Abstract
Additive manufacturing (AM) includes a series of techniques used to create products, in several different materials, such as metal, polymer or ceramics, with digital models. The main advantage of AM is that it allows the creation of complex structures, but AM promises several additional advantages including the possibility to manufacture on demand or replacing smaller worn parts by directly building on an existing piece. Therefore, the interest for and establishment of AM is rapidly expanding, which is positive, however it is important to be aware that new techniques may also result in new challenges regarding health and safety issues. Metals in blood and possible clinical effects due to metal exposure were investigated in AM operators at one of the first serial producing AM facilities in the world during two consecutive years with implementation of preventive measures in-between. As comparison, welders and office workers as control group were investigated. Health investigations comprised of surveys, lung function tests, antioxidant activity and vascular inflammation as well as renal- and hepatic function analysis. AM operators had significantly reduced nickel levels in blood (10.8 vs 6.2 nmol/L) as well as improved lung function (80 vs 92% of predicted) from year 1 to year 2. This is in line with previously published results displaying reduced exposure. Blood cobalt and nickel levels correlated with previously reported urinary levels, while blood chromium did not. Multivariate modelling showed that blood cobalt, antioxidant/inflammatory marker serum amyloid A1/serum paraoxonase/arylesterase 1 activity and the hepatic markers aspartate transaminase, alanine transaminase, and alkaline phosphatase were higher in AM operators compared to controls. The study show that the selected clinical analyses could function as a complement to metal analyses in biological fluids when investigating exposure-related health effects in AM operators. However, validation in larger cohorts is necessary before more definite conclusions could be drawn.
Highlights
Additive manufacturing (AM) is represented by a series of techniques used to create products, with several different materials such as metals, polymers or ceramics, from the bottom-up using digital models [1]
All operators working at the AM facility at year 1 were invited to participate in the study, at year 2, the number of AM operators was restricted to 12 volunteers
All participants that experienced problems with draft/air movement were enrolled in year 2, and a statistical comparison showed that AM operators enrolled year 2 had significantly more problems than those enrolled year 1 (p
Summary
Additive manufacturing (AM) is represented by a series of techniques used to create products, with several different materials such as metals, polymers or ceramics, from the bottom-up using digital models [1]. Access to guidelines for exposure related health effects in AM environments is still limited. An experimental exposure study of volunteers to polymer materials for 1 h showed no acute effect on inflammatory markers in nasal secretions or urine but increased exhaled nitric oxide [6]. Since metal AM involve both ultrafine and fine metal particles, and in general similar elements as can be found in metal production environments, it could be expected that AM operators have similar exposure related health risks as other metalworkers [7,8]. The risk of negative effects on renal function as result of chromium exposure [16] and hepatotoxic effects as result of chromium exposures have been suggested [17]
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