.5 was associated with decreases of 2.157% in FEV1, 2.806% in PEF, 4.328% in FEF25%, 5.047% in FEF50%, and 7.205% in FEF75%. An IQR increase in PM2.5 led to increases of 42.155 µg/g in ∆α1-antitrypsin and 16.273 µg/g in ∆ITIH4. Notably, IQR increases in various urinary metals were associated with increases in specific biomarkers, such as post-urinary α1-antitrypsin and ITIH4. Moreover, increases in ∆ α1-antitrypsin and ∆ITIH4 were associated with decreases in FEV1/FVC by 0.008% and 0.020%, respectively, and an increase in ∆8-isoprostane resulted in a 1.538% decline in FVC.

CONCLUSION

Our study suggests that urinary α1-antitrypsin and ITIH4 could indicate early lung function decline in shipyard workers exposed to metal fume PM2.5, underscoring the need for better safety and health monitoring to reduce respiratory risks.

Welding fume exposure and prevalence of chronic respiratory symptoms among welders in micro- and small-scale enterprise in Akaki Kality sub-city, Addis Ababa, Ethiopia: a comparative cross-sectional study

BACKGROUND

Exposure to welding fumes can lead to different respiratory health disorders, including lung cancer, due to long-term exposures. In Ethiopia, large numbers of people are engaged in the welding sector. Often, these workers are exposed to welding fumes at their workplaces, however, the level of exposure and its health effects have never been studied.

OBJECTIVE

To measure the level of personal welding fume exposure and assess chronic respiratory symptoms and associated factors, among micro and small-scale enterprise metal workshop workers, in Akaki Kality Sub city, Ethiopia.

METHODS

A comparative cross-sectional study involving 226 welders and 217 controls. Chronic respiratory symptoms were assessed using a standardized questionnaire adopted from the American Thoracic Society (ATS). Welding fumes were collected from the welder's breathing zone using 37 mm close-faced plastic cassettes fitted with Polyvinyl Chloride (PVC) filters connected to Casella pumps at an airflow rate of 2 L/min.

RESULT

The overall prevalence of chronic respiratory symptoms among welders and controls were 54 (23.9%) and 20 (9.2%) respectively. The geometric mean and geometric standard deviation (GSD) of personal welding fume exposure, among welders was 5.98 mg/m3 (± GSD = 1.54). In this study, 53.3% of the samples exceeded the Occupational Exposure Limit defined by the American Conference of Governmental Industrial Hygiene. Chronic respiratory symptoms were significantly associated with educational status (Adjusted Odds Ratio (AOR): 5.11, 95% CI: 1.35, 19.33), respiratory protective equipment use (AOR: 3.33, 95% CI: 1.52, 7.31), safety training (AOR: 2.41, 95% CI: 1.10, 5.28), smoking (AOR:3.57, 95% CI: 1.54, 8.23), welding machine maintenance (AOR: 1.87, 95% CI: 1.01, 3.59) and welding site (i.e. indoors vs. outdoor) (AOR: 6.85. 95% CI: 2.36, 19.89).

CONCLUSIONS

The prevalence of chronic respiratory symptoms among welding workers was significantly higher than controls. More than half of the samples exceeded the Occupational Exposure Limit. Educational status, implementation of safety training, and welding sites were significantly associated with chronic respiratory symptoms. The results suggested a need to reduce welding fume exposure to improve the respiratory health of the workers.

Exposure and Health Risks Posed by Potentially Toxic Elements in Soils of Metal Fabrication Workshops in Mbarara City, Uganda

Metal fabrication workshops (MFWs) are common businesses in Ugandan cities, and especially those producing metallic security gates, window and door frames (burglar-proof), and balcony and staircase rails. The objective of this study was to comparatively assess the pollution levels and potential health risks of manganese (Mn), chromium (Cr), cadmium (Cd), lead (Pd) and nickel (Ni) in pooled surface soil samples from four 5-, 7-, 8-, and 10-year-old MFWs (n = 28) and a control site (n = 8) in Mbarara City, Uganda. The concentration of the potentially toxic elements (PTEs) was determined using inductively coupled plasma-optical emission spectrometry. Contamination, ecological, and human health risk assessment indices and models were used to identify any risks that the PTEs could pose to the pristine environment and humans. Our results showed that PTE pollution of soils is occuring in the MFWs than at the control site. The mean concentrations of the PTEs (mg kg-1) in the samples were: Mn (2012.75 ± 0.23-3377.14 ± 0.31), Cr (237.55 ± 0.29-424.93 ± 0.31), Cd (0.73 ± 0.13-1.29 ± 0.02), Pb (107.80 ± 0.23-262.01 ± 0.19), and Ni (74.85 ± 0.25-211.37 ± 0.14). These results indicate that the PTEs could plausibly derive from the fabrication activities in these workshops, which is supported by the high values of contamination factors, index of geoaccumulation, and the overall increase in pollution load indices with the number of years of operation of the MFWs. Human health risk assessment showed that there are non-carcinogenic health risks that could be experienced by children who ingest PTEs in the soils from the 7-, 8- and 10-year-old MFWs. The incremental life cancer risk assessment suggested that there are potential cancerous health effects of Cd and Ni that could be experienced in children (who ingest soils from all the four MFWs) and adults (ingesting soils from the 8- and 10-year-old MFWs). This study underscores the need to implement regulatory guidelines on the operation and location of MFWs in Uganda. Further research should be undertaken to investigate the emission of the PTEs during welding operations in the MFWs.

