Pneumoconiosis – Causes, Treatment, and Prevention.

Description

Pneumoconiosis is a general term given to any lung disease caused by dust that is breathed in and then deposited deep in the lungs causing damage. Pneumoconiosis is usually considered an occupational lung disease because exposure to the dust that can cause pneumoconiosis often are found in the workplace. Pneumoconiosis is mainly due to exposure to inorganic dust that is retained in the lung parenchyma and inciting fibrosis. There is no cure for pneumoconiosis, but it can be prevented with appropriate respiratory protection.

Types

Based on the exposure of chemical agent the type of Pneumoconiosis is as follows with two classifications based on the nature of the dust:

Fibrotic

• Coal dust – coal worker’s pneumoconiosis
• Silica – silicosis
• Asbestos – asbestosis
• Cotton, flax – byssinosis
• Bagasse – bagassosis
• Moldy hay – farmer’s lung

Non-fibrotic

• Tin oxide – stannosis
• Barium sulfate – baritosis
• Iron oxide – siderosis
• Beryllium – berylliosis

Pathophysiology of Pneumoconiosis

• After inhalation of dust, the alveolar macrophages converge upon extra-cellular particles and engulf them. If the number of particles is large, the elimination mechanism fails and dust containing macrophages collect in the interstitium especially in perivascular and peribronchiolar regions.
• According to the amount of dust and cell accumulation, the alveolar walls either protrude into the alveolar spaces or obliterate them.
• At the same time, a delicate supporting framework of fine reticulin fibers develops between the cells and in the case of dust with fibrogenic potential, the proliferation of collagen fibers follows.
• The dust particles are released and reingested by other macrophages.
• Some dust-laden macrophages continually migrate to lymphatics or to bronchioles where these are eliminated.
• Migration is increased by infection or edema of the lungs.

Causes

• A wide variety of organic and inorganic dust can result in pneumoconiosis and exposure is often associated with an occupational activity.
• Long-term inhalation of coal dust can result in a pneumoconiosis and is observed most frequently in coal miners.
• Long-term inhalation of silica dust can result in a pneumoconiosis and is observed most frequently in workers in the mining, sand-blasting, or stone cutting industries.
• Pneumoconiosis is mostly caused by inhalation of organic dust and results in a component of hypersensitivity pneumonitis.

Risk factors of Pneumoconiosis

• Occupational exposure to silica
• Occupational exposure to coal

Workers in the coal mine

• Occupational exposure to beryllium
• A high cumulative dose of inhaled silica or sand

The workers in the sand dust

• plumbers, roofers, and builders who work with asbestos
• textile worker
• Cigarette smoking

Symptoms

• A chronic feeling of tightness in the chest
• An increased production of mucus
• The development of a blue tint in the lips or fingernails (cyanosis)
• A cough
• Shortness of breath
• Chest pain
• Difficulty breathing
• Wheezing
• Bluish coloration of the skin
• Swelling of feet
• Liver enlargement due to heart failure
• If pneumoconiosis causes severe lung fibrosis, breathing can become extremely difficult. When this happens, the patient’s lips and fingernails may have a bluish tinge.
• In very advanced disease, there also may be signs of leg swelling caused by too much strain on the heart.

Complications of Pneumoconiosis

• Tuberculosis in almost 25% patients
• Pulmonary massive fibrosis
• Autoimmune diseases like rheumatoid arthritis and scleroderma
• Lung cancer
• Death especially in acute and accelerated silicosis
• Mesothelioma
• Cancer of the peritoneum
• Cor pulmonale

Diagnosis and test

Pneumoconiosis is diagnosed using several pieces of information:

• Your history, including the details about your symptoms and exposures.
• A physical examination
• Pulmonary function tests (breathing tests)

Potential techniques for the detection of pulmonary complications in patients with pneumoconiosis are as follows.

• Computed tomography (CT)
• Ultrasonography (US)
• Magnetic resonance imaging (MRI)

Treatment and medication

There are no specific treatments or medications for pneumoconiosis, and there is no cure.

• Most treatments for patients with pneumoconiosis are aimed at limiting further damage to the lung, decreasing symptoms and improving quality of life.
• A person who is short of breath may benefit from oxygen therapy and pulmonary rehabilitation to make activities of daily living easier and sometimes drugs to keep the airways open and free of mucus (bronchodilators).
• In rare, very severe cases, your healthcare provider may refer you for a lung transplant. You would have many tests to find out if you are healthy enough to undergo a lung transplant and if it would improve or prolong your life.
• If you are a smoker, you will be strongly advised to quit smoking. Quitting cigarette smoking (or smoking any other drugs) is very important to prevent further decline in lung function.

Prevention of Pneumoconiosis

Steps that can be taken to help prevent pneumoconiosis in the workplace include:

• Keeping levels of dust down
• Ventilating a workspace properly
• Providing regular medical examinations
• Making sure workers wear a face mask and protective clothing
• Washing hands and face before eating or drinking
• Avoid cigarette smoking
• Workers who routinely deal with mineral dust always should use approved measures (protective equipment and clothing). If a mask or respirator is worn as a protection against dust, it must fit properly and be used according to the manufacturer’s directions.
• Prevent exposure to asbestos at home – Check your house, especially if you own an older house, for areas of exposed asbestos-containing insulation or deteriorating asbestos.
• The asbestos in these areas must be removed or safely sealed away (encapsulated) professionally.