"A broader term used is hard metal lung disease (HMLD) which also takes into account the non-fibrotic stages/forms such as bronchitis/obliterative bronchitis caused by hard metal lung disease."
Expected headings
"Histology"
"Diagnostic criteria"
"Typical at-risk occupations include manufacturers and sharpeners of tools, machine operators (e.g. grinders and lathes), diamond polishers (the polishing discs employ hard metals)."
"Clinical presentation can be similar to that of hypersensitivity pneumonitis, with some patients having episodes of work-related subacute disease and some patients evolving, more or less rapidly, to lung fibrosis 6."
"Histopathological manifestations of hard-metal disease can range from bronchitis to subacute fibrosing alveolitis to interstitial fibrosis 8. A combination of electron microscopy and energy-dispersive x-ray fluorescence spectrometry is required in suspected cases to identify the tiny particles of hard metals in the tissue samples. Tungsten particles are usually in high concentration; conversely cobalt is often low concentration only, due to the easier solubility of the cobalt in body fluids and its more rapid clearance in the tissues 10."