Hypersensitivity pneumonitis from inhaled antigens.
Metalworking Fluids Symposium II, The Industrial Metalworking Environment: Assessment and Control of Metal Removal Fluids. September 15-17, 1997, Detroit, Michigan. DA Felinski, JB D'ARcy, eds., Washington, DC: American Automobile Manufacturers Association, 1998 Sep; :55-58
Hypersensitivity pneumonitis is an interstitial lung disease, characterized by granulomatous inflammation and increased lymphocyte proportions in bronchoalveolar lavage, which occurs in occupational settings with bioaerosol exposure of fungal, bacterial, or higher organism origin. The symptoms of shortness of breath and cough overlap with other chest diseases, including asthma, from which it must be differentiated by clinical signs and laboratory tests. The most important implication of the diagnosis is restriction from further exposure to the antigen that caused the disease, since sensitized workers can react immunologically to low levels of exposure. With exposure cessation, some cases will have complete recovery, and others will require corticosteroid treatment for suppression of their immunologic response. The most sensitive means of screening is by symptom questionnaire, with referral of symptomatic workers for clinical diagnosis. A workforce with one sentinel case of hypersensitivity pneumonitis merits surveillance to identify other cases and risk factors for disease. Where cause is clear and exposure relationships for sensitization are established, environmental surveillance may be sufficient for prevention of hypersensitivity pneumonitis.
Lung-disease; Hypersensitivity; Disease-prevention; Pathogenicity; Antigens; Inhalation-studies; Epidemiology; Pulmonary-system-disorders; Respiratory-system-disorders; Exposure-levels; Exposure-assessment; Immunological-tests; Questionnaires; Clinical-diagnosis; Workers; Diseases; Risk-factors
Kathleen Kreiss, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, 1095 Willowdale Road, MS-234, Morgantown, WV 26505
Metalworking Fluids Symposium II, The Industrial Metalworking Environment: Assessment and Control of Metal Removal Fluids. September 15-17, 1997, Detroit, Michigan