Indium Lung Disease

Details

• Personal Author:
  Chonan, Tatsuya ; Cummings, Kristin J. ; Day, Gregory A. ; Harley, Russell A. ; Hebisawa, Akira ; Kreiss, Kathleen ; Nakano, Makiko ; Omae, Kazuyaki ; Roggli, Victor L. ; Saito, Rena ; Stanton, Marcia L. ; Suarthana, Eva ; Takeuchi, Koichiro ; Tallaksen, Robert J. ; Trapnell, Bruce C. ; Xiao, Yong-Long
• Description:
  BACKGROUND: Reports of pulmonary fibrosis, emphysema, and, more recently, pulmonary alveolar proteinosis (PAP) in indium workers suggested that workplace exposure to indium compounds caused several different lung diseases. METHODS: To better understand the pathogenesis and natural history of indium lung disease, a detailed, systematic, multidisciplinary analysis of clinical, histopathological, radiological, and epidemiologic data for all reported cases and workplaces was undertaken. RESULTS: Ten men (median age, 35 years) who produced, used, or reclaimed indium compounds were diagnosed with interstitial lung disease (ILD) 4-13 years after first exposure (n=7) or PAP 1-2 years after first exposure (n=3). Common pulmonary histopathological features in these patients included intraalveolar exudate typical of alveolar proteinosis (n=9), cholesterol clefts and granulomas (n=10), and fibrosis (n=9). Two patients with ILD had pneumothoraces. Lung disease progressed following cessation of exposure in most patients and was fatal in two. Radiographical data revealed that two patients with PAP subsequently developed fibrosis and one also developed emphysematous changes. Epidemiologic investigations demonstrated the potential for exposure to respirable particles and an excess of lung abnormalities among co-workers. CONCLUSIONS: Occupational exposure to indium compounds was associated with PAP, cholesterol ester crystals and granulomas, pulmonary fibrosis, emphysema, and pneumothoraces. The available evidence suggests exposure to indium compounds causes a novel lung disease that may begin with PAP and progress to include fibrosis and emphysema, and, in some cases, premature death. Prospective studies are needed to better define the natural history and prognosis of this emerging lung disease and identify effective prevention strategies. [Description provided by NIOSH]
• Subjects:
  Epidemiology Fibrosis Lung Lung Diseases Metals Occupational Health Radiation Respiratory System Respiratory Tract Diseases Safety
• Keywords:
  Pulmonary-disorders; Pulmonary-function; Pulmonary-system; Fibrosis; Lung; Lung-disorders; Lung-fibrosis; Lung-function; Lung-disease; Pulmonary-system-disorders; Epidemiology; Histopathology; Radiology; Humans; Men; Metallic-compounds; Respiration; Respiratory-system-disorders
• ISSN:
  0012-3692
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  District of Columbia ; Georgia ; North Carolina ; Ohio ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 5 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  6 pdf pages
• NIOSHTIC Number:
  nn:20040194
• Citation:
  Chest 2012 Jun; 141(6):1512-1521
• Contact Point Address:
  Kristin J. Cummings, MD, MPH, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1095 Willowdale Road, MS 2800 47 Morgantown, WV 26505
• Email:
  kcummings@cdc.gov
• CAS Registry Number:
  3-8-Angiotensin II (CAS RN 12676-15-2) ; Indium (CAS RN 7440-74-6) ; Indium arsenide (CAS RN 1303-11-3) ; Indium oxide (CAS RN 1312-43-2) ; Indium phosphide (CAS RN 22398-80-7) ; Indium tin oxide (In1.69Sn0.15O2.85) (CAS RN 71243-84-0) ; Indium trihydroxide (CAS RN 20661-21-6) ; Tin oxide (SnO2) (CAS RN 18282-10-5)
• Federal Fiscal Year:
  2012
• Peer Reviewed:
  True
• Source Full Name:
  Chest
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:ae3554be1e55677906951de0c8040ca61672b930bff0fec88efd0b358a5b81c280fb0e768a5f0c7dac9ed34b425c77954fd6c889d89e8730c63d1a25fc050b09
• Download URL:
  https://stacks.cdc.gov/view/cdc/231579/cdc_231579_DS1.pdf
• File Type:
  [PDF - 6.47 MB ]