Cases reported "Pneumoconiosis"

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11/63. Hard metal pneumoconiosis and the association of tumor necrosis factor-alpha.

    Hard metal pneumoconiosis is a recently recognized occupational lung disease associated with the exposure to cobalt fumes in the workplace. Chronic exposure in susceptible individuals results in interstitial lung disease histopathologically manifested as interstitial fibrosis with an associated mononuclear cell infiltrate and the presence of "cannibalistic" multinucleated giant cells in the alveolar airspaces. The majority of patients present with symptoms of chronic cough and dyspnea. Interestingly, in addition, patients uniformly report significant weight loss out of proportion to their degree of respiratory impairment. In this case report we demonstrate the association of tumor necrosis factor-alpha (TNF) and hard metal (cobalt) pneumoconiosis and suggest that TNF may have a potential role in the etiology of the constitutional symptoms and the pathogenesis of interstitial lung disease.
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12/63. pneumoconiosis in a female worker exposed to a primer used in the production of non-stick pans: clinical case.

    The primary prevention programmes carried out in the 1950's and 1960's in industrialized countries brought about a significant reduction in the incidence of pneumoconiosis. Nevertheless, it is still possible to diagnose new cases, perhaps in relatively unusual working activities. OBJECTIVE: To describe a case of q 2/2 pneumoconiosis associated with mixed powder containing less than 1% quartz that occurred in a 37 year-old female worker, who had been previously employed (1987-1994) in manually spraying a primer solution on the bottom of non-stick aluminium pans. methods: The manufacturing firm supplied details of the composition of the primer. The physiological, pathological and occupational history was obtained for the worker, who also underwent: respiratory functional exploration, chest radiographs and HRCT of the thorax, fibrobronchoscopy, with transbronchial biopsy and BAL collection. The lung tissue sample was examined via light microscopy and scanning electron microscope analysis. RESULTS: The primer contained 6.8% talc, free from asbestos or silica, 3.8% iron oxides and 0.6% bentonite which, in turn, contained less than 1% crystalline silica. The job was performed in a semi-confined environment, with an inefficient aspiration system. The worker had never complained of respiratory symptoms. Radiographs and HRCT showed widespread micronodulation. light microscopy of pulmonary tissue showed multinucleate giant cell granulomas with intracytoplasmatic inclusions. Scanning electron microscope analysis revealed that these consisted of agglomerated particles, microanalysis of which showed the presence of a silicate. CONCLUSIONS: Particular jobs performed up to few years ago in italy in a semi-confined environment can still involve exposure to doses of mineral dusts such as to cause pneumoconiosis. This is the first case of mixed powder pneumoconiosis described in a worker employed in the production of non-stick aluminium pans.
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13/63. Mini review of high altitude health problems in Ladakh.

    Ladakh is a sparsely populated area of Indian Himalaya lying at 3-4500 m altitude mainly consisting of arid desert. This paper will discuss high altitude health problems in Ladakh under the following headings. 1. Acute altitude illness: acute mountain sickness (AMS), high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE). 2. Effects of prolonged and permanent exposure to high altitude: (subacute and chronic mountain sickness). 3. Environmental dust and domestic fire pollution resulting in non-occupational pneumoconiosis and high prevalence of respiratory morbidity.
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14/63. Induced sputum as an additional tool in the identification of metal-induced sarcoid-like reaction.

    BACKGROUND: Aluminium dust exposure produces asthma, chronic bronchitis, pulmonary fibrosis and granulomatous lung diseases. There is an increased risk of mistaken diagnosis of sarcoidosis when other interstitial lung diseases of known origin are occurring. CASE REPORT: We describe a case of a welder working in a stainless steel factory who had been exposed for more than 20 years to a dusty environment containing high levels of hazardous dust. He underwent lung function studies, a beryllium-lymphocyte transformation test (BeLTT), induced sputum (IS) analysis, aluminum-induced blastic proliferation test, and mineralogical and immunologic studies. The lung function tests raised the suspicion of sarcoidosis. T cell subsets recovered from induced sputum disclosed a helper T lymphocyte alveolitis, and transbronchial biopsies showed sarcoid-like epithelioid granulomata. Peripheral blood lymphocytes exhibited blastic transformation in the presence of soluble aluminium compounds. Scanning electron microscope studies from induced sputum-retrieved material showed abundant particles of aluminum. His final diagnosis was sarcoid-like granulomatous-induced aluminium disease. CONCLUSION: We propose an alternative non-invasive approach to identify antigenic metals in occupational exposures.
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ranking = 111.89954951574
keywords = occupational exposure, exposure
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15/63. pneumoconiosis after sericite inhalation.

    BACKGROUND: Between 1997 and 1999 three sericite plant workers in Parana, brazil, were diagnosed with pneumoconiosis. AIMS: To investigate and describe the radiological, clinical, and pathological changes in miners and millers exposed to sericite dust with mineralogical characteristics of inhaled dust. methods: The working premises were visited to examine the sericite processing and to classify the jobs according to make qualitative evaluation. Respirable dust was collected and the amount of crystalline silica and particle size distribution were measured. Forty four workers were examined by a standard questionnaire for respiratory symptoms, spirometry, and chest x ray. Material from an open lung biopsy was reviewed for histopathological and mineralogical analysis, together with sericite samples from the work site to compare the mineral characteristics in lung lesions and work area. RESULTS: Respirable dust contained 4.5-10.0% crystalline silica. particle size distribution showed a heavy burden of very fine particles (23-55%) with a mean diameter of <0.5 microm. Mean age of sericite miners was 41.0 (11.9) and mean number of years of exposure was 13.5 (10.1). In 52.3% of workers (23/44), chest radiographs presented a median category of 1/0 or above, and 18.2% (8/44) had a reduced FEV1. There was a significant association between exposure indices and x ray category. Histological studies of the lung biopsy showed lesions compatible with mixed dust fibrosis with no silicotic nodules. x Ray diffraction analysis of the lung dust residue and the bulk samples collected from work area showed similar mineralogical characteristics. Muscovite and kaolinite were the major mineral particle inclusions in the lung. CONCLUSION: Exposure to fine sericite particles is associated with the development of functional and radiological changes in workers inducing mixed dust lesions, which are distinct histologically from silicosis.
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16/63. Hard metal interstitial pulmonary disease associated with a form of welding in a metal parts coating plant.

