Abstract
Most surveys of outbreaks of hypersensitivity pneumonitis (HP) in subjects with occupational exposure to water-based metalworking fluids (MWFs) were unable to detect a clear link between symptoms and the precise causative agents. We studied the case of a male 41-year-old industrial knife grinder with exposure to water-based MWFs since 12 years. The diagnosis of HP was made by typical work-related symptoms, the demonstration of high lymphocyte numbers in bronchoalveolar lavage and elevated IgG antibody concentrations to various molds in the patient’s serum, and complete recovery after early exposure cessation. Whereas an environmental survey showed only low numbers of mold contamination in one sump sample, high antigenic activity was demonstrated in the same sample by antigen-specific IgG inhibition tests. We conclude that the detection of antigenic molds in water-based MWFs by culture methods may be limited. The link between occupational exposure to specific molds in MWFs and hypersensitivity pneumonitis can be established by the demonstration of antigenic activity by antigen-specific IgG inhibition tests.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Danneberg, G., & Driesel A. (1999). Microorganisms in the workplace atmosphere – Actinomycetes. Commission for Occupational Health and Safety and Standardization (Report No. 13, 2nd ed.). Rheinbreitbach: Druckerei Plump.
Fishwick, D., Tate, P., Elms, J., Robinson, E., Crook, B., Gallagher, F., Lennox, R., & Curran, A. (2005). Respiratory symptoms, immunology and organism identification in contaminated metalworking fluid workers. What you see is not what you get. Occupational Medicine (London), 55, 238–241.
Fox, J., Anderson, H., Moen, T., Gruetzmacher, G., Hanrahan, L., & Fink, J. (1999). Metal working fluid-associated hypersensitivity pneumonitis: An outbreak investigation and case–control study. American Journal of Industrial Medicine, 35, 58–67.
Hodgson, M. J., Bracker, A., Yang, C., Storey, E., Jarvis, B. J., Milton, D., Lummus, Z., Bernstein, D., & Cole, S. (2001). Hypersensitivity pneumonitis in a metal-working environment. American Journal of Industrial Medicine, 39, 616–628.
Holt, G. H. (Ed.). (1994). Bergey’s manual of determinative bacteriology (9th ed.). Baltimore: Williams & Wilkins.
Khan, I. U., & Yadav, J. S. (2004). Real-time PCR assays for genus-specific detection and quantification of culturable and non-culturable mycobacteria and pseudomonads in metalworking fluids. Molecular and Cellular Probes, 18, 67–73.
Kurup, V. P., Zacharisen, M. C., & Fink, J. N. (2006). Hypersensitivity pneumonitis. Indian Journal of Chest Disease/Allied Sciences, 48, 115–128.
Medical Standards Committee. (1996). Medical microbiology – Diagnosis of tuberculosis. Part 3. Detection of mycobacteria by culture method (DIN 58943-3). Berlin: Beuth Verlag.
Merget, R., Sander, I., Ewig, S., Sennekamp, J., & Bruening, T. (2009). Consort hypersensitivity pneumonitis. European Respiratory Journal, 33, 1223–1225.
Robertson, W., Robertson, A. S., Burge, C. B., Moore, V. C., Jaakkola, M. S., Dawkins, P. A., Burd, M., Rawbone, R., Gardner, I., Kinoulty, M., Crook, B., Evans, G. S., Harris-Roberts, J., Rice, S., & Burge, P. S. (2007). Clinical investigation of an outbreak of alveolitis and asthma in a car engine manufacturing plant. Thorax, 62, 981–990.
Tillie-Leblond, I., Grenouillet, F., Reboux, G., Roussel, S., Chouraki, B., Lorthois, C., Dalphin, J. C., Wallaert, B., & Millon, L. (2011). Hypersensitivity pneumonitis and metalworking fluids contaminated by mycobacteria. European Respiratory Journal, 37, 640–647.
Conflicts of Interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Merget, R. et al. (2013). Hypersensitivity Pneumonitis due to Metalworking Fluids: How to Find the Antigens. In: Pokorski, M. (eds) Neurobiology of Respiration. Advances in Experimental Medicine and Biology, vol 788. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6627-3_45
Download citation
DOI: https://doi.org/10.1007/978-94-007-6627-3_45
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-007-6626-6
Online ISBN: 978-94-007-6627-3
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)