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Respiratory > Occupational lung disorders > Flashcards

Occupational lung disorders Flashcards

1
Q

What 4 types of exposure lead to occupational lung disease?

A

vapour
gases
dusts
fumes

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2
Q

What is a vapour?

A

liquid or solid substances suspended in air

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3
Q

What is dust?

A

aerosolised solid particles

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4
Q

What types of conditions result within minutes/hours of exposure?

A

direct injury eg acute irritant asthma
infection eg silicotuberculosis
allergy eg asthma, EAA

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5
Q

What types of condition result from years of exposure?

A
  1. chronic inflammation eg COPD, bronchiolitis
  2. destruction of lung tissue eg emphysema
  3. lung/pleural fibrosis
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6
Q

What type of condition takes decades to present?

A

carcinogenesis

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7
Q

What is the treatment like for historical exposure?

A

supportive - not much treatment that will impact on prognosis

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8
Q

Give an example of historical exposure

A

asbestosis

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9
Q

What can be done to prevent sb getting worse from a current exposure?

A

identify and cease exposure

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10
Q

Give examples of historical places of work with VDGF exposures

A

mines
foundry - a worksop or factory for casting metal
stone masons - making buildings, structures and sculptures from stone
silica

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11
Q

Give examples of current exposures

A

car paint spraying

baker

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12
Q

Give examples of gases that cause OLDs

A

CO
SO2
NO2

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13
Q

What type of damage to the lung is immediate?

A

direct injury by catastrophic exposure

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14
Q

What conditions are caused by catastrophic exposure?

A

EAA

acute pulmonary oedema

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15
Q

What might differ between different people who are exposed/have OLDs?

A

susceptibility
severity
reversibility
working/unemployed

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16
Q

What are the two biggest occupational lung diseases?

A

non-malignant pleural disease

mesothelioma

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17
Q

What percentage of occupational asthma is allergy at work?

A

90%

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18
Q

What percentage of all asthma is occupational?

A

9-15%

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19
Q

What are the common causes of occupational asthma in the UK?

A 
isocyanates
flour
cleaning products
wood dust
enzymes
20
Q

What happens to the PFT results if you are continuously exposed?

A

accelerated FEV1 decline

21
Q

What is the positive work effect index?

A

much worse FEV1 when at work than at the weekends

22
Q

What are the features of acute EAA?

A 
breathlessness
chesty cough
phlegm
wheezing
constitutional symptoms: weight loss, fever, flu-like symptoms, headache
23
Q

What tissue of the lung does EAA affect?

A

interstitium

24
Q

What feature defines chronic EAA?

A

fibrosis

25
Q

What type of reaction is asthma?

A

type 1 hypersensitivity

26
Q

What part of the immune system mediates EAA?

A

cell mediated immunity and humoral immunity

27
Q

What are the four main causes of EAA?

A

microorganisms
animals
vegetation
chemicals

28
Q

What is a big determinant of prognosis in OLDs?

A

recognition of exposure and cease exposure

29
Q

What percentage of COPD is occupational?

A

15%

30
Q

Give examples of exposures that can lead to COPD

A

coal
silica
grain
concrete dust

31
Q

What is the normal FEV1 decline per year for a man and a woman?

A

men - 30ml/yr

women 25ml/year

32
Q

What condition does alpha 1 antitrypsin deficiency predispose to?

A

emphysema

33
Q

Give examples of asbestos related lung disease

A 
pleural plaques
diffuse pleural thickening
asbestosis 
lung cancer 
mesothelioma
34
Q

What is asbestos?

A

naturally occurring mineral fibre

35
Q

Why was asbestos used?

A

good insulator
strong tensile strength for ropes
fire retardant

36
Q

What are pleural plaques?

A

asbestos fibres accumulate and cause deposition of collagen in the pleura, which may or may not calcify

37
Q

What is seen on a CXR in diffuse pleural thickening?

A

obliteration of the costophrenic angle

38
Q

What can diffuse pleural thickening lead to?

A

restriction of expansion
SOB
resp failure

39
Q

diffuse pleural thickening is a progressive condition. T or F

A

T

40
Q

What is asbestosis?

A

pulmonary fibrosis due to asbestos

41
Q

What increases the risk of cancer with asbestos exposure?

A

smoking

42
Q

What is mesothelioma?

A

Cancer of the pleura

43
Q

What is one cause of unexplained pleural effusion?

A

mesothelioma

44
Q

What are the symptoms of mesothelioma?

A

progressive breathlessness
chest pain
weight loss

45
Q

What is the prognosis for mesothelioma?

A

8-14 month survival

46
Q

What are the prevention strategies for OLDs?

A 
elimination
substitution
engineering controls - eg ventilation 
worker education
RPE
health surveillance

Respiratory (12 decks)

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