Safety and Health at Work

Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency (산업안전보건연구원)
권호 표지
DOI QR코드

DOI QR Code

Cancer Risks among Welders and Occasional Welders in a National Population-Based Cohort Study: Canadian Census Health and Environmental Cohort

  • MacLeod, Jill S. (Occupational Cancer Research Centre, Prevention and Cancer Control, Cancer Care Ontario) ;
  • Harris, M. Anne (Occupational Cancer Research Centre, Prevention and Cancer Control, Cancer Care Ontario) ;
  • Tjepkema, Michael (Health Analysis Division, Statistics Canada) ;
  • Peters, Paul A. (Departments of Sociology and Economics, University of New Brunswick Fredericton Campus) ;
  • Demers, Paul A. (Occupational Cancer Research Centre, Prevention and Cancer Control, Cancer Care Ontario)
  • Received : 2016.08.02
  • Accepted : 2016.12.13
  • Published : 2017.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Welders are exposed to many known and suspected carcinogens. An excess lung cancer risk among welders is well established, but whether this is attributable to welding fumes is unclear. Excess risks of other cancers have been suggested, but not established. We investigated welding cancer risks in the population-based Canadian Census Health and Environmental Cohort. Methods: Among 1.1 million male workers, 12,845 welders were identified using Standard Occupational Classification codes and followed through retrospective linkage of 1991 Canadian Long Form Census and Canadian Cancer Registry (1992-2010) records. Hazard ratios (HRs) were calculated using Cox proportional hazards models based on estimated risks of lung cancer, mesothelioma, and nasal, brain, stomach, kidney, and bladder cancers, and ocular melanoma. Lung cancer histological subtypes and risks by industry group and for occasional welders were examined. Some analyses restricted comparisons to blue-collar workers to minimize effects of potential confounders. Results: Among welders, elevated risks were observed for lung cancer [HR: 1.16, 95% confidence interval (CI): 1.03-1.31], mesothelioma (HR: 1.78, 95% CI: 1.01-3.18), bladder cancer (HR: 1.40, 95% CI: 1.15-1.70), and kidney cancer (HR: 1.30, 95% CI: 1.01-1.67). When restricted to blue-collar workers, lung cancer and mesothelioma risks were attenuated, while bladder and kidney cancer risks increased. Conclusion: Excess risks of lung cancer and mesothelioma may be partly attributable to factors including smoking and asbestos. Welding-specific exposures may increase bladder and kidney cancer risks, and particular sources of exposure should be investigated. Studies that are able to disentangle welding effects from smoking and asbestos exposure are needed.

Keywords

References

  1. Husgafvel-Pursiainen K, Siemiatycki J. Welding fumes in identification of research needs to resolve the carcinogencity of high-priority IARC carcinogens. Lyon, France: International Agency for Research on Cancer (IARC), 2009. Technical Report No.: 42. p. 40-9.
  2. International Agency for Research on Cancer (IARC). IARC monographs on the evaluation of carcinogenic risks to humans. Chromium, nickel and welding, vol. 49. Lyon, France: IARC; 1990. 677 p.
  3. 't Mannetje A, Brennan P, Zaridze D, Szeszenia-Dabrowska N, Rudnai P, Lissowska J, Fabianova E, Cassidy A, Mates D, Bencko V, Foretova L, Janout V, Fevotte J, Fletcher T, Boffetta P. Welding and lung cancer in Central and Eastern Europe and the United Kingdom. Am J Epidemiol 2012;175:706-14. https://doi.org/10.1093/aje/kwr358
  4. Moulin JJ. A meta-analysis of epidemiologic studies of lung cancer in welders. Scand J Work Environ Health 1997;23:104-13. https://doi.org/10.5271/sjweh.187
  5. Simonato L, Fletcher AC, Andersen A, Anderson K, Becker N, Chang-Claude J, Ferro G, Gerin M, Gray CN, Hansen KS. A historical prospective study of European stainless steel, mild steel, and shipyard welders. Br J Ind Med 1991;48:145-54.
