Asthma, hypersensitivity pneumonitis and other respiratory diseases caused by metalworking fluids

ABSTRACTHypersensitivity pneumonitis, also known as “machine operator's lung” (MOL), has been related to microorganisms growing in metalworking fluids (MWFs), especiallyMycobacterium immunogenum. We aimed to (i) describe the microbiological contamination of MWFs and (ii) look for chemical, physical, and environmental parameters associated with variations in microbiological profiles. We microbiologically analyzed 180 MWF samples from nonautomotive plants (e.g., screw-machining or metal-cutting plants) in the Franche-Comté region in eastern France and 165 samples from three French automotive plants in which cases of MOL had been proven. Our results revealed two types of microbial biomes: the first was from the nonautomotive industry, showed predominantly Gram-negative rods (GNR), and was associated with a low risk of MOL, and the second came from the automotive industry that was affected by cases of MOL and showed predominantly Gram-positive rods (GPR). Traces ofM. immunogenumwere sporadically detected in the first type, while it was highly prevalent in the automotive sector, with up to 38% of samples testing positive. The use of chromium, nickel, or iron was associated with growth of Gram-negative rods; conversely, growth of Gram-positive rods was associated with the absence of these metals. Synthetic MWFs were more frequently sterile than emulsions. Vegetable oil-based emulsions were associated with GNR, while mineral ones were associated with GPR. Our results suggest that metal types and the nature of MWF play a part in MWF contamination, and this work shall be followed by furtherin vitrosimulation experiments on the kinetics of microbial populations, focusing on the phenomena of inhibition and synergy.

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Hypersensitivity pneumonitis and metalworking fluids contaminated by mycobacteria

European Respiratory Journal ◽

10.1183/09031936.00027611 ◽

2011 ◽

Vol 38 (2) ◽

pp. 486-487 ◽

Cited By ~ 3

Author(s):

C. M. Barber ◽

C. Burton ◽

E. Robinson ◽

B. Crook ◽

G. Evans ◽

...

Keyword(s):

Hypersensitivity Pneumonitis ◽

Metalworking Fluids

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Treatment of water-based metalworking fluids to prevent hypersensitivity pneumonitis associated with Mycobacterium spp.

Journal of Applied Microbiology ◽

10.1111/j.1365-2672.2007.03600.x ◽

2007 ◽

Vol 0 (0) ◽

pp. 071027034549002-???

Author(s):

K. Steinhauer ◽

P. Goroncy-Bermes

Keyword(s):

Hypersensitivity Pneumonitis ◽

Metalworking Fluids ◽

Water Based ◽

Mycobacterium Spp

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Hypersensitivity pneumonitis in a cystic fibrosis patient

Occupational Medicine ◽

10.1093/occmed/kqz115 ◽

2019 ◽

Author(s):

A P Bellanger ◽

H Morisse-Pradier ◽

G Reboux ◽

E Scherer ◽

S Pramil ◽

...

Keyword(s):

Cystic Fibrosis ◽

Lung Disease ◽

Cystic Fibrosis Patient ◽

Pulmonary Disease ◽

Hypersensitivity Pneumonitis ◽

Metalworking Fluids ◽

Aetiological Agent ◽

Pseudomonas Oleovorans ◽

Inflammatory Lung Disease

Abstract Hypersensitivity pneumonitis (HP) is a chronic inflammatory lung disease caused by repeated inhalation of antigenic substances. We present a case of metalworking fluids (MWFs)-HP sensitized to Pseudomonas oleovorans in a cystic fibrosis patient. This case illustrates that HP diagnosis remains challenging, especially in patients with another pulmonary disease, and that serodiagnosis contributes to identifying the precise microorganism involved. It also demonstrates that P. oleovorans is an important secondary aetiological agent in MWF-HP, less known than Mycobacterium immunogenum.

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Presence of a Single Genotype of the Newly Described Species Mycobacterium immunogenum in Industrial Metalworking Fluids Associated with Hypersensitivity Pneumonitis

Applied and Environmental Microbiology ◽

10.1128/aem.68.11.5580-5584.2002 ◽

2002 ◽

Vol 68 (11) ◽

pp. 5580-5584 ◽

Cited By ~ 74

Author(s):

Richard J. Wallace, ◽

Yansheng Zhang ◽

Rebecca W. Wilson ◽

Linda Mann ◽

Harold Rossmoore

Keyword(s):

