Alerts and Notices
SynopsisPneumoconiosis refers to a group of occupational lung diseases caused by inhalation of organic or inorganic dust particles that cause lung damage. In some cases, the inhaled particles are inert, and while they may be radiographically evident and alarming, they may not cause clinical disease or impair lung function. Other particles, such as asbestos and crystalline silica, are fibrogenic and cause inflammation and subsequent fibrosis with resultant symptoms and lung function impairment.
The primary cause is work-related exposure where dust particles are more likely to be encountered; rarely, environmental exposures cause the disease. Usually, the disease will manifest chronically, taking a decade or more to develop. In some cases, such as silicosis, the disease may develop and manifest itself rapidly and acutely after a short period of severe exposure. Research indicates that smokers may be at increased risk.
Pneumoconiosis includes, but is not limited to, asbestosis, silicosis, berylliosis, talcosis, byssinosis (brown lung disease), vineyard sprayer's lung disease, hard metal pneumoconiosis, flock worker's lung disease, and coal worker's pneumoconiosis (CWP). The diagnosis is made in patients with documented exposure to harmful agents, latency from the exposure period, clinical manifestations, and the exclusion of other diagnoses.
Clinical signs and symptoms depend on the severity of disease and the type of particulate stimulant. Common symptoms include cough and dyspnea. High-resolution CT is the preferred imaging modality to assist with diagnosis. The International Labor Office (ILO) formulated imaging criteria in order to characterize the pattern of lung injury.
Pneumoconiosis cannot be cured; treatment is targeted toward preventing disease progression and managing symptoms. Treatment typically includes avoidance of irritants (including smoking) and the use of bronchodilators to increase airflow to the lungs.
J64 – Unspecified pneumoconiosis
40122008 – Pneumoconiosis
Differential Diagnosis & Pitfalls
- Hypersensitivity pneumonitis (extrinsic allergic alveolitis)
- Interstitial lung diseases marked by fibrosis (eg, idiopathic pulmonary fibrosis, nonspecific interstitial pneumonia, desquamative interstitial pneumonia)
- Lung cancer – Particularly when large or cavitated nodules or masses are seen.
- Infection – Particularly fungal pneumonias, which manifest as nodules, or mycobacterial disease, which can cavitate.
- Emphysema / chronic obstructive pulmonary disease
- Congestive heart failure