A Case of Hypersensitivity Pneumonitis in a Worker Exposed to Metal Working Fluid / 대한산업의학회지

INTRODUCTION: There have been no reports of hypersensitivity pneumonitis caused by metal working fluids in Korea, despite their existence in other countries. Here, we report the first such case, along with an assessment of work-relatedness through exposure assessment. CASE REPORT: A 64-year old male patient visited the hospital with dyspnea after metal pipe cutting for about a year. He was diagnosed with hypersensitivity pneumonitis from the evidence of specific exposure history, clinical symptoms, and radiologic findings. The air exposure levels of the oil mist, endotoxin, total bacteria and fungus in the work environment was TWA(8-hr) 0.531 mg/m3, 6.33 EU/m3, 100 CFU/m3 and 75 CFU/m3, respectively. The concentrations of the endotoxin, total bacteria and fungus within the metal working fluid was 1.5x10(4) EU/mL, 4.6x10(5) CFU/mL and 1.8x10(5) CFU/mL, respectively. DISCUSSION: Although the patient did not receive a specific precipitating antibody test, the microbial concentration within the metal working fluid was higher than normal and similar to previous case reports, The oil mist level in the air exceeded the NIOSH REL and ACGIH NIC, and were similar or higher than previous cases. By excluding other causes of hypersensitivity pneumonitis, we concluded that the disease developed from exposure to microbial antigens in the metal working fluid.

A Case of Hypersensitivity Pneumonitis in a Worker Exposed to Metal Working Fluid / 대한산업의학회지

INTRODUCTION: There have been no reports of hypersensitivity pneumonitis caused by metal working fluids in Korea, despite their existence in other countries. Here, we report the first such case, along with an assessment of work-relatedness through exposure assessment. CASE REPORT: A 64-year old male patient visited the hospital with dyspnea after metal pipe cutting for about a year. He was diagnosed with hypersensitivity pneumonitis from the evidence of specific exposure history, clinical symptoms, and radiologic findings. The air exposure levels of the oil mist, endotoxin, total bacteria and fungus in the work environment was TWA(8-hr) 0.531 mg/m3, 6.33 EU/m3, 100 CFU/m3 and 75 CFU/m3, respectively. The concentrations of the endotoxin, total bacteria and fungus within the metal working fluid was 1.5x10(4) EU/mL, 4.6x10(5) CFU/mL and 1.8x10(5) CFU/mL, respectively. DISCUSSION: Although the patient did not receive a specific precipitating antibody test, the microbial concentration within the metal working fluid was higher than normal and similar to previous case reports, The oil mist level in the air exceeded the NIOSH REL and ACGIH NIC, and were similar or higher than previous cases. By excluding other causes of hypersensitivity pneumonitis, we concluded that the disease developed from exposure to microbial antigens in the metal working fluid.

Clinical utility of live blood analysis

BACKGROUND: Recently Live blood analysis was populated in korean society. so we evaluated clinical utility of Live blood analysis, as compared the Live blood analysis result of patients who have confirmed diagnosis of disease with that of controls who have no known health problems. METHODS: We carried out Live blood analysis to patients(n=30) who was entered to an admission in Yongdong severance hospital from February 2000 to March 2000 and to controls(n=30) who worked in that hospital at same time. We examined 3 abnormal finding; rouleau formation, spicule, protoplast, which were often observed in Live blood analysis. RESULTS: At comparison of patient group and control group, rouleau formation was observed in 27 patients except 3 patients and it was observed in all 30 controls. Spicule was observed 2in 9 patients except 1 patients and it was observed in all 30 controls. Protoplast was observed in 16 patients and 13 controls. There was no difference between patients and controls in observing 3 abnormal finding. CONCLUSION: We conclude that Live blood analysis may have no clinical significance.