Heart rate variability, hemostatic and acute inflammatory blood parameters in healthy adults after short-term exposure to welding fume

  • E. Scharrer
  • H. Hessel
  • A. Kronseder
  • W. Guth
  • B. Rolinski
  • R. A. Jörres
  • K. Radon
  • R. Schierl
  • P. Angerer
  • D. Nowak
Original Article


The present study aimed to investigate, whether short-term experimental exposure to high levels of welding fumes would be capable of exerting acute effects in healthy subjects. Specifically, we assessed cardiovascular function in terms of heart rate variability (HRV) as well as the concentrations of inflammatory mediators and hemostatic proteins in blood as outcome measures. Twenty subjects without a history of airway and cardiovascular diseases were exposed to either control air or welding fume for 1 h on 2 separate days under standardized conditions. The median concentration of the alveolar particle fraction during welding was 3.5 mg/m3 (quartiles: 1.4–6.3 mg/m3; range 1.0–25.3 mg/m3). Five hours later a panel of clinical assessments was performed, including HRV measurement and drawing of blood samples. There were no changes in symptom ratings or lung function after welding fume exposure. Exposures did also not differ regarding effects on time- and frequency-domain parameters of HRV. Similarly, blood leukocyte numbers, cell differentials and the blood levels of fibrinogen, C-reactive protein, antithrombin III, factor VIII, von Willebrand factor, ristocetin cofactor, sICAM-1, tumor necrosis factor alpha, interleukin 6, interleukin 8 and epithelial neutrophil activating peptide 78 were not altered by welding fume inhalation. However, there was a significant fall in the level of endothelin-1 (P < 0.01). In conclusion, the data did not indicate effects of clinical significance of a short-term high-level exposure to welding fumes on HRV or a set of blood hemostatic and acute inflammatory parameters in healthy subjects. The small but statistically significant effect on endothelin levels demonstrated that measurable effects could be elicited even in these individuals. Overall, welding fumes are not likely to exert acute cardiovascular effects in healthy individuals.


Particulate matter Interleukin Tumor necrosis factor alpha von Willebrand factor C-reactive protein Time- and frequency domain Standard deviation of intervals from normal R-wave to the following normal (SDNN) 


  1. Ando M, Shima M, Adachi M, Tsunetoshi Y (2001) The role of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and regulated on activation, normal T-cell expressed and secreted (RANTES) in the relationship between air pollution and asthma among children. Arch Environ Health 56:227–233PubMedGoogle Scholar
  2. Antonini JM (2003) Health effects of welding. Crit Rev Toxicol 33:61–103PubMedGoogle Scholar
  3. Becker S, Quay J, Soukup J (1991) Cytokine (tumor necrosis factor, IL-6, and IL-8) production by respiratory syncytial virus-infected human alveolar macrophages. J Immunol 147:4307–4312PubMedGoogle Scholar
  4. Brook RD, Brook JR, Urch B, Vincent R, Rajagopalan S, Silverman F (2002) Inhalation of fine particulate air pollution and ozone causes acute arterial vasoconstriction in healthy adults. Circulation 105:1534–1536PubMedCrossRefGoogle Scholar
  5. Brook RD, Franklin B, Cascio W, Hong Y, Howard G, Lipsett M, Luepker R, Mittleman M, Samet J, Smith SCJ, Tager I (2004) Air pollution and cardiovascular disease: a statement for healthcare professionals from the Expert Panel on Population and Prevention Science of the American Heart Association. Circulation 109:2655–2671PubMedCrossRefGoogle Scholar
  6. Clarke RW, Coull B, Reinisch U, Catalano P, Killingsworth CR, Koutrakis P, Kavouras I, Murthy GG, Lawrence J, Lovett E, Wolfson JM, Verrier RL, Godleski JJ (2000) Inhaled concentrated ambient particles are associated with hematologic and bronchoalveolar lavage changes in canines. Environ Health Perspect 108:1179–1187PubMedGoogle Scholar
