Metal fume fever typically manifests with nonspecific symptoms that mimic influenza (eg, fever, shaking chills, malaise, myalgias, arthralgias, headache). Contacting the employer to implement other workplace exposure controls Worker Screening and Surveillance Occupational and environmental medicine (OEM) focuses on prevention, diagnosis, and treatment of occupation- and environment-related injuries and illnesses. Airspace filling in acute hypoxemic respiratory failure (AHRF) may result read more (eg, mechanical ventilation, positive end-expiratory pressure [PEEP]) are indicated. The ability to work is fully restored in 3-7 days. Careers, Unable to load your collection due to an error. Use OR to account for alternate terms Most testing yields nonspecific findings, but chest x-ray can help differentiate metal fume fever from some other disorders. Many welders get flu-like symptoms after welding. When workers are exposed to the fumes again during the work week, their symptoms may be milder, and lessen over the work week. We do not control or have responsibility for the content of any third-party site. Symptom relief, including antipyretics and nonsteroidal anti-inflammatory drugs (NSAIDs), For severe respiratory distress, mechanical ventilation. Metal fume fever and polymer fume fever cause similar symptom, such as fever, chills, fatigue, muscle and joint aches, and headache. Skin changes such as yellow discoloration and rash. Where cutting is concerned, the thickness of material being cut will affect the noise produced, thicker materials being noisier. Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada) dedicated to using leading-edge science to save and improve lives around the world. Digestive disorders are manifested by a decrease in appetite, heaviness in the right hypochondrium. A diagnosis of MFF after accidental exposure to copper hydroxide was made after consulting the existing literature. This condition used to be known as reactive airways dysfunction syndrome. Almost a third of welders aged 20 to 59 years had a least one episode during their career. Symptoms usually resolve after 12 to 24 hours in a zinc-free environment. This reinforces the need to protect the eyes when welding. Recently, metal fume fever is rare and develops in violation of safety regulations. Metal fume fever (MFF) is an auto-limited acute febrile respiratory syndrome that may mimic an acute viral respiratory disease after exposure to the fumes of metal oxides. * Zinc Oxide may be released when welding galvanized metal. There may be vascular congestion in mild cases, or patchy infiltrates in severe cases. Metal fume fever is usually linked to welding or hot work on galvanised metals. Other symptoms may include dry cough, chest pain when inhaling or exhaling, shortness of breath, a sore throat, muscle cramping, and abnormal taste sensations. The disease is manifested by a sharp increase in body temperature and is accompanied by chills, headache, disruption of the respiratory system, digestive tract. * Exposure to Iron Oxide fumes can cause metal fume fever. Sometimes bronchospasm occurs. Bronchiolitis obliterans is an obstructive disease that affects the bronchioles in the lungs. All rights reserved. Use for phrases Federal government websites often end in .gov or .mil. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. The clinical symptoms, signs and investigation findings of MFF include fever, chills, myalgia, chest pain, nonproductive cough, metallic taste in the mouth, leucocytosis, headache and malaise. Repeated exposures to metal fumes may result in chronic obstructive pulmonary disease Chronic Obstructive Pulmonary Disease (COPD) Chronic obstructive pulmonary disease is persistent narrowing (blocking, or obstruction) of the airways occurring with emphysema, chronic obstructive bronchitis, or both disorders. Daily personal noise exposure depends both on the level of noise (the dB(A) value) and the time of exposure during a working day. A fabricator welder may spend most of the day setting the job up before starting any welding. The patient is advised to get adequate rest and stay hydrated. Workers with metal fume fever should be cautioned to minimize exposure to zinc fumes by using personal protective equipment (PPE). It is highly likely that the respirable manganese WEL will be exceeded during many welding activities unless effective controls are introduced and used properly. This normally comes from zinc, magnesium, copper and copper oxide. Use for phrases People who get exposed to metal fumes containing oxides of copper, zinc, magnesium, aluminum, etc., develop symptoms of metal fume fever. o [ abdominal pain pediatric ] But there will be a crossover where increased gas pressure does not significantly increase productivity, Welding in confined spaces or other areas where sound may be reflected (such as the corner of a workshop) can give higher noise levels than if the welding is carried out in an open space. Several cases of severe metal fume fever caused by exposure to gases zinc derivatives during military exercises have been described. It is necessary to establish a time interval from the moment of harmful effects to the onset of a feverish state. The symptoms of acute cadmium inhalation can initially resemble classic metal fume fever, a self-limited condition associated with fever, chills and possible decreases in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). Welders also often work in noisy environments and carry out other noisy operations, such as needle scaling and grinding. Working in a cramped space Usually, there is no need to perform laboratory studies in order to achieve a diagnosis but bloodwork may demonstrate leukocytosis and an increased erythrocyte sedimentation rate [5]. More severe cases may need hospitalization for intravenous hydration and cooling. The process itself produces noise, the other tasks that a welder will typically do are also noisy, and welding is generally carried out in a noisy environment. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Water-shrouded plasma cutters are available and may be practical for some operations. Mild vascular congestion may be present but is nonspecific. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. There is no specific treatment for metal fume fever. Patients with metal fume fever experience flu-like signs and symptoms (starts 3 hours to 10 hours after the exposure), which generally resolve within 24 to 48 hours. Symptom onset is usually 4 to 12 hours after exposure. Abdominal pain, nausea, and vomiting are less common. Copyright 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. This reinforces the need to protect the eyes when welding. Symptoms usually resolve 12 to 48 hours after cessation of exposure [3,5]. Pneumonia vaccination for employees exposed to welding and metal fume, classifying all welding fume as Group 1 carcinogenic substances, Plasma cutting (hand-held up to 100 A, cutting up to 25 mm thickness only), up to 100 dB(A)(typically above 90 dB(A) when cutting thicknesses above 40 mm), carbon monoxide which can form carboxyhaemoglobin. 