occupational lung disease and pollution Flashcards
1
Q
what are occupational lung diseases? 5
A
- Range of lung diseases caused by exposures in the workplace
- Typically, long latency stats reflect previous working conditions
COPD - malignant diseases lung cancer (asbestos and non-asbestos related), mesothelioma
- occupational asthma
- pneumoconiosis (mineral dust) coal worker’s lung, asbestosis, silicosis
2
Q
how do we take an occupational history? 2
A
- detailed history of exposure type of material, duration, intensity, temporal relationship to onset of symptoms
- symptoms improvement away from workplace
3
Q
what is pneumoconiosis? 3
A
- coal workers pneumoconiosis140 deaths a year, UK coalfields
- uncomplicated CWP mild disease
- progression of massive fibrosis activation of alveolar macrophages, progressive scarring causing stiff lungs
4
Q
what is silicosis? 8
A
- slate workers (wales)
- potters
- knife grinders
- hard rock miners
- sand blasting
- foundry workers
- Fibrotic lung disease activation of macrophages, restrictive lung function deficit, eggshell calcification of lymph nodes
- Risk factor for TB and lung cancer
5
Q
how do we treat pneumoconiosis? 5
A
- Prevent further exposure
- Stop smoking
- Monitor lung function
- Symptomatic treatment cough, dyspnoea, cor pulmonale
- No specific treatment or cure for the disease itself
6
Q
what is asbestos? 3
A
- Used in building, power stations, ship building, railways and cars in the 1930-70s
- Occupation history is vital
- Risk of washing contaminated clothes
7
Q
descrie benign asbestos and the lung? 4
A
- Pleural plaques (marker of exposure)
- Benign pleural effusion
- Pleural thickening (with subsequent restriction on lung function)
- Asbestosis interstitial lung disease-restrictive lung function with reduction in forced vital capacity and reduced gas transfer
8
Q
describe malignant asbestos and the lung? 7
A
- Lung cancer
- Mesothelioma:
- Malignancy of pleura and peritoneum caused by asbestos
- Pleural plaques on previous CXR
- Persistent unexplained chest pain
- Weight loss
- Breathless/ unilateral pleural effusion
9
Q
how do we diagnose someone with occupational asthma? 6
A
- is it really asthma? differentials= COPD, heart failure, interstitial lung disease
- risk factors= atopy, rhinitis, smoking
- recognition of a high risk job
- co-workers similarly affected?
- recent changes in products used and task undertaken?
- preventative measures= ventilation, masks
10
Q
describe high molecular weight allergic occupational asthma? 4
A
- Proteins, polysaccharides
- Sensitisation with latency period (weeks-years)
- IgE-dependent
- Skin prick/allergy testing four, animals, latex, enzymes
11
Q
describe low molecular weight allergic occupational asthma? 3
A
- Mechanism poorly understood
- Usually, independent IgE
- Limited utility of skin prick/allergy testing isocyanates, metals, dyes
12
Q
what is irritant induced/ non allergic asthma?
A
- Direct effect on airways, not immune mediated, occurs without pre-existing asthma
13
Q
describe acute irritant induced/ non allergic asthma? 8
A
- Reactive airways dysfunction syndrome (RADS)
- Develops within hours of a single, very high exposure to an irritant
- Caustic vapours
- Ammonia
- Fire/smoke
- Chlorine
- Tear gas
- Floor sealants
14
Q
describe subacute irritant induced/ non allergic asthma?
A
- Insidious onset of asthma symptoms after multiple moderate/high exposure incidents
15
Q
what is a toxin?
A
naturally occurring poison produced within living cells and organisms
