title: Occupational exposure to cobalt is not associated with incipient signs of dilated cardiomyopathy in a Belgian refinery.
abstract: BACKGROUND
  Excessive absorption of cobalt has been associated with cases of dilated cardiomyopathy in the past, but it is unclear whether occupationally exposed populations are at risk.
  
  
  OBJECTIVE
  To assess the possible relationship between occupational exposure to cobalt and incipient signs of dilated cardiomyopathy.
  
  
  METHODS
  A cross-sectional survey was conducted in a cobalt production facility in Belgium constituting one of the largest occupational populations worldwide (n=256 male workers). Exposure to cobalt was assessed by measuring urinary cobalt concentration (µg/gcreat), reflecting recent exposure, and by computing an integrated exposure index (µg/gcreat×years), reflecting long-term exposure. The effect on the myocardium was investigated by echocardiography and electrocardiography, and dose-effect relations with cobalt exposure were traced by multiple regression analysis.
  
  
  RESULTS
  No dose-effect relationship between exposure to cobalt and parameters reflecting dilated cardiomyopathy was found in a population of workers characterised by a median recent cobalturia of 4 µg/gcreat and a median long-term cobalturia of 100 µg/gcreat×years. A reduction in the dimensions of the left ventricular internal cavity was associated with recent exposure to cobalt.
  
  
  CONCLUSIONS
  Occupational exposure to cobalt does not appear associated with incipient signs of dilated cardiomyopathy within the gradient of exposure recorded in this population.
authors.affiliation: Louvain Centre for Toxicology and Applied Pharmacology, Institut de Recherche Expérimentale et clinique (IREC), Université catholique de Louvain, Brussels, Belgium.
authors.forename: Anne-Catherine
authors.initials: AC
authors.lastname: Lantin
authors.forename: Jan
authors.initials: J
authors.lastname: Vermeulen
authors.forename: Alex
authors.initials: A
authors.lastname: Mallants
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vanoverschelde
authors.forename: Niko
authors.initials: N
authors.lastname: Speybroeck
authors.forename: Bert
authors.initials: B
authors.lastname: Swennen
authors.forename: Perrine
authors.initials: P
authors.lastname: Hoet
authors.forename: Dominique
authors.initials: D
authors.lastname: Lison
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects / Q000032:analysis*; D001530:Belgium; D015415:Biomarkers / Q000097:blood; D002311:Cardiomyopathy, Dilated / Q000209:etiology / Q000652:urine; D002617:Chemical Industry; D003035:Cobalt / Q000009:adverse effects / Q000652:urine; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004452:Echocardiography; D004562:Electrocardiography; D006321:Heart / Q000187:drug effects*; D006352:Heart Ventricles / Q000187:drug effects; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009206:Myocardium; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D009790:Occupations; D055815:Young Adult
chemical_list: D000395:Air Pollutants, Occupational; D015415:Biomarkers; D003035:Cobalt