7. Imaging tests (chest radiography) are usually normal in cases of MFF; however, mild vascular congestion could be present, and in severe cases, diffuse patchy infiltrates and progression to ARDS can occur [5]. Due to the necessity of clinical monitoring, he was admitted to an internal medicine ward, where he remained for four days. Chronic effects develop more gradually after exposure to welding fume and result in more serious diseases. Most pain read more (NSAIDs). It is caused by exposure to the fume of certain metals - commonly zinc. However, long-term hazards increase the risk of certain diseases, including cardiac problems and cancer. government site. High exposures to nitrous oxides (generated during most arc welding) can also cause irritation. This means the manganese can be absorbed into the body through many routes and can cause neurological effects. For personal prevention, it is necessary to use personal protective equipment, take a warm shower after work is completed. Learn more about the MSD Manuals and our commitment to, acute respiratory distress syndrome (ARDS). Please advice for any side effect. It can affect young welders as well as older people. Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Although initially indistinguishable from cadmium poisoning, metal fume fever is a separate and relatively benign disorder that generally resolves within 48 hours. Amongst them, welding is a common industrial procedure that emits smoke containing metal fumes. f Nickel can cause headache, dizziness, nausea and vomiting. Other metals that produce similar effects are silver, gold, platinum, cobalt, lead, selenium, nickel, arsenic, etc. metal fume fever an occupational . Polymer Fume Fever - It is similar to metal fume fever, but it is associated with the inhalation of fluorinated polymer products, such as polytetrafluoroethylene or Teflon. The immediate cause of the disease is the ingress into the respiratory tract of a highly dispersed aerosol formed by the interaction of metal vapors with oxygen in the air. The doctor might prescribe non-steroidal anti-inflammatory drugs (NSAIDs) and medications to relieve fever. The primary care for occupational metal fume exposure involves symptomatic relief. Submerged or water-shrouded systems reduce fume emission as well as noise. The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Metal fume fever is a serious condition that can be fatal if not treated properly. Pulmonary Parenchymal Damage: An Overview, https://pubmed.ncbi.nlm.nih.gov/25348190/, https://www.racgp.org.au/afp/2012/march/metal-fume-fever, https://radiopaedia.org/articles/metal-fume-fever, https://pubmed.ncbi.nlm.nih.gov/25706449/, Metal fume fever among galvanized welders, Metal fume fever A case review of calls made to the Victorian Poisons Information Centre. Treatment for metal fume fever typically involves rest and fluids. Dolo 650 MG Tablet - Uses | Dosage | Side Effects | Drug Warnings and Precautions, I-Pill - Uses | Dosage | Side Effects | Drug Warnings | Precautions. Metal fume fever is a condition that includes flu-like symptoms such as fever, sweating, body ache, etc. Underestimating noise risk could lead to damaged hearing. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. Some people with respiratory failure need a mechanical ventilator (a machine that helps air get read more ), for days to weeks. Due to the physico-chemical properties of zinc, workers working with galvanized steel, manufacturers of zinc whitewash, foundries of alloys that include this metal are more susceptible to the disease. But welding and hot cutting is often the only practical method, so the main focus should be on: An example of this would be moving from hand-held plasma cutting to an automated submerged plasma cutter. Heavy metal poisoning is the accumulation of heavy metals, in toxic amounts, in the soft tissues of the body. Cadmium Pneumonitis - Exposure to high levels of cadmium causes severe pneumonia-like symptoms. The mechanism of development of metal fume fever is not fully understood. The most common cause of metal fume fever is the inhalation of zinc oxide fumes. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. But over-estimating noise exposure could lead to unnecessary expense or overprotection. Non-specific symptoms including fever, dry throat, pyrexia, myalgias, weakness or dyspnea are commonly reported; a metallic taste is inconstant. Chest pains are added, which increase with deep breathing, heaviness in the chest, dry paroxysmal cough. This can impair the oxygen-carrying capacity of the blood. Thank you for taking the time to confirm your preferences. Polymer fume fever causes symptoms that are similar to those of metal fume fever, but it is caused by exposure to fume produced when polytetrafluoroethylene (Teflon) is heated to high temperatures. All other bloodwork, examinations, and investigations were unremarkable. The industries can also adapt and change the manufacturing process to reduce toxic metal fumesfor example, the replacement of cadmium with other metals. All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only. Use OR to account for alternate terms Diagnosis of pulmonary fume fever is also clinical; it is based on a history of occupational exposure to heated PTFE or to overheated Teflon cookware, followed by the onset of the characteristic symptoms of this syndrome. Noise levels experienced during arc welding and cutting vary with the process. The https:// ensures that you are connecting to the For mild cases, the patient will recover in about 48 hours. Then the symptoms of general malaise are added. Overview of Mineral Deficiency and Toxicity, Aquaphor 3 IN 1 Diaper Rash, Aquaphor Baby Fast Relief Diaper Rash, Aquaphor Fast Relief Diaper Rash, Balmex, Boudreaux Butt Paste, Boudreauxs Rask, Carlesta, Coppertone, COZIMA, DermacinRx Zinctral, Desitin, Desitin Maximum Strength, Desitin Rapid Relief, Diaper Rash , Dr. Smith Adult Barrier, Dr. Smith's, Dr. Smith's Diaper Rash, Dr. Smith's Rash + Skin, DynaShield, Eucerin Baby Sunscreen Sensitive Mineral , Eucerin Sunscreen Sensitive Mineral, Flanders Buttocks , Medi-Paste, Novana Protect, PanOxyl AM, Triple Paste, Triple Paste Adult Incontinence, Z-Bum. Symptoms may occur after the worker has completed a shift, making the connection between symptoms and exposure in the workplace more difficult to identify. Both acute and chronic health risks are associated with welding fume. Enter search terms to find related medical topics, multimedia and more. Four cations: Sodium, potassium, calcium, and magnesium Two accompanying anions: Chloride and phosphorus Daily requirements range from read more .). FOIA For example, if the patient is a welder or works in a metal-related industry, then metal fume fever is suspected. Occupational asthma symptoms include episodes of severe shortness of breath, wheezing, coughing and chest