For studentws of allied health sciences

1. Pneumoconiosis
Dr.CSBR.Prasad., MD., MNAMS.,

2. INTRO
• We breath 7000ml of air a minute
• We breath over 5000 times a day
• Your right lung has 3 lobes while the left lung
only has 2
• 90% of the lung is filled with air and only 10%
is solid tissue
• The speed of a sneeze over a 160 km/hr and
a cough is only 96 km/hr
• Lung cancer is the most common cancer
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3. Terms
• Alveoli
• Tracheobronchial tree
• Mucus
• Macrophages
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4. Some fundamentals
• What is the function of lungs
• What your body does when foreign
substance enters into your
tracheobronchial tree?
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5. Definition - Pneumoniosis
Lung disease due to exposure to
– mineral dust
– chemical fumes and
– Vapors
What happens to the lungs?
– Fibrosis
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6. Normal lung Fibrosed lung
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7. Normal lung Fibrosed lung
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8. Factors that influence the development
of dust born pneumoconiosis
• Particle size: 1 to 5µm Can reach the
alveoli
• Solubility: High solubility -> rapid onset of
injury
• Tobacco smoking: worsens the effects of
inhaled mineral dust
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9. Who are at risk?
• Mine workers
• Metal casting
• Working with insulation material
• Welding
• Farming (Insecticides, Hay)
• Textile industry
• Bird handling
• Accidental exposure (Ammonia, Benzene)
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10. Coal workers’ pneumoconiosis
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11. silicosis
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12. Hay

13. Bagassosis

14. Cotton -
Byssinosis

15. Mineral dust and associated
disease
Mineral Dust Disease Occupation
Coal dust Anthracosis Coal mining
Silica Silicosis Stone cutting, Pottery
Asbestos Asbestosis Asbestos mining,
Insulation work
Moldy hay Farmer’s lung Farming
Bagasse Bagassosis Paper industry
Cotton Byssinosis Textile industry
Bird droppings Bird breeder’s lung Bird handling
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16. Normal chest X-ray and
Pneumoconiosis

17. Normal chest X-ray and
Pneumoconiosis

18. Advanced Pneumoconiosis

19. General Clinical features
• Breathlessness
• Productive Cough
• Herat failure
• Fever
• Joint pains – Arthritis
• Some may develop cancer
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20. Coal workers’ pneumoconiosis
• Due to inhalation of coal particles (carbon
dust)
• May be asymptomatic – Anthracosis
• May symptomatic – Lung Fibrosis
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21. Coal workers’ pneumoconiosis
Gross and microscopy:
• Lungs become black in color
• Coal nodules (carbon lade]den
macrophages and fibrous tissue)
• Surrounding lung show emphysema
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22. Anthracosis with
Emphysematous bullae
Normal lung Emphysematous bullae
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23. Anthracosis

24. Anthracosis

25. Coal workers’ pneumoconiosis
Clinical features:
• Pulmonary dysfunction
• Pulmonary hypertension
• Cor pulmonale
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26. Silicosis
• Due to inhalation of silica particles
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27. Silicosis
Gross and microscopy:
• Lungs show hard scars due to collagen
deposition
• Silicosis is a nodular fibrosing disease
• Some nodules may undergo central cavitation
• Hilar lymphnodes also may show fibrosis and
calcification
• Micro: Nodules show collagen deposition at the
center macrophages and macropahges at the
periphery
• Polarized light may show silica particles
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28. Silicosis - Massive fibrosis with eggshell calcification
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29. The lung on the left has silicosis
and the lung on the right is healthy
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30. Silicosis

31. Silicosis

32. Silicosis
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33. Silicosis – under Polarizer
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34. Silicosis
Clinical features:
• Pulmonary dysfunction
• Pulmonary hypertension
• Cor pulmonale
• They are susceptible for Tuberculosis
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35. Asbestos
• Asbestos is a family of crystalline
hydrated silicates that form fibers
• Greek word – unquenchable
• Coal is a lot of dust and little fibrosis
• Asbestos is little dust and lot of fibrosis
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36. Asbestosis
• Heating insulations
• Mining for asbestos
• Roofing industry
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37. Asbestos
Amosite – (Amphibole) Crystals of asbestos
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38. Asbestos
• In nature – exists as thin long fibrils which
are fire resistant and can be spun into
yarns
• Applications:
Thermal insulation
Electrical insulation
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39. Workers at risk
• Miners
Fabrication of
• Pipes
• Tiles
• Roofs
• Textiles
• Brake lining
Manufacture of
• Textiles
• Insulating boards
• Sewer conduits
• Water conduits
• Clutch casting
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40. Geometric forms
Serpentine
• Chrysotile
Amphibole
• Crocidolite (blue)
• Amosite (brown)
• Tremolite
• Anthophyllite
• Actinolyte
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41. Asbestosis - general remarks
• Oncogenic: free radical injury
• Adsorbed toxic chemicals
• Asbestosis is a diffuse fibrosing disease
• Diffuse fibrosis because:
• Asbestos reaches alveoli consistently
• Penetrate epithelial cells
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42. Asbestos induced diseases
1. Asbestosis
2. Pleural diseases
 Pleural effusion
 Visceral pleural fibrosis
 Pleural plaques
3. Tumors
Bronchogenic carcinoma
Malignant mesothelioma
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43. Asbestosis
• Diffuse pulmonary fibrosis
• Histologically: Asbestos bodies
• Gross: small, firm lungs
Thick pleura
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44. Asbestos - microscopy
1. Non specific interstitial fibrosis
2. Asbestos bodies
3. Emphysematous changes
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45. Asbestos bodies
 Golden brown, fusiform / beaded rods with
translucent center
 Consists of asbestos fibres coated with
iron containing protenaceous material
 Iron derived from phagocyte ferritin
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46. This long, thin object is an asbestos fiber
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47. Asbestos body - Typical beading and knobbed ends (arrow)
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48. Pleural disease
 Pleural effusion: Serous effusion
 Visceral pleural fibrosis: Encases the lung
 Micro:
 Hyalinized collagenous tissue
 Calcification
 No asbestos bodies
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49. Diffuse visceral
Pleural fibrosis
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50. Fibrous pleural plaque
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51. Asbestos - Tumors
• Lung carcinoma 5x
• Malignant mesothelioma 1000x
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52. Asbestosis - Clinical features
• Slow insidious, asymptomatic
• Dyspnoea
• Dry / productive cough
• Advanced cases:
Caplan syndrome
Pul. HTN
cor pulmonale
various Cancers
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53. E N D
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