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Metal fume fever is a benign, self-limiting occupational respiratory disease that results from the inhalation of fine metal particles. Whilst the exact mechanism for this condition is not known, the primary cause is thought to relate to the inhalation of zinc oxide fumes produced when zinc-coated steel or zinc-containing alloys (e.g. brass) are heated to high temperatures. A variety of other names for this condition is used, such as copper fever, brazier’s disease, welder’s ague, foundry fever, brass chills and spelter shakes.
Welders are commonly exposed to substances from the base metal, plating or filler that cause metal fume fever. Brazing and soldering can also cause metal poisoning due to exposure to lead, zinc, copper or cadmium. In extreme cases, cadmium (present in some older silver solder alloys) can cause loss of consciousness.
The signs and symptoms are generally flu-like, such as chills, myalgia, chest pain, non-productive cough, metallic taste in the mouth, leukocytosis, headache, fatigue and malaise. A sweet or metallic taste in the mouth may also be reported, along with a dry or irritated throat which may lead to hoarseness. Symptoms of a more severe metal toxicity may also include a burning sensation in the body, shock, no urine output, collapse, convulsions, shortness of breath, yellow eyes or yellow skin, rash, vomiting, watery or bloody diarrhea or low or high blood pressure, which require prompt medical attention. Flu-like symptoms normally disappear within 24 to 48 hours. Full recovery often requires one to three weeks.
This is one of the difficult parts, because symptoms vary from person to person. Sometimes the white blood cell count goes down and, in some cases, the zinc content is increased in urine and blood.
The symptoms also resemble other normal diseases which increases the difficulty to make a diagnosis through normal physical examination. It is therefore important to verify the patient’s history in the environment of metal oxide, work history, job nature, etc.
The best way to prevent metal fume fever is to follow these guidelines:
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