    We describe two cases of hard metal pulmonary disease (one fatal) in workers employed in the same area of a metal coating plant using the detonation gun process for applying a durable metal surface to metal parts. In this form of welding, a mixture of powdered metals, including tungsten carbide and cobalt, is heated by ignition of a flammable gas and propelled from the end of the "gun" at high temperature and velocity to form a welded metal coating. This process is done in an enclosed chamber and with each application, large volumes of fine aerosols are created. inhalation exposure to hard metal may occur during the mounting and removal of the metal parts between applications, in spite of engineering controls and industrial hygiene surveillance. One of the cases presented with minimal chest x-ray abnormalities and an obstructive pattern on pulmonary function testing, although subsequent open lung biopsy showed diffuse interstitial pulmonary fibrosis. The fact that two cases of hard metal pulmonary interstitial disease occurred where thorough exposure control procedures and a surveillance program for cobalt were in place may indicate the need for revisions of the current technology used when hard metal is applied in the detonation gun process.
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17/63. pulmonary fibrosis in a patient with exposure to glass wool fibers.

    glass wool or vitreous fibers are non-crystalline, fibrous inorganic substances (silicates) made primarily from rock, slag, glass, or other processed minerals. They belong to the man-made mineral fibers (MMMFs) group and their respiratory effects are well described by De Vuyst et al. [1995]. The authors pointed out the absence of firm evidence that exposure to these fibers is associated with lung fibrosis, pleural lesions, or non-specific respiratory disease in humans. Because of this observation, we find it of importance to present a case of interstitial fibrosis, which implies a direct association between long-term exposure to glass wool and the clinical outcome.
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18/63. A 26-year-old welder with severe non-reversible obstructive lung disease.

    A 26-year-old white male, lifelong non-smoker presented with a history of increased shortness of breath, for approximately 1 year. He had a history of welding aluminum parts. He had evidence of partially reversible reactive airways disease with a non obstructive component as well. VATS biopsy revealed evidence of airway and parenchymal inflammation consistent with aluminum pneumoconiosis. Approximately 5-10% of COPD is attributable to non-smoking causes including occupational exposures. There are studies to suggest that the persistence of aluminum particulate may cause ongoing inflammation despite removal from exposure. It is possible that the persistence of particulate matter from tobacco smoke remaining in the lung may contribute to the persistent inflammatory response found in former smokers. Further study is required to examine the importance of this potential inflammatory mechanism both in occupationally exposed and in cigarette smokers. Reduction of certain particulate components of cigarette smoke may have implications for prevention of disease or at least disease progression in some COPD patients.
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ranking = 111.89954951574
keywords = occupational exposure, exposure
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19/63. Trace metal lung diseases: a new fatal case of hard metal pneumoconiosis.

    Four subjects working in sharpening and grinding operations of hard metal tools were examined. Only 1 worker, a 37-year-old female exposed for 7 years to hard metal dusts, developed hard metal pneumoconiosis, which rapidly progressed to death. Cytology of the bronchoalveolar lavage (BAL) showed a high number of eosinophils, more than 30% of the cell population. biopsy of the lung revealed interstitial fibrosis with hyperplasia of the pneumocytes of the second type and inflammatory cellular infiltration of the interstitium. High tungsten (W) and tantalum concentrations were determined in the admission BAL and in the biopsy 4 months later by neutron activation analysis while cobalt (Co) levels were near to normal values. The content of Co and W in blood and urine and particularly in pubic hair and toe nails of the patients was significantly higher than the normal values. This suggests that these biological specimens could be used as indicators of chronic exposure to hard metal dusts.
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20/63. Rapidly fatal progression of cobalt lung in a diamond polisher.

    Interstitial lung disease was diagnosed in a 52-yr-old male diamond polisher, who worked with polishing disks containing cobalt. After a further 7 months of probably high occupational exposure without any specific treatment, he had to quit work because of dyspnea. Despite treatment with systemic corticosteroids and continuous oxygen administration, he died 3 months later in respiratory distress. Postmortem examination of the lung tissue showed a typical giant-cell interstitial fibrosis, with active inflammatory cell infiltration superimposed on an established centrilobular fibrosis. The lung tissue contained 2.1 micrograms cobalt/g wet weight (more than 100-fold the normal concentration); cobalt particles, mainly localized in macrophages, were identified by transmission electron microscopy and energy-dispersive X-ray analysis. We speculate that the rapid deterioration and fatal outcome resulted from the continued exposure to cobalt, leading to a high pulmonary concentration of cobalt, and from the oxygen treatment because cobalt promotes the formation of hydroxyl free radicals.
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ranking = 111.89954951574
keywords = occupational exposure, exposure
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