Rounded Atelectasis After Exposure to Refectory Ceramic Fibres - A Case Report

Abstract

Background: Refractory Ceramic fibres (RCF) are man-made mineral fibres used in high performance thermal insulation applications and mostly to line furnaces, kilns and other industrial heaters. Analogous to asbestos fibres, RCF are respirable, show a pleural drift and can persist in human lung tissue for more than 20 years after exposure. Pleural changes such as localised or diffuse pleural thickening as well as pleural calcification were reported. Case presentation: A 45 years old man worked in high performance thermal insulation applications using refractory ceramic fibres (RCF) for almost 20 years. During a biennial occupational medical prophylaxis to ensure early diagnosis of disorders caused by inhalation of aluminium silicate fibres with X-ray including high-resolution computed tomography (HRCT) showed bilateral pleural thickening and a pleural calcification next to a rounded atelectasis. Asbestos exposure could be excluded. In pulmonary function test a restrictive lung pattern could be revealed. In work samples scanning electron microscopy (SEM) including energy dispersive X-ray analysis (EDX) classified aluminium silicate fibres. X-ray powder diffraction and transmission electron microscopy (TEM) showed crystalline as well as amorphous fibres. Conclusions: A comprehensive lung function analysis and in case of restrictive lung disorders additional CT scans are needed in RCF exposed workers in accordance to the guidelines for medical occupational examinations comparable to asbestos exposed workers.