397 Accelerated pneumoconiosis by alginates in a worker in the chemical-pharmaceutical industry. case report

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Abstract

Introduction

Pneumoconiosis is a respiratory disease produced by the inhalation of silicon dioxide, in its crystalline and cryptocrystalline forms, it is common to accompany other powders in the working environment. The accelerated form develops within the first ten years of the beginning of exposure to high silica level, presenting symptoms consisting of chronic cough and dyspnea of exertion accompanied by worsening of radiological images; with a national rate in Mexico of 0.48–2.39 cases per 10 000 workers.

Methods

27-year-old female worker, production manager and responsible for the area of alginates in a manufacturing company for the dental industry for 6 years, with inhalation exposure to inorganic powders and alginate vapours whose composition is calcined diatomaceous flow. Begins current disease after entering the alginate area, presenting dry cough, burning sensation in the nose and epistaxis, without going to medical attention. 5 years later she presented dyspnea of great efforts and non-productive cough, evolving at 5 months to dyspnea of moderate efforts and tachycardia; with spirometry that concluded severe restriction. Pneumoconiosis was diagnosed 10 months later by Pneumology, presenting severe dyspnea, tachycardia and nail cyanosis at moderate efforts, requiring the use of home and ambulatory oxygen and treatment with bronchodilators.

Results

Symmetrical thorax, decreased respiratory movements, fine rales in the right hemithorax and upper lobe of the left hemithorax, Plethysmography FVC 47%, TLC 64.4%, six-minute walk test suspended at 2 min by SO2 <85%, oscillometry: increased resistance in distal airway, bronchoscopy with cytopathologic: negative to malignancy, BAAR (-).

Discussion

High exposure and no personal protective equipment suitable for alginates within industrial processes can lead to the accelerated development of pneumoconiosis; in the company visit, the inhalation exposure to composite powders with calcined diatomaceous flow was corroborated, which together with the paraclinical studies and the symptomatology presented demonstrated the cause-effect relationship, work-injury.

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