Welding, longitudinal lung function decline and chronic respiratory symptoms: a systematic review of cohort studies

Eur Respir J. 2013 Nov;42(5):1186-93. doi: 10.1183/09031936.00206011. Epub 2012 Dec 20.

Abstract

While the acute respiratory risks of welding are well characterised, more chronic effects, including those on lung function, are less clear. We carried out a systematic review of published longitudinal studies of lung function decline in welders. Original cohort studies documenting two or more sequential measurements of lung function were reviewed. Meta-analysis was carried out on studies with suitable data on forced expiratory volume in 1 s (FEV1). Seven studies were included; their quality (measured on the Newcastle-Ottawa scale) was good, although exposure assessment was limited and the studies showed significant heterogeneity. Five had data suitable for meta-analysis; the pooled estimate of the difference in FEV1 decline between welders and nonwelders was -9.0 mL · year(-1) (95% CI -22.5-4.5; p=0.193). The pooled estimates of difference in annual FEV1 decline between welders and referents who smoked was -13.7 mL · year(-1) (95% CI -33.6-6.3; p=0.179). For welders and referents who did not smoke the estimated difference was -3.8 mL · year(-1) (95% CI -20.2-12.6; p=0.650). Symptom prevalence data were mainly narrative; smoking appeared to have the greatest effect on symptom evolution. Collectively, available longitudinal data on decline of lung function in welders and respiratory symptoms suggest a greater effect in those who smoke, supporting a focus on smoking cessation as well as control of fume exposure in this trade. Further prospective studies are required to confirm these findings.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Air Pollutants, Occupational
  • Bronchitis / etiology
  • Bronchitis / physiopathology
  • Cohort Studies
  • Forced Expiratory Volume
  • Humans
  • Lung / physiopathology*
  • Metals
  • Occupational Diseases / epidemiology
  • Occupational Diseases / physiopathology
  • Occupational Exposure*
  • Occupational Health
  • Respiration Disorders / epidemiology*
  • Respiration Disorders / etiology*
  • Respiratory Function Tests
  • Smoking / adverse effects
  • Welding*

Substances

  • Air Pollutants, Occupational
  • Metals