Pneumoconiosis
Pneumoconiosis | |
---|---|
ferruginous bodies), a type of pneumoconiosis. H&E stain. | |
Specialty | Pulmonology |
Pneumoconiosis is the general term for a class of
Types
Depending upon the type of dust, the disease is given different names:
- Aluminosis – Aluminium
- Asbestosis – asbestos
- crystalline silica dust
- Bauxite fibrosis – bauxite
- Berylliosis – beryllium
- Siderosis – iron
- Byssinosis – Byssinosis is caused by cotton dust inhalation and typically demonstrates a different pattern of lung abnormalities from most other pneumoconiosis.[1]
- stonecutting
- Silicosiderosis (also sometimes called iron miner's lung[10]) – mixed dust containing silica and iron[11]
- Labrador lung (found in miners in Labrador, Canada) – mixed dust containing iron, silica and anthophyllite, a type of asbestos
- Stannosis – tin oxide
- Talcosis – talc
- Baritosis - a benign type of pneumoconiosis caused by barium inhalation; it typically causes little or no overgrowth, hardening, and/or fibrosis.[12]
- Mixed-dust pneumoconiosis[1]
Pathogenesis
The reaction of the lung to mineral dusts depends on many variables, including size, shape, solubility, and reactivity of the particles.[13] For example, particles greater than 5 to 10 μm are unlikely to reach distal airways, whereas particles smaller than 0.5 μm move into and out of alveoli, often without substantial deposition and injury.[14] Particles that are 1 to 5 μm in diameter are the most dangerous, because they lodge at the bifurcation of the distal airways. Coal dust is relatively inert, and large amounts must be deposited in the lungs before lung disease is clinically detectable. Silica, asbestos, and beryllium are more reactive than coal dust, resulting in fibrotic reactions at lower concentrations. Most inhaled dust is entrapped in the mucus blanket and rapidly removed from the lung by ciliary movement. However, some of the particles become stuck at alveolar duct bifurcations, where macrophages accumulate and engulf the trapped particulates. The pulmonary alveolar macrophage is a key cellular element in the initiation and perpetuation of lung injury and fibrosis. Many particles activate the inflammasome and induce IL-1 production. The more reactive particles trigger the macrophages to release a number of products that mediate an inflammatory response and initiate fibroblast proliferation and collagen deposition. Some of the inhaled particles may reach the lymphatics either by direct drainage or within migrating macrophages and thereby initiate an immune response to components of the particulates and/or to self-proteins that are modified by the particles. This then leads to an amplification and extension of the local reaction. Tobacco smoking worsens the effects of all inhaled mineral dusts, more so with asbestos than with any other particle.[7]
Diagnosis
Typical indications on patient assessment include:[15]
- Cough
- Shortness of breath
- Chest tightness
- Chest X-ray may show a characteristic patchy, subpleural, bibasilar interstitial infiltrates or small cystic
Pneumoconiosis in combination with multiple pulmonary
Epidemiology
The prevalence as of 2021 of pneumoconiosis is around 527,500 cases, with over 60,000 new patients reported globally in 2017. Prevalence has trended somewhat downward since 2015.[2] The mortality of pneumoconiosis patients remained at a high level in recent years, with over 21,000 deaths each year since 2015.[2] It is likely that pneumoconiosis is under-diagnosed and under-reported, especially in countries without highly developed healthcare systems.[2]
Treatment and Prognosis
Lung damage due to pneumoconiosis cannot be reversed.[22] However, some steps can slow down disease progression and relieve symptoms. These include the prescription of medications and breathing treatments to open airways and reduce inflammation.[22] Pulmonary rehabilitation and supplemental oxygen may also be recommended.[22] A lung transplant may be needed in cases of serious diseases. If the patient smokes, smoking cessation is also important.[22] Regular testing, such as X-rays or lung function tests, may be indicated to monitor disease progression.
