Occupational Lung Diseases/Exposures

Question 1

True or False: the clinical and pathologic expressions of occupational lung diseases is indistinguishable from those of non-occupational diseases

Answer 1

True. So you really have to use occupational history to find out.

Question 2

With occupational lung diseases is often a ____ between the onset of exposure and first expression of disease.

Answer 2

latency period

Question 3

It is important to consider exposure ____ when thinking about occupational lung diseases

Answer 3

dose

Question 4

What are the 3 major determinants of site and severity of occupational lung disease? know this slide well

Answer 4

1. Dose (dose = duration x concentration)
2. Solubility (more water soluble agents deposit in the upper airway and less water soluble agents deposit in the distal airways/bronchioles)
3. Particle size (greater than 10 microns are filtered in the upper airway while less than 10 microns penetrate more deeply into the lung. less than 2.5 microns may affect small airways and alveoli.)

Question 5

What questions should you ask when evaluating for occupational lung disease/exposure?

Answer 5

Where do you work?
What job titles have you had?
What were your specific job duties?
Use of PPE?
Similar symptoms in coworkers?
Description of work place and processes?

Question 6

What are the 2 general categories of occupational lung disease?

Answer 6

Airway disease and interstitial disease

Question 7

Name the 4 occupational airway diseases

Answer 7

1. Immunologic asthma (asthma w latency) - isocyanates*
2. Irritant asthma (RADS) - chemical spill*
3. Emphysema/COPD (coal mine dust/silica*)
4. Bronchiolitis (obliterative/constrictive)

Question 8

What is pneumoconiosis? (3)

Answer 8

Dust related lung disease

Asbestos-related lung disease
Silicosis
Coal miners pneumoconiosis

Question 9

When an adult without history of asthma gets asthma, what should you think?

Answer 9

Occupational and environmental causes.

Question 10

What are isocyanates?

Answer 10

Spray paint, auto body repair

Question 11

What is the big difference between occupational asthma and irritant asthma (RADS)? know this one

Answer 11

Onset of occupational asthma may be months to years after the exposure. There is a temporal pattern in the symptoms of SOB and wheezing on weekends and holidays.

RADS doesn’t have latency period. It expresses symptoms immediately or within 24-48 hours.

Question 12

True or False: exposure to isocyanates that causes asthma can be respiratory or dermal

Answer 12

True

Question 13

What is RADS?

Answer 13

Reactive airway dysfunction syndrome

Airway epithelial injury from exposure to inhalants with irritant properties, leading to persistent hyper responsiveness and airflow obstruction. This can be caused by noxious irritant gas/vapors/dusts (e.g. WTC works exposed to high pH alkaline dust), chlorine exposure

Question 14

What is the most common cause of COPD and emphysema occupationally?

Answer 14

Silica. Lung can’t clear.

Question 15

If you hear “pleural plaques” what should you think?

Answer 15

Asbestos exposure

Question 16

Silicosis has a ____ latency period

Answer 16

long

Question 17

Coal Workers pneumoconiosis has ___ latency period

Answer 17

long

Question 18

Black lung

Answer 18

Coal Worker Pneumoconiosis

Question 19

Hypersensitivity Pneumonitis

Answer 19

Think birds, animal dander, farmers

Question 20

Why not asking about presentation?

Answer 20

Bc they are all similar. The key to this lecture is concentrating on occupational and environmental history.

Question 21

Causes of silica

Answer 21

Mining, sand blasting, foundry work

Question 22

Pleural plaques

Answer 22

Asbestos

Question 23

Fibrosis

Answer 23

Silica exposure