Dag G Ellingsen1, Maxim Chashchin2,3,4, Ingebjørg Seljeflot5,6, Balazs Berlinger7, Valery Chashchin2,4, Leo Stockfelt8, Yngvar Thomassen7. 1. National Institute of Occupational Health, P.O. Box 5330 Dep, 0304, Oslo, Norway. dag.ellingsen@stami.no. 2. Northwest Public Health Research Centre, Saint Petersburg, Russia. 3. City Centre of Occupational Health, Saint Petersburg, Russia. 4. North-Western State Medical University Named After I.I. Mechnikov, Saint Petersburg, Russia. 5. Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital, Ullevål, Norway. 6. Faculty of Medicine, University of Oslo, Oslo, Norway. 7. National Institute of Occupational Health, P.O. Box 5330 Dep, 0304, Oslo, Norway. 8. Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
Abstract
INTRODUCTION: Studies have shown that welders have increased cardiovascular mortality. This may be due to airborne particulate matter (PM) exposure. Elevated levels of PM in polluted urban air have been associated with increased cardiovascular mortality and morbidity. This study seeks to explore potential mechanisms for the increased cardiovascular mortality in welders. METHODS: Seventy welders were compared to 74 referents. Exposure to PM was assessed by personal full-shift sampling of work room air the last 2 days before collection of blood samples. Selected biomarkers of pro-coagulant activity, endothelial/platelet activation and systemic inflammation were determined in the samples. RESULTS: The welders had been occupationally exposed to PM for 15 years on average. The geometric mean current exposure to PM was 8.1 mg/m3. They had statistically significantly higher concentrations of TNF-α, P-selectin, CD40L, prothrombin fragment 1 + 2 and D-dimer than the referents. Increasing concentrations of D-dimer and CD40L were observed by increasing current exposure to PM. DISCUSSION: The study shows that welders highly exposed to welding PM were in a pro-thrombotic state with increased thrombin generation and consequently higher D-dimer concentrations. The welders had also increased endothelial/platelet activation as compared to the referents. These alterations are compatible with increased cardiovascular mortality as previously reported among welders.
INTRODUCTION: Studies have shown that welders have increased cardiovascular mortality. This may be due to airborne particulate matter (PM) exposure. Elevated levels of PM in polluted urban air have been associated with increased cardiovascular mortality and morbidity. This study seeks to explore potential mechanisms for the increased cardiovascular mortality in welders. METHODS: Seventy welders were compared to 74 referents. Exposure to PM was assessed by personal full-shift sampling of work room air the last 2 days before collection of blood samples. Selected biomarkers of pro-coagulant activity, endothelial/platelet activation and systemic inflammation were determined in the samples. RESULTS: The welders had been occupationally exposed to PM for 15 years on average. The geometric mean current exposure to PM was 8.1 mg/m3. They had statistically significantly higher concentrations of TNF-α, P-selectin, CD40L, prothrombin fragment 1 + 2 and D-dimer than the referents. Increasing concentrations of D-dimer and CD40L were observed by increasing current exposure to PM. DISCUSSION: The study shows that welders highly exposed to welding PM were in a pro-thrombotic state with increased thrombin generation and consequently higher D-dimer concentrations. The welders had also increased endothelial/platelet activation as compared to the referents. These alterations are compatible with increased cardiovascular mortality as previously reported among welders.
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