A case of pneumoconiosis complicated by rheumatoid arthritis in electric welder

Introduction. Until now, the development of rheumatoid arthritis has been customarily not considered as a typical complication of pneumoconiosis in electric welders and gas cutters.

Materials and methods. The medical documentation related to the circumstances of the examination in the clinic of the North-West Scientific Center for Hygiene and Public Health in an electric welder of a shipbuilding enterprise, who was found to have a combination of diffuse focal opacities in the lungs with rheumatoid arthritis, was studied and analyzed.

Results. The diffuse focal opacities in the lungs typical for pneumoconiosis and symptoms of rheumatoid arthritis had been developed in a shipbuilding enterprise welder with about 15–16 years of experience. The pathology was classified as welder’s pneumoconiosis complicated by rheumatoid arthritis. The investigation of the case of occupational disease, has been going on for more than 3 years due to the difficulties in collecting information about the patient’s working conditions at several different enterprises in the past. At that period of time, the patient was unjustifiably dismissed from work without adequate financial compensation. Following up the patient demonstrated the development of methotrexate-induced alveolitis as a complication of the rheumatoid arthritis treatment. The presented clinical case demonstrated certain shortcomings of the regulatory framework for occupational pathology, requiring clearer regulation.

Limitations. The described observation is referred to isolated cases, therefore, for more representative conclusions, generalizations based on larger factual data are desirable.

Conclusion. In the clinical aspect, the described case is an argument in favor of the possibility of recognizing rheumatoid arthritis as a complication of pneumoconiosis caused by exposure to metal condensation aerosols, including pneumoconiosis of electric welders and gas cutters.

Compliance with ethical standards. The study was performed using non-invasive methods and complies with the ethical standards of the Helsinki Declaration of the WMA, the principles of the National Standard of the Russian Federation GOST R 52379-2005 “Good Clinical Practice” and other regulatory requirements of the Russian Federation. Before the start of the study, approval was obtained from the Local Ethics Committee of the Northwestern Scientific Center of Hygiene and Public Health, protocol No. 531.1 dated January 16, 2025.

Contribution:
Boiko I.V. — concept and design of the study, writing the text, editing;
Shalukho E.S. — collection of material and data processing;
Orlova G.P. — collection of material and data processing, writing the text;
Andreenko O.N. — collection of material, data processing, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Funding. The study had no sponsorship.

Received: April 25, 2025 / Accepted: June 26, 2025 / Published: September 25, 2025

1. Navrotskii V.K. Pneumoconiosis in Ukraine and measures to combat it. Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 1967; 46(7): 50–4. (in Russian)

2. Glotova V.K. Pneumoconiosis of electric welders and gas cutters. In: Handbook of Occupational Diseases, volume II [Rukovodstvo po professional’nym zabolevaniyam, tom II]. Moscow; 1983: 77–80. (in Russian)

3. Artemova L.V., Babanov S.A., Buryakina E.A., Bushmanov A.Yu., Vasileva O.S., Garipova R.V., et al. Occupational diseases of the tracheobronchial tree. In: Bukhtiyarov I.V., ed. Occupational Pathology: National Guide [Professional’naya patologiya: natsional’noe rukovodstvo]. Moscow: GEOTAR-Media; 2024: 202–409. https://elibrary.ru/axivji (in Russian)

4. Libis R.A., Kulbaisov A.M., Solonovich T.G. Peculiarities of occupational pathology in electric welders. Clinical cases. Klinicheskie sluchai. Terapevt. 2011; (7): 49–52. https://elibrary.ru/pfrgfv (in Russian)

5. Mogilevets O.N., Deshko T.A., Kotova K.V. Features of pneumoconiosis epidemiology in the Grodno region. In: Current Problems of Medicine: Materials of the Annual Final Scientific-Practical Conference January 25, 2019 [Aktual’nye problemy meditsiny: materialy ezhegodnoi itogovoi nauchno-prakticheskoi konferentsii 25 yanvarya 2019 g.]. Grodno; 2019: 381–4. (in Russian)