Prevention
To reduce the likelihood of developing pneumoconiosis, individuals working in affected industries should wear a mask, wash skin that comes in contact with dust, remove dust from clothing and wash the face and hands before eating or drinking.[22] In addition, governments often regulate industry, especially mines, to limit how much dust is in the air.[23] In the United States, coal miners injured by pneumoconiosis and their families may receive monthly payments and medical benefits under the Black Lung Benefits Act.[24]
See also
- Aluminosis
- Black Lung Benefits Act of 1972
- Chalicosis
- Philip D'Arcy Hart
- Pneumonoultramicroscopicsilicovolcanoconiosis
- Popcorn workers' lung disease — diacetyl emissions and airborne dust from butter flavorings used in microwave popcorn production
References
- ^ a b c d "Pneumoconioses | NIOSH | CDC". www.cdc.gov. 2022-03-21. Retrieved 2022-04-01.
- ^ PMID 33879753.
- PMID 32310362, retrieved 2022-04-01
- PMID 15355871.
- PMID 31302880.
- ^ Shih, Gerry (15 December 2019). "They built a Chinese boomtown. It left them dying of lung disease with nowhere to turn". New York Times. Retrieved 16 December 2019.
- ^ ISBN 978-1-4377-1781-5.)
{{cite book}}
: CS1 maint: multiple names: authors list (link - PMID 19590695.
- ^ DeLight, Navina (2020). Pneumoconiosis. StatPearls.
- ^ "Silicosiderosis". NORD (National Organization for Rare Disorders). Retrieved 2022-04-01.
- ^ "Silicosiderosis | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program". rarediseases.info.nih.gov. Retrieved 2022-04-01.
- ^ "Baritosis | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program". rarediseases.info.nih.gov. Retrieved 2022-04-01.
- PMID 10741774.
- PMID 3060352.
- ^ "Diagnosing and Treating Pneumoconiosis". www.lung.org. Retrieved 2022-04-01.
- PMID 16418244.
- PMID 12405491.
- PMID 21427324.
- PMID 33689008.
- ^ Andreoli, Thomas, ed. CECIL Essentials of Medicine. Saunders: Pennsylvania, 2004. p. 737.
- ^ "Rheumatoid pneumoconiosis: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 2022-04-01.
- ^ a b c d e "Pneumoconiosis Symptoms, Causes and Risk Factors". www.lung.org. Retrieved 2022-04-01.
- ^ Office, U. S. Government Accountability. "Mine Safety: Reports and Key Studies Support the Scientific Conclusions Underlying the Proposed Exposure Limit for Respirable Coal Mine Dust". www.gao.gov. Retrieved 2022-04-01.
- ^ "General | U.S. Department of Labor". www.dol.gov. Retrieved 2022-04-01.
Further reading
- Cochrane, A.L.; Blythe, M. (1989). One Man's Medicine, an autobiography of Professor Archie Cochrane. London: BMJ Books. ISBN 0954088433.
External links
- "Pneumoconioses". NIOSH Safety and Health Topic. Center for Disease Control. 30 March 2022.
- "Black Lung Benefits Act". U.S. Department of Labor. Archived from the original on 2010-05-27. Retrieved 2007-03-02.
- Coal Workers' Pneumoconiosis at Merck Manual of Diagnosis and Therapy Professional Edition
- Black Lung — United Mine Workers of America
- "Black Lung" (PDF). U.S. Department of Labor Mine Safety and Health Administration. Archived from the original (PDF) on 2010-05-30.
- A Conversation about Mining and Black Lung Disease
- Flavorings-Related Lung Disease Archived 2010-08-29 at the Wayback Machine
- The Institute of Occupational Medicine and its research into pneumocomiosis
- Miller, B.G.; Kinnear, A.G. Pneumoconiosis in coalminers and exposure to dust of variable quartz content (PDF) (Technical report). Institute of Occupational Medicine. TM/88/17.