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1/91. mycobacterium sp. as a possible cause of hypersensitivity pneumonitis in machine workers.

    hypersensitivity pneumonitis (HP) in workers exposed to metal removal fluids (MRFs) is increasing. This study supports the hypothesis that aerosolized mycobacteria colonizing the MRFs likely cause the disease. Three case studies of HP outbreaks among metal workers showed potentially high exposures to a rare and newly proposed mycobacterium species. Retrospective review of samples submitted to our laboratory showed an association between presence of mycobacteria and HP.
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keywords = exposure
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2/91. Extrinsic allergic alveolitis due to rat serum proteins.

    In a research assistant with recurrent episodes of extrinsic allergic alveolitis on exposure to rats, typical systemic and pulmonary reactions on inhalation and positive reaction on prick testing were elicited only by tests with rat serum; precipitins were present against rat serum and rat pelt, but not rat fur, and were also present against rat urine, which may contain large amounts of serum protein and which may have been a main source of antigenic exposure.
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ranking = 2
keywords = exposure
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3/91. hypersensitivity pneumonitis resulting from community exposure to canada goose droppings: when an external environmental antigen becomes an indoor environmental antigen.

    BACKGROUND: In the past, hypersensitivity pneumonitis has been attributed to occupational, agricultural, or home environmental exposure. OBJECTIVE: This report describes the first case of hypersensitivity pneumonitis due to community exposure to droppings from canada geese migrating through a suburban environment. METHOD: Clinical and serologic information was used in making the diagnosis of hypersensitivity pneumonitis. RESULTS: Serologic analysis demonstrated precipitating antibodies against goose droppings and against an extract made from washings from a filter taken from the patient's office. These studies also showed that the antigens in the office filter were goose dropping antigens. CONCLUSION: hypersensitivity pneumonitis can result from exposure to goose dropping antigens in the community that enter buildings through ventilation systems. This represents a new form of an old disease.
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ranking = 7
keywords = exposure
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4/91. Two year follow-up of a garbage collector with allergic bronchopulmonary aspergillosis (ABPA).

    BACKGROUND: Separate collection of biodegradable garbage and recyclable waste is expected to become mandatory in some western countries. A growing number of persons engaged in garbage collection and separation might become endangered by high loads of bacteria and fungi. Case history and examination A 29 year old garbage collector involved in emptying so-called biological garbage complained of dyspnea, fever, and flu-like symptoms during work beginning in the summer of 1992. Chest x-ray showed streaky shadows near both hili reaching into the upper regions. IgE- and IgG-antibodies (CAP, Pharmacia, sweden) were strongly positive for aspergillus fumigatus with 90.5 kU/L and 186%, respectively. Total-IgE was also strongly elevated with 5430 kU/L. Bronchial challenge testing with commercially available aspergillus fumigatus extract resulted in an immediate-type asthmatic reaction. Two years later he was still symptomatic and antibodies persisted at lower levels. CONCLUSIONS: Our diagnosis was allergic bronchopulmonary aspergillosis (ABPA) including asthmatic responses as well as hypersensitivity pneumonitis (extrinsic allergic alveolitis) due to exposure to moldy household waste. A growing number of persons engaged in garbage collection and handling are exposed and at risk to develop sensitization to fungi due to exposure to dust of biodegradable waste. Further studies are necessary to show if separate collection of biodegradable waste increases the health risks due to exposure to bacteria and fungi in comparison to waste collection without separation.
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ranking = 3
keywords = exposure
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5/91. Respiratory syndrome very similar to extrinsic allergic alveolitis due to penicillium verrucosum in workers in a cheese factory.

    A respiratory syndrome very similar to extrinsic allergic alveolitis due to penicillium verrucosum was recognized in 4 workers employed in a Gorgonzola cheese factory. A mycogen allergy to P. verrucosum, used as starter in the production, was demonstrated by positive sputum culture and detection of specific antibodies in the blood. Intense and prolonged exposure to inhalation of fungal spores could have lead to the development of this allergic response. The fact that 2 of the subjects are siblings seems to indicate host susceptibility or immunological constitution in the pathogenesis of the respiratory allergy.
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6/91. hypersensitivity pneumonitis from ordinary residential exposures.

