Fatal Emphysema in Two Men Making a Copper Cadmium Alloy

Abstract

This paper gives an account of two patients who died of emphysema after working for a few years in a small foundry making various copper alloys, including one of copper cadmium. Acute cadmium poisoning has been recognized for many years, and the injurious effects of the metal fume upon the respiratory tract after single sharp exposures have been reported on several occasions. The earlier literature was well summarized by Prodan (1932). A report of 15 cases including two deaths was made by Bulmer and his fellow workers in 1938.* The clinical picture was one of intense respiratory irritation, causing praecordial pain and severe dyspnoea. This came on a few hours after exposure which at the time did not cause sufficient discomfort to make the men leave their work. In the fatal cases death occurred in five to eight days ; no signs of systemic poisoning were noted. W?hle (1932) recorded acute poisoning in a man making copper cadmium alloy ; he had praecordial and epigastric pain, with vomiting and severe dyspnoea. The possibility of chronic cadmium poisoning occurring in men exposed to repeated small doses of cadmium metal fume was first suggested by Hardy and Skinner (1947). They recorded undue fatigue and vague gastro-intestinal symptoms in five men subjected to minor degrees of cadmium exposure. Friberg (1950) first drew attention to an unusual proteinuria in workers exposed to cadmium oxide and at the same time described anosmia and emphysema in the same group. Emphysema was confirmed at the necropsy of one patient and reduced respiratory efficiency was found in others. Baader (1951) made similar observations in a group of men exposed to cadmium oxide. Process