A case of pneumoconiosis complicated by rheumatoid arthritis in electric welder

Introduction. Until now, the development of rheumatoid arthritis has been customarily not considered as a typical complication of pneumoconiosis in electric welders and gas cutters. Materials and methods. The medical documentation related to the circumstances of the examination in the clinic of the North-West Scientific Center for Hygiene and Public Health in an electric welder of a shipbuilding enterprise, who was found to have a combination of diffuse focal opacities in the lungs with rheumatoid arthritis, was studied and analyzed. Results. The diffuse focal opacities in the lungs typical for pneumoconiosis and symptoms of rheumatoid arthritis had been developed in a shipbuilding enterprise welder with about 15–16 years of experience. The pathology was classified as welder’s pneumoconiosis complicated by rheumatoid arthritis. The investigation of the case of occupational disease, has been going on for more than 3 years due to the difficulties in collecting information about the patient’s working conditions at several different enterprises in the past. At that period of time, the patient was unjustifiably dismissed from work without adequate financial compensation. Following up the patient demonstrated the development of methotrexate-induced alveolitis as a complication of the rheumatoid arthritis treatment. The presented clinical case demonstrated certain shortcomings of the regulatory framework for occupational pathology, requiring clearer regulation. Limitations. The described observation is referred to isolated cases, therefore, for more representative conclusions, generalizations based on larger factual data are desirable. Conclusion. In the clinical aspect, the described case is an argument in favor of the possibility of recognizing rheumatoid arthritis as a complication of pneumoconiosis caused by exposure to metal condensation aerosols, including pneumoconiosis of electric welders and gas cutters.