Pulmonary alveolar proteinosis in workers at an indium processing facility

Am J Respir Crit Care Med. 2010 Mar 1;181(5):458-64. doi: 10.1164/rccm.200907-1022CR. Epub 2009 Dec 17.


Two cases of pulmonary alveolar proteinosis, including one death, occurred in workers at a facility producing indium-tin oxide (ITO), a compound used in recent years to make flat panel displays. Both workers were exposed to airborne ITO dust and had indium in lung tissue specimens. One worker was tested for autoantibodies to granulocytemacrophage-colonystimulating factor (GM-CSF) and found to have an elevated level. These cases suggest that inhalational exposure to ITO causes pulmonary alveolar proteinosis, which may occur via an autoimmune mechanism.

Publication types

  • Case Reports
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Autoantibodies / immunology
  • Granulocyte-Macrophage Colony-Stimulating Factor / immunology
  • Humans
  • Industry
  • Lung / drug effects
  • Lung / pathology
  • Male
  • Middle Aged
  • Occupational Diseases / chemically induced*
  • Occupational Diseases / immunology
  • Occupational Exposure / adverse effects
  • Pulmonary Alveolar Proteinosis / chemically induced*
  • Pulmonary Alveolar Proteinosis / immunology
  • Pulmonary Alveolar Proteinosis / pathology
  • Tin Compounds / adverse effects*
  • Tomography Scanners, X-Ray Computed
  • United States


  • Autoantibodies
  • Tin Compounds
  • indium tin oxide
  • Granulocyte-Macrophage Colony-Stimulating Factor