Pulmonary alveolar proteinosis and cement dust: a case report - a preliminary report.
Proceedings of the VIIth International Pneumoconioses Conference, August 23-26, 1988, Pittsburgh, Pennsylvania, USA. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 90-108, 1990 Nov; (Part II):852-861
A case of pulmonary alveolar proteinosis (PAP) due to occupational exposure to cement dust was examined. A 29 year old white male who had been recently diagnosed with PAP was referred for an occupational medical consultation. He had been employed as a cement truck driver in a railroad freight yard for 2 years. He had smoked 1.5 packs of cigarettes a day for 15 years. A review of his clinical history confirmed the diagnosis of PAP. Lung biopsy specimens obtained by bronchoscopy were analyzed for silica (14808607) by electron dispersive spectroscopy. Silica particles were found in the macrophages and alveolar fluid. A review of the patient's occupational history revealed that he had been heavily exposed to Portland-cement (65997151). He stated that his hair, nose, and skin were covered with dust by the end of the working day. He did not use any respiratory protection. Air monitoring of cement dust had not been performed at the patient's workplace. A review of published data on the composition of Portland and other types of cement revealed that the dusts to which the patient was exposed contained at least 20% silica. The authors conclude that the patient developed PAP probably as a response to occupational exposure to Portland-cement dust. It cannot be determined with certainty if he is at risk of a recurrence of PAP if he receives further exposure to cement dust. Since PAP is a potential life threatening illness such exposure should be avoided.
Case-studies; Respiratory-system-disorders; Dust-exposure; Occupational-exposure; Cements; Risk-analysis; Silica-dusts; Chemical-composition; Clinical-diagnosis
DHHS (NIOSH) Publication No. 90-108
Proceedings of the VIIth International Pneumoconioses Conference, August 23-26, 1988, Pittsburgh, Pennsylvania, USA