ABSTRACT
Firefighters are exposed to irritating, asphyxiating toxic gases and aerosols. Previous studies indicate that this may result in acute as well as chronic lung function impairment. It is well known that inhalation of organic material can cause alveolitis. The purpose of this study was to investigate whether firefighters repeatedly exposed to fire gases and other combustion products develop inflammatory changes in the lower airways and, if so, what subtype of cells and soluble components accumulate. Thirteen nonsmoking firefighters underwent bronchoalveolar lavage (BAL), and the results were compared to a reference group of 112 nonsmoking healthy volunteers. The firefighters showed lower recovery of instilled lavage fluid (61% vs 72%; P < 0.01) and an increase in the proportion of lymphocytes in that fluid (8.2% vs 5.7%; P < 0.05). Alveolar macrophage fluorescence, which is a sign of uptake of inhaled fluorescent material, rather than a reflection of the degree of inflammation, was increased in two firefighters. Further, the lavage fluid had higher concentrations of native fibronectin (34.6 vs 22.0 micrograms/L; P < 0.01) and hyaluronic acid (27.7 vs 10.0 micrograms/L; P < 0.05). This may indicate local cell activation, since the alveolar capillary membrane probably was intact, as indicated by an unaffected albumin concentration. The observed changes in the deep airways are probably caused by exposure to smoke. It cannot be concluded whether these changes are permanent or are part of a natural temporary defense mechanism.
Subject(s)
Bronchoalveolar Lavage Fluid/cytology , Fires , Occupational Exposure/adverse effects , Pulmonary Alveoli/pathology , Smoke/adverse effects , Adult , Bronchoalveolar Lavage Fluid/chemistry , Case-Control Studies , Cell Separation , Enzyme-Linked Immunosorbent Assay , Female , Fibronectins/analysis , Flow Cytometry , Humans , Hyaluronic Acid/analysis , Inflammation/pathology , Macrophages, Alveolar , Male , Middle Aged , Statistics, Nonparametric , Vitronectin/analysisSubject(s)
Euthanasia , Public Opinion , Attitude to Death , Ethics, Medical , Euthanasia/legislation & jurisprudence , Euthanasia/psychology , Humans , SwedenABSTRACT
We present the case of a 37 year old non-smoking man with a tumour like infiltration of the left lung caused by sarcoidosis with pleural involvement not detectable at chest X-ray. The diagnosis was made at thoracotomy and confirmed by a Kveim test.
Subject(s)
Lung Neoplasms/diagnosis , Pleural Diseases/diagnosis , Sarcoidosis/diagnosis , Solitary Pulmonary Nodule/diagnosis , Adult , Diagnosis, Differential , Humans , Lung/diagnostic imaging , Lung/pathology , Lung Neoplasms/diagnostic imaging , Male , Pleura/diagnostic imaging , Pleura/pathology , Pleural Diseases/diagnostic imaging , Pleural Diseases/pathology , Radiography , Sarcoidosis/diagnostic imaging , Sarcoidosis/pathology , Solitary Pulmonary Nodule/diagnostic imagingABSTRACT
A fire-fighter, who developed chronic severe asthma after exposure to decomposition products of plastics during routine fire-fighting, is described. The outcome was fatal 25 months after onset of the disease.