Genomic Dna ◽

Hypersensitivity Pneumonitis ◽

The United States ◽

Clinical Isolates ◽

Metalworking Fluids ◽

Enzyme Analysis ◽

Restriction Enzyme Analysis ◽

Clinical Patient ◽

Industrial Sites ◽

Single Genotype

ABSTRACT Outbreaks of hypersensitivity pneumonitis (HP) among industrial metal-grinding machinists working with water-based metalworking fluids (MWF) have frequently been associated with high levels of mycobacteria in the MWF, but little is known about these organisms. We collected 107 MWF isolates of mycobacteria from multiple industrial sites where HP had been diagnosed and identified them to the species level by a molecular method (PCR restriction enzyme analysis [PRA]). Their genomic DNA restriction fragment length polymorphism (RFLP) patterns, as determined by pulsed-field gel electrophoresis (PFGE), were compared to those of 15 clinical (patient) isolates of the recently described rapidly growing mycobacterial species Mycobacterium immunogenum. A total of 102 of 107 (95%) MWF isolates (from 10 industrial sites within the United States and Canada) were identified as M. immunogenum and gave PRA patterns identical to those of the clinical isolates. Using genomic DNA, PFGE was performed on 80 of these isolates. According to RFLP analysis using the restriction enzymes DraI and XbaI, 78 of 80 (98%) of the MWF isolates represented a single clone. In contrast, none of the 15 clinical isolates had genetic patterns the same as or closely related to those of any of the others. Given the genomic heterogeneity of clinical isolates of M. immunogenum, the finding that a single genotype was present at all industrial sites is remarkable. This suggests that this genotype possesses unusual features that may relate to its virulence and its potential etiologic role in HP and/or to its resistance to biocides frequently used in MWF.

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Hypersensitivity pneumonitis and metalworking fluids contaminated by mycobacteria

European Respiratory Journal ◽

10.1183/09031936.00036811 ◽

2011 ◽

Vol 38 (2) ◽

pp. 487-488

Author(s):

G. Reboux ◽

I. Tillie-Leblond ◽

F. Grenouillet ◽

S. Roussel ◽

L. Millon

Keyword(s):

Hypersensitivity Pneumonitis ◽

Metalworking Fluids

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Hypersensitivity pneumonitis in workers exposed to metalworking fluids

American Journal of Industrial Medicine ◽

10.1002/ajim.22337 ◽

2014 ◽

Vol 57 (8) ◽

pp. 872-880 ◽

Cited By ~ 15

Author(s):

Christopher M. Barber ◽

Clare M. Burton ◽

David J. Hendrick ◽

C Anthony C. Pickering ◽

Alastair S. Robertson ◽

...

Keyword(s):

Hypersensitivity Pneumonitis ◽

Metalworking Fluids

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Diagnostic yield of specific inhalation challenge in hypersensitivity pneumonitis

European Respiratory Journal ◽

10.1183/09031936.00060714 ◽

2014 ◽

Vol 44 (6) ◽

pp. 1658-1665 ◽

Cited By ~ 46

Author(s):

Xavier Muñoz ◽

Mónica Sánchez-Ortiz ◽

Ferran Torres ◽

Ana Villar ◽

Ferran Morell ◽

...

Keyword(s):

Respiratory Diseases ◽

Hypersensitivity Pneumonitis ◽

Vital Capacity ◽

Diagnostic Yield ◽

False Negative ◽

Diffusing Capacity ◽

Negative Group ◽

Specific Inhalation Challenge ◽

Inhalation Challenge ◽

Reliable Methods

Reliable methods are needed to diagnose hypersensitivity pneumonitis. The aim of the study was to establish the diagnostic yield of specific inhalation challenge (SIC) in patients with hypersensitivity pneumonitis.All patients with suspected hypersensitivity pneumonitis in whom SIC was performed (n=113) were included. SIC was considered positive when patients showed a decrease of >15% in forced vital capacity (FVC) or >20% in diffusing capacity of the lung for carbon dioxide, or a decrease of 10% to 15% in FVC accompanied by a temperature increase of 0.5°C within 24 h of inhalation of the antigen.SIC was positive to the agents tested in 68 patients: 64 received a diagnosis of hypersensitivity pneumonitis and SIC results were considered false-positive in the remaining four patients. In the SIC-negative group (n=45), 24 patients received a diagnosis of hypersensitivity pneumonitis and SIC results were considered false-negative, and 21 patients were diagnosed with other respiratory diseases. The sensitivity and specificity of the test were 72.7% and 84%, respectively. Having hypersensitivity pneumonitis caused by an antigen other than birds or fungi predicted a false-negative result (p=0.001).In hypersensitivity pneumonitis, positive SIC testing virtually confirms the diagnosis, whereas negative testing does not rule it out, especially when the antigenic sources are not birds or fungi.

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