Pneumoconioses are a group of diseases caused by chronic inhalation, due to work-related reasons, of dust capable of causing lung damage. From the site: legalnewsdaily.net
Belonging to the category of occupational diseases, pneumoconioses are characterized by their slow and gradual onset, and by the permanent damage they cause to the lungs .
The main symptoms of pneumoconiosis are: dyspnea , chest pain , recurrent tiredness and cyanosis . At an advanced stage, severe pneumoconiosis can also lead to the onset of lung cancer .
For a correct diagnosis, doctors use an accurate work history and some diagnostic imaging tests .
Unfortunately, pneumoconiosis currently remains an incurable disease.
What Is Pneumoconiosis
Pneumoconioses are diseases whose consequences appear very slowly. Sometimes, in fact, more than 10 years can pass since the sick person was constantly exposed to harmful dust. It is for this reason that people affected by pneumoconiosis are usually individuals over the age of 50.
MAIN CONSEQUENCES OF PNEUMOCONIOSIS
More severe pneumoconioses (malignant forms) are responsible for pulmonary granulomatosis and pulmonary fibrosis .
- Pulmonary granulomatosis is a condition characterized by the appearance of granulomas in the lungs . Granulomas are limited and nodular proliferations of connective tissue , which are formed as a result of an immune reaction. In pneumoconiosis, the appearance of granulomas is caused by toxic dust particles that reach the lungs and cause inflammation ( granulomas from exogenous foreign bodies ).
- Pulmonary fibrosis, on the other hand, is a disease marked by hardening and scarring of the lung tissue that surrounds and is interposed between the alveoli . From a histological point of view, the normal lung tissue disappears and is progressively replaced by so-called fibrotic tissue .
Pulmonary granulomatosis and pulmonary fibrosis make the lungs less elastic and prevent normal breathing .
Therefore, pneumoconiosis sufferers suffer from more or less serious respiratory disorders, depending on the number of granulomas present and the extent of the fibrotic tissue.
What are alveoli?
The alveoli, more correctly called pulmonary alveoli , are small cavities in the lungs, in which gas exchanges between the blood and the atmosphere take place. Inside the alveoli, in fact, the blood is enriched by the oxygen contained in the breathed air and “frees” itself from the carbon dioxide discarded by the tissues, after their spraying.
PNEUMOCONIOSES ARE OCCUPATIONAL DISEASES
Pneumoconioses are included in the list of so-called occupational diseases (or technopathies ). An occupational disease is a pathology that an individual contracts during his work activity, due to the presence of harmful factors in the work environment.
The use of so-called PPE (personal protective equipment), such as masks, overalls, glasses and gloves, is extremely important to safeguard the health of workers exposed to the risk of pneumoconiosis
Occupational diseases differ from accidents at work, as the latter tend to occur immediately, while the former develop over time and gradually.
Attention : those who are diagnosed with pneumoconiosis, due to work carried out in the past, can apply for professional disability.
TYPES OF PNEUMOCONIOSIS
Doctors and researchers have given pneumoconiosis different specific names, depending on the type of dust that is continuously inhaled.
Therefore, there are:
- Silicosis , due to inhalation of silica dust.
- Asbestosis , due to inhalation and contact with asbestos and its dust.
- Berylliosis , due to inhalation and exposure to beryllium.
- Byssinosis , caused by inhaling cotton, linen or hemp dust .
- Siderosis , caused by inhalation of ferruginous dust. Siderosis of the lungs is also commonly called “welder’s lung”.
- Kaolinosis (or kaolin pneumoconiosis ), induced by inhalation of kaolin powder.
- Anthracosis , due to inhalation and contact with coal.
- Stasis , caused by inhaling tin dust.
- Bauxite pneumoconiosis ( or bauxite fibrosis ), due to inhalation of bauxite dust, a rock that mainly contains aluminum and silica.
- Baritosis , induced by inhalation of barium dust.
- Silicosiderosis , caused by inhalation of silica and ferruginous dust.
- Hard metal pneumoconiosis , induced by inhalation of metal dust such as cobalt or tungsten.
- Graphitosis , caused by inhaling graphite dust.
Silica is a compound of silicon (Si), contained in many minerals commonly found in nature and which represent, together with oxygen, a large part of the earth’s crust . They contain silica: sand, granite and sandstone rocks, flint, slate and many raw minerals.
As long as they are not processed, these minerals and rocks are harmless. When they are drilled, cut and/or crushed, they produce dust which, if breathed for a long time and for many years, damages the lung tissue.
People most at risk of silicosis are:
- Those who work in mines, because they come into contact with minerals and quartz rocks on a daily basis.
- Those who work in granite, gravel, sand and sandstone quarries.
