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ISSN 2007-1752 (Print)
Archivos de Medicina de Urgencia de México

2025, Number 2-3

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Arch Med Urg Mex 2025; 17 (2-3)

Chemical pneumonitis due to occupational exposure in a tanneryt

Mendoza-Velázquez JA, González-Cruz ML, García-Quintana IJ

Language: Spanish
References: 24
Page: 164-169
PDF size: 312.42 Kb.


ABSTRACT

Acute chemical pneumonitis is a severe condition that can rapidly progress to respiratory failure and acute respiratory distress syndrome (ARDS). We present the clinical case of a 42-year-old male, previously healthy, who suffered accidental exposure in his workplace within a tannery, inhaling and being submerged in an unspecified chemical mixture. Upon arrival to the emergency department, he was pulseless and presented agonal respirations; after cardiopulmonary resuscitation and advanced airway management, laryngeal edema and acute chemical pneumonitis with bilateral pulmonary consolidations were documented on chest computed tomography. During his stay in the intensive care unit, he remained under protective mechanical ventilation, vasopressors, broad-spectrum antibiotics, bronchodilators, and intravenous methylprednisolone (80 mg/day). Despite treatment, he developed severe hypoxemia (PaFi < 100), persistent respiratory acidosis, recurrent hyperkalemia, and severe sepsis with procalcitonin of 24 ng/mL, progressing to ARDS and refractory septic shock with fatal outcome on day 8. This case highlights the importance of recognizing occupational chemical pneumonitis as a major respiratory emergency that must be managed based on the pathophysiology of alveolocapillary injury and oxidative inflammatory response. Early administration of corticosteroids and intensive support may improve outcomes in the initial stages; however, current evidence remains limited.


REFERENCES

  1. Sarwar F, Alam K, Chow CW, Saeed M, Malik RNN. Pulmonarydysfunction augmenting bacterial aerosols in leather tanneriesof Punjab, Pakistan. Int J Chron Obstr Pulm Dis. 2021;16:2933-2940. doi:10.2147/COPD.S328129

  2. Chao YJ, Lai PT, Lai YT, Chao CJ. Severe chemical pneumonitisby vanadium pentoxide responded well to aggressive steroidtherapy. Respir Med Case Rep. 2024;48:102003. doi:10.1016/j.rmcr.2024.102003

  3. Khalid I, Godfrey AM, Ouellette DR. Chemical pneumonitis andsubsequent reactive airways dysfunction syndrome after a singleexposure to a household product: a case report. J Med Case Reports.2009;3:112. Available from: http://www.jmedicalcaserep

  4. Weibrecht KW, Rhyee SH. Acute respiratory distress associatedwith inhaled hydrocarbon. American Journal of Industrial Medicine.2011 Jul 27;54(12):911–

  5. Mesa P, Perez I, Bejar.Neumonitis química secundaria a desinfecciónde superficies Chemical pneumonitis secondary to surfacedisinfection.Elsevier.2021

  6. Wiergowski M, Sołtyszewski I, Sein Anand J, Kaliszan M, WilmanowskaJA, Jankowski Z, et al. Difficulties in interpretationwhen assessing prolonged and subacute exposure to the toxiceffects of chlorine. Journal of Forensic and Legal Medicine. 2018Aug;58:82–6.

  7. P, A. B. S. (2020). Lung Function Abnormalities among TanneryWorkers in Vellore District. International Journal Of Physiology.Lung Function Abnormalities among Tannery Workers in VelloreDistrict | International Journal of Physiology

  8. Revista Pediatría Crítica. (s. f.). Revista Pediatría Crítica. https://revistapediatriacritica.com/articulo/neumonitis-qu%C3%ADmica-por-hidrocarburos-en-un-lactante-importancia-del-manejo-precoz

  9. Tadesse, G. L., & Guya, T. K. (2017). Impacts of tannery effluenton environments and human health. Journal of Environment andEarth Science, 7(3), 88–95. https://core.ac.uk/display/234664866

  10. Dalju, I., Dessie, A., Bogale, L., & Mekonnen, T. H. (2019). Occupationalrisk factors associated with respiratory symptoms amongtannery workers in Mojo town, Southeast Ethiopia, 2018: A comparativecross-sectional study. Multidisciplinary Respiratory Medicine,14(27), 1–8. https://doi.org/10.1186/s40248-019-0188-1

  11. Theran León, J. S., & Esteban Badillo, L. Y. (2021). Neumonitisquímica secundaria por inhalación de disolventes orgánicos. Revistade Neumología Clínica, 57(3), 210–213.

