Introduction
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History and exposure assessment
Laboratory tests
Determinants of inhalational exposure
Occupational exposures and pulmonary disease
Asbestos-related diseases ???
- ???(???), ??? ????, ???
- Related disease
- Pleural effusions and pleural plaques
- Progressive pulmonary fibrosis
- Most predominant in the lower lobes and by the presence of asbestos bodies
- Bronchogenic carcinoma
- M/c malignancy. Asbestos exposure alone increases the risk by ~6-fold
- ??? additional 10-fold risk increase
- Malignant mesothelioma
- Clinical features
- ? ? ???? crepitation, ??????, ????, ????
- Histology
- Sputum? papanicolau stain – asbestos body ??
- Ferruginous bodies are believed to be formed by macrophages that have phagocytosed and attempted to digest the fibers.
- No specific treatment, Vaccination
Silicosis ???
- ???, ???, ??, ??????
- ?? ?? ??? progressive pulmonary fibrosis ??. ??????.
- ???, ??? ?. ???, ??? ?? ??. ??, ??? ??.
- CXR
- Egg shell type calcification of hilar nodes (20%)
- Histology
- Birefringent silicate particles within dense, whorled collagenous nodules surrounded by dust-laden macrophages.
- No specific Tx, Vaccination
Coal worker’s pneumoconiosis (CWP)
- ?? ??
- CXR
- Small irregular opacities. ???? pulmonary fibrosis? ??.
- Histology
- From nodal, perilymphatic lung tissue.
- Carbon-laden macrophages (black intracytoplasmic aggregates)
- ??? ??! O2,??? ???? ????.
Chronic beryllium disease
- Beryllium is used in the aerospace manufacturing and nuclear weapon industries.
- CXR
- Pulmonary berylliosis closely resembles sarcoidosis
- Ill-defined nodular infiltrates, enlarged lymph nodes
- Histology
- Noncaseating granuloma
Other metals
Other inorganic dusts
Organic dusts ?????-???
- ??? byssinosis
- Monday morning cough.
- Obstructive pattern
- ????, ????(tar), ??????
- ????? Welder’s lung
- ??? ??? ?? ??.
- ????? ?? ???? ???? ??
Toxic chemicals
Petroleum processing – exposure to sulfur oxides, aromatic hydrocarbons – occupational asthma
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