Occupational exposure to insulating materials and risk of coronary artery diseases

ABSTRACT Background Although previous reports link exposure to insulating materials with an increased risk of mesothelioma and chronic respiratory diseases, studies evaluating their associations with the risk of coronary artery diseases (CAD) are lacking. Aims We aimed at evaluating associations between exposure to insulating materials and the 10-year risk of CAD among insulators. Methods In this cross-sectional study, we recruited 643 adults (≥18 years) who were full-time insulators from the Local 110 Heat and Frost Insulators and Allied Workers Union in Edmonton, Alberta. We obtained demographic information, personal and family history, and job-exposure history including experience (years) and types of exposure to insulating materials. Clinical profiling including Framingham risk scores (FRS) was assessed. Results Of all insulators, 89% were male (mean±SD age: 47±12 years), 27% had a parental history of cardiac diseases, and 22% had a comorbid chronic respiratory disease. 53% reported exposure to asbestos while 61, 82, and 94% reported exposure to ceramic fibers, fiberglass, and mineral fibers, respectively. In single-exposure multivariable regression models adjusted for experience, marital status, and body mass index (BMI), asbestos was found to be associated with higher FRS (β: 1.004; 95%CI: 0.003 to 2.00). The association remained consistent in multi-exposure models and a higher association between asbestos exposure and FRS among insulators with comorbid chronic respiratory disease. Conclusions Our study demonstrates that apart from cancer and chronic respiratory diseases, asbestos exposure may also have a cardiac effect and thus warranting the need for systematic surveillance to protect workers from the adverse effects of these materials. KEY LEARNING POINTS What is already known about this subject Insulating materials, particularly asbestos and man-made vitreous fibres (MMVFs) are well-known occupational hazards, and both long- and short-term exposure to these materials have been found to associate with increased risk of chronic respiratory diseases and cancers, and mortality due to those diseases. Evidence of the cardiovascular effects of asbestos and other MMVFs is scanty and only limited to empirical retrospective mortality studies; however, most of those studies produced mixed results on the roles of asbestos and other MMVFs on cardiovascular health. It is important to learn the effects of these insulating materials on organ systems other than the lungs in order to identify the potential health hazards of these materials and upgrade surveillance and current safety measures to protect the workers. What this study adds We studied over 800 workers who were exposed to a variety of insulating materials including asbestos and MMVFs and our results indicate an association between asbestos exposure and increased Framingham risk score (10-year estimated risk of cardiovascular diseases). Further long-term prospective studies are needed to assess the short and long-term effects of these exposures on disease development, particularly among non-smokers. Furthermore, the quantitation of workplace exposure is also important to understand the dose-response nature of these exposures. What impact this may have on practice or policy Our findings provide new evidence of asbestos-associated increased risk of cardiovascular diseases, which underscores the need for a more rigorous systematic monitoring of the health of workers. Our findings also warrant a more comprehensive knowledge of the physicians, particularly occupational physicians regarding the possible occupational risk factors for chronic diseases, including cardiovascular diseases. Our findings may provide a basis for further research and amendment of policies related to the workers’ health, protection, compensation, and benefits. TEASER TEXT Previous studies have demonstrated that exposure to insulating materials including asbestos is associated with an increased risk of mesothelioma and other chronic respiratory diseases. However, these materials have not been systematically investigated as possible risk factors for coronary artery diseases (CAD). Our study is the first to demonstrate an association between exposure to insulating materials, particularly asbestos, and an increased 10-year predicted risk of CAD. These findings warrant further control of exposure to these materials.

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