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BLOCK B - RESPIRATION > Occupational lung diseases > Flashcards

Occupational lung diseases Flashcards

1
Q

Which type of cancer accounts for 55-75% of occupational cancers?

A

Lung cancer (even though only 4-8% of all cancers are occupational)

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2
Q

85-90% of male mesotheliomas are caused by…

A

occupational asbestos exposure

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3
Q

What exposure accounts for 50% of occupational cancers?

A

Asbestos exposure

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4
Q

Why do we still see asbestos-related pneumoconioses and cancers despite improving trends in work exposures and occupational diseases?

A

Because of long latency periods

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5
Q

What is the latency of a disease?

A

The period between the exposure to a pathogen and onset of symptoms.

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6
Q

What pulmonary disease occurs immediately (within 24 hours) of exposure to irritants?

A

RADS: reactive airway dysfunction syndrome

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7
Q

What pulmonary disease occurs many hours after a repetitive exposure?

A

Hypersensitivity pneumonitis

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8
Q

What pulmonary disease take days, weeks, months, years to develop before becoming symptomatic and improves on weekends and vacations?

A

Asthma

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9
Q

What are two main dust-related occupational diseases?

A
  1. Asbestos-related
  2. Silica-related
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10
Q

How long does asbestosis take to develop?

A

20 years after asbestos exposure

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11
Q

How long does mesothelioma take to develop?

A

30 years after exposure (even if exposure is minimal)

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12
Q

How long does it take for plaques, pleural effusions and pleural thickening to develop (asbestos)?

A

10-20 years after exposure

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13
Q

How long does simple silicosis take to develop?

A

15 years
(acute silicosis < 5 years)
(accelerated silicosis 5-15 years)

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14
Q

What are the two major categories of occupational lung disease? Define them

A
  1. Pneumoconiosis: Dust inhalation
  2. Airway disease: Inhalation of low or high grade molecular weight compounds
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15
Q

Name 2 important diseases that fall under pneumoconiosis and 2 important diseases that fall under airway disease.

A

Pneumoconioses:
* asbestosis
* silicosis

Airway disease:
* Occupational asthma
* Reactive airways dysfunction syndrome (RADS)

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16
Q

How can we measure the intensity of exposure to dusts? (3)

A
  1. History (job type, duration)
  2. Radiologic findings (more interstitial lung abnormalities = more cumulative exposure)
  3. Microscopy of lung biopsy
    * Asbestos: count fibres of asbestos bodies
    * Silicosis: count silicotic nodules
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17
Q

What is asbestos? What are its two major types?

What subtype is most common in Quebec?

A

Naturally occuring mineral, fibrous magnesium silicate

Two major types:
1. serpentine (93% of commerial use)
* Chrysotile (subtype): most common in Quebec
2. amphibole (7% of commercial use)

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18
Q

What are some common asbestos products and uses?

A

Thermal insulation
Cement products
Fireproof panels
Flooring
Roofing
etc.

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19
Q

Commonly exposed jobs (asbestos)

A

Insulators
Plumbers, pipe-fitters, steam-fitters
Electricians, carpenters, laborers
Janitors, cleaners in old buildings
Welders, grinders, cutters, machinists
Brake/clutch automechanics
etc.

20
Q

What are some non-occupational asbestos exposures? (3)

A
  • Geographic (living near mines)
  • Domestic (washing spouse’s clothes)
  • Environmental (household items/insulation)
21
Q

Why is vermiculite insulation dangerous?

A

It is often contaminated by asbestos

22
Q

Describe the dose-response relationship for asbestos and the diseases it can cause.

