Evaluation of right and left ventricular function in hard metal workers

Area of Science:

• Occupational Health
• Cardiology
• Toxicology

Background:

• Cobalt exposure has been controversially linked to congestive cardiomyopathy.
• Previous studies on industrial cobalt exposure and heart disease are limited.
• Understanding the cardiac effects of occupational cobalt exposure is crucial.

Purpose of the Study:

• To investigate the cardiac effects of prolonged occupational cobalt exposure in cemented tungsten carbide workers.
• To assess biventricular function at rest and during exercise in exposed workers.
• To explore correlations between exposure duration, chest x-ray findings, and cardiac function.

Main Methods:

• Radionuclide ventriculography was used to measure resting and exercise right and left ventricular ejection fractions.
• Thirty cemented tungsten carbide workers with a mean exposure of 9.9 years participated.
• Chest x-rays were analyzed for parenchymal abnormalities.

Main Results:

• Overall, resting and exercise biventricular function was normal in the study group.
• A weak inverse correlation was found between cobalt exposure duration and resting left ventricular function (r = -0.40, p < 0.03).
• Workers with abnormal chest x-rays exhibited lower exercise right ventricular ejection fractions and showed inverse relations between ejection fraction and x-ray abnormalities (r = -0.44, p < 0.01).

Conclusions:

• Overt left ventricular dysfunction was not observed in this cohort.
• Prolonged industrial cobalt exposure may act as a weak cardiomyopathic agent.
• Diminished right ventricular reserve is likely linked to lung disease and early cor pulmonale from cobalt exposure.