Abstract
Objectives
To report the ocular surface and respiratory tract damages due to a sub-chronic (3 months), occupational exposure to fluorspar dust in case of inconsistent use of personal protective equipment.
Methods
A 50-year-old man was referred to our clinic with bilateral conjunctival injection, ocular foreign body sensation and symptoms of ocular discomfort. He reported having 3 days before an urgent hospital admission for dyspnoea with odynophagia, hyposmia, nausea, vomiting, headache and asthenia. Otorhinolaryngological examination revealed a severe hypertrophic rhinopharyngitis and a significant decrease in overall sensitivity to olfactory stimuli. General anamnesis was negative for previous diseases or medication use.
Results
Ocular examination revealed a diffuse injection of the ocular surface with some areas of conjunctival and limbal ischaemia, a best-corrected visual acuity of 20/25 in both eyes, an intraocular pressure of 23 and 21 mmHg, respectively, in the right and in the left eyes, and a normal fundus oculi. Assessment of the tear film and ocular surface showed the presence of dry eye disease. Based on medical history and clinical tests, initial diagnostic hypothesis was ocular surface burn due to chemical exposure, i.e. to fluorspar. Therefore, anterior segment fluorescein angiography was performed to confirm the extension of conjunctival and limbal ischaemia. Thus, ocular ischaemia was detected in approximately 10 clock hours of limbus and in 50% of conjunctiva.
Conclusions
The present work remarks the importance of using protective equipment for preventing ocular and respiratory tract damages in workers occupationally exposed to the ‘acid-grade fluorite’.
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References
Villiers AJ, Windish JP (1964) Lung cancer in a fluorspar mining community: I. Radiation, dust, and mortality experience. Occup Env Med 21(2):94–109
Alarcon-Herrera MT et al (2001) Well water fluoride, dental fluorosis, and bone fractures in the Guadiana Valley of Mexico. Fluoride 34(2):139–149
Napoli PE et al (2016) A simple novel technique of infrared meibography by means of spectral-domain optical coherence tomography: a cross-sectional clinical study. PloS one 11(10):e0165558
Napoli PE et al (2014) Evaluation of the adhesive properties of the cornea by means of optical coherence tomography in patients with meibomian gland dysfunction and lacrimal tear deficiency. PloS one 9(12):e115762
Barbier O, Arreola-Mendoza L, Del Razo LM (2010) Molecular mechanisms of fluoride toxicity. Chem Biol Interact 188(2):319–333
Mullett T, Zoeller T, Bingham H, Pepine CJ, Prida XE, Castenholz R, Kirby R (1987) Fatal hydrofluoric acid cutaneous exposure with refractory ventricular fibrillation. J Burn Care Rehabil 8:216
McCulley P, Whiting DW, Petitt MG, Lauber SE (1983) Hydrofluoric acid burns of the eye. J Occup Med 25:447
Ridley W, Matsuoka M (2009) Fluoride-induced cyclooxygenase-2 expression and prostaglandin E2 production in A549 human pulmonary epithelial cells. Toxicol Lett 188(3):180–185
Dua HS, King AJ, Joseph A (2001) A new classification of ocular surface burns. Br J Ophthalmol 85(11):1379–1383
Viragh E et al (2006) Health effects of occupational exposure to fluorine and its compounds in a small-scale enterprise. Ind Health 44(1):64–68
Mullenix PJ (2005) Fluoride poisoning: a puzzle with hidden pieces. Int J Occup Env Health 11(4):404–414
Amoore JE (1986) Effects of chemical exposure on olfaction in humans. In: Burrow CS (ed) Toxicology of the nasal passages. Hemisphere Publishing, Washington, DC, pp 155–190
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The authors declare no conflict of interest.
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The authors confirm that all data underlying the findings are fully available without restriction. Authors confirm that all data underlying the findings in the present study are freely available in the manuscript. No additional data available.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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The patient involved in this case report gave written informed consent to publish the present paper.
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Pietro Emanuele Napoli and Matteo Nioi have contributed equally to this work.
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Napoli, P.E., Nioi, M., Iovino, C. et al. Ocular surface and respiratory tract damages from occupational, sub-chronic exposure to fluorspar: case report and other considerations. Int Ophthalmol 39, 1175–1178 (2019). https://doi.org/10.1007/s10792-018-0915-1
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DOI: https://doi.org/10.1007/s10792-018-0915-1