A

Low exposure (<1 fibre-year): pleural plaques and thickening (benign)

Intermediate exposure (1 fibre-year): mesothelioma

High exposure (25 fibre-years): asbestosis

23
Q

Benign (non-cancerous) asbestos-related disease can be…(2)

A
  1. Pleural (envelope of the lung)
    * hyaline plaques
    * diffuse pleural thickening
    * pleural effusion
  2. Parenchymal (lung itself)
    * asbestosis
24
Q

Hyaline plaques (asbestos) (3)

A
  • Indicate exposure to asbestos
  • Do not affect lung (asymptomatic)
  • Not compensatable
25
Q

Diffuse pleural thickening (asbestos) (4)

A
  • Costophrenic angle blunting
  • Loss of lung function
  • Different from mesothelioma in that the thickening is smooth rather than irregular or nodular
  • Compensatable
26
Q

Benign pleural effusions (asbestos) (4)

A
  • painful
  • recurrent
  • bloody
  • eosinophilic
27
Q

Define rounded atelectasis

A

Partial collapse of the lung
* May look like lung mass (rounded opacity)
* Entrapped lung in a whorl (comet tail)

Results from pleural effusion caused by asbestos exposure

28
Q

Describe asbestosis (6)

A
  • Interstitial lung disease (lung fibrosis due to asbestos)
  • Causes dry cough and dyspnea
  • Untreatable
  • Causes restrictive lung function
  • Risk is dose dependent
  • Compensatable
29
Q

What benign asbestos-related disease can increase risk of lung cancer?

A

Asbestosis

30
Q

What are the two types of malignant asbestos-related disease?

A
  1. Pleural: mesothelioma
  2. Parenchymal: lung cancer
31
Q

Mesothelioma

A

Cancer of the pleura due to asbestos exposure

32
Q

What are some key features of mesothelioma? (5)

A
  • Pleural irregular and nodular thickening
  • Aggressive local invasion/spread
  • Exposure can be minimal yet lead to mesothelioma
  • Poor prognosis (1-1.5 years)
  • Compensatable
33
Q

What disease is caused by silica exposure?

A

Silicosis

34
Q

What contains silica?

A

Quartz, sand, granite, slate

35
Q

Silicosis can increase risk of…

A

infections
rheumatologic (autoimmune diseases)
lung cancer

36
Q

What are common exposure sources of silica?

A

Mining, tunnelling, quarrying, foundry work, crushing or drilling rock and concrete, sandblasting, masonry, concrete work, ceramics, glass manufacturing, pottery, ceramics

37
Q

“Eggshell calcifiction” is a feature of…
a) absestosis
b) silicosis

A

b) silicosis

38
Q

Describe the nodules seen on radiology in silicosis

A

Upper lobe bilateral nodules
Usually non-calcified
May cause fibrosis and cavitation

39
Q

Describe the clinical features of :
1. Simple silicosis
2. Conglomerate silicosis
3. Acute silicosis
4. Accelerated silicosis

A
  1. Simple silicosis: normal lung function, asymptomatic
  2. Conglomerate silicosis: loss of function
  3. Acute silicosis: very sick, hypoxemia
  4. Accelerated silicosis: progress rapidly
40
Q

Work related-asthma encompasses… (2)

A
  1. occupational asthma
  2. work-exacerbated asthma
41
Q

Two subtypes of occupational asthma

A
  1. Sensitizer-induced (allergic response)
  2. Irritant-induced (direct irritation)
42
Q

What are the most common causes of occupational asthma?

A

High molecular weight agents:
* Flour
* Cereal
* Animal dander
* Latex
* Crab/seafood processing
* Detergent enzymes

43
Q

Important low-molecular weight agents, common cause of occupational asthma in Quebec

A

Isocyanates (found in polyurethane, insulation, spray paint, plastic)

44
Q

What is the most common phenotype of irritant-induced occupational asthma?

A

RADS: reactive airways dysfunction syndrome

45
Q

2 examples of main RADS-inducing agents?

A

Chlorine and ozone

46
Q

What is the CNESST?

A

Paragovernmental commission funded by the province’s employers acting as a worker’s compensation board (ensures workplace safety)

BLOCK B - RESPIRATION (31 decks)

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