Prolonged respiratory symptoms caused by thermal degradation products of freons.
OBJECTIVE
The chlorofluorocarbons (CFC) used in refrigeration systems decompose on heating and produce substances that are highly irritating to the airways (eg, chlorine, carbonyl fluoride, and hydrogen fluoride). This study examined persistent respiratory symptoms among several workers exposed to thermal decomposition products of CFC.


METHODS
Seven patients with respiratory symptoms caused by inadvertent exposure to thermal decomposition products of CFC in a restaurant kitchen or during refrigerator repair were studied with the use of spirometry, peak flow follow-up, and histamine challenge tests. Three patients also underwent bronchoscopy and bronchoalveolar lavage.


RESULTS
In five of the cases, cough or dyspnea lasted longer than 1 month; for three of the five, the symptoms lasted more than 4 years. Three cases showed increased bronchial hyperreactivity, and two of the three had increased diurnal peak flow variation. Three patients fulfilled the criteria for acute irritant-induced asthma or reactive airway dysfunction syndrome. One case exhibited bronchiolitis while, for the other six, the clinical picture was consistent with bronchitis.


CONCLUSIONS
The studied cases indicate that the thermal decomposition products of CFC used in refrigerators may cause irritant-induced airway diseases of long duration.
Piirilä
Päivi
P
Department of Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland. paivi.piirila@hus.fi
Espo
Timo
T
Pfäffli
Pirkko
P
Riihimäki
Vesa
V
Wolff
Henrik
H
Nordman
Henrik
H
D000328:Adult; D016535:Bronchial Hyperreactivity / Q000139:chemically induced*; D001992:Bronchoalveolar Lavage Fluid; D001999:Bronchoscopy; D005617:Chlorofluorocarbons, Methane / Q000009:adverse effects* / Q000737:chemistry; D003371:Cough / Q000139:chemically induced*; D004417:Dyspnea / Q000139:chemically induced*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D013147:Spirometry
D005617:Chlorofluorocarbons, Methane