Diffuse alveolar damage after exposure to an oil fly ash

Epidemiological investigation has established an association between exposu re to particulate matter (PM) and both human mortality and diverse indices of human morbidity. However, attributing adverse health effects of specific individuals to PM exposure in these studies is not possible. Consequently, their clinical presentation remains ill-defined. We describe a 42-yr-old m ale with both respiratory damage, abnormal blood end points, and cardiac ef fects following an exposure to an emission source air pollution particle ae rsolized during the cleaning of his domestic oil-burning stove. Early sympt oms of shortness of breath and wheezing progressed over 2 wk to hypoxic res piratory failure necessitating mechanical ventilation. Blood indices were a bnormal. Thoracoscopic biopsy demonstrated particle-laden macrophages and d iffuse alveolar damage. Symptomatic and objective improvement rapidly follo wed initiation of corticosteroids. He developed typical anginal symptoms wi thin 2 wk of discharge; however, coronary angiography did not identify any significant narrowing of the epicardial coronary arteries. This patient pre sents with the aggregate of potential injuries described by epidemiological methods to be associated with air pollution particle exposure.