Hard metal lung disease: importance of XXXX in coolants.

@entity1 @entity3675 @entity565 @entity45480 @entity56 @entity1953
Four @entity1 were found to react to occupational exposure to grinding of hard metal ( @entity45480 ). Three of the @entity1 had symptoms and signs compatible with an @entity56 , the symptoms disappearing and the chest radiograph clearing when they were absent from work for a few months. Re-exposure to the offending agent led to new signs and symptoms. The first @entity1 was re-exposed twice and each time reacted a little more seriously. After the last episode her chest radiograph has not cleared completely, in contrast to the first two times. The fourth @entity1 had more typical occupational @entity565 . All the cases occurred in the part of the factory where air concentrations of @entity1953 were the lowest. The @entity1953 there is dissolved in the coolant necessary for grinding the hard metal. It occurs mainly in the ionised form, which is known to react with proteins and therefore presumably acts as a hapten. Protective measures, including choosing a coolant with minimal ability to dissolve @entity1953 and an effective exhaust system, should minimise the risk of this @entity3675 in the future.
