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Pulmonary injury associated with spray of a water-based nano-sized waterproofing product: a case study

BACKGROUND: In most reported cases of lung trauma with water proofing products, volatile organic compounds (VOC) have a prominent role. Here we report on a case involving ten workers exposed to a sprayed product containing nanoparticles in a water solution with only a few percent VOC. CASE PRESENTAT...

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Autores principales: Scheepers, Paul T. J., Masen-Poos, Lucie, van Rooy, Frits G. B. G. J., Oerlemans, Arné, van Daalen, Eline, Cremers, Robbert, Lichtenbeld, Hera, Biesma, Bonne, Sørli, Jorid B., Koponen, Ismo K., Larsen, Søren Thor, Wolkoff, Peder, Nørgaard, Asger W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721695/
https://www.ncbi.nlm.nih.gov/pubmed/29234454
http://dx.doi.org/10.1186/s12995-017-0180-7
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author Scheepers, Paul T. J.
Masen-Poos, Lucie
van Rooy, Frits G. B. G. J.
Oerlemans, Arné
van Daalen, Eline
Cremers, Robbert
Lichtenbeld, Hera
Biesma, Bonne
Sørli, Jorid B.
Koponen, Ismo K.
Larsen, Søren Thor
Wolkoff, Peder
Nørgaard, Asger W.
author_facet Scheepers, Paul T. J.
Masen-Poos, Lucie
van Rooy, Frits G. B. G. J.
Oerlemans, Arné
van Daalen, Eline
Cremers, Robbert
Lichtenbeld, Hera
Biesma, Bonne
Sørli, Jorid B.
Koponen, Ismo K.
Larsen, Søren Thor
Wolkoff, Peder
Nørgaard, Asger W.
author_sort Scheepers, Paul T. J.
collection PubMed
description BACKGROUND: In most reported cases of lung trauma with water proofing products, volatile organic compounds (VOC) have a prominent role. Here we report on a case involving ten workers exposed to a sprayed product containing nanoparticles in a water solution with only a few percent VOC. CASE PRESENTATION: Ten workers suffered from respiratory symptoms following spray impregnation of hardwood furniture using a waterproofing product that contained positively charged fluorinated acrylate copolymer solid cores with a median diameter of 70 nm (1.3 w%) in aqueous suspension with 3.3 w% VOC and 0.3 w% quaternary ammonium. The worker who applied one liter of the product in a wood workshop, using an air mix spray gun, did not report any health complaints. Another worker, who entered the workshop 3 h later and had rolled and smoked two cigarettes, was hospitalized with severe chemical pneumonitis. A chest X-ray (CXR) showed bilateral infiltrative impairment in the lower lobe regions. On the next day a second CXR showed increased patchiness marking in all fields. A high-resolution Computer Tomography (CT)-scan demonstrated extensive bilateral areas of ground-glass opacities predominantly in the lower regions of the upper lobes, the right middle lobe and the apical regions of the lower lobes, compatible with severe chemical pneumonitis. On the following morning, nine workers in an adjacent workplace in the same building, experienced dry cough, chest tightness and substernal pain upon physical exercise. Reconstruction of the spray application in a climate chamber confirmed trimethyl silanol, glycol ethers and fluoroalkenes in the gas phase. Immediately after the spray application, aerosols were observed at a maximum concentration of 6.3 × 10(4) cm(−3). Mass concentrations were 0.095 and 10 mg/m(3) in the size ranges 5.6-560 nm and 0.22-30 μm, respectively, decreasing to less than 10 μg/m(3) in both size ranges after 15 h. CONCLUSION: The hospitalized worker had smoked cigarettes contaminated with fluoropolymers which is a plausible explanation for the lung trauma. Respiratory symptoms in the nine workers may be caused by inhalation of particles that became airborne by resuspension from surfaces when workers entered the adjacent workplace the next day. A contribution from VOC appears less likely because measurements and modelling showed that concentrations in the mg/m(3) range could have occurred only if the building was assumed to be completely airtight. