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We performed manual searching for articles in the Library of the Surgeon General's Office (the precursor to Index Medicus), in the Hathi Trust database, in PubMed, andby screening reference lists in literature appearing before the introduction of PubMed. An early body of literature, from the 1890s onward, recognized that pneumonia was linked to \u201cThomas slag,\u201d a steel industry byproduct containing iron, manganese, and lime. Researchers, mainly in Germany, showed that workers in metal\u2010dust\u2010exposed occupations, especially using manganese, manifested an increased incidence of pneumococcal pneumonia. An outbreak of pneumococcal pneumonia in the 1930s implicated manganese fume in its etiology. In the immediate post\u2010World War II period, there was a brief flurry of interest in pneumonia from exposure to potassium permanganate that was soon dismissed as a chemical pneumonitis. After a hiatus of two decades, epidemiologic investigations drew attention to the pneumonia risks of welding and related metal fume exposure, bringing renewed interest to the forgotten role of pneumococcal pneumonia as an occupational disease. Occupational or environmental inhalation of manganese, iron, or irritants may be causally related to increased pneumococcal pneumonia risk. In particular, the risk associated with manganese seems to be overlooked in recent literature. An important conclusion is the importance of obtaining additional evidence through a deeper assessment of the literature in a broad historical context.<\/jats:p>","DOI":"10.1002\/ajim.23352","type":"journal-article","created":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T02:44:57Z","timestamp":1648608297000},"page":"517-524","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Pneumococcal pneumonia on the job: Uncovering the past story of occupational exposure to metal fumes and dust"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8509-7603","authenticated-orcid":false,"given":"Kjell","family":"Tor\u00e9n","sequence":"first","affiliation":[{"name":"Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"},{"name":"Department of Occupational and Environmental Medicine Sahlgrenska University Hospital Gothenburg Sweden"},{"name":"Discipline of Occupational and Environmental Health University of KwaZulu\u2010Natal Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2318-4004","authenticated-orcid":false,"given":"Rajen N.","family":"Naidoo","sequence":"additional","affiliation":[{"name":"Discipline of Occupational and Environmental Health University of KwaZulu\u2010Natal Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9043-175X","authenticated-orcid":false,"given":"Paul D.","family":"Blanc","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Occupational and Environmental Medicine University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)91056-1"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwf188"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.114280"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2011-200707"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2017.06.010"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2010.02.2268"},{"key":"e_1_2_10_8_1","first-page":"781","article-title":"A fatal form of septicaemia in the rabbit, produced by the subcutaneous injection of human saliva. 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