Occupational Lung Diseases
Dr. Mohamed seyam phd. Pt.
Assistant professor of physical therapy
Types OF Occupational Lung Diseases
Depending upon the type of dust, the disease is given different names:
1. Coalworker's pneumoconiosis (also known as miner's lung, black lung or anthracosis)
— coal, carbon
2. Asbestosis — asbestos
3. Silicosis (also known as "grinder's disease" or Potter's rot) — silica
4. Bauxite fibrosis — bauxite
5. Berylliosis — beryllium
6. Siderosis — iron
7. Byssinosis — cotton known as (brown lung)
8. Silicosiderosis — mixed dust containing silica and iron
9. Labrador lung (found in miners in Labrador, Canada) — mixed dust containing iron,
silica and anthophyllite, a type of asbestos
10. Stannosis — tin oxide
Pneumoconiosis
Pneumoconiosis is an occupational lung disease and a restrictive
lung disease caused by the inhalation of dust, often in mines.
The term is currently defined by the International Labor
Organization (ILO) as the accumulation of dust in the lungs and
the tissue reactions to its presence;
tissue reaction may be non-collagenous (minimal stromal
reaction) or collagenous (when scarring is permanent).
Diagnosis
Positive indications on patient assessment:
1. Shortness of breath
2. Chest X-ray may show a characteristic patchy, subpleural,
bibasilar interstitial infiltrates or small cystic radiolucencies
called honeycombing.
3. Pneumoconiosis in combination with multiple pulmonary
rheumatoid nodules in rheumatoid arthritis patients is known
as Caplan's syndrome
1) Asbestosis
Asbestosis is a chronic inflammatory and fibrotic medical
condition affecting the parenchymal tissue of the lungs
caused by the inhalation and retention of asbestos fibers.
A very fibrogenic dust, that causes
1. pulmonary fibrosis
2. pleural plaques,
3. benign pleural effusions
4. carcinoma of the lung
It usually occurs after high intensity and/or long-term exposure
to asbestos (particularly in those individuals working on the
production or end-use of products containing asbestos) and is
therefore regarded as an occupational lung disease.
People with extensive occupational exposure to the mining,
manufacturing, handling, or removal of asbestos are at risk of
developing asbestosis.
Sufferers may experience severe dyspnea (shortness of breath)
and are at an increased risk for certain malignancies, including
lung cancer but especially mesothelioma.
Asbestosis specifically refers to interstitial (parenchymal) fibrosis
from asbestos, and not pleural fibrosis or plaquing.
2) Silicosis
Simple Silicosis: small nodules, predominately upper lobes;
patient often asymptomatic
Complicated Silicosis (Progressive Massive Fibrosis): coalescence
into large nodules or masses with retraction of upper lobes
Tuberculosis is a common complication
Silicosis is a form of occupational lung disease caused by inhalation
of crystalline silica dust, and is marked by inflammation and scarring
in the form of nodular lesions in the upper lobes of the lungs.
It is a type of pneumoconiosis.
Silicosis (particularly the acute form) is characterized by shortness
of breath, cough, fever, and cyanosis (bluish skin).
 It may often be misdiagnosed as pulmonary edema (fluid in the
lungs), pneumonia, or tuberculosis.
Because chronic silicosis is slow to develop, signs and symptoms may not appear until years
after exposure.
Signs and symptoms include:
1.
2.
3.
4.
5.
6.
7.
8.
Dyspnea (shortness of breath) exacerbated by exertion
Cough, often persistent and sometimes severe
Fatigue
Tachypnea (rapid breathing) which is often labored
Loss of appetite and weight loss
Chest pain
Fever
Gradual dark shallow rifts in nails eventually leading to cracks as protein fibers within nail
beds are destroyed.
In advanced cases, the following may also occur:
1. Cyanosis (blue skin)
2. Cor pulmonale (right ventricle heart disease)
3. Respiratory insufficiency
3) Byssinosis
Byssinosis, also called "brown lung disease" or "Monday fever",
It is an occupational lung disease caused by exposure to cotton dust
in inadequately ventilated working environments.
Byssinosis commonly occurs in workers who are employed in yarn
and fabric manufacture industries.
It is now thought that the cotton dust directly causes the disease and
some believe that the causative agents are endotoxins that come
from the cell walls of gram negative bacteria that grow on the
cotton.
symptoms
1.
2.
3.
4.
5.
Breathing difficulties
Chest tightness
Wheezing
Cough
Brown lung can ultimately result in narrowing of the airways,
lung scarring and death from infection or respiratory failure.
4) Coal Worker’s
Coal dust is inert and not particularly fibrogenic.
Can cause industrial bronchitis, emphysema, and progressive
massive fibrosis.
Xray looks worse than patient
Many symptomatic coal miners have silicosis or tobacco
induced COPD
TREATMENT
Oxygen therapy at home is often necessary to relieve the shortness of breath and correct
underlying hypoxia.
Physica therapy inform of respiratory physiotherapy to remove secretions
from the lungs by postural drainage, chest percussion, and vibration.
Nebulized medications may be prescribed in order to loosen secretions or treat underlying
Chronic Obstructive Pulmonary Disease.
Immunization against pneumococcal pneumonia and annual influenza vaccination is
administered due to increased sensitivity to the diseases.
Patients are at increased risk for certain malignancies.
If the patient smokes, cessation reduces further damage.
Periodic PFTs, chest x-rays, and clinical evaluations, including cancer screening/evaluations,
are given to detect additional hazards.
PHYSIOTHERAPY TO INCREASE LUNG VOLUME
1. Controlled mobilization
2. Positioning
3. Breathing exercises
• Deep breathing
• End-inspiratory hold
• Abdominal breathing
• Sniff
• Neurophysiological facilitation
4. Mechanical aids to increase lung volume
• Incentive spirometry
• Continuous positive airway pressure
• Intermittent positive pressure breathing
PHYSIOTHERAPY TO REDUCE THE WORK OF BREATHING
1.
2.
3.
4.
SLEEP AND REST
POSITIONING
RELAXATION
BREATHING RE-EDUCATION
POSITIONING
High side-lying
Sitting upright in a chair with supporte arms; for many patients, it is easier to Breathe in
this position than in bed. Some like to lean back for support, others prefer to lean
slightly forward to put some stretch on the diaphragm.
Sitting leaning forward from the waist, arms resting on pillows on a table, feet on the
floor
Standing relaxed, leaning forwards with arms resting on a support such as a window sill.
Standing relaxed, leaning back against a wall with legs slightly apart.
Standing relaxed leaning sideways against a wall, arms in pockets if support is needed
for the accessory muscles.
Occasionally, lying flat is beneficial because of pressure from the abdominal contents
against the diaphragm.
PHYSIOTHERAPY TO CLEAR SECRETIONS
5. Mechanical aids
1. Hydration and
humidification
• Positive expiratory pressure(PEP)
• Flutter
2. Postural drainage
•
Cornet
3. Manual techniques
• Percussors, vibrators and oscillators
4. Breathing techniques • Intermittent positive pressure
breathing(IPPB).
• Active cycle of
breathing
• Autogenic drainage