Abstract
Objectives
The neurotoxicity of occupational exposure to aluminium (Al)-containing welding fumes has been discussed with controversial results. The aim of the longitudinal study was to examine a group of Al welders for significant central nervous changes in comparison with a non-exposed cohort.
Methods
A group of 98 Al welders (mean age 37 years) in the car-body construction industry, with a median of 6 years of occupational exposure to Al welding fumes, and an education-matched, gender-matched, age-matched control group of 50 car-production workers (mean age 36 years) at the same plant, were included in this longitudinal study. Two cross-sectional studies were done in 1999 and 2001. In the second cross-sectional study 97 welders and 50 controls could be examined. The examination programme consisted, for example, of a standardised anamnesis, focussing on occupational history, education, illnesses, medication, accidents and current alcohol consumption, a physical examination that included neurological status, and the assessment of Al concentration in plasma and urine. The neurobehavioral methods included a symptom questionnaire, modified Q16, and computerised and non-computerised tests: psychomotor performance (steadiness, line tracing, aiming, tapping), verbal intelligence (WST), simple reaction time, digit span, block design (HAWIE), symbol–digit substitution, digit span, switching attention (European neurobehavioral evaluation system, EURO-NES), and standard progressive matrices. The data were analysed by multivariate analysis of covariance (MANCOVA) for repeated measurements with covariates age, education, and carbohydrate-deficient transferrin in plasma (CDT).
Results
The median Al urine concentration (mean preshift/postshift) was 52.4 μg/g creatinine (2001) and 57.6 μg/g creatinine (1999). Median respirable air dust was 0.67 mg/m3 (2001) and 0.47 mg/m3 (1999). Welders and controls did not report significantly more symptoms in the modified Q16. Furthermore, no significant differences in psychomotor performance and other neurobehavioral tasks, except for reaction time, were seen between welders and non-welders. Regression analyses reveal a significant relationship between reaction time and Al excretion in urine that was confounded by other factors.
Conclusions
At present the outcome for reaction time has to be interpreted as a single result. However, as the modified Q16 questionnaire and the rest of the psychomotor performance showed no significant changes, the next cross-sectional study, in 2003, will provide further information on which a final conclusion can be based.
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References
Akila R, Stollery B, Riihimäki V (1999) Decrements in cognitive performance in metal inert gas welders exposed to aluminium. Occup Environ Med 56:632–639
Alfrey AC, LeGendre GR, Kaehne WD (1976) The dialysis encephalopathy syndrome. Possible aluminum intoxication. N Engl J Med 294:184–188
Armstrong, RA, Winsper, SJ, Blair JA (1996) Aluminium and Alzheimer's disease: review of possible pathogenic mechanisms. Dementia 7:1–9
Bast-Pettersen R, Skaug V, Ellingsen D (2000) Neurobehavioral performance in aluminium welders. Am J Ind Med 37:184–192
Dietz MC, Ihrig A, Wrazidlo W, Bader M, Jansen O, Triebig G (2001) Results of magnetic resonance imaging in long-term manganese dioxide-exposed workers. Environ Res 85:37–40
Doll R (1993) Alzheimer's disease and environmental aluminium. Age Ageing 22:138–153
Gilioli R (1993) EURONEST (1993) a concerted action of the European community for the study of organic solvents neurotoxicity. Environ Res 62:89–98
Hänninen H, Matikainen E, Kovala T (1994) Internal load of aluminium and the central nervous system function of aluminium workers. Scand J Work Environ Health 20:279–285
Heller KA, Kratzmeier H, Lengfelder A (1988) Matritzen-Test-Manual zu den Standard Progressive Matrices von J.C. Raven. Beltz Test, Göttingen
Hogstedt C, Andersson K, Hane M (1984) A questionnaire approach to the monitoring of early disturbances in central nervous functions. In: Aitio A, Riihimaki V, Vaninio H (eds) Biological monitoring and surveillance of workers exposed to chemicals. Hemisphere, Washington, pp 275–287
Hosovki E, Mastelica Z, Sunderic D (1990) Mental abilities of workers exposed to aluminium. Med Lav 81:119–123
Ihrig A, Triebig G, Dietz MC (2001) Evaluation of a modified German version of the Q16 questionnaire for neurotoxic symptoms in workers exposed to solvents. Occup Environ Med 58:19–23
Iregren A, Gamberale F, Kjellberg A (1996) SPES: a psychological test system to diagnose environmental hazards. Neurotoxicol Teratol 18:485–491
Iregren A, Sjörgen B, Gustafsson K, Hagman M, Nylén L, Frech W, Andersson M, Ljunggren KG, Wennberg A (2001) Effects on the nervous system in different groups of workers exposed to aluminium. Occup Environ Med 58:453–460
Lehnert G, Schaller KH, Angerer J (1999) Report on the status of the external quality-control programs for occupational—medical and environmental—medical toxicological analyses in biological materials in Germany. Int Arch Occup Environ Health 72:60–64
Letz R, Pieper WA, Morris RD (1996) NES test performance in a large US army veteran sample: relationship with both demographic factors and traditional neuropsychological measures. Neurotoxicol Teratol 18:381–390
Letzel S, Schaller KH, Hilla W, Windorfer K, Kraus T (1999) Untersuchung zur biologischen Halbwertszeit der realen Alumiumausscheidung bei Alumiumschweissern: Arbeitsmed Sozialmed Umweltmed 11:456–460
Letzel S, Lang CJG, Schaller KH, Angerer J, Fuchs S, Neundörfer B, Lehnert G (2000) Longitudinal study of neurotoxicity with occupational exposure to aluminium dust. Neurology 54:997–1000
Oswald WD, Roth E (1997) Der Zahlenverbindungstest, ZVT (trail making). Hogrefe, Göttingen
Rifat SL, Eastwood MR, Crapper McLachlan DR, Corey PN (1990) Effects of exposure of miners to aluminium powder. Lancet 336:1162–1165
Savory J, Exley C, Forbes WF, Huang Y, Joshi JG, Kruck T, McLachlan DRC, Wakayama I (1996) Can the controversy of the role of aluminium in Alzheimer's disease be resolved? What are the suggested approaches to this controversy and methodological issues to be considered? J Toxicol Environ Health 48:615–635
Schmidt KH, Metzler P (1992) WST Wortschatztest 1992. Beltz, Weinheim
Sjörgen B, Iregren A, Frech W (1996) Effects on the nervous system among welders exposed to aluminium and manganese. Occup Environ Med 53:32–40
Thomas, Dahl (1969) Zur Validität der Intelligenzdiagnostik im reduzierten Wechslertest (WIP). Psychol Beitr 4:543–550
Acknowledgments
We thank Hauptverband der gewerblichen Berufsgenossenschaften (HVBG) and Vereinigung der Metallberufsgenossenschaften (VMBG) for financial support for the study. Some data were taken from the medical dissertation of A. Kuhlmann.
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Buchta, M., Kiesswetter, E., Otto, A. et al. Longitudinal study examining the neurotoxicity of occupational exposure to aluminium-containing welding fumes. Int Arch Occup Environ Health 76, 539–548 (2003). https://doi.org/10.1007/s00420-003-0450-9
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DOI: https://doi.org/10.1007/s00420-003-0450-9