Occupational lung disease

occupational lung disease


Occupational asthma - Two types of OA

• OA with latency (more common)
• Immune sensitization
• LMW compounds or not IgE mediated
• Isocyanates - auto body shops; paint, upholstery, glues
• Anhydrides
• Wood dusts
• Metals
• HMW compounds or IgE mediated
• Animal Products
• Plant products
• Biologic enzymes
• OA without latency
• Non-allergic irritant mediated
• RADS (Reactive airways Dysfunction Syndrome) (high incidence in 9-11 first responders)
• Chlorine and ammonia

         peak flows in OA (days 8-10 = weekend)

Interstitial Lung Disease: 

• Pneumoconiosis
• Silicosis simple or progressive massive fibrosis (PMF)
• inc. risk for TB & lung cancer
• may occur with SLE and cause PMF = Caplan's Syndrome
• occupational exposures
• Mining
• Quarrying
• Tunneling
• Stone cutting
• Abrasive blasting
• Glass manufacture
• Ceramics
• Coal Workers Pneumoconiosis
• coal dust macule = macs filled with coal dust
• COPD common
• radiology similar to silicocic - nodules - upper lobe predominance
• Caplan's syndrome
• Asbestosis - 
  • Mining
  • Construction
  • Ship yard work
  • Automobile repair: brake linings
• Parenchymal:
• Asbestosis -late
• Lung Cancer - late
• Rounded Atelectasis
• local area of pleural thickening
• Pleural:
• Benign Asbestos Related Pleural Effusion - early
• Pleural Plaques - early or late
• Pleural Thickening
• Malignant Mesothelioma - late
• Granulomatous Diseases:
• Chronic Beryllium Lung Disease - common in NM
• Hypersensitivity Pneumonitis - 
• Most common
• • Farmers Lung (thermophilic actinomyces) - fungi in hay
  • Pigeon fanciers’ Disease (avian proteins) - feather proteins
  • Humidifier’s Lung (thermophilic actinomyces) 
  • "hot tub lung" - mycobacteria in indoor hot tubs
  • swamp cooler lung
• path = sarcoid like granulomas

Occupational Thoracic Malignancies

• Lung Cancer
• cadmium
• chromium
• radon # 1 cause of environmental cancer
• beryllium
• asbestis
• Mesothelioma