CASE REPORT
Lung fibrosis and exposure to wood dusts: Two cases report and review of the literature
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Italian National Health Service, Local Health Unit of Parma, Langhirano, Italy
(Occupational Health and Safety Unit, Department of Prevention)
Corresponding author
Matteo Riccò
Italian National Health Service, Local Health Unit of Parma, Occupational Health and Safety Unit, Department of Prevention, Via Roma 42, 43010 Langhirano, Italy
Med Pr Work Health Saf. 2015;66(5):739-47
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ABSTRACT
Introduction: Increasing evidence suggests that idiopathic pulmonary fibrosis (IPF) occurs more often in subjects previously
exposed to wood dusts than in non-exposed subjects. Here we report 2 cases of the IPF among workers prolongedly exposed to
high levels of hardwood dusts. Case report: The case No. 1: An 83 year-old male former smoker, retired joiner developed mild
dyspnoea and chronic dry cough over the period preceding the examination. Pulmonary function tests (PFT) identified a mild
restrictive pattern and diffusion capacity for carbon dioxide (CO2) that was severely impaired (57% of predicted value). High
resolution computer tomography (HRCT) identified bilateral, subpleural basal reticular opacities in honeycombing, without any
nodules or ground-glass opacities. The case No. 2: A 73 year-old male retired joiner, never smoker, presented a 3-year history of
progressive breathlessness and non-productive cough in mild hypoxemia. Pulmonary function tests suggested a moderate restrictive
pattern in severely impaired diffusion capacity for CO2 (54% of predicted value). High resolution computer tomography
identified diffuse peripheral reticular opacities and honeycombing of lower fields, with apico-basilar gradient. Both cases received
diagnosis of the idiopathic pulmonary fibrosis. Discussion: The pulmonary fibrosis is a common feature of several diseases and
may be induced by inflammatory disorders following inhalation of organic and inorganic dusts (e.g., asbestos, silica), and several
reports suggest that many cases of the IPF may be in fact secondary to occupational dust exposure as in the case reports we present
here. Conclusions: Occupational exposure to wood dusts may be a risk factor for the IPF. Unfortunately, exposure reconstruction
is frequently inconsistent and anamnesis often misses other causes of the pulmonary fibrosis (e.g., extrinsic allergic alveolitis).
Med Pr 2015;66(5):739–747