title: Diagnosing metal fume fever--an integrated approach.
abstract: BACKGROUND
  Exposure to high concentrations of zinc oxide fume can cause metal fume fever (MFF). Two cases occurring following the oxy-acetylene cutting of galvanized steel frames are reported.
  
  
  OBJECTIVE
  To show that integrated working is valuable as secondary health care staff may not be familiar with MFF.
  
  
  METHODS
  Site visits by Her Majesty's Medical, Health and Safety (H&S) and Specialist Occupational Hygiene Inspectors to gather information and cooperation with occupational health, primary and secondary health care staff to diagnose MFF.
  
  
  RESULTS
  Poor exposure control caused metal fume inhalation in these cases. Multidisciplinary working established diagnosis, causation and compliance with H&S legislation.
  
  
  CONCLUSIONS
  Risk assessments are required to identify health risks and to determine required exposure control measures. Failure to do this resulted in an unusual case of MFF leading to hospital admission. Diagnosis can be delayed if a full occupational history is not taken. Successful investigation of such cases benefits from collaborative working.
authors.affiliation: National Specialist Group (Occupational Hygiene), Health and Safety Executive, Marshalls Mill, Leeds, UK. john.cain@hse.gsi.gov.uk
authors.forename: J R
authors.initials: JR
authors.lastname: Cain
authors.forename: R M
authors.initials: RM
authors.lastname: Fletcher
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005334:Fever / Q000139:chemically induced* / Q000175:diagnosis; D005740:Gases / Q000633:toxicity*; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis; D014896:Welding; D015034:Zinc Oxide / Q000633:toxicity*
chemical_list: D005740:Gases; D015034:Zinc Oxide