Welding Fumes Exposure and the Risk of Head and Neck and Gastrointestinal Cancer: A Systematic Review and Meta-Analysis
Contenuto principale dell'articolo
Keywords
Abstract
Background: The association between welding fumes and cancers other than lung cancer remains undefined. We conducted a systematic review and meta-analysis on occupational exposure to welding fumes and the risk of head and neck cancer (HN, comprising oral, pharynx, and larynx) and gastrointestinal cancer (GI, comprising esophagus, stomach, colorectal, liver, and pancreas). Methods: A systematic search was performed in PubMed, Scopus, and Embase using PRISMA guidelines. Cohort studies on occupational exposure to welding fumes were identified. Study quality was assessed through the CASP score. Data were analyzed in random-effects models to calculate the relative risks (RR) and 95% confidence intervals (CI) of HN and GI cancer overall and stratified by cancer site. Results: Seven independent studies with data on oral, pharynx, larynx, esophagus, stomach, colorectal, liver, or pancreas cancer were identified. We observed the following associations: HN RR=1.10 (95% CI 1.00-1.22); GI RR= 1.03 (95% CI 0.97-1.10); oral and pharynx RR=1.06 (95%, CI 0.93-1.20, eleven risk estimates); larynx RR=1.17 (95%, CI 1.01-1.37, nine risk estimates); esophagus RR=0.98 (95%, CI 0.83-1.15, three risk estimates); stomach RR= 1.10 (95%, CI 1.02-1.19, five risk estimates); colorectal RR=0.99 (95%, CI 0.85-1.15, seven risk estimates); liver RR=1.23 (95%, CI 0.79-1.90, five risk estimates); and pancreas cancer RR=1.05 (95%, CI 0.94-1.16, three risk estimates).Conclusions: We observed an association between occupational exposure to welding fumes and larynx and stomach cancer. No association was found for other HN or GI cancers. Our study stresses the need to investigate the risk of cancers other than lung following occupational exposure to welding fumes.
Riferimenti bibliografici
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25. Schildt EB, Eriksson M, Hardell L, Magnuson A. Occupational exposures as risk factors for oral cancer evaluated in a Swedish case-control study. Oncol Rep. 1999;6(2):317-20.
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27. Merletti F, Boffetta P, Ferro G, Pisani P, Terracini B. Occupation and cancer of the oral cavity or oropharynx in Turin, Italy. Scand J Work Environ Health. 1991;17(4):248-54. Doi: 10.5271/sjweh.1706.
28. Goldberg P, Leclerc A, Luce D, Morcet JF, Brugère J. Laryngeal and hypopharyngeal cancer and occupation: results of a case-control study. Occup Environ Med. 1997;54(7):477-82. Doi: 10.1136/oem.54.7.477.
29. Huebner WW, Schoenberg JB, Kelsey JL, et al. Oral and pharyngeal cancer and occupation: a case-control study. Epidemiology. 1992 Jul;3(4):300-9. Doi: 10.1097/00001648-199207000-00005.
30. Vaughan TL. Occupation and squamous cell cancers of the pharynx and sinonasal cavity. Am J Ind Med. 1989;16(5):493-510. Doi: 10.1002/ajim.4700160503.
31. Ahrens W, Jöckel KH, Patzak W, Elsner G. Alcohol, smoking, and occupational factors in cancer of the larynx: a case-control study. Am J Ind Med. 1991;20(4):477-93. Doi: 10.1002/ajim.4700200404.
32. Wortley P, Vaughan TL, Davis S, Morgan MS, Thomas DB. A case-control study of occupational risk factors for laryngeal cancer. Br J Ind Med. 1992;49(12):837-44. Doi: 10.1136/oem.49.12.837.
33. De Stefani E, Boffetta P, Oreggia F, Ronco A, Kogevinas M, Mendilaharsu M. Occupation and the risk of laryngeal cancer in Uruguay. Am J Ind Med. 1998 Jun;33(6):537-42. Doi: 10.1002/(sici)1097-0274(199806)33:6<537::aid-ajim3>3.0.co;2-n.
34. Elci OC, Dosemeci M, Blair A. Occupation and the risk of laryngeal cancer in Turkey. Scand J Work Environ Health. 2001;27(4):233-9. Doi: 10.5271/sjweh.610.
35. Gustavsson P, Jakobsson R, Johansson H, Lewin F, Norell S, Rutkvist LE. Occupational exposures and squamous cell carcinoma of the oral cavity, pharynx, larynx, and oesophagus: a case-control study in Sweden. Occup Environ Med. 1998;55(6):393-400. Doi: 10.1136/oem.55.6.393.
