pneumoconiosis

Pneumoconiosis refers to a group of interstitial lung diseases caused by inhalation and deposition of mineral dusts in the lungs, leading to inflammation and fibrosis. It is typically occupational.

The most common forms are coal workers' pneumoconiosis (CWP), silicosis from crystalline silica, and asbestosis from asbestos. Other forms include berylliosis and talcosis. The disease may be chronic, accelerated, or acute depending on dust type, concentration, and exposure duration.

Pathophysiology involves inhaled particles reaching the alveoli, uptake by macrophages, cytokine release, and fibrotic remodeling. Silica is particularly fibrogenic and can cause granulomatous nodules. Radiographic patterns vary by type: CWP shows upper-lobe nodules and possible progression to massive fibrosis; silicosis shows nodules with or without eggshell calcification of hilar lymph nodes; asbestosis shows subpleural lower-lobe fibrosis and pleural plaques.

Symptoms include progressive dyspnea on exertion, chronic cough, chest tightness, and reduced exercise tolerance. Diagnosis combines occupational history, imaging (chest X-ray or high-resolution CT), and pulmonary function testing showing restrictive physiology.

Management centers on removing exposure, supportive care, vaccination, pulmonary rehabilitation, and treatment of complications. There is no cure. Prevention hinges on dust control, protective equipment, and regular surveillance in high-risk jobs. Prognosis depends on dust type and exposure; silica exposure carries higher risks for tuberculosis and respiratory failure.