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Encyclopedia of Health and Medicine

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220 The Pulmonary System<br />

FORMS OF PNEUMOCONIOSIS<br />

Form <strong>of</strong> Pneumoconiosis Causative Substance Occupational Exposure<br />

anthracosis coal dust coal mining<br />

asbestosis asbestos fibers <strong>and</strong> dust insulation, aerospace components, brake lining,<br />

shipbuilding<br />

berylliosis beryllium dust electronics, aerospace manufacturing, metal working,<br />

metal reclamation processing<br />

byssinosis raw cotton fibers <strong>and</strong> dust raw cotton processing, textile production<br />

silicosis silica dust s<strong>and</strong>blasting, s<strong>and</strong> <strong>and</strong> gravel mining<br />

may show symptoms after relatively short periods<br />

<strong>of</strong> exposure <strong>and</strong> <strong>of</strong>ten improves when exposure<br />

ceases. Asbestosis may develop after relatively<br />

short exposure though symptoms typically do not<br />

become apparent for decades after exposure. The<br />

diagnostic path focuses on occupational history<br />

<strong>and</strong> exposure patterns. Diagnostic examination<br />

typically includes AUSCULTATION, chest X-RAY, pulmonary<br />

function tests, <strong>and</strong> imaging procedures<br />

such as ULTRASOUND, COMPUTED TOMOGRAPHY (CT)<br />

SCAN, or MAGNETIC RESONANCE IMAGING (MRI). The<br />

pulmonologist may also perform BRONCHOSCOPY,<br />

BRONCHOALVEOLAR LAVAGE, or lung biopsy to rule<br />

out other causes <strong>of</strong> symptoms.<br />

Treatment Options <strong>and</strong> Outlook<br />

The first <strong>and</strong> most important element <strong>of</strong> treatment<br />

is to end the exposure. Nearly all forms <strong>of</strong> pneumoconiosis<br />

improve with this measure. Permanent<br />

damage to the lungs that has already<br />

occurred, such as fibrosis, does not reverse though<br />

its progression may stop. The disease process <strong>of</strong><br />

asbestosis is such that damage continues long after<br />

exposure ceases. The outlook depends on the form<br />

<strong>of</strong> pneumoconiosis, the length or extent <strong>of</strong> exposure,<br />

<strong>and</strong> whether the person also smokes. Cigarette<br />

smoking significantly worsens both the<br />

disease process <strong>and</strong> the outlook.<br />

Risk Factors <strong>and</strong> Preventive Measures<br />

Occupational pneumoconiosis develops with<br />

exposure to substances that enter <strong>and</strong> remain in<br />

the lungs. Avoiding such exposure is the only certain<br />

means <strong>of</strong> prevention. Workplace measures to<br />

reduce exposure to the lowest possible levels<br />

include environmental controls to filter or otherwise<br />

contain dusts <strong>and</strong> fibers. Personal protective<br />

equipment may include clothing, masks, <strong>and</strong> respirators.<br />

See also ASTHMA; BRONCHITIS; CHRONIC OBSTRUC-<br />

TIVE PULMONARY DISEASE (COPD); INDOOR AIR QUALITY;<br />

OCCUPATIONAL HEALTH AND SAFETY.<br />

pneumonectomy<br />

See THORACOTOMY.<br />

pneumonia INFLAMMATION <strong>of</strong> the LUNGS, usually<br />

the result <strong>of</strong> an INFECTION, that causes the alveolar<br />

sacs to fill with fluid or pus. Pneumonia is the<br />

most serious consequence <strong>of</strong> INFLUENZA, <strong>and</strong> in<br />

combination with influenza is the seventh leading<br />

cause <strong>of</strong> death in the United States. Pneumonia<br />

may be lobar, affecting the entire lobe <strong>of</strong> the lung,<br />

or bronchial, affecting diffuse areas <strong>of</strong> lung. The<br />

more <strong>of</strong> the lung that is involved, the more serious<br />

the consequences. People most vulnerable to<br />

infection resulting in pneumonia <strong>and</strong> complications<br />

from pneumonia are the very young, the<br />

very old, <strong>and</strong> those who have immunodeficiency<br />

disorders such as HIV/AIDS or other serious health<br />

conditions such as CANCER. About two million people<br />

in the United States develop pneumonia each<br />

year, <strong>and</strong> about 60,000 die as a result <strong>of</strong> the infection<br />

or its complications.

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