Pneumokonioser

Pneumokonioser, or pneumoconioses, are a group of interstitial lung diseases caused by chronic inhalation of inorganic dusts in occupational settings. The most common agents are crystalline silica, coal dust, asbestos fibers, and beryllium. The condition develops after long-term exposure and leads to progressive inflammation and fibrosis that impair lung function.

Types include coal workers' pneumoconiosis, silicosis, asbestosis, and berylliosis. Coal workers' pneumoconiosis presents with small nodules in the upper lungs and may progress to progressive massive fibrosis. Silicosis results from crystalline silica exposure and also affects the upper lobes, increasing the risk of tuberculosis. Asbestosis causes interstitial fibrosis, often in the lower lung zones, and is associated with pleural plaques and increased risk of mesothelioma and lung cancer. Berylliosis resembles sarcoidosis with noncaseating granulomas and can involve multiple organs.

Diagnosis relies on exposure history, clinical assessment, and imaging. Chest radiographs or CT scans show characteristic patterns, such as nodules or reticulation; pulmonary function tests usually reveal a restrictive defect.

Management focuses on prevention and symptom relief, as there is no cure. Avoiding further dust exposure, smoking cessation, pulmonary rehabilitation, and supplemental oxygen for hypoxemia are common strategies. Vaccination against respiratory infections and careful monitoring for complications, such as progressive massive fibrosis, pulmonary hypertension, or tuberculosis (particularly in silicosis), are important. Treatment of established disease is supportive; advanced cases may require transplant consideration in select settings.

Prevention through dust control, engineering measures, and protective equipment is essential. Pneumokonioser remain a concern in occupations with insufficient dust reductions, although incidence has declined where controls are strong.