Rapidly fatal progression of cobalt lung in a diamond polisher.
Interstitial lung disease was diagnosed in a 52-yr-old male diamond polisher, who worked with polishing disks containing cobalt. After a further 7 months of probably high occupational exposure without any specific treatment, he had to quit work because of dyspnea. Despite treatment with systemic corticosteroids and continuous oxygen administration, he died 3 months later in respiratory distress. Postmortem examination of the lung tissue showed a typical giant-cell interstitial fibrosis, with active inflammatory cell infiltration superimposed on an established centrilobular fibrosis. The lung tissue contained 2.1 micrograms cobalt/g wet weight (more than 100-fold the normal concentration); cobalt particles, mainly localized in macrophages, were identified by transmission electron microscopy and energy-dispersive X-ray analysis. We speculate that the rapid deterioration and fatal outcome resulted from the continued exposure to cobalt, leading to a high pulmonary concentration of cobalt, and from the oxygen treatment because cobalt promotes the formation of hydroxyl free radicals.
Nemery
B
B
Department of Pathology, Katholieke Universiteit Leuven, Belgium.
Nagels
J
J
Verbeken
E
E
Dinsdale
D
D
Demedts
M
M
D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D002244:Carbon; D003035:Cobalt / Q000009:adverse effects*; D018130:Diamond; D015726:Giant Cells / Q000473:pathology; D006801:Humans; D008168:Lung / Q000648:ultrastructure; D008297:Male; D008875:Middle Aged; D011009:Pneumoconiosis / Q000209:etiology* / Q000473:pathology; D011658:Pulmonary Fibrosis / Q000139:chemically induced / Q000473:pathology
D000395:Air Pollutants, Occupational; D003035:Cobalt; D002244:Carbon; D018130:Diamond