Occupational Airway Diseases

Schachter, E. Neil; Zuskin, E; Šarić, Marko

doi:10.1515/reveh.2001.16.2.87

Cited by 11 publications

(7 citation statements)

References 24 publications

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“…There is a broad range of agents that have been reported as known or suspected causes of either chronic bronchitis, bronchiolitis, BO disease, and/or similar small airways disease in humans, as illustrated for environmental exposures and disease states in Table 2 [3] , [5] , [8] , [10] , [12] , [52] , [56] , [68] , [73] , [79] , [85] , [87] , [97] , [106] , [110] . With respect to pharmaceutical or iatrogenic associations (see Table 3 ), most cases of BO disease are linked to heart/lung and bone marrow transplants and autoimmune connective tissue disease risk factors listed in Table 3 , with the infectious agents more prominently affecting young children [12] , [17] , [79] .…”

Section: Risk Factors For Restrictive and Obstructive Lung Diseases Amentioning

confidence: 99%

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Pathology, toxicology, and latency of irritant gases known to cause bronchiolitis obliterans disease: Does diacetyl fit the pattern?

Kerger

Fedoruk

2015

Toxicology Reports

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Bronchiolitis obliterans (BO) is a rare disease involving concentric bronchiolar fibrosis that develops rapidly following inhalation of certain irritant gases at sufficiently high acute doses. While there are many potential causes of bronchiolar lesions involved in a variety of chronic lung diseases, failure to clearly define the clinical features and pathological characteristics can lead to ambiguous diagnoses. Irritant gases known to cause BO follow a similar pathologic process and time course of disease onset in humans. Studies of inhaled irritant gases known to cause BO (e.g., chlorine, hydrochloric acid, ammonia, nitrogen oxides, sulfur oxides, sulfur or nitrogen mustards, and phosgene) indicate that the time course between causal chemical exposures and development of clinically significant BO disease is typically limited to a few months. The mechanism of toxic action exerted by these irritant gases generally involves widespread and severe injury of the epithelial lining of the bronchioles that leads to acute respiratory symptoms which can include lung edema within days. Repeated exposures to inhaled irritant gases at concentrations insufficient to cause marked respiratory distress or edema may lead to adaptive responses that can reduce or prevent severe bronchiolar fibrotic changes. Risk of BO from irritant gases is driven substantially by toxicokinetics affecting concentrations occurring at the bronchiolar epithelium. Highly soluble irritant gases that cause BO like ammonia generally follow a threshold-dependent cytotoxic mechanism of action that at sufficiently high doses results in severe inflammation of the upper respiratory tract and the bronchiolar epithelium concurrently. This is followed by acute respiratory distress, pulmonary edema, and post inflammatory concentric fibrosis that become clinically obvious within a few months. In contrast, irritant gases with lower solubility like phosgene also follow a threshold-dependent mechanism of cytotoxicity action but can exhibit more insidious and isolated bronchiolar tissue damage with a similar latency to fibrosis. To date, animal and human studies on the highly soluble gas, diacetyl, have not identified a coherent pattern of pathology and latency that would be expected based on studies of other known causes of bronchiolitis obliterans disease.

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Section: Risk Factors For Restrictive and Obstructive Lung Diseases Amentioning

confidence: 99%

“…Additional insights regarding the potential causes of BO disease can be gleaned from the magnitude of exposure and timing between the suspected causal exposure and the onset of airway injury responses. Schacter and colleagues [87] noted,…”

Section: Time Course and Pathology Associated With Inhaled Irritant Gmentioning

confidence: 99%

Pathology, toxicology, and latency of irritant gases known to cause bronchiolitis obliterans disease: Does diacetyl fit the pattern?

Kerger

Fedoruk

2015

Toxicology Reports

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“…1,61 Although there are several patterns of primary bronchiolitis, constrictive bronchiolitis (also called obliterative bronchiolitis or bronchiolitis obliterans) is the most pertinent for a discussion of inhalation injuries. 61 Constrictive bronchiolitis often accompanies a connective tissue disorders.…”

Section: Bronchiolitis Obliteransmentioning

confidence: 99%

“…1,[61][62][63][64] There were sporadic cases of bronchiolitis obliterans among nylon-flock workers, workers who sprayed prints onto textiles ͓with polyamide-amine (Acramin FWN, Bayer) dyes͔, battery workers (who were exposed to thionyl chloride fumes), and workers in the food-flavoring industry. 65 Purportedly, there is a classic 3-phase pattern of response to gaseous exposures such as nitrogen dioxide.…”

Section: Brooksmentioning

confidence: 99%

“…If the intensity or toxicity of the exposure is great, consequential outcomes may be upper airways damage (corneal damage, swelling of the tongue, persistent rhinitis, closure of the glottis and larynx), asthma reactive airways dysfunction syndrome (RADS), adult respiratory distress syndrome (ARDS), or persistent bronchiolar obstruction (bronchiolitis obliterans). 1 In 1985, Brooks et al reported the clinical and pathologic descriptions of RADS. 2 Although this type of airways disorder was not a new entity, it attracted a lot of attention.…”

mentioning

confidence: 99%

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