6. Orlova G.P., Yakovleva N.S., Il’kovich M.M. Drug-induced lung injuries. In: Ilkovich M.M., ed. Diffuse Parenchymal Lung Diseases [Diffuznye parenkhimatoznye zabolevaniya legkikh]. Moscow; 2021: 174–218. (in Russian)

7. Bourmistrova T.B., Komarova T.A. Peculiarities of pulmonary x-ray changes due to exposure to welding aerosol. Meditsina truda i promyshlennaya ekologiya. 2009; 49(9): 23–9. https://elibrary.ru/kvmwxl (in Russian)

8. Babanov S., Strizhakov L., Budash D., Baikova A., Vostroknutova M. Pneumoconiosis: view modifications, molecular genetic markers, pharmacotherapy. Vrach. 2019; 30(2): 19–26. https://doi.org/10.29296/25877305-2019-02-03 https://elibrary.ru/yybmqx (in Russian)

9. Babanov S.A., Gailis P.V. Pneumoconioses from exposure to industrial dust of varying fibrogenicity. Trudnyi patsient. 2010; 5(8): 35–8. https://elibrary.ru/ogbnuf (in Russian)

10. Babanov S.A., Strizhakov L.A., Lebedeva M.V., Fomin V.V., Budash D.S., Baikova A.G. Pneumoconiosises: modern view. Terapevticheskii arkhiv. 2019; 91(3): 107–13. https://doi.org/10.26442/00403660.2019.03.000066 https://elibrary.ru/zdfpdv (in Russian)

11. Grinberg L.M., Valamina I.E., Meshcheryakova E.Y., Roslaya N.A. The algorithm of morphological diagnosis of dusty lesions of the lungs in tumors according to resection data. Meditsina truda i promyshlennaya ekologiya. 2020; 60(2): 93–9. https://doi.org/10.31089/1026-9428-2020-60-2-93-99 https://elibrary.ru/ajrmdi (in Russian)

12. Elifanov A.V., Kovyazina O.L., Lepunova O.N., Shalabodov A.D. The impact of working conditions on indicators of cardiorespiratory system and blood in electric welders with different lengh of work. Ekologiya cheloveka. 2018; (3): 27–32. https://doi.org/10.33396/1728-0869-2018-3-27-32 https://elibrary.ru/yrflvd (in Russian)

13. Fernández Álvarez R., Martínez González C., Quero Martínez A., Blanco Pérez J.J., Carazo Fernández L., Prieto Fernández A. Guidelines for the diagnosis and monitoring of silicosis. Arch. Bronconeumol. 2015; 51(2): 86–93. https://doi.org/10.1016/j.arbres.2014.07.010

14. Chuntyzheva E.G., Lunyakov V.A., Tverdova L.V., Panfilov Yu.A. Caplan’s syndrome as a rare complication of silicosis in clinical practice. Zemskii vrach. 2017; (1): 56–9. https://elibrary.ru/zvhyql (in Russian)

15. Chuntyzheva E.G., Lunyakov V.A., Uryasev O.M. Cases of rare silicosis complications in clinical practice. Meditsina truda i promyshlennaya ekologiya. 2017; 57(5): 50–4. https://elibrary.ru/ynunib (in Russian)

16. Yates D.H., Johnson A.R. Silicosis and other silica-related lung disorders. In: Occupational and Environmental Lung Disease. ERS Monograph. ERS Publications; 2020: 150–75. https://doi.org/10.1183/2312508X.10034819

17. Boiko I.V., Grebenkov S.V., Vinogradova E.V., Dedcova L.E. Common shortcomings of labor hygienic characteristics complications from view occupational diseases doctor. Sanitarnyi vrach. 2014; (9): 26–30. https://elibrary.ru/szojxf (in Russian)