  6. Siew SS, Kauppinen T, Kyyronen P, Heikkila P, Pukkala E. Exposure to iron and welding fumes and the risk of lung cancer. Scand J Work Environ Health 2008;34:444-50. https://doi.org/10.5271/sjweh.1296
  7. Pukkala E, Martinsen JI, Lynge E, Gunnarsdottir HK, SparEn P, Tryggvadottir L, Weiderpass E, Kjaerheim K. Occupation and cancer-follow-up of 15 million people in five Nordic countries. Acta Oncol 2009;48:646-790. https://doi.org/10.1080/02841860902913546
  8. Jockel KH, Ahrens W, Pohlabeln H, Bolm-Audorff U, Muller KM. Lung cancer risk and welding: results from a caseecontrol study in Germany. Am J Ind Med 1998;33:313-20. https://doi.org/10.1002/(SICI)1097-0274(199804)33:4<313::AID-AJIM1>3.0.CO;2-V
  9. Kendzia B, Behrens T, Jockel KH, Siemiatycki J, Kromhout H, Vermeulen R, Peters S, Van Gelder R, Olsson A, Bruske I, Wichmann HE, Stucker I, Guida F, Tardon A, Merletti F, Mirabelli D, Richiardi L, Pohlabeln H, Ahrens W, Landi MT, Caporaso N, Consonni D, Zaridze D, Szeszenia-Dabrowska N, Lissowska J, Gustavsson P, Marcus M, Fabianova E, 't Mannetje A, Pearce N, Tse LA, Yu IT, Rudnai P, Bencko V, Janout V, Mates D, Foretova L, Forastiere F, McLaughlin J, Demers P, Bueno-de-Mesquita B, Boffetta P, Schuz J, Straif K, Pesch B, Bruning T. Welding and lung cancer in a pooled analysis of casecontrol studies. Am J Epidemiol 2013;178:1513-25. https://doi.org/10.1093/aje/kwt201
  10. Lerchen ML, Wiggins CL, Samet JM. Lung cancer and occupation in New Mexico. J Natl Cancer Inst 1987;79:639-45.
  11. Breslow L, Hoaglin L, Rasmussen G, Abrams HK. Occupations and cigarette smoking as factors in lung cancer. Am J Public Health Nations Health 1954;44:171-81. https://doi.org/10.2105/AJPH.44.2.171
  12. Ambroise D, Wild P, Moulin JJ. Update of a meta-analysis on lung cancer and welding. Scand J Work Environ Health 2006;32:22-31. https://doi.org/10.5271/sjweh.973
  13. Sjogren B, Hansen KS, Kjuus H, Persson PG. Exposure to stainless steel welding fumes and lung cancer: a meta-analysis. Occup Environ Med 1994;51:335-6. https://doi.org/10.1136/oem.51.5.335
  14. Antonini JM. Health effects of welding. Crit Rev Toxicol 2003;33:61-103. https://doi.org/10.1080/713611032
  15. Kjuus H, Skjaerven R, Langard S, Lien JT, Aamodt T. A case-referent study of lung cancer, occupational exposures and smoking. I. Comparison of title-based and exposure-based occupational information. Scand J Work Environ Health 1986;12:193-202. https://doi.org/10.5271/sjweh.2158
  16. International Agency for Research on Cancer (IARC). Agents classified by the IARC monographs, volumes 1-113 [Internet]. Lyon, France: IARC. 2016 [cited 2016 Apr 7]. Available from: http://monographs.iarc.fr/ENG/Classification/.
  17. Ward EM, Schulte PA, Straif K, Hopf NB, Caldwell JC, Carreon T, DeMarini DM, Fowler BA, Goldstein BD, Hemminki K, Hines CJ, Pursiainen KH, Kuempel E, Lewtas J, Lunn RM, Lynge E, McElvenny DM, Muhle H, Nakajima T, Robertson LW, Rothman N, Ruder AM, Schubauer-Berigan MK, Siemiatycki J, Silverman D, Smith MT, Sorahan T, Steenland K, Stevens RG, Vineis P, Zahm SH, Zeise L, Cogliano VJ. Research recommendations for selected IARCclassified agents. Environ Health Perspect 2010;118:1355-62. https://doi.org/10.1289/ehp.0901828
  18. International Agency for Research on Cancer (IARC). Report of the advisory group to recommend priorities for IARC Monographs during 2015-2019. Lyon, France: World Health Organization, 2014. Report No.: 14/002. p. 54.
  19. Steenland K. Ten-year update on mortality among mild-steel welders. Scand J Work Environ Health 2002;28:163-7. https://doi.org/10.5271/sjweh.660
  20. Lauritsen JM, Hansen KS. Lung cancer mortality in stainless steel and mild steel welders: a nested case-referent study. Am J Ind Med 1996;30:383-91. https://doi.org/10.1002/(SICI)1097-0274(199610)30:4<383::AID-AJIM2>3.0.CO;2-X
  21. Zeidler-Erdely PC, Kashon ML, Battelli LA, Young SH, Erdely A, Roberts JR, Reynolds SH, Antonini JM. Pulmonary inflammation and tumor induction in lung tumor susceptible A/J and resistant C57BL/6J mice exposed to welding fume. Part Fibre Toxicol 2008;5:12. https://doi.org/10.1186/1743-8977-5-12
  22. Hayden SP, Pincock AC, Hayden J, Tyler LE, Cross KW, Bishop JM. Respiratory symptoms and pulmonary function of welders in the engineering industry. Thorax 1984;39:442-7. https://doi.org/10.1136/thx.39.6.442
  23. McMillan GH. The health of welders in naval dockyards. The risk of asbestosrelated diseases occurring in welders. J Occup Med 1983;25:727-30. https://doi.org/10.1097/00043764-198310000-00011
  24. Szram J, Schofield SJ, Cosgrove MP, Cullinan P. Welding, longitudinal lung function decline and chronic respiratory symptoms: a systematic review of cohort studies. Eur Respir J 2013;42:1186-93. https://doi.org/10.1183/09031936.00206011
  25. Becker N. Cancer mortality among arc welders exposed to fumes containing chromium and nickel: results of a third follow-up: 1989-1995. J Occup Environ Med 1999;41:294-303. https://doi.org/10.1097/00043764-199904000-00012
  26. Khuder SA. Effect of cigarette smoking on major histological types of lung cancer: a meta-analysis. Lung cancer 2001;31:139-48. https://doi.org/10.1016/S0169-5002(00)00181-1
  27. Pesch B, Kendzia B, Gustavsson P, Jockel KH, Johnen G, Pohlabeln H, Olsson A, Ahrens W, Gross IM, Bruske I, Wichmann HE, Merletti F, Richiardi L, Simonato L, Fortes C, Siemiatycki J, Parent ME, Consonni D, Landi MT, Caporaso N, Zaridze D, Cassidy A, Szeszenia-Dabrowska N, Rudnai P, Lissowska J, Stucker I, Fabianova E, Dumitru RS, Bencko V, Foretova L, Janout V, Rudin CM, Brennan P, Boffetta P, Straif K, Bruning T. Cigarette smoking and lung cancer e relative risk estimates for the major histological types from a pooled analysis of case-control studies. Int J Cancer 2012;131:1210-9. https://doi.org/10.1002/ijc.27339
  28. Raffn E, Lynge E, Korsgaard B. Incidence of lung cancer by histological type among asbestos cement workers in Denmark. Br J Ind Med 1993;50:85-9.
  29. Mollo F, Piolatto G, Bellis D, Andrion A, Delsedime L, Bernardi P, Pira E, Ardissone F. Asbestos exposure and histologic cell types of lung cancer in surgical and autopsy series. Int J Cancer 1990;46:576-80. https://doi.org/10.1002/ijc.2910460404
  30. Karjalainen A, Anttila S, Vanhala E, Vainio H. Asbestos exposure and the risk of lung cancer in a general urban population. Scand J Work Environ Health 1994;20:243-50. https://doi.org/10.5271/sjweh.1401
  31. Husgafvel-Pursiainen K, Karjalainen A, Kannio A, Anttila S, Partanen T, Ojajarvi A, Vainio H. Lung cancer and past occupational exposure to asbestos. Role of p53 and K-ras mutations. Am J Respir Cell and Mol Biol 1999;20:667-74. https://doi.org/10.1165/ajrcmb.20.4.3404
  32. CAREX Canada. Welders and related machine operators: occupational exposure summary package [Internet]. Vancouver, British Columbia. 2015 [cited 2016 May 5]. Available from: http://www.carexcanada.ca/CAREX_Welder_Package_July-16-2015.pdf.
