Clinico-Radiological Profile of Welders and Metal Fumes Exposure Patients and the Role of Bronchoalveolar Lavage Ferritin Levels in the Diagnosis of Welder’s Pneumoconiosis

Background: Welding is a widely employed industrial process that utilizes high temperatures to merge metals. This process produces certain metal fumes and toxic gases that pose a significant risk of development of respiratory disorders. Objectives: To study the clinical and radiological profile of welders, metal fumes exposure patients, and to study the contribution of broncho-alveolar lavage (BAL) ferritin levels in the diagnosis of welder pneumoconiosis. Methods: This was a cross-sectional analytical study conducted on 74 welders and metal fumes exposure patients attending the outpatient and inpatient department of Respiratory Medicine at a tertiary care center in North India. The data were tabulated on MS-Excel (2021). Results were analyzed using Statistical Package for Social Sciences (SPSS) version 19. Results: All patients were male with a mean age of 36 years. Chest pain was the most common clinical presentation, reported by 78.3% of the patients. Seventy-seven percent of the patients were non-smokers. 47.3% of the patients work as arc welders, followed by Metal Inert Gas (MIG) welders (25.7%). They get exposure to both Arc and MIG welding (12.2%), gas welding (2.7%), zinc fumes exposure (2.7%), aluminum exposure (5.4%), and copper exposure (4%), with a mean duration of exposure 14.9 years. Spirometry showed an obstructive pattern in 40.5% of the patients, a restrictive pattern in 24.3% of the patients, mixed pattern in 12.2% of the patients, and normal in 23% of the patients. Centrilobular nodules were the most frequently observed computed tomography finding, seen in 58% of the patients. The mean St. George Respiratory Questionnaire (SGRQ) score was 39.81. Fifty-eight percent of the patients had BAL ferritin levels exceeding 200 ng/mL. Conclusions: BAL ferritin levels correlate with the duration of exposure and the respiratory morbidity in welders; thus, can be used as predictors of lung fibrosis and in the diagnosis of welder pneumoconiosis.