Pulmonary injury associated with spray of a water-based nano-sized waterproofing product: a case study

Abstract

BackgroundIn most reported cases of lung trauma with water proofing products, volatile organic compounds (VOC) have a prominent role. Here we report on a case involving ten workers exposed to a sprayed product containing nanoparticles in a water solution with only a few percent VOC.Case presentationTen workers suffered from respiratory symptoms following spray impregnation of hardwood furniture using a waterproofing product that contained positively charged fluorinated acrylate copolymer solid cores with a median diameter of 70 nm (1.3 w%) in aqueous suspension with 3.3 w% VOC and 0.3 w% quaternary ammonium. The worker who applied one liter of the product in a wood workshop, using an air mix spray gun, did not report any health complaints. Another worker, who entered the workshop 3 h later and had rolled and smoked two cigarettes, was hospitalized with severe chemical pneumonitis. A chest X-ray (CXR) showed bilateral infiltrative impairment in the lower lobe regions. On the next day a second CXR showed increased patchiness marking in all fields. A high-resolution Computer Tomography (CT)-scan demonstrated extensive bilateral areas of ground-glass opacities predominantly in the lower regions of the upper lobes, the right middle lobe and the apical regions of the lower lobes, compatible with severe chemical pneumonitis. On the following morning, nine workers in an adjacent workplace in the same building, experienced dry cough, chest tightness and substernal pain upon physical exercise. Reconstruction of the spray application in a climate chamber confirmed trimethyl silanol, glycol ethers and fluoroalkenes in the gas phase. Immediately after the spray application, aerosols were observed at a maximum concentration of 6.3 × 104 cm−3. Mass concentrations were 0.095 and 10 mg/m3 in the size ranges 5.6-560 nm and 0.22-30 μm, respectively, decreasing to less than 10 μg/m3 in both size ranges after 15 h.ConclusionThe hospitalized worker had smoked cigarettes contaminated with fluoropolymers which is a plausible explanation for the lung trauma. Respiratory symptoms in the nine workers may be caused by inhalation of particles that became airborne by resuspension from surfaces when workers entered the adjacent workplace the next day. A contribution from VOC appears less likely because measurements and modelling showed that concentrations in the mg/m3 range could have occurred only if the building was assumed to be completely airtight.Electronic supplementary materialThe online version of this article (10.1186/s12995-017-0180-7) contains supplementary material, which is available to authorized users.

An adverse outcome pathway for lung surfactant function inhibition leading to decreased lung function

“…For impregnation products, there are products that have a large market share and thus have frequent use, but only occasionally cause decreased lung function, or where many people are exposed and only a few develop symptoms ( Scheepers et al, 2017 , Cormican and Rees, 2006 ). The explanation for this could have to do with dosimetry, i.e.…”

“…Respiratory symptoms following exposure to airborne substances (chemicals or particles) are reported regularly. In private homes, impregnation products are among the most commonly reported triggers of such symptoms ( Lazor-Blanchet et al, 2004 , Vernez et al, 2006 , Khalid et al, 2009 , Scheepers et al, 2017 , Tashiro et al, 1998 , Duch et al, 2014 , Laliberté et al, 1995 , Burkhart et al, 1996 , Malik and Chappell, 2003 ). In occupational settings, respiratory clinical signs of toxicity have been observed after workers’ exposure to cleaning products ( Clausen et al, 2020 , Medina-Ramon et al, 2006 , Vizcaya et al, 2015 ) and pesticides ( Slavica et al, 2018 ), among others.…”

New Occupational Exposures with Respiratory Effects

“…Exposure to polyacrylate nanoparticles was found associated with pleural effusion, pulmonary fibrosis, and granuloma among seven female workers working in a print plant 155 . Another study showed severe chemical pneumonitis with extensive bilateral ground-glass opacities in a worker exposed to nanosized positively charged fluorinated acrylate during spray painting wooden furnitures 156 . In a cross-sectional study on 28 workers of a Chinese manufacturing industry, Li and colleagues (2018) 157 reported a significant reduction in lung function of the workers as a result of long-term exposure to nanosized calcium carbonate.…”

Rare occupational respiratory diseases

“…W badaniach laboratoryjnych u części pacjentów wykazano leukocytozę [68]. W wykonanych badaniach w zależności od stanu klinicznego obserwowano hipoksję [68], zaburzenia restrykcyjne w badaniu spirometrycznym oraz obniżenie zdolności dyfuzyjnej [69].…”