  7. Committee of the Environmental, Occupational Health Assembly of the American Thoracic Society (1996) Health effects of outdoor air pollution. Am J Respir Crit Care Med 153:3–50Google Scholar
  8. Conway DS, Pearce LA, Chin BS, Hart RG, Lip GY (2002) Plasma von Willebrand factor and soluble P-selectin as indices of endothelial damage and platelet activation in 1321 patients with nonvalvular atrial fibrillation. Circulation 106:1962–1967PubMedCrossRefGoogle Scholar
  9. Devalia JL, Bayram H, Abdelaziz MM, Sapsford RJ, Davies RJ (1999) Differences between cytokine release from bronchial epithelial cells of asthmatic patients and non-asthmatic subjects: effect of exposure to diesel exhaust particles. Int Arch Allergy Immunol 118:437–439PubMedCrossRefGoogle Scholar
  10. Devlin RB, Ghio AJ, Kehrl H, Sanders G, Cascio W (2003) Elderly humans exposed to concentrated air pollution particles have decreased heart variability. Eur Respir J Suppl 40:76s–80sPubMedCrossRefGoogle Scholar
  11. Dockery DW (2001) Epidemiologic evidence of cardiovascular effects of particulate air pollution. Environ Health Perspect 109(Suppl. 4):483–486PubMedGoogle Scholar
  12. Donaldson K, Tran L, Jimenez LA, Duffin R, Newby DE, Mills N, Macnee W, Stone V (2005) Combustion-derived nanoparticles: a review of their toxicology following inhalation exposure. Part Fibre Toxicol 2:10PubMedCrossRefGoogle Scholar
  13. Dreher K, Jaskot R, Kodavant U, Lehmann J, Winsett D, Costa D (1996) Soluble transition metals mediate the acute pulmonary injury and airway hyperreactivity induced by residual oil fly ash particles. Chest 109:33s–34sPubMedGoogle Scholar
  14. Folsom AR, Wu KK, Rosamond WD, Sharrett AR, Chambless LE (1997) Prospective study of hemostatic factors and incidence of coronary heart disease. Circulation 96:1102–1108PubMedGoogle Scholar
  15. Frampton MW, Utell MJ, Zareba W, Oberdörster G, Cox C, Huang LS, Morrow PE, Lee FE, Chalupa D, Frasier LM, Speers DM, Stewart J (2004) Effects of exposure to ultrafine carbon particles in healthy subjects and subjects with asthma. Res Rep Health Eff Inst 126:1–47; discussion 49–63Google Scholar
  16. Godleski JJ, Verrier RL, Koutrakis P, Catalano P, Coull B, Reinisch U, Lovett EG, Lawrence J, Murthy GG, Wolfson JM, Clarke RW, Nearing BD, Killingsworth C (2000) Mechanisms of morbidity and mortality from exposure to ambient air particles. Res Rep Health Eff Inst 91:5–88; discussion 89–103Google Scholar
  17. Gold DR, Litonjua A, Schwartz J, Lovett E, Larson A, Nearing B, Allen G, Verrier M, Cherry R, Verrier R (2000) Ambient pollution and heart rate variability. Circulation 101:1267–1273PubMedGoogle Scholar
  18. Gong H Jr, Linn WS, Terrell SL, Clark KW, Geller MD, Anderson KR, Cascio WE, Sioutas C (2004) Altered heart-rate variability in asthmatic and healthy volunteers exposed to concentrated ambient coarse particles. Inhal Toxicol 16:335–343PubMedCrossRefGoogle Scholar
  19. Grabowski GM, Paulauskis JD, Godleski JJ (2000) Mediating phosphorylation events in the vanadium-induced respiratory burst of alveolar macrophages. Toxicol Appl Pharmacol 156:170–178CrossRefGoogle Scholar
  20. Kang YJ, Li Y, Zhou Z, Roberts AM, Cai L, Myers SR, Wang L, Schuchke DA (2002) Elevation of serum endothelins and cardiotoxicity induced by particulate matter (PM2.5) in rats with acute myocardial infarction. Cardiovasc Toxicol 2:253–261PubMedCrossRefGoogle Scholar
  21. Kim JY, Chen JC, Boyce PD, Chrisitani DC (2005) Exposure to welding fumes is associated with acute systemic inflammatory responses. Occup Environ Med 62:157–163PubMedCrossRefGoogle Scholar
  22. Kleiger RE, Miller JP, Bigger JT, Moss AR, Multicenter Post-Infarction Research Group (1987) Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 59:256–262Google Scholar
  23. Künzli N, Kaiser R, Rapp R, Sommer H, Wanner HU, Seethaler R, Ackermann-Liebrich U (1997) Air pollution in Switzerland—quantification of health effects using epidemiologic data. Schweiz Med Wochenschr 127:1361–1370PubMedGoogle Scholar
