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Interstitial pulmonary fibrosis after severe exposure to welding fumes
U Buerke1, J Schneider, J Rösler
1Institute and Outpatient Clinic for Occupational and Social Medicine, Justus-Liebig University, Giessen, Germany. ubuerke@yahoo.com
Background:
Interstitial pulmonary fibrosis (IPF) is reported after long term, severe exposure to welding fumes in poorly ventilated workplaces.
Methods:
Fifteen welders with IPF were examined--13 in our outpatient clinic--from 1990 to 1997. Occupational histories and examinations, lung function analyses, symptoms and clinical findings, histological analyses in 13 patients partly including SEM/EDX-analyses, chest X-rays, chest computed tomographies were conducted.
Results:
Duration of work as welders was 28 years and the cumulative dose of welding fumes 221 mg/m(3) x years (median). Lung function studies found pattern of restriction or combined restriction-obstruction, lower diffusion capacity, and reduced blood oxygen tension at exercise. Histologically, patchy interstitial fibrosis was noted. Accumulations of particulate matter typically for welding fume were detected. EDX showed increase of iron load and close topographical relationship to welding fume particles embedded in areas of scattered fibrosis.
Conclusion:
While epidemiological data are limited, it is reasonable to conclude that a causal relationship exists between IPF in welders with long term exposure to high concentrations of welding fumes.