Acute Lung Injury after Inhalation of Water-Proofing Spray while Smoking a Cigarette

Abstract

A 34-year-old Japanese woman developed acute lung injury soon after inhaling a water-proofing spray which she applied onto her ski suit while smoking a cigarette at the same time. She initially demonstrated arterial hypoxemia (PaO₂ = 59 mm Hg) and ground-glass opacities in both lung fields on the CT scan, which both returned to normal without any medication. Several water-proofing sprays, which are easily obtainable in Japan, contain 1,1,1-trichloroethane, liquefied petroleum gas and fluoride resin. Although these components have not been reported to be toxic to the lung yet, high concentrations of these components and/or the pyrolytic products of fluoride resin may have caused acute lung injury in this case.

Acute pulmonary toxicity following occupational exposure to a floor stain protector in the building industry in Switzerland

“…As reported in previously published observations [2,7,18], influenza-like symptoms often accompany acute respiratory symptoms and are similar to those observed in polymer fume fever. In patient 2, heat decomposition products of the fluoro-resin, resulting from cigarette smoking with spray-contaminated fingers during or just after coating, might have led to worsening of symptoms.…”

Effectiveness of CT for Clinical Stratification of Occupational Lung Edema

“…The periphery of the lungs was reported to be normal except in the seriously ill cases 7,13,14) . These findings are the same as those in the cases of the present study.…”

“…Previous studies have found that smoking and indoor heating are responsible for the development of lung injury following the use of waterproof sprays [7][8][9][10] . Lit cigarettes or heaters can induce pyrolysis of PTFE particles, and pyrolytic products of PTFE and other fluororesins can cause lung injury such as the so-called 'polymer fume fever' 3-8, 10, 16) .…”

“…A previous case report relates the case of a woman who began to complain of cough and dyspnea 5 h after inhalation of a waterproofing spray 10) . The period of latency between exposure and the development of dyspnea varies from almost no delay to several hours or more [7][8][9][10][11] . Our patients began to complain of dyspnea more than 12 h after exposure to the spray.…”

“…Many similar cases were reported abroad [3][4][5][6] . PTFE and fluororesin produce hazardous materials when heated and are known to cause lung injury [7][8][9][10][11] . Smoke flares are used by the police and armed forces in the course of active duty and during training.…”