Pneumoconiosis is a pulmonary fibrosis caused by the inhalation of inorganic dusts. The best known form of pneumoconiosis is silicosis, which is caused by the inhalation of quartz dust.
Silicosis was already mentioned in the 3,500-year-old Egyptian Ebers Papyrus as an occupational disease affecting stonemasons, while Paracelsus also described it as the “miners’ disease” in the 16th century.
Silicosis was the worst occupational disease in Switzerland during the last century, with almost 11,000 workers falling ill and more than 3,000 dying of this lung disease. At the start of the 1970s, Suva recognised approximately 300 cases per year as an occupational disease. Silicosis was often a delayed effect of working in mining, quarrying, tunnelling and the construction of dams, as well as from exposure in foundries, the steel industry and the construction of roads and railways, etc. Silicosis occurs decades after exposure and is incurable.
While it is now much rarer, Suva still recognises under 20 cases of silicosis per year as an occupational disease. A significant proportion of these silicoses may be the result of exposure prior to the determination of the current limit for crystalline silica (1974). This limit was often not adhered to and many cases of pneumoconiosis were acquired abroad before the workers immigrated to Switzerland [Koller MF et al: Silicosis in Switzerland (2018) Int J Occ Med Env Health; 31;5:1-18 (http://ijomeh.eu/Silicosis-in-Switzerland,81531,0,2.html)]
This picture shows a complete silicosis lung cut from an autopsy.
left: Macroscopic image of a sectional surface of the lung
right: Microscopic image of a histological section of a lung with silicosis nodules
Asbestosis is another form of pneumoconiosis that requires years of intensive exposure to asbestos to develop. Such high levels of long-term exposure no longer occur, which explains why asbestosis is now rare.
There are many other forms of pneumoconiosis besides silicosis and asbestosis.
This type of pneumoconiosis is caused by coal dust.
The pneumoconiosis is triggered by iron dust.
Here the pneumoconiosis is caused by aluminum.
Talcosis is the pneumoconiosis caused by talc.
Here the pneumoconiosis is triggered by beryllium.
The pneumoconiosis can also be triggered by hard metal dust.
Exogenous Allergic Alveolitis
Contact with organic dusts can lead to exogenous allergic alveolitis (also called hypersensitivity pneumonitis). Exogenous allergic alveolitis is an allergic type III and IV reaction to microorganisms (e.g. farmer’s lung, bird fancier’s lung, humidifier lung, etc.) or certain chemical substances such as isocyanates, trimellitic anhydride, etc. Recurrent exogenous-allergic alveolitis also eventually results in pulmonary fibrosis, but the term pneumoconiosis is reserved for cases of pulmonary fibrosis resulting from exposure to inorganic dusts.