1/4. hypersensitivity pneumonitis associated with environmental mycobacteria.A previously healthy man working as a machine operator in an automotive factory developed respiratory symptoms. Medical evaluation showed abnormal pulmonary function tests, a lung biopsy showed hypersensitivity pneumonitis, and his illness was traced to his work environment. His physician asked the employer to remove him from exposure to metalworking fluids. Symptoms reoccurred when he was later reexposed to metalworking fluids, and further permanent decrement in his lung function occurred. Investigation of his workplace showed that five of six large reservoirs of metalworking fluids (cutting oils) grew mycobacterium chelonae (or Mycobacterium immunogenum), an organism previously associated with outbreaks of hypersensitivity pneumonitis in automaking factories. His lung function remained stable after complete removal from exposure. The employer, metalworking fluid supplier, union, and the National Institute for Occupational safety and Health were notified of this sentinel health event. No further cases have been documented in this workplace.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. Diagnostic problems in hypersensitivity lung disease.hypersensitivity lung disease (HLD) includes hypersensitivity Pneumonitis (HP), IgE triggered asthma and Allergic Bronchopulmonary aspergillosis (ABPA). HP and ABPA are neither common nor rare. Both are important to diagnose as they can result in progressive irreversible lung damage. serologic tests are useful in diagnosing or excluding HP and ABPA although the diagnostic skill of the physician is of prime importance. We report eight cases which were diagnostic problems in which the initial serologic examinations were incorrect. The diagnostician must be aware of both the clinical possibility of the HLD but also of the possibility or probability that the serologic report is not correct.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/4. Building-related asthma in Denver office workers.OBJECTIVES. Reported cases of building-related asthma and hypersensitivity pneumonitis among workers in a Denver office building prompted an epidemiologic investigation. methods. A cross-sectional, self-administered survey of employees in the office building of the reported cases was compared with that of employees in a comparison building. RESULTS. A significant excess of respiratory disease existed among 512 Denver workers (case building) compared with 281 office workers in a suburban agency (control building). Denver employees had a higher prevalence of respiratory symptoms, and the prevalence of physician-diagnosed asthma with onset or exacerbation since building occupancy was 4.9 times greater for Denver employees than for suburban employees. asthma was not associated with any particular ventilation system in the building. water incursion from a below-grade wall may have contributed to the problem, but the etiology is unknown. CONCLUSIONS. This investigation provided evidence of office building-related asthma. Individual cases may be sentinel events for other cases of work-related asthma or hypersensitivity pneumonitis and may indicate a need for public health investigation of remediable causes.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/4. biopsy-confirmed hypersensitivity pneumonitis in automobile production workers exposed to metalworking fluids--michigan, 1994-1995.In 1994, union and management officials and local physicians in southeastern michigan noted the occurrence among automobile production workers of respiratory illness consistent with hypersensitivity pneumonitis (HP). Local and national health authorities reviewed medical records, and in June 1994, individual employees and the union requested that CDC's National Institute for Occupational safety and Health (NIOSH) evaluate potential occupational exposures associated with these illnesses. This report summarizes preliminary findings of the evaluation, including detailed information about one HP case and a summary description of the six biopsy-confirmed cases among automobile production workers from three different plants (plants A, B, and C) in southeastern michigan; all six workers had jobs that entailed frequent exposure to metalworking fluids (MWFs). The findings suggest the need for further evaluation of a possible association of occupational exposure to MWFs with HP.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |