Upon AUSCULTATIONwith a STETHOSCOPEthe doc-
tor can hear an abnormal abrasive sound called a
pleural rub, which is the sound of the irritated
layers of the pleura rubbing against each other.
Chest X-RAYconfirms whether there is PLEURAL
EFFUSION in which the pleural cavity contains
excessive fluid. The doctor may also choose to do
an ULTRASOUNDorCOMPUTED TOMOGRAPHY(CT) SCAN
of the thorax.
Treatment targets any underlying cause, when
identified. For simple pleurisy, treatment is usually
NONSTEROIDAL ANTI-INFLAMMATORY DRUGS(NSAIDS) to
relieve inflammation and pain. The doctor may
also prescribe a cough medicine to control cough-
ing. Most people cover fully and uneventfully
from an episode of pleurisy. People who have
chronic pulmonary conditions or who smoke may
have recurrent pleurisy, which can result in long-
term thickening or scarring of the pleura.
See also BRONCHITIS; PERICARDITIS; PNEUMONITIS;
SMOKING AND HEALTH.
pneumoconiosis The collective term for pul-
monary conditions that result from occupational
exposure to dust and fiber irritants. The conditions
result in the same end-stage disease, pulmonary
fibrosis, though follow different patterns of pro-
gression, depending on the substance and exposure
patterns. The primary forms of pneumoconiosis
that occur in the United States are
- ANTHRACOSIS, also called coal worker’s pneumo-
coniosis (CWP) and black lung disease, which
results from inhalation of coal dust - ASBESTOSIS, which results from inhalation of
asbestos fibers and dust - BERYLLIOSIS, which results from inhalation of
beryllium dust - BYSSINOSIS, also called brown lung and cotton
bract disease, which results from inhalation of
raw cotton fibers and dust
•SILICOSIS, which results from inhalation of silica
dust
U.S. occupational health experts and federal
agencies began tracking and reporting deaths due
to pneumoconiosis in 1968, as data related to
occupational health. The federal Coal Mine Health
and Safety Act of 1969, which established levels of
dust exposure standards, was the first substantial
effort in the United States to reduce such deaths.
The Black Lung Act of 1972 further acknowledged
the significant occupational health problems of
coal workers, expanding the regulatory scope of
the 1969 legislation and establishing a program of
government-funded health care for coal workers
who developed anthracosis (called black lung dis-
ease in the legislation and regulations).
Federal regulation controls occupational expo-
sure to other sources of pneumoconiosis, notably
silica, as well. Health experts attribute the declining
numbers of diagnoses and deaths in all pneumoco-
nioses, except asbestosis, largely to such controls.
The number of people diagnosed with and who die
from asbestosis continues to climb, however,
because the time between exposure and illness is a
minimum of 20 years. Regulatory changes will
benefit workers who began working in affected
occupations in the last decades of the 20th century,
though health experts anticipate that asbestosis will
keep rising among those whose work history pre-
dates regulations as their average age increases.
Peak exposure to asbestos in the United States
occurred in 1975, according to the U.S. Centers for
Disease Control and Prevention (CDC), so health
experts expect asbestos-exposure related illness to
peak between 2015 and 2020. However, asbestos
exposure in general dropped significantly after the
late 1970s when federal legislation restricted the
use of asbestos in materials such as building insula-
tion, ceiling tiles, and flooring.
The other key factor contributing to diminish-
ing disease and death rates for pneumoconiosis is
the declining numbers of people working in occu-
pations where exposure is a hazard. The number
of coal miners in the United States dropped by
half between the 1980s and the 1990s, for exam-
ple, as more mining functions have become auto-
mated or mechanized. Automation continues to
reduce hazardous occupational exposures in most
industries.Symptoms and Diagnostic Path
Dry, nonproductive COUGHand DYSPNEA(shortness
of breath), particularly with exertion, are the key
symptoms of most forms of pneumoconiosis.
Anthracosis, berylliosis, byssinosis, and silicosispneumoconiosis 219