Occupational Etiology of Oropharyngeal Cancer: A Literature Review

While abundant evidence exists linking alcohol, tobacco, and HPV infection to a carcinogenic impact on the oropharynx, the contribution of inhalational workplace hazards remains ill-defined. We aim to determine whether the literature reveals occupational environments at a higher-than-average risk of developing oropharyngeal cancer (OPC) and summarize the available data. To identify studies assessing the relationship between occupational exposure and risk of OPC, a search of the literature through the PubMed-NCBI database was carried out and, ultimately, 15 original articles meeting eligibility criteria were selected. Only original articles in English focusing on the association between occupational exposure and risk or death of specifically OPC were included. The available data are supportive of a potentially increased risk of OPC in waiters, cooks and stewards, artistic workers, poultry and meat workers, mechanics, and World Trade Center responders exposed to dust. However, the available literature on occupation-related OPC is limited. To identify occupational categories at risk, large cohorts with long follow-ups are needed. Identification of causal associations with occupation-related factors would require dose-response analyses adequately adjusted for confounders.

Therapeutic effect of trace elements on multiple myeloma and mechanisms of cancer process

In the human body, trace elements and other micronutrients play a vital role in growth, health and immune system function. The trace elements are Iron, Manganese, Copper, Iodine, Zinc, Cobalt, Fluoride, and Selenium. Estimating the serum levels of trace elements in hematologic malignancy patients can determine the severity of the tumor. Multiple myeloma (MM) is a hematopoietic malignancy and is characterized by plasma cell clonal expansion in bone marrow. Despite the advances in treatment methods, myeloma remains largely incurable. In addition to conventional medicine, treatment is moving toward less expensive noninvasive alternatives. One of the alternative treatments is the use of dietary supplements. In this review, we focused on the effect of three trace elements including iron, zinc and selenium on important mechanisms such as the immune system, oxidative and antioxidant factors and cell cycle. Using some trace minerals in combination with approved drugs can increase patients' recovery speed. Trace elements can be used as not only a preventive but also a therapeutic tool, especially in reducing inflammation in hematological cancers such as multiple myeloma. We hope that the prospect of the correct use of trace element supplements in the future could be promising for the treatment of diseases.

Health risk assessment of exposure to various vapors and fumes in a factory of automobile manufacturing

This study aimed to comprehensively evaluate the health risk of exposure to various vapors and fumes in a factory of automobile manufacturing. This study was performed in 2021 on 115 workers. Vapors and fumes were gathered by the adsorbent tubes of activated charcoal and mixed cellulose esters (MCE) membrane filter, respectively. The flow rate for vapors and fumes were between 0.05 and 0.20 L per min and 1 to 4 L per min, respectively. After preparing, samples were analyzed. To assess the non-cancer and cancer risk of the pollutants, the method proposed environmental protection agency (EPA) was applied. The total concentration of copper (1.031 ppm), manganese (0.114), and 2-butoxyethanol (91.767 ppm) were found to be higher than The threshold limit values (TLVs). The values of non-cancer risk (HQ) due to exposure to vapors of benzene (6.583), toluene (1.396), ethyl benzene (1.212), xylene (31.148), 2-butoxyethanol (89.302), 2-propanol (4.695), 1,2,3-trimethylbenzene (1.923), copper (2.336), manganese (715.82), aluminum (3.772), and chromium (107.066) were higher than the acceptable limit. Moreover, the estimated LCR for benzene (2.15 × 10-4), ethyl benzene (3.97 × 10-4), vinyl chloride (1.25 × 10-4), and chromium (2.11 × 10-2) were higher than the threshold risk level set by EPA. It is emphasized that preventive measures are performed.

Physiology and Biomarkers for Surveillance of Occupational Lung Disease

Respiratory surveillance is the process whereby a group of exposed workers are regularly tested (or screened) for those lung diseases which occur as a result of a specific work exposure. Surveillance is performed by assessing various measures of biological or pathological processes (or biomarkers) for change over time. These traditionally include questionnaires, lung physiological assessments (especially spirometry), and imaging. Early detection of pathological processes or disease can enable removal of a worker from a potentially harmful exposure at an early stage. In this article, we summarize the physiological biomarkers currently used for respiratory surveillance, while commenting on differences in interpretative strategies between different professional groups. We also briefly review the many new techniques which are currently being assessed for respiratory surveillance in prospective research studies and which are likely to significantly broaden and enhance this field in the near future.

