Metal fume fever is a disease most often associated with welders. Welding may cause pulmonary inflammation from the submicron particles of metal oxides in the fumes. Most often, the metal oxide is zinc oxide, but cadmium and manganese and their oxides are also present in some welding processes. Metal fume fever presents as a flu-like syndrome with fever, malaise, bronchospasm, and bi-weekly variations in severity. Symptoms are classically weakest on Sundays and strongest after returning to work on Mondays and Tuesdays. Laboratory evaluation and chest X-rays are normal, except in severe cases. Inter-professional teams are essential in identifying that this is an occupational illness and that welding requires special masking, ventilation, and length of workplace rules.
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