Metal toxicity and the respiratory tract

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 oedema or to acute tracheobronchitis. Metal fume fever, which may follow the inhalation of metal fumes e.g. zinc (Zn), copper (Cu) and many others, is a poorly understood influenza-like reaction, accompanied by an acute self-limiting neutrophil alveolitis. Chronic obstructive lung disease may result from occupational exposure to mineral dusts, including probably some metallic dusts, or from jobs involving the working of metal compounds, such as welding. Exposure to cadmium may lead to emphysema. Bronchial asthma may be caused by complex platinum salts, nickel, chromium or cobalt, presumably on the basis of allergic sensitization. The cause of asthma in aluminium workers is unknown. It is remarkable that asthma induced by nickel (Ni) or chromium (Cr) is apparently infrequent, considering their potency and frequent involvement as dermal sensitizers. Metallic dusts deposited in the lung may give rise to pulmonary fibrosis and functional impairment, depending on the fibrogenic potential of the agent and on poorly understood host factors. Inhalation of iron compounds causes siderosis, a pneumoconiosis with little or no fibrosis. Hard metal lung disease is a fibrosis characterized by desquamative and giant cell interstitial pneumonitis and is probably caused by cobalt, since a similar disease has been observed in workers exposed to cobalt in the absence of tungsten carbide. Chronic beryllium disease is a fibrosis with sarcoid-like epitheloid granulomas and is presumably due to a cell-mediated immune response to beryllium. Such a mechanism may be responsible for the pulmonary fibrosis occasionally found in subjects exposed to other metals e.g. aluminium (Al), titanium (Ti), rare earths. The proportion of lung cancer attributable to occupation is around 15%, with exposure to metals being frequently incriminated. Underground mining of e.g. uranium or iron is associated with a high incidence of lung cancer, as a result of exposure to radon. At least some forms of arsenic, chromium and nickel are well established lung carcinogens in humans. There is also evidence for increased lung cancer mortality in cadmium workers and in iron or steel workers.

This article has been cited by other articles:

				G. M. Keegan, I. D. Learmonth, and C. P. Case Orthopaedic metals and their potential toxicity in the arthroplasty patient: A REVIEW OF CURRENT KNOWLEDGE AND FUTURE STRATEGIES J Bone Joint Surg Br, May 1, 2007; 89-B(5): 567 - 573. [Abstract] [Full Text] [PDF]

				C. R. Lage, A. Nayak, and C. H. Kim Arsenic ecotoxicology and innate immunity Integr. Comp. Biol., December 1, 2006; 46(6): 1040 - 1054. [Abstract] [Full Text] [PDF]

				T. Hannu, R. Piipari, H. Kasurinen, H. Keskinen, M. Tuppurainen, and T. Tuomi Occupational asthma due to manual metal-arc welding of special stainless steels Eur. Respir. J., October 1, 2005; 26(4): 736 - 739. [Abstract] [Full Text] [PDF]

				R. M. Grasseschi, R. B. Ramaswamy, D. J. Levine, C. D. Klaassen, and L. J. Wesselius Cadmium Accumulation and Detoxification by Alveolar Macrophages of Cigarette Smokers Chest, November 1, 2003; 124(5): 1924 - 1928. [Abstract] [Full Text] [PDF]

				M. Zelenina, A. A. Bondar, S. Zelenin, and A. Aperia Nickel and Extracellular Acidification Inhibit the Water Permeability of Human Aquaporin-3 in Lung Epithelial Cells J. Biol. Chem., August 8, 2003; 278(32): 30037 - 30043. [Abstract] [Full Text] [PDF]

				O Vandenplas, F Binard-Van Cangh, J Gregoire, A Brumagne, and A Larbanois Fever and neutrophilic alveolitis caused by a vanadium based catalyst Occup. Environ. Med., November 1, 2002; 59(11): 785 - 787. [Abstract] [Full Text] [PDF]

				I. J. Yu, K. S. Song, H. K. Chang, J. H. Han, K. J. Kim, Y. H. Chung, S. H. Maeng, S. H. Park, K. T. Han, K. H. Chung, et al. Lung Fibrosis in Sprague-Dawley Rats, Induced by Exposure to Manual Metal Arc-Stainless Steel Welding Fumes Toxicol. Sci., September 1, 2001; 63(1): 99 - 106. [Abstract] [Full Text] [PDF]

				G. Lombardi, C. Germain, J. Uren, M. T. Fiorillo, R. M. du Bois, W. Jones-Williams, C. Saltini, R. Sorrentino, and R. Lechler HLA-DP Allele-Specific T Cell Responses to Beryllium Account for DP-Associated Susceptibility to Chronic Beryllium Disease J. Immunol., March 1, 2001; 166(5): 3549 - 3555. [Abstract] [Full Text] [PDF]

				R. Wegner, R. Heinrich-Ramm, D. Nowak, K. Olma, B. Poschadel, and D. Szadkowski Lung function, biological monitoring, and biological effect monitoring of gemstone cutters exposed to beryls Occup. Environ. Med., February 1, 2000; 57(2): 133 - 139. [Abstract] [Full Text] [PDF]

				J. M. Samet, R. Silbajoris, W. Wu, and L. M. Graves Tyrosine Phosphatases as Targets in Metal-Induced Signaling in Human Airway Epithelial Cells Am. J. Respir. Cell Mol. Biol., September 1, 1999; 21(3): 357 - 364. [Abstract] [Full Text]

				J. M. Samet, L. M. Graves, J. Quay, L. A. Dailey, R. B. Devlin, A. J. Ghio, W. Wu, P. A. Bromberg, and W. Reed Activation of MAPKs in human bronchial epithelial cells exposed to metals Am J Physiol Lung Cell Mol Physiol, September 1, 1998; 275(3): L551 - L558. [Abstract] [Full Text] [PDF]

				M. Lindahl, P. Leanderson, and C. Tagesson Novel aspect on metal fume fever: zinc stimulates oxygen radical formation in human neutrophils Human and Experimental Toxicology, February 1, 1998; 17(2): 105 - 110. [Abstract] [PDF]

				L Richeldi, R Sorrentino, and C Saltini HLA-DPB1 glutamate 69: a genetic marker of beryllium disease Science, October 8, 1993; 262(5131): 242 - 244. [Abstract] [PDF]