Nakano Makiko, Tanaka Akiyo, Hirata Miyuki, Kumazoe Hiroyuki, Wakamatsu Kentaro, Kamada Dan, Omae Kazuyuki
Department of Preventive Medicine and Public Health, School of Medicine, Keio University.
J Occup Health. 2016 Sep 30;58(5):477-481. doi: 10.1539/joh.16-0076-CS. Epub 2016 Aug 4.
To report the occurrence of an advanced case of indium lung disease with severely progressive emphysema in an indium-exposed worker.
A healthy 42-year-old male smoker was employed to primarily grind indium-tin oxide (ITO) target plates, exposing him to indium for 9 years (1998-2008). In 2004, an epidemiological study was conducted on indium-exposed workers at the factory in which he worked. The subject's serum indium concentration (In-S) was 99.7 μg/l, while his serum Krebs von den Lungen-6 level was 2,350 U/ml. Pulmonary function tests showed forced vital capacity (FVC) of 4.17 l (91.5% of the JRS predicted value), forced expiratory volume in 1 s (FEV) of 3.19 l (80.8% of predicted), and an FEV-to-FVC ratio of 76.5%. A high-resolution chest computed tomography (HRCT) scan showed mild interlobular septal thickening and mild emphysematous changes. In 2008, he was transferred from the ITO grinding workplace to an inspection work section, where indium concentrations in total dusts had a range of 0.001-0.002 mg/m. In 2009, the subject's In-S had increased to 132.1 μg/l, and pulmonary function tests revealed obstructive changes. In addition, HRCT scan showed clear evidence of progressive lung destruction with accompanying severe centrilobular emphysema and interlobular septal thickening in both lung fields. The subject's condition gradually worsened, and in 2015, he was registered with the Japan Organ Transplant Network for lung transplantation (LTx).
Heavy indium exposure is a risk factor for emphysema, which can lead to a severity level that requires LTx as the final therapeutic option.
报告一名铟暴露工人发生的伴有严重进行性肺气肿的晚期铟肺病病例。
一名42岁健康男性吸烟者受雇主要研磨铟锡氧化物（ITO）靶板，使其暴露于铟环境9年（1998 - 2008年）。2004年，对其工作的工厂中铟暴露工人进行了一项流行病学研究。该受试者的血清铟浓度（In - S）为99.7μg/l，而其血清克雷布斯冯登伦格 - 6水平为2350U/ml。肺功能测试显示用力肺活量（FVC）为4.17l（占日本呼吸学会预测值的91.5%），第1秒用力呼气量（FEV）为3.19l（占预测值的80.8%），FEV与FVC比值为76.5%。高分辨率胸部计算机断层扫描（HRCT）显示轻度小叶间隔增厚和轻度肺气肿改变。2008年，他从ITO研磨工作场所调至检查工作区，那里总粉尘中的铟浓度范围为0.001 - 0.002mg/m。2009年，该受试者的In - S升至132.1μg/l，肺功能测试显示有阻塞性改变。此外，HRCT扫描显示有明显的进行性肺破坏证据，伴有双肺野严重的小叶中心型肺气肿和小叶间隔增厚。该受试者的病情逐渐恶化，2015年，他在日本器官移植网络登记等待肺移植（LTx）。
大量铟暴露是肺气肿的一个危险因素，可导致严重程度达到需要肺移植作为最终治疗选择的地步。
