ABSTRACT
Metal fume fever and pneumosiderosis is an occupational Lung disease acquired when welders are exposure to welding fumes and iron particles during their occupation. A total of one hundred and fifty four (154) sputum samples were collected for the purpose of this study. One hundred and four (104) sputum samples were collected from welders in different locations in owerri. While fifty (50) sputum samples were collected from apparently healthy controls of non welders. The age range 21-30 years recorded highest with 46 (44.23%) frequency of occurrence, followed by age range of 31-40 years with 30 (28.84%) and the Least was from the age range of 51-60 years with 4 (3.85%) frequency of occurrence for the test subjects. The Length of the exposure to welding fumes and iron particles reveals that those exposed from 7-13 years recorded the highest with 30 (28.85%) frequency of occurrence followed by age range 1-6 years with 25 (24.04%) and the Least duration of exposure was recorded among the rest ranging from 27-33 years having 10 (9.61%) each. Many iron deposits were detected in the sputum specimen giving positive reactions with Perls Prussian Blue method with 37 (71.15%) frequency and only l5 (28.85%) recorded as Negative for test subjects. Papanicolaou method was adopted for this research; some cytological findings observed were variables. Long-term exposure to welding fumes and metallic dust particles, inadequate working ventilation as well as the unawareness of its effects were among the risk factors that increased the infection, even among the apparently healthy individual.
CHAPTER ONE
1.0 INTRODUCTION
Welding process involves joining metal parts by heating the pieces to melting temperature (Kimet et al., 2005). Soldering process as a type of welding produces various contaminants at a sufficient rate to cause both short term and long term health effects, especially if not properly controlled (Antonini et al., 1998). The metal composition of the generated fume during welding of metals is mostly dependent on the welding electrode or wire which is consumed during the process (Solano et al., 2006). Based on epidemiology more than two million workers worldwide perform welding process as part of their work duties (Solano et al., 2006). Previous studies showed that 22% of welders or solderers or persons working near welding or solderers were found to be suffering from occupational asthma and other lung diseases (Palmer et al.,1997).
One of the main limitations to study the adverse health effects of welding fumes is the variable environmental condition of the work places. This includes different ventilation qualities and also exposure to a number of other toxic materials such as asbestos, smoking, silica and organic solvent (Antonini et al., 1998).Chronic exposure to Welding fumes is also associated with a significant reduction in lung function. There is growing evidence that welding fume exposure may be associated with increased cardiovascular disease. Although the exact mechanisms for cardiovascular disease are unknown, it seems that systemic inflammation resulting from occupational exposure to these fumes may be partly responsible for the increased cardiovascular risk in welders (Kimet et al., 2005). Fumes inhalation exposure for workers in confined and poorly ventilated spaces have been found to exhibit more negative lung function than workers in chromium, and manganese. Nickel and hexavalent chromium are classified as potential occupational carcinogens (NIOSH 2003).
Generally, welding fumes and gases come from the base material; paints and coatings on the metal and covering the electrode; shielding gases; chemical reactions from arc ultraviolet light and heat; process and consumable; and contaminants in the air, such as vapours from cleaners and degreasers. Welding smoke can also irritate the eyes, nose, chest, and respiratory tract and cause coughing, shortness of breath, bronchitis, pulmonary edema (fluid in the lungs), and pneumonitis (inflammation of the lung) Gastrointestinal effects, such as nausea, appetite loss, vomiting, cramps, and slow digestion, also have been associated with welding smoke. Some welding fume components and welding processes can be especially dangerous in a short period of time. Cadmium in welding fumes can be fatal in a short time. Ultraviolet radiation given off by welding reacts with oxygen and nitrogen in the air to form ozone and nitrogen oxides, which are deadly at high doses, irritate the nose and throat, and cause serious lung disease (Vicski, 2004). Studies show that welders and those involved in brazing, soldering, and metal cutting have an increased risk of lung cancer and possible larynx and urinary tract cancer. According to the AFSCME fact sheet, these findings are not surprising in view of the large quantity of toxic substances in welding smoke, including cancer-causing agents such as cadmium, nickel, beryllium, chromium, and arsenic. Pneumosiderosis or welder’s lung is an occupational lung disease, which is usually seen after chronic exposure to iron dust particles especially in welders and other metal workers (Imran et al, 2009). Siderosis is suffix derived from a Greek word “sidero” meaning iron, while “Pneumo” is a prefix derives from Greek word meaning breath. Therefore, siderosis is a chronic inflammation of the lungs caused by excessive inhalation of dust containing iron salts or particles (American Heritage Dictionary; 2009). Siderosis is a form inhalation of iron or other metallic particles, excess of ill in blood, deposition of iron in the tissue. The tissues on which the iron can be deposited include the eye or skin which causes injury as the iron chemically reacts with cells and tissues (Fidan et al., 2005). Iron oxide present in welding material is the causative agent of pneumosiderosis. It can also be caused by powdered hematite (Strobel et al., 2002).
There are different metallic products which when exposed to the dust particles can affect the body such as Iron, Aluminum, silver, Nickel, magnesium etc. Although it takes years of exposure for a patient to become symptomatic, the symptoms are usually non-specific which most commonly includes shortness of breath, cough and sputum production. With continued exposure, patients can develop chronic interstitial lung disease, chronic bronchitis (regardless of smoking), decline in pulmonary function and persistent symptoms (Imran et al., 2009). Activities such as burning, welding, sawing, brazing, machining and grinding may result in the following effects if there is exposures to metallic products; the target organs is respiratory system.
- Acute effects through inhalation of metal dust into the eyes, skin and mucous membrane.
- Chronic effects that are associated with iron oxide which may result in benign pneumoconiosis called “siderosis”.
1.1 AIM
The general aim of this study is to evaluate the morphology of cells in Papanicoloau and Perls Prussian blue stained sputum samples of welders in Owerri, Imo State.
1.2 SPECIFIC OBJECTIVE
The specific objectives of this study include:
- To evaluate the effect of iron particles inhaled into the lungs on cellular morphology in sputa of welders.
- To determine the relationship between the electrode fumes inhalation and cellular atypia in sputa of welders.
- To establish the relationship between duration of exposure and cytological abnormalities in sputa of welders.
1.3 JUSTIFICATION/SIGNIFICANCE OF THE STUDY
There is increased campaign that the inhalation of Welding fumes, iron particles and other toxic gaseous compounds released from different iron and welding materials are etiologic to lung cancer and other respiratory tract problems. This study therefore, seeks to evaluate the effect of the welding fumes on the lungs epithelia cells. It is hoped that the conclusion that shall be reached may reveal the effect of the welding fumes and iron particles which will further inform welders on side effect of long period of exposure to these fumes.
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