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Microbial contamination in water-based metalworking fluid as trigger for occupational hypersensitivity pneumonitis -
Sabine Kespohl1, Isabell Warfolomeow2, Gerd Schneider3
1Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum.
Abstract:
Microbially contaminated metal-working fluid (MWF) can cause respiratory symptoms in exposed workers in the form of exogenous allergic alveolitis/hypersensitivity pneumonitis (HP). The diagnosis of HP is based, among others, on the identification of the culprit and the detection of corresponding specific IgG antibodies (sIgG) in the patient's serum. Commercial antigen tools for the detection of these HP triggers are rarely available; therefore, antigens from contaminated MWF workplace samples were isolated exemplarily for diagnosis of a suspected HP case. Various MWF-specific bacteria were identified in the workplace samples, including Pseudomonas oleovorans, Pseudomonas alcaliphila, Pseudomonas spec., Paenibacillus glucanolyticus, and Corynebacterium amycolatum. The sIgG antigen binding, detected by ImmunoCAP system against MWF antigens from workplace samples and against the identified bacterial antigens, was much stronger in the patient serum compared to selected reference sera. The highest sIgG concentrations in the patient's serum could be determined against Pseudomonas antigens. Inhibition tests showed cross-reactions of MWF and Pseudomonas antigens, whereby the Pseudomonas antigens cross-reacted less with each other. For in-vitro diagnosis in case of suspected HP caused by contaminated MWF, workplace-related antigens are now available.
Insights
Workers exposed to contaminated metal-working fluid (MWF) can develop hypersensitivity pneumonitis (HP). This study isolated MWF antigens for diagnosing HP by detecting specific IgG antibodies in patient serum.
Area of Science:
- Occupational Health
- Immunology
- Microbiology
Background:
- Metal-working fluid (MWF) contamination by microbes can lead to occupational hypersensitivity pneumonitis (HP) in exposed workers.
- Diagnosing HP typically involves identifying the causative agent and detecting specific IgG antibodies (sIgG) in patient serum.
Observation:
- Commercial diagnostic tools for HP triggers are scarce.
- Antigens were isolated from contaminated MWF workplace samples for diagnosing a suspected HP case.
- Identified MWF-specific bacteria included *Pseudomonas oleovorans*, *Pseudomonas alcaliphila*, *Pseudomonas* spec., *Paenibacillus glucanolyticus*, and *Corynebacterium amycolatum*.
Findings:
- Patient serum showed significantly stronger sIgG binding to MWF and bacterial antigens compared to reference sera.
- The highest sIgG concentrations were against *Pseudomonas* antigens.
- Inhibition tests indicated cross-reactivity between MWF and *Pseudomonas* antigens, with less cross-reactivity among *Pseudomonas* antigens themselves.
Implications:
- Workplace-derived antigens are now available for *in vitro* diagnosis of HP caused by MWF exposure.
- This facilitates accurate diagnosis and management of occupational lung diseases.
- Enables targeted identification of causative agents in hypersensitivity pneumonitis.
