{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T07:03:45Z","timestamp":1778569425796,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T00:00:00Z","timestamp":1616371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Inhalation of welding fume may cause pulmonary disease known as welder's lung. At our centre we came across a number of welders with systemic iron overload and prolonged occupational history and we aimed at characterizing this novel clinical form of iron overload.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>After exclusion of other known causes of iron overload, 20 welders were fully evaluated for working history, hepatic, metabolic and iron status. MRI iron assessment was performed in 19 patients and liver biopsy in 12. We included 40 HFE\u2010HH patients and 24 healthy controls for comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>75% of patients showed lung HRCT alterations; 90% had s\u2010FERR\u00a0&gt;\u00a01000\u00a0ng\/mL and 60% had TSAT\u00a0&gt;\u00a045%. Liver iron overload was mild in 8 and moderate\u2010severe in 12. The median iron removed was 7.8\u00a0g. Welders showed significantly lower TSAT and higher SIS and SIS\/TIS ratio than HFE\u2010HH patients. Serum hepcidin was significantly higher in welders than in HFE\u2010HH patients and healthy controls. At liver biopsy, 50% showed liver fibrosis that was mild in four, and moderate\u2010severe in two. Liver staging correlated with liver iron overload.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Welders with prolonged fume exposure can develop severe liver iron overload. The mechanism of liver iron accumulation is quite different to that of HFE\u2010HH suggesting that reticuloendothelial cells may be the initial site of deposition. We recommend routine measurement of serum iron indices in welders to provide adequate diagnosis and therapy, and the inclusion of prolonged welding fume exposure in the list of acquired causes of hyperferritinemia and iron overload.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14874","type":"journal-article","created":{"date-parts":[[2021,3,13]],"date-time":"2021-03-13T16:41:39Z","timestamp":1615653699000},"page":"1600-1607","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Prolonged exposure to welding fumes as a novel cause of systemic iron overload"],"prefix":"10.1111","volume":"41","author":[{"given":"Raffaella","family":"Mariani","sequence":"first","affiliation":[{"name":"Centre for Rare Diseases \u2010 Disorders of Iron Metabolism \u2010 ASST\u2010Monza Centre of European Reference Network (EuroBloodNet) San Gerardo Hospital Monza Monza 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