special subjects
Metal Fume Fever and Polymer Fume Fever
Introduction
Metal fume feveris a clinical syndrome most commonly caused by occupational exposure to fumes that contain metal, generated by welding and related processes.Polymer fume feveris clinically similar to metal fume fever but is caused by exposure to specific fluorinated polymer products, such as polytetrafluoroethylene (PTFE, known as Teflon®). Diagnosis is by clinical evaluation. Treatment is supportive. Metal fume fever was first recognized in the 1800s in association with zinc fume and the pouring of molten brass. In the 1970s, metal fume fever was fairly common among welders; 31% of welders aged 20 to 59 years had a least one episode during their career. In the US, improvements in safety regulations and workplace exposure controls have made metal fume fever less common today; now, an estimated 1500 to 2500 cases occur annually in the US. Metal fume fever may also affect welders in nonoccupational settings, such as artists or hobbyists. The most common type of metal implicated in metal fume fever is zinc, although other metals have been suggested as potential causes in case reports. Metal fume fever is distinct from cadmium pneumonitis, a more severe syndrome associated with hypoxia and respiratory failure. Polymer fume fever is clinically similar to metal fume fever but is caused by exposure to fumes generated when polytetrafluoroethylene (Teflon®) is heated to > 300° C. Polymer fume fever was first reported in 1951 in a case series of workers handling PTFE at elevated temperatures. In the US, improvements in workplace hygiene have decreased the incidence of occupational polymer fume fever. Exposure to PTFE fume due to overheating of Teflon® cookware in home kitchens has resulted in polymer fume fever in people and has been fatal to pet birds. 