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PMID: 10931787 Published · ppublish English Journal Article Review

Inorganic dust pneumonias: the metal-related parenchymal disorders.

Environmental health perspectives ·Vol. 108 Suppl 4 ·2000-08-00 ·Pages 685-96

Kelleher P, Pacheco K, Newman LS

Abstract

In recent years the greatest progress in our understanding of pneumoconioses, other than those produced by asbestos, silica, and coal, has been in the arena of metal-induced parenchymal lung disorders. Inhalation of metal dusts and fumes can induce a wide range of lung pathology, including airways disorders, cancer, and parenchymal diseases. The emphasis of this update is on parenchymal diseases caused by metal inhalation, including granulomatous disease, giant cell interstitial pneumonitis, chemical pneumonitis, and interstitial fibrosis, among others. The clinical characteristics, epidemiology, and pathogenesis of disorders arising from exposure to aluminum, beryllium, cadmium, cobalt, copper, iron, mercury, and nickel are presented in detail. Metal fume fever, an inhalation fever syndrome attributed to exposure to a number of metals, is also discussed. Advances in our knowledge of antigen-specific immunologic reactions in the lung are particularly evident in disorders secondary to beryllium and nickel exposure, where immunologic mechanisms have been well characterized. For example, current evidence suggests that beryllium acts as an antigen, or hapten, and is presented by antigen-presenting cells to CD4+ T cells, which possess specific surface antigen receptors. Other metals such as cadmium and mercury induce nonspecific damage, probably by initiating production of reactive oxygen species. Additionally, genetic susceptibility markers associated with increased risk have been identified in some metal-related diseases such as chronic beryllium disease and hard metal disease. Future research needs include development of biologic markers of metal-induced immunologic disease, detailed characterization of human exposure, examination of gene alleles that might confer risk, and association of exposure data with that of genetic susceptibility.

MeSH Terms
Air Pollutants/adverse effects Dust/adverse effects Humans Inhalation Exposure/adverse effects Inorganic Chemicals/adverse effects Metals, Heavy/adverse effects Pneumoconiosis/etiology
Chemicals
Air Pollutants Dust Inorganic Chemicals Metals, Heavy
Authors & Affiliations
3 authors, click to expand affiliations / ORCID
Kelleher P
Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Medical and Research Center, Denver, Colorado 80206, USA.
Pacheco K
Newman L S
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Article Info
Journal
Environmental health perspectives
Abbr.
Environ Health Perspect
ISSN
0091-6765
DOI
10.1289/ehp.00108s4685
Published
2000-08-00
Pages
685-96
Language
English
Region
United States
NLM ID
0330411
PMCID
PMC1637664
Subset
IM
External Links
PubMed source DOI: 10.1289/ehp.00108s4685 PMC Full Text View journal details
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