Inhalation fever, fumes

CASES/YEAR
5,000 (US); 100,000 (Global)
CATEGORY
Immune-Related
AGENT TYPE
Other
OTHER NAMES
Metal fume fever; Polymer fume fever;
ACUITY
Acute-Moderate
INCUBATION
3 to 10 hours
INITIAL SYMPTOMS
Flu-like illness and cough; Metal fume fever: may have metallic taste in mouth;
PRECAUTIONS
COMMENTS
Metal fume fever occurs after heavy exposure to zinc oxide fume or dust, e.g., after welding or flame cutting of galvanized steel, high temperature zinc coating processes, or metal pouring in brass foundries. (Brass is an alloy of copper and zinc.) After an episode, there is a temporary period of tolerance for a day or two. [Harber, p. 245] Copper and magnesium fume can also cause metal fume fever. [LaDou, p. 323] It is important to distinguish metal fume fever from cadmium pneumonitis. Zinc fume appears white, while cadmium fume appears yellow. [Rosenstock, p. 955] Polymer fume fever occurs after a heavy exposure to the pyrolysis products of polytetrafluoroethylene (PTFE, trade names Fluon, Teflon, Halon). The pyrolysis products are the result of PTFE being heated to 300 degrees C. When PTFE is heated above 450 degrees C., different pyrolysis products are formed that may cause acute lung injury if controls to enclose the fume have not been installed. [Rom, p. 412-3] "Infiltrates on the chest radiograph can occur with neutrophilia and hypoxemia that can mimic acute pneumonia or acute hypersensitivity pneumonitis." Workers usually have complete resolution of symptoms within 24-48 hours. Symptoms become milder with daily repeated exposures. [Cecil, p. 576] See "Inhalation fever, bioaerosols." See "Hypersensitivity pneumonitis."
DIAGNOSTIC
Clinical
SCOPE
Global
SIGNS & SYMPTOMS
  • >fever
  • >myalgia
  • H leukocytosis
  • N headache
  • R chest pain
  • R cough
  • R dyspnea
  • X lung infiltrates
  • *pneumonitis
ANTIMICROBIC

No

VACCINE

No

ENTRY
Inhalation
SOURCE
RESERVOIR
RISK FACTORS
TREATMENT
No specific therapy;
DRUG LINK
REFERENCES FOR CASES/YEAR
1. (US) No data found; Guesstimate: 5000 cases/year;
2. (Global) 20 X US cases/yr;