  33. Järup L. Hazards of heavy metal contamination. Br Med Bull 2003;68:167-82. https://doi.org/10.1093/bmb/ldg032
  34. World Health Organization. Exposure to lead: a major public health concern [Internet]. Geneva, Switzerland: World Health Organization. 2010 [cited 2016 May 5]. Available from: http://www.who.int/ipcs/features/lead..pdf.
  35. Driscoll TR, Carey RN, Peters S, Glass DC, Benke G, Reid A, Fritschi L. The Australian work exposures study: occupational exposure to lead and lead compounds. Ann Occup Hyg 2016;60:113-23.
  36. Arrandale VH, Beach J, Cembrowski GS, Cherry NM. Urinary metal concentrations among female welders. Ann Occup Hyg 2015;59:52-61.
  37. Pesch B, Haerting J, Ranft U, Klimpel A, Oelschlagel B, Schill W. Occupational risk factors for renal cell carcinoma: agent-specific results from a case-control study in Germany. Int J Epidemiol 2000;29:1014-24. https://doi.org/10.1093/ije/29.6.1014
  38. International Agency for Research on Cancer (IARC). IARC monographs on the evaluation of carcinogenic risks to humans. Inorganic and organic lead compounds, vol. 87. Lyon: IARC; 2006. 506 p.
  39. d'Errico A, Pasian S, Baratti A, Zanelli R, Alfonzo S, Gilardi L, Beatrice F, Bena A, Costa G. A case-control study on occupational risk factors for sino-nasal cancer. Occup Environ Med 2009;66:448-55. https://doi.org/10.1136/oem.2008.041277
  40. Hernberg S, Westerholm P, Schultz-Larsen K, Degerth R, Kuosma E, Englund A, Engzell U, Hansen HS, Mutanen P. Nasal and sinonasal cancer. Connection with occupational exposures in Denmark, Finland and Sweden. Scand J Work Environ Health 1983;9:315-26. https://doi.org/10.5271/sjweh.2405
  41. Nawrot TS, Martens DS, Hara A, Plusquin M, Vangronsveld J, Roels HA, Staessen JA. Association of total cancer and lung cancer with environmental exposure to cadmium: the meta-analytical evidence. Cancer Causes Control 2015;26:1281-8. https://doi.org/10.1007/s10552-015-0621-5
  42. Feki-Tounsi M, Hamza-Chaffai A. Cadmium as a possible cause of bladder cancer: a review of accumulated evidence. Environ Sci Pollut Res Int 2014;21:10561-73. https://doi.org/10.1007/s11356-014-2970-0
  43. International Agency for Research on Cancer (IARC). IARC monographs on the evaluation of carcinogenic risks to humans. Radiation, vol. 100D. Lyon: IARC;2012. 341 p.
  44. Williams PR, Phelka AD, Paustenbach DJ. A review of historical exposures to asbestos among skilled craftsmen (1940-2006). J Toxicol Environ Health B Crit Rev 2007;10:319-77. https://doi.org/10.1080/10937400601034191
  45. Wilkins R, Tjepkema M, Mustard C, Choiniere R. The Canadian census mortality follow-up study, 1991 through 2001. Health Rep 2008;19:25-43.
  46. Peters PA, Tjepkema M, editors. 1991-2011 Census health outcomes followup. Proceedings of the Statistics Canada Symposium 2010. Social statistics: the interplay among censuses, surveys and administrative data. Ottawa: Statistics Canada; 2011. p. 150-6. Catalogue 11-522-XCB.
  47. Peters PA, Tjepkema M, Wilkins R, Fines P, Crouse DL, Chan PC, Burnett RT. Data resource profile: 1991 Canadian census cohort. Int J Epidemiol 2013;42:1319-26. https://doi.org/10.1093/ije/dyt147
  48. Medicode (Firm). ICD-9-CM: International classification of diseases, 9th revision, clinical modification. Salt Lake City (UT): Medicode; 1996.
  49. World Health Organization. ICD-O-3: International Classification of Diseases for Oncology. 3rd ed. Lyon, France: World Health Organization; 2000.
  50. Ferlay J, Rous B. Chapter 4. Histological groups. In: Forman D, Bray F, Brewster DHM, C.G., Kohler B, Pineros M, Steliarova-Foucher E, editors. Cancer incidence in five continents. IARC Sci Publ No. 164. Vol. X. Lyon: International Agency for Research on Cancer; 2014.
