Respiratory bronchiolitis associated with interstitial lung disease

A 52 year-old man, who had been smoking about 20 cigarettes per day for thirty years, worked for about 40 years in mechanical workshops on the maintenance staff repairing diesel engines and pneumatic brakes. The inherent risks in this kind of work are exposure to different toxic substances, many of which are considered irritating to the res-piratory apparatus: acid fumes (electric battery), exhaust fumes, powders from braking systems, as-bestos fibres, exhalation from oil and oily liquids. The man suffered for years from a persistent cough in the mornings and light exertional dyspnoea. In May 2000 he underwent a chest X-ray for the De-partment of Occupational Medicine, which evi-denced reticular micro-nodular interstitial lun