Bronchiolitis obliterans in an animal feed worker

Spain, Blake A.; Cummings, Oscar W.; Garcia, Joe G.N.

doi:10.1002/ajim.4700280312

Cited by 14 publications

(8 citation statements)

References 8 publications

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“…We have not found any reports that indicate an association between human neoplasms and amorphous silica exposure. Recently, a case of bronchiolitis obliterans was reported in an animal feeder who had been exposed to a large number of agents, including crystalline and amorphous silicas, microorganisms, proteolytic enzymes, and various organic substances, but the specific effect of amorphous silica was not delineated (Spain et al, 1995). Table 1 summarizes epidemiologic studies, including cross-sectional surveys and cohort studies, of health effects among workers that were known to have been exposed to amorphous silicas.…”

Section: Health Effects Of Amorphous Silica Exposure On Humansmentioning

confidence: 96%

Amorphous silica: A review of health effects from inhalation exposure with particular reference to cancer

McLaughlin

Chow

Levy

1997

Journal of Toxicology and Environmental Health

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Silicas and silicates are some of the most abundant compounds found naturally in the earth's crust. Excessive exposure to crystalline silicas can cause serious lung disease such as silicosis and has been associated with lung cancer in some studies, but the potential health effects of amorphous silicas (silicon dioxide without crystalline structure) have not been well studied. Results from animal studies of amorphous silicas, unlike those seen with crystalline silicas, have suggested limited and largely reversible cytotoxic and possibly fibrogenic effects associated with some forms, but data on cancer outcomes are scanty and for the most part negative. Epidemiologic investigations to date for any potential cancer risk are not informative because the effects of crystalline and amorphous silicas have not been separated. Any future epidemiologic study should attempt to clarify the health effects of amorphous silicas from those of crystalline silicas, particularly with regard to any potential for carcinogenicity.

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Section: Health Effects Of Amorphous Silica Exposure On Humansmentioning

confidence: 96%

Amorphous silica: A review of health effects from inhalation exposure with particular reference to cancer

McLaughlin

Chow

Levy

1997

Journal of Toxicology and Environmental Health

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“…Occupational factors are typically recognised when workers develop fixed airways obstruction following acute lung injury caused by high workplace concentrations of noxious gases, including nitrogen dioxide, sulphur dioxide, phosgene, ammonia and chlorine [1]. The implicated causal exposures usually arise from chemical spills or other unanticipated circumstances, rather than in the course of routine work [2][3][4][5]. Nine cases of bronchiolitis obliterans syndrome without a history of chemical spills or high levels of acute exposure to recognised hazardous occupational agents from a popcorn production plant are reported here.…”

mentioning

confidence: 99%

Bronchiolitis obliterans syndrome in popcorn production plant workers

Akpinar‐Elci¹,

Travis²,

Lynch³

et al. 2004

Eur Respir J

191

177

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Following sentinel case recognition, an excess of fixed airways obstruction was found among current workers in a microwave popcorn plant associated with butter flavouring exposures.In order to characterise the clinical presentation of sentinel cases, the medical records of sentinel cases were reviewed, interviews conducted and serial spirometric testing performed.Cases worked in microwave popcorn production, and five of the nine cases had mixed flavourings. Most had never smoked or smoked minimally. Cases showed onset of cough, shortness of breath and wheezing 5 months to 9 yrs after starting work at the popcorn plant. Initial forced expiratory volume in one second ranged 14.0-66.8% of the predicted value. Eight high-resolution computed tomography scans showed marked bronchial wall thickening and mosaic attenuation with air trapping. Open lung biopsy results were consistent with, or diagnostic of, constrictive bronchiolitis in two of three cases. Five cases are on lung transplantation waiting lists. After leaving employment, nearly all cases experienced stabilisation of their lung function within 2 yrs.Astute clinicians can help identify new causes of airways obstruction by alerting public health authorities to unexplained disease cases occurring in groups of workers.

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“…These include burning jet fuel, combustion of trash pits, sand from sandstorms, aerosolised metal from detonated Improvised Explosive Devices (IEDs) and mustard gas 7. Normal, everyday environmental exposures such as inhaling animal feed and cigarette smoke have also been reported to cause CB 8. Less commonly, CB can be a result of viral or atypical mycoplasma infection and has been linked to rheumatoid arthritis 1.…”

Section: Discussionmentioning

confidence: 99%

Constrictive bronchiolitis presenting with a mixed obstructive and restrictive pattern, associated with acid reflux

Capel

Shih

2017

BMJ Case Reports

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A previously healthy 55-year-old woman presented with worsening dyspnoea on exertion. The patient lived at altitude, did not smoke and had no exposure to occupational or environmental toxins. Her physical examination, including pulmonary, was unremarkable. Pulmonary function tests showed forced expiratory volume in 1 s/forced vital capacity ratio 74% predicted, diffusing capacity for carbon monoxide (DLCO) 92% predicted and residual volume 213% predicted. Rheumatological workup was negative. Chest radiograph showed hyperinflation without consolidation, and high-resolution chest CT showed mosaic attenuation with air trapping on expiratory imaging. A decreasing DLCO lead to transbronchial biopsies that were inconclusive. A video-assisted thoracic surgery lung biopsy showed small airway disease suggestive of constrictive bronchiolitis. Oesophagram and a barium swallow showed a hiatal hernia with large volume gastro-oesophageal reflux to the level of the clavicles. The development of constrictive bronchiolitis in this patient was possibly secondary to hiatal hernia and silent gastroesophageal reflux disease (GERD). In the face of presumably idiopathic lung disease, clinicians should perform a GERD workup even in the absence of GERD symptoms.

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Bronchiolitis obliterans in an animal feed worker

Cited by 14 publications

References 8 publications

Amorphous silica: A review of health effects from inhalation exposure with particular reference to cancer

Amorphous silica: A review of health effects from inhalation exposure with particular reference to cancer

Bronchiolitis obliterans syndrome in popcorn production plant workers

Constrictive bronchiolitis presenting with a mixed obstructive and restrictive pattern, associated with acid reflux

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