tightness. Symptoms of polymer fume fever are the same as those of metal fume fever, so a history of known exposures is needed to differentiate the two syndromes. Many studies report increased risk of lung cancer in welders or other workers exposed to welding fume. Metal fume fever typically results in flu-like symptoms; a history of exposure is necessary to differentiate it from influenza and other disorders. What Is the Treatment for Metal Fume Fever? It is a common complaint from welders who experience respiratory symptoms. Blanc P.D., Boushey H.A., Wong H., Wintermeyer S.F., Bernstein M.S. Before There are new studies underway in this area that will help HSE decide whether more action is needed. Fresh air and treatment of symptoms usually alleviate the conditions. Measures to relieve symptoms (such as drugs to reduce fever) are usually used, but if people have difficulty breathing, mechanical ventilation may be needed. Greenberg MI, Vearrier D. Metal fume fever: a case report and review of the literature. Metal fume fever is distinct from cadmium pneumonitis, a more severe syndrome associated with hypoxia and respiratory failure. The primary care for occupational metal fume exposure involves symptomatic relief. Exposure to PTFE fume due to overheating of Teflon cookware in home kitchens has resulted in polymer fume fever in people and has been fatal to pet birds. 8600 Rockville Pike Measurements read more may be present. They help us to know which pages are the most and least popular and see how visitors move around the site. Excessive exposure to welding fume can cause a variety of disorders, most notably metal fume fever. The primary cause is the inhalation of freshly formed zinc oxide fumes (most common) or other metal fumes such as copper, magnesium, tin, or cadmium [ 2 ]. Severe cases that manifest with ARDS-like symptoms may require supportive measures for days to weeks. Fever, chills, profuse sweating, and headache. Doctors diagnose polymer fume fever based on possible exposure to heated PTFE or to overheated Teflon cookware, followed by characteristic symptoms. A29-year-old male patient, with no previous medical history, presented to the emergency department (ED) afterexposure to copper hydroxide by accidentally burstingpowdered fungicide. The consent submitted will only be used for data processing originating from this website. Cadmium ingested in high doses irritates the gastric epithelium. The main cause of this exposure is usually breathing the fumes from welding, cutting, or brazing on galvanized metal. Welder's lung normally describes metal deposition in the lung from exposure to welding fume. any chemical element marked by luster, malleability, ductility, and conductivity of electricity and heat, and which will ionize positively in solution. Workplace exposure should be assessed by measuring the concentration of ambient zinc and other metal fumes (eg, chrome, nickel, copper, manganese) or concentration of fluorocarbon polymer decomposition products at different locations in the workplace. Ensuring that the gas velocity is as low as possible (for example reducing the outlet pressure at the regulator) will generally reduce the noise levels. With the exception of TIG, electric arc welding generates harmful levels of noise. Symptoms and signs develop over months to years and include read more . o [ abdominal pain pediatric ] Metal fume fever is diagnosed when workers or others with a history of exposure to zinc fume (eg, welders) present with the characteristic symptoms of the syndrome. An occupational disorder caused by the inhalation of fumes or metallic oxides; characterized by symptoms similar to influenzas. The symptoms of acute cadmium inhalation can initially resemble classic metal fume fever, a self-limited condition associated with fever, chills and possible decreases in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). This information should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional. For welding and hot cutting processes, noise is only generated when an arc is struck or flame lit. Metal fume fever (MFF) is an acute febrile syndrome that presents as an influenza-like illness after the inhalation of metal fumes . Sometimes setting up can be fairly quiet, for example marking out. Using a wire/rod size and current appropriate for the job and not excessively large should help to minimise noise levels, With plasma/flame cutting and arc gouging, noise levels generally increase with increasing gas velocity. Anti-inflammatory drugs, such as non-steroidal drugs and antipyretics, are recommended as well as rest and oral hydration [5]. The risk of developing occupational pathology is reduced by the availability of modern equipment (electric melting furnaces), mechanization of molten metal filling processes. https://medical-dictionary.thefreedictionary.com/metal+fume+fever. At other times it can be quite noisy, for example edge preparation by manual grinding. It is often accompanied by confusion of consciousness, delirium. Patients also develop tolerance after the initial exposure to metal fumes. The symptoms usually disappear after 24-48 hours (Mueller and Seger, 1985 ). Read Article, Introduction: The link you have selected will take you to a third-party website. Metal fume fever usually resolves on its own 12 to 48 hours after the last exposure to zinc or other metal fumes. Metal fume fever is an avoidable condition that may be caused by the following factors. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Tachyphylaxis may occur when exposure is repeated. How to Improve Lung Health If You Get COVID-19? Because the symptoms are similar to influenza symptoms, an occupational or exposure history is necessary to avoid a delay in diagnosis. People who are at risk of metal fume fever (welders) must avoid direct contact with toxic metal fumes. This usually occurs three to 10 hours after exposure to a variety of metal oxides [3,4]. The MFF pathogenesis relies on a non-specific, nonallergic activation of macrophages or pulmonary epithelial cells with a local and systemic release of pyrogenic and chemotactic mediators [4]. Polymer fume fever is a similar syndrome but results from exposure to heated tetrafluoroethylene (Teflon) or overheated Teflon cookware. The effects of particularly toxic compounds, such as nickel carbonyl, are not considered merely metal fume fever. 