- Ceramists and glassmakers
- Steel mill and foundry workers
- Those who work in the shipping and railway industries
- Those who work in cement factories
Asbestos , or asbestos , is a set of minerals (inosilicates and phyllosilicates), arranged in elongated bodies called fibres . When asbestos is handled, the metal fibers that make it up can become airborne and easily inhaled by those nearby. The easy dispersion of asbestos fibers in the air is due to the shape and small size of the fibers themselves. Before its abolition, asbestos was widely used in industrial plants, due to its resistance to fire, acids, microorganisms and wear, and for its ductility. The places of greatest exposure to asbestos were:
- The cement plants that produced Eternit
- The textile industries where sheets, overalls and gloves based on asbestos and derivatives were produced
- Shipyards and railways
- Building systems
- Friction materials industries, such as brakes and clutches
- Quarries for the extraction of the minerals that make up asbestos
KAOLIN PNEUMOCONIOSIS (OR KAOLINOSIS)
Kaolin is a rock consisting predominantly of kaolinite , a hydrosilicate aluminum mineral. Kaolin is widely used in the production of ceramic products and in the pharmaceutical, cosmetic and paper fields.
ANTHROCOSIS AND SIDEROSIS
The people most at risk of anthracosis are those who work in coal mines and who transport coal.
As regards siderosis, however, the people most exposed to this pneumoconiosis are those who work in the steel industries, foundries or iron mines.
Symptoms And Complications
Typical symptoms and signs of pneumoconiosis are:
- Sense of tightness and pain in the chest
- Dyspnea ( shortness of breath ), both under exertion ( exertional dyspnea ) and at rest ( rest dyspnea )
- Chronic dry cough
- Chronic bronchitis
- Breathing problems
- Fatigue and feeling of tiredness
- Pulmonary emphysema
- Increased heart rate ( tachycardia )
- Bronchial sounds
The speed of appearance and severity of the aforementioned pathological manifestations depend on several factors, including:
- The time of exposure to a given dust/substance . Clearly, the longer an individual has been in contact with harmful dust, the more serious the symptomatic picture will be.
- The heterogeneity of harmful dust inhaled during work . Often, those who work in industrial plants, miners or ceramists are exposed, during their working lives, to various toxic substances capable of causing pneumoconiosis. This accelerates the processes of pulmonary granulomatosis and pulmonary fibrosis, and deepens the consequences on the lungs.
During their course, several pneumoconioses (e.g. silicosis) are accompanied by chronic obstructive pulmonary disease ( COPD ), tuberculosis and autoimmune diseases ( scleroderma or rheumatoid arthritis ).
Furthermore, a prolonged situation of pulmonary fibrosis can lead to the establishment of other serious pathological conditions, such as pulmonary hypertension , cor pulmonale , respiratory failure and lung cancer (or lung carcinoma ).
The continuous inhalation of some dusts causes not only pneumoconiosis, but also other serious diseases. Asbestos, for example, can cause asbestosis, but also pleural mesothelioma and peritoneal mesothelioma .
Introduction : if an individual presents respiratory problems and claims to have carried out, for many years, a job considered to be at risk, doctors are required to suspect pneumoconiosis and shed light on the origin of the disorders.
Chest x-ray of an individual with anthracosis. The arrows indicate the areas of the lungs changed by inhaling coal dust.
The diagnostic protocol for pneumoconiosis requires, first of all, an accurate work history . This means that the doctor will ask the patient for information relating to the industrial sector in which he worked, the tasks performed, the tasks to which he was assigned and the duration of the work activity (to get an idea of how long the exposure to the toxic substances).
Once the medical history has been completed (NB: the contribution that family members can provide is also important), the doctor
- Analyzes the symptoms and signs experienced by the patient (dyspnea, cough and bronchial sounds are the most significant manifestations)
- Prescribes diagnostic imaging tests, such as chest x-ray or CT scan (if the chest x-ray is unclear)
- Assess lung function
- He orders a lung biopsy
An accurate diagnosis also serves to establish the severity of the ongoing pneumoconiosis. Knowing the severity of the disease allows you to plan the most appropriate therapy.
Unfortunately, pneumoconioses are incurable diseases, the consequences of which, at the lung level, are irreversible. For example, the scar tissue that forms as a result of pulmonary fibrosis is permanent.
However, although recovery is impossible, with appropriate symptomatic therapy it is possible to alleviate the complaints and slow down the progression of the disease.
Possible treatments include corticosteroid drugs and immunosuppressants , oxygen therapy , respiratory rehabilitation and, finally, lung transplantation (reserved for the most serious cases).
As regards lifestyle, patients are advised to stop smoking (if they are smokers ), avoid places frequented by smokers and adopt a healthy diet .
Reducing the risk of pneumoconiosis to zero is a difficult, if not impossible, undertaking. The production of toxic dust should be kept to a minimum and ensure that exposed workers are fully protected.
The prevention and protection measures to be adopted in workplaces at risk consist of:
- Provide workers with appropriate protective masks to prevent inhalation of dust.
- Keep the levels of harmful dust circulating in the air to a minimum.
- Ventilate the work environment appropriately and periodically.
- Establish a plan for the periodic sanitization of the working environment and the clothing used by workers (overalls, gloves, masks, etc.).
- Prepare a department (or area) where workers can wash and clean themselves adequately from dust residues before leaving the working environment.
Given the lack of specific treatments, pneumoconiosis always has a negative prognosis.