Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, West Virginia.
Division of Field Studies and Engineering, NIOSH, CDC, Cincinnati, Ohio, USA.
Curr Opin Allergy Clin Immunol. 2021 Apr 1;21(2):121-127. doi: 10.1097/ACI.0000000000000717.
To examine respiratory and skin diseases that occur among workers exposed to metalworking fluids (MWFs) used during machining processes.
Five cases of a severe and previously unrecognized lung disease characterized by B-cell bronchiolitis and alveolar ductitis with emphysema (BADE) were identified among workers at a machining facility that used MWFs, although MWF exposure could not be confirmed as the etiology. In the United Kingdom, MWF is now the predominant cause of occupational hypersensitivity pneumonitis (HP). Under continuous conditions associated with respiratory disease outbreaks, over a working lifetime of 45 years, workers exposed to MWF at 0.1 mg/m3 are estimated to have a 45.3% risk of acquiring HP or occupational asthma under outbreak conditions and a 3.0% risk assuming outbreak conditions exist in 5% of MWF environments. In addition to respiratory outcomes, skin diseases such as allergic and irritant contact dermatitis persist as frequent causes of occupational disease following MWF exposure.
Healthcare providers need to consider MWF exposure as a potential cause for work-related respiratory and skin diseases. Additional work is necessary to more definitively characterize any potential association between MWF exposures and BADE. Medical surveillance should be implemented for workers regularly exposed to MWF.
研究在机械加工过程中使用金属加工液（MWF）时接触该物质的工人所患的呼吸和皮肤疾病。
在一家使用 MWF 的机械加工设施中，发现了五例以前未被认识到的严重肺部疾病，其特征为 B 细胞细支气管炎和肺泡管炎伴肺气肿（BADE），尽管不能确定 MWF 暴露是病因。在英国，MWF 现在是职业性过敏性肺炎（HP）的主要原因。在与呼吸道疾病暴发相关的连续条件下，在 45 年的工作生涯中，估计暴露于浓度为 0.1mg/m3 的 MWF 的工人在暴发条件下有 45.3%的机会患上 HP 或职业性哮喘，而假设在 5%的 MWF 环境中存在暴发条件，则有 3.0%的机会患上 HP 或职业性哮喘。除了呼吸道疾病外，接触性皮炎（包括变应性和刺激性接触性皮炎）等皮肤疾病仍是 MWF 暴露后常见的职业病。
医疗保健提供者需要考虑 MWF 暴露作为与工作相关的呼吸道和皮肤疾病的潜在原因。需要开展更多工作以更明确地描述 MWF 暴露与 BADE 之间的任何潜在关联。应针对经常接触 MWF 的工人实施医疗监测。
