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January 1990

The Respiratory Effects of Cobalt

Author Affiliations

From the Department of Medicine, Northwestern University Medical School and Northwestern Memorial Hospital, Chicago (Drs Cugell and Rubin) and the Chest Diseases Unit, University Hospital and University of Western Ontario, London (Drs Morgan and Perkins). Dr Perkins is now with the Department of Pathology, Ottawa (Ontario) Civic Hospital. Dr Rubin is now with the Department of Medicine, Rambam Medical Center and the Medical Faculty, Technion Institute of Technology, Haifa, Israel.

Arch Intern Med. 1990;150(1):177-183. doi:10.1001/archinte.1990.00390130149024

• We studied seven subjects with certain manifestations of cobalt-induced lung disease. All worked with cobalt and were involved in either the production or use of hard metal. The mode of presentation varied from an acute hypersensitivity pneumonitis that cleared completely when exposure ceased to progressive severe interstitial fibrosis of the lungs. In one subject reexposure was followed by a recurrence of the symptoms. All subjects showed restrictive ventilatory impairment and a reduction of their diffusing capacity. The radiologic appearances varied greatly. While two subjects had clear roentgenograms with small lung volumes, others had a micronodular pattern or small blotchy nodular infiltrates, and one had diffuse reticulonodulation as is seen in cryptogenic fibrosing alveolitis. The pathologic appearances varied between desquamative interstitial pneumonia and overt mural fibrosis of the alveoli. Six of the seven patients had multinucleated giant cells in their biopsy specimens or bronchoalveolar lavage fluid.

(Arch Intern Med. 1990;150:177-183)