What is the pathophysiology of metal fume fever caused by smoke inhalation?

Updated: Oct 15, 2021
  • Author: Keith A Lafferty, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Metal fume fever (MFF) is a well-documented acute disease induced by intense inhalation of metal oxides. MFF is primarily associated with the inhalation of zinc oxide fumes that are produced when zinc-oxide coated steel (galvanized) or zinc containing alloys (eg, brass) is exposed to high temperatures. Keyes found that 1 in 5 welders has experienced MFF by age 30 years. [22]

MFF is a self-limited syndrome characterized by fever, myalgias, headache, and nausea. Symptoms develop 4-12 hours after exposure and typically last several hours; severe cases generally resolve in 1-2 days. Observation is usually all that is necessary.

The exact pathology of MFF is not well understood but likely involves the deposition of fine metal particulates in the alveoli. A study by Kuschner et al on human volunteers showed that pulmonary cytokines such as tumor necrosis factor (TNF), interleukin 6 (IL-6), and interleukin 8 (IL-8) may play important initial roles in mediating metal fume fever. [23]

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