kaolinite and Pulmonary-Fibrosis

Topics: Aluminum Silicates; Animals; Asbestos; Coal; Dust; Humans; Kaolin; Metals; Pulmonary Fibrosis; Silicon Dioxide; Talc

Kaolin is found along the "fall line" in Georgia, and parenchymal changes, both simple and complicated pneumoconiosis, have been previously described. This study was done to determine whether pleural thickening occurs in workers with mild kaolin pneumoconiosis.. We evaluated 350 workers at a kaolin plant in Georgia. Thirty-two workers with abnormal chest radiographs were clinically evaluated. Twelve workers with mild kaolinosis but without any evidence of pleural changes on chest roentgenograms had computed tomography (CT) of the chest to assess the presence of pleural thickening.. Nineteen workers had radiographic changes consistent with kaolin pneumoconiosis (prevalence 5.4%), and four workers had evidence of pleural plaques (prevalence 1.1%). Five of the 12 workers had evidence of pleural thickening on CT.. This study shows that pleural thickening may be common on chest tomography in workers with kaolinosis and that the exposure to kaolin dust should be considered in the differential diagnosis of pleural thickening.

Topics: Adult; Diagnosis, Differential; Dust; Georgia; Humans; Kaolin; Lung Diseases, Obstructive; Middle Aged; Mining; Occupational Exposure; Pleural Diseases; Pneumoconiosis; Prevalence; Pulmonary Fibrosis; Radiography, Thoracic; Tomography, X-Ray Computed

A 62-year-old white male employed for 43 years in the polishing room of a cotton textile mill was admitted to a tertiary care center with progressive dyspnea and productive cough that had not responded to therapy for tuberculosis. In spite of aggressive antibiotic therapy and respiratory support, the patient died as a consequence of respiratory failure. Small rounded and irregular opacities had been noted on the chest radiograph. Review of job-site spirometry demonstrated a worsening restrictive pattern over a 4-year period prior to his death. Additional occupational history revealed long-term exposure to kaolin in the polishing room, and pathologic examination of lung tissue confirmed extensive fibrosis and substantial quantities of kaolin. Kaolinosis is a disease typically found among individuals involved in mining or processing this material rather than in user industries. This case illustrates the importance of obtaining a complete occupational history in reaching a diagnosis. The clinicopathologic aspects of kaolinosis are also reviewed.

Topics: Fatal Outcome; Gossypium; Humans; Kaolin; Lung; Male; Middle Aged; Occupational Diseases; Pneumoconiosis; Pulmonary Fibrosis; Respiratory Insufficiency

The macrophage-like cell line, P388D1, was exposed to dipalmitoyl lecithin (DPL)-coated respirable quartz and kaolin, and the disappearance of the DPL was monitored for up to 9 days. The coating was removed rapidly at first (about 50% in the first 3 days) and then more slowly over the remaining 6 days, until about 30% remained on day 9. The rate of DPL digestion was independent of the type of dust and the amount of coated dust within the cell, indicating the existence of an extracellular phospholipase activity. This extracellular phospholipase activity was partially characterized. It was sensitive to temperatures above 56 degrees C, the presence of EDTA, the action of the proteases trypsin and proteinase K, and pH, being active at pH 7 but not at pH 5. This is consistent with reports in the literature of the existence of an extralysosomal phospholipase which is active at pH 7 and dependent on the presence of divalent metal ions. There was a dust-dependent difference in the extracellular rate of DPL digestion from quartz and kaolin. The coating was removed more slowly from the kaolin than it was from quartz. The removal of the DPL coating seen in the presence of cells was presumably due to both an intracellular and an extracellular phospholipase.

Topics: 1,2-Dipalmitoylphosphatidylcholine; Animals; Cell Line; Dust; Humans; Kaolin; Macrophages; Macrophages, Alveolar; Phospholipases; Pulmonary Fibrosis; Pulmonary Surfactants; Quartz

Topics: Environmental Exposure; Forecasting; Humans; Kaolin; Lung; Occupational Diseases; Pneumoconiosis; Pulmonary Fibrosis; Radiography, Thoracic

The dust content and composition of lesions and hilar lymph nodes from the lungs of British coalworkers have been examined. Samples of macules, fibrotic nodules, and massive fibrosis (both peripheral and central sites) were dissected from 49 lungs. The highest mean dust concentrations (about 20%) were found in nodules and massive fibrosis. Overall there were no significant differences between the selected lesion types and their respective whole lung dust composition, although the central sites of massive fibrosis were found to contain on average a higher proportion of coal and a lower proportion of ash and its measured constituents, quartz and kaolin plus mica, than the edge of the lesion (p less than 0.001 for each component). There were striking differences between recovered lung and lymph node dusts. An examination of 180 specimens showed a mean quartz in lymph node dust of 20.3% compared with 6.1% in lung dust. As expected the proportion of quartz was greater in lymph nodes and lungs from men who had worked "low" rank (high ash) coal. By contrast with the corresponding figures for lung dusts, however, the mean proportion of quartz in nodes did not increase over the pathological range of pneumoconiotic lung disease. On average the proportions of kaolin and mica in lymph nodes reflect those found in lungs. The lymphotrophic nature of quartz was clearly shown although it was not possible to show an association between this clearance pathway and any particular type of lesion.

Topics: Coal; Coal Mining; Dust; Humans; Kaolin; Lung; Lymph Nodes; Male; Occupational Diseases; Pulmonary Fibrosis; Quartz

A short account of the industrial process used to produce kaolin is given. The chest radiographs of 68 selected cases of kaolinosis were reviewed and the radiological appearances are presented. We also describe two cases of Caplan's syndrome occurring in kaolinosis.

Topics: Caplan Syndrome; England; Humans; Kaolin; Pneumoconiosis; Pulmonary Fibrosis; Radiography; Silicosis

Topics: Acute Disease; Adolescent; Adult; Aluminum Compounds; Aluminum Silicates; Female; Humans; Immunosuppression Therapy; Kaolin; Lung; Magnesium Compounds; Male; Middle Aged; Paraquat; Pulmonary Fibrosis; Renal Dialysis; Silicates; Suicide, Attempted; Superoxide Dismutase

The problems encountered in diagnosing the rare types of pneumoconiosis ( silicatosis other than asbestosis, aluminosis and hard metals fibrosis), result from the difficulties in realising a good occupational anamnese and from the disease pattern by itself. The classical examinations, (X-rays of the thorax and lung function measurements), are not able to detect the cause of these diseases, which are fundamentally characterised by an absence of specificity. These last years, new methods of diagnoses (angiotensin converting enzyme, gallium scan, transbronchial biopsies, mineralogical, cytological and histological examinations of the lung tissues and of the bronchial alveolar lavage) were developed and progressively introduced in the daily practice in pneumology. Only the examination of lung biopsies and of the products of bronchial alveolar lavage, in particular the mineralogical examinations, may usefully orientate the diagnosis. The bronchial alveolar lavage has the advantage of an easy repetition and of a small invasive character. Moreover this technique is of a rather low financial cost. However the results of these examinations must be interpreted with the greatest caution, in function of the complete medical and occupational data. The experience following more than 500 BAL shows that the discovery of talc and kaolin is very significant for an exposition since these minerals were never observed among not exposed subjects. The evidence of these minerals argues also for the diagnosis of talcosis or kaolinosis if there are radiological lesions that are compatible with these diseases. On the other hand a recent study suggests that the identification of multinuclear macrophages and of tungsten and/of tantalum in the bronchial alveolar lavage is pathognomonic of the pathology of the hard metals.

Topics: Adult; Aged; Biopsy; Bronchi; Diagnosis, Differential; Female; Humans; Kaolin; Male; Metals; Middle Aged; Pneumoconiosis; Pulmonary Fibrosis; Silicosis; Talc; Therapeutic Irrigation

A 35-year-old man who had been occupationally exposed to aerosolized kaolin for 17 years in a Georgia processing plant had diffuse reticulonodular pulmonary infiltrates and an upper lobe mass. Exploratory thoracotomy, performed to evaluate the nature of the mass, revealed an 8 X 12 X 10-cm conglomerate pneumoconiotic lesion containing large amounts of kaolinite. Coincident deposition of silica in the tissue was not demonstrable by either analytic scanning electron microscopy or x-ray diffraction. The case illustrates the effect of chronic kaolin exposure on the human lung and emphasizes the need for periodic evaluation of exposed workers.

Topics: Adult; Air Pollutants, Occupational; Environmental Exposure; Humans; Industry; Kaolin; Male; Pneumoconiosis; Pulmonary Fibrosis

A case of tobacco-associated pulmonary fibrosis, with the results of histological, ultrastructural, and spectrometric analysis is reported. Abnormalities of the alveolar macrophages, which are particularly affected by tobacco inhalation were found. The size of the macrophages was increased and many large, polymorphous inclusions, including fat vacuoles and granular deposits, which were either homogeneous or electron lucent vacuoles, were seen in the cytoplasm. A few laminar structures were observed. All of these lesions are frequently found in cigarette smokers. Still more interesting was the discovery of numerous fiber-, needle-, or laminar-like inclusions that varied in size from 0.2 to more than 2 mu. The digestions of the inclusions with potassium hydroxide confirmed the presence of various metals, such as sodium, magnesium, potassium, iron, sulfur, and especially, aluminum, and silicon; these last two elements correspond to the presence of kaolinite in the tissue, as has been previously described, and can be considered as evidence of the use of tobacco.

Topics: Aged; Cytoplasmic Granules; Humans; Inclusion Bodies; Kaolin; Macrophages; Male; Microscopy, Electron; Pulmonary Alveoli; Pulmonary Fibrosis; Smoking; X-Ray Diffraction

Correlations between in vitro hemolytic activity and the in vivo fibrogenic activity of a number of particulate materials are demonstrated. Fibrogenic particles are capable of inducing hemolysis, while non-fibrogenic particles are not. It is suggested that particulates inducing a rate of hemolysis greater than 1 X 10(-4) min-1 may be fibrogenic.

Topics: Animals; Asbestos; Biphenyl Compounds; Calcium; Ceramics; Erythrocytes; Hemolysis; Hydrocarbons, Brominated; Kaolin; Magnesium; Particle Size; Phosphates; Pulmonary Fibrosis; Rats; Silicic Acid; Silicon Dioxide; Talc; Titanium

Topics: Aluminum Silicates; Animals; Kaolin; Pulmonary Fibrosis; Rats; Silicon Dioxide