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Are welders more at risk of respiratory infections? Findings from a cross-sectional survey and analysis of medical records in shipyard workers: the WELSHIP project
  1. Andrea Marongiu1,2,
  2. Omar Hasan3,
  3. Anila Ali3,
  4. Sharoon Bakhsh3,
  5. Bobby George3,
  6. Nabeel Irfan3,
  7. Cosetta Minelli1,
  8. Cristina Canova1,4,
  9. Susie Schofield1,
  10. Sara De Matteis1,2,
  11. Paul Cullinan1,2
  1. 1Department of Occupational and Environmental Medicine, National Heart & Lung Institute, Imperial College London, London, UK
  2. 2MRC-PHE Centre for Environment & Health, St Mary's Campus, Imperial College London, London, UK
  3. 3Medical Department, DryDocks World Dubai, Dubai, UAE
  4. 4Department of Molecular Medicine, University of Padova, Padova, Italy
  1. Correspondence to Paul Cullinan, Imperial College (NHLI) London, Emmanuel Kaye Building G51, 1b Manresa Rd, London SW3 6LR, UK; p.cullinan{at}


Background Exposure to welding fume increases the risk of pneumococcal infection; whether such susceptibility extends to other respiratory infections is unclear. We report findings from a survey and from medical consultation data for workers in a large shipyard in the Middle East.

Methods Between January 2013 and December 2013, we collected cross-sectional information from 529 male workers variously exposed to welding fume. Adjusted ORs for respiratory symptoms (cough, phlegm, wheezing, shortness of breath and ‘chest illness’) were estimated using multivariable logistic regression. Subsequently, we examined consultation records from 2000 to 2011 for 15 954 workers who had 103 840 consultations for respiratory infections; the associations between respiratory infections and levels of welding exposure were estimated using a count regression model with a negative binomial distribution.

Results 13% of surveyed workers reported respiratory symptoms with a higher prevalence in winter, particularly among welders. The adjusted OR in welders versus other manual labourers was 1.72 (95% CI 1.02 to 3.01) overall and 2.31 (1.05 to 5.10) in winter months; no effect was observed in summer. The risk of consultation for respiratory infections was higher in welders than in manual labourers, with an adjusted incidence rate ratio of 1.45 (1.59 to 1.83) overall, 1.47 (1.42 to 1.52) in winter and 1.33 (1.23 to 1.44) in summer (interaction, p<0.001).

Conclusions The observation that respiratory symptoms and consultations for respiratory infection in welders are more common in winter may indicate an enhanced vulnerability to a broad range of infections. If confirmed, this would have important implications for the occupational healthcare of a very large, global workforce.

  • Respiratory Infection
  • Occupational Lung Disease

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