Metal fume fever: specific clues to making the diagnosis.
Authors
Blanc PD; Boushey HA
Source
J Respir Dis 1992 Jan; 13(1):14
Link
NIOSHTIC No.
00233396
Abstract
The pathophysiology, diagnosis and treatment of metal fume fever were addressed in this clinical discussion. Metal fume fever was defined as a self limited syndrome characterized by a flu like illness most commonly occurring 4 to 8 hours after inhalation of zinc-oxide (1314132) (ZO) fume or dust. The population at risk according to an estimate made in 1975 included approximately 50,000 workers in the United States involved in foundry operations, welding of galvanized materials, brazing or flame cutting of brass or galvanized metal, and galvanizing. The only route of exposure causing metal fume fever is inhalation; ingestion, skin contact or parenteral administration do not cause the signs or symptoms of metal fume fever in humans. The pathophysiology of metal fume fever has not been elucidated, however evidence suggests that there is an underlying inflammatory response. The inhalation of ZO fumes has been shown to cause peripheral leukocytosis and a pulmonary inflammatory response documented by bronchoalveolar lavage; however, conflicting data exist on the effects of ZO exposure on pulmonary function. It was recommended that the diagnosis of metal fume fever be considered in any patient with a flu like illness 4 to 24 hours after even a brief exposure to ZO. The authors note that leukocytosis is the only consistent abnormal laboratory finding that distinguishes metal fume fever from other illnesses. The treatment of metal fume fever has been supportive and nonspecific. The authors conclude that metal fume fever can be avoided with appropriate ventilation and other workplace controls.
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