Occupational Lung Diseases
Hypersensitivity Pneumonitis, Asbestosis, Silicosis
Occupational Lung Diseases
Hypersensitivity Pneumonitis, Asbestosis, Silicosis
Penyaji Materi :
dr.Sinatra Gunawan,MK3,SpOk
Referensi :
Amer Rassam MD1, Gerry San
Pedro MD2, Daniel Banks MD1.
Department of Internal Medicine
LSUHSC-Shreveport
Occupational Lung Disease
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OLDs have been recognized for centuries.
Lung illness was realized to be part of
miner’s life even in the 16th century.
Governments of many countries have
implemented formal policies of workers’
compensation.
The relationship between exposure at work
and disease is underestimated.
Occupational Lung Disease
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Although OLDs are thought to be
preventable, they continue to occur.
The magnitude of the problem is
underestimated due to long latency.
Wearing protective respiratory devices is
an unrealistic expectation.
The most notorious failures of OLD have
occurred in reported epidemics of silicosis
in the American workplace.
Occupational Lung Disease
Inhaled Dusts
Occupational Lung Diseases
1. Hypersensitivity pneumonitis
2. Organic dusts (Byssinosis)
3. Inorganic dusts (Asbestosis,
Silicosis, Berylliosis, and
Coal worker’s pneumoconiosis)
Hypersensitivity pneumonitis
General
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Immune mediated granulomatous reaction
Reaction to organic antigen
Not many people get it
Poorly-formed granulomas are typical
It has a wide range of causes
Hypersensitivity pneumonitis
Causes
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Moldy hay (thermophilic actinomycetes)
“farmer’s lung”
Pet birds “bird fanciers lung”
Grain dusts
Isocyanates
Air conditioning system
Hypersensitivity pneumonitis
Clinical
• Acute, subacute, and chronic forms
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Recurrent chest infiltrates with fever & WBC
Slowly progressive pulmonary fibrosis
Diagnosis by history
Serum precipitins are non-specific
CXR – Recurrent infiltrates “fleeting”
Treatment - remove pt from offending antigen
Byssinosis
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Inhalation of cotton, flax, or hemp dust
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Frequency of symptoms slowly increases
Not immune related
Early stage - Occasional chest tightness
Late stage – Regular chest tightness
towards the end of the 1st day of the
workweek “Monday chest tightness”
Mineral Dust Pneumoconiosis
Nonfibrogenic
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Iron, Zirconium, Tin, Barium, and Aluminum
Striking CXR – Dense nodular opacities
No symptoms, physical findings, or
impairment.
Mineral Dust Pneumoconiosis
Fibrogenic
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Asbestosis
Silicosis
Berylliosis
Coal worker’s pneumoconiosis