Skip to main content
PMC home page
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2005 Oct;62(10):688–694. doi: 10.1136/oem.2004.018796

Is metal fume fever a determinant of welding related respiratory symptoms and/or increased bronchial responsiveness? A longitudinal study

M El-Zein 1, C Infante-Rivard 1, J Malo 1, D Gautrin 1
PMCID: PMC1740873  PMID: 16169914

Abstract

Background: The current prospective study investigated the hypothesis of metal fume fever (MFF) being a predictor for the development of respiratory symptoms and functional abnormalities.

Methods: The study consisted of a pre-exposure and two follow up assessments of 286 welding apprentices during an average period of 15 months. A respiratory and a systemic symptom questionnaire, skin prick tests to common allergens and metal salts, spirometry, and methacholine challenge tests were administered.

Results: Developing at least one positive skin prick test to a metallic salt solution was found in 11.8% of apprentices. Possible MFF (at least one of fever, feelings of flu, general malaise, chills, dry cough, metallic taste, or shortness of breath) was reported by 39.2% of apprentices. The presence of at least one welding related respiratory symptom (cough, wheezing, or chest tightness) suggestive of welding related asthma was reported by 13.8%. MFF was significantly associated with these respiratory symptoms (OR = 4.92, 95% CI 2.10 to 11.52), after adjusting for age, atopy, smoking, physician diagnosed asthma, and symptoms of non-welding related asthma. Apprentices with possible MFF, and no welding related respiratory symptoms suggestive of welding related asthma at the first follow up, had an increased risk of developing the latter symptoms by the second follow up visit (OR = 7.4, 95% CI 1.97 to 27.45) compared with those not having MFF. MFF was not significantly associated with an increase in bronchial responsiveness.

Conclusion: MFF could be a predictor for the development of respiratory symptoms but not for functional abnormalities in welders.

