[Dysphonia and cacosmia in a worker in sterilized rooms]

A 39 year male pharmaceutical worker employed in a clean-room developed in 2003 acute dysphonia after environmental disinfection with glutaric aldehyde and isopropyl alcohol. Laryngoscopic examination showed glottis edema; the syndrome healed after a cycle of cortisone. In subsequent years, withdrawal from exposure to irritating chemicals was observed. The worker, however, complained for recurrent episodes of dysphonia, in the absence of abnormalities of the larynx, and gradually developed intolerance for perfume, solvents, and other smelling substances. He came to our observation in 2007, showing strong conviction that occupational exposure had a causative effect in his complaints. He was working in an office open to public, and fragrance exposure appeared to be the main cause of dysphonic episodes. We rejected the hypothesis of association between complaint and job exposure, and advised him to work in a well defined working situation, such as in a clean room, where chemical contamination may be effectively controlled over time.