Asbestos fibers can cause pulmonary interstitial fibrosis with restrictive lung disease, and there is an increased risk of malignancy. Individuals who have been exposed to asbestos and who smoke have a greatly increased incidence of bronchogenic carcinoma. Mesothelioma is uncommon, even in individuals with asbestos exposure, but virtually all occurrences of malignant mesothelioma are in individuals who have been exposed to asbestos. Arsenic exposure is a risk factor for skin cancer. Chronic beryllium exposure may lead to sarcoid like granuloma formation. Chromium exposure increases the risk of carcinomas of the upper respiratory tract and lung. Nickel exposure is associated with cancers of the respiratory tract.