THE SPECTRUM OF RESPIRATORY-DISEASE ASSOCIATED WITH EXPOSURE TO METAL-WORKING FLUIDS

Occupational respiratory diseases have been reported following exposur e to metal working fluids. We report a spectrum of respiratory illness es occurring in an outbreak in 30 workers of an automobile parts engin e manufacturing plant. Workers presented with respiratory complaints a nd, after clinical and laboratory evaluations, were classified as thos e having hypersensitivity pneumonitis, occupational asthma, or industr ial bronchitis, or those without occupational lung disease. Hypersensi tivity pneumonitis affected seven workers, with six exhibiting serum p recipitins to Acinetobacter Iwoffii. Occupational asthma and industria l bronchitis affected 12 and six workers, respectively. Oil-mist expos ures were below current recommendations. Cram-negative bacteria, but n o fungi, Thermophiles, or Legionella, were identified. Although specif ic agents responsible for each individual case could not be identified , probably both specific sensitizing agents and non-specific irritants from metal working fluids, additives, or contaminants contributed to this spectrum of occupational respiratory illness.