ABSTRACT
This report describes the case of a 44-year-old man with pulmonary nodules whose histological analysis initially suggested tuberculosis. The Mycobacterium tuberculosis (MT) culture was negative and a questionnaire revealed a professional activity of brushing and polishing surgical instruments without any protection for 7 years. A mineralogical analysis by optical and electron microscopy was performed on both a healthy lung tissue biopsy and a lung nodule in a paraffin block. Electron microscopy analysis revealed the presence of metal particles (iron oxide, titanium oxide, aluminum oxide and steel) in both samples. This study suggests that mineralogical analysis combined with a questionnaire on dust exposure could help redirect the diagnosis of a dust-related disease.
Subject(s)
Dust , Granuloma, Respiratory Tract/chemically induced , Metals/adverse effects , Multiple Pulmonary Nodules/chemically induced , Occupational Diseases/chemically induced , Occupational Health , Occupations , Sarcoidosis, Pulmonary/chemically induced , Surgical Instruments/adverse effects , Adult , Biopsy , Diagnosis, Differential , Dust/analysis , Equipment Design , Ferric Compounds/adverse effects , Granuloma, Respiratory Tract/diagnosis , Humans , Inhalation Exposure/adverse effects , Male , Metals/analysis , Microscopy, Electron , Multiple Pulmonary Nodules/diagnosis , Occupational Diseases/diagnosis , Occupational Exposure/adverse effects , Predictive Value of Tests , Sarcoidosis, Pulmonary/diagnosis , Steel/adverse effects , Titanium/adverse effectsABSTRACT
The current nosology and etiology of silicosis were officially adopted by the 1930 International Labor Office (ILO) Conference on silicosis in Johannesburg. Convened by the International Labor Office and by the Transvaal Chamber of Mines, it paved the way to the adoption of a 1934 ILO convention which recognized silicosis as an occupational disease. Even though it constituted a social and sanitary turning point, the Johannesburg conference, strongly influenced by South African physicians working for the gold mining industry, reduced silica hazards to silicosis, an equation which is questioned nowadays. While the definition of silicosis adopted in 1930 was a major step in the recognition of occupational pneumoconioses, it also led to the under-identification of some pathogenic effects of silica. Going back to history opens new avenues for contemporary medical research.