    A previously healthy woman developed hypersensitivity pneumonitis of such severity that she required chronic systemic corticosteroid therapy for symptom control. Detailed investigation of her workplace and home environments revealed fungi in her typical suburban home, to which she had specific serum precipitating antibodies. Efforts to remove mold from the home were unsuccessful in relieving symptoms, and moving to another residence was the only intervention that allowed her to be withdrawn from corticosteroid therapy. hypersensitivity pneumonitis is commonly associated with occupational or avocational exposures, such as moldy hay in farmers or bird antigen in bird breeders. We propose that hypersensitivity pneumonitis may occur in north america, as it does in japan, from domestic exposures alone.
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ranking = 6
keywords = exposure
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7/91. Haemorrhagic hypersensitivity pneumonitis due to naphthylene-1,5-diisocyanate.

    Symptoms of hypersensitivity pneumonitis and massive pulmonary haemorrhage occurred in a 24-yr-old male shortly after occupational exposure to naphthylene-1,5-diisocyanate (NDI). The present examination was performed approximately 1-yr after the initial life-threatening haemoptysis and following an uneventful recovery after resection of the middle lobe, which had been identified bronchoscopically as the bleeding source. Histological re-examination of the lung was compatible with hypersensitivity pneumonitis. After a chamber challenge with NDI (5 parts per billion (ppb) for 10 min, 10 ppb for 110 min), rales were heard in both lungs, and a fall in vital capacity and partial pressure of arterial oxygen as well as a rise in body temperature were documented. Isocyanate-specific immunoglobulin-G antibodies could not be detected in the patient's serum, possibly due to the long period without exposure to isocyanates. The authors conclude that naphthylene-1,5-diisocyanate may cause immunological pulmonary haemorrhage. The underlying disease is consistent with hypersensitivity pneumonitis and may be triggered by low concentrations of the diisocyanate.
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ranking = 49.628274136557
keywords = occupational exposure, exposure
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8/91. Respiratory illness in workers exposed to metalworking fluid contaminated with nontuberculous mycobacteria--ohio, 2001.

    In January 2001, three machinists at an automobile brake manufacturing facility in ohio (plant A) were hospitalized with respiratory illness characterized by dyspnea, cough, fatigue, weight loss, hypoxia, and pulmonary infiltrates. hypersensitivity pneumonitis (HP) was diagnosed in all three workers. In March 2001, additional employees began seeking medical attention for respiratory and systemic symptoms. In May 2001, union and management representatives requested assistance from CDC's National Institute for Occupational safety and Health (NIOSH) in determining the cause of the illnesses and preventing further illness in employees. This report describes two case reports and the preliminary results of the ongoing investigation, which found that exposure to aerosolized nontuberculous mycobacteria (NTM) might be contributing to the observed respiratory illnesses in this manufacturing facility. Clinicians and public health professionals should be alert to the variable presentation of occupational respiratory disease that might occur in workers in the machining industry.
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ranking = 1
keywords = exposure
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9/91. hypersensitivity pneumonitis induced by the spore of pleurotus Eryngii (Eringi).

    We reported the first case of hypersensitivity pneumonitis (HP) by an edible mushroom, pleurotus Eryngii (Eringi). A 54-year-old woman had worked in a Bunashimeji mushroom factory for 42 months, and she moved to a new factory producing Eringi. Two months after, she was found to have HP by the spore of Eringi. Although no radiological finding was detected 6 months before the onset of HP, serum surfactant protein D (SP-D) had been elevated. We speculated that type II pneumocyte activation might prepare the ground for HP during the former exposure to Bunashimeji, and serum SP-D levels might reflect their conditions.
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keywords = exposure
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10/91. fever and neutrophilic alveolitis caused by a vanadium based catalyst.

    AIMS: To investigate a worker who experienced systemic and respiratory symptoms when exposed to a vanadium containing powder used as a catalyst in the production of maleic anhydride. methods: The investigation included inhalation challenge with the suspected compound combined with monitoring of lung function tests and post-challenge bronchoalveolar lavage. RESULTS: Exposure to the vanadium containing catalyst for 120 minutes resulted in a sustained decline in forced vital capacity and forced expiratory volume in one second, while the transfer factor for carbon monoxide did not change significantly. The subject developed fever and peripheral blood neutrophilia. bronchoalveolar lavage performed 48 hours after the end of challenge exposure showed a marked increase in neutrophils (60% of total cell count). CONCLUSIONS: Exposure to vanadium can cause a metal fume fever-like syndrome associated with neutrophilic alveolitis.
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ranking = 1
keywords = exposure
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