INTERSTITIAL LUNG-DISEASE MORE THAN 40 YEARS AFTER A 5-YEAR OCCUPATIONAL EXPOSURE TO TALC

A 62 yr old woman was initially diagnosed with sarcoidosis until a tho racoscopic biopsy revealed the presence of numerous birefringent parti cles in fibrotic areas of the centrilobular lung zones. These particle s mere examined by electron microscopy and X-ray spectrometry and char acterized as impure talc. Further inquiry into her occupational histor y revealed that she had worked from the age of 14-18 yrs in a factory making rubber hoses, where she had had an intense exposure to talc. Th ere was no evidence of silicosis or asbestosis, and other significant causes of interstitial lung disease mere excluded. This case emphasize s the importance of a thorough occupational history, which may reveal a remote and forgotten exposure to a significant cause of interstitial lung disease, Although this presentation of talcosis is unusual, this case suggests that even a relatively short, but presumably intense ex posure to talc more than 40 yrs previously may be a cause of progressi ve lung fibrosis.