On the occupational bronchiolitis obliterans and dermatitis caused by the use of agricultural chemicals

Abstract

In this report is stated a case of farmer with bronchiolitis obliterans and dermatitis due to agricultural chemicals, who, 59 years of age, has been cultivating in the vinyl-covered hot house such flowers as carnation, sweetpea, freesia, iris, gladiolous, lily and so on, since 1970. He visited our allergy clinic recently with the complaint of eruptions around his eyes and on limbs since 1975, accompanied with an episode of dyspnoea since November of 1980, following the use of agricultural chemicals in the vinyl-house. In spite of such allergical examinations as the intracutaneous test, including the determining test of the threshold concentration, and RAST, the author could not find any allergen substances. On the pulmonary function test, marked obstructive disturbance was proved. As to the X-ray findings of the chest, the increase of lung marking with miliary or fine nodular discemination was observed. In addition to this, the scintigraphy of the lung with 99mTc-MAA showed decrease of blood flow in the peripheral lung field, suggesting the existence of the abnormality in local lung function. However, the decrease of cholinesterase was not noticed, nor the disturbance of liver function was recognized. Judging from the clinical history and the results of investigations, the above-mentioned dyspnoea is not considered to be asthmatic attacks, but to be occupational bronchiolitis obliterans closely related with the exposure to agricultural chemicals. In recent books of the author it was pointed out that various kinds of respiratory disorders may develop in such closed working environment as vinyl-house, making reference to reports on the occupational asthma in Japan. And from a national-scale investigation on the occupational history in cases with idiopathic diffuse interstitial fibrosing pneumonitis, the author reported that the patients with this illness were found in high frequency among the farmers especially who made use of agricultural chemicals. Consequently the author would emphasize that the respiratory disorders not only in the acute type but also in the chronic type due to agricultural chemicals must be taken up as a serious problem clinically and from the view-point of public health, and that preventive measures must be radically taken as soon as possible.