eMedicine Specialties > Pulmonology > Occupational Lung Diseases
Silicosis: Follow-up
Updated: Apr 16, 2008
Follow-up
Deterrence/Prevention
- Monitoring of air quality and dust concentration in the workplace is essential to prevent silicosis and other pneumoconioses.
- Limiting exposure to harmful dusts can be achieved further by suppressing dust generation, filtering or capturing dust particles, diluting the concentration with fresh air, and using personal protective respiratory equipment as further possible means of preventing silicosis.
- The Occupational Safety and Health Administration (OSHA) has set a permissible exposure limit for respirable silica of 10 mg/m3. The National Institute for Occupational Safety and Health (NIOSH) standard is a more stringent exposure limit of 0.05 mg/m3.
- In addition to the primary prevention measures, secondary methods include monitoring workers with chest radiograph and spirometry to identify early disease and to stop further exposure to silica.
Complications
- Airflow obstruction
- Chronic bronchitis
- Cor pulmonale
- Respiratory failure
- Increased incidence of mycobacterial diseases
- Increased risk of lung cancer (see the Medscape Lung Cancer Resource Center)
- Association with connective-tissue disorders (eg, rheumatoid arthritis, systemic lupus erythematosus, mixed connective-tissue disease,5 systemic vasculitis6
Prognosis
- The clinical presentation at the time of diagnosis is somewhat predictive of the prognosis, but the rate of progression varies.
- Silicoproteinosis worsens quickly, and death may occur in months.
- Complicated silicosis shows gradual worsening of symptoms, deterioration of lung function, and increasing disability.
- On the other hand, patients with simple silicosis may be asymptomatic and may remain stable for many years both clinically and radiographically.
Patient Education
- Prevent further exposure to silica dust.
- Strongly advise patients to quit smoking and provide help in smoking cessation efforts.
Miscellaneous
Medicolegal Pitfalls
- Assessment of impairment and disability is difficult and is best left to experienced experts in this area. The degree of impairment demonstrated does not necessarily translate to the same degree of disability. Impairment may be defined as a physiological abnormality of function that persists after treatment. Disability may be defined as an inability to carry out a specific task or job, or the development of undue distress during the performance of the job or task. Therefore, to evaluate disability due to silicosis, one must document a reduction in pulmonary function that is sufficient to prevent the person from engaging in gainful employment or activities of daily living.
- Early diagnosis of other diseases emerging in patients with silicosis is important so that treatment can be started. Mycobacterial disease and lung cancer in patients with silicosis are examples of this scenario. Diagnosis is difficult because the symptoms of cough, malaise, and weight loss and the chest radiographic appearance of nodules and masses may not be discernibly different from that of complicated silicosis.
- Diagnosis of silicosis is based on exposure history of sufficient intensity and/or duration, chest radiograph and/or CT scan showing abnormalities consistent with silicosis, and absence of other diseases to account for the observed radiographic abnormalities.
More on Silicosis |
| Overview: Silicosis |
| Differential Diagnoses & Workup: Silicosis |
| Treatment & Medication: Silicosis |
Follow-up: Silicosis |
| References |
| « Previous Page |
References
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Further Reading
Keywords
silicosis, pneumoconiosis, pneumoconioses, fibronodular lung disease, work-related illness, mining illness, mining, tunneling, quarrying, drilling, crushing stone, chipping, grinding, sandblasting, cement manufacturing, building construction, occupational hazard, cutting bricks, manufacturing bricks, silica dust, silica exposure
Follow-up: Silicosis