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Practice

Occupational hypersensitivity pneumonitis after polyurethane adhesive exposure

Arbaaz Patel, Aasim Hasany and Susan M. Tarlo
CMAJ August 02, 2022 194 (29) E1027-E1030; DOI: https://doi.org/10.1503/cmaj.220052
Arbaaz Patel
Michael G. DeGroote School of Medicine (Patel), McMaster University, Hamilton, Ont.; Michael G. DeGroote School of Medicine (Hasany), Niagara Regional Campus, McMaster University, St. Catharines, Ont.; University Health Network (Tarlo), University of Toronto, Toronto, Ont.
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Aasim Hasany
Michael G. DeGroote School of Medicine (Patel), McMaster University, Hamilton, Ont.; Michael G. DeGroote School of Medicine (Hasany), Niagara Regional Campus, McMaster University, St. Catharines, Ont.; University Health Network (Tarlo), University of Toronto, Toronto, Ont.
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Susan M. Tarlo
Michael G. DeGroote School of Medicine (Patel), McMaster University, Hamilton, Ont.; Michael G. DeGroote School of Medicine (Hasany), Niagara Regional Campus, McMaster University, St. Catharines, Ont.; University Health Network (Tarlo), University of Toronto, Toronto, Ont.
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    Figure 1:

    Computed tomography scan (with contrast) of the chest of a 47-year-old woman with hypersensitivity pneumonitis at the time of hospital admission, showing diffuse, centrilobular ground glass opacities bilaterally.

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    Figure 2:

    High-resolution computed tomography scan of the chest of a 47-year-old woman with hypersensitivity pneumonitis after treatment and avoidance of the antigen, showing complete resolution of centrilobular ground glass opacities.

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    Figure 3:

    Classification of select types of interstitial lung diseases (ILDs). Note: IIP = idiopathic interstitial pneumonia. Adapted from Cottin and colleagues2 and published with permission from the European Respiratory Society.

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    Table 1:

    Select list of important agents known to cause occupational hypersensitivity pneumonitis*

    TypeAgentExposure examples
    BacteriaThermophilic actinomycetesFarmers, bagasse workers, mushroom workers, potato riddlers, compost workers, ventilation systems
    Lichtheimia corymbiferaFarmers
    Acinetobacter, OchrobactrumMetal working fluids
    Streptomyces albusCompost workers
    Klebsiella oxytocaHumidifiers
    Bacillus subtilis enzymesDetergent industry
    Mycobacterium avium complex and other nontuberculous mycobacteriaSpa workers
    Mycobacterium immunogenumMetal working fluids, machine operators
    FungiAlternaria alternataHumidifiers, wood workers
    Aspergillus spp.Stucco workers, tobacco growers, malt workers
    Trichosporon cutaneumSeasonal mold contamination in homes
    Penicillium speciesCork workers, cheese workers, food processors, peat moss processors
    Cryptostroma corticaleMaple bark strippers, florists
    Botrytis cinereaWine makers
    Mucor stoloniferPaprika slicers
    RhodotorulaHumidifiers
    Various mushrooms (Shiitaki, Bunashimeji, Pleurotus, Pholiota, Shimeji, Agaricus)Mushroom workers
    EnzymesPhytase, subtilisinAnimal feeding, cleaners
    Animal & insect proteinsAvian serum and feather proteinsBird breeders
    Rat serum proteinsLaboratory workers
    PearlPearl industry
    Mollusk shellNacre industry
    SilkTextile workers
    CarmineFood and cosmetic industry
    Sitophilus granariusFarmers
    Plant proteinsTiger nuts, legumes (e.g., soy), maltFood processors
    AlginateSeaweed workers
    Woods (ramin, pine)Wood workers
    Esparto dustStucco workers
    Low-molecular-weight chemicalsDi-isocyanatesChemical and polyurethane industry, painters
    Acid anhydridesPlastic workers, aircraft industry
    Acrylate compoundsDental technicians
    Triglycidyl isocyanuratePainters (powder paint)
    Pharmaceutical agents (penicillins, cephalosporins)Pharmaceutical industry
    Dimethyl phthalate and styreneYacht manufacturing
    MetalsCobaltHard-metal workers
    ZincSmelters
    ZirconiumCeramic workers
    • ↵* Adapted from Quirce and colleagues6 and published with permission from John Wiley and Sons.

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Canadian Medical Association Journal: 194 (29)
CMAJ
Vol. 194, Issue 29
2 Aug 2022
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Occupational hypersensitivity pneumonitis after polyurethane adhesive exposure
Arbaaz Patel, Aasim Hasany, Susan M. Tarlo
CMAJ Aug 2022, 194 (29) E1027-E1030; DOI: 10.1503/cmaj.220052

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Occupational hypersensitivity pneumonitis after polyurethane adhesive exposure
Arbaaz Patel, Aasim Hasany, Susan M. Tarlo
CMAJ Aug 2022, 194 (29) E1027-E1030; DOI: 10.1503/cmaj.220052
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