Occupational Lung Disease/ Exposures

Question 1

What are the 3 main determinants of the site and severity of occupational lung disease?

Answer 1

1. Dose (= duration x concentration)
2. solubility
3. particle size

Question 2

What is the difference in onset of symptoms between occupational asthma and reactive airways dysfunction syndrome (RADS)?

Answer 2

No latency with RADS, symptoms occur within 24-48 hours after exposure

Question 3

What are the 3 major types of pneumoconioses?

Answer 3

1. Asbestos-related lung diseases
2. Silicosis Coal Workers
3. Pneumoconiosis (Black Lung)

Question 4

Which lung disease is most commonly associated with isocyanate exposure?

Answer 4

Occupational asthma

Question 5

What exposures lead to silicosis? What effect does it have on your lung

Answer 5

Exposures: crystalline silica (quartz, cristobalite, tridamite)

• exposed workers who blast, cut, grind with/on respirable silica containing materials,
• think hard rock miners (gold, silver), foundry workers, sandblasters (stone-washed jean manufacturers)

Causes progressive fibrosis (remember that buzzword)

BOLD ARE TQs

Question 6

What exposures lead to pleural plaques/ thickening?

Answer 6

Asbestos

Navy workers

Question 7

You suspect that a patient has hypersensitivity pneumonitis. What aspects of his social history makes you think this?

Answer 7

Exposed to animal dander/ proteins

• Causes:
  
  • some animal proteins (mainly birds) – parrots, cockatiels, cockatoos, finches;
  • microbial aerosols
  • fungi
  • bacteria inhaled from contaminated hay (farmer’s lung), hot tubs & indoor pools (due to non-tuberculous mycobacteria and gram-negative organisms),
  • humidifiers, machining/metal-working fluids

Question 8

What types of workers are most exposed to isocyanates?

Answer 8

Autobody/ paint workers

Question 9

“I think I have the black lung pa”. Why?

Answer 9

Inhalation of coal dust

Interstitial disease similar to silica toxicity

Long latency (10 -30 years)

Question 10

If a worker from an airforce base comes in with chronic dyspnea and cough, would should you think of?

Answer 10

Berylium disease