Characterization of welding fume and airborne heavy metals in electronic manufacturing workshops in Hangzhou, China: implication for occupational population exposure

Occupational exposure to contaminants created by electronic manufacturing process is not well characterized. The aim of this study was to carry out risk assessments of exposure to welding fume and airborne heavy metals (HMs) in electronic manufacturing workshops. Seventy-six air samples were collected from five sites in Hangzhou, China. In welding workshops, the most abundant contaminant found was welding fume, followed by Fe, Mn, Zn, Cu, Pb, Cd, and Cr. The concentration of Mn was positively correlated with Fe (r = 0.906). When compared with non-welding workshops, the Fe content in the air of welding workshops increased significantly (P < 0.05), while the Cu content decreased significantly (P < 0.05). Singapore semi-quantitative health risk assessment model and the United States Environmental Protection Agency (US EPA) inhalation risk assessment model were applied to assess the occupational exposure. In welding workshops, the levels of 8-h time weighted average (8 h-TWA) calculated for welding fume (range 0.288 ~ 6.281 mg/m³), Mn (range Nd ~ 0.829 mg/m³), and Fe (range 0.027 ~ 2.234 mg/m³) partly exceeded the permissible limits. While, in non-welding workshops, the average of 8 h-TWA for Cu (0.411 mg/m³) was higher than the limit. The risk rates (RR) assessed for Pb (2.4 vs 1.7), Mn (2.0 vs 1.4), and Fe (1.4 vs 1.0) were higher in welding workshops than that in non-welding workshops, but Cu (1.0 vs 2.2) were lower. The mean excess lifetime cancer risks (ELCR) in welding (5.59E - 06 per 1000 people) and non-welding (1.88E - 06 per 1000 people) workshops were acceptable. The mean non-cancer risk (HQ) estimated for Mn was greater than 10 in both welding (HQ = 164) and non-welding (HQ = 11.1) workshops. These results indicate that there was a risk of occupational exposure implication in the electronic manufacturing workshops. Reducing contaminant exposure through engineering controls and management strategies, such as efficient ventilation and reducing exposure hours, is thus suggested.

Occupational Exposure to Metal Fumes Among Iranian Welders: Systematic Review and Simulation-Based Health Risk Assessment

There have been numerous reports of welder's worker exposure to metal fumes. Carcinogenic and non-carcinogenic (neurological, dermal, and etc.) effects are the adverse outcomes of exposure to welding fumes. In this review study, data were collected from previous studies conducted in Iran from 1900 to 2020. The risk of carcinogenicity and non-carcinogenicity due to exposure to welding metal fumes was assessed using the United States Environmental Protection Agency (USEPA) method based on the Monte Carlo simulation (MCS). Results showed mean of metal fume concentration in gas welding was in the range of 1.8248 to 1060.6 (µg/m³) and in arc welding was 54.935 to 4882.72 (µg/m³). The mean concentration of fumes in gas welding is below the recommended American Conference of Governmental Industrial Hygienists (ACGIH) standard exposure limit except for manganese, and in the arc welding, all metal fume concentrations are below the standard exposure limit except for manganese and aluminum. The results showed that the risk of carcinogenicity due to exposure to nickel, manganese in both gas and arc welding, and cadmium in gas welding was higher than standard level (hazard quotient (HQ) more than 1). Cancer risk due to exposure to nickel in both gas and arc welding was probable (1 × 10^-6 < cancer risk (CR) < 1 × 10^-4). Health risk assessment showed that welders are exposed to health risks. Preventive measures should be applied in welding workplaces to reduce the concentrations of metal fumes.

An unusual case of interstitial lung disease: Revisiting peribronchiolar metaplasia interstitial lung disease (PBM-ILD)

Peribronchiolar metaplasia (PBM) is a histological finding of uncertain significance commonly seen in interstitial lung disease (ILD). PBM is thought to be secondary to small airway injury from insults such as tobacco smoke and other environmental exposures. The term PBM-ILD has been proposed for patients with ILD where PBM is the major histologic finding, however a lack of radiographic changes supportive of ILD in previously reported cases has limited recognition of the diagnosis. We present a rare case of welding-associated ILD with clinical, radiographic, and histologic evidence consistent with the proposed definition of PBM-ILD. We outline an approach to its consideration as a diagnosis based on our experience through multidisciplinary discussion.