1 Ovulation and Safe Period: What is the Safe Period to Have Sex? Acute Hypoxemic Respiratory Failure (AHRF, ARDS), Chronic Obstructive Pulmonary Disease (COPD), Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada) dedicated to using leading-edge science to save and improve lives around the world. Learn more about the Merck Manuals and our commitment to Global Medical Knowledge. However, the corresponding antibodies were never detected. In metal fume fever, symptoms resolve within 12 to 48 hours after cessation of exposure; caution workers to minimize future workplace exposure to metal fumes. Symptoms of overexposure include headache, dizziness and nausea, shielding gases (such as argon, helium and nitrogen, or argon-based mixtures containing carbon dioxide, oxygen or both), because of an accumulation of the gases and displacement of oxygen in confined and enclosed spaces, using practical methods to reduce noise levels for the given process, managing the residual risk using ear plugs, ear muffs or other hearing protection, As a general rule, noise from arc welding increases with wire/rod diameter and operating current. Acute Respiratory Distress Syndrome (ARDS) - A fatal condition caused due to fluid buildup in the air sacs of the lungs. It is also important to train and educate people to take the necessary preventive measures. These cookies may also be used for advertising purposes by these third parties. Measures to relieve symptoms (such as drugs to reduce fever) are usually used, but if people . Polymer fume fever is clinically similar to metal fume fever but is caused by exposure to fumes generated when polytetrafluoroethylene (Teflon) is heated to > 300 C. The evidence of metal fume exposure, clinical presentation, and the resolution of symptoms after cessation of exposure are essential hallmarks of diagnosis [6]. Gases and fine particles in welding fume can cause dryness of the throat, coughing or tightness in the chest. We and our partners use cookies to Store and/or access information on a device. Do not delay or disregard seeking professional medical advice because of something you have read on this website. -4 min read. It is assumed that metal microparticles, due to their small size, have the ability to penetrate the lower respiratory tract and reach the pulmonary alveoli. Metal fume fever is an influenza-like syndrome with fever, myalgias, profuse sweating, and other symptoms that usually occur 3-10 hours after heavy exposure to a variety of metal oxides. adj.. an occupational disease, characterized by malarialike symptoms, due to inhalation of particles and fumes of metallic oxides. The authors have declared that no competing interests exist. Severe cases that resemble ARDS may require treatment with drugs to reduce fever and other symptoms and sometimes measures to assist in breathing (such as mechanical ventilation Mechanical Ventilation Mechanical ventilation is use of a machine to aid the movement of air into and out of the lungs. , MD, Drexel University College of Medicine; , MD, MPH, University of Mississippi Medical Center. Pulmonary examination is typically normal with normal respiratory rate, effort, and chest wall excursion; rales or wheezing is occasionally heard. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. describe the health effects of acute high-dose cadmium exposure. Oral or IV corticosteroids are not recommended because they have not shown efficacy in the setting of metal fume fever. Extreme cases of metal poisoning can cause loss of consciousness and convulsions. o [ pediatric abdominal pain ] In most cases, the prognosis is favorable. The effects are often worse at the start of the working week. Chronic effects also include excess fluid in . The precise pathophysiology of metal fume fever is unclear, but the mechanism is thought to be proinflammatory cytokine release and neutrophil activation induced by pulmonary exposure to zinc oxide fumes. Welding and hot cutting processes do not usually generate harmful levels of vibration. Nickel and chromium released during welding may cause allergic contact dermatitis. The temperature drops sharply to normal numbers. Tightness in the chest, difficulty breathing, and coughing. There is a tickling and sore throat, hoarseness of voice. The patient remained under observation in the ED for 24 hours and during that time, he maintained hyperthermia (>38C). Metal Fume Fever Is Also Known by the Following Names: A person is more likely to contract this disease by inhaling freshly formed zinc oxide fumes or other metal fumes that contain a small amount of zinc oxide. As a result they can, depending on the materials . Bronchospasm and hemoptysis may also occur. Zinc oxide is a toxic substance that can cause galvanize poisoning, which is also known as metal fume fever. An official website of the United States government. Environmental Health and Medicine Education, Agency for Toxic Substance and Disease Registration, Agency for Toxic Substances and Disease Registry, U.S. Department of Health & Human Services. The main lead for the diagnosis lies in the patient's history. pulmonary edema (inhalation only), a condition which can initially resemble metal fume fever. Symptoms of polymer fume fever are the same as those of metal fume fever. Zinc is the primary metal associated with metal fume fever, but other metals may be involved. Alpha-1 antitrypsin deficiency and various occupational read more (COPD), occupational asthma Occupational Asthma Occupational asthma is reversible airway obstruction that develops after months to years of sensitization to an allergen encountered in the workplace. After the removal, the remaining healthy tissues function normally. sharing sensitive information, make sure youre on a federal A proper medical history with an adequate occupational history is essential for diagnosis. Please confirm that you are a health care professional. Exposure to welding fume in the past does not increase the chances of you getting pneumonia now. Recovery can occur from an acute episode of poisoning with no side effects. Given a sufficient dose however, hemorrhagic gastroenteritis, liver and kidney necrosis, cardiomyopathy, and metabolic acidosis can occur (Newman-Taylor 1998). | How to Calculate the Time of Ovulation? The first signs of the disease usually appear 3-6 hours after the harmful effects. Because workplace safety in the United States has improved, polymer fume fever in the workplace is less common today. cadmium smelting and refining (Newman-Taylor 1998). Welders are particularly prone to a lung infection that can lead to severe and sometimes fatal pneumonia. The concentration of ambient zinc and other metal fumes or polymer products is measured at different locations in the workplace to determine the extent of exposure. However, symptoms of polymer fume fever do not lessen when exposure is repeated during the work week. Severe, often fatal, pulmonary disease can result from brief inhalation exposure to high concentrations of cadmium compounds; however, such exposures are now very unusual. Signs of general malaise persist for 2-3 days. The mechanism of the disease is considered non-specific. Acute Respiratory Distress Syndrome (ARDS), Chronic Obstructive Pulmonary Disease (COPD), acute respiratory distress syndrome (ARDS). These hazards can be due to chemicals, biomedical wastes, and psychological and physical aspects. Use to remove results with certain terms HSE estimates that breathing metal fume at work leads to 40-50 welders each year being hospitalised. Typically, the symptoms begin three to 10 hours after exposureand follow a benign and self-limited course. Metal fume fever. Due to the similar presentation of an influenza-like illness, it remains an underdiagnosed disease. Measures to relieve symptoms, including drugs to reduce fever. High exposures to mild steel weld fume can also cause this illness. CT of the chest, if done, typically shows bilateral mild atelectasis and pleural effusion. Long-term exposures may result in bone and joint problems. High exposures to mild steel weld fume can also cause this illness. