Acute exogenous lipoid pneumonia presenting as spontaneous air leak following accidental baby oil aspiration.

Exogenous lipoid pneumonia (ELP) is an uncommon cause of respiratory distress. The practice of oil massage and oil instillation into the nostrils is common in the Indian subcontinent. Accidental aspiration of baby oil may lead to significant chemical pneumonitis. This presentation may vary from subtle to severe respiratory distress requiring intensive care management. Spontaneous air leaks are rare in acute ELP. We successfully managed a six-month-old girl presenting with mineral oil-induced ELP and air leaks. However, these children require long-term follow-up, as a small proportion may evolve into chronic lung disease.

Risks linked to accidental inoculation of humans with veterinary vaccines: a 7-year prospective study.

AIM: Accidental inoculation of humans with veterinary vaccines can lead to early and late complications. The aim of our study is to describe these complications and their risk factors. METHODS: Prospective observational study conducted from 2007 to 2014 at Angers University Hospital's Poison Control Centre. The endpoints examined were: early and late locoregional complications, surgical treatment, and absence from work. The statistical analysis was based on a multivariate analysis. DISCUSSION: The presence of mineral oil adjuvants, the injection of the vaccine under pressure and injection in joint and tendon of the hand significantly increased early locoregional complications and surgery but only the presence of mineral oil adjuvant increased significantly late locoregional complications at one month. Absence from work is significantly correlated to the site of injection and the presence of mineral oil adjuvant. CONCLUSION: It is important to know about the contents of the veterinary vaccine in order to anticipate early and late complications that may arise (particularly due to the presence of mineral oil adjuvants). Special attention must also be given do the site of injection. We think that any accidental injection of veterinary vaccine into humans, especially those containing mineral oils, must lead to an early medical consultation. This must also be indicated on the product.

Usage of skin care products and risk of rheumatoid arthritis: results from the Swedish EIRA study.

INTRODUCTION: The aim of this study was to investigate the association between exposure to cosmetics, often containing mineral oil, and the risk of developing rheumatoid arthritis (RA). The study was performed against the background that occupational exposure to mineral oil has recently been shown to be associated with an increased risk for RA in man, and that injection of or percutaneous exposure to mineral-oil-containing cosmetics can induce arthritis in certain rat strains. METHODS: A population-based case-control study of incident cases of RA was performed among the population aged 18 to 70 years in a defined area of Sweden during May 1996 to December 2003. A case was defined as an individual from the study base, who received for the first time a diagnosis of RA according to the 1987 American College of Rheumatology criteria. Controls were randomly selected from the study base with consideration taken for age, gender and residential area. Cases (n = 1,419) and controls (n = 1,674) answered an extensive questionnaire regarding environmental and lifestyle factors including habits of cosmetic usage. The relative risk of developing RA was calculated for subjects with different cosmetic usage compared with subjects with low or no usage. Analysis was also performed stratifying the cases for presence/absence of rheumatoid factor and antibodies to citrulline-containing peptides. RESULTS: The relative risks of developing RA associated with use of cosmetics were all close to one, both for women and men, for different exposure categories, and in relation to different subgroups of RA. CONCLUSION: This study does not support the hypothesis that ordinary usage of common cosmetics as body lotions, skin creams, and ointments, often containing mineral oil, increase the risk for RA in the population in general. We cannot exclude, however, that these cosmetics can contribute to arthritis in individuals carrying certain genotypes or simultaneously being exposed to other arthritis-inducing environmental agents.

Diffuse lipogranulomatosis involving soft tissues of the head and neck due to multiple self-injections of mineral oil.

We describe imaging findings of a 45-year-old man with a 6-month history of gradually increasing diffuse swelling of the neck. CT showed diffuse thickening and infiltration of the superficial and deep soft tissues bilaterally. On further investigation of his history, the patient stated that he had injected mineral oil into his neck to clean out his body from drugs. Biopsy results showed multinucleated giant cells and inflammatory infiltrates confirming the diagnosis of lipogranulomatosis.

