# Pneumoconiosis - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Asbestosis - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK555985/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class RD70.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Pneumoconiosis - disease-level clinical article (pneumoconiosis-full.txt) - Verified date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care - Pneumoconiosis - disease-level clinical article (pneumoconiosis-full.txt) ## Treatment metadata - Stop the exposure, rehabilitate, refer (Recognition & Referral) ## Complete treatment card ```text PNEUMOCONIOSIS Sources: Asbestosis - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK555985/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class RD70.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Pneumoconiosis - disease-level clinical article (pneumoconiosis-full.txt) Review status: REVIEWED against 2 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (6) - The symptoms are non-specific and overlap with chronic bronchitis, COPD and emphysema - Breathlessness, reduced exercise tolerance and cough of gradual onset [breathlessness · cough] - The cough is typically non-productive, and some patients have no symptoms at all, with only an abnormal chest x-ray [cough] - Coal workers' pneumoconiosis can produce black-pigmented sputum [sputum] - Take a thorough occupational history covering both the exposure and how long it lasted; length of employment correlates with risk - In silicosis, signs begin after 10 to 20 years of working in that environment SIGNS - what you find (3) - Tachypnoea and end-inspiratory crackles on examination [crackles · tachypnoea] - A friction rub or wheeze may be heard on auscultation [friction rub · wheeze] - Cardiac auscultation may reveal accentuation of P2 at the left upper sternal border TESTS (6) - Three criteria make the diagnosis: exposure to the inhalant at high dose over a long period, a characteristic chest x-ray, and the absence of an illness that could be mistaken for it - Pleural plaques on x-ray are pathognomonic of asbestosis - Silicosis and coal workers' pneumoconiosis show small interstitial nodules in the upper and mid zones; eggshell calcification of lymph node peripheries can appear in simple silicosis - CT shows small nodules throughout but concentrated in the upper zones; lung biopsy is rarely needed - Lung function is restrictive: reduced FVC with the FEV1-to-FVC ratio preserved, and a reduced diffusion capacity that may precede the fall in lung volumes - On T2-weighted MRI, lung cancer is high signal while progressive massive fibrosis is low signal - that is how the two are separated IF NOT THIS - what else fits (5) - Fibrotic pneumoconiosis follows inhaled silica, asbestos fibres, beryllium, talc or coal dust, almost always at work - Not everyone exposed develops lung pathology, and the disease is latent for years - Silica exposure raises the risk of tuberculosis, cancer and emphysema; coal workers are also at raised risk of tuberculosis - Asbestosis is linked to benign pleural effusion and plaques, malignant mesothelioma and bronchogenic carcinoma, with at least 20 years between exposure and mesothelioma - Severe pulmonary fibrosis leads on to hypoxia, pulmonary hypertension and right heart failure Source StatPearls "Pneumoconiosis" (NBK555902) - disease-level clinical article; its Clinical Pathology section is the diagnostic content Status traced to the source above 1. STOP THE EXPOSURE, REHABILITATE, REFER (RECOGNITION & REFERRAL)[1st line] Adult Chronic interstitial lung fibrosis from years of inhaled occupational dust - silica, asbestos, coal - which is Egypt's construction, quarrying and textile workforce. There is no cure. What actually helps: the patient must avoid any further exposure to the dust, and that comes first; a patient who smokes should be helped to give up; and pulmonary rehabilitation, run in the community or at home, is what treats the symptoms and builds exercise tolerance. Refer to a chest physician for diagnosis, monitoring and occupational-health reporting. - Refer, with advice Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. Source No dose - referral pathway, no medicine given in primary care Why Chronic interstitial lung fibrosis from years of inhaled occupational dust - silica, asbestos, coal - which is Egypt's construction, quarrying and textile workforce. There is no cure. What actually helps: the patient must avoid any further exposure to the dust, and that comes first; a patient who smokes should be helped to give up; and pulmonary rehabilitation, run in the community or at home, is what treats the symptoms and builds exercise tolerance. Refer to a chest physician for diagnosis, monitoring and occupational-health reporting. Caution No drug row is listed here because the article names no drug for this disease: it states plainly that pneumoconiosis has no cure and that the outlook is poor once the fibrotic phase is reached, and it asks for the patient to be kept under review for progression, with symptoms treated as they arise. Where the disease reaches its end stage, the article raises transplantation as a possibility. (Pneumoconiosis - StatPearls - NCBI Bookshelf, NBK555902) Pulmonary rehabilitation is the prescription. As the article describes them, most programmes combine breathing re-training, exercise training at low or high intensity, endurance work and strength work, and many add health education, psychosocial support for low mood, and advice on nutrition; most run for eight weeks. (Pneumoconiosis - StatPearls - NCBI Bookshelf, NBK555902) Treat the COPD that comes with it - the article notes that emphysema or COPD is commonly superimposed on pneumoconiosis. That IS drug treatment, and it is listed under COPD rather than here. (Pneumoconiosis - StatPearls - NCBI Bookshelf, NBK555902) RED FLAG - Progressive breathlessness in a worker with a dust-exposure history, signs of respiratory failure or right heart strain, or occupational asbestos exposure, which carries an increased lung cancer and mesothelioma risk needing surveillance. 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