Occupational lung disease Flashcards
Name 3 occupational airways diseases.
Occupational asthma, occupational rhinitis and occupational COPD.
Describe occupational asthma.
Can be true occupational asthma, RADS (reactive airways dysfunction syndrome) which is a direct irritation of the airways, or work aggravated asthma (trigger of existing asthma).
Who’s responsibility is management of occupational asthma?
Employer. Treat them as a normal asthma patient.
Define hypersensitivity pneumonitis.
A group of immunologically mediated diseases localised in the alveoli and distal bronchioles caused by a wide variety of organic dusts. Type 3 and 4 hypersensitivity reactions.
Give examples of hypersensitivity pneumonitis.
Farmer’s lung (thermophilic actinomycetes) and a variety of others. Can develop into progressive fibrosis.
What is silicosis?
Caused by inhalation of crystalline silicone dioxide which is highly fibrogenic and toxic to macrophages. Miners, quarrymen, stonemasons and fettlers.
What are the disease patterns of silicosis?
Acute: rare and usually fatal, progressive restriction and reduced gas transfer. Accelerated: relatively rate, occurs within 2-5 years of exposure. Simple silicosis: subtle changes on CXR and symptoms. Progressive massive fibrosis (PMF): progressive restrictive defect, no effect on airways, reduced gas transfer. Silico-tuberculosis.
What is coal workers pneumoconiosis?
If silica is in coal, causes problems. Nodular changes on CXR and symptoms of breathlessness. Progressive massive fibrosis: extensive in upper lobes and debilitating breathlessness.
What is asbestos?
Highly fibrous, naturally occurring material. Crocidolite (blue) is the most harmful.Gives materials commercially profitable properties - high strength, fire resistance etc. Disease occurs 20-40 years after exposure.
Name some asbestos-related diseases.
Pleural plaques, benign asbestos pleurisy, pleural fibrosis, asbestosis, lung cancer and mesothelioma.
Which pleural diseases are benign?
Pleural plaques, diffuse pleural thickening and benign asbestol pleurisy.
What is asbestosis?
20 year latency, progressive breathlessness and cough. Crackles and bubbling. Restricts lung function and reduced gas transfer.
What is mesothelioma?
Pleural malignancy 80% attributable to asbestos. Breathlessness and chest wall pain. Usually unilateral and causes diffuse of localised pleural thickening. Deaths expected to peak 2010-2020.
Name some causes of occupational lung and nasal cancer.
Asbestos, hexavalent chromium fumes, arsenic fumes, hardwood dust, radon gas etc.
