Occupational Lung Diseases 1:

Pneumoconises (Hazardous Mineral

Dusts)

Patience Erick
 Introduction

 Occupational lung diseases are a major cause of

premature retirement and death among people
working in mines.
 Occupational diseases are defines as any
condition listed in the Factories Act.
 Occupational lung disease may result in illness,
premature retirement because of disability or
death.
 Definition of dust
Dust can be defined as a collection of solid particles
which:
 Are dispersed in a gaseous medium
 Will remain suspended in the gaseous medium for a
relatively long time; and
 Have a high surface area to volume
 Health effects of inhaled particles

 An excessive exposure and/or prolonged exposure to airborne dust

can cause a variety of occupational diseases.
 The biological response to the various inhaled particulates may be
non-injurious, slight or serious.
 The soluble particles may evoke a temporary response with no
permanent or severe damage to tissue,
 While insoluble particles may irritate the tissue to a greater or
lesser extent depending on their interaction with the tissue.
 Silicosis

 Is the most important occupational lung disease in gold mining, quarries and clay
works.
 Is a pulmonary fibrosis which is caused by the inhalation of dust particulates
containing free crystalline silica (quartz).
 Inhalation of silica dust – produced by drilling , blasting, scraping and other mining
operations.
 Risk of silicosis – occurs in all types of hard rock mining, tunnelling, quarrying and
crushing where crystalline silica particles are liberated.
 Silicosis develops slowly over time.
 Simple silicosis
 Simple (chronic) silicosis is the most common
manifestation of silica dust exposure
 Develops after 10-15 years of dust exposure
 Nodules 1-3.5 mm in size become evident on the chest x-
ray, usually in the upper zone of the lung
 As the condition progresses the nodules become more
numerous and may become larger, 3.5-10 mm.
 Slowly progressive over time.
 Complicated silicosis
(Progressive massive fibrosis)
 In approx. 5% of cases of simple silicosis the nodules in the lung coalesce into larger
nodules > 1cm in size.
 Significant lung function impairment and reduced life expectancy
 Determinants of progression of SS tp PMF are:
 High cumulative dust exposure
 Young age of onset of pneumoconiosis
 Continued dust exposure in the presence of simple pneumoconiosis
Coal workers’ pneumoconiosis (CWP)
 Develops after 10-15 years of coal mine dust exposure
 Nodules <1mm in size become evident on the chest x-ray
 Nodules become more numerous as the condition progresses
 Frequently complicated by chronic obstructive pulmonary disease (COPD).
 Progresses slowly over time.
 Asbestos related diseases
 Asbestos is a family of crystalline hydrated silicates forming fibres, i.e. with a ratio of
length to diameter, or aspect ratio of more than 3:1.
 Asbestos fibres thus differ from silica or coal dust particles, which are roughly
spherical.
 The difference in the geometry of the particles is important for the causation of the
disease.
 Asbestos fibres that are retained in the lungs can be far larger and tend to be deposited
in the lower zones of the lung.
 Macrophages are unable to engulf such large fibres and many remain in the alveoli.
 Chemical reactions take place on the surface of the asbestos particles that are toxic to
the lung tissue, resulting in the cell death and scar formation.
 Asbestos related diseases

 Pleural plagues: are the most common manifestation of exposure to asbestos.

They occur as har, discrete and often calcified, flat lesions on the surface
lining if the inner chest wall.
 Diffuse pleural thickening and pleural effusion: is often consequence of a
pleural effusion that has become organised with fibrosis. When widespread
there may be significant functional impairment.
 Asbestosis: refers to fibrosis of the lung tissue.
 Mesothelioma: is a malignant cancer arising from the pleura or peritoneum
(the membrane lining the organs and walls of the chest and abdominal
cavities).
 Lung cancer: is a malignancy that arises either in the bronchial tubes or in
the lung tissue. Usually occurs in people who already have asbestosis.
 Chronic obstructive pulmonary
disease (COPD)
 COPD is the result of a combination of environmental exposures and generic
susceptibility.
 The term COPD is used to describe three inter-related disorders that are often
present together to a varying degree:
 Chronic bronchitis: which is the consequence of airway inflammation and
resultant gland hyperplasis.
 Emphysema: which is the destruction of the gas exchanging tissue of the
lung consequent on a chronic inflammatory response to environmental
exposures.
 Chronic airflow limitation which result from narrowing of the airways as a
consequence of both the inflammation occurring in chronic bronchitis and
the loss of lung elastic recoil that occurs in emphysema.
 Lung function tests are required both to confirm the diagnosis of COPD and to
assess its severity.