Comments
Hard metal disease is a "giant cell interstitial pneumonitis" that affects a small minority of workers who manufacture or use high-speed tungsten carbide saw tips, drill tips, or discs. These tools are used to polish diamonds and to cut hard materials such as metals, hardwoods, and cement. The workers are exposed to fume or dust from the cobalt used as a binder in the cemented tungsten carbide metal. The usual symptoms are dyspnea on exertion, cough, and fatigue. The chest x-ray may show infiltrates, and the pulmonary function test may reveal a restrictive defect. The same workers are at risk for cobalt-induced asthma. [LaDou, p. 377] Hard metal disease is caused by the cobalt/tungsten carbide composite material. Little relation between disease and length of exposure has been found. [Nordberg, p. 753]
Diagnostic
Chest x-ray; Pulmonary function test: [LaDou] Findings on HRCT include, "reticulation, traction bronchiectasis, and large peripheral cystic spaces in a mid and upper lung distribution." [Nordberg, p. 753]