Pneumoconiosis Flashcards
Define pneumoconiosis
Fibrosing interstitial lung disease caused by chronic inhalation of mineral dusts.
Types:
Simple: Coalworker’s penumoconiosis or silicosis or black lung disease (symptom-free)
Complicated: pneumoconiosis results in loss of lung fx
Asbestosis: pneumoconiosis in which diffue parenchymal fibrosis occurs due to prolonged asbestos exposure
Talcosis, siderosis…
Explain the aetiology/risk factors of pneumoconiosis
Caused by inhalation of particles of coal dust, silica, asbestos. These activate cytokines which turn fibroblasts into myofibroblasts resulting in scarring and fibrosis.
Risk factors:
- smoking
- TB
- exposure to particles: power plants, construction, demolition, sandblasting, plumbers, ship builders, steel foundries, stone cutting, quarrying)
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Sumarise the epidemiology of pneumoconiosis
Incidence increasing in dev countries
Prevalence increasing
Disability and mortality from asbestos will increase for 20-30 y
Middle aged ~50yo
Recognise the presenting symptoms of pneumoconiosis
Asymptomatic
Symptomatic:
- dry cough
- insidious SOBOE
- black sputum in coalworkers - melanoptysis
- pleuritic chest pain due to acute asbestos pleurisy
Recognise the presenting signs of pneumoconiosis
Examination may be NORMAL
Coalworkers and silicosis:
- decreased BS
- ±wheeze and prolonged exp in concomitant COPD
Asbestosis: end-inspiratory creps, clubbing, signs of pleural effusion or RHF, cor pulmonale
Progressive-advanced: barrel chest, cyanosis, WT, dull on percussion due to fibrosis
Identify the appropriate investigations for pneumoconiosis
CXR:
- simple: micronodular mottling
- complicated: nodular opacities upper lobes, micronodular shadowing, eggshell calcification (silicosis), bilateral lower zone reticulonodular shadow and pleural plaques (asbestosis)
CT: early fibrotic changes
Bronchoscopy + BAL
Lung fx tests: restrictive pattern
