The diffuse (interstitial) lung diseases have attracted an unprecedented level of interest over the past 5 years. Statements from the American Thoracic Society/European Respiratory Society committees on idiopathic pulmonary fibrosis (IPF), sarcoidosis and the idiopathic interstitial pneumonias, and from the British Thoracic Society on diffuse parenchymal lung diseases [1–3] have defined the phe...

Sporadic cases of chemical poisoning have occurred in Japan recently, and even though these cases are rare, this situation is not permissible. These cases involve not only newly identified types of poisoning, but also the reemer-gence of poisoning with known hazardous chemicals. Recent examples of known types of poisoning are lead poisoning, lung cancer caused by exposure to beryllium, and blad...

OBJECTIVES This section of the guideline aims to review the role of occupational and environmental factors in causing and contributing to cough. It also aims to indicate when such causes should be considered in a clinical setting, and a general approach to assessment and management. METHODS A review was performed of published data between 1985 and 2004 using PubMed. The search terms used incl...

The parenchymal lung diseases caused by metal inhalation include interstitial fibrosis, giant cell interstitial pneumonitis, chemical pneumonitis, and granulomatous disease, among others. We reported two cases of granulomatous lung disease with occupational exposure to metal dusts other than beryllium. They had worked in the battery manufacturing industry for 7 years and in an aluminum-processi...

CD14dimCD16+ and CD14brightCD16+ cells, which compose a minor population of monocytes in human peripheral blood mononuclear cells (PBMC), have been implicated in several inflammatory diseases. The aim of this study was to investigate whether this phenotype was present as a subset of lung infiltrative alveolar macrophages (AMs) in the granulomatous lung disease, chronic beryllium disease (CBD). ...

Work in Department of Energy (DOE) facilities has exposed workers to multiple toxic agents leading to acute and chronic diseases. Many exposures were common to numerous work sites. Exposure to crystalline silica was primarily restricted to a few facilities. I present the case of a 63-year-old male who worked in DOE facilities for 30 years as a weapons testing technician. In addition to silica, ...

Beryllium (Be) presentation to CD4 T cells from patients with chronic beryllium disease (CBD) results in T cell activation, and these Be-specific CD4 T cells undergo clonal proliferation and T-helper 1-type cytokine production. In exposed workers, genetic susceptibility to this granulomatous disorder is associated with particular HLA-DPB1 alleles. We hypothesized that these HLA-DP molecules cou...

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 disease...

TO THE EDITOR—In their editorial, LugoVillarino and Neyrolles [1] refer to the publication by Feng et al [2] and conclude that these authors have come “closer . . . to solving the enigma of how the macrophage population undergoes changes in response to Mycobacterium tuberculosis.” Jones Williams et al [3], however, have demonstrated by electron microscopy that the epithelioid cell in tuberculos...

The type of lung disease caused by metal compounds depends on the nature of the offending agent, its physicochemical form, the dose, exposure conditions and host factors. The fumes or gaseous forms of several metals, e.g. cadmium (Cd), manganese (Mn), mercury (Hg), nickel carbonyl (Nl(CO)4, zinc chloride (ZnCl2), vanadium pentoxide (V2O5), may lead to acute chemical pneumonitis and pulmonary oe...