Polyethylene flock-associated interstitial lung disease in a Spanish female

Abstract

This case study presents a female aged 54 yrs with a 12 months history of progressive pulmonary impairment after a 7-yr period of occupational exposure to rotary-cut polyethylene. An open lung biopsy revealed the histopathology of follicular bronchiolitis that is viewed as a stereotypical feature for flock worker9s lung. It seems to be the first case of plastic flock-associated interstitial lung disease reported outside North America.

The respiratory effects of occupational polypropylene flock exposure

“…In general, these were symptomatic patients and further clinical investigation into them led to a diagnosis of ILD [1][2][3][4]6]. The first case of polyethylene flock-associated ILD was reported by BARROSO et al [4] in a woman who presented with a 12 months history of dyspnoea on effort and dry cough after a 7-year period of occupational exposure to rotary cut polyethylene [4].…”

“…Several cases of overt occupational ILD, referred to as ''flock worker's lung'', have been reported among flock processing workers in recent years [1][2][3][4]. In general, these were symptomatic patients and further clinical investigation into them led to a diagnosis of ILD [1][2][3][4]6].…”

“…Since 1999, several cases of a particular occupational interstitial lung disease (ILD), termed ''flock worker's lung'', have been reported among workers exposed to nylon flock in the USA and Canada [1][2][3]. In Europe, BARROSO et al [4] reported a case of ILD in a woman who had had a longstanding occupational exposure to polyethylene flock.…”

ERS position paper: work-related respiratory diseases in the EU

“…Thus, in the 1990s a very severe form of interstitial lung disease, called Ardystil syndrome, affected Spanish and Algerian textile workers who had been engaged in spraying paints that were reputedly non-toxic [22,23]. Another novel pulmonary disease, flock worker's lung, has recently been described in workers exposed to synthetic micro fibres (flock) of nylon [24], polyethylene [25] or polypropylene [26], although such polymeric materials are generally considered to be devoid of significant toxicity. Recently, serious airways disease affected workers from plants producing microwave popcorn ''popcorn worker's lung'' [27,28], probably as a result of their inhalatory exposure to artificial flavouring agents that are ''generally recognised as safe'' [28].…”

Health hazard evaluation report: HETA #2004-0013-2990, Hallmark Cards, Inc., Lawrence, Kansas.

“…While the initial case clusters and several sporadic cases of flock workers' lung have been reported in the nylon flock industry in North America, more recently reported cases in Europe have been associated with other types of flock. A case of flock workers' lung was described in a worker exposed to polyethylene flock in Spain [Barroso 2002]. In Turkey, a cross-sectional study in the polypropylene flock industry showed a 3.6-fold increase in respiratory symptoms in exposed workers compared to unexposed controls [Atis 2005].…”