Painter says he was fired over sick days. Doctors say he had ‘Monday fever’ from job
At some point in everyone’s career, you get a case of the Mondays. You’ve had a fantastic weekend with friends or family, and the dread of the Monday morning alarm almost makes you hit snooze and call in sick to hang on to your restful feeling.
For most, the feeling passes when you get back into the swing of your work week, the weekend now days behind you.
But for one commercial painter in Germany, the sick feeling that hit him at the beginning of each week couldn’t be fixed by a few extra hours of sleep or a cup of coffee, and it cost him his job.
Then, doctors discovered the same job was to blame for his very real illness.
The case
A German man, now 33 years old, finished his apprenticeship as a painter and varnisher in 2006, then spent the next three years working as a spray painter for various companies, according to a case report published July 10 in the Journal of Medical Case Reports.
In July 2020, he joined a new company and spent a year without any health concerns, aside from his smoking, doctors said.
He spent his days painting in a hall without exhaust systems, doctors said, and wore only a half mask with a filter that wasn’t replaced often. He was in charge of spray painting large parts of machinery, a process completed in cold temperatures, according to the case report.
Then, in June 2021, he started to experience shortness of breath, tightness in his chest and “flu-like” symptoms when he would come home from work, sometimes with a fever in the evenings, according to the case report.
This went on for three months before the painter took a vacation, lasting three weeks, and didn’t experience any of the same symptoms, doctors said.
After just one day back at work, his respiratory tract was irritated again, he was sweating and feeling like he had the flu, according to the case report.
Three days after he came back from vacation, he had a fever of 104 degrees Fahrenheit and took another three weeks of sick leave, doctors said. Again, his symptoms subsided and he returned to work.
This time, just hours after he was back painting his symptoms began and he requested more time off, according to the case report.
It was one leave too many for his employer.
“He was dismissed by his employer owing to repetitive sick leaves,” doctors said, just six months after his symptoms began.
That is when he arrived at the Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, hoping to find some answers.
The diagnosis
When the painter filled out his medical history, he wrote that he believed he was working in poor conditions, according to the case report.
He regularly used zinc-based paint without a mask, becoming coated in a “zinc mist,” when his half mask became too coated to breathe through.
During his medical evaluation, doctors were unable to find any airway obstructions that could explain his difficulty breathing while working, according to the report, and lab chemistry and urine samples returned normal.
Doctors thought the cause of the symptoms may then be environmental.
The man completed a questionnaire that described his exact symptoms at each time that he requested leave from work, including “muscle pain, chills, feeling sick, feeling unwell, feeling feverish, feeling cold, shortness of breath, headache, fatigue, nausea and a metallic taste in the mouth.”
The painter had zinc poisoning, or “metal fume fever,” doctors concluded.
“Zinc fever is particularly known to develop during the welding of zinc-coated materials,” doctors wrote. “The highly heated zinc oxidizes in the air to ZnO and can be released into the environment as a zinc-containing aerosol. Inhaled ZnO causes systemic and local effects in the organism.”
Monday Fever
The symptoms only occur directly after exposure, according to the report, so zinc fever is also sometimes known as “Monday fever” because workers will be exposed during the week and feel ill, then have a weekend without exposure to feel better, only to fall ill again on Monday when the exposure resumes.
Zinc fever has been well-recorded in welders, doctors said, who regularly work with zinc at high heats, but it has never before been documented in a painter.
“When ZnO is inhaled as an aerosol (like spray paint), it is partially deposited in the respiratory tract. In the alveoli, the particles are taken up and decomposed by macrophages for elimination from the lungs,” according to the report.
As the ZnO breaks down, zinc ions are released in high concentrations, causing a buildup that leads to the “flu-like” symptoms, doctors said.
After the painter was let go, the company he worked for began taking “preventive measures” to protect his colleagues, according to the report.
“In the worker’s case, several episodes of an occupational accident were overlooked. Dismissal was possibly unlawful,” doctors said.
They noted that the symptoms of Monday fever could easily be overlooked because of their similarity to respiratory illnesses, and doctors said the working conditions for those using zinc products should now also consider aerosols and low temperatures.
The Institute of the Ruhr-Universität Bochum is located in northwestern Germany.
