Environmental health

Question 1

Give examples of occupational lung diseases

Answer 1

1. Occupational asthma
2. COPD
3. Pneumoconiosis
4. Toxic pneumonitis
5. Hypersensitivity pneumonitis
6. Benign pleural disease
7. Infections including TB
8. Malignancy of lung and pleura
9. Silicosis

Question 2

What is the most common occupational lung disease in the UK?

Answer 2

Occupational asthma

Question 3

Occupations which are involved in development of occupational asthma

Answer 3

1. Bakers
2. Welders
3. Paint sprayers
4. Laboratory workers

Question 4

Occupational causes of COPD

Answer 4

1. Coal mining
2. Agriculture
3. Construction
4. Dock workers
5. Brick making

Question 5

What is pneumoconiosis?

Answer 5

An occupational lung disease and a restrictive lung disease caused by inhalation of dust

Question 6

What is pneumoconiosis mainly caused by?

Answer 6

1. Coal dust
2. Silica
3. Asbestos

Question 7

What is silicosis?

Answer 7

A form of occupational lung disease caused by inhalation of crystalline silica dust

• It is marked by inflammation and scarring in the form of nodular lesions in the upper lobes of the lung
• IT IS A TYPE OF PNEUMOCONIOSIS

Question 8

What does silicosis predispose you to?

Answer 8

TB and lung cancer

Question 9

How does the body deal with white vs blue & brown asbestos?

Answer 9

• White asbestos is cleared with mucociliary escalator

- Blue & brown asbestos stay in the lungs, prolonged exposure to fibres and development of malignancy

Question 10

Signs of asbestosis on a CXR

Answer 10

Small, stiff lungs (restrictive lung disease)

- Lower lobes have honeycomb shadowing (fibrotic cysts)

Question 11

Examination signs of asbestosis

Answer 11

Very breathless

‘velcro-like’ crackles on auscultation

Question 12

What is siderosis?

Answer 12

Siderosis is the deposition of iron in tissue

• Usually refers to an environmental disease
• CXR shows shadowing of iron
• Not associated with any symptoms or functional abnormality
• Iron stays in the lung but has no effect

Question 13

What is acute pneumonitis? Signs and symptoms?

Answer 13

Rare, severe lung disease that affects otherwise healthy individuals

• It is the acute inhalation of a substance that causes symptoms immediately, including:
  1. Streaming eyes
  2. Runny nose
  3. Sore throat
  4. Stridor
  5. Breathlessness

Question 14

What is hypersensitive pneumonitis? Symptoms? Causes? Treatment?

Answer 14

Type 3 hypersensitive reaction (immune complex deposition)
- Inflammation of the alveoli within the lung caused by hypersensitivity to inhaled organic dust

• Symptoms: cough and breathlessness
• Causes:
  1. Bird fancier’s lung: due to feathers and bird droppings
  2. Farmer’s lung: due to mouldy hay (moulds and bacteria)
  3. Metalworking fluids HP: due to mist from metalworking fluids (non-TB mycobacterium)
• Treatment:
  1. Steroids if acutely ill
  2. Advise to change lifestyle e.g. get rid of birds, how to stop getting mouldy hay for farmers