The Spectrum of Respiratory Disease Associated With Exposure to Metal Working Fluids

Abstract

Occupational respiratory diseases have been reported following exposure to metal working fluids. We report a spectrum of respiratory illnesses occurring in an outbreak in 30 workers of an automobile parts engine manufacturing plant. Workers presented with respiratory complaints and, after clinical and laboratory evaluations, were classified as those having hypersensitivity pneumonitis, occupational asthma, or industrial bronchitis, or those without occupational lung disease. Hypersensitivity pneumonitis affected seven workers, with six exhibiting serum precipitins to Acinetobacter Iwoffii. Occupational asthma and industrial bronchitis affected 12 and six workers, respectively. Oil-mist exposures were below current recommendations. Gram-negative bacteria, but no fungi, Thermophiles, or Legionella, were identified. Although specific agents responsible for each individual case could not be identified, probably both specific sensitizing agents and non-specific irritants from metal working fluids, additives, or contaminants contributed to this spectrum of occupational respiratory illness.

Health hazard evaluation report: HETA #2001-0303-2893, TRW Automotive, Mt. Vernon, Ohio.

“…Vernon employees have experienced work-related respiratory illness, with first reported onset of symptoms in the fall of 2000. As has been observed in other outbreaks of respiratory illness among workers exposed to MWF in machine shops, 16 a spectrum of illness was observed among TRW workers.…”

Respiratory symptoms and conditions related to occupational exposures in machine shops

“…Previous studies focusing on specific workplaces, mainly in the automobile industry, have linked exposure to metalworking fluids with respiratory symptoms, lung function changes, and occupational asthma, bronchitis or allergic alveolitis (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Most of these studies were conducted in North America.…”

Early immunopathological events in acute model of mycobacterial hypersensitivity pneumonitis in mice

“…Environmental mycobacteria of the M. chelonae-M. abscessus (MCA) group -particularly M. immunogenum -have been associated with outbreaks of HP in factory workers inhalationally exposed to contaminated metalworking fluid (MWF) aerosols (Kreiss & Cox-Ganser 1997;Moore et al 2000;Wilson et al 2001;Falkinham 2003;Beckett et al 2005;Tillie-Leblond et al 2011). HP cases presenting variable clinical forms (acute, subacute, chronic) have been observed in machinists exposed to contaminated MWF (Freeman et al 1998;Zacharisen et al 1998;Beckett et al 2005;Rosenman 2009). While there has been increasing interest in both clinical and research aspects of MWF-associated HP (Gupta et al 2009;Tillie-Leblond et al 2011;Roussel et al 2011;Burton et al 2012;Chandra et al 2013Chandra et al , 2015, differential diagnosis and immunological mechanisms of this occupational lung disease are still poorly understood.…”