COBALT-INDUCED CARDIOMYOPATHY IN HARD ALLOY MANUFACTURE

Four male patients aged 32 to 42 years were followed up. The clinical picture of the disease was typical of dilated (congestive) cardiomyopathy with a subacute onset, development of pronounced heart failure; all the patients were found to have exudate pericarditis. All the men were of the same occupation; they worked at the hard alloy works at a bay of wet grinding in ethanol of metallic Co and hard alloy carbides. The content of Co in the air of the working premises exceeded the MAC and amounted to 7.8-10 mg/m3. Besides, 47 workers of the same occupation (90% of the number of persons engaged in making up powdered compositions of hard alloys) were examined in addition. 16 persons showed the signs of alcoholization, including 9 (out of 11) working at a bay of wet grinding. During the recent 20 years, no cases of respiratory occupational diseases were recorded at the bay. The cardiotoxic properties of Co manifest themselves after the preceding toxic exposures, among which the leading part is played by alcohol. Of the 4 patients, 3 developed the disease in the presence of alcoholism, in 1 patient, it was coupled with tuberculous intoxication. Marked tendency towards polycythemia and increase of the content of hemoglobin was a frequently occurring manifestation of Co action on the workers (rather than a sign of intoxication).