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Effets sur la santé associés à l’inhalation d’imperméabilisants ou d’autres aérosols de résines hydrophobes. Revue de la littérature. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2018. [DOI: 10.1016/j.toxac.2018.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Scheepers PTJ, Masen-Poos L, van Rooy FGBGJ, Oerlemans A, van Daalen E, Cremers R, Lichtenbeld H, Biesma B, Sørli JB, Koponen IK, Larsen ST, Wolkoff P, Nørgaard AW. Pulmonary injury associated with spray of a water-based nano-sized waterproofing product: a case study. J Occup Med Toxicol 2017; 12:33. [PMID: 29234454 PMCID: PMC5721695 DOI: 10.1186/s12995-017-0180-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 11/23/2017] [Indexed: 12/24/2022] Open
Abstract
Background In 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 presentation Ten 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. Conclusion The 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 material The online version of this article (10.1186/s12995-017-0180-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paul T J Scheepers
- Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Lucie Masen-Poos
- Department of Lung Diseases, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | | | - Arné Oerlemans
- Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Eline van Daalen
- Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, PO Box 9101, 6500 HB Nijmegen, The Netherlands.,Present address: Ministry of Social Affairs and Employment, The Hague, The Netherlands
| | - Robbert Cremers
- Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, PO Box 9101, 6500 HB Nijmegen, The Netherlands.,Present address: Witteveen+Bos Consulting, The Hague, The Netherlands
| | | | - Bonne Biesma
- Department of Lung Diseases, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Jorid B Sørli
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Ismo K Koponen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Søren Thor Larsen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Peder Wolkoff
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Asger W Nørgaard
- The National Research Centre for the Working Environment, Copenhagen, Denmark
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Toxic alveolitis after inhalation of a water repellent. Int J Occup Med Environ Health 2011; 24:409-13. [PMID: 22002324 DOI: 10.2478/s13382-011-0038-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Accepted: 07/22/2011] [Indexed: 11/20/2022] Open
Abstract
Inhalation of fluorocarbon polymers can cause pulmonary toxicity. Although multiple cases of lung injury have been reported, cellular characterization of the associated alveolitis occurring acutely after inhalation is limited. We report the case of a previously healthy woman who presented at our Emergency Department with an acute pneumonitis following inhalation of a fluorocarbon polymer-based rain-proofing spray. Bronchoalveolar lavage (BAL) performed shortly after the presentation showed an elevated total cell count, with a high proportion of neutrophils (58%) and eosinophils (9%). In addition, a lipid stain (Oil-Red-O-stain) showed a high level of lipid laden macrophages, a marker that could reflect a direct toxic effect of the spray on alveolar cells. The patient made a full recovery after four days of in-hospital observation with supportive care.
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Testud F, Sabouraud S, Lecoq-Jammes F. Fièvre des polymères après fartage intensif de snowboards en milieu confiné : 3 observations. ARCH MAL PROF ENVIRO 2010. [DOI: 10.1016/j.admp.2010.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cormican LJ, Rees PJ. Hill Walkers’ Lung. Respiration 2006; 73:836-9. [PMID: 17119356 DOI: 10.1159/000095911] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2005] [Accepted: 03/07/2006] [Indexed: 11/19/2022] Open
Abstract
A previously healthy female presented with a 7-week history of dyspnoea on exertion following inhalation of a fluorochemical-based water repellent spray, which was applied to footwear, in the living area that she shared with 8 members of her family while on a hill walking holiday. Clinical examination, serial lung function studies, bronchoalveolar lavage, transbronchial biopsies and high-resolution CT thorax confirmed a sub-acute interstitial pneumonitis, which did not resolve until 15 weeks following exposure. None of her family members were affected despite similar exposure. Interstitial pneumonitis due to inhalation of fluorochemical-based water repellent, though rarely described, usually presents in an acute severe form necessitating immediate therapy and resolves in 1-4 weeks. Pulmonary fibrosis can also occur. Sub-acute interstitial pneumonitis following inhalation of fluorochemical-based water repellent spray should always be considered as a cause of unexplained persistent respiratory symptoms in otherwise healthy individuals involved in outdoor pursuits.
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Affiliation(s)
- Liam J Cormican
- Department of Respiratory Medicine, Kings College Hospital, London, UK.
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Testud F, Jacques D, Magaud-Camus I, Descotes J. Toxicité pulmonaire des imperméabilisants pour le cuir et les tissus : intoxication mortelle dans un pressing. ARCH MAL PROF ENVIRO 2004. [DOI: 10.1016/s1775-8785(04)93525-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Lazor-Blanchet C, Rusca S, Vernez D, Berry R, Albrecht E, Droz PO, Boillat MA. Acute pulmonary toxicity following occupational exposure to a floor stain protector in the building industry in Switzerland. Int Arch Occup Environ Health 2004; 77:244-8. [PMID: 15007653 DOI: 10.1007/s00420-004-0505-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2003] [Accepted: 01/16/2004] [Indexed: 11/25/2022]
Abstract
BACKGROUND Waterproofing agents are widely applied to leather and textile garments; they are also used as floor stain protectors by professionals. Acute respiratory injury is described in three cases of young healthy adults following occupational inhalation of a new waterproofing formulation containing an acrylate fluoropolymer. Within 1 or 2 h after exposure they developed a rapidly progressive dyspnoea; two of them had hypoxaemia and flu-like reactions. All patients improved with supportive treatment in a few days. The mechanism of toxicity is still under investigation, but experimental data suggest the role of this new acrylate fluoropolymer. CONCLUSION Tilers should be warned against spraying floor stain repellents; there is also a need to make consumers aware that the spraying of waterproofing agents in a closed environment and concomitant smoking should be avoided.
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