Overview

• Result of long term exposure to irritants being breathed into the lungs.
• Coal Workers’ Pneuomoconiosis
  • Coal Miners ⇒ diagnosis usually 15-20 years after initial exposure to coal dust
  • Simple Pneumoconiosis → patients are often asymptomatic. Increases risk of lung diseases of COPD. May lead to progressive massive fibrosis.
  • Progressive Massive Fibrosis → considerable exertional dyspnoea and cough +/- black sputum. Most common in upper lobes.
  • Investigations ⇒ CXR (upper zone fibrosis) and Spirometry (restrictive pattern).
• Silica
  • Silicosis → dyspnoea and cough. Fibrotic lung disease caused by inhalation of silica. Risk factor for developing TB.
  • Stonemason, Pottery, Ceramics
  • ‘Egg Shell’ calcification of hilar lymph nodes on CXR
  • Risk factor for developing TB
• Asbestos → asbestosis and mesothelioma
  • Mesothelioma ⇒ progressive SOB, chest pain, pleural effusion. Malignant disease of the pleura.

Making Diagnosis

Clinical Features:

• Insidious onset SOB
• Dry Cough
• Black Sputum → in coalworkers pneumoconiosis
• Pleuritic Chest Pain → due to acute asbestos pleurisy

Investigations:

• CXR
• CT Scan
• Pulmonary Function Tests (spirometry) → restrictive pattern