  51. Statistics Canada. Standard Occupational Classification (SOC). 1991 [Internet]. Ottawa: Statistics Canada. 2014 [cited 2016 Apr 7]. Available from: http:// www23.statcan.gc.ca/imdb/p3VD.pl?Function=getVD&TVD=143375.
  52. Vallières E, Pintos J, LavouE J, Parent M-E, Rachet B, Siemiatycki J. Exposure to welding fumes increases lung cancer risk among light smokers but not among heavy smokers: evidence from two caseecontrol studies in Montreal. Cancer Med 2012;1:47-58. https://doi.org/10.1002/cam4.6
  53. StatisticsCanada. Standard IndustrialClassificationeEstablishments (SIC-E) 1980. [Internet]. Ottawa: Statistics Canada. 2014 [cited 2016 Apr 7]. Available from: http://www23.statcan.gc.ca/imdb/p3VD.pl?Function=getVD&TVD=53446.
  54. Rolland P, Gramond C, Lacourt A, Astoul P, Chamming's S, Ducamp S, Frenay C, Galateau-Salle F, Ilg AG, Imbernon E, Le Stang N, Pairon JC, Goldberg M, Brochard P. Occupations and industries in France at high risk for pleural mesothelioma: a population-based case-control study (1998-2002). Am J Ind Med 2010;53:1207-19. https://doi.org/10.1002/ajim.20895
  55. Pezzotto SM, Poletto L. Occupation and histopathology of lung cancer: a casee control study in Rosario, Argentina. Am J Ind Med 1999;36:437-43. https://doi.org/10.1002/(SICI)1097-0274(199910)36:4<437::AID-AJIM4>3.0.CO;2-C
  56. Brodkin CA, McCullough J, Stover B, Balmes J, Hammar S, Omenn GS, Checkoway H, Barnhart S. Lobe of origin and histologic type of lung cancer associated with asbestos exposure in the Carotene and Retinol Efficacy Trial (CARET). Am J Ind Med 1997;32:582-91. https://doi.org/10.1002/(SICI)1097-0274(199712)32:6<582::AID-AJIM2>3.0.CO;2-S
  57. Erren TC, Jacobsen M, Piekarski C. Synergy between asbestos and smoking on lung cancer risks. Epidemiology 1999;10:405-11. https://doi.org/10.1097/00001648-199907000-00011
  58. Aminian O, Saburi A, Mohseni H, Akbari H, Chavoshi F, Akbari H. Occupational risk of bladder cancer among Iranian male workers. Urol Ann 2014;6:135-8. https://doi.org/10.4103/0974-7796.130643
  59. Cordier S, Clavel J, Limasset JC, Boccon-Gibod L, Le Moual N, Mandereau L, Hemon D. Occupational risks of bladder cancer in France: a multicentre casecontrol study. Int J Epidemiol 1993;22:403-11. https://doi.org/10.1093/ije/22.3.403
  60. Gaertner RR, Trpeski L, Johnson KC. A caseecontrol study of occupational risk factors for bladder cancer in Canada. Cancer Causes Control 2004;15:1007-19. https://doi.org/10.1007/s10552-004-1448-7
  61. Melkild A, Langard S, Andersen A, Tonnessen JN. Incidence of cancer among welders and other workers in a Norwegian shipyard. Scand J Work Environ Health 1989;15:387-94. https://doi.org/10.5271/sjweh.1834
  62. Becker N, Chang-Claude J, Frentzel-Beyme R. Risk of cancer for arc welders in the Federal Republic of Germany: results of a second follow up (1983-8). Br J Ind Med 1991;48:675-83.
  63. Il'yasova D, Schwartz GG. Cadmium and renal cancer. Toxicol Appl Pharmacol 2005;207:179-86.
  64. Song J, Luo H, Yin X, Huang G, Luo S, Lin du R, Yuan DB, Zhang W, Zhu J. Association between cadmium exposure and renal cancer risk: a metaanalysis of observational studies. Sci Rep 2015;5:17976.