  24. Lee KW, Lip GY (2003) Effects of lifestyle on hemostasis, fibrinolysis, and platelet reactivity: a systematic review. Arch Intern Med 163:2368–2392PubMedCrossRefGoogle Scholar
  25. Liao D, Creason J, Shy C, Williams R, Watts R, Zweidinger R (1999) Daily variation of particulate air pollution and poor cardiac autonomic control in the elderly. Environ Health Perspect 107:521–525PubMedGoogle Scholar
  26. Liao D, Duan Y, Whitsel EA, Zheng ZJ, Heiss G, Chinchilli VM, Lin HM (2004) Association of higher levels of ambient criteria pollutants with impaired cardiac autonomic control: a population-based study. Am J Epidemiol 159:768–777PubMedCrossRefGoogle Scholar
  27. Liao D, Heiss G, Chinchilli VM, Duan Y, Folsom AR, Lin HM, Salomaa V (2005) Association of criteria pollutants with plasma hemostatic/inflammatory markers: a population-based study. J Expo Anal Environ Epidemiol 15:319–328PubMedCrossRefGoogle Scholar
  28. Lombardi F, Mortara A (1998) Heart rate variability and cardiac failure. Heart 80:213–214PubMedGoogle Scholar
  29. Magari SR, Hauser R, Schwartz J, Williams PL, Smith TJ, Christiani DC (2001) Association of heart rate variability with occupational and environmental exposure to particulate air pollution. Circulation 104:986–991PubMedGoogle Scholar
  30. Magari SR, Schwartz J, Williams PL, Hauser R, Smith TJ, Christiani DC (2002) The association of particulate air metal concentrations with heart rate variability. Environ Health Perspect 110:875–880PubMedGoogle Scholar
  31. McNeilly JD, Heal MR, Beverland IJ, Howe A, Gibson MD, Hibbs LR, MacNee W, Donaldson K (2004) Soluble transition metals cause the pro-inflammatory effects of welding fumes in vitro. Toxicol Appl Pharmacol 196:95–107PubMedCrossRefGoogle Scholar
  32. McNeilly JD, Jimenez LA, Clay MF, MacNee W, Howe A, Heal MR, Beverland IJ, Donaldson K (2005) Soluble transition metals in welding fumes cause inflammation via activation of NF-κB and AP-1. Toxicol Lett 158:152–157PubMedCrossRefGoogle Scholar
  33. Oberdörster G (2001) Pulmonary effects of inhaled ultrafine particles. Int Arch Occup Environ Health 74:1–8PubMedCrossRefGoogle Scholar
  34. Park SK, O’Neill MS, Vokonas PS, Sparrow D, Schwartz J (2005) Effects of air pollution on heart rate variability: the VA normative aging study. Environ Health Perspect 113:304–309PubMedGoogle Scholar
  35. Peters A, Döring A, Wichmann HE, Koenig W (1997) Increased plasma viscosity during an air pollution episode: a link to mortality? Lancet 349:1582–1587PubMedCrossRefGoogle Scholar
  36. Peters A, Dockery DW, Muller JE, Mittleman MA (2001) Increased particulate air pollution and the triggering of myocardial infarction. Circulation 103:2810–2815PubMedGoogle Scholar
  37. Pope CA 3rd, Verrier RL, Lovett EG, Larson AC, Raizenne ME, Kanner RE, Schwartz J, Villegas GM, Gold DR, Dockery DW (1999) Heart rate variability associated with particulate air pollution. Am Heart J 138:890–899PubMedCrossRefGoogle Scholar
  38. Pope CA, Eatough DJ, Gold DR, Pang Y, Nielsen KR, Nath P, Verrier RL, Kanner RE (2001) Acute exposure to environmental tobacco smoke and heart rate variability. Environ Health Perspect 109:711–716PubMedGoogle Scholar
  39. Pope CA 3rd, Hansen ML, Long RW, Nielsen KR, Eatough NL, Wilson WE, Eatough DJ (2004) Ambient particulate air pollution, heart rate variability, and blood markers of inflammation in a panel of elderly subjects. Environ Health Perspect 112:339–345PubMedCrossRefGoogle Scholar
  40. Prescott GJ, Cohen GR, Elton RA, Fowkkes FG, Agius RM (1998) Urban air pollution and cardiopulmonary ill health: a 14.5 year time series study. Occup Environ Med 55:697–704PubMedCrossRefGoogle Scholar
  41. Prescott GJ, Lee JR, Cohen GR, Elton RA, Lee AJ, Fowkes FG, Agius RM (2000) Investigation of factors which might indicate susceptibility to particulate air pollution. Occup Environ Med 57:53–57PubMedCrossRefGoogle Scholar
  42. Riediker M, Cascio WE, Griggs TR, Herbst MC, Bromberg PA, Neas L, Williams RW, Devlin RB (2004) Particulate matter exposure in cars is associated with cardiovascular effects in healthy young men. Am J Respir Crit Care Med 169:934–940PubMedCrossRefGoogle Scholar
