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Zirconium Compound-Induced Pulmonary Fibrosis

Thaddeus Bartter, MD; Richard S. Irwin, MD; Jerrold L. Abraham, MD; Andre Dascal, MD; Gerald Nash, MD; Jay S. Himmelstein, MD; Peter J. Jederlinic, MD
Arch Intern Med. 1991;151(6):1197-1201. doi:10.1001/archinte.1991.00400060117020.
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Despite suspicion that inhalation of zirconium should be capable of causing human pulmonary disease, documentation of zirconium pneumoconiosis in humans has been lacking. We studied a likely case of zirconium compound-induced pulmonary fibrosis. The diagnosis was based on the following: (1) a history of gradual increase in symptoms and slowly progressing pulmonary fibrosis by chest roentgenogram compatible with a pneumoconiosis; (2) an appropriate history of exposure and a latency period of about 15 years before the onset of dyspnea and of roentgenographic changes; (3) analysis of open lung biopsy material revealing end-stage fibrosis and honeycombing, a moderate number of birefringent particles, and extremely high levels of a variety of zirconium compounds; and (4) no other potential cause of fibrosis. We conclude that zirconium should be considered a likely cause of pneumoconiosis and that appropriate precautions should be taken in the workplace.

(Arch Intern Med. 1991;151:1197-1201)

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