Human biomonitoring and personal air monitoring. An integrated approach to assess exposure of stainless-steel welders to metal-oxide nanoparticles

In welding, there is a potential risk due to metal-oxide nanoparticles (MONPs) exposure of workers. To investigate this possibility, the diameter and number particles concentration of MONPs were evaluated in different biological matrices and in personal air samples collected from 18 stainless-steel welders and 15 unexposed administrative employees engaged in two Italian mechanical engineering Companies. Exhaled breath condensate (EBC) and urine were sampled at pre-shift on 1st day and post-shift on 5th day of the workweek, while plasma and inhalable particulate matter (IPM) at post-shift on 5th day and analysed using the Single Particle Mass Spectrometry (SP-ICP-MS) technique to assess possible exposure to Cr₂O₃, Mn₃O₄ and NiO nanoparticles (NPs) in welders. The NPs in IPM at both Companies presented a multi-oxide composition consisting of Cr₂O₃ (median, 871,574 particles/m³; 70 nm), Mn₃O₄ (median, 713,481 particles/m³; 92 nm) and NiO (median, 369,324 particles/m³; 55 nm). The EBC of welders at both Companies showed Cr₂O₃ NPs median concentration significantly higher at post-shift (64,645 particles/mL; 55 nm) than at pre-shift (15,836 particles/mL; 58 nm). Significantly lower Cr₂O₃ NPs median concentration and size (7762 particles/mL; 44 nm) were observed in plasma compared to EBC of welders. At one Company, NiO NPs median concentration in EBC (22,000 particles/mL; 65 nm) and plasma (8248 particles/mL; 37 nm) were detected only at post-shift. No particles of Cr₂O_3, Mn₃O₄ and NiO were detected in urine of welders at both Companies. The combined analyses of biological matrices and air samples were a valid approach to investigate both internal and external exposure of welding workers to MONPs. Overall, results may inform suitable risk assessment and management procedures in welding operations.

Chemistry and lung toxicity of particulate matter emitted from firearms

Smoke emissions produced by firearms contain hazardous chemicals, but little is known if their properties change depending on firearm and ammunition type and whether such changes affect toxicity outcomes. Pulmonary toxicity was assessed in mice exposed by oropharyngeal aspiration to six different types of smoke-related particulate matter (PM) samples; (1) handgun PM, (2) rifle PM, (3) copper (Cu) particles (a surrogate for Cu in the rifle PM) with and without the Cu chelator penicillamine, (4) water-soluble components of the rifle PM, (5) soluble components with removal of metal ions, and (6) insoluble components of the rifle PM. Gun firing smoke PM was in the respirable size range but the chemical composition varied with high levels of Pb in the handgun and Cu in the rifle smoke. The handgun PM did not induce appreciable lung toxicity at 4 and 24 h post-exposure while the rifle PM significantly increased lung inflammation and reduced lung function. The same levels of pure Cu particles alone and the soluble components from the rifle fire PM increased neutrophil numbers but did not cause appreciable cellular damage or lung function changes when compared to the negative (saline) control. Penicillamine treated rifle PM or Cu, slightly reduced lung inflammation and injury but did not improve the lung function decrements. Chelation of the soluble metal ions from the rifle fire PM neutralized the lung toxicity while the insoluble components induced the lung toxicity to the same degree as the rifle PM. The results show that different firearm types can generate contrasting chemical spectra in their emissions and that the rifle PM effects were mostly driven by water-insoluble components containing high levels of Cu. These findings provide better knowledge of hazardous substances in gun firing smoke and their potential toxicological profile.

In vivo and in vitro toxicity of a stainless-steel aerosol generated during thermal spray coating

Thermal spray coating is an industrial process in which molten metal is sprayed at high velocity onto a surface as a protective coating. An automated electric arc wire thermal spray coating aerosol generator and inhalation exposure system was developed to simulate an occupational exposure and, using this system, male Sprague-Dawley rats were exposed to stainless steel PMET720 aerosols at 25 mg/m³ × 4 h/day × 9 day. Lung injury, inflammation, and cytokine alteration were determined. Resolution was assessed by evaluating these parameters at 1, 7, 14 and 28 d after exposure. The aerosols generated were also collected and characterized. Macrophages were exposed in vitro over a wide dose range (0-200 µg/ml) to determine cytotoxicity and to screen for known mechanisms of toxicity. Welding fumes were used as comparative particulate controls. In vivo lung damage, inflammation and alteration in cytokines were observed 1 day post exposure and this response resolved by day 7. Alveolar macrophages retained the particulates even after 28 day post-exposure. In line with the pulmonary toxicity findings, in vitro cytotoxicity and membrane damage in macrophages were observed only at the higher doses. Electron paramagnetic resonance showed in an acellular environment the particulate generated free radicals and a dose-dependent increase in intracellular oxidative stress and NF-kB/AP-1 activity was observed. PMET720 particles were internalized via clathrin and caveolar mediated endocytosis as well as actin-dependent pinocytosis/phagocytosis. The results suggest that compared to stainless steel welding fumes, the PMET 720 aerosols were not as overtly toxic, and the animals recovered from the acute pulmonary injury by 7 days.

