Pulmonary edema caused by inhalation of vapors from water-soluble paint

To report the effects of inhaling vapor from water-soluble paint after a recent encounter with 16 patients treated in our emergency department.

We examined a series of chest computed tomography (CT) images from the 16 affected patients. Computed tomography was carried out on days 1, 2, 5, and 19 after the inhalation event.

Twelve of the patients were found to have pulmonary edema, based on their CT findings. Patients with pulmonary edema were classified as its persisted period. In the severe group, its pulmonary edema persisted over 5 days include, exacerbated edema, delayed-onset edema (during the follow-up), or edema amelioration. One patient had exacerbated edema, three patients had delayed-onset edema, and one patient experienced amelioration of their edema in the severe group. In all cases, the pulmonary edema had disappeared from the CT images by day 19 after the inhalation event. Thirteen of the 16 patients had a fever of ≥37°C. Three kinds of solutes (ethylene glycol, titanium dioxide, and silicon oxide) had been blended in the water-soluble paint. The titanium dioxide was considered the probable cause of the pulmonary edema.

Inhalation of vapors from water-soluble paints is considered relatively safe. However, our observations suggest that new lesions might develop and existing lesions could worsen, even if the edema is not severe immediately after the exposure. Thus, follow-up imaging is needed for approximately 2 weeks in such cases.