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Chapter 18. Pneumoconiosis

David W Kamp, MD, FCCP
DOI: 10.1378/pulm.26.18
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Sections

Objectives 
  • Review the epidemiology, pathophysiology, and clinical manifestations of silicosis and coal workers' pneumoconiosis.

  • Understand the pulmonary manifestations of asbestos-induced diseases of the lung (asbestosis and rounded atelectasis) and of the pleura (effusions and plaques).

  • Discuss the malignancies associated with asbestos exposure (bronchogenic carcinoma and mesothelioma).

  • Review a variety of other pneumoconioses (talcosis, berylliosis, and hard-metal lung disease).

Synopsis 

Pneumoconiosis includes lung diseases associated with mineral dust exposure. The term is often restricted to nonneoplastic disease excluding asthma, chronic bronchitis, and emphysema, all of which can occur with occupational dust exposure. The patient with a pneumoconiosis often presents with nonspecific respiratory symptoms (eg, cough and dyspnea) and/or abnormal chest imaging findings. A thorough lifetime occupational history is crucial in identifying the origin of a particular patient's complaints. Mineral dusts cause pulmonary interstitial lung diseases and malignancies by molecular mechanisms that are not fully understood. The mode of action underlying each pneumoconiosis appears distinct depending upon the mineral dust type and host genetics affecting susceptibility. In this chapter we focus on four broad areas including (1) reviewing the epidemiology, pathophysiology, and clinical manifestations of silicosis and coal workers' pneumoconiosis; (2) understanding the pulmonary manifestations of asbestos-induced diseases of the lung and of the pleura; (3) discussing the malignancies associated with asbestos exposure; and (4) reviewing some of the other relevant pneumoconioses, such as talcosis, berylliosis, and hard-metal lung disease. A better understanding of the clinical manifestations and the underlying molecular basis of mineral dust-induced lung diseases will hopefully augment early diagnosis, as well as the development of novel therapeutic targets for managing these diseases and other more common degenerative diseases (eg, pulmonary fibrosis), lung cancer, and aging for which effective management is lacking.

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