Occupational Lung Disease/Exposures

Question 1

The clinical and pathologic expressions of most of occupational/exposure diseases are indistinguishable from ___________.

Answer 1

non-exposure-based cases

Question 2

There is often a latency period between ___________.

Answer 2

exposure and development of disease

Question 3

Clinical effects usually correlate with ________.

Answer 3

dose of exposure

Question 4

What is the formula for dose of exposure?

Answer 4

Dose = duration x concentration

Question 5

How does solubility affect where particles deposit in the lungs?

Answer 5

More water-soluble particles get stuck in the upper airways, and less water-soluble particles get stuck in the distal airways/bronchioles

Question 6

Describe the relationship between particle size and where things are likely to get stuck in the lungs.

Answer 6

Greater than 10 microns: upper airways
Between 2.5 microns and 10 microns: bronchioles
Less than 2.5 microns: alveoli

Question 7

What three questions are important to ask patients regarding occupational history?

Answer 7

Where do you work?
What job titles have you had?
What were your specific job duties?

Question 8

What things should you focus on in gathering occupational details?

Answer 8

Specific exposures (e.g., asbestos, beryllium)
Symptoms in coworkers
Use of PPE

Question 9

What is the most common cause of occupational asthma?

Answer 9

Isocyanates (a chemical found in spray paint)

Question 10

What is the main difference between occupational asthma and RADS?

Answer 10

Occupational asthma has a latent period between exposure and symptoms.

Question 11

What high molecular weight compounds cause occupational asthma?

Answer 11

Animal proteins
Baking flours
Enzymes

Question 12

What low molecular weight compounds cause occupational asthma?

Answer 12

Isocyanate
Plicatic acid
Epoxy
Platinum compounds

Question 13

What is RADS?

Answer 13

Reactive airway dysfunction syndrome

Question 14

What is the pathophysiology of RADS?

Answer 14

Respiratory epithelium get damaged due to exposure to an irritant; symptoms rapidly develop (typically within 24 to 48 hours); frequently associated with strong acids or bases

Question 15

What exposures can cause occupational COPD?

Answer 15

Biomass combustion
Vanadium
Organic dusts
Coal mine dust

Question 16

What exposures can cause occupational constrictive/obliterative bronchiolitis?

Answer 16

Noxious gases such as oxides of nitrogen and sulfur

Diacetyl

Question 17

What three groups are most at risk of asbestos exposure?

Answer 17

Construction workers
Dock workers
Mechanics who work on brakes

Question 18

What is a foundry?

Answer 18

A metal-working plant

Question 19

What industry uses beryllium?

Answer 19

The aerospace industry–beryllium is a lightweight metal

Question 20

What are the three main determinants of site and severity of occupational lung disease?

Answer 20

Dose
Solubility
Particle size

Question 21

Other than neoplasm, what can asbestos exposure cause?

Answer 21

Pleural effusion, pleural thickening, and atelectasis

Question 22

What is the mechanism of injury in silicosis?

Answer 22

Silicate particles generate free radicals that induce inflammation; usually a long latency period

Question 23

Describe hypersensitivity pneumonitis.

Answer 23

Caused by exposure to animal dander/proteins
T-cell mediated reaction
Typically acute symptoms

Question 24

Define pneumoconiosis.

Answer 24

(n.) a disease of the lung due to inhalation of dust

Question 25

The pneumoconioses, hypersensitivity pneumonitis, and chronic beryllium disease are all ___________ diseases.

Answer 25

interstitial lung