Pulmonary toxicity of stable and radioactive lanthanides

The pulmonary toxicity of inhaled lanthanides has been the subject of debate. In question have been the relative contributions of radioactive vs. stable elements in the development of lanthanide-associated progressive pulmonary interstitial fibrosis. The central question of this debate is: Are lanthanide dusts that are devoid of radioactive contaminants capable of producing progressive pulmonary disease, or are lanthanide-induced lesions more appropriately termed "benign pneumoconioses"? This paper examines the epidemiologic and experimental record in order to answer the above question. It is clear from the available data that significant pathogenic potential of inhaled lanthanides exists and is related to the type and physicochemical form of the material inhaled and to the dose and duration of exposure. Contamination of the dust with radioactive materials may accelerate and enhance the pathologic response, depending on the form and dose of radioactivity encountered. Nevertheless, there is little evidence to suggest that the level of radioactive contamination of occupationally encountered lanthanide dusts is sufficient to be included as a risk factor for pulmonary disease. Thus, the pulmonary syndrome induced by stable rare earths includes progressive pulmonary fibrosis and should not be referred to as "benign pneumoconiosis."