[Diffuse interstitial lung disorders caused by the environment and occupation].

Diffuse interstitial lung diseases caused by exogenous factors can be divided into those that arise as a result of a progressive accumulation of (mainly) mineral particles in the lung parenchyma, and those that essentially result from a particular susceptibility of the host for specific agents. The former category consists mainly of silicosis, coal worker's pneumoconiosis and asbestosis, as well as other mineral pneumoconioses. The latter category contains extrinsic allergic alveolitis, which is mainly caused by the inhalation of bio-aerosols, chronic beryllium disease and other sarcoid-like diseases, and hard-metal or cobalt lung. Individual susceptibility is based on a genetic tendency for becoming immunologically sensitized (demonstrated for beryllium) and/or possibly on a poor defense against oxidative stress (probably relevant for cobalt). Recent outbreaks of interstitial lung disease resulting from inhalatory exposure to some polymers ("Ardystil syndrome" and "flock worker's lung") show that one should remain vigilant for the occurrence of novel occupational causes of pulmonary disease.