Occupational Lung disease Flashcards
What is pneumoconiosis?
A common dust disease in countries that have or have had underground coal mines. It resluts from inhalation of coal dust particles over 15-20 years. These particles are ingested by macrophages, which die and release enzymes, leading to pulmonary fibrosis
What are the main causes of pneumoconiosis?
- Coal
- Silica
- Beryllium
What is silicosis?
Restrictive lung disease caused by inhalation of silica particles, which are very fibrogenic
What jobs may be associated with the development of silicosis?
- Metal mining
- Stone quarrying
- Snadblasting
- Pottery/ceramic manufacture
What are features of pneumoconiosis?
Often asymptomatic
- Dyspnoea
- Cough
- Chest tightness/wheezing
- Clubbing
What respiratory problem commonly co-exists with pneumoconiosis?
Bronchitis
How might you investigate someone with suspected pneumoconiosis?
- PFTs
- CXR/CT
What might you see on CXR in someone with pneumoconiosis?
Many round opacities, especially in the upper zones
How would you manage pneumoconiosis?
- Avoid dust exposure
- Stop smoking
- Treat co-exisitng bronchitis
- Consider pulmonary rehab
- Consider supplemental oxygen therapy
Can those with pneumoconiosis claim compensation?
Yes (industrial injuries act)
What are clinical featurs of silicosis?
Progressive dyspnoea
What respiratory infection is found more commonly in those with silicosis?
TB
What might you find on CXR in someone with silicosis?
- Diffuse miliary or nodular pattern in upper and mid-zones
- Egg shell calcificaiton of hilar nodes
What is caplan’s syndrome?
A combination of rheumatoid arthritis (RA) and pneumoconiosis that manifests as intrapulmonary nodules, which appear homogenous and well-defined on chest X-ray
What spirometric defect will someone with silicosis have?
Restrictive
What is asbestosis?
Asbestosis is diffuse interstitial fibrosis of the lung as a consequence of exposure to asbestos fibres
What might you see on CXR in someone with asbestosis?
- Lower zone linear interstitial fibrosis -> spreads to entire lung
- Pleural thickening
- Plaques
What is mesothelioma?
Malignant mesothelioma is an aggressive epithelial neoplasm arising from the lining of the lung, abdomen, pericardium, or tunica vaginalis.
It is one of the few cancers related directly to an environmental exposure; asbestos is the chief causative agent.
What might you see on CXR in someone with mesothelioma?
- Unilateral pleural effusion
- Irregular pleural thickening
- Reduced lung volumes
- Parenchymal changes related to asbestos exposure (e.g., lower zone linear interstitial fibrosis)
