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June 1991

Zirconium Compound-Induced Pulmonary Fibrosis

Author Affiliations

From the Division of Pulmonary and Critical Care Medicine, Cooper Hospital, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School at Camden (Dr Bartter); Division of Pulmonary and Critical Care Medicine, Department of Pathology, and Occupational Health Program, University of Massachusetts Medical School, Worcester (Drs Irwin, Nash, Himmelstein, and Jederlinic); Department of Pathology, State University of New York, Health Science Center, Syracuse (Dr Abraham); and Department of Medicine, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec (Dr Dascal).

Arch Intern Med. 1991;151(6):1197-1201. doi:10.1001/archinte.1991.00400060117020

Despite suspicion that inhalation of zirconium should be capable of causing human pulmonary disease, documentation of zirconium pneumoconiosis in humans has been lacking. We studied a likely case of zirconium compound-induced pulmonary fibrosis. The diagnosis was based on the following: (1) a history of gradual increase in symptoms and slowly progressing pulmonary fibrosis by chest roentgenogram compatible with a pneumoconiosis; (2) an appropriate history of exposure and a latency period of about 15 years before the onset of dyspnea and of roentgenographic changes; (3) analysis of open lung biopsy material revealing end-stage fibrosis and honeycombing, a moderate number of birefringent particles, and extremely high levels of a variety of zirconium compounds; and (4) no other potential cause of fibrosis. We conclude that zirconium should be considered a likely cause of pneumoconiosis and that appropriate precautions should be taken in the workplace.

(Arch Intern Med. 1991;151:1197-1201)