Hypothesis: exposure to solvents may cause fibrosing alveolitis

The incidence of fibrosing alveolitis, which can be caused by many agents, is increasing. In a proportion of patients, the aetiology is unknown (cryptogenic fibrosing alveolitis), but it has been suggested that environmental factors may play an important, but unrecognized, role in its pathogenesis. A review of the literature suggests that there may be a link between exposure to solvents, widespread occupational pollutants, and fibrosing alveolitis. Experimental work in animals has shown that exposure to solvents produces changes in the lung similar to those found in fibrosing alveolitis. Occupational exposure to a wide number of solvents has been associated with the development of systemic sclerosis. Pulmonary involvement in systemic sclerosis is morphologically indistinguishable from fibrosing alveolitis, and a close relationship between the two diseases seems to exist. This close relationship and the experimental work linking solvent exposure to fibrosing alveolitis suggest that solvent exposure may be one cause of cryptogenic fibrosing alveolitis. Determination of any occupational exposure of patients with cryptogenic fibrosing alveolitis may help in the understanding and prevention of this disease.