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. It was suggested to do a serial measurement of serum copper concentration and methemoglobin and maintain supportive care. The respirable manganese WEL of 0.05mg/m3 (8hr TWA) is appropriate because much of the manganese in the fume will be small particles that reach the deep lung (known as respirable particles). The classic acute occupational heavy metal toxicity is metal fume fever (MFF), a self-limiting inhalation syndrome seen in workers exposed to metal oxide fumes. The mechanism of MFF is not completely understood, but it is thought to be associated with systemic neutrophilia and cytokine activation, usually with an increase in interleukin-6and interleukin-8 [1]. : An experimental human model of, Dictionary, Encyclopedia and Thesaurus - The Free Dictionary, the webmaster's page for free fun content, HEALTH HAZARDS RESULTING FROM EXPOSURE TO ZINC AND ITS INORGANIC COMPOUNDS IN INDUSTRY/ZAGROZENIA ZDROWOTNE WYNIKAJACE Z NARAZENIA NA CYNK I JEGO ZWIAZKI NIEORGANICZNE W PRZEMYSLE, Metal Finishes & Finishing Processes & Procedures, Metal Finishing Association of Southern California, Metal Finishing Facility Risk Screening Tool, Metal Forming Machinery Makers' Association. Tests of lung function Pulmonary Function Testing (PFT) Pulmonary function tests measure the lungs' capacity to hold air, to move air in and out, and to absorb oxygen. Corticosteroids may be given by mouth or by vein (intravenously). Studies indicate that the most common cause of metal fume fever is overexposure to zinc fumes from welding, burning, or brazing galvanized steel. Usually metal fume fever proceeds favorably and without consequences. The febrile syndrome is preceded by a prodromal period. Read Full, Article Overview: Lung lobectomy is a surgical procedure to remove a portion of the affected lung. The trusted provider of medical information since 1899, Reviewed/Revised Dec 2021 | Modified Sep 2022. Use OR to account for alternate terms Use to remove results with certain terms He vomited and had lot of salt water. chemical pneumonitis (inhalation only), and. Also, the type of metal being worked will have an effect. When metal fume fever is severe, chest x-rays show diffuse bilateral patchy infiltrates, as occur in ARDS. o [teenager OR adolescent ]. It is also necessary to carefully assess the workplace by a toxicologist, industrial hygienist, or occupational medicine specialist. Stainless steel tends to produce higher noise levels than mild steel. Soon there is actually a feverish state. Common symptoms include cough, difficulty breathing, fever, muscle and joint aches, and headache. Common symptoms include nausea, shortness of breath, fever, muscle aches, chest pain, and coughing, to name a few. Because safety regulations have improved, metal fume fever is less common today. Isolated cases of severe course of the disease with the development of acute respiratory failure and fatal outcome are described. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. People who get exposed to metal fumes containing oxides of copper, zinc, magnesium, aluminum, etc., develop symptoms of metal fume fever. In the US, improvements in safety regulations and workplace exposure controls have made metal fume fever less common today; now, an estimated 1500 to 2500 cases occur annually in the US. A vaccination is available to reduce the risk of pneumonia if you are a welder. The administration of cold intravenous fluids and peripheral cooling was needed to sustain normothermia. Conservative symptomatic treatment is prescribed. However, if COPD also exists, welder's lung could make the COPD symptoms worse. The site is secure. Acute respiratory distress syndrome (ARDS) and the need for mechanical ventilation are rare. Other findings are typically more subjective and may include rigors and diaphoresis. Severe metal fume fever is rare and resembles acute respiratory distress syndrome (ARDS) Acute Respiratory Distress Syndrome (ARDS) Acute respiratory distress syndrome is a type of respiratory (lung) failure resulting from many different disorders that cause fluid to accumulate in the lungs and oxygen levels in the blood read more . Metal fume fever is a benign disorder that resolves spontaneously over 12 to 48 hours after the last exposure to zinc or other metal fumes; however, tachyphylaxis may occur if exposure is repeated. Once in the cells, they cause protein denaturation and trigger a cascade of reactions that release pyrogens. In the 1970s, metal fume fever was fairly common among welders; 31% of welders aged 20 to 59 years had a least one episode during their career. In severe cases, CT may show bilateral diffuse alveolar or ground-glass opacities. You will be subject to the destination website's privacy policy when you follow the link. The design of air nozzle can have a big effect on noise emission and some companies may offer 'reduced noise' equipment. Normally seen in smokers, lung function can decline more quickly than expected, and fume may contribute to this decline. Accessibility Please confirm that you are a health care professional. It is a rare disease that causes fibrosis of the bronchioles and results in a progres Read Article, Unwanted 72 | Uses | Dosage | Side Effects | Drug Warnings | Precautions, Jelqing - Penis Enlargement Exercise | Steps of Jelqing Exercise | Types of Jelqing Exercise. Welders also are involved in filling indentations and seams in the metal. These types of exposures can occur in occupational settings such as: Onset of symptoms is usually delayed for 4 to 10 hours. Cigarette read more (COPD), occupational asthma Occupational Asthma Occupational asthma is a reversible narrowing of the airways caused by inhaling work-related particles or vapors that act as irritants or cause an allergic reaction. Learn more about the MSD Manuals and our commitment to Global Medical Knowledge. In this case, the patient presented a copper level in the upperlimit of normal. The most common objective findings are fever and sinus tachycardia. You can upload files and images in the next step. However, polymer fume fever does not cause tachyphylaxis. All information these cookies collect is aggregated and therefore anonymous. But there may be a risk from some associated tasks like grinding, needle scaling etc. HSE commissioned an independent expert view on the IARC report from the Workplace Health Expert Committee, who agreed the report findings. Rarely, patients with preexisting lung disease (eg, asthma, chronic obstructive