Full Text

The Full Text of this article is available as a PDF (86.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Block G. T., Yeung M. Asthma induced by nickel. JAMA. 1982 Mar 19;247(11):1600–1602. [PubMed] [Google Scholar]
  2. Burney P. G., Laitinen L. A., Perdrizet S., Huckauf H., Tattersfield A. E., Chinn S., Poisson N., Heeren A., Britton J. R., Jones T. Validity and repeatability of the IUATLD (1984) Bronchial Symptoms Questionnaire: an international comparison. Eur Respir J. 1989 Nov;2(10):940–945. [PubMed] [Google Scholar]
  3. Cockcroft D. W., Killian D. N., Mellon J. J., Hargreave F. E. Bronchial reactivity to inhaled histamine: a method and clinical survey. Clin Allergy. 1977 May;7(3):235–243. doi: 10.1111/j.1365-2222.1977.tb01448.x. [DOI] [PubMed] [Google Scholar]
  4. Contreras G. R., Chan-Yeung M. Bronchial reactions to exposure to welding fumes. Occup Environ Med. 1997 Nov;54(11):836–839. doi: 10.1136/oem.54.11.836. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dehaut P., Rachiele A., Martin R. R., Malo J. L. Histamine dose-response curves in asthma: reproducibility and sensitivity of different indices to assess response. Thorax. 1983 Jul;38(7):516–522. doi: 10.1136/thx.38.7.516. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. El-Zein M., Malo J-L, Infante-Rivard C., Gautrin D. Prevalence and association of welding related systemic and respiratory symptoms in welders. Occup Environ Med. 2003 Sep;60(9):655–661. doi: 10.1136/oem.60.9.655. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. El-Zein M., Malo J. L., Infante-Rivard C., Gautrin D. Incidence of probable occupational asthma and changes in airway calibre and responsiveness in apprentice welders. Eur Respir J. 2003 Sep;22(3):513–518. doi: 10.1183/09031936.03.00000903. [DOI] [PubMed] [Google Scholar]
  8. Gautrin D., Ghezzo H., Infante-Rivard C., Malo J. L. Incidence and determinants of IgE-mediated sensitization in apprentices. A prospective study. Am J Respir Crit Care Med. 2000 Oct;162(4 Pt 1):1222–1228. doi: 10.1164/ajrccm.162.4.2001023. [DOI] [PubMed] [Google Scholar]
  9. Groth M., Lyngenbo O. Respiratory symptoms in Danish welders. Scand J Soc Med. 1989;17(4):271–276. doi: 10.1177/140349488901700403. [DOI] [PubMed] [Google Scholar]
  10. Kawane H., Soejima R., Umeki S., Niki Y. Metal fume fever and asthma. Chest. 1988 May;93(5):1116–1117. doi: 10.1378/chest.93.5.1116b. [DOI] [PubMed] [Google Scholar]
  11. Keskinen H., Kalliomäki P. L., Alanko K. Occupational asthma due to stainless steel welding fumes. Clin Allergy. 1980 Mar;10(2):151–159. doi: 10.1111/j.1365-2222.1980.tb02092.x. [DOI] [PubMed] [Google Scholar]
  12. Kilburn K. H., Warshaw R. H., Boylen C. T., Thornton J. C. Respiratory symptoms and functional impairment from acute (cross-shift) exposure to welding gases and fumes. Am J Med Sci. 1989 Nov;298(5):314–319. doi: 10.1097/00000441-198911000-00007. [DOI] [PubMed] [Google Scholar]
  13. Kusaka Y., Nakano Y., Shirakawa T., Fujimura N., Kato M., Heki S. Lymphocyte transformation test with nickel in hard metal asthma: another sensitizing component of hard metal. Ind Health. 1991;29(4):153–160. doi: 10.2486/indhealth.29.153. [DOI] [PubMed] [Google Scholar]
  14. Lemière Catherine. Non-invasive assessment of airway inflammation in occupational lung diseases. Curr Opin Allergy Clin Immunol. 2002 Apr;2(2):109–114. doi: 10.1097/00130832-200204000-00005. [DOI] [PubMed] [Google Scholar]
  15. Malo J. L., Cartier A., Doepner M., Nieboer E., Evans S., Dolovich J. Occupational asthma caused by nickel sulfate. J Allergy Clin Immunol. 1982 Jan;69(1 Pt 1):55–59. doi: 10.1016/0091-6749(82)90088-4. [DOI] [PubMed] [Google Scholar]
  16. Malo J. L., Cartier A. Occupational asthma due to fumes of galvanized metal. Chest. 1987 Aug;92(2):375–377. doi: 10.1378/chest.92.2.375. [DOI] [PubMed] [Google Scholar]
  17. Menzies R., Tamblyn R., Farant J. P., Hanley J., Nunes F., Tamblyn R. The effect of varying levels of outdoor-air supply on the symptoms of sick building syndrome. N Engl J Med. 1993 Mar 25;328(12):821–827. doi: 10.1056/NEJM199303253281201. [DOI] [PubMed] [Google Scholar]
  18. Moller D. R., Brooks S. M., Bernstein D. I., Cassedy K., Enrione M., Bernstein I. L. Delayed anaphylactoid reaction in a worker exposed to chromium. J Allergy Clin Immunol. 1986 Mar;77(3):451–456. doi: 10.1016/0091-6749(86)90179-x. [DOI] [PubMed] [Google Scholar]
  19. Monsó E., Malo J. L., Infante-Rivard C., Ghezzo H., Magnan M., L'Archevèque J., Trudeau C., Gautrin D. Individual characteristics and quitting in apprentices exposed to high-molecular-weight agents. Am J Respir Crit Care Med. 2000 May;161(5):1508–1512. doi: 10.1164/ajrccm.161.5.9906113. [DOI] [PubMed] [Google Scholar]
  20. Oosterhoff Y., Jansen M. A., Postma D. S., Koëter G. H. Airway responsiveness to adenosine 5'-monophosphate in smokers and nonsmokers with atopic asthma. J Allergy Clin Immunol. 1993 Nov;92(5):773–776. doi: 10.1016/0091-6749(93)90023-9. [DOI] [PubMed] [Google Scholar]
  21. Pepys J. Types of allergic reaction. Clin Allergy. 1973 Dec;3 (Suppl):491–509. doi: 10.1111/j.1365-2222.1973.tb03057.x. [DOI] [PubMed] [Google Scholar]
  22. Rastogi S. K., Gupta B. N., Husain T., Mathur N., Srivastava S. Spirometric abnormalities among welders. Environ Res. 1991 Oct;56(1):15–24. doi: 10.1016/s0013-9351(05)80105-7. [DOI] [PubMed] [Google Scholar]
  23. Torén K. Self reported rate of occupational asthma in Sweden 1990-2. Occup Environ Med. 1996 Nov;53(11):757–761. doi: 10.1136/oem.53.11.757. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Vandenplas O., Dargent F., Auverdin J. J., Boulanger J., Bossiroy J. M., Roosels D., Vande Weyer R. Occupational asthma due to gas metal arc welding on mild steel. Thorax. 1995 May;50(5):587–589. doi: 10.1136/thx.50.5.587. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES