Tojima H, Ando T, Kishikawa H, Tokudome T
Tokyo Rosai Hospital, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Apr;36(4):394-8.
A 61-year-old man with a 32-year occupational history of welding developed malaise, cough, and dyspnea after inhalation of smoke while welding galvanized steel. On admission, peripheral leukocytosis, hypoxemia, and diffuse granular and linear opacities on a chest X-ray were present. The bronchioli were exaggerated in a chest high-resolution CT. Bronchoalveolar lavage revealed mild lymphocytosis and transbronchial lung biopsy showed siderosis and exudation of fibrin and neutrophils into alveolar spaces. The clinical and radiographic findings later improved except for an obstructive disorder on pulmonary function test. The respiratory health hazards associated with welding vary according to the materials and the concentration of inhaled substances. Acute chemical pneumonitis caused by inhalation of zinc fumes (zinc oxide) was accompanied by chronic siderosis in this case. It is well known that metal fume fever commonly occurs when inhaling zinc oxide fumes. However acute chemical pneumonitis after exposure to zinc oxide during welding has been only rarely reported.
一名61岁男性，有32年焊接工作史，在焊接镀锌钢时吸入烟雾后出现不适、咳嗽和呼吸困难。入院时，外周血白细胞增多、低氧血症，胸部X线显示弥漫性颗粒状和线状阴影。胸部高分辨率CT显示细支气管增粗。支气管肺泡灌洗显示轻度淋巴细胞增多，经支气管肺活检显示肺铁末沉着症以及纤维蛋白和中性粒细胞渗入肺泡腔。除肺功能测试显示阻塞性疾病外，临床和影像学表现后来有所改善。与焊接相关的呼吸健康危害因材料和吸入物质的浓度而异。本病例中，吸入锌烟（氧化锌）引起的急性化学性肺炎伴有慢性肺铁末沉着症。众所周知，吸入氧化锌烟雾时通常会发生金属烟热。然而，焊接过程中接触氧化锌后发生急性化学性肺炎的情况鲜有报道。
