Pneumoconiosis

Pneumoconiosis

- restrictive occupational lung disease resulting from anorganic dust

inhalation

-> dependent on the type of dust the name changes

-> occupational because -> exposure mostly at workplaces

epidemiology:

- 2013: 260.000 deaths globally

-> 46.000 silicosis

-> 25.000 anthracosis

-> 24.000 asbestosis

pathogenesis taking asbestosis as example:

asbestosis in Germany

not so physiological lung tissue

asbestos induced pleural plague

physiological lung tissue

Ferruginous

bodies

extensive

restrictive

fibrosis

alveolar

m/ph

(s. dust cell)

anthracosis

or

smoker

fibroblasts

(?)

-> asbestos (< 3 diameter

> 5 length)

types of pneumoconiosis:

1.) active pneumoconiosis (causing symptoms/malignant)

- asbestosis - asbest dust (builders & other asbest proc. workers)

- silicosis - silica dust (mine workers)

- anthracosis - coal dust (coal workers)

- aluminosis - aluminium dust (aluminium proc. workers)

- bauxite pneumoconiosis - bauxite dust (bauxite proc. workers)

- berylliosis - beryllium dust (beryllium proc. workers)

- byssinosis - cotton dust (cotton proc. workers)

2.) passive/inert pneumoconiosis (no symptoms/benign)

- siderosis - iron dust

- stannosis - tin oxide

- 500.000 workers are registered to be at risk for developing asbestosis

-> actual number might be x2

- asbestos induced cancers -> most common cancers of occupational

origin

-> due to latency of developing a mesothelioma (15-50y)

-> peak of disease in 2020

0.) starting to work without

appropriate PPE

1.) asbestos fibers are inhalted

at work over months - years

2.) deposition of fibers in

specific regions of the

lung tissue

-> mucociliary apparatus ''collapse''

-> first terminal bronchioles later also alveolar walls

3.) initiation of chronic fibrotic immune reaction

-> degradation incapability of asbestos fibers by m/ph

4.) pleurotropicity

-> tendency of fibers to move towards pleura into the

subpleural space -> building of plagues

5.) pathological properties: - fibrinogenic effect

-> restrictive lung disease

- carcinogenic effect

-> mesothelioma, lung carcinoma

larynx carcinoma

Thank you!

Were doing asbestos we can!

symptoms:

- only in advanced cases

-> triad: 1.) dyspnoea

2.) alveolar crackles during auscultation

(fibrotic alveolar septa -> increased surface

tension -> early collapse during inhalation)

3.) fibrotic lung tissue during X-Ray

diagnose:

- anamnesis

- X-Ray

- restrictive form spirogram

- Bronchoscopy w. histologic biopsy -> Ferruginous/asbestos

bodies

- BAL (bronchoalveolar lavage) -> asbestos

treatment:

- none- (only symptomatic or of neoplastic complications)

prevention:

- primary: - prohibition of using asbestos as building material

- secondary: - use of appropriate PPE