ORIGINAL ARTICLE

Exposure to welding fumes is associated with acute systemic inflammatory responses

J Y Kim¹, J-C Chen¹, P D Boyce² and D C Christiani¹

¹ Department of Environmental Health, Occupational Health Program, Harvard School of Public Health, Boston, MA 02115, USA
² Pulmonary and Critical Care Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA

Correspondence to:
Correspondence to:
Prof. D C Christiani
Harvard School of Public Health, Occupational Health Program, Building I, Room 1402, 665 Huntington Avenue, Boston, MA 02115, USA; dchristi{at}hsph.harvard.edu

Aims: To investigate the acute systemic inflammatory response to welding fume exposure.

Methods: Twenty four welders (42% smokers) and 13 non-exposed controls (23% smokers) were monitored at a welding school. Exposure to fine particulate matter (PM_2.5) was assessed using cyclone samplers. Markers of systemic inflammation, including C-reactive protein (CRP), fibrinogen, and white blood cell (WBC) levels, were determined in peripheral blood samples collected at baseline and after 5.3 (SD 1.0) hours of exposure.

Results: The median PM_2.5 concentration for welders was 1.66 mg/m³, which was significantly greater than that for controls (0.04 mg/m³). Compared to non-smokers, smokers had a significantly higher baseline WBC count, but comparable levels of CRP and fibrinogen. In non-smokers, welding fume exposure was associated with a significant increase in WBC and neutrophil counts immediately following exposure (+0.8x10³/µl, 95% CI 0.1 to 1.6, and +1.0x10³/µl, 95% CI 0.4 to 1.7, respectively). A significant decrease in fibrinogen levels was observed in non-smokers (–32 mg/dl, 95% CI –63 to –1). No significant changes in WBC, neutrophil, and fibrinogen levels were found in smokers. Sixteen hours after welding exposure, CRP levels were found to be significantly increased in both non-smokers and smokers (0.90 mg/l, 95% CI 0.17 to 1.64). PM_2.5 concentrations were found to be significantly associated with absolute neutrophil counts in non-smokers, and CRP levels in both non-smokers and smokers.

Conclusions: High levels of welding fume exposure induce acute systemic inflammation in a relatively young, healthy working population. These results also suggest that smoking may modify the effect of welding fume exposure on specific inflammatory markers.

Abbreviations: 95% CI, 95% confidence interval; ATS, American Thoracic Society; CRP, C-reactive protein; PM_2.5, particulate matter with an aerodynamic mass median diameter 2.5 µm; PM₁₀, particulate matter with an aerodynamic mass median diameter 10 µm; RBC, red blood cell; SD, standard deviation; SEM, standard error of the mean; WBC, white blood cell

Keywords: C-reactive protein; inflammation; systemic; occupational health; particulate matter; welding fume

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