Pneumoconiosis in a vermiculite end-product user.
BACKGROUND
Vermiculite is a silicate used as an insulating agent, soil additive, and carrier for chemicals and fertilizers. It is currently perceived to have no adverse effects to "end-product" users. An 82-year-old man presented with complaints of progressive dyspnea on exertion.


METHODS
A clinical evaluation included a chest radiograph, complete pulmonary function testing, CT scan of the thorax, and comprehensive occupational and environmental history.


RESULTS
The patient had clinical and radiographic features of advanced pulmonary interstitial fibrosis. The presence of calcified pleural plaques, together with the other clinical and radiographic features, strongly supported a diagnosis of asbestosis. His only significant exposure was to vermiculite used in the workplace for several hours per day from 1970 to 1987.


CONCLUSIONS
This case represents the first report of an end-product vermiculite-user with probable asbestosis, and together with recent similar findings in a vermiculite expansion plant worker, requires further epidemiologic investigations.
Howard
Thomas Peter
TP
Brevard VA Clinic, Viera, Florida 32940, USA. Thomas.Howard@Med.VA.Gov
D000368:Aged; D000538:Aluminum Silicates / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011009:Pneumoconiosis / Q000209:etiology*; D011658:Pulmonary Fibrosis / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed
D000538:Aluminum Silicates; C003760:vermiculite