  12. Chandrasekaran, V., Dilara, K., & Ramaswamy, P. (2014). Pulmonaryfunctions in tannery workers: A cross sectional study. IndianJournal of Physiology and Pharmacology, 58(3), 205–208. https://www.researchgate.net/publication/275357571.

  13. Sarwar F, Alam K, Chow CW, Saeed M, Malik RNN. Pulmonarydysfunction augmenting bacterial aerosols in leather tanneriesof Punjab, Pakistan. Int J Chron Obstr Pulm Dis. 2021;16:2933-2940. doi:10.2147/COPD.S328129.

  14. Chao YJ, Lai PT, Lai YT, Chao CJ. Severe chemical pneumonitisby vanadium pentoxide responded well to aggressive steroidtherapy. Respir Med Case Rep. 2024;48:102003. doi:10.1016/j.rmcr.2024.102003

  15. Khalid I, Godfrey AM, Ouellette DR. Chemical pneumonitis andsubsequent reactive airways dysfunction syndrome after a singleexposure to a household product: a case report. J Med Case Reports.2009;3:112. Available from: http://www.jmedicalcaserep

  16. Weibrecht KW, Rhyee SH. Acute respiratory distress associatedwith inhaled hydrocarbon. American Journal of Industrial Medicine.2011 Jul 27;54(12):911–4.

  17. Mesa P, Perez I, Bejar.Neumonitis química secundaria a desinfecciónde superficies Chemical pneumonitis secondary to surfacedisinfection.Elsevier.2021

  18. Wiergowski M, Sołtyszewski I, Sein Anand J, Kaliszan M, WilmanowskaJA, Jankowski Z, et al. Difficulties in interpretationwhen assessing prolonged and subacute exposure to the toxiceffects of chlorine. Journal of Forensic and Legal Medicine. 2018Aug;58:82–6.

  19. P, A. B. S. (2020). Lung Function Abnormalities among TanneryWorkers in Vellore District. International Journal Of Physiology.Lung Function Abnormalities among Tannery Workers in VelloreDistrict | International Journal of Physiology

  20. Revista Pediatría Crítica. (s. f.). Revista Pediatría Crítica. https://revistapediatriacritica.com/articulo/neumonitis-qu%C3%ADmica-por-hidrocarburos-en-un-lactante-importancia-del-manejo-precoz

  21. Tadesse, G. L., & Guya, T. K. (2017). Impacts of tannery effluenton environments and human health. Journal of Environment andEarth Science, 7(3), 88–95. https://core.ac.uk/display/234664866

  22. Chandrasekaran, V., Dilara, K., & Ramaswamy, P. (2014). Pulmonaryfunctions in tannery workers: A cross sectional study. IndianJournal of Physiology and Pharmacology, 58(3), 205–208. https://www.researchgate.net/publication/275357571.

  23. Theran León, J. S., & Esteban Badillo, L. Y. (2021). Neumonitisquímica secundaria por inhalación de disolventes orgánicos. Revistade Neumología Clínica, 57(3), 210–213.

  24. Dalju, I., Dessie, A., Bogale, L., & Mekonnen, T. H. (2019). Occupationalrisk factors associated with respiratory symptomsamong tannery workers in Mojo town, Southeast Ethiopia,2018: A comparative cross-sectional study. MultidisciplinaryRespiratory Medicine, 14(27), 1–8. https://doi.org/10.1186/s40248-019-0188-1




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