Tungsten (wolfram) is a hard metal with numerous uses in metallurgy, hard metal alloys, electrical and mechanical engineering, armaments and munitions. Whilst it was regarded as an element of low toxic risk, concerns have arisen over a possible relationship between childhood leukaemia and exposure to residues from mining. The carcinogenic risk from tungsten in shrapnel in military combat is unresolved. Greatest concern relates to the use of tungsten carbide in hard metal composites for drilling, grinding and rock cutting. In vitro studies point to these composites containing cobalt as a “binder” as being cytotoxic, genotoxic, mutagenic and capable of inducing reactive oxygen species. Epidemiological studies are claimed to show that workers inhaling hard metal dusts are twice as likely to develop lung cancers, but actual numbers of cancer cases reported in Swedish and French surveys are small and the reliability of the data is questioned. Data reviewed indicate that tungsten metal and tungstates present no clear carcinogenic risk following expected patterns of exposure. Risks associated with inhalation of hard metal dust may exist, although available evidence points to the presence of cobalt as being the principal hazard and not the tungsten or tungsten carbide constituents.