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[Case of polymer fume fever with interstitial pneumonia caused by inhalation of polytetrafluoroethylene (Teflon)].

A 30-year old man was admitted to our hospital with cough, slight fever, and dyspnea that he had developed several hours after inhaling the fumes produced from a Teflon-coated pan, after evaporation of the water in the pan. Chest radiography revealed diffuse infiltrations, and a computed tomography (CT) scan revealed patchy interstitial shadows in both lungs. In pulmonary function tests, the diffusing capacity of the lungs showed a moderate decrease. Leukocytosis and slight hypoxemia were observed. The patient recovered clinically in a few days without any specific treatment. We speculated that the pulmonary problems in this patient may have been induced by the products of thermal degradation of Teflon that were present in the fumes. When Teflon is heated, the fumes generated cause an influenza like syndrome (polymer fume fever) or cause severe toxic effects such as pulmonary edema, pneumonitis, and death in the exposed individual.

Acute Disease↗

[Case of lung edema occurring as a result of inhalation of fumes from a Teflon-coated flying pan overheated for 4 hours].

The patient was a 59-year-old man who had been treated with continuous positive airway pressure for a diagnosis of obstructive sleep apnea syndrome. While cooking buckwheat noodles, the patient fell asleep with a frying pan on the fire. After four hours, he was awakened by the smell of burning as well as pharyngalgia, and visited this hospital. He was found to have hypoxia, and diagnostic imaging showed diffuse concentration increase with peripheral clear zones in bilateral lung fields, a typical finding of pulmonary edema. In view of the peculiar temporal course of his disease and inhalation of Teflon fumes immediately before its occurrence, he was considered to have polymer fume fever with non-cardiogenic pulmonary edema. After admission, he was treated with oxygen inhalation and diuretics, and experienced a rapid improvement of his general condition and findings on diagnostic imaging. In European countries and the United States, cases with a history of inhalation of Teflon fumes have been given a diagnosis of polymer fume fever. This case is of interest as it is apparently the first such disease reported in Japan.

Acute Disease↗

[Tin bubble pots].

In the sixteenth century Ambroise Pard uses of an hermetic pewter pot to obtain a beef-tea as a medical therapy. He describes the protocol to prepare it and the way to ordain the beef-tea to patients. The same hermetic spheric pewter pot is always in use in the middle of nineteenth century. At that period the discovery of creatin confirms the usefulness of that medical pewter pot who seems to be an only French production.

Animals↗

Lead intoxication in infancy.

Four years of experience in the evaluation and management of lead intoxication in the first year of life were reviewed. This study was conducted in a lead referral program within the state of Massachusetts, whose comprehensive lead laws include extensive (and now mandatory) lead screening of all children. Over the period of study, 50 (14%) of 370 new patients enrolled in the program were infants aged 12 months or younger. Median age of these infants was 11 months (range 1 through 12 months). Mean peak lead level was 39.0 micrograms/dL while the mean peak erythrocyte protoporphyrin concentration was 111.9 micrograms/dL of whole blood. Thirty-two percent of infants were ambulatory at the time lead intoxication was diagnosed; only 24% had a history of pica. Twenty-six percent of parents were welfare dependent. Apparent sources of plumbism included house-hold renovation (n = 20), direct ingestion of paint chips (n = 10), formula preparation with lead-contaminated water (n = 9), lead dust importation (n = 1), and congenital exposure to elevated maternal lead level (n = 1). In 9 cases the source was not found. When this profile was compared with that of a randomly selected group of 47 children aged 18 through 30 months, who were seen in the lead program during the same interval, apparent sources of intoxication in the older group were paint chip ingestion (n = 41), household renovation (n = 2), and unknown (n = 4) (P less than .0001). On the basis of these data, it is concluded that lead intoxication in infants is common and has significantly different origins from that in toddlers.(ABSTRACT TRUNCATED AT 250 WORDS)

Cooking and Eating Utensils↗

[Head injuries caused by beer glasses and bottles].

The authors investigated head injuries in 23 subjects caused by beer glasses and bottles, differentiating thin-walled and thick-walled glasses, full and empty bottles and whether the injury was caused by hitting with the bottle or throwing it. A large range of injuries was found--from trivial ones to serious health damage. From the character of the injury the injuring object cannot be assessed.

Beer↗

[Earthenware and lead poisoning. Description of a case].

A case of acute lead poisoning caused by drinking wine that had been kept in a decorative amphora is reported. Chomico-physical analysis of the internal surface of the recipient evidenced a layer of lead paint very soluble in wine. It is hoped that this report will draw the attention of the practising physician and Preventive Medicine Departments to this unusual cause of saturnism. The craft production of earthenware recipients that have been inadequately glazed and their improper use as containers of drings of foods could be commoner than might be thought on the basis of the sporadic reporting of such cases of lead poisoning.

Adult↗

[Stab wounds of the spinal cord by a kitchen knife: report of a case].

