title: Pulmonary toxicity following exposure to a tile coating product containing alkylsiloxanes. A clinical and toxicological evaluation.
abstract: BACKGROUND
  Coating products are widely used for making surfaces water and dirt repellent. However, on several occasions the use of these products has been associated with lung toxicity.
  
  
  OBJECTIVE
  In the present study, we evaluated the toxic effects of an aerosolized tile-coating product.
  
  
  METHODS
  Thirty-nine persons, who reported respiratory and systemic symptoms following exposure to the tile-coating product, were clinically examined. The product was analysed chemically and furthermore, the exposure scenario was reconstructed using a climate chamber and the toxicological properties of the product were studied using in vivo and by in vitro surfactometry.
  
  
  RESULTS
  The symptoms developed within few hours and included coughing, tachypnoea, chest pain, general malaise and fever. The physical examination revealed perihilar lung infiltrates on chest radiograph and reduced blood oxygen saturation. The acute symptoms resolved gradually within 1-3 days and no delayed symptoms were observed. By means of mass spectrometry and X-ray spectroscopy, it was shown that the product contained non-fluorinated alkylsiloxanes. The exposure conditions in the supermarket were reconstructed under controlled conditions in a climate chamber and particle and gas exposure levels were monitored over time allowing estimation of human exposure levels. Mice exposed to the product developed symptoms of acute pulmonary toxicity in a concentration-and time-dependent manner. The symptoms of acute pulmonary toxicity likely resulted from inhibition of the pulmonary surfactant function as demonstrated by in vitro surfactometry. Among these patients only a partial association between the level of exposure and the degree of respiratory symptoms was observed, which could be because of a high inter-individual difference in sensitivity and time-dependent changes in the chemical composition of the aerosol.
  
  
  CONCLUSIONS
  Workers need to cautiously apply surface coating products because the contents can be highly toxic through inhalation, and the aerosols can disperse to locations remote from the worksite and affect bystanders.
authors.affiliation: Department of Anaesthesiology, Bispebjerg University Hospital , Copenhagen , Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Duch
authors.forename: A W
authors.initials: AW
authors.lastname: Nørgaard
authors.forename: J S
authors.initials: JS
authors.lastname: Hansen
authors.forename: J B
authors.initials: JB
authors.lastname: Sørli
authors.forename: P
authors.initials: P
authors.lastname: Jacobsen
authors.forename: F
authors.initials: F
authors.lastname: Lynggard
authors.forename: M
authors.initials: M
authors.lastname: Levin
authors.forename: G D
authors.initials: GD
authors.lastname: Nielsen
authors.forename: P
authors.initials: P
authors.lastname: Wolkoff
authors.forename: N E
authors.initials: NE
authors.lastname: Ebbehøj
authors.forename: S T
authors.initials: ST
authors.lastname: Larsen
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000336:Aerosols; D000818:Animals; D002637:Chest Pain / Q000139:chemically induced; D003371:Cough / Q000139:chemically induced; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D008168:Lung / Q000187:drug effects* / Q000473:pathology; D008297:Male; D013058:Mass Spectrometry; D051379:Mice; D008807:Mice, Inbred BALB C; D008875:Middle Aged; D037661:Pulmonary Surfactant-Associated Proteins / Q000037:antagonists & inhibitors*; D012833:Siloxanes / Q000008:administration & dosage / Q000737:chemistry / Q000633:toxicity*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000336:Aerosols; D037661:Pulmonary Surfactant-Associated Proteins; D012833:Siloxanes
keywords: Aerosols; Coating product; Occupational exposure; Respiratory disorder; Sealing product