Intoxicaciones con aceite de lamparillas en sacerdotes católicos / Intoxications with lamp oil in catholic priests

Este estudio se llevó a cabo ante la detección de casos de ingestión de aceite de lamparillas por parte de sacerdotes católicos de diferentes comunidades autónomas españolas. Los datos analizados, desde enero de 1991 a Julio del 2003, fueron: edad del paciente, circunstancias de la exposición (horario, lugar, cantidad) y manifestaciones clínicas. Un total de 16 casos cumplieron los parámetros de inclusión. La primera consulta se recibió en noviembre de 1997. El número de exposiciones fue mayor los miércoles, sábados y domingos. El horario de los incidentes reflejó los horarios de las misas (por la mañana temprano 2, mediodía 5, tarde 3 y tarde-noche, 6 casos). La edad media de los pacientes fue de 49 años. El aceite se bebía después de ser mezclado con el vino durante la misa o directamente de la botella, en el intervalo entre las celebraciones. La cantidad ingerida fue de solo uno o dos tragos aunque ocasionalmente la mezcla de aceite y vino se bebió totalmente (unos 200 ml). Los síntomas fueron: diarrea (4), vómitos (2), dolor abdominal (2) y esputo hemoptoico (1). En 10 episodios los pacientes permanecieron asintomáticos. Las intoxicaciones laborales en el ambiente religioso representan una circunstancia infrecuente. La confusión se debió a la similitud del envase de aceite de parafina con las botellas de agua mineral. Los datos reportados indican que es necesario hacer toxicovigilancia en lugares inusuales

This investigation was prompted by the detection of lamp oil ingestions among catholic priests from different regions of Spain. Data analysed from January 1991 to July 2003 was for patient age, circumstances of exposure (timetable, site, amount) and clinical symptoms. A number of 16 cases met inclusion criteria. The first case was recorded in November 1997. The number of exposures was higher on Wednesday, Sunday and Saturday. Time of the incidents reflected the timetable of Mass (early morning 2, midday 5, afternoon 3 and evening 6 cases). The mean age was 49 year old. Lamp oil was drunk after being mixed with wine during the Mass or directly from the bottle between services. The amount swallowed was only one or two sips although occasionally the mixture of oil and wine was drunk totally (around 200 ml). Symptoms were: diarrhoea (4), vomiting (2), abdominal pain (2) and hemoptoic sputa (1). In 10 occasions the patients remained asymptomatic. Occupational toxic exposure in a religious environment is an uncommon event. The confusion was due to the similarity of the paraffin oil container with the bottles of mineral water. Data reported in this study indicates the need for workplace surveillance in unusual places

Cold injury from liquid petroleum gas.

Cold injury by liquid petroleum gas is produced by evaporation that causes damage by cold to vital structures. We present two cases of exposure to pressurised liquid petroleum gas during an industrial accident.

Acute hydrocarbon pneumonia after white spirit aspiration: sequential HRCT findings.

Hydrocarbon pneumonia is a very uncommon condition resulting from aspiration of mineral oil into the lung. We report the first description of early and sequential high-resolution computed tomographic (HRCT) findings of hydrocarbon pneumonia following attempted suicide by white spirit aspiration. Initial HRCT showed patchy opacities of coalescing masses with well-defined walls. They were visible in the middle lobe, lingula and lower lobes. Follow-up CT showed regression of the alveolar opacities, the presence of pneumatoceles and right asymptomatic pneumothorax. After 23 months of follow-up, the patient remained asymptomatic, and the follow-up CT scan was considered normal. The radiological features and a review of the relevant literature are briefly discussed.

Effects of the mosquito larvicide GB-1111 on bird eggs.

Golden Bear Oil (GB-1111; legal trade name for GB-1313) is a petroleum distillate used in the United States and other countries as a mosquito larvicide. As part of an evaluation of the potential effects of GB-1111 on birds, fertile eggs of mallards (Anas platyrhynchos) and bobwhite (Colinus virginianus) were incubated in the laboratory, and treated on day 4 of incubation with external applications equivalent to either 0, 1/3, 1, 3 or 10 times the maximum rate (X) of 47 l/ha (5 gal/A) of field application of GB-1111. Hatching success was significantly reduced in mallards treated at 3 and 10 times the maximum field application, with a calculated approximate LD50 of 1.9 times the maximum field application. Most mortality occurred within a week of treatment. Hepatic P450-associated monooxygenase activity (ethoxyresorufin-O-dealkylase; EROD) was negatively related to dose. In the 3X group there was a significant increase in the concentration of hepatic reduced glutathione (GSH) but a decrease in protein-bound thiols (PBSH). Hatching success of bobwhite was marginally reduced at the highest level of treatment (10X). Other effects at this level in bobwhite included a significant increase in incidence of abnormal embryos or hatchlings, lower body and liver weights, and a two-fold increase in hepatic microsomal EROD activity in hatchlings. The recommended maximum rate of field application of GB-1111 is unlikely to impair the survival or development of bobwhite embryos but is potentially toxic to mallard embryos under conditions of larvicide drift or spray overlap.

