title: Pulmonary fibrosis and exposure to steel welding fume.
abstract: BACKGROUND
  Arc welders who have been exposed to high concentrations of steel welding fume for prolonged periods of time may develop pulmonary fibrosis but the nature of the fibrotic changes has been debated over the last 80 years without any clear international consensus.
  
  
  OBJECTIVE
  To characterize the nature of the pulmonary fibrosis that develops in response to steel welding fume exposure and to provide a working hypothesis that would explain the findings of the existing research, to provide a platform for future research and to inform future occupational and clinical management of welders with pulmonary effects from welding fume.
  
  
  METHODS
  Review of the world literature on pulmonary fibrosis and welding of steel in all languages using PubMed, with further secondary search of references in the articles found in the primary search. Google and Reference Manager were used as further confirmatory search tools.
  
  
  RESULTS
  Only case series and case reports were found but these provided consistent evidence that the consequence of exposure to steel welding fume at high levels for a prolonged period of time is a type of pulmonary fibrosis similar to, and possibly the same as, respiratory bronchiolitis which eventually develops into desquamative interstitial pneumonia with ongoing exposure.
  
  
  CONCLUSIONS
  Steel welding fume may cause an occupational respiratory bronchiolitis which may develop into de squamative interstitial pneumonia with ongoing exposure. This concept may explain the difficulties in interpreting the wider literature on welding fume and lung function at lower exposures and may also explain the increased risk of lung cancer in welders.
authors.affiliation: Department of Employee Health and Wellbeing, Airedale Hospital, Keighley, West Yorkshire BD20 6TD, UK. drmartincosgrove@fastmail.fm.
authors.forename: M P
authors.initials: MP
authors.lastname: Cosgrove
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects* / Q000737:chemistry; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D009784:Occupational Diseases / Q000139:chemically induced* / Q000473:pathology; D016273:Occupational Exposure / Q000009:adverse effects*; D011658:Pulmonary Fibrosis / Q000139:chemically induced* / Q000473:pathology; D013232:Steel / Q000009:adverse effects* / Q000737:chemistry; D014896:Welding
chemical_list: D000395:Air Pollutants, Occupational; D013232:Steel
keywords: Arc welders’ lung; desquamative interstitial pneumonia; lung; pneumoconiosis; pulmonary fibrosis; respiratory bronchiolitis; siderofibrosis; siderosis; welding.