0071643192.pdf

THORACIC AND RESPIRATORY

DISORDERS

■ CXR: Generally signs of interstitial fibrosis
■ Asbestosis: Coarse honeycombing in advanced disease; pleural
plaques
■ Silicosis:Basilar alveolar filling patternin acute silicosis; nodular
opacitiesin simple silicosis; large upper- or midzone opacitiesin
progressive massive fibrosis
■ Carbon (coal miners lung): Small, rounded opacities first seen in
the upper lobes
■ PFTs reveal reduced lung volumes, particularly vital capacity and
total lung capacity, diminished single breath DLCO, ↓compliance,
usuallyabsence of obstruction.
■ Absence of other causes of interstitial fibrosis

TREATMENT

■ Mainly prevention and supportive
■ Smoking cessation
■ Supplemental O 2 as needed
■ Pneumococcal and influenza vaccination
■ Corticosteroids may be helpful

COMPLICATIONS

■ Respiratory failure, especially with concomitant pulmonary infection
■ Cancer
■ TB in cases of silicosis

Toxic Gases, Fumes, Vapors

Chemical irritants in the form of gases, fumes, and vapors are readily
absorbed by the lung lining and can cause inflammation and edema that can
→chronic bronchitis. Toxicity depends on concentration and duration of
exposure.

TABLE 10.19. Common Pneumoconiosis

SUBSTANCE SOURCE OCCUPATIONS

Asbestos Home insulation, fireproof Construction workers, miners,

materials, tiles for floors demolition workers, ship builders,

and auto mechanics

Silicon dioxide Sand, sandstone, slate, Sandblasters, miners, tunnel

clay, granite builders, quarry workers

Carbon Coal, graphite Coal miners

Talc Talc mining and milling Miners and millers, IVDU

Kaolin Ceramics, papers, medicines, Miners and millers

(china clay) costmetics, toothpaste

Siderosis Iron Welders or silver polishers