Objective This study investigated whether low-to-moderate exposure to welding fumes is associated with adverse effects on the cardiovascular system.

Methods To test this, we performed a longitudinal analysis of 78 mild steel welders and 96 controls; these subjects were examined twice, six years apart (ie, timepoints 1 and 2). All subjects (male and non-smoking at recruitment) completed questionnaires describing their health, work history, and lifestyle. We measured their blood pressure, endothelial function (by EndoPAT), and risk markers for cardiovascular disease [low-density lioprotein (LDL), homocysteine, C-reactive protein]. Exposure to welding fumes was assessed from the responses to questionnaires and measurements of respirable dust in their breathing zones adjusted for use of respiratory protection equipment. Linear mixed-effect regression models were used for the longitudinal analysis.

Results Median respirable dust concentrations, adjusted for respirable protection, of the welders were 0.7 (5–95 percentile range 0.2–4.2) and 0.5 (0.1–1.9) mg/m³ at timepoints 1 and 2, respectively. Over the six-year period, welders showed a statistically significant increase in systolic [5.11 mm Hg, 95% confidence interval (CI) 1.92–8.31] and diastolic (3.12 mm Hg, 95% CI 0.74–5.5) blood pressure compared with controls (multi-variable adjusted mixed effect models). Diastolic blood pressure increased non-significantly by 0.22 mm Hg (95% CI -0.02–0.45) with every additional year of welding work. No consistent significant associations were found between exposure and endothelial function, LDL, homocysteine, or C-reactive protein.

Conclusion Exposure to welding fumes at low-to-moderate levels is associated with increased blood pressure, suggesting that reducing the occupational exposure limit (2.5 mg/m³ for inorganic respirable dust in Sweden) is needed to protect cardiovascular health of workers.

Key terms biomarker; blood pressure; C-reactive protein; cardiovascular; cardiovascular disease; CVD; endothelial function; fume; homocysteine; LDL; longitudinal study; metal; occupational medicine; particle; welding; welding fume

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