Chronic Asthma
AMERICAN JOURNAL OF INDUSTRIAL MEDICINE 29:209-2 14 (1 996)
Chronic Lung Disease Secondary to Ammonia Inhalation Injury: A Report on Three Cases
Rafael E. de la Hoz, MD, MPH, Donald P. Schlueter, MD, and William N. Rom, MD, MPH
Inhalation of highly hydrosoluble toxicants, like ammonia, can be associated with chronic lung diseases, which have been partially characterized. We present the cases of three patients who were evaluated 2 years after massive exposure to ammonia in occupational settings. They presented with chronic dyspnea, and clinical pictures consistent with restrictive lung dysfunction, obstructive lung disease, and bronchial hyper-reactivity and small airways disease, respectively. The findings in 94 reported cases of inhalation injury due to massive exposure to ammonia are reviewed; in 35 cases follow-up for at least 1 year was available. The range of chronic pulmonary diseases associated with ammonia inhalation injury is reviewed, and suggestions for appropriate diagnostic evaluation are made.
0 1996 Wilev-Liss, Inc.
KEY WORDS: ammonia, lung diseases, occupational diseases, asthma
INTRODUCTION
Overexposure to ammonia in the occupational setting can be associated with a range of anatomic and functional abnormalities of the respiratory tract that have been sporadically reported in the medical literature [Slot, 1938; Caplin, 1941; Brille et al., 1957; Lepine and Soucy, 1962; Derobert et a]., 1964; Levy et a]., 1964; Sestier et al., 1969; Kass et al., 1972; Walton, 1973; Sobonya, 1977; Close et al., 1980; Hoeffleret al., 1982; Flury et al., 1983; Bernstein and Bemstein, 1989; Leduc et al., 19921. In those who survive an acute episode, the injury to the respiratory tract can result in disabling chronic pulmonary disease. In this paper we describe the cases of three men who were all evaluated ap-
proximately 2 years after exposure to large amounts of ammonia in occupational settings. They all presented with complaints of persistent
Chronic Lung Disease Secondary to Ammonia Inhalation Injury: A Report on Three Cases
Rafael E. de la Hoz, MD, MPH, Donald P. Schlueter, MD, and William N. Rom, MD, MPH
Inhalation of highly hydrosoluble toxicants, like ammonia, can be associated with chronic lung diseases, which have been partially characterized. We present the cases of three patients who were evaluated 2 years after massive exposure to ammonia in occupational settings. They presented with chronic dyspnea, and clinical pictures consistent with restrictive lung dysfunction, obstructive lung disease, and bronchial hyper-reactivity and small airways disease, respectively. The findings in 94 reported cases of inhalation injury due to massive exposure to ammonia are reviewed; in 35 cases follow-up for at least 1 year was available. The range of chronic pulmonary diseases associated with ammonia inhalation injury is reviewed, and suggestions for appropriate diagnostic evaluation are made.
0 1996 Wilev-Liss, Inc.
KEY WORDS: ammonia, lung diseases, occupational diseases, asthma
INTRODUCTION
Overexposure to ammonia in the occupational setting can be associated with a range of anatomic and functional abnormalities of the respiratory tract that have been sporadically reported in the medical literature [Slot, 1938; Caplin, 1941; Brille et al., 1957; Lepine and Soucy, 1962; Derobert et a]., 1964; Levy et a]., 1964; Sestier et al., 1969; Kass et al., 1972; Walton, 1973; Sobonya, 1977; Close et al., 1980; Hoeffleret al., 1982; Flury et al., 1983; Bernstein and Bemstein, 1989; Leduc et al., 19921. In those who survive an acute episode, the injury to the respiratory tract can result in disabling chronic pulmonary disease. In this paper we describe the cases of three men who were all evaluated ap-
proximately 2 years after exposure to large amounts of ammonia in occupational settings. They all presented with complaints of persistent
References: REFERENCES American Thoracic Society (1986): Evaluation of impairmenUdisability secondary to respiratory disorders