Vaccinating Welders against Pneumococcus: Evidence from a Systematic Review and Meta-Analysis
Workers occupationally exposed to welding dusts and fumes have been suspected to be at increased risk of invasive pneumococcal disease (IPD). Since the 2010s, the United Kingdom Department of Health and the German Ständige Impfkommission (STIKO) actively recommend welders undergo immunization with t...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-09-01
|
| Series: | Vaccines |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-393X/11/9/1495 |
| _version_ | 1797576504744345600 |
|---|---|
| author | Matteo Riccò Pietro Ferraro Salvatore Zaffina Vincenzo Camisa Federico Marchesi Davide Gori |
| author_facet | Matteo Riccò Pietro Ferraro Salvatore Zaffina Vincenzo Camisa Federico Marchesi Davide Gori |
| author_sort | Matteo Riccò |
| collection | DOAJ |
| description | Workers occupationally exposed to welding dusts and fumes have been suspected to be at increased risk of invasive pneumococcal disease (IPD). Since the 2010s, the United Kingdom Department of Health and the German Ständige Impfkommission (STIKO) actively recommend welders undergo immunization with the 23-valent polysaccharide (PPV23) pneumococcal vaccine, but this recommendation has not been extensively shared by international health authorities. The present meta-analysis was therefore designed to collect available evidence on the occurrence of pneumococcal infection and IPD among welders and workers exposed to welding fumes, in order to ascertain the effective base of evidence for this recommendation. PubMed, Embase and MedRxiv databases were searched without a timeframe restriction for the occurrence of pneumococcal infections and IPD among welders and workers exposed to metal dusts, and articles meeting the inclusion criteria were included in a random-effect meta-analysis model. From 854 entries, 14 articles (1.6%) underwent quantitative analysis, including eight retrospective studies (publication range: 1980–2010), and six reports of professional clusters in shipbuilding (range: 2017–2020). Welders had an increased likelihood of developing IPD compared with non-welders (odds ratio 2.59, 95% CI 2.00–3.35, I<sup>2</sup> = 0%, <i>p</i> = 0.58), and an increased likelihood of dying from IPD (standardized mortality ratio (SMR) 2.42, 95% CI 1.96-2.99, I<sup>2</sup> = 0%, <i>p</i> = 0.58). Serotype typing was available for 72 cases, 60.3% of which were represented by serotype 4, followed by 12F (19.2%) and serotype 8 (8.2%). Although the available data derive from a limited number of studies, available results suggest that pneumococcal vaccination should be recommended for workers exposed to welding fumes, and vaccination strategies should consider the delivery of recombinant formulates in order to combine the direct protection against serotypes of occupational interest with the mucosal immunization, reducing the circulation of the pathogen in occupational settings characterized by close interpersonal contact. |
| first_indexed | 2024-03-10T21:52:55Z |
| format | Article |
| id | doaj.art-ca216c61f27f4564b1f6434b3ec67b06 |
| institution | Directory Open Access Journal |
| issn | 2076-393X |
| language | English |
| last_indexed | 2024-03-10T21:52:55Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj.art-ca216c61f27f4564b1f6434b3ec67b062023-11-19T13:19:45ZengMDPI AGVaccines2076-393X2023-09-01119149510.3390/vaccines11091495Vaccinating Welders against Pneumococcus: Evidence from a Systematic Review and Meta-AnalysisMatteo Riccò0Pietro Ferraro1Salvatore Zaffina2Vincenzo Camisa3Federico Marchesi4Davide Gori5Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), AUSL-IRCCS di Reggio Emilia, Via Amendola n.2, I-42122 Reggio Emilia, ItalyOccupational Medicine Unit, Direzione Sanità, Italian Railways’ Infrastructure Division, RFI SpA, I-00161 Rome, ItalyOccupational Medicine Unit, Bambino Gesù Children’s Hospital IRCCS, I-00152 Rome, ItalyOccupational Medicine Unit, Bambino Gesù Children’s Hospital IRCCS, I-00152 Rome, ItalyDepartment of Medicine and Surgery, University of Parma, Via Gramsci, 14, I-43126 Parma, ItalyDepartment