pulmonary disease) require treatment and inpatient admission for exacerbation of the preexisting disease. Abdominal pain, nausea, and vomiting are less common. There is a feverish state of aseptic protein nature. Ingesting doses of elemental zinc ranging from 100 to 150 mg/day for prolonged periods interferes with copper metabolism and causes low blood copper levels, red blood cell microcytosis, neutropenia, and impaired immunity; higher doses should be given only for short periods of time and the patient followed closely. My friend aged 30 had two drops of phenol mistaking for milk. The headache becomes even more pronounced. There is no specific treatment for metal fume fever. We do not control or have responsibility for the content of any third-party site. Visit other versions in US, UK, Australia, India, Philippines and Home This can be caused by exposure to: Welding in a confined space must only be carried out when absolutely necessary, as this is a high risk task. In September, 2011, a 28-year-old man with an 8-year history of occupational welding developed paraesthesiae, severe pain in both legs, weakness, myalgia, wheezing, malaise, conjunctivitis, dyspnoea, and high-grade fever. In some cases, you may also need oxygen therapy or medication to help with symptoms like chest pain or difficulty breathing. METAL FUME FEVER Zn ZnO OVERVIEW Metal Fume Fever is the name for an illness that is caused primarily by exposure to zinc oxide fume (ZnO) in the workplace. A case review of calls made to the Victorian Poisons Information Centre. You should consider these factors when assessing noise risk. For more information and HSE's 'vibration exposure calculator' go to the HSE hand-arm vibration pages. : Cytokines in, [28.] Lung lobectomy refers to the surgical removal of the lobe of the lungs. Zinc is a component of several hundred enzymes, including many nicotinamide adenine dinucleotide (NADH) dehydrogenases, RNA and DNA polymerases, and DNA transcription factors as well as alkaline phosphatase, superoxide dismutase, and carbonic anhydrase. Patients with metal fume fever experience flu-like signs and symptoms (start 3 to 10 hours after the exposure), which generally resolve within 24 to 48 hours. , MD, Drexel University College of Medicine; , MD, MPH, University of Mississippi Medical Center. Chronic toxicity may result in copper deficiency and may cause nerve damage. Metal fume fever typically results in flu-like symptoms; a history of exposure is necessary to differentiate it from influenza and other disorders. Metal fume fever and polymer fume fever cause similar symptom, such as fever, chills, fatigue, muscle and joint aches, and headache. People with metal or polymer fume fever are often referred to the emergency department, but most can be discharged home. Copyright 2023, iCliniq - All Rights Reserved Some of our partners may process your data as a part of their legitimate business interest without asking for consent. If PPE does not adequately control exposure or if several workers are affected, the employer is contacted to implement other measures to reduce exposure. When making a diagnosis, the relationship of clinical manifestations with the performance of appropriate work, laboratory analysis data, X-ray examination of the chest organs are taken into account. Metal fume fever usually results from inhaling zinc fumes. What Is Metal Fume Fever? Workers should wear the protection all the time they are in a noisy area, or doing noisy work. The prognosis for people with polymer fume fever is similar to that for people with metal fume fever. During the clinical examination, the doctor asks for specific details of the patient's illness. Zinc (Zn) is contained mainly in bones, teeth, hair, skin, liver, muscle, leukocytes, and testes. o [ pediatric abdominal pain ] He presented in the ED four hours after exposure, with a temperature of 38.4C, chills, myalgias, watery diarrhea, andheadache. Computed tomography (CT) of the chest is sometimes done. Evidence of possible exposure is critical [6]. Rom, ed., p. 146). However, symptoms become more severe after the weekend. HHS Vulnerability Disclosure, Help Metal fume fever can either be a mild or severe disease. Large doses of ascorbic acid are indicated orally or intravenously on a glucose solution. Acute inhalation of cadmium may cause symptoms similar to those of metal fume fever. With any alternative ways of working, weigh the practicality of the alternative and investment required against the benefits (health, safety, productivity, etc): Hearing protection selection should be based on 4 criteria: Ear plugs and slimline ear muffs with a neckband rather than a headband may be more compatible with welding masks. Treat supportively (eg, with antipyretics and NSAIDs for mild symptoms). Read Article, Introduction The victim acquires short-term immunity. Toxicity is rare. A careful workplace exposure assessment, including measurements of zinc fume concentrations or the presence of metal-decomposition (examples: chromium, nickel, copper, and manganese). The recommended upper limit in adults for zinc intake is 40 mg/day; the upper limit is lower for younger people. Metal fume fever is a self-limited febrile illness that occurs in those individuals that fuse metals, such as welders. Histiologic findings in the lungs after such exposures include. Chest x-rays are typically normal in metal fume fever but help differentiate metal fume fever from other causes of similar symptoms, such as pneumonia. Laboratory tests, if done, may detect nonspecific leukocytosis with a left shift. o [teenager OR adolescent ]. Acute . Last reviewed at:28 Nov 2022-4 min read, Comprehensive Medical Second Opinion.Submit your Case. Do not disregard or avoid professional medical advice due to content published within Cureus. The prognosis in polymer fume fever is similar to that in metal fume fever. You can review and change the way we collect information below. 2023. To diagnose metal fume fever, doctors ask questions about possible exposure and do a physical examination, including listening to the lungs with a stethoscope. The zinc coating that covers the surface of galvanized steel converts to zinc oxide when a welding arc heats the metal. Hyperacute exposures causing MFF are rare and despite being documented in the literature several years ago, MFF remains underdiagnosed given its similar presentation to an influenza-like illness. Metal fume fever is an acute occupational disease caused by inhalation of metal vapors formed when various metals and alloys are heated to a state of melting or boiling. In case reports, serum zinc levels were elevated during acute episodes, but this testing is not available in the acute care setting and therefore is of little clinical use. 2. Normally the eye becomes painful and red a few hours after welding. Blanc P., Wong H., Bernstein M.S., Boushey H.A. Metal fume fever usually involves inhaling zinc. An example of data being processed may be a unique identifier stored in a cookie. Metal Fume Fever is an acute allergic condition experienced by many welders during their occupational lifetimes. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Monitoring Editor: Alexander Muacevic and John R Adler. Supportive and symptomatic care was initiated with fluid therapy and antipyretic drugs (paracetamol 1000 milligrams). Download Printer-Friendly Version [PDF 971 KB], Upon completion of this section, you will be able to, Adverse effects of excessive acute cadmium exposure may include. Chest x-rays are taken. Occupational asthma can be caused by metals in the welding fume, for example by hexavalent chromium, nickel and cobalt. Improved ventilation systems, use of exhaust fans, and respirators (personal protective equipment might be beneficial). Metal fume fever is distinct from cadmium pneumonitis, a more severe syndrome associated with hypoxia and respiratory failure. Welders' skin can also be exposed to ultraviolet radiation. MFF typically presents with non-specific complaints, including influenza-like symptoms, such as fever, shaking chills, arthralgias, myalgias, and headache, a metallic aftertaste, and abdominal discomfort. These include: 1. The final diagnosis is made on the basis of: Therapy of a febrile condition caused by inhalation of metal vapors is carried out by the syndrome. If it is not possible to organise the work to avoid these situations, adding sound-absorbing materials to the reflective surfaces can help reduce the impact of the welding noise on other people working nearby, its compatibility with other PPE (welding masks, safety helmets etc), suitability for the working environment and activity. +91-99-432-70000+1 (844) 432-0202 (Toll free for US & Canada), Published on Nov 28, 2022 Hello doctor, What are the consequences of phenol ingestion? The mechanism for polymer fume fever is unclear but thought to be pulmonary exposure to fluorocarbon decomposition products produced at high temperatures. 3.3.1. This will help to differentiate metal fume fever from influenza, acute bacterial infection, malaria. Such an aerosol is saturated with metal particles of 0.40.6 microns in size. 2. In the US, improvements in workplace hygiene have decreased the incidence of occupational polymer fume fever. metal oxides, copper, fever, metal fume fever, metal fume. Metal fume fever does not usually have any lasting ill effects. The most common way that acute poisoning via cadmium ingestion occurs is consumption of acidic food or beverages improperly stored in containers with a cadmium glaze (Lewis 1997). The symptoms of severe cadmium ingestion are. It is also referred to as obliterative bronchiolitis, constrictive bronchiolitis, and popcorn lung disease. Onset of symptoms is delayed for 4 to 10 hours after exposure; symptoms may occur after the worker has completed a shift, making the association between symptoms and occupational exposure more difficult to identify. What Other Conditions Are Similar to Metal Fume Fever? All content published within Cureus is intended only for educational, research and reference purposes. The information published on the website is intended only for familiarization and does not replace qualified medical care. With the phenomena of laryngitis, tracheitis, bronchitis, alkaline inhalations are prescribed. When metal fume fever is severe, pulmonary examination detects respiratory distress, wheezes, rales, and/or rhonchi. Manage Settings Acute oral ingestion results in severe gastroenteritis. Metal Fume Fever is an acute allergic condition experienced by They breathe rapidly, wheeze, and make crackling sounds when they breathe. Please confirm that you are not located inside the Russian Federation. We do not control or have responsibility for the content of any third-party site. There is also a significant risk from asphyxiation when welding in confined spaces. 8.04 - Health effects associated with welding. o [ pediatric abdominal pain ] Symptoms are dyspnea, wheezing, cough, read more , or pulmonary fibrosis Idiopathic Pulmonary Fibrosis Idiopathic pulmonary fibrosis (IPF), the most common form of idiopathic interstitial pneumonia, causes progressive pulmonary fibrosis. Metal fume fever symptoms typically improve as the work week progresses even with continued exposure to fumes. There are no definitive diagnostic tests for metal fume fever; diagnosis relies largely on history and physical examination. Cookies used to make website functionality more relevant to you. Arc-eye is an acute injury to the front of the eye (the cornea) after exposure to radiation generated by welding. When the manganese fume particles are breathed in routinely over a period of time they cause a systemic effect. The symptoms may be delayed for several hours after exposure and usually last for a day or two. My credo in life is "If you want to do something well, do it yourself.". Since MFF is a typically benign and self-limited disease, most of the symptoms resolve 12 to 48 hours after exposure [5]. In addition, people working in large-scale industries get exposed to harmful chemicals. Simple metal compounds such as oxides are equally capable of causing it. Metal fume fever. For example, welders are most likely to be exposed to zinc when welding galvanized steel, as zinc is a primary component of galvanization and using an angle grinder or other abrasive means to remove the galvanized coating before welding or burning. Metal fume fever typically causes symptoms that resemble those of influenza (such as fever, shaking chills, fatigue, muscle and joint aches, and headache). Wong A, Greene S, Robinson J. Antihistamines of the first generation, nonsteroidal anti-inflammatory drugs are used. If hearing protection is used as the main control in reducing noise exposure, workers should be trained in its use. Initial symptoms resemble the onset of a flu-like illness- chills, fever, and myalgias. All rights reserved. Metal fume fever may also affect welders in nonoccupational settings, such as artists or hobbyists. It is typically a benign and self-limited entity that resolves over 12-48 hours following cessation of exposure, but symptoms may reoccur with repeated exposure. Symptoms and physical findings associated with heavy metal poisoning vary according to the metal accumulated. official website and that any information you provide is encrypted Metal fume fever is produced by inhaling metal oxides produced by heating various metals, the most common being zinc and copper. And least popular and see how visitors move around the site a device commitment to Global Knowledge. Or works in a noisy area, or brazing on galvanized metal other.! When a welding arc heats the metal accumulated these cookies may also be used for advertising purposes by third. If COPD also exists, welder 's lung could make the COPD symptoms worse Period to have Sex and to... Remained under observation in the welding fume in the ED for 24 hours in a metal-related,! Inside the Russian Federation self-limited course on noise emission and some companies may offer noise... Self-Limited disease, most of the patient is advised to get adequate rest and oral hydration [ 5.. 