Background: Molecular pathways found to be important in pulmonary fibrosis are also involved in cancer pathogenesis, suggesting common pathways in the development of pulmonary fibrosis and lung cancer.Research question: Is pulmonary fibrosis from exposure to occupational carcinogens an independent risk factor for lung cancer?Study design and methods: A comprehensive search of PubMed, Embase, Web of Science and Cochrane databases with over 100 search terms regarding occupational hazards causing pulmonary fibrosis was conducted. After screening and extraction, quality of evidence and eligibility criteria for meta-analysis were assessed. Meta-analysis was performed using a random-effects model.Results: 52 studies were identified for systematic review. Meta-analysis of subgroups identified silicosis as a risk factor for lung cancer when investigating odds ratios for silicosis in autopsy studies (OR 1.47, 95% CI 1.13–1.90) and for lung cancer mortality in patients with silicosis (OR 3.21, 95% CI 2.67–3.87). Only considering studies with an adjustment for smoking as a confounder identified a significant increase in lung cancer risk (OR 1.58, 95% CI 1.34–1.87). However, due to a lack of studies including cumulative exposure, no adjustments could be included. In a qualitative review, no definitive conclusion could be reached for asbestosis and silicosis as independent risk factors for lung cancer, partly because the studies did not take cumulative exposure into account.Interpretation: This systematic review confirms the current knowledge regarding asbestosis and silicosis, indicating a higher risk of lung cancer in exposed individuals compared to exposed workers without fibrosis. These individuals should be monitored for lung cancer, especially when asbestosis or silicosis is present.

Objective: Recently, the proinflammatory effects of welding fumes containing zinc and copper have been demonstrated. In the present study, it was investigated if the inflammation persists under repeated exposure. Methods: Fifteen healthy male subjects were exposed to 6 hours of exposure with zinc- and copper-containing welding fumes on 4 consecutive days under controlled conditions. Results: Inflammatory marker serum levels showed significant increases compared with baseline either 6 or 24 hours after the first exposure and stayed elevated for all following exposures. In nasal secret samples only C-reactive protein levels were increased compared with baseline. Conclusions: The current study demonstrates a persistent increase of systemic inflammatory markers indicating an elevated risk for welders chronically exposed to zinc- and copper-containing welding fumes. Topical inflammation of the upper airways did not occur.

In the isolation of polymorphonuclear neutrophils (PMNs) the technique and other external factors can have great influence on the quality and quantity of isolated neutrophils. To elucidate the influence of the blood collection technique, anticoagulants and storing temperature on isolated PMNs healthy volunteers provided blood samples with different needles and collection techniques, anticoagulants (EDTA, heparin, citrate) and storing temperatures (4, 22, 37 °C). From each blood sample PMNs were isolated and compared regarding number of PMNs and oxidative burst. The blood collection technique, anticoagulants and storing temperature had minor impact on isolated PMNs. All three tested cannulas and anticoagulants can be used to obtain blood samples for PMN isolation. For storing temperatures 37 °C should be preferred. Regarding time between the PMN isolation and the actual experiments, a time span of maximum 1 h should be targeted.

An asymptomatic systemic inflammation after exposure to zinc- and copper-containing welding fumes has been described as mild form of metal fume fever in recent studies. Since chronic systemic inflammation leads to a higher cardiovascular risk, examining the inflammation with the underlying pathomechanism is necessary to estimate and hopefully prevent long-term effects of welding. We established a whole blood assay to investigate the effects of zinc- and copper-containing welding fume particles on the blood immune response. Increased levels of IL-6, IL-8, TNFα and IL-1β determined after 24 hours of exposure indicated an acute systemic inflammatory reaction. In vitro increases of IL-6 were comparable to in vivo increases of serum IL-6 levels in a study with welding fume exposure of human subjects. Inhibition of PTP1B was identified as one pathway responsible for the effects of zinc- and copper-containing welding fumes and therefore welding fume fever. In conclusion, the whole blood assay is a reliable and feasible method to investigate effects of zinc- and copper-containing welding fumes on the immune system and as a surrogate for systemic inflammation and welding fume fever. Future research can utilize whole blood assays to reduce and partially replace human exposure studies for further investigations of welding fume fever.

Argon exerts neuroprotection. Thus, it might improve patients’ neurological outcome after cerebral disorders or cardiopulmonary resuscitation. However, limited data are available concerning its effect on pulmonary vessel and airways. We used rat isolated perfused lungs (IPL) and precision-cut lung slices (PCLS) of rats and humans to assess this topic. IPL: Airway and perfusion parameters, oedema formation and the pulmonary capillary pressure (P_cap) were measured and the precapillary and postcapillary resistance (R_post) was calculated. In IPLs and PCLS, the pulmonary vessel tone was enhanced with ET-1 or remained unchanged. IPLs were ventilated and PCLS were gassed with argon-mixture or room-air. IPL: Argon reduced the ET-1-induced increase of P_cap, R_post and oedema formation (p < 0.05). PCLS (rat): Argon relaxed naïve pulmonary arteries (PAs) (p < 0.05). PCLS (rat/human): Argon attenuated the ET-1-induced contraction in PAs (p < 0.05). Inhibition of GABA_B-receptors abolished argon-induced relaxation (p < 0.05) in naïve or ET-1-pre-contracted PAs; whereas inhibition of GABA_A-receptors only affected ET-1-pre-contracted PAs (p < 0.01). GABA_A/B-receptor agonists attenuated ET-1-induced contraction in PAs and baclofen (GABA_B-agonist) even in pulmonary veins (p < 0.001). PLCS (rat): Argon did not affect the airways. Finally, argon decreases the pulmonary vessel tone by activation of GABA-receptors. Hence, argon might be applicable in patients with pulmonary hypertension and right ventricular failure.

Background/Objectives: Artificial intelligence (AI) has evolved from early diagnostic expert systems to advanced generative models, such as GPT-4, which are increasingly being used in healthcare. Concerns persist regarding inaccuracies and input dependency. This study aimed to deliver initial insights into whether gender influences the interaction of medical professionals with generative AI. Methods: This analysis investigated gender differences in medical students’ and physicians’ interactions with ChatGPT-4 while researching occupational medicine cases in a randomized controlled study. Participants assessed cases involving asbestos-related disease, metal sulfate allergy, and berylliosis using ChatGPT. Inputs and outputs were evaluated for accuracy, confabulations, communication styles, and user satisfaction. Demographic data and self-assessments of occupational medicine knowledge before and after the tasks were also collected. Results: Among 27 participants (63% women, 37% men), women showed greater knowledge improvement after using ChatGPT, particularly in asbestos-related cancer identification. No significant gender differences emerged in diagnostic accuracy, reporting procedures, or satisfaction with ChatGPT. Women exhibited significantly higher self-rated competence after using the ChatGPT application, while men only showed minimal change. Input from the female participants led to more confabulations, although response accuracy remained comparable. Conclusions: This study offers the first real-world insights into the use of generative AI in occupational medicine, highlighting the importance of understanding user-dependent variability in AI-supported clinical practice and decision-making. These findings underscore the need for gender-sensitive AI literacy training in medical education, accommodating diverse interaction styles and strategies to mitigate AI-generated misinformation. Future research with larger and more diverse cohorts could provide deeper insights into the influence of gender, age, and experience on AI utilization in healthcare. Integrating gender-based interaction differences into AI training and applications may improve clinical performance and promote more equitable healthcare practices.