Occupational Lung Diseases Hypersensitivity Pneumonitis, Asbestosis, Silicosis

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• Occupational Lung Diseases Hypersensitivity
  Pneumonitis, Asbestosis, Silicosis

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Occupational Lung Diseases Hypersensitivity
Pneumonitis, Asbestosis, Silicosis

• Penyaji Materi
• dr.Sinatra Gunawan,MK3,SpOk
• Referensi
• Amer Rassam MD1, Gerry San Pedro MD2, Daniel
  Banks MD1.
• Department of Internal Medicine
• LSUHSC-Shreveport

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Occupational Lung Disease

• OLDs have been recognized for centuries.
• Lung illness was realized to be part of miners
  life even in the 16th century.
• Governments of many countries have implemented
  formal policies of workers compensation.
• The relationship between exposure at work and
  disease is underestimated.

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Occupational Lung Disease

• Although OLDs are thought to be preventable, they
  continue to occur.
• The magnitude of the problem is underestimated
  due to long latency.
• Wearing protective respiratory devices is an
  unrealistic expectation.
• The most notorious failures of OLD have occurred
  in reported epidemics of silicosis in the
  American workplace.

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Occupational Lung Disease Inhaled Dusts
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Occupational Lung Diseases

• Hypersensitivity pneumonitis
• Organic dusts (Byssinosis)
• Inorganic dusts (Asbestosis,
• Silicosis, Berylliosis, and
• Coal workers pneumoconiosis)

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Hypersensitivity pneumonitis
General

• Immune mediated granulomatous reaction
• Reaction to organic antigen
• Not many people get it
• Poorly-formed granulomas are typical
• It has a wide range of causes

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Hypersensitivity pneumonitis
Causes

• Moldy hay (thermophilic actinomycetes)
  farmers lung
• Pet birds bird fanciers lung
• Grain dusts
• Isocyanates
• Air conditioning system

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Hypersensitivity pneumonitis
Clinical

• Acute, subacute, and chronic forms
• Recurrent chest infiltrates with fever WBC
• Slowly progressive pulmonary fibrosis
• Diagnosis by history
• Serum precipitins are non-specific
• CXR Recurrent infiltrates fleeting
• Treatment - remove pt from offending antigen

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Byssinosis

• Inhalation of cotton, flax, or hemp dust
• Not immune related
• Early stage - Occasional chest tightness
• Late stage Regular chest tightness towards
  the end of the 1st day of the workweek Monday
  chest tightness
• Frequency of symptoms slowly increases

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Mineral Dust Pneumoconiosis
Nonfibrogenic

• Iron, Zirconium, Tin, Barium, and Aluminum
• Striking CXR Dense nodular opacities
• No symptoms, physical findings, or impairment.

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Mineral Dust Pneumoconiosis
Fibrogenic

1. Asbestosis
2. Silicosis
3. Berylliosis
4. Coal workers pneumoconiosis