Metal fume fever from a historical perspective

Metal fume fever is a well-described occupational yndrome marked by fever, chills, malaise and leucocytosis. Metal fume fever follows inhalation of zi nc oxide fumes. Historically the most common source of exposure has been br ass foundries. Brass is an alloy of copper and zinc. Despite the ancient or igins of brass, metal fume fever was first described only in the 19th centu ry. Charles Thackrah, the British occupational medicine pioneer, initially reported metal fume fever in his second (1832) edition of The Effects of Ar ts Trades and Professions. Neither Ramazinni nor any of his annotators thro ugh Patissier (1822) described a syndrome resembling metal fume fever. The explanation of the sudden "appearance" of metal fume fever, despite the ant iquity if brass, can be found in a critical change in the technology by whi ch the alloy was made. Up until the mid-18th century, brass in Europe was m ade by the cementation process; uniting zinc carbonate or zinc oxide with c opper. The process was slow, but released little to no zinc fume. In the mi d-18th century, metallic zinc became more available in the West, originally coming from China. High zinc content brass using metallic zinc could be ma de quickly and cheaply, but this process generated heavy clouds of zinc oxi de fume. Although brass-making has become a less important industry over th e last 150 years, electric are welding on galvanized (zinc-coated) steel ha s guaranteed that industrial exposure to zinc oxide fume remains a common p roblem. The story of metal fume fever is an important example of how, by tr acking changing technologies, the history of occupational diseases can be m on fully understood.