Occupational Lung Disease

Question 1

Coal Workers Pneumoconiosis

Answer 1

Aetiology: inhaled dust, due to mineral dust exposure
Simple -> No symptoms, just a CXR abnormality
Complicated -> massive fibrosis in patches

Question 2

Silicosis

Answer 2

Aetiology: mining, boiler workers, glass workers
Simple -> no symptoms, just CXR abnormality (egg shell calcification)
Complicated -> pulmonary fibrosis

Question 3

Asbestosis

Answer 3

Aetiology: mining, ship yard, boilers, piping, construction
Pleural disease - benign pleural plaques (assymptomatic)
Pulmonary fibrosis
Bronchial carcinoma
Mesothelioma

Question 4

Mesothelioma

Answer 4

Malignant tumour of the lining of the lung, surrounds the pleural lining
Takes 30-40 years to develop
Cause: asbestos exposure

Question 5

Mesothelioma - Clinical presentation

Answer 5

Breathless
Chest pain
Weight loss
Recurrent pleural effusions

Question 6

Mesothelioma - Clinical signs

Answer 6

Finger Clubbing

Lymphadenopathy

Question 7

Mesothelioma - Investigations

Answer 7

CXR - pleural thickening
CT - pleural thickening
Pleural aspiration - avoid repeat aspiration!!
Thorascopy - for diagnosis

Question 8

Mesothelioma - Management

Answer 8

Radiotherapy
Chemotherapy
Surgery - rare