Disorder	Risk Factors	Objective Findings	Complications
Silicosis	Mine worker with silica or glass, sandblasting, ceramics	Upper zone predominant nodular infiltrates ± calcifications, hilar adenopathy	Massive fibrosis, emphysema, risk for TB
Asbestosis	Jobs involving insulation, demolition, construction or shipbuilding decades prior to presentation	Calcified linear pleural plaques, ferruginous bodies in alveolar septae	Increased risk for lung cancer (especially in smokers), particularly bronchogenic carcinoma; mesothelioma
Anthracosis (Coal Dust)	Coal Miners	Upper zone nodular infiltrates	Massive fibrosis, emphysema
Berylliosis	Nuclear or aerospace field worker, ceramics worker	Diffuse opacities, hilar adenopathy, noncaseating granulomas	Respiratory impairment, may require long-term corticosteroids

Mnemonic

• Asbestos is from the roof (was common in insulation), but affects the base (lower lobes).
• Silica, coal, and berries are from the base (earth), but affect the roof (upper lobes).

Etiology

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Pathophysiology

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Classifications

Asbestosis

• Etiology: Airborne asbestos fibers
• Population at risk:
  • Asbestos miners and millers
  • Brake linings and insulation manufactures
  • Ship construction workers
  • Demolishers
• Clinical features:
  • Symptoms typically develop 15–20 years after initial exposure.
  • Exertional dyspnea
  • Dry cough that transforms into productive cough
  • Digital clubbing
  • Ferruginous bodies in alveolar septa on histology
  • Complications
    • Lung cancer (smoking increases the risk):bronchogenic carcinoma is most common
    • Mesothelioma: rarely occurs without a history of asbestos exposure
• Chest x-ray:
  • Diffuse bilateral infiltrates predominantly in the lower lobes
  • Interstitial fibrosis
  • Calcified pleural plaques (usually indicate benign pleural disease)
• Microscopic
  • 

  This is the causative agent for asbestosis, a long, thin asbestos fiber. Some houses, business locations, and ships still contain building products with asbestos, particularly insulation materials, so care must be taken when doing remodelling or reconstruction.

Silicosis

• Etiology
  • Inhalation of crystalline silica, most commonly as dust
  • High-risk occupations for the development of silicosis include sandblasting, mining, and working in foundries

Mnemonic

The silly egg sandwich I found is mine!

• Clinical features
  • Chronic cough (often with sputum) and exertional dyspnea
  • Caplan syndrome: pneumoconiosis in combination with rheumatoid arthritis; characterized by rapid development of basilar nodules and mild obstruction of ventilation
• Chest x-ray
  • Eggshell calcification: well-defined sickle-shaped calcification of the rims of hilar lymph nodes
  • Bilateral diffuse ground glass opacities
  • Large number of rounded, solitary, small (≤ 1 cm in diameter) opacities particularly in the upper lobe of the lungs
• Etiology:
• Population at risk:
• Clinical features:
• Chest x-ray:
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Clinical features

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Diagnostics

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Treatment

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