1. Coal Worker’s Pneumoconiosis
Penyaji :
Dr. Sinatra Gunawan, MK3, SpOk
Referensi :
Amer Rassam MD1, Gerry San Pedro MD2, Daniel Banks MD1.
Department of Internal Medicine
LSUHSC-Shreveport

2. Coal Worker’s Pneumoconiosis
Simple CWP
Asymptomatic
Black dust macules in respiratory bronchioles
CXR – Bilateral, small parenchymal nodules
Simple silicosis and simple CWP look identical on CXR

3. Coal Worker’s Pneumoconiosis
Progressive CWP
Large fibrotic lung masses called progressive massive fibrosis (PMF)
PMF of nodules > 2 cm
Melanoptysis
No hilar involvement
No association with TB
No specific treatment

4. Berylliosis

5. 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

6. Berylliosis Acute Exposure Massive accidental exposure
CXR – Pulmonary edema
Treat immediately with prednisone
Recovery within 1-6 months
Risk of death is 5-10%

7. Berylliosis 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

8. 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)

9. Hard-Metal Lung Disease

10. 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

11. BERLANJUT KE PAK bag-4