WordNet

a rise in the temperature of the body; frequently a symptom of infection (同)febrility, febricity, pyrexia, feverishness
intense nervous anticipation; "in a fever of resentment"
cover with metal
be mad, angry, or furious
emit a cloud of fine particles; "The chimney was fuming" (同)smoke
highly excited; "a fevered imagination"

PrepTutorEJDIC

〈U〉《しばしばa fever》(身体の異常な)『熱』,発熱 / 〈U〉『熱病』 / 〈U〉〈C〉(…に対する)『興奮』,熱狂《+『for』+『名』》
〈C〉(個々の)『金属』;〈U〉(材料としての)金属 / 〈U〉合金(真ちゅう,真銅など) / 〈U〉気性,気質 / 〈U〉《英》(舗装用・鉄道用の)砕石 / …‘に'金属をかぶせる / 《英》〈道路〉‘に'砕石を敷く
(悪臭を放つ)煙,ガス,蒸気 / 〈煙・ガス蒸気が〉出る,煙る / 怒る,いらだつ
(比較変化なし)《名詞の前にのみ用いて》熱のある,熱病にかかった / 熱にうかされたような,興奮した / (憎しみなどが)異常に強い

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/09/27 16:43:14」(JST)

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Metal fume fever, also known as brass founders' ague, brass shakes,^[1] zinc shakes, galvie flu, metal dust fever, or Monday morning fever,^[2] is an illness caused primarily by exposure to certain fumes. Workers breathe in fumes from chemicals such as zinc oxide (ZnO) or magnesium oxide (MgO), which are themselves created by heating or welding certain metals, particularly galvanized steel.^[3] Chromium^[4] is also a hazard, from stainless steel. Cadmium,^[5] present in some older silver solder alloys can, in extreme cases, cause loss of consciousness within a matter of minutes. Iron itself, and so most simple steels, does not give rise to it.^{[citation needed]}

Symptoms[edit]

The symptoms are nonspecific but are generally flu-like including fever, chills, nausea, headache, fatigue, muscle aches, joint pains, shortness of breath, chest pain, and cough. A sweet or metallic taste in the mouth may also be reported along with a dry or irritated throat which may lead to hoarseness. ^[6] 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 blood pressure, which require prompt medical attention.^[7] Flu-like symptoms will normally disappear within 24 to 48 hours. It often takes 4 days to fully recover.

Cause[edit]

Metal fume fever is due to the inhalation of certain metals, either as fine dust or most commonly as fumes. Simple compounds of the metals, such as their oxides, are equally capable of causing it. The effects of particularly toxic compounds, such as nickel carbonyl, are not considered as a mere metal fume fever.

Exposure usually arises through hot metalworking processes, such as smelting and casting of zinc alloys, or welding of galvanized metals. If the metal concerned is particularly high-risk, then cold sanding processes may also cause it, even though the dose is lower. This may also occur with electroplated surfaces or metal-rich anti-corrosion paint, such as cadmium passivated steel or zinc chromate primer on aluminium aircraft parts. Exposure has also been reported in use of lead free ammunition, by the harder steel core stripping excess metal from the jacket of the bullet and barrel of the rifle.^[8]

The most plausible mechanism accounting for the symptoms involves a dose-dependent release of certain cytokines, an event which occurs by inhaled metal oxide fumes which injure the lung cells. This is not an allergic reaction, though allergic reactions to metal fumes can occur. ^[9]

Diagnosis[edit]

Diagnosis primarily depends upon a good occupational history. Diagnosis of metal fume fever can be easily missed, as the complaints are non-specific, resemble a number of other common illnesses, and presentation occurs typically 1-2 days after the exposure. When respiratory symptoms are prominent, metal fume fever may be confused with acute bronchitis or pneumonia. The diagnosis is based primarily upon a history of exposure to metal oxide fumes. Cain and Fletcher (2010) report a case of metal fume fever that was diagnosed only by taking a full occupational history and by close collaboration between primary and secondary health care personnel.^[10]

Physical examination findings vary among persons exposed, depending largely upon the stage in the course of the syndrome during which examination occurs. Patients may present with wheezing or crackles in the lungs. They typically have an increased white blood cell count, and urine, blood plasma and skin zinc levels may (unsurprisingly) be elevated. Chest X-ray findings may also be present. ^[11]

An interesting feature of metal fume fever involves rapid adaptation to the development of the syndrome following repeated metal oxide exposure. Workers with a history of recurrent metal fume fever often develop a tolerance to the fumes. This tolerance, however, is transient, and only persists through the work week. After a weekend hiatus, the tolerance has usually disappeared. This phenomenon of tolerance is what led to the name "Monday Fever".

In 2006, there were approximately 700 metal fume exposures reported to United States Poison control center. The American Welding Society estimated that 2500 employees in the steel industry develop metal fume fever in the US each year since the majority of the cases are not reported.

Treatment[edit]

Treatment of mild metal fume fever consists of bedrest, and symptomatic therapy (e.g. aspirin for headaches) as indicated. In the case of non-allergic acute lung injury in the setting of metal fume fever, a standard or even recommended approach to treatment has not been studied.^[12]

A traditional remedy is to consume large quantities of cow's milk, either before or immediately after exposure.^[1] However, this advice is challenged by the United Kingdom Health and Safety Executive (the national independent watchdog for work-related health, safety and illness), who write "Don’t believe the stories about drinking milk before welding. It does not prevent you getting metal fume fever."^[13]

Prevention[edit]

Prevention of metal fume fever in workers who are at potential risk (such as welders) involves avoidance of direct contact with potentially toxic fumes, improved engineering controls (exhaust ventilation systems), personal protective equipment (respirators), and education of workers regarding the features of the syndrome itself and proactive measures which can be taken to prevent its development.

