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.
Beckett
William
W
Pulmonary and Critical Care Division, Occupational Medicine Program and Finger Lakes Occupational Health Services, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA. Bill_Beckett@urmc.rochester.edu
Kallay
Michael
M
Sood
Akshay
A
Zuo
Zhengfa
Z
Milton
Donald
D
D000542:Alveolitis, Extrinsic Allergic / Q000382:microbiology*; D006801:Humans; D007219:Industrial Oils / Q000382:microbiology*; D008297:Male; D008669:Metallurgy; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000209:etiology*; D016926:Mycobacterium chelonae / Q000302:isolation & purification / Q000472:pathogenicity; D009784:Occupational Diseases / Q000175:diagnosis / Q000382:microbiology*; D016273:Occupational Exposure; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed