oa Current Allergy & Clinical Immunology - Running short of breath : a case study of hard-metal lung disease in an asbestos-exposed worker - allergies in the workplace

Volume 32 Number 2
  • ISSN : 1609-3607



In cases of workers previously exposed to asbestos and subjected to screening programmes for asbestos-related lung disease, it is possible that clinicians may not consider investigating them further for other possible aetiologies for their lung disease. This case involves a 58-year-old male fitter and turner employed at a naval dockyard. The patient presented with worsening symptoms of dyspnoea and a change in chest X-ray findings during an asbestos-screening programme. After further investigation that included high-resolution computed tomography and a lung biopsy, the histological picture was in keeping with a diagnosis of hard-metal lung disease. This case highlights the necessity of always considering a differential diagnosis in workers with exposure to multiple respiratory toxins and pathogens. This requires a thorough clinical examination to be performed. Such an examination should elicit a comprehensive occupational history that details all exposures and relevant special investigations in order to ensure that one does not fail to make the correct diagnosis.

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