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Occupational exposure to cobalt is not associated with incipient signs of dilated cardiomyopathy in a Belgian refinery
  1. Anne-Catherine Lantin1,
  2. Jan Vermeulen2,
  3. Alex Mallants3,
  4. Jean-Louis Vanoverschelde4,
  5. Niko Speybroeck5,
  6. Bert Swennen3,
  7. Perrine Hoet1,
  8. Dominique Lison1
  1. 1Louvain centre for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale et clinique (IREC), Université catholique de Louvain, Brussels, Belgium
  2. 2Cardiology Department, St Dimpna Hospital, Geel, Belgium
  3. 3Occupational Health Department, Umicore, Olen, Belgium
  4. 4Institut de Recherche Expérimentale et Clinique(IREC), Department of Cardiovascular Pathology, Université catholique de Louvain, Brussels, Belgium
  5. 5Research Institute for Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
  1. Correspondence to Professor Dominique Lison, Louvain Centre for Toxicology and Applied Pharmacology, Université catholique de Louvain, Avenue E. Mounier 52 B1.52.12, Brussels 1200, Belgium; dominique.lison{at}


Background Excessive absorption of cobalt has been associated with cases of dilated cardiomyopathy in the past, but it is unclear whether occupationally exposed populations are at risk.

Objective To assess the possible relationship between occupational exposure to cobalt and incipient signs of dilated cardiomyopathy.

Methods A cross-sectional survey was conducted in a cobalt production facility in Belgium constituting one of the largest occupational populations worldwide (n=256 male workers). Exposure to cobalt was assessed by measuring urinary cobalt concentration (µg/gcreat), reflecting recent exposure, and by computing an integrated exposure index (µg/gcreat×years), reflecting long-term exposure. The effect on the myocardium was investigated by echocardiography and electrocardiography, and dose–effect relations with cobalt exposure were traced by multiple regression analysis.

Results No dose–effect relationship between exposure to cobalt and parameters reflecting dilated cardiomyopathy was found in a population of workers characterised by a median recent cobalturia of 4 µg/gcreat and a median long-term cobalturia of 100 µg/gcreat×years. A reduction in the dimensions of the left ventricular internal cavity was associated with recent exposure to cobalt.

Conclusions Occupational exposure to cobalt does not appear associated with incipient signs of dilated cardiomyopathy within the gradient of exposure recorded in this population.

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