36. Olsen J, Sabroe S, Lajer M. Welding and cancer of the larynx: a case-control study. Eur J Cancer Clin Oncol. 1984;20(5):639-43. Doi: 10.1016/0277-5379(84)90010-5
37. Khetan P, Boffetta P, Luce D, et al. D. Occupations and the Risk of Head and Neck Cancer: A Pooled Analysis of the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. J Occup Environ Med. 2019;61(5):397-404. Doi: 10.1097/JOM.0000000000001563.
38. Keller JE, Howe HL. Cancer in Illinois construction workers: a study. Am J Ind Med. 1993;24(2):223-30. Doi: 10.1002/ajim.4700240208.
39. Kauppinen T, Riala R, Seitsamo J, Hernberg S. Primary liver cancer and occupational exposure. Scand J Work Environ Health. 1992;18(1):18-25. Doi: 10.5271/sjweh.1616.
40. Boffetta P, Boccia S, La Vecchia C. A Quick Guide to Cancer Epidemiology. Springer. 2014. ISBN-10: 9783319050676
41. Ilic M, Ilic I. Epidemiology of stomach cancer. World J Gastroenterol. 2022;28(12):1187–1203. Doi: 10.3748/wjg.v28.i12.1187. PMID: 35431510
42. Hu JX, Zhao CF, Chen WB, et al. Pancreatic cancer: A review of epidemiology, trend, and risk factors. World J Gastroenterol. 2021; 21;27(27):4298-4321. Doi: 10.3748/wjg.v27.i27.4298. PMID: 34366606
43. Hull CJ, Doyle E, Peters JM, Garabrant DH, Bernstein L, Preston-Martin S. Case-control study of lung cancer in Los Angeles County welders. Am J Ind Med. 1989;16 (1):103-112. Doi:10.1002/ajim.4700160111
44. Pandol SJ, Apte MV, Wilson JS, Gukovskaya AS, Edderkaoui M. The burning question: why is smoking a risk factor for pancreatic cancer? Pancreatology. 2012;12(4):344-349. Doi:10.1016/j.pan.2012.06.002
45. Testino G, Leone S, Borro P. Alcohol and hepatocellular carcinoma: a review and a point of view. World J Gastroenterol. 2014;20(43):15943-15954. Doi:10.3748/wjg.v20.i43.15943
46. Collatuzzo G, Hamdani M, Boffetta P. Risk of bladder, kidney and prostate cancer from occupational exposure to welding fumes: a systematic review and meta-analysis. Int Arch Occup Environ Health. 2024 17. Doi: 10.1007/s00420-023-02040-0. PMID: 38231405
2. Villaume JE, Wasti K, Liss-Suter D, Hsiao S. Effects of Welding on Health. American Welding Society. 1979. Eds., Vol. I, Miami, FL.
3. International Agency for Research on Cancer (IARC). Evaluation of carcinogenic risks to humans: welding, in-dium tin oxide, molybdenum trioxide. Vol. 118, 2018.
4. Guha N, Loomis D, Guyton KZ, et al. Carcinogenicity of welding, molybdenum trioxide, and indium tin oxide. Lancet Oncol 2017;18:581–2. Doi:10.1016/S1470-2045(17)30255-3
5. International Agency for Research on Cancer (IARC). Evaluation of carcinogenic risks to humans. Chromium, nickel and welding. Vol. 49, 1990.
6. Honaryar MK, Lunn RM, Luce D, et al. Welding fumes and lung cancer: a meta-analysis of case-control and cohort studies. Occup Environ Med. 2019;76(6):422-431. Doi:10.1136/oemed-2018-105447
7. International Agency for Research on Cancer. List Of Classifications – IARC Monographs On The Identification Of Carcinogenic Hazards To Humans. Monographs.Iarc.Who.Int, 2023. Available at: https://monographs.iarc.who.int/list-of-classifications.
8. Barul C, Matrat M, Auguste A, et al. Welding and the risk of head and neck cancer: the ICARE study. Occup Environ Med. 2020 May;77(5):293-300. Doi: 10.1136/oemed-2019-106080.
9. Dekkers OM, Vandenbroucke JP, Cevallos M, Renehan AG, Altman DG, Egger M. COSMOS-E: Guidance on con-ducting systematic reviews and meta-analyses of observational studies of etiology. PLoS Med. 2019 21;16(2):e1002742. Doi: 10.1371/journal.pmed.1002742. PMID: 30789892; PMCID: PMC6383865.
