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Review
. 2021 Apr 1;21(2):121-127.
doi: 10.1097/ACI.0000000000000717.

Occupational respiratory and skin diseases among workers exposed to metalworking fluids

Randall J Nett  1 , Marcia Stanton  1 , George R Grimes  2
Affiliations
Review

Occupational respiratory and skin diseases among workers exposed to metalworking fluids

Randall J Nett et al. Curr Opin Allergy Clin Immunol. .

Abstract

Purpose of review: To examine respiratory and skin diseases that occur among workers exposed to metalworking fluids (MWFs) used during machining processes.

Recent findings: 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.

Summary: 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.

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References

    1. Rosenman K. Occupational diseases in individuals exposed to metal working fluids. Curr Opin Allergy Clin Immunol 2015; 15:131–136.
    1. National Institute for Occupational Safety and Health (NIOSH). Metalworking fluids 2013. Available from: https://www.cdc.gov/niosh/topics/metalworking/default.html [Accessed 7 September 2020].
    1. Park RM. Risk assessment for metal working fluids and respiratory outcomes. Saf Health Work 2019; 10:428–436.
    1. Cummings KJ, Stanton ML, Kreiss K, et al. Work-related adverse respiratory health outcomes at a machine manufacturing facility with a cluster of bronchiolitis, alveolar ductitis and emphysema (BADE). Occup Environ Med 2020; 77:386–392.
    1. Cummings KJ, Stanton ML, Nett RJ, et al. Severe lung disease characterized by lymphocytic bronchiolitis, alveolar ductitis, and emphysema (BADE) in industrial machine-manufacturing workers. Am J Ind Med 2019; 62:927–937.

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