Manganese, Iron, Lead, and Zinc Levels and Haematological Profile among Welders in Bibiani Anhwiaso Bekwai District, Ghana

Welders are exposed to metal ions or oxides through direct contact at occupational sites or indirectly through uptake from contaminated dust or air. This study was a case-control study designed to assess the levels of some heavy metals and the hematological profile of welders (cases) as compared to nonwelders (controls) from Bibiani Anhwiaso Bekwai District of Ghana, comparatively to determine whether their values are within acceptable international range. A quantitative-based survey using structured questionnaires was used to collect demographic data from purposively selected welders (n = 40) and nonwelders (n = 40) from the study area. Five (5 mL) blood samples were collected from the study participants and analyzed for blood cell count as well as levels of Mn, Fe, Pb, and Zn. There were no significant differences in the Mn, Zn, and Fe levels between the welders and nonwelders ( $p=0.431$ , 0.53 vs. 0.23 mg/L, $p=0.05$ , 0.41 vs. 0.15, $p=0.886$ , 1.82 vs. 1.11). The level of Pb was, however, significantly lower among welders compared to the nonwelders ( $p=0.016$ , 0.09 < 0.3 mg/L). The total white blood cell count did not differ significantly between welders and nonwelders ( $p=0.365$ , 5.16 vs. 4.85 × 109/L). However, the mixed cell fraction was significantly higher among welders compared to nonwelders ( $p=0.027$ , 0.34 × 109/L > 0.28 × 109/L). Red blood cell count and indices showed no significant differences between the welders and nonwelders. Hemoglobin levels in welders were, however, higher (14.47 g/dL) but this was not statistically significant compared to their nonwelder counterparts (13.85 g/dL). It was concluded from the study that welders in Bibiani Anhwiaso Bekwai District of the Western Region of Ghana had elevated levels of Pb in their bodies. This was associated with an increase in mixed white blood cell fraction platelets. However, the recorded levels were within the accepted physiological limits suggesting that the heavy metal exposure of welders had no clinically pathological significance.

Chemical Pneumonitis Caused by the Inhalation of Zinc Oxide Fumes in an Arc Welder

Acute respiratory illness caused by exposure to welding-associated zinc oxide fumes is known as metal fume fever (MFF). MFF is generally characterized as a self-limiting disease. Few studies have reported chemical pneumonitis associated with zinc fume inhalation. We report a case study involving severe episodes of MFF accompanied by chemical pneumonitis due to the inhalation of zinc oxide fumes while operating an arc welder. A 54-year-old man developed flu-like symptoms after arc welding galvanized steel in a poorly ventilated area. Despite intravenous antibiotics therapy, his clinical course worsened, and his urine zinc concentration was remarkably elevated (3579 μg/24 h; reference range, 0–616 μg/24 h). A chest computed tomography revealed extensive consolidation, ground-glass opacity in the lungs, and right pleural effusion. After corticosteroid treatment, the patient’s symptoms and radiologic findings significantly improved. It should be noted that the inhalation of zinc oxide fumes can occasionally induce acute lung injury via inflammatory responses and oxidative stress.

Modelled lung deposition and retention of welding fume particles in occupational scenarios: a comparison to doses used in vitro

Translating particle dose from in vitro systems to relevant human exposure remains a major challenge for the use of in vitro studies in assessing occupational hazard and risk of particle exposure. This study aimed to model the lung deposition and retention of welding fume particles following occupational scenarios and subsequently compare the lung doses to those used in vitro. We reviewed published welding fume concentrations and size distributions to identify input values simulating real-life exposure scenarios in the multiple path particle dosimetry (MPPD) model. The majority of the particles were reported to be below 0.1 μm and mass concentrations ranged between 0.05 and 45 mg/m³. Following 6-h exposure to 5 mg/m³ with a count median diameter of 50 nm, the tracheobronchial lung dose (0.89 µg/cm²) was found to exceed the in vitro cytotoxic cell dose (0.125 µg/cm²) previously assessed by us in human bronchial epithelial cells (HBEC-3kt). However, the tracheobronchial retention decreased rapidly when no exposure occurred, in contrast to the alveolar retention which builds-up over time and exceeded the in vitro cytotoxic cell dose after 1.5 working week. After 1 year, the tracheobronchial and alveolar retention was estimated to be 1.15 and 2.85 µg/cm², respectively. Exposure to low-end aerosol concentrations resulted in alveolar retention comparable to cytotoxic in vitro dose in HBEC-3kt after 15-20 years of welding. This study demonstrates the potential of combining real-life exposure data with particle deposition modelling to improve the understanding of in vitro concentrations in the context of human occupational exposure.

