Lung fibrosis and exposure to wood dusts: Two cases report and review of the literature

摘要

Introduction: Increasing evidence suggests that idiopathic pulmonary fibrosis (IPF) occurs more often in subjects previouslyexposed to wood dusts than in non-exposed subjects. Here we report 2 cases of the IPF among workers prolongedly exposed tohigh levels of hardwood dusts. Case report: The case No. 1: An 83 year-old male former smoker, retired joiner developed milddyspnoea and chronic dry cough over the period preceding the examination. Pulmonary function tests (PFT) identified a mildrestrictive pattern and diffusion capacity for carbon dioxide (CO2) that was severely impaired (57% of predicted value). Highresolution computer tomography (HRCT) identified bilateral, subpleural basal reticular opacities in honeycombing, without anynodules or ground-glass opacities. The case No. 2: A 73 year-old male retired joiner, never smoker, presented a 3-year history ofprogressive breathlessness and non-productive cough in mild hypoxemia. Pulmonary function tests suggested a moderate restrictivepattern in severely impaired diffusion capacity for CO2 (54% of predicted value). High resolution computer tomographyidentified diffuse peripheral reticular opacities and honeycombing of lower fields, with apico-basilar gradient. Both cases receiveddiagnosis of the idiopathic pulmonary fibrosis. Discussion: The pulmonary fibrosis is a common feature of several diseases andmay be induced by inflammatory disorders following inhalation of organic and inorganic dusts (e.g., asbestos, silica), and severalreports suggest that many cases of the IPF may be in fact secondary to occupational dust exposure as in the case reports we presenthere. Conclusions: Occupational exposure to wood dusts may be a risk factor for the IPF. Unfortunately, exposure reconstructionis frequently inconsistent and anamnesis often misses other causes of the pulmonary fibrosis (e.g., extrinsic allergic alveolitis).Med Pr 2015;66(5):739–747