Pneumoconiosis
Etiology:
Pneumoconiosis is a fibronodular lung disease. The patient is affected when they inhale any but most commonly, silica or coal dust. The same can be said for the inhalation of graphite, tin, chromate, barium, and iron dusts. It is common in miners or people who work in carbon black and carbon electrode manufacturing. The substances collect in the alveoli or air sacs in the lung. Silica particles outlive the alveolar macrophages that ingest them, thereby continuing the cycle of injury.
Signs and Symptoms:
The walls of air sacs are inflamed. The lung stiffens from scarring on tissue. They are affected by chronic coughing and shortness of breath. Overtime as coal settles, lung hardens. The substances can scar delicate lung tissue and contribute to a build up of fluid in the lungs which can be very dangerous to the sufferer. Physical signs are often unremarkable if any. Other symptoms include:
- Tightness in the chest
- Shortness of
breath - Cough
- Wheezing
- Respiratory
problems - Breathlessness
- Weight
loss - Fatigue
- Cyanosis
- Bronchitis
- Emphysema
Pathology:
- cor pulmonale (failure of right side of heart)
- lung cancer
- pulmonary tuberculosis
respiratory failure - likely to develop progressive massive fibrosis (PMF).
The disease starts off slowly, and can only occur with constant exposure to silica, asbestos, or carbon which is why it is seen so often in miners. It doesn't always have to be occupational in origin, in fact city-dwellers have an increased chance of developing some form of the disease due to all of the dust particles found in the atmosphere of an urban environment. As the disease progresses, the patient might not realize there is a problem until the amount of coal reaches critically high levels to the point that the patient is extremely sick. This disease causes plaque to form in the lungs over time which stimulates symptoms extremely similar to that of a smoker. It becomes harder to breath due to complications in gas exchange which impairs the respiratory system.
Treatment:
- No treatment
- Can treat symptoms and complications
- Can be prevented by wearing masks when working around coal
- DON’T SMOKE!
- Workers are supposed to wear masks and follow standards set by Occupational Safety and Health Administration (OSHA)
Health Care Professionals Who Can Help:
Pulmonologists, a sub-specialty of internal medicine, treat the respiratory system, including the lungs. Because of the critical nature of the respiratory system, pulmonologists work in hospitals as well as in private practice. A pulmonologist must first be certified by the American Board of Internal Medicine and then obtain additional training in the sub-specialty. They determine the disease by the use of:
- chest x-rays
- occupational history
- pulmonary function tests
Additional Facts:
- Coal worker’s pneumoconiosis (CWP) simple
- Progressive massive fibrosis (PMF) complicated
- Most of the workers suffering from pneumoconiosis are over 50 years of age.
- Approximately 6 out of 100,000 people suffer from a form of pneumoconiosis
A lung that has been affected with pneumoconiosis differs from a healthy lung by many attributing factors. For example, a healthy lung has the appropriate amount of fluid between the two pleura. However, a lung affected by pneumoconiosis, fluid builds up in order to compensate for the coal dust that can dry up the lungs. This can be a painful experience for the patient. Other complications can occur along with this disease, including mesothelioma, which is associated with hardening of the lungs, as well as lung cancer. The chances of developing lung cancer can increase by tenfold within those whom have already been diagnosed with pneumoconiosis. The gas exchange rate lowers dramatically, making it more difficult to breathe, leading to either emphysema or respiratory distress syndrome.