Pneumoconiosis is the term which refers to a number of chronic occupational lung diseases. This condition occurs by the inhalation of dust or fibres from carrying out work which generates respirable airborne particulate which enters deep into the lung, triggering the body's autoimmune response system. The pathological effects and body's response to the particulate can lead to scarring of the lung tissue and damage in the alveolus.
How Big is the Problem?
It is estimated that 12,000 lung diseases deaths each year are linked to exposure at work. Along with 18,000 estimated new cases of breathing or lung issues due to work. The types of inhaled dust depend on which form of lung disease is likely to develop, there are 3 common types of disease: Coal Dust (from in inhalation of Coal dust), Silicosis (from the inhalation of respirable crystalline silica) and Asbestosis (from the inhalation of asbestos fibres).
Toxicology and Common Symptoms of Occupational Disease
The problem with identifying work-induced pneumoconiosis is that the effects of exposure are not usually seen for 10 or more years in many cases. Once the airborne dust is inhaled at work, the particles enter the airways and then the alveoli.
Cells within the lungs can be damaged by cytotoxic releases of lipases and proteases, activation of oxidant production by pulmonary macrophages, activation of mediator release from alveolar macrophages leading to the production of cytokines and reactive species. Responses to the particulate can cause inflammation of the lung and can eventually result in fibrosis (scarring), where the damage to the tissue in the air sacs and air passage becomes thick and stiff from the scaring. This can then affect the passing of oxygen.
These effects may not be seen for years after repeated exposure due to the conditions extended latency periods. However, symptoms include shortness of breath, the regurgitation of phlegm and tightness in the chest. These symptoms if severe enough can cause permanent disability or early death. It is worth noting that some patients may not experience severe symptoms, particularly is the disease is in its early stages.
Statistics show an overall decrease in fatalities due to pneumoconiosis over the past decade, we believe that is it due to the development of new and improving working conditions, therefore the majority of patients that are still seeing the effects today are retired or no longer having exposure of dust.
The different forms of the disease depend on the type of dust the workers are exposed to, the risk of development is increased by smoking and being exposed to high levels of dust for a long time.
Coal Workers Pneumoconiosis
Coal workers pneumoconiosis is the most common form of the disease. Through many years of repeated exposure to carbon-containing particles with limited protective equipment meaning the death rate has been constant throughout the decades. However, the coal mining industry has decreased and therefore we expect to see an overall reduction and fewer fatalities related to coal dust in the future.
Asbestosis
Asbestosis is caused by the inhalation of asbestos fibres, these fibres are particularly resistant and once entered into the deep lung can cause scarring and inflammation. Workers who are mainly at risk of developing asbestos-related illness are plumbers, roofers, mechanics and shipyard works. However, due to the decreasing use of asbestos being used in industry, the death rates have been falling over the last decade.
Silicosis
Silicosis is a disease that developed from the inhalation of respirable crystalline silica. Examples of workers that are most likely to be affected are stonemasons and bricklayers, construction related occupations, mining and quarrying. High dust exposure is related to the use of high energy tools, mainly with sand and rock. It is worth noting that even small amounts of exposure over many years can still develop into “progressive fibrosis”.
Other Variations to Consider
Here are some more common variations of the disease:
Aluminosis – Aluminium
Bauxite fibrosis – Bauxite
Berylliosis – Beryllium
Siderosis – Iron
Byssinosis – Cotton
Silicosiderosis – Mixed dust containing silica and iron
Stannosis – Tin Oxide
Talcosis - Talc
The Severity of the Condition
It is important to understand that pneumoconiosis can not be cured and if untreated it can lead to fatal illnesses such as lung cancer, respiratory failure, tuberculosis and heart failure. Therefore, it is crucial that preventative action is taken in order to reduce personal exposures.
Exposures should be reduced to levels below the assigned workplace exposure limits. In some cases, for example with respirable crystalline silica, exposures of any level can lead to industrial disease, including pneumoconiosis.
Checking and Measuring Exposures
The measurement of hazardous substances should be carried out to quantify the risk of exposure. During specific tasks, workplace air monitoring can be utilised to obtain important information which can be used to determine airborne concentrations of substances capable of causing pneumoconiosis. That said, air monitoring can be used to check that current controls are in fact working as they should be. Methods should be undertaken in line with the approved air monitoring standards outlined in the HSE MDHS Series or by utilising the OSHA and NIOSH approves sampling methods. This type of assessment should be carried out by professional and qualified occupational hygienists.
Health Surveillance
Organisations should have implemented a routine health surveillance program whereby a professional occupational health professional would undertake lung function testing and other health checks. A doctor should be consulted whereby chest x-rays can be carried out to check for scarring and evidence of tissue damage in the lugs. Routine health surveillance will allow for any early signs of the disease to be discovered and reported.
It is hoped that this article goes some way to providing a brief overview of pneumoconiosis. If you wish to know more on this subject or need support with your COSHH assessments, exposure monitoring or the testing of your LEV systems, RPE Fit Testing then please feel free to get in touch with us through social media or our website (www.workplacescientifics.com), by email at support@workplacescientifics.com or simply give us a call on 01709 931299.
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