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Asbestose and Silica
Mainolfi
18
Medical
Graduate
01/27/2012

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Term
Asbestosis
Definition
-> Heavy dose over a short exposure 25-110fiber/ml/yr

example jobs: miners & millers , textile workers, insulators.

--> lower exposure the longer it takes to develop.
Term
Asbestosis events
Definition
Uptake in type 1 cell
- macrophage accumulation
- cascade of events: cytotoxic release by macrophages --> recruitment of fibroblasts & proliferation

Aveolitis --> progression of fibrosis and
Term
Asbestos Benign Pleurisy
Definition
1st decade of exposure
Pleural Effusion without sxs or reoccurance
Exudative : increase protein and increase mononuclear lymphocytes
Term
Asbestos Half life
Definition
Amphiboles persist in lung tissue more than crysotile

Amphibole 1/2 half life in terms of decades

Chrysotile 1/2 life in terms of months
Term
Asbestos Pleural Plaques
Definition
Marker of exposure
if calcified = 20 yrs
Asymptomatic
Term
Asbestos Workup
Definition
X-ray may be normal --> Ct scan helps demonstrate structural pathology for biopsy.

BAL with Biopsy
AFB with pleural plaques
Term
Asbestos Xray
Definition
Honeycombing
Pleural change and Pleural Plaques

Heavy exposure: involvement of parenchyma and pleura. Linear interstitial changes.
Term
Asbestos OSHA standard
Definition
0.1 fibers /cm3
Term
Exposure Asbestos
Definition
Increase the risk of cancer with increase exposure

Increase risk cancer with thin <0.5 , long, >10 um fibers
Term
Mesothelioms
Definition
associated with Amosite, crocidolit, and actinolite

Malignant tumor of viscera which takes decades of low lvl to develop. Interlobular

Associated with Pleural Plaques

Death by restriction of vital structures.
Term
Asbestos bodies
Definition
Small marker for exposure
Asbestos bodies in BAL do not correlate w TFB = total fiber burden

pleural = low exposure
prenchymal = high exposure
Term
Asbestos types
Definition
Serpintine
- chysotile (white = least dangerous)

Amphobiles (ass with mesothleioma)
crocidolite (blue) , amosite
Term
Silica Nephropathy
Definition
Glomerulonephritis , nephrotic syndrome, end stage uremia, fabrys disease
Term
treatment of silicosis
Definition
remove employee from setting
lung transplant
monoclonal antibodies
tatradine, xinix , lavage
Term
Silicosis Chronic
Definition
occurs after >20 yrs of exposure
- Hyaline nodules (round opacities) in upper lungs and hilar adenopathy due to fibrosis
- Normal pulm functioning
- Increased risk of TB
Term
Complicated Silicosis
Definition
>1 cm nodules with calcified hylar nodes. (egg shell calcifications0
- may have symptoms of core pulmonale and decreased PFT's
Term
Acute Silicosis
Definition
1-3 years to develop with lipoprotenosis
respiratory failure
>90%
Term
Accelerated Silicosis
Definition
-10-15 yrs
-More diffuse fibrosis
-Smaller fibrotic nodules <80%
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