Clinical Manifestations After Exposure to a "Not Dangerous" Product in Two Patients

• Published in: Clinical toxicology (Philadelphia, Pa.) Vol. 46; no. 5; p. 414
• Main Authors: Giampreti, A, Petrolini, V, Lonati, D, Vecchio, S, Locatelli, C, Manzo, L
• Format: Journal Article
• Language: English
• Published: 01.06.2008
• ISSN: 1556-3650

Triethoxyoctylsilane / 2-butoxyethanol aqueous emulsion (Pulvistop Geal registered ) is a water-repellent product used particularly in the building trade. According to European dispositions it is considered a "not dangerous" product and no indications about use with compressor-machines are mentioned in technical issues. Objective: We describe two cases of chemical alveolitis after inhalation of Pulvistop Geal registered emulsion nebulized through a compressor-machine. Case series: Case 1 - A 34 year old man was admitted to the Emergency Department (ED) eight hours after exposure to a silane aqueous emulsion; the product was nebulized with a compressor-machine and inhaled for two hours. At admission the patient presented with chest pain and dyspnoea; gas analysis revealed arterial hypoxia so oxygen was immediately administered. The chest radiograph was normal and a CT scan subsequently performed revealed a bilateral alveolo-interstitial infiltrate in the medium-upper lung areas. CPAP was started and corticosteroids and antibiotics were administered. A complete clinical recovery was obtained in three days without sequelae. Case 2 - A 50 year old man presented to the ED after inhalation of a silane emulsion sprayed from a compressor-machine in the morning. After exposure he manifested chest tightness, upper airways burning sensation and expiratory whistle. At presentation the patient presented with mild upper airways irritation and neutrophilic leukocytosis. Vital parameters and gas analysis were normal. Chest radiograph showed thickening of peribronchovascular interstitium at medium-upper lung areas and CT scan confirmed a diffused chemical alveolitis with interstitial consolidation. Oxygen, bronchodilators and corticosteroids were administered and a complete clinical recovery occurred during the next day. CT scan repeated seven days later showed a complete restitutio ad integrum. Conclusion: Exposure to "not dangerous" products may be associated with negative effects on health when the product is used in an incorrect way. After these cases the producer was alerted and product documentation was altered to include the phrase "do not use with compressors" and to both the product documentation and Safety Data Sheet were added the caution phrase "do not breathe vapors/aerosol". Poison Control Centres can play a key role in toxicovigilance and in detection of newly emerging poisonings.