Occupational and environmental exposures causing pneumoconiosis

What it is

The pneumoconioses are the lung diseases of occupational dusts: asbestosis, berylliosis, coal workers' pneumoconiosis and silicosis. One rule places them in the lung. Asbestos is from the roof, since it was common in insulation, but it affects the base, the lower lobes; silica and coal are from the base, the earth, but they affect the roof, the upper lobes.

Causes and risk

Each disease carries its own exposure.

• Asbestos gives asbestosis, and is associated with shipbuilding, roofing and plumbing.
• Beryllium gives berylliosis, or beryllium disease, and is associated with exposure to beryllium in aerospace and manufacturing industries.
• Coal gives coal workers' pneumoconiosis: prolonged coal dust exposure leads to macrophages laden with carbon, then inflammation and fibrosis. It is also known as black lung disease.
• Silica gives silicosis, and is associated with sandblasting, foundries and mines. Macrophages respond to silica and release fibrogenic factors, leading to fibrosis.

The environmental exposures to ask about are birds, mold, and animals or hay. Exposure to thermophilic actinomyces gives hypersensitivity pneumonitis.