Respiratory health disorders among workers in some Egyptian welding enterprises

Welding fumes contain a complex mixture of metallic oxides that pose a risk to welders' respiratory systems. This study aimed to evaluate respiratory health disorders among workers in some Egyptian welding enterprises and their relationship to the workplace environment. This research was performed from January 1^st, 2019 to February 28^th, 2021 in welding enterprises in Birket El-Sabaa, a randomly selected district of Menoufia governorate, Egypt. A cross-sectional comparative study was conducted on 110 welders and 110 non-occupationally exposed subjects. Environmental studies were carried out for total welding fumes, respirable dust, and manganese air levels. Spirometric measures and manganese levels in whole blood were applied. Analysis of the personal air samples revealed that the mean values of welding fumes, respirable dust, and manganese air levels were higher than the international permissible levels. Welders had a higher significant prevalence of respiratory manifestations (rhinitis, cough, expectoration, wheezes, dyspnea, and chronic bronchitis) as well as decreased spirometric measures (FVC%, FEV₁%, FEV₁/FVC%, and FEF_25-75%) than controls. The mean value of whole blood manganese level was statistically significantly higher among welders than that of the controls (3.35 ± 0.5 and 1.81 ± 0.79 ng/mL; respectively). A significant relationship was reported between longer work time and the prevalence of respiratory manifestations and decreased spirometric measurements. The use of masks/respirators was associated with a reduced prevalence of respiratory manifestations. Finally, welders that are exposed to welding fumes at concentrations higher than the permissible levels in welding establishments suffer from adverse respiratory problems, as shown by increased prevalence of respiratory manifestations and lower spirometric measurements. Regular use of high-quality personal protective equipment, especially masks, as well as periodic medical examinations for welders, is highly urged.

A case of welder's pneumoconiosis treated with corticosteroid followed by nintedanib

A 32-year-old man who had worked as a welder for 13 years was hospitalized for a fever and hemosputum with dyspnea. He was diagnosed with welding fume-associated lung disease with alveolar hemorrhaging and acute respiratory failure. Despite surviving the acute phase with corticosteroid therapy, hypoxemia persisted after a month and a half, requiring home oxygen therapy. As a result of the introduction of nintedanib, his clinical findings gradually improved, and the patient was weaned from oxygen therapy after six months. Inhalation of a large amount of welding fumes in a short period can cause alveolar hemorrhaging and prolonged pulmonary dysfunction.

Cytokinesis-block micronucleus cytome (CBMN-CYT) assay and its relationship with genetic polymorphisms in welders

Fumes generated in the welding process are composed of micrometric and nanometric particles that form when metal fumes condense. The International Agency for Research on Cancer established that many compounds derived from the welding process are carcinogenic to humans. Still, there are few studies related to the role of genetic polymorphisms. This work aimed to analyze the influence of OGG1 Ser326Cys, XRCC1 Arg280His, XRCC1 Arg194Thr, XRCC1 Arg399Gln, XRCC3 Thr241Met, GSTM1, and GSTT1 gene polymorphisms on DNA damage of 98 subjects occupationally exposed to welding fumes and 100 non exposed individuals. The results showed that individuals exposed to welding fumes with XRCC3 Thr241Thr, XRCC3 Thr241Met, and GSTM1 null genotypes demonstrated a significantly higher micronucleus frequency in lymphocytes. In contrast, individuals with XRCC1 Arg399Gln and XRCC1 Gln399Gln genotypes had significant levels of NPBs. OGG1 326 Ser/Cys, OGG1 326 Cys/Cys, XRCC1 194Arg/Thr, XRCC1 194Thr/Thr, and GSTT1 null genotypes exhibited significantly higher apoptotic values. Also, XRCC1 194Arg/Trp, XRCC1 194Thr/Thr, and GSTM1 null genotype carriers had higher necrotic levels compared to XRCC1 194Arg/Arg and GSTM1 nonnull carriers. Compositional analysis revealed the presence of iron, manganese, silicon as well as particles smaller than 2 μm that adhere to each other and form agglomerates. These results may be associated with a mixture of components, such as nitrogen dioxide, carbon monoxide, and metallic fumes, leading to significant DNA damage and cell death processes. These findings demonstrated the importance of the association between individual susceptibility and DNA damage levels due to occupational exposure to welding fumes; and constitute one of the first studies carried out in exposed workers from Colombia.

Challenges in Diagnosing Occupational Chronic Obstructive Pulmonary Disease

Occupational chronic obstructive pulmonary disease (oCOPD) represents 15–20% of the global burden of this disease. Even if industrial bronchitis has long been known, new occupational hazards continue to emerge and enlarge the number of people exposed to risk. This review discusses the challenges related to the early detection of oCOPD, in the context of new exposures and of limited usage of methods for an efficient disease occupational screening. It underlines that a better translation into clinical practice of the new methods for lung function impairment measurements, imaging techniques, or the use of serum or exhaled breath inflammation biomarkers could add significant value in the early detection of oCOPD. Such an approach would increase the chance to stop exposure at an earlier moment and to prevent or at least slow down the further deterioration of the lung function as a result of exposure to occupational (inhaled) hazards.

