Occupational Lung Disease

Question 1

What is occupational lung disease?

Answer 1

A group of diagnoses caused by inhalation of dusts, chemicals, or proteins

Question 2

Give some occupational lung diseases

Answer 2

• Asthma (not always obvs)
• Extrinsic allergic alveolitis
• Coal workers pneumoconiosis and silicosis
• Asbestos-related lung disease

Question 3

How is occupational asthma identified?

Answer 3

Patient his history of asthma during week, with relative improvement over weekend

Question 4

What should be done if occupational asthma is suspected?

Answer 4

• Carry out serial peak flow measurements at work and home

- Confirm diagnosis with IgE assay, skin prick test, or specific allergen testing

Question 5

What will happen in occupational asthma is sensitiser-induced?

Answer 5

There is latent period between exposure and symptoms

Question 6

What will happen if occupational asthma is irritant-induced?

Answer 6

Symptoms start within hours of exposure

Question 7

What is extrinsic allergic alveolitis (EAA)?

Answer 7

The process in which granulomatous inflammation occurs in the lung due to inhaling organic or chemical antigens or proteins

Question 8

What are the types of EAA?

Answer 8

• Farmer’s lung
• Bird fancier’s lung
• Malt worker’s lung
• Mushroom workers lung

Question 9

What is farmer’s lung linked to?

Answer 9

Inhalation of material in mouldy hay

Question 10

What is bird fanciers lung linked to?

Answer 10

Inhalation of organic proteins in bird droppings

Question 11

What are the clinical features of EAA?

Answer 11

• Expectorant cough
• Shortness of breath
• Flu-like illness

Present up to 8 hours after exposure

Question 12

What happens in many cases of EAA?

Answer 12

Symptoms resolve within a week

Question 13

How can acute forms of EAA be managed?

Answer 13

Supportively

Question 14

What are the features of chronic EAA?

Answer 14

• Gradually reducing exercise tolerance
• Weight loss
• Recurrent symptoms
• Crackles on lung examination

Question 15

How are patients with chronic EAA managed?

Answer 15

• Supportive treatment

- Removal of offending antigen (may need change in profession)

Question 16

What may be required in progressive or severe EAA?

Answer 16

Corticosteroids

Question 17

What is pneumoconiosis?

Answer 17

Fibrosis that occurs secondary to repeated inflammation caused by harmful dusts and particles, including silica

Question 18

What occupations often have histories of silica exposure?

Answer 18

• Coal workers
• Bricklayers
• Tunnelling
• Pottery and ceramics

Question 19

What is it called when coal workers pneumoconiosis is associated with RA?

Answer 19

Caplan syndrome

Question 20

What is it important to do in the history in pneumoconiosis?

Answer 20

Obtain a thorough occupational history and consider social side of management, as may be eligible for financial compensation

Question 21

Is coal workers pneumoconiosis a notifiable disease?

Answer 21

Yes

Question 22

How are pneumoconiosis and silicosis managed?

Answer 22

Have no specific therapy, but symptomatic management should be offered