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J Occup Med Toxicol

Title:		Pulmonary injury associated with spray of a water-based nano-sized waterproofing product: a case study
Author(s):		Scheepers PTJ; Masen-Poos L; van Rooy F; Oerlemans A; van Daalen E; Cremers R; Lichtenbeld H; Biesma B; Sorli JB; Koponen IK; Larsen ST; Wolkoff P; Norgaard AW;
Address:		"Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, PO Box 9101, 6500 HB Nijmegen, The Netherlands. ISNI: 0000 0004 0444 9382. GRID: grid.10417.33 Department of Lung Diseases, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands. ISNI: 0000 0004 0501 9798. GRID: grid.413508.b Arbo Unie Expert Centre for Chemical Risk Management, Utrecht, The Netherlands. Present address: Ministry of Social Affairs and Employment, The Hague, The Netherlands. Present address: Witteveen+Bos Consulting, The Hague, The Netherlands. Oxility BV, Best, The Netherlands. The National Research Centre for the Working Environment, Copenhagen, Denmark. ISNI: 0000 0000 9531 3915. GRID: grid.418079.3"
Journal Title:		J Occup Med Toxicol
Year:		2017
Volume:		20171208
Issue:
Page Number:		33 -
DOI:		10.1186/s12995-017-0180-7
ISSN/ISBN:		1745-6673 (Print) 1745-6673 (Electronic) 1745-6673 (Linking)
Abstract:		"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 x 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 mum, respectively, decreasing to less than 10 mug/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"
Keywords:		Chemical pneumonitis Exposure reconstruction Inhalation injury Occupational accident Waterproofing;
Notes:		"PubMed-not-MEDLINEScheepers, Paul T J Masen-Poos, Lucie van Rooy, Frits G B G J Oerlemans, Arne van Daalen, Eline Cremers, Robbert Lichtenbeld, Hera Biesma, Bonne Sorli, Jorid B Koponen, Ismo K Larsen, Soren Thor Wolkoff, Peder Norgaard, Asger W eng Case Reports England 2017/12/14 J Occup Med Toxicol. 2017 Dec 8; 12:33. doi: 10.1186/s12995-017-0180-7. eCollection 2017"