Cancer incidence and mortality in workers employed at a transformer manufacturing plant: update to a cohort study.

BACKGROUND: This study is an extension of a previously published analysis of cancer mortality in a transformer manufacturing plant where there had been extensive use of mineral oil transformer fluid. The objectives of the present study were to update the mortality analysis and include deaths for the past 6 years as well as to do an analysis of cancer incidence of the cohort. METHODS: A cohort of 2,222 males working at a transformer manufacturing plant between 1946 and 1975 was constructed. Using a classical historical cohort study design, cancer incidence and mortality were determined through record linkage with Canadian provincial and national registries. The rates of cancer incidence and mortality experienced by this cohort were compared to that of the Canadian male population. RESULTS: A statistically significant increased risk of developing and dying of pancreatic cancer was found but not an increase in overall cancer mortality. This was consistent with the previous report from this group. Interestingly, the cohort demonstrated a statistically significant risk of overall cancer incidence and specific increased incidence of gallbladder cancer. CONCLUSIONS: This study contributes further evidence to the growing body of literature indicating the carcinogenic properties of mineral oils used in occupational settings, in particular those used prior to 1970s.

Disseminated lipogranulomas and sudden death from self-administered mineral oil injection.

The cosmetic injection of exogenous lipids and more recently of polydimethyl siloxane (injectable silicone) into the scrotum has been described since 1899. Sclerosing lipogranuloma and paraffinoma are terms applied to a complication of this practice in which the injected oils or silicone elicit a marked granulomatous reaction with prominent surrounding fibrosis. Although this complication has been described as a localized process occurring mainly in the scrotal area and regional lymph nodes, few studies have documented systemic manifestations. In this report we describe the autopsy findings of a 48-year-old man who had scrotal and systemic lipogranulomas from repeated self-administered injection of mineral oil. In addition, severe acute pulmonary edema resulted in sudden unexpected death. To our knowledge, this fatal complication of exogenous lipogranuloma has not been previously reported.

BAL fluid LDH activity and LDH isoenzyme pattern in lipoid pneumonia caused by an intravenous injection of lamp oil.

A 30 year old man developed lipoid pneumonia after an injection of lamp oil. In addition to "foamy" alveolar macrophages, bronchoalveolar lavage (BAL) fluid analysis showed an increased number of neutrophils. Moreover, lactate dehydrogenase (LDH) and alkaline phosphatase activities were elevated. The increase seen in LDH activity both in serum and BAL fluid was accompanied by shifts in the isoenzyme pattern in similar directions for both fluids. These findings suggest a pulmonary source for the temporary serum as well as BAL fluid LDH increase. This case indicates the usefulness of bronchoalveolar lavage fluid analysis as a probe to detect pulmonary injury caused by a pneumotoxicant and, probably, to monitor recovery or deterioration.

Severe lipoid pneumonia following attempted suicide by mineral oil immersion.

Following an attempted suicide by drowning in a vat of mineral oil, a previously fit man survived the usually fatal lipoid pneumonia resulting from total immersion after intensive support and prolonged steroid therapy with recovery of chest radiography and pulmonary function at one year.

Mortality studies of machining fluid exposure in the automobile industry. III: A case-control study of larynx cancer.

A case-control study of larynx cancer was conducted within a cohort of automobile workers exposed to metal working fluids, commonly referred to as machining fluids (MF). Results are based on 108 cases of larynx cancer and 5:1 matched controls. Risks associated with specific types of MF, as well as specific components of the fluids were evaluated. Based on a retrospective exposure assessment, lifetime exposures to straight and soluble fluids, grinding particulate, biocides, selected metals, sulfur, and chlorine were examined. Exposure to asbestos and acid mists at two of the three study sites was also characterized. Results suggest that straight mineral oils are associated with almost a two-fold excess in larynx cancer risk. There was also evidence of an association with elemental sulfur, commonly added to straight MF to improve the integrity of the materials under extreme pressure and heat. It is not clear whether sulfur is causally related to an excess relative risk of larynx cancer or whether the observed association is the result of unmeasured confounding by another contaminant or process feature. For example, the high stress operations that require MF enriched with sulfur are also more likely to produce polycyclic aromatic hydrocarbons (PAHs) during the process. Thus, the observed association with sulfur may be due to an association with PAH. The finding of excess risk of laryngeal cancer associated with MF is consistent with several previous reports in the literature. This is the first study, however, to distinguish straight mineral oils from other types of MF. Based on these findings, a general reduction in concentrations of straight mineral oil particulate in occupational environments would be prudent.

Exogenous lipoid pneumonia.

Although a rare form of nonresolving pulmonary infiltrate, exogenous lipoid pneumonia is a great mimicker. It often is mistaken for bacterial pneumonia or cancer. Many cases have been diagnosed only by open lung biopsy or other invasive procedures. Depending on the type of lipid ingested and the degree of inflammation that occurs, damage to the lung can be little to none or can fulminate to necrosis and hemorrhage. Symptoms may range from none to respiratory failure. In the case presented, the patient was ingesting Vaseline Intensive Care Lotion and baby oil as laxatives. This information was elicited only after diagnosis was made by open lung biopsy.

Exposure to cutting oils and its relation to skin tumors and premalignant skin lesions on the hands and forearms.

In a cohort study the incidence of skin tumors on the hands and forearms of 682 turners exposed to cutting oils was compared to the incidence of the general male population and of office workers. Among the 682 turners, five premalignant squamous cell tumors and eight keratoacanthomas were found between 1960 and 1980. Five of this total of 13 turners with primary skin tumors had another skin tumor as well. Among the 682 men there were four cases of scrotal cancer. Among the 375 office workers examined, no malignant or premalignant tumors or keratoacanthomas were found on the hands or forearms. No primary skin tumors were found among the turners after 1975, when the acid-refined mineral oils were replaced by solvent-refined oils containing a far lower concentration of polyaromatic hydrocarbons, which are probably the cancerogenic agent in the oils. The study shows a greatly increased risk of skin tumors on the hands and forearms of workers exposed to acid-refined mineral oils. Individual susceptibility also seems to be indicated.

Lipoid pneumonia secondary to baby oil aspiration: a case report and review of the literature.

Baby oil is a common household product that is frequently used when there are infants or toddlers in the house. However, it is often overlooked as a potential source of danger to these youngsters. In 1983, 36,700 cases of ingestion were reported to the poisoning surveillance and epidemiology branch of the Food and Drug Administration. Topical preparations used in the care of infants accounted for 480 of the cases. Ten percent of these required hospitalization. In 36 cases, the product ingested was baby oil. This figure does not include baby lotions and other skin products with a mineral oil base. Aspiration of mineral oil, the main component of baby oil, has been described as a cause of lipoid pneumonia and oleomas. However, there is very little information in the modern literature concerning acute lipoid pneumonitis in children. We herein present a patient with lipoid pneumonia caused by aspirated baby oil, who followed a severe clinical course. The paucity of information regarding this subject points to the need for increased public and physician awareness of the problem and for their direct participation in the prevention of this potentially fatal condition.

[Used motor oil poisoning in cattle. Report of a clinical case]. / Altölvergiftung beim Rind. Fallbericht.

The clinical signs observed in a cow after oral ingestion of used motor oil (tractor crankcase oil) are described. The treatment consisted of rumentomy with removal of all the ingesta, establishing a temporary rumen fistula, and administration of rumen fluid and sodium sulphate. Isotonic saline, dextrose, sorbitol and amino acid solutions were administered parenterally for stabilisation of the circulatory and metabolic system. The factors coming into question for the toxic effect of used motor oil are discussed.

[Toxic lichenoid melanodermatitis]. / Melanodermitis tóxica liquenoide.

A 28-year-old man, that handled mineral oils was affected by liquenoid toxic melanodermitis with a history of four years. Optic and ultrastructural studies showed increased melanic pigment and another one, unknown, of different electronic density.

Mineral seal oil excreted in urine.

There is a paucity of reported cases demonstrating the gastrointestinal absorption and renal excretion of mineral seal oil, a petroleum distillate. In 1972, a teenager attempted suicide by purposely ingesting an entire 8 ounce bottle of furniture polish containing 99% mineral seal oil. She arrived in the F.R. two hours post-ingestion and was lavaged with two liters of normal saline and given two ounces of mineral oil and 20 ml of 50% magnesium sulfate by the tube. The stomach contents were yellow, thick, oily, and smelled like furniture polish. She was admitted for psychiatric evaluation and observation for the ingestion. The patient did not suffer any respiratory or CNS complications. However, she excreted oil droplets which coalasced to form an oil layer in her urine! She suffered no kidney damage or abnormality as could be detected by routine renal function studies. Pictures revealing oil in the urine will be shown.