Coal Worker

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Coal Workers Pneumoconiosis

• Penyaji
• Dr. Sinatra Gunawan, MK3, SpOk
• Referensi
• Amer Rassam MD1, Gerry San Pedro MD2, Daniel
  Banks MD1.
• Department of Internal Medicine
• LSUHSC-Shreveport

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Coal Workers Pneumoconiosis

1. Simple CWP

• Asymptomatic
• Black dust macules in respiratory bronchioles
• CXR Bilateral, small parenchymal nodules
• Simple silicosis and simple CWP look identical on
  CXR

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Coal Workers Pneumoconiosis

1. Progressive CWP

• Large fibrotic lung masses called progressive
  massive fibrosis (PMF)
• PMF of nodules gt 2 cm
• Melanoptysis
• No hilar involvement
• No association with TB
• No specific treatment

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Berylliosis
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Berylliosis

• Causative agent Beryllium
• Cell-mediated immune response
• Working in high-tech electronics, alloys,
  ceramics, and pre-1950 fluorescent light
  manufacturing
• 2 year exposure to even slight amount can cause
  disease
• Chronic interstitial pneumonitis (upper lobes)
• Hilar lymphadenopathy identical to Sarcoidosis

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Berylliosis

1. Acute Exposure

• Massive accidental exposure
• CXR Pulmonary edema
• Treat immediately with prednisone
• Recovery within 1-6 months
• Risk of death is 5-10

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Berylliosis

1. Chronic Exposure

• Granulomatous disorder
• Skin lesions, granulomatous hepatitis,
  hypercalcemia
• Beryllium lymphocyte proliferation test (this is
  how to separate from Sarcoidosis)
• Treat with prednisone
• Beryllium clearance from the lungs is slow

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Berylliosis
Again Remember !

• Beryllium lymphocyte proliferation test is the
  single best test to identify beryllium
  sensitization and beryllium chronic disease
• Beryllium is the only pneumoconiosis that can be
  treated (corticosteroids)

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Hard-Metal Lung Disease
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Hard-Metal Lung Disease

• Exposure to tungsten carbide and cobalt
• Used as an abrasive or metal cutting tool
• Cause air flow obstruction or diffuse
  interstitial fibrosis.
• Asthma-like syndrome towards the end of the work
  shift or in the evening.
• Develop rapidly within a year of employment
• P/E Basilar rales. CXR irregular opacities
  with hilar prominence

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• BERLANJUT KE PAK bag-4