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Coal Worker’s Pneumoconiosis

Coal Worker’s Pneumoconiosis . Penyaji : Dr. Sinatra Gunawan, MK3, SpOk Referensi : Amer Rassam MD 1 , Gerry San Pedro MD 2 , Daniel Banks MD 1 . Department of Internal Medicine LSUHSC-Shreveport. Coal Worker’s Pneumoconiosis . Simple CWP. Asymptomatic

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Coal Worker’s Pneumoconiosis

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  1. Coal Worker’s Pneumoconiosis Penyaji : Dr. Sinatra Gunawan, MK3, SpOk Referensi : Amer Rassam MD1, Gerry San Pedro MD2, Daniel Banks MD1. Department of Internal Medicine LSUHSC-Shreveport

  2. Coal Worker’s Pneumoconiosis • Simple CWP • Asymptomatic • Black dust macules in respiratory bronchioles • CXR – Bilateral, small parenchymal nodules • Simple silicosis and simple CWP look identical on CXR

  3. Coal Worker’s Pneumoconiosis • Progressive CWP • Large fibrotic lung masses called progressive massive fibrosis (PMF) • PMF of nodules > 2 cm • Melanoptysis • No hilar involvement • No association with TB • No specific treatment

  4. Berylliosis

  5. Berylliosis • Causative agent: Beryllium • Cell-mediated immune response • Working in high-tech electronics, alloys, ceramics, and pre-1950 fluorescent light manufacturing • 2 year exposure to even slight amount can cause disease • Chronic interstitial pneumonitis (upper lobes) • Hilar lymphadenopathy identical to Sarcoidosis

  6. Berylliosis • Acute Exposure • Massive accidental exposure • CXR – Pulmonary edema • Treat immediately with prednisone • Recovery within 1-6 months • Risk of death is 5-10%

  7. Berylliosis • Chronic Exposure • Granulomatous disorder • Skin lesions, granulomatous hepatitis, hypercalcemia • Beryllium lymphocyte proliferation test (this is how to separate from Sarcoidosis) • Treat with prednisone • Beryllium clearance from the lungs is slow

  8. Berylliosis Again … Remember ! • Beryllium lymphocyte proliferation test is the single best test to identify beryllium sensitization and beryllium chronic disease • Beryllium is the only pneumoconiosis that can be treated (corticosteroids)

  9. Hard-Metal Lung Disease

  10. Hard-Metal Lung Disease • Exposure to tungsten carbide and cobalt • Used as an abrasive or metal cutting tool • Cause air flow obstruction or diffuse interstitial fibrosis. • Asthma-like syndrome towards the end of the work shift or in the evening. • Develop rapidly within a year of employment • P/E – Basilar rales. CXR – irregular opacities with hilar prominence

  11. BERLANJUT KE PAK bag-4

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