Which ones, when and why should renin-angiotensin system inhibitors work against COVID-19?

The article describes the possible pathophysiological origin of COVID-19 and the crucial role of renin-angiotensin system (RAS), providing several “converging” evidence in support of this hypothesis. SARS-CoV-2 has been shown to initially upregulate ACE2 systemic activity (early phase), which can subsequently induce compensatory responses leading to upregulation of both arms of the RAS (late phase) and consequently to critical, advanced and untreatable stages of COVID-19 disease. The main and initial actors of the process are ACE2 and ADAM17 zinc-metalloproteases, which, initially triggered by SARS-CoV-2 spike proteins, work together in increasing circulating Ang 1–7 and Ang 1–9 peptides and downstream (Mas and Angiotensin type 2 receptors) pathways with anti-inflammatory, hypotensive and antithrombotic activities. During the late phase of severe COVID-19, compensatory secretion of renin and ACE enzymes are subsequently upregulated, leading to inflammation, hypertension and thrombosis, which further sustain ACE2 and ADAM17 upregulation. Based on this hypothesis, COVID-19-phase-specific inhibition of different RAS enzymes is proposed as a pharmacological strategy against COVID-19 and vaccine-induced adverse effects. The aim is to prevent the establishment of positive feedback-loops, which can sustain hyperactivity of both arms of the RAS independently of viral trigger and, in some cases, may lead to Long-COVID syndrome.

Endotyping asthma related to three different work exposures

BACKGROUND

Work exposures play a significant role in adult-onset asthma, but mechanisms of work-related asthma are not fully elucidated.

OBJECTIVE

We aimed to reveal the molecular mechanisms of work-related asthma associated with flour (FA), isocyanate (IA) or welding fume (WA) exposures and identify potential biomarkers that distinguish these groups from each other.

METHODS

We used a combination of clinical tests, transcriptomic analysis and associated pathway analyses to investigate underlying disease mechanisms of the blood immune cells and the airway epithelium of 61 men.

RESULTS

Compared to the healthy controls, the WA patients had more differentially expressed genes than the FA and IA patients both in the airway epithelia and in the blood immune cells. In the airway epithelia, active inflammation was detected only in WA patients. In contrast, large number of differentially expressed genes were detected in all asthma groups in blood cells. Disease-related immune functions in blood cells were suppressed in all the asthma groups including leukocyte migration and inflammatory responses and decreased expression of upstream cytokines such as TNF and IFNγ. In transcriptome-phenotype correlations, hyperresponsiveness (R∼|0.6|) had the highest clinical relevance and associated with a set of exposure-group specific genes. Finally, biomarker subsets of only 5 genes specifically distinguished each of the asthma exposure group.

CONCLUSIONS

This study provides novel data on the molecular mechanisms underlying work-related asthma. We identified set of 5 promising biomarkers in asthma related to flour, isocyanate and welding exposure to be tested and clinically validated in future studies.

Genotoxicity and inflammatory potential of stainless steel welding fume particles: an in vitro study on standard vs Cr(VI)-reduced flux-cored wires and the role of released metals

Welders are daily exposed to various levels of welding fumes containing several metals. This exposure can lead to an increased risk for different health effects which serves as a driving force to develop new methods that generate less toxic fumes. The aim of this study was to explore the role of released metals for welding particle-induced toxicity and to test the hypothesis that a reduction of Cr(VI) in welding fumes results in less toxicity by comparing the welding fume particles of optimized Cr(VI)-reduced flux-cored wires (FCWs) to standard FCWs. The welding particles were thoroughly characterized, and toxicity (cell viability, DNA damage and inflammation) was assessed following exposure to welding particles as well as their released metal fraction using cultured human bronchial epithelial cells (HBEC-3kt, 5–100 µg/mL) and human monocyte-derived macrophages (THP-1, 10–50 µg/mL). The results showed that all Cr was released as Cr(VI) for welding particles generated using standard FCWs whereas only minor levels (< 3% of total Cr) were released from the newly developed FCWs. Furthermore, the new FCWs were considerably less cytotoxic and did not cause any DNA damage in the doses tested. For the standard FCWs, the Cr(VI) released in cell media seemed to explain a large part of the cytotoxicity and DNA damage. In contrast, all particles caused rather similar inflammatory effects suggesting different underlying mechanisms. Taken together, this study suggests a potential benefit of substituting standard FCWs with Cr(VI)-reduced wires to achieve less toxic welding fumes and thus reduced risks for welders.

