A study of atherothrombotic biomarkers in 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...