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2010 ; 118
(2
): 249-52
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Case report: analytical electron microscopy of lung granulomas associated with
exposure to coating materials carried by glass wool fibers
#MMPMID20123612
Ferreira AS
; Moreira VB
; Castro MC
; Soares PJ
; Algranti E
; Andrade LR
Environ Health Perspect
2010[Feb]; 118
(2
): 249-52
PMID20123612
show ga
CONTEXT: Man-made vitreous fibers (MMVFs) are noncrystalline inorganic fibrous
material used for thermal and acoustical insulation (e.g., rock wool, glass wool,
glass microfibers, and refractory ceramic fibers). Neither epidemiologic studies
of human exposure nor animal studies have shown a noticeable hazardous effect of
glass wools on health. However, MMVFs have been anecdotally associated with
granulomatous lung disease in several case reports. CASE PRESENTATION: Here, we
describe the case of a patient with multiple bilateral nodular opacities who was
exposed to glass wool fibers and coating materials for 7 years. Bronchoalveolar
lavage fluid revealed an increased total cell count (predominantly macrophages)
with numerous cytoplasmic particles. Lung biopsy showed peribronchiolar
infiltration of lymphoid cells and many foreign-body-type granulomas. Alveolar
macrophages had numerous round and elongated platelike particles inside the
cytoplasm. X-ray microanalysis of these particles detected mainly
oxygen/aluminum/silicon and oxygen/magnesium/silicon, compatible with kaolinite
and talc, respectively. No elemental evidence for glass fibers was found in lung
biopsy. DISCUSSION: The contribution of analytical electron microscopy applied in
the lung biopsy was imperative to confirm the diagnosis of pneumoconiosis
associated with a complex occupational exposure that included both MMVFs and
coating materials. RELEVANCE TO CLINICAL OR PROFESSIONAL PRACTICE: This case
study points out the possible participation of other components (coating
materials), beyond MMVFs, in the etiology of pneumoconiosis.