Occupational respiratory diseases. Merchant JA, Bochlecke BA, Taylor G, eds. Morgantown, WV: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 86-102, 1986 Sep; :607-625
The acute systemic effects associated with respiratory disorders such as brass founder's ague, caster's fever, spelter shakes, mill fever, and weaver's cough are reviewed with regard to causative agents, occupations at risk, prevalence of disease, epidemiology, pathology, etiology and diagnostic criteria, methods of prevention, and research needs. Causative agents are grouped into freshly generated finely particulate metallic oxides, combustion products of fluorocarbon polymers and telomers, organic dusts containing bacterial endotoxins, and mycotoxins. The inhalation of these agents results in an acute, short term, noninfectious, febrile reaction often associated with myalgia and minor respiratory tract symptoms. Polymorphonuclear leukocytosis is common as is tolerance after repeated exposure to the agent. Occupations at risk for metal fume fever include alloy makers, braziers, electroplaters, foundry workers, galvanizers, junk metal refiners, metal burners, cutters, polishers, sprayers, metallic pigment makers, shipyard workers, smelters and welders. Occupations at risk for polymer fume fever include persons involved in fluorocarbon polymer product manufacture and those working in proximity to fluorocarbon polymers or telomers. Workers at risk for organic dust fever include cottonseed oil operators, cotton ginners, textile workers, grain handlers and inspectors, weavers, cotton classers and warehousemen, and cotton waste workers. The author identifies critical research needs as being determination of the relationship between fever and causative agent, dose response relationships in previously exposed and unexposed workers, and long term effects.