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Metalworking fluid hypersensitivity pneumonitis — DOccMed MCQ

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HardOccupational Lung DiseaseMetalworking fluid hypersensitivity pneumonitisDOccMed

A 58-year-old CNC machinist has recurrent Monday fevers, dry cough and exertional desaturation. Symptoms improve after a week off; several colleagues report similar illness and the sump fluid has high microbial counts. What is the most likely occupational diagnosis?

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Correct answer: A — Hypersensitivity pneumonitis related to contaminated metalworking fluid

Clustered systemic respiratory illness linked to contaminated metalworking fluid suggests hypersensitivity pneumonitis. The Monday pattern after re-exposure and improvement away from work support an occupational cause. Occupational asthma would more typically cause variable wheeze and obstruction. Legionella is possible in some water systems but the repeated work-related pattern and sump findings favour hypersensitivity pneumonitis.

Reference: HSE Metalworking Fluids guidance; COSHH Regulations