J Korean Med Sci.  2013 Oct;28(10):1540-1542. 10.3346/jkms.2013.28.10.1540.

Case Report of Occupational Asthma Induced by Polyvinyl Chloride and Nickel

• Song GW
• Ban GY
• Nam YH
• Park HS
• Ye YM

• KMID: 1777695
• DOI: http://doi.org/10.3346/jkms.2013.28.10.1540

Abstract

Polyvinyl chloride (PVC) is a widely used chemical for production of plastics. However occupational asthma (OA) caused by PVC has been reported only rarely. We report a 34-yr-old male wallpaper factory worker with OA due to PVC and nickel (Ni) whose job was mixing PVC with plasticizers. He visited the emergency room due to an asthma attack with moderate airflow obstruction and markedly increased sputum eosinophil numbers. A methacholine challenge test was positive (PC20 2.5 mg/mL). Bronchoprovocation tests with both PVC and Ni showed early and late asthmatic responses, respectively. Moreover, the fractional concentration of exhaled nitric oxide (FeNO) was increased after challenge with PVC. To our knowledge, this is the first case of OA in Korea induced by exposure to both PVC and Ni. We suggest that eosinophilic inflammation may be involved in the pathogenesis of PVC-induced OA and that FeNO monitoring can be used for its diagnosis.

Keyword

Asthma, Occupational; Polyvinyl Chloride; Nickel

MeSH Terms

Adult
Asthma, Occupational/*chemically induced/*diagnosis
Breath Tests
Bronchial Provocation Tests
Environmental Exposure
Eosinophilia/*diagnosis
Exhalation
Humans
Leukocyte Count
Male
Nickel
Nitric Oxide/metabolism
Occupational Exposure
Plasticizers
Polyvinyl Chloride
Nickel
Nitric Oxide
Plasticizers
Polyvinyl Chloride

Figure

• 

  Fig. 1 Results of specific bronchoprovocation tests involving exposure to PVC for 2 hr (□) and 3 hr (■). The fractional concentration of exhaled nitric oxide (FeNO) was measured at baseline and 4 hr after the challenge tests (○2 hr and ●3 hr exposure).

• 

  Fig. 2 Results of specific bronchoprovocation test with Ni (▴). The percent of sputum eosinophil (▵) was measured.

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