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KMID : 0358520080200010037
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Korean Journal of Occupational and Environmental Medicine
2008 Volume.20 No. 1 p.37 ~ p.45
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A Case of Hypersensitivity Pneumonitis in a Worker Exposed to Metal Working Fluid
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Lee Sun-Wung
Koh Dong-Hee
Jin Ku-Won
Park Dong-Uk
Lee Jung-Tak
Song Yoon-Hee
Lee Sang-Yun
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Abstract
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Introduction: There have been no reports of hypersensitivity pneumonitis caused by metal working
fluids in Korea, despite their existence in other countries. Here, we report the first such case, along with
an assessment of work-relatedness through exposure assessment.
Case report: A 64-year old male patient visited the hospital with dyspnea after metal pipe cutting for
about a year. He was diagnosed with hypersensitivity pneumonitis from the evidence of specific exposure
history, clinical symptoms, and radiologic findings. The air exposure levels of the oil mist, endotoxin,
total bacteria and fungus in the work environment was TWA(8-hr) 0.531 mg/m3, 6.33 EU/m3, 100
CFU/m3 and 75 CFU/m3, respectively. The concentrations of the endotoxin, total bacteria and fungus
within the metal working fluid was 1.5×104 EU/mL, 4.6×105 CFU/mL and 1.8×105 CFU/mL, respectively.
Discussion: Although the patient did not receive a specific precipitating antibody test, the microbial
concentration within the metal working fluid was higher than normal and similar to previous case reports,
The oil mist level in the air exceeded the NIOSH REL and ACGIH NIC, and were similar or higher than
previous cases. By excluding other causes of hypersensitivity pneumonitis, we concluded that the disease
developed from exposure to microbial antigens in the metal working fluid.
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KEYWORD
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Hypersensitivity pneumonitis, Metal working fluid
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