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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.

Abstract
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)

Author Affiliations
From the Division of Pulmonary and Critical Care Medicine, Cooper Hospital, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School at Camden (Dr Bartter); Division of Pulmonary and Critical Care Medicine, Department of Pathology, and Occupational Health Program, University of Massachusetts Medical School, Worcester (Drs Irwin, Nash, Himmelstein, and Jederlinic); Department of Pathology, State University of New York, Health Science Center, Syracuse (Dr Abraham); and Department of Medicine, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec (Dr Dascal).

Footnotes
Accepted for publication November 19, 1990.

Reprint requests to Division of Pulmonary and Critical Care Medicine, University of Massachusetts Medical Center, 55 Lake Ave N, Worcester, MA 01655 (Dr Irwin).

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