Hard metal lung disease and pneumothorax

This case report describes a case of spontaneous pneumothorax in a metal grinder that failed to resolve with medical management. A lung biopsy taken during the subsequent thoracotomy revealed changes that were characteristic of giant cell interstitial pneumonia, as seen in hard metal disease. Pneumothorax has been described in many forms of interstitial lung disease but not in this type of occupational disease. Awareness of this possible association can result in: (1) the removal of an affected worker from his adverse work environment before advanced disease develops; and (2) the safe control of the work environment, to the advantage of other similarly exposed workers.