Pneumoconiosis literally means dust in the lungs. The
disease therefore includes a variety of pulmonary pathologies depending
on the type of dusts inhaled. Some merely involve an overload of the
lungs, without affecting the pulmonary function, whereas other entail
major lung discases, particularly due to fibrogenic dust.
As part of this symposium aimed at comparing the western
and Chinese visions of the monitoring and treatment of pneumoconiotics,
we propose to briefly describe pneumoconioses and associated pathologies
by basing ourselves on the example of silicosis.
The clinical signs are often scanty at the outset and
the disease is discovered on account of its radiological manifestations.
These show the classical anatomic lesions of silicosis:
confined fibro-hyaline nodules, with or without a confluence. In some
cases diffuse pulmonary fibrosis can be observed.
Complications may also be visible, for instance emphysema
bullae, owing to retraction of the masses.
Clinical symptoins appear only after a few years: dyspnea
on effort at the beginning, permanent dyspnea at the end, and a worsening
of general health involving weight loss, asthenia, coughing and thoracic
pains.
These symptoms often in fact expose the many complications
or associated pathologies:
- infections: more frequent in these weakened organs. Tuberculosis
was classical, but also intracavity aspergillomas or atypical mycobacterial
infections ;
- Chronic pulmonary heart disease, resulting from a reduction in blood
formation and chronic respiratory insufficiency
- Obstructive chronic bronchitis
- Emphysema
- Pneumothorax;
- Necrosis of the pseudotumoral. masses
- Pulmonary cancer: an increase in pulmonary cancer cases among silicotics
is now a proven fact ;
- Silicotic nephropathies.
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D.LAFON