Internal Medicine

0521779407-16 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:18

Occupational Pulmonary Disease 1081

➣acute HP

pneumonia, bronchitis

➣chronic HP

pneumoconioses

other interstitial lung diseases

management

Occupational Asthma

■Environmental

➣avoidance of exposure single most critical element

➣avoidance can have significant financial impact (job change) so

accurate diagnosis is important

■Clinical management

➣supplemental to exposure management

➣treat as for nonoccupational asthma

➣follow with spirometry

Pneumoconioses

■No effective treatment for any pneumoconiosis

■Asbestosis:

➣Environmental

minimize future exposure

➣Clinical

smoking cessation

cardiopulmonary rehabilitation

screen for mesothelioma

follow periodically

■Silicosis:

➣Environmental

minimize future exposure

➣Clinical

cardiopulmonary rehabilitation

screen for TB

follow periodically

■Coal workers pneumoconiosis:

➣Environmental

minimize future exposure (change jobs)

➣Clinical

cardiopulmonary rehabilitation

follow periodically