Welding fumes are a risk factor for welder pneumoconiosis. However, there is a lack of population information on the occurrence of welding fume-induced lung cancer, and little is known about the welding fume pathogenesis. Welding fume and metal ion concentrations were assessed in a vehicle factory in Wuhan. A Cox regression model estimated lung-related disease risk in workers by independent and combined factors. Workers' exposures were divided into four grades; the highest exposure was among the welders in the maintenance workshop, the highest Mn and Fe exposure was 4 grades, and the highest Cr exposure was 3 grades. Subgroup analysis found that the risk of lung-related disease was 2.17 < in welders compared with non-welders, and the risk of pulmonary disease in male welders was 2.24 < compared to non-welders. Smoking welders had a 2.44 < higher incidence of lung-related diseases than non-welders. Total years of work as an independent protective factor for lung-related disease risk was 0.72 < . As an independent risk factor, high-high and high-low exposure had a 5.39 < and 2.17 < higher risk for lung-related diseases, respectively. High welding fume exposure is a significant risk factor for lung-related disease in workers.