Common chemical hazards include metal particulates and gases How

Common chemical hazards include metal particulates and gases. However, the fume and noxious gases formed during the SCH727965 in vitro welding process are considered to be the most harmful exposure in comparison with the other byproducts of welding. Significant levels of different toxic gases (i.e., carbon

monoxide, ozone, nitrogen oxides) and metal fumes (i.e. aluminum, barium, cadmium, chromium, copper, iron, magnesium, nickel and tin) may be formed during common arc welding processes.3 Many pulmonary problems, usually attributed to these toxic fumes and gases, have been described in the literature until now. Lung cancer, occupational asthma, rhinitis, cough, dyspnea, obstructive and restrictive lung disease, pneumoconiosis, lung function impairment and pneumonia are among the most frequent respiratory problems due to welding process.4 In addition, welding workers suffer from non-pulmonary health problems such as eye irritation, photokeratitis,

cataract, skin irritation, erythema, pterygium, non-melanocytic skin cancer, malignant melanoma, reduced sperm count, motility and infertility.1 There are a lot of pulmonary and systemic diseases reasons of hemoptysis,5 however, to our knowledge, welding has not been listed as an etiology in any study. Alveolar hemorrhage due to welding fumes has never been defined before. We attributed alveolar hemorrhage to welding fumes in our patient in three ways: 1) We exclude all possible reasons of the pulmonary hemorrhage Cytidine deaminase (i.e. Behcet’s Syndrome and other vasculitides, PCI-32765 supplier tuberculosis, benign and malign tumors, acute and chronic bronchitis, hemorrhagic diatheses, systemic diseases) clinically, radiologically and with serological markers; 2) The patient was working as welder for a long time and he has been suffering diseases such as

chronic headache and chronic conjunctivitis demonstrating chronic welding fumes exposure; 3) Patient’s alveolar hemorrhage was reduced after avoidance welding fumes in a few days without any specific treatment, and no relapse was observed in 2-year follow-up period. The pathogenesis of hazardous effects of welding fumes has not been studied extensively before. However, many pulmonary effects of welding fumes has been connected to carcinogenic, fibrinojenic and irritative effects of metal constituents such as barium, cadmium, chromium, zinc and nickel, etc. of welding fumes. In animal studies,6 and 7 it has been shown that welding fumes especially manuel metal arc welding using a stainless steel electrode cause an elevated toxic lung response by means of enhanced macrophage production of highly reactive oxygen radicals and inflammatory cytokines. We think that welding fumes may produce an inflammatory and irritative response resulting with bronchial epithelial damage finally causing hemoptysis and even alveolar hemorrhage as in our patient. This case shows that welding fumes can hazard alveolar epithelium and vasculature and lead to massive hemorrhage.

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