occupational lung disease

1. Presented by : DR.VISHAKHA D P
Moderator : DR. K. N. JAMADAR
Date-1/12/2020

2. 
 Definition
 objectives
 Epidemiology
 Etio-Pathophysiology
 Clinical Features
 Differential Diagnosis
 Investigations
 Complications
 Homoeopathic Management
 Recent updates
 Reference
OVERVIEW

3. 
 Occupational health should aim at the promotion and
maintenance of the highest degree of physical, mental
and social well-being of workers in all occupations.
 The term pneumoconiosis derives its meaning from the
Greek words: pneuma = air and konis = dust
 Pneumoconiosis can be defined as the non-neoplastic
reaction of lungs to inhaled minerals or organic dust
and the resultant alteration in their structure excluding
asthma, bronchitis and emphysema
Definition

4. 
 The maintenance and promotion of workers health and
working capacity
 Development of work organizations and working cultures
in a direction which supports health and safety at work
and in doing so also promotes a positive social climate
and smooth operation and may enhance productivity of
the undertakings
Objectives

5. 
OCCUPATIONAL HAZARDS

6. 
 Diseases due to chemical agents
1.Gases:
co2,HCN,NH3,N2,HCL,SO2
2.Dusts(pneumoconiosis)
i. Inorganic dusts:
a. Coal dust:anthracosis
b. Silica-silicosis
c. Asbestosis-asbestosis,cancer lung
d. iron-siderosis
ii. organic dusts:
a. Cane fibre-bagassosis
b. Cotton dust-byssinosis
c. Hay or grain dust-farmer’s lung
Occupational lung diseases are
grouped as follows

7. 
3. Metals and their compounds-toxic hazardous from
mercury,cadmium,arsenic.
4. chemicals:acids,alkalies

8. 
 Dusts within the rangeof 0.5 micron to 3 micron is a
health hazard producing, after a variable period of
exposure, a lung disease known as pneumoconiosis,
which may gradually cripple a man by reducing his work
capacity due to lung fibrosis and other complications
PNEUMOCONIOSIS

9. 
1. Chemical compound
2. Fineness
3. Concentration of dust in the air
4. Period of exposure
5. Health status of person exposed
Hazardous effects of dust on
lungs depends on factors

10. 
• Caused by inhalation of dust
containing free silica or silicon
dioxide.
• people who are working in
mining industry,pottery and
ceramic industry,sand
blasting,building and
construction works and several
others.
Silicosis

11. 
 Incubation period may vary from few months upto 6
yrs of exposure.
 Pathology:Quartz is transported widely in the lung
via lymphatic,much of it deposited in the hilar nodes
which it destroys.This destruction of the nodes is
very likely to be responsible for blockage of exit
route for further inhaled dust,therefore it retains in
the lung ,thus progressive massive fibrosis or even
acute silicosis starts

12. 
1. Acute silicosis ,Accelerated silicosis ,chronic silicosis
2. pt becomes intensely breathless,cough,weight loss
and die within months.
3. Less exposure causes progressively less
symptoms,ranging from progressive upper lobe
fibrosis with slowly increasing exertional dyspnoea
over 5 to 15 yrs after exposure
4. Snow storm appearance in X ray
CLINICAL FEATURES

13. 

14. 
• It is caused by inhalation of dust
containing coal miners.
• First phase is called simple pneumoconiasis
which is associated with little impairment.
• Second phase is characterized by
Progressive massive fibrosis
Anthracosis

15. 
 The primary lesion in CWP is coal macule.
 It consist of focal collection of coal dust
 macrophages around the respiratory bronchioles
tapering off towards alveoli.
 Lung fibroblast secrete fine network of reticulin
fibres around the macule.
 The lesion increase in size and number with increase
in dust deposition.The nodule increase in size more
than 2 cm in diameter..
PATHOLOGY:

16. 
 Pt may present with cough,black sputum and
dyspnoea.
 It is usually progressive and leading to respiratory
failure,cor-pulmonale and death.
 The risk of death among coal miners has been nearly
twice that of general population
CLINICAL FEATURES

17. 
• Inhalation of cotton fibre dust over long periods of, time.
• Incidence rate -7-8% in India
 The symptoms are
• Chronic cough
• Progressive dyspnoea,
• Chronic bronchitis
Byssinosis

18. 
• Caused by inhalation of bagasse or sugar-cane dust.
• Bagassosis has been shown to be due to a
thermophilic actinomycet for which the name
 The symptoms
• Breathlessness
• Cough
• Haemoptysis
• slight fever
• Skygram –Mottling of lung or shadow
Bagassosis

19. 
Asbestosis

20. 
• Asbestos is of two types- serpentine or chrysolite varietyand
amphibole type.
• Clinically the disease is characterized by dyspnoea.
• Clubbing of fingers,
• Cardiac distress and cyanosis.
• The sputum shows "asbestos bodies"
• An X-ray of the chest shows a ground-glass appearance in the lower
two thirds of the lung fields
Asbestosis

21. 
• Ground glass
appearance in X ray
chest

22. 

