Occupational Diseases Flashcards
True or false: Tobacco smoking is the number #1 cause of preventable death in the US?
True
What fraction of smokers who continue to smoke will die from it?
1/2
What risk of developing lung cancer in about (__)x higher in male smokers, and (__)x higher in female smokers?
23x for males
13x for females
How many adults die d/t lung CA in the US each year as a result of second hand smoke?
3400
What is the most common occupational lung disease in the US?
asthma
What percent of adults in the US have a diagnosis of asthma?
7.5%
What is the best way to diagnose occupational asthma?
History–improvements over long breaks or weekends
What are the two types of occupational asthma?
- Asthma with latency (immunologic)
- Without latency (Reactive airway dysfunction syndrome)
What test can you order to determine if a patient’s airway is reactive? What is the use of this with occupational asthma?
Methacholine challenge
Can see if there is hyperreactivity of the airway
What indicates a positive test in a methacholine challenge?
FEV1 drops by 20% at less than PD20
What are the objective tests for occupational asthma?
Pre and post shift monitoring of lung function (spirometry)
What percent of COPD is attributable to occupation?
15%
What are the common causes of occupational COPD?
Inorganic/organic dust exposure
What percent of E-cigs contain diacetyl or acetyl propionyl
75%
What is popcorn lung/flavorings lung disease?
Bronchiolitis obliterans caused by diacetyl (flavoring component of butter)
What is hypersensitivity pneumonitis?
A spectrum of granulomatous, interstitial, and alveolar filling lung diseases that result from repeated inhalation of and sensitization to a wide variety of organic dusts
What are the type of exposures that can lead to hypersensitivity pneumonitis?
Thermophilic bacteria
Fungal species
Birth feathers
What type of immune reaction is hypersensitivity pneumonitis?
CD8 + influx of alveolar macrophages, with ill defined granuloma formation
What are the ssx of hypersensitivity pneumonitis?
Sudden onset of fever, chills, malaise, cough, SOB.
Tachypnea and diffuse, fine crackles
What might a CXR show with hypersensitivity pneumonitis?
Patchy, micronodular infiltrates
What does ground glass appearance on imaging tell you, generally?
That the alveoli are affected
What can chronic hypersensitivity pneumonitis lead to?
Pulmonary fibrosis and digital clubbing
What are the three main types of pneumoconiosis?
- Asbestosis
- Silicosis
- Coal dust
What is pneumoconiosis?
Group of ILDs caused by the inhalation of certain dusts and the lungs reaction to it
True or false: silicosis is associated with TB
True
What are the radiological findings of silicosis?
Egg shell calcifications
What are the histological findings of silicosis?
Alveolar filling with proteinaceous material
What are the radiographic features of coal worker’s pneumoconiosis?
Similar to silicosis
Where in the lung is asbestosis most commonly occur?
Pleura
What is the latency period for asbestosis?
20-50 years
What are the classic radiological findings of asbestosis?
Pleural plaques (diaphragmatic plaques)
True or false: asbestosis can range from asymptomatic, to a debilitating restrictive lung disease
True
How much more common is lung cancer in smokers with asbestosis?
50x
What are the occupations that use Co-W carbide alloy? What disease does this cause?
Machine cutting tools
Parenchyma fibrosis
What is the elemental gas that is associated with the development of lung cancer? What is this a breakdown product of?
Ra
Breakdown product of uranium and radium
What is the cutoff limit for Ra gas to be considered safe?
4 piL
What is the leading cause of death related to fires? How does this produce injury?
Smoke inhalation
Thermal injury to the upper airway, CO, CN
What is the half life of CO with 100% O2 at 1 ATM? At 3 ATM?
- 3
23. 3
At what level of COHb is hyperbaric O2 recommended?
25%
What is the MOA of HCN?
Binds to Fe ions, like the cytochrome C, to block the respiratory cycle
