Synonym: hard metal interstitial lung disease (HMILD)
Features of heavy metal lung disease:
(1) A worker who cuts or grinds metals with the generation of very small particles that can be inhaled into the alveoli.
(2) There is a mixture of metal dusts including cobalt alloy and tungsten carbide. Cobalt metal dust alone may not cause the reaction.
(3) Failure to wear respiratory protection in the workplace.
(4) Development of a diffuse interstitial pneumonitis and/or allergic alveolitis.
(5) Some patients may be allergic to cobalt and/or nickel.
Clinical findings may include:
(1) cough
(2) chest tightness
(3) dyspnea
(4) weight loss
(5) restrictive lung disease
(6) impaired gas diffusion
(7) progressive respiratory failure, which may be rapid
