Pulmonary disease from occupational exposure to an artificial aluminium silicate used for cat litter.

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Abstract
All available workers engaged in bagging an artificial crystalline aluminium silicate, the kiln-dried residue from the calcining and water extraction of alunite (a hydrated sulfate of Al and K) that was classified as a nuisance dust, were studied after a complaint of respiratory and systemic symptoms, including arthritis, by an employee of the factory, who showed physiological and radiographic evidence of diffuse pulmonary fibrosis and in whom lung biopsy showed diffuse fibrosis with granulomas. Inhalation challenge produced a transient decrease in transfer factor and transfer factor standardized for alveolar volume. Subjects (25) were known to have been exposed at some time to the dust of alunite-residue. Subjects (17) filled out respiratory questionnaire and occupational history and had pulmonary functon testing (spirometry, lung volumes, gas transfer) and posteroanterior chest radiograph. Six subjects considered occupational exposure to dust responsible for respiratory symptoms. Subjects (3) had abnormality of chest radiograph consistent with pulmonary fibrosis. Mean percentage of predicted tranfer factor standardized for effective alveolar volume was 71.1% in subjects with abnormal chest radiographs and 86.6% in subjects with normal radiographs (P = 0.10). There was a trend in correlation between percentage of predicted transfer factor standardized for effective alveolar volume and total dust exposure (sum of products of grade of severity of each exposure period and duration of each exposure period in months) (r = 0.40; P = 0.10). This study suggested that there might be a relation between inhalation of aluminium silicate dust and pulmonary fibrosis.