10. Critical Appraisal Skills Programme (2018). CASP Qualitative Checklist. 2018. Available at: https://casp-uk.b-cdn.net/wp-content/uploads/2018/03/CASP-Qualitative-Checklist-2018_fillable_form.pdf. Accessed: Date Accessed.
11. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986 Sep;7(3):177-88. Doi: 10.1016/0197-2456(86)90046-2. PMID: 3802833.
12. Egger M, Davey Smith G, Schneider M, Minder CE. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629-34.
13. STATA StataCorp. 2019. Stata Statistical Software: Release 16. College Station, TX: StataCorp LLC.
14. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. Doi: 10.1136/bmj.n71
15. Pukkala E, Martinsen JI, Lynge E, et al. Occupation and cancer - follow-up of 15 million people in five Nordic countries. Acta Oncol. 2009;48(5):646-790. Doi: 10.1080/02841860902913546.
16. Puntoni R, Merlo F, Borsa L, Reggiardo G, Garrone E, Ceppi M. A historical cohort mortality study among shipyard workers in Genoa, Italy. Am J Ind Med. 2001;40(4):363-370. Doi: 10.1002/ajim.1110
17. Moulin JJ, Wild P, Haguenoer JM, et al. A mortality study among mild steel and stainless steel welders. Br J Ind Med. 1993;50(3):234-243. Doi: 10.1136/oem.50.3.234
18. 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(4):294-303. Doi: 10.1097/00043764-199904000-00012
19. MacLeod JS, Harris MA, Tjepkema M, Peters PA, Demers PA. Cancer Risks among Welders and Occasional Welders in a National Population-Based Cohort Study: Canadian Census Health and Environmental Cohort. Saf Health Work. 2017;8(3):258-266. Doi: 10.1016/j.shaw.2016.12.001. Epub 2017 Jan 12.
20. Krstev S, Stewart P, Rusiecki J, Blair A. Mortality among shipyard Coast Guard workers: a retrospective co-hort study. Occup Environ Med. 2007;64(10):651-658. Doi: 10.1136/oem.2006.029652
21. Simonato L, Fletcher AC, Andersen A, et al. A historical prospective study of European stainless steel, mild steel, and shipyard welders. Br J Ind Med. 1991;48(3):145-154. Doi: 10.1136/oem.48.3.145
22. Axelson O. Aspects on confounding in occupational health epidemiology. Scand J Work Environ Health 1978;4:85-9.
23. Boffetta P, Richiardi L, Berrino F, et al. Occupation and larynx and hypopharynx cancer: an international case-control study in France, Italy, Spain, and Switzerland. Cancer Causes Control. 2003;14(3):203-12. Doi: 10.1023/a:1023699717598.
24. Shangina O, Brennan P, Szeszenia-Dabrowska N, et al. Occupational exposure and laryngeal and hypopharyngeal cancer risk in central and eastern Europe. Am J Epidemiol. 2006;164(4):367-75. Doi: 10.1093/aje/kwj208
25. Schildt EB, Eriksson M, Hardell L, Magnuson A. Occupational exposures as risk factors for oral cancer evaluated in a Swedish case-control study. Oncol Rep. 1999;6(2):317-20.
26. Brown LM, Mason TJ, Pickle LW, et al. Occupational risk factors for laryngeal cancer on the Texas Gulf Coast. Cancer Res. 1988;48(7):1960-4. PMID: 3349470.
27. Merletti F, Boffetta P, Ferro G, Pisani P, Terracini B. Occupation and cancer of the oral cavity or oropharynx in Turin, Italy. Scand J Work Environ Health. 1991;17(4):248-54. Doi: 10.5271/sjweh.1706.
28. Goldberg P, Leclerc A, Luce D, Morcet JF, Brugère J. Laryngeal and hypopharyngeal cancer and occupation: results of a case-control study. Occup Environ Med. 1997;54(7):477-82. Doi: 10.1136/oem.54.7.477.
29. Huebner WW, Schoenberg JB, Kelsey JL, et al. Oral and pharyngeal cancer and occupation: a case-control study. Epidemiology. 1992 Jul;3(4):300-9. Doi: 10.1097/00001648-199207000-00005.
30. Vaughan TL. Occupation and squamous cell cancers of the pharynx and sinonasal cavity. Am J Ind Med. 1989;16(5):493-510. Doi: 10.1002/ajim.4700160503.
31. Ahrens W, Jöckel KH, Patzak W, Elsner G. Alcohol, smoking, and occupational factors in cancer of the larynx: a case-control study. Am J Ind Med. 1991;20(4):477-93. Doi: 10.1002/ajim.4700200404.