A case of spinal cord injury due to stab wounds by a kitchen knife is presented. A 41-year-old male was hospitalized because of spinal cord injury resulting from stab wounds inflicted with a kitchen knife in the posterior cervical area. Neurological examination on admission showed paraplegia, disappearance of deep tendon reflex in both lower extremities, sensory disturbance below T1 level, left Horner's syndrome and urinary disturbance. In addition to these symptoms cerebrospinal fluid was leaking from the wounds. An emergency operation was performed. After laminectomy of C7 and T1, we found that the spinal cord was almost completely split at C7/T1 level. Dural plasty was performed. Neurologically, sensory disturbance was slightly improved at 4 months after the injury. Initial MRI (TR: 200 msec, TE: 20 msec) revealed high intensity at C7/T1 level which was damaged by the kitchen knife. MRI 5 months after the injury revealed low intensity on T1 weighted imaged, high intensity on T2 and proton weighted image. The occurrence of the spinal cord injury due to stab wounds by a kitchen knife is very rare in Japan. MRI is useful in the diagnosis of stab wounds of the spinal cord.

Adult↗

Investigation of the amount of dissolved iron in food cooked in Chinese iron pots and estimation of daily iron intake.

The amount of dissolved iron in food cooked in Chinese iron pots and that in food cooked in aluminum, stainless steel, and clay pots were determined. It was found that the amount of dissolved iron in food cooked in Chinese iron pots was two to five times higher than that in food cooked in the other types of pots. According to the test results, the estimated increase in daily iron intake was about 14.5 mg for adults and 7.4 mg for children when Chinese iron pots were used.

Aluminum↗

Influence of automatic dishwashings and scrubbings on release of lead from glazed ceramicware.

Use of lead glazes on ceramicware and the release of lead from finished glazes are reviewed. Single units of ceramicware with initial lead leach levels from less than 0.1 to 470 micrograms/mL were subjected to multiple automatic dishwashings with intermediate scrubbing of the ware by plastic fiber pads. Ware was periodically leached with 4% acetic acid solution at room temperature for 24 h, and the solutions were analyzed for lead. Release of lead under these conditions is discussed. Results indicated that neither passive leachings nor multiple dishwashings and scrubbings can predict future lead-release characteristics of glazes and decorations.

Ceramics↗

[Efficient hygiene precautions in the household today].

The results of epidemiological investigations justifies the assumption that increasing health defects, especially enteritis infectiosa, are caused inter alia by inadequate hygienic conditions in households. The number of such diseases ranges between 100,000 and more than 1,000,000 cases per year in the FRG. Responsible for this development is a lack of information about the behaviour of microorganisms in the environment and its pathways of distribution. In addition risks are growing with the recommendation of cleansing methods, which had been adequate for the kitchen techniques in former centuries, but must fall under the conditions of the modern supply, processing and conservation. The described investigations are directed at the determination of the distribution of germs by working in normal household kitchens and at the effectiveness of surface-decontamination-cleansers (so-called FD-preparations). Test principle was the production of a complete dinner by each of 79 housewives with use of minced meat, which was contaminated with micrococcus luteus. After final cleaning of the kitchen we determined the degree of contamination of surfaces, machines and of the components of the meal with use of rodacplates, swabs and quantitative cultures respectively. The experiments are completed by interviews with the housewives. The results let conclude that the use of household cleansers with germicidal properties even in the hand of housewives will reduce the distribution of unwanted microorganisms in the kitchens. In this respect surfaces, on which components of the meal are prepared, and the machines, like cutting machines, waring blenders a.o., are of utmost importance. Disinfections of other parts of the flats including toilets are unnecessary (exception: severe infectious diseases). Therefore the use of FD-preparations outside of the kitchens is not required, but acceptable (it is not necessary to use a cleanser in the kitchen, another one in the toilet and a third one for the bath tube etc.). We do not recommend adapting cleaning and disinfective methods of the hospitals to the normal households. Instead of medical disinfections one should use detergents with nontoxic germicidal additives (e.g. H2O2) in this area, which do not require changing the traditional cleaning techniques. They also should guarantee that cleanliness, absence of odor and minimization of germs are achieved. In addition normal kitchen soaps should be replaced by HD-preparations.

Communicable Disease Control↗

[Carbon monoxide poisoning caused by a hot plate].

The autopsy of a woman aged 85 years who was found dead sitting in her kitchen bent over the kitchen-table revealed a fatal carbon monoxide poisoning. Subsequent inquiries excluded the chimney flue and above all the gas-fired water heater from being the CO-generator. Operating experiments upon the gas stove including the ultimately used pot and the Hot Plate likewise found showed a CO-content of 100 ppm in the room-air after half an hour, there upon an over-proportional ascent of the CO-concentration. This CO-production was brought about by the considerable deformation of the Hot Plate, which has obviously been used for years. The lack of an adequate warning in the directions for use of such products is remarked critically.

Aged↗

Spoon vs bottle: a controlled evaluation of milk feeding in young infants.

Fifty infants under the age of six months who were on artificial milk and who had attended the hospital for diarrhea, were taken up for study. They were divided into two groups. In Group I (n = 25) infants were given milk by spoon and in Group II (n = 25) by bottle. Mothers were given education relevant to the method of feeding on an individual basis. Follow up over a period of 3 months showed a fall in the number of diarrheal episodes which was similar in the two groups. Maternal compliance was significantly better in the bottle-fed group where only one mother expressed a desire to change over to the use of cup and spoon. The weight gain was better in the bottle-fed group, the difference being statistically significant relevant to the weight gain in the second and third month and to the total weight gain in the three months period (t = 3.24, p less than 0.01; t = 2.03 p less than 0.05; and t = 2.24, p less than 0.05, respectively).

Animals↗