A Proposal to Help Prevent Welder Pneumonia

By Jeffrey Jacobs, M.D., M.P.H.

However you choose to pronounce the acronym, it’s helpful to understand the origins of ORCHSE Strategies.

The company was established as Organization Resources Counselors, Inc., in 1972 to facilitate industry understanding of governmental occupational health, safety and environmental policy and regulatory decision-making. Health, Safety and Environment was later added to the name to represent the interests of member organizations in diverse industry sectors.

I recently attended an ORCHSE meeting in northern Virginia to meet with other EH&S professionals. I was impressed with the quality of the presentations. One in particular stood out.

James Wesdock, M.D., M.P.H., Global Health Director at Alcoa, presented a straight-forward proposal to offer all welders a vaccine to protect against pneumonia. He explained the reasoning behind this initiative:

  1. International research consistently demonstrates an increased risk of pneumonia in welders compared to the general public. Additionally, welders who develop pneumonia (invasive pulmonary disease or IPD) have an increased risk of dying from pneumonia at a rate two-to-three times greater than their counterparts in the general public. The risk window for developing pneumonia is related to recent welding exposures (within the last 12 months). The risk level reverts to the general population rate after retirement. Exposure to iron metal fumes during welding is believed to be a contributing fact in the development of IPD.
  2. A safe and inexpensive pneumococcal vaccine is available to prevent IPD. This is important because the vaccine protects against Streptococcus Pneumoniae (pneumococcus), the bacterium that poses the greatest risk to welders who contract the disease. Most healthy adults develop immunity to pneumococcus within a month after vaccination; about 75 percent remain protected for up to 10 years. Side effects typically include vaccination site soreness, swelling and redness, headache, fatigue and muscle aches. Adverse reactions are similar to other types of vaccine reactions, such as influenza vaccines.

According to data presented by Dr. Wesdock:

  • Vaccinating 588 welders would prevent one case of IPD in 10 years
  • Vaccinating 4,900 welders would prevent 1 death from IPD in 10 years

By comparison, about 1 million people get pneumonia and approximately 50,000 die of it annually in the U.S., the Centers for Disease Control and Prevention reports. Vaccination could help prevent many of these illnesses and deaths.

Alcoa has offered voluntary vaccination to its employees since June 2017. Nearly 800 welders have been vaccinated (about 30 percent of eligible employees). In Brazil, a group of 76 Aloca workers uniformly accepted the vaccine. In the United States, only about 13 percent of eligible individuals have agreed to receive the vaccine.

It appears that cultural norms influence vaccination rates. For example, Dr. Wesdock said Brazilian workers may be more willing to trust medical authorities and accept their recommendations than employees in the U.S.

He encourages corporate medical directors in companies with welders to consider this preventive approach. For more information, contact Dr. Jacobs: Jeffrey.jacobs@workcare.com

Dr. Jeffrey Jacobs is Vice President/Clinical Lead, Medical Exams & Travel, and an Associate Medical Director at WorkCare.

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