Particularly for cadmium, the design of the product may be changed so as to eliminate it. NiCd rechargeable batteries are being replaced by NiMH. Cadmium plating is replaced with zinc or nickel. Silver solder alloys now rarely contain it.

References[edit]

^ ^a ^b Chastain, Steve (2004). Metal Casting: A Sand Casting Manual for the Small Foundry. p. 8. ISBN 0-9702203-2-4.
^ Kaye P, Young H, O'Sullivan I (May 2002). "Metal fume fever: a case report and review of the literature". Emerg Med J 19 (3): 268–9. doi:10.1136/emj.19.3.268. PMC 1725877. PMID 11971851.
^ El-Zein M, Malo JL, Infante-Rivard C, Gautrin D (September 2003). "Prevalence and association of welding related systemic and respiratory symptoms in welders". Occup Environ Med 60 (9): 655–61. doi:10.1136/oem.60.9.655. PMC 1740619. PMID 12937186.
^ "Chromium and you" (pdf). HSE (UK).
^ "Cadmium and you - working with Cadmium - are you at risk?" (pdf). HSE (UK).
^ [1]
^ "Medline Medical Encyclopedia: Zinc"
^ http://forsvaret.no/aktuelt/publisert/nyheter/Sider/blyfri-ammo-helseplager.aspx
^ [Kunimasa K, et al. Chemical Pneumonitis and Acute Lung Injury Caused by Inhalation of Nickel Fumes. Internal Medicine. 50:2035-2038, 2011]
^ Cain, J. R.; R. M. Fletcher (2010). "Diagnosing metal fume fever - an integrated approach". Occupational Medicine (London) 60 (5): 398–400. doi:10.1093/occmed/kqq036. PMID 20407044. |accessdate= requires |url= (help) edit
^ [Kunimasa K, et al. Chemical Pneumonitis and Acute Lung Injury Caused by Inhalation of Nickel Fumes. Internal Medicine. 50:2035-2038, 2011]
^ [Kunimasa K, et al. Chemical Pneumonitis and Acute Lung Injury Caused by Inhalation of Nickel Fumes. Internal Medicine. 50:2035-2038, 2011]
^ "Illness caused by welding fume and gases". Health and Safety Executive (UK). Retrieved 9 May 2013.

External links[edit]

Inhalation fever
http://files.aws.org/technical/facts/FACT-25.pdf
Inorganic Dust Pneumonias

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1. 過敏性肺臓炎（外因性アレルギー性肺胞炎）の診断 diagnosis of hypersensitivity pneumonitis extrinsic allergic alveolitis

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Occupational rhinitis due to steel welding fumes.

Castano R1, Suarthana E.
American journal of industrial medicine.Am J Ind Med.2014 Sep 25. doi: 10.1002/ajim.22365. [Epub ahead of print]
Exposure to welding fumes is a recognized respiratory hazard. Occupational asthma but not occupational rhinitis has been documented in workers exposed to steel welding fumes. We report a 26-year-old male with work-related rhinitis symptoms as well as lower airways symptoms suggestive of occupational
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[Two cases of acute respiratory distress syndrome related to zinc fumes and zinc dust inhalation].

Ishimoto H1, Yatera K, Oda K, Kawanami T, Soda H, Kohno S, Mukae H.
Journal of UOEH.J UOEH.2014 Jun 1;36(2):147-52.
Two cases of acute respiratory distress syndrome related to zinc fume inhalation and zinc powder inhalation are presented. Case 1 demonstrated acute respiratory symptoms during the work of distortion correction of iron boards, coated with a rust preventative including rich zinc using an acetylene ga
PMID 24930880

Acute inhalation exposure to titanium ethanolate as a possible cause of metal fume fever.

Ahmadimanesh M, Shadnia S, Ghazi-Khansari M1.
The international journal of occupational and environmental medicine.Int J Occup Environ Med.2014 Apr;5(2):106-8.
Occupational inhalation exposure to noxious agents is not uncommon. Herein, we present a 26-year-old male student who had accidental acute inhalation exposure to a large quantity of titanium ethanolate and hydrogen chloride in chemistry lab. He was referred to the emergency department of our hospita
PMID 24748002

Japanese Journal

亜鉛含有防錆剤に関連した急性呼吸窮迫症候群の2例

石本裕士,矢寺和博,小田桂士,川波敏則,早田宏,河野茂,迎寛
産業医科大学雑誌 36(2), 147-152, 2014-06-01
亜鉛含有防錆剤に関連した急性呼吸窮迫症候群を呈した2例を報告する.症例1は,亜鉛を主成分とする防錆剤で加工された鉄板をアセチレンガスバーナーによって整形作業(歪み取り)している最中に急性呼吸窮迫症候群を生じていた.症例2は,亜鉛を多く含んだ防錆剤をエアレスコンプレッサーにて塗布する作業中に急性呼吸窮迫症候群が発生していた.両者ともに船倉内で防護具の使用を怠り作業にあたっていたことから,亜鉛ヒューム …
NAID 110009823335

亜鉛含有防錆剤に関連した急性呼吸窮迫症候群の２例

石本裕士,矢寺和博,小田桂士,川波敏則,早田宏,河野茂,迎寛
Journal of UOEH 36(2), 147-152, 2014
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