ORGANIZING PNEUMONIA IN TEXTILE PRINTING WORKERS - A CLINICAL DESCRIPTION

In April 1992 an outbreak of severe respiratory illness occurred among aerographic textile workers in the area of Alcoi, Autonomous Communit y of Valencia, Spain, An epidemiological study linked this outbreak to the use of a reformulated aerosolized product, Acramin-FWN. We analyz ed clinical, laboratory, and pathological data of the first 14 patient s with confirmed organizing pneumonia (OP) secondary to this newly rec ognized occupational toxicant. The mean age of the patients was 30 yrs , The most common clinical findings were cough (86%), epistaxis (71%), dyspnoea (64%), oppressive chest pain (57%), and crackles (50%), A re strictive functional pattern was evident in 64%, Radiographic findings consisted predominantly of patchy infiltrates in 65% and a micronodul ar pattern in 35%. Treatment with corticosteroids did not prevent init ial progression in 11 of the 14 patients and development of irreversib le respiratory failure in five patients, At necropsy, besides features of OP, interstitial fibrosis and diffuse alveolar damage were evident , A low total lung capacity, the presence of crackles at admission, an d increases in the alveolar-arterial oxygen difference were predictive of death. The organizing pneumonia caused by the inhalation of Acrami n-FWN is characterized by a tendency to evolve into progressive inters titial fibrosis despite the use of corticosteroids. The illness is res tricted to the respiratory system and once respiratory failure has dev eloped the prognosis is poor.