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12995-017-0180-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-57216952017-12-12 Pulmonary injury associated with spray of a water-based nano-sized waterproofing product: a case study Scheepers, Paul T. J. Masen-Poos, Lucie van Rooy, Frits G. B. G. J. Oerlemans, Arné van Daalen, Eline Cremers, Robbert Lichtenbeld, Hera Biesma, Bonne Sørli, Jorid B. Koponen, Ismo K. Larsen, Søren Thor Wolkoff, Peder Nørgaard, Asger W. J Occup Med Toxicol Case Report BACKGROUND: In most reported cases of lung trauma with water proofing products, volatile organic compounds (VOC) have a prominent role. Here we report on a case involving ten workers exposed to a sprayed product containing nanoparticles in a water solution with only a few percent VOC. CASE PRESENTATION: Ten workers suffered from respiratory symptoms following spray impregnation of hardwood furniture using a waterproofing product that contained positively charged fluorinated acrylate copolymer solid cores with a median diameter of 70 nm (1.3 w%) in aqueous suspension with 3.3 w% VOC and 0.3 w% quaternary ammonium. The worker who applied one liter of the product in a wood workshop, using an air mix spray gun, did not report any health complaints. Another worker, who entered the workshop 3 h later and had rolled and smoked two cigarettes, was hospitalized with severe chemical pneumonitis. A chest X-ray (CXR) showed bilateral infiltrative impairment in the lower lobe regions. On the next day a second CXR showed increased patchiness marking in all fields. A high-resolution Computer Tomography (CT)-scan demonstrated extensive bilateral areas of ground-glass opacities predominantly in the lower regions of the upper lobes, the right middle lobe and the apical regions of the lower lobes, compatible with severe chemical pneumonitis. On the following morning, nine workers in an adjacent workplace in the same building, experienced dry cough, chest tightness and substernal pain upon physical exercise. Reconstruction of the spray application in a climate chamber confirmed trimethyl silanol, glycol ethers and fluoroalkenes in the gas phase. Immediately after the spray application, aerosols were observed at a maximum concentration of 6.3 × 10(4) cm(−3). Mass concentrations were 0.095 and 10 mg/m(3) in the size ranges 5.6-560 nm and 0.22-30 μm, respectively, decreasing to less than 10 μg/m(3) in both size ranges after 15 h. CONCLUSION: The hospitalized worker had smoked cigarettes contaminated with fluoropolymers which is a plausible explanation for the lung trauma. Respiratory symptoms in the nine workers may be caused by inhalation of particles that became airborne by resuspension from surfaces when workers entered the adjacent workplace the next day. A contribution from VOC appears less likely because measurements and modelling showed that concentrations in the mg/m(3) range could have occurred only if the building was assumed to be completely airtight. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12995-017-0180-7) contains supplementary material, which is available to authorized users. BioMed Central 2017-12-08 /pmc/articles/PMC5721695/ /pubmed/29234454 http://dx.doi.org/10.1186/s12995-017-0180-7 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Scheepers, Paul T. J.
Masen-Poos, Lucie
van Rooy, Frits G. B. G. J.
Oerlemans, Arné
van Daalen, Eline
Cremers, Robbert
Lichtenbeld, Hera
Biesma, Bonne
Sørli, Jorid B.
Koponen, Ismo K.
Larsen, Søren Thor
Wolkoff, Peder
Nørgaard, Asger W.
Pulmonary injury associated with spray of a water-based nano-sized waterproofing product: a case study
title Pulmonary injury associated with spray of a water-based nano-sized waterproofing product: a case study
title_full Pulmonary injury associated with spray of a water-based nano-sized waterproofing product: a case study
title_fullStr Pulmonary injury associated with spray of a water-based nano-sized waterproofing product: a case study
title_full_unstemmed Pulmonary injury associated with spray of a water-based nano-sized waterproofing product: a case study
title_short Pulmonary injury associated with spray of a water-based nano-sized waterproofing product: a case study
title_sort pulmonary injury associated with spray of a water-based nano-sized waterproofing product: a case study
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721695/
https://www.ncbi.nlm.nih.gov/pubmed/29234454
http://dx.doi.org/10.1186/s12995-017-0180-7
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