[Pulmonary fibrosis caused by hard-metal dusts]

Hardmetals are broadly used in many different branches. In the FRG lung fibrosis caused by hardmetal-dust are recognized as occupational diseases (no. 4107). New findings concerning pathogenesis of this disease should be considered. Not only the dust of the presintered material is hazardous but also the inhalation of the sintered material. There is a special risk for tool-grinders. Cobalt is suspected to be the causal agent. In tool-grinders an elevated external and internal Cobalt-burden has been objectified. We report about 14 persons who suffered from lung fibrosis and worked in the hard metal industry. X-ray and pathohistological examinations may give some hints but there is no specific histological correlate. So the notifying procedure may be difficult. For this reason any case of aetiologically unknown lung fibrosis the lung biopsy and quantitative chemical analysis using AAS should be performed. In one patient the Cobalt-level in lung-tissue was significantly elevated. Toleration of invasive diagnostic measurements can not be demanded. Tool-grinders need more medical surveillance in future. As a preventive strategy the cobalt-exposure is to be reduced to a minimum. The external cobalt-burden at work-place can be estimated by the determination of the renal Cobalt-excretion.