Case Report: Gold Miner’s Lung: A Case of Chronic Hypersensitivity Pneumonia in Amazonian Forest

Houari Aissaoui,Milene Chaptal,Vincent Thomas,Kinan Drak Alsibai,Dominique Louvel,Antoine Adenis

doi:10.3389/fitd.2021.685248

Houari Aissaoui, Milene Chaptal + Show 4 more

Open Access

https://doi.org/10.3389/fitd.2021.685248

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Abstract

The hostile conditions at informal and illegal mining sites in the Amazonian forest erode the miner’s health, exposing workers to a broad range of diseases because most of the gold is extracted using mercury (Hg). The Hg vapor used daily at gold panning sites presents an environmental threat to the ecosystems and human health. We report the case of a 58-year-old man who has worked in gold panning for over 30 years, presented with diffuse interstitial pneumonia characterized by bilateral images of ground glass and mosaic opacities on the chest CT scan. Based on the negative differential diagnosis (cardiovascular, infectious, autoimmune or cancer), the context of chronic exposure to Hg in a patient who has been working for decades on illegal gold panning sites, we concluded to a chronic form of heavy metal hypersensitivity pneumonia. This hypothesis was supported by high levels of mercury in blood and urine. Mercury hypersensitivity pneumonia might be more frequent than presently thought with thousands of workers chronically exposed to high mercury concentrations among others pollutants. Medical practitioners should systematically seek for chronic respiratory illnesses associated with pollutants exposure in these vulnerable workers with poor health.

Highlights

French Guiana is a European territory located on the Guiana Shield in South America where informal and illegal gold panning takes place on its entire plateau
The annual production of this informal gold panning is around 10 tons of gold for 10,000 illegal gold miners working in about 600 sites in the Amazonian forest [1]
Considering the diffuse interstitial pneumonia, characterized by bilateral images of ground glass and mosaic opacities on the chest computed tomography (CT) scan, the negative workup looking at differential diagnoses, the context of chronic exposure to pollutants in a patient working for decades at illegal gold panning sites, we concluded on a chronic form of heavy metals hypersensitivity pneumonia

Summary

INTRODUCTION

French Guiana is a European territory located on the Guiana Shield in South America where informal and illegal gold panning takes place on its entire plateau. Considering the diffuse interstitial pneumonia, characterized by bilateral images of ground glass and mosaic opacities on the chest CT scan, the negative workup looking at differential diagnoses (cardiovascular, infectious, autoimmune or cancer), the context of chronic exposure to pollutants in a patient working for decades at illegal gold panning sites, we concluded on a chronic form of heavy metals hypersensitivity pneumonia. This hypothesis was supported by the occupational exposure to mercury during the entire period of gold panning (> 30 years) and the high levels of mercury in blood and urine. The chest CT scan performed 6 months later showed stable lung lesions

DISCUSSION

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CONCLUSION

ETHICS STATEMENT