  65. Danielsen TE, Langard S, Andersen A. Incidence of cancer among welders and other shipyard workers with information on previous work history. J Occup Environ Med 2000;42:101-9. https://doi.org/10.1097/00043764-200001000-00023
  66. Canadian Cancer Society. Canadian Cancer Statistics 2015 [Internet]. Toronto: Canadian Cancer Society. 2015 [cited 2016 Nov 22]. Available from: https://www.cancer.ca/w/media/cancer.ca/CW/cancer%20information/cancer%20101/Canadian%20cancer%20statistics/Canadian-Cancer-Statistics-2015-EN.pdf.
  67. KonE Pefoyo AJ, Genesove L, Moore K, Del Bianco A, Kramer D. Exploring the usefulness of occupational exposure registries for surveillance: the case of the Ontario Asbestos Workers Registry (1986-2012). J Occup Environ Med 2014;56:1100-10. https://doi.org/10.1097/JOM.0000000000000235
  68. United Nations Environment Program, Chemicals Branch, DTIE. Final review of scientific information on cadmium; 2010. 201 p.
  69. Dasch J, D'Arcy J. Physical and chemical characterization of airborne particles from welding operations in automotive plants. J Occup Environ Hyg 2008;5:444-54. https://doi.org/10.1080/15459620802122720
  70. Guerreiro C, Gomes JF, Carvalho P, Santos TJ, Miranda RM, Albuquerque P. Characterization of airborne particles generated from metal active gas welding process. Inhal Toxicol 2014;26:345-52. https://doi.org/10.3109/08958378.2014.897400
  71. Persoons R, Arnoux D, Monssu T, Culie O, Roche G, Duffaud B, Chalaye D, Maitre A. Determinants of occupational exposure to metals by gas metal arc welding and risk management measures: a biomonitoring study. Toxicol Lett 2014;231:135-41. https://doi.org/10.1016/j.toxlet.2014.09.008
  72. Pouzou JG, Warner C, Neitzel RL, Croteau GA, Yost MG, Seixas NS. Confined space ventilation by shipyard welders: observed use and effectiveness. Ann Occup Hyg 2015;59:116-21.
  73. Wetter DW, Cofta-Gunn L, Fouladi RT, Irvin JE, Daza P, Mazas C, Wright K, Cinciripini PM, Gritz ER. Understanding the associations among education, employment characteristics, and smoking. Addict Behav 2005;30:905-14. https://doi.org/10.1016/j.addbeh.2004.09.006
  74. Schoenberg JB, Stemhagen A, Mason TJ, Patterson J, Bill J, Altman R. Occupation and lung cancer risk among New Jersey white males. J Ntl Cancer Inst 1987;79:13-21.
  75. Newhouse ML, Oakes D, Woolley AJ. Mortality of welders and other craftsmen at a shipyard in NE England. Br J Ind Med 1985;42:406-10.
  76. Hull CJ, Doyle E, Peters JM, Garabrant DH, Bernstein L, Preston-Martin S. Casee control study of lung cancer in Los Angeles county welders. Am J Ind Med 1989;16:103-12. https://doi.org/10.1002/ajim.4700160111

Cited by

  1. Welding Incident Mitigation at Mechanical Engineering vol.927, pp.None, 2017, https://doi.org/10.4028/www.scientific.net/msf.927.6
  2. Workplace exposure to asbestos and the risk of kidney cancer in Canadian men vol.109, pp.4, 2018, https://doi.org/10.17269/s41997-018-0095-9
  3. Occupation and Risk of Kidney Cancer in Nordic Countries vol.61, pp.1, 2017, https://doi.org/10.1097/jom.0000000000001468
  4. Welding fumes and lung cancer: a meta-analysis of case-control and cohort studies vol.76, pp.6, 2017, https://doi.org/10.1136/oemed-2018-105447
  5. Implementing sensor technology applications for workplace health promotion: a needs assessment among workers with physically demanding work vol.19, pp.1, 2017, https://doi.org/10.1186/s12889-019-7364-2
  6. Use of a Canadian Population-Based Surveillance Cohort to Test Relationships Between Shift Work and Breast, Ovarian, and Prostate Cancer vol.64, pp.4, 2017, https://doi.org/10.1093/annweh/wxaa017
  7. Machine Learning and Bioinformatics Models to Identify Pathways that Mediate Influences of Welding Fumes on Cancer Progression vol.10, pp.None, 2017, https://doi.org/10.1038/s41598-020-57916-9