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Occupational Lung Diseases Hypersensitivity Pneumonitis, Asbestosis, Silicosis. Occupational Lung Diseases Hypersensitivity Pneumonitis, Asbestosis, Silicosis. Penyaji Materi : dr.Sinatra Gunawan,MK3,SpOk Referensi : Amer Rassam MD 1 , Gerry San Pedro MD 2 , Daniel Banks MD 1 .
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Occupational Lung DiseasesHypersensitivity Pneumonitis, Asbestosis, Silicosis
Occupational Lung Diseases Hypersensitivity Pneumonitis, Asbestosis, Silicosis Penyaji Materi : dr.Sinatra Gunawan,MK3,SpOk Referensi : Amer Rassam MD1, Gerry San Pedro MD2, Daniel Banks MD1. Department of Internal Medicine LSUHSC-Shreveport
Occupational Lung Disease • OLDs have been recognized for centuries. • Lung illness was realized to be part of miner’s life even in the 16th century. • Governments of many countries have implemented formal policies of workers’ compensation. • The relationship between exposure at work and disease is underestimated.
Occupational Lung Disease • Although OLDs are thought to be preventable, they continue to occur. • The magnitude of the problem is underestimated due to long latency. • Wearing protective respiratory devices is an unrealistic expectation. • The most notorious failures of OLD have occurred in reported epidemics of silicosis in the American workplace.
Occupational Lung Diseases • Hypersensitivity pneumonitis • Organic dusts (Byssinosis) • Inorganic dusts (Asbestosis, • Silicosis, Berylliosis, and • Coal worker’s pneumoconiosis)
Hypersensitivity pneumonitis General • Immune mediated granulomatous reaction • Reaction to organic antigen • Not many people get it • Poorly-formed granulomas are typical • It has a wide range of causes
Hypersensitivity pneumonitis Causes • Moldy hay (thermophilic actinomycetes) “farmer’s lung” • Pet birds “bird fanciers lung” • Grain dusts • Isocyanates • Air conditioning system
Hypersensitivity pneumonitis Clinical • Acute, subacute, and chronic forms • Recurrent chest infiltrates with fever & WBC • Slowly progressive pulmonary fibrosis • Diagnosis by history • Serum precipitins are non-specific • CXR – Recurrent infiltrates “fleeting” • Treatment - remove pt from offending antigen
Byssinosis • Inhalation of cotton, flax, or hemp dust • Not immune related • Early stage - Occasional chest tightness • Late stage – Regular chest tightness towards the end of the 1st day of the workweek “Monday chest tightness” • Frequency of symptoms slowly increases
Mineral Dust Pneumoconiosis Nonfibrogenic • Iron, Zirconium, Tin, Barium, and Aluminum • Striking CXR – Dense nodular opacities • No symptoms, physical findings, or impairment.
Mineral Dust Pneumoconiosis Fibrogenic • Asbestosis • Silicosis • Berylliosis • Coal worker’s pneumoconiosis