Occupational Lung Disease: Overview

00:01 Extrinsic lung disease is dealing with, well, what was the patient exposed to? Was it occupation of different types? Was it or maybe helmets and company? And when we take a look at everything that this patient has been exposed to, extrinsically then at some point in time it maybe there was a disease process that kicked in for the lung, resulting on in a restrictive lung type of issue.

00:28 To begin.

00:30 So under diffuse lung diseases, where are we? We're down by the occupational / inhalation.

00:37 And we'll walk through many of these categories: Hypersensitivity, asbestosis, silicosis, coal, toxic gases.

00:46 In addition, we'll also take a look at some of those infections that become important to us, especially the helminthic Let's first take a look at occupational lung diseases and what it means.

00:57 Now, this is a lecture series you want to pay attention to because I find...

01:03 with my experience, that students tend to get this confused and end up choosing the wrong diagnosis because, well, they're not broadening their thinking.

01:13 So, first, my patient got exposed to some type of occupation, or in the occupation got exposed to some type of element.

01:22 Upon exposure to that element, maybe perhaps the changes that were taking place in the lung, pathologically, are rather benign in nature.

01:31 But then at some point, guess what happened? Massively went into fibrosis.

01:37 And as soon as you go into massive fibrosis, isn't that kind of like end stage any disease? Fibrosis of the liver, end stage liver disease Fibrosis of the lung, honeycomb right? So once they get into fibrosis, maybe maybe the right side of the heart starts to failing, hypertrophy and perhaps even cor pulmonale.

01:57 All right, so give yourself a storyline as to what you can expect when your patient is then being exposed to a various various antigens during his or her time in an occupation.

02:12 May present as obstructive lung disease, occupational asthma, keep that in mind.

02:17 So if there's something as an environmental allergen that the patient is then exposed do then keep in mind that this could be an obstructive type of nature, asthma, right? Next, our focus in this lecture series, however, will be the theme that we have been clinging on to the whole time, which in fact is your restrictive lung disease, is that clear? Now with restricted lung disease, you can expect there to be compromise of that lung.

02:43 And so therefore, the lung become stiffer non-compliant.

02:45 And so therefore, we'll present as restrictive.

02:49 Several occupation exposures that we'll walk through, include the dust that you may then get from silica or maybe perhaps you are breathing in particles of asbestos and such.

03:03 And then we will take a look at a very important, and separate category known as hypersensitivity pneumonitis.

03:10 And that gets a little tricky and extremely, extremely important in industrialized nations, such as the US from coast to coast, where the patient might then be exposed to various types of allergens.

03:22 But I'm going to be very selective and very careful as to the word allergen here, because it's really about the proteins and such that you are then been exposed to, in which as we shall see in hypersensitivity pneumonitis, as to how your patients going to present.

03:39 Some exposure can cause cancer.

03:42 For example, if you are dealing with asbestos, and at some point in time, decades down the road, upon exposure, let's say that your patient is working with brake lining, a mechanic or maybe your patient is working with Naval Shipyard, and so on and so forth.

03:57 And so therefore, this individual in decades later may then develop what's known as bronchogenic.

04:04 bronchogenic type of cancer.

04:08 Now, at first, with the occupational lung diseases, the topic is pneumoconiosis and with pneumoconiosis, we'll be focusing upon four different elements, depending as to what the occupation the patient has been, and exposure to these common type of particles.

04:28 Keep in mind that if very possible that two particles might be exposed at the same time.

04:34 You'll see what I'm referring to.

04:35 So occupation exposure, resulting in a restricted lung pattern is what we're sticking with in this lecture series.

04:42 At some point in time, could to be asthma like issues, sure, but that would be much more...

04:48 A different type of presentation with asthma.

04:53 All involved will have an increased risk for cor pulmonale.

04:58 We just talked about that.

05:00 Meaning to say, that there's increased deposition of collagen and fibrosis ends up kicking in, then it's the right side of the heart, which is now extremely vulnerable to damage, isn't it? Welcome to core pulmonale.

05:12 Next, another topic that I had briefly touched upon, when we talked about connective tissue diseases they may result in changes in the interstitium that are nonspecific by nonspecific we mean patchy infiltration or patchy infiltration of inflammatory cells without the fiberglass, nonspecific.

05:32 Whereas, if it was usual interstitial, then there's quite a bit of fibrosis and this was in the setting of rheumatoid arthritis.

05:40 And so therefore, in a patient rheumatoid arthritis, with rheumatoid nodules, and along with that, your patient has now developed an occupational type of lung disease.

05:50 You then call this ladies and gentlemen, Caplan syndrome.

05:53 C-A-P-L-A-N.

05:55 Not a typo.