A young woman was employed for five years as a “flash filler” in a fireworks factory, using a mixture containing aluminium powder. The powder reached a considerable concentration in the atmosphere of the small room in which the patient worked, after she had swept the room. This was done several times a day.
The patient had developed marked dyspnoea on mild exertion at the end of the five-year period. She was found to have limitation of chest movement with marked tracheal deviation. The radiograph showed the hila to be displaced upwards, a fine granular shadowing throughout the lung fields, and a small pulmonary cyst at the right lung apex. Lung function studies showed a marked reduction in lung volumes and a severely impaired diffusing capacity, while the mechanical function was only slightly below normal. Over the right upper lung lobe a small pneumothorax developed, which gradually resolved.
The similarity of this case to other reported cases in workers with particulate aluminium is noted, as is the view that rheumatoid disease may have had some action in the development of the lung lesion. An alternative diagnosis is considered. Finally, the possibility that personal idiosyncrasy may be responsible for the development of such lung lesions in aluminium workers is mentioned.
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