32. Wortley P, Vaughan TL, Davis S, Morgan MS, Thomas DB. A case-control study of occupational risk factors for laryngeal cancer. Br J Ind Med. 1992;49(12):837-44. Doi: 10.1136/oem.49.12.837.
33. De Stefani E, Boffetta P, Oreggia F, Ronco A, Kogevinas M, Mendilaharsu M. Occupation and the risk of laryngeal cancer in Uruguay. Am J Ind Med. 1998 Jun;33(6):537-42. Doi: 10.1002/(sici)1097-0274(199806)33:6<537::aid-ajim3>3.0.co;2-n.
34. Elci OC, Dosemeci M, Blair A. Occupation and the risk of laryngeal cancer in Turkey. Scand J Work Environ Health. 2001;27(4):233-9. Doi: 10.5271/sjweh.610.
35. Gustavsson P, Jakobsson R, Johansson H, Lewin F, Norell S, Rutkvist LE. Occupational exposures and squamous cell carcinoma of the oral cavity, pharynx, larynx, and oesophagus: a case-control study in Sweden. Occup Environ Med. 1998;55(6):393-400. Doi: 10.1136/oem.55.6.393.
36. Olsen J, Sabroe S, Lajer M. Welding and cancer of the larynx: a case-control study. Eur J Cancer Clin Oncol. 1984;20(5):639-43. Doi: 10.1016/0277-5379(84)90010-5
37. Khetan P, Boffetta P, Luce D, et al. D. Occupations and the Risk of Head and Neck Cancer: A Pooled Analysis of the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. J Occup Environ Med. 2019;61(5):397-404. Doi: 10.1097/JOM.0000000000001563.
38. Keller JE, Howe HL. Cancer in Illinois construction workers: a study. Am J Ind Med. 1993;24(2):223-30. Doi: 10.1002/ajim.4700240208.
39. Kauppinen T, Riala R, Seitsamo J, Hernberg S. Primary liver cancer and occupational exposure. Scand J Work Environ Health. 1992;18(1):18-25. Doi: 10.5271/sjweh.1616.
40. Boffetta P, Boccia S, La Vecchia C. A Quick Guide to Cancer Epidemiology. Springer. 2014. ISBN-10: 9783319050676
41. Ilic M, Ilic I. Epidemiology of stomach cancer. World J Gastroenterol. 2022;28(12):1187–1203. Doi: 10.3748/wjg.v28.i12.1187. PMID: 35431510
42. Hu JX, Zhao CF, Chen WB, et al. Pancreatic cancer: A review of epidemiology, trend, and risk factors. World J Gastroenterol. 2021; 21;27(27):4298-4321. Doi: 10.3748/wjg.v27.i27.4298. PMID: 34366606
43. Hull CJ, Doyle E, Peters JM, Garabrant DH, Bernstein L, Preston-Martin S. Case-control study of lung cancer in Los Angeles County welders. Am J Ind Med. 1989;16 (1):103-112. Doi:10.1002/ajim.4700160111
44. Pandol SJ, Apte MV, Wilson JS, Gukovskaya AS, Edderkaoui M. The burning question: why is smoking a risk factor for pancreatic cancer? Pancreatology. 2012;12(4):344-349. Doi:10.1016/j.pan.2012.06.002
45. Testino G, Leone S, Borro P. Alcohol and hepatocellular carcinoma: a review and a point of view. World J Gastroenterol. 2014;20(43):15943-15954. Doi:10.3748/wjg.v20.i43.15943
46. Collatuzzo G, Hamdani M, Boffetta P. Risk of bladder, kidney and prostate cancer from occupational exposure to welding fumes: a systematic review and meta-analysis. Int Arch Occup Environ Health. 2024 17. Doi: 10.1007/s00420-023-02040-0. PMID: 38231405
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2025-04-17
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Siea AC, Collatuzzo G, Hamdani M, Boffetta P. Welding Fumes Exposure and the Risk of Head and Neck and Gastrointestinal Cancer: A Systematic Review and Meta-Analysis. Med Lav [Internet]. 2025 Apr. 17 [cited 2025 Apr. 19];116(2):16092. Available from: https://mail.mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/16092
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Come citare
1.
Siea AC, Collatuzzo G, Hamdani M, Boffetta P. Welding Fumes Exposure and the Risk of Head and Neck and Gastrointestinal Cancer: A Systematic Review and Meta-Analysis. Med Lav [Internet]. 2025 Apr. 17 [cited 2025 Apr. 19];116(2):16092. Available from: https://mail.mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/16092
