Pneumoconiosis in a polytetrafluoroethylene (PTFE) spray worker: a case report with an occupational hygiene study

Abstract

BackgroundUsing analysis of air samples from the workplace, we report on one case of pneumoconiosis in an individual who has been working in a polytetrafluoroethylene (PTFE) spraying process for 28 years.Case presentationThe patient was diagnosed with granulomatous lung disease caused by PTFE using computed tomography (CT), lung biopsy and electron microscopy. To assess the qualitative and quantitative exposure to PTFE in workplace, Fourier transform infrared spectroscopy (FT-IR), energy-dispersive X-ray spectroscopy (EDX) and thermogravimetric analysis (TGA) were performed on air samples from the workplace. The presence of PTFE particles was confirmed, and the airborne concentration of PTFE was estimated to be 0.75 mg/m3.ConclusionsThis case demonstrates that long-term exposure to PTFE spraying can cause granulomatous lung lesions such as pneumoconiosis; such lesions appear to be caused not by the degradation products of PTFE from high temperatures but by spraying the particles of PTFE. Along with air-sampling analysis, we suggest monitoring the concentration of airborne PTFE particles related to chronic lung disease.

Occupational Lung Disease Caused by Exposure to Polytetrafluoroethylene

“…Round atelectasis is known to result from any type of pleural inflammatory reaction with resultant fibrosis ( 8 ). In the present case, the right lung mass lesion gradually increased in size as the pleural effusion persisted due to an infection that had started two years earlier, and the lesions other than the mass lesion showed small granular shadows, similar to previous reports ( 6 , 7 ). These observations suggest that the mass lesion in the right lung was not due to granulomatous inflammation alone.…”

“…As the distribution of fluorine was found widely in this case, we considered chronic exposure to PTFE to have caused the granulomatous lesions. Recent reports from Korea have described several cases of chronic granulomatous pulmonary lesions related to PTFE inhalation, similar to our case ( 6 , 7 ). Lee et al reported the size of PTFE particles (1-22 μm) from air sampling of the work environment, which corresponded to the PTFE particle size used in the spraying process ( 6 ).…”

“…Recent reports from Korea have described several cases of chronic granulomatous pulmonary lesions related to PTFE inhalation, similar to our case ( 6 , 7 ). Lee et al reported the size of PTFE particles (1-22 μm) from air sampling of the work environment, which corresponded to the PTFE particle size used in the spraying process ( 6 ). The size of the pyrolyzed particles during the coating process is smaller than PTFE particles during the spraying process; they therefore concluded that the lung lesions had been caused by the PTFE spraying procedure.…”

Safety Assessment of Polyfluorinated Polymers as Used in Cosmetics

“…Pneumoconiosis was observed in a patient who had been exposed to PTFE during a PTFE spray-coating process over a period of 28 yr. 47 The spray solution contained 55 to 65% PTFE. Spraying was performed 2000 to 3000 times per day (50 cm away from the face), and the patient worked 6 d/wk (10 h/d) without a respirator.…”

Parkinson's disease in a worker exposed to insecticides at a greenhouse

“…Many case reports in the discipline of occupational medicine have focused on assuming the level of exposure without previous epidemiological evidence, and hypothetical exposure models have been more critical than causal relationships between exposure and the disease itself for determining work-relatedness [ 12 13 14 15 ]. If exposure could not be estimated or assumed, however, epidemiological evidence was more significant.…”