MEDICINE AND

MEDICAL NURSING
OCCUPATIONAL HEALTH AND SAFETY DISEASES (SILICOSIS)
COMPILED BY GUNDA GADZIKA (RN)
INTRODUCTION

• Occupational health diseases are diseases that are caused

by harmful particles, mists, vapors or gases inhaled while
a person works. Exposure to such factors can cause
different types of lung diseases such as asbestosis,
silicosis and coal workers pneumoconiosis among others.
• In this presentation wee will focus on Silicosis
GENERAL OBJECTIVE

• At the end of this presentation student nurses must have a general understanding of occupational
health hazards, its diseases as well as a depth of understanding of silicosis and how it can be managed.
SPECIFIC OBJECTIVES

• Define Silicosis
• Understand the pathophysiology of Silicosis
• Discuss the Clinical Presentation
• State the Classifications
• State the diagnosis
• Understand the Treatment
• Nursing Care Problems
SILICOSIS

• Silicosis is a permanent scarring of the lungs caused

by inhalation of silica dust.
PATHOPHYSIOLOGY

• When small silica dust particles are inhaled, they can embed themselves deeply
into the tiny alveolar sacs and ducts in the lungs, where oxygen and carbon
dioxide gases are exchanged. There, the lungs cannot clear out the dust by
mucous or coughing.
• When fine particles of silica dust are deposited in the lungs, macrophages that
ingest the dust particles will set off an inflammation response by releasing tumor
necrosis factors, interleukin-1, leukotriene B4 and other cytokines. In turn, these
stimulate fibroblasts to proliferate and produce collagen around the silica
particle, thus resulting in fibrosis and the formation of the nodular lesions.
CLINICAL PRESENTATION

• Initially patient is asymptomatic

• Dyspnea (shortness of breath) exacerbated by exertion
• Cough, often persistent and sometimes severe
• Fatigue
• Tachypnea (rapid breathing) which is often labored
• Loss of appetite and weight loss
• Chest pain
• Fever
• Gradual dark shallow rifts in nails eventually leading to
cracks as protein fibers within nail beds are destroyed.
CLASSIFICATIONS

• Classification of silicosis is made according to the disease's

severity), onset, and rapidity of progression. These include:
• Acute silicosis
• Chronic simple silicosis
• Accelerated silicosis
• Complicated silicosis
ACUTE SILICOSIS
• The onset is sudden, and occurs within few weeks to 5 years after
exposure to high concentrations of silica dust.
• Signs and symptoms
• Rapid onset of severe shortness of breath
• cough
• weakness
• weight loss
CHRONIC SIMPLE SILICOSIS
• The onset is gradual usually results from long-term exposure to
relatively low concentrations of silica dust and usually appearing
10–30 years after first exposure. It is the most common type of
silicosis.
• Signs and symptoms
• Initially patient is asymptomatic
• Dyspnea (shortness of breath) exacerbated by exertion
• Cough, often persistent and sometimes severe
• Fatigue
CONT…….

• Tachypnea (rapid breathing) which is often labored

• Loss of appetite and weight loss
• Chest pain
• Fever
• Gradual dark shallow rifts in nails eventually leading to cracks as
protein fibers within nail beds are destroyed.
ACCELERATED SILICOSIS

• This type of Silicosis develops over 5–10 years after first exposure
to higher concentrations of silica dust. Symptoms and x-ray
findings are similar to chronic simple silicosis, but occur earlier and
tend to progress more rapidly. Accelerated silicosis can easily
complicate to complicated silicosis.
COMPLICATED SILICOSIS

• Silicosis can become "complicated" by the development of severe

scarring (progressive massive fibrosis). This type is associated with
more severe symptoms and respiratory impairment than simple
disease. Other lung conditions such as tuberculosis, non-
tuberculous mycobacterial infection, and fungal infection, certain
autoimmune diseases, and lung cancer can worsen the condition.
DIAGNOSIS

• History taking and physical examination

• Chest x-ray will show distinctive patterns of scarring and nodules
• Arterial blood gas analysis reveals low blood oxygen concentration.
• Pulmonary function test shows reduced vital capacity in
complicated silicosis.
TREATMENT

• Silicosis is an irreversible condition with no cure. Treatment options currently

focus on alleviating the symptoms and preventing complications. These
include:
• Stopping further exposure to silica and other lung irritants, including
tobacco smoking.
• Cough suppressants.
• Antibiotics for bacterial lung infection.
• TB prophylaxis for those with positive tuberculin skin test or IGRA blood
test.
• Prolonged anti-tuberculosis (multi-drug regimen) for those with active TB.
CONT.……..

• Chest physiotherapy to help the bronchial drainage of mucus.

• Oxygen administration to treat hypoxemia, if present.
• Bronchodilators to facilitate breathing.
• Lung transplantation to replace the damaged lung tissue is the
most effective treatment, but is associated with severe risks of its
own.
CONT.……

• For acute silicosis, Whole-lung lavage may alleviate symptoms, but

does not decrease overall mortality.
• Corticosteroids therapy
• Adequate fluid intake
• Provide high calorie, high protein diet
NURSING CARE PROBLEMS

1. Ineffective airway clearance related to increased production of

secretions.
2. Disturbed Sleep Pattern Related Excessive Coughing
3. Imbalanced Nutritional Status less than body requirement related
to loss of appetite, nausea and vomiting.
4. Impaired Gaseous Exchange related to Obstructed Airway
5. Risk for infection related to chronic disease process
CONT.……..

• Chronic Pain related to inflammation fo the lung

parenchyma
• Risk for Fluid Volume Deficit
• Knowledge Deficit
• Activity Intolerance
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