Define Pneumoconiosis and its types, sign and symptoms, diagnosis, treatment and prevention

What is the origin of the word Pneumoconiosis?

Pneumo-coni-osis; Pneumo: English word means relating to the lung, coni that stems
from the Latin word (konis) which means dust and the suffix osis.

What is Pneumoconiosis?

As we can conclude from the word origin, it is a group of diseases that affect the lung tissue as a result of breathing in certain types of dust for a prolonged time or in very large amounts which typically occurs in certain occupations that is why Pneumoconiosis is called occupational lung disease.

Chest xray of lung with pneumoconiosis
Chest xray of lung with pneumoconiosis

What are those certain types of dust?

Dust particles that known to cause pneumoconiosis might include:

Asbestos, that cause asbestosis, is a group of silicate minerals that are used in many industries as the building and construction, shipbuilding, it is also used in insulation, sound absorption, roofing, fireproofing and many others. In New York and New Jersey in the 1970s, asbestosis could be diagnosed in over than 70 percent of asbestos insulation workers with greater than 20 years of exposure.

Crystalline Silica, that causes silicosis, is very abundant mineral in the earth’s crust and in the rocks so any industry including disrupting the earth’s crust, dealing with rocks or sand containing silica puts the person at a risk. Such industries include glass, ceramics, ferrosilicon and sandblasting in metal and textile industries. It is even used in jeans manufacturing.

Carbon particles from coal or graphite inhaled from working at coal mining, synthetic graphite manufacturing and ship coaling. These particles cause coal worker’s disease which also called black lung disease.

Coal workers pneumoconiosis
coal workers pneumoconiosis x ray

Kaolin, also called china clay, that is used in ceramic, paper, medicine and cosmetics industries.

Beryllium can cause berylliosis, Beryllium is used in automotive electronics, electrical components, aircrafts engines and injection and blow mold tooling.

Iron can cause siderosis, also referred to as welder’s lung or silver polisher’s lung, the person can be exposed to iron dust in certain occupations as in mining, steel polishing, soldering, and iron rolling.

Cotton fibers can cause Byssinosis as a result of exposure and inhalation of the fibers in yarn and fabrics industries.

Although these materials are present in nature, it is their mining and commercial use that generates the toxic exposure for humans.

types of pneumoconiosis

What happens when a person breathes in such particles?

Generally, our lungs have mechanisms to clear any foreign particles or dust one can inhale. However, when these particles are inhaled in excessive amount or for prolonged periods, such mechanisms become overwhelmed and can not act as effectively as before. This leads to deposition of dust particles in the lung tissue according to its different sizes leading to inflammation and subsequently scar formation which can be limited or extensive. Such scars result in loss of the lung’s ability to expand with inhalation. In other words, the lungs become stiff as if you are blowing into a plastic bottle. Such restriction in the lungs movements is the reason why pneumoconiosis is called restrictive lung disease.

So, what is the clinical presentation of Pneumoconiosis?

It may presents without any manifestations. However, It might cause a cough with a copious amount of phlegm or dry, it also causes chest tightness, wheezing and shortness of breath. In more progressed cases, it can cause chronic bronchitis and emphysema.

How physicians diagnose Pneumoconiosis?

Besides clinical manifestations and history of exposure to any kind of dust particles that are known to cause pneumoconiosis, chest radiography (Chest X-ray, CT ) help to reach the diagnosis. Pulmonary function tests can be done and it might reveals restriction of the lung function. In certain cases physician might do Bronchoscopy which is a flexible tube is inserted into the lung and very small piece of the lung tissue is removed to be examined in the laboratory to reach a definitive diagnosis.

What are the complications of pneumoconiosis?

Pneumoconiosis comes with many serious complications as TB (Tuberculosis) especially with silicosis, Lung cancer as mesothelioma especially with Asbestosis, extensive lung fibrosis, and progressive respiratory failure, autoimmune diseases such as rheumatoid arthritis in addition to heart failure and even death. Data from the NIOSH ( National Occupational Respiratory Mortality System) indicates that 33,973 individuals had pneumoconiosis listed as either a primary or contributing cause of death in the United States between 2000 and 2014.

Any hope for a cure?

Unfortunately, there is no cure for pneumoconiosis and once it is diagnosed, the
treatment aims to preserve the remaining lung function and improve the patients’
quality of life. Such treatment includes smoking cessation in case of smoking,
prevention of any further dust exposure, usage of medications as bronchodilators to
keep the airway patent and in more severe cases oxygen therapy may be
recommended in case of impaired blood oxygenation as a result of lung tissue
destruction.

How can we prevent pneumoconiosis?

As we all know prevention is better than cure particularly when there is no available cure. The National Institute for Occupational Safety and Health (NIOSH) recommends the following to reduce exposure and prevent pneumoconiosis in workplaces:

  • Decrease dust exposure in workplaces using dust control systems and keeping them in good working order.
  • Practice good personal hygiene to avoid unnecessary exposure to work site contaminants as Washing hands and face before eating, drinking, or smoking outside dusty areas.
  • Use protective clothes at the work sites and shower and change into clean clothes before leaving the work site.
  • Use adequate respiratory protection as wearing well-fitting face masks during work
  • Have periodic medical examinations and check-up.

Pneumoconiosis not only affects the people’s life but also affects the countries’economy. Estimates of the cost of occupational diseases exceed $26 billion annually, with future costs likely higher due to ongoing exposures to toxic respirable substances in the workplace, as well as poor compliance with protective measures on the part of businesses and individual workers.

prevention and control of pneumoconiosis
Image Source:http://www.richardalois.com

What if I am already a patient with Pneumoconiosis?

There are many community resources for patients living with pneumoconiosis. The American Lung Association has Better Breathers clubs all around the country to help the patients. Patients also may be entitled to work compensation via the state workers’ compensation board. In addition, it is also advisable to lead healthier lifestyles and considering:

  1. Flu shots every year and pneumococcal vaccinations.
  2. avoidance of secondhand smoking and smoking cessation.
  3. Regular exercise and plenty of sleep.
  4. pulmonary rehabilitation programs.
  5. well-balanced diet.

Facts about pneumoconiosis:

– The global annual mortality rate ( per 100,000 people) is 4.3.
– The global annual years of healthy life lost ( per 100,000 people) is 85.3.
– Percentage of years of healthy life lost attributed to risk factors is 3.1 %.
– Worldwide, the three countries with the highest mortality rate from pneumoconiosis in 2013 were India, Nepal, and Bhutan respectively.
– In Africa, the three countries with the highest mortality rate from pneumoconiosis in 2013 were Lesotho, Madagascar, and Swaziland respectively
– In Asia, the three countries with the highest mortality rate from pneumoconiosis in 2013 were India, Nepal, and Bhutan respectively
– In Europe, the three countries with the highest mortality rate from pneumoconiosis in 2013 were Georgia, Azerbaijan, and Bulgaria respectively.
– In North America, the three countries with the highest mortality rate from pneumoconiosis in 2013 were Haiti, Belize, and Grenada respectively.
– In South America, the three countries with the highest mortality rate from pneumoconiosis in 2013 were Bolivia, Paraguay, and Peru respectively.

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