Top

International Archives of Occupational and Environmental Health

Published in:

01-04-2015 | Review Article

Risk of ischemic heart disease following occupational exposure to welding fumes: a systematic review with meta-analysis

Authors: Emina Mocevic, Pernille Kristiansen, Jens Peter Bonde

Published in: International Archives of Occupational and Environmental Health | Issue 3/2015

Abstract

Purpose

Air pollution has been linked to an increased risk of ischemic heart disease (IHD), but less is known about occupational exposure to welding fumes and the risk of IHD. The objective of this paper was to review the epidemiological evidence on causal links between welding fume exposure and risk of IHD and to investigate whether the risk of IHD depends on specific welding characteristics.

Methods

A systematic search in Medline 1979–2013 and EMBASE 1974–2013 identified 18 epidemiological studies with at least one risk estimate of IHD morbidity or mortality among workers exposed to welding fumes. Following an assessment of completeness of reporting, confounding, and bias, each risk estimate was characterized as more or less reliable. Pooled risk estimates were computed across studies by random effect meta-analyses.

Results

The weighted relative risk (RR) for IHD following exposure to welding fumes was 1.09 [95 % confidence interval (CI) 1.00, 1.19]. We calculated a RR of 1.39 (95 % CI 0.96, 2.02) among studies using an internal reference group and 1.08 (95 % CI 0.99, 1.18) for studies using an external reference group. An increased risk was observed for acute myocardial infarction RR = 1.69 (95 % CI 1.18, 2.42) and other IHDs RR = 1.06 (95 % CI 0.98, 1.14). There was too limited evidence to evaluate the risk of IHD related to specific welding characteristics.

Conclusion

Several studies indicate that welding is associated with a moderately increased risk of IHD; however, bias and confounding cannot be ruled out with reasonable confidence.

Beaumont JJ, Weiss NS (1980) Mortality of welders, shipfitters, and other metal trades workers in boilermakers local no. 104, AFL-CIO. Am J Epidemiol 112(6):775–786

Borenstein M, Hedges LV, Higgins JPT, Rothstein HR (2009) Introduction to meta-analysis. Wiley, LondonCrossRef

Fang SC, Cassidy A, Christiani DC (2010) A systematic review of occupational exposure to particulate matter and cardiovascular disease. Int J Environ Res Public Health 7(4):1773–1806CrossRef

Hansen EB (1981) Procesbetingede hygiejniske grænseværdier ved svejsning. Svejsecentralen, København

Hilt B, Qvenild T, Rømyhr O (1999) Morbidity from ischemic heart disease in workers at a stainless steel welding factory. Norsk Epidemiologi 9(1):21–26

Hoshuyama T, Pan G, Tanaka C, Feng Y, Yu L, Liu T, Liu L, Hanaoka T, Takahashi K (2006) Mortality of iron–steel workers in Anshan, China: a retrospective cohort study. Int J Occup Environ Health 12(3):3–202CrossRef

Ibfelt E, Bonde JP, Hansen J (2010) Exposure to metal welding fume particles and risk for cardiovascular disease in Denmark: a prospective cohort study. Occup Environ Med 67(11):772–777CrossRef

Kaplan GA, Keil JE (1993) Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation 88(4 Pt 1):1973–1998CrossRef

Krstev S, Stewart P, Rusiecki J, Blair A (2007) Mortality among shipyard Coast Guard workers: a retrospective cohort study. Occup Environ Med 64(10):651–658CrossRef

Lehnert M, Pesch B, Lotz A, Pelzer J, Kendzia B, Gawrych K, Heinze E, Van GR, Punkenburg E, Weiss T, Mattenklott M, Hahn JU, Mohlmann C, Berges M, Hartwig A, Bruning T (2012) Exposure to inhalable, respirable, and ultrafine particles in welding fume. Ann Occup Hyg 56(5):557–567

Marmot MG, Shipley MJ, Hemingway H, Head J, Brunner EJ (2008) Biological and behavioural explanations of social inequalities in coronary heart disease: the Whitehall II study. Diabetologia 51(11):1980–1988CrossRef

McMichael AJ (1976) Standardized mortality ratios and the “healthy worker effect”: scratching beneath the surface. J Occup Med 18(3):165–168CrossRef

McMillan GH, Pethybridge RJ (1983) The health of welders in naval dockyards: proportional mortality study of welders and two control groups. J Soc Occup Med 33(2):75–84CrossRef

Merlo F, Costantini M, Doria M (1989) Cause specific mortality among workers exposed to welding fumes and gases: a historical prospective study. J UOEH 11(Suppl):302–315

Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 62(10):1006–1012CrossRef

Moulin JJ, Wild P, Mur JM, Toamain JP, Haguenoer JM, Faucon D, Moulin M, De G, Mereau M, Gary Y, Birembaut Y, Blanc M, Debiolles MP, Jegaden D, Laterriere B, Leonard M, Marini F, Massardier C, Reure M (1993) A mortality study among mild steel and stainless steel welders. Br J Ind Med 50(3):234–243

Newhouse ML, Oakes D, Woolley AJ (1985) Mortality of welders and other craftsmen at a shipyard in NE England. Br J Ind Med 42(6):406–410

Puntoni R, Vercelli M, Merlo F, Valerio F, Santi L (1979) Mortality among shipyard workers in Genoa, Italy. Ann N Y Acad Sci 330:353–377CrossRef

Puntoni R, Merlo F, Borsa L, Reggiardo G, Garrone E, Ceppi M (2001) A historical cohort mortality study among shipyard workers in Genoa, Italy. Am J Ind Med 40(4):363–370CrossRef

Simonato L, Fletcher AC, Andersen A, Anderson K, Becker N, Chang-Claude J, Ferro G, Gerin M, Gray CN, Hansen KS, Kalliomaki PL, Kurppa K, Laangard S, Merlo F, Moulin JJ, Newhouse ML, Peto J, Pukkala E, Sjögren B (1991) A historical prospective study of European stainless steel, mild steel, and shipyard welders. Br J Ind Med 48(3):145–154

Sjögren B (1980) A retrospective cohort study of mortality among stainless steel welders. Scand J Work Environ Health 6(3):197–200CrossRef

Sjögren B, Gustavsson A, Hedstrom L (1987) Mortality in two cohorts of welders exposed to high- and low-levels of hexavalent chromium. Scand J Work Environ Health 13(3):247–251CrossRef

Sjögren B, Fossum T, Lindh T, Weiner J (2002) Welding and ischemic heart disease. Int J Occup Environ Health 8(4):309–311CrossRef

Sjögren B, Gyntelberg F, Hilt B (2006) Ischemic heart disease and welding in Scandinavian studies. Scand J Work Environ Health 2(Suppl):50–53

Steenland K (2002) Ten-year update on mortality among mild-steel welders. Scand J Work Environ Health 28(3):163–167CrossRef

Stern FB, Sweeney MH, Ward E (1997) Proportionate mortality among unionized construction ironworkers. Am J Ind Med 31(2):176–187CrossRef

Sterne JAC (2009) Meta-analysis in Stata: an updated collection from the Stata Journal. Stata Press, College Station

Suadicani P, Hein HO, Gyntelberg F (2002) Airborne occupational exposure, ABO phenotype and risk of ischaemic heart disease in the Copenhagen Male Study. J Cardiovasc Risk 9(4):191–198CrossRef

Toren K, Bergdahl IA, Nilsson T, Jarvholm B (2007) Occupational exposure to particulate air pollution and mortality due to ischaemic heart disease and cerebrovascular disease. Occup Environ Med 64(8):515–519CrossRef

Unal B, Critchley JA, Capewell S (2009) Explaining the decline in coronary heart disease mortality in England and Wales between 1981 and 2000. Circulation 109(9):1101–1107CrossRef

Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB (1998) Prediction of coronary heart disease using risk factor categories. Circulation 97(18):1837–1847CrossRef

World Health Organization and International Agency for Research on Cancer (1990) IARC monographs on the evaluation of carcinogenic risks to humans—chromium, nickel and welding, vol 49. IARC, Lyon, France

Title: Risk of ischemic heart disease following occupational exposure to welding fumes: a systematic review with meta-analysis
Authors: Emina Mocevic
Pernille Kristiansen
Jens Peter Bonde
Publication date: 01-04-2015
Publisher: Springer Berlin Heidelberg
Published in: International Archives of Occupational and Environmental Health / Issue 3/2015
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-014-0965-2

At a glance: The STEP trials

Springer Medicine

Risk of ischemic heart disease following occupational exposure to welding fumes: a systematic review with meta-analysis

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2015

1-Hydroxypyrene and oxidative stress marker levels among painting workers and office workers at shipyard

Who gets fired, who gets re-hired: the role of workers’ contract, age, health, work ability, performance, work satisfaction and employee investments

Does rare use of assistive devices during patient handling increase the risk of low back pain? A prospective cohort study among female healthcare workers

Need for recovery across work careers: the impact of work, health and personal characteristics

Environmental lead exposure is associated with visit-to-visit systolic blood pressure variability in the US adults

The association of effort–reward imbalance and asthma: findings from two cross-sectional studies