Pulmonary fibrosis following household exposure to asbestos dust?
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CASE REPORT
Open Access
Pulmonary fibrosis following household exposure to asbestos dust? Joachim Schneider1*, Bernd Brückel1, Ludger Fink2 and Hans-Joachim Woitowitz1
Abstract An 81-year-old woman was dying from histologically confirmed pulmonary fibrosis without having had any asbestos exposure in the workplace. The lung dust fibre analysis showed significantly increased “asbestos bodies” (AB) (2,640 AB per gram of wet lung tissue) and asbestos fibre concentrations (8,600,000 amphibole fibres of all lengths and 540,000 amphibole fibres with a length ≥5 μm per gram of dry lung tissue). Asbestos exposure was revealed to have occurred during household contact after 27 years of washing her husband’s industrial clothing that had been contaminated by asbestos at his workplace in an asbestos textile factory. Household asbestos dust exposure as a risk or co-factor in the aetiology of the fatal pulmonary fibrosis is discussed. Keywords: Asbestos, Lung fibrosis, Indoor air pollution, Household contact, Lung dust fibre burden
Introduction Over 100 years ago, Murray in London [1] identified the first case of pulmonary fibrosis in an asbestos textile worker. Epidemiologically there is no doubt about the causal relationship between occupational asbestos exposure and the risk of mesothelioma, pleural plaques, parenchymal fibrosis of the lung, and lung cancer. Furthermore, asbestos-induced mesotheliomas in housewives have been observed after para-occupational exposure by cleaning asbestos-contaminated work clothing [2], and small, irregular opacities in X-ray examinations as a sign of asbestosis in housewives without occupational exposure have been reported, albeit rarely for review see [3]. Case report The 81-year-old housewife cleaned her husband’s asbestoscontaminated work clothing daily for over 27 years by shaking out, brushing out, and washing. The husband was employed as a mechanical engineer in an asbestos textile factory with about 500 employees in the 1960s. His workplace was at a mill, spinnery, and carding facility. Asbestos dust was all over the factory and consequently in his hair and clothes. Their home was located approximately 2 km away from the plant. The wife and her daughter visited the * Correspondence: [email protected] 1 Institute and Outpatient Clinic for Occupational and Social Medicine, University Medical Center Giessen, Aulweg 129/III, D-35385 Giessen, Germany Full list of author information is available at the end of the article
husband at work about once a month. The woman had been previously employed working at the counter of a post office, but after she married, she became a full-time housewife. The woman did not remember any work-related contact with asbestos. At the age of 69 she suffered from arterial hypertension, diet-controlled diabetes mellitus, and a myocardial infarction in the septum area. Apart from intermittent feverish bronchitis, there was no further need for medical consultation. After a latency of about 40 years, chest X-rays showed mitral heart config
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