  43. Rosito GB, Tofler GH (1996) Hemostatic factors as triggers of cardiovascular events. Cardiol Clin 14:239–250PubMedGoogle Scholar
  44. Sadler JE, Mannucci PM, Berntorp E, Bochkov N, Boulyjenkov V, Ginsburg D, Meyer D, Peake I, Rodeghiero F, Srivastava A (2000) Impact, diagnosis and treatment of von Willebrand disease. Thromb Haemost 84:160–174PubMedGoogle Scholar
  45. Samet JM, Curriero FC, Coursac I, Zeger SL (2000) Fine particulate air pollution and mortality in 20 U.S. cities, 1987–1994. N Engl J Med 343:1742–1749PubMedCrossRefGoogle Scholar
  46. Schwartz J (1999) Air pollution and hospital admissions for heart disease in eight US counties. Epidemiology 10:17–22PubMedCrossRefGoogle Scholar
  47. Schwartz J, Dockery DW (1992) Increased mortality in Philadelphia associated with daily air pollution concentrations. Am Rev Respir Dis 145:600–604PubMedGoogle Scholar
  48. Schwartz J, Dockery DW, Neas LM (1996) Is daily mortality associated specifically with fine particles? J Air Waste Manag Assoc 46:927–939PubMedGoogle Scholar
  49. Schwartz J, Laden F, Zanobetti A (2002) The concentration–response relation between PM(2.5) and daily deaths. Environ Health Perspect 110:1025–1029PubMedGoogle Scholar
  50. Seaton A, Soutar A, Crawford V, Elton R, McNerlan S, Cherrie J, Watt M, Agius R, Stout R (1999) Particulate air pollution and the blood. Thorax 54:1027–1032PubMedCrossRefGoogle Scholar
  51. Sinisalo J, Paronen J, Mattila KJ, Syrjälä M, Alfthan G, Palusuo T, Nieminen MS, Vaarala O (2000) Relation of inflammation to vascular function in patients with coronary heart disease. Atherosclerosis 149:403–411PubMedCrossRefGoogle Scholar
  52. Smith AP, Demoncheaux EA, Higenbottam TW (2002) Nitric oxide gas decreases endothelin-1 mRNA in cultured pulmonary artery endothelial cells. Nitric Oxide 6:153–159PubMedCrossRefGoogle Scholar
  53. Task Force of the European Society of Cardiology, the North American Society of Pacing and electrophysiology (1996) Heart rate variability: standards of measurements, physiological interpretation, and clinical use. Circulation 93:1043–1065Google Scholar
  54. Tefferi A, Nichols WL (1997) Acquired von Willebrand disease: concise review of occurrence, diagnosis, pathogenesis, and treatment. Am J Med 103:536–540PubMedCrossRefGoogle Scholar
  55. Thomson E, Kumarathasan P, Goegan P, Aubin RA, Vincent R (2005) Differential regulation of the lung endothelin system by urban particulate matter and ozone. Toxicol Sci 88:103–113PubMedCrossRefGoogle Scholar
  56. Tsuji H, Larson MG, Venditti FJ Jr, Manders ES, Evans JC, Feldman CL, Levy D (1996) Impact of reduced heart rate variability on risk for cardiac events: the Framingham Heart Study. Circulation 90:2850–2855Google Scholar
  57. Vermylen J, Nemmar A, Nemery B, Hoylaerts MF (2005) Ambient air pollution and acute myocardial infarction. J Thromb Haemost 3:1955–1961PubMedCrossRefGoogle Scholar
  58. Wilson R, Spengler J (1996) Particles in our air. In: Exposures and health effects. Harvard University Press, CambridgeGoogle Scholar
  59. Zareba W, Nomura A, Couderc JP (2001) Cardiovascular effects of air pollution: what to measure in ECG? Environ Health Perspect 109:533–538PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • E. Scharrer
    • 1
    • 2
  • H. Hessel
    • 1
    • 3
  • A. Kronseder
    • 1
  • W. Guth
    • 1
  • B. Rolinski
    • 4
    • 5
  • R. A. Jörres
    • 1
  • K. Radon
    • 1
  • R. Schierl
    • 1
  • P. Angerer
    • 1
  • D. Nowak
    • 1
  1. 1.Institute and Outpatient Clinic for Occupational and Environmental MedicineLudwig-Maximilians-UniversityMunichGermany
  2. 2.Department of Dermatology and AllergologyLudwig-Maximilians-UniversityMunichGermany
  3. 3.Institute of PathologyLudwig-Maximilians-UniversityMunichGermany
  4. 4.Institute of Clinical ChemistryMunich Municipal HospitalMunichGermany
  5. 5.Department of Clinical ChemistryLudwig-Maximilians-UniversityMunichGermany

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