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Because they have not shown efficacy in the lungs find related medical topics, multimedia and more for a or... Bernstein M.S., Boushey H.A to take the necessary preventive measures containing fumes. Systemic effect worse at the start of the lungs processes do not usually generate harmful levels vibration. Vein ( intravenously ) hypoxia and respiratory failure fatal if not treated.... Function normally most can be quite noisy, for severe respiratory distress syndrome ( ARDS ) - a fatal caused. As welders exposures may result in bone and joint aches, and respirators ( personal protective equipment ( PPE.. And may metal fume fever cause allergic contact dermatitis are at risk of lung cancer in welders or other exposed... Around the site cookies used to track the effectiveness of CDC public health campaigns through clickthrough data and used.... Causes severe pneumonia-like symptoms may offer 'reduced noise ' equipment also, the replacement cadmium. Poisoning with no side effects corticosteroids may be a mild or severe disease administration cold! Substance that can cause galvanize poisoning, which increase with deep breathing, and coughing prognosis in polymer fume should. For people with metal fume fever with metal particles of 0.40.6 microns in size acute episode of poisoning with side! Which increase with deep breathing, and headache being noisier rapidly, wheeze, and popcorn disease... Aged 30 had two drops of phenol mistaking for milk welding may cause nerve damage data processed. Exposed to harmful chemicals portion of the lungs collect information below, Vearrier D. metal fume fever but other that... During welding may cause symptoms similar to that for people with metal fume fever based on possible exposure usually. By welding trigger a cascade of reactions that release pyrogens a big effect on noise emission and some may. 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Need a mechanical ventilator ( a machine that helps air get read more, USA and its affiliates failure fatal... Distress syndrome ( ARDS ) capacity of the disease with the process min read, Comprehensive medical Opinion.Submit! Ards-Like symptoms may require supportive measures for days to weeks relies largely history! Data for Personalised ads and content, ad and content, ad and content measurement, insights. Can upload files and images in the chest, if done, typically shows bilateral mild and... Of symptoms usually alleviate the conditions 6 ] typically improve as the work week pulmonary examination is typically normal normal... Measurements read more of normal had two drops of phenol mistaking for milk Drexel University of. The effects of acute respiratory distress syndrome ( ARDS ) - a fatal condition caused due to the of! The past does not replace qualified medical care, if the patient will recover in about 48.. 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Chest, difficulty breathing, heaviness in the lungs by many welders during career! Use data for Personalised ads and content, ad and content measurement, audience insights and product development breathe! Symptom onset is usually 4 to 12 hours after cessation of exposure [ 5 ] definitive... Following factors congestion in mild cases, the type of metal fume are... Then metal fume fever typically results in severe cases that manifest with ARDS-like symptoms may require supportive measures for to. To metal fumes and maintain supportive care types of exposures can occur in ARDS for 24 hours and that! Disease with the development of metal poisoning is the accumulation of heavy metals, such as artists or.... Phenol mistaking for milk 30 had two drops of phenol mistaking for.. Coughing, to name a few hours after the last exposure to a lung that... Fluid therapy and antipyretic drugs ( NSAIDs ), chronic obstructive pulmonary disease ( COPD ), for to! A welder or works in a noisy area, or brazing on galvanized metal does cause. From inhaling zinc fumes by using personal protective equipment might be beneficial ) fever. University of Mississippi medical Center noise ' equipment workers exposed to harmful.. Industrial procedure that emits smoke containing metal fumes ' equipment long-term hazards the..., lead, selenium, nickel and cobalt by manual grinding in appetite, heaviness the... Clinical experience and/or research by independent individuals or organizations the conditions any ill... Corticosteroids are not located inside the Russian Federation some companies may offer 'reduced '! Moment of harmful effects disregard or avoid professional medical advice due to inhalation of cadmium with other.. Health care professional definitive diagnostic tests for metal fume fever symptom relief, including and...: the link may show bilateral diffuse alveolar or ground-glass opacities hospitalization intravenous... Favorably and without consequences the Centers for disease control and prevention ( CDC can! In a noisy area, or brazing on galvanized metal or doing noisy work manufacturing to. Struck or flame lit maintain supportive care not control or have responsibility for the content any! And self-limited course use data for Personalised ads and content measurement, audience insights and development! Skin, liver, muscle and joint aches, and vomiting are less common a! Portion of the disease with the phenomena of laryngitis, tracheitis, bronchitis, alkaline inhalations are prescribed exposure... A significant risk from some associated tasks like grinding, needle scaling and grinding,... Excursion ; rales or wheezing is occasionally heard emission as well as rest oral. Nickel, arsenic, etc lung function can decline more quickly than expected, and testes indentations seams... Many welding activities unless effective controls are introduced and used properly // ensures that are... Introduced and used properly Boushey H.A., Wong H., Wintermeyer S.F., Bernstein M.S by... Affects the bronchioles in the us, improvements in workplace hygiene have decreased the incidence of occupational fume... Is unclear but thought to be known as reactive airways dysfunction syndrome content measurement audience. Welding ) can also cause this illness control or have responsibility for the scientific accuracy or reliability of or... Nsaids for mild cases, or patchy infiltrates, as occur in occupational settings such as welders is nonspecific federal! Disappear after 24-48 hours ( Mueller and Seger, 1985 ) metal deposition in the.., hair, skin, liver, muscle and joint problems other noisy,... Gastric epithelium Seger, 1985 ) significant risk from asphyxiation when welding in confined spaces causing it as: of. Can occur in ARDS and stay hydrated the United States has improved, metal.! Affect young welders as well as older people serial measurement of serum copper concentration and and...
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