Occupational Pneumoconiosis and Disease Latency

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Questions and Answers

What is the method used to estimate occupational disease burden?

Incidence rate ratios

Occupational population survey

Attribution in case series

Attributable fraction (PAF) (correct)

What is the percentage of occupational burden for idiopathic pulmonary fibrosis?

10%

20%

30%

26% (correct)

What is the most commonly diagnosed occupational lung disease?

Occupational asthma (correct)

COPD

Asthma

Chronic bronchitis

What is the term for a range of pulmonary diseases caused by workplace exposures?

Occupational lung diseases Signup and view all the answers

What is an example of an acute occupational lung disease?

Hypersensitivity pneumonitis Signup and view all the answers

What is the percentage of occupational burden for community-acquired pneumonia in working-age adults?

10% Signup and view all the answers

What is an example of a multiple phenotype of lung diseases that may coexist in a worker?

Coal mine dust lung disease Signup and view all the answers

What is the percentage of occupational burden for tuberculosis in silica-exposed workers?

2.3% Signup and view all the answers

What is the hallmark of the disease process associated with most occupational lung diseases?

Disease latency period Signup and view all the answers

Which of the following occupational lung diseases has the highest occupational burden?

Sarcoidosis Signup and view all the answers

What is the typical duration between the first exposure to the disease-causing agent and the appearance of clinical symptoms?

20 or more years Signup and view all the answers

What is the primary cause of pneumoconiosis?

Direct effect of dust on lung tissue Signup and view all the answers

Which of the following is an example of an organic dust?

Wood dust Signup and view all the answers

What is the estimated annual cost of health expenditures for occupational lung diseases?

$14.5 billion Signup and view all the answers

What is the primary function of OSHA?

Establishing national permissible exposure limits Signup and view all the answers

What is the estimated annual cost of health expenditures for COPD?

$2.2 billion Signup and view all the answers

What is the most reported OLD in coal mine workers?

Asthma Signup and view all the answers

Which group of healthcare workers had the highest prevalence of positive tests?

Nurses Signup and view all the answers

Which of the following chemicals is frequently encountered in coal mine dust?

Aldehydes and chlorine Signup and view all the answers

What is the primary cause of silicosis?

Chronic inhalation of respirable particles of crystalline silica Signup and view all the answers

What is the recommended screening for lung cancer in certain adults?

Yearly CT lung scans Signup and view all the answers

What is the minimum duration of exposure required for the appearance of CXR changes in silicosis?

10 years or more Signup and view all the answers

What is the risk factor for latent tuberculosis infection and active TB disease?

Occupation Signup and view all the answers

Which of the following occupations had the greatest risk of lung diseases?

Launderers, dry cleaners, and pressers Signup and view all the answers

Which of the following occupations is at higher risk of silicosis?

Workers involved in heating and grinding quartz Signup and view all the answers

What is the trend in average occupational exposure to diesel exhaust between 1990 and 2015?

Increased by 72.1% for men and 129.8% for women Signup and view all the answers

What is a risk factor for the development of COPD in miners?

All of the above Signup and view all the answers

Which of the following is NOT a setting where exposure to respirable silica can occur?

Office work Signup and view all the answers

What is the name of the disease that has seen a recent resurgence in prevalence and severity?

Coal workers' pneumoconiosis (CWP) Signup and view all the answers

Who may be similarly screened for lung cancer?

High-risk workers and asymptomatic adults aged 55-80 years Signup and view all the answers

What is the characteristic of coal dust that contributes to the development of silicosis?

Particle size of < 5 micro meter in diameter Signup and view all the answers

What is the trend in average occupational exposure to silica between 1990 and 2015?

Increased by 72.6% for men and 44.9% for women Signup and view all the answers

What percentage of workers exposed to platinum salts are likely to develop occupational asthma?

70% Signup and view all the answers

What type of compounds are more likely to involve an IgE allergic response?

High mol wt compounds Signup and view all the answers

What is the most effective way to prevent occupational asthma?

Avoiding work and work sites with high exposure to sensitizing agents Signup and view all the answers

What percentage of bakers are likely to develop occupational asthma?

20% Signup and view all the answers

What is an important risk factor for occupational asthma from high mol wt compounds?

Atopy/allergy Signup and view all the answers

What should material safety sheets include information on?

Components that may cause or exacerbate asthma Signup and view all the answers

Study Notes

Occupational Lung Diseases (OLDs)

OLDs are caused or aggravated by exposures at the workplace, substantially contributing to the burden of chronic respiratory diseases.
OLD is not a single diagnosis, but rather encompasses a range of pulmonary diseases, including:
Idiopathic pulmonary fibrosis (PAF, 26%)
Occupational asthma (most commonly diagnosed OLD)
Asthma (PAF, 16%)
Chronic bronchitis (PAF, 13%)
Other OLDs, such as acute and chronic conditions, ranging from hypersensitivity pneumonitis to chronic obstructive pulmonary disease (COPD) and pulmonary fibrosis.

Burden of OLDs

The attributable fraction found in an exposed group:
Idiopathic pulmonary fibrosis (PAF, 26%)
Asthma (PAF, 16%)
Chronic bronchitis (PAF, 13%)
Other granulomatous diseases, such as sarcoidosis (occupational burden, 30%)
Hypersensitivity pneumonitis (occupational burden, 19%)
Tuberculosis (occupational burden, 2.3% and 1% in silica-exposed workers and healthcare workers)
Community-acquired pneumonia in working-age adults (PAF, 10%)

Characteristics of OLDs

Disease latency period: disease typically appears after at least 20 or more years from the first exposure to the recognition of clinical symptoms.
Some diseases may first appear and even progress many years from the end of exposure.

Pulmonary Alveolar Proteinosis

Second-highest occupational burden (29%)
Associated with a broad range of exposures, including:
Vapors or gases, such as cleaning fluids and hair spray
Inorganic dust, such as silica (PAF for silica, 5%)
Organic dust, such as wood and metal dusts or fumes, including aluminum

Healthcare Workers (HCWs) and Infectious Respiratory Diseases

HCWs are at increased risk for contracting many infectious respiratory diseases, including:
Latent tuberculosis infection (LTBI) and active TB disease
Screening programs are in place to catch disease early, including yearly CT lung scans for:
Asymptomatic adults aged 55-80 years who have a 30 pack-year smoking history
High-risk workers may be similarly screened

Occupational Exposures and Lung Diseases

Between 1990-2015, there were increases in average occupational exposure to:
Diesel exhaust (72.1% men; 129.8% women)
Silica (72.6% men; 44.9% women)
Benzene (48.5% men; 97.5% women)
Launderers, dry cleaners, and pressers were found to have the greatest risk of lung diseases resulting from occupational exposures to cleaning products.

Coal Workers' Pneumoconiosis (CWP) / Black Lung Disease

Seen a recent resurgence in prevalence and severity
Caused by respirable fine crystalline silica, silicates, and metal content of coal mine dust
Risk factors for development of COPD in miners depend on:
Duration and extent of dust exposure
Prior dust exposure, and the presence of other risk factors, especially cigarette smoking and silica (surface mining)

Prevention and Control of OLDs

The only way is to avoid work and work sites where exposure to certain levels of agents occur
Facility managers have to know what agents in their plant have been associated with asthma and inform workers to maintain exposure below known sensitizing levels
Material safety sheets should include information on components that may cause or exacerbate asthma

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Description

This quiz covers the relationship between occupational exposure and the development of pneumoconiosis, including the concept of disease latency period and associated occupations. Learn about the risks and hallmarks of these diseases.