Introduction

•Recent decades have seen a

marked increase in concern about
the adverse health effects of
hazardous exposures in the
workplace and elsewhere in the
environment

•The lung – with its extensive

surface area, high blood flow and
thin alveolar epithelium– – is an
important site of contact with
these substances in the
environment
• Occupational lung diseases are a
broad group of diagnoses caused by
the inhalation of dusts, chemicals, or
proteins

• “Pneumoconiosis” is the term used for

the diseases associated with inhaling
mineral dusts and lung reaction

• The severity of the disease is

related to the material inhaled and
the intensity and duration of the
exposure

• The incidence of the disease

increased dramatically with the
development of modern industry.
 Industrial dust
•Inorganic dust (consists of particles of
minerals and metals)
•Organic dust (contains particles of
plant and animal origin, and also
microorganisms that are on them, and their
waste products)
•Mixed dust
 Classification

1- Fibrotic pneumoconiosis
A- Major pneumoconiosis.
B- Minor pneumoconiosis.

2 - Non- fibrotic pneumoconiosis (Benign).

Pathogenesis
The effects of an inhaled agent depend on
many factors
its physical and chemical properties
the susceptibility of the exposed person
the site of deposition within the bronchial
tree
Silica Dust Exposure – Risk Factors
Any work that exposes silica
dust:
◦ mining
◦ stone cutting
◦ quarrying
◦ road and building construction
◦ work with abrasives
◦ glass manufacturing
◦ sand blasting
◦ also, some hobbies can involve
exposure to silica (sculptor,
glass blower)
Silicosis - Sandblasting
 Silicosis

 Silica is silicon dioxide, the oxide of silicon, chemical formula

SiO2

 SiO2 is the most abundant mineral on earth.

 Silicosis is lung disease caused by inhalation of free silica

dust, the dust causes inflammation and then scarring of the lungs.

 There is no effective treatment for any pneumoconiosis,

including silicosis
 Three ‘types’ of silicosis
 Simple chronic silicosis From long-term exposure (10-20
years) to low amounts of silica dust. Nodules of chronic
inflammation and scarring, provoked by the silica dust, form in
the lungs and chest lymph nodes. Patients often asymptomatic,
seen for other reasons.
 Accelerated silicosis (= PMF, progressive massive fibrosis)
Occurs after exposure to larger amounts of silica over a shorter
period of time (5-10 years). Inflammation, scarring, and
symptoms progress faster in accelerated silicosis than in simple
silicosis. Patients have symptoms, especially shortness of breath.

 Acute silicosis From short-term exposure to very large amounts

of silica dust. The lungs become very inflamed, causing severe
shortness of breath and low blood oxygen level.
 Diagnosis
(1) Occupational and environmental history –
single most helpful tool in the diagnostic workup
1. Employment details
 Job title
 Type of industry and specific work
 Name of employer
 Years employed
2. Exposure information
 General description of job process and overall
hygiene
 Materials used by worker and others
 Specific workplace exposures
 Ventilation / exhaust system
 Use of respiratory protection
 Industrial hygiene informations provided by the
employer to the employee
3. Environmental non-occupational factors
Smoking
Diet
Hobbies
4. Details about past employments in chronological
order
5. Other details
Does the patient think symptoms / problem is
related to anything at work?
Are other workers affected?
Work absenteeism
Prior pulmonary problems and medications used
Symptoms

shortness of breath while

exercising
fever
occasional bluish skin at ear lobes
or lips
fatigue
loss of appetite
(3)Physical examinations
Generally un-revealing about specific
cause
It is most helpful in periodic ex.
nonoccupational causes of respiratory
symptoms or diseases (cardiac problems
or connective tissue disorders)
(4) Investigations:
A - Chest radiography - is the most important
diagnostic test for occupational lung diseases
Note:
The chest radiographic findings can be
nonspecific.

„ „ Silicosis is a radiological diagnosis.

„ „ personal variations
ILO – International Classification of
radiographs of pneumoconiosis,1971, 2002
Small opacities (less than 1cm.)
- Regular (round): diameter
p : <1.5mm.
q : 1.5 –3mm.
r : 3 - 10mm.
- Irregular : width
p : <1.5mm.
q : 1.5 –3mm.
r : 3 - 10mm.
 2 . Profusion:
Category 0: small rounded opacities may absent,
normal bronco-vascular marking.
Category 1: small rounded opacities definitely
present but few in number, normal bronco-vascular
marking.
Category 2: small rounded opacities numerous.
Bronco-vascular marking are hesitated but still
visible.
Category 3: small or large opacities very
numerous. Bronco-vascular marking are partially or
totally obscured
 Complications:
Increases risk of tuberculosis.
Respiratory failure.
Heart failure.
Bronchogenic carcinoma.
Thanks for attention!