Nickel-related cancer in welders

Our plain-English summary of Nickel-related cancer in welders, by S. Langård (The Science of the Total Environment, 1994).

The study

• Author: S. Langård
• Journal: The Science of the Total Environment
• Published: 1994;148(2-3):303-9
• Type of article: Review
• Cited by: 39 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

During stainless steel (SS) welding, solid aerosols are generated from elemental compounds which are generally considered to be human carcinogens; i.e. compounds of hexavalent chromium (CrVI) and nickel. Epidemiological studies among groups of SS-welders have indicated that they may carry a higher risk of acquiring lung cancer than mild steel (MS) welders using the same welding techniques. This excess risk has been demonstrated in cohort as well as by case-control studies. The present evidence does not support the view that exposure to SS-welding fumes poses a hazard of cancer at any other site. Exposure to asbestos and smoking are generally major confounders in these studies. The number of SS-welders world-wide seems to be increasing, thus these findings may be of significance to SS-welders and to the welding industry. Despite the information on the possible cancer hazard among SS-welders, current epidemiological data on cancer incidence and mortality do not offer clear evidence to determine whether exposure to nickel or CrVI compounds constitutes the more important risk factor for lung cancer.

In plain English

This article is the author's review of published epidemiological studies of cancer in welders, focusing on nickel and hexavalent chromium in stainless steel welding fumes. Because both metals are present in stainless steel, the author noted that their effects cannot be fully separated. A reviewed Swedish cohort of 234 subjects who had welded only stainless steel for 5 years or more had three pulmonary tumors versus 0.8 expected. In a nine-country European study of 11 092 mild and stainless steel welders, stainless steel welders analyzed by year of first employment had a lung cancer SMR as high as 157 (13 deaths vs. 8.3 expected). In a Norwegian case-control study, men who had welded stainless steel for more than 3 years had an odds ratio of 3.3. The author described asbestos and smoking as major confounders, and mesotheliomas were reported in some welder groups. The author concluded that stainless steel welding appeared to carry a slightly higher lung cancer hazard than mild steel welding with comparable techniques, but that no conclusive evidence showed whether chromium, nickel or toxic gases was the main cause.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Review of published epidemiological (cohort and case-control) and chromosome studies of cancer in welders
• Who was studied: Mild steel and stainless steel welders in published studies from the US, Sweden, Germany, Norway, Finland, Italy, Canada and a nine-country European study
• Exposure: Welding fumes from stainless steel welding (containing nickel and hexavalent chromium compounds) compared with mild steel welding; asbestos and tobacco smoking considered as confounders
• Main results:
  • In a reviewed Swedish cohort of 234 subjects who had welded only stainless steel for 5 years or more during 1950-1965, three pulmonary tumors were found versus 0.8 expected; on later follow-up there were five lung cancer cases versus 2.5 expected
  • In the reviewed IARC multi-national study, the lung cancer SMR among stainless steel welders analyzed by year of first employment was as high as 157 (13 deaths vs. 8.3 expected); the whole study had 116 lung cancer deaths (E = 86.8)
  • In a reviewed German cohort of stainless steel welders compared with turners, there were 14 lung cancer deaths (E = 12.4) among welders and three probable mesotheliomas in the welders versus none in the turners
  • In a reviewed Norwegian case-control study of 176 male lung cancer cases, 28 had been welders for more than 3 years (OR = 1.9) and 16 had welded stainless steel for more than 3 years (OR = 3.3)
  • In a reviewed Los Angeles case-control study, 61 case subjects who had only welded MMA on stainless steel had an OR of 1.3, not significant
  • In a Norwegian shipyard cohort, 783 mild steel welders had seven lung cancer cases versus 3.2 expected, and two malignant mesotheliomas (E = 0.7) occurred in the total population, which the author took to indicate possible confounding by asbestos fibers
  • The author stated that asbestos exposure and smoking are generally major confounders in these studies
• The authors' conclusion: The author concluded that there is evidence that stainless steel welding fumes pose a slightly higher lung cancer hazard than mild steel welding with comparable techniques, but that no conclusive evidence identifies the prime causative substances (chromium VI or nickel compounds, or toxic gases)
• Limitations the authors state:
  • Many of the reviewed studies lacked specific data on the welding method used
  • The two supporting case-control studies had few welder cases, so the evidence on causality from them is weak
  • The effects of nickel and chromium cannot be completely separated because both are present in stainless steel and its welding rods

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Welders.

Medical terms in this study, explained in our Lexicon: Lung Cancer.

Related studies

• Cancer incidence among mild steel and stainless steel welders and other metal workers — K.S. Hansen, J.M. Lauritsen, et al. (1996)
• A historical prospective study of European stainless steel, mild steel, and shipyard welders — L. Simonato, A.C. Fletcher, et al. (1991)
• The health of welders in naval dockyards. The risk of asbestos-related diseases occurring in welders — G.H. McMillan (1983)
• Incidence of cancer among Norwegian boiler welders — T.E. Danielsen, S. Langård, et al. (1996)
• Incidence of cancer among welders, platers, machinists, and pipe fitters in shipyards and machine shops — S. Tola, P.L. Kalliomäki, et al. (1988)
• Case-control study of lung cancer in Los Angeles county welders — C.J. Hull, E. Doyle, et al. (1989)

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