Introduction:
Occupational hazards are the risks and diseases associated with a particular occupation. These hazards can be due to chemicals, biomedical wastes, and psychological and physical aspects. These hazards can affect the long-term (chronic) or short-term (acute). For example, sudden accidents at the workplace include physical and chemical injuries. However, long-term hazards increase the risk of certain diseases, including cardiac problems and cancer. In addition, people working in large-scale industries get exposed to harmful chemicals. Amongst them, welding is a common industrial procedure that emits smoke-containing metal fumes.
What Is Metal Fume Fever?
Metal fume fever is a condition that includes flu-like symptoms such as fever, sweating, body ache, etc. It is a common complaint from welders who experience respiratory symptoms. People who get exposed to metal fumes containing oxides of copper, zinc, magnesium, aluminum, etc., develop symptoms of metal fume fever. Other metals that produce similar effects are silver, gold, platinum, cobalt, lead, selenium, nickel, arsenic, etc. From the base metal, plating, or filler, welders routinely come into contact with substances that may cause 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 Is Also Known by the Following Names:
1. Founder's ague.
2. Brass shakes.
3. Zinc shakes.
4. Galvie flu.
5. Galvo poisoning.
6. Metal dust fever.
7. Welding shivers.
8. Monday morning fever.
What Causes Metal Fume Fever?
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. The mechanism of the disease is considered non-specific. Activation of white blood cells and chemical mediators that cause local inflammation in the respiratory tissue is responsible for the symptoms. Although the symptoms might appear severe, it is usually self-resolving. Patients also develop tolerance after the initial exposure to metal fumes.
What Are the Symptoms of Metal Fume Fever?
Patients with metal fume fever experience flu-like signs and symptoms (which starts 3 hours to 10 hours after the exposure), which generally resolve within 24 to 48 hours. These include:
1. Fever, chills, profuse sweating, and headache.
2. Nausea, vomiting, loss of appetite, and diarrhea.
3. Body aches, joint pain, and fatigue.
4. Tightness in the chest, difficulty breathing, and coughing.
5. Blood pressure changes, dizziness.
6. Pneumonia-like symptoms.
7. Skin changes such as yellow discoloration and rash.
8. Extreme cases of metal poisoning can cause loss of consciousness and convulsions.
How Is Metal Fume Fever Diagnosed?
The main lead for the diagnosis lies in the patient's history. During the clinical examination, the doctor asks for specific details of the patient's illness. The occupation of the patient reveals details of the condition. For example, if the patient is a welder or works in a metal-related industry, then metal fume fever is suspected. Additionally, the patient's personal history and the history of signs and symptoms are correlated to arrive at the diagnosis. For example, conventional chest radiographs (X-rays) might demonstrate lung changes that indicate respiratory illness. There may be vascular congestion in mild cases, or patchy infiltrates in severe cases.
What Is the Treatment for Metal Fume Fever?
There is no specific treatment for metal fume fever. The primary care for occupational metal fume exposure involves symptomatic relief. The doctor might prescribe non-steroidal anti-inflammatory drugs (NSAIDs) and medications to relieve fever. The patient is advised to get adequate rest and stay hydrated. It is also necessary to carefully assess the workplace by a toxicologist, industrial hygienist, or occupational medicine specialist.
How to Prevent Metal Fume Fever?
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A careful workplace exposure assessment, including measurements of zinc fume concentrations or the presence of metal decomposition (examples: chromium, nickel, copper, and manganese).
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People who are at risk of metal fume fever (welders) must avoid direct contact with toxic metal fumes.
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Improved ventilation systems, use of exhaust fans, and respirators (personal protective equipment might be beneficial).
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It is also important to train and educate people to take the necessary preventive measures.
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The industries can also adapt and change the manufacturing process to reduce toxic metal fumes—for example, the replacement of cadmium with other metals. For example, cadmium can be replaced by zinc or nickel plating, and the filler alloys used in brazing no longer contain heavy metals.
What Are Other Conditions Are Similar to Metal Fume Fever?
1. 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.
2. Cadmium Pneumonitis - Exposure to high levels of cadmium causes severe pneumonia-like symptoms.
3. Acute Respiratory Distress Syndrome (ARDS) - A fatal condition caused due to fluid buildup in the air sacs of the lungs.
4. Pulmonary Edema - A condition characterized by fluid buildup in the lungs due to infections, drugs, high altitudes, etc.
Conclusion:
Welding and related processes that generate metal-containing fumes lead to a condition known as metal fume fever. People who get exposed to metal fumes containing oxides of copper, zinc, magnesium, aluminum, etc., develop symptoms of metal fume fever. 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. The symptoms are usually mild and include fever, cough, chills, fatigue, headache, etc. Extreme cases of metal poisoning can cause loss of consciousness and convulsions. The main lead for the diagnosis lies in the patient's history. There is no specific treatment for metal fume fever. The primary care for occupational metal fume exposure involves symptomatic relief.
