Exposure to stainless steel welding fumes and lung cancer: a meta-analysis.

Abstract

Stainless steel welding is associated with exposure to metals including hexavalent chromium and nickel. This study is a meta-analysis of five studies of stainless steel welders and the occurrence of lung cancer. Asbestos exposure and smoking habits have been taken into account. The calculated pooled relative risk estimate was 1*94 with a 95% confidence interval of 1-2S-2-93. This result suggests a causal relation between exposure to stainless steel welding and lung cancer. The study showed an association between lung cancer and welders exposed to nickel. All the welders exposed to nickel who had lung cancer were also exposed to chromium. The odds ratio (OR) was 3-3 with the corresponding 95% confidence interval (95% CI) 1 2-9 2. Adjustments were made for age, ethnic group, social class, and smoking habits. Other possible confounders such as asbestos exposure were coded on an extensive checklist. Asbestos exposure was not sufficiently correlated with nickel exposure and with lung cancer to have artificially created such a large OR between nickel and lung cancer.4In a case-referent study nested in a cohort of Danish welders the OR for lung cancer associated with ever stainless steel welding was 1-57 (95% CI 0-85-2-89) after adjusting for smoking and asbestos exposure. Exposure to stainless steel welding fumes for at least two decades increased the OR to 1-93 (95% CI 0-74-5 06).5A cohort of 2721 French welders were compared with 6683. non-welding manual workers and with the-eneral French population. The mortality of the two cohorts was studied from 1975 to 1988. Smoking was more prevalent among the welders and this was assumed to lead to a 6% excess of lung cancer v the non-welding referents. Asbestos exposure was probably higher in shipyards than in other factories and asbestos exposure was not assumed to be responsible for lung cancers among non-shipyard welders. The cohort of non-shipyard welders included a subcohort of welders exposed to stainless steel welding fumes. Welders were included in this subcohort if more than 70% of their welding activities, for at least one year, comprised manual metal arc welding of stainless steel or armoured steel with stainless steel coated electrodes or oxyacetylene welding or cutting of stainless steel. The number of lung cancers found within this subcohort of predominantly stainless steel welders was 2 v 1-95 expected (standardised mortality ratio (SMR = 1-03) from the general French population.6Assuming the smoking habits among the subcohort of the stainless steel welders to be the same as the main cohort of welders and the habits among the non-welding referents to be the same as the general French population, the calculated SMR would be 0-97. In a Norwegian case-referent study of lung cancer an increased OR was found for welders exposed to stainless steel welding fumes when smoking habits were taken into account, OR = 3-3 (95% CI 12-9-3). When both asbestos exposure and smoking were included in the logistic regression equation the association was weaker, OR = 2-56...

Mortality among Former Shipbreaking Workers—A 13‐Year Retrospective Follow‐up Study in Taiwan

“…Their SMR value (0.89) was lower than welders had experienced in Germany (SMR=1.09) 4) , Norway (SIR=1.13) 21) and Sweden (RR=1.37) 22) , but similar to that in France (SMR=0.93) 19) . Higher lung cancer risk was found among welders in other studies [16][17][18][19] . Sjögren, et al 17) concluded in a meta-analysis that exposure to stainless steel welding fume leads to a higher risk of lung cancer.…”

“…Higher lung cancer risk was found among welders in other studies [16][17][18][19] . Sjögren, et al 17) concluded in a meta-analysis that exposure to stainless steel welding fume leads to a higher risk of lung cancer. For 13 yr of follow-up, the evidence is not strong enough yet to indicate that previous shipbreaking work increases the risk of contracting these diseases in this study.…”

“…Shipyard work and arc welding exposure have been considered to be contributing factors in increased risk of respiratory symptoms and mortality [16][17][18][19] . To the best of the authors' knowledge, there are few investigations on the health effects experienced by shipbreaking workers.…”

Epidemiologic estimate of the proportion of fatalities related to occupational factors in Finland

“…The following substances were included as independent risk factors: asbestos (and its interaction with smoking), arsenic (and its interaction with smoking), and cadmium, chromium, crystalline silica, diesel engine exhaust, lead, nickel, radon and welding fumes [mild steel welding (52,77)]. Hexavalent chromium and nickel welders [stainless steel welding (78)] were excluded from the estimate of the size of the chromium-and nickel-exposed populations in Finland. Excluded exposures included, among others, polycyclic aromatic hydrocarbons, man-made mineral fibers, metal dust (replaced by specific studies on exposure to arsenic, cadmium, lead, and nickel), leaded engine exhaust (46), solvent exposure of painters, and fertilizer exposure of chemical process workers.…”

Integrating toxicity reduction strategies for materials and components into product design: A case study on utility meters

“…Stainless steel's main toxicity concern is attributed to Ni and Cr with Material TPI scores of 38.0 and 66.9 per mg, respectively. Ni and Cr (which can be transformed into hexavalent Cr in fumes during stainless steel processing) are both known carcinogens (Sjögren et al 1994;WHO 1997). Stainless steel is used in components such as the brackets and housing for the PulsePoint and RegistRead, respectively.…”