Uncommon evolution of fibrosing alveolitis in a hard metal grinder exposed to cobalt dusts

Zanelli, R.; Barbic, Franca; Migliori, Maurizio; Michetti, Giovanni

doi:10.1016/0048-9697(94)90157-0

Cited by 14 publications

(6 citation statements)

References 7 publications

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“…Previous study reported that chronic lung injury is related to diffuse pulmonary inflammation, which may promote interstitial pulmonary fibrotic disease such as IPF [27]. The pulmonary fibrosis has been shown to be associated with exposure to several chemical [28, 29].…”

Section: Discussionmentioning

confidence: 99%

Family-based case-control study of exposure to household humidifier disinfectants and risk of idiopathic interstitial pneumonia

et al. 2019

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Background In Korea, several household humidifier disinfectants (HDs) were clinically confirmed to cause HD-associated lung injury (HDLI). Polyhexamethylene guanidine (PHMG) phosphate is the main ingredient of the HDs found to be associated with lung disease. However, the association of HDs with other interstitial lung disease including idiopathic interstitial pneumonia (IIP) is not clear. We examined the relationship between HD exposure and IIP in a family-based study. Methods This case-control study included 244 IIP cases and 244 family controls who lived with the IIP patients. The IIP cases were divided into two groups, HDLI and other IIP, and were matched to family controls based on age and gender. Information on exposure to HDs was obtained from a structured questionnaire and field investigations. Conditional logistic regression was used to estimate odds ratio (ORs) and their corresponding 95% confidence interval (CI), investigating the association of HD-related exposure characteristics with IIP risk. Results The risks of IIP increased two-fold or more in the highest compared with the lowest quartile of several HD use characteristics, including average total use hours per day, cumulative sleep hours, use of HD during sleep, and cumulative exposure level. In analyses separated by HDLI and other IIP, the risks of HDLI were associated with airborne HD concentrations (adjusted OR = 3.01, 95% CI = 1.34–6.76; Q 4 versus Q 1 ) and cumulative exposure level (adjusted OR = 3.57, 95% CI = 1.59–8.01; Q 4 versus Q 1 ), but this relationship was not significant in the patients with other IIP. In comparison between HDLI and other IIP, the odds ratios of average total use hours, cumulative use hours, and cumulative sleeps hours was higher for other IIP. Conclusion The use of household HDs is associated not only with HDLI but also with other IIP.

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Section: Discussionmentioning

confidence: 99%

Family-based case-control study of exposure to household humidifier disinfectants and risk of idiopathic interstitial pneumonia

et al. 2019

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“…In the subacute form, dyspnea, cough, and constitutional symptoms including fevers, chills, and weight loss occur within months to years of the exposure [10,33,34]. Symptoms often occur during the exposure and may improve with removal from the exposure [35]. The latency period for the subacute form is months to years [10].…”

Section: Pulmonary Symptomsmentioning

confidence: 99%

Cobalt related interstitial lung disease

Adams

Butt

Batra

et al. 2017

Respiratory Medicine

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Cobalt exposure in the hard metal and bonded diamond tool industry is a well-established cause of ILD. The primary theories regarding the underlying mechanism of cobalt related ILD include an immunologic mechanism and an oxidant injury mechanism. Cobalt related ILD may present in subacute and chronic forms and often has associated upper respiratory symptoms. The evaluation begins with a thorough occupational history and includes PFTs, HRCT, and bronchoalveolar lavage. HRCT findings are nonspecific and may resemble NSIP, UIP, sarcoidosis, or HP. The finding of cannibalistic multinucleated giant cells is diagnostic provided there is a history of exposure and appropriate changes on imaging; however, when these cells are not found on lavage, lung biopsy is required for diagnosis. Giant cell interstitial pneumonia is the classic pathologic pattern, but cobalt related ILD may also present with pathologic findings of UIP, DIP, or HP. When cobalt related ILD is suspected, removal from exposure is the most important step in treatment. Case reports suggest that treatment with steroids results in symptomatic, physiologic, and radiographic improvement.

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“…Häufig kann ein unmittelbarer Bezug der Beschwerden zur beruflichen Tätigkeit belegt und in Frühstadien eine Symptomrückbildung nach Pausieren bzw. Aufgabe der Tätigkeit beobachtet werden [108]. Wie bei der EAA ist durch Reexposition die Auslçsung einer erneuten Symptomatik mçglich [109].…”

Section: Krankheitsbilderunclassified