Acute Respiratory Distress Syndrome Caused by Occupational Exposure to Waterproofing Spray: A Case Report and Literature Review

Abstract

BackgroundAcute respiratory distress syndrome (ARDS) is a serious respiratory disease, caused by severe infection, trauma, shock, inhalation of harmful gases and poisons and presented with acute-onset and high mortality. Timely and accurate identification will be helpful to the treatment and prognosis of ARDS cases. Herein, we report a case of ARDS caused by occupational exposure to waterproofing spray. To our knowledge, inhalation of waterproofing spray is an uncommon cause of ARDS, and what makes our case special is that we ruled out concurrent infections with some pathogens by using metagenomic next-generation sequencing (mNGS) as an auxiliary diagnosis, which presents the most comprehensive etiological examination of similar reports.Case PresentationA previously healthy 25 years old delivery man developed hyperpyrexia, chest tightness, cough and expectoration. The symptoms occurred and gradually exacerbated after exposure to a waterproofing spray. The chest computed tomography (CT) finding showed diffuse ground glass and infiltrative shadows in both lungs. The diagnosis of ARDS related to waterproofing spray was established on the basis of comprehensive differential diagnosis and etiological examination. The patient achieved good curative effect after proper systemic glucocorticoid therapy.ConclusionsThe diagnosis and differential diagnosis of acute respiratory failure for outdoor workers, such as delivery drivers or hikers, should be considered whether toxic aerosol exposure exists from daily contacts. The case can educate the public that more attention should be paid to avoid exposure to these chemicals by aerosols/ingestion mode and some preventive strategies should be taken in occupational environment. The treatment effect of glucocorticoids is significant in ARDS patients with general chemical damage caused by inhaling toxic gases and substances.

Waterproofing Spray-Associated Lung Injury Review: Differences between Cases of Early and Delayed Improvement of Waterproofing Spray-Associated Lung Injury

“…Patients with chemical pneumonitis due to the inhalation of products other than waterproofing sprays were excluded, and the articles that did not report the duration of improvement and laboratory data were excluded. The age, sex, pack-years, chief complaints, radiological findings, use of steroid treatment (or not), and duration of WALI improvement were investigated [ 2 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ].…”

Tiny Guides, Big Impact: Focus on the Opportunities and Challenges of miR-Based Treatments for ARDS

“…There are over 60 known causes of Acute Respiratory Distress Syndrome (ARDS) [ 1 , 2 ], including pneumonia (e.g., infection by bacteria [ 3 , 4 ], viruses [ 5 , 6 , 7 , 8 ], and fungi [ 9 ]), systemic diseases (e.g., sepsis) [ 10 , 11 ], severe trauma [ 12 ], multiple transfusions [ 13 ], chemotherapy [ 14 ], toxic inhalations [ 15 ], pancreatitis [ 16 ], and chemical/biological warfare [ 17 ]—all of which may require advanced respiratory support such as supplemental oxygen, mechanical ventilation (MV), or extracorporeal membrane oxygenation (ECMO) [ 18 ].…”