Pneumoconiosis is defined as an occupational lung disease caused by the inhalation of dust, commonly found in miners([FOOTNOTE=Kenny LC, Hurley F, Warren ND. Estimation of the risk of contracting pneumoconiosis in the UK coal mining industry. Ann Occup Hyg. 2002; 46 (suppl 1): 257-260.],[ANCHOR=],[LINK=]) and agricultural workers. While dust particles smaller than 0.5μm move freely in and out of alveoli, and particles larger than 10μm cannot make their way deep into the lungs, particles 0.5μm to 10μm in size can get lodged at the bifurcation of the distal airways.([FOOTNOTE=Fishwick, D. Pneumoconiosis, systemic and parenchymal lung diseases. Medicine. 2008; 36(5):258–261],[ANCHOR=],[LINK=]) While most inhaled dust will be removed from the lung through ciliary movement, dust within this size range can become trapped, eventually being engulfed by microphages, leading to fibrosis.
Patients with pneumoconiosis will present symptoms like shortness of breath, tightness in the chest and a chronic cough.
The disease is given different designations depending on the type of dust inhaled.
As the symptoms are like other lung diseases, setting the right diagnosis in time is extremely important. This can be made using the following information:([FOOTNOTE=Petsonk EL, Rose C, Cohen R. Coal mine dust lung disease: New lessons from old exposure. Concise Clinical Review. 2013;187(11):1178-1185.],[ANCHOR=],[LINK=])
X-ray and CT scan imaging may show nodules, areas of inflammation, cystic radiolucencies (honeycombing) and excessive fluid in pneumoconiosis patients. While invasive methods are not generally necessary in obtaining an accurate diagnosis of pneumoconiosis, such tests may be required to rule out other diagnoses.
No specific treatment exists for pneumoconiosis, thus the focus is instead on improving the patient’s quality of life by stopping progression and minimising the impact of complications. Sufferers are advised to cease smoking immediately([FOOTNOTE=Alvarez RF, Gonzalez CM, Martinez AQ, et al. Guidelines for the diagnosis and monitoring of silicosis. Arch Bronconeumol. 2015; 51(2):86-93],[ANCHOR=],[LINK=]) and seek annual influenza vaccines, as contracting the flu will seriously exacerbate the condition.
Oxygen therapy, inhalers and steroids may help to manage the condition day-to-day. Short term corticosteroid therapy may be used to treat exacerbations of the condition. In critical care patients with pneumoconiosis that are admitted to the ICU for their first episode of acute respiratory failure, might require non-invasive mechanical ventilation.