Spray fabric dye linked to pneumonia.

The origin of a rare type of potentially deadly pneumonia, called organizing pneumonia, has stumped physicians. Some patients diagnosed with the infection also have connective tissue diseases, such as arthritis. Others are drug users. In England, some people suffer episodes every spring.

Scientists have for the first time connected some cases of this mysterious pneumonia to exposure to chemicals in the workplace, according to Carmen Moya of the Health and Consumer Council in Valencia, Spain, and her colleagues.

Health experts tracked down the disease in Valencia while investigating why three employees at one textile factory developed lung disorders between February and April 1992, Moya's group reports in the Aug. 20 LANCET.

The researchers examined 257 people at eight factories in Valencia whose jobs related to spraying fabric dye, similar work as that performed by the three people who became ill.

They found 71 cases of the pneumonia. After 1 year, six of the patients had died. By July 1992, the two factories where the illnesses occurred stopped spray printing -- and people stopped getting sick.

A variety of clues convinced the scientists that aerosolized chemicals caused the illness. For example, most of the patients who became sick worked at the factory with the highest concentrations of airborne aerosol, Moya's team reports.

Workers at the two factories handled products not used at the other sites the researchers studies. One of those chemicals had been reformulated in 1991 -- Acramin FWR, a powder, became Acramin FWN, a liquid.

Other busiensses use the new product without problems, the researchers say. But the workers at the Valencia factories were not following the manufacturer's instructions. They mixed Acramin FWN with a chemical solvent instead of water and sprayed it instead of applying it with a brush or sponge. They ended up creating a toxic aerosol.

The researchers note that they aren't the only ones finding health risks from reformulated products. The Centers for Disease Control and Prevention in Atlanta recently described cases of respiratory illness caused by inhalation of two sprays used in waterproofing and conditioning leather. Both chemicals had been reformulated to eliminate ozone-depleting solvents and propellants.