23. 
 Farmer's lung is due to the inhalation of mouldy hay or
grain dust
 hay containing spores of thermophilic actinomycetes
that produce hypersensitive pneumonitis.A pt with
acute farmer’s lung presents 4-8 hrs after exposure
with chills,fever,maliase,cough and dyspnoea
without wheezing.
Farmer's lung

24. 
 MODE OFABSORPTION
(1) INHALATION.
(2) INGESTION.
(3) SKIN
LEAD POISONING

25. 
 The toxic effects of inorganic exposure
 abdominal colic
 Constipation
 loss of appetite
blue-line on the gums stippling
of red cells Anaemia
 wrist drop
 foot drop

26. 
• The toxic effects of organic lead compounds are mostly
on the central nervous system
• Insomnia
• Headache
• Mental confusion
• Delirium

27. 
 History
 Physical examination X ray
 CT
 Lung biopsy
DIAGNOSIS

28. 
Preventive Measures

29. 
 Medical measures
 Engineering measures
 Other measures
Preventive measures: –

30. 
1. Pre-placement examination –
2. Periodical examination –
3. Medical and health care services –
4. Notification –
5. Maintenance and analysis of records –
6. Health education and counselling –
7. Practicing good personal hygiene Preventive
measures
Medical measures

31. 

32. 

33. 
1. Design of building –
2. Conduct air monitoring to measure the workers’
exposure to crystalline silica.
3. Minimize exposures by controlling the creation of
airborne particles, for example, use wet drilling, local
exhaust ventilation.
4. Personal Protective Equipments: Provide workers with
protective clothes, respiratory protection, and facilities
for washing (showers) and changing.
5. Enclosure / isolation
6. Environmental monitoring Preventive measures
Engineering measures

34. 
 It is a non maismatic disease.
 Disesae occurs due to exposure of dust or chemicals
so it does not come under miasmatic
Classification of disease

35. 
 Aconitum Napellus-
Constant pressure in left chest; oppressed breathing on least motion. Hoarse, dry,
croupy cough; loud, labored breathing. Child grasps at throat every time he coughs.
Very sensitive to inspired air. Shortness of breath. Larynx sensitive. Stitches through
chest. Cough, dry, short, hacking; worse at night and after midnight. Hot feeling in
lungs. Blood comes up with hawking. Tingling in chest after cough.
Ammonium Carbonicum-
Cough every morning about three o'clock, with dyspnœa, palpitation, burning in
chest; worse ascending. Chest feels tired. Emphysema. Much oppression in
breathing; worse after any effort, and entering warm room, or ascending even a few
steps. Asthenic Pneumonia. Slow labored, stertorous breathing; bubbling sound.
Winter catarrh, with slimy sputum and specks of blood. Pulmonary œdema.
HOMOEOPATHIC
MANAGEMENT

36. 
 Ammonium Muriaticum-
Hoarseness and burning in larynx. Dry, hacking,
scraping cough; worse lying on back or right side.
Stitches in chest. Cough loose in afternoon, with
profuse expectoration and rattling of mucus.
Oppression of chest. Burning at small spots in chest.
Scanty secretion. Cough with profuse salivation.

37. 
 Antimonium Tartaricum-
Great rattling of mucus, but very little is expectorated. Velvety feeling in chest.
Burning sensation in chest, which ascends to throat. Rapid, short, difficult
breathing; seems as if he would suffocate; must sit up. Emphysema of the aged.
Coughing and gaping consecutively. Bronchial tubes overloaded with mucus.
Cough excited by eating, with pain in chest and larynx. Edema and impending
paralysis of lungs. Much palpitation, with uncomfortable hot feeling. Pulse
rapid, weak, trembling. Dizziness, with cough. Dyspnea relieved by eructation.
Cough and Dyspnea better lying on right side
Arsenicum Album-
Unable to lie down; fears suffocation. Air-passages constricted. Asthma worse
midnight. Burning in chest. Suffocative catarrh. Cough worse after midnight;
worse lying on back. Expectoration scanty, frothy. Darting pain through upper
third of right lung. Wheezing respiration. Hæmoptysis with pain between
shoulders; burning heat all over. Cough dry, as from sulphur fumes; after
drinking.

38. 
 Drosera-
Spasmodic, dry irritative cough, like whooping-cough,
the paroxysms following each other very rapidly; can
scarcely breathe; chokes. Cough very deep and hoarse;
worse, after midnight; yellow expectoration, with
bleeding from nose and mouth; retching. Deep, hoarse
voice; hoarseness; laryngitis. Rough, scraping sensation
deep in the fauces and soft palate. Sensation as if crumbs
were in the throat, of feather in larynx. Asthma when
talking, with contraction of the throat at every word
uttered.

39. 
 Ferrum Phosphoricum-
First stage of all inflammatory affections. Congestions of lungs.
Hæmoptysis. Short, painful tickling cough. Croup. Hard, dry
cough, with sore chest. Hoarseness. Expectoration of pure
blood in pneumonia (Millefol). Cough better at night.
Veratrum Viride-
Congestion of lungs. Difficult breathing. Sensation of a heavy
load on chest. Pneumonia, with faint feeling in stomach and
violent congestion. Croup

40. 
 63rd National Conference of Indian Association of
Occupational Health was held in Bengaluru, 22nd – 25th
January, 2013.
 “An International meet on climate, the workplace and the
lungs” 6th -8th December 2012.
 Main topics discussed were
1. – Integration of occupational health with primary health care
2. – Imaging for occupational and environmental respiratory
disorders
 Study of Pneumoconiosis in Thermal Power Station Workers, –
K. D. Garkal, Shete Anjali N. in International Journal of Recent
Trends in Science And Technology, Beed district, Maharashtra
2012
Recent updates

41. 
1. Practice of medicine –P K Das
2. API text book of medicine
3. Textbook of Pulmonary Medicine , D Behera
4. Homeopathic materia medica –kent,Dubey
5. Preventive and social Medicine- K Park
Reference

42. 
THANK YOU