Exposure to welding fume increases the risk of pneumococcal infection; whether such susceptibility extends to other respiratory infections is unclear. We report findings from a survey and from medical consultation data for workers in a large shipyard in the Middle East.Between January 2013 and December 2013, we collected cross-sectional information from 529 male workers variously exposed to welding fume. Adjusted ORs for respiratory symptoms (cough, phlegm, wheezing, shortness of breath and 'chest illness') were estimated using multivariable logistic regression. Subsequently, we examined consultation records from 2000 to 2011 for 15 954 workers who had 103 840 consultations for respiratory infections; the associations between respiratory infections and levels of welding exposure were estimated using a count regression model with a negative binomial distribution.13% of surveyed workers reported respiratory symptoms with a higher prevalence in winter, particularly among welders. The adjusted OR in welders versus other manual labourers was 1.72 (95% CI 1.02 to 3.01) overall and 2.31 (1.05 to 5.10) in winter months; no effect was observed in summer. The risk of consultation for respiratory infections was higher in welders than in manual labourers, with an adjusted incidence rate ratio of 1.45 (1.59 to 1.83) overall, 1.47 (1.42 to 1.52) in winter and 1.33 (1.23 to 1.44) in summer (interaction, p<0.001).The observation that respiratory symptoms and consultations for respiratory infection in welders are more common in winter may indicate an enhanced vulnerability to a broad range of infections. If confirmed, this would have important implications for the occupational healthcare of a very large, global workforce.
Increasingly, global manufacturing is shifting to emerging economies and with it the use of arc-welding for applications in different industries. The chronic respiratory adverse effects resulting from exposure to gases and ultrafine metal particles in welding fume are incompletely understood. We aimed to measure the prevalence of arc-welding related pulmonary obstructive outcomes by analysing data collected in a shipyard in the Middle East.
Method
Between January and December 2013, through cross-sectional survey, we collected spirometry data and behavioural, occupational and respiratory symptoms information from a random sample of male shipyard workers; 397 were exposed to welding fume and 127 were non-exposed. The sample was selected from a total population of about 8000 employees, by frequency matching for ethnicity and age relatively to full-time welders (‘highly’ exposed).
Results
Of the 580 workers invited, 26 subsequently left their job; of the remainder, 95%(524) agreed to participate. The participants, from the Indian subcontinent (90%) or Philippines (10%), had a median age of 38 years. Ever smoking was reported by 37%, with full-time welders reporting the lowest proportion of current smoking, 18%(24/131). Overall, 13% reported respiratory symptoms with a higher prevalence in the winter months. Post-bronchodilator spirometry data were available for 91% of workers. Mean values for FEV1 and FVC were 2.87L and 3.48L, with no statistically significant differences across exposure groups (p-values: 0.71 and 0.48).
Conclusions
These preliminary results need to be explored further in relation to smoking, past and current occupational exposure. This population, it is hoped, will form the basis for a longitudinal study.
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