Pneumoconiosis and systemic sclerosis following 10 years of exposure to polyvinyl chloride dust

The case history is presented of a 58 year old man who was exposed to thermoplastic dusts, mainly polyvinyl chloride (PVC), for 10 years. Radiography and high resolution computed tomographic scans of the lungs suggested both pneumoconiotic and scleroderma-like lesions. Transbronchial biopsy revealed foreign body granulomas with macrophages laden with birefringent inclusions which ultrastructurally resembled PVC dust. Biopsy samples of thickened skin showed histological evidence of extensive fibrosis. During follow up Raynaud's phenomenon and oesophageal involvement developed. The antinuclear antibody titre was 1:640, and the Sc1-70 subset was positive. It is concluded that exposure to PVC dust may cause pneumoconiosis and secondary systemic sclerosis.