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263 The risk of redemption of asthma pharmaceuticals among welders: a nationwide follow-up study
  1. P K Kristiansen1,
  2. Jørgensen2,
  3. Bonde2
  1. 1Copenhagen NV, Denmark
  2. 2Department of Occupational and Environmental Medicin, Bispebjerg Hospital, Copenhagen NV, Denmark


Objectives The purpose was to examine if stainless steel and mild steel welding confers an increased risk of bronchial asthma.

Methods A Danish national company-based historical cohort of 5,499 ever-welders and 1,514 never-welders was with the Danish Medicinal Product Registry followed from 1995 through 2011 to identify the first-time redemption of asthma pharmaceuticals including Beta-2-adrenoreceptor agonists, Adrenergic and other drugs for obstructive airway diseases, Inhaled Glucocorticoids. Lifetime exposure to welding fume particulates was estimated by combining questionnaire data on welding work with a welding exposure matrix based on more than 1000 personal measurements of ambient air concentrations of welding fume particulates. The estimated exposure accounted for calendar-time, welding intermittence, type of steel, welding methods, local exhaustion and welding in confined spaces. Hazard ratios (HR) with 95% confidence intervals (CI) were calculated using a Cox proportional hazards model adjusting for potential confounders.

Results The average incidence of redemption of asthma pharmaceuticals in the cohort was 17/1000 years (95% CI 0.01–0.02). Asthma pharmaceuticals were not redeemed more often among stainless steel (n = 3874) and mild steel welders (n = 1625) than among never-welders. Among ever-welders redemption of asthma pharmaceuticals was not related to life-long exposure to welding fume. Analyses of specific subgroups of asthma pharmaceuticals did not reveal consistent associations with welding exposure. However, among non-smoking stainless steel welders the risk increased with cumulative welding dust exposure (HR for high- vs. low level exposed 1.41, 95% CI 1.06–1.89).

Conclusions The results showed no consistent association between lifetime exposure to welding fume and use of asthma pharmaceuticals. However, an increased risk of asthma pharmaceuticals among non-smoking stainless welders may indicate that stainless welding does confer an increased risk of asthma, which escapes detection among smokers having a high prevalence of obstructive airway disease.

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