title: Acute respiratory symptoms following massive carbon black exposure.
abstract: BACKGROUND
  Chronic carbon black exposure in the work environment can cause both respiratory symptoms and changes in lung function. There is limited information on the respiratory effects of acute exposure to carbon black.
  
  
  METHODS
  Case report and literature review.
  
  
  RESULTS
  A 44-year-old man had intense exposure to carbon black when his crane ran into a truck with a trailer filled with carbon black. One week after this exposure he developed shortness of breath and cough with sputum production. These symptoms persisted and increased in intensity. Physical examination revealed expiratory wheezes when in the supine position. Pulmonary function tests revealed a mild obstructive ventilatory defect with a reduced FEV(1)/FVC ratio. The patient responded to treatment with fluticasone and salmeterol with a reduction in symptoms and improvement in his spirometry to a normal range.
  
  
  CONCLUSIONS
  Acute exposure to carbon black can cause respiratory symptoms and an obstructive ventilatory defect. This presentation suggests a small airway disease which improved over time with inhaled steroids and long-acting beta-agonists. Patients with intense carbon black exposure following industrial accidents will need frequent evaluation to manage any related respiratory tract injury.
authors.affiliation: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Hailemariam
authors.forename: H Mojazi
authors.initials: HM
authors.lastname: Amiri
authors.forename: K
authors.initials: K
authors.lastname: Nugent
mesh_terms: D000062:Accidents, Occupational; D000328:Adult; D000420:Albuterol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000730:Androstadienes / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D000068298:Fluticasone; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D018986:Motor Vehicles; D009784:Occupational Diseases / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects*; D012120:Respiration Disorders / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D012129:Respiratory Function Tests; D000068299:Salmeterol Xinafoate; D053260:Soot / Q000009:adverse effects*; D016896:Treatment Outcome; D014481:United States
chemical_list: D000730:Androstadienes; D001993:Bronchodilator Agents; D053260:Soot; D000068299:Salmeterol Xinafoate; D000068298:Fluticasone; D000420:Albuterol