The Finnish Institute of Occupational Health and THL recommend pneumococcal vaccination for shipyard workers exposed to metal vapours

Publication date 17 Oct 2023

The Meyer Turku Oy shipyard is experiencing a pneumococcal disease outbreak with about a dozen cases of the disease. The Finnish Institute of Occupational Health and the Finnish Institute for Health and Welfare (THL) recommend pneumococcal vaccination for shipyard workers exposed to metal vapours as a precautionary occupational safety and health measure.

Scientific evidence has shown that welding work where various metal vapours are released to the respiratory air is associated with a heightened risk of pneumococcal pneumonia and, in particular, lobar pneumonia and invasive pneumococcal disease. 

Pneumococcal disease has been diagnosed in people other than welders at the Turku shipyard, primarily people who work in the same spaces as the welders, i.e. spaces where there metal vapours generated by welding are present. The congestion and poor ventilation of the working conditions increase the risk of contracting the disease. 

As part of their normal occupational safety and health obligations, the Turku Meyer shipyard and its networks have highlighted the importance of hygiene to their employees and made more hand sanitizer freely available. In addition, particular attention has been paid to the proper use of respirators. The shipyard recommends all people working at the shipyard to get vaccinated against pneumococcal disease.

Occupational safety and health measures have been planned in co-operation with the Wellbeing Services County of Southwest Finland, occupational health care professionals and officials.

Vaccinations protect against pneumococcal infections

Persons at a risk of contracting a pneumococcal infection in their work can be protected efficiently with vaccinations. A polysaccharide vaccine or conjugate vaccine will decrease the risk of a severe disease caused by most common types of pneumococci. In addition, conjugate vaccines can prevent pneumococcal infections and break possible chains of transmission as they reduce the throat carriage of pneumococcal bacteria covered by the vaccine. This provides indirect protection to unvaccinated employees and the general public. 

Employer carries out the risk assessment and occupational health services administer the vaccinations
As the hazards of the disease are work-related, the vaccinations are part of the occupational health services organized by the employer. The employer must assess work-related risks and offer employees the vaccinations required to be protected against them.

In addition to the vaccinations, it is important to carry out other protective measures to reduce the respiratory exposure of employees to welding vapours, metal dust, viruses and bacteria. 

The autumn’s influenza season also increases the risk of pneumococcal diseases at shipyards. 

Further information 

Heikki Frilander
Chief Physician
Finnish Institute of Occupational Health
tel. +358 (0)46 850 5040
[email protected]

Hille Suojalehto
Chief Physician
Finnish Institute of Occupational Health
tel. +358 (0)43 820 0363
[email protected]

Hanna Nohynek
Chief Physician,
THL
tel. +358 (0)29 524 8246
[email protected]

Pneumococcal vaccines (THL)

Literature

Palmer KT, Cosgrove MP. In-depth review. Vaccinating welders against pneumonia. Occupational Medicine 2012;62:325–330

Wong et al. Welders are at increased risk for invasive pneumococcal disease. Int J Infect Dis e796-9. 2010.
Cassir N, Luciani L, Ferrieux D, Levasseur A, Fournier P-E, Parola P. Pneumococcal pneumonia among shipyard workers: Inside the features of disease onset. Travel medicine and Infectious Disease https://doi.org/10.1016/j.tmaid.2021.102183 Nov-Dec 2021.

Linkevicius M, Cristea V, Siira L, Mäkelä H, Toropainen M, Pitkäpaasi M, Dub T, Nohynek H, Puumalainen T, Rintala E, Laaksonen ME, Feuth T, Grönroos JO, Peltoniemi J, Frilander H, Lindström I, Sane J. Outbreak of invasive pneumococcal disease among shipyard workers, Turku, Finland, May to November 2019. Euro Surveill. 2019 Dec;24(49):1900681. doi: 10.2807/1560-7917.ES.2019.24.49.1900681

Gladstone RA, Siira L, Brynildsrud OB, Vestrheim DF, Turner P, Clarke SC, Srifuengfung S, Ford R, Lehmann D, Egorova E, Voropaeva E, Haraldsson G, Kristinsson KG, McGee L, Breiman RF, Bentley SD, Sheppard CL, Fry NK, Corander J, Toropainen M, Steens A; Global Pneumococcal Sequencing Consortium. International links between Streptococcus pneumoniae vaccine serotype 4 sequence type (ST) 801 in Northern European shipyard outbreaks of invasive pneumococcal disease. Vaccine. 2022 Feb 11;40(7):1054-1060. doi: 10.1016/j.vaccine.2021.10.046. Epub 2022 Jan 5. PMID: 34996643; PMCID: PMC8820377.
 

Infectious diseases Infektiotaudit ja rokotukset rokotukset - Infectious diseases