22- OCCUPATIONAL LUNG DISEASE

• Asbestosis

  Prolonged inhalation of asbestos dust leads to lung parenchymal fibrosis
• Asbestosis

  • Usually presents 15-20 years after initial exposure
  • Diagnosed by clear history of occupational exposure (builders, plumbers, shipyard workers) and typical CXR appearance (pleural thickening & diaphragmatic calcification)
  • Confirmed by HRCT
  • May lead to pleural effusion, pleural thickening, mesothelioma, lung adenocarcinoma
• Silicosis


  Caused by inhalation of silica dust (mining, glass & pottery making, sandblasting)
• Silicosis

  • Similar to asbestosis, but may have an acute form caused by massive exposure that causes lung failure in months
• Coal worker's pneumoconiosis

  • Starts as simple coal worker's pneumoconiosis with small pulmonary nodules
  • Small coal particles reach acinus, initiate inflammatory reaction and subsequent fibrosis
  • Continued exposure leads to progressive massive fibrosis with large fibrotic masses (1-10cm)
• Coal worker's pneumoconiosis

  • May progress even after exposure to coal has ceased
  • Symptoms are breathlessness and cough productive of black sputum
  • May lead to respiratory failure