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Why Pneumoconiosis?

“In epidemiologic studies, the dust burden in the lung can be assessed only indirectly. However, at an
individual level, exposure can be estimated more directly from the job history, from the engineering
history of the plant, including the efficiency of dust control, and from environmental measurements.”

“there may be heavily exposed individuals who remain unaffected and lightly exposed individuals with
disease. a clinician should not reject the diagnosis of pneumoconiosis solely on the grounds that
exposure was too remote, too short, or in a workplace where the threshold limit value was maintained.”

**hanggang dito lang iyong restricted sa “pneumoconiosis” since under nman iyong silicosis, coal
worker’s etc etc dito.

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OTHER BASES

1. SILICOSIS:

WHY SILICOSIS:

 History of exposure
 Latency of 10 to 20 years is common
 Patients have high risk for COPD, Chronic bronchitis, TB, and Lung Ca

RADIOGRAPHIC/DIAGNOSTIC FEATURES:

 Radiologic features may be UNUSUAL:


o Hilar lymphadenopathy
o Large lung opacities
o Absence of typical small nodules
 Detection of silica in BAL (bronchioalveolar leverage?)
 LUNG BIOPSY to distinguish progressive massive fibrosis or other atypical features from lung
cancer, TB, and other diagnoses
o May also detect SILICA
 Eggshell calcification is suggestive but not pathognomonic

WHY NOT:

 Chest pain is not a feature of silicosis nor are systemic symptoms such as fever and weight loss,
which should be attributed to tuberculosis or lung cancer until proved otherwise.

2. CWP
 Coexistent silicosis is common among workers in coal mines where thin coal seams are
separated by silica-containing rock
 Usually asymptomatic;

RADIOGRAPHIC/DIAGNOSTIC FEATURES:
 chest radiograph resembles silicosis
o small round opacities in lung parenchyma
 CT
o Small round opacities first in upper zones and other zones at late stage
 Eggshell calcification is abnormal

WHY NOT:

 No history of coal minig; silica may coexist with CWP but is not the primary role of causation for
CWP
 Mucus hypersecretion is common in coal workers but doesn’t play a role in COPD. Resolves after
withdrawal from dust exposure