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Original Research |

Uncontrolled Occupational Exposure to 1,1-Dichloro-1-Fluoroethane (HCFC-141b) Is Associated With Acute Pulmonary Toxicity

Jaehee Lee, MD; Chaeyong Lee, MD; Chang Ho Kim, MD*
Author and Funding Information

*From the Departments of Internal Medicine (Drs. J. Lee) and Occupational and Environmental Medicine (Dr. C. Lee), Pochon CHA University Hospital, Gumi, Republic of Korea; and the Department of Internal Medicine (Dr. Kim), Kyungpook National University Hospital, Jung-Gu, Daegu, Republic of Korea.

Correspondence to: Chang Ho Kim, Kyungpook National University Hospital, Department of Internal Medicine, 50 Samduk-2ga, Jung-Gu Daegu 700-721, Republic of Korea; e-mail: kimch@knu.ac.kr

*Values are given as the mean ± SD or No. (%).

*Values are given as the mean ± SD (%), unless otherwise indicated.

The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(1):149-155. doi:10.1378/chest.08-0489
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Background:  The toxicity of 1,1-dichloro-1-fluoroethane (HCFC-141b), a hydrochlorofluorocarbon (HCFC), is low according to animal studies. However, pulmonary manifestations associated with acute HCFC exposure by inhalation have not been reported as yet in man. We evaluated the pulmonary effects of HCFC-141b inhalation, caused by an accident, in previously healthy individuals.

Methods:  The subjects in this study were 15 workers in whom unpleasant symptoms developed after inhaling HCFC-141b at work. Clinical manifestations, radiologic findings, and changes in pulmonary function and airway hyperresponsiveness (AHR) over time were assessed, and BAL fluid analyses findings for four subjects were compared with those of four healthy volunteers (control subjects).

Results:  (1) Cough, shortness of breath, and malaise developed in most patients, but only two patients complained of a sore throat. (2) A high-resolution CT scan of the chest revealed bilateral diffuse ground-glass opacities that were predominant in upper lung zones. (3) The mean (± SD) FVC was 71.4 ± 18.86% predicted, and the mean FEV1/FVC ratio was 92.9 ± 4.25%. Eleven patients (73%) showed restrictive ventilatory impairments during the initial tests. FVC gradually improved, and the FEV1/FVC ratio gradually decreased with time. (4) AHR was observed in four subjects during the initial tests. (5) BAL fluid samples revealed significantly higher neutrophil counts than those in control subjects.

Conclusions:  Overexposure to HCFC-141b was associated with parenchymal lung injury that was characterized by ground-glass opacities, elevated BAL neutrophil counts, and restrictive ventilatory impairment. Restrictive impairments improved with time after exposure.

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