The impact of environmental and occupational exposures of manganese on pulmonary, hepatic, and renal functions

Manganese (Mn) is an essential trace element for humans, but long-term environmental or occupational exposures can lead to numerous health problems. Although many studies have identified an association between Mn exposures and neurological abnormalities, emerging data suggest that occupationally and environmentally relevant levels of Mn may also be linked to multiple organ dysfunction in the general population. In this regard, many experimental and clinical studies provide support for a causal link between Mn exposure and structural and functional changes that are responsible for organ dysfunction in major organs like lung, liver, and kidney. The underlying mechanisms suggested to Mn toxicity include altered activities of the components of intracellular signaling cascades, oxidative stress, apoptosis, affected cell cycle regulation, autophagy, angiogenesis, and an inflammatory response. We further discussed the sources and possible mechanisms of Mn absorption and distribution in different organs. Finally, treatment strategies available for treating Mn toxicity as well as directions for future studies were discussed.

Upregulation of the Renin-Angiotensin System Pathways and SARS-CoV-2 Infection: The Rationale for the Administration of Zinc-Chelating Agents in COVID-19 Patients

The article describes the rationale for the administration of zinc-chelating agents in COVID-19 patients. In a previous work I have highlighted that the binding of the SARS-CoV spike proteins to the zinc-metalloprotease ACE2 has been shown to induce ACE2 shedding by activating the zinc-metalloprotease ADAM17, which ultimately leads to systemic upregulation of ACE2 activity. Moreover, based on experimental models, it was also shown the detrimental effect of the excessive systemic activity of ACE2 through its downstream pathways, which leads to "clinical" manifestations resembling COVID-19. In this regard, strong upregulation of circulating ACE2 activity was recently reported in COVID-19 patients, thus supporting the previous hypothesis that COVID-19 may derive from upregulation of ACE2 activity. Based on this, a reasonable hypothesis of using inhibitors that curb the upregulation of both ACE2 and ADAM17 zinc-metalloprotease activities and consequent positive feedback-loops (initially triggered by SARS-CoV-2 and subsequently sustained independently on viral trigger) is proposed as therapy for COVID-19. In particular, zinc-chelating agents such as citrate and ethylenediaminetetraacetic acid (EDTA) alone or in combination are expected to act in protecting from COVID-19 at different levels thanks to their both anticoagulant properties and inhibitory activity on zinc-metalloproteases. Several arguments are presented in support of this hypothesis and based on the current knowledge of both beneficial/harmful effects and cost/effectiveness, the use of chelating agents in the prevention and therapy of COVID-19 is proposed. In this regard, clinical trials (currently absent) employing citrate/EDTA in COVID-19 are urgently needed in order to shed more light on the efficacy of zinc chelators against SARS-CoV-2 infection in vivo.

Impact of the Samples’ Surface State on the Glow Discharge Stability in the Metals’ Treatment and Welding Processes

The low temperature plasma of glow discharge has found a widespread use as a heating source in welding and surface treatment of metals. The meticulous analysis of glow discharge’s instabilities in these processes allowed us to highlight the physicochemical characteristics of the cathode surface (the welded or treated samples) as one of the main reasons of its transition into an electric arc—as a more stable form of gas discharges. The prolonged arc action on the samples surfaces inevitably leads to the disruption of the technological process and, consequently, to undesirable overheating of samples. In this regard, the main aim of this work is to study the influence of the macro- and micro relief of the cathode on the stable glow discharge existence in the processes of metals treatment and diffusion welding. It has been analytically established and experimentally supported that the glow discharge’s stability is mainly affected by the sharp protrusions generated on the cathode surface because of samples pre-treatment by machining before welding. It has been established that the rough surface pre-treatment with the Rz about 60–80 µm decreases the pressure range of glow discharge sustainable existence from 1.33–13.3 kPa to 1.33–5.3 kPa compared with the surface machining with the Rz about 10 µm.

The Yin and Yang of ACE/ACE2 Pathways: The Rationale for the Use of Renin-Angiotensin System Inhibitors in COVID-19 Patients

The article describes the rationale for inhibition of the renin-angiotensin system (RAS) pathways as specific targets in patients infected by SARS-CoV-2 in order to prevent positive feedback-loop mechanisms. Based purely on experimental studies in which RAS pathway inhibitors were administered in vivo to humans/rodents, a reasonable hypothesis of using inhibitors that block both ACE and ACE2 zinc metalloproteases and their downstream pathways in COVID-19 patients will be proposed. In particular, metal (zinc) chelators and renin inhibitors may work alone or in combination to inhibit the positive feedback loops (initially triggered by SARS-CoV-2 and subsequently sustained by hypoxia independently on viral trigger) as both arms of renin-angiotensin system are upregulated, leading to critical, advanced and untreatable stages of the disease.