Pneumoconiosis

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Background

Pneumoconiosis is a chronic inflammatory lung disease caused by inhalation of particles, typically occupationally related, that typically results in pulmonary fibrosis and eventually restrictive lung disease.

Types based on inhaled particle

  • Asbestosis: shipping, roofing, plumbing, demolition
  • Berylliosis: aerospace, fluorescent bulbs
  • Byssinosis: cotton
  • Silicosis: foundries, sandblasting, mines
  • Coal worker's lung: coal
  • Siderosis: iron
  • Stannosis: tin

Clinical Features

  • May be asymptomatic, with normal PFTs, especially initially
  • Dyspnea
  • Crackles on exam
  • Features of restrictive and/or obstructive pulmonary dysfunction
  • If severe, clubbing, cyanosis

Differential Diagnosis

Pulmonary Fibrosis

Evaluation

Evaluate for and treat for reversible causes of symptoms or exacerbation of symptoms

  • CXR:
    • Coal workers': diffuse nodular opacities, especially prominent in upper lung
    • Silicosis: Large conglomerate densities in upper lung
    • Asbestosis: linear streaking at bases, opacities, honeycomb changes if advanced
  • CT Chest
    • Best imaging for asbestosis, can detect parenchymal fibrosis and characterize pleural plaques
  • TB testing
    • Increased incidence of TB in patients with silicosis

Management

  • Treatment is supportive

Disposition

See Also

References

  • Meyer KC. Beryllium and lung disease. Chest. Sep 1994;106(3):942-6.
  • Kreiss K, Miller F, Newman LS, Ojo-Amaize EA, Rossman MD, Saltini C. Chronic beryllium disease--from the workplace to cellular immunology, molecular immunogenetics, and back. Clin Immunol Immunopathol. May 1994;71(2):123-9.