Current Environmental Health Reports

, Volume 5, Issue 4, pp 486–498 | Cite as

Metal-Induced Pulmonary Fibrosis

  • Nour Assad
  • Akshay Sood
  • Matthew J. Campen
  • Katherine E. ZychowskiEmail author
Metals and Health (A Barchowsky, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Metals and Health


Purpose of Review

The incidence of pulmonary fibrosis is increasing worldwide and may, in part, be due to occupational and environmental exposures. Secondary fibrotic interstitial lung diseases may be mistaken for idiopathic pulmonary fibrosis with important implications for both disease management and prognosis. The purposes of this review are to shed light on possible underlying causes of interstitial pulmonary fibrosis and to encourage dialogue on the importance of acquiring a thorough patient history of occupational and environmental exposures.

Recent Findings

A recent appreciation for various occupational and environmental metals inducing both antigen-specific immune reactions in the lung and nonspecific “innate” immune system responses has emerged and with it a growing awareness of the potential hazards to the lung caused by low-level metal exposures. Advancements in the contrast and quality of high-resolution CT scans and identification of histopathological patterns of interstitial pulmonary fibrosis have improved clinical diagnostics. Moreover, recent findings indicate specific hotspots of pulmonary fibrosis within the USA. Increased prevalence of lung disease in these areas appears to be linked to occupational/environmental metal exposure and ethnic susceptibility/vulnerability.


A systematic overview of possible occupational and environmental metals causing interstitial pulmonary fibrosis and a detailed evaluation of vulnerable/susceptible populations may facilitate a broader understanding of potential underlying causes and highlight risks of disease predisposition.


Pulmonary fibrosis Interstitial lung disease Metals Environmental health Occupational exposure Health disparities 



We would like to thank Dr. Jesse Denson for editing this manuscript.

Funding Information

This work was supported by NIEHS (K99 ES029104; R01 ES026673), HRSA (2H1GRH27375, H37RH0057, D04RH31788) and Alpha Foundation (AFC719).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures performed in cited studies involving human participants conducted by the authors were in accordance with the ethical standards of the University of New Mexico Institutional Review Board. Animal studies performed by the authors were performed in accordance with the Animal Care and Use Committee.


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Nour Assad
    • 1
  • Akshay Sood
    • 1
    • 2
  • Matthew J. Campen
    • 3
  • Katherine E. Zychowski
    • 3
    Email author
  1. 1.Department of Internal MedicineUniversity of New Mexico School of MedicineAlbuquerqueUSA
  2. 2.Miners’ Colfax Medical CenterRatonUSA
  3. 3.Department of Pharmaceutical SciencesUniversity of New Mexico-Health Sciences CenterAlbuquerqueUSA

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