of Biomedical and Neuromotor Sciences, University of Bologna, I-40126 Bologna, ItalyWorkers occupationally exposed to welding dusts and fumes have been suspected to be at increased risk of invasive pneumococcal disease (IPD). Since the 2010s, the United Kingdom Department of Health and the German Ständige Impfkommission (STIKO) actively recommend welders undergo immunization with the 23-valent polysaccharide (PPV23) pneumococcal vaccine, but this recommendation has not been extensively shared by international health authorities. The present meta-analysis was therefore designed to collect available evidence on the occurrence of pneumococcal infection and IPD among welders and workers exposed to welding fumes, in order to ascertain the effective base of evidence for this recommendation. PubMed, Embase and MedRxiv databases were searched without a timeframe restriction for the occurrence of pneumococcal infections and IPD among welders and workers exposed to metal dusts, and articles meeting the inclusion criteria were included in a random-effect meta-analysis model. From 854 entries, 14 articles (1.6%) underwent quantitative analysis, including eight retrospective studies (publication range: 1980–2010), and six reports of professional clusters in shipbuilding (range: 2017–2020). Welders had an increased likelihood of developing IPD compared with non-welders (odds ratio 2.59, 95% CI 2.00–3.35, I<sup>2</sup> = 0%, <i>p</i> = 0.58), and an increased likelihood of dying from IPD (standardized mortality ratio (SMR) 2.42, 95% CI 1.96-2.99, I<sup>2</sup> = 0%, <i>p</i> = 0.58). Serotype typing was available for 72 cases, 60.3% of which were represented by serotype 4, followed by 12F (19.2%) and serotype 8 (8.2%). Although the available data derive from a limited number of studies, available results suggest that pneumococcal vaccination should be recommended for workers exposed to welding fumes, and vaccination strategies should consider the delivery of recombinant formulates in order to combine the direct protection against serotypes of occupational interest with the mucosal immunization, reducing the circulation of the pathogen in occupational settings characterized by close interpersonal contact.https://www.mdpi.com/2076-393X/11/9/1495pneumococcus<i>Streptococcus pneumoniae</i>invasive pneumococcal diseaseoccupational diseaseprevalence |
| spellingShingle | Matteo Riccò Pietro Ferraro Salvatore Zaffina Vincenzo Camisa Federico Marchesi Davide Gori Vaccinating Welders against Pneumococcus: Evidence from a Systematic Review and Meta-Analysis Vaccines pneumococcus <i>Streptococcus pneumoniae</i> invasive pneumococcal disease occupational disease prevalence |
| title | Vaccinating Welders against Pneumococcus: Evidence from a Systematic Review and Meta-Analysis |
| title_full | Vaccinating Welders against Pneumococcus: Evidence from a Systematic Review and Meta-Analysis |
| title_fullStr | Vaccinating Welders against Pneumococcus: Evidence from a Systematic Review and Meta-Analysis |
| title_full_unstemmed | Vaccinating Welders against Pneumococcus: Evidence from a Systematic Review and Meta-Analysis |
| title_short | Vaccinating Welders against Pneumococcus: Evidence from a Systematic Review and Meta-Analysis |
| title_sort | vaccinating welders against pneumococcus evidence from a systematic review and meta analysis |
| topic | pneumococcus <i>Streptococcus pneumoniae</i> invasive pneumococcal disease occupational disease prevalence |
| url | https://www.mdpi.com/2076-393X/11/9/1495 |
| work_keys_str_mv | AT matteoricco vaccinatingweldersagainstpneumococcusevidencefromasystematicreviewandmetaanalysis AT pietroferraro vaccinatingweldersagainstpneumococcusevidencefromasystematicreviewandmetaanalysis AT salvatorezaffina vaccinatingweldersagainstpneumococcusevidencefromasystematicreviewandmetaanalysis AT vincenzocamisa vaccinatingweldersagainstpneumococcusevidencefromasystematicreviewandmetaanalysis AT federicomarchesi vaccinatingweldersagainstpneumococcusevidencefromasystematicreviewandmetaanalysis AT davidegori vaccinatingweldersagainstpneumococcusevidencefromasystematicreviewandmetaanalysis |