Occupational lung disease Flashcards
What chemicals are associated with occupational asthma
Isocyanates - most common cause
found in spray painting, foam moulding etc
platinum salts
flour
epoxy resins
proteolytic enzymes
How may someone with occupational asthma present with
concerns chemicals at work worsening asthma
asthma better at weekends, when not at work
What investigations are required for occupational asthma
serial measurements of peak expiratory flow are recommended at work and away from work
What management is required for occupational asthma
referral to respiratory specialist
What is coal workers pneumoconiosis
caused by long term exposure to coal dust particles
severity is linked to extent of exposure
What is the epidemiology of coal workers pneumoconiosis
prevalence higher in populations with higher levels of exposure
male
diagnosis usually after 15-20 years after initial exposure to the coal dust
What is the pathophysiology of coal workers pneumoconiosis
coal dust is inhaled and enters lung
dust reaches terminal bronchioles and engulfed by macrophages
removed from body as mucus
in coal miners body is overwhelmed , macrophages accumulate in alveoli and starts immune response which damages the lung tissue
What is simple pneumoconiosis
most common type
patients often asymptomatic
presence increases risk of other lung diseases such as COPD
What can simple pneumoconiosis lead to
progressive massive fibrosis
What is the staging for simple pneumoconiosis
graded on appearance of chest x ray using categories outlined by International labour office -
Category 1 - some opacities but normal lung markings visible
Category 2- large normal of opacities but normal lung markings visible
Category 3- large number of opacities with normal lung not visible
What is progressive massive fibrosis
dust exposure leads to round fibrotic masses
most commonly in upper lobes
How do patients with progressive massive fibrosis present
symptomatic
breathlessness on exertion and cough
can have black sputum
What will lung function test of someone with progressive massive fibrosis show
mixed obstructive/restrictive picture
What investigations are required for pneumoconiosis
CXR– upper zone fibrosis
Spirometry
How do you manage pneumoconiosis
avoid exposure to coal dust / other irritants
manage symptoms
