Polymer fume fever is a rare disease that arises due to inhalation of polytetrafluoroethylene (PTFE) or Teflon(®) that is degraded during heating processes such as cooking or in the occupational setting. Signs and symptoms start several hours after exposure, most common being a flu-like illness with fever, chills, a sore throat, weakness, and dyspnea in severe cases. Spontaneous resolution within a few days is observed in the majority of cases. Data obtained during history taking is crucial to make the diagnosis.
Presentation
Polymer fume fever is now considered to be a rare occurrence in clinical practice and was initially described as an occupational disease [1] [2] [3]. The pathogenesis involves inhalation of degraded polytetrafluoroethylene or Teflon(®), either during various industrial heating processes (> 350°C) or during household cooking using Teflon-lined pans that release fumes containing this fluorocarbon [1] [4] [5]. The exact reason why signs and symptoms appear after inhalation of these fumes remains unclear, but it is assumed that a pro-inflammatory reaction in the lungs with subsequent formation of reactive oxygen species is the main mechanism [6]. The clinical presentation usually starts several hours after inhalation of polytetrafluoroethylene and most reports suggest that a "flu-like" illness comprised of a dry cough, fever, chills, a sore throat, and even dyspnea is the main presenting feature [1] [3] [4] [7] [8]. Joint pain may also be reported [2]. Spontaneous resolution of symptoms is noted within a few days and their complete absence during the weekend is observed in the setting of occupational exposure [2] [6]. In rare cases, however, polymer fume fever can lead to severe pulmonary changes such as edema, consolidation, and pneumonitis, whereas fatalities from polymer fume fever, although very rare, have also been documented [1] [4] [8]. Cigarette smoking is one of the most important risk factors, which led to severe smoking prohibitions in industrial areas where polytetrafluoroethylene is released in fumes [1] [2].
Workup
The rare appearance of polymer fume fever today can be challenging for the physician. For this reason, a detailed patient history is of crucial importance in order to arrive at a diagnosis [2] [4]. Basic features of symptoms (their pattern, time of onset, and duration) should be assessed, together with an occupational history that will reveal to which hazardous compounds the individual exposed to. Inhalation of fumes in households during cooking might also be a route of exposure [5], further emphasizing the essential role of a detailed assessment of activities that preceded the onset of symptoms. Imaging studies of the lungs may be necessary when severe symptoms are present, but it is not uncommon for chest X-rays to yield normal findings [6]. However, consolidation and patchy infiltration of the lungs might be observed on plain radiography or computed tomography (CT) [1] [6]. Pulmonary edema, although being a rare entity in polymer fume fever, can be seen as a bilateral ground-glass opacity or consolidation on CT [8]. Other notable findings in the workup include reduced lung capacity on pulmonary function testing, leukocytosis, and elevated erythrocyte sedimentation rate (ESR) [3] [6] [7].
Treatment
Treatment for Polymer Fume Fever is mainly supportive. Patients are advised to rest, stay hydrated, and use over-the-counter medications like acetaminophen or ibuprofen to alleviate fever and body aches. In most cases, symptoms resolve on their own within a couple of days. Avoiding further exposure to PTFE fumes is critical to prevent recurrence.
Prognosis
The prognosis for Polymer Fume Fever is excellent, as it is a self-limiting condition with no known long-term health effects. Symptoms typically resolve within 24 to 48 hours, and patients can return to normal activities once they feel better. However, repeated exposure should be avoided to prevent recurrent episodes.
Etiology
Polymer Fume Fever is caused by inhaling fumes from overheated PTFE, a synthetic fluoropolymer used in various applications, including non-stick cookware and industrial processes. When PTFE is heated above 300°C (572°F), it releases fumes that can irritate the respiratory system and cause the symptoms associated with this condition.
Epidemiology
Polymer Fume Fever is relatively rare and primarily affects individuals who work in environments where PTFE is heated, such as in certain manufacturing industries or kitchens using non-stick cookware. The condition is more common in occupational settings than in the general population.
Pathophysiology
The pathophysiology of Polymer Fume Fever involves the inhalation of PTFE fumes, which contain ultrafine particles and gases that irritate the respiratory tract. This irritation triggers an inflammatory response, leading to the flu-like symptoms experienced by affected individuals. The exact mechanism by which these fumes cause symptoms is not fully understood.
Prevention
Preventing Polymer Fume Fever involves minimizing exposure to PTFE fumes. This can be achieved by using proper ventilation in areas where PTFE is heated, maintaining cookware at safe temperatures, and using protective equipment in occupational settings. Educating workers and the public about the risks associated with overheating PTFE is also essential.
Summary
Polymer Fume Fever is a temporary, flu-like illness caused by inhaling fumes from overheated PTFE. It presents with symptoms such as fever, chills, and body aches, which resolve within a couple of days. Diagnosis is based on exposure history, and treatment is supportive. Preventive measures focus on reducing exposure to PTFE fumes.
Patient Information
If you experience flu-like symptoms after being exposed to fumes from non-stick cookware or other PTFE materials, you may have Polymer Fume Fever. Symptoms include fever, chills, and body aches, and they usually go away on their own within a day or two. To prevent this condition, ensure good ventilation when using non-stick cookware and avoid overheating it. If symptoms persist or worsen, consult a healthcare professional for further evaluation.
References
- Shusterman DJ. Polymer fume fever and other fluorocarbon pyrolysis-related syndromes. Occup Med. 1993;8:519–531.
- Centers for Disease Control (CDC). Polymer-fume fever associated with cigarette smoking and the use of tetrafluoroethylene--Mississippi. MMWR Morb Mortal Wkly Rep. 1987;36(31):515-5166, 521-522.
- Son M, Maruyama E, Shindo Y, Suganuma N, Sato S, Ogawa M. Case of polymer fume fever with interstitial pneumonia caused by inhalation of polytetrafluoroethylene (Teflon). Chudoku Kenkyu 2006;19:279–282.
- Shimizu T, Hamada O, Sasaki A, Ikeda M. Polymer fume fever. BMJ Case Rep. 2012;2012:bcr2012007790.
- Kales SN Christiani DC . Progression of chronic obstructive pulmonary disease after multiple episodes of an occupational inhalation fever. J Occup Med 1994;36:75–78.
- Greenberg MI, Vearrier D. Metal fume fever and polymer fume fever. Clin Toxicol (Phila). 2015;53(4):195-203.
- Sharman P, Wood-Baker R. Interstitial lung disease due to fumes from heat-cutting polymer rope. Occup Med (Lond). 2013;63(6):451-453.
- Hamaya R, Ono Y, Chida Y, et al. Polytetrafluoroethylene fume-induced pulmonary edema: a case report and review of the literature. J Med Case Rep. 2015;9:111.