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They are caused by the inhalation of various substances include: Chemicals Dusts Fumes & Gases & other particulate that are present in certain settings.Cont………d: Cont………d All the clients are not exposed to occupational inhalants experience Lung Disease.Effect on Lungs: Effect on Lungs Harmful effects depends on: The nature of the exposure. The duration & intensity of the exposure c) The client who are smokers or who have underlying lung disease are at greater risk.Most commonly occupational lung disease: Most commonly occupational lung disease ACUTE RESPIRATORY IRRITATION: OCCUPATIONAL ASTHMA HYPERSENSITIVITY PNEUMONITIS PNEUMOCONIOSISa) Acute respiratory irritation : a) Acute respiratory irritation It results from the inhalation of chemicals: ammonia ,chlorine ,nitrogen oxide in the form of gases ,aerosols. If such irritants reach the lower airways it damage the alveoli’s & pulmonary edema may occur. Although the effect of irritants are usually short lived ,some may cause chronic alveolar damage or airway obstruction.Onset of symptoms : Onset of symptoms Immediate onset : within minutes of exposure. Pulmonary edema may be delayed for hours.Diagnosis of acute respiratory irritation : Diagnosis of acute respiratory irritation it is diagnosed by making the consistent history. Physical findings of respiratory tract irritation. TREATMENT: - Avoidance of exposure. - respiratory support as needed.Clinical Course: Clinical Course The acute respiratory irritation resolves in hours to days. Pulmonary edema may last days to weeks.2) Occupational asthma : 2) Occupational asthma Occupational asthma is a form of lung disease in which the breathing passages shrink, swell, or become inflamed or congested as a result of exposure to irritants in the workplace. It is estoimated that approximately 10% of all adults asthma cases can be attributed to workplace exposure.It include:: It include : animal hair dander dust composed of bacteria, protein, or organic matter like cereal, grains, cotton, and flax fumes created by metal soldering insulation and packaging materials mites and other insects paintsCauses and symptoms: Causes and symptoms shortness of breath , hoarseness. Even short-term exposure to low levels of one or more irritating substances can cause a very sensitive person to develop symptoms of occupational asthma. A person who has occupational asthma has one or more symptoms, including coughing, shortness of breath, tightness in the chest, and wheezing . Symptoms may appear less than 24 hours after the person is first exposed to the irritant or develop two or three years later. At first, symptoms appear while the person is at work or several hours after the end of the workday. Symptoms disappear or diminish when the person spends time away from the workplace and return or intensify when exposure is renewed.Diagnosis : Diagnosis An allergist, occupational medicine specialist, or a doctor who treats lung disease performs a thorough physical examination and takes a medical history that explores: the kind of work the patient has done the types of exposures the patient may have experienced what symptoms the patient has had when, how often, and how severely symptoms have occurred Performed before and after work, Laboratory analysis of blood and sputum may confirm a diagnosis of workplace asthma.Treatment : Treatment Avoidance of exposure Asthma medications Steroids Bronchodilator physical therapy, and breathing aids may be needed to relieve symptoms of advanced occupational asthma involving airway damage.Prevention : Prevention Industries and environments where employees have a heightened exposure to substances known to cause occupational asthma can take measures to diminish or eliminate the amount of pollution in the atmosphere or decrease the number of exposed workers. Regular medical screening of workers in these environments may enable doctors to diagnose occupational asthma before permanent lung damage takes place.c) Hypersensitivity Pneumonitis or allergic alveolitis : c) Hypersensitivity Pneumonitis or allergic alveolitis Hypersensitivity pneumonitis refers to an inflammation of the lungs caused by repeated breathing in of a foreign substance, such an organic dust, a fungus, or a mold The body's immune system reacts to these substances, called antigens, by forming antibodies. The combination of antigen and antibody produces acute inflammation, or pneumonitis (a hypersensitivity reaction), which later can develop into chronic lung disease that impairs the lungs' ability to take oxygen from the air and eliminate carbon dioxide.Cont…………d: Cont…………d Hypersensitivity pneumonitis (HP) is sometimes called "allergic alveolitis." "Allergic" refers to the antigen-antibody reaction, and "alveolitis" means an inflammation of the tiny air sacs in the lungs where oxygen and CO2 are exchanged, the alveoliCauses and symptoms : Causes and symptoms A number of different types of HP are known,. Some of the more common forms are: Farmer's lung . Can affect any farmer who works with hay or other moldy dust. Small farmers who have to directly thresh and handle their hay are most at risk, as are those living in cold and humid areas where damp weather is common. Pigeon breeder's lung . Also called "bird fancier's lung," it is second to farmer's lung as the best known type of HP. A substance has been found in pigeon droppings that may cause the allergic reaction, Besides pigeons, the disorder may follow exposure to ducks, geese, Most patients are middle-aged women, who usually care for birds either at home or on bird breeding farms.Cont………d: Cont………d Bagassosis . Caused by bagasse, a substance produced when juice is extracted from sugar cane and is used in making paper and explosives. A fungus is probably responsible. Young and middle-aged men who work in the sugar industry are at risk. Byssinosis . A similar condition affecting workers who inhale dust from cotton, Other antigens . HP has been seen in persons working with detergents, silicone, mushrooms, cheese, wood dust, coffee, and furs.Sign & symptoms : Sign & symptoms In the acute stage, patients with HP begin coughing, develop fever, tightness in the chest as well as extreme tiredness and aching, lose their appetite, lose weight, and generally feel ill. Finally, in the chronic stage, the patient will have increasing trouble breathing and may sometimes wheeze. \With advanced disease, the skin may appear bluish (because too little oxygen is getting into the blood). When the physician listens to the patient's chest with a stethoscope, there may be crackling sounds or loud wheezing. In the late stages, club-shaped fingertips are a sign that the patient has not been getting enough oxygen . The onset of symptoms is within a few hours of exposureDiagnosis : Diagnosis The chest x ray Pft test should be done to confirm the dignosis .Treatment : Treatment Treatment of HP requires identifying the offending antigen and avoiding further exposure. In some cases, (like pigeon breeder's lung), wearing a mask can prevent exposure. If acute symptoms are severe, the patient may be treated with a steroid hormone for two to six weeks. This often suppresses the inflammatory response and allows the lungs a chance to recover. In the chronic stage, steroid treatment can delay further damage to the lungs and help preserve their function.4) Pneumoconiosis : 4) Pneumoconiosis Pneumoconiosis is a group of lung diseases caused by inhaled dust particles. It is a disease characterized by fibrosis and caused by the chronic inhalation of mineral dusts, esp. silica and asbestos. It is seen in specific occupations such as coal mining and construction industries where the concentration of dust particles is very high. Thus it can be considered as occupational lung disease. The most common types of pneumoconiosis include silicosis, asbestosis and coal worker''s pneumoconiosisPathophysiology : Pathophysiology The lung tissue in normal people is very elastic. This allows it to expand and contract while breathing In the common types of pneumoconiosis, fibrous tissue gets deposited in the lungs, the condition being called fibrosis. Fibrosis tends to stiffen the lung tissue and restrict its expansion. The affected person may develop breathing problems, cancer and may even die due to the condition. It is important to diagnose the condition early, as the patient must be removed from the environment at the earlier.Sign & symptom : Sign & symptom The symptoms include : Cough progressing to dyspnea Shortness of breath, Chest pain, Difficulty breathing, Wheezing, Bluish coloration of the skinDiagnosis : Diagnosis A history from the patient regarding exposure to certain dust particles helps to diagnose the condition Physical examination - A doctor should examine the patient to determine the severity of lung disease. Lung function tests - In these tests, the patient is asked to breathe forcefully out into an instrument. This test assesses the severity of the lung condition and measures the lung capacity .Cont…………d: Cont…………d Radiological tests X-rays and CT scan help in diagnosing the type of pneumoconiosis and the severity of disease. Bronchoscopy In this test, a tube is inserted into the bronchi to obtain some secretions that may be tested.Complications : Complications Tuberculosis in almost 25% patients Lung cancerTREATMENT : : TREATMENT : It is important to diagnose pneumoconiosis early to prevent further complications. The patient should be removed from the site of exposure as soon as possible. Corticosteroids with or without oxygen treatment may be needed in some cases. The patient is advised to quit smoking and smoking cessation programs should be offered to the patient. Vaccines against flu and pneumococcus should be administered to protect the patient from infections.Outcome management of occupational Lung disease: Outcome management of occupational Lung disease The respiratory history should include: a) A complete occupational history & questions of actual job performance. b) Exposure to organic & inorganic substances in job c) The physical examination should include: - Assessment of respiratory pattern. - Presence of cough .,lung sound . Cont……………..d: Cont……………..d Safety measures include adequate